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Sample records for glycemic variability comparison

  1. Comparison of glycemic control and variability in patients with type 2 and posttransplantation diabetes mellitus.

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    Werzowa, Johannes; Pacini, Giovanni; Hecking, Manfred; Fidler, Catharina; Haidinger, Michael; Brath, Helmut; Thomas, Andreas; Säemann, Marcus D; Tura, Andrea

    2015-01-01

    Posttransplantation diabetes mellitus (PTDM) is a common complication after renal transplantation leading to increased cardiovascular morbidity and mortality. In subjects with type 2 diabetes (T2DM) increased glycemic variability and poor glycemic control have been associated with cardiovascular complications. We therefore aimed at determining glycemic variability and glycemic control in subjects with PTDM in comparison to T2DM subjects. In this observational study we analyzed 10 transplanted subjects without diabetes (Control), 10 transplanted subjects with PTDM, and 8 non-transplanted T2DM subjects using Continuous Glucose Monitoring (CGM). Several indices of glycemic control quality and variability were computed. Many indices of both glycemic control quality and variability were different between control and PTDM subjects, with worse values in PTDM. The indices of glycemic control, such as glucose mean, GRADE and M-value, were similar in PTDM and T2DM, but some indices of glycemic variability, that is CONGA, lability index and shape index, showed a markedly higher (i.e., worse) value in T2DM than in PTDM (P value range: 0.001-0.035). Although PTDM and T2DM subjects showed similar glycemic control quality, glycemic variability was significantly higher in T2DM. These data underscore potential important pathophysiological differences between T2DM and PTDM indicating that increased glycemic variability may not be a key factor for the excess cardiovascular mortality in patients with PTDM. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Glycemic variability: Clinical implications

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    Surabhi Venkata Satya Krishna

    2013-01-01

    Full Text Available Glycemic control and its benefits in preventing microvascular diabetic complications are convincingly proved by various prospective trials. Diabetes control and complications trial (DCCT had reported variable glycated hemoglobin (HbA1C as a cause of increased microvascular complications in conventional glycemic control group versus intensive one. However, in spite of several indirect evidences, its link with cardiovascular events or macrovascular complications is still not proved. Glycemic variability (GV is one more tool to explain relation between hyperglycemia and increased cardiovascular risk in diabetic patients. In fact GV along with fasting blood sugar, postprandial blood sugar, HbA1C, and quality of life has been proposed to form glycemic pentad, which needs to be considered in diabetes management. Postprandial spikes in blood glucose as well as hypoglycemic events, both are blamed for increased cardiovascular events in Type 2 diabetics. GV includes both these events and hence minimizing GV can prevent future cardiovascular events. Modern diabetes management modalities including improved sulfonylureas, glucagon like peptide-1 (GLP-1-based therapy, newer basal insulins, and modern insulin pumps address the issue of GV effectively. This article highlights mechanism, clinical implications, and measures to control GV in clinical practice.

  3. Skin Autofluorescence and Glycemic Variability

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    Noordzij, M. J.; Lefrandt, J. D.; Graaff, R.; Smit, A. J.

    Background: Accumulation of advanced glycation end products (AGEs) is accelerated during glycemic and oxidative stress and is an important predictor of complications in diabetes mellitus (DM). Study Design: Here we both review and present original data on the relationship between skin

  4. [Glycemic variability and continuous monitoring of glycemia].

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    Prázný, Martin; Soupal, Jan

    2014-09-01

    Blood glucose levels are not constant in ther human body even in physiological status. It fluctuates depending on food intake, exercise, psychological and other factors. Normally it fluctuates between 3.9 to 7.5 mmol/l and in fasting in the standard conditions it does not exceed even more narrow range 3.9 to 5.5 mmol/l. Fluctuations are more pronounced in patient with diabetes. Hyperglycemia is a common and basic pathology in diabetes, however, antidiabetic drug often cause hypoglycemia, both increasing the range for glucose fluctuations. The level of glucose fluctuation is called glycemic variability (GV). Glycemic variability is now a favorite target of scientific research in dia-betology. Increased glycemic variability is associated with hypoglycemia, possibly may contribute to chronic dia-betes complications and negatively influences quality of life of diabetic patients. Last but not least, thanks to the new technology of continuous glucose monitoring, we can better describe and measure it. Finally, glycemic variability emerges as a potentially important therapeutical target.Key words: continuous glucose monitoring - glycemic variability - insulin pump - sensor augmented pump.

  5. The Role of Glycemic Control and Variability in Diabetic Retinopathy.

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    Chatziralli, Irini P

    2018-02-01

    Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM) and is considered the leading cause of visual impairment in working-aged adults worldwide. The duration of DM and hyperglycemia have been associated with DR, although the exact role in the pathogenesis of DR and diabetic macular edema remains controversial. As a result, a reasonable question arising is whether control of blood glucose levels may alter the course of DR. Studies have shown that glycemic control remains an important factor for the presence and progression of DR. HbA1c seems to be an indicator which cannot demonstrate exactly the degree of glycemic control, while sudden variations of blood glucose may play an important role in DR; therefore, glycemic variability may be useful to predict DM complications, such as DR.

  6. Shared Responsibility for Type 1 Diabetes Care Is Associated With Glycemic Variability and Risk of Glycemic Excursions in Youth.

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    Marker, Arwen M; Noser, Amy E; Clements, Mark A; Patton, Susana R

    2018-01-01

    We examined how parent and youth responsibility for type 1 diabetes (T1D) care is related to adherence and glycemic outcomes, namely, glycemic variability and risk of glycemic excursions. One hundred thirty-five parent-youth dyads (10-16 years old; diagnosed with T1D for at least 6 months) participated in this study. Percent responsibility of T1D care attributed to the youth, parent, or shared was measured using the Diabetes Family Responsibility Questionnaire. We collected youth's hemoglobin A1c (HbA1c) and glucometer downloads to examine relationships between responsibility and HbA1c, frequency of blood glucose monitoring (self-monitoring blood glucose, SMBG), risk of glycemic excursions, and actual glycemic variability using bivariate correlations and path analysis. Participants reported shared responsibility for almost half of T1D self-care tasks. Bivariate correlations showed shared responsibility was associated with less variability, whereas parent responsibility was associated with greater glycemic variability and risk for glycemic excursions. Youth responsibility was associated with lower frequency of SMBG. The path analyses confirmed our correlational findings (pshypothesis that shared T1D responsibility is associated with better diabetes outcomes in youth. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  7. Associations between bolus infusion of hydrocortisone, glycemic variability and insulin infusion rate variability in critically Ill patients under moderate glycemic control

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    van Hooijdonk, Roosmarijn T. M.; Binnekade, Jan M.; Bos, Lieuwe D. J.; Horn, Janneke; Juffermans, Nicole P.; Abu-Hanna, Ameen; Schultz, Marcus J.

    2015-01-01

    We retrospectively studied associations between bolus infusion of hydrocortisone and variability of the blood glucose level and changes in insulin rates in intensive care unit (ICU) patients. 'Glycemic variability' and 'insulin infusion rate variability' were calculated from and expressed as the

  8. Correlations of the glycemic variability with oxidative stress and erythrocytes membrane stability in patients with type 1 diabetes under intensive treatment.

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    Rodrigues, Ricardo; Alves de Medeiros, Luciana; Moreira Cunha, Lucas; da Silva Garrote-Filho, Mario; Bernardino Neto, Morun; Tannus Jorge, Paulo; Santos Resende, Elmiro; Penha-Silva, Nilson

    2018-02-07

    This study aimed to evaluate the correlations of glycemic variability with erythrocyte membrane stability parameters and oxidative stress markers in patients with DM1 under intensive treatment. 90 patients with DM1 and under intensive treatment of the disease were evaluated in relation to anthropometric indices, records of glycemic averages and parameters of glycemic variability, biochemical dosages (glucose, uric acid, lipidogram, glycated hemoglobin, microalbuminuria, creatinine and iron) reticulocyte count, erythrocyte membrane stability parameters and oxidative stress markers (thiobarbituric acid reactive substances, TBARS, and glutathione reductase, GR). Indicators of glycemic variability in the short and long term showed correlations with parameters of membrane stability and markers of oxidative stress (GR). In addition, the comparison of these same parameters between the subgroups consisting of quartiles of GV or glycemic control also showed significant differences. In the DM1 patients studied here, glycemic variability showed correlations with oxidative stress and erythrocyte membrane stability variables. This corroborates the hypothesis that glycemic fluctuations interfere with lipid peroxidation and cell membrane behavior, emphasizing its participation in mechanisms related to the development of chronic complications of diabetes. Copyright © 2018 Elsevier B.V. All rights reserved.

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

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

    2010-07-01

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

  10. Glycemic variability in patients with Wolfram syndrome is lower than in type 1 diabetes.

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    Zmyslowska, A; Fendler, W; Szadkowska, A; Borowiec, M; Mysliwiec, M; Baranowska-Jazwiecka, A; Buraczewska, M; Fulmanska-Anders, M; Mianowska, B; Pietrzak, I; Rzeznik, D; Mlynarski, W

    2015-12-01

    Wolfram syndrome (WFS) is diagnosed as coexistence of diabetes mellitus and optic atrophy, where pancreatic beta cell destruction is associated with neurodegeneration. Typically, WFS necessitates insulin treatment similar to type 1 diabetes (T1D), but the mechanism of beta cell mass reduction leading to hyperglycemia is different. The aim of the study was to assess glycemic variability using the continuous glucose monitoring (CGM) system in seven pediatric patients with genetically confirmed WFS and compare the results with data obtained from 21 propensity score-matched patients with T1D. The "GlyCulator" application was used for the calculation of glycemic variability indices. CGM recordings showed similarities in glycemic variability among WFS patients, but differing from those of the T1D group. Coefficient of variation (%CV), CONGA4h, and GONGA6h were significantly (p < 0.05) lower in WFS patients (28.08 ± 7.37, 54.96 ± 11.92, and 55.99 ± 10.58) than in T1D patients (37.87 ± 14.24, 74.12 ± 28.74, p = 0.02, and 80.26 ± 35.05, respectively). In WFS patients, the percentage of values above 126 mg/dL was 69.79 (52.08-77.43), whereas in patients with T1D, the percentage was significantly lower-47.22 (35.07-62.85, p = 0.018). Curiously, a tendency toward a lower percentage of measurements below 70 mg/dL was noted in the WFS group [0 (0-7.29)] in comparison with the T1D group [6.25 (0-18.06), p = 0.122]. WFS patients had a significantly higher C-peptide level (0.31 ± 0.2 ng/mL) than T1D patients (0.04 ± 0.04 ng/mL; p = 0.006). Patients with WFS show smaller glycemic variability than individuals with T1D, and this may be associated with persistent residual insulin secretion.

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

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    I L Alimova

    2013-03-01

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

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

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    Xingran Cui

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

  13. Estimating the reliability of glycemic index values and potential sources of methodological and biological variability.

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    Matthan, Nirupa R; Ausman, Lynne M; Meng, Huicui; Tighiouart, Hocine; Lichtenstein, Alice H

    2016-10-01

    The utility of glycemic index (GI) values for chronic disease risk management remains controversial. Although absolute GI value determinations for individual foods have been shown to vary significantly in individuals with diabetes, there is a dearth of data on the reliability of GI value determinations and potential sources of variability among healthy adults. We examined the intra- and inter-individual variability in glycemic response to a single food challenge and methodologic and biological factors that potentially mediate this response. The GI value for white bread was determined by using standardized methodology in 63 volunteers free from chronic disease and recruited to differ by sex, age (18-85 y), and body mass index [BMI (in kg/m 2 ): 20-35]. Volunteers randomly underwent 3 sets of food challenges involving glucose (reference) and white bread (test food), both providing 50 g available carbohydrates. Serum glucose and insulin were monitored for 5 h postingestion, and GI values were calculated by using different area under the curve (AUC) methods. Biochemical variables were measured by using standard assays and body composition by dual-energy X-ray absorptiometry. The mean ± SD GI value for white bread was 62 ± 15 when calculated by using the recommended method. Mean intra- and interindividual CVs were 20% and 25%, respectively. Increasing sample size, replication of reference and test foods, and length of blood sampling, as well as AUC calculation method, did not improve the CVs. Among the biological factors assessed, insulin index and glycated hemoglobin values explained 15% and 16% of the variability in mean GI value for white bread, respectively. These data indicate that there is substantial variability in individual responses to GI value determinations, demonstrating that it is unlikely to be a good approach to guiding food choices. Additionally, even in healthy individuals, glycemic status significantly contributes to the variability in GI value

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

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

    2015-01-01

    and 39 women with non-insulin-treated type 2 diabetes and a known duration of diabetes ... variability as assessed by MAGE. This was not the case in men. The association in women persisted in a multivariate regression analysis controlling for weight, mean heart rate, blood pressure (systolic), and triglycerides. CONCLUSIONS: In patients with newly diagnosed and well-controlled type 2 diabetes......OBJECTIVE: To investigate the sex differences in cardiac autonomic modulation in patients with newly diagnosed type 2 diabetes and to determine whether cardiac autonomic modulation is associated with glycemic variability. RESEARCH DESIGN AND METHODS: We investigated a cohort consisting of 48 men...

  15. The Effect of Basal Analog Insulin on the Glycemic Variability in Type 2 Diabetics

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    Soner Cander

    2014-06-01

    Full Text Available Purpose: The aim of this study was to investigate the effect of insulin detemir and glargine on glycemic variability as determined by capillary blood glucose measurements in Type 2 diabetics treated with oral antidiabetic drugs. Material and Method: A total of 64 insulin-naive type 2 diabetics with a HbA1c level of 7.5%-10% were included in the study. The patients were randomized into 3 groups according to the basal insulin analog started; Group 1 (n=22 was started on once-daily detemir, Group 2 (n=22 twice-daily detemir, and Group 3 (n=20 insulin glargine. Basal insulin doses were titrated according to the morning/evening fasting capillary blood glucose levels. Standard deviations of the 8-point intraday fasting and postprandial blood glucose values were compared. Results: The fasting blood glucose intraday standard deviation values showed an improvement of 22.4% in Group 1, 21.4% in Group 2, and 26.4% in Group 3, while the intraday standard deviation for the postprandial values showed an improvement of 14.4%, 15.2%, and 38.7%, respectively (p>0.05. The standard deviation values did not show statistical significance when the groups were compared with each other. Baseline HbA1c values and insulin doses negatively correlated with the glycemic variability. Dicussion: Basal insulin added to treatment in Type 2 diabetics provided an improvement of 14.4% to 38.7% in glycemic variability. There was no significant difference between insulin glargine and detemir regarding this effect. Turk Jem 2014; 2: 33-38

  16. Glycemic variability is an important risk factor for cardiovascular autonomic neuropathy in newly diagnosed type 2 diabetic patients.

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    Xu, Wen; Zhu, Yanhua; Yang, Xubin; Deng, Hongrong; Yan, Jinhua; Lin, Shaoda; Yang, Huazhang; Chen, Hong; Weng, Jianping

    2016-07-15

    The relationship between glycemic variability, another component of glycemic disorders as well as chronic sustained hyperglycemia, and cardiovascular autonomic neuropathy (CAN) has not been clarified. Our aim is to investigate the association between glycemic variability and CAN in newly diagnosed type 2 diabetic patients. Ewing tests were performed in 90 newly diagnosed type 2 diabetic patients and 37 participants with normal glucose tolerance as control from May 1, 2009, through September 30, 2010. According to the scores from Ewing tests, diabetic patients were divided into two groups: without CAN (CAN-) and with CAN (CAN+). All participants underwent a 48-h to 72-h continuous glucose monitoring (CGM). Coefficient of variability of glycemia (%CV), mean amplitude of glycemic excursions (MAGE) and means of daily differences (MODD) were calculated with the CGM data. The prevalence of CAN in patients with newly diagnosed type 2 diabetes was 22.2%. An increasing trend of glycemic variability was found from control group, CAN- group to CAN+ group. MAGE in CAN+ group was significantly higher than that in CAN- group (5.27±1.99mmol/L vs. 4.04±1.39mmol/L, P=0.001). In the Logistic regression analysis, a significant relationship was shown between MAGE and CAN [odds ratio (OR): 1.73, 95% confidence interval (CI): 1.01-2.73, P=0.018)]. The area under the receiver-operating characteristic curve for MAGE was superior to those for other dysglycemic indices in detecting CAN. Glycemic variability is associated with CAN in patients with newly diagnosed type 2 diabetes. Among the glycemic variability indices, MAGE is a significant indicator for detecting CAN. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. The association between glycemic variability and diabetic cardiovascular autonomic neuropathy in patients with type 2 diabetes.

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    Jun, Ji Eun; Jin, Sang-Man; Baek, Jongha; Oh, Sewon; Hur, Kyu Yeon; Lee, Myung-Shik; Lee, Moon-Kyu; Kim, Jae Hyeon

    2015-06-04

    It is presently unclear whether glycemic variability is associated with diabetic cardiovascular autonomic neuropathy (CAN). The aim of this study was to examine whether short- and/or long-term glycemic variability (GV) contribute to CAN. A total of 110 patients with type 2 diabetes who underwent three-day continuous glucose monitoring (CGM) completed five standardized autonomic neuropathy tests. Short-term GV was measured by the standard deviation (SD), coefficient of variation (CV) of glucose, and the mean amplitude of glycemic excursions (MAGE) in CGM. HbA1c variability was calculated from the intrapersonal SD, adjusted SD, and CV of serial HbA1c over 2-year period. CAN was defined as the presence of at least two abnormal parasympathetic function tests. The severity of CAN was evaluated by total scores of five autonomic function tests. In univariate analysis, not only SD and CV in CGM but also all parameters of HbA1c variability were significantly higher in the patients with CAN (n = 47, 42.7 %) than in those without CAN. In multivariate analysis, CV (Odds ratio [OR] 1.07, 95 % confidence interval [CI] 1.01-1.13; p = 0.033), but neither SD nor MAGE in CGM, independently correlated with the presence of CAN. All parameters of HbA1c variability, such as SD of HbA1c (OR 12.10 [95 % CI 2.29-63.94], p = 0.003), adjusted SD of HbA1c (OR 17.02 [95 % CI 2.66-108.86], p = 0.003), and log CV of HbA1c (OR 24.00 [95 % CI 3.09-186.48], p = 0.002), were significantly associated with the presence of CAN. The patients with higher HbA1c variability had an increased risk of advanced CAN. CV in CGM and all parameters of HbA1c variability were independently associated with the presence of CAN in patients with inadequately controlled type 2 diabetes requiring CGM.

  18. Continuous intraperitoneal insulin infusion versus subcutaneous insulin therapy in the treatment of type 1 diabetes: effects on glycemic variability

    NARCIS (Netherlands)

    van Dijk, Peter R.; Groenier, Klaas H.; DeVries, J. Hans; Gans, Reinold O. B.; Kleefstra, Nanno; Bilo, Henk J. G.; Logtenberg, Susan J. J.

    2015-01-01

    As continuous intraperitoneal insulin infusion (CIPII) results in a more physiologic action of insulin than subcutaneous (SC) insulin administration, we hypothesized that CIPII would result in less glycemic variability (GV) than SC insulin therapy among type 1 diabetes mellitus (T1DM) patients. Data

  19. Retinal neurodegeneration in patients with type 1 diabetes mellitus: the role of glycemic variability.

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    Picconi, Fabiana; Parravano, Mariacristina; Ylli, Dorina; Pasqualetti, Patrizio; Coluzzi, Sara; Giordani, Ilaria; Malandrucco, Ilaria; Lauro, Davide; Scarinci, Fabio; Giorno, Paola; Varano, Monica; Frontoni, Simona

    2017-05-01

    Recent studies have identified neuroretinal abnormalities in persons affected by diabetes mellitus, before the onset of microvascular alterations. However, the role of glycemic variability (GV) on early retinal neurodegeneration is still not clarified. To explore the relationship between glycemic control and neuroretinal characteristics, 37 persons with Type 1 diabetes mellitus (Type 1 DM) divided into two groups with no signs (noRD) and with mild non-proliferative diabetic retinopathy (NPDR) compared to 13 healthy control participants (C) were recruited. All persons underwent an optical coherence tomography with automatic segmentation of all neuroretinal layers. Measurements of mean of nasal (N)/temporal (T)/superior (S)/inferior (I) macular quadrants for individual layer were also calculated. Metabolic control was evaluated by glycated hemoglobin (HbA1c), and indexes of GV were calculated from continuous glucose monitoring. The difference among the three groups in terms of RNFL thickness was significantly dependent on quadrant (F(6;132) = 2.315; p = 0.037). This interaction was due to a specific difference in RNFL-N thickness, where both Type 1 DM groups showed a similar reduction versus C (-3.9 for noDR and -4.9 for NPDR), without any relevant difference between them (-1.0). Inner nuclear layer (INL) was increased in all quadrants in the two Type 1 DM groups compared to C (mean difference = 7.73; 95% CI: 0.32-15.14, p = 0.043; mean difference = 7.74; 95% CI: 0.33-15.15, p = 0.043, respectively). A negative correlation between RNFL-N and low blood glucose index (r = -0.382, p = 0.034) and positive correlation between INL and continuous overall net glycemic action -1, -2, -4 h (r = 0.40, p = 0.025; r = 0.39, p = 0.031; r = 0.41, p = 0.021, respectively) were observed in Type 1 DM patients. The triglycerides were positively and significantly correlated to INL (r = 0.48, p = 0.011), in Type 1 DM subjects. GV and triglycerides

  20. Association of glycemic variability and the presence and severity of coronary artery disease in patients with type 2 diabetes

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    Zheng Hong

    2011-02-01

    Full Text Available Abstract Background Glucose variability is one of components of the dysglycemia in diabetes and may play an important role in development of diabetic vascular complications. The objective of this study was to assess the relationship between glycemic variability determined by a continuous glucose monitoring (CGM system and the presence and severity of coronary artery disease (CAD in patients with type 2 diabetes mellitus (T2DM. Methods In 344 T2DM patients with chest pain, coronary angiography revealed CAD (coronary stenosis ≥ 50% luminal diameter narrowing in 252 patients and 92 patients without CAD. Gensini score was used to assess the severity of CAD. All participants' CGM parameters and biochemical characteristics were measured at baseline. Results Diabetic patients with CAD were older, and more were male and cigarette smokers compared with the controls. Levels of the mean amplitude of glycemic excursions (MAGE (3.7 ± 1.4 mmol/L vs. 3.2 ± 1.2 mmol/L, p 1c (HbA1c, hs-CRP and total cholesterol (TC. Multivariate analysis indicated that age (p 1c (p = 0.022 and hs-CRP (p = 0.005 were independent determinants for Gensini score. Logistic regression analysis revealed that MAGE ≥ 3.4 mmol/L was an independent predictor for CAD. The area under the receiver-operating characteristic curve for MAGE (0.618, p = 0.001 was superior to that for HbA1c (0.554, p = 0.129. Conclusions The intraday glycemic variability is associated with the presence and severity of CAD in patients with T2DM. Effects of glycemic excursions on vascular complications should not be neglected in diabetes.

  1. Roles of increased glycemic variability, GLP-1 and glucagon in hypoglycaemia after Roux-en-Y gastric bypass

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    Tharakan, George; Behary, Preeshila; Wewer Albrechtsen, Nicolai Jacob

    2017-01-01

    Objective Roux-en-Y Gastric Bypass (RYGB) surgery is currently the most effective treatment for diabetes and obesity. An increasingly recognized complication of RYGB surgery is postprandial hypoglycemia (PPH). The pathophysiology of PPH remains unclear with multiple mechanisms suggested including...... to reversal of RYGB. A greater understanding of the pathophysiology of PPH could guide the development of new therapeutic strategies. Methods We studied a cohort of PPH patients at the Imperial Weight Center. We performed continuous glucose monitoring to characterize their altered glycemic variability. We...

  2. The median is not the only message: a clinician's perspective on mathematical analysis of glycemic variability and modeling in diabetes mellitus.

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    McCall, Anthony L; Kovatchev, Boris P

    2009-01-01

    Hemoglobin A1c (HbA1c), a long-term, integrated average of tissue exposure to hyperglycemia, is the best reflection of average glucose concentrations and the best proven predictor of microvascular complications of diabetes mellitus. However, HbA1c fails to capture glycemic variability and the risks associated with extremes of hypoglycemia and hyperglycemia. These risks are the primary barrier to achieving the level of average glucose control that will minimize both the microvascular and the long-term macrovascular complications of type 1 diabetes. High blood glucose levels largely due to prandial excursions produce oxidative and inflammatory stress with potential acceleration of preexisting atherosclerosis and increased cardiovascular risk. Moreover, some temporal aspects of glycemic variation, including the rates of rise and fall of glucose, are associated with adverse cognitive and mood symptoms in those with diabetes. Methods to quantify the risk of glycemic extremes, both high and low, and the variability including its temporal aspects are now more precise than ever. These important endpoints should be included for use in clinical trials as useful metrics and recognized by regulatory agencies, which has not been the case in the past. Precise evaluation of glycemic variability and its attendant risks are essential in the design of optimal therapies; for these reasons, inclusion of these metrics and the pulsatile hormone patterns in mathematical models may be essential. For the clinician, the incursion of mathematical models that simulate normal and pathophysiological mechanisms of glycemic control is a reality and should be also gradually incorporated into clinical practice. © Diabetes Technology Society

  3. Distinct impacts of sleep-disordered breathing on glycemic variability in patients with and without diabetes mellitus.

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    Kei Nakata

    Full Text Available Sleep-disordered breathing (SDB is highly prevalent in patients with diabetes mellitus (DM and heart failure (HF and contributes to poor cardiovascular outcomes. Enlarged glycemic variability (GV is a risk factor of cardiac events independently of average blood glucose level, but the influence of SDB on GV is uncertain. In this study, we examined whether the impact of SDB on GV is modified by the presence of DM with or without HF.Two hundred three patients (67.5±14.1 [SD] years old, 132 males who were admitted to our institute for examination or treatment of DM and/or HF underwent continuous glucose monitoring and polysomnography. Both HbA1c (8.0±2.0 vs. 5.7±0.4% and mean amplitude of glycemic excursion (MAGE, median: 95.5 vs. 63.5 mg/dl were significantly higher in a DM group (n = 100 than in a non-DM group (n = 103, but apnea-hypopnea index (AHI: 29.0±22.7 vs. 29.3±21.5 was similar in the two groups. AHI was correlated with log MAGE in the non-DM group but not in the DM group, and multivariate regression analysis revealed that AHI was an independent variable for log MAGE in the non-DM group but not in the DM group. We then divided the non-DM patients into two subgroups according to BNP level (100 pg/ml. AHI was positively correlated with log MAGE (r = 0.74, p<0.001 in the non-DM low-BNP subgroup, but such a correlation was not found in the non-DM high-BNP subgroup. Continuous positive airway pressure (CPAP reduced MAGE from 75.3 to 53.0 mg/dl in the non-DM group but did not reduce MAGE in the DM group.Severity of SDB was associated with higher GV, but DM as well as HF diminished the contribution of SDB to GV. Treatment with CPAP was effective for reduction of GV only in patients without DM.

  4. Distinct impacts of sleep-disordered breathing on glycemic variability in patients with and without diabetes mellitus.

    Science.gov (United States)

    Nakata, Kei; Miki, Takayuki; Tanno, Masaya; Ohnishi, Hirofumi; Yano, Toshiyuki; Muranaka, Atsuko; Sato, Tatsuya; Oshima, Hiroto; Tatekoshi, Yuki; Mizuno, Masashi; Abe, Koki; Miura, Tetsuji

    2017-01-01

    Sleep-disordered breathing (SDB) is highly prevalent in patients with diabetes mellitus (DM) and heart failure (HF) and contributes to poor cardiovascular outcomes. Enlarged glycemic variability (GV) is a risk factor of cardiac events independently of average blood glucose level, but the influence of SDB on GV is uncertain. In this study, we examined whether the impact of SDB on GV is modified by the presence of DM with or without HF. Two hundred three patients (67.5±14.1 [SD] years old, 132 males) who were admitted to our institute for examination or treatment of DM and/or HF underwent continuous glucose monitoring and polysomnography. Both HbA1c (8.0±2.0 vs. 5.7±0.4%) and mean amplitude of glycemic excursion (MAGE, median: 95.5 vs. 63.5 mg/dl) were significantly higher in a DM group (n = 100) than in a non-DM group (n = 103), but apnea-hypopnea index (AHI: 29.0±22.7 vs. 29.3±21.5) was similar in the two groups. AHI was correlated with log MAGE in the non-DM group but not in the DM group, and multivariate regression analysis revealed that AHI was an independent variable for log MAGE in the non-DM group but not in the DM group. We then divided the non-DM patients into two subgroups according to BNP level (100 pg/ml). AHI was positively correlated with log MAGE (r = 0.74, p<0.001) in the non-DM low-BNP subgroup, but such a correlation was not found in the non-DM high-BNP subgroup. Continuous positive airway pressure (CPAP) reduced MAGE from 75.3 to 53.0 mg/dl in the non-DM group but did not reduce MAGE in the DM group. Severity of SDB was associated with higher GV, but DM as well as HF diminished the contribution of SDB to GV. Treatment with CPAP was effective for reduction of GV only in patients without DM.

  5. Dysglycemia, Glycemic Variability, and Outcome After Cardiac Arrest and Temperature Management at 33°C and 36°C

    DEFF Research Database (Denmark)

    Borgquist, Ola; Wise, Matt P; Nielsen, Niklas

    2017-01-01

    OBJECTIVES: Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes...... of patients randomized to targeted temperature management at 33°C or 36°C after cardiac arrest. DESIGN: Post hoc analysis of the multicenter TTM-trial. Primary outcome of this analysis was neurologic outcome after 6 months, referred to as "Cerebral Performance Category." SETTING: Thirty-six sites in Europe...... and Australia. PATIENTS: All 939 patients with out-of-hospital cardiac arrest of presumed cardiac cause that had been included in the TTM-trial. INTERVENTIONS: Targeted temperature management at 33°C or 36°C. MEASUREMENTS AND MAIN RESULTS: Nonparametric tests as well as multiple logistic regression and mixed...

  6. Glycemic variability and insulin needs in patients with type 1 diabetes mellitus supplemented with vitamin D: a pilot study using continuous glucose monitoring system.

    Science.gov (United States)

    Felício, Karem Miléo; de Souza, Ana Carolina Contente Braga; Neto, João Felício Abrahão; de Melo, Franciane Trindade Cunha; Carvalho, Carolina Tavares; Arbage, Thaís Pontes; de Rider Brito, Hana Andrade; Peixoto, Amanda Soares; de Oliveira, Alana Ferreira; de Souza Resende, Fabricio; Reis, Scarlatt Sousa; Motta, Ana Regina; da Costa Miranda, Henrique; Janaú, Luísa Corrêa; Yamada, Elizabeth Sumi; Felício, João Soares

    2017-06-15

    Recent studies suggest that glycemic variability could influence the risk of complications in type 1 diabetes mellitus (T1DM). There are no data about the action of vitamin D (VD) on glycemic variability. Our pilot study aims to evaluate glycemic variability and insulin needs in patients with T1DM supplemented with VD. 22 patients received doses of 4000 and 10000 IU/day of cholecalciferol for 12 weeks, according to the patient's baseline VD levels and underwent continuous glucose monitoring system. Correlations were found between percentage variation (∆) of glycemia standard deviation (∆SDG), calculated using continuous glucose monitoring, with ∆ of basal (r= 0.6; p needed by patients is lower when VD status is better. We divided patients in two subgroups: SDG improved (subgroup 1; n =12 (55%)) and SDG worsened (subgroup 2; n =10 (45%)). Group 1, compared to subgroup 2, required a lower insulin dose (∆basal insulin dose = -8.0 vs 6.3%; p needs and lower frequency of hypoglycemia in patients with T1DM. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  7. Comparative study between the Phramongkutklao's diabetic blenderized diets and commercial diabetic diets on glycemic variability in continuous tube fed patients with type 2 diabetes.

    Science.gov (United States)

    Tiyapanjanit, Teeranun; Boonyavarakul, Apussanee

    2014-11-01

    Rapid glucose fluctuations over daily period play an important role on diabetic complications. To compare glycemic variability, mean plasma glucose, number ofcapillary blood glucose tests, and cost between the Phramongkutklao's diabetic formula and commercial diabetic formula in continuous tube fed patients with stable condition in type 2 diabetes. A cross-over design study was performed between October 2010 and February 2011 in the medical department in Phramongkutklao Hospital. The researchers enrolled type 2 diabetic patients with stable condition who were on continuous tube fed. Seventy-two-hour continuous subcutaneous glucose monitoring was performed in all patients. Comparison ofmean amplitude ofglycemic excursions (MAGE), mean plasma glucose, cost, and number of capillary blood glucose tests were analyzed by using non-parametric Wilcoxon signed-rank test. Significance was defined as pDiabetic Formula resulted in significantly lower mean plasma glucose (122±26.25 vs. 144.68±36.91 mg/dL, p = 0.022), cost (550.1±33.57 vs. 797.81±42.29 baht, p = 0.004), and number of capillary blood glucose tests (5±0.94 vs. 5.3±0.82 times, p = 0.083) when compared with commercial diabetic formula, but no significant difference in MAGE level (5.86±2.78 vs. 7.71±4.34 mg/dL, p = 0.333). The Phramongkutklao's diabetic formula has significantly lower mean plasma glucose, less number of capillary blood glucose tests, and is less expensive than commercial diabetic formula. The glucose variability (MAGE) of the Phramongkutklao diabetic formula has also less than commercial diabetic formula, but does not reach statistical significance. The level ofplasma glucose was lower than 180 mg/dL in both formulas.

  8. Exploring the Variability in Acute Glycemic Responses to Exercise in Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Tasuku Terada

    2013-01-01

    Full Text Available Aim. To explore the factors associated with exercise-induced acute capillary glucose (CapBG changes in individuals with type 2 diabetes (T2D. Methods. Fifteen individuals with T2D were randomly assigned to energy-matched high intensity interval exercise (HI-IE and moderate intensity continuous exercise (MI-CE interventions and performed a designated exercise protocol 5 days per week for 12 weeks. The duration of exercise progressed from 30 to 60 minutes. CapBG was measured immediately before and after each exercise session. Timing of food and antihyperglycemic medication intake prior to exercise was recorded. Results. Overall, the mean CapBG was lowered by 1.9 mmol/L (P<0.001 with the change ranging from −8.9 to +2.7 mmol/L. Preexercise CapBG (44%; P<0.001, medication (5%; P<0.001, food intake (4%; P=0.043, exercise duration (5%; P<0.001, and exercise intensity (1%; P=0.007 were all associated with CapBG changes, explaining 59% of the variability. Conclusion. The greater reduction in CapBG seen in individuals with higher preexercise CapBG may suggest the importance of exercise in the population with elevated glycemia. Lower blood glucose can be achieved with moderate intensity exercise, but prolonging exercise duration and/or including brief bouts of intense exercise accentuate the reduction, which can further be magnified by performing exercise after meals and antihyperglycemic medication. This trial is registered with ClinicalTrial.gov NCT01144078.

  9. A Comparison of Glycemic Control, Sleep, Fatigue, and Depression in Type 2 Diabetes with and without Restless Legs Syndrome

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    Cuellar, Norma G.; Ratcliffe, Sarah J.

    2008-01-01

    Objective: The purpose of this pilot study was to determine how sleep quality, glycemic control, sleepiness, fatigue, and depression differ in persons with type 2 diabetes with and without restless legs syndrome (RLS). Research Designs/Methods: The design was a descriptive, case-control study of participants with type 2 diabetes with and without RLS at the University of Pennsylvania, Rodebaugh Diabetes Center. Thirty-nine participants (adults over 21 years of age who had been diagnosed with type 2 diabetes and had a HbA1c in the last 3 months) were stratified based on RLS diagnostic criteria. Exclusion criteria included severe hypoglycemia identified by seizures or coma related to hypoglycemia or known sleep disorder other than RLS. The primary outcome of sleep was measured by self-report sleep quality (Pittsburgh Sleep Quality Index) with secondary outcomes including HbA1c, sleepiness (Epworth Sleepiness Scale), fatigue (Fatigue Severity Scale), and depression (Center for Epidemiologic Studies-Depression Scale). Results: Participants with type 2 diabetes with RLS reported a significant difference in quality of sleep (p = .001), sleep latency (p = .04), sleep efficiency (p = .035), use of sleep medications (p < .001), and daytime dysfunction (p = .005). In the total group, higher HbA1c levels were positively correlated with sleepiness (p = .038). Global Pittsburgh Sleep Quality Index scores were positively correlated with fatigue (r = .58, p = .002) and depression (r = .74, p < .001). As well, fatigue and sleepiness were positively correlated (r = .36, p = .04). Conclusions: RLS is a significant sleep disorder that may have an impact on diabetes management and health outcomes. More research should be conducted on the impact of RLS in sleep to improve diabetic management. Citation: Cuellar NG; Ratcliffe SJ. A comparison of glycemic control, sleep, fatigue, and depression in type 2 diabetes with and without restless legs syndrome. J Clin Sleep Med 2008

  10. Glycemic variability evaluated by continuous glucose monitoring system is associated with the 10-y cardiovascular risk of diabetic patients with well-controlled HbA1c.

    Science.gov (United States)

    Tang, Xixiang; Li, Suhua; Wang, Yina; Wang, Manman; Yin, Qiongli; Mu, Panwei; Lin, Shuo; Qian, Xiaoxian; Ye, Xiaoming; Chen, Yanming

    2016-10-01

    The present study aimed to identify the relationship between glycemic variability (GV) and the 10-y risk of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM) patients with good glycemic control. Two-hundred forty consecutive T2DM patients (HbA1c≤7.0%) without CVD were included to calculate the 10-y CVD risk by Framingham risk score (FRS), and divided into 3 groups: low-risk group (FRS≤10%), intermediate-risk group (>10%, ≤20%) and high-risk group (>20%). Inter-group differences of GV were determined by comparing the SD of blood glucose (SDBG), mean amplitudes of glycemic excursion (MAGE), and mean of daily differences (MODD) gathered from 72-h continuous glucose monitoring system. The levels of SDBG and MAGE significantly increased along with the raises of 10-y CVD risk of T2DM patients (ppatients with high urine albumin excretion rates [OR: 1.743(1.247-2.793), prisk. GV predicts independently the 10-y CVD risk of T2DM patients with well-controlled HbA1c. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Dysglycemia, Glycemic Variability, and Outcome After Cardiac Arrest and Temperature Management at 33°C and 36°C.

    Science.gov (United States)

    Borgquist, Ola; Wise, Matt P; Nielsen, Niklas; Al-Subaie, Nawaf; Cranshaw, Julius; Cronberg, Tobias; Glover, Guy; Hassager, Christian; Kjaergaard, Jesper; Kuiper, Michael; Smid, Ondrej; Walden, Andrew; Friberg, Hans

    2017-08-01

    Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes of patients randomized to targeted temperature management at 33°C or 36°C after cardiac arrest. Post hoc analysis of the multicenter TTM-trial. Primary outcome of this analysis was neurologic outcome after 6 months, referred to as "Cerebral Performance Category." Thirty-six sites in Europe and Australia. All 939 patients with out-of-hospital cardiac arrest of presumed cardiac cause that had been included in the TTM-trial. Targeted temperature management at 33°C or 36°C. Nonparametric tests as well as multiple logistic regression and mixed effects logistic regression models were used. Median glucose concentrations on hospital admission differed significantly between Cerebral Performance Category outcomes (p variability, were associated with poor neurologic outcome and death. More patients in the 33°C treatment arm had hyperglycemia.

  12. Short-term effects of a hypocaloric diet with low glycemic index and low glycemic load on body adiposity, metabolic variables, ghrelin, leptin, and pregnancy rate in overweight and obese infertile women: a randomized controlled trial.

    Science.gov (United States)

    Becker, Geórgia F; Passos, Eduardo P; Moulin, Cileide C

    2015-12-01

    Obesity is related to hormonal disorders that affect the reproductive system. Low-glycemic index (LGI) diets seem to exert a positive effect on weight loss and on metabolic changes that result from obesity. We investigated the effects of a hypocaloric diet with an LGI and low glycemic load on anthropometric and metabolic variables, ghrelin and leptin concentrations, and the pregnancy rate in overweight and obese infertile women who were undergoing in vitro fertilization (IVF). The study was a randomized block-design controlled trial in which we analyzed 26 overweight or obese infertile women. Patients were assigned to a hypocaloric LGI-diet group or a control group and followed the protocol for 12 wk. Body weight, body mass index (BMI), percentage of body fat, glucose, insulin, homeostasis model assessment of insulin resistance, serum lipids, reproductive hormones, leptin, acylated ghrelin, number of oocytes retrieved in the IVF cycle, and pregnancy rate were determined. There were greater reductions in body mass, BMI, percentage of body fat, waist:hip ratio, and leptin in the LGI-diet group than in the control group (P diet group had 85.4% more oocytes retrieved than did the control group (7.75 ± 1.44 and 4.18 ± 0.87, respectively; P = 0.039) in the IVF cycle. Three patients (21.4%) in the LGI group experienced a spontaneous pregnancy during the follow-up, which generated 3 live births. The hypocaloric LGI diet promoted a decrease in BMI, percentage of body fat, and leptin concentrations, which improved oocyte development and pregnancy rate. These results support the clinical recommendation to advise overweight and obese women to lose weight through a balanced diet before being submitted for treatment with assisted reproduction technologies. A hypocaloric diet combined with LGI foods seems to be beneficial for these patients, but additional studies are required before this treatment is recommended. This trial was registered at clinicaltrials.gov as NCT02416960

  13. The Association of Glucose Variability and Home Discharge Among Survivors of Critical Illness Managed With a Computerized Decision-Support Tool for Glycemic Control.

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    Oud, Lavi; Spellman, Craig

    2014-03-01

    In-intensive care unit (ICU) glucose variability (GV) is associated with increased mortality. However, the impact of GV on hospital survivors' morbidity and associated changes in destination at time of hospital discharge are unknown. We studied a retrospective patient cohort in a medical/surgical ICU, requiring insulin infusion, using computer-guided insulin dosing software. Standard deviation (Glu SD ) and coefficient of variation (Glu CV ) were used as GV measures. We examined rates of home discharge (H) in the whole cohort and selected subgroups across GV quartiles, between patients with and without H, determinants of H, and determinants of GV and its association with patients' ICU length of stay (LOS). A total of 351 patients met study criteria. The association of GV and H varied among examined subgroups. H increased with GV quartile (Glu SD ; P = .004). GV was higher in patients with H than non-H (Glu SD 36.1 vs 30.0 mg/dl, respectively; P = .002). Increased GV was not a predictor of reduced H on multivariate analysis. GV was inversely associated with patients' ICU LOS in all examined subgroups. Increased number of hypoglycemic events and time to attain target glycemia were independent predictors of reduced H. GV was not associated with adverse impact on H in the present cohort, and its prognostic impact should be considered in the context of ICU LOS of examined patient populations. Further studies are needed to examine the morbidity effects of GV and other glycemia-related measures among hospital survivors of critical illness across varying ICU populations, glycemic control approaches, and glycemic targets. © 2014 Diabetes Technology Society.

  14. Carbohydrate and protein but not fat or fiber affects glycemic index and glycemic load value determinations

    Science.gov (United States)

    Introduction: Dietary glycemic index (GI) and glycemic load (GL) values have been calculated using data derived from instruments designed to estimate daily food intake. Since the absolute amount of carbohydrate (CHO) and combination of CHO with other macronutrients and fiber is highly variable among...

  15. Comparison of 2 intravenous insulin protocols: Glycemia variability in critically ill patients.

    Science.gov (United States)

    Gómez-Garrido, Marta; Rodilla-Fiz, Ana M; Girón-Lacasa, María; Rodríguez-Rubio, Laura; Martínez-Blázquez, Anselmo; Martínez-López, Fernando; Pardo-Ibáñez, María Dolores; Núñez-Marín, Juan M

    2017-05-01

    Glycemic variability is an independent predictor of mortality in critically ill patients. The objective of this study was to compare two intravenous insulin protocols in critically ill patients regarding the glycemic variability. This was a retrospective observational study performed by reviewing clinical records of patients from a Critical Care Unit for 4 consecutive months. First, a simpler Scale-Based Intravenous Insulin Protocol (SBIIP) was reviewed and later it was compared for the same months of the following year with a Sliding Scale-Based Intravenous Insulin Protocol (SSBIIP). All adult patients admitted to the unit during the referred months were included. Patients in whom the protocol was not adequately followed were excluded. A total of 557 patients were reviewed, of whom they had needed intravenous insulin 73 in the first group and 52 in the second group. Four and two patients were excluded in each group respectively. Glycemic variability for both day 1 (DS1) and total stay (DST) was lower in SSBIIP patients compared to SBIIP patients: SD1 34.88 vs 18.16 and SDT 36.45 vs 23.65 (P<.001). A glycemic management protocol in critically ill patients based on sliding scales decreases glycemic variability. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Relation between psychosocial variables and the glycemic control of patients with type 2 diabetes: A cross-sectional and prospective study

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    Kawai Keisuke

    2009-03-01

    Full Text Available Abstract Background This cross-sectional and prospective study used a variety of psychological inventories to evaluate the relationship between psychosocial factors and the glycemic control of patients with type 2 diabetes. Methods Participants were 304 patients with type 2 diabetes who were treated as outpatients at diabetes clinics. All participants were assessed for HbA1c and completed the following self-report psychological inventories: 1 Diabetes Treatment Satisfaction Questionnaire (DTSQ, 2 Problem Areas in Diabetes Survey (PAID, 3 Well-being Questionnaire 12 (W-BQ12, 4 Self-Esteem Scale (SES, 5 Social Support Scale, and 6 Self-Efficacy Scale. HbA1c was again measured one year later. The relationships between the psychosocial variables obtained by analysis of the psychological inventories and baseline or one-year follow-up HbA1c were determined. Results Baseline HbA1cwas significantly correlated with age, diet treatment regimen, number of microvascular complication of diabetes, and the total scores of DTSQ, W-BQ12, PAID, SES and the Self-Efficacy Scale. Hierarchical stepwise multiple regression revealed that significant predictors of baseline HbA1c were total DTSQ and PAID scores, along with age, diet treatment regimen, and number of microvascular complication of diabetes after adjustment for demographic, clinical and other psychosocial variables. Two hundred and ninety patients (95.4% of 304 were followed and assessed one year after baseline. Hierarchical stepwise multiple regression analysis showed the significant predictors of follow-up HbA1c to be total DTSQ and PAID scores, along with age and diet treatment regimen. However, the correlation between baseline and follow-up HbA1c was so high that the only other variable to retain significance was diet treatment regimen once baseline HbA1c was included in the regression of follow-up HbA1c. Conclusion The DTSQ and the PAID predicted both current and future HbA1c to a similar and

  17. Comparison of fixed versus variable biofuels incentives

    International Nuclear Information System (INIS)

    Tyner, Wallace E.; Taheripour, Farzad; Perkis, David

    2010-01-01

    We evaluated several variants of a variable biofuel subsidy and compared them with the fixed subsidy and Renewable Fuel Standard using two different modeling approaches. First we used a partial equilibrium model encompassing crude oil, gasoline, ethanol, corn, and ethanol by-products. Second, we used a stochastic simulation model of a prototypical ethanol plant. From the partial equilibrium analysis, it appears the variable subsidy provides a safety net for ethanol producers when oil prices are low; yet, it does not put undue pressure on corn prices when oil prices are high. At high oil prices, the level of ethanol production is driven by market forces. From the plant level stochastic analysis, essentially the same conclusions are reached. As with the fixed subsidy, the variable subsidy can increase the net present value (NPV) sufficiently to encourage investment, but with lower risk for the producer, lower probability of a loss from the investment, and often lower expected cost to government. Finally, in the US, the ethanol industry is up against a blending limit called the blend wall. If the blending wall remains in place and no way around it is found, it does not matter much what other policy options are used.

  18. Impact of glycemic control on the incidence of acute kidney injury in critically ill patients: a comparison of two strategies using the RIFLE criteria

    Directory of Open Access Journals (Sweden)

    José Raimundo Araújo de Azevedo

    2010-06-01

    Full Text Available OBJECTIVE: To compare the renal outcome in patients submitted to two different regimens of glycemic control, using the RIFLE criteria to define acute kidney injury. INTRODUCTION: The impact of intensive insulin therapy on renal function outcome is controversial. The lack of a criterion for AKI definition may play a role on that. METHODS: Included as the subjects were 228 randomly selected, critically ill patients engaged in intensive insulin therapyor in a carbohydrate-restrictive strategy. Renal outcome was evaluated through the comparison of the last RIFLE score obtained during the ICU stay and the RIFLE score at admission; the outcome was classified as favorable, stable or unfavorable. RESULTS: The two groups were comparable regarding demographic data. AKI developed in 52% of the patients and was associated with a higher mortality (39.4% compared with those who did not have AKI (8.2% (p60, acute kidney injury and hypoglycemia were risk factors for mortality. CONCLUSION: Intensive insulin therapy and a carbohydrate-restrictive strategy were comparable regarding the incidence of acute kidney injury evaluated using RIFLE criteria.

  19. A comparison of glycemic control, water retention, and musculoskeletal effects of balaglitazone and pioglitazone in diet-induced obese rats

    DEFF Research Database (Denmark)

    Henriksen, Kim; Byrjalsen, Inger; Nielsen, Rasmus H

    2009-01-01

    Agonists of Perioxisome Proliferator-Activator Receptor gamma (PPARgamma), which work as insulin sensitizers, are approved for type 2 diabetes. However, adverse effects, such as oedemas, infarctions, and increased fracture rates, limit their applicability. We performed a head-to-head comparison...

  20. Managing variability in the summary and comparison of gait data

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    Chau Tom

    2005-07-01

    Full Text Available Abstract Variability in quantitative gait data arises from many potential sources, including natural temporal dynamics of neuromotor control, pathologies of the neurological or musculoskeletal systems, the effects of aging, as well as variations in the external environment, assistive devices, instrumentation or data collection methodologies. In light of this variability, unidimensional, cycle-based gait variables such as stride period should be viewed as random variables and prototypical single-cycle kinematic or kinetic curves ought to be considered as random functions of time. Within this framework, we exemplify some practical solutions to a number of commonly encountered analytical challenges in dealing with gait variability. On the topic of univariate gait variables, robust estimation is proposed as a means of coping with contaminated gait data, and the summary of non-normally distributed gait data is demonstrated by way of empirical examples. On the summary of gait curves, we discuss methods to manage undesirable phase variation and non-robust spread estimates. To overcome the limitations of conventional comparisons among curve landmarks or parameters, we propose as a viable alternative, the combination of curve registration, robust estimation, and formal statistical testing of curves as coherent units. On the basis of these discussions, we provide heuristic guidelines for the summary of gait variables and the comparison of gait curves.

  1. Comparison of seasonal variability in European domestic radon measurements

    Science.gov (United States)

    Groves-Kirkby, C. J.; Denman, A. R.; Phillips, P. S.; Crockett, R. G. M.; Sinclair, J. M.

    2010-03-01

    Analysis of published data characterising seasonal variability of domestic radon concentrations in Europe and elsewhere shows significant variability between different countries and between regions where regional data is available. Comparison is facilitated by application of the Gini Coefficient methodology to reported seasonal variation data. Overall, radon-rich sedimentary strata, particularly high-porosity limestones, exhibit high seasonal variation, while radon-rich igneous lithologies demonstrate relatively constant, but somewhat higher, radon concentrations. High-variability regions include the Pennines and South Downs in England, Languedoc and Brittany in France, and especially Switzerland. Low-variability high-radon regions include the granite-rich Cornwall/Devon peninsula in England, and Auvergne and Ardennes in France, all components of the Devonian-Carboniferous Hercynian belt.

  2. Comparison of seasonal variability in European domestic radon measurements

    Directory of Open Access Journals (Sweden)

    C. J. Groves-Kirkby

    2010-03-01

    Full Text Available Analysis of published data characterising seasonal variability of domestic radon concentrations in Europe and elsewhere shows significant variability between different countries and between regions where regional data is available. Comparison is facilitated by application of the Gini Coefficient methodology to reported seasonal variation data. Overall, radon-rich sedimentary strata, particularly high-porosity limestones, exhibit high seasonal variation, while radon-rich igneous lithologies demonstrate relatively constant, but somewhat higher, radon concentrations. High-variability regions include the Pennines and South Downs in England, Languedoc and Brittany in France, and especially Switzerland. Low-variability high-radon regions include the granite-rich Cornwall/Devon peninsula in England, and Auvergne and Ardennes in France, all components of the Devonian-Carboniferous Hercynian belt.

  3. Comparison between adherence assessments and blood glucose monitoring measures to predict glycemic control in adults with type 1 diabetes: a cross-sectional study.

    Science.gov (United States)

    Telo, Gabriela Heiden; de Souza, Martina Schaan; Andrade, Thais Stürmer; Schaan, Beatriz D'Agord

    2016-01-01

    Adherence to treatment has been defined as the degree to which a patient's behavior corresponds to medical or health advice; however, the most appropriate method to evaluate adherence to diabetes care has yet to be identified. We conducted analyses to compare adherence assessments and blood glucose monitoring measures with regard to their ability to predict glycemic control in adults with type 1 diabetes. We analyzed four instruments to evaluate adherence: Self-Care Inventory-Revised, a self-administered survey; Diabetes Self-Monitoring Profile (DSMP), administered by trained researchers; a categorical (yes/no/sometimes) adherence self-evaluation; and a continuous (0-100) adherence self-evaluation. Blood glucose monitoring frequency was evaluated by self-report, diary, and meter download. Participants (n = 82) were aged 39.0 ± 13.1 years with a mean diabetes duration of 21.2 ± 11.1 years; 27 % monitored blood glucose >4 times/day. The DSMP score was the strongest predictor of glycemic control (r = -0.32, P = 0.004) among adherence assessments, while blood glucose monitoring frequency assessed by meter download was the strongest predictor among blood glucose monitoring measures (r = -40, P self-report assessments had a significant but weak correlation with glycemic control (r ≤ 0.28, P ≤ 0.02). The final adjusted model identified the assessment of blood glucose monitoring frequency by meter download as the most robust predictor of HbA1c (estimate effect size = -0.58, P = 0.003). In efforts to evaluate adherence, blood glucose monitoring frequency assessed by meter download has the strongest relationship with glycemic control in adults with type 1 diabetes.

  4. Comparison of glycated hemoglobin with fasting plasma glucose in definition of glycemic component of the metabolic syndrome in an Iranian population.

    Science.gov (United States)

    Janghorbani, Mohsen; Amini, Masoud

    2012-01-01

    The aim of this study was to compare the utility of glycated hemoglobin (GHb) versus the fasting plasma glucose (FPG) in definition of glycemic component of the metabolic syndrome (MetS) in a non-diabetic Iranian population. A cross-sectional study of first-degree relatives (FDRs) of patients with type 2 diabetes was conducted from 2003 to 2005. A total of 2410 non-diabetic FDRs of consecutive patients with type 2 diabetes 30-60 years old were examined. All subjects underwent a standard 75 g 2-h oral glucose tolerance test and GHb measurement. Consensus criteria in 2009 were used to identify MetS. Glycemic component of MetS was defined as either FPG≥100 mg/dl or GHb≥5.7%. The mean (SD) age of participants was 43.6 (6.5) years. The prevalence of MetS was 33.5% (95% confidence interval (CI): 31.6, 35.4) based on FPG criterion alone and 28.6% (95% CI: 26.8, 30.4) based on GHb criterion alone. Use of combination of both criteria increased the prevalence of MetS (36.7%; 95% CI: 34.8, 38.6). There was 88.7% (95% CI: 87.5, 90.0) agreement between the GHb and FPG when either was used to define MetS (κ coefficient=0.737). These data indicate that using GHb may be an acceptable surrogate of FPG to define glycemic component of MetS. Copyright © 2012 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  5. Glycemic control of diabetes patients under continuous rocket attacks.

    Science.gov (United States)

    Soskolne, Varda; Dekel, Rachel; Vinker, Shlomo

    2016-01-01

    Evidence regarding the detrimental effects of exposure to stress on glycemic control among diabetes patients has mainly focused on personal life events or acute trauma. However, the effects of continuous exposure to extreme stress on type 2 diabetes patients have rarely been studied. The aim of the current study was to examine the association of continuous exposure to rocket attacks with glycemic control and with risk factors for diabetes complications among civilian type 2 diabetes patients. We focus on patients residing in the Western Negev in the south of Israel that has been subjected to rocket attacks fired from Gaza since the end of 2001. A two-arm retrospective cohort study of type 2 diabetes patients, aged 35-70 years, residing in a region with chronic exposure to rocket attacks (N = 1697) and in a non-exposed comparison region in Israel (N = 3000). Data were retrieved from the Health Maintenance Organization (HMO)'s database for four time periods representing exposure: chronic-2008; elevated-2009 (post'Cast Lead' operation); return to chronic-2010, 2011. Data included socio-demographic variables, HbA 1c , BMI, LDL cholesterol, blood pressure. General Linear Models (GLM) were used for analysis. For HbA 1c , the model yielded a significant main effect for time, a borderline significance main effect for region, and a significant time by region interaction: no differences in HbA 1c levels between the regions in 2008 and 2009, followed by significant differences between the regions in 2010 and 2011 when HbA 1c continued to increase in the exposed region but decreased in the comparison region. Regarding risk factors, a significant main effect for time for LDL cholesterol only, and significant main effects for region were found in all factors: BMI and LDL cholesterol were higher in the exposed than in the comparison region, but blood pressure values were lower. Continuous exposure to rocket attacks is associated with glycemic control and risk factors in a

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

    DEFF Research Database (Denmark)

    Lau, Cathrine; Pedersen, Oluf; Færch, Kristine

    2005-01-01

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

  7. A multimodel comparison of centennial Atlantic meridional overturning circulation variability

    Energy Technology Data Exchange (ETDEWEB)

    Menary, Matthew B.; Vellinga, Michael; Palmer, Matthew D. [Met Office Hadley Centre, Exeter, Devon (United Kingdom); Park, Wonsun; Latif, Mojib [IFM-GEOMAR, Leibniz-Institut fuer Meereswissenschaften, Kiel (Germany); Lohmann, Katja; Jungclaus, Johann H. [Max Planck Inst Meteorol, Hamburg (Germany)

    2012-06-15

    A mechanism contributing to centennial variability of the Atlantic Meridional Overturning Circulation (AMOC) is tested with multi-millennial control simulations of several coupled general circulation models (CGCMs). These are a substantially extended integration of the 3rd Hadley Centre Coupled Climate Model (HadCM3), the Kiel Climate Model (KCM), and the Max Plank Institute Earth System Model (MPI-ESM). Significant AMOC variability on time scales of around 100 years is simulated in these models. The centennial mechanism links changes in the strength of the AMOC with oceanic salinities and surface temperatures, and atmospheric phenomena such as the Intertropical Convergence Zone (ITCZ). 2 of the 3 models reproduce all aspects of the mechanism, with the third (MPI-ESM) reproducing most of them. A comparison with a high resolution paleo-proxy for Sea Surface Temperatures (SSTs) north of Iceland over the last 4,000 years, also linked to the ITCZ, suggests that elements of this mechanism may also be detectable in the real world. (orig.)

  8. Health and economic impact of combining metformin with nateglinide to achieve glycemic control: Comparison of the lifetime costs of complications in the U.K

    Directory of Open Access Journals (Sweden)

    Salas Maribel

    2004-04-01

    Full Text Available Abstract Background To reduce the likelihood of complications in persons with type 2 diabetes, it is critical to control hyperglycaemia. Monotherapy with metformin or insulin secretagogues may fail to sustain control after an initial reduction in glycemic levels. Thus, combining metformin with other agents is frequently necessary. These analyses model the potential long-term economic and health impact of using combination therapy to improve glycemic control. Methods An existing model that simulates the long-term course of type 2 diabetes in relation to glycosylated haemoglobin (HbA1c and post-prandial glucose (PPG was used to compare the combination of nateglinide with metformin to monotherapy with metformin. Complication rates were estimated for major diabetes-related complications (macrovascular and microvascular based on existing epidemiologic studies and clinical trial data. Utilities and costs were estimated using data collected in the United Kingdom Prospective Diabetes Study (UKPDS. Survival, life years gained (LYG, quality-adjusted life years (QALY, complication rates and associated costs were estimated. Costs were discounted at 6% and benefits at 1.5% per year. Results Combination therapy was predicted to reduce complication rates and associated costs compared with metformin. Survival increased by 0.39 (0.32 discounted and QALY by 0.46 years (0.37 discounted implying costs of £6,772 per discounted LYG and £5,609 per discounted QALY. Sensitivity analyses showed the results to be consistent over broad ranges. Conclusion Although drug treatment costs are increased by combination therapy, this cost is expected to be partially offset by a reduction in the costs of treating long-term diabetes complications.

  9. A Comparison of Food-grade Folium mori Extract and 1-Deoxynojirimycin for Glycemic Control and Renal Function in Streptozotocin-induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Shiang-Suo Huang

    2014-07-01

    Full Text Available Folium mori (桑葉 Sāng Yè, leaf of Morus alba L.; FM is known to possess hypoglycemic effects, and 1-deoxynojirimycin (1-DNJ has been proposed as an important functional compound in FM. However, the hypoglycemic activity of purified 1-DNJ has been rarely studied. It is also not known how FM and 1-DNJ affect the development of DM nephropathy. This study compared the antidiabetic effect of a commercial FM product with that of purified 1-DNJ in streptozotocin-induced diabetic rats. Seven days after induction, the diabetic rats were gavaged with FM (1, 3, 10, and 30 mg/kg/day, 1-DNJ (30 mg/kg/day, or vehicle (distilled deionized water; 2 ml/kg/day for 7 days. All doses of FM ameliorated fasting and post-prandial blood glucose concomitantly with an increase in peripheral and pancreatic levels of insulin and improved homeostasis model assessment (HOMA-IR in diabetic rats in a dose-dependent manner. Increased thiobarbituric acid reactive substances (TBARS and nitrate/nitrite levels in the kidney, liver, and muscle of diabetic rats were reversed by all doses of FM. The renal function of the diabetic rats was normalized by all doses of FM, while blood pressure changes were reversed by FM at doses of 3 mg/kg and above. Moreover, most of the above-mentioned parameters were improved by FM at doses of 3 mg/kg and above to a similar extent as that of 1-DNJ. The results showed superior antidiabetic potential of the commercial FM product for glycemic control and protection against the development of diabetic nephropathy.

  10. Comparison of Perimeters: Improving Students' Performance by Increasing the Salience of the Relevant Variable

    Science.gov (United States)

    Babai, Reuven; Nattiv, Laura; Stavy, Ruth

    2016-01-01

    Students' difficulties in mathematics and science may stem from interference of irrelevant salient variables. We focus on the comparison of perimeters task, in which area is the irrelevant salient variable. A previous fMRI brain-imaging study related to the comparison of perimeters task suggested that increasing the level of salience of the…

  11. Honey and Glycemic Index

    Directory of Open Access Journals (Sweden)

    Sibel Silici

    2015-02-01

    Full Text Available Honey is a natural substance produced by honeybees (Apis mellifera L. from the nectar of blossoms or from secretions of living parts of plants or excretions of plant sucking insects on the living parts of plants, which honeybees collect, transform and combine with specific substances of their own, store and leave in the honey comb to ripen and mature. Besides being of carbohydrate-rich food, honey has been used as a functional food for its potential health benefits. To explain how different kinds of carbohydrate-rich foods directly affect blood sugar, the researchers developed the concept of the “glycemic index” (GI that ranks carbohydrates on a scale based on how quickly and how much they raise blood sugar levels after eating. The diet should include adequate and healthy balance of nutrients, and according to many health professionals the concept of GI provides a useful means of selecting the most appropriate carbohydrate containing foods for the maintenance of health and the treatment of several disease states. There have been some studies on determining the GI of honey. Further more, we need to determine the GI of various honey types with different botanical and geografical origin. Researches on the issue will serve to bring awareness in the public consciousness.

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

    Directory of Open Access Journals (Sweden)

    G Girish

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Giovanna Masala

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

  14. Glycemic Index Diet: What's Behind the Claims

    Science.gov (United States)

    Healthy Lifestyle Nutrition and healthy eating By Mayo Clinic Staff A glycemic index diet is an eating plan ... 01, 2017 Original article: http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/glycemic-index- ...

  15. Factors associated with glycemic control in people with diabetes at the Family Health Strategy in Pernambuco

    Directory of Open Access Journals (Sweden)

    Rodrigo Fonseca Lima

    Full Text Available Abstract OBJECTIVE Identifying factors associated with glycemic control in people with type 2 Diabetes Mellitus (DM registered in the Family Health Strategy (FHS in Pernambuco, Brazil. METHOD Associations between glycemic control (glycosylated hemoglobin A lower or equal to 7% presented by people with DM and variables related to sociodemographic conditions, lifestyle, characteristics of diabetes, treatment and follow-up of patients by health services were investigated by multiple regression. RESULTS More than 65% of the participants presented inadequate glycemic control, especially those with lower age, longer illness duration, more annual contacts with FHS and complex therapeutic regimen. People with DM without referrals to specialists presented greater glycemic control. Associations with education level and obesity did not remain significant in the multivariate model. CONCLUSION The evolution of diabetes hinders adequate control, however, attention to younger people with DM and referrals to specialists are factors that can improve glycemic control.

  16. A numeric comparison of variable selection algorithms for supervised learning

    International Nuclear Information System (INIS)

    Palombo, G.; Narsky, I.

    2009-01-01

    Datasets in modern High Energy Physics (HEP) experiments are often described by dozens or even hundreds of input variables. Reducing a full variable set to a subset that most completely represents information about data is therefore an important task in analysis of HEP data. We compare various variable selection algorithms for supervised learning using several datasets such as, for instance, imaging gamma-ray Cherenkov telescope (MAGIC) data found at the UCI repository. We use classifiers and variable selection methods implemented in the statistical package StatPatternRecognition (SPR), a free open-source C++ package developed in the HEP community ( (http://sourceforge.net/projects/statpatrec/)). For each dataset, we select a powerful classifier and estimate its learning accuracy on variable subsets obtained by various selection algorithms. When possible, we also estimate the CPU time needed for the variable subset selection. The results of this analysis are compared with those published previously for these datasets using other statistical packages such as R and Weka. We show that the most accurate, yet slowest, method is a wrapper algorithm known as generalized sequential forward selection ('Add N Remove R') implemented in SPR.

  17. Comparison of Methods for Estimating and Testing Latent Variable Interactions.

    Science.gov (United States)

    Moulder, Bradley C.; Algina, James

    2002-01-01

    Used simulation to compare structural equation modeling methods for estimating and testing hypotheses about an interaction between continuous variables. Findings indicate that the two-stage least squares procedure exhibited more bias and lower power than the other methods. The Jaccard-Wan procedure (J. Jaccard and C. Wan, 1995) and maximum…

  18. Effects of dietary fiber and low glycemic index diet on glucose control in subjects with type 2 diabetes mellitus.

    Science.gov (United States)

    Bajorek, Sarah A; Morello, Candis M

    2010-11-01

    To review the effects of dietary fiber and a low glycemic index diet on glycemic risk factors in people with type 2 diabetes mellitus (T2DM) or T2DM and dyslipidemia. Literature search was conducted using PubMed, Cochrane Library, The Natural Standard, and The Natural Medicines through July 2010 using the terms type 2 diabetes mellitus, dietary fiber, psyllium, and glycemic index. Articles included were randomized controlled studies or meta-analyses examining the effects of dietary interventions (dietary fiber, low glycemic index diet, or psyllium) on glycemic risk factors (glycosylated hemoglobin A₁(c) [A1C] or postprandial plasma glucose [PPG] concentrations) in subjects with T2DM or T2DM and dyslipidemia. Both psyllium supplementation and low glycemic index diets have been studied as monotherapy in the treatment of T2DM. Seven studies were reviewed (3 randomized crossover studies, 1 randomized parallel study, 3 randomized blinded parallel studies). Individually, psyllium supplementation and a low glycemic index diet improved glycemic risk factors. PPG and A1C decreased with psyllium 10.2 g per day, while A1C decreased with a low glycemic index diet (average glycemic index 59). However, the results for the low glycemic index diet are controversial. One study was underpowered to detect changes in A1C, while another study had psyllium fiber as a confounding variable. Psyllium supplementation might be an additional therapeutic option for people with T2DM who are already receiving diabetes medication and who still experience elevated PPG concentrations. Further well-designed clinical trials and adjustment for confounding variables are needed to determine the role of a low glycemic index diet in the treatment of T2DM.

  19. State-variable public goods and social comparisons

    OpenAIRE

    Aronsson, Thomas; Johansson-Stenman, Olof

    2014-01-01

    The optimal provision of a state-variable public good, where the global climate is the prime example, is analyzed in a model where people care about their relative consumption. We consider both keeping-up-with-the-Joneses preferences (where people compare their own current consumption with others’ current consumption) and catching-up-with-the-Joneses preferences (where people compare their own current consumption with others’ past consumption) in an economy with two productivity types, overla...

  20. Continuous-variable quantum error correction I: code comparison

    Science.gov (United States)

    Albert, Victor V.; Duivenvoorden, Kasper; Noh, Kyungjoo; Brierley, R. T.; Reinhold, Philip; Li, Linshu; Shen, Chao; Schoelkopf, R. J.; Girvin, S. M.; Terhal, Barbara M.; Jiang, Liang

    There are currently four types of non-trivial encodings of quantum information in a single bosonic mode: cat, binomial, and numerically optimized codes are designed to protect against bosonic loss errors, while GKP codes are designed to protect against bosonic displacement errors. These four code types have yet to be compared using the same error model. We report on a numerical comparison of the entanglement fidelity of all codes with respect to the lossy bosonic channel, given an average occupation number constraint and the optimal recovery operation. GKP codes demonstrate the highest fidelities for all but the smallest values of the boson loss probability (the parameter which quantifies the strength of amplitude damping). Although designed to protect against small displacement noise, GKP codes can offer a high degree of protection against bosonic loss errors. We also examine the performance of the four code types with respect to the combination of amplitude damping and a strong Kerr non-linearity.

  1. Metabolic pathways variability and sequence/networks comparisons

    Science.gov (United States)

    Tun, Kyaw; Dhar, Pawan K; Palumbo, Maria Concetta; Giuliani, Alessandro

    2006-01-01

    Background In this work a simple method for the computation of relative similarities between homologous metabolic network modules is presented. The method is similar to classical sequence alignment and allows for the generation of phenotypic trees amenable to be compared with correspondent sequence based trees. The procedure can be applied to both single metabolic modules and whole metabolic network data without the need of any specific assumption. Results We demonstrate both the ability of the proposed method to build reliable biological classification of a set of microrganisms and the strong correlation between the metabolic network wiringand involved enzymes sequence space. Conclusion The method represents a valuable tool for the investigation of genotype/phenotype correlationsallowing for a direct comparison of different species as for their metabolic machinery. In addition the detection of enzymes whose sequence space is maximally correlated with the metabolicnetwork space gives an indication of the most crucial (on an evolutionary viewpoint) steps of the metabolic process. PMID:16420696

  2. Metabolic pathways variability and sequence/networks comparisons

    Directory of Open Access Journals (Sweden)

    Palumbo Maria

    2006-01-01

    Full Text Available Abstract Background In this work a simple method for the computation of relative similarities between homologous metabolic network modules is presented. The method is similar to classical sequence alignment and allows for the generation of phenotypic trees amenable to be compared with correspondent sequence based trees. The procedure can be applied to both single metabolic modules and whole metabolic network data without the need of any specific assumption. Results We demonstrate both the ability of the proposed method to build reliable biological classification of a set of microrganisms and the strong correlation between the metabolic network wiringand involved enzymes sequence space. Conclusion The method represents a valuable tool for the investigation of genotype/phenotype correlationsallowing for a direct comparison of different species as for their metabolic machinery. In addition the detection of enzymes whose sequence space is maximally correlated with the metabolicnetwork space gives an indication of the most crucial (on an evolutionary viewpoint steps of the metabolic process.

  3. COMPARISON OF GLYCEMIC EFFECT OF ADRENALIN CONTAINING LOCAL ANESTHETIC IN DIABETIC AND NON-DIABETIC PATIENTS UNDERGOING MINOR ORAL SURGICAL PROCEDURE

    Directory of Open Access Journals (Sweden)

    Pradeep

    2015-12-01

    Full Text Available AIM To compare the changes in blood glucose level associated with administration of adrenaline containing local anesthetic in diabetic and non-diabetic patients undergoing minor oral surgical procedures. METHODS AND MATERIAL The study included 150 well controlled diabetic patients and 150 non-diabetic healthy patients in age group of 40-60 years who underwent minor oral surgical procedures (trans alveolar extractions, alveoplasty and flap surgeries. Patients in both the group were administered 1.8ml of local anesthetic agent containing 1:100,000 adrenaline for inferior alveolar nerve block and 0.2 ml of anesthetic agent for long buccal nerve block. Blood glucose levels were assessed and compared during pre-operative and one hour post-operative period. STATISTICAL ANALYSIS The comparison of the random blood sugar levels preop and postop in both the groups were compared using paired t test and RBS levels between two groups were analysed using unpaired t test. P value less than 0.05 was considered statistically significant. RESULTS No statistically significant change in post-operative blood glucose level was noted between the diabetic and non-diabetic patients. CONCLUSION The study concluded that it is safe to administer local anesthetic containing 1:100,000 adrenaline in smaller volumes to well controlled diabetic patients.

  4. On the mid-infrared variability of candidate eruptive variables (exors): A comparison between Spitzer and WISE data

    Energy Technology Data Exchange (ETDEWEB)

    Antoniucci, S.; Giannini, T.; Li Causi, G.; Lorenzetti, D., E-mail: simone.antoniucci@oa-roma.inaf.it, E-mail: teresa.giannini@oa-roma.inaf.it, E-mail: gianluca.licausi@oa-roma.inaf.it, E-mail: dario.lorenzetti@oa-roma.inaf.it [INAF-Osservatorio Astronomico di Roma, via Frascati 33, I-00040 Monte Porzio (Italy)

    2014-02-10

    Aiming to statistically study the variability in the mid-IR of young stellar objects, we have compared the 3.6, 4.5, and 24 μm Spitzer fluxes of 1478 sources belonging to the C2D (Cores to Disks) legacy program with the WISE fluxes at 3.4, 4.6, and 22 μm. From this comparison, we have selected a robust sample of 34 variable sources. Their variations were classified per spectral Class (according to the widely accepted scheme of Class I/flat/II/III protostars), and per star forming region. On average, the number of variable sources decreases with increasing Class and is definitely higher in Perseus and Ophiuchus than in Chamaeleon and Lupus. According to the paradigm Class ≡ Evolution, the photometric variability can be considered to be a feature more pronounced in less evolved protostars, and, as such, related to accretion processes. Moreover, our statistical findings agree with the current knowledge of star formation activity in different regions. The 34 selected variables were further investigated for similarities with known young eruptive variables, namely the EXors. In particular, we analyzed (1) the shape of the spectral energy distribution, (2) the IR excess over the stellar photosphere, (3) magnitude versus color variations, and (4) output parameters of model fitting. This first systematic search for EXors ends up with 11 bona fide candidates that can be considered as suitable targets for monitoring or future investigations.

  5. [Comparison of heart rate variability measurements between ballistocardiogram and electrocardiography].

    Science.gov (United States)

    Wang, Kun; Zhu, Tiangang; Zhang, Xianwen; Yu, Chao; Cao, Xinrong; Tang, Jintian; Wan, Zheng

    2015-05-01

    To compare the heart rate variability (HRV) measurements between ballistocardiogram (BCG) and electrocardiography (ECG). The signals of BCG and ECG of 21 patients were collected synchronously. JJ intervals of BCG and RR intervals of ECG were used to calculate the cardiac periods. The parameters of HRV analysis were calculated in time domain analysis, frequency domain analysis and nonlinear analysis. The results derived from BCG and ECG were compared. The parameters of HRV analysis calculated from BCG and ECG had high similarity. The correlation coefficients of SDNN, TP, LF, HF and SD2 between the BCG and ECG methods were high (r = 1). The correlation coefficients of rMSSD and SD2 were 0.99 and of PNN50 and LF/HF were 0.98 between the two methods. HRV analysis results derived from the two methods were similar (P > 0.05). HRV could also be measured reliably by calculating the JJ interval from BCG.

  6. Effects of Acute Ingestion of Native Banana Starch on Glycemic Response Evaluated by Continuous Glucose Monitoring in Obese and Lean Subjects

    Directory of Open Access Journals (Sweden)

    Guadalupe Jiménez-Domínguez

    2015-07-01

    Full Text Available An abnormal glycemic profile, including postprandial glycemia and acute glucose spikes, precedes the onset of overt diabetes in obese subjects. Previous studies have shown the beneficial effects of chronic native banana starch (NBS supplementation. In this study, we examined the effects of acute ingestion of NBS on glycemic profiles by means of continuous glucose monitoring in obese and lean subjects. In a crossover study, obese and lean subjects consumed beverages containing either 38.3 g of NBS or 38.3 g of digestible corn starch (DCS twice daily during 4 days. On day 5, a 3-h meal tolerance test (MTT was performed to evaluate glucose and insulin responses. After 1 week of washout period, treatments were inverted. NBS supplementation reduced the 48-h glycemia AUC in lean, obese, and in the combined group of lean and obese subjects in comparison with DCS. Postprandial glucose and insulin responses at MTT were reduced after NBS in comparison with DCS in all groups. However, no changes were observed in glycemic variability (GV indexes between groups. In conclusion, acute NBS supplementation improved postprandial glucose and insulin responses in obese and lean subjects during 48 h of everyday life and at MTT. Further research to elucidate the mechanism behind these changes is required.

  7. FLORISTIC COMPARISON BETWEEN TWO TREE COMMUNITIES ASSOCIATED WITH HABITAT DESCRIPTOR VARIABLES

    Directory of Open Access Journals (Sweden)

    Jean Daniel Morel

    2015-12-01

    Full Text Available The knowledge about the influence of habitat variables is essential to understand the underlying ecological patterns in vegetation. This study compared the floristic composition of two forest communities located in different altitudes. Associated with this comparison, we used a methodology where habitat descriptor variables were scaled and interpreted by the biotic set sampled. We constructed one matrix with scores given to physical, biotic, vegetation, and anthropogenic variables in the field and one matrix with the species sampled and performed multivariate analyses. We found that the floristic communities differ between the different altitudes and that the methodology used showed significant variables for the ecological characterization of the sampled habitat.

  8. Sleep and glycemic control in type 1 diabetes.

    Science.gov (United States)

    Barone, Mark Thomaz Ugliara; Wey, Daniela; Schorr, Fabiola; Franco, Denise Reis; Carra, Mario Kehdi; Lorenzi Filho, Geraldo; Menna-Barreto, Luiz

    2015-02-01

    Our aim in the present study was to elucidate how type 1 diabetes mellitus (T1DM) and sleep parameters interact, which was rarely evaluated up to the moment. Eighteen T1DM subjects without chronic complications, and 9 control subjects, matched for age and BMI, were studied. The following instruments used to evaluate sleep: the Epworth Sleepiness Scale, sleep diaries, actimeters, and polysomnography in a Sleep Lab. Glycemic control in T1DM individuals was evaluated through: A1C, home fingertip glucometer for 10 days (concomitant with the sleep diary and actimeter), and CGM or concomitant with continuous glucose monitoring (during the polysomnography night). Comparing with the control group, individuals with diabetes presented more pronounced sleep extension from weekdays to weekends than control subjects (p = 0.0303). Among T1DM, glycemic variability (SD) was positively correlated with sleep latency (r = 0.6525, p = 0.0033); full awakening index and arousal index were positively correlated with A1C (r = 0.6544, p = 0.0081; and r = 0.5680, p = 0.0272, respectively); and mean glycemia values were negatively correlated with sleep quality in T1DM individuals with better glycemic control (mean glycemia < 154 mg/dL). Our results support the hypothesis of an interaction between sleep parameters and T1DM, where the glycemic control plays an important role. More studies are needed to unveil the mechanisms behind this interaction, which may allow, in the future, clinicians and educators to consider sleep in the effort of regulating glycemic control.

  9. Glycemic index and glycemic load in relation to glucose intolerance among Greenland's Inuit population

    DEFF Research Database (Denmark)

    van Aerde, Marieke A; Witte, Daniel Rinse; Jeppesen, Charlotte

    2012-01-01

    Intake of carbohydrates which elicit a large glycemic response is hypothesized to increase the risk of diabetes. However, studies assessing the relationship between glycemic index (GI) and glycemic load (GL) and diabetes are inconsistent. Only few studies have studied the relationship between GI ...

  10. The concept of low glycemic index and glycemic load foods as ...

    African Journals Online (AJOL)

    Background: This article examines the concepts of low glycemic indices (GIs) and glycemic load (GL) foods as key drivers in the dietary management of type 2 diabetes as well as their shortcomings. The controversies arising from the analysis of glycemic index (GI) and GL of foods such as their reproducibility as well as their ...

  11. How is the weather? Forecasting inpatient glycemic control.

    Science.gov (United States)

    Saulnier, George E; Castro, Janna C; Cook, Curtiss B; Thompson, Bithika M

    2017-11-01

    Apply methods of damped trend analysis to forecast inpatient glycemic control. Observed and calculated point-of-care blood glucose data trends were determined over 62 weeks. Mean absolute percent error was used to calculate differences between observed and forecasted values. Comparisons were drawn between model results and linear regression forecasting. The forecasted mean glucose trends observed during the first 24 and 48 weeks of projections compared favorably to the results provided by linear regression forecasting. However, in some scenarios, the damped trend method changed inferences compared with linear regression. In all scenarios, mean absolute percent error values remained below the 10% accepted by demand industries. Results indicate that forecasting methods historically applied within demand industries can project future inpatient glycemic control. Additional study is needed to determine if forecasting is useful in the analyses of other glucometric parameters and, if so, how to apply the techniques to quality improvement.

  12. Statistics in experimental cerebrovascular research—comparison of two groups with a continuous outcome variable

    Science.gov (United States)

    Schlattmann, Peter; Dirnagl, Ulrich

    2010-01-01

    Part one of this mini-series on statistics in cerebrovascular research uses the simplest yet most common comparison in experimental research (two groups with a continuous outcome variable) to introduce the very basic concepts of statistical testing: a priori formulation of hypotheses and definition of planned statistical analysis, error considerations, and power analysis. PMID:20051976

  13. Glycemic Status in Organophosphorus Poisoning.

    Science.gov (United States)

    Panda, S; Nanda, R; Mangaraj, M; Rathod, P K; Mishra, P K

    2015-01-01

    Organophosphorus(OP) poisoning, in addition to its cholinergic manifestations shows metabolic derangements leading to hyperglycemia. Apart from inhibiting acetylcholinesterase it also induces oxidative stress to exhibit this manifestation. The present study aims to assess the glycemic status of OP poisoned patients and its association with various factors in OP poisoning like oxidative stress and dose of atropine. This is a prospective study which recruited 102 patients above 18 years of age with history of OP poisoning. They were categorized into 3 grades-mild, moderate and severe based on the Peradeniya Organophosphorus Poisining Scale. The routine biochemical parameters along with serum malondialdehyde (MDA) and cholinesterase were estimated in the study group. Hyperglycemia and glycosuria were observed, with majority cases of hyperglycemia (57%) noticed in the severe group. There was a rise in the random plasma glucose (RPG), serum malondialdehyde (MDA), total dose of atropine across the groups along with a fall in the serum cholinesterase with increase in severity of poisoning. The fall in plasma glucose at the time of discharge was significant in all three groups when compared to the admission random plasma glucose(RPG) level. This transient hyperglycemia exhibited a significant positive association with serum MDA and dose of atropine administered during treatment (p<0.05). Glycemic status in OP poisoning may play a role in identifying the severity of poisoning at the time of admission.

  14. Poor agreement of computerized calculators for mean amplitude of glycemic excursions

    NARCIS (Netherlands)

    Sechterberger, Marjolein K.; Luijf, Yoeri M.; DeVries, J. Hans

    2014-01-01

    Glucose variability has been identified as a predictor of hypoglycemia and has been associated with mortality in critically ill patients without diabetes. A popular metric to quantify glucose variability is the mean amplitude of glycemic excursions (MAGE). The "ruler and pencil" approach to

  15. Glycemic index and glycemic load of commercial Italian foods.

    Science.gov (United States)

    Scazzina, F; Dall'Asta, M; Casiraghi, M C; Sieri, S; Del Rio, D; Pellegrini, N; Brighenti, F

    2016-05-01

    The glycemic index (GI) and glycemic load (GL) are useful parameters in the nutritional classification of carbohydrate foods. Diets characterized by a low GI and/or a low GL have been repeatedly and independently associated with decreased risk of diabetes and other chronic diseases. The aim of this study is to report the GI and GL value of carbohydrate-rich foods available on the Italian market and mostly consumed in Italy. GI values were determined according to FAO/WHO (1997) and ISO (2010). Overall, the 141 commercial foods that were analyzed represent food categories that are the source of >80% carbohydrate intake in Italy. The food items chosen were based mainly on the market share of the brand within each food category and grouped into 13 food categories: 1) beverages: fermented milk drink, juice, smoothie, soft drink; 2) biscuits; 3) breads; 4) bread substitutes; 5) breakfast cereals; 6) cakes and snacks; 7) candy and confectionery; 8) cereals; 9) desserts and ice-creams; 10) marmalade and jam; 11) pasta; 12) pizza; 13) sugar and sweetener. This database of commercial Italian foods partly overcomes the lack of information on GI and GL of local foods, contributing to a better understanding of the association between GI/GL and health and providing a more informed choice to Italian consumers and health practitioners. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Chen, Ya-Jun; Sun, Feng-Hua; Wong, Stephen Heung-Sang; Huang, Ya-Jun

    2010-03-28

    To determine the glycemic index (GI) and glycemic load (GL) values of Chinese traditional foods in Hong Kong. Fifteen healthy subjects (8 males and 7 females) volunteered to consume either glucose or one of 23 test foods after 10-14 h overnight fast. The blood glucose concentrations were analyzed immediately before, 15, 30, 45, 60, 90 and 120 min after food consumption using capillary blood samples. The GI value of each test food was calculated by expressing the incremental area under the blood glucose response curve (IAUC) value for the test food as a percentage of each subject's average IAUC value for the glucose. The GL value of each test food was calculated as the GI value of the food multiplied by the amount of the available carbohydrate in a usual portion size, divided by 100. Among all the 23 Chinese traditional foods tested, 6 of them belonged to low GI foods (Tuna Fish Bun, Egg Tart, Green Bean Dessert, Chinese Herbal Jelly, Fried Rice Vermicelli in Singapore-style, and Spring Roll), 10 of them belonged to moderate GI foods (Baked Barbecued Pork Puff, Fried Fritter, "Mai-Lai" Cake, "Pineapple" Bun, Fried Rice Noodles with Sliced Beef, Barbecue Pork Bun, Moon Cakes, Glutinous Rice Ball, Instant Sweet Milky Bun, and Salted Meat Rice Dumpling), the others belonged to high GI foods (Fried Rice in Yangzhou-Style, Sticky Rice Wrapped in Lotus Leaf, Steamed Glutinous Rice Roll, Jam and Peanut Butter Toast, Plain Steamed Vermicelli Roll, Red Bean Dessert, and Frozen Sweet Milky Bun). The GI and GL values for these Chinese traditional foods will provide some valuable information to both researchers and public on their food preference.

  17. Comparison of simulators for variable-speed wind turbine transient analysis

    DEFF Research Database (Denmark)

    Seman, S.; Iov, Florin; Niiranen, J.

    2006-01-01

    This paper presents a comparison of three variable-speed wind turbine simulators used for a 2 MW wind turbine short-term transient behaviour study during a symmetrical network disturbance. The simulator with doubly fed induction generator (DFIG) analytical model, the simulator with a finite element...... method (FEM) DFIG model and the wind turbine simulator with an analytical model of DFIG are compared. The comparison of the simulation results shows the influence of the different modelling approaches on the short-term transient simulation accuracy...

  18. Evidence evaluation in fingerprint comparison and automated fingerprint identification systems--Modeling between finger variability.

    Science.gov (United States)

    Egli Anthonioz, N M; Champod, C

    2014-02-01

    In the context of the investigation of the use of automated fingerprint identification systems (AFIS) for the evaluation of fingerprint evidence, the current study presents investigations into the variability of scores from an AFIS system when fingermarks from a known donor are compared to fingerprints that are not from the same source. The ultimate goal is to propose a model, based on likelihood ratios, which allows the evaluation of mark-to-print comparisons. In particular, this model, through its use of AFIS technology, benefits from the possibility of using a large amount of data, as well as from an already built-in proximity measure, the AFIS score. More precisely, the numerator of the LR is obtained from scores issued from comparisons between impressions from the same source and showing the same minutia configuration. The denominator of the LR is obtained by extracting scores from comparisons of the questioned mark with a database of non-matching sources. This paper focuses solely on the assignment of the denominator of the LR. We refer to it by the generic term of between-finger variability. The issues addressed in this paper in relation to between-finger variability are the required sample size, the influence of the finger number and general pattern, as well as that of the number of minutiae included and their configuration on a given finger. Results show that reliable estimation of between-finger variability is feasible with 10,000 scores. These scores should come from the appropriate finger number/general pattern combination as defined by the mark. Furthermore, strategies of obtaining between-finger variability when these elements cannot be conclusively seen on the mark (and its position with respect to other marks for finger number) have been presented. These results immediately allow case-by-case estimation of the between-finger variability in an operational setting. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Reply #1 to: Glycemic Choreoballism

    Directory of Open Access Journals (Sweden)

    Carlos Cosentino

    2016-12-01

    Full Text Available This Author Reply Letter was written in response to a Letter to the Editor:Lee D, Ahn T. Glycemic choreoballism. Tremor Other Hyperkinet Mov. 2016; 6. doi: 10.7916/D8QJ7HNFThe Letter to the Editor, above, was written in response to these two Case Reports:Roy U, Das SK, Mukherjee A, et al. Irreversible hemichoreahemiballism in a case of nonketotic hyperglycemia presenting as the initial manifestation of diabetes mellitus. Tremor Other Hyperkinet Mov. 2016; 6. doi: 10.7916/D8QZ2B3FCosentino C, Torres L, Nuñez Y, et al. Hemichorea/hemiballism associated with hyperglycemia: report of twenty cases. Tremor Other Hyperkinet Mov. 2016; 6. doi: 10.7916/D8DN454P

  20. Identifying older diabetic patients at risk of poor glycemic control

    Directory of Open Access Journals (Sweden)

    Mazzei Bruno

    2002-08-01

    Full Text Available Abstract Background Optimal glycemic control prevents the onset of diabetes complications. Identifying diabetic patients at risk of poor glycemic control could help promoting dedicated interventions. The purpose of this study was to identify predictors of poor short-term and long-term glycemic control in older diabetic in-patients. Methods A total of 1354 older diabetic in-patients consecutively enrolled in a multicenter study formed the training population (retrospective arm; 264 patients consecutively admitted to a ward of general medicine formed the testing population (prospective arm. Glycated hemoglobin (HbA1c was measured on admission and one year after the discharge in the testing population. Independent correlates of a discharge glycemia ≥ 140 mg/dl in the training population were assessed by logistic regression analysis and a clinical prediction rule was developed. The ability of the prediction rule and that of admission HbA1c to predict discharge glycemia ≥ 140 mg/dl and HbA1c > 7% one year after discharge was assessed in the testing population. Results Selected admission variables (diastolic arterial pressure 218 mg/dl, history of insulinic or combined hypoglycemic therapy, Charlson's index > 2 were combined to obtain a score predicting a discharge fasting glycemia ≥ 140 mg/dl in the training population. A modified score was obtained by adding 1 if admission HbA1c exceeded 7.8%. The modified score was the best predictor of both discharge glycemia ≥ 140 mg/dl (sensitivity = 79%, specificity = 63% and 1 year HbA1c > 7% (sensitivity = 72%, specificity = 71% in the testing population. Conclusion A simple clinical prediction rule might help identify older diabetic in-patients at risk of both short and long term poor glycemic control.

  1. Evaluation of a New Digital Automated Glycemic Pattern Detection Tool.

    Science.gov (United States)

    Comellas, María José; Albiñana, Emma; Artes, Maite; Corcoy, Rosa; Fernández-García, Diego; García-Alemán, Jorge; García-Cuartero, Beatriz; González, Cintia; Rivero, María Teresa; Casamira, Núria; Weissmann, Jörg

    2017-11-01

    Blood glucose meters are reliable devices for data collection, providing electronic logs of historical data easier to interpret than handwritten logbooks. Automated tools to analyze these data are necessary to facilitate glucose pattern detection and support treatment adjustment. These tools emerge in a broad variety in a more or less nonevaluated manner. The aim of this study was to compare eDetecta, a new automated pattern detection tool, to nonautomated pattern analysis in terms of time investment, data interpretation, and clinical utility, with the overarching goal to identify early in development and implementation of tool areas of improvement and potential safety risks. Multicenter web-based evaluation in which 37 endocrinologists were asked to assess glycemic patterns of 4 real reports (2 continuous subcutaneous insulin infusion [CSII] and 2 multiple daily injection [MDI]). Endocrinologist and eDetecta analyses were compared on time spent to analyze each report and agreement on the presence or absence of defined patterns. eDetecta module markedly reduced the time taken to analyze each case on the basis of the emminens eConecta reports (CSII: 18 min; MDI: 12.5), compared to the automatic eDetecta analysis. Agreement between endocrinologists and eDetecta varied depending on the patterns, with high level of agreement in patterns of glycemic variability. Further analysis of low level of agreement led to identifying areas where algorithms used could be improved to optimize trend pattern identification. eDetecta was a useful tool for glycemic pattern detection, helping clinicians to reduce time required to review emminens eConecta glycemic reports. No safety risks were identified during the study.

  2. Relation of Dietary Glycemic Index and Glycemic Load to Coronary Artery Calcium in Asymptomatic Korean Adults.

    Science.gov (United States)

    Choi, Yuni; Chang, Yoosoo; Ryu, Seungho; Cho, Juhee; Kim, Mi Kyung; Ahn, Younjhin; Lee, Jung Eun; Sung, Eunju; Kim, Boyoung; Ahn, Jiin; Kim, Chan-Won; Rampal, Sanjay; Zhao, Di; Zhang, Yiyi; Pastor-Barriuso, Roberto; Lima, Joao A C; Chung, Eun Chul; Shin, Hocheol; Guallar, Eliseo

    2015-08-15

    The relation between glycemic index, glycemic load, and subclinical coronary atherosclerosis is unknown. The aim of the study was to evaluate the associations between energy-adjusted glycemic index, glycemic load, and coronary artery calcium (CAC). This study was cross-sectional analysis of 28,429 asymptomatic Korean men and women (mean age 41.4 years) without a history of diabetes or cardiovascular disease. All participants underwent a health screening examination between March 2011 and April 2013, and dietary intake over the preceding year was estimated using a validated food frequency questionnaire. Cardiac computed tomography was used for CAC scoring. The prevalence of detectable CAC (CAC score >0) was 12.4%. In multivariable-adjusted models, the CAC score ratios (95% confidence intervals) comparing the highest to the lowest quintile of glycemic index and glycemic load were 1.74 (1.08 to 2.81; p trend = 0.03) and 3.04 (1.43 to 6.46; p trend = 0.005), respectively. These associations did not differ by clinical subgroups, including the participants at low cardiovascular risk. In conclusion, these findings suggest that high dietary glycemic index and glycemic load were associated with a greater prevalence and degree of CAC, with glycemic load having a stronger association. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Poor agreement of computerized calculators for mean amplitude of glycemic excursions.

    Science.gov (United States)

    Sechterberger, Marjolein K; Luijf, Yoeri M; Devries, J Hans

    2014-02-01

    Glucose variability has been identified as a predictor of hypoglycemia and has been associated with mortality in critically ill patients without diabetes. A popular metric to quantify glucose variability is the mean amplitude of glycemic excursions (MAGE). The "ruler and pencil" approach to calculate MAGE is operator-dependent and time-consuming for analysis of continuous glucose monitoring data. Therefore, several computer software programs have been developed for the automated calculation of MAGE. The aim of our study was to evaluate the agreement of currently available MAGE calculators when applied to the same set of continuous glucose monitoring (CGM) traces. Four software programs for calculation of MAGE were identified and used to calculate MAGE of 21 CGM traces from seven patients with type 1 diabetes. Subsequently, the median MAGE per calculator was calculated. The correlation between the MAGE calculators was evaluated by Spearman's correlation analysis. Between-group comparison was performed using analysis of variance. The median MAGE (interquartile range) per calculator was 8.7 (7.1-10.7), 6.7 (5.5-8.6), 6.7 (5.2-8.6), and 5.8 (4.3-7.1), which was statistically different overall (Pcalculators ranged from 0.787 to 0.999. Available computer programs developed to calculate MAGE show varying agreement. Although software programs for the calculation of MAGE would seem attractive to assess glucose variability, their use has limitations by different outcomes, in the absence of a gold standard.

  4. Comparison of the effects of a new 32-gauge × 4-mm pen needle and a 32-gauge × 6-mm pen needle on glycemic control, safety, and patient ratings in Japanese adults with diabetes.

    Science.gov (United States)

    Miwa, Takashi; Itoh, Rokuro; Kobayashi, Takaaki; Tanabe, Takashi; Shikuma, Junpei; Takahashi, Tomono; Odawara, Masato

    2012-12-01

    This study was designed to evaluate two pen needles (PNs) with the same diameter but different lengths (4 mm and 6 mm) and different needle tip shapes (straight and tapered) to compare their effects on glycemic control, perceived pain, safety, patients' ease of use and preferences, and visual impression. In this prospective, open-label, controlled crossover study, 41 insulin-treated patients with type 1 or type 2 diabetes were randomized into either Group 1 (the 32-gauge × 4-mm PN was used during Study Period 1, then the 32-gauge × 6-mm PN was used during Study Period 2) or Group 2 (the order for using the PNs was reversed). The 32-gauge × 4-mm PN provided an equivalent glycemic control in diabetes patients as the 32-gauge × 6-mm PN, with an equivalent occurrence rate of adverse events. The 32-gauge × 4-mm PN was perceived as significantly less painful and rated as significantly more favorable than the 32-gauge × 6-mm PN according to the survey results on patients' ease of use and preferences and on their visual impressions. The 32-gauge × 4-mm PN was not only as safe and efficacious as the 32-gauge × 6-mm PN, but also was perceived as less painful, easier to use, and more favorable to Japanese adult patients with diabetes.

  5. Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Kyoung Jin Kim

    2017-08-01

    Full Text Available BackgroundLong-term durable glycemic control is a difficult goal in the management of type 2 diabetes mellitus (T2DM. We evaluated the factors associated with durable glycemic control in a real clinical setting.MethodsWe retrospectively reviewed the medical records of 194 new-onset, drug-naïve patients with T2DM who were diagnosed between January 2011 and March 2013, and were followed up for >2 years. Glycemic durability was defined as the maintenance of optimal glycemic control (glycosylated hemoglobin [HbA1c] <7.0% for 2 years without substitution or adding other glucose-lowering agents. Clinical factors and glycemic markers associated with glycemic durability were compared between two groups: a durability group and a non-durability group.ResultsPatients in the durability group had a higher baseline body mass index (26.1 kg/m2 vs. 24.9 kg/m2 and lower HbA1c (8.6% vs. 9.7% than the non-durability group. The initial choice of glucose-lowering agents was similar in both groups, except for insulin and sulfonylureas, which were more frequently prescribed in the non-durability group. In multiple logistic regression analyses, higher levels of education, physical activity, and homeostasis model assessment of β-cell function (HOMA-β were associated with glycemic durability. Notably, lower HbA1c (<7.0% at baseline and first follow-up were significantly associated with glycemic durability (adjusted odds ratio [OR], 7.48; 95% confidence interval [CI], 2.51 to 22.3 (adjusted OR, 9.27; 95% CI, 1.62 to 53.1, respectively, after adjusting for confounding variables including the types of glucose-lowering agents.ConclusionEarly achievement of HbA1c level within the glycemic target was a determinant of long-term glycemic durability in new-onset T2DM, as were higher levels of education, physical activity, and HOMA-β.

  6. Serum glycated albumin as a glycemic control marker in diabetic cats.

    Science.gov (United States)

    Mori, Akihiro; Lee, Peter; Mizutani, Hisashi; Takahashi, Tomoya; Azakami, Daigo; Mizukoshi, Mina; Fukuta, Hiroko; Sakusabe, Noriko; Sakusabe, Arihito; Kiyosawa, Yoshio; Arai, Toshiro; Sako, Toshinori

    2009-01-01

    Measurements of glycated proteins such as serum fructosamine, glycated hemoglobin, and glycated albumin (GA) are increasingly used to complement serum glucose concentration for better management of diabetes mellitus. For example, the degree of glycemic control in diabetic cats can be determined by evaluating fructosamine concentration. Unfortunately, fructosamine tests are currently not performed in Japan, and as such, the measurement of GA may serve as a replacement test. The objectives of the current study were 2-fold. First, serum GA and fructosamine level were evaluated for positive correlation in cats as a preliminary gauge on whether serum GA use is applicable. Second, a GA percentage reference range was determined from healthy control cats for possible future diagnostic use. A positive correlation was determined for fructosamine and GA in both normal and diabetic cats. Moreover, the serum GA percentage reference interval based on control cats was determined to be 7.5-13.9% (95% nonparametric interfractile interval). Interestingly, no significant difference in serum GA percentages was observed between samples from diabetic cats with excellent glycemic control and control cats. However, good, fair, and poor glycemic control diabetic cats resulted in a significant increase in serum GA percentages in comparison to control cats. Therefore, these results indicate that serum GA may be a useful glycemic control indicator that could substitute for fructosamine to monitor glycemic control in diabetic cats.

  7. Effect of glycemic control on diabetic dyslipidemia

    International Nuclear Information System (INIS)

    Ahmed, W.; Arshad, A.R.

    2010-01-01

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

  8. Liberal Glycemic Control in Critically Ill Patients With Type 2 Diabetes: An Exploratory Study.

    Science.gov (United States)

    Kar, Palash; Plummer, Mark P; Bellomo, Rinaldo; Jenkins, Alicia J; Januszewski, Andrzej S; Chapman, Marianne J; Jones, Karen L; Horowitz, Michael; Deane, Adam M

    2016-09-01

    The optimal blood glucose target in critically ill patients with preexisting diabetes and chronic hyperglycemia is unknown. In such patients, we aimed to determine whether a " liberal" approach to glycemic control would reduce hypoglycemia and glycemic variability and appear safe. Prospective, open-label, sequential-period exploratory study. Medical-surgical ICU. During sequential 6-month periods, we studied 83 patients with preexisting type 2 diabetes and chronic hyperglycemia (glycated hemoglobin, ≥ 7.0% at ICU admission). During the "standard care" period, 52 patients received insulin to treat blood glucose concentrations greater than 10 mmol/L whereas during the "liberal" period, 31 patients received insulin to treat blood glucose concentrations greater than 14 mmol/L. Time-weighted mean glucose concentrations and the number and duration of moderate (liberal: 10.3 [2.1] mmol/L; p = 0.02) and nadir blood glucose (4.4 [1.5] vs 5.5 [1.6] mmol/L; p liberal period. There was a signal toward reduced risk of moderate-severe hypoglycemia (relative risk: liberal compared with standard care: 0.47 [95% CI, 0.19-1.13]; p = 0.09). Ten patients (19%) during the standard period and one patient (3%) during the liberal period had recurrent episodes of moderate-severe hypoglycemia. Liberal therapy reduced glycemic variability (coefficient of variability, 33.2% [12.9%] vs 23.8% [7.7%]; p liberal glycemic control appears to attenuate glycemic variability and may reduce the prevalence of moderate-severe hypoglycemia.

  9. Mercury in urban soils: A comparison of local spatial variability in six European cities

    International Nuclear Information System (INIS)

    Rodrigues, S.; Pereira, M.E.; Duarte, A.C.; Ajmone-Marsan, F.; Davidson, C.M.; Grcman, H.; Hossack, I.; Hursthouse, A.S.; Ljung, K.; Martini, C.; Otabbong, E.; Reinoso, R.; Ruiz-Cortes, E.; Urquhart, G.J.; Vrscaj, B.

    2006-01-01

    The objective of this study was to quantify and assess for the first time the variability of total mercury in urban soils at a European level, using a systematic sampling strategy and a common methodology. We report results from a comparison between soil samples from Aveiro (Portugal), Glasgow (Scotland), Ljubljana (Slovenia), Sevilla (Spain), Torino (Italy) and Uppsala (Sweden). At least 25 sampling points (in about 4-5 ha) from a park in each city were sampled at two depths (0-10 and 10-20 cm). Total mercury was determined by pyrolysis atomic absorption spectrometry with gold amalgamation. The quality of results was monitored using certified reference materials (BCR 142R and BCR 141R). Measured total mercury contents varied from 0.015 to 6.3 mg kg -1 . The lowest median values were found in Aveiro, for both surface (0-10 cm) and sub-surface (10-20 cm) samples (0.055 and 0.054 mg kg -1 , respectively). The highest median mercury contents in soil samples were found in samples from Glasgow (1.2 and 1.3 mg kg -1 , for surface and sub-surface samples, respectively). High variability of mercury concentrations was observed, both within each park and between cities. This variability reflecting contributions from natural background, previous anthropogenic activities and differences in the ages of cities and land use, local environmental conditions as well as the influence of their location within the urban area. Short-range variability of mercury concentrations was found to be up to an order of magnitude over the distance of only a few 10 m

  10. Índice glicêmico e carga glicêmica de dietas consumidas por indivíduos obesos Glycemic index and glycemic load of diets consumed by obese individuals

    Directory of Open Access Journals (Sweden)

    Helena Alves de Carvalho Sampaio

    2007-12-01

    Full Text Available OBJETIVO: Avaliar o índice glicêmico e a carga glicêmica de dietas de indivíduos obesos. MÉTODOS: Trata-se de estudo retrospectivo, que analisou as fichas clínicas de 80 adultos obesos, acompanhados em um serviço privado localizado em Fortaleza, Ceará. Determinaram-se o índice glicêmico e a carga glicêmica da dieta. Para verificação da associação entre índice glicêmico e carga glicêmica, e dessas variáveis com a ingestão energética diária e com o índice de massa corporal dos indivíduos, utilizou-se o teste de correlação de Pearson. O teste "t" de Student foi utilizado para verificar diferenças entre os dois índices e o sexo. Em ambos os testes adotou-se pOBJECTIVE: To evaluate the glycemic index and glycemic load of diets of obese individuals. METHODS: This is a retrospective study that analyzed the medical records of 80 obese adults attending a private health care service in Fortaleza, Ceará. The glycemic index and load of their diet was determined. The Pearson correlation test was used to verify if there was an association between glycemic index and glycemic load and of these variables with their daily energy intake and body mass index. The Student's "t" test was used to verify the differences between the two indexes and gender. A significance level of p<0.05 was adopted for both tests. RESULTS: Inadequate (moderate or high glycemic index prevailed at breakfast (82.9%, afternoon snack (60.0% and dinner (64.6%. The daily glycemic index was inadequate for 78.7% of the group and predominantly moderate according to the mean found (59.23, however it was less inadequate than the daily glycemic load which was high (143.8 and worse among males. The body mass index of the group, in general and according to gender, was not associated with any of the indices. Daily energy intake was associated only with glycemic load, both generally and taking gender into account. CONCLUSION: The results point toward a higher glycemic load in

  11. Effect of insulin degludec versus insulin glargine on glycemic control and daily fasting blood glucose variability in insulin-naïve Japanese patients with type 2 diabetes: I'D GOT trial.

    Science.gov (United States)

    Aso, Yoshimasa; Suzuki, Kunihiro; Chiba, Yasuko; Sato, Minoru; Fujita, Nobuya; Takada, Yoshihisa; Murano, Shunichi; Kuroda, Hisamoto

    2017-08-01

    Insulin degludec (IDeg) is an ultra-long-acting insulin that has a smooth time/action profile over more than 42h. The present study compared the effects of IDeg and insulin glargine (IGlar) on HbA1c reduction and on within-subject day-to-day variability of fasting blood glucose (FBG) in insulin-naïve patients with type 2 diabetes. Eligible patients were randomly allocated at a 3:1 ratio to receive once-daily IDeg (n=31) or IGlar (n=12). Both basal insulins were administered before breakfast and titrated to achieve a target FBG type 2 diabetes. The day-to-day variation of FBG was smaller in patients receiving IDeg. Copyright © 2017. Published by Elsevier B.V.

  12. A comparison of experiment and theory for sound propagation in variable area ducts

    Science.gov (United States)

    Nayfeh, A. H.; Kaiser, J. E.; Marshall, R. L.; Hurst, C. J.

    1980-01-01

    An experimental and analytical program has been carried out to evaluate sound suppression techniques in ducts that produce refraction effects due to axial velocity gradients. The analytical program employs a computer code based on the method of multiple scales to calculate the influence of axial variations due to slow changes in the cross-sectional area as well as transverse gradients due to the wall boundary layers. Detailed comparisons between the analytical predictions and the experimental measurements have been made. The circumferential variations of pressure amplitudes and phases at several axial positions have been examined in straight and variable area ducts, with hard walls and lined sections, and with and without a mean flow. Reasonable agreement between the theoretical and experimental results has been found.

  13. Glycemic control during consecutive days with prolonged walking exercise in individuals with type 1 diabetes mellitus.

    Science.gov (United States)

    van Dijk, Jan-Willem; Eijsvogels, Thijs M; Nyakayiru, Jean; Schreuder, Tim H A; Hopman, Maria T; Thijssen, Dick H; van Loon, Luc J C

    2016-07-01

    Despite its general benefits for health, exercise complicates the maintenance of stable blood glucose concentrations in individuals with type 1 diabetes. The aim of the current study was to examine changes in food intake, insulin administration, and 24-h glycemic control in response to consecutive days with prolonged walking exercise (∼8h daily) in individuals with type 1 diabetes. Ten individuals with type 1 diabetes participating in the worlds' largest walking event were recruited for this observational study. Simultaneous measurements of 24-h glycemic control (continuous glucose monitoring), insulin administration and food intake were performed during a non-walking day (control) and during three subsequent days with prolonged walking exercise (daily distance 40 or 50km). Despite an increase in daily energy (31±18%; p10 mmol/L) and hypoglycemia (blood glucose 0.05 for all variables). The prolonged walking exercise was associated with a modest increase in glycemic variability compared with the control day (pexercise allows for profound reductions in daily insulin administration in persons with type 1 diabetes, despite large increments in energy and carbohydrate intake. When taking such adjustments into account, prolonged moderate-intensity exercise does not necessarily impair 24-h glycemic control. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Comparison of open cholecystectomy with laparoscopic cholecystectomy using latest variables of pulmonary functions as parameters

    International Nuclear Information System (INIS)

    Ahmed, W.I.; Mian, M.A.; Hussain, S.M.

    2015-01-01

    Comparison of open cholecystectomy with laparoscopic cholecystectomy using latest variables of pulmonary functions as parameters To compare open holecystectomy with laparoscopic cholecystectomy using latest variables of pulmonary functions as parameters. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Surgery, CMH Rawalpindi from May 2010 to Nov 2010. Patients and Methods: Patients with symptomatic cholelithiasis subjected to elective cholecystectomy were studied. The patients were divided into two groups. Open Cholecystectomy was performed on patients in group I, and laparoscopic cholecystectomy was performed in patients in group II. Respiratory function tests were performed preoperatively and on the morning of the 1st post-operative day. Results: Preoperative pulmonary function tests were normal and did not differ significantly between the two groups. After operation a significant reduction in the FEV1 (Forced Expiratory Volume in first second), FEV6 (Forced expiratory volume in first six seconds) and their ratio FEV1/FEV6 occurred after both open and laparoscopic cholecystectomy. However, mean reductions in FEV1, FEV6 and FEV1/FEV6 in the laparoscopic cholecystectomy group were significantly (p<0.05) less as compared with those after open holecystectomy. Conclusion: Laparoscopic cholecystectomy causes less impairment of lung function than cholecystectomy performed through a subcostal incision. (author)

  15. Comparison of Physiological Variables Between the Elliptical Bicycle and Run Training in Experienced Runners.

    Science.gov (United States)

    Klein, Ian E; White, Jason B; Rana, Sharon R

    2016-11-01

    Klein, IE, White, JB, and Rana, SR. Comparison of physiological variables between the elliptical bicycle and run training in experienced runners. J Strength Cond Res 30(11): 2998-3006, 2016-A novel outdoor elliptical bicycle (EBIKE) has been designed to elicit running-similar physiological adaptations while reducing the impact forces that commonly lead to injury. Various cross-training methods have been used to reduce injury risk, restore or maintain fitness, and prevent detraining. The purpose of this study was to compare 4 weeks of EBIKE-only training to run-only training on maximal oxygen consumption, ventilatory threshold, respiratory compensation point, running economy, and 5,000 m time trial times. Twelve experienced runners (age, 22.33 ± 3.33 years; running experience, 9.25 ± 4.53 years) completed 4 weeks of randomly assigned EBIKE or run training. Physiological and performance testing procedures were repeated, and subjects then performed a second matched 4-week training period in a crossover design. Ventilatory threshold was significantly greater after EBIKE (p ≤ 0.05; 41.60 ± 6.15 ml·kg·min) and run training (p ≤ 0.05; 42.33 ± 6.96 ml·kg·min) compared with the initial time point (40.17 ± 6.47 ml·kg·min). There were no significant group differences (p > 0.05) for these variables at any time point. In conclusion, EBIKE-only training yielded similar physiological and performance maintenance or improvements compared with run-only training. These results suggest that EBIKE training can be an effective cross-training method to maintain and improve certain physiological and performance variables in experienced runners over a 4-week period.

  16. Factors related to glycemic control in IDDM and insulin-treated NIDDM patients in current practice. A comparison of care policies. SIEMTIC Group. Studio Italiano Epidemiologico Multicentrico su Terapia Insulin e Controllo Metabolico.

    Science.gov (United States)

    Garancini, M P; Gallus, G; Cucinotta, D; Rossi, A; Riccardi, G

    1997-11-01

    To evaluate, under routine conditions, the relation between different diabetes care policies and glycemic control through a by-center analysis procedure aimed at reducing some drawbacks of cross-sectional data. A survey on insulin-treated diabetes care management (IDDM and NIDDM) involved 16 Italian randomly selected diabetes outpatient clinics. A total of 2,142 representative patients were investigated. The standardized HbA1c average value of each center was related, by regression models, to some indicators of center care policy (average number of injections, average BMI, proportion of cases with recent fundus oculi examinations, or frequent visits) as well as to patients' average social levels (employment type). Homogeneity in patient admission criteria is assumed among the investigated centers as a basic condition for the procedure validity. Some known imbalance were controlled for both design and analysis. HbA1c showed a univariate inverse relation with daily number of injections in IDDM (P = 0.0009, r2 = 0.56) but not in NIDDM (P = 0.33). It was inversely related to both fundus examination (IDDM P = 0.04; NIDDM P = 0.099) and qualified employment (IDDM P = 0.06; NIDDM P = 0.026). A stepwise regression analysis left in the model insulin injections (P = 0.0002) in IDDM (total r2 = 0.68) and qualified employment (P = 0.016) and fundus examination (P = 0.14) in NIDDM (total r2 = 0.53), after controlling for age, sex, disease duration, insulin therapy starting delay, and insulin dose per kilogram. These results suggest that the confirmed benefits of a multiple-injection regimen in IDDM cannot be simply extrapolated to NIDDM, where patients' awareness and medical attention to complications proved to be the most important factors in current practice.

  17. Suboptimal glycemic control in type 2 diabetes

    DEFF Research Database (Denmark)

    Nefs, Giesje; Pouwer, F; Denollet, J

    2012-01-01

    Recent studies examining the relationship between depression and glycosylated hemoglobin (HbA(1c)) concentrations in patients with type 2 diabetes have yielded mixed findings. One explanation may lie in the heterogeneity of depression. Therefore, we examined whether distinct features of depression...... were differentially associated with suboptimal glycemic control. Cross-sectional baseline data from a dynamic cohort study of primary care patients with type 2 diabetes from the Eindhoven region, The Netherlands, were analyzed. A total of 5772 individuals completed baseline measurements of demographic...... adjustment for the other depression measures (OR 1.33, 1.11-1.59). Alcohol consumption and physical activity met criteria for mediation, but did not attenuate the association between anhedonia and glycemic control by more than 5%. Although diabetes duration was identified as a confounder and controlled for...

  18. Glycemic load, glycemic index, bread and incidence of overweight/obesity in a Mediterranean cohort: the SUN project.

    Science.gov (United States)

    de la Fuente-Arrillaga, Carmen; Martinez-Gonzalez, Miguel Angel; Zazpe, Itziar; Vazquez-Ruiz, Zenaida; Benito-Corchon, Silvia; Bes-Rastrollo, Maira

    2014-10-22

    To evaluate prospectively the relationship between white, or whole grain bread, and glycemic index, or glycemic load from diet and weight change in a Mediterranean cohort. We followed-up 9 267 Spanish university graduates for a mean period of 5 years. Dietary habits at baseline were assessed using a semi-quantitative 136-item food-frequency questionnaire. Average yearly weight change was evaluated according to quintiles of baseline glycemic index, glycemic load, and categories of bread consumption. We also assessed the association between bread consumption, glycemic index, or glycemic load, and the incidence of overweight/obesity. White bread and whole-grain bread were not associated with higher weight gain. No association between glycemic index, glycemic load and weight change was found.White bread consumption was directly associated with a higher risk of becoming overweight/obese (adjusted OR (≥2 portions/day) versus (≤1 portion/week): 1.40; 95% CI: 1.08-1.81; p for trend: 0.008). However, no statistically significant association was observed between whole-grain bread, glycemic index or glycemic load and overweight/obesity. Consumption of white bread (≥2 portions/day) showed a significant direct association with the risk of becoming overweight/obese.

  19. Statistics in experimental cerebrovascular research?€”comparison of two groups with a continuous outcome variable

    OpenAIRE

    Schlattmann, Peter; Dirnagl, Ulrich

    2010-01-01

    Part one of this mini-series on statistics in cerebrovascular research uses the simplest yet most common comparison in experimental research (two groups with a continuous outcome variable) to introduce the very basic concepts of statistical testing: a priori formulation of hypotheses and definition of planned statistical analysis, error considerations, and power analysis.

  20. Influenza Virus and Glycemic Variability in Diabetes: A Killer Combination?

    Directory of Open Access Journals (Sweden)

    Katina D. Hulme

    2017-05-01

    Full Text Available Following the 2009 H1N1 influenza virus pandemic, numerous studies identified the striking link between diabetes mellitus and influenza disease severity. Typically, influenza virus is a self-limiting infection but in individuals who have a pre-existing chronic illness, such as diabetes mellitus, severe influenza can develop. Here, we discuss the latest clinical and experimental evidence for the role of diabetes in predisposing the host to severe influenza. We explore the possible mechanisms that underlie this synergy and highlight the, as yet, unexplored role that blood glucose oscillations may play in disease development. Diabetes is one of the world’s fastest growing chronic diseases and influenza virus represents a constant and pervasive threat to human health. It is therefore imperative that we understand how diabetes increases influenza severity in order to mitigate the burden of future influenza epidemics and pandemics.

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

    Directory of Open Access Journals (Sweden)

    Tatiana Uchôa Passos

    2015-03-01

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

  2. Direct and indirect effects of neighborhood factors and self-care on glycemic control in adults with type 2 diabetes.

    Science.gov (United States)

    Smalls, Brittany L; Gregory, Chris M; Zoller, James S; Egede, Leonard E

    2015-03-01

    To determine whether neighborhood factors have direct or indirect effects, via self-care behaviors on glycemic control. Adult patients with type 2 diabetes were recruited from an academic medical center and Veterans Affairs Medical Center in the southeastern United States. Confirmatory factor analysis was used to create latent variables for neighborhood factors and diabetes self-care behavior. Structural equation modeling was used to test direct and indirect effects between neighborhood factors and glycemic control as assessed by HbA1c levels. CFA yielded four latent variables for neighborhood factors (neighborhood violence, access to healthy food, social support, and neighborhood aesthetics) and one latent variable diabetes self-care. We found that social support (β=0.28, z=4.86, paccess to healthy foods (β=-0.17, z=-2.95, p=0.003) had direct effects on self-care; self-care (β=-0.15, z=-2.48, p=0.013) and neighborhood aesthetics (β=0.12, z=2.19, p=0.03) had direct effects on glycemic control; while social support (β=-0.04, z=-2.26, p=0.02) had an indirect effect on glycemic control via self-care. This study showed that self-care behaviors and neighborhood aesthetics have direct effects on glycemic control, social support and access to health foods had direct effects on self-care, and social support had an indirect effect on glycemic control via self-care. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. High dietary glycemic load and glycemic index increase risk of cardiovascular disease among middle-aged women : a population-based follow-up study

    NARCIS (Netherlands)

    Beulens, Joline W. J.; de Bruijne, Leonie M.; Stolk, Ronald P.; Peeters, Petra H. M.; Bots, Michiel L.; Grobbee, Diederick E.; van der Schouw, Yvonne T.

    2007-01-01

    Objectives The goal of this work was to assess whether high dietary glycemic load and glycemic index are associated with an increased risk of cardiovascular disease (CVD). Background The associations of dietary glycemic index and glycemic load with risk of CVD are not well established, particularly

  4. Practice variability and efficacy of clonazepam, lorazepam, and midazolam in status epilepticus: A multicenter comparison.

    Science.gov (United States)

    Alvarez, Vincent; Lee, Jong Woo; Drislane, Frank W; Westover, M Brandon; Novy, Jan; Dworetzky, Barbara A; Rossetti, Andrea O

    2015-08-01

    Benzodiazepines (BZD) are recommended as first-line treatment for status epilepticus (SE), with lorazepam (LZP) and midazolam (MDZ) being the most widely used drugs and part of current treatment guidelines. Clonazepam (CLZ) is also utilized in many countries; however, there is no systematic comparison of these agents for treatment of SE to date. We identified all patients treated with CLZ, LZP, or MDZ as a first-line agent from a prospectively collected observational cohort of adult patients treated for SE in four tertiary care centers. Relative efficacies of CLZ, LZP, and MDZ were compared by assessing the risk of developing refractory SE and the number of antiseizure drugs (ASDs) required to control SE. Among 177 patients, 72 patients (40.62%) received CLZ, 82 patients (46.33%) LZP, and 23 (12.99%) MDZ; groups were similar in demographics and SE characteristics. Loading dose was considered insufficient in the majority of cases for LZP, with a similar rate (84%, 95%, and 87.5%) in the centers involved, and CLZ was used as recommended in 52% of patients. After adjustment for relevant variables, LZP was associated with an increased risk of refractoriness as compared to CLZ (odds ratio [OR] 6.4, 95% confidence interval [CI] 2.66-15.5) and with an increased number of ASDs needed for SE control (OR 4.35, 95% CI 1.8-10.49). CLZ seems to be an effective alternative to LZP and MDZ. LZP is frequently underdosed in this setting. These findings are highly relevant, since they may impact daily practice. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

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

    Directory of Open Access Journals (Sweden)

    Spolar Matt

    2006-08-01

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

  6. Glycemic Index values of some Jaffna fruits

    Directory of Open Access Journals (Sweden)

    Selladurai Pirasath

    2012-02-01

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

  7. Evaluation of Glycemic Indices of Rice (served with stew) prepared ...

    African Journals Online (AJOL)

    Objectives: The increasing rate of diabetic patients in Nigeria calls for concern. There is also the need for enough information on the glycemic index (GI) of many commonly consumed foods in Nigeria. This study was therefore designed to determine the glycemic indices of local varieties of rice produced in Abakaliki and to ...

  8. Glycemic allostasis during mental activities on fasting in non alcohol ...

    African Journals Online (AJOL)

    Glycemic allostasis is the process by which blood glucose stabilization is achieved through the balancing of glucose consumption rate and release into the blood stream under a variety of stressors.This paper reviews findings on the dynamics of glycemic levels during mental activities on fasting in non‑alcohol users and ...

  9. Solar irradiance variability: a six-year comparison between SORCE observations and the SATIRE model

    Science.gov (United States)

    Ball, W. T.; Unruh, Y. C.; Krivova, N. A.; Solanki, S.; Harder, J. W.

    2011-06-01

    Aims: We investigate how well modeled solar irradiances agree with measurements from the SORCE satellite, both for total solar irradiance and broken down into spectral regions on timescales of several years. Methods: We use the SATIRE model and compare modeled total solar irradiance (TSI) with TSI measurements over the period 25 February 2003 to 1 November 2009. Spectral solar irradiance over 200-1630 nm is compared with the SIM instrument on SORCE over the period 21 April 2004 to 1 November 2009. We discuss the overall change in flux and the rotational and long-term trends during this period of decline from moderate activity to the recent solar minimum in ~10 nm bands and for three spectral regions of significant interest: the UV integrated over 200-300 nm, the visible over 400-691 nm and the IR between 972-1630 nm. Results: The model captures 97% of the observed TSI variation. This is on the order at which TSI detectors agree with each other during the period considered. In the spectral comparison, rotational variability is well reproduced, especially between 400 and 1200 nm. The magnitude of change in the long-term trends is many times larger in SIM at almost all wavelengths while trends in SIM oppose SATIRE in the visible between 500 and 700 nm and again between 1000 and 1200 nm. We discuss the remaining issues with both SIM data and the identified limits of the model, particularly with the way facular contributions are dealt with, the limit of flux identification in MDI magnetograms during solar minimum and the model atmospheres in the IR employed by SATIRE. However, it is unlikely that improvements in these areas will significantly enhance the agreement in the long-term trends. This disagreement implies that some mechanism other than surface magnetism is causing SSI variations, in particular between 2004 and 2006, if the SIM data are correct. Since SATIRE was able to reproduce UV irradiance between 1991 and 2002 from UARS, either the solar mechanism for SSI

  10. Glycemic Response to Black Beans and Chickpeas as Part of a Rice Meal: A Randomized Cross-Over Trial.

    Science.gov (United States)

    Winham, Donna M; Hutchins, Andrea M; Thompson, Sharon V

    2017-10-04

    Legumes, such as black beans ( Phaseolus vulgaris L.) and chickpeas ( Cicer arietinum L.), have a low glycemic index, and may reduce the glycemic load of meals in which they are included. Although the low glycemic response of beans consumed alone has been documented, few studies have examined the glycemic response to traditional food combinations such as black beans and rice or chickpeas and rice. This randomized cross-over study examined the glycemic and insulinemic impact of 50 grams of available carbohydrate from three test meals: plain white rice (control), black beans with rice, and chickpeas with rice among healthy adult women ( n = 12, 18-65 years). Treatments were consumed on different mornings, a minimum of 7 days apart. Blood samples were collected at time 0 (fasting), and at 30, 60, 90, and 120 min postprandial, and were subsequently analyzed for glucose and insulin concentrations. Glucose response based on the incremental area under the curve showed a significant difference by treatment ( p = 0.027). Changes in blood glucose concentrations were significantly different for the black bean meal and the chickpea meal in comparison to rice alone at 60 min ( p = 0.026 and p = 0.024), 90 min ( p = 0.001 and p = 0.012) and 120 min post prandial ( p = 0.024; black bean meal). Findings indicate that combinations of black beans and chickpeas with white rice improve glycemic response, providing evidence that has promising implications for dietary guidance to reduce postprandial glucose and related health risks through traditional food patterns.

  11. Glycemic Response to Black Beans and Chickpeas as Part of a Rice Meal: A Randomized Cross-Over Trial

    Directory of Open Access Journals (Sweden)

    Donna M. Winham

    2017-10-01

    Full Text Available Legumes, such as black beans (Phaseolus vulgaris L. and chickpeas (Cicer arietinum L., have a low glycemic index, and may reduce the glycemic load of meals in which they are included. Although the low glycemic response of beans consumed alone has been documented, few studies have examined the glycemic response to traditional food combinations such as black beans and rice or chickpeas and rice. This randomized cross-over study examined the glycemic and insulinemic impact of 50 grams of available carbohydrate from three test meals: plain white rice (control, black beans with rice, and chickpeas with rice among healthy adult women (n = 12, 18–65 years. Treatments were consumed on different mornings, a minimum of 7 days apart. Blood samples were collected at time 0 (fasting, and at 30, 60, 90, and 120 min postprandial, and were subsequently analyzed for glucose and insulin concentrations. Glucose response based on the incremental area under the curve showed a significant difference by treatment (p = 0.027. Changes in blood glucose concentrations were significantly different for the black bean meal and the chickpea meal in comparison to rice alone at 60 min (p = 0.026 and p = 0.024, 90 min (p = 0.001 and p = 0.012 and 120 min post prandial (p = 0.024; black bean meal. Findings indicate that combinations of black beans and chickpeas with white rice improve glycemic response, providing evidence that has promising implications for dietary guidance to reduce postprandial glucose and related health risks through traditional food patterns.

  12. Dietary Fiber, Carbohydrates, Glycemic Index, and Glycemic Load in Relation to Breast Cancer Prognosis in the HEAL Cohort

    NARCIS (Netherlands)

    Belle, F.N.; Kampman, E.; McTiernan, A.; Bernstein, L.; Baumgartner, K.; Baumgartner, R.; Ambs, A.; Ballard-Barbash, R.; Neuhouser, M.L.

    2011-01-01

    Background: Dietary intake of fiber, carbohydrate, glycemic index (GI), and glycemic load (GL) may influence breast cancer survival, but consistent and convincing evidence is lacking. Methods: We investigated associations of dietary fiber, carbohydrates, GI, and GL with breast cancer prognosis among

  13. Dietary fiber, carbohydrates, glycemic index, and glycemic load in relation to breast cancer prognosis in the HEAL cohort

    NARCIS (Netherlands)

    Belle, F.N.; Kampman, E.; McTiernan, A.; Bernstein, L.; Baumgartner, K.; Baumgartner, R.; Ambs, A.; Ballard-Barbash, R.; Neuhouser, M.L.

    2011-01-01

    BACKGROUND: Dietary intake of fiber, carbohydrate, glycemic index (GI), and glycemic load (GL) may influence breast cancer survival, but consistent and convincing evidence is lacking. METHODS: We investigated associations of dietary fiber, carbohydrates, GI, and GL with breast cancer prognosis among

  14. A Randomized Trial about Glycemic Index and Glycemic Load Improves Outcomes among Adults with Type 2 Diabetes

    Science.gov (United States)

    Miller, Carla K.; Gutschall, Melissa

    2009-01-01

    Glycemic index (GI) represents the postprandial glucose response of carbohydrate foods, and glycemic load (GL) represents the quantity and quality of carbohydrate consumed. A diet lower in GI and GL may improve diabetes management. A 9-week intervention regarding GI and GL was evaluated among adults in the age range of 40-70 years who had had type…

  15. Nutritional composition, glycemic index, glycemic load, and organoleptical quality of glucomannan-enriched soy milk ice cream

    Science.gov (United States)

    Sa'adah, S.; Candra, O. M.; Nugrahani, G.; Pramono, A.; Afifah, D. N.

    2018-01-01

    Over the past decades, the number of childhood obesity cases has increased significantly, which led to an increase in the number of adults suffering from degenerative diseases such as diabetes mellitus (DM). Glucomannan-Enriched Soy Milk Ice Cream (GSMIC) may prevent obesity in children. The aim of the study was to test the level of carbohydrates, protein, fat, dietary fiber, glycemic index, glycemic load, and organoleptic quality of GSMIC. This experiment used a completely randomized design to test three formulations of glucomannan flour and soy milk (0.5%, 1.5%, and 2.5%). The products were tested for nutritional composition, and evaluated on glycemic index, glycemic load, and organoleptic quality. GSMIC 2.5% had higher levels of dietary fiber and high carbohydrate, protein, and fat content compared to ice cream (3.99%, 30.7%, 1.50%, 1.33%, respectively). The glycemic index of ice cream and 2.5% GSMIC were 75.83 (75%) and 51.48 (51%), respectively, while the glycemic load of ice cream and 2.5% GSMIC were 9.04 and 11.61, respectively. Based on the organoleptic analysis, formulation preferred by the panellists was 2.5% glucomannan flour. Glucomannan flour affected the level of carbohydrates, protein, fat, dietary fiber, glycemic index, glycemic load, and organoleptic quality in soy milk ice cream.

  16. Kiwifruit, carbohydrate availability, and the glycemic response.

    Science.gov (United States)

    Monro, John A

    2013-01-01

    An appreciable proportion, about 10%, of the dry weight of kiwifruit consists of primary cell walls. About 80% of dry matter is available carbohydrate consisting of glucose, fructose, and sucrose, and about 10% is digestible protein. The cell wall component, being nonstarch polysaccharide, is undigested in the stomach and small intestine, so the component increases in relative concentration in the gut lumen where its physicochemical properties may be important in modulating carbohydrate digestion and absorption. Released from the constraint of fruit structure, the dietary fiber swells to four times its original volume during in vitro digestion. When the digested remnants are allowed to settle into a packed but uncompressed state, as in the gut, they reduce the rate of glucose diffusion by about 40% and profoundly reduce digesta mixing, especially in the presence of a low background of soluble viscous polysaccharide. An in vitro estimation of the glycemic index (GI) of carbohydrate in kiwifruit, and in vivo estimates show the carbohydrate to be of low GI. On a whole fruit basis because of the high water content of kiwifruit, a 100g kiwifruit would be equivalent to about 5g (1 teaspoon) of glucose in its effect on blood glucose; thus, kiwifruit have low glycemic impact and are suitable for those with diabetes. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. A comparison of methods for creating multiple imputations of nominal variables

    NARCIS (Netherlands)

    Lang, K.M.; Wu, Wei

    2017-01-01

    Many variables that are analyzed by social scientists are nominal in nature. When missing data occur on these variables, optimal recovery of the analysis model's parameters is a challenging endeavor. One of the most popular methods to deal with missing nominal data is multiple imputation (MI). This

  18. Thermal tolerance ranges and climate variability : A comparison between bivalves from differing climates

    NARCIS (Netherlands)

    Compton, Tanya J.; Rijkenberg, Micha J. A.; Drent, Jan; Piersma, Theunis

    2007-01-01

    The climate variability hypothesis proposes that in variable temperate climates poikilothermic animals have wide thermal tolerance windows, whereas in constant tropical climates they have small thermal tolerance windows. In this study we quantified and compared the upper and lower lethal thermal

  19. A Comparison of Methods to Test Mediation and Other Intervening Variable Effects

    Science.gov (United States)

    MacKinnon, David P.; Lockwood, Chondra M.; Hoffman, Jeanne M.; West, Stephen G.; Sheets, Virgil

    2010-01-01

    A Monte Carlo study compared 14 methods to test the statistical significance of the intervening variable effect. An intervening variable (mediator) transmits the effect of an independent variable to a dependent variable. The commonly used R. M. Baron and D. A. Kenny (1986) approach has low statistical power. Two methods based on the distribution of the product and 2 difference-in-coefficients methods have the most accurate Type I error rates and greatest statistical power except in 1 important case in which Type I error rates are too high. The best balance of Type I error and statistical power across all cases is the test of the joint significance of the two effects comprising the intervening variable effect. PMID:11928892

  20. Polyphenol content and glycemic load of pasta enriched with Faba bean flour

    Directory of Open Access Journals (Sweden)

    Imma Turco

    2016-05-01

    Full Text Available Background: Legumes contain elevated levels of health functional components. The objective of the present paper was to evaluate the nutritional properties and the post-prandial glycaemic responses of pasta obtained using 35% Vicia Faba (VF bean flour, which is an important source of fiber and phytochemical compounds. Results: Protein and fiber content were higher in VF pasta compared with durum wheat semolina (DWS pasta. The total phenol content in VF pasta was about two fold higher compared to that of DWS pasta. A higher total flavonoid content, higher antioxidant activity against peroxyl radicals evaluated by oxygen radical absorbance capacity (ORAC assay was also observed in VF pasta. The comparison of post-prandial increase of glucose after VF intake or DWS demonstrated significant differences and VF pasta exhibited a lower glycemic index value, a lower glycemic load and higher glycemic profile compared with DWS pasta. Conclusion: The results suggest that enrichment with 35% Vicia faba bean has potential health benefits and that VF flour can be used as an ingredient to prepare added-value products.

  1. Comparison of variability in pork carcass composition and quality between barrows and gilts.

    Science.gov (United States)

    Overholt, M F; Arkfeld, E K; Mohrhauser, D A; King, D A; Wheeler, T L; Dilger, A C; Shackelford, S D; Boler, D D

    2016-10-01

    Pigs ( = 8,042) raised in 8 different barns representing 2 seasons (cold and hot) and 2 production focuses (lean growth and meat quality) were used to characterize variability of carcass composition and quality traits between barrows and gilts. Data were collected on 7,684 pigs at the abattoir. Carcass characteristics, subjective loin quality, and fresh ham face color (muscles) were measured on a targeted 100% of carcasses. Fresh belly characteristics, boneless loin weight, instrumental loin color, and ultimate loin pH measurements were collected from 50% of the carcasses each slaughter day. Adipose tissue iodine value (IV), 30-min loin pH, LM slice shear force, and fresh ham muscle characteristic measurements were recorded on 10% of carcasses each slaughter day. Data were analyzed using the MIXED procedure of SAS as a 1-way ANOVA in a randomized complete block design with 2 levels (barrows and gilts). Barn (block), marketing group, production focus, and season were random variables. A 2-variance model was fit using the REPEATED statement of the MIXED procedure, grouped by sex for analysis of least squares means. Homogeneity of variance was tested on raw data using Levene's test of the GLM procedure. Hot carcass weight of pigs (94.6 kg) in this study was similar to U.S. industry average HCW (93.1 kg). Therefore, these data are representative of typical U.S. pork carcasses. There was no difference ( ≥ 0.09) in variability of HCW or loin depth between barrow and gilt carcasses. Back fat depth and estimated carcass lean were more variable ( ≤ 0.0001) and IV was less variable ( = 0.05) in carcasses from barrows than in carcasses from gilts. Fresh belly weight and thickness were more variable ( ≤ 0.01) for bellies of barrows than bellies of gilts, but there was no difference in variability for belly length, width, or flop distance ( ≥ 0.06). Fresh loin subjective color was less variable ( < 0.01) and subjective marbling was more variable ( < 0.0001) in loins

  2. Quantification of collateral flow in humans: a comparison of angiographic, electrocardiographic and hemodynamic variables

    NARCIS (Netherlands)

    van Liebergen, R. A.; Piek, J. J.; Koch, K. T.; de Winter, R. J.; Schotborgh, C. E.; Lie, K. I.

    1999-01-01

    Evaluation of collateral vascular circulation according to hemodynamic variables and its relation to myocardial ischemia. There is limited information regarding the hemodynamic quantification of recruitable collateral vessels. Angiography of the donor coronary artery was performed before and during

  3. Comparison of different calibration methods suited for calibration problems with many variables

    DEFF Research Database (Denmark)

    Holst, Helle

    1992-01-01

    This paper describes and compares different kinds of statistical methods proposed in the literature as suited for solving calibration problems with many variables. These are: principal component regression, partial least-squares, and ridge regression. The statistical techniques themselves do...

  4. Comparison of Sparse and Jack-knife partial least squares regression methods for variable selection

    DEFF Research Database (Denmark)

    Karaman, Ibrahim; Qannari, El Mostafa; Martens, Harald

    2013-01-01

    is often used by chemometricians. In order to evaluate the predictive ability of both methods, cross model validation was implemented. The performance of both methods was assessed using FTIR spectroscopic data, on the one hand, and a set of simulated data. The stability of the variable selection procedures......The objective of this study was to compare two different techniques of variable selection, Sparse PLSR and Jack-knife PLSR, with respect to their predictive ability and their ability to identify relevant variables. Sparse PLSR is a method that is frequently used in genomics, whereas Jack-knife PLSR...... was highlighted by the frequency of the selection of each variable in the cross model validation segments. Computationally, Jack-knife PLSR was much faster than Sparse PLSR. But while it was found that both methods have more or less the same predictive ability, Sparse PLSR turned out to be generally very stable...

  5. The comparison of multiple F-wave variable studies and magnetic resonance imaging examinations in the assessment of cervical radiculopathy.

    Science.gov (United States)

    Lin, Chu-Hsu; Tsai, Yuan-Hsiung; Chang, Chia-Hao; Chen, Chien-Min; Hsu, Hung-Chih; Wu, Chun-Yen; Hong, Chang-Zern

    2013-09-01

    The aims of this study were to investigate the correlation of the findings of multiple median and ulnar F-wave variables and magnetic resonance imaging examinations in the prediction of cervical radiculopathy. The data of 68 patients who underwent both nerve conduction studies of the upper extremities and cervical spine magnetic resonance imaging within 3 mos of the nerve conduction studies were retrospectively reviewed and reinterpreted. The associations between multiple median and ulnar F-wave variables (including persistence, chronodispersion, and minimal, maximal, and mean latencies) and magnetic resonance imaging evidence of lower cervical spondylotic radiculopathy (i.e., C7, C8, and T1 radiculopathy) were investigated. Patients with lower cervical radiculopathy exhibited reduced right median F-wave persistence (P = 0.011), increased right ulnar F-wave chronodispersion (P = 0.041), and a trend toward increased left ulnar F-wave chronodispersion (P = 0.059); however, there were no other consistent significant differences in the F-wave variables between patients with and patients without magnetic resonance imaging evidence of lower cervical radiculopathy. In comparison with normal reference values established previously, the sensitivity and positive predictive value of F-wave variable abnormalities for predicting lower cervical radiculopathy were low. There was a low correlation between F-wave studies and magnetic resonance imaging examinations. The diagnostic utility of multiple F-wave variables in the prediction of cervical radiculopathy was not supported by this study.

  6. Exploring Variation in Glycemic Control Across and Within Eight High-Income Countries

    DEFF Research Database (Denmark)

    Charalampopoulos, Dimitrios; Hermann, Julia M; Svensson, Jannet

    2018-01-01

    benchmarking and policy recommendations. RESEARCH DESIGN AND METHODS: Data were collected between 2013 and 2014 from 64,666 children with T1D who were across 528 centers in Germany, Austria, England, Wales, US, Sweden, Denmark, and Norway. We used fixed and random-effects models adjusted...... attending centers with more variable glycemic results had higher HbA1c levels (5.6 mmol/mol [0.5%] per 5 mmol/mol [0.5%] increase in center HbA1c SD). CONCLUSIONS: At similar average levels of HbA1c, countries display different levels of center variation. The distribution of glycemic achievement within...... variation and children's glycemic control. RESULTS: Sweden had the lowest mean HbA1c (59 mmol/mol [7.6%]) and together with Norway and Denmark showed the lowest between-center variations (ICC ≤ 4%). Germany and Austria had the next lowest mean HbA1c (61-62 mmol/mol [7.7-7.8%]) but showed the largest center...

  7. A Comparison of Recurrent Non-specific Low Back Pain Patients and Healthy Subjects in Variability of Anticipatory Postural Adjustments

    Directory of Open Access Journals (Sweden)

    Rozita Hedayati

    2010-10-01

    Full Text Available Objective: The purpose of this study was to ivestigate of the postural strategies variability in low back pain patients, as a criterion in the adaptability evaluation of this system to the environmental demands and comparison of patients with healthy persons and also the importance of psychological factors associated with pain as an effective factor in postural disturbances was assessed. Materials & Methods: This analytical, cross-sectional and case-control study was performed on twenty one recurrent non-specific low back pain patients whom had been selected simply and conveniently and twenty one healthy persons whom had been matched with patients. The electromyographic activity of Deltoid, External Oblique, Transverse Abdominis / Internal Oblique and Erector Spinae muscles of each person was recorded in 75 rapid arm flexion with maximum acceleration. To study the patient’s avoidance belief and disability, two standard tools Fear-Avoidance Belief Questionnaire (FABQ and Roland-Morris Questionnaire were used respectively. Data were analyzed by MANOVA and Pearson correlation coefficient. Results: The results showed that chronic low back pain patients exhibit less variability in their anticipatory postural adjustments than the control group(P=0.047. However, the decrease in variability of the timing of anticipatory postural adjustments of External Oblique(P=0.45 and Erector Spinae(P=0.6 muscles was not significant. The correlation between the timing variability of anticipatory postural adjustments and fear-avoidance belief questionnaire scores was significant(P=0.006, however there was no significant correlation between this variable and disability(P=0.09 in the patients. Conclusion: There is a decrease in variability of postural control system of recurrent non-specific low back pain patients that can result in the persistence of pain and chronicity by decreasing the adaptability to environmental demands. The restoration of variability to

  8. Glycemic control in patients with type 2 diabetes mellitus in Spain.

    Science.gov (United States)

    Pérez, A; Mediavilla, J J; Miñambres, I; González-Segura, D

    2014-11-01

    To evaluate the degree of glycemic control in patients with type 2 diabetes in Spain and identify factors associated with glycemic control. This was a cross-sectional, multicenter, epidemiological study that used consecutive sampling and was conducted in primary care practices in Spain. A total of 5591 patients with type 2 diabetes mellitus lasting more than 1 year and who were treated with hypoglycemic agents for more than 3 months were included in the study. At a single visit, HbA1c levels were measured (A1cNow+ system) and demographic and clinical variables related to diabetes and its treatment were recorded. During the visit, CV risk factors (CVRF), the presence of target-organ damage (TOD), the presence of hypoglycemia and body weight changes within the previous year were recorded. We analyzed data from 5382 patients (mean age 66.7 [10.8] years, mean duration of the diabetes 8.8 [6.3] years). TOD was present in 43.6% of the patients and 59.1% were taking 2 or more drugs. The patients' mean HbA1c was 7.1 (1.1)%, and 48.6% had HbA1c levels 70 years were associated with improved glycemic control. Patients with poorly controlled type 2 diabetes mellitus are highly prevalent in Spain. Factors associated with poorer glycemic control include the complexity of both the disease and the hypoglycemic therapy, a history of hypoglycemia and weight gain. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  9. Gastritis in patients undergoing sleeve gastrectomy: Prevalence, ethnic distribution, and impact on glycemic.

    Science.gov (United States)

    Rath-Wolfson, Lea; Varona, Roy; Bubis, Golan; Tatarov, Alexander; Koren, Rumelia; Ram, Edward

    2017-04-01

    Laparoscopic sleeve gastrectomy (LSG) is a therapeutic option in severely obese patients. The aim of this study was to evaluate the presence of Helicobacter pylori (HP) gastritis and non-Helicobacter gastritis in the gastrectomy specimens, and its association to other variables.One hundred six sleeve gastrectomy specimens were examined histopathologically for the presence of gastritis and its relation to other factors like ethnicity, glycemic control, and postoperative complications.Twelve patients had HP gastritis, 39 had non-HP gastritis, and 55 had normal mucosa. There was a statistical difference between the Arab and Jewish Israeli patients in our study. Twenty-eight of the Arab patients had HP gastritis and 48% had non-HP gastritis. In the Jewish population 6% had HP gastritis and 34% had non-HP gastritis. The preoperative glycemic control was worse in the gastritis group with a mean HbA1c of 8.344% while in the normal mucosa group the mean HbA1c was 6.55. After operation the glycemic control reverted to normal in most the diabetic patients. There were few postoperative complications however, they were not related to HP.There is a high incidence of gastritis in obese patients. The incidence of gastritis in the Arab population in our study was higher than that in the Jewish population. The glycemic control before surgery was worse in patients with gastritis than in the normal mucosa group. HP bares no risk for postoperative complications after LSG and does not affect weight loss. However a larger cohort of patients must be studied to arrive at conclusive results.

  10. High glycemic index foods, overeating, and obesity.

    Science.gov (United States)

    Ludwig, D S; Majzoub, J A; Al-Zahrani, A; Dallal, G E; Blanco, I; Roberts, S B

    1999-03-01

    The prevalence of obesity has increased dramatically in recent years. However, the role of dietary composition in body weight regulation remains unclear. The purpose of this work was to investigate the acute effects of dietary glycemic index (GI) on energy metabolism and voluntary food intake in obese subjects. Twelve obese teenage boys were evaluated on three separate occasions using a crossover study protocol. During each evaluation, subjects consumed identical test meals at breakfast and lunch that had a low, medium, or high GI. The high- and medium-GI meals were designed to have similar macronutrient composition, fiber content, and palatability, and all meals for each subject had equal energy content. After breakfast, plasma and serum concentrations of metabolic fuels and hormones were measured. Ad libitum food intake was determined in the 5-hour period after lunch. Voluntary energy intake after the high-GI meal (5.8 megajoule [mJ]) was 53% greater than after the medium-GI meal (3.8 mJ), and 81% greater than after the low-GI meal (3.2 mJ). In addition, compared with the low-GI meal, the high-GI meal resulted in higher serum insulin levels, lower plasma glucagon levels, lower postabsorptive plasma glucose and serum fatty acids levels, and elevation in plasma epinephrine. The area under the glycemic response curve for each test meal accounted for 53% of the variance in food intake within subjects. The rapid absorption of glucose after consumption of high-GI meals induces a sequence of hormonal and metabolic changes that promote excessive food intake in obese subjects. Additional studies are needed to examine the relationship between dietary GI and long-term body weight regulation.

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

    International Nuclear Information System (INIS)

    Parvez, A.; Ihsanullah; Rafiq, A.; Ahmad, N.; Khan, E.H.

    2010-01-01

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

  12. Modeling Chronic Toxicity: A Comparison of Experimental Variability With (QSAR/Read-Across Predictions

    Directory of Open Access Journals (Sweden)

    Christoph Helma

    2018-04-01

    Full Text Available This study compares the accuracy of (QSAR/read-across predictions with the experimental variability of chronic lowest-observed-adverse-effect levels (LOAELs from in vivo experiments. We could demonstrate that predictions of the lazy structure-activity relationships (lazar algorithm within the applicability domain of the training data have the same variability as the experimental training data. Predictions with a lower similarity threshold (i.e., a larger distance from the applicability domain are also significantly better than random guessing, but the errors to be expected are higher and a manual inspection of prediction results is highly recommended.

  13. Selection of variables for neural network analysis. Comparisons of several methods with high energy physics data

    International Nuclear Information System (INIS)

    Proriol, J.

    1994-01-01

    Five different methods are compared for selecting the most important variables with a view to classifying high energy physics events with neural networks. The different methods are: the F-test, Principal Component Analysis (PCA), a decision tree method: CART, weight evaluation, and Optimal Cell Damage (OCD). The neural networks use the variables selected with the different methods. We compare the percentages of events properly classified by each neural network. The learning set and the test set are the same for all the neural networks. (author)

  14. Evaluation of sympathetic nerve system activity with MIBG. Comparison with heart rate variability

    International Nuclear Information System (INIS)

    Kurata, Chinori; Wakabayashi, Yasushi; Shouda, Sakae; Mikami, Tadashi; Tawarahara, Kei; Sugiyama, Tsuyoshi; Nakano, Tomoyasu; Suzuki, Toshihiko.

    1997-01-01

    Authors attempted to elucidate the relations of plasma concentration of norepinephrine (pNE) and findings of heart rate variability and MIBG myocardial scintigraphy and evaluated cardiac autonomic nervous activity in chronic renal failure. Subjects were 211 patients with various heart diseases (coronary artery lesion, cardiomyopathy, hypertension, diabetes mellitus, renal failure and so on), 60 patients with artificial kidney due to chronic renal failure, 13 of whom were found to have coronary arterial disease by Tl myocardial scintigraphy, and 14 normal volunteers. ECG was recorded with the portable recorder for heart rate variability. Together with collection of blood for pNE measurement, myocardial scintigraphy was done at 15 and 150 min after intravenous administration of 111 MBq of MIBG for acquisition of early and delayed, respectively, images of the frontal breast. Accumulation at and elimination during the time points of MIBG were computed in cps unit. Variability of heart rate was found to have the correlation positive with MIBG delayed accumulation and negative with the elimination, and pNE, negative with heart rate variability and the delayed accumulation and positive with the elimination. Thus cardiac autonomic nervous abnormality was suggested to occur before uremic cardiomyopathy. (K.H.)

  15. Predicting outcome after cardiac surgery : comparison of global haemodynamic and tonometric variables

    NARCIS (Netherlands)

    Bams, JL; Mariani, MA; Groeneveld, ABJ

    To compare how outcome can be predicted from global haemodynamic compared with regional perfusion-related variables (gastric intramucosal pH (pHi) and intramucosal-arterial PCO2 difference (Delta PCO2)), we measured global haemodynamics, gastric pHi and Delta PCO2 in 68 haemodynamically compromised

  16. Comparison of a transdermal contraceptive patch vs. oral contraceptives on hemostasis variables

    NARCIS (Netherlands)

    Kluft, C.; Meijer, P.; LaGuardia, K.D.; Fisher, A.C.

    2008-01-01

    Purpose: The aim of this study was to compare effects of the transdermal contraceptive patch, a desogestrel/ethinyl estradiol (EE)-containing, monophasic combination oral contraceptive (COC) and a levonorgestrel/EE-containing, triphasic COC on hemostasis variables. Study Design: This was a

  17. Comparison of operative procedure variables on pulpal viability in an ex vivo model.

    Science.gov (United States)

    Murray, P E; Smith, A J; Garcia-Godoy, F; Lumley, P J

    2008-05-01

    To measure and compare the responses of pulp tissue to cavity preparation and restoration variables using a novel tooth slice culture model. Experimental cavities (265) were continuously cut, under carefully controlled conditions, into the dentine of the labial aspect of 28-day-old Wistar rat incisors, and slices of these teeth maintained in organ culture for up to 2 weeks. The experimental variables examined were: the preparation method, remaining dentine thickness, coolant, drill speed, conditioning with EDTA and filling materials. The reactions of the dentine-pulp complex to the experimental variables were measured using pathohistometric analysis and the correlations between variables were determined using analysis of variance statistical tests. In rank order of surgically induced restorative pulpal injury, from the most to the least injurious were: remaining dentine thickness, absence of coolant during cavity preparation, bur speed, cavity conditioning treatments and the filling material. To reduce pulp injury and to promote pulpal repair activity, the correct use of appropriate materials are important. However, of relatively greater importance is the operative technique adopted, the need to avoid the excess removal of dentine and to minimize trauma during preparation.

  18. Comparison of personal, social and academic variables related to University Dropout and Persistence

    Directory of Open Access Journals (Sweden)

    Ana B. Bernardo

    2016-10-01

    Full Text Available Dropping out of university has serious consequences not only for the student who drops out but also for the institution and society as a whole. Although this phenomenon has been widely studied, there is a need for broader knowledge of the context in which it occurs. Yet research on the subject often focuses on variables that, although they affect drop-out rates, lie beyond a university's control. This makes it hard to come up with effective preventive measures. That is why a northern Spanish university has undertaken a ex post facto holistic research study on 1,311 freshmen (2008/9, 2009/10 and 2010/11 cohorts. The study falls within the framework of the ALFA-GUIA European Project and focuses on those drop-out factors where there is scope for taking remedial measures. This research explored the possible relationship of degree dropout and different categories of variables: variables related to the educational stage prior to university entry (path to entry university and main reason for degree choice, variables related to integration and coexistence at university (social integration, academic integration, relationships with teachers/ peers and value of the living environment financial status and performance during university studies (in terms ofcompliance with the program, time devoted to study, use of study techniques and class attendance. Descriptive, correlational and variance analyses were conducted to discover which of these variables really distinguish those students who drop out from their peers who complete their studies. Results highlight the influence of vocation as main reason for degree choice, path to university entry, financial independency, social and academic adaptation, time devoted to study, use of study techniques and program compliance in the studied phenomenon.

  19. Comparison of Personal, Social and Academic Variables Related to University Drop-out and Persistence.

    Science.gov (United States)

    Bernardo, Ana; Esteban, María; Fernández, Estrella; Cervero, Antonio; Tuero, Ellián; Solano, Paula

    2016-01-01

    Dropping out of university has serious consequences not only for the student who drops out but also for the institution and society as a whole. Although this phenomenon has been widely studied, there is a need for broader knowledge of the context in which it occurs. Yet research on the subject often focuses on variables that, although they affect drop-out rates, lie beyond a university's control. This makes it hard to come up with effective preventive measures. That is why a northern Spanish university has undertaken a ex post facto holistic research study on 1,311 freshmen (2008/9, 2009/10, and 2010/11 cohorts). The study falls within the framework of the ALFA-GUIA European Project and focuses on those drop-out factors where there is scope for taking remedial measures. This research explored the possible relationship of degree drop-out and different categories of variables: variables related to the educational stage prior to university entry (path to entry university and main reason for degree choice), variables related to integration and coexistence at university (social integration, academic integration, relationships with teachers/peers and value of the living environment) financial status and performance during university studies (in terms of compliance with the program, time devoted to study, use of study techniques and class attendance). Descriptive, correlational and variance analyses were conducted to discover which of these variables really distinguish those students who drop-out from their peers who complete their studies. Results highlight the influence of vocation as main reason for degree choice, path to university entry, financial independency, social and academic adaptation, time devoted to study, use of study techniques and program compliance in the studied phenomenon.

  20. Test-retest reliability of jump execution variables using mechanography: a comparison of jump protocols.

    Science.gov (United States)

    Fitzgerald, John S; Johnson, LuAnn; Tomkinson, Grant; Stein, Jesse; Roemmich, James N

    2018-05-01

    Mechanography during the vertical jump may enhance screening and determining mechanistic causes underlying physical performance changes. Utility of jump mechanography for evaluation is limited by scant test-retest reliability data on force-time variables. This study examined the test-retest reliability of eight jump execution variables assessed from mechanography. Thirty-two women (mean±SD: age 20.8 ± 1.3 yr) and 16 men (age 22.1 ± 1.9 yr) attended a familiarization session and two testing sessions, all one week apart. Participants performed two variations of the squat jump with squat depth self-selected and controlled using a goniometer to 80º knee flexion. Test-retest reliability was quantified as the systematic error (using effect size between jumps), random error (using coefficients of variation), and test-retest correlations (using intra-class correlation coefficients). Overall, jump execution variables demonstrated acceptable reliability, evidenced by small systematic errors (mean±95%CI: 0.2 ± 0.07), moderate random errors (mean±95%CI: 17.8 ± 3.7%), and very strong test-retest correlations (range: 0.73-0.97). Differences in random errors between controlled and self-selected protocols were negligible (mean±95%CI: 1.3 ± 2.3%). Jump execution variables demonstrated acceptable reliability, with no meaningful differences between the controlled and self-selected jump protocols. To simplify testing, a self-selected jump protocol can be used to assess force-time variables with negligible impact on measurement error.

  1. Fathers' involvement in preadolescents' diabetes adherence and glycemic control.

    Science.gov (United States)

    Hilliard, Marisa E; Rohan, Jennifer M; Carle, Adam C; Pendley, Jennifer Shroff; Delamater, Alan; Drotar, Dennis

    2011-09-01

    To examine the relationship of paternal involvement in diabetes care with adherence and glycemic control. One hundred and thirty-six mothers and fathers of preadolescents (aged 9-12 years) with type 1 diabetes reported on paternal involvement. Adherence was measured by interview and blood glucose meter downloads. Mothers' and fathers' ratings of paternal involvement in diabetes care were compared. We evaluated three structural equation models linking paternal involvement with adherence and glycemic control. Mothers and fathers reported similar amounts of paternal involvement, yet mothers rated paternal involvement as more helpful. The data supported a model indicating links between more paternal involvement and higher HbA1c and between lower adherence and higher HbA1c. Mediation and moderation models were not supported. Although paternal involvement was not directly associated with treatment adherence, it was associated with poorer glycemic control. Some fathers may increase their involvement in response to suboptimal glycemic outcomes.

  2. Dyadic Measures of the Parent-Child Relationship During the Transition to Adolescence and Glycemic Control in Children with Type 1 Diabetes

    Science.gov (United States)

    Anderson, Barbara J.; Holmbeck, Grayson; Iannotti, Ronald J.; McKay, Siripoom V.; Lochrie, Amanda; Volkening, Lisa K.; Laffel, Lori

    2009-01-01

    To identify aspects of family behavior associated with glycemic control in youth with type 1 diabetes mellitus (T1DM) during the transition to adolescence, we studied 121 9- to 14-year-olds (M = 12.1 yrs) and their parents, who completed the Diabetes Family Conflict Scale (DFCS) and the Diabetes Family Responsibility Questionnaire (DFRQ). From the DFRQ, we derived 2 dyadic variables, frequency of agreement (parent and child concurred exactly on who was responsible for a task) and frequency of discordance (parent and child had completely opposite reports of who was responsible). To examine the relationship between these variables and age, we divided the cohort into Younger (n = 57, M = 10.6 yrs) and Older (n = 64, M = 13.5 yrs) age groups. Family conflict was significantly related to glycemic control in the entire cohort and in both the Younger and Older age groups. However, only in the Younger (pre-teen) group was Agreement about responsibility for diabetes tasks related to glycemic control, with higher Agreement associated with better glycemic control. Findings suggest that Agreement about sharing of diabetes management responsibilities may be an important target for family-based interventions with pre-teen youth to optimize glycemic control during their transition to adolescence. PMID:19630455

  3. Comparisons of model simulations of climate variability with data, Task 2. [Progress report

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-31

    Significant progress has been made in our investigations aimed at diagnosing low frequency variations of climate in General Circulation Models. We have analyzed three versions of the Oregon State University General Circulation Model (OSU GCM). These are: (1) the Slab Model in which the ocean is treated as a static heat reservoir of fixed depth, (2) the coupled upper ocean-atmosphere model in which the ocean dynamics are calculated in two layers of variable depths representing the mixed layers and the thermocline; this model is referred to OSU2 in the following discussion, and (3) the coupled full ocean-atmosphere model in which the ocean is represented by six layers of variable depth; this model is referred to as OSU6 GCM in the discussion.

  4. Comparisons of model simulations of climate variability with data, Task 2

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    Significant progress has been made in our investigations aimed at diagnosing low frequency variations of climate in General Circulation Models. We have analyzed three versions of the Oregon State University General Circulation Model (OSU GCM). These are: (1) the Slab Model in which the ocean is treated as a static heat reservoir of fixed depth, (2) the coupled upper ocean-atmosphere model in which the ocean dynamics are calculated in two layers of variable depths representing the mixed layers and the thermocline; this model is referred to OSU2 in the following discussion, and (3) the coupled full ocean-atmosphere model in which the ocean is represented by six layers of variable depth; this model is referred to as OSU6 GCM in the discussion.

  5. Comparison of environmental forcings affecting suspended sediments variability in two macrotidal, highly-turbid estuaries

    Science.gov (United States)

    Jalón-Rojas, Isabel; Schmidt, Sabine; Sottolichio, Aldo

    2017-11-01

    The relative contribution of environmental forcing frequencies on turbidity variability is, for the first time, quantified at seasonal and multiannual time scales in tidal estuarine systems. With a decade of high-frequency, multi-site turbidity monitoring, the two nearby, macrotidal and highly-turbid Gironde and Loire estuaries (west France) are excellent natural laboratories for this purpose. Singular Spectrum Analyses, combined with Lomb-Scargle periodograms and Wavelet Transforms, were applied to the continuous multiannual turbidity time series. Frequencies of the main environmental factors affecting turbidity were identified: hydrological regime (high versus low river discharges), river flow variability, tidal range, tidal cycles, and turbulence. Their relative influences show similar patterns in both estuaries and depend on the estuarine region (lower or upper estuary) and the time scale (multiannual or seasonal). On the multiannual time scale, the relative contribution of tidal frequencies (tidal cycles and range) to turbidity variability decreases up-estuary from 68% to 47%, while the influence of river flow frequencies increases from 3% to 42%. On the seasonal time scale, the relative influence of forcings frequencies remains almost constant in the lower estuary, dominated by tidal frequencies (60% and 30% for tidal cycles and tidal range, respectively); in the upper reaches, it is variable depending on hydrological regime, even if tidal frequencies are responsible for up 50% of turbidity variance. These quantifications show the potential of combined spectral analyses to compare the behavior of suspended sediment in tidal estuaries throughout the world and to evaluate long-term changes in environmental forcings, especially in a context of global change. The relevance of this approach to compare nearby and overseas systems and to support management strategies is discussed (e.g., selection of effective operation frequencies/regions, prediction of the most

  6. Gait variability measurements in lumbar spinal stenosis patients: part A. Comparison with healthy subjects

    International Nuclear Information System (INIS)

    Papadakis, N C; Christakis, D G; Tzagarakis, G N; Chlouverakis, G I; Kampanis, N A; Stergiopoulos, K N; Katonis, P G

    2009-01-01

    The objective of this study is to compare the gait variability of patients with lumbar spinal stenosis (experimental group) with healthy individuals (control group). The hypothesis is that the preoperative gait variability of the experimental group is higher than the control group. The experimental group consisted of 35 adults (18 males, 17 females). The subjects of the experimental group suffered exclusively from spinal stenosis. The patients were determined by MRI scans. A tri-axial accelerometer sensor was used for the gait measurement, and differential entropy algorithm was used to quantify the gait acceleration signal. The Oswestry Low Back Pain Questionnaire was used to determine the condition on the day of the measurement. Receiver operating characteristic (ROC) was utilized to assess the diagnostic value of the method and determine a cut-off value. There is a statistically significant difference between gait variability in the control group and the experimental group. ROC analysis determines a cut-off differential entropy value. The cut-off value has a 97.6% probability of separating patients with spinal stenosis from healthy subjects. The Oswestry Low Back Questionnaire is well correlated with the spectral differential entropy values

  7. Conventional QT Variability Measurement vs. Template Matching Techniques: Comparison of Performance Using Simulated and Real ECG

    Science.gov (United States)

    Baumert, Mathias; Starc, Vito; Porta, Alberto

    2012-01-01

    Increased beat-to-beat variability in the QT interval (QTV) of ECG has been associated with increased risk for sudden cardiac death, but its measurement is technically challenging and currently not standardized. The aim of this study was to investigate the performance of commonly used beat-to-beat QT interval measurement algorithms. Three different methods (conventional, template stretching and template time shifting) were subjected to simulated data featuring typical ECG recording issues (broadband noise, baseline wander, amplitude modulation) and real short-term ECG of patients before and after infusion of sotalol, a QT interval prolonging drug. Among the three algorithms, the conventional algorithm was most susceptible to noise whereas the template time shifting algorithm showed superior overall performance on simulated and real ECG. None of the algorithms was able to detect increased beat-to-beat QT interval variability after sotalol infusion despite marked prolongation of the average QT interval. The QTV estimates of all three algorithms were inversely correlated with the amplitude of the T wave. In conclusion, template matching algorithms, in particular the time shifting algorithm, are recommended for beat-to-beat variability measurement of QT interval in body surface ECG. Recording noise, T wave amplitude and the beat-rejection strategy are important factors of QTV measurement and require further investigation. PMID:22860030

  8. Conventional QT variability measurement vs. template matching techniques: comparison of performance using simulated and real ECG.

    Directory of Open Access Journals (Sweden)

    Mathias Baumert

    Full Text Available Increased beat-to-beat variability in the QT interval (QTV of ECG has been associated with increased risk for sudden cardiac death, but its measurement is technically challenging and currently not standardized. The aim of this study was to investigate the performance of commonly used beat-to-beat QT interval measurement algorithms. Three different methods (conventional, template stretching and template time shifting were subjected to simulated data featuring typical ECG recording issues (broadband noise, baseline wander, amplitude modulation and real short-term ECG of patients before and after infusion of sotalol, a QT interval prolonging drug. Among the three algorithms, the conventional algorithm was most susceptible to noise whereas the template time shifting algorithm showed superior overall performance on simulated and real ECG. None of the algorithms was able to detect increased beat-to-beat QT interval variability after sotalol infusion despite marked prolongation of the average QT interval. The QTV estimates of all three algorithms were inversely correlated with the amplitude of the T wave. In conclusion, template matching algorithms, in particular the time shifting algorithm, are recommended for beat-to-beat variability measurement of QT interval in body surface ECG. Recording noise, T wave amplitude and the beat-rejection strategy are important factors of QTV measurement and require further investigation.

  9. Acute effect of meal glycemic index and glycemic load on blood glucose and insulin responses in humans

    Science.gov (United States)

    Galgani, José; Aguirre, Carolina; Díaz, Erik

    2006-01-01

    Objective Foods with contrasting glycemic index when incorporated into a meal, are able to differentially modify glycemia and insulinemia. However, little is known about whether this is dependent on the size of the meal. The purposes of this study were: i) to determine if the differential impact on blood glucose and insulin responses induced by contrasting GI foods is similar when provided in meals of different sizes, and; ii) to determine the relationship between the total meal glycemic load and the observed serum glucose and insulin responses. Methods Twelve obese women (BMI 33.7 ± 2.4 kg/m2) were recruited. Subjects received 4 different meals in random order. Two meals had a low glycemic index (40–43%) and two had a high-glycemic index (86–91%). Both meal types were given as two meal sizes with energy supply corresponding to 23% and 49% of predicted basal metabolic rate. Thus, meals with three different glycemic loads (95, 45–48 and 22 g) were administered. Blood samples were taken before and after each meal to determine glucose, free-fatty acids, insulin and glucagon concentrations over a 5-h period. Results An almost 2-fold higher serum glucose and insulin incremental area under the curve (AUC) over 2 h for the high- versus low-glycemic index same sized meals was observed (p < 0.05), however, for the serum glucose response in small meals this was not significant (p = 0.38). Calculated meal glycemic load was associated with 2 and 5 h serum glucose (r = 0.58, p < 0.01) and insulin (r = 0.54, p < 0.01) incremental and total AUC. In fact, when comparing the two meals with similar glycemic load but differing carbohydrate amount and type, very similar serum glucose and insulin responses were found. No differences were observed for serum free-fatty acids and glucagon profile in response to meal glycemic index. Conclusion This study showed that foods of contrasting glycemic index induced a proportionally comparable difference in serum insulin response when

  10. Cultural differences are reflected in variables associated with carer burden in FTD: a comparison study between India and Australia

    Science.gov (United States)

    Mekala, Shailaja; Alladi, Suvarna; Chandrasekar, Kammammettu; Fathima, Safiya; M.O.'Connor, Claire; McKinnon, Colleen; Hornberger, Michael; Piguet, Olivier; Hodges, John R.; Mioshi, Eneida

    2013-01-01

    There is great need to understand variables behind carer burden, especially in FTD. Carer burden is a complex construct, and its factors are likely to vary depending on the type of dementia, carer characteristics and cultural background. OBJECTIVE The present study aimed to compare profiles and severity of carer burden, depression, anxiety and stress in carers of FTD patients in India in comparison to Australia; to investigate which carer variables are associated with carer burden in each country. METHODS Data of 138 participants (69 dyads of carers-patients) from India and Australia (India, n=31; Australia, n=38). Carer burden was assessed with the short Zarit Burden Inventory; carer depression, anxiety and stress were measured with the Depression, Anxiety and Stress-21. Dementia severity was determined with the Frontotemporal Dementia Rating Scale (FTD-FRS), and a range of demographic variables regarding the carer and patient were also obtained. RESULTS Overall, levels of carer burden were not significantly different across India and Australia, despite more hours delivering care and higher dementia severity in India. Variables associated with burden, however, differed between countries, with carer depression, anxiety and stress strongly associated with burden in India. By contrast, depression, stress, and dementia severity were associated with burden in Australia. CONCLUSION This study demonstrated that variables associated with carer burden in FTD differ between cultures. Consequently, cultural considerations should be taken into account when planning for interventions to reduce burden. This study suggests that addressing carers' skills and coping mechanisms are likely to result in more efficacious outcomes than targeting patient symptoms alone. PMID:29213826

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

    DEFF Research Database (Denmark)

    Lau, C.; Toft, U.; Tetens, Inge

    2006-01-01

    Background: The few studies examining the potential associations between glycemic index (GI), glycemic load (GL), and body mass index (BMI) have provided no clear pictures. Underreporting of energy intake may be one explanation for this. Objective: We examined the associations between GI, GL...... a positive association between GI, GL, and BMI. Energy adjustment and the exclusion of LERs significantly affected the results of the analysis; thus, we stress the importance of energy adjustment....

  12. Acute effect of meal glycemic index and glycemic load on blood glucose and insulin responses in humans

    Directory of Open Access Journals (Sweden)

    Díaz Erik

    2006-09-01

    Full Text Available Abstract Objective Foods with contrasting glycemic index when incorporated into a meal, are able to differentially modify glycemia and insulinemia. However, little is known about whether this is dependent on the size of the meal. The purposes of this study were: i to determine if the differential impact on blood glucose and insulin responses induced by contrasting GI foods is similar when provided in meals of different sizes, and; ii to determine the relationship between the total meal glycemic load and the observed serum glucose and insulin responses. Methods Twelve obese women (BMI 33.7 ± 2.4 kg/m2 were recruited. Subjects received 4 different meals in random order. Two meals had a low glycemic index (40–43% and two had a high-glycemic index (86–91%. Both meal types were given as two meal sizes with energy supply corresponding to 23% and 49% of predicted basal metabolic rate. Thus, meals with three different glycemic loads (95, 45–48 and 22 g were administered. Blood samples were taken before and after each meal to determine glucose, free-fatty acids, insulin and glucagon concentrations over a 5-h period. Results An almost 2-fold higher serum glucose and insulin incremental area under the curve (AUC over 2 h for the high- versus low-glycemic index same sized meals was observed (p Conclusion This study showed that foods of contrasting glycemic index induced a proportionally comparable difference in serum insulin response when provided in both small and large meals. The same was true for the serum glucose response but only in large meals. Glycemic load was useful in predicting the acute impact on blood glucose and insulin responses within the context of mixed meals.

  13. Baseline OCT measurements in the idiopathic intracranial hypertension treatment trial, part I: quality control, comparisons, and variability.

    Science.gov (United States)

    Auinger, Peggy; Durbin, Mary; Feldon, Steven; Garvin, Mona; Kardon, Randy; Keltner, John; Kupersmith, Mark; Sibony, Patrick; Plumb, Kim; Wang, Jui-Kai; Werner, John S

    2014-11-04

    Optical coherence tomography (OCT) has been used to investigate papilledema in single-site, mostly retrospective studies. We investigated whether spectral-domain OCT (SD-OCT), which provides thickness and volume measurements of the optic nerve head and retina, could reliably demonstrate structural changes due to papilledema in a prospective multisite clinical trial setting. At entry, 126 subjects in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) with mild visual field loss had optic disc and macular scans, using the Cirrus SD-OCT. Images were analyzed by using the proprietary commercial and custom 3D-segmentation algorithms to calculate retinal nerve fiber layer (RNFL), total retinal thickness (TRT), optic nerve head volume (ONHV), and retinal ganglion cell layer (GCL) thickness. We evaluated variability, with interocular comparison and correlation between results for both methods. The average RNFL thickness > 95% of normal controls in 90% of eyes and the RNFL, TRT, ONH height, and ONHV showed strong (r > 0.8) correlations for interocular comparisons. Variability for repeated testing of OCT parameters was low for both methods and intraclass correlations > 0.9 except for the proprietary GCL thickness. The proprietary algorithm-derived RNFL, TRT, and GCL thickness measurements had failure rates of 10%, 16%, and 20% for all eyes respectively, which were uncommon with 3D-segmentation-derived measurements. Only 7% of eyes had GCL thinning that was less than fifth percentile of normal age-matched control eyes by both methods. Spectral-domain OCT provides reliable continuous variables and quantified assessment of structural alterations due to papilledema. (ClinicalTrials.gov number, NCT01003639.). Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  14. Quantitative Comparison of the Variability in Observed and Simulated Shortwave Reflectance

    Science.gov (United States)

    Roberts, Yolanda, L.; Pilewskie, P.; Kindel, B. C.; Feldman, D. R.; Collins, W. D.

    2013-01-01

    The Climate Absolute Radiance and Refractivity Observatory (CLARREO) is a climate observation system that has been designed to monitor the Earth's climate with unprecedented absolute radiometric accuracy and SI traceability. Climate Observation System Simulation Experiments (OSSEs) have been generated to simulate CLARREO hyperspectral shortwave imager measurements to help define the measurement characteristics needed for CLARREO to achieve its objectives. To evaluate how well the OSSE-simulated reflectance spectra reproduce the Earth s climate variability at the beginning of the 21st century, we compared the variability of the OSSE reflectance spectra to that of the reflectance spectra measured by the Scanning Imaging Absorption Spectrometer for Atmospheric Cartography (SCIAMACHY). Principal component analysis (PCA) is a multivariate decomposition technique used to represent and study the variability of hyperspectral radiation measurements. Using PCA, between 99.7%and 99.9%of the total variance the OSSE and SCIAMACHY data sets can be explained by subspaces defined by six principal components (PCs). To quantify how much information is shared between the simulated and observed data sets, we spectrally decomposed the intersection of the two data set subspaces. The results from four cases in 2004 showed that the two data sets share eight (January and October) and seven (April and July) dimensions, which correspond to about 99.9% of the total SCIAMACHY variance for each month. The spectral nature of these shared spaces, understood by examining the transformed eigenvectors calculated from the subspace intersections, exhibit similar physical characteristics to the original PCs calculated from each data set, such as water vapor absorption, vegetation reflectance, and cloud reflectance.

  15. Quantitative comparison of the variability in observed and simulated shortwave reflectance

    Directory of Open Access Journals (Sweden)

    Y. L. Roberts

    2013-03-01

    Full Text Available The Climate Absolute Radiance and Refractivity Observatory (CLARREO is a climate observation system that has been designed to monitor the Earth's climate with unprecedented absolute radiometric accuracy and SI traceability. Climate Observation System Simulation Experiments (OSSEs have been generated to simulate CLARREO hyperspectral shortwave imager measurements to help define the measurement characteristics needed for CLARREO to achieve its objectives. To evaluate how well the OSSE-simulated reflectance spectra reproduce the Earth's climate variability at the beginning of the 21st century, we compared the variability of the OSSE reflectance spectra to that of the reflectance spectra measured by the Scanning Imaging Absorption Spectrometer for Atmospheric Cartography (SCIAMACHY. Principal component analysis (PCA is a multivariate decomposition technique used to represent and study the variability of hyperspectral radiation measurements. Using PCA, between 99.7% and 99.9% of the total variance the OSSE and SCIAMACHY data sets can be explained by subspaces defined by six principal components (PCs. To quantify how much information is shared between the simulated and observed data sets, we spectrally decomposed the intersection of the two data set subspaces. The results from four cases in 2004 showed that the two data sets share eight (January and October and seven (April and July dimensions, which correspond to about 99.9% of the total SCIAMACHY variance for each month. The spectral nature of these shared spaces, understood by examining the transformed eigenvectors calculated from the subspace intersections, exhibit similar physical characteristics to the original PCs calculated from each data set, such as water vapor absorption, vegetation reflectance, and cloud reflectance.

  16. State of the art vs biological variability: Comparison on hematology parameters using Spanish EQAS data.

    Science.gov (United States)

    Molina, A; Guiñon, L; Perez, A; Segurana, A; Bedini, J L; Reverter, J C; Merino, A

    2018-02-05

    It is important for clinical laboratories to maintain under control the possible sources of error in its analytical determinations. The objective of this work is to perform an analysis of the total error committed by laboratories using the data extracted from the Spanish External Quality Assessment Program in Hematology and to compare them with the specifications based on the biological variability proposed by the Ricós group. We analyzed a total of 3 89 000 results during the period 2015-2016 from the following quantitative schemes of Spanish External Quality Assessment Program: complete blood count, blood coagulation tests, differential leukocyte count, reticulocytes, hemoglobin A 2 , antithrombin, factor VIII, protein C, and von Willebrand factor. It has been considered as an indicator of the current performance the value of total error that 90% of laboratories are able to achieve, taking into account 75% of their results. We found some magnitudes whose biological variability specifications are achievable by most of the laboratories for either minimum, desirable, or optimum criteria: white blood cells, red blood cells, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, platelets, fibrinogen, neutrophils, lymphocytes, eosinophils, von Willebrand factor, and protein C. However, current performance for mean corpuscular hemoglobin concentration and hemoglobin A 2 only allows to meet the specifications based on the state of the art. Our results reflect the feasibility of establishing specifications based on biological variability criteria or the state of the art, which may help to select the proper criteria for each parameter. © 2018 John Wiley & Sons Ltd.

  17. Comparison between genomic predictions using daughter yield deviation and conventional estimated breeding value as response variables

    DEFF Research Database (Denmark)

    Guo, Gang; Lund, Mogens Sandø; Zhang, Y

    2010-01-01

    This study compared genomic predictions using conventional estimated breeding values (EBV) and daughter yield deviations (DYD) as response variables based on simulated data. Eight scenarios were simulated in regard to heritability (0.05 and 0.30), number of daughters per sire (30, 100, and unequal...... genotype. Moreover, the results showed that the correlation between GEBV and conventional parent average (PA) was lower (corresponding to a relatively larger gain by including PA) when using the DYD approach than when using the EBV approach. Consequently, the two approaches led to similar reliability...

  18. Performance comparison of control schemes for variable-speed wind turbines

    Science.gov (United States)

    Bottasso, C. L.; Croce, A.; Savini, B.

    2007-07-01

    We analyze the performance of different control schemes when applied to the regulation problem of a variable-speed representative wind turbine. In particular, we formulate and compare a wind-scheduled PID, a LQR controller and a novel adaptive non-linear model predictive controller, equipped with observers of the tower states and wind. The simulations include gusts and turbulent winds of varying intensity in nominal as well as off-design operating conditions. The experiments highlight the possible advantages of model-based non-linear control strategies.

  19. Performance comparison of control schemes for variable-speed wind turbines

    International Nuclear Information System (INIS)

    Bottasso, C L; Croce, A; Savini, B

    2007-01-01

    We analyze the performance of different control schemes when applied to the regulation problem of a variable-speed representative wind turbine. In particular, we formulate and compare a wind-scheduled PID, a LQR controller and a novel adaptive non-linear model predictive controller, equipped with observers of the tower states and wind. The simulations include gusts and turbulent winds of varying intensity in nominal as well as off-design operating conditions. The experiments highlight the possible advantages of model-based non-linear control strategies

  20. Factors associated with glycemic control in people with diabetes at the Family Health Strategy in Pernambuco.

    Science.gov (United States)

    Lima, Rodrigo Fonseca; Fontbonne, Annick; Carvalho, Eduardo Maia Freese de; Montarroyos, Ulisses Ramos; Barreto, Maria Nelly Sobreira de Carvalho; Cesse, Eduarda Ângela Pessoa

    2016-01-01

    Identifying factors associated with glycemic control in people with type 2 Diabetes Mellitus (DM) registered in the Family Health Strategy (FHS) in Pernambuco, Brazil. Associations between glycemic control (glycosylated hemoglobin A lower or equal to 7%) presented by people with DM and variables related to sociodemographic conditions, lifestyle, characteristics of diabetes, treatment and follow-up of patients by health services were investigated by multiple regression. More than 65% of the participants presented inadequate glycemic control, especially those with lower age, longer illness duration, more annual contacts with FHS and complex therapeutic regimen. People with DM without referrals to specialists presented greater glycemic control. Associations with education level and obesity did not remain significant in the multivariate model. The evolution of diabetes hinders adequate control, however, attention to younger people with DM and referrals to specialists are factors that can improve glycemic control. Identificar fatores associados ao controle glicêmico em pessoas com Diabetes Mellitus (DM) tipo 2 cadastradas na Estratégia Saúde da Família (ESF) em Pernambuco, Brasil. Foram investigadas, por regressão múltipla, as associações entre o controle glicêmico (hemoglobina A glicosilada menor ou maior ou igual a 7%) apresentado pelas pessoas com DM e variáveis relacionadas com condições sociodemográficas, hábitos de vida, características do diabetes, de seu tratamento e acompanhamento dos pacientes pelos serviços de saúde. Mais de 65% dos participantes apresentaram controle glicêmico inadequado, principalmente aqueles com idade menor, duração da doença mais longa, mais contatos anuais com a ESF e regime terapêutico complexo. Pessoas com DM sem encaminhamentos para especialistas apresentaram um maior descontrole glicêmico. Associações com escolaridade e obesidade não permaneceram significativas no modelo multivariado. A evolução do

  1. Ozone Temporal Variability in the Subarctic Region: Comparison of Satellite Measurements with Numerical Simulations

    Science.gov (United States)

    Shved, G. M.; Virolainen, Ya. A.; Timofeyev, Yu. M.; Ermolenko, S. I.; Smyshlyaev, S. P.; Motsakov, M. A.; Kirner, O.

    2018-01-01

    Fourier and wavelet spectra of time series for the ozone column abundance in the atmospheric 0-25 and 25-60 km layers are analyzed from SBUV satellite observations and from numerical simulations based on the RSHU and EMAC models. The analysis uses datasets for three subarctic locations (St. Petersburg, Harestua, and Kiruna) for 2000-2014. The Fourier and wavelet spectra show periodicities in the range from 10 days to 10 years and from 1 day to 2 years, respectively. The comparison of the spectra shows overall agreement between the observational and modeled datasets. However, the analysis has revealed differences both between the measurements and the models and between the models themselves. The differences primarily concern the Rossby wave period region and the 11-year and semiannual periodicities. Possible reasons are given for the differences between the models and the measurements.

  2. Interannual Variabilities in High Cloud Cover from AIRS Data and Comparison to Climate Models

    Science.gov (United States)

    Li, K. F.; Mak, S. N.; Chang, T. M.; Antilla, K.; Su, H.; Wong, S.; Jiang, J. H.; Yung, Y. L.

    2015-12-01

    The Atmospheric Infrared Sounder (AIRS) has been providing high quality data of global high cloud distribution since 2003. We identify the dominant modes of variabilities and associated spatial patterns, and relate them to sea surface temperature (SST). The first two empirical orthogonal functions (EOFs) are highly correlated to the El Niño-Southern Oscillation (ENSO) — including both EP-ENSO (canonical ENSO) and CP-ENSO (ENSO Modoki). These modes are compared with those obtained using the CloudSat data. The same EOF analysis is applied to simulations from 20 AMIP5 models. In general, the models are able to simulate the first EOF, the EP-ENSO, in the data. However, only about half of the AMIP5 models could realistically reproduce the second EOF, the CP-ENSO. Improved understanding of high cloud variabilities will advance climate model simulations and facilitate more accurate predictions of future climate, specifically the climate response to increasing greenhouse gases such as carbon dioxide.

  3. Effect of glycemic index on obesity control.

    Science.gov (United States)

    Pereira, Elisângela Vitoriano; Costa, Jorge de Assis; Alfenas, Rita de Cássia Gonçalves

    2015-06-01

    Evaluate the effect of glycemic index (GI) on biochemical parameters, food intake, energy metabolism, anthropometric measures and body composition in overweight subjects. Simple blind study, in which nineteen subjects were randomly assigned to consume in the laboratory two daily low GI (n = 10) or high GI (n = 9) meals, for forty-five consecutive days. Habitual food intake was assessed at baseline. Food intake, anthropometric measures and body composition were assessed at each 15 days. Energy metabolism and biochemical parameters were evaluated at baseline and the end of the study. Low GI meals increased fat oxidation, and reduced waist circumference and HOMA-IR, while high GI meals increased daily dietary fiber and energy intake compared to baseline. There was a higher reduction on waist circumference and body fat, and a higher increase on postprandial fat oxidation in response to the LGI meals than after high GI meals. High GI meals increased fasting respiratory coefficient compared to baseline and low GI meals. The results of the present study showed that the consumption of two daily low GI meals for forty-five consecutive days has a positive effect on obesity control, whereas, the consumption of high GI meals result has the opposite effect.

  4. Variable selection methods in PLS regression - a comparison study on metabolomics data

    DEFF Research Database (Denmark)

    Karaman, İbrahim; Hedemann, Mette Skou; Knudsen, Knud Erik Bach

    Partial least squares regression (PLSR) has been applied to various fields such as psychometrics, consumer science, econometrics and process control. Recently it has been applied to metabolomics based data sets (GC/LC-MS, NMR) and proven to be a very powerful in situations with many variables...... for the purpose of reducing over-fitting problems and providing useful interpretation tools. It has excellent possibilities for giving a graphical overview of sample and variation patterns. It can handle co-linearity in an efficient way and make it possible to use different highly correlated data sets in one...... Integrating Omics data. Statistical Applications in Genetics and Molecular Biology, 7:Article 35, 2008. 2. Martens H and Martens M. Modifed Jack-knife estimation of parameter uncertainty in bilinear modelling by partial least squares regression (PLSR). Food Quality and Preference, 11:5-16, 2000....

  5. Recent and Past Musical Activity Predicts Cognitive Aging Variability: Direct Comparison with Leisure Activities

    Directory of Open Access Journals (Sweden)

    Brenda eHanna-Pladdy

    2012-07-01

    Full Text Available Studies evaluating the impact of modifiable lifestyle factors on cognition offer potential insights into sources of cognitive aging variability. Recently, we reported an association between extent of musical instrumental practice throughout the life span (greater than 10 years on preserved cognitive functioning in advanced age . These findings raise the question of whether there are training-induced brain changes in musicians that can transfer to nonmusical cognitive abilities to allow for compensation of age-related cognitive declines. However, because of the relationship between engagement in lifestyle activities and preserved cognition, it remains unclear whether these findings are specifically driven by musical training or the types of individuals likely to engage in greater activities in general. The current study examined the type of leisure activity (musical versus other as well as the timing of engagement (age of acquisition, past versus recent in predictive models of successful cognitive aging. Seventy age and education matched older musicians (> 10 years and nonmusicians (ages 59-80 were evaluated on neuropsychological tests and life-style activities (AAP. Partition analyses were conducted on significant cognitive measures to explain performance variance in musicians. Musicians scored higher on tests of phonemic fluency, verbal immediate recall, judgment of line orientation (JLO, and Letter Number Sequencing (LNS, but not the AAP. The first partition analysis revealed education best predicted JLO in musicians, followed by recent musical engagement which offset low education. In the second partition analysis, early age of musical acquisition (< 9 years predicted enhanced LNS in musicians, while analyses for AAP, verbal recall and fluency were not predictive. Recent and past musical activity, but not leisure activity, predicted variability across verbal and visuospatial domains in aging. Early musical acquisition predicted auditory

  6. Recent and past musical activity predicts cognitive aging variability: direct comparison with general lifestyle activities.

    Science.gov (United States)

    Hanna-Pladdy, Brenda; Gajewski, Byron

    2012-01-01

    Studies evaluating the impact of modifiable lifestyle factors on cognition offer potential insights into sources of cognitive aging variability. Recently, we reported an association between extent of musical instrumental practice throughout the life span (greater than 10 years) on preserved cognitive functioning in advanced age. These findings raise the question of whether there are training-induced brain changes in musicians that can transfer to non-musical cognitive abilities to allow for compensation of age-related cognitive declines. However, because of the relationship between engagement in general lifestyle activities and preserved cognition, it remains unclear whether these findings are specifically driven by musical training or the types of individuals likely to engage in greater activities in general. The current study controlled for general activity level in evaluating cognition between musicians and nomusicians. Also, the timing of engagement (age of acquisition, past versus recent) was assessed in predictive models of successful cognitive aging. Seventy age and education matched older musicians (>10 years) and non-musicians (ages 59-80) were evaluated on neuropsychological tests and general lifestyle activities. Musicians scored higher on tests of phonemic fluency, verbal working memory, verbal immediate recall, visuospatial judgment, and motor dexterity, but did not differ in other general leisure activities. Partition analyses were conducted on significant cognitive measures to determine aspects of musical training predictive of enhanced cognition. The first partition analysis revealed education best predicted visuospatial functions in musicians, followed by recent musical engagement which offset low education. In the second partition analysis, early age of musical acquisition (memory in musicians, while analyses for other measures were not predictive. Recent and past musical activity, but not general lifestyle activities, predicted variability

  7. A comparison of two total contact cast constructs with variable body mass.

    Science.gov (United States)

    Pirozzi, Kelly; McGuire, James; Meyr, Andrew J

    2014-07-01

    There is a growing body of evidence implicating obesity as having a negative effect on the development and treatment of diabetic foot disease. The aim of this study was to increase the body of knowledge on the effects of obesity on foot function, specifically as it relates to peak plantar pressures in the total contact cast (TCC). Our investigational objectives were to compare the effect of two different TCC designs on mean peak plantar pressures, and to evaluate the efficacy of two TCC constructs with increasing body mass. The primary outcome measure was mean peak plantar pressure in the heel, midfoot, forefoot and first metatarsal as measured with an in-shoe pressure measurement system. The variables were patient weight (from 'normal' body mass index (BMI) to 'overweight', 'obese' and 'morbidly obese') and the TCC construct (with both a standard and alternate cast design). The standard TCC is considered the gold standard for off-loading of the diabetic foot. The alternate TCC was designed to use the essential offloading component of the traditional TCC, namely the total contact leg section, with use of an open cell polyurethane foam to transfer load from the foot to the lower leg, thereby offloading the foot by suspending it within a padded fiberglass walking cast. We did not observe statistically significant differences in mean peak plantar pressures in any plantar foot anatomic area or with any body mass between the two TCC designs. Based on the results, we concluded that the alternate TCC design provides another viable TCC construct option for practitioners working with the neuropathic foot. This investigation also provides specific data on changes that occur in peak plantar pressures with use of the total contact cast and variable BMIs. none.

  8. New York State: Comparison of Treatment Outcomes for Unruptured Cerebral Aneurysms Using an Instrumental Variable Analysis.

    Science.gov (United States)

    Bekelis, Kimon; Missios, Symeon; Coy, Shannon; Singer, Robert J; MacKenzie, Todd A

    2015-07-13

    There is wide regional variation in the predominant treatment for unruptured cerebral aneurysms. We investigated the association of elective surgical clipping and endovascular coiling with mortality, readmission rate, length of stay, and discharge to rehabilitation. We performed a cohort study involving patients with unruptured cerebral aneurysms, who underwent surgical clipping or endovascular coiling from 2009 to 2013 and were registered in the Statewide Planning and Research Cooperative System database. An instrumental variable analysis was used to investigate the association of treatment technique with outcomes. Of the 4643 patients undergoing treatment, 3190 (68.7%) underwent coiling, and 1453 (31.3%) underwent clipping. Using an instrumental variable analysis, we did not identify a difference in inpatient mortality (marginal effect, 0.13; 95% CI, -0.30, 0.57), or the rate of 30-day readmission (marginal effect, -1.84; 95% CI -4.06, -0.37) between the 2 treatment techniques for patients with unruptured cerebral aneurysms. Clipping was associated with a higher rate of discharge to rehabilitation (marginal effect, 2.31; 95% CI 0.21, 4.41), and longer length of stay (β, 2.01; 95% CI 0.85, 3.04). In sensitivity analysis, mixed-effect regression, and propensity score, adjusted regression models demonstrated identical results. Using a comprehensive all-payer cohort of patients in New York State with unruptured cerebral aneurysms, we did not identify an association of treatment method with mortality or 30-day readmission. Clipping was associated with a higher rate of discharge to rehabilitation and longer length of stay. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  9. Glycemic control in diabetes in three Danish counties.

    Science.gov (United States)

    Jørgensen, Lone G M; Petersen, Per Hyltoft; Heickendorff, Lene; Møller, Holger Jon; Hendel, Jørn; Christensen, Cramer; Schmitz, Anita; Reinholdt, Birgitte; Lund, Erik D; Christensen, Niels J; Hansen, Erik Kjaersgaard; Hastrup, Jens; Skjødt, Hanne; Eriksen, Ebbe Wendel; Brandslund, Ivan

    2005-01-01

    Hemoglobin A1c (HbA1c) is a proxy measure for glycemic control in diabetes. We investigated the trend for glycemic control in patients from three Danish counties using HbA1c measurements. We studied 2454 patients from a population of 807,000 inhabitants for whom routine monitoring of diabetes using HbA1c-DCCT aligned was initiated in 2001. We estimated the incidence of monitored patients in the population. The progress in patients with originally diabetic HbA1c levels was investigated by cumulative probability plots, and the individual trend in clinical outcome was investigated by a modified difference plot. The age-standardized incidence of monitored patients was or=6.62% HbA1c) showed on average 15% improved glycemic control in the first year. Further improvement was limited. The overall percentage above the treatment target (>or=6.62% HbA1c) was 51% in 2003 compared to 59% in 2001, and the percentage with poor glycemic control (>or=10.0% HbA1c) was reduced from 19% to 4%. Of patients with originally diabetic HbA1c levels, 15% showed progress in glycemic control, and 28% reached treatment targets. In patients with originally normal HbA1c, 75% showed an upward trend in HbA1c levels, which reached diabetic concentrations in 17%. Patients with diabetic first HbA1c concentrations (>or=6.62% HbA1c) showed on average 15% improved glycemic control in the first year. Further improvement was limited. In individual patients, 75% with originally diabetic HbA1c levels showed improved glycemic control after 3 years, while 78% with originally normal concentrations showed an upward trend in HbA1c levels.

  10. Glycemic index and glycemic load in the Opuntia ficus-indica fruit

    Science.gov (United States)

    Ibarra-Salas, María de Jesús; Novelo-Huerta, Hilda Irene; De León-Salas, Marcela Alejandra; Sánchez-Murillo, Mayra Elisa; Mata-Obregón, María Del Carmen; Garza-Juárez, Aurora de Jesús

    2017-01-01

    There is evidence that support the clinical usage of glycemic index (GI) and glycemic load (GL) in the prevention of chronic disease. To determine the GI and GL of the Opuntia ficus-indica fruit. An analytic, transversal study was made involving 25 healthy volunteers accepted by an informed consent with a normal body mass index, glucose, glycoside hemoglobin, cholesterol and serum triglycerides. The homogeneity of the population was evaluated with anthropometrical and biochemical data using principal component analysis (PCA). The equivalent of 50 g of carbohydrates test food (tuna) and 50 g of dextrose as food standard was provided for the measure of the glucose curve. The GI was determined by calculating the area under the curve by the triangulation method. The CG was reported as the product of IG by carbohydrate loading provided. The IG of the tuna was 48.01 ± 17.4, classified as low, while the CG was 24.0 ± 8.7 rated as high. The chemometric analysis by PCA showed that the selection of the normal population for determining the IG, it is important to consider the values of cholesterol and triglycerides. Copyright: © 2017 SecretarÍa de Salud

  11. Endotoxin exposure in sewage treatment workers: investigation of exposure variability and comparison of analytical techniques.

    Science.gov (United States)

    Spaan, Suzanne; Smit, Lidwien A M; Eduard, Wijnand; Larsson, Lennart; Arts, Huib J J M; Wouters, Inge M; Heederik, Dick J J

    2008-01-01

    Objectives were to give an overview of endotoxin exposure and its determinants in sewage treatment workers, and to study exposure to culturable and non-culturable microorganisms and the applicability of the LAL assay in this work environment. In 43 Dutch sewage treatment plants 470 full-shift, 123 task-based personal and 54 stationary inhalable dust samples were collected. Endotoxin concentration was determined with the LAL-assay. Mixed effects models were used to investigate possible determinants of exposure. Simultaneous parallel filter samples, impinger samples and viable total bacteria and Gram-negative bacterial samples were taken to compare analytical techniques. Filter and impinger samples were analyzed with the LAL-assay, gas chromatography-mass spectrometry (GC-MS) and fluorescence microscopy. Endotoxin exposure levels were moderate to low (geometric mean personal exposure 27 EU/m(3), stationary 33 EU/m(3), task-based 64 EU/m(3)), yet differences between jobs and sources and some determinants of exposure were identified. Exposure varied more from day to day than between workers. Concentrations in filter samples were higher and more consistent than in impinger samples. Fungi and Gram-positive bacteria were found in higher levels than Gram-negative bacteria. The LAL assay and GC-MS showed comparable endotoxin levels. Endotoxin exposure in Dutch sewage treatment workers was relatively low. Comparison of sampling and analytical techniques suggests that the LAL-assay did not result in much exposure misclassification. It thus seems justified to perform filter measurements in combination with the LAL-assay to measure endotoxin exposure in sewage treatment plants.

  12. Time-variable gravity potential components for optical clock comparisons and the definition of international time scales

    Science.gov (United States)

    Voigt, C.; Denker, H.; Timmen, L.

    2016-12-01

    The latest generation of optical atomic clocks is approaching the level of one part in 1018 in terms of frequency stability and uncertainty. For clock comparisons and the definition of international time scales, a relativistic redshift effect of the clock frequencies has to be taken into account at a corresponding uncertainty level of about 0.1 m2 s-2 and 0.01 m in terms of gravity potential and height, respectively. Besides the predominant static part of the gravity potential, temporal variations must be considered in order to avoid systematic frequency shifts. Time-variable gravity potential components induced by tides and non-tidal mass redistributions are investigated with regard to the level of one part in 1018. The magnitudes and dominant time periods of the individual gravity potential contributions are investigated globally and for specific laboratory sites together with the related uncertainty estimates. The basics of the computation methods are presented along with the applied models, data sets and software. Solid Earth tides contribute by far the most dominant signal with a global maximum amplitude of 4.2 m2 s-2 for the potential and a range (maximum-to-minimum) of up to 1.3 and 10.0 m2 s-2 in terms of potential differences between specific laboratories over continental and intercontinental scales, respectively. Amplitudes of the ocean tidal loading potential can amount up to 1.25 m2 s-2, while the range of the potential between specific laboratories is 0.3 and 1.1 m2 s-2 over continental and intercontinental scales, respectively. These are the only two contributors being relevant at a 10-17 level. However, several other time-variable potential effects can particularly affect clock comparisons at the 10-18 level. Besides solid Earth pole tides, these are non-tidal mass redistributions in the atmosphere, the oceans and the continental water storage.

  13. Variability in the results of inr (international normalized ratio: a comparison of six commercial thromboplastin brands

    Directory of Open Access Journals (Sweden)

    Fernanda Daniela Serralvo

    2015-05-01

    Full Text Available Introduction: The efficacy and safety in treatment with oral anticoagulants are dependent on the monitoring of the effect of anticoagulants by the prothrombin time (PT. The system INR (International Normalized Ratio was developed to minimize the variability in the PT, mainly because of the thromboplastin reagent used. Objective: Compare the results of INR employing six thromboplastins and plasmas of patients using oral anticoagulants. Materials and Methods: For this study, 96 patients using oral anticoagulants and that had TP collected for monitoring anticoagulants were selected randomly. INR values were determined using six commercially available thromboplastin brands. Results and Discussion: Of the 96 patients, 29 were with the INR between 2 and 3 when used reagents Dade-Behring®, Human do Brasil® and Diagnostica Stago®. Regardless of the range of INR, the results obtained with the reagent Labtest® were statistically different from the Dade-Behring®, from Diagnostica Stago®, Trinity Biotech and Bios Diagnostica®. With INR between 2 and 3 only differences were observed between the results of brands and Bios Diagnostica® Labtest®. With INR above 3, the results of Labtest® were different from the Dade-Behring®, from Diagnostica Stago®, Trinity Biotech® and Bios Diagnostica®. Conclusion: Despite the establishment of INR, there are still significant differences in INR results depending on the thromboplastin brand used, which can interfere with the therapeutic approach in relation to oral anticoagulants.

  14. Postexercise heart rate variability following treadmill and cycle exercise: a comparison study.

    Science.gov (United States)

    Esco, Michael R; Flatt, Andrew A; Williford, Henry N

    2017-05-01

    The purpose of this study was to compare postexercise heart rate variability (HRV) immediately following acute bouts of treadmill (T) and cycle (C) exercise at 65% of mode-specific maximal oxygen consumption reserve (65% VO 2 R). Fourteen apparently healthy men participated in this study. On two separate and randomized days, each participant performed 30 min of exercise at 65% VO 2 R on T and C. Supine HRV was evaluated as normalized and log-transformed (ln) high-frequency (HF) and low-frequency (LF) spectral power, as well as the LF:HF ratio in 5-min segments immediately before (PRE) and at 10-15 min (POST1) and 25-30 min (POST2) following each exercise bout. There were no significant differences in the HRV values at PRE between the modalities. Following each exercise bout, lnHF was significantly lower at POST2 following C compared to T. In addition, lnLF and LF:HF were significantly higher at POST1 and POST2 following C compared to T. All HRV metrics returned towards baseline 30 min following T but remained significantly different than PRE values after C. These results suggest that following exercise at 65% of mode-specific VO 2 R, C is associated with a greater delay of postexercise HRV recovery than T in apparently healthy men. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  15. Comparison of insight and clinical variables in homeless and non-homeless psychiatric inpatients in China.

    Science.gov (United States)

    Fu, Yan-Nan; Cao, Xiao-Lan; Hou, Cai-Lan; Ng, Chee H; Ungvari, Gabor S; Chiu, Helen F K; Lin, Yong-Qiang; Wang, Lihui; Zheng, Xiaocong; Jia, Fu-Jun; Xiang, Yu-Tao

    2017-09-01

    There are no published data on insight in homeless patients with psychiatric disorders in China. This study examined insight in homeless and non-homeless Chinese psychiatric inpatients in relation to demographic and clinical variables. A total of 278 homeless and 222 non-homeless inpatients matched in age and gender were included in the study. Demographic and clinical characteristics were collected based on a review of medical charts and a clinical interview with standardized instruments. Insight was evaluated with the Insight and Treatment Attitudes Questionnaire. Altogether 20.5% of homeless inpatients and 43.7% of the non-homeless controls had good insight. Compared with homeless inpatients with impaired insight, homeless inpatients with good insight had higher physical quality of life, longer duration of illness and less severe positive and negative symptoms. Impaired insight appeared more common in homeless psychiatric inpatients in China. Further studies should address the need for effective therapeutic interventions that promote homeless patients' insight. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  16. Comparison of Three Plot Selection Methods for Estimating Change in Temporally Variable, Spatially Clustered Populations.

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, William L. [Bonneville Power Administration, Portland, OR (US). Environment, Fish and Wildlife

    2001-07-01

    Monitoring population numbers is important for assessing trends and meeting various legislative mandates. However, sampling across time introduces a temporal aspect to survey design in addition to the spatial one. For instance, a sample that is initially representative may lose this attribute if there is a shift in numbers and/or spatial distribution in the underlying population that is not reflected in later sampled plots. Plot selection methods that account for this temporal variability will produce the best trend estimates. Consequently, I used simulation to compare bias and relative precision of estimates of population change among stratified and unstratified sampling designs based on permanent, temporary, and partial replacement plots under varying levels of spatial clustering, density, and temporal shifting of populations. Permanent plots produced more precise estimates of change than temporary plots across all factors. Further, permanent plots performed better than partial replacement plots except for high density (5 and 10 individuals per plot) and 25% - 50% shifts in the population. Stratified designs always produced less precise estimates of population change for all three plot selection methods, and often produced biased change estimates and greatly inflated variance estimates under sampling with partial replacement. Hence, stratification that remains fixed across time should be avoided when monitoring populations that are likely to exhibit large changes in numbers and/or spatial distribution during the study period. Key words: bias; change estimation; monitoring; permanent plots; relative precision; sampling with partial replacement; temporary plots.

  17. Comparison of Cephalometric Variables in Non-obese and Obese Patients with Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Önder Öztürk

    2011-09-01

    Full Text Available Objective: To compare the cephalometric variables of obese (body mass index (BMI ≥30 and non-obese (BMI<30 Turkish male patients with obstructive sleep apnea syndrome (OSAS. Materials and Methods: OSAS diagnosed 85 patients who were obese [n=37; mean age (±SE, 49.41±1.54 year] and non-obese [n=48; mean age (±SE 46.92±1.39 year] were included in the study. The cephalometric measurements and polysomnographic data of the patients were compared and a discriminatory analysis was performed.Results: The apnea-hypopnea index (AHI was significantly higher in obese patients (p<0.01. Bimaxillary protrusion was found in obese patients (p<0.05. The non-obese patients with AHI ≥ 30 had an increased mandibular plane angle In the stepwise discriminant analysis done separately in obese and non-obese patients according to AHI; only the hyoid bone position was included in the model in obese patients and the estimated success of discrimination of AHI’s level (<30 and ≥30 was 70.3%. Age, anterior face and posterior face height were included to the model in non-obese patients and the estimated success of discrimination was found as 79.2%. Conclusion: Craniofacial morphology has an effect on the severity of OSAS. If the craniofacial morphology tends toward a worsening of OSAS with obesity, the severity of the OSAS increases.

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

    Science.gov (United States)

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

    1991-01-01

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

  19. Comparison of body condition score and urinalysis variables between dogs with and without calcium oxalate uroliths

    Science.gov (United States)

    Kennedy, Stephanie M.; Lulich, Jody P.; Ritt, Michelle G.; Furrow, Eva

    2017-01-01

    OBJECTIVE To compare body condition score (BCS) and urinalysis variables between dogs with and without calcium oxalate (CaOx) uroliths. DESIGN Case-control study. ANIMALS 46 Miniature Schnauzers, 16 Bichons Frises, and 6 Shih Tzus. PROCEDURES Medical records were reviewed for Miniature Schnauzers, Bichons Frises, and Shih Tzus that were examined between January 2001 and November 2014 for another urolithiasis study or for a urolith removal procedure. Dogs with CaOx uroliths were classified as cases. Dogs without a history of urinary tract disease and with no evidence of radiopaque uroliths on abdominal radiographs were classified as controls. Each case was matched with 1 control on the basis of age (± 2 years), sex, and breed. Body condition score and urinalysis results were compared between cases and controls, and the relationship between BCS and urine pH was analyzed. RESULTS Median BCS was significantly greater for cases than controls, although the proportion of overweight dogs did not differ significantly between the 2 groups. Urine pH was negatively associated with age, but was not associated with BCS or the presence of CaOx uroliths. Cases infrequently had acidic urine or CaOx crystalluria but frequently had hematuria and proteinuria. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dogs with CaOx uroliths had a greater median BCS than control dogs, but the clinical importance of that finding was unclear. Acidic urine and CaOx crystalluria were uncommon and not adequate predictors of CaOx urolith status. Hematuria and proteinuria were commonly observed in dogs with CaOx urolithiasis, but they are not pathognomonic for that condition. PMID:27875079

  20. Phenotypic variability in Angelman syndrome: comparison among different deletion classes and between deletion and UPD subjects.

    Science.gov (United States)

    Varela, Monica Castro; Kok, Fernando; Otto, Paulo Alberto; Koiffmann, Celia Priszkulnik

    2004-12-01

    Angelman syndrome (AS) can result from either a 15q11-q13 deletion (del), paternal uniparental disomy (UPD), imprinting, or UBE3A mutations. Here, we describe the phenotypic and behavioral variability detected in 49 patients with different classes of deletions and nine patients with UPD. Diagnosis was made by methylation pattern analysis of exon 1 of the SNRPN-SNURF gene and by microsatellite profiling of loci within and outside the 15q11-q13 region. There were no major phenotypic differences between the two main classes (BP1-BP3; BP2-BP3) of AS deletion patients, except for the absence of vocalization, more prevalent in patients with BP1-BP3 deletions, and for the age of sitting without support, which was lower in patients with BP2-BP3 deletions. Our data suggest that gene deletions (NIPA1, NIPA2, CYF1P1, GCP5) mapped to the region between breakpoints BP1 and BP2 may be involved in the severity of speech impairment, since all BP1-BP3 deletion patients showed complete absence of vocalization, while 38.1% of the BP2-BP3 deletion patients were able to pronounce syllabic sounds, with doubtful meaning. Compared to UPD patients, deletion patients presented a higher incidence of swallowing disorders (73.9% del x 22.2% UPD) and hypotonia (73.3% del x 28.57% UPD). In addition, children with UPD showed better physical growth, fewer or no seizures, a lower incidence of microcephaly, less ataxia and higher cognitive skills. As a consequence of their milder or less typical phenotype, AS may remain undiagnosed, leading to an overall underdiagnosis of the disease.

  1. Comparison of cardiopulmonary exercise testing variables in COPD patients with and without coronary artery disease.

    Science.gov (United States)

    Thirapatarapong, Wilawan; Armstrong, Hilary F; Bartels, Matthew N

    2014-01-01

    Coronary artery disease (CAD) is a common concomitant condition and an important cause of morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). Since COPD and CAD can both independently cause reduced exercise capacity, it is reasonable to hypothesize that the combination of these diseases may compound the abnormalities observed during cardiopulmonary exercise testing (CPET). However, little is known about the impact of CAD on the CPET response in COPD patients. The aim of this study is to compare exercise capacity and gas exchange variables in COPD patients with and without CAD. Fifty-four COPD subjects without CAD (COPDnoCAD) were matched to 54 COPD subjects diagnosed with CAD (COPD/CAD) according to age, gender, body mass index and severity of COPD. All subjects underwent resting pulmonary function and symptom-limited CPET. Comparing COPDnoCAD patients with COPD/CAD patients revealed that exercise capacity, as measured by % peak oxygen consumption (42 ± 16% vs 53 ± 19%, p = 0.002) and % peak wattage (23 ± 13% vs 32 ± 16%, p = 0.001), was significantly lower in COPD/CAD. Ventilatory response, as measured by VE/VCO2 nadir (36 ± 9 vs 32 ± 5, p = 0.001), was significantly higher in COPD/CAD, with % peak VO2 and VE/VCO2 nadir correlating to % FEV1 and inversely correlating with %DLCO. COPD patients with CAD have significantly impaired CPET responses with lower exercise capacity and impaired gas exchange compared to COPD patients without CAD. These findings may affect the clinical interpretation of CPET data in COPD patients who have concomitant CAD. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Comparison of Metabolomics Approaches for Evaluating the Variability of Complex Botanical Preparations: Green Tea (Camellia sinensis) as a Case Study.

    Science.gov (United States)

    Kellogg, Joshua J; Graf, Tyler N; Paine, Mary F; McCune, Jeannine S; Kvalheim, Olav M; Oberlies, Nicholas H; Cech, Nadja B

    2017-05-26

    A challenge that must be addressed when conducting studies with complex natural products is how to evaluate their complexity and variability. Traditional methods of quantifying a single or a small range of metabolites may not capture the full chemical complexity of multiple samples. Different metabolomics approaches were evaluated to discern how they facilitated comparison of the chemical composition of commercial green tea [Camellia sinensis (L.) Kuntze] products, with the goal of capturing the variability of commercially used products and selecting representative products for in vitro or clinical evaluation. Three metabolomic-related methods-untargeted ultraperformance liquid chromatography-mass spectrometry (UPLC-MS), targeted UPLC-MS, and untargeted, quantitative 1 HNMR-were employed to characterize 34 commercially available green tea samples. Of these methods, untargeted UPLC-MS was most effective at discriminating between green tea, green tea supplement, and non-green-tea products. A method using reproduced correlation coefficients calculated from principal component analysis models was developed to quantitatively compare differences among samples. The obtained results demonstrated the utility of metabolomics employing UPLC-MS data for evaluating similarities and differences between complex botanical products.

  3. [Comparison of self-reported anthropometric variables and real measurement data].

    Science.gov (United States)

    Díaz-García, J; González-Zapata, L I; Estrada-Restrepo, A

    2012-06-01

    The objectives of this study were to evaluate self-reporting of weight, height, and waist circumference, and to compare that perception with the real measurements in college students of the MESPYN cohort--Medellin, Salud Pública y Nutrición--from the University of Antioquia (UdeA), Colombia. A cross-sectional study was conducted starting with the first measurement of the MESPYN Cohort 2009-2010. The sample included volunteer students from different academic areas. Self-perception of weight, height, and waist circumference were recorded before the real measurements were performed. Intraclass correlation coefficients (ICC) were calculated for all the variables, and an alpha of 0.05 was used. The concordance between real measurements and self-referred values was evaluated with the Bland and Altman method. 424 volunteer students were included. The average real weight (kg) in males was 67.4 +/- 10.4 and self-reported: 67.0 +/- 11.0; in females the real value was 55.7 +/- 10.1 and self-reported: 55.0 +/- 9.0. The average real height (m) in males was 1.73 +/- 6.1 and self-reported: 1.73 +/- 6.0; in females the real value was 1.60 +/- 5.9 and self-reported: 1.61 +/- 6.0. In males, the average real waist circumference (cm) was 76.6 +/- 8.0 and self-reported: 75.0 +/- 14.0; in females the real value was 69.9 +/- 8.0 and self-reported: 70.0 +/- 9.0. Weight ICC: 0.956, 95% CI (0.95; 0.97), (p < 0.01); height ICC: 0.953, 95%IC (0.91; 0.97), (p < 0.01), and waist circumference ICC: 0.593, 95% IC (0.55; 0.65), (p < 0.01). In conclusion, anthropometric nutritional evaluation of UdeA students can be performed with self-reported data for weight and height, but the evaluation of abdominal obesity requires direct measurement of waist circumference.

  4. Methodologic considerations in the measurement of glycemic index: glycemic response to rye bread, oatmeal porridge, and mashed potato.

    Science.gov (United States)

    Hätönen, Katja A; Similä, Minna E; Virtamo, Jarmo R; Eriksson, Johan G; Hannila, Marja-Leena; Sinkko, Harri K; Sundvall, Jouko E; Mykkänen, Hannu M; Valsta, Liisa M

    2006-11-01

    Methodologic choices affect measures of the glycemic index (GI). The effects on GI values of blood sampling site, reference food type, and the number of repeat tests have been insufficiently determined. The objective was to study the effect of methodologic choices on GI values. Comparisons were made between venous and capillary blood sampling and between glucose and white bread as the reference food. The number of tests needed for the reference food was assessed. Rye bread, oatmeal porridge, and instant mashed potato were used as the test foods. Twelve healthy volunteers were served each test food once and both reference foods 3 times at 1-wk intervals in a random order after they had fasted overnight. Capillary and venous blood samples were drawn at intervals for 3 h after each study meal. GIs and their CVs based on capillary samples were lower than those based on venous samples. Two tests of glucose solution as the reference provided stable capillary GIs for the test foods. The capillary GIs did not differ significantly when white bread was used as the reference 1, 2, or 3 times, but the variation was lower when tests were performed 2 and 3 times. Capillary GIs with white bread as the reference were 1.3 times as high as those with glucose as the reference. The capillary GIs of rye bread, oatmeal porridge, and mashed potato were 77, 74, and 80, respectively, with glucose as the reference. Capillary blood sampling should be used in the measurement of GI, and reference tests with glucose or white bread should be performed at least twice.

  5. Impact of diabetes mellitus and glycemic control on the osseointegration of dental implants: a systematic literature review.

    Science.gov (United States)

    Javed, Fawad; Romanos, George E

    2009-11-01

    Implant treatment is an attractive substitute to traditional fixed/removable prosthetic appliances. In patients with diabetes, dental implant therapy has been considered a contraindication. Hyperglycemia augments the severity of periodontal disease, and glycemic control is an essential variable in determining the success of dental implants in subjects with diabetes. Subjects with well-controlled diabetes may not be significantly compromised and can have high dental implant success rates compared to individuals with poorly controlled diabetes. The focused questions addressed in this systematic review were as follows: Can patients with diabetes be good candidates for dental implant therapy? And how does hyperglycemia and glycemic control influence osseointegration? A systematic literature search of MEDLINE/PubMed articles published from 1982 up to and including July 2009 was independently performed by two investigators. In addition, reference lists of original and review articles were searched. The search strategy was to use the following terms in different combinations: dental implants, immediate implants, osseointegration, periodontal disease, diabetes, hyperglycemia, metabolic control, and glycemic control. The search included studies on humans and diabetes-induced animal models. The selection criteria included all levels of available evidence. Suitable variables included the implant survival rate among individuals with diabetes, effects of hyperglycemia and glycemic control on bone, and maintenance of dental implants in subjects with diabetes. Articles published only in the English language were considered, and unpublished data were not sought. We initially identified 33 studies. Fifteen studies, which did not fulfill the selection criteria, were excluded. The included studies reported that poorly controlled diabetes negatively affects implant osseointegration; however, under optimal serum glycemic control, osseointegration can successfully occur in patients with

  6. Psychological distress, self-efficacy and glycemic control in type 2 diabetes.

    Science.gov (United States)

    Indelicato, L; Dauriz, M; Santi, L; Bonora, F; Negri, C; Cacciatori, V; Targher, G; Trento, M; Bonora, E

    2017-04-01

    To investigate the association of glycemic control with depression, anxiety, self-efficacy and other diabetes-specific psychological measures in a cohort of adult patients with type 2 diabetes (T2D) free of severe chronic diabetes-related complications. In 172 T2D outpatients consecutively recruited at the Diabetes Center of Verona City Hospital, we performed a standard medical assessment and completed the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI) and the Multidimensional Diabetes Questionnaire (MDQ) Age, body mass index (BMI) and glycosylated hemoglobin (HbA1c) were (median [IQR]): 64.0 [58.0-69.0] years, 31.0 [28.0-34.4] kg/m 2 , and 7.3 [6.7-8.0] %, respectively. The overall prevalence of anxiety and depression was 14.5% and 18.6%, respectively. Higher levels of HbA1c were significantly (p diabetes severity (rho = 0.28) and lower self-efficacy (rho = -0.27), but not with depression or anxiety. These three variables were also independent predictors of higher HbA1c levels, when entered in a multivariable stepwise-forward regression model that also included age, BMI, diabetes duration and diabetes-specific social support as covariates. Lower self-efficacy and higher diabetes distress were closely associated with poorer glycemic control. No direct association between HbA1c and clinical psychological symptoms was detected. These results highlight that a number of diabetes-specific psychological variables may play a role amidst psychological distress and glycemic control. Further studies are needed to elucidate the relevance of diabetes distress and self-efficacy to the achievement of individual glycemic targets. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  7. Relationship Among Mothers' Glycemic Level, Periodontitis, and Birth Weight.

    Science.gov (United States)

    Gomes-Filho, Isaac S; Pereira, Eliesita C; Cruz, Simone S; Adan, Luis Fernando F; Vianna, Maria Isabel P; Passos-Soares, Johelle S; Trindade, Soraya C; Oliveira, Ernesto P; Oliveira, Michelle T; Cerqueira, Eneida de M M; Pereira, Antonio Luis; Barreto, Maurício L; Seymour, Gregory John

    2016-03-01

    The aim of this study is to determine the influence of glycemic level on the relationship between periodontitis and low birth weight (LBW). A case-control study was conducted with 372 females divided into cases (109 mothers of newborns with birth weight periodontal status. Results were analyzed using logistic regression. The likelihood of having children with LBW among the mothers with periodontitis was six times greater than that observed among mothers without periodontitis (adjusted odds ratio [OR adjusted] = 6.02, 95% confidence interval [CI] = 2.47 to 15.17), even after adjustment. There was also a strong, statistically significant relationship between periodontitis and LBW in both the normal glycemic-level group (HbA1c levels Periodontitis and glycemic levels appeared to have opposing influences on birth weight, with periodontitis being associated with LBW and the magnitude of the association being altered depending on maternal blood glucose level.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    Objective: Our objective was to explore whether childhood exposure to perfluorinated and polyfluorinated compounds (PFCs), widely used stain- and grease-repellent chemicals, is associated with adiposity and markers of glycemic control. Materials and Methods: Body mass index, skinfold thickness......, waist circumference, leptin, adiponectin, insulin, glucose, and triglyceride concentrations were assessed in 8- to 10-year-old children in 1997 in a subset of the European Youth Heart Study, Danish component. Plasma PFC concentrations were available from 499 children. Linear regression models were...... performed to determine the association between PFC exposure and indicators of adiposity and markers of glycemic control. Results: There was no association between PFC exposures and adiposity or markers of glycemic control in normal-weight children. Among overweight children, an increase of 10 ng...

  9. Influence of psychosocial factors on self-care behaviors and glycemic control in Turkish patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Cosansu, Gulhan; Erdogan, Semra

    2014-01-01

    The main purpose of this study was to investigate the direct and indirect effects of psychosocial factors on self-care behavior and glycemic control in Turkish patients with type 2 diabetes mellitus. The study used a cross-sectional questionnaire survey design (N = 350). Data were collected using the Summary of Diabetes Self-Care Activities Scale and the Multidimensional Diabetes Questionnaire. The relationship between the study variables was analyzed using Pearson's correlation coefficient and structural equation modeling. Self-efficacy was associated with social support, outcome expectancies, perceived interference, educational level, and self-care and A1C. According to the structural equation model, self-efficacy was the predictor variable that influenced both self-care and glycemic control. Self-efficacy in achieving desired health outcomes was found to play a central role in Turkish patients. Although interventions are planned and implemented to achieve and maintain self-management in individuals with diabetes, strengthening psychosocial factors, particularly self-efficacy, may contribute to adjustment to disease and good glycemic control in the long term.

  10. Perioperative glycemic control in diabetic patients undergoing coronary artery bypass graft surgery

    OpenAIRE

    Ehab A. Wahby; Mohamed M. Abo Elnasr; Michael I. Eissa; Sahbaa M. Mahmoud

    2016-01-01

    Background: The concept of perioperative glycemic control in cardiac surgery patients was conducted in many studies, however, it remains unclear how tight the glycemic control should be. Our aim is to study the effect of perioperative tight glycemic control versus moderate glycemic control on the outcome of diabetic patients undergoing coronary artery bypass graft (CABG) surgery. Methods: This study is a randomized prospective study conducted on 135 diabetic patients planned for CABG surge...

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

    International Nuclear Information System (INIS)

    Pu Li; Ji Ning; Zhu Wei

    2011-01-01

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

  12. Association of lipocalin-2 level, glycemic status and obesity in type 2 diabetes mellitus.

    Science.gov (United States)

    Elkhidir, Areej E; Eltaher, Halima B; Mohamed, Abdelrahim O

    2017-07-14

    Management of type 2 diabetes mellitus aims to maintain a normal glycemic status, which if not, it may lead to acute and/or chronic diabetic complications. Earlier studies found Lipocalin-2 elevated in complications associated with type 2 diabetes mellitus such as ischemic heart disease. These lipocalin-2 changes had been linked to obesity and uncontrolled diabetes. So, it could be useful to understand the effect of glycemic control and obesity on lipocalin-2. This was a case control study. Fifty-seven patients with type 2 diabetes and 30 non-diabetic controls participated after getting a written consent. Weight (kg), height (m) and waist circumference (cm) were measured then the body mass index (kg/m 2 ) was determined. Blood samples were collected after an overnight fasting. HbA1c, lipid profile and serum creatinine were measured using enzymatic methods. Lipocalin-2 was measured using sandwich ELISA. Lipocalin-2 was found significantly higher in patients with type 2 diabetes (P = 0.001). However, it had no significant correlation with any of the studied variables. Females had elevated BMI compared to males in the patients group (P diabetes (P diabetics, obese and non-obese. There was a significant elevation in waist circumference in uncontrolled diabetics compared to controlled ones. Lipocalin-2 had no significant changes between controlled and uncontrolled diabetics nor non-obese and obese patients. Patients with type 2 diabetes mellitus have elevated level of serum lipocalin-2. There was no significant association found between lipocalin-2 and glycemic control nor obesity.

  13. Fruit and Glycemic Control in Type 2 Diabetes

    DEFF Research Database (Denmark)

    Christensen, Allan Stubbe; Viggers, Lone; Gregersen, Søren

    2015-01-01

    Health professionals often advise subjects with type 2 diabetes (T2D) to restrict fruit intake. We show here that there is no supportive scientific evidence for this. At least 19 studies have tested intake of fruit on postprandial glucose in T2D. Only two long-term intervention studies have inves...... under normal conditions has deleterious health effects. In summary, we find no evidence for a negative impact of fruit on glycemic control in T2D. Subjects with T2D should eat fruit just as the general population, without fearing worsening of their glycemic control....

  14. Glycemic index in the management of Obesity and Metabolic syndrome

    OpenAIRE

    Juanola Falgarona, Martí

    2014-01-01

    Obesity and Metabolic Syndrome (MetS) are one of the main causes of disability and death worldwide. It has been proposed that high glycemic index (GI) and high glycemic load (GL) diets are associated with increased risks of obesity, type 2 diabetes mellitus, MetS and cardiovascular disease. To date, evidence suggests possible benefits of the GI/GL for the prevention and management of obesity and MetS. We aimed to analyze the association between dietary GI and GL and the risk of to develop Met...

  15. Glycemic Control and the Risk of Tuberculosis: A Cohort Study.

    Directory of Open Access Journals (Sweden)

    Pin-Hui Lee

    2016-08-01

    Full Text Available Diabetes is a well-known risk factor for tuberculosis (TB and is increasingly prevalent in low- and middle-income countries, where the burden of TB is high. Glycemic control has the potential to modify the risk of TB. However, there are few studies on the association between glycemic control and TB risk, and the results are inconsistent.We assembled a cohort using 123,546 individuals who participated in a community-based health screening service in northern Taiwan from 5 March 2005 to 27 July 2008. Glycemic control was measured using fasting plasma glucose (FPG at the time of screening. The cohort was followed up to 31 December 2012 for the occurrence of TB by cross-matching the screening database to the national health insurance database. Multiple imputation was used to handle missing information. During a median follow-up of 4.6 y, 327 cases of TB occurred. In the multivariable Cox regression model, diabetic patients with poor glycemic control (FPG > 130 mg/dl had a significantly higher hazard of TB (adjusted hazard ratio [aHR] 2.21, 95% CI 1.63-2.99, p < 0.001 compared to those without diabetes. The hazard of TB in diabetic patients with good glycemic control (FPG ≤ 130 mg/dl did not differ significantly from that in nondiabetic individuals (aHR 0.69, 95% CI 0.35-1.36, p = 0.281. In the linear dose-response analysis, the hazard of TB increased with FPG (aHR 1.06 per 10-mg/dl increase in FPG, 95% CI 1.03-1.08, p < 0.001. Assuming the observed association between glycemic control and TB was causal, an estimated 7.5% (95% CI 4.1%-11.5% of incident TB in the study population could be attributed to poor glycemic control. Limitations of the study include one-time measurement of fasting glucose at baseline and voluntary participation in the health screening service.Good glycemic control could potentially modify the risk of TB among diabetic patients and may contribute to the control of TB in settings where diabetes and TB are prevalent.

  16. Low-glycemic-load diets: impact on obesity and chronic diseases.

    Science.gov (United States)

    Bell, Stacey J; Sears, Barry

    2003-01-01

    Historically, carbohydrates have been thought to play only a minor role in promoting weight gain and in predicting the risk of development of chronic disease. Most of the focus had been on reducing total dietary fat. During the last 20 years, fat intake decreased, while the number of individuals who were overweight or developed a chronic conditions have dramatically increased. Simultaneously, the calories coming from carbohydrate have also increased. Carbohydrates can be classified by their post-prandial glycemic effect, called the glycemic index or glycemic load. Carbohydrates with high glycemic indexes and high glycemic loads produce substantial increases in blood glucose and insulin levels after ingestion. Within a few hours after their consumption, blood sugar levels begin to decline rapidly due to an exaggerated increase in insulin secretion. A profound state of hunger is created. The continued intake of high-glycemic load meals is associated with an increased risk of chronic diseases such as obesity, cardiovascular disease, and diabetes. In this review, the terms glycemic index and glycemic load are defined, coupled with an overview of short- and long-term changes that occur from eating diets of different glycemic indexes and glycemic loads. Finally, practical strategies for how to design low-glycemic-load diets consisting primarily of low-glycemic carbohydrates are provided.

  17. Influence of socioeconomic and psychological factors in glycemic control in young children with type 1 diabetes mellitus.

    Science.gov (United States)

    Andrade, Carlos Jefferson do Nascimento; Alves, Crésio de Aragão Dantas

    2018-01-04

    To evaluate the influence of socioeconomic and psychological factors on glycemic control in young children with type 1 diabetes mellitus. This was a cross-sectional study assessing prepubertal children with type 1 diabetes mellitus. The authors analyzed the socioeconomic status using the Brazil Economic Classification Criterion (Critério de Classificação Econômica Brasil [CCEB]) and psychological conditions through the Brazilian version of the Problem Areas in Diabetes, associated with glycemic control, measured by glycated hemoglobin (HbA1c). Descriptive analysis was used. The variables were assessed by bivariate and multivariate robust Poisson regression model, as well as Fisher's exact and Pearson's chi-squared tests to obtain the ratios of gross and adjusted prevalence ratio, with confidence interval being estimated at 95%. A total of 68 children with type 1 diabetes mellitus were included in the study. A negative association between glycemic control (glycated hemoglobin levels), socioeconomic status (Brazil Economic Classification Criterion), and psychological condition (Brazilian version of the Problem Areas in Diabetes) was observed. Among the study participants, 73.5% (n=50) of the children had an unfavorable socioeconomic status; these participants were 1.4 times more likely to present altered glycated hemoglobin values. In relation to individuals with compromised psychological status, 26 (38.2%) had a score above 70, thus being classified with psychological stress; these children were 1.68 times more likely (95% confidence interval: 1.101, 1.301) to have higher glycated hemoglobin levels. The socioeconomic conditions and psychological characteristics of the study participants were negatively associated with glycated hemoglobin results. These data reinforce the importance of the studied variables as predictors of glycemic control. Copyright © 2017. Published by Elsevier Editora Ltda.

  18. Effect of Probiotics on Glycemic Control: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials.

    Science.gov (United States)

    Ruan, Yuting; Sun, Jia; He, Jie; Chen, Fangyao; Chen, Rongping; Chen, Hong

    2015-01-01

    Previous clinical trials indicate that probiotic consumption may improve blood glucose control, however, results from randomized trials on glycemic control have been inconsistent. To investigate the effects of probiotics on glycemic control in a systematic review and meta-analysis of randomized controlled trials. PubMed, Embase, Cochrane Library, and Clinicaltrial.gov through October 2014. Two independent reviewers extracted relevant data and assessed study quality and risk of bias. Data were pooled using a random-effects model and expressed as mean differences (MD) with 95% CI. Heterogeneity was assessed (Cochran Q-statistic) and quantified (I2). Seventeen randomized controlled trials were included, in which 17 fasting blood glucose (n = 1105), 11 fasting plasma insulin (n = 788), 8 homeostasis model assessment of insulin resistance (n = 635) comparisons were reported. Probiotic consumption, compared with placebo, significantly reduced fasting glucose (MD = -0.31 mmol/L; 95% CI 0.56, 0.06; p = 0.02), fasting plasma insulin (MD = -1.29 μU/mL; 95% CI -2.17, -0.41; p = 0.004), and HOMA-IR (MD = 0.48; 95% CI -0.83, -0.13; p = 0.007). Probiotic consumption may improve glycemic control modestly. Modification of gut microbiota by probiotic supplementation may be a method for preventing and control hyperglycemia in clinical practice.

  19. Effect of Probiotics on Glycemic Control: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Yuting Ruan

    Full Text Available Previous clinical trials indicate that probiotic consumption may improve blood glucose control, however, results from randomized trials on glycemic control have been inconsistent.To investigate the effects of probiotics on glycemic control in a systematic review and meta-analysis of randomized controlled trials.PubMed, Embase, Cochrane Library, and Clinicaltrial.gov through October 2014.Two independent reviewers extracted relevant data and assessed study quality and risk of bias. Data were pooled using a random-effects model and expressed as mean differences (MD with 95% CI. Heterogeneity was assessed (Cochran Q-statistic and quantified (I2.Seventeen randomized controlled trials were included, in which 17 fasting blood glucose (n = 1105, 11 fasting plasma insulin (n = 788, 8 homeostasis model assessment of insulin resistance (n = 635 comparisons were reported. Probiotic consumption, compared with placebo, significantly reduced fasting glucose (MD = -0.31 mmol/L; 95% CI 0.56, 0.06; p = 0.02, fasting plasma insulin (MD = -1.29 μU/mL; 95% CI -2.17, -0.41; p = 0.004, and HOMA-IR (MD = 0.48; 95% CI -0.83, -0.13; p = 0.007.Probiotic consumption may improve glycemic control modestly. Modification of gut microbiota by probiotic supplementation may be a method for preventing and control hyperglycemia in clinical practice.

  20. THE EFFECTS OF POOR GLYCEMIC CONTROL AND OF NON-SURGICAL PERIODONTAL THERAPY IN PATIENTS WITH DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Cornelia OANȚĂ

    2015-09-01

    Full Text Available Aim: The aim of the study was to evaluate the relationship between the diabetic status and severity of the periodontal involvement, and also of the non-surgical periodontal therapy on the periodontal status of patients with diabetes mellitus. Materials and method: The study was conducted on 21 patients with type 1 diabetes mellitus (study group and 10 systemically healthy subjects (control group. We examined: the degree of glycemic control (by measuring the glycated hemoglobin, the periodontal and oral hygiene parameters at the baseline and 4 weeks, 6 months and 12 months after the periodontal treatment (scaling and root planning. Results and discussion: Subjects with a poor glycemic control presented a higher percentage of sites with attachment loss, significantly higher amounts of bacterial plaque, sub-gingival calculus and gingival bleeding - when compared with the control group or with subjects with good or moderated glycemic control. In the same group, a rapid recurrence of the deep periodontal pockets was observed after 12 months. Conclusions: A prolonged poor control of glycemia and the time elapsed from the debut of diabetes were closely related with its complications. The comparison between the diabetes and the control groups demonstrated that diabetes mellitus is a risk factor for the periodontal disease.

  1. Comparison of the effectiveness of analytical wake models for wind farm with constant and variable hub heights

    International Nuclear Information System (INIS)

    Wang, Longyan; Tan, Andy C.C.; Cholette, Michael; Gu, Yuantong

    2016-01-01

    Highlights: • The effectiveness of three analytical wake models is studied. • The results of the analytical wake models are compared with the CFD simulations. • The results of CFD simulation are verified by comparison to the offshore wind farm observation data. • The onshore wind farm with both constant and different hub height turbines are analyzed. • PARK model is able to predict the total wind farm power production well with tuned surface roughness value. - Abstract: Extensive power losses of wind farm have been witnessed due to the wake interactions between wind turbines. By applying analytical wake models which describe the wind speed deficits in the wake quantitatively, the power losses can be regained to a large extent through wind farm layout optimization, and this has been extensively reported in literature. Nevertheless, the effectiveness of the analytical wake models in predicting the wind farm power production have rarely been studied and compared for wind farm with both constant and variable wind turbine hub heights. In this study, the effectiveness of three different analytical wake models (PARK model, Larsen model and B-P model) is thoroughly compared over a wide range of wake properties. After the validation with the observation data from offshore wind farm, CFD simulations are used to verify the effectiveness of the analytical wake models for an onshore wind farm. The results show that when using the PARK model the surface roughness value (z 0 ) must be carefully tuned to achieve good performance in predicting the wind farm power production. For the other two analytical wake models, their effectiveness varies depending on the situation of wind farm (offshore or onshore) and the wind turbine hub heights (constant or variable). It was found that the results of B-P model agree well with the CFD simulations for offshore wind farm, but not for the onshore wind farm. The Larsen model is more accurate for the wind farm with variable wind turbine

  2. Performance Comparison of Time-Frequency Distributions for Estimation of Instantaneous Frequency of Heart Rate Variability Signals

    Directory of Open Access Journals (Sweden)

    Nabeel Ali Khan

    2017-02-01

    Full Text Available The instantaneous frequency (IF of a non-stationary signal is usually estimated from a time-frequency distribution (TFD. The IF of heart rate variability (HRV is an important parameter because the power in a frequency band around the IF can be used for the interpretation and analysis of the respiratory rate but also for a more accurate analysis of heart rate (HR signals. In this study, we compare the performance of five states of the art kernel-based time-frequency distributions (TFDs in terms of their ability to accurately estimate the IF of HR signals. The selected TFDs include three widely used fixed kernel methods: the modified B distribution, the S-method and the spectrogram; and two adaptive kernel methods: the adaptive optimal kernel TFD and the recently developed adaptive directional TFD. The IF of the respiratory signal, which is usually easier to estimate as the respiratory signal is a mono-component with small amplitude variations with time, is used as a reference to examine the accuracy of the HRV IF estimates. Experimental results indicate that the most reliable estimates are obtained using the adaptive directional TFD in comparison to other commonly used methods such as the adaptive optimal kernel TFD and the modified B distribution.

  3. A comparison of outpatient healthcare expenditures between public and private medical institutions in urban China: an instrumental variable approach.

    Science.gov (United States)

    Xu, Judy; Liu, Gordon; Deng, Guoying; Li, Lin; Xiong, Xianjun; Basu, Kisalaya

    2015-03-01

    The growth of healthcare expenditure provokes constant comments and discussions, as countries battle the issues on cost containment and cost effectiveness. Prior to 1978, medical institutions in China were either state-owned or were collective public hospitals. Since 1978, China has been trying to rebuild its healthcare system, which was destroyed during the 'cultural revolution', allowing private medical institutions to deliver healthcare services. As a result, private medical institutions have grown from 0% to 28.57% between 1978 and 2010. In this context, we compare outpatient healthcare expenditures between public and private medical institutions. The central problem of this comparison is that the choice of medical institution is endogenous. So we apply an instrumental variable (IV) framework utilizing geographic information (whether the closest medical institution is private) as the instrument while controlling for severity of health and other relevant confounding factors. Using China's Urban Resident Basic Medical Insurance Survey 2008-2010, we found that there is no difference in expenditure between public and private medical institutions when IV framework is used. Our econometric tests suggest that our IV model is specified appropriately. However, the ordinary least square model, which is inconsistent in the presence of endogenous regressor(s), reveals that public medical institutions are more expensive. Copyright © 2013 John Wiley & Sons, Ltd.

  4. Effect of processing on in vitro glycemic indices and carbohydrate ...

    African Journals Online (AJOL)

    Effect of processing on in vitro glycemic indices and carbohydrate catabolizing enzyme inhibitory properties of some tropical grain legumes. ... used as a measure of how a particular food can elicit rise in blood glucose and low GI foods have often been advocated as therapeutically important in managing hyperglycemia.

  5. Gastrointestinal Tolerance and Glycemic Response of Isomaltooligosaccharides in Healthy Adults

    Directory of Open Access Journals (Sweden)

    Vishnupriya Gourineni

    2018-03-01

    Full Text Available Ingredients delivering functional and nutritional benefits are of interest to food manufacturers. Isomaltooligosaccharides (IMOs which serve as alternate sweeteners fit into this category. IMOs are a mixture of α-(1 → 6 and α-(1 → 4-linked glucose oligomers, synthesized by an enzymatic reaction from starch (corn, tapioca. The aim of this study was to evaluate the fermentability and glycemic response of IMO in a healthy population. Two randomized, double-blind, placebo-controlled, cross-over human studies were conducted. In the first study (n = 26, participants’ breath hydrogen over 24 h, gastrointestinal tolerance, and glycemic and insulinemic response to BIOLIGOTM IL5040 isomaltooligosaccharide were measured. In another study (n = 10, participants’ two-hour post-prandial glycemic response to BIOLIGOTM IL5040 isomaltooligosaccharide and BIOLIGOTM IL7010 isomaltooligosaccharide was measured compared to dextrose (control. The IMOs differed in the composition of mono and di-saccharide sugars. IMO syrup dose was matched for 50 g of total carbohydrates and was consumed by mixing in water (237 mL/8 oz.. Mean composite gastrointestinal score was not significantly different (p = 0.322 between the control (1.42 and IMO (1.38. Lack of difference in glycemic response (p = 0.662, with no impact on breath hydrogen (24 h; p = 0.319 and intestinal tolerance, demonstrates that IMO is digestible and can be used to replace sugars in product formulations.

  6. Glycemic index of chocolate fortified with pumpkin ( Cucurbita ...

    African Journals Online (AJOL)

    This study aimed to determine Glycemic Index of chocolate fortified with pumpkin and taro powder and observed its effect on mood and cognitive functions of UniSZA female students. Two groups of female students (n = 30) were asked to consume control chocolate (Group A) and fortified chocolate (Group B) for four weeks.

  7. The Effect Of Glycemic Control On Serum Lipids And Calcium ...

    African Journals Online (AJOL)

    The Effect Of Glycemic Control On Serum Lipids And Calcium – Phosphate Profiles In Patients With Type 2 Diabetes Mellitus. ... control levels in type 2 diabetic patients on the serum lipids and lipoprotein profiles and the serum levels of calcium, ... The patients were classified into two groups depending on their glycosylated

  8. Characterization of Factors Affecting Attainment of Glycemic Control in Asian Americans With Diabetes in a Culturally Specific Program

    Science.gov (United States)

    Le, Hung; Wong, Sophia; Iftikar, Tracy; Keenan, Hillary; King, George L.; Hsu, William C.

    2014-01-01

    Purpose The purpose of this study is to examine the effectiveness of a culturally specific pilot clinic for Asian Americans (AA) in reaching glycemic target and to characterize factors affecting the attainment of glycemic control in comparison with white counterparts. Methods This electronic health record review included all new AA patients with type 2 diabetes (n = 109) in a culturally specific program and a randomly selected sample of new white patients with type 2 diabetes (n = 218) in the adult clinic within the same time period and diabetes center. Results AA and whites had a comparable proportion of patients with A1C ≤7% (32.1%, 34.9%; P = .621) at baseline and after 12 months of care (48.6%, 56.0%; P = .210), with a similar A1C decline (−0.9% ± 1.6%, −0.8% ± 1.7%, P = .710) by 12 months. Factors associated with the lack of success in reaching target in AA but not in whites included older age, lower educational attainment, less likelihood of having health insurance, and a need for more educational visits. The percentage of AA reaching A1C ≤7%, as compared to whites, worsened among those with highest initial A1C when stratified by ascending quartiles (96.7% vs 85.2%, P = .101; 61.9% vs 58.9%, P = .813; 24.0% vs 37.7%, P = .230; 15.2% vs 35.4%, P = .044). Conclusion While a culturally specific diabetes program in a specialty setting achieved a similar glycemic outcome for AA compared with whites, reasons for not reaching glycemic target differed. The findings suggest that the elimination of diabetes disparities requires not only culturally and linguistically specific programs, but must also identify and address the socio-environmental differences unique to each population. PMID:23771841

  9. Socioeconomic Status and Glycemic Control in Type 2 Diabetes; Race by Gender Differences.

    Science.gov (United States)

    Assari, Shervin; Moghani Lankarani, Maryam; Piette, John D; Aikens, James E

    2017-11-01

    Background : This study aimed to investigate differences in the association between socioeconomic status (SES) and glycemic control in type 2 diabetes mellitus (DM) across race by gender groups. Methods : Using a convenient sampling strategy, participants were 112 patients with type 2 DM who were prescribed insulin (ns = 38 Black women, 34 Black men, 14 White women, and 26 White men, respectively). Linear regression was used to test the associations between sociodemographic variables (race, gender, SES, governmental insurance) and Hemoglobin A1c (HbA1c) in the pooled sample and within subgroups defined by race and gender. Results : In the pooled sample, neither SES nor governmental insurance were associated with HbA1c. However, the race by gender interaction approached statistical significance (B = 0.34, 95% CI = -0.24-3.00, p =0.094), suggesting higher HbA1c in Black women, compared to other race by gender groups. In stratified models, SES (B = -0.33, 95% CI = -0.10-0.00, p = 0.050), and governmental insurance (B = 0.35, 95% CI = 0.05-2.42, p = 0.042) were associated with HbA1c for Black men, but not for any of the other race by gender subgroups. Conclusion : Socioeconomic factors may relate to health outcomes differently across race by gender subgroups. In particular, SES may be uniquely important for glycemic control of Black men. Due to lack of generalizability of the findings, additional research is needed.

  10. Sleep in Type 1 Diabetes: Implications for Glycemic Control and Diabetes Management.

    Science.gov (United States)

    Perez, Katia M; Hamburger, Emily R; Lyttle, Morgan; Williams, Rodayne; Bergner, Erin; Kahanda, Sachini; Cobry, Erin; Jaser, Sarah S

    2018-02-05

    To highlight recent findings from studies of sleep in type 1 diabetes (T1D), with a focus on the role of sleep in self-management, the cognitive and psychosocial outcomes related to sleep disturbances, and factors associated with sleep disturbances specific to T1D. People with T1D experience higher rates of sleep disturbances than people without diabetes, and these disturbances have negative implications for glycemic control and diabetes management, as well as psychosocial and cognitive outcomes. Inconsistent sleep timing (bedtime and wake time) has emerged as a potential target for interventions, as variability in sleep timing has been linked with poorer glycemic control and adherence to treatment. Sleep-promoting interventions and new diabetes technology have the potential to improve sleep in people with T1D. Sleep is increasingly considered a critical factor in diabetes management, but more multi-method and longitudinal research is needed. We emphasize the importance of sufficient and consistent sleep for people with T1D, and the need for providers to routinely assess sleep among patients with T1D.

  11. Bread Affects Clinical Parameters and Induces Gut Microbiome-Associated Personal Glycemic Responses.

    Science.gov (United States)

    Korem, Tal; Zeevi, David; Zmora, Niv; Weissbrod, Omer; Bar, Noam; Lotan-Pompan, Maya; Avnit-Sagi, Tali; Kosower, Noa; Malka, Gal; Rein, Michal; Suez, Jotham; Goldberg, Ben Z; Weinberger, Adina; Levy, Avraham A; Elinav, Eran; Segal, Eran

    2017-06-06

    Bread is consumed daily by billions of people, yet evidence regarding its clinical effects is contradicting. Here, we performed a randomized crossover trial of two 1-week-long dietary interventions comprising consumption of either traditionally made sourdough-leavened whole-grain bread or industrially made white bread. We found no significant differential effects of bread type on multiple clinical parameters. The gut microbiota composition remained person specific throughout this trial and was generally resilient to the intervention. We demonstrate statistically significant interpersonal variability in the glycemic response to different bread types, suggesting that the lack of phenotypic difference between the bread types stems from a person-specific effect. We further show that the type of bread that induces the lower glycemic response in each person can be predicted based solely on microbiome data prior to the intervention. Together, we present marked personalization in both bread metabolism and the gut microbiome, suggesting that understanding dietary effects requires integration of person-specific factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Chamomile tea improves glycemic indices and antioxidants status in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Zemestani, Maryam; Rafraf, Maryam; Asghari-Jafarabadi, Mohammad

    2016-01-01

    Oxidative stress is a major factor in the pathogenesis of diabetes complications. The objectives were to investigate the effects of chamomile tea consumption on glycemic control and antioxidant status in subjects with type 2 diabetes mellitus (T2 DM). This single-blind randomized controlled clinical trial was conducted on 64 subjects with T2 DM (males and females) ages 30 to 60 y. The intervention group (n = 32) consumed chamomile tea (3 g/150 mL hot water) 3 times per day immediately after meals for 8 wk. The control group (n = 32) followed a water regimen for same intervention period. Fasting blood samples, anthropometric measurements, and 3-d, 24-h dietary recalls were collected at the baseline and at the end of the trial. Data were analyzed by independent t test, paired t test, and analysis of covariance. Chamomile tea significantly decreased concentration of glycosylated hemoglobin, serum insulin levels, homeostatic model assessment for insulin resistance, and serum malondialdehyde, compared with control group (all P chamomile group compared with these variables in control group at the end of the intervention (all P chamomile tea has beneficial effects on glycemic control and antioxidant status in patients with T2 DM. A larger sample population and a longer intervention period may be required to show significant clinical improvements. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Glycemic Control and the Risk of Tuberculosis: A Cohort Study.

    Science.gov (United States)

    Lee, Pin-Hui; Fu, Han; Lai, Ting-Chun; Chiang, Chen-Yuan; Chan, Chang-Chuan; Lin, Hsien-Ho

    2016-08-01

    Diabetes is a well-known risk factor for tuberculosis (TB) and is increasingly prevalent in low- and middle-income countries, where the burden of TB is high. Glycemic control has the potential to modify the risk of TB. However, there are few studies on the association between glycemic control and TB risk, and the results are inconsistent. We assembled a cohort using 123,546 individuals who participated in a community-based health screening service in northern Taiwan from 5 March 2005 to 27 July 2008. Glycemic control was measured using fasting plasma glucose (FPG) at the time of screening. The cohort was followed up to 31 December 2012 for the occurrence of TB by cross-matching the screening database to the national health insurance database. Multiple imputation was used to handle missing information. During a median follow-up of 4.6 y, 327 cases of TB occurred. In the multivariable Cox regression model, diabetic patients with poor glycemic control (FPG > 130 mg/dl) had a significantly higher hazard of TB (adjusted hazard ratio [aHR] 2.21, 95% CI 1.63-2.99, p diabetes. The hazard of TB in diabetic patients with good glycemic control (FPG ≤ 130 mg/dl) did not differ significantly from that in nondiabetic individuals (aHR 0.69, 95% CI 0.35-1.36, p = 0.281). In the linear dose-response analysis, the hazard of TB increased with FPG (aHR 1.06 per 10-mg/dl increase in FPG, 95% CI 1.03-1.08, p diabetic patients and may contribute to the control of TB in settings where diabetes and TB are prevalent.

  14. Preoperative glycemic control status as a significant predictor of biochemical recurrence in prostate cancer patients after radical prostatectomy.

    Science.gov (United States)

    Lee, Hakmin; Kuk, Harim; Byun, Seok-Soo; Lee, Sang Eun; Hong, Sung Kyu

    2015-01-01

    The effect of diabetes mellitus (DM) on prostate cancer (PCa) outcome remains controversial. Thus, we investigated the association of DM history, glycemic control, and metformin use with oncologic outcomes after radical prostatectomy (RP). We reviewed the records of 746 contemporary patients who had hemoglobin A1c (HbA1c) measured within the 6 months preceding RP. The associations between clinical variables and risk of adverse pathological features and biochemical recurrence (BCR) were tested using a multivariate logistic regression and multiple Cox-proportional hazards model, respectively. BCR was defined as prostatic specific antigen (PSA) > 0.2 ng/mL in 2 consecutive tests. There were no significant differences in the rates of adverse pathologic features and BCR-free survival between patients with (n = 209) and without (n = 537) a history of DM diagnosis (all p > 0.05). In multivariate analyses, high HbA1c level (≥ 6.5%) was significantly related with high pathologic Gleason score (≥ 4+3; odds ratio [OR] 1.704, p = 0.019) and BCR-free survival (OR 1.853, p = 0.007). Metformin use was not associated with BCR-free survival (OR 0.662, p = 0.125). Poor glycemic control was significantly associated with BCR after RP. Meanwhile, metformin use was not associated with biochemical outcome after RP. Further investigation would be needed to identify exact mechanism underlying the impact of glycemic control on PCa treatment outcome.

  15. Dietary glycemic index, glycemic load and metabolic profile in children with phenylketonuria.

    Science.gov (United States)

    Moretti, F; Pellegrini, N; Salvatici, E; Rovelli, V; Banderali, G; Radaelli, G; Scazzina, F; Giovannini, M; Verduci, E

    2017-02-01

    No data exist in the current literature on the glycemic index (GI) and glycemic load (GL) of the diet of phenylketonuric (PKU) children. The aims of this study were to examine the dietary GI and GL in PKU children on a low-phenylalanine (Phe)-diet and to evaluate whether an association may exist between the carbohydrate quality and the metabolic profile. Twenty-one PKU children (age 5-11 years) and 21 healthy children, gender and age matched, were enrolled. Dietary (including GI and GL) and blood biochemical assessments were performed. No difference was observed for daily energy intake between PKU and healthy children. Compared to healthy controls, PKU children consumed less protein (p = 0.001) and fat (p = 0.028), and more carbohydrate (% of total energy, p = 0.004) and fiber (p = 0.009). PKU children had higher daily GI than healthy children (mean difference (95% confidence interval), 13.7 (9.3-18.3)) and higher GL (31.7 (10.1-53.2)). PKU children exhibited lower blood total and low density lipoprotein cholesterol (LDL) levels (p < 0.01) and higher triglyceride level (p = 0.014) than healthy children, while glucose and insulin concentrations did not differ. In PKU children the dietary GL was associated with triglyceride glucose index (Spearman's correlation coefficient = 0.515, p = 0.034). In PKU children a relationship of the dietary treatment with GI and GL, blood triglycerides and triglyceride glucose index may exist. Improvement towards an optimal diet for PKU children could include additional attention to the management of dietary carbohydrate quality. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  16. Correlates of Nocturia and Relationships of Nocturia With Sleep Quality and Glycemic Control in Women With Type 2 Diabetes.

    Science.gov (United States)

    Chang, Chun-Jen; Pei, Dee; Wu, Chien-Chih; Palmer, Mary H; Su, Ching-Chieh; Kuo, Shu-Fen; Liao, Yuan-Mei

    2017-07-01

    To explore correlates of nocturia, compare sleep quality and glycemic control for women with and without nocturia, and examine relationships of nocturia with sleep quality and glycemic control in women with diabetes. This study was a cross-sectional, correlational study with data collected from 275 women with type 2 diabetes. Data were collected using a structured questionnaire. Multivariate logistic regression analyses were used to identify correlates. Chi-squared tests were used to identify candidate variables for the first logistic regression model. A one-way analysis of variance was used to compare sleep quality and glycemic control for women with and those without nocturia. Pearson correlations were used to examine the relationships of nocturia with sleep quality and glycemic control. Of the 275 participants, 124 (45.1%) had experienced nocturia (at least two voids per night). Waist circumference, parity, time since diagnosis of diabetes, sleep quality, and increased daytime urinary frequency were correlated with nocturia after adjusting for age. Compared to women without nocturia, women who had nocturia reported poorer sleep quality. A significant correlation was found between the number of nocturnal episodes and sleep quality. Nocturia and poor sleep are common among women with diabetes. The multifactorial nature of nocturia supports the delivered management and treatments being targeted to underlying etiologies in order to optimize women's symptom management. Interventions aimed at modifiable correlates may include maintaining a normal body weight and regular physical exercise for maintaining a normal waist circumference, and decreasing caffeine consumption, implementing feasible modifications in sleeping environments and maintaining sleep hygiene to improve sleep quality. Healthcare professionals should screen for nocturia and poor sleep and offer appropriate nonpharmacological lifestyle management, behavioral interventions, or pharmacotherapy for women

  17. Sleep Pattern, Duration and Quality in Relation with Glycemic Control in People with Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Gozashti, Mohammad Hossein; Eslami, Nazanin; Radfar, Mohammad Hadi; Pakmanesh, Hamid

    2016-11-01

    Sleep disturbances have been shown to be associated with diabetes control, but the relation between planned wakings or napping with glycemic indices has not been evaluated yet. This study evaluated the relation between sleep quality, duration, and pattern, including daytime napping of people with diabetes and their glycemic control. A cross-sectional correlation research design was used for this study. We enrolled 118 people with type 2 diabetes receiving oral agents without major complications at the Shahid Bahonar Center, Kerman. The age, weight, height, serum HbA1c, as well as other glycemic indices and lipid profile were measured. BMI was also calculated. All participants were requested to fill in the Pittsburgh Sleep Quality Index (PSQI) questionnaire to evaluate their sleep quality. In addition, they were inquired about their sleep schedule during day and night. Pearson correlation and multiple regression analyses were conducted to examine the correlation between HbA1c and sleep pattern variables. The variables were also compared between participants with or without napping using t-test. All analyses were performed with the SPSS version 19 (SPSS, Chicago, IL, USA). The mean age was 58±11 years and mean HbA1c (%) was 7.8±11 (62±13 mmol/mol). Sleep duration and the number of sleep segments significantly predicted HbA1c (F (2,114)=5.232, P=0.007, R2=0.084). A one-hour increment in sleep duration was associated with a 0.174% (1.4 mmol/mol) decrement in HbA1c. PSQI score did not contribute to the regression model. Moreover, participants who napped (66%) had a lower HbA1c (7.6±1) compared to others (8.1±1.3) (P=0.04). We concluded that napping and segmented sleep are associated with a better glycemic control in type 2 diabetes and there is a linear correlation between sleep duration and better glycemic control.

  18. Sleep Pattern, Duration and Quality in Relation with Glycemic Control in People with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Gozashti

    2016-11-01

    Full Text Available Sleep disturbances have been shown to be associated with diabetes control, but the relation between planned wakings or napping with glycemic indices has not been evaluated yet. This study evaluated the relation between sleep quality, duration, and pattern, including daytime napping of people with diabetes and their glycemic control. A cross-sectional correlation research design was used for this study. We enrolled 118 people with type 2 diabetes receiving oral agents without major complications at the Shahid Bahonar Center, Kerman. The age, weight, height, serum HbA1c, as well as other glycemic indices and lipid profile were measured. BMI was also calculated. All participants were requested to fill in the Pittsburgh Sleep Quality Index (PSQI questionnaire to evaluate their sleep quality. In addition, they were inquired about their sleep schedule during day and night. Pearson correlation and multiple regression analyses were conducted to examine the correlation between HbA1c and sleep pattern variables. The variables were also compared between participants with or without napping using t-test. All analyses were performed with the SPSS version 19 (SPSS, Chicago, IL, USA. The mean age was 58±11 years and mean HbA1c (% was 7.8±11 (62±13 mmol/mol. Sleep duration and the number of sleep segments significantly predicted HbA1c (F (2,114=5.232, P=0.007, R2=0.084. A one-hour increment in sleep duration was associated with a 0.174% (1.4 mmol/mol decrement in HbA1c. PSQI score did not contribute to the regression model. Moreover, participants who napped (66% had a lower HbA1c (7.6±1 compared to others (8.1±1.3 (P=0.04. We concluded that napping and segmented sleep are associated with a better glycemic control in type 2 diabetes and there is a linear correlation between sleep duration and better glycemic control.

  19. Comparison of variability in breast density assessment by BI-RADS category according to the level of experience.

    Science.gov (United States)

    Eom, Hye-Joung; Cha, Joo Hee; Kang, Ji-Won; Choi, Woo Jung; Kim, Han Jun; Go, EunChae

    2017-01-01

    Background Only few studies have assessed variability in the results obtained by the readers with different experience levels in comparison with automated volumetric breast density measurements. Purpose To examine the variations in breast density assessment according to BI-RADS categories among readers with different experience levels and to compare it with the results of automated quantitative measurements. Material and Methods Density assignment was done for 1000 screening mammograms by six readers with three different experience levels (breast-imaging experts, general radiologists, and students). Agreement level between the results obtained by the readers and the Volpara automated volumetric breast density measurements was assessed. The agreement analysis using two categories-non-dense and dense breast tissue-was also performed. Results Intra-reader agreement for experts, general radiologists, and students were almost perfect or substantial (k = 0.74-0.95). The agreement between visual assessments of the breast-imaging experts and volumetric assessments by Volpara was substantial (k = 0.77). The agreement was moderate between the experts and general radiologists (k = 0.67) and slight between the students and Volpara (k = 0.01). The agreement for the two category groups (nondense and dense) was almost perfect between the experts and Volpara (k = 0.83). The agreement was substantial between the experts and general radiologists (k = 0.78). Conclusion We observed similar high agreement levels between visual assessments of breast density performed by radiologists and the volumetric assessments. However, agreement levels were substantially lower for the untrained readers.

  20. A pilot study examining the effects of consuming a high-protein vs normal-protein breakfast on free-living glycemic control in overweight/obese 'breakfast skipping' adolescents.

    Science.gov (United States)

    Bauer, L B; Reynolds, L J; Douglas, S M; Kearney, M L; Hoertel, H A; Shafer, R S; Thyfault, J P; Leidy, H J

    2015-09-01

    To examine whether the daily consumption of normal-protein (NP) vs higher-protein (HP) breakfasts improve free-living glycemic control in overweight/obese, 'breakfast skipping' adolescents. Twenty-eight healthy, but overweight, teens (age: 19±1 year; BMI: 29.9±0.8 kg m(-2)) completed a 12-week randomized parallel-arm study in which the adolescents consumed either a 350 kcal NP breakfast (13 g protein) or HP breakfast (35 g protein). Pre- and post-study 24-h blood glucose measures were assessed using continuous glucose monitoring. Although no main effects of time or group were detected, time by group interactions were observed. Post hoc pairwise comparisons assessing the post-pre changes revealed that the daily consumption of the HP breakfasts tended to reduce the 24-h glucose variability (s.d.) vs NP (-0.17±0.09 vs +0.09±0.10 s.d.; P=0.06) and tended to reduce the time spent above the high glucose limit (-292±118 vs -24±80 min; P=0.09). The consumption of the HP breakfasts also reduced the 24-h maximal (peak) glucose response (-0.94±0.36 vs +0.30±0.18 mmol l(-1); Pbreakfast, containing 35 g of high-quality protein, has better efficacy at improving free-living glycemic control compared with a NP breakfast in overweight/obese, but otherwise healthy, 'breakfast skipping' adolescents.

  1. Cost comparison of natural-gas reciprocating engines and electric motors in variable-load industrial applications. Topical report Dec 84-Mar 85

    Energy Technology Data Exchange (ETDEWEB)

    Chockie, A.D.

    1985-03-01

    This report compares natural gas-fired reciprocating engines and electrical motors, with and without variable-frequency speed controller, for one such industrial application. Two types of engines, with and without heat recovery, and three types of motors, standard, high efficiency, and high efficiency with variable-frequency speed controller, are considered. The total life-cycle costs of these five prime movers are compared for three scenarios with varying extent of part-load operations. The relative importance of each cost component is evaluated based on this comparison. The effect of engine heat utilization is addressed parametrically to demonstrate this additional benefit from gas prime movers.

  2. Preservation of renal function by intensive glycemic control

    Directory of Open Access Journals (Sweden)

    Naoya Toriu

    2018-01-01

    Full Text Available We report the case of a 67-year-old Japanese woman with type 1 diabetes mellitus. At 47 years of age, her hemoglobin A1c (HbA1c was 10.0%, and she had overt nephropathy. The first renal biopsy yielded a diagnosis of diabetic nephropathy. Intensive glycemic control was initiated and her HbA1c improved to 6.0%. Renal dysfunction showed no progression for 15 years. At 62 years of age, a second renal biopsy was performed. Glomerular lesions did not show progression but tubulointerstitial fibrosis and vascular lesions showed progression compared with the first biopsy. Intensive glycemic control can prevent the progression of glomerular lesions, but might not be effective for interstitial and vascular lesions.

  3. INDEKS GLISEMIK KACANG-KACANGAN [Glycemic Index of Selected Legumes

    Directory of Open Access Journals (Sweden)

    Y. Marsono 1

    2002-12-01

    Full Text Available Nutritional management for diabetic patients based on selection of low available carbohydrate foods has been criticized because the same availability of carbohydrate in different foods may result in different degree of glycemic response. This management is now being corrected by additional aid in selecting foods with the glycemic index (GI of foods. GI is a measure of the glycemic response to the carbohydrate component within a food relative to the response to an equal carbohydrate portion of reference food (glucose or white bread. In Indonesia, data of the glycemic index of foods is still very limited. The objectives of the research are to provide GI of selected legumes, including red bean (Vigna umbellata, Mung bean (Phaseolus aureus, cow pea (Vigna sinensis ENDL, pigeon pea (Cajanus cajan MILLSPAUGH, edible podded peas (Pisum sativum LINN and soy bean (Glycine max MERR. Eleventh health and normal volunteers (not diabetic were provided. The volunteers took an overnight fasting, blood were drawn in the morning and analyzed for serum glucose. Then they were given the test legumes containing total carbohydrates equivalent to 25-g glucose to be consumed. Blood samples were drawn for glucose measurement every 30 minutes until 120 min after meal. Serum glucose was determined enzymatically and the glucose responses were drawn graphically. The GI of the beans studied was lowest for red bean (26 and highest for mung bean (76, Edible podded pea and soy bean had similar value of GI i.e. 30 and 31; whereas pigeon and cow pea had a higher value i.e. 35 and 51, respectively.

  4. Diabetes, glycemic control, and urinary incontinence in women

    Science.gov (United States)

    Wang, Rui; Lefevre, Roger; Hacker, Michele R.; Golen, Toni H.

    2015-01-01

    OBJECTIVES To estimate the association between urinary incontinence and glycemic control in women ages 20 to 85. METHODS We included 7,270 women from the 2005–2010 National Health and Nutrition Examination Survey, stratified into three groups of glycemic control defined by hemoglobin A1c (HbA1c): i) those below the diagnostic threshold (HbA1c8.5%) to allow for a different relationship between glycemic control and urinary incontinence within each group. The primary outcomes were the presence of any, only stress, only urgency, and mixed urinary incontinence. We calculated adjusted risk ratios using Poisson regressions with robust variance estimates. RESULTS The survey-weighted prevalence was 52.9% for any, 27.2% for only stress, 9.9% for only urgency, and 15.8% for mixed urinary incontinence. Among women with relatively controlled diabetes, each one-unit increase in HbA1c was associated with a 13% (95% CI: 1.03–1.25) increase for any urinary incontinence and a 34% (95% CI 1.06–1.69) increase in risk for only stress incontinence but was not significantly associated with only urgency and mixed incontinence. Other risk factors included body mass index, hormone replacement therapy, smoking, and physical activity. CONCLUSIONS Worsening glycemic control is associated with an increased risk for stress incontinence for women with relatively controlled diabetes. For those either below the diagnostic threshold or with poorly controlled diabetes, the risk may be driven by other factors. Further prospective investigation of HbA1c as a modifiable risk factor may motivate measures to improve continence in women with diabetes. PMID:26313496

  5. Sleep and glycemic control in type 1 diabetes

    OpenAIRE

    Barone,Mark Thomaz Ugliara; Wey,Daniela; Schorr,Fabiola; Franco,Denise Reis; Carra,Mario Kehdi; Lorenzi Filho,Geraldo; Menna-Barreto,Luiz

    2015-01-01

    Objective Our aim in the present study was to elucidate how type 1 diabetes mellitus (T1DM) and sleep parameters interact, which was rarely evaluated up to the moment. Materials and methods Eighteen T1DM subjects without chronic complications, and 9 control subjects, matched for age and BMI, were studied. The following instruments used to evaluate sleep: the Epworth Sleepiness Scale, sleep diaries, actimeters, and polysomnography in a Sleep Lab. Glycemic control in T1DM individuals was evalua...

  6. Glycemic control in the diabetic pregnancy: is tighter always better?

    Science.gov (United States)

    Rosenn, B M; Miodovnik, M

    2000-01-01

    Glucose is the principal nutrient that the mother supplies to the fetus through the placenta by way of concentration-dependent mechanisms. In the presence of maternal hypoglycemia, with limited glucose supply, fetal hypoglycemia and hypoinsulinism ensue. This may be viewed as an adaptive mechanism to increase the chances of fetal survival in the face of limited maternal supply, albeit of a growth-restricted fetus. Fetal nutrient deprivation and the resulting hypoinsulinism may have both short- and long-term consequences. Intrauterine growth failure is associated with higher rates of gestational age-specific neonatal mortality and with long-term cognitive deficits. Furthermore, epidemiologic data suggest that diabetes, coronary artery disease, and hypertension are more common among adults who were small for gestational age at birth. Thus, pancreatic failure in adulthood may be either a response to excessive exposure to glucose as a result of maternal hyperglycemia, or as a result of hypoglycemia where nutrient deprivation leads to fetal growth restriction and reduced islet cell proliferation. Because low mean concentrations of maternal glucose in gestational diabetes are associated with an increased risk of fetal growth restriction, overzealous glycemic control during pregnancy may raise concerns regarding the possible effects on the infant. In the mother with Type 1 diabetes, strict glycemic control is often associated with an increased incidence of severe hypoglycemia. Up to 40% of women report at least one episode of severe hypoglycemia during pregnancy, requiring assistance by another person or professional intervention. It is quite possible that in some patients striving to optimize pregnancy outcome by maintaining the best possible glycemic control jeopardizes the well-being of the mother and the fetus. Thus, with respect to tight glycemic control of pregnant women with diabetes, the question arises: How tight is too tight? Is there a threshold below which the

  7. Variable RBE in proton therapy: comparison of different model predictions and their influence on clinical-like scenarios

    International Nuclear Information System (INIS)

    Giovannini, Giulia; Böhlen, Till; Cabal, Gonzalo; Bauer, Julia; Tessonnier, Thomas; Frey, Kathrin; Debus, Jürgen; Mairani, Andrea; Parodi, Katia

    2016-01-01

    In proton radiation therapy a constant relative biological effectiveness (RBE) of 1.1 is usually assumed. However, biological experiments have evidenced RBE dependencies on dose level, proton linear energy transfer (LET) and tissue type. This work compares the predictions of three of the main radio-biological models proposed in the literature by Carabe-Fernandez, Wedenberg, Scholz and coworkers. Using the chosen models, a spread-out Bragg peak (SOBP) as well as two exemplary clinical cases (single field and two fields) for cranial proton irradiation, all delivered with state-of-the-art pencil-beam scanning, have been analyzed in terms of absorbed dose, dose-averaged LET (LET D ), RBE-weighted dose (D RBE ) and biological range shift distributions. In the systematic comparison of RBE predictions by the three models we could show different levels of agreement depending on (α/β) x and LET values. The SOBP study emphasizes the variation of LET D and RBE not only as a function of depth but also of lateral distance from the central beam axis. Application to clinical-like scenario shows consistent discrepancies from the values obtained for a constant RBE of 1.1, when using a variable RBE scheme for proton irradiation in tissues with low (α/β) x , regardless of the model. Biological range shifts of 0.6– 2.4 mm (for high (α/β) x ) and 3.0 – 5.4 mm (for low (α/β) x ) were found from the fall-off analysis of individual profiles of RBE-weighted fraction dose along the beam penetration depth. Although more experimental evidence is needed to validate the accuracy of the investigated models and their input parameters, their consistent trend suggests that their main RBE dependencies (dose, LET and (α/β) x ) should be included in treatment planning systems. In particular, our results suggest that simpler models based on the linear-quadratic formalism and LET D might already be sufficient to reproduce important RBE dependencies for re-evaluation of plans optimized with

  8. Glycemic control and radiographic manifestations of tuberculosis in diabetic patients.

    Directory of Open Access Journals (Sweden)

    Chen-Yuan Chiang

    Full Text Available BACKGROUND: Radiographic manifestations of pulmonary tuberculosis (TB in patients with diabetes mellitus (DM have previously been reported, with inconsistent results. We conducted a study to investigate whether glycemic control has an impact on radiographic manifestations of pulmonary TB. METHODS: Consecutive patients with culture-positive pulmonary TB who had DM in three tertiary care hospitals from 2005-2010 were selected for review and compared with a similar number without DM. Glycemic control was assessed by glycated haemoglobin A1C (HbA1C. A pre-treatment chest radiograph was read independently by two qualified pulmonologists blinded to patients' diabetic status. Films with any discordant reading were read by a third reader. RESULTS: 1209 culture positive pulmonary TB patients (581 with DM and 628 without DM were enrolled. Compared with those without DM, TB patients with DM were significantly more likely to have opacity over lower lung fields, extensive parenchymal lesions, any cavity, multiple cavities and large cavities (>3 cm. The relative risk of lower lung field opacities was 0.80 (95% CI 0.46-1.42 for those with DM with A1C9%; and that of any cavity over no cavity was 0.87 (95% CI 0.46-1.62 for patients with DM with A1C9%, relative to patients without DM. CONCLUSIONS: Glycemic control significantly influenced radiographic manifestations of pulmonary TB in patients with DM.

  9. Evaluation of glycemic control in patients with type 2 diabetes mellitus in Chinese communities: a cross-sectional study.

    Science.gov (United States)

    Shan, Shan; Gu, Liubao; Lou, Qinglin; Ouyang, Xiaojun; Yu, Yun; Wu, Haidi; Bian, Rongwen

    2017-02-01

    This study aimed to evaluate the glycemic levels in Chinese patients with type 2 diabetes mellitus (T2DM) and to explore the factors related to the results of glycemic control. A total of 2454 T2DM patients from 11 communities were examined for glycosylated hemoglobin levels and glycemic control options. Potential factors related to the results of glycemic control were analyzed using logistic regression. Of all the patients, 55.3 % achieved the glycemic control target of HbA1c diet and exercise, insulin injection was most strongly associated with poor glycemic control (OR 6.210, 95 % CI 4.054-9.514; P diabetic durations showed poor glycemic control, which was not found in female patients. Glycemic control was not satisfactory in T2DM patients of Nanjing communities. Various factors are associated with poor results of glycemic control.

  10. Effect of Poor Glycemic Control in Newly Diagnosed Patients with Smear-Positive Pulmonary Tuberculosis and Type-2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Vinay Mahishale

    2017-03-01

    Full Text Available Background: There is growing evidence that diabetes mellitus (DM is an important risk factor for tuberculosis (TB. A significant number of DM patients have poor glycemic control. This study was carried out to find the impact of poor glycemic control on newly diagnosed smear-positive pulmonary tuberculosis patients with type-2 diabetes mellitus in a tertiary care hospital. Methods: In a hospital-based prospective study, newly diagnosed smear-positive pulmonary TB with DM patients were classified as poorly controlled diabetes (HBA1C≥7% and optimal control diabetics (HbA1c<7%. Patients were started on anti-TB treatment and followed for 2 years for severity and treatment outcome. ANOVA was used for numerical variables in the univariable analysis. Logistic regression analysis was used for multivariable analysis of treatment outcome. The significance level was kept at a P≤0.05. Results: A total of 630 individuals who met the inclusion criteria were analyzed; of which 423 patients had poor glycemic control (PGC and 207 patients had optimal glycemic control (OGC. The average HbA1c was 10±2.6 and 5±1.50 in the PGC and OGC groups, respectively. The mean symptom score was significantly higher in the PGC group compared with patients in the OGC group (4.55±0.80 vs. 2.70±0.82, P<0.001. PGC was associated with more extensive lung disease, lung cavitation, and positive sputum smear at the baseline. In PGC, sputum smears were significantly more likely to remain positive after 2 months of treatment. PGC patients had significantly higher rates of treatment failure (adj. OR 0.72, 95% CI 0.58-0.74, P<0.001 and relapse (adj. OR 2.83, 95% CI 2.60-2.92, P<0.001. Conclusion: Poor glycemic control is associated with an increased risk of advanced and more severe TB disease in the form of lung cavitations, positive sputum smear, and slower smear conversion. It has a profound negative effect on treatment completion, cure, and relapse rates in patients with

  11. Effect of glycemic control and type of diabetes treatment on unsuccessful TB treatment outcomes among people with TB-Diabetes: A systematic review.

    Directory of Open Access Journals (Sweden)

    Hemant Deepak Shewade

    Full Text Available Stringent glycemic control by using insulin as a replacement or in addition to oral hypoglycemic agents (OHAs has been recommended for people with tuberculosis and diabetes mellitus (TB-DM. This systematic review (PROSPERO 2016:CRD42016039101 analyses whether this improves TB treatment outcomes.Among people with drug-susceptible TB and DM on anti-TB treatment, to determine the effect of i glycemic control (stringent or less stringent compared to poor glycemic control and ii insulin (only or with OHAs compared to 'OHAs only' on unsuccessful TB treatment outcome(s. We looked for unfavourable TB treatment outcomes at the end of intensive phase and/or end of TB treatment (minimum six months and maximum 12 months follow up. Secondary outcomes were development of MDR-TB during the course of treatment, recurrence after 6 months and/or after 1 year post successful treatment completion and development of adverse events related to glucose lowering treatment (including hypoglycemic episodes.All interventional studies (with comparison arm and cohort studies on people with TB-DM on anti-TB treatment reporting glycemic control, DM treatment details and TB treatment outcomes were eligible. We searched electronic databases (EMBASE, PubMed, Google Scholar and grey literature between 1996 and April 2017. Screening, data extraction and risk of bias assessment were done independently by two investigators and recourse to a third investigator, for resolution of differences.After removal of duplicates from 2326 identified articles, 2054 underwent title and abstract screening. Following full text screening of 56 articles, nine cohort studies were included. Considering high methodological and clinical heterogeneity, we decided to report the results qualitatively and not perform a meta-analysis. Eight studies dealt with glycemic control, of which only two were free of the risk of bias (with confounder-adjusted measures of effect. An Indian study reported 30% fewer

  12. Effect of glycemic control and type of diabetes treatment on unsuccessful TB treatment outcomes among people with TB-Diabetes: A systematic review.

    Science.gov (United States)

    Shewade, Hemant Deepak; Jeyashree, Kathiresan; Mahajan, Preetam; Shah, Amar N; Kirubakaran, Richard; Rao, Raghuram; Kumar, Ajay M V

    2017-01-01

    Stringent glycemic control by using insulin as a replacement or in addition to oral hypoglycemic agents (OHAs) has been recommended for people with tuberculosis and diabetes mellitus (TB-DM). This systematic review (PROSPERO 2016:CRD42016039101) analyses whether this improves TB treatment outcomes. Among people with drug-susceptible TB and DM on anti-TB treatment, to determine the effect of i) glycemic control (stringent or less stringent) compared to poor glycemic control and ii) insulin (only or with OHAs) compared to 'OHAs only' on unsuccessful TB treatment outcome(s). We looked for unfavourable TB treatment outcomes at the end of intensive phase and/or end of TB treatment (minimum six months and maximum 12 months follow up). Secondary outcomes were development of MDR-TB during the course of treatment, recurrence after 6 months and/or after 1 year post successful treatment completion and development of adverse events related to glucose lowering treatment (including hypoglycemic episodes). All interventional studies (with comparison arm) and cohort studies on people with TB-DM on anti-TB treatment reporting glycemic control, DM treatment details and TB treatment outcomes were eligible. We searched electronic databases (EMBASE, PubMed, Google Scholar) and grey literature between 1996 and April 2017. Screening, data extraction and risk of bias assessment were done independently by two investigators and recourse to a third investigator, for resolution of differences. After removal of duplicates from 2326 identified articles, 2054 underwent title and abstract screening. Following full text screening of 56 articles, nine cohort studies were included. Considering high methodological and clinical heterogeneity, we decided to report the results qualitatively and not perform a meta-analysis. Eight studies dealt with glycemic control, of which only two were free of the risk of bias (with confounder-adjusted measures of effect). An Indian study reported 30% fewer

  13. A comparison of methods to handle skew distributed cost variables in the analysis of the resource consumption in schizophrenia treatment.

    Science.gov (United States)

    Kilian, Reinhold; Matschinger, Herbert; Löeffler, Walter; Roick, Christiane; Angermeyer, Matthias C

    2002-03-01

    Transformation of the dependent cost variable is often used to solve the problems of heteroscedasticity and skewness in linear ordinary least square regression of health service cost data. However, transformation may cause difficulties in the interpretation of regression coefficients and the retransformation of predicted values. The study compares the advantages and disadvantages of different methods to estimate regression based cost functions using data on the annual costs of schizophrenia treatment. Annual costs of psychiatric service use and clinical and socio-demographic characteristics of the patients were assessed for a sample of 254 patients with a diagnosis of schizophrenia (ICD-10 F 20.0) living in Leipzig. The clinical characteristics of the participants were assessed by means of the BPRS 4.0, the GAF, and the CAN for service needs. Quality of life was measured by WHOQOL-BREF. A linear OLS regression model with non-parametric standard errors, a log-transformed OLS model and a generalized linear model with a log-link and a gamma distribution were used to estimate service costs. For the estimation of robust non-parametric standard errors, the variance estimator by White and a bootstrap estimator based on 2000 replications were employed. Models were evaluated by the comparison of the R2 and the root mean squared error (RMSE). RMSE of the log-transformed OLS model was computed with three different methods of bias-correction. The 95% confidence intervals for the differences between the RMSE were computed by means of bootstrapping. A split-sample-cross-validation procedure was used to forecast the costs for the one half of the sample on the basis of a regression equation computed for the other half of the sample. All three methods showed significant positive influences of psychiatric symptoms and met psychiatric service needs on service costs. Only the log- transformed OLS model showed a significant negative impact of age, and only the GLM shows a significant

  14. Glycemic Responses, Glycemic Index, and Glycemic Load Values of Some Street Foods Prepared from Plantain (Musa spp., AAB Genome) in Côte d'Ivoire.

    Science.gov (United States)

    Kouamé, Camille Adam; Kouassi, Nestor Kouakou; N'dri, Denis Yao; Pereko, Kingsley Kwadwo Asare; Casiraghi, Maria Cristina; Rhedoor, Abodo Jacko; Amani, Georges N'guessan

    2017-09-16

    The glycemic index (GI) and glycemic load (GL) of four culinary preferences including five local street dishes prepared from three varieties of plantain at different maturity stages was determined. The GI was obtained following ISO/FDI 26642:2010 protocol, and the GL was calculated from test foods' GI, considering the amount of available carbohydrate in the traditional portion size. GI values were 44 for Klaclo (with Ameletiha variety at all black stage), 39 for Aloco (with Agnrin variety at full yellow stage), 39 for Aloco (with Agnrin variety at full yellow with black spots stage); 45 for Chips (with Ameletiha variety at green stage) and 89 for Banane braisée (with Afoto variety at light green stage). GI values were inversely correlated with the total sugar and carbohydrate in foods ( p foods were high (GL > 20). Contrary to Banane braisée, the consumption of Klaclo, Aloco, and Chips may promote the control of postprandial glucose response. Data provides the first GI published values of plantain-based foods commonly consumed in the urban area of Abidjan (Côte d'Ivoire).

  15. Diurnal Glycemic Patterns during an 8-Week Open-Label Proof-of-Concept Trial of Empagliflozin in Type 1 Diabetes

    Science.gov (United States)

    Lee, Justin A.; Partridge, Helen; Tschirhart, Holly; Zinman, Bernard; Mazze, Roger; Fagan, Nora; Kaspers, Stefan; Woerle, Hans-Juergen; Broedl, Uli C.; Johansen, Odd Erik

    2015-01-01

    Background We recently reported improved glycemic control with reduced insulin dose in subjects with type 1 diabetes treated with the sodium glucose co-transporter-2 inhibitor empagliflozin. To further characterize the effects, we analyzed diurnal glycemic patterns by continuous glucose monitoring (CGM). Methods In an 8-week single-arm open-label pilot study of empagliflozin, we compared ambulatory glucose profiles produced from CGM data during 2-week intervals in a placebo run-in baseline period, end-of-treatment, and post-treatment. Change in glycemic exposure was evaluated by area under the median curve according to time of day (AUCTOTAL 12:00am-11:55pm; AUCDAY 7:05am-10:55pm, AUCNIGHT 11:00pm-7:00am), as well as glycemic variability, glycemic stability and time-in-target (≥70 to ≤140mg/dL). Results The 40 patients (26 on insulin pump) were aged 24±5 years and BMI 24.5±3.2 kg/m2. Consistent with the observed HbA1c decrease (8.0±0.9% to 7.6±0.9%, pempagliflozin was discontinued, these worsened relative to baseline (89.3±19.3mg/dL, p = 0.04 and 11.8±3.7mg/dL/hr, p = 0.08). Time-in-target numerically increased (40.2±11.9 to 43.1±13.5%, p = 0.69) at end-of-treatment but reversed post-treatment. Findings were similar on stratification of pump and MDI subjects. Conclusions We observed that empagliflozin was associated with patterns of improved nighttime glycemia more prominent than daytime. Trial Registration Clinicaltrials.gov NCT01392560 PMID:26544192

  16. Indications for Insulin Pump Therapy in Type 1 Diabetes and Associations With Glycemic Control.

    Science.gov (United States)

    Jendle, Johan H; Rawshani, Araz; Svensson, Ann-Marie; Avdic, Tarik; Gudbjörnsdóttir, Soffia

    2016-09-01

    Real-world data regarding indications for use of insulin pump remain sparse. We investigated characteristics among individuals with type 1 diabetes (T1D) in relation to indication for use of insulin pump (CSII). Comparison was made with T1D subjects using multiple daily injections (MDI). We included all individuals with T1D who had at least 1 registration in the National Diabetes Register during 2014-2015. Among 46 874 individuals, we excluded 2350 due to missing data. We examined 35 725 on MDI and 8799 on CSII regarding characteristics in relation to insulin delivery method, as well as association between insulin delivery and glycemic control (HbA1c) and presence of albuminuria. Unadjusted mean (SD) HbA1c was 63.84 (15.07) mmol/mol (7.99 [1.38]%) and 63.75 (13.19) mmol/mol (7.99 [1.21]%) in the MDI and CSII group, respectively. MDI and CSII users were on average 48.8 and 41.5 years old, respectively. MDI users were on average 26 years old and CSII users 17 years old at the time of diabetes diagnosis. Overall, a higher proportion of CSII users were females (53.5%). As compared with MDI, use of CSII was associated with up to 7.84 mmol/mol (0.72%) lower HbA1c in a multivariable adjusted model. Use of CSII was, however, not associated with risk of having albuminuria. CSII was used more frequently in younger individuals, early-onset diabetes, and problematic glycemic control. The use of CSII was associated with lower HbA1c among CSII users except from those who started CSII due to high HbA1c. © 2016 Diabetes Technology Society.

  17. Association between poor glycemic control, impaired sleep quality, and increased arterial thickening in type 2 diabetic patients.

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    Koichiro Yoda

    Full Text Available Poor sleep quality is an independent predictor of cardiovascular events. However, little is known about the association between glycemic control and objective sleep architecture and its influence on arteriosclerosis in patients with type-2 diabetes mellitus (DM. The present study examined the association of objective sleep architecture with both glycemic control and arteriosclerosis in type-2 DM patients.Cross-sectional study in vascular laboratory.The subjects were 63 type-2 DM inpatients (M/F, 32/31; age, 57.5±13.1 without taking any sleeping promoting drug and chronic kidney disease. We examined objective sleep architecture by single-channel electroencephalography and arteriosclerosis by carotid-artery intima-media thickness (CA-IMT.HbA1c was associated significantly in a negative manner with REM sleep latency (interval between sleep-onset and the first REM period (β=-0.280, p=0.033, but not with other measurements of sleep quality. REM sleep latency associated significantly in a positive manner with log delta power (the marker of deep sleep during that period (β=0.544, p=0.001. In the model including variables univariately correlated with CA-IMT (REM sleep latency, age, DM duration, systolic blood pressure, and HbA1c as independent variables, REM sleep latency (β=-0.232, p=0.038, but not HbA1c were significantly associated with CA-IMT. When log delta power was included in place of REM sleep latency, log delta power (β=-0.257, p=0.023 emerged as a significant factor associated with CA-IMT.In type-2 DM patients, poor glycemic control was independently associated with poor quality of sleep as represented by decrease of REM sleep latency which might be responsible for increased CA-IMT, a relevant marker for arterial wall thickening.

  18. Fitness and physical activity in youth with type 1 diabetes mellitus in good or poor glycemic control.

    Science.gov (United States)

    Nguyen, Thanh; Obeid, Joyce; Walker, Rachel G; Krause, Matthew P; Hawke, Thomas J; McAssey, Karen; Vandermeulen, John; Timmons, Brian W

    2015-02-01

    Patients with type 1 diabetes mellitus (T1DM) may experience poor muscle health as a result of chronic hyperglycemia. Despite this, muscle function in children with T1DM with good or poor glycemic control has yet to be examined in detail. To assess differences in muscle-related fitness variables in children with T1DM with good glycemic control (T1DM-G), as well as those with poor glycemic control (T1DM-P), and non-diabetic, healthy controls. Eight children with T1DM-G [glycosylated hemoglobin (HbA1c) ≤ 7.5% for 9 months], eight children with T1DM-P (HbA1c ≥ 9.0% for 9 months), and eight healthy controls completed one exercise session. Anaerobic and aerobic muscle functions were assessed with a maximal isometric grip strength test, a Wingate test, and an incremental continuous cycling test until exhaustion. Blood samples were collected at rest to determine HbA1c at the time of testing. Physical activity was monitored over 7 d using accelerometry. Children with T1DM-P displayed lower peak oxygen consumption (VO2peak ) values (mL/kg/min) compared to healthy controls (T1DM-P: 33.2 ± 5.6, controls: 43.5 ± 6.3, p physical activity variables. Children with T1DM-G did not display signs of impaired muscle function, while children with T1DM-P have signs of altered aerobic muscle capacity. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Intermittent Vagal Nerve Block for Improvements in Obesity, Cardiovascular Risk Factors, and Glycemic Control in Patients with Type 2 Diabetes Mellitus: 2-Year Results of the VBLOC DM2 Study.

    Science.gov (United States)

    Shikora, Scott A; Toouli, James; Herrera, Miguel F; Kulseng, Bård; Brancatisano, Roy; Kow, Lilian; Pantoja, Juan P; Johnsen, Gjermund; Brancatisano, Anthony; Tweden, Katherine S; Knudson, Mark B; Billington, Charles J; Billingto, Charles J

    2016-05-01

    One-year results of the VBLOC DM2 study found that intermittent vagal blocking (VBLOC therapy) was safe among subjects with obesity and type 2 diabetes mellitus (T2DM) and led to significant weight loss and improvements in glycemic parameters and cardiovascular risk factors. Longer-term data are needed to determine whether the results are sustained. VBLOC DM2 is a prospective, observational study of 28 subjects with T2DM and body mass index (BMI) between 30 and 40 kg/m(2) to assess mid-term safety and weight loss and improvements in glycemic parameters, and other cardiovascular risk factors with VBLOC therapy. Continuous outcome variables are reported using mixed models. At 24 months, the mean percentage of excess weight loss was 22% (95% CI, 15 to 28, p obesity and glycemic control were largely sustained after 2 years of treatment with VBLOC therapy with a well-tolerated risk profile.

  20. Searching for faint AGN in the CDFS: an X-ray (Chandra) vs optical variability (HST) comparison.

    Science.gov (United States)

    Georgantopoulos, I.; Pouliasis, E.; Bonanos, A.; Sokolovsky, K.; Yang, M.; Hatzidimitriou, D.; Bellas, I.; Gavras, P.; Spetsieri, Z.

    2017-10-01

    X-ray surveys are believed to be the most efficient way to detect AGN. Recently though, optical variability studies are claimed to probe even fainter AGN. We are presenting results from an HST study aimed to identify Active Galactic Nuclei (AGN) through optical variability selection in the CDFS.. This work is part of the 'Hubble Catalogue of Variables'project of ESA that aims to identify variable sources in the Hubble Source Catalogue.' In particular, we used Hubble Space Telescope (HST) z-band images taken over 5 epochs and performed aperture photometry to derive the lightcurves of the sources. Two statistical methods (standard deviation & interquartile range) resulting in a final sample of 175 variable AGN candidates, having removed the artifacts by visual inspection and known stars and supernovae. The fact that the majority of the sources are extended and variable indicates AGN activity. We compare the efficiency of the method by comparing with the 7Ms Chandra detections. Our work shows that the optical variability probes AGN at comparable redshifts but at deeper optical magnitudes. Our candidate AGN (non detected in X-rays) have luminosities of L_x<6×10^{40} erg/sec at z˜0.7 suggesting that these are associated with low luminosity Seyferts and LINERS.

  1. Variability characteristics and comparison of Carex arenaria L. and Carex ligerica Gay populations based on rhizome characters

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    Lech Urbaniak

    2014-01-01

    Full Text Available The studies included 9 populations of Carex arenaria L. and 7 populations of Carex ligerica Gay, compared with each other on grounds of variability analysis, related to rhizome characters. The sedges reach in the area of Poland their eastern range limits, with isolated populations spread along the range margins. The studied plants were placed in a greenhouse in homogenous conditions,which made possible an analysis of genetic variability in the populations. The obtained results point to the absence of gene flow between the studied species and, thus, to their clearly distinct character. Genetic drift was postulated as one of the causes of the obtained variability pattern.

  2. Socioeconomic Status and Glycemic Control in Type 2 Diabetes; Race by Gender Differences

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    Shervin Assari

    2017-11-01

    Full Text Available Background: This study aimed to investigate differences in the association between socioeconomic status (SES and glycemic control in type 2 diabetes mellitus (DM across race by gender groups. Methods: Using a convenient sampling strategy, participants were 112 patients with type 2 DM who were prescribed insulin (ns = 38 Black women, 34 Black men, 14 White women, and 26 White men, respectively. Linear regression was used to test the associations between sociodemographic variables (race, gender, SES, governmental insurance and Hemoglobin A1c (HbA1c in the pooled sample and within subgroups defined by race and gender. Results: In the pooled sample, neither SES nor governmental insurance were associated with HbA1c. However, the race by gender interaction approached statistical significance (B = 0.34, 95% CI = −0.24–3.00, p =0.094, suggesting higher HbA1c in Black women, compared to other race by gender groups. In stratified models, SES (B = −0.33, 95% CI = −0.10–0.00, p = 0.050, and governmental insurance (B = 0.35, 95% CI = 0.05–2.42, p = 0.042 were associated with HbA1c for Black men, but not for any of the other race by gender subgroups. Conclusion: Socioeconomic factors may relate to health outcomes differently across race by gender subgroups. In particular, SES may be uniquely important for glycemic control of Black men. Due to lack of generalizability of the findings, additional research is needed.

  3. The Effect of Glycemic Status on Kidney Stone Disease in Patients with Prediabetes

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    Tzu-Hsien Lien

    2016-04-01

    Full Text Available BackgroundWhile the evidence supporting a positive association between diabetes mellitus and kidney stone disease (KSD is solid, studies examining the association between impaired fasting glucose (IFG and KSD show inconsistent results. Currently, there are no studies examining the relationship between impaired glucose tolerance (IGT and KSD. The objective of this study is to investigate the effects of different glycemic statuses on KSD. The results may help to motivate patients with diabetes to conform to treatment regimens.MethodsWe conducted a cross sectional study of a population that underwent health check-ups between January 2000 and August 2009 at the Health Evaluation Center of National Cheng Kung University Hospital. A total of 14,186 subjects were enrolled. The following categories of glycemic status were used according to the criteria of the 2009 American Diabetes Association: normal glucose tolerance, isolated IGT, isolated IFG, combined IFG/IGT, and diabetes. The existence of KSD was evaluated using renal ultrasonography, and the presence of any hyperechoic structures causing acoustic shadowing was considered to be indicative of KSD.ResultsThe prevalence of KSD was 7.4% (712/9,621, 9.3% (163/1,755, 10.8% (78/719, 12.0% (66/548, and 11.3% (174/1,543 in subjects with NGT, isolated IGT, isolated IFG, combined IFG/IGT, and diabetes, respectively. Isolated IFG, combined IFG/IGT, and diabetes were associated with KSD after adjusting for other clinical variables, but isolated IGT was not. Age (41 to 64 years vs. ≤40 years, ≥65 years vs. ≤40 years, male gender, hypertension, and hyperuricemia were also independently associated with KSD.ConclusionIsolated IFG, combined IFG/IGT, and diabetes, but not isolated IGT, were associated with a higher risk of KSD.

  4. Predictive Clinical Parameters and Glycemic Efficacy of Vildagliptin Treatment in Korean Subjects with Type 2 Diabetes

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    Jin-Sun Chang

    2013-02-01

    Full Text Available BackgroundThe aims of this study are to investigate the glycemic efficacy and predictive parameters of vildagliptin therapy in Korean subjects with type 2 diabetes.MethodsIn this retrospective study, we retrieved data for subjects who were on twice-daily 50 mg vildagliptin for at least 6 months, and classified the subjects into five treatment groups. In three of the groups, we added vildagliptin to their existing medication regimen; in the other two groups, we replaced one of their existing medications with vildagliptin. We then analyzed the changes in glucose parameters and clinical characteristics.ResultsUltimately, 327 subjects were analyzed in this study. Vildagliptin significantly improved hemoglobin A1c (HbA1c levels over 6 months. The changes in HbA1c levels (ΔHbA1c at month 6 were -2.24% (P=0.000, -0.77% (P=0.000, -0.80% (P=0.001, -0.61% (P=0.000, and -0.34% (P=0.025 for groups 1, 2, 3, 4, and 5, respectively, with significance. We also found significant decrements in fasting plasma glucose levels in groups 1, 2, 3, and 4 (P<0.05. Of the variables, initial HbA1c levels (P=0.032 and history of sulfonylurea use (P=0.026 were independently associated with responsiveness to vildagliptin treatment.ConclusionVildagliptin was effective when it was used in subjects with poor glycemic control. It controlled fasting plasma glucose levels as well as sulfonylurea treatment in Korean type 2 diabetic subjects.

  5. Effect of adding the novel fiber, PGX®, to commonly consumed foods on glycemic response, glycemic index and GRIP: a simple and effective strategy for reducing post prandial blood glucose levels - a randomized, controlled trial

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    Lyon Michael

    2010-11-01

    Full Text Available Abstract Background Reductions in postprandial glycemia have been demonstrated previously with the addition of the novel viscous polysaccharide (NVP, PolyGlycopleX® (PGX®, to an OGTT or white bread. This study explores whether these reductions are sustained when NVP is added to a range of commonly consumed foods or incorporated into a breakfast cereal. Methods Ten healthy subjects (4M, 6F; age 37.3 ± 3.6 y; BMI 23.8 ± 1.3 kg/m2, participated in an acute, randomized controlled trial. The glycemic response to cornflakes, rice, yogurt, and a frozen dinner with and without 5 g of NVP sprinkled onto the food was determined. In addition, 3 granolas with different levels of NVP and 3 control white breads and one white bread and milk were also consumed. All meals contained 50 g of available carbohydrate. Capillary blood samples were taken fasting and at 15, 30, 45, 60, 90 and 120 min after the start of the meal. The glycemic index (GI and the glycemic reduction index potential (GRIP were calculated. The blood glucose concentrations at each time and the iAUC values were subjected to repeated-measures analysis of variance (ANOVA examining for the effect of test meal. After demonstration of significant heterogeneity, differences between individual means was assessed using GLM ANOVA with Tukey test to adjust for multiple comparisons. Results Addition of NVP reduced blood glucose response irrespective of food or dose (p Conclusion Sprinkling or incorporation of NVP into a variety of different foods is highly effective in reducing postprandial glycemia and lowering the GI of a food. Clinical Trial registration NCT00935350.

  6. Effect of adding the novel fiber, PGX®, to commonly consumed foods on glycemic response, glycemic index and GRIP: a simple and effective strategy for reducing post prandial blood glucose levels--a randomized, controlled trial.

    Science.gov (United States)

    Jenkins, Alexandra L; Kacinik, Veronica; Lyon, Michael; Wolever, Thomas Ms

    2010-11-22

    Reductions in postprandial glycemia have been demonstrated previously with the addition of the novel viscous polysaccharide (NVP), PolyGlycopleX® (PGX®), to an OGTT or white bread. This study explores whether these reductions are sustained when NVP is added to a range of commonly consumed foods or incorporated into a breakfast cereal. Ten healthy subjects (4M, 6F; age 37.3 ± 3.6 y; BMI 23.8 ± 1.3 kg/m2), participated in an acute, randomized controlled trial. The glycemic response to cornflakes, rice, yogurt, and a frozen dinner with and without 5 g of NVP sprinkled onto the food was determined. In addition, 3 granolas with different levels of NVP and 3 control white breads and one white bread and milk were also consumed. All meals contained 50 g of available carbohydrate. Capillary blood samples were taken fasting and at 15, 30, 45, 60, 90 and 120 min after the start of the meal. The glycemic index (GI) and the glycemic reduction index potential (GRIP) were calculated. The blood glucose concentrations at each time and the iAUC values were subjected to repeated-measures analysis of variance (ANOVA) examining for the effect of test meal. After demonstration of significant heterogeneity, differences between individual means was assessed using GLM ANOVA with Tukey test to adjust for multiple comparisons. Addition of NVP reduced blood glucose response irrespective of food or dose (p granola, and granolas with 2.5 and 5 g of NVP were 64 ± 6, 33 ± 5, and 22 ± 3 respectively. GRIP was 6.8 ± 0.9 units per/g of NVP. Sprinkling or incorporation of NVP into a variety of different foods is highly effective in reducing postprandial glycemia and lowering the GI of a food. NCT00935350.

  7. Effect of adding the novel fiber, PGX®, to commonly consumed foods on glycemic response, glycemic index and GRIP: a simple and effective strategy for reducing post prandial blood glucose levels - a randomized, controlled trial

    Science.gov (United States)

    2010-01-01

    Background Reductions in postprandial glycemia have been demonstrated previously with the addition of the novel viscous polysaccharide (NVP), PolyGlycopleX® (PGX®), to an OGTT or white bread. This study explores whether these reductions are sustained when NVP is added to a range of commonly consumed foods or incorporated into a breakfast cereal. Methods Ten healthy subjects (4M, 6F; age 37.3 ± 3.6 y; BMI 23.8 ± 1.3 kg/m2), participated in an acute, randomized controlled trial. The glycemic response to cornflakes, rice, yogurt, and a frozen dinner with and without 5 g of NVP sprinkled onto the food was determined. In addition, 3 granolas with different levels of NVP and 3 control white breads and one white bread and milk were also consumed. All meals contained 50 g of available carbohydrate. Capillary blood samples were taken fasting and at 15, 30, 45, 60, 90 and 120 min after the start of the meal. The glycemic index (GI) and the glycemic reduction index potential (GRIP) were calculated. The blood glucose concentrations at each time and the iAUC values were subjected to repeated-measures analysis of variance (ANOVA) examining for the effect of test meal. After demonstration of significant heterogeneity, differences between individual means was assessed using GLM ANOVA with Tukey test to adjust for multiple comparisons. Results Addition of NVP reduced blood glucose response irrespective of food or dose (p granola, and granolas with 2.5 and 5 g of NVP were 64 ± 6, 33 ± 5, and 22 ± 3 respectively. GRIP was 6.8 ± 0.9 units per/g of NVP. Conclusion Sprinkling or incorporation of NVP into a variety of different foods is highly effective in reducing postprandial glycemia and lowering the GI of a food. Clinical Trial registration NCT00935350. PMID:21092221

  8. Relative roles of weather variables and change in human population in malaria: comparison over different states of India.

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    Prashant Goswami

    Full Text Available Pro-active and effective control as well as quantitative assessment of impact of climate change on malaria requires identification of the major drivers of the epidemic. Malaria depends on vector abundance which, in turn, depends on a combination of weather variables. However, there remain several gaps in our understanding and assessment of malaria in a changing climate. Most of the studies have considered weekly or even monthly mean values of weather variables, while the malaria vector is sensitive to daily variations. Secondly, rarely all the relevant meteorological variables have been considered together. An important question is the relative roles of weather variables (vector abundance and change in host (human population, in the change in disease load.We consider the 28 states of India, characterized by diverse climatic zones and changing population as well as complex variability in malaria, as a natural test bed. An annual vector load for each of the 28 states is defined based on the number of vector genesis days computed using daily values of temperature, rainfall and humidity from NCEP daily Reanalysis; a prediction of potential malaria load is defined by taking into consideration changes in the human population and compared with the reported number of malaria cases.For most states, the number of malaria cases is very well correlated with the vector load calculated with the combined conditions of daily values of temperature, rainfall and humidity; no single weather variable has any significant association with the observed disease prevalence.The association between vector-load and daily values of weather variables is robust and holds for different climatic regions (states of India. Thus use of all the three weather variables provides a reliable means of pro-active and efficient vector sanitation and control as well as assessment of impact of climate change on malaria.

  9. Relative roles of weather variables and change in human population in malaria: comparison over different states of India.

    Science.gov (United States)

    Goswami, Prashant; Murty, Upadhayula Suryanarayana; Mutheneni, Srinivasa Rao; Krishnan, Swathi Trithala

    2014-01-01

    Pro-active and effective control as well as quantitative assessment of impact of climate change on malaria requires identification of the major drivers of the epidemic. Malaria depends on vector abundance which, in turn, depends on a combination of weather variables. However, there remain several gaps in our understanding and assessment of malaria in a changing climate. Most of the studies have considered weekly or even monthly mean values of weather variables, while the malaria vector is sensitive to daily variations. Secondly, rarely all the relevant meteorological variables have been considered together. An important question is the relative roles of weather variables (vector abundance) and change in host (human) population, in the change in disease load. We consider the 28 states of India, characterized by diverse climatic zones and changing population as well as complex variability in malaria, as a natural test bed. An annual vector load for each of the 28 states is defined based on the number of vector genesis days computed using daily values of temperature, rainfall and humidity from NCEP daily Reanalysis; a prediction of potential malaria load is defined by taking into consideration changes in the human population and compared with the reported number of malaria cases. For most states, the number of malaria cases is very well correlated with the vector load calculated with the combined conditions of daily values of temperature, rainfall and humidity; no single weather variable has any significant association with the observed disease prevalence. The association between vector-load and daily values of weather variables is robust and holds for different climatic regions (states of India). Thus use of all the three weather variables provides a reliable means of pro-active and efficient vector sanitation and control as well as assessment of impact of climate change on malaria.

  10. On Comparison of SimTandem with State-of-the-Art Peptide Identification Tools, Efficiency of Precursor Mass Filter and Dealing with Variable Modifications

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    Novák Jiří

    2013-12-01

    Full Text Available The similarity search in theoretical mass spectra generated from protein sequence databases is a widely accepted approach for identification of peptides from query mass spectra produced by shotgun proteomics. Growing protein sequence databases and noisy query spectra demand database indexing techniques and better similarity measures for the comparison of theoretical spectra against query spectra. We employ a modification of previously proposed parameterized Hausdorff distance for comparisons of mass spectra. The new distance outperforms the original distance, the angle distance and state-of-the-art peptide identification tools OMSSA and X!Tandem in the number of identified peptides even though the q-value is only 0.001. When a precursor mass filter is used as a database indexing technique, our method outperforms OMSSA in the speed of search. When variable modifications are not searched, the search time is similar to X!Tandem. We show that the precursor mass filter is an efficient database indexing technique for high-accuracy data even though many variable modifications are being searched. We demonstrate that the number of identified peptides is bigger when variable modifications are searched separately by more search runs of a peptide identification engine. Otherwise, the false discovery rates are affected by mixing unmodified and modified spectra together resulting in a lower number of identified peptides. Our method is implemented in the freely available application SimTandem which can be used in the framework TOPP based on OpenMS.

  11. Skin autofluorescence reflects integration of past long-term glycemic control in patients with type 1 diabetes.

    Science.gov (United States)

    Sugisawa, Eri; Miura, Junnosuke; Iwamoto, Yasuhiko; Uchigata, Yasuko

    2013-08-01

    The aim was to investigate the relationships between skin autofluorescence (AF) and the impact of past glycemic control and microvascular complications in Japanese patients with type 1 diabetes. Two hundred forty-one patients and 110 controls were enrolled. Advanced glycation end product accumulation was measured with AF reader. Three monthly HbA1c levels during the past 20 years were determined from medical records, and the HbA1c area under the curve (AUC) was calculated. We performed multivariate regression analyses to examine the associations between the severity of diabetes complications and various variables. Skin AF values increased with increasing the severity of retinopathy (P analysis) and nephropathy (P skin AF values (past 5 years: R = 0.35, P Multivariate analyses in which HbA1c AUC value was removed from the independent variables indicated that only skin AF was independently associated with nephropathy, whereas age at registration, age at onset of diabetes, and skin AF were independently associated with retinopathy. Skin AF reflects past long-term glycemic control and may serve as a surrogate marker for the development of microvascular complications in place of HbA1c AUC value.

  12. Periodontitis and glycemic control in diabetes: NHANES 2009 to 2012.

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    Garcia, Dina; Tarima, Sergey; Okunseri, Christopher

    2015-04-01

    This study examines the association between periodontitis, diabetes (DM), and glycemic control. National Health and Nutrition Examination Survey data for 2009 to 2012 were analyzed. Periodontitis status of each participant was assessed using the full-mouth periodontal examination protocol, classified using the Centers for Disease Control and Prevention and the American Academy of Periodontology surveillance case definition for total periodontitis. Self-reported DM status was defined as yes or no. Glycemic control was assessed using glycohemoglobin data at cutoff points of 7.0%, 7.5%, 8.0%, 8.5%, and 9.0%. Descriptive statistics and logistic regression analyses were performed, and all analyses were adjusted for the survey design. Overall, 7,042 adults ≥30 years old with complete data were included in the study. The mean glycohemoglobin levels for individuals with and without periodontitis were 5.9% and 5.6%, respectively, and increased to 7.4% and 7.0% for participants with DM. The majority of participants with and without periodontitis were aged 50 to 64 and 35 to 49 years (37.4% versus 44.5%), respectively. In the bivariate analysis, several demographic factors were significantly associated with having periodontitis, including self-reported DM status and glycemic control. In the multivariate analysis, demographic factors, glycohemoglobin cutoff values of 8.0%, 8.5%, and 9.0%, and mean glycohemoglobin level remained significant, but self-reported DM status was not. This study demonstrates that glycohemoglobin and demographic factors are significantly associated with periodontitis, but not self-reported status.

  13. Yogurt Is a Low-Glycemic Index Food.

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    Wolever, Thomas Ms

    2017-07-01

    High yogurt intake is associated with a reduced risk of type 2 diabetes (T2DM). Although several mechanisms could explain this association, this paper addresses the glycemic and insulinemic impact of yogurt. There is evidence that low-glycemic index (GI) and low-glycemic load (GL) diets are associated with a reduced risk of T2DM. The 93 GI values for yogurt in the University of Sydney's GI database have a mean ± SD of 34 ± 13, and 92% of the yogurts are low-GI (≤55). The 43 plain yogurts in the database have a lower GI than the 50 sweetened yogurts, 27 ± 11 compared with 41 ± 11 ( P yogurt. Although yogurt has a low GI, its insulinemic index (II) is higher than its GI. High insulin responses may be deleterious because hyperinsulinemia is associated with an increased risk of T2DM. Nevertheless, this may not be a concern for yogurt because, although its II is higher than its GI, the II of yogurt is within the range of II values for nondairy low-GI foods. In addition, mixed meals containing dairy protein elicit insulin responses similar to those elicited by mixed meals of similar composition containing nondairy protein. Because the GI of yogurt is lower than that of most other carbohydrate foods, exchanging yogurt for other protein and carbohydrate sources can reduce the GI and GL of the diet, and is in line with recommended dietary patterns, which include whole grains, fruits, vegetables, nuts, legumes, fish, vegetable oils, and yogurt. © 2017 American Society for Nutrition.

  14. A Comparison of Teacher Classroom Management Practices and Presage Variables on High and Low Performing Elementary Schools

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    Kinloch, Karen Elizabeth

    2013-01-01

    According to an extensive review of the literature, effective instructional delivery and "classroom management" practices are critical factors to elevate student achievement (Shindler, Jones, Williams, Taylor, & Cadenas, 2012). The purpose of this study was to analyze a comparison of classroom management practices on student…

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

    Directory of Open Access Journals (Sweden)

    Woodard LD

    2014-07-01

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

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

    Science.gov (United States)

    Steil, Garry M; Agus, Michael S D

    2014-06-27

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

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

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, B

    2006-01-01

    The report of Williams et al. gives rise to at least two important questions regarding diabetic patients on maintenance hemodialysis: (1) Does glycemic control play a significant role? (2) Is HbA1c a reliable measure of glycemic control? These questions are discussed. It is recommended that you...... treat ESRD patients with diabetes according to guidelines given for patients without ESRD....

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  19. Carbohydrates, glycemic index, glycemic load, and breast cancer risk: a systematic review and dose-response meta-analysis of prospective studies.

    Science.gov (United States)

    Schlesinger, Sabrina; Chan, Doris S M; Vingeliene, Snieguole; Vieira, Ana R; Abar, Leila; Polemiti, Elli; Stevens, Christophe A T; Greenwood, Darren C; Aune, Dagfinn; Norat, Teresa

    2017-06-01

    The investigation of dose-response associations between carbohydrate intake, glycemic index, glycemic load, and risk of breast cancer stratified by menopausal status, hormone receptor status, and body mass index (BMI) remains inconclusive. A systematic review and dose-response meta-analyses was conducted to investigate these associations. As part of the World Cancer Research Fund/American Institute for Cancer Research Continuous Update Project, PubMed was searched up to May 2015 for relevant studies on these associations. Prospective studies reporting associations between carbohydrate intake, glycemic index, or glycemic load and breast cancer risk were included. Two investigators independently extracted data from included studies. Random-effects models were used to summarize relative risks (RRs) and 95%CIs. Heterogeneity between subgroups, including menopausal status, hormone receptor status, and BMI was explored using meta-regression. Nineteen publications were included. The summary RRs (95%CIs) for breast cancer were 1.04 (1.00-1.07) per 10 units/d for glycemic index, 1.01 (0.98-1.04) per 50 units/d for glycemic load, and 1.00 (0.96-1.05) per 50 g/d for carbohydrate intake. For glycemic index, the association appeared slightly stronger among postmenopausal women (summary RR per 10 units/d, 1.06; 95%CI, 1.02-1.10) than among premenopausal women, though the difference was not statistically significant (Pheterogeneity = 0.15). Glycemic load and carbohydrate intake were positively associated with breast cancer among postmenopausal women with estrogen-negative tumors (summary RR for glycemic load, 1.28; 95%CI, 1.08-1.52; and summary RR for carbohydrates, 1.13; 95%CI, 1.02-1.25). No differences in BMI were detected. Menopausal and hormone receptor status, but not BMI, might be potential influencing factors for the associations between carbohydrate intake, glycemic index, glycemic load, and breast cancer. © The Author(s) 2017. Published by Oxford University Press

  20. Dietary glycemic index, glycemic load and incidence of type 2 diabetes in Japanese men and women: the Japan Public Health Center-based Prospective Study.

    Science.gov (United States)

    Oba, Shino; Nanri, Akiko; Kurotani, Kayo; Goto, Atsushi; Kato, Masayuki; Mizoue, Tetsuya; Noda, Mitsuhiko; Inoue, Manami; Tsugane, Shoichiro

    2013-12-27

    Japanese diets contain a relatively high amount of carbohydrates, and its high dietary glycemic index and glycemic load may raise the risk of diabetes in the Japanese population. The current study evaluated the associations between the dietary glycemic index, glycemic load, and the risk of type 2 diabetes in a population based cohort in Japan. We observed 27,769 men and 36,864 women (45-75 y) who participated in the second survey of the Japan Public Health Center-based Prospective Study. The dietary glycemic index and glycemic load were estimated using a food-frequency questionnaire. The development of diabetes was reported in a questionnaire administered five years later, and the associations were analyzed using logistic regression after controlling for age, area, total energy intake, smoking status, family history of diabetes, physical activity, hypertension, BMI, alcohol intake, magnesium, calcium, dietary fiber and coffee intake, and occupation. The dietary glycemic load was positively associated with the risk of diabetes among women: the multivariable-adjusted odds ratio comparing the highest vs. the lowest quartile was 1.52 (95% CI, 1.13-2.04; P-trend = 0.01). The association was implied to be stronger among women with BMI women with BMI ≥ 25. The dietary glycemic index was positively associated with the risk of diabetes among men with a high intake of total fat: the multivariable-adjusted odds ratio comparing the highest vs. the lowest quartile was 1.46 (95% CI, 0.94-2.28; P-trend = 0.04). Among women with a high total fat intake, those in the first and second quartiles of the dietary glycemic index had a significant reduced risk of diabetes, compared with those in the first quartile who had a lower total fat level (multivariable-adjusted odds ratio = 0.59 with 95% CI, 0.37-0.94, and odds ratio = 0.63 with 95% CI, 0.40-0.998 respectively). The population-based cohort study in Japan indicated that diets with a high dietary glycemic

  1. Advanced predictive methods for wine age prediction: Part I - A comparison study of single-block regression approaches based on variable selection, penalized regression, latent variables and tree-based ensemble methods.

    Science.gov (United States)

    Rendall, Ricardo; Pereira, Ana Cristina; Reis, Marco S

    2017-08-15

    In this paper we test and compare advanced predictive approaches for estimating wine age in the context of the production of a high quality fortified wine - Madeira Wine. We consider four different data sets, namely, volatile, polyphenols, organic acids and the UV-vis spectra. Each one of these data sets contain chemical information of a different nature and present diverse data structures, namely a different dimensionality, level of collinearity and degree of sparsity. These different aspects may imply the use of different modelling approaches in order to better explore the data set's information content, namely their predictive potential for wine age. This happens to be so, because different regression methods have different prior assumptions regarding the predictors, response variable(s) and the data generating mechanism, which may or may not find good adherence to the case study under analysis. In order to cover a wide range of modelling domains, we have incorporated in this work methods belonging to four very distinct classes of approaches that cover most applications found in practice: linear regression with variable selection, penalized regression, latent variables regression and tree-based ensemble methods. We have also developed a rigorous comparison framework based on a double Monte Carlo cross-validation scheme, in order to perform the relative assessment of the performance of the various methods. Upon comparison, models built using the polyphenols and volatile composition data sets led to better wine age predictions, showing lower errors under testing conditions. Furthermore, the results obtained for the polyphenols data set suggest a more sparse structure that can be further explored in order to reduce the number of measured variables. In terms of regression methods, tree-based methods, and boosted regression trees in particular, presented the best results for the polyphenols, volatile and the organic acid data sets, suggesting a possible presence of a

  2. Hydroclimate variability in Scandinavia over the last millennium – insights from a climate model–proxy data comparison

    Directory of Open Access Journals (Sweden)

    K. Seftigen

    2017-12-01

    Full Text Available The integration of climate proxy information with general circulation model (GCM results offers considerable potential for deriving greater understanding of the mechanisms underlying climate variability, as well as unique opportunities for out-of-sample evaluations of model performance. In this study, we combine insights from a new tree-ring hydroclimate reconstruction from Scandinavia with projections from a suite of forced transient simulations of the last millennium and historical intervals from the CMIP5 and PMIP3 archives. Model simulations and proxy reconstruction data are found to broadly agree on the modes of atmospheric variability that produce droughts–pluvials in the region. Despite these dynamical similarities, large differences between simulated and reconstructed hydroclimate time series remain. We find that the GCM-simulated multi-decadal and/or longer hydroclimate variability is systematically smaller than the proxy-based estimates, whereas the dominance of GCM-simulated high-frequency components of variability is not reflected in the proxy record. Furthermore, the paleoclimate evidence indicates in-phase coherencies between regional hydroclimate and temperature on decadal timescales, i.e., sustained wet periods have often been concurrent with warm periods and vice versa. The CMIP5–PMIP3 archive suggests, however, out-of-phase coherencies between the two variables in the last millennium. The lack of adequate understanding of mechanisms linking temperature and moisture supply on longer timescales has serious implications for attribution and prediction of regional hydroclimate changes. Our findings stress the need for further paleoclimate data–model intercomparison efforts to expand our understanding of the dynamics of hydroclimate variability and change, to enhance our ability to evaluate climate models, and to provide a more comprehensive view of future drought and pluvial risks.

  3. A comparison of acoustic and observed sediment classifications as predictor variables for modelling biotope distributions in Galway Bay, Ireland

    Science.gov (United States)

    O'Carroll, Jack P. J.; Kennedy, Robert; Ren, Lei; Nash, Stephen; Hartnett, Michael; Brown, Colin

    2017-10-01

    The INFOMAR (Integrated Mapping For the Sustainable Development of Ireland's Marine Resource) initiative has acoustically mapped and classified a significant proportion of Ireland's Exclusive Economic Zone (EEZ), and is likely to be an important tool in Ireland's efforts to meet the criteria of the MSFD. In this study, open source and relic data were used in combination with new grab survey data to model EUNIS level 4 biotope distributions in Galway Bay, Ireland. The correct prediction rates of two artificial neural networks (ANNs) were compared to assess the effectiveness of acoustic sediment classifications versus sediments that were visually classified by an expert in the field as predictor variables. To test for autocorrelation between predictor variables the RELATE routine with Spearman rank correlation method was used. Optimal models were derived by iteratively removing predictor variables and comparing the correct prediction rates of each model. The models with the highest correct prediction rates were chosen as optimal. The optimal models each used a combination of salinity (binary; 0 = polyhaline and 1 = euhaline), proximity to reef (binary; 0 = within 50 m and 1 = outside 50 m), depth (continuous; metres) and a sediment descriptor (acoustic or observed) as predictor variables. As the status of benthic habitats is required to be assessed under the MSFD the Ecological Status (ES) of the subtidal sediments of Galway Bay was also assessed using the Infaunal Quality Index. The ANN that used observed sediment classes as predictor variables could correctly predict the distribution of biotopes 67% of the time, compared to 63% for the ANN using acoustic sediment classes. Acoustic sediment ANN predictions were affected by local sediment heterogeneity, and the lack of a mixed sediment class. The all-round poor performance of ANNs is likely to be a result of the temporally variable and sparsely distributed data within the study area.

  4. Hydroclimate variability in Scandinavia over the last millennium - insights from a climate model-proxy data comparison

    Science.gov (United States)

    Seftigen, Kristina; Goosse, Hugues; Klein, Francois; Chen, Deliang

    2017-12-01

    The integration of climate proxy information with general circulation model (GCM) results offers considerable potential for deriving greater understanding of the mechanisms underlying climate variability, as well as unique opportunities for out-of-sample evaluations of model performance. In this study, we combine insights from a new tree-ring hydroclimate reconstruction from Scandinavia with projections from a suite of forced transient simulations of the last millennium and historical intervals from the CMIP5 and PMIP3 archives. Model simulations and proxy reconstruction data are found to broadly agree on the modes of atmospheric variability that produce droughts-pluvials in the region. Despite these dynamical similarities, large differences between simulated and reconstructed hydroclimate time series remain. We find that the GCM-simulated multi-decadal and/or longer hydroclimate variability is systematically smaller than the proxy-based estimates, whereas the dominance of GCM-simulated high-frequency components of variability is not reflected in the proxy record. Furthermore, the paleoclimate evidence indicates in-phase coherencies between regional hydroclimate and temperature on decadal timescales, i.e., sustained wet periods have often been concurrent with warm periods and vice versa. The CMIP5-PMIP3 archive suggests, however, out-of-phase coherencies between the two variables in the last millennium. The lack of adequate understanding of mechanisms linking temperature and moisture supply on longer timescales has serious implications for attribution and prediction of regional hydroclimate changes. Our findings stress the need for further paleoclimate data-model intercomparison efforts to expand our understanding of the dynamics of hydroclimate variability and change, to enhance our ability to evaluate climate models, and to provide a more comprehensive view of future drought and pluvial risks.

  5. Interannual Variability of Dust and Ice in the Mars Atmosphere: Comparison of MRO Mars Climate Sounder Retrievals with MGS-TES Limb Sounding Retrievals

    Science.gov (United States)

    Shirley, J. H.; McConnochie, T. H.; Kleinbohl, A.; Schofield, J. T.; Kass, D.; Heavens, N. G.; Benson, J.; McCleese, D. J.

    2011-01-01

    Dust and ice play important roles in Martian atmospheric dynamics on all time scales. Dust loading in particular exerts an important control on atmospheric temperatures and thereby on the strength of the atmospheric circulation in any given year. We present the first comparisons of MGS-TES aerosol opacity profiles with MRO-MCS aerosol opacity profiles. While the differences in vertical resolution are significant (a factor of 2), we find good agreement at particular seasons between nightside zonal average dust opacity profiles from the two instruments. Derived water ice opacities are likewise similar but show greater variability.

  6. Reduced glycemic index and glycemic load diets do not increase the effects of energy restriction on weight loss and insulin sensitivity in obese men and women.

    Science.gov (United States)

    Raatz, Susan K; Torkelson, Carolyn J; Redmon, J Bruce; Reck, Kristell P; Kwong, Christine A; Swanson, Joyce E; Liu, Chengcheng; Thomas, William; Bantle, John P

    2005-10-01

    Reducing the dietary glycemic load and the glycemic index was proposed as a novel approach to weight reduction. A parallel-design, randomized 12-wk controlled feeding trial with a 24-wk follow-up phase was conducted to test the hypothesis that a hypocaloric diet designed to reduce the glycemic load and the glycemic index would result in greater sustained weight loss than other hypocaloric diets. Obese subjects (n = 29) were randomly assigned to 1 of 3 diets providing 3138 kJ less than estimated energy needs: high glycemic index (HGI), low glycemic index (LGI), or high fat (HF). For the first 12 wk, all food was provided to subjects (feeding phase). Subjects (n = 22) were instructed to follow the assigned diet for 24 additional weeks (free-living phase). Total body weight was obtained and body composition was assessed by skinfold measurements. Insulin sensitivity was assessed by the homeostasis model (HOMA). At 12 wk, weight changes from baseline were significant in all groups but not different among groups (-9.3 +/- 1.3 kg for the HGI diet, -9.9 +/- 1.4 kg for the LGI diet, and -8.4 +/- 1.5 kg for the HF diet). All groups improved in insulin sensitivity at the end of the feeding phase of the study. During the free-living phase, all groups maintained their initial weight loss and their improved insulin sensitivity. Weight loss and improved insulin sensitivity scores were independent of diet composition. In summary, lowering the glycemic load and glycemic index of weight reduction diets does not provide any added benefit to energy restriction in promoting weight loss in obese subjects.

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

    OpenAIRE

    Mavropoulos John C; Yancy William S; Westman Eric C; Marquart Megan; McDuffie Jennifer R

    2008-01-01

    Abstract Objective Dietary carbohydrate is the major determinant of postprandial glucose levels, and several clinical studies have shown that low-carbohydrate diets improve glycemic control. In this study, we tested the hypothesis that a diet lower in carbohydrate would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and type 2 diabetes mellitus. Research design and methods Eighty-four community volunteers with obesity and type 2 diabetes were ra...

  8. Interobserver variability in visual evaluation of thoracic CT scans and comparison with automatic computer measurements of CT lung density

    DEFF Research Database (Denmark)

    Winkler Wille, Mathilde Marie; Thomsen, Laura Hohwü; Dirksen, Asger

    2012-01-01

    Introduction – Emphysema is defined by pathology, but is most precisely evaluated in vivo by computed tomography (CT). Aims – were to determine the reproducibility of visual evaluation of emphysema, i.e. the observer variability, and furthermore to compare the visual evaluations to automatic CT...... information. The lung was segmented automatically by in-house developed computer software, and the percentage of pixels below -950 HU was used as a surrogate marker for emphysema. The observer variability, as well as the correlation with the lung density measurements, was analysed using Spearman’s rank...

  9. Depression, obesity, and smoking were independently associated with inadequate glycemic control in patients with type 1 diabetes.

    Science.gov (United States)

    Melin, Eva O; Thunander, Maria; Svensson, Ralph; Landin-Olsson, Mona; Thulesius, Hans O

    2013-06-01

    The aim of this study was to explore the associations between inadequate glycemic control of diabetes and psychological, anthropometric, and lifestyle variables in a population-based cohort of type 1 diabetes patients. Cross-sectional study. In this study, 292 patients with type 1 diabetes, aged 1859 years, participated. psychological data were assessed by self-report instruments: Hospital Anxiety and Depression Scale and Toronto Alexithymia Scale-20. Anthropometrics, blood analyses, data from medical records, and data from the Swedish National Diabetes Registry were collected. Self-reported depression (adjusted odds ratio (AOR) 4.8), obesity (AOR 4.3), and smoking (AOR 3.0) were independently associated with inadequate glycemic control of diabetes (HbA1c>8.6%). Gender-stratified analyses showed that self-reported depression (AOR 19.8) and obesity (AOR 7.0) in women and smoking in men (AOR 4.2) were associated with HbA1c>8.6%. Alexithymia, antidepressant medication, and physical inactivity were associated with HbA1c>8.6% only in bivariate analyses. Alexithymia, self-rated anxiety, physical inactivity, and absence of abdominal obesity were associated with self-reported depression. Depression was the only psychological factor independently associated with HbA1c>8.6%. The association was of comparable importance as obesity and smoking, well-known risk factors for inadequate glycemic control and diabetes complications. The association between depression and HbA1c>8.6% was particularly strong for women. Alexithymia, which is a relatively stable personality trait, was associated with depression. In the future care of patients with diabetes, psychological aspects should be considered alongside anthropometrics and lifestyle factors in order to achieve the goals for HbA1c.

  10. Diabetes fatalism and its emotional distress subscale are independent predictors of glycemic control among Lebanese patients with type 2 diabetes.

    Science.gov (United States)

    Sukkarieh-Haraty, Ola; Egede, Leonard E; Abi Kharma, Joelle; Bassil, Maya

    2017-09-04

    Achieving and sustaining optimal glycemic control in type 2 diabetes (T2DM) is difficult because of socio-cultural and psychosocial factors including diabetes fatalism. Diabetes fatalism is 'a complex psychological cycle characterized by perceptions of despair, hopelessness, and powerlessness'. The purpose of this paper is to explore whether diabetes fatalism and other psychosocial and socio-cultural variables are correlates of glycemic control in Lebanese population with T2DM. A convenience sample of 280 adult participants with T2DM were recruited from a major hospital in greater Beirut-Lebanon area and from the community. Diabetes fatalism was assessed using the Arabic version of 12-item Diabetes Fatalism Scale. Multiple linear regression models were used to assess the relationship between HbA1c and psychosocial and socio-cultural characteristics including diabetes fatalism. Four models were run to examine the independent association between HbA1c and diabetes fatalism and to identify which of the 3 subscales (emotional distress, spiritual coping and perceived self-efficacy) were associated with HbA1c. The mean age of the participants was 58.24(SD = 13.48) and the majority were females (53.76%), while 32.73% of the sample had diabetes for more than 10 years. Fully adjusted multiple linear regression models showed that higher scores on diabetes fatalism and the emotional distress subscale (P = 0.018) were significantly associated with higher HbA1c values. In addition, having diabetes for more than 11 years (P = 0.05) and a higher number of diabetes complications (P fatalism as an independent predictor of glycemic control among Lebanese. Future studies should further investigate this construct to guide interventions that can address it for better diabetes outcomes.

  11. A comparison of multivariate analysis techniques and variable selection strategies in a laser-induced breakdown spectroscopy bacterial classification

    Energy Technology Data Exchange (ETDEWEB)

    Putnam, Russell A., E-mail: putnamr@uwindsor.ca [Department of Physics, University of Windsor, Windsor, Ontario N9B 3P4 (Canada); Mohaidat, Qassem I., E-mail: q.muhaidat@yu.edu.jo [Department of Physics, Yarmouk University, Irbid 21163 (Jordan); Daabous, Andrew, E-mail: daabousa@uwindsor.ca [Department of Physics, University of Windsor, Windsor, Ontario N9B 3P4 (Canada); Rehse, Steven J., E-mail: rehse@uwindsor.ca [Department of Physics, University of Windsor, Windsor, Ontario N9B 3P4 (Canada)

    2013-09-01

    Laser-induced breakdown spectroscopy has been used to obtain spectral fingerprints from live bacterial specimens from thirteen distinct taxonomic bacterial classes representative of five bacterial genera. By taking sums, ratios, and complex ratios of measured atomic emission line intensities three unique sets of independent variables (models) were constructed to determine which choice of independent variables provided optimal genus-level classification of unknown specimens utilizing a discriminant function analysis. A model composed of 80 independent variables constructed from simple and complex ratios of the measured emission line intensities was found to provide the greatest sensitivity and specificity. This model was then used in a partial least squares discriminant analysis to compare the performance of this multivariate technique with a discriminant function analysis. The partial least squares discriminant analysis possessed a higher true positive rate, possessed a higher false positive rate, and was more effective at distinguishing between highly similar spectra from closely related bacterial genera. This suggests it may be the preferred multivariate technique in future species-level or strain-level classifications. - Highlights: • Laser-induced breakdown spectroscopy was used to classify bacteria by genus. • We examine three different independent variable down selection models. • A PLS-DA returned higher rates of true positives than a DFA. • A PLS-DA returned higher rates of false positives than a DFA. • A PLS-DA was better able to discriminate similar spectra compared to DFA.

  12. Self Concept: A Comparison of Negro-, Anglo- and Spanish-American Students Across Ethnic, Sex, and Socioeconomic Variables.

    Science.gov (United States)

    Healey, Gary W.

    The purposes of this study were to determine: (1) if differences existed in the self-concept among Negro, Anglo, and Spanish American students; and (2) the extent to which these differences were influenced by ethnic group membership, socioeconomic position, sex, or the interaction among these variables. This study was carried out in a New Mexico…

  13. Comparison of the trunk-pelvis and lower extremities sagittal plane inter-segmental coordination and variability during walking in persons with and without chronic low back pain.

    Science.gov (United States)

    Ebrahimi, Samaneh; Kamali, Fahimeh; Razeghi, Mohsen; Haghpanah, Seyyed Arash

    2017-04-01

    Inter-segmental coordination can be influenced by chronic low back pain (CLBP). The sagittal plane lower extremities inter-segmental coordination pattern and variability, in conjunction with the pelvis and trunk, were assessed in subjects with and without non-specific CLBP during free-speed walking. Kinematic data were collected from 10 non-specific CLBP and 10 non-CLBP control volunteers while the subjects were walking at their preferred speed. Sagittal plane time-normalized segmental angles and velocities were used to calculate continuous relative phase for each data point. Mean absolute relative phase (MARP) and deviation phase (DP) were derived to quantify the trunk-pelvis and bilateral pelvis-thigh, thigh-shank and shank-foot coordination pattern and variability over the stance and swing phases of gait. Mann-Whitney U test was employed to compare the means of DP and MARP values between two groups (same side comparison). Statistical analysis revealed more in-phase/less variable trunk-pelvis coordination in the CLBP group (Pfoot MARP values in the CLBP group, were more in-phase than left MARP values in the non-CLBP control group during the swing phase (Pplane lower extremities, pelvis and trunk coordination pattern and variability could be generally affected by CLBP during walking. These changes can be possible compensatory strategies of the motor control system which can be considered in the CLBP subjects. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Peri-implant conditions and levels of advanced glycation end products among patients with different glycemic control.

    Science.gov (United States)

    Al-Sowygh, Zeyad H; Ghani, Siti Mariam Ab; Sergis, Konstantinos; Vohra, Fahim; Akram, Zohaib

    2018-01-19

    A close relationship between poor glycemic control and peri-implant break down has been demonstrated. It is hypothesized that levels of advanced glycation end products (AGEs) in peri-implant sulcular fluid (PISF) are higher with increased glycemic levels in type 2 diabetes mellitus patients. In the present study, we examined the clinical and radiographic peri-implant parameters and levels of AGEs among different glycemic levels in diabetic patients and assessed whether the levels of AGEs correlate with clinical peri-implant parameters. Ninety-three patients who participated in this study were divided into four groups; Group-1: HbA1c 6.1%-8%; Group-2: HbA1c 8.1%-10%; Group-3: HbA1c > 10%; Group-4: non-diabetic individuals with HbA1c implant plaque index (PI), bleeding on probing (BOP), probing depth (PD) and crestal bone loss (CBL) were recorded. Levels of AGEs in PISF were quantified using enzyme-linked immunosorbent assay. Between-group comparison of means was verified with Kruskal-Wallis test and Pearson correlation coefficient for correlations of AGE levels with peri-implant parameters. Peri-implant PI, BOP, PD, and CBL were significantly higher in group-1, -2, and -3 as compared to non-diabetic patients (P  .05). Mean levels of AGEs in PISF were significantly higher in relation to higher levels of HbA1c levels. Significant positive correlations were found between AGEs and PD (P = .0221) and CBL (P = .0425); and significant negative correlation was found for PI (P = .0376) in patients with HbA1c levels >10%, respectively. Clinical and radiographic peri-implant parameters were poor and levels of AGEs were significantly high in patients with high glycemic levels. These findings suggest that AGEs may be considered as potential marker of inflammation in diabetic individuals with peri-implantitis. © 2018 Wiley Periodicals, Inc.

  15. Glycemic index, insulinemic index, and satiety index of kefir.

    Science.gov (United States)

    Kong, Kai Ling; Hendrich, Suzanne

    2012-08-01

    To determine glycemic, insulinemic, and satiety indices of 3 types of kefir. This study was divided into 3 phases. In phase 1, 50 g of available carbohydrate from low-fat strawberry kefir or orange kefir was tested, and in phase 2, low-fat plain kefir containing 25 g of available carbohydrates was tested for glycemic index (GI), in both cases compared with an equivalent amount of glucose. In phase 3, 1000-kJ portions of all 3 types of kefirs were compared with white bread with the same energy content to determine the insulinemic index (II) and satiety index (SI) of all 3 kefirs. In all phases, a single-meal, randomized crossover design was performed in which the test meals were given to healthy adults, 5 men and 5 women. The total incremental plasma glucose area under the curve (iAUC) for strawberry, orange, and plain kefirs was significantly lower compared with the respective high-GI control food, which was glucose solution. However, the IIs and SIs of kefir did not differ significantly from the white bread. Kefir is a low- to moderate-GI food; however, its II was high. Although kefir had higher water content, the SI of kefir was not significantly different from white bread.

  16. Geriatric Family Support and Diabetic Type-2 Glycemic Control

    Directory of Open Access Journals (Sweden)

    Shiva Heidari

    2008-07-01

    Full Text Available Objectives: As the most part of geriatric (65 years and older diabetic care is given at home, family support has an important role in their blood sugar level control care. This study aimed to assess the relationship between family support and blood sugar level control in such elderly suffering type-2 diabetes. Methods & Materials: Via descriptive-correlative study, one hundred fifty geriatric patients with type-2 diabetes, who referred to Institute of Endocrinology and Metabolism in Iran University of Medical Sciences were selected. Samplings based on nonrandomized and convenience. The questionnaire consisted of three sections: demographic data glucose-labeled hemoglobin (HbA1C and received-perceived family support by applying the standard questionnaire of "Diabetes Social Support-Family Version" format. Data were analyzed by SPSS version 15 by using Chi-square and Pierson Tests. Results: Results showed a significant relationship between family support and glycemic control (r=-0.56, P<0.0001. Also there were significant relationships between family support, gender and marital status (P<0.0001. There were also significant relationships between glycemic control and marital status (P=0.02, financial status (P=0.04 and educational level (P=0.05. Conclusion: Findings of this research added further evidence about the impact of family support on the health of older adults with diabetes. These findings suggest using family centered nursing interventions and collaboration of family members in care of the elderly with type-2 diabetes.

  17. A Comparison of Southern Hemisphere Cyclone Track Climatology and Interannual Variability in Coarse-Gridded Reanalysis Datasets

    OpenAIRE

    Eichler, Timothy Paul; Gottschalck, Jon

    2013-01-01

    Southern Hemisphere (SH) extratropical cyclones have received less study than their Northern Hemisphere (NH) counterparts. Generating SH cyclone tracks from global reanalysis datasets is problematic due to data reliability, especially prior to 1979. It is therefore prudent to compare the climatology and variability of SH cyclone tracks from different reanalysis datasets. We generate cyclone track frequency and intensity climatologies from three reanalysis datasets: The National Center for Env...

  18. Sedentary Patterns, Physical Activity, and Cardiorespiratory Fitness in Association to Glycemic Control in Type 2 Diabetes Patients

    Directory of Open Access Journals (Sweden)

    Luís B. Sardinha

    2017-04-01

    Full Text Available Background: Sedentary behavior has been considered an independent risk factor for type-2 diabetes (T2D, with a negative impact on several physiological outcomes, whereas breaks in sedentary time (BST have been proposed as a viable solution to mitigate some of these effects. However, little is known about the independent associations of sedentary pursuits, physical activity, and cardiorespiratory fitness (CRF variables with glycemic control. We investigated the independent associations of total sedentary time, BST, moderate-to-vigorous physical activity (MVPA, and CRF with glycemic outcomes in patients with T2D.Methods: Total sedentary time, BST, and MVPA were assessed in 66 participants (29 women with T2D, using accelerometry. Glucose and insulin were measured during a mixed meal tolerance test, with the respective calculations of HOMA-IR and Matsuda index. Glycated hemoglobin (HbA1c was also analyzed. CRF was measured in a maximal treadmill test with breath-by-breath gases analysis. Multiple regressions were used for data analysis.Results: Regardless of CRF, total sedentary time was positively associated with HbA1c (β = 0.25, p = 0.044. Adjusting for MVPA, total sedentary time was related to fasting glucose (β = 0.32, p = 0.037. No associations between total sedentary time and the remaining glycemic outcomes, after adjusting for MVPA. BST had favorable associations with HOMA-IR (β = −0.28, p = 0.047 and fasting glucose (β = −0.25, p = 0.046, when adjusted for MVPA, and with HOMA-IR (β = −0.25, p = 0.036, Matsuda index (β = 0.26, p = 0.036, and fasting glucose (β = −0.22, p = 0.038, following adjustment for CRF. When adjusting for total sedentary time, only CRF yielded favorable associations with HOMA-IR (β = −0.29, p = 0.039, fasting glucose (β = −0.32, p = 0.012, and glucose at 120-min (β = −0.26, p = 0.035, and no associations were found for MVPA with none of the metabolic outcomes.Conclusion: The results from this

  19. A comparison of elastic-plastic and variable modulus-cracking constitutive models for prestressed concrete reactor vessels

    International Nuclear Information System (INIS)

    Anderson, C.A.; Smith, P.D.

    1979-01-01

    Numerical prediction of the behavior of prestressed concrete reactor vessels (PCRVs) under static, dynamic and long term loadings is complicated by the currently ill-defined behavior of concrete under stress and the three-dimensional nature of PCRVs. Which constitutive model most closely approximates the behavior of concrete in PCRVs under load has not yet been decided. Many equations for accurately modeling the three-dimensional behavior of PCRVs tax the capability of a most up-to-date computing system. The main purpose of this paper is to compare the characteristics of two constitutive models which have been proposed for concrete, variable modulus cracking model and elastic-plastic model. Moreover, the behavior of typical concrete structures was compared, the materials of which obey these constitutive laws. The response to internal pressure of PCRV structure, the constitutive models for concrete, the test problems using a thick-walled concrete ring and a rectangular concrete plate, and the analysis of an axisymmetric concrete pressure vessel PV-26 using the variable modulus cracking model of the ADINA code are explained. The variable modulus cracking model can predict the behavior of reinforced concrete structures well into the range of nonlinear behavior. (Kako, I.)

  20. [Effect of consumption of bread with amaranth (Amaranthus dubius Mart. ex Thell.) on glycemic response and biochemical parameters in Sprague dawley rats].

    Science.gov (United States)

    Montero-Quintero, Keyla Carolina; Moreno-Rojas, Rafael; Molina, Edgar Alí; Colina-Barriga, Máximo Segundo; Sánchez-Urdaneta, Adriana Beatriz

    2014-11-01

    The incorporation of functional ingredients like amaranth (Amaranthus dubius Mart. ex Thell.) in bread making is a strategy to increase fiber intake, which is associated with beneficial health effects, improving glycemic response and lipid profile. Thirty male Sprague dawley rats were randomized into three groups: diet of bread with 0% amaranth (PA0, control), diet of bread with 10% amaranth (PA10) and bread diet with 20% amaranth (PA20) for determining the feed intake, weight gain, triglyceride, total cholesterol, VLDL-C, LDL-C, HDL-C, protein and postprandial glycemic response. Data were analyzed using a completely randomized with 10 replications analysis, using the comparison test of Tukey for biochemical parameters. Postprandial glycemic response was analyzed by the method of repeated measures over time. The daily intake and weight gain was not affected (P>0.05) in the groups with PA10 and PA20. The concentration of glucose, triglycerides and protein showed statistically significant differences (P>0.05) by the difference in content of amaranth diets. The values of total cholesterol, LDL-C, and atherogenic risk factor index were statistically significant (P. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  1. The application of the glycemic index and glycemic load in weight loss: A review of the clinical evidence.

    Science.gov (United States)

    Esfahani, Amin; Wong, Julia M W; Mirrahimi, Arash; Villa, Chris R; Kendall, Cyril W C

    2011-01-01

    Obesity is rapidly becoming a global epidemic. As it is a significant risk factor for several chronic diseases, including type 2 diabetes and cardiovascular disease, it is imperative to study dietary and lifestyle approaches that help reduce its prevalence. Recently, due to its possible link to appetite control and metabolism, several clinical studies have assessed the effect of low glycemic index (GI) and glycemic load (GL) diets on weight loss. To determine the application of GI/GL in the prevention and treatment of obesity, we searched several databases and identified 23 clinical trials that examined low GI/GL diets and weight loss as the primary outcome measure. In general, these studies showed much inconsistency in their findings. While a few studies found significantly greater weight loss on the low GI/GL diets, most of the other studies showed a non-significant trend that favored low GI/GL diets; suggesting that factors other than GI/GL may play a role. It would be helpful if a pooled analysis were undertaken to clarify the current findings and outline the limitations of these studies. There is also a need for more long-term randomized, controlled trials that not only focus on weight loss but also on weight maintenance and body composition. Copyright © 2011 Wiley Periodicals, Inc.

  2. Effects of Carbohydrate and Dietary Fiber Intake, Glycemic Index and Glycemic Load on HDL Metabolism in Asian Populations.

    Science.gov (United States)

    Yanai, Hidekatsu; Katsuyama, Hisayuki; Hamasaki, Hidetaka; Abe, Shinichi; Tada, Norio; Sako, Akahito

    2014-10-01

    High-density lipoprotein (HDL) is a lipoprotein which has anti-atherogenic property by reverse cholesterol transport from the peripheral tissues to liver. Low HDL-cholesterol (HDL-C) levels are associated with the development of coronary artery diseases (CADs). Various epidemiological studies have suggested that the development of CAD increase in individuals with less than 40 mg/dL of HDL-C. In spite of accumulation of evidences which suggest a significant association between low HDL-C and cardiovascular diseases, effects of dietary factors on HDL metabolism remained largely unknown. There may be interracial differences in effects of dietary factors on HDL metabolism. Here we reviewed published articles about effects of carbohydrate and dietary fiber intake, glycemic index (GI) and glycemic load (GL), on HDL-C metabolism, regarding meta-analyses and clinical studies performed in Asian population as important articles. Low carbohydrate intake, GI and GL may be beneficially associated with HDL metabolism. Dietary fiber intake may be favorably associated with HDL metabolism in Asian populations.

  3. Mycobacterial Interspersed Repetitive-Unit–Variable-Number Tandem-Repeat (MIRU-VNTR) Genotyping of Mycobacterium intracellulare for Strain Comparison with Establishment of a PCR-Based Database

    Science.gov (United States)

    Iakhiaeva, Elena; McNulty, Steven; Brown Elliott, Barbara A.; Falkinham, Joseph O.; Williams, Myra D.; Vasireddy, Ravikiran; Wilson, Rebecca W.; Turenne, Christine

    2013-01-01

    Strain comparison is important to population genetics and to evaluate relapses in patients with Mycobacterium avium complex (MAC) lung disease, but the “gold standard” of pulsed-field gel electrophoresis (PFGE) is time-consuming and complex. We used variable-number tandem repeats (VNTR) for fingerprinting of respiratory isolates of M. intracellulare from patients with underlying bronchiectasis, to establish a nonsequence-based database for population analysis. Different genotypes identified by PFGE underwent species identification using a 16S rRNA gene multiplex PCR. Genotypes of M. intracellulare were confirmed by internal transcribed spacer 1 (ITS1) sequencing and characterized using seven VNTR primers. The pattern of VNTR amplicon sizes and repeat number defined each specific VNTR type. Forty-two VNTR types were identified among 84 genotypes. PFGE revealed most isolates with the same VNTR type to be clonal or exhibit similar grouping of bands. Repetitive sequence-based PCR (rep-PCR) showed minimal pattern diversity between VNTR types compared to PFGE. Fingerprinting of relapse isolates from 31 treated patients using VNTR combined with 16S multiplex PCR unambiguously and reliably distinguished different genotypes from the same patient, with results comparable to those of PFGE. VNTR for strain comparison is easier and faster than PFGE, is as accurate as PFGE, and does not require sequencing. Starting with a collection of 167 M. intracellulare isolates, VNTR distinguished M. intracellulare into 42 clonal groups. Comparison of isolates from different geographic areas, habitats, and clinical settings is now possible. PMID:23175249

  4. Mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) genotyping of mycobacterium intracellulare for strain comparison with establishment of a PCR-based database.

    Science.gov (United States)

    Iakhiaeva, Elena; McNulty, Steven; Brown Elliott, Barbara A; Falkinham, Joseph O; Williams, Myra D; Vasireddy, Ravikiran; Wilson, Rebecca W; Turenne, Christine; Wallace, Richard J

    2013-02-01

    Strain comparison is important to population genetics and to evaluate relapses in patients with Mycobacterium avium complex (MAC) lung disease, but the "gold standard" of pulsed-field gel electrophoresis (PFGE) is time-consuming and complex. We used variable-number tandem repeats (VNTR) for fingerprinting of respiratory isolates of M. intracellulare from patients with underlying bronchiectasis, to establish a nonsequence-based database for population analysis. Different genotypes identified by PFGE underwent species identification using a 16S rRNA gene multiplex PCR. Genotypes of M. intracellulare were confirmed by internal transcribed spacer 1 (ITS1) sequencing and characterized using seven VNTR primers. The pattern of VNTR amplicon sizes and repeat number defined each specific VNTR type. Forty-two VNTR types were identified among 84 genotypes. PFGE revealed most isolates with the same VNTR type to be clonal or exhibit similar grouping of bands. Repetitive sequence-based PCR (rep-PCR) showed minimal pattern diversity between VNTR types compared to PFGE. Fingerprinting of relapse isolates from 31 treated patients using VNTR combined with 16S multiplex PCR unambiguously and reliably distinguished different genotypes from the same patient, with results comparable to those of PFGE. VNTR for strain comparison is easier and faster than PFGE, is as accurate as PFGE, and does not require sequencing. Starting with a collection of 167 M. intracellulare isolates, VNTR distinguished M. intracellulare into 42 clonal groups. Comparison of isolates from different geographic areas, habitats, and clinical settings is now possible.

  5. The effects of various diets on glycemic outcomes during pregnancy: A systematic review and network meta-analysis.

    Directory of Open Access Journals (Sweden)

    Vanessa Ha

    Full Text Available Evidence to support dietary modifications to improve glycemia during pregnancy is limited, and the benefits of diet beyond limiting gestational weight gain is unclear. Therefore, a systematic review and network meta-analysis of randomized trials was conducted to compare the effects of various common diets, stratified by the addition of gestational weight gain advice, on fasting glucose and insulin, hemoglobin A1c (HbA1c, and homeostatic model assessment for insulin resistance (HOMA-IR in pregnant women.MEDLINE, EMBASE, Cochrane database, and reference lists of published studies were searched through April 2017. Randomized trials directly comparing two or more diets for ≥2-weeks were eligible. Bayesian network meta-analysis was performed for fasting glucose. Owing to a lack of similar dietary comparisons, a standard pairwise meta-analysis for the other glycemic outcomes was performed. The certainty of the pooled effect estimates was assessed using the GRADE tool.Twenty-one trials (1,865 participants were included. In general, when given alongside gestational weight gain advice, fasting glucose improved in most diets compared to diets that gave gestational weight gain advice only. However, fasting glucose increased in high unsaturated or monounsaturated fatty acids diets. In the absence of gestational weight gain advice, fasting glucose improved in DASH-style diets compared to standard of care. Although most were non-significant, similar trends were observed for these same diets for the other glycemic outcomes. Dietary comparisons ranged from moderate to very low in quality of evidence.Alongside with gestational weight gain advice, most diets, with the exception of a high unsaturated or a high monounsaturated fatty acid diet, demonstrated a fasting glucose improvement compared with gestational weight gain advice only. When gestational weight gain advice was not given, the DASH-style diet appeared optimal on fasting glucose. However, a small

  6. The effects of various diets on glycemic outcomes during pregnancy: A systematic review and network meta-analysis

    Science.gov (United States)

    Ha, Vanessa; Bonner, Ashley J.; Jadoo, Jaynendr K.; Beyene, Joseph; Anand, Sonia S.

    2017-01-01

    Aims Evidence to support dietary modifications to improve glycemia during pregnancy is limited, and the benefits of diet beyond limiting gestational weight gain is unclear. Therefore, a systematic review and network meta-analysis of randomized trials was conducted to compare the effects of various common diets, stratified by the addition of gestational weight gain advice, on fasting glucose and insulin, hemoglobin A1c (HbA1c), and homeostatic model assessment for insulin resistance (HOMA-IR) in pregnant women. Methods MEDLINE, EMBASE, Cochrane database, and reference lists of published studies were searched through April 2017. Randomized trials directly comparing two or more diets for ≥2-weeks were eligible. Bayesian network meta-analysis was performed for fasting glucose. Owing to a lack of similar dietary comparisons, a standard pairwise meta-analysis for the other glycemic outcomes was performed. The certainty of the pooled effect estimates was assessed using the GRADE tool. Results Twenty-one trials (1,865 participants) were included. In general, when given alongside gestational weight gain advice, fasting glucose improved in most diets compared to diets that gave gestational weight gain advice only. However, fasting glucose increased in high unsaturated or monounsaturated fatty acids diets. In the absence of gestational weight gain advice, fasting glucose improved in DASH-style diets compared to standard of care. Although most were non-significant, similar trends were observed for these same diets for the other glycemic outcomes. Dietary comparisons ranged from moderate to very low in quality of evidence. Conclusion/Interpretation Alongside with gestational weight gain advice, most diets, with the exception of a high unsaturated or a high monounsaturated fatty acid diet, demonstrated a fasting glucose improvement compared with gestational weight gain advice only. When gestational weight gain advice was not given, the DASH-style diet appeared optimal on

  7. Study the Effect of Exercise on Bone Markers, Glycemic and Anthropometric Indices in Postmenopausal Women with Diabetes

    Directory of Open Access Journals (Sweden)

    Bahloul Ghorbanian

    2017-04-01

    Full Text Available Abstract Background: Diabetes mellitus is a common disease in human societies that dealing with its complications imposes enormous cost to the health system. The previous studies have shown that bone biochemical markers can be used for evaluation of bone metabolism in response to physical activity. The purpose of this study was to examine the effect of increasing 10-week aerobic exercise (AE on serum osteocalcin, PTH and glycemic and anthropometric indices in postmenopausal women with type II diabetes. Materials and Methods: In this semi-experimental study, 40 postmenopausal women with type II diabetes (40-60 years as available subjects were selected and randomly assigned into two exercise (20 and control (20 groups. Exercise protocol was AE and walking activity for 10 weeks (3d/wk, 45 to 60 min/d with 45% to 60% HRRmax intensity. Blood samples were taken before and after exercise to measure serum variables. Data were analyzed by T-test and statistical significance criterion was set as p0.05. Conclusion: Due to the favorable effects of AE on osteocalcin and glycemic indices, it seems that this training method can be recommended as a non-invasive treatment for maintaining bone density and controlling blood glucose in diabetic patients.

  8. Dietary glycemic index is associated with less favorable anthropometric and metabolic profiles in polycystic ovary syndrome women with different phenotypes.

    Science.gov (United States)

    Graff, Scheila Karen; Mário, Fernanda Missio; Alves, Bruna Cherubini; Spritzer, Poli Mara

    2013-10-01

    To compare glycemic index (GI) in the usual diet of polycystic ovary syndrome (PCOS) and control women and to investigate whether dietary GI is associated with body composition and anthropometric and metabolic variables across PCOS phenotypes. Cross-sectional study. University hospital outpatient clinic. Sixty-one women with PCOS and 44 nonhirsute women with ovulatory cycles. Metabolic work-up, biochemical and hormonal assays, assessment of body composition and rest metabolic rate, physical activity (pedometer), and food consumption (food frequency questionnaire). GI, glycemic load, dietary intake, and hormone and metabolic profile in PCOS versus control and in PCOS women stratified by tertiles of GI and PCOS phenotype. Mean age was 23.7 ± 6.3 years. Participants with PCOS had higher body fat percentage, fasting insulin, insulin resistance, lipid accumulation product, and androgen levels compared with control women. PCOS and control women in the highest tertile of GI had higher body mass index and waist circumference than those in the lowest tertile. Dietary GI was higher in the classic PCOS group. Obesity and this more severe PCOS phenotype explained 28.3% of variance in dietary GI. Dietary GI is increased in the classic PCOS phenotype and associated with a less favorable anthropometric and metabolic profile. Obesity and classic PCOS phenotype are age-independent predictors of higher dietary GI. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Glycemic Index Biscuits Formulation of Pedada Flour (Sonneratia caseolaris) with Tubers Starch

    Science.gov (United States)

    Jariyah; Susiloningsih, E. K. B.; Nilasari, K.

    2018-01-01

    The glycemic index of food is the level of food according to its effect on blood glucose levels. Foods with low glycemic index have been shown to improve glucose and fat levels in people with diabetes mellitus and improve insulin resistance. Pedada Fruits (Sonneratia caseolaris) is the one of mangrove fruits has a high fiber content, so it can be used as a raw material in biscuits production. The aim of this research to evaluate the glycemic index on the formula biscuit from the pedada flour and starch from white sweet potato, arrowroot, taro, potato and cassava mixed. This research used completely randomized design in factorial patern with one factor and five levels on formulation biscuit of pedada flour with tubers starch (20% : 80%). The biscuits product were measured of the proximate, crude fiber, glycemic index and glycemic load on wistar rats. The best treatment was 20% of pedada flour with 80% of taro starch which produced biscuit with 76.24% of yield, 2.58% of protein, 15.55% of fat, 2.72% of crude fiber, 48.83 of glycemic index and 7.39 of glycemic load.

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

    Science.gov (United States)

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

    2014-01-01

    The objective of this study was to test a comprehensive model of biologic (pubertal status), family (communication and conflict), and psychological influences (behavioral autonomy) on diabetes management and glycemic control in a sample of youth (N = 226) with type 1 diabetes recruited during late childhood/early adolescence (ages 9–11 years). The study design was a prospective, multisite, multi-method study involving prediction of diabetes management and glycemic control 1 year post-baseline. The primary outcome measures included diabetes management behaviors based on the Diabetes Self-Management Profile (DSMP) administered separately to mothers and youth and glycemic control measured by glycated hemoglobin (HbA1c) obtained by blood samples and analyzed by a central laboratory to ensure standardization. Our hypothesized predictive model received partial support based on structural equation modeling analyses. Family conflict predicted less adequate glycemic control 1 year later (p < 0.05). Higher conflict predicted less adequate diabetes management and less adequate glycemic control. More advanced pubertal status also predicted less adequate glycemic control, but behavioral autonomy did not. Family conflict is an important, potentially clinically significant influence on glycemic control that should be considered in primary and secondary prevention in the management of type 1 diabetes in youth. PMID:22569775

  11. A Comparison of Southern Hemisphere Cyclone Track Climatology and Interannual Variability in Coarse-Gridded Reanalysis Datasets

    Directory of Open Access Journals (Sweden)

    Timothy Paul Eichler

    2013-01-01

    Full Text Available Southern Hemisphere (SH extratropical cyclones have received less study than their Northern Hemisphere (NH counterparts. Generating SH cyclone tracks from global reanalysis datasets is problematic due to data reliability, especially prior to 1979. It is therefore prudent to compare the climatology and variability of SH cyclone tracks from different reanalysis datasets. We generate cyclone track frequency and intensity climatologies from three reanalysis datasets: The National Center for Environmental Prediction’s Reanalysis I and Reanalysis II datasets and the European Centre for Medium Range Weather Forecasts ERA-40 dataset. Our results show that ERA-40 produces more intense cyclones in the SH active cyclone region compared to NCEP reanalyses. More intense storms are also found in the SH active cyclone region in NCEP reanalyses data post-1979 reflecting the positive trend in the AAO in the past few decades. When evaluating interannual variability, our results show Rossby wave trains including the Pacific South American (PSA and the East Indian Ocean pattern in response to anomalous heating linked to El Niño and the Indian Ocean Dipole (IOD, respectively. Response to the AAO shows a robust annular structure for cyclone track frequency, but not intensity suggesting a weak relationship between cyclone frequency and cyclone intensity.

  12. Rice: a high or low glycemic index food?

    Science.gov (United States)

    Miller, J B; Pang, E; Bramall, L

    1992-12-01

    We determined the glycemic (GI) and insulin-index (II) values for 12 rice products, using eight healthy subjects. The products were brown and white versions of three commercial varieties of rice [two varieties with normal amylose content (20%) and the other with 28% amylose], a waxy rice (0-2% amylose), a converted rice, a quick-cooking brown rice, puffed rice cakes, rice pasta, and rice bran. The GI of the rices ranged from 64 +/- 9 to 93 +/- 11, where glucose = 100. The high amylose rice gave a lower GI and II (P rice varieties. The converted rice and most other rice products gave a high GI. Insulin indices correlated positively with GI (r = 0.75, P rice, whether white, brown, or parboiled, should be classified as high GI foods. Only high-amylose varieties are potentially useful in low-GI diets.

  13. A comparison on parameter-estimation methods in multiple regression analysis with existence of multicollinearity among independent variables

    Directory of Open Access Journals (Sweden)

    Hukharnsusatrue, A.

    2005-11-01

    Full Text Available The objective of this research is to compare multiple regression coefficients estimating methods with existence of multicollinearity among independent variables. The estimation methods are Ordinary Least Squares method (OLS, Restricted Least Squares method (RLS, Restricted Ridge Regression method (RRR and Restricted Liu method (RL when restrictions are true and restrictions are not true. The study used the Monte Carlo Simulation method. The experiment was repeated 1,000 times under each situation. The analyzed results of the data are demonstrated as follows. CASE 1: The restrictions are true. In all cases, RRR and RL methods have a smaller Average Mean Square Error (AMSE than OLS and RLS method, respectively. RRR method provides the smallest AMSE when the level of correlations is high and also provides the smallest AMSE for all level of correlations and all sample sizes when standard deviation is equal to 5. However, RL method provides the smallest AMSE when the level of correlations is low and middle, except in the case of standard deviation equal to 3, small sample sizes, RRR method provides the smallest AMSE.The AMSE varies with, most to least, respectively, level of correlations, standard deviation and number of independent variables but inversely with to sample size.CASE 2: The restrictions are not true.In all cases, RRR method provides the smallest AMSE, except in the case of standard deviation equal to 1 and error of restrictions equal to 5%, OLS method provides the smallest AMSE when the level of correlations is low or median and there is a large sample size, but the small sample sizes, RL method provides the smallest AMSE. In addition, when error of restrictions is increased, OLS method provides the smallest AMSE for all level, of correlations and all sample sizes, except when the level of correlations is high and sample sizes small. Moreover, the case OLS method provides the smallest AMSE, the most RLS method has a smaller AMSE than

  14. Sleep and glycemic control in adolescents with type 1 diabetes.

    Science.gov (United States)

    von Schnurbein, Julia; Boettcher, Claudia; Brandt, Stephanie; Karges, Beate; Dunstheimer, Desiree; Galler, Angela; Denzer, Christian; Denzer, Friederike; Vollbach, Heike; Wabitsch, Martin; Roenneberg, Till; Vetter, Celine

    2018-02-01

    Increasing evidence link sleep curtailment and circadian misalignment with adverse metabolic outcome. Adolescents might be most affected, given their late sleep timing and early school and work start times. Our aim was to examine the impact of poor sleeping habits on glycemic control in adolescents with type 1 diabetes. This was a non-interventional multicenter study across Germany recruiting pubertally mature adolescents with type 1 diabetes. Medical records were used to collect information on diabetes duration, treatment, and complications. Participants self-reported sleep quality, timing, chronotype, and social jetlag-a measure of circadian misalignment. Hemoglobin A1c (HbA1c) was determined at the time of questionnaire response. We used multivariable linear regression models to examine associations between sleep and glycemic control. A total of 191 patients aged 16.5 years (mean HbA1c 8.0% [64 mmol/mol]) were included in this study. In multivariable adjusted analyses, sleep quality was significantly associated with HbA1c (mean difference; β = -0.07, P = .05). Stratified analysis indicated that this association might be stronger in boys and also in children with migration background. In contrast, neither sleep duration, sleep debt, chronotype, nor social jetlag was associated with HbA1c . Secondary analyses showed that social jetlag was significantly associated with levels of insulin requirements (mean difference; β = 0.035, P = .03). Our study suggests that poor sleep quality is associated with increased HbA1c in adolescents with type 1 diabetes and that higher levels of circadian misalignment are associated with increased insulin requirements. If replicated, our results indicate a clinical relevance of sleep habits in adolescents with type 1 diabetes. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    Marina Cassab Carreira

    2004-08-01

    Full Text Available This study was carried out to evaluate the influence of food storage under low temperature (-20ºC and the resistant starch formation, both on the glycemic index (GI. The GI of only cooked and cooked and stored foods under -20ºC for 30 days was evaluated in short-term tests with humans. Significant increase on the RS content was evidenced for all the stored foods. The food storage resulted in a significant decrease on the GI of beans and chick-peas; the GI of pasta remained the same and the GI of corn meal increased. Thus, the RS formation showed reduced influence on the glycemic index. The storage of starchy foods under low temperature can collaborate to the RS intake but its effect on the GI will depend on the characteristics of the carbohydrates of each food.O estudo foi realizado para avaliar a influência do armazenamento de alimentos sob baixa temperatura e a formação de amido resistente sobre o índice glicêmico (IG. O IG de alimentos cozidos ou cozidos e armazenados a -20ºC por 30 dias foi avaliado em ensaios de curta duração com humanos. Aumento significativo no conteúdo de AR foi evidenciado para todos os alimentos armazenados. O armazenamento dos alimentos resultou em significativa redução no IG do feijão e do grão de bico. O IG do macarrão foi o mesmo e da polenta sofreu aumento. Desta forma, a evidenciada formação de AR mostrou reduzida influência no IG. O armazenamento de alimentos fonte de amido sob baixa temperatura pode colaborar com a ingestão de AR, mas o efeito sobre o IG vai depender das características dos carboidratos de cada alimento.

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

    Science.gov (United States)

    Koch, Christian A; Uwaifo, Gabriel I

    2008-09-01

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

  17. Phenotype variability and early onset ataxia symptoms in spinocerebellar ataxia type 7: comparison and correlation with other spinocerebellar ataxias

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius Cristino de Albuquerque

    2015-01-01

    Full Text Available The spinocerebellar ataxias (SCA are a group of neurodegenerative disorders characterized by heterogeneous clinical presentation. Spinocerebellar ataxia type 7 (SCA7 is caused by an abnormal CAG repeat expansion and includes cerebellar signs associated with visual loss and ophthalmoplegia. Marked anticipation and dynamic mutation is observed in SCA7. Moreover, phenotype variability and very early onset of symptoms may occur. In this article, a large series of Brazilian patients with different SCA subtypes was evaluated, and we compared the age of onset of SCA7 with other SCA. From the 26 patients with SCA7, 4 manifested their symptoms before 10-year-old. Also, occasionally the parents may have the onset of symptoms after their children. In conclusion, our study highlights the genetic anticipation phenomenon that occurs in SCA7 families. Patients with very early onset ataxia in the context of a remarkable family history, must be considered and tested for SCA7.

  18. Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).

    Science.gov (United States)

    Romieu, Isabelle; Ferrari, Pietro; Rinaldi, Sabina; Slimani, Nadia; Jenab, Mazda; Olsen, Anja; Tjonneland, Anne; Overvad, Kim; Boutron-Ruault, Marie-Christine; Lajous, Martin; Kaaks, Rudolf; Teucher, Birgit; Boeing, Heiner; Trichopoulou, Antonia; Naska, Androniki; Vasilopoulo, Effie; Sacerdote, Carlotta; Tumino, Rosario; Masala, Giovanna; Sieri, Sabina; Panico, Salvatore; Bueno-de-Mesquita, H Bas; Van-der-A, Daphne; van Gils, Carla H; Peeters, Petra H M; Lund, Eiliv; Skeie, Guri; Asli, Lene Angell; Rodriguez, Laudina; Navarro, Carmen; Amiano, Pilar; Sanchez, Maria-José; Barricarte, Aurelio; Buckland, Genevieve; Sonestedt, Emily; Wirfält, Elisabet; Hallmans, Göran; Johansson, Ingegerd; Key, Timothy J; Allen, Naomi E; Khaw, Kay-Tee; Wareham, Nicholas J; Norat, Teresa; Riboli, Elio; Clavel-Chapelon, Françoise

    2012-08-01

    The glycemic potential of a diet is associated with chronically elevated insulin concentrations, which may augment breast cancer (BC) risk by stimulating insulin receptor or by affecting insulin-like growth factor I (IGF-I)-mediated mitogenesis. It is unclear whether this effect differs by BC phenotype. The objective was to investigate the relation between glycemic index (GI), glycemic load (GL), and total carbohydrate intake with BC by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). We identified 11,576 women with invasive BC among 334,849 EPIC women aged 34-66 y (5th to 95th percentiles) at baseline over a median follow-up of 11.5 y. Dietary GI and GL were calculated from country-specific dietary questionnaires. We used multivariable Cox proportional hazards models to quantify the association between GI, GL, and carbohydrate intake and BC risk. BC tumors were classified by receptor status. Overall GI, GL, and carbohydrates were not related to BC. Among postmenopausal women, GL and carbohydate intake were significantly associated with an increased risk of estrogen receptor-negative (ER(-)) BC when extreme quintiles (Q) were compared [multivariable HR(Q5-Q1) (95% CI) = 1.36 (1.02, 1.82; P-trend = 0.010) and HR(Q5-Q1) = 1.41 (1.05, 1.89; P-trend = 0.009), respectively]. Further stratification by progesterone receptor (PR) status showed slightly stronger associations with ER(-)/PR(-) BC [HR(Q5-Q1) (95% CI) = 1.48 (1.07, 2.05; P-trend = 0.010) for GL and HR(Q5-Q1) = 1.62 (1.15, 2.30; P-trend = 0.005) for carbohydrates]. No significant association with ER-positive BC was observed. Our results indicate that a diet with a high GL and carbohydrate intake is positively associated with an increased risk of developing ER(-) and ER(-)/PR(-) BC among postmenopausal women.

  19. Comparison of statistically downscaled precipitation in terms of future climate indices and daily variability for southern Ontario and Quebec, Canada

    Science.gov (United States)

    Gaitan, Carlos F.; Hsieh, William W.; Cannon, Alex J.

    2014-12-01

    Given the coarse resolution of global climate models, downscaling techniques are often needed to generate finer scale projections of variables affected by local-scale processes such as precipitation. However, classical statistical downscaling experiments for future climate rely on the time-invariance assumption as one cannot know the true change in the variable of interest, nor validate the models with data not yet observed. Our experimental setup involves using the Canadian regional climate model (CRCM) outputs as pseudo-observations to estimate model performance in the context of future climate projections by replacing historical and future observations with model simulations from the CRCM, nested within the domain of the Canadian global climate model (CGCM). In particular, we evaluated statistically downscaled daily precipitation time series in terms of the Peirce skill score, mean absolute errors, and climate indices. Specifically, we used a variety of linear and nonlinear methods such as artificial neural networks (ANN), decision trees and ensembles, multiple linear regression, and k-nearest neighbors to generate present and future daily precipitation occurrences and amounts. We obtained the predictors from the CGCM 3.1 20C3M (1971-2000) and A2 (2041-2070) simulations, and precipitation outputs from the CRCM 4.2 (forced with the CGCM 3.1 boundary conditions) as predictands. Overall, ANN models and tree ensembles outscored the linear models and simple nonlinear models in terms of precipitation occurrences, without performance deteriorating in future climate. In contrast, for the precipitation amounts and related climate indices, the performance of downscaling models deteriorated in future climate.

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

    Science.gov (United States)

    Westman, Eric C; Yancy, William S; Mavropoulos, John C; Marquart, Megan; McDuffie, Jennifer R

    2008-12-19

    Dietary carbohydrate is the major determinant of postprandial glucose levels, and several clinical studies have shown that low-carbohydrate diets improve glycemic control. In this study, we tested the hypothesis that a diet lower in carbohydrate would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and type 2 diabetes mellitus. Eighty-four community volunteers with obesity and type 2 diabetes were randomized to either a low-carbohydrate, ketogenic diet (diet (500 kcal/day deficit from weight maintenance diet; LGID). Both groups received group meetings, nutritional supplementation, and an exercise recommendation. The main outcome was glycemic control, measured by hemoglobin A1c. Forty-nine (58.3%) participants completed the study. Both interventions led to improvements in hemoglobin A1c, fasting glucose, fasting insulin, and weight loss. The LCKD group had greater improvements in hemoglobin A1c (-1.5% vs. -0.5%, p = 0.03), body weight (-11.1 kg vs. -6.9 kg, p = 0.008), and high density lipoprotein cholesterol (+5.6 mg/dL vs. 0 mg/dL, p Diabetes medications were reduced or eliminated in 95.2% of LCKD vs. 62% of LGID participants (p diabetes. The diet lower in carbohydrate led to greater improvements in glycemic control, and more frequent medication reduction/elimination than the low glycemic index diet. Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes.

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

    Directory of Open Access Journals (Sweden)

    Mavropoulos John C

    2008-12-01

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

  2. submitter Variable RBE in proton therapy: comparison of different model predictions and their influence on clinical-like scenarios

    CERN Document Server

    Giovannini, Giulia; Cabal, Gonzalo; Bauer, Julia; Tessonnier, Thomas; Frey, Kathrin; Debus, Jürgen; Mairani, Andrea; Parodi, Katia

    2016-01-01

    Background: In proton radiation therapy a constant relative biological effectiveness (RBE) of 1.1 is usually assumed. However, biological experiments have evidenced RBE dependencies on dose level, proton linear energy transfer (LET) and tissue type. This work compares the predictions of three of the main radio-biological models proposed in the literature by Carabe-Fernandez, Wedenberg, Scholz and coworkers. Methods: Using the chosen models, a spread-out Bragg peak (SOBP) as well as two exemplary clinical cases (single field and two fields) for cranial proton irradiation, all delivered with state-of-the-art pencil-beam scanning, have been analyzed in terms of absorbed dose, dose-averaged LET $(LET_D)$, RBE-weighted dose $(D_{RBE})$ and biological range shift distributions. Results: In the systematic comparison of RBE predictions by the three models we could show different levels of agreement depending on $(α/β) x$ and LET values. The SOBP study emphasizes the variation of LET D and RBE not only as a functi...

  3. Cross-Calibration and Comparison of Variability in Two Bone Densitometers in a Research Setting: The Framingham Experience

    Science.gov (United States)

    Gagnon, David R.; McLean, Robert R.; Hannan, Marian T.; Cupples, L. Adrienne; Hogan, Mary; Kiel, Douglas P.

    2010-01-01

    New technology introduced over time results in changes in densitometers during longitudinal studies of bone mineral density (BMD). This requires that a cross-calibration process be completed to translate measurements from the old densitometer to the new one. Previously described cross-calibration methods for research settings have collected single measures on each densitometer and used linear regression to estimate cross-calibration corrections. Thus, these methods may produce corrections that have limited precision and underestimate the variability in converted BMD values. Furthermore, most prior studies have included small samples recruited from specialized populations. Increasing the sample size, obtaining multiple measures on each machine, and utilizing linear mixed models to account for between- and within-subject variability may improve cross-calibration estimates. The purpose of this study was to conduct an in vivo cross-calibration of a Lunar DPX-L with a Lunar Prodigy densitometer using a sample of 249 healthy volunteers who were scanned twice on each densitometer, without repositioning, at both the femur and spine. Scans were analyzed using both automated and manual placement of regions of interest. Wilcoxon rank-sum tests and Bland-Altman plots were used to examine possible differences between repeat scans within and across densitometers. We used linear mixed models to determine the cross-calibration equations for the femoral neck, trochanter, total hip and lumbar spine (L2-L4) regions. Results using automated and manual placement of the regions of interest did not differ significantly The DPX–L exhibited larger median absolute differences in repeat scans for femoral neck [0.016 vs. 0.012, p=0.1] and trochanter [0.011 vs. 0.009, p=0.06] BMD values compared to the Prodigy. The Bland-Altman plots revealed no statistically significant linear relation between the difference in paired measures between machines and mean BMD. In our large sample of healthy

  4. Reexamining age, race, site, and thermometer type as variables affecting temperature measurement in adults – A comparison study

    Directory of Open Access Journals (Sweden)

    Smith Linda S

    2003-06-01

    Full Text Available Abstract Background As a result of the recent international vigilance regarding disease assessment, accurate measurement of body temperature has become increasingly important. Yet, trusted low-tech, portable mercury glass thermometers are no longer available. Thus, comparing accuracy of mercury-free thermometers with mercury devices is essential. Study purposes were 1 to examine age, race, site as variables affecting temperature measurement in adults, and 2 to compare clinical accuracy of low-tech Galinstan-in-glass device to mercury-in-glass at oral, axillary, groin, and rectal sites in adults. Methods Setting 176 bed accredited healthcare facility, rural northwest US Participants Convenience sample (N = 120 of hospitalized persons ≥ 18 years old. Instruments Temperatures (°F measured at oral, skin (simultaneous, immediately followed by rectal sites with four each mercury-glass (BD and Galinstan-glass (Geratherm thermometers; 10 minute dwell times. Results Participants averaged 61.6 years (SD 17.9, 188 pounds (SD 55.3; 61% female; race: 85% White, 8.3% Native Am., 4.2% Hispanic, 1.7 % Asian, 0.8% Black. For both mercury and Galinstan-glass thermometers, within-subject temperature readings were highest rectally; followed by oral, then skin sites. Galinstan assessments demonstrated rectal sites 0.91°F > oral and ≅ 1.3°F > skin sites. Devices strongly correlated between and across sites. Site difference scores between devices showed greatest variability at skin sites; least at rectal site. 95% confidence intervals of difference scores by site (°F: oral (0.142 – 0.265, axilla (0.167 – 0.339, groin (0.037 – 0.321, and rectal (-0.111 – 0.111. Race correlated with age, temperature readings each site and device. Conclusion Temperature readings varied by age, race. Mercury readings correlated with Galinstan thermometer readings at all sites. Site mean differences between devices were considered clinically insignificant. Still considered

  5. [Glycemic index and insulin response to the ingestion of precooked corn flour in the form of "arepa" in healthy individuals].

    Science.gov (United States)

    Semprún-Fereira, M; Ryder, E; Morales, L M; Gómez, M E; Raleigh, X

    1994-09-01

    With the purpose of exploring the glucose and insulin responses to a breakfast composed of a complex carbohydrate (CC) in the form of a "arepa" prepared with precooked corn flour, with or without the addition of protein and fat (CC + P + F), we studied 6 healthy volunteers, ages ranging from 26-50 years and body mass index of 24.5 +/- 1.32. Three tests were performed on each individual: 1) 75 g OGTT, 2) Ingestion of 75 g of CC ("arepa") and 3) Ingestion of 75 g of CC + 6.7 g protein (low fat cheese) and 4 g fat (margarine). Glycemic values (glucose - oxidase method) and insulinemia (radioimmunoassay) were determined at basal, 30, 60, 120, 180 and 240 min. Glucose (GA) and insulin (IA) areas, glycemic index (GI) and insulin/glucose ratio (I/G) were calculated. We found that the "arepa" has a high GI (71.5%) that it is increased, although not significatively to 140% with the addition of protein and fat. Total GA as well as IA obtained for CC and for CC + P + F were similar to OGTT, however the profiles of the glucose and insulin responses during CC and CC + P + F were less abrupt but more prolonged, resulting in a greater I/G ratio for OGTT in comparison with CC or CC + P + F during the initial steps. We conclude that GI of this corn bread ("arepa") is high in comparison to other complex carbohydrates and it is not altered by the addition of protein and fat. This is possibly due to glucose and insulin responses similar to that produced by OGTT.

  6. Risk adjustment models for interhospital comparison of CS rates using Robson's ten group classification system and other socio-demographic and clinical variables.

    Science.gov (United States)

    Colais, Paola; Fantini, Maria P; Fusco, Danilo; Carretta, Elisa; Stivanello, Elisa; Lenzi, Jacopo; Pieri, Giulia; Perucci, Carlo A

    2012-06-21

    Caesarean section (CS) rate is a quality of health care indicator frequently used at national and international level. The aim of this study was to assess whether adjustment for Robson's Ten Group Classification System (TGCS), and clinical and socio-demographic variables of the mother and the fetus is necessary for inter-hospital comparisons of CS rates. The study population includes 64,423 deliveries in Emilia-Romagna between January 1, 2003 and December 31, 2004, classified according to theTGCS. Poisson regression was used to estimate crude and adjusted hospital relative risks of CS compared to a reference category. Analyses were carried out in the overall population and separately according to the Robson groups (groups I, II, III, IV and V-X combined). Adjusted relative risks (RR) of CS were estimated using two risk-adjustment models; the first (M1) including the TGCS group as the only adjustment factor; the second (M2) including in addition demographic and clinical confounders identified using a stepwise selection procedure. Percentage variations between crude and adjusted RRs by hospital were calculated to evaluate the confounding effect of covariates. The percentage variations from crude to adjusted RR proved to be similar in M1 and M2 model. However, stratified analyses by Robson's classification groups showed that residual confounding for clinical and demographic variables was present in groups I (nulliparous, single, cephalic, ≥37 weeks, spontaneous labour) and III (multiparous, excluding previous CS, single, cephalic, ≥37 weeks, spontaneous labour) and IV (multiparous, excluding previous CS, single, cephalic, ≥37 weeks, induced or CS before labour) and to a minor extent in groups II (nulliparous, single, cephalic, ≥37 weeks, induced or CS before labour) and IV (multiparous, excluding previous CS, single, cephalic, ≥37 weeks, induced or CS before labour). The TGCS classification is useful for inter-hospital comparison of CS section rates, but

  7. The non-contact measure of the heart rate variability by laser Doppler vibrometry: comparison with electrocardiography

    Science.gov (United States)

    Cosoli, G.; Casacanditella, L.; Tomasini, E. P.; Scalise, L.

    2016-06-01

    The assessment of the heart rate variability (HRV) is of utmost importance, being one of the most promising markers of the activity of the autonomic nervous system and associated to cardiovascular mortality. Different signals can be used to perform HRV, primarily electrocardiography (ECG), photoplethysmography (PPG), phonocardiography (PCG) or vibrocardiography (VCG), since the fundamental aspect is the individuation of a periodic feature strictly correlated with cardiac activity (i.e. R-peak in ECG or the first sound in PCG). In this work, the authors demonstrate that the VCG performances in HRV analysis are sufficiently accurate if compared to the ones measured by ECG (i.e. standard methodology); moreover, the authors want to prove the feasibility of such measurement in correspondence of different measurement points (i.e. carotid artery—which is the typical VCG measurement point—and the radial artery on the wrist)1. Results show that VCG has a mean deviation of  heart rate (HR) measurement; carotid artery is the most accurate site for the assessment, but also the radial artery is a valid site, even if with a reduced SNR. With regards to HRV parameters, the mean percentage deviation is  <10% in correspondence of carotid artery, and  ≈16% for the radial artery. So, VCG allows for non-contact monitoring of the cardiac activity.

  8. Heart rate variability during high heat stress: a comparison between young and older adults with and without Type 2 diabetes.

    Science.gov (United States)

    Carrillo, Andres E; Flouris, Andreas D; Herry, Christophe L; Poirier, Martin P; Boulay, Pierre; Dervis, Sheila; Friesen, Brian J; Malcolm, Janine; Sigal, Ronald J; Seely, Andrew J E; Kenny, Glen P

    2016-10-01

    We examined whether older individuals with and without Type 2 diabetes (T2D) experience differences in heart rate variability (HRV) during a 3-h exposure to high heat stress compared with young adults. Young (Young; n = 22; 23 ± 3 yr) and older individuals with (T2D; n = 11; 59 ± 9 yr) and without (Older; n = 25; 63 ± 5 yr) T2D were exposed to heat stress (44°C, 30% relative humidity) for 3 h. Fifty-five HRV measures were assessed for 15 min at baseline and at minutes 82.5-97.5 (Mid) and minutes 165-180 (End) during heat stress. When compared with Young, a similar number of HRV indices were significantly different (P Young group's HRV during heat stress compared with Older and T2D; the number of significantly different (P Young, Older, and T2D, respectively. Analysis of specific HRV domains suggest that the Young group experienced greater sympathetic activity during heat stress compared with Older and T2D. In conclusion, when compared with young, older individuals with and without T2D demonstrate low HRV at baseline and less change in HRV (including an attenuated sympathetic response) during 3 h high heat stress, potentially contributing to impaired thermoregulatory function. Copyright © 2016 the American Physiological Society.

  9. Comparison of Newly Diagnosed Ocular Hypertension and Open-Angle Glaucoma: Ocular Variables, Risk Factors, and Disease Severity

    Science.gov (United States)

    Buys, Yvonne M.; Harasymowycz, Paul; Gaspo, Rania; Kwok, Kenneth; Hutnik, Cindy M. L.; Blondeau, Pierre; Birt, Catherine M.; Piemontesi, Robert L. G.; Gould, Lisa F.; Lesk, Mark R.; Ahmed, Iqbal K.

    2012-01-01

    Purpose. To describe the distribution of ocular variables, risk factors, and disease severity in newly diagnosed ocular hypertension (OH) or open-angle glaucoma (OAG). Methods. Eligible subjects underwent a complete history and examination. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) obtained from multiple logistic regression models were used to compare OAG to OH and advanced to early/moderate OAG. Results. 405 subjects were enrolled: 292 (72.1%) with OAG and 113 (27.9%) with OH. 51.7% had early, 27.1% moderate, and 20.9% advanced OAG. The OR for OAG versus OH was 8.19 (P < 0.0001) for disc notch, 5.36 (P < 0.0001) for abnormal visual field, 1.45 (P = 0.001) for worsening mean deviation, 1.91 (P < 0.0001) for increased cupping, 1.03 for increased age (P = 0.030), and 0.36 (P = 0.010) for smoking. Conclusions. Increased age was a risk for OAG, and smoking decreased the risk of OAG compared to OH. Almost half of the OAG subjects had moderate/advanced disease at diagnosis. PMID:21869921

  10. Comparison of Newly Diagnosed Ocular Hypertension and Open-Angle Glaucoma: Ocular Variables, Risk Factors, and Disease Severity

    Directory of Open Access Journals (Sweden)

    Yvonne M. Buys

    2012-01-01

    Full Text Available Purpose. To describe the distribution of ocular variables, risk factors, and disease severity in newly diagnosed ocular hypertension (OH or open-angle glaucoma (OAG. Methods. Eligible subjects underwent a complete history and examination. Adjusted odds ratios (ORs and 95% confidence intervals (CIs obtained from multiple logistic regression models were used to compare OAG to OH and advanced to early/moderate OAG. Results. 405 subjects were enrolled: 292 (72.1% with OAG and 113 (27.9% with OH. 51.7% had early, 27.1% moderate, and 20.9% advanced OAG. The OR for OAG versus OH was 8.19 (P<0.0001 for disc notch, 5.36 (P<0.0001 for abnormal visual field, 1.45 (P=0.001 for worsening mean deviation, 1.91 (P<0.0001 for increased cupping, 1.03 for increased age (P=0.030, and 0.36 (P=0.010 for smoking. Conclusions. Increased age was a risk for OAG, and smoking decreased the risk of OAG compared to OH. Almost half of the OAG subjects had moderate/advanced disease at diagnosis.

  11. The safety assessment of saffron (Crocus sativus L.) on sympathovagal balance and heart rate variability; a comparison with amiodarone.

    Science.gov (United States)

    Joukar, Siyavash; Dehesh, Mohammad-Moein

    2015-12-01

    Dry stigmas of the Crocus sativus L. (Saffron) are well known in world as a popular flavouring and therapeutic agent. The anxiolytic, antidepressant, anticonvulsant and antiarrhythmic effects of saffron suggest that it may affect the autonomic control of the heart. This study assessed its safety on cardiac sympathovagal balance and heart rate variability in rat. Experimental groups were control, Saf50, Saf100, Saf200 (received saffron at dosages of 50 and 100 and 200 mg/kg/d, orally, respectively) and Amio (received 30 mg/mL/kg/d of amiodarone, orally, for 7 days) groups. On day 8, the frequency domain and time domain indices of animals' electrocardiograms were calculated. The heart rate decreased and RR interval increased in Saf200 and Amio groups (Psaffron not only has no harmful effect on activity of cardiac autonomic nervous system, but it may improve the stability of heart sympathovagal balance in normal rat. © 2016 John Wiley & Sons Ltd.

  12. Variability of plasma melatonin level in pony mares (Equus caballus), comparison with the hybrid: mules and with jennies (Equus asinus).

    Science.gov (United States)

    Guillaume, Daniel; Zarazaga, Luiz A; Malpaux, Benoît; Chemineau, Philippe

    2006-01-01

    In long-day breeders like horses, the length of nocturnal melatonin secretion is the main messenger of photoperiod. Previous studies have shown that the nocturnal jugular melatonin concentration is lower in horses, than in mules but is unknown in donkeys. The aim of this study was to estimate the inter-animal variability of plasma melatonin concentration in domestic mares and to compare this concentration with those observed in domestic jennies and in their hybrid mules. In the autumn, blood samples were collected at 22 h, 23 h, 0 h and 1 h during 2 nights at 3 weeks intervals, in 110 pony mares, 10 jennies and 6 mules maintained under natural photoperiod. Melatonin was assayed by a validated RIA method. The statistical analysis of the measures was done with a specific unbalanced analysis of variance model. The effect of species and individuals (nested under species) was highly significant. The mean melatonin concentration was 24 pg.mL(-1) in mares and was significantly lower than in jennies and in mules which were 90 pg.mL(-1) and 169 pg.mL(-1) respectively. The melatonin plasma concentration was higher in jennies than in mares. These results suggest that the melatonin concentration is genetically determined.

  13. Pathways from emotional adjustment to glycemic control in youths with diabetes in Hong Kong.

    Science.gov (United States)

    Stewart, S M; Lee, P W; Low, L C; Cheng, A; Yeung, W; Huen, K F; O'Donnell, D

    2000-09-01

    To examine factors that influence emotional adjustment, adherence to diabetic care, and glycemic control in Hong Kong youths with insulin-dependent diabetes mellitus (IDDM). Seventy youths, their mothers, and matched controls provided information on health beliefs, authoritarian parenting style, parent-child conflict, emotional adjustment, and adherence to medical regimen. Glycosylated hemoglobin levels were obtained to measure glycemic control. Predictors explained 34% of the variance in emotional adjustment and 39% of the variance in glycemic control. The data supported a pathway from emotional adjustment to self-efficacy to adherence behaviors to glycemic control. In contrast to Western culture and consistent with prediction, parenting style did not associate with negative outcomes, and even relatively low levels of parent-child conflict correlated negatively with emotional adjustment in this culture. Management of conflict and self-efficacy enhancing interactions are suggested interventions to enhance adherence to diabetic care in Hong Kong youths with IDDM.

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

    Science.gov (United States)

    Trepanowski, John F; Varady, Krista A

    2015-01-01

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

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

    DEFF Research Database (Denmark)

    Jensen, Lotte

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

  16. Perioperative glycemic control in diabetic patients undergoing coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Ehab A. Wahby

    2016-08-01

    Conclusion: Tight glycemic control improved perioperative outcome in diabetic CABG patients. Maintaining perioperative blood glucose level between 110 and 149 mg/dl is safe and should be recommended as a routine practice in diabetic patients undergoing CABG surgery.

  17. Starch composition, glycemic indices, phenolic constituents, and antioxidative and antidiabetic properties of some common tropical fruits

    Directory of Open Access Journals (Sweden)

    Ganiyu Oboh

    2015-06-01

    Conclusion: The fruits' low glycemic indices, strong antioxidant properties, and inhibition of α-amylase and α-glucosidase activities could be possible mechanisms for their use in the management and prevention of type-2 diabetes.

  18. Glycemic control strategies and the occurrence of surgical site infection: a systematic review

    Directory of Open Access Journals (Sweden)

    Caroline Maria Herrero Domingos

    Full Text Available Abstract OBJECTIVE To analyze the evidence available in the scientific literature regarding the relationship between the glycemic control strategies used and the occurrence of surgical site infection in adult patients undergoing surgery. METHOD This is a systematic review performed through search on the databases of CINAHL, MEDLINE, LILACS, Cochrane Database of Systematic Reviews and EMBASE. RESULTS Eight randomized controlled trials were selected. Despite the diversity of tested interventions, studies agree that glycemic control is essential to reduce rates of surgical site infection, and should be maintained between 80 and 120 mg/dL during the perioperative period. Compared to other strategies, insulin continuous infusion during surgery was the most tested and seems to get better results in reducing rates of surgical site infection and achieving success in glycemic control. CONCLUSION Tight glycemic control during the perioperative period benefits the recovery of surgical patients, and the role of the nursing team is key for the successful implementation of the measure.

  19. [GLYCEMIC CONTROL IN DIABETES MELLITUS PATIENTS WITH CHRONIC KIDNEY DISEASE – HOW TO CHOOSE HYPOGLYCEMIC AGENT]?

    Science.gov (United States)

    Baretić, M; Lang, V Bralić

    2016-12-01

    The management of hyperglycemia in patients with chronic kidney disease (CKD) is complex, and the goals and methods regarding glycemic control are not clearly defined. Although aggressive glycemic control seems to be advantageous in early diabetic nephropathy, outcome data supporting tight glycemic control in patients with advanced CKD are lacking. Challenges in the management of such patients include monitoring difficulties and the complexity of available treatments. In this article, we review the current treatment options for patients with diabetes and CKD discussing all hypoglycemic agents that currently are available, as well as insulin, along with their indications and contraindications. The aim is to provide useful information to family physicians when deciding on individualized glycemic goals and appropriate therapy for patients with early or end stages of CKD.

  20. Microvascular Complications Associated With Rapid Improvements in Glycemic Control in Diabetes.

    Science.gov (United States)

    Gibbons, Christopher H; Goebel-Fabbri, Ann

    2017-07-01

    Aggressive glycemic control has become the standard clinical approach to diabetes care. Unintended consequences have included the development of microvascular complications that are related to the rapidity of glycemic improvement. Diabetic neuropathy may develop in up to 10% of individuals secondary to aggressive glycemic control. The neuropathy is predominantly small fiber sensory and autonomic, and the severity of the neuropathy is tied to the change in the glycosylated hemoglobin A1C. Other microvascular complications such as retinopathy and nephropathy are common and may occur in parallel with the neuropathy. Eating disorders are a common comorbid risk factor. Individuals with uncontrolled diabetes for prolonged periods, particularly those with a history of eating disorders involving insulin restriction for calorie purging, are at high risk for developing treatment-induced microvascular complications. Gradual glycemic improvements should be encouraged but future research is needed to optimize treatment and prevention strategies.

  1. Comparison of heart rate variability between resting state and external-cuff-inflation-and-deflation state: a pilot study.

    Science.gov (United States)

    Ji, Lizhen; Liu, Chengyu; Li, Peng; Wang, Xinpei; Yan, Chang; Liu, Changchun

    2015-10-01

    Heart rate variability (HRV) has been widely used in clinical research to provide an insight into the autonomic control of the cardiovascular system. Measurement of HRV is generally performed under a relaxed resting state. The effects of other conditions on HRV measurement, such as running, mountaineering, head-up tilt, etc, have also been investigated. This study aimed to explore whether an inflation-and-deflation process applied to a unilateral upper arm cuff would influence the HRV measurement. Fifty healthy young volunteers aged between 21 and 30 were enrolled in this study. Electrocardiogram (ECG) signals were recorded for each subject over a five minute resting state followed by a five minute external-cuff-inflation-and-deflation state (ECID state). A one minute gap was scheduled between the two measurements. Consecutive RR intervals in the ECG were extracted automatically to form the HRV data for each of the two states. Time domain (SDNN, RMSSD and PNN50), frequency domain (LFn, HFn and LF/HF) and nonlinear (VLI, VAI and SampEn) HRV indices were analyzed and compared between the two states. In addition, the effects of mean artery pressure (MAP) and heart rate (HR) on the aforementioned HRV indices were assessed for the two states, respectively, by Pearson correlation analysis. The results showed no significant difference in all aforementioned HRV indices between the resting and the ECID states (all p  >  0.05). The corresponding HRV indices had significant positive correlation (all p    0.05) for either state. Besides, none of the indices showed HR-related change (all p  >  0.05) for either state except the index of VLI in the resting state. To conclude, this pilot study suggested that the applied ECID process hardly influenced those commonly used HRV indices. It would thus be applicable to simultaneously measure both blood pressure and HRV indices in clinical practice.

  2. Comparison of particulate matter dose and acute heart rate variability response in cyclists, pedestrians, bus and train passengers.

    Science.gov (United States)

    Nyhan, Marguerite; McNabola, Aonghus; Misstear, Bruce

    2014-01-15

    Exposure to airborne particulate matter (PM) has been linked to cardiovascular morbidity and mortality. Heart rate variability (HRV) is a measure of the change in cardiac autonomic function, and consistent links between PM exposure and decreased HRV have been documented in studies. This study quantitatively assesses the acute relative variation of HRV with predicted PM dose in the lungs of commuters. Personal PM exposure, HR and HRV were monitored in 32 young healthy cyclists, pedestrians, bus and train passengers. Inhaled and lung deposited PM doses were determined using a numerical model of the human respiratory tract which accounted for varying ventilation rates between subjects and during commutes. Linear mixed models were used to examine air pollution dose and HRV response relationships in 122 commutes sampled. Elevated PM2.5 and PM10 inhaled and lung deposited doses were significantly (pbus (-3.2%, 95% CI: -6.4, -0.1) and train (-1.8%, -7.5, 3.8) passengers. A similar trend was observed in the case of PM2.5 lung deposited dose and results for rMSSD (the square root of the squared differences of successive normal RR intervals) followed similar trends to SDNN. Inhaled and lung deposited doses accounting for varying ventilation rates between modes, individuals and during commutes have been neglected in other studies relating PM to HRV. The findings here indicate that exercise whilst commuting has an influence on inhaled PM and PM lung deposited dose, and these were significantly associated with acute declines in HRV, especially in pedestrians and cyclists. © 2013.

  3. Comparison of variables affecting the surgical outcomes of tubularized incised plate urethroplasty in adult and pediatric hypospadias.

    Science.gov (United States)

    Bhat, A; Bhat, M; Kumar, V; Kumar, R; Mittal, R; Saksena, G

    2016-04-01

    poor wound healing and increased complication rates. The limitation of the study was the small number of patients with mid and proximal hypospadias having lesser incidences in comparison with distal hypospadias. Adequate number of patients in these subgroups could have further strengthened the statistical correlation. Secondly, there was no objective criterion like uroflowmetry to assess urinary stream. Complication rates were higher in adults undergoing TIPU compared with pediatric patients, which was also statistically significant in distal hypospadias. The important factors in surgical outcome were: severity of hypospadias, degree of curvature, quality of spongiosum, and urethral plate width. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  5. Essential oil from Artemisia herba-alba Asso grown wild in Algeria: Variability assessment and comparison with an updated literature survey

    Directory of Open Access Journals (Sweden)

    Rachid Belhattab

    2014-04-01

    Full Text Available The chemical variability of the essential oils of Artemisia herba-alba Asso aerial parts, collected at Algeria was evaluated. A. herba-alba populations were collected in four regions, Benifouda; Bougaa; Boussaada and Boutaleb, at two different periods, July (flowering phase, and October and November (vegetative phase. The essential oils were isolated by hydrodistillation and analyzed by Gas Chromatography (GC and Gas Chromatography-Mass Spectrometry (GC-MS. The essential oils yield ranged between 0.2% and 0.9% (v/d.w.. Fifty components were identified in A. herba-alba oils, oxygen-containing monoterpenes being dominant in all cases (72–80%. Camphor (17–33%, α-thujone (7–28% and chrysanthenone (4–19% were the major oil components. Despite the similarity in main components, three types of oils could be defined, (a α-thujone : camphor (23–28:17–28%, (b camphor : chrysanthenone (33:12% and (c α-thujone : camphor : chrysanthenone (24:19:19%. The comparison between the present data and an updated survey of the existing literature reinforces the major variability of A. herba-alba essential oils and stresses the importance of obtaining a defined chemical type crop production avoiding the wild harvest.

  6. Variables contributing to an excellent customer service management profile within the regulated electric utility industry: A comparison of self-concept with customer satisfaction for customer service management

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, L.E.

    1991-01-01

    This research sought to address the relationship between self-concept and customer satisfaction: can customer satisfaction with a major electric utility be explained in terms of the self-reported, self-concept of the utility's managers The population to which the results of this study were generalized consisted of customer service managers in public electric utilities across the United States. In order to represent this population, a sample was selected consisting of customer service managers at a midwestern electric utility based in a large metropolitan area. Participants in this study were managers of four direct customer contact service organizations within six geographic division organizations. The methodology included comparisons of these four customer contact service organizations on twelve independent, self-concept variables and six customer satisfaction dependent variables using Analysis of Variance (ANOVA), Scheffe' tests, Chi-Square, and Stepwise multiple regression. The groups were found not to be significantly different and knowledge of the self-concept scores for managers will not increase the ability to predict customer satisfaction over no knowledge of self-concept scores.

  7. Comparison of modeled sampling strategies for estimation of dairy herd lameness prevalence and cow-level variables associated with lameness.

    Science.gov (United States)

    Hoffman, A C; Moore, D A; Wenz, J R; Vanegas, J

    2013-09-01

    obtained by locomotion score of all cows in the pen was variable and not reliably predictive of herd-level prevalence. Cows of Holstein breed, parity >1, and exiting the milking parlor in the last 20% of the pen had greater odds of lameness compared with other breeds, parities, and milking parlor exit order groups in a multivariate analysis. This study indicates that the sampling strategies using the middle of milking parlor exit order and a calculated sample distributed across the herd may be used to obtain an estimate of herd lameness prevalence. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  8. Short-term sandbar variability based on video imagery: Comparison between Time-Average and Time-Variance techniques

    Science.gov (United States)

    Guedes, R.M.C.; Calliari, L.J.; Holland, K.T.; Plant, N.G.; Pereira, P.S.; Alves, F.N.A.

    2011-01-01

    Time-exposure intensity (averaged) images are commonly used to locate the nearshore sandbar position (xb), based on the cross-shore locations of maximum pixel intensity (xi) of the bright bands in the images. It is not known, however, how the breaking patterns seen in Variance images (i.e. those created through standard deviation of pixel intensity over time) are related to the sandbar locations. We investigated the suitability of both Time-exposure and Variance images for sandbar detection within a multiple bar system on the southern coast of Brazil, and verified the relation between wave breaking patterns, observed as bands of high intensity in these images and cross-shore profiles of modeled wave energy dissipation (xD). Not only is Time-exposure maximum pixel intensity location (xi-Ti) well related to xb, but also to the maximum pixel intensity location of Variance images (xi-Va), although the latter was typically located 15m offshore of the former. In addition, xi-Va was observed to be better associated with xD even though xi-Ti is commonly assumed as maximum wave energy dissipation. Significant wave height (Hs) and water level (??) were observed to affect the two types of images in a similar way, with an increase in both Hs and ?? resulting in xi shifting offshore. This ??-induced xi variability has an opposite behavior to what is described in the literature, and is likely an indirect effect of higher waves breaking farther offshore during periods of storm surges. Multiple regression models performed on xi, Hs and ?? allowed the reduction of the residual errors between xb and xi, yielding accurate estimates with most residuals less than 10m. Additionally, it was found that the sandbar position was best estimated using xi-Ti (xi-Va) when xb was located shoreward (seaward) of its mean position, for both the first and the second bar. Although it is unknown whether this is an indirect hydrodynamic effect or is indeed related to the morphology, we found that this

  9. Comparison of a spatio-temporal speleothem-based reconstruction of late Holocene climate variability to the timing of cultural developments

    Science.gov (United States)

    Deininger, Michael; Lippold, Jörg; Abele, Florian; McDermott, Frank

    2016-04-01

    Speleothems are considered as a valuable continental climate archive. Their δ18O records provide information onto past changes of the atmospheric circulation accompanied by changes in surface air temperature and precipitation. During the last decades European speleothem studies have assembled a European speleothem network (including numerous speleothem δ18O records) that allow now not only to picture past climate variability in time but also in space. In particular the climate variability of the last 4.5 ka was investigated by these studies. This allows the comparison of the speleothem-based reconstructed palaeoclimate with the timings of the rise and fall of ancient civilisations in this period - including the Dark Ages. Here we evaluate a compilation of 10 speleothem δ18O records covering the last 4.5 ka using a Monte Carlo based Principal Component Analysis (MC-PCA) that accounts for uncertainties in individual speleothem age models and for the different and varying temporal resolutions of each speleothem δ18O record. Our MC-PCA approach allows not only the identification of temporally coherent changes in δ18O records, i.e. the common signal in all investigated speleothem δ18O records, but it also facilitates their depiction and evaluation spatially. The speleothem δ18O records are spanning almost the entire European continent ranging from the western Margin of the European continent to Northern Turkey and from Northern Italy to Norway. For the MC-PCA analysis the 4.5 ka are divided into eight 1ka long time windows that overlap the subsequent time window by 500 years to allow a comparison of the spatio-temporal evolution of the common signal. For every single time window we derive a common mode of climate variability of all speleothem δ18O records as well as its spatial extent. This allows us to compare the rise and fall of ancient civilisations, like the Hittite and the Roman Empire, with our reconstructed spatio-temporal record.

  10. The Effects of Free-Living Interval-Walking Training on Glycemic Control, Body Composition, and Physical Fitness in Type 2 Diabetes Patients

    DEFF Research Database (Denmark)

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

    2013-01-01

    at moderate intensity, whereas interval walkers alternated 3-min repetitions at low and high intensity. Before and after the 4-month intervention, the following variables were measured: VO(2)max, body composition, and glycemic control (fasting glucose, HbA(1c), oral glucose tolerance test, and continuous...... glucose monitoring [CGM]).RESULTSTraining adherence was high (89 ± 4%), and training energy expenditure and mean intensity were comparable. VO(2)max increased 16.1 ± 3.7% in the interval-walking group (P

  11. Diurnal Glycemic Patterns during an 8-Week Open-Label Proof-of-Concept Trial of Empagliflozin in Type 1 Diabetes.

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    Bruce A Perkins

    Full Text Available We recently reported improved glycemic control with reduced insulin dose in subjects with type 1 diabetes treated with the sodium glucose co-transporter-2 inhibitor empagliflozin. To further characterize the effects, we analyzed diurnal glycemic patterns by continuous glucose monitoring (CGM.In an 8-week single-arm open-label pilot study of empagliflozin, we compared ambulatory glucose profiles produced from CGM data during 2-week intervals in a placebo run-in baseline period, end-of-treatment, and post-treatment. Change in glycemic exposure was evaluated by area under the median curve according to time of day (AUCTOTAL 12:00am-11:55pm; AUCDAY 7:05am-10:55pm, AUCNIGHT 11:00pm-7:00am, as well as glycemic variability, glycemic stability and time-in-target (≥70 to ≤140mg/dL.The 40 patients (26 on insulin pump were aged 24±5 years and BMI 24.5±3.2 kg/m2. Consistent with the observed HbA1c decrease (8.0±0.9% to 7.6±0.9%, p<0.0001, normalized AUCTOTAL CGM decreased from 153.7±25.4 to 149.0±30.2mg/dL∙h at end-of-treatment (p = 0.31, and significantly increased post-treatment (164.1±29.5mg/dL∙h, p = 0.02. The numerical decrease in normalized AUCNIGHT (152.0±36.6 to 141.9±34.4mg/dL∙h, p = 0.13 exceeded AUCDAY (154.5±24.5 to 152.6±30.4mg/dL∙h, p = 0.65. Trends toward lower glycemic variability (83.1±18.9 to 75.6±28.6mg/dL, p = 0.06 and little change in glycemic stability (10.8±3.6 to 10.3±4.5mg/dL/h, p = 0.51 were observed. When empagliflozin was discontinued, these worsened relative to baseline (89.3±19.3mg/dL, p = 0.04 and 11.8±3.7mg/dL/hr, p = 0.08. Time-in-target numerically increased (40.2±11.9 to 43.1±13.5%, p = 0.69 at end-of-treatment but reversed post-treatment. Findings were similar on stratification of pump and MDI subjects.We observed that empagliflozin was associated with patterns of improved nighttime glycemia more prominent than daytime.Clinicaltrials.gov NCT01392560.

  12. Implementation of a referral to discharge glycemic control initiative for reduction of surgical site infections in gynecologic oncology patients.

    Science.gov (United States)

    Hopkins, Laura; Brown-Broderick, Jennifer; Hearn, James; Malcolm, Janine; Chan, James; Hicks-Boucher, Wendy; De Sousa, Filomena; Walker, Mark C; Gagné, Sylvain

    2017-08-01

    To evaluate the frequency of surgical site infections before and after implementation of a comprehensive, multidisciplinary perioperative glycemic control initiative. As part of a CUSP (Comprehensive Unit-based Safety Program) initiative, between January 5 and December 18, 2015, we implemented comprehensive, multidisciplinary glycemic control initiative to reduce SSI rates in patients undergoing major pelvic surgery for a gynecologic malignancy ('Group II'). Key components of this quality of care initiative included pre-operative HbA1c measurement with special triage for patients meeting criteria for diabetes or pre-diabetes, standardization of available intraoperative insulin choices, rigorous pre-op/intra-op/post-op glucose monitoring with control targets set to maintain BG ≤10mmol/L (180mg/dL) and communication/notification with primary care providers. Effectiveness was evaluated against a similar control group of patients ('Group I') undergoing surgery in 2014 prior to implementation of this initiative. We studied a total of 462 patients. Subjects in the screened (Group II) and comparison (Group I) groups were of similar age (avg. 61.0, 60.0years; p=0.422) and BMI (avg. 31.1, 32.3kg/m 2 ; p=0.257). Descriptive statistics served to compare surgical site infection (SSI) rates and other characteristics across groups. Women undergoing surgery prior to implementation of this algorithm (n=165) had an infection rate of 14.6%. Group II (n=297) showed an over 2-fold reduction in SSI compared to Group I [5.7%; p=0.001, adjRR: 0.45, 95% CI: (0.25, 0.81)]. Additionally, approximately 19% of Group II patients were newly diagnosed with either prediabetes (HbA1C 6.0-6.4) or diabetes (HbA1C≥6.5) and were referred to family or internal medicine for appropriate management. Implementation of a comprehensive multidisciplinary glycemic control initiative can lead to a significant reduction in surgical site infections in addition to early identification of an important health

  13. Fibrinogen titer and glycemic status in women using contraceptives

    International Nuclear Information System (INIS)

    Syed, S.; Qureshi, M.A.

    2002-01-01

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

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

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    Pao-Hwa Lin

    2012-06-01

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

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

    OpenAIRE

    C. E. Gonçalves Reis; J. Dullius

    2011-01-01

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

  16. Comparison of the lumbar disc herniation patients randomized in SPORT to 6,846 discectomy patients from NSQIP: demographics, perioperative variables, and complications correlate well.

    Science.gov (United States)

    Golinvaux, Nicholas S; Bohl, Daniel D; Basques, Bryce A; Yacob, Alem; Grauer, Jonathan N

    2015-04-01

    The Spine Patient Outcomes Research Trial (SPORT) is a highly referenced clinical trial that randomized patients with lumbar pathology to receive surgery or continued conservative treatment. The purpose of this study was to compare the SPORT lumbar disc herniation cohort and an analogous cohort from the National Surgical Quality Improvement Program (NSQIP) database. This is a retrospective cohort study comparing a national database population to a randomized clinical trial. Elective lumbar discectomies from NSQIP between 2010 and 2012 were used. Demographics were compared between the randomized SPORT cohorts (surgical and nonoperative) and NSQIP. Perioperative factors and complications were then compared between SPORT discectomy patients and NSQIP. Using current procedural terminology and International Classification of Diseases, ninth revision codes, all elective lumbar discectomies from NSQIP between 2010 and 2012 were identified. Where possible based on the published data and variables available in each cohort, the two populations were compared. A total of 6,846 NSQIP discectomy patients were compared with the randomized SPORT surgical and nonoperative cohorts. Demographic comparisons showed that NSQIP patients were older (average age 48.2±14.5 years [mean±standard deviation] vs. 41.7±11.8 and 43.0±11.3 years, respectively [pSPORT nonoperative group and NSQIP but was higher in NSQIP compared with SPORT surgical patients (p=.020 by 7%). Comparisons of perioperative factors and complications between the SPORT surgical cohort and NSQIP showed no statistical difference in average operative time, length of stay, deep wound infections, wound dehiscence, total wound complications, or blood transfusions. Spine Patient Outcomes Research Trial superficial wound infection rates were higher than NSQIP (p=.029 by 1.4%). As expected, SPORT 1-year reoperation rates were higher than NSQIP 30-day rates (7% vs. 2%, pSPORT lumbar disc herniation results. Copyright © 2015

  17. Low Glycemic Index Carbohydrates versus All Types of Carbohydrates for Treating Diabetes in Pregnancy: A Randomized Clinical Trial to Evaluate the Effect of Glycemic Control

    Directory of Open Access Journals (Sweden)

    Otilia Perichart-Perera

    2012-01-01

    Full Text Available Background. Due to the higher prevalence of obesity and diabetes mellitus (DM, more pregnant women complicated with diabetes are in need of clinical care. Purpose. Compare the effect of including only low glycemic index (GI carbohydrates (CHO against all types of CHO on maternal glycemic control and on the maternal and newborn’s nutritional status of women with type 2 DM and gestational diabetes mellitus (GDM. Methods. Women (n=107, ≤29 weeks of gestation were randomly assigned to one of two nutrition intervention groups: moderate energy and CHO restriction (Group 1: all types of CHO, Group 2: low GI foods. Results. No baseline differences in clinical data were observed. Capillary glucose concentrations throughout pregnancy were similar between groups. Fewer women in Group 2 exceeded weight gain recommendations. Higher risk of prematurity was observed in women in Group 2. No differences in glycemic control were observed between women with type 2 DM and those with GDM. Conclusions. Inclusion of low GI CHO as part of a comprehensive nutrition intervention is equally effective in improving glycemic control as compared to all types of CHO. This strategy had a positive effect in preventing excessive maternal weight gain but increased the risk of prematurity.

  18. Health Literacy, Diabetes Self-Care, and Glycemic Control in Adults with Type 2 Diabetes

    Science.gov (United States)

    Osborn, Chandra Y.; Bains, Sujeev S.

    2010-01-01

    Abstract Background Although limited health literacy is a barrier to disease management and has been associated with poor glycemic control, the mechanisms underlying the relationships between health literacy and diabetes outcomes are unknown. We examined the relationships between health literacy, determinants of diabetes self-care, and glycemic control in adults with type 2 diabetes. Methods Patients with diabetes were recruited from an outpatient primary care clinic. We collected information on demographics, health literacy, diabetes knowledge, diabetes fatalism, social support, and diabetes self-care, and hemoglobin A1c values were extracted from the medical record. Structural equation models tested the predicted pathways linking health literacy to diabetes self-care and glycemic control. Results No direct relationship was observed between health literacy and diabetes self-care or glycemic control. Health literacy had a direct effect on social support (r = −0.20, P fatalism (r = −0.22, P < 0.05), and more social support (r = 0.27, P < 0.01) were independent, direct predictors of diabetes self-care and through self-care were related to glycemic control (r = −0.20, P < 0.05). Conclusions Our findings suggest health literacy has an indirect effect on diabetes self-care and glycemic control through its association with social support. This suggests that for patients with limited health literacy, enhancing social support would facilitate diabetes self-care and improved glycemic control. PMID:20879964

  19. Poor glycemic control impacts linear and non-linear dynamics of heart rate in DM type 2

    Directory of Open Access Journals (Sweden)

    Daniela Bassi

    2015-08-01

    Full Text Available INTRODUCTION: It is well known that type 2 diabetes mellitus (T2DM produces cardiovascular autonomic neuropathy (CAN, which may affect the cardiac autonomic modulation. However, it is unclear whether the lack of glycemic control in T2DM without CAN could impact negatively on cardiac autonomic modulation. Objective: To evaluate the relationship between glycemic control and cardiac autonomic modulation in individuals with T2DM without CAN. Descriptive, prospective and cross sectional study.METHODS: Forty-nine patients with T2DM (51±7 years were divided into two groups according to glycosylated hemoglobin (HbA1c: G1≤7% and G2>7.0%. Resting heart rate (HR and RR interval (RRi were obtained and calculated by linear (Mean iRR; Mean HR; rMSSD; STD RR; LF; HF; LF/HF, TINN and RR Tri, and non-linear (SD1; SD2; DFα1; DFα2, Shannon entropy; ApEn; SampEn and CD methods of heart rate variability (HRV. Insulin, HOMA-IR, fasting glucose and HbA1c were obtained by blood tests.RESULTS: G2 (HbA1c≤7% showed lower values for the mean of iRR; STD RR; RR Tri, TINN, SD2, CD and higher mean HR when compared with G1 (HbA1c > 7%. Additionally, HbA1c correlated negatively with mean RRi (r=0.28, p=0.044; STD RR (r=0.33, p=0.017; RR Tri (r=-0.35, p=0.013, SD2 (r=-0.39, p=0.004 and positively with mean HR (r=0.28, p=0.045. Finally, fasting glucose correlated negatively with STD RR (r=-0.36, p=0.010; RR Tri (r=-0.36, p=0.010; TINN (r=-0.33, p=0.019 and SD2 (r=-0.42, p=0.002.CONCLUSION: We concluded that poor glycemic control is related to cardiac autonomic modulation indices in individuals with T2DM even if they do not present cardiovascular autonomic neuropathy.

  20. Association between glycemic control and morning blood surge with vascular endothelial dysfunction in type 2 diabetes mellitus patients

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    Rama Kumari Nuthalapati

    2016-01-01

    Full Text Available Objective: Morning blood pressure surge (MBPS is an independent predictor of cardiovascular events. However, little is known about the association between glycemic control and MBPS, and its effect on vascular injury in patients with type 2 diabetes mellitus (T2DM. The current study examined the association between glycemic control and MBPS and the involvement of MBPS in the development of vascular dysfunction in T2DM patients. Materials and Methods: One hundred and twenty-two consecutive T2DM outpatients from the Department of Cardiology and Endocrinology were enrolled in this study. We did MBPS in T2DM patients, 85 (male (69.7% patients and 37 (female patients (30.3%; mean age 60.1 ± 9.39; (n = 122 using 24 h ambulatory blood pressure monitoring and assessed vascular function by brachial artery flow-mediated dilation (FMD and nitroglycerin-mediated dilation (NMD. Results: The correlation between MBPS and various clinical variables were examined by single regression analysis in all subjects. MBPS showed significant and positive correlation with pulse rate (P = 0.01, fasting blood sugar (P = 0.002, and postprandial blood sugar (P = 0.05. To further confirm the association of insulin resistance (IR with MBPS in T2DM patients, we examined the correlation between homeostasis model assessment-IR (HOMA-IR, an established marker of IR and MBPS in diabetic (DM patients who were not taking insulin no significant association with MBPS in T2DM patients (P = 0.41, angiotensin-converting enzyme/angiotensin receptor blocker (P = 0.07. We examined the relationship between MBPS and vascular injury by measuring endothelium-dependent FMD and endothelium-independent NMD in T2DM patients. Among the various traditional risk factors for atherosclerosis such as DM duration (P = 0.04, platelet reactivity (P = 0.04 and morning surge (P = 0.002 emerged as significant factors. HOMA-IR was a negative correlation with FMD. Conclusions: The current study demonstrated that

  1. Biological variability of glycated hemoglobin.

    Science.gov (United States)

    Braga, Federica; Dolci, Alberto; Mosca, Andrea; Panteghini, Mauro

    2010-11-11

    The measurement of glycated hemoglobin (HbA(1c)) has a pivotal role in monitoring glycemic state in diabetic patients. Furthermore, the American Diabetes Association has recently recommended the use of HbA(1c) for diabetes diagnosis, but a clear definition of the clinically allowable measurement error is still lacking. Information on biological variability of the analyte can be used to achieve this goal. We systematically reviewed the published studies on the biological variation of HbA(1c) to check consistency of available data in order to accurately define analytical goals. The nine recruited studies were limited by choice of analytic methodology, population selection, protocol application and statistical analyses. There is an urgent need to determine biological variability of HbA(1c) using a specific and traceable assay, appropriate protocol and appropriate statistical evaluation of data. 2010 Elsevier B.V. All rights reserved.

  2. A Comparison Study between Two MPPT Control Methods for a Large Variable-Speed Wind Turbine under Different Wind Speed Characteristics

    Directory of Open Access Journals (Sweden)

    Dongran Song

    2017-05-01

    Full Text Available Variable speed wind turbines (VSWTs usually adopt a maximum power point tracking (MPPT method to optimize energy capture performance. Nevertheless, obtained performance offered by different MPPT methods may be affected by the impact of wind turbine (WT’s inertia and wind speed characteristics and it needs to be clarified. In this paper, the tip speed ratio (TSR and optimal torque (OT methods are investigated in terms of their performance under different wind speed characteristics on a 1.5 MW wind turbine model. To this end, the TSR control method based on an effective wind speed estimator and the OT control method are firstly presented. Then, their performance is investigated and compared through simulation test results under different wind speeds using Bladed software. Comparison results show that the TSR control method can capture slightly more wind energy at the cost of high component loads than the other one under all wind conditions. Furthermore, it is found that both control methods present similar trends of power reduction that is relevant to mean wind speed and turbulence intensity. From the obtained results, we demonstrate that, to further improve MPPT capability of large VSWTs, other advanced control methods using wind speed prediction information need to be addressed.

  3. Performance analysis and comparison of an Atkinson cycle coupled to variable temperature heat reservoirs under maximum power and maximum power density conditions

    International Nuclear Information System (INIS)

    Wang, P.-Y.; Hou, S.-S.

    2005-01-01

    In this paper, performance analysis and comparison based on the maximum power and maximum power density conditions have been conducted for an Atkinson cycle coupled to variable temperature heat reservoirs. The Atkinson cycle is internally reversible but externally irreversible, since there is external irreversibility of heat transfer during the processes of constant volume heat addition and constant pressure heat rejection. This study is based purely on classical thermodynamic analysis methodology. It should be especially emphasized that all the results and conclusions are based on classical thermodynamics. The power density, defined as the ratio of power output to maximum specific volume in the cycle, is taken as the optimization objective because it considers the effects of engine size as related to investment cost. The results show that an engine design based on maximum power density with constant effectiveness of the hot and cold side heat exchangers or constant inlet temperature ratio of the heat reservoirs will have smaller size but higher efficiency, compression ratio, expansion ratio and maximum temperature than one based on maximum power. From the view points of engine size and thermal efficiency, an engine design based on maximum power density is better than one based on maximum power conditions. However, due to the higher compression ratio and maximum temperature in the cycle, an engine design based on maximum power density conditions requires tougher materials for engine construction than one based on maximum power conditions

  4. Evaluation of day-to-day variability of serial blood glucose concentration curves in diabetic dogs.

    Science.gov (United States)

    Fleeman, Linda M; Rand, Jacquie S

    2003-02-01

    To evaluate day-to-day variability of serial blood glucose concentration curves in dogs with diabetes mellitus. Prospective clinical study. 10 dogs with diabetes mellitus. Paired 12-hour serial blood glucose concentration curves performed during 2 consecutive days were obtained on 3 occasions from each dog. Dogs received the same dose of insulin and meal every 12 hours on both days. For each pair of curves, comparison was made between the results of days 1 and 2. Mean absolute difference (without regard to sign) between days 1 and 2 for each parameter was significantly > 0, disproving the hypothesis that there is minimal day-to-day variability of serial blood glucose concentration curves when insulin dose and meals are kept constant. Coefficient of variation of the absolute difference between days 1 and 2 for each parameter ranged from 68 to 103%. Evaluation of the paired curves led to an opposite recommendation for adjustment of the insulin dose on day 2, compared with day 1, on 27% of occasions. Disparity between dosage recommendations was more pronounced when glucose concentration nadir was dogs. Day-to-day variability of serial blood glucose concentration curves has important clinical implications, particularly in dogs with good glycemic control.

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

    Directory of Open Access Journals (Sweden)

    Huri HZ

    2015-08-01

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

  6. Determinants of glycemic control among persons with type 2 diabetes mellitus in Niger Delta

    Directory of Open Access Journals (Sweden)

    Chukwuani Ufuoma

    2016-01-01

    Full Text Available Background: The rising burden of type 2 diabetes mellitus (T2DM with its attendant′s complication can be successively steamed in the face of appropriate self-care management. The latter is positively imparted by the level of knowledge of the disease itself, its impact on quality of life and available basic technique of its control. Aims: The study is, therefore, aimed to assess the level of glycemic control and its determinants among type 2 subjects attending a secondary hospital in Niger Delta. Subjects and Methods: Two hundred consenting adult type 2 diabetes patients of age more than 40 years and attended diabetes outpatient clinics at the Central Hospital Warri between March and August 2014 were used for this cross-sectional study. Two different questionnaires were administered to all the participants to collect the necessary information on diabetes knowledge as well as factors that might affect their glycemic control. Blood samples were collected for fasting blood glucose (FBG and glycosylated hemoglobin (HbA1c for all the respondents. Weight and height were also measured to the nearest 0.5 kilogram and centimeter using standardized equipment. Body mass index was then calculated as the ratio of weight in kilogram and height in meters square (kg/m 2 . Statistical Analysis Used: Statistical Package for Social Science Version 16 was used to compute the data generated. Results: The mean age and diabetic duration of all participants were 54.8 ± 11.9 years and 8.5 ± 3.2 years, respectively. The overall mean knowledge score of the subjects was 6.90 ± 1.8 (69.0 ± 18.2% The mean FBG level and HbA1c of respondents were 7.89 ± 3.6 mmol/L (range 4-20 mmol/L and 8.2%, respectively, with 55% of the population having poor glycemic control and 45% good glycemic control. The diabetic knowledge scoring of those with poor glycemic control was significantly lower than those with good glycemic control. In addition, diabetics′ with poor glycemic control

  7. Frequency and predictors of suboptimal glycemic control in an African diabetic population

    Directory of Open Access Journals (Sweden)

    Kibirige D

    2017-02-01

    Full Text Available Davis Kibirige,1 George Patrick Akabwai,2 Leaticia Kampiire,3 Daniel Ssekikubo Kiggundu,4 William Lumu5 1Department of Medicine/Diabetic and Hypertension Clinics, Our Lady of Consolota Hospital, Kisubi, 2Baylor College of Medicine, Children’s Foundation, 3Infectious Diseases Research Collaboration, Kampala, 4Nephrology Unit, Mulago National Referral and Teaching Hospital, Kampala, 5Department of Medicine and Diabetes/Endocrine Unit, Mengo Hospital, Mengo, Uganda Background: Persistent suboptimal glycemic control is invariably associated with onset and progression of acute and chronic diabetic complications in diabetic patients. In Uganda, studies documenting the magnitude and predictors of suboptimal glycemic control in adult ambulatory diabetic patients are limited. This study aimed at determining the frequency and predictors of suboptimal glycemic control in adult diabetic patients attending three urban outpatient diabetic clinics in Uganda. Methods: In this hospital-based cross-sectional study, eligible ambulatory adult diabetic patients attending outpatient diabetic clinics of three urban hospitals were consecutively enrolled over 11 months. Suboptimal glycemic control was defined as glycated hemoglobin (HbA1c level ≥7%. Multivariable analysis was applied to determine the predictors. Results: The mean age of the study participants was 52.2±14.4 years, and the majority of them were females (283, 66.9%. The median (interquartile range HbA1c level was 9% (6.8%–12.4%. Suboptimal glycemic control was noted in 311 study participants, accounting for 73.52% of the participants. HbA1c levels of 7%–8%, 8.1%–9.9%, and ≥10% were noted in 56 (13.24%, 76 (17.97%, and 179 (42.32% study participants, respectively. The documented predictors of suboptimal glycemic control were metformin monotherapy (odds ratio: 0.36, 95% confidence interval: 0.21–0.63, p<0.005 and insulin therapy (odds ratio: 2.41, 95% confidence interval: 1.41–4.12, p=0

  8. Obstructive sleep apnea in Type 2 diabetes and impact of continuous positive airway pressure therapy on glycemic control

    Directory of Open Access Journals (Sweden)

    Javid Ahmad Malik

    2017-01-01

    Full Text Available Background: Obstructive sleep apnea (OSA and type 2 diabetes mellitus (T2DM are two interacting epidemics both with high prevalence and morbidity. Both epidemiologic and clinical studies suggest that the majority of patients with T2DM also have OSA and untreated OSA in these patients results in poor glycemic control leading to acceleration of diabetes-related complications. Objectives: To assess the prevalence and severity of OSA in T2DM patients and to assess the impact of OSA treatment on presenting symptoms and hemoglobin A1c (HbA1c. Methods: We performed polysomnography (PSG studies and measured HbA1c in 62 consecutive patients with T2DM that were referred from various subspecialty clinics from July 2011 to August 2013. Results: In our 62 diabetic patients, 59 (95.2% had abnormal PSG. Based on Apnea–Hypopnea Index (AHI score, 3 (5.1% patients had mild, 28 (47.5% had moderate, and 28 (47.5% had severe OSA. The mean AHI of diabetic patients was significantly more than nondiabetic patients, i.e., 25.7 versus 19.7 (P = 0.001. Variables that significantly correlated with the presence of OSA include age, gender, body mass index (BMI, hypertension, diabetes, and cardiovascular disease (P < 0.05; however, on logistic regression only BMI, hypertension, and nocturia correlated with OSA. Overall, 59% of diabetic patients showed improvement in their glycemic control as measured by HbA1c with continuous positive airway pressure (CPAP treatment. Significant, moderate, and mild categories of treatment response were respectively observed in 7%, 20%, and 32% of patients. Conclusion: Treatment of OSA with CPAP reduces HbA1c in a significant number of diabetics.

  9. The Relationship Between Sleep Duration and Glycemic Control Among Hispanic Adults With Uncontrolled Type 2 Diabetes.

    Science.gov (United States)

    Full, Kelsie M; Schmied, Emily A; Parada, Humberto; Cherrington, Andrea; Horton, Lucy A; Ayala, Guadalupe X

    2017-10-01

    Purpose The purpose of this study was to examine the relationship between sleep duration and glycemic control in adult Hispanic patients with uncontrolled type 2 diabetes. Methods This cross-sectional study used baseline data from 317 Hispanic adults with uncontrolled type 2 diabetes who participated in a randomized controlled trial testing a peer support intervention to improve diabetes control. To be eligible, participants had to be 18 years or older and have A1C >7% in the 3 months prior to randomization. Glycemic control was assessed by A1C ascertained through medical chart review; higher A1C levels reflected poorer glycemic control. Sleep duration (hours/night), diabetes control behaviors, and demographics were obtained by interviewer-administered questionnaire. We used multivariable generalized linear models to estimate the association between sleep duration and glycemic control. Results Forty-three percent of participants reported sleeping fewer than 7 hours per night. Sleep duration (hours/night) was inversely associated with A1C levels; however, the relationship was no longer statistically significant after adjusting for insulin status. Conclusions Sleep duration was not significantly associated with glycemic control in this sample of Hispanic adults with uncontrolled type 2 diabetes when adjusting for insulin. Future research should continue to explore this relationship among Hispanic adults with diabetes using an objective measure of sleep duration and a larger sample of Hispanic adults with both controlled and uncontrolled type 2 diabetes to determine if these results hold true.

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

    Directory of Open Access Journals (Sweden)

    Davis Dianne

    2006-10-01

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

  11. Serum Fructosamine: A Simple and Inexpensive Test for Assessing Preoperative Glycemic Control.

    Science.gov (United States)

    Shohat, Noam; Tarabichi, Majd; Tischler, Eric H; Jabbour, Serge; Parvizi, Javad

    2017-11-15

    Although the medical community acknowledges the importance of preoperative glycemic control, the literature is inconclusive and the proper metric for assessment of glycemic control remains unclear. Serum fructosamine reflects the mean glycemic control in a shorter time period compared with glycated hemoglobin (HbA1c). Our aim was to examine its role in predicting adverse outcomes following total joint arthroplasty. Between 2012 and 2013, we screened all patients undergoing total joint arthroplasty preoperatively using serum HbA1c, fructosamine, and blood glucose levels. On the basis of the recommendations of the American Diabetes Association, 7% was chosen as the cutoff for HbA1c being indicative of poor glycemic control. This threshold correlated with a fructosamine level of 292 μmol/L. All patients were followed and total joint arthroplasty complications were evaluated. We were particularly interested in retrieving details on surgical-site infection (superficial and deep). Patients with fructosamine levels of ≥292 μmol/L were compared with those with fructosamine levels of simple and inexpensive test that appears to be a good predictor of adverse outcome in patients with known diabetes and those with unrecognized diabetes or hyperglycemia. Our findings suggest that fructosamine can serve as an alternative to HbA1c in the setting of preoperative glycemic assessment. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

  12. Glycemic outcome not predicted by baseline psychological measures in a diabetes management program.

    Science.gov (United States)

    Graco, Marnie; Hutchinson, Anastasia; Barker, Anna; Lawlor, Vicki; Wong, Rita; Fourlanos, Spiros

    2012-06-01

    The Northern Health Diabetes Hospital Admission Risk Program is a chronic disease management program that aims to improve the glycemic management of patients with diabetes. The aim of this project was to determine if there was any relationship between psychological characteristics and glycemic outcome in a diabetes management program. A prospective study of patients attending the diabetes management program investigated validated measures of cognition, stage of change, locus of control, self-efficacy, depression and anxiety, and quality of life. The study investigated 86 type 2 diabetes patients (mean age 59 years, 49% female). Glycemic control (HbA1c) was measured at baseline and after 12 months in the program. Glycemic control was poor on admission to the service with a mean HbA1c of 8.9%. The measures of cognition, self-efficacy, locus of control, mental health, and quality of life were not associated with improvements in HbA1c. Those participants with shorter duration of disease and more contacts with the service were significantly more likely to experience improvements in HbA1c. Psychometric data were not predictive of glycemic outcome. Rather, in this chronic disease management program, glycemia improved more in patients who were seen earlier in their disease course and managed more intensively, regardless of their psychometric status.

  13. Relationships among diabetic retinopathy, antioxidants, and glycemic control.

    Science.gov (United States)

    Lam, Carly S Y; Benzie, Iris F F; Choi, Siu Wai; Chan, Lily Y L; Yeung, Vincent T F; Woo, George C

    2011-02-01

    Type 2 Diabetes Mellitus (DM) is increasing worldwide and affects ∼11% of the Hong Kong population. Diabetic retinopathy (DR) is a common cause of vision loss in type 2 DM. Risk of DR is increased by poor glycemic control, elevated lipids, and blood pressure, but it is not possible to predict the development or progression of DR at an individual level. Increased oxidative stress is thought to play a role. The use of a wider biomarker profile incorporating biomarkers of antioxidant status and oxidative stress may aid identification of individuals at higher risk or at very early stages of developing DR. Four hundred twenty type 2 DM subjects without diabetic complications were investigated. Eyes were examined for DR and anterior and posterior ocular segment pathology. DR was graded according to Early Treatment Diabetic Retinopathy Study criteria. Demographic data were collected. Traditional risk factors plus biomarkers of antioxidant status and oxidative stress in fasting blood and urine were determined. Overall DR prevalence was 89%. No significant differences in any demographic measures or biomarkers were found among those subjects with different DR grades, or in those without DR. Significant correlations (p < 0.0001) between HbA1c and DNA damage, (ρ = 0.32) and fasting plasma glucose and DNA damage (ρ = 0.52) were seen. DNA damage was also significantly and inversely correlated (p < 0.0001) with both plasma ascorbic acid (ρ = -0.41) and plasma total antioxidant level (ρ = -0.21). DR prevalence was very high in this group, but no biomarker differences were seen in those with DR compared to those free of DR, or in those with different degrees of severity of DR. This group of 420 subjects is being followed up to investigate whether the extended biomarker profile at baseline is related to progression of and/or incident DR.

  14. Effect of prebiotic intake on gut microbiota, intestinal permeability and glycemic control in children with type 1 diabetes: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Ho, Josephine; Reimer, Raylene A; Doulla, Manpreet; Huang, Carol

    2016-07-26

    The gut microbiome is increasingly recognized as a contributor to disease states. Patients with type 1 diabetes (DM1) have distinct gut microbiota in comparison to non-diabetic individuals, and it has been linked to changes in intestinal permeability, inflammation and insulin resistance. Prebiotics are non-digestible carbohydrates that alter gut microbiota and could potentially improve glycemic control in children with DM1. This pilot study aims to determine the feasibility of a 12-week dietary intervention with prebiotics in children with DM1. This pilot study is a single-centre, randomized, double-blind, placebo-controlled trial in children aged 8 to 17 years with DM1 for at least one year. Participants will be randomized to receive either placebo (maltodextrin 3.3 g orally/day) or prebiotics (oligofructose-enriched inulin 8 g orally/day; Synergy1, Beneo, Mannheim, Germany). Measures to be assessed at baseline, 3 months and 6 months include: anthropometric measures, insulin doses/regimens, frequency of diabetic ketoacidosis, frequency of severe hypoglycemia, average number of episodes of hypoglycemia per week, serum C-peptide, HbA1c, serum inflammatory markers (IL-6, IFN-gamma, TNF-alpha, and IL-10), GLP-1 and GLP-2, intestinal permeability using urine assessment after ingestion of lactulose, mannitol and 3-O-methylglucose, and stool sample collection for gut microbiota profiling. This is a novel pilot study designed to test feasibility for a fully powered study. We hypothesize that consumption of prebiotics will alter gut microbiota and intestinal permeability, leading to improved glycemic control. Prebiotics are a potentially novel, inexpensive, low-risk treatment addition for DM1 that may improve glycemic control by changes in gut microbiota, gut permeability and inflammation. ClinicalTrials.gov: NCT02442544 . Registered on 10 March 2015.

  15. Evaluation of micronutrient (Zinc, Magnesium, and Copper levels in serum and glycemic status after nonsurgical periodontal therapy in type 2 diabetic patients with chronic periodontitis

    Directory of Open Access Journals (Sweden)

    Gopalakrishnan Sundaram

    2017-01-01

    Full Text Available Aims and Objectives: To find out the effect of nonsurgical periodontal therapy on serum zinc (Zn, magnesium (Mg, and copper (Cu concentration and glycemic status in type 2 diabetes with chronic periodontitis (CP. Materials and Methods: One hundred and twenty patients were included in this study, which was further divided into three groups. Group 1 consisted of forty patients with CP, Group 2 consisted of forty patients of CP with controlled diabetes, and Group 3 consisted of forty patients of CP with uncontrolled diabetes. Periodontal parameters such as plaque index, gingival index, bleeding on probing, pocket depth, and clinical attachment levels (CALs were evaluated. Blood samples were collected to assess the levels of fasting blood sugar, glycosylated hemoglobin, Zn, Mg, and Cu. All parameters were evaluated at baseline and 3 months after nonsurgical periodontal therapy. Results: The results showed statistically significant reduction in all the clinical parameters within the groups except for the CAL in group 1 patients (P = 0.05. The glycemic status also showed a statistically significant reduction after treatment (P < 0.001. The intragroup comparison was taken between the values of micronutrients, showed substantial increase in the levels of both Zn and Mg and decrease in the level of Cu after nonsurgical periodontal treatment (P < 0.001. Conclusion: Patients with diabetes and periodontitis had altered metabolism of Zn, Mg, and Cu contributing to the progression and complication of diabetes mellitus and periodontitis. Nonsurgical periodontal treatment improved the variation and concentration of plasma micronutrients and also the periodontal status and glycemic level.

  16. Baseline ALT levels as a marker of glycemic response to treatment with GLP-1 receptor agonists.

    Science.gov (United States)

    Gimeno-Orna, Jose A; Verdes-Sanz, Guayente; Borau-Maorad, Laura; Campos-Fernández, Julia; Lardiés-Sánchez, Beatriz; Monreal-Villanueva, Marta

    2016-04-01

    This study aimed to assess if ALT levels, as a marker of non-alcoholic fatty liver disease, may predict HbA1c response to treatment with GLP-1 receptor agonists (GLP-1 RAs). A retrospective, longitudinal, analytical study was conducted including patients with type 2 diabetes mellitus continuously treated with GLP-1 agonists (85% with liraglutide) for one year. Patients were divided into two groups according to baseline ALT levels, with 24 U/L (the median of the distribution) as the cut-off point. The dependent variable was HbA1c change (one-year follow-up minus baseline). The predictive value of ALT levels above 24 U/L and ALT change was analyzed using multivariate linear regression adjusted to age, gender, diabetes duration, type and dose of GLP-1 RA, baseline HbA1c, baseline body mass index (BMI), and change in BMI. A total of 117 patients (48% females) aged 58.6 (SD 9.6) years were enrolled into the study. Treatment was associated with a change in ALT of -4.3 U/L (p=0.041) and a change in HbA1c of -1.1% (pALT (-9.25 vs 0.46 U/L; p=0.002) were significantly higher in patients with ALT levels above the median. In the multivariate analysis, both ALT>24 U/L (b=-0.74; 95%CI: -1.31 to -0.18; p=0.011) and ALT change (b=0.028; 95%CI: 0.010 to 0.046; p=0.003), were significant response predictors. Elevated baseline transaminase values and decreased transaminase levels during follow-up are associated to a favorable glycemic response to GLP-1 RAs. Copyright © 2016 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  17. The obesity epidemic: is glycemic index the key to unlocking a hidden addiction?

    Science.gov (United States)

    Thornley, Simon; McRobbie, Hayden; Eyles, Helen; Walker, Natalie; Simmons, Greg

    2008-11-01

    High body mass index (BMI) is an important cause of a range of diseases and is estimated to be the seventh leading cause of death globally. In this paper we discuss evidence that food consumption shows similarities to features of other addictive behaviours, such as automaticity and loss of control. Glycemic index is hypothesised to be the element of food that predicts its addictive potential. Although we do not have substantive evidence of a withdrawal syndrome from high glycemic food abstinence, anecdotal reports exist. Empirical scientific and clinical studies support an addictive component of eating behaviour, with similar neurotransmitters and neural pathways triggered by food consumption, as with other drugs of addiction. The public health implications of such a theory are discussed, with reference to tobacco control. Subtle changes in the preparation and manufacturing of commonly consumed food items, reducing glycemic index through regulatory channels, may break such a cycle of addiction and draw large public health benefits.

  18. Exercise and Glycemic Control: Focus on Redox Homeostasis and Redox-Sensitive Protein Signaling

    Science.gov (United States)

    Parker, Lewan; Shaw, Christopher S.; Stepto, Nigel K.; Levinger, Itamar

    2017-01-01

    Physical inactivity, excess energy consumption, and obesity are associated with elevated systemic oxidative stress and the sustained activation of redox-sensitive stress-activated protein kinase (SAPK) and mitogen-activated protein kinase signaling pathways. Sustained SAPK activation leads to aberrant insulin signaling, impaired glycemic control, and the development and progression of cardiometabolic disease. Paradoxically, acute exercise transiently increases oxidative stress and SAPK signaling, yet postexercise glycemic control and skeletal muscle function are enhanced. Furthermore, regular exercise leads to the upregulation of antioxidant defense, which likely assists in the mitigation of chronic oxidative stress-associated disease. In this review, we explore the complex spatiotemporal interplay between exercise, oxidative stress, and glycemic control, and highlight exercise-induced reactive oxygen species and redox-sensitive protein signaling as important regulators of glucose homeostasis. PMID:28529499

  19. The Importance of Social Support on Glycemic Control in Low-Income Latinos with Type 2 Diabetes

    Science.gov (United States)

    Rotberg, Britt; Junqueira, Yasmine; Gosdin, Lucas; Mejia, Roberto; Umpierrez, Guillermo E.

    2016-01-01

    Background: The U.S. Latino population exhibits poorer glycemic control than the white population, leading to more frequent health complications and greater disease severity. Social support has been shown a significant factor in health and well-being. Purpose: To determine the association between glycemic control and social support in patients…

  20. Impact of weight loss and maintenance with ad libitum diets varying in protein and glycemic index content on metabolic syndrome

    DEFF Research Database (Denmark)

    Papadaki, Angeliki; Linardakis, Manolis; Plada, Maria

    2014-01-01

    We investigated the effects of weight loss and maintenance with diets that varied with regard to protein content and glycemic index (GI) on metabolic syndrome (MetSyn) status.......We investigated the effects of weight loss and maintenance with diets that varied with regard to protein content and glycemic index (GI) on metabolic syndrome (MetSyn) status....

  1. Dietary Glycemic Index during Pregnancy Is Associated with Biomarkers of the Metabolic Syndrome in Offspring at Age 20 Years

    DEFF Research Database (Denmark)

    Danielsen, Inge; Granström, Charlotta; Haldorsson, Thorhallur

    2013-01-01

    Growing evidence indicates that metabolic syndrome is rooted in fetal life with a potential key role of nutrition during pregnancy. The objective of the study was to assess the possible associations between the dietary glycemic index (GI) and glycemic load (GL) during pregnancy and biomarkers...... of the metabolic syndrome in young adult offspring....

  2. The influence of aspirin dose and glycemic control on platelet inhibition in patients with type 2 diabetes mellitus

    NARCIS (Netherlands)

    Lemkes, B. A.; Bahler, L.; Kamphuisen, P. W.; Stroobants, A. K.; van den Dool, E. J.; Hoekstra, J. B.; Nieuwland, R.; Gerdes, V. E.; Holleman, F.

    Background: Low-dose aspirin seems to offer no benefit in the primary prevention of cardiovascular disease in type 2 diabetes mellitus (DM2). The anti-platelet effect may be diminished by poor glycemic control or inadequate dosing of aspirin. Objectives: To study the effects of both glycemic control

  3. Glycemic instability in type 1 diabetic patients: Possible role of ketosis or ketoacidosis at onset of diabetes.

    Science.gov (United States)

    Sassa, Mariko; Yamada, Yuichiro; Hosokawa, Masaya; Fukuda, Kazuhito; Fujimoto, Shimpei; Toyoda, Kentaro; Tsukiyama, Katsushi; Seino, Yutaka; Inagaki, Nobuya

    2008-08-01

    In type 1 diabetic patients, some have glycemic instability while others glycemic stability. We have developed criteria for evaluating glycemic instability and investigated the factors responsible. Glycemic instability in 52 type 1 diabetic patients was assessed by the mean amplitude of glycemic excursions (MAGE) and M-value, and clinical characteristics of good, fair and poor control groups were compared. The median MAGE and M-value was 6.6mmol/L and 18.7, respectively. Then MAGE >or=6.6mmol/L and M-value >or=18.7 was defined as poor control. In the 32 patients without detectable C-peptide levels, 18 patients (56%) showed poor control. The frequency of ketosis or ketoacidosis at onset of diabetes was dramatically higher in the poor control group not only in the patients as a whole but also in those without detectable C-peptide levels. A decreased level of C-peptide is a significant factor in glycemic instability. However, some patients have glycemic stability though beta-cell function is completely depleted. The presence of ketosis or ketoacidosis at onset of diabetes may be a factor in later glycemic instability, suggesting the importance of examining patients in detail at onset of diabetes for careful follow-up to prevent progression of acute and chronic complications of diabetes.

  4. Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes A Randomized Clinical Trial

    DEFF Research Database (Denmark)

    Johansen, Mette Yun; MacDonald, Christopher Scott; Hansen, Katrine Bagge

    2017-01-01

    IMPORTANCE It is unclear whether a lifestyle intervention can maintain glycemic control in patients with type 2 diabetes. OBJECTIVE To test whether an intensive lifestyle intervention results in equivalent glycemic control compared with standard care and, secondarily, leads to a reduction in gluc...

  5. Food insecurity is related to glycemic control deterioration in patients with type 2 diabetes.

    Science.gov (United States)

    Bawadi, Hiba Ahmad; Ammari, Fawaz; Abu-Jamous, Dima; Khader, Yousef Saleh; Bataineh, Safa'a; Tayyem, Reema Fayez

    2012-04-01

    Poor glycemic control has been shown to play a major role in the development and progression of diabetes complications. This cross-sectional study tested the hypothesis that food insecurity may deteriorate glycemic control in patients with type 2 diabetes. The objectives of this study were to assess the prevalence of food insecurity among type 2 diabetics in a major hospital that serves the area of northern Jordan, and to investigate its relation to glycemic control. A sample of 843 patients diagnosed with type 2 diabetes participated in the study. Socioeconomic and health data were collected by interview-based questionnaire. Weight and height were measured by a trained nutritionist. Dietary assessment was done using food frequency questionnaire. Dietary data were processed using food processor software. Food insecurity was assessed by the short form of the U.S. food security survey module. Glycemic control was assessed by measuring glycosyated hemoglobin (HbA1c). Statistical procedures used to analyze the data were chi-square, and post-hoc analysis of variance. About 22% of the tested sample were food secure (FS); 51% were moderately food insecure (MFIS); and 27% were severely food insecure (SFIS). Higher BMI was associated with SFIS patients. After adjusting for age, gender, income, education, and duration of diabetes, body mass index, and caloric consumption; moderate and severe food insecurity were associated with poor glycemic control (p = 0.04). food insecurity may be associated with glycemic control deterioration in patients with type 2 diabetes. Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  6. Effects of High Performance Inulin Supplementation on Glycemic Status and Lipid Profile in Women with Type 2 Diabetes: A Randomized, Placebo-Controlled Clinical Trial

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    Parvin Dehghan

    2013-06-01

    Full Text Available Background: Type 2 diabetes mellitus, as a noncommunicable disease, is the main public health challenge in the 21st century. The prevalence of di¬abetes mellitus adjusted for the world population in Iran was 8% until the year 2010. Lipid levels are considered as important parameters to be eva¬luated, as high serum lipid levels are often reported as a complication in patients with diabetes mellitus. It is claimed that functional foods may im¬prove complications of diabetes mellitus, so this study was designed to evaluate the effects of high performance inulin on glycemic status and lipid profile of women with type 2 diabetes.Methods: The study was a randomized controlled clinical trial. Forty-nine type 2 diabetic females (fiber intake <30g/d, 25Glycemic status and lipid profile indices were measured pre and post intervention. Data were analyzed using SPSS software (verision11.5. Paired, unpaired t-test and ANCOVA were used to compare quantitative variables.Results: Supplementation with inulin caused a significant reduction in FBS (8.50%, HbA1c (10.40%, total cholesterol (12.90%, triglyceride (23.60 %, LDL-c (35.30 %, LDL-c/HDL-c ratio (16.25% and TC/HDL-c ratio (25.20% and increased HDL-c (19.90%. The changes for the control group parameters were not significant at the end of study. Conclusion: Inulin may help to control diabetes and its complications via improving glycemic and lipid parameters.

  7. A protein-enriched low glycemic index diet with omega-3 polyunsaturated fatty acid supplementation exerts beneficial effects on metabolic control in type 2 diabetes.

    Science.gov (United States)

    Moosheer, Simone M; Waldschütz, Wolfgang; Itariu, Bianca K; Brath, Helmut; Stulnig, Thomas M

    2014-12-01

    The current study aims to investigate practicability and effects of a combined dietary intervention with increased relative protein content supplemented with omega-3 polyunsaturated fatty acids (PUFA) on metabolic control and inflammatory parameters in a real life situation in type 2 diabetes patients. In this observational study we advised thirty mostly obese patients with type 2 diabetes to follow a protein-enriched diet with carbohydrates of low glycemic index (low GI) and moderate fat reduction supplemented with omega-3 PUFA for 24 weeks. Primary efficacy parameter was the change in HbA1c; secondary parameters included changes in systemic inflammation (measured by ultrasensitive C-reactive protein, usCRP), body weight, waist circumference, fat mass. The study is registered at clinicaltrials.gov (NCT01474603). The dietary intervention significantly reduced the primary efficacy variable HbA1c from a baseline value of 63±11mmol/mol to 59±14mmol/mol (P=0.033) and 56±12mmol/mol (P=0.001) after 12 and 24 weeks, respectively. In addition, usCRP decreased significantly at 24 weeks (P=0.039). Waist circumference, an important indicator for cardiometabolic-risk and silent inflammation, decreased from baseline 116.0±14.1cm to 114.9±13.5cm (P=0.019), 114.0±14.4cm (P=0.001), and 112.7±13.4cm (P=0.049), after 3, 12 and 24 weeks, respectively. Counseling a protein enriched and low glycemic index diet supplemented with long-chain omega-3 PUFA in a real-life clinical setting improves glycemic control and also reduces waist circumference and silent inflammation in overweight or obese patients with type 2 diabetes. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  8. Comparison of the capillary and agarose electrophoresis based multiple locus VNTR (variable number of tandem repeats) analysis (MLVA) on Mycobacterium bovis isolates.

    Science.gov (United States)

    Jenkins, A O; Venter, E H; Hutamo, K; Godfroid, J

    2010-09-28

    Electrophoretic techniques that can be used for genotyping of bacterial pathogens ranges from manual, low-cost, agarose gels to high-throughput capillary electrophoresis sequencing machines. These two methods are currently employed in the electrophoresis of PCR products used in multiple locus VNTR (variable number of tandem repeats) analysis (MLVA), i.e. the agarose electrophoresis (AE) and the capillary electrophoresis (CE). Some authors have suggested that clusters generated by AE are less reliable than those generated by CE and that the latter is a more sensitive technique than the former when typing Mycobacterium tuberculosis complex (MTC) isolates. Because such a claim could have significant consequences for investigators in this field, a comparison was made on 19 Belgian Mycobacterium bovis strains which had previously been genotyped using CE VNTR analysis. The VNTR profiles of the CE VNTR analysis were compared with those obtained by AE VNTR analysis at 14 VNTR loci. Our results indicated that there were no differences in copy numbers at all loci tested when the copy numbers obtained by the AE VNTR analysis were compared with those obtained by CE VNTR analysis. The use of AE VNTR analysis in mycobacterial genotyping does not alter the sensitivity of the MLVA technique compared with the CE VNTR analysis. The AE VNTR can therefore be regarded as a viable alternative in moderately equipped laboratories that cannot afford the expensive equipment required for CE VNTR analysis and data obtained by AE VNTR analysis can be shared between laboratories which use the CE VNTR method. (c) 2010 Elsevier B.V. All rights reserved.

  9. Comparison of Variable-Number Tandem-Repeat Markers typing and IS1245 Restriction Fragment Length Polymorphism fingerprinting of Mycobacterium avium subsp. hominissuis from human and porcine origins

    Directory of Open Access Journals (Sweden)

    Marttila Harri

    2010-03-01

    Full Text Available Abstract Background Animal mycobacterioses are regarded as a potential zoonotic risk and cause economical losses world wide. M. avium subsp. hominissuis is a slow-growing subspecies found in mycobacterial infected humans and pigs and therefore rapid and discriminatory typing methods are needed for epidemiological studies. The genetic similarity of M. avium subsp. hominissuis from human and porcine origins using two different typing methods have not been studied earlier. The objective of this study was to compare the IS1245 RFLP pattern and MIRU-VNTR typing to study the genetic relatedness of M. avium strains isolated from slaughter pigs and humans in Finland with regard to public health aspects. Methods A novel PCR-based genotyping method, variable number tandem repeat (VNTR typing of eight mycobacterial interspersed repetitive units (MIRUs, was evaluated for its ability to characterize Finnish Mycobacterium avium subsp. hominissuis strains isolated from pigs (n = 16 and humans (n = 13 and the results were compared with those obtained by the conventional IS1245 RFLP method. Results The MIRU-VNTR results showed a discriminatory index (DI of 0,92 and the IS1245 RFLP resulted in DI 0,98. The combined DI for both methods was 0,98. The MIRU-VNTR test has the advantages of being simple, reproducible, non-subjective, which makes it suitable for large-scale screening of M. avium strains. Conclusions Both typing methods demonstrated a high degree of similarity between the strains of human and porcine origin. The parallel application of the methods adds epidemiological value to the comparison of the strains and their origins. The present approach and results support the hypothesis that there is a common source of M. avium subsp. hominissuis infection for pigs and humans or alternatively one species may be the infective source to the other.

  10. The retinal nerve fibre layer thickness in glaucomatous hydrophthalmic eyes assessed by scanning laser polarimetry with variable corneal compensation in comparison with age-matched healthy children.

    Science.gov (United States)

    Hložánek, Martin; Ošmera, Jakub; Ležatková, Pavlína; Sedláčková, Petra; Filouš, Aleš

    2012-12-01

    To compare the thickness of the retinal nerve fibre layer (RNFL) in hydrophthalmic glaucomatous eyes in children with age-matched healthy controls using scanning laser polarimetry with variable corneal compensation (GDxVCC). Twenty hydrophthalmic eyes of 20 patients with the mean age of 10.64 ± 3.02 years being treated for congenital or infantile glaucoma were included in the analysis. Evaluation of RNFL thickness measured by GDxVCC in standard Temporal-Superior-Nasal-Inferior-Temporal (TSNIT) parameters was performed. The results were compared to TSNIT values of an age-matched control group of 120 healthy children published recently as referential values. The correlation between horizontal corneal diameter and RNFL thickness in hydrophthalmic eyes was also investigated. The mean ± SD values in TSNIT Average, Superior Average, Inferior Average and TSNIT SD in hydrophthalmic eyes were 52.3 ± 11.4, 59.7 ± 17.1, 62.0 ± 15.6 and 20.0 ± 7.8 μm, respectively. All these values were significantly lower compared to referential TSNIT parameters of age-matched healthy eyes (p = 0.021, p = 0.001, p = 0.003 and p = 0.018, respectively). A substantial number of hydrophthalmic eyes laid below the level of 5% probability of normality in respective TSNIT parameters: 30% of the eyes in TSNIT average, 50% of the eyes in superior average, 30% of the eyes in inferior average and 45% of the eyes in TSNIT SD. No significant correlation between enlarged corneal diameter and RNFL thickness was found. The mean values of all standard TSNIT parameters assessed using GDxVCC in hydrophthalmic glaucomatous eyes in children were significantly lower in comparison with referential values of healthy age-matched children. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

  11. Modification and application of TOUGH2 as a variable-density, saturated-flow code and comparison to SWIFT II results

    International Nuclear Information System (INIS)

    Christian-Frear, T.L.; Webb, S.W.

    1995-01-01

    Human intrusion scenarios at the Waste Isolation Pilot Plant (WIPP) involve penetration of the repository and an underlying brine reservoir by a future borehole. Brine and gas from the brine reservoir and the repository may flow up the borehole and into the overlying Culebra formation, which is saturated with water containing different amounts of dissolved 'solids resulting in a spatially varying density. Current modeling approaches involve perturbing a steady-state Culebra flow field by inflow of gas and/or brine from a breach borehole that has passed through the repository. Previous studies simulating steady-state flow in the Culebra have been done. One specific study by LaVenue et al. (1990) used the SWIFT 2 code, a single-phase flow and transport code, to develop the steady-state flow field. Because gas may also be present in the fluids from the intrusion borehole, a two-phase code such as TOUGH2 can be used to determine the effect that emitted fluids may have on the steady-state Culebra flow field. Thus a comparison between TOUGH2 and SWIFT2 was prompted. In order to compare the two codes and to evaluate the influence of gas on flow in the Culebra, modifications were made to TOUGH2. Modifications were performed by the authors to allow for element-specific values of permeability, porosity, and elevation. The analysis also used a new equation of state module for a water-brine-air mixture, EOS7 (Pruess, 1991), which was developed to simulate variable water densities by assuming a miscible mixture of water and brine phases and allows for element-specific brine concentration in the INCON file

  12. [Socioeconomic, demographic, nutritional, and physical activity factors in the glycemic control of adolescents with type 1 diabetes mellitus].

    Science.gov (United States)

    Marques, Rosana de Morais Borges; Fornés, Nélida Schmid; Stringhini, Maria Luiza Ferreira

    2011-04-01

    To identify the association of socioeconomic, demographic, nutritional and of physical activity factors in the glycemic control of adolescents with T1DM. Sectional study of 71 adolescents with type 1 diabetes. Socioeconomic, demographic and anthropometric data were obtained. The glycemic control was classified by the index of glycated hemoglobin (A1C). Four 24-hours recalls of food consumption and physical activity were applied. The A1C was inadequate for the majority of the adolescents. The low educational level of the caregivers influenced the inadequate glycemic control. Patients with lower insulin dose presented better glycemic control. The food consumption was high of fat and poor of carbohydrate. Most of the patients were sedentary. Factors related to education, insulin and food consumption influenced the glycemic control.

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

    Directory of Open Access Journals (Sweden)

    Priscilla Moura Rolim

    2011-06-01

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

  14. Inflammatory markers in gingival crevicular fluid of periodontitis patients with type 2 diabetes mellitus according to glycemic control: A pilot study.

    Science.gov (United States)

    Longo, Priscila Larcher; Artese, Hilana Paula Carilo; Horliana, Anna Carolina Ratto Tempestini; Gomes, Giovane Hisse; Romito, Giuseppe Alexandre; Dib, Sergio Atala; Mayer, Marcia Pinto Alves

    2015-01-01

    Type 2 diabetes mellitus (T2DM) and periodontitis are inflammatory conditions with a bidirectional association. This pilot study aimed to evaluate whether T2DM and glycemic control interfere in inflammatory markers profiles in gingival crevicular fluid (GCF) in periodontitis patients. Fourteen diabetic periodontitis patients were enrolled in this study, seven with adequate glycemic control (glycated hemoglobin [HbA1c] periodontitis patients without diabetes formed the control group (P). GCF was obtained from diseased sites (probing depth >6 mm) of an entirely hemiarch, pooled and cytokines levels determined using multiplex beads immunoassay. Clinical periodontal parameters were analyzed by Mann-Whitney test and levels of cytokines by Kruskal-Wallis and Dunn's multiple comparison tests with confidence level of 95% (P periodontal pockets presented high levels of inflammatory cytokines, and there were no statistical differences between levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor-α according to presence of diabetes or percentage of HbA1c among the groups, despite groups with T2DM and periodontitis exhibit higher levels of PD. Within the limitations of this study, inflammatory mediators in GCF are dependent to the local response and do not correlate with the diabetic status.

  15. Inflammatory markers in gingival crevicular fluid of periodontitis patients with type 2 diabetes mellitus according to glycemic control: A pilot study

    Directory of Open Access Journals (Sweden)

    Priscila Larcher Longo

    2015-01-01

    Full Text Available Background: Type 2 diabetes mellitus (T2DM and periodontitis are inflammatory conditions with a bidirectional association. This pilot study aimed to evaluate whether T2DM and glycemic control interfere in inflammatory markers profiles in gingival crevicular fluid (GCF in periodontitis patients. Materials and Methods: Fourteen diabetic periodontitis patients were enrolled in this study, seven with adequate glycemic control (glycated hemoglobin [HbA1c] 6 mm of an entirely hemiarch, pooled and cytokines levels determined using multiplex beads immunoassay. Clinical periodontal parameters were analyzed by Mann-Whitney test and levels of cytokines by Kruskal-Wallis and Dunn′s multiple comparison tests with confidence level of 95% (P < 0.05. Results: Cytokines profile of GCF obtained from deep periodontal pockets presented high levels of inflammatory cytokines, and there were no statistical differences between levels of interleukin-6 (IL-6, IL-8 and tumor necrosis factor-α according to presence of diabetes or percentage of HbA1c among the groups, despite groups with T2DM and periodontitis exhibit higher levels of PD. Conclusion: Within the limitations of this study, inflammatory mediators in GCF are dependent to the local response and do not correlate with the diabetic status.

  16. The glycemic, insulinemic and plasma amino acid responses to equi-carbohydrate milk meals, a pilot- study of bovine and human milk

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    Gunnerud Ulrika

    2012-10-01

    Full Text Available Abstract Background Dairy proteins, in particular the whey fraction, exert insulinogenic properties and facilitate glycemic regulation through a mechanism involving elevation of certain plasma amino acids, and stimulation of incretins. Human milk is rich in whey protein and has not been investigated in this respect. Method Nine healthy volunteers were served test meals consisting of human milk, bovine milk, reconstituted bovine whey- or casein protein in random order. All test meals contributed with 25g intrinsic or added lactose, and a white wheat bread (WWB meal was used as reference, providing 25g starch. Post-prandial levels in plasma of glucose, insulin, incretins and amino acids were investigated at time intervals for up to 2 h. Results All test meals elicited lower postprandial blood glucose responses, expressed as iAUC 0–120 min compared with the WWB (P  Conclusion This study shows that the glycemic response was significantly lower following all milk/milk protein based test meals, in comparison with WWB. The effect appears to originate from the protein fraction and early phase plasma amino acids and incretins were involved in the insulin secretion. Despite its lower protein content, the human milk was a potent GLP-1 secretagogue and showed insulinogenic properties similar to that seen with reconstituted bovine whey-protein, possibly due to the comparatively high proportion of whey in human milk.

  17. The joint impact of habitual exercise and glycemic control on the incidence of chronic kidney disease (CKD) in middle-aged and older males.

    Science.gov (United States)

    Michishita, Ryoma; Matsuda, Takuro; Kawakami, Shotaro; Tanaka, Satoshi; Kiyonaga, Akira; Tanaka, Hiroaki; Morito, Natsumi; Higaki, Yasuki

    2017-11-06

    This retrospective study evaluated the influence of the joint impact of habitual exercise and glycemic control on the incidence of chronic kidney disease (CKD) during a 6-year follow-up period in middle-aged and older males. The study population included 303 males without a history of cardiovascular disease, stroke, renal dysfunction, or dialysis treatment. Their lifestyle behaviors regarding exercise and physical activity were evaluated using a standardized self-administered questionnaire. The participants were divided into four categories according to the performance or non-performance of habitual exercise and the presence or absence of hyperglycemia. After 6 years, 32 subjects (10.6%) developed CKD (estimated glomerular filtration rate exercise and hyperglycemic subjects (log-rank test: p exercise (HR = 2.82, 95% confidence of interval (CI) = 1.07-7.36, p = 0.034) and that in hyperglycemic subjects who did not perform habitual exercise (HR = 5.89, 95% CI = 1.87-16.63, p = 0.003) were significantly higher in comparison to the subjects with a NGT who performed habitual exercise. These results suggest that the habitual exercise and good glycemic control and their combination were associated with the incidence of CKD.

  18. Effects of Cinnamon, Cardamom, Saffron, and Ginger Consumption on Markers of Glycemic Control, Lipid Profile, Oxidative Stress, and Inflammation in Type 2 Diabetes Patients.

    Science.gov (United States)

    Azimi, Paria; Ghiasvand, Reza; Feizi, Awat; Hariri, Mitra; Abbasi, Behnoud

    2014-01-01

    Type 2 diabetes (T2D) may be caused by elevated oxidative stress, inflammation, and hyperglycemia. The phytochemicals in several herbal medicines are reported to effectively improve diabetes and to ameliorate diabetic complications. The aim of the present study was to determine the effects of cinnamon, cardamom, saffron, and ginger as supplementary remedies in T2D. This randomized controlled, clinical trial included 204 T2D patients. The participants were randomly assigned to four intervention groups receiving 3 glasses of black tea and either 3 g cardamom, or cinnamon, or ginger, or 1 g saffron and one control group which consumed only 3 tea glasses without any herbal medicine for 8 weeks. Markers of inflammation, oxidative stress, fasting blood sugar, lipid profile, and anthropometric measures were evaluated at baseline and after 8 weeks of intervention. After 8 weeks of intervention, cinnamon, cardamom, ginger, and saffron consumption had significant effects on total cholesterol, LDL, and HDL levels (p < 0.05) compared with controls. However, the herbal products did not have significant effects on measures of glycemic control, anthropometry, inflammation, and oxidative stress. In within-group comparisons only, cinnamon intake significantly decreased fasting blood sugar (FBS). The herbal remedies examined had significantly beneficial effects on cholesterol, but not on measures of glycemic control, oxidative stress, and inflammation. Based on the contradictory results reported in the literature, the effects of herbal medicine in diabetic patients should undergo further detailed investigation.

  19. Informing food choices and health outcomes by use of the dietary glycemic index

    Science.gov (United States)

    Considerable epidemiologic evidence links consuming lower glycemic index (GI) diets with good health, particularly upon aging. The GI is a kinetic parameter that reflects the ability of carbohydrate (CHO) contained in consumed foods to raise blood glucose in vivo. Newer nutritional, clinical, and ex...

  20. Glycemic index differences of high-fat diets modulate primarily lipid metabolism in murine adipose tissue

    NARCIS (Netherlands)

    Schothorst, van E.M.; Bunschoten, J.E.; Verlinde, E.; Schrauwen, P.; Keijer, J.

    2011-01-01

    A low vs. high glycemic index of a high-fat (HF) diet (LGI and HGI, respectively) significantly retarded adverse health effects in adult male C57BL/6J mice, as shown recently (Van Schothorst EM, Bunschoten A, Schrauwen P, Mensink RP, Keijer J. FASEB J 23: 1092–1101, 2009). The LGI diet enhanced

  1. Cr-enriched yeast: beyond fibers for the management of postprandial glycemic response to bread.

    Science.gov (United States)

    Yanni, Amalia E; Stamataki, Nikoleta; Stoupaki, Maria; Konstantopoulos, Panagiotis; Pateras, Irene; Tentolouris, Nikolaos; Perrea, Despoina; T Karathanos, Vaios

    2017-06-01

    Efforts regarding the amelioration of postprandial glycemic response to bread are mainly focused in the addition of soluble dietary fibers. The current study presents another approach which is based on the supplementation of flour with Cr-enriched yeast. Cr is known for its beneficial effects on improvement of glucose tolerance and enhancement of insulin sensitivity. Twelve normoglycemic subjects were provided with white bread (WB, reference food) or whole wheat bread with Cr-enriched yeast (WWCrB, rich in insoluble fibers) or white wheat bread with Cr-enriched yeast (WCrB, poor in fibers) or whole wheat-rye-barley bread enriched with oat beta glucans (BGB, rich in soluble fibers) with 1-week intervals in amounts that yielded 50 g of available carbohydrates. Postprandial glucose, insulin and ghrelin responses as well as glycemic index (GI) were evaluated. Ingestion of WWCrB, WCrB and BGB elicited lower incremental area under the curve (iAUC) for 120-min glycemic response compared to WB (1033.02 ± 282.32, 701.69 ± 330.86 and 748.95 ± 185.42 vs 2070.87 ± 518.44 mg/dL min, respectively, P bread without the necessity of high fiber amounts, providing with another strategy for the management of glycemic control.

  2. Exploration of Low-Glycemic-Impact Sugars and Polyols, using SRC, DSC, and RVA

    Science.gov (United States)

    The anti-plasticizing action of the high sucrose concentration in a cookie formula inhibits both gluten development during dough mixing and starch gelatinization/pasting during baking. If alternative sugars and polyols with lower glycemic impact are used to replace sucrose, the resulting absence of ...

  3. Estimated glycemic index and dietary fiber content of cookies elaborated with extruded wheat bran.

    Science.gov (United States)

    Reyes-Pérez, Faviola; Salazar-García, María Guadalupe; Romero-Baranzini, Ana Lourdes; Islas-Rubio, Alma Rosa; Ramírez-Wong, Benjamín

    2013-03-01

    The increasing demand for high-fiber products has favored the design of numerous bakery products rich in fiber such as bread, cookies, and cakes. The objective of this study was to evaluate the dietary fiber and estimated glycemic index of cookies containing extruded wheat bran. Wheat bran was subjected to extrusion process under three temperature profiles: TP1;(60, 75, 85 and 100 °C), TP2;(60, 80, 100 and 120 °C), and TP3;(60, 80, 110 and 140 °C) and three moisture contents: (15, 23, and 31 %). Cookies were elaborated using extruded wheat bran (30 %), separated into two fractions (coarse and fine). The dietary fiber content of cookies elaborated with extruded wheat bran was higher than the controls; C0 (100 % wheat flour) and C1 (30 % of no extruded bran coarse fraction) and C2 (30 % of no extruded bran fine fraction). The higher values of dietary fiber were observed on cookies from treatments 5 (TP1, 31 % moisture content and coarse fraction) and 11 (TP2, 31 % moisture content and coarse fraction). The estimated glycemic index of cookies ranged from 68.54 to 80.16. The dietary fiber content of cookies was increased and the lowest glycemic index corresponded to the cookies elaborated with extruded wheat bran. Cookie made with the treatment 11 had a better dietary fiber content and lower estimated glycemic index.

  4. Improved Glycemic Control With Intraperitoneal Versus Subcutaneous Insulin in Type 1 Diabetes A randomized controlled trial

    NARCIS (Netherlands)

    Logtenberg, Susan J.; Kleefstra, Nanne; Houweling, Sebastiaan T.; Groenier, Klaas H.; Gans, Reinold O.; van Ballegooie, Evert; Bilo, Henk J.

    OBJECTIVE - Continuous intraperitoneal insulin infusion (CIPII) with an implantable pump has been available for the past 25 years. CIPII, with its specific pharmacodynamic properties, may be a viable treatment alternative to improve glycemic control in patients with type I diabetes for whom other

  5. Dietary fiber intake, dietary glycemic load, and the risk for gestational diabetes mellitus.

    Science.gov (United States)

    Zhang, Cuilin; Liu, Simin; Solomon, Caren G; Hu, Frank B

    2006-10-01

    We aimed to examine whether pregravid dietary fiber consumptions from cereal, fruit, and vegetable sources and dietary glycemic load were related to gestational diabetes mellitus (GDM) risk. This study was a prospective cohort study among 13,110 eligible women in the Nurses' Health Study II. GDM was self-reported and validated by medical record review in a subsample. We documented 758 incident GDM cases during 8 years of follow-up. After adjustment for age, parity, prepregnancy BMI, and other covariates, dietary total fiber and cereal and fruit fiber were strongly associated with GDM risk. Each 10-g/day increment in total fiber intake was associated with 26% (95% CI 9-49) reduction in risk; each 5-g/day increment in cereal or fruit fiber was associated with a 23% (9-36) or 26% (5-42) reduction, respectively. Dietary glycemic load was positively related to GDM risk. Multivariate relative risk for highest versus lowest quintiles was 1.61 (1.02-2.53) (P for trend 0.03). The combination of high-glycemic load and low-cereal fiber diet was associated with 2.15-fold (1.04-4.29) increased risk compared with the reciprocal diet. These findings suggested that prepregnancy diet might be associated with women's GDM risk. In particular, diet with low fiber and high glycemic load was associated with an increased risk. Future clinical and metabolic studies are warranted to confirm these findings.

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

    Science.gov (United States)

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

    2016-01-01

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

  7. Glycemic control in the infectious diseases ward; role of clinical pharmacist interventions.

    Science.gov (United States)

    Farsaei, Shadi; Karimzadeh, Iman; Elyasi, Sepideh; Hatamkhani, Shima; Khalili, Hossein

    2014-04-15

    Hyperglycemia is one of the most frequent metabolic complications in hospitalized patients. Increased risk of infection following hyperglycemia has been reported in hospitalized patients and infections may also cause insulin resistance which complicates the control of blood glucose level. In this study the impact of the clinical pharmacist interventions on the glycemic control in patients admitted to infectious diseases ward has been evaluated. We conducted a prospective, pre-post interventional study among patients with hyperglycemia. The clinical pharmacist-led multidisciplinary team managed the glycemic profile of patients according to an established insulin protocol commonly used in internal wards. Clinical pharmacists reviewed patients' medical charts for proper insulin administration, evaluated nurses' technique for insulin injection and blood glucose measurement, and educated patients about symptoms of hypoglycemia and the importance of adherence to different aspects of their glycemic management. The percentage of controlled random blood sugar increased from 13.8% in the pre-intervention to 22.3% in the post-intervention group (p value percentage of controlled fasting blood sugars in the post-intervention group was non-significantly higher than in the pre-intervention group. Pharmacists and additional health care providers from other departments such as nursing and dietary departments need to be devoted to glycemic control service. Collaborative practice agreement between physicians is necessary to promote this service and help to increase the use of such services in different settings for diabetes control.

  8. Effects on Glycemic Control in Impaired Wound Healing in Spontaneously Diabetic Torii (SDT) Fatty Rats.

    Science.gov (United States)

    Katsuhiro, Miyajima; Hui Teoh, Soon; Yamashiro, Hideaki; Shinohara, Masami; Fatchiyah, Fatchiyah; Ohta, Takeshi; Yamada, Takahisa

    2018-02-01

    Impaired diabetic wound healing is an important issue in diabetic complications. The present study aims to evaluate the protective effect on glycemic control against impaired diabetic wound healing using a diabetic rat model. We investigated the wound healing process and effect on the impaired wound repair by glycemic control in the Spontaneously Diabetic Torii (SDT) fatty rat, which is a new animal model of obese type 2 diabetes and may be a good model for study impaired wound healing. Male SDT fatty rats at 15 weeks of age were administered orally with sodium glucose co-transporter (SGLT) 2 inhibitor for 3 weeks. Wounds were induced at 2 weeks after SGLT 2 inhibitor treatment, and the wound areas were periodically examined in morphological and histological analyses. The SDT fatty rats showed a delayed wound healing as compared with the normal rats, but a glycemic control improved the impaired wound healing. In histological analysis in the skin of SDT fatty rats showed severe infiltration of inflammatory cell, hemorrhage and many bacterial masses in the remaining and slight fibrosis of crust on skin tissue . Thought that this results skin performance to be a delay of crust formation and regeneration of epithelium; however, these findings were ameliorated in the SGLT 2 inhibitor treated group. Glycemic control is effective for treatment in diabetic wounds and the SDT fatty rat may be useful to investigate pathophysiological changes in impaired diabetic wound healing.

  9. Symptoms and well-being in relation to glycemic control in type II diabetes

    NARCIS (Netherlands)

    Van Der Does, Ferdinand E.E.; De Neeling, J. Nico D.; Snoek, Frank J.; Kostense, Pieter J.; Grootenhuis, Peter A.; Bouter, Lex M.; Heine, Robert J.

    1996-01-01

    OBJECTIVE - To describe the cross-sectional relation between glycemic control and physical symptoms, emotional well-being, and general well-being in patients with type II diabetes. RESEARCH DESIGN AND METHODS - The study population consisted of 188 patients with type II diabetes between 40 and 75

  10. Glycemic, insulinemic, and appetite responses of patients with type 2 diabetes to commonly consumed breads.

    Science.gov (United States)

    Breen, Cathy; Ryan, Miriam; Gibney, Michael J; Corrigan, Michelle; O'Shea, Donal

    2013-01-01

    The purpose of this study was to identify the breads most commonly consumed by adults with type 2 diabetes (T2DM) and then examine the postprandial glycemic, insulinemic, and appetite responses that these breads elicit. One hundred people with T2DM were surveyed to identify the varieties of bread they most frequently consumed. According to a randomized crossover design, 11 fasting participants with T2DM consumed 50 g of available carbohydrate from 4 breads. Glucose and insulin concentrations and appetite ratings were determined over 270 minutes. Three commonly consumed varieties (white, whole wheat buttermilk, whole grain) identified in the survey-plus a lower-glycemic-index "control" bread (pumpernickel rye)-were tested in the second phase. Despite perceived differences between "brown" and "white" breads, the white, whole wheat buttermilk, and wholegrain breads promoted similar glycemic and insulinemic responses. Pumpernickel bread resulted in a significantly lower peak glucose (P breads and a lower peak insulin (P bread. Similar appetite responses were found with all 4 breads. Adults with T2DM are choosing a variety of breads with perceived differential effects on glycemic, insulinemic, and appetite responses. Appreciable benefits, however, are not conferred by the commonly consumed breads. If breads known to promote favorable metabolic responses are unavailable, the primary emphasis in education should be placed on portion control. Conveying this information to patients is crucial if nutrition education is to achieve its aim of empowering individuals to manage their diabetes through their food choices.

  11. Glycemic control in diabetic children and adolescents after attending diabetic camp

    Directory of Open Access Journals (Sweden)

    Erwin P. Soenggono

    2011-10-01

    Conclusion Glycemic control in T1DM children and adolescents was significantly improved 3 months after attending diabetic camp compared to that before attending camp. According to subjects’ self-assessment by PedsQL questionnaire, no subjects indicated a poor quality of life for the duration of their illness. [Paediatr Indones. 2011;51:294-7].

  12. Diabetes with comorbid depression: role of SSRI in better glycemic control.

    Science.gov (United States)

    Gehlawat, Pratibha; Gupta, Rajiv; Rajput, Rajesh; Gahlan, Deepak; Gehlawat, Virender Kumar

    2013-10-01

    The presence of depression in patients with diabetes mellitus is reported to be associated with poor glycemic control and an increased risk of diabetic complications. Treatment of depression with selective serotonin reuptake inhibitors (SSRIs) may improve glycemic control and may be beneficial for patients with comorbid depression and diabetes. To study the effect of Escitalopram (SSRI) in patients with diabetes mellitus with comorbid depression and the relationship of treatment response for depression and glycemic control. 40 patients received open-label Escitalopram therapy for up to 12 weeks. Clinical outcome measures included Hamilton Depression rating scale (HAM-D) assessment at 3, 6, and 12 weeks. In addition, fasting and post-prandial plasma glucose level, weight and waist circumference, glycosylated hemoglobin level (HbA1C), lipid profile, renal function test and fundus examination were done before and during Escitalopram therapy. A significant decline in mean HAM-D scores was observed 3 weeks onwards till the end of the study during Escitalopram therapy. There was a corresponding decline in mean fasting and post-prandial plasma glucose level at 6 and 12 weeks respectively and glycosylated hemoglobin level at 12 weeks was observed. Escitalopram is effective in treating depression in patients with diabetes mellitus, and has beneficial effects on glycemic control. Copyright © 2013. Published by Elsevier B.V.

  13. Bile acid sequestrants for glycemic control in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Hansen, Morten; Sonne, David P; Mikkelsen, Kristian H

    2017-01-01

    by the control group and no evidence of publication bias or small study effects. CONCLUSIONS: Our analyses found that BAS treatment improves glycemic control. The size of the effect was clinically relevant and despite limited safety data, our findings support the inclusion of BASs in current diabetes management...

  14. Canagliflozin Slows Progression of Renal Function Decline Independently of Glycemic Effects

    NARCIS (Netherlands)

    Heerspink, Hiddo J. L.; Desai, Mehul; Jardine, Meg; Balis, Dainius; Meininger, Gary; Perkovic, Vlado

    Sodium-glucose cotransporter 2 inhibition with canagliflozin decreases HbA1c, body weight, BP, and albuminuria, implying that canagliflozin confers renoprotection. We determined whether canagliflozin decreases albuminuria and reduces renal function decline independently of its glycemic effects in a

  15. No influence of carbonation on glycemic response, gastric emptying, and satiety of sweetened drinks.

    Science.gov (United States)

    Lau, Evelyn Rou Lin; Henry, Christiani Jeyakumar

    The aim of this study was to examine the effect of carbonation of sweetened beverages on glycemic response, gastric emptying, and satiety. After an overnight fast, 15 healthy individuals (6 women, 9 men) consumed a 500 mL beverage containing 50 g glucose that was noncarbonated (NC), low carbonated (LC), or high carbonated (HC) at a standardized rate of consumption (100 mL/min). Blood glucose was measured at baseline and at 15, 30, 45, 60, 90, and 120 min after beverage consumption. Antral cross-sectional area was measured using ultrasound at baseline, 5, 10, 20, 30, 40, 50, 60, 90, and 120 min; for the estimation of gastric volume and gastric emptying rate. Satiety was assessed using electronic visual analog scales at the same time points as the blood glucose measurement. There were no significant differences in glycemic response among the test beverages. Higher carbonation levels significantly increased antral cross-sectional area during the first 20 min after beverage consumption (P carbonation on satiety, but the area under the curve for thirst was significantly lower for HC compared with NC (P = 0.009). The carbonation of a simple glucose solution did not increase glycemic response nor alter gastric emptying and subjective feelings of satiety (with the exception of thirst). The present study suggests that carbonation does not alter glycemic response. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Association of Exercise Stages of Change with Glycemic Control in Individuals with Type 2 Diabetes.

    Science.gov (United States)

    Natarajan, Sundar; Clyburn, Ernest B.; Brown, Ronald T.

    2002-01-01

    Investigated the distribution of diabetic patients' stages of change to follow an exercise regimen, examining whether later stages of change were associated with better glycemic control. Data on participants from a primary care clinic (who were predominantly black, female, and indigent) indicated that over half of were in pre-contemplation,…

  17. Exercise and 24-h Glycemic Control: Equal Effects for All Type 2 Diabetes Patients?

    NARCIS (Netherlands)

    van Dijk, J.W.; Manders, R.J.F.; Canfora, E.E.; van Mechelen, W.; Hartgens, F.; Stehouwer, C.D.A.; van Loon, L.J.C.

    2013-01-01

    Purpose: We assessed the effect of a single bout of moderate-intensity exercise on subsequent 24-h glycemic control in 60 type 2 diabetes patients. Moreover, we examined whether individual responses to exercise were related to subjects' baseline characteristics, including age, body mass index,

  18. Glycemic control during consecutive days with prolonged walking exercise in individuals with type 1 diabetes mellitus.

    NARCIS (Netherlands)

    Dijk, J.W.; Eijsvogels, T.M.H.; Nyakayiru, J.D.O.A.; Schreuder, T.H.A.; Hopman, M.T.E.; Thijssen, D.H.J.; Loon, L.J. van

    2016-01-01

    AIMS: Despite its general benefits for health, exercise complicates the maintenance of stable blood glucose concentrations in individuals with type 1 diabetes. The aim of the current study was to examine changes in food intake, insulin administration, and 24-h glycemic control in response to

  19. Calculating the Mean Amplitude of Glycemic Excursions from Continuous Glucose Data Using an Open-Code Programmable Algorithm Based on the Integer Nonlinear Method

    Directory of Open Access Journals (Sweden)

    Xuefei Yu

    2018-01-01

    Full Text Available The mean amplitude of glycemic excursions (MAGE is an essential index for glycemic variability assessment, which is treated as a key reference for blood glucose controlling at clinic. However, the traditional “ruler and pencil” manual method for the calculation of MAGE is time-consuming and prone to error due to the huge data size, making the development of robust computer-aided program an urgent requirement. Although several software products are available instead of manual calculation, poor agreement among them is reported. Therefore, more studies are required in this field. In this paper, we developed a mathematical algorithm based on integer nonlinear programming. Following the proposed mathematical method, an open-code computer program named MAGECAA v1.0 was developed and validated. The results of the statistical analysis indicated that the developed program was robust compared to the manual method. The agreement among the developed program and currently available popular software is satisfied, indicating that the worry about the disagreement among different software products is not necessary. The open-code programmable algorithm is an extra resource for those peers who are interested in the related study on methodology in the future.

  20. Low glycemic index treatment for seizures in Angelman syndrome.

    Science.gov (United States)

    Thibert, Ronald L; Pfeifer, Heidi H; Larson, Anna M; Raby, Annabel R; Reynolds, Ashley A; Morgan, Amy K; Thiele, Elizabeth A

    2012-09-01

    The low glycemic index treatment (LGIT) is a high fat, limited carbohydrate diet used in the treatment of epilepsy. The purpose of this study was to assess the efficacy and tolerability of the LGIT for the treatment of refractory seizures in pediatric patients with Angelman syndrome. A pediatric Angelman syndrome cohort with refractory epilepsy was treated with the LGIT and followed prospectively over 4 months. Parents recorded a daily seizure log for a minimum of 1 month prior to the start of treatment as well as throughout the LGIT trial. Electroencephalography (EEG) and neuropsychological assessments (Scales of Independent Behavior-Revised and the Vineland Adaptive Behavior Scales-2nd Edition were obtained for each subject at both baseline and 4-month follow-up time points. Clinical evaluations of subjects were completed by a neurologist and dietitian at the time of enrollment, as well as following both the first and fourth months of dietary therapy. At each time point, blood for laboratory chemistries was drawn and anthropometric measures were obtained. Six children (mean age 3.3 years, range 1.1-4.8) with genetically confirmed Angelman syndrome initiated the LGIT, and completed the trial with no significant adverse events. Cohort averages for indices of seizure severity were as follows: age of 1.6 years at seizure onset, 3 lifetime antiepileptic drugs tried (range 1-6), and baseline seizure frequency of 10.1 events/week (range: 0.4-30.9). All subjects had a decrease in seizure frequency on the LGIT, with five of six exhibiting >80% seizure frequency reduction. All posttrial EEG studies showed improvement and three of four children with epileptiform activity on his or her baseline EEG had no discharges present on follow-up EEG. Developmental gains were noted by parents in all cases, although few of these neurocognitive gains were statistically significant on neuropsychological assessment. This is the first prospective study assessing the LGIT for epilepsy. Our

  1. The influence of carbohydrate consumption on glycemic control in pregnant women with type 1 diabetes.

    Science.gov (United States)

    Ásbjörnsdóttir, Björg; Akueson, Cecelia E; Ronneby, Helle; Rytter, Ane; Andersen, Jens R; Damm, Peter; Mathiesen, Elisabeth R

    2017-05-01

    To study the influence of the quantity and the quality of carbohydrate consumption on glycemic control in early pregnancy among women with type 1 diabetes. A retrospective study of 107 women with type 1 diabetes who completed 1-3days of diet recording before first antenatal visit, as a part of routine care. The total daily carbohydrate consumption from the major sources (e.g. bread, potatoes, rice, pasta, dairy products, fruits, candy) was calculated. A dietician estimated the overall glycemic index score (scale 0-7). At least two days of diet recording were available in 75% of the 107 women at mean 64 (SD±14) gestational days. The quantity of carbohydrate consumption from major sources was 180 (±51)g/day. HbA1c was positively associated with the quantity of carbohydrate consumption (β=0.41; 95% CI 0.13-0.70, P=0.005), corresponding to an increase of 0.4% in HbA1c per 100g carbohydrates consumed daily, when adjusted for insulin dose/bodyweight and use of insulin pump treatment. The median (IQR) glycemic index score was 2 (0-3). An adjusted association between HbA1c and glycemic index score was not demonstrated. The women using carbohydrate counting daily (45%) had lower HbA1c compared to the remaining women (6.4 (±0.5) vs. 6.8 (±0.9)% (47±6 vs. 51±10mmol/mol), P=0.01). HbA1c in early pregnancy was positively associated with the quantity of carbohydrate consumption regardless of insulin treatment. Carbohydrate counting is probably important for glycemic control in pregnant women with type 1 diabetes. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. A psychosocial risk index for poor glycemic control in children and adolescents with type 1 diabetes.

    Science.gov (United States)

    Schwartz, David D; Axelrad, Marni E; Anderson, Barbara J

    2014-05-01

    The aim of this study was to develop and validate a psychosocial screening tool to predict risk for poor glycemic control in children with type 1 diabetes. Participants seen for psychological screening were 196 children aged 3-18 yr at diabetes diagnosis. A psychosocial risk index was developed to predict poor glycemic control [mean hemoglobin A1c (HbA1c) ≥ 9.5%; 80 mmol/mol] 1-4 yr post diagnosis. Cutoff scores were derived for multiple levels of risk from receiver operating characteristic (ROC) curves and likelihood ratios (LRs). Discrimination and calibration were examined in the sample, and validated in 1000 bootstrap samples. Ability to predict diabetes-related emergency-room (ER) visits and diabetic ketoacidosis (DKA) was also tested. The risk index accounted for 16.2% of variance in mean HbA1c, discriminated between children with and without poor glycemic control [area under the receiver operating characteristic curve (AUC) = 0.814, 0.713-0.915; p risk for poor glycemic control of approximately 10% (LRs = 1.7, 3.2, 5.8, and 9.3). Sensitivity and specificity were 0.68 (0.43-0.86) and 0.79 (0.72-0.84) for detecting patients at moderate risk, and 0.53 (0.29-0.75) and 0.91 (0.85-0.95) for detecting high-risk patients. The index performed equally well in validation samples. This paper presents the first psychosocial risk index for poor glycemic control in children newly diagnosed with type 1 diabetes. It is brief, easily administered, and provides a single score that translates directly into an estimate of risk that can help guide routine diabetes care. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Dietary glycemic load, insulin load, and weight loss in obese, insulin resistant adolescents: RESIST study.

    Science.gov (United States)

    Joslowski, Gesa; Halim, Jocelyn; Goletzke, Janina; Gow, Megan; Ho, Mandy; Louie, Jimmy C-Y; Buyken, Anette E; Cowell, Chris T; Garnett, Sarah P

    2015-02-01

    The optimal dietary approach for weight loss and improving insulin sensitivity in adolescents is unknown. This study aimed to explore the association between the estimated insulin demand of the diet, as measured by glycemic and insulin load, weight loss, percentage body fat and insulin sensitivity index (ISI) in obese adolescents with clinical features of insulin resistance and/or prediabetes after a 3 month lifestyle and metformin intervention. Secondary data analysis of 91 adolescents (median age 12.7 years (range 10.1-17.4) participating in a randomized controlled trial, known as RESIST; ACTRN12608000416392. Weight change between baseline and 3 months was measured by BMI expressed as percentage of the 95th centile (BMI %95). Body composition was measured by dual energy X-ray absorptiometry and ISI was determined by an oral glucose tolerance test. Higher dietary glycemic load and insulin load were associated with less weight loss (BMI %95), adjusted for sex and pubertal stage, β = 0.0466, P = 0.007 and β = 0.0124, P = 0.040, respectively. Inclusion of total energy intake in the model explained observed associations between dietary glycemic load and insulin load and change in BMI %95. Neither dietary glycemic load nor insulin load were associated with changes in percentage body fat or ISI. Dietary glycemic index and macronutrient content (% of total energy) were not associated to changes in BMI %95, percentage body fat or ISI. Reduced energy diet contributes to weight loss in obese, insulin resistant adolescents. Diets with a lower insulin demand were associated with a lower energy intake and may hence assist with weight loss. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  4. Fortification of seaweed (Eucheuma cottonii) flour on nutrition, iodine, and glycemic index of pasta

    Science.gov (United States)

    Firdaus, Muhamad; Yahya; Raditya Hardany Nugraha, Galih; Dwi Utari, Dyah

    2017-10-01

    Pasta is a nutritious and energy product which produced from the dough of wheat flour and water. It contains less of iodine and high of glycemic index. Euchema cottonii belongs of red seaweed is food substance that contains much of iodine and dietary fiber. The objective of this study was to know the fortification effect of E. cottonii flour on the nutrition, iodine, and glycemic index of pasta. E. cottonii was collected from the culture farm of E. cottonii on the Wongsorejo beach, District of Banyuwangi, East Java on April-June 2015. Wheat flour and pasta ingredients were obtained locally at shops of Pasar Besar, Malang. Pasta was produced by weighing of components, mixing, dough, milling, steaming and drying. E. cottonii flour was added on mixing process at 0; 7; 14 and 21 % of ingredients. The parameter of this study was the level of water, lipid, protein, ash, and carbohydrate (by difference), iodine, crude fiber, the total of dietary fiber, soluble fiber, insoluble fiber, and glycemic index, respectively. Data were analyzed by variance and the least square difference used to determine the difference between treatments. The highest concentration group showed more nutritious than other treatments. The characters of its product were water 6.70%, lipid 2.26%, protein 23.09%, ash 14.11%, carbohydrate 53.84%, iodine 3.71 ppm, crude fiber 8.02%, the total of dietary fiber 20.88%, soluble fiber 11.69%, insoluble fiber 9.19%, and glycemic index 44.45, respectively. In conclusion, the fortification of E. cottonii flour enhances the nutrition value, iodine content, and glycemic index of pasta.

  5. Predictive-property-ranked variable reduction in partial least squares modelling with final complexity adapted models: comparison of properties for ranking.

    Science.gov (United States)

    Andries, Jan P M; Vander Heyden, Yvan; Buydens, Lutgarde M C

    2013-01-14

    The calibration performance of partial least squares regression for one response (PLS1) can be improved by eliminating uninformative variables. Many variable-reduction methods are based on so-called predictor-variable properties or predictive properties, which are functions of various PLS-model parameters, and which may change during the steps of the variable-reduction process. Recently, a new predictive-property-ranked variable reduction method with final complexity adapted models, denoted as PPRVR-FCAM or simply FCAM, was introduced. It is a backward variable elimination method applied on the predictive-property-ranked variables. The variable number is first reduced, with constant PLS1 model complexity A, until A variables remain, followed by a further decrease in PLS complexity, allowing the final selection of small numbers of variables. In this study for three data sets the utility and effectiveness of six individual and nine combined predictor-variable properties are investigated, when used in the FCAM method. The individual properties include the absolute value of the PLS1 regression coefficient (REG), the significance of the PLS1 regression coefficient (SIG), the norm of the loading weight (NLW) vector, the variable importance in the projection (VIP), the selectivity ratio (SR), and the squared correlation coefficient of a predictor variable with the response y (COR). The selective and predictive performances of the models resulting from the use of these properties are statistically compared using the one-tailed Wilcoxon signed rank test. The results indicate that the models, resulting from variable reduction with the FCAM method, using individual or combined properties, have similar or better predictive abilities than the full spectrum models. After mean-centring of the data, REG and SIG, provide low numbers of informative variables, with a meaning relevant to the response, and lower than the other individual properties, while the predictive abilities are

  6. Effects of Variability in Fundamental Frequency on L2 Vocabulary Learning: A Comparison between Learners Who Do and Do Not Speak a Tone Language

    Science.gov (United States)

    Barcroft, Joe; Sommers, Mitchell S.

    2014-01-01

    Previous studies (Barcroft & Sommers, 2005; Sommers & Barcroft, 2007) have demonstrated that variability in talker, speaking style, and speaking rate positively affect second language vocabulary learning, whereas variability in overall amplitude and fundamental frequency (F0) do not, at least for native English speakers. Sommers and…

  7. Glycemic Control, Self-Efficacy and Fear of Hypoglycemia Among Iranian Children with Type 1 Diabetes.

    Science.gov (United States)

    Amiri, Fatemehsadat; Vafa, Mohammadreza; Gonder-Frederick, Linda

    2015-08-01

    This study was designed to test the reliability of a Persian version of 2 questionnaires to assess the level of fear of hypoglycemia (FoH) and self-efficacy in diabetes management and their association with glycated hemoglobin (A1C) and parents' demographic characteristics in a sample of children with type 1 diabetes. We assessed 61 children with type 1 diabetes (35 boys and girls, 6.0 to 12.7 years of age) using the Hypoglycemia Fear Survey-Child version (HFS-C) and Self-Efficacy for Diabetes Scale-Child version (SED-C). Their glycemic control was evaluated by A1C levels. The internal consistency of the Persian version of HFS-C and SED-C were very good. Our results showed that children older than 10 years of age report lower levels of FoH, which are related to higher levels of self-efficacy (r=-.30, p=0.025 and r=-.30, p=0.02, respectively). Of the children, 42.3% of girls and 31.4% of boys reported that low blood sugar is a big problem for them. These findings suggest that FoH is a significant concern for this target group. Only 19.7% of children had controlled diabetes based on A1C levels. There was no significant association between higher A1C levels and other variables, including HFS-C, SED-C and parents' demographic characteristics. The Persian version of HFS-C and SED-C are reliable and valid measures of the fear of hypoglycemia and of self-efficacy in children with type 1 diabetes, and these questionnaires could be used in our country for identifying those children who may need diabetes education and other supports. The association between greater self-efficacy and lower fear of hypoglycemia suggests that addressing self-efficacy in diabetes education courses may be effective in helping to overcome FoH. Copyright © 2015 Canadian Diabetes Association. All rights reserved.

  8. Influence of the glycemic index and glycemic load of the diet in the glycemic control of diabetic children and teenagers Influencia del índice glicémico y la carga glucémica de la dieta en el control glucémico de niños y adolescentes diabéticos

    OpenAIRE

    K. C. Queiroz; I. Novato Silva; R. de Cássia Gonçalves Alfenas

    2012-01-01

    Objective: Evaluate the influence of the glycemic index (GI) and glycemic load (GL) of the diet in the glycemic control of children and teenagers with type 1 diabetes mellitus (DM1). Methods: A total of 146 subjects, aged 7-19 years, monitored at the Division of Pediatric Endocrinology at the HC/UFMG participated in the study. The consumed diet was evaluated using a quantitative food frequency questionnaire previously validated and tested in a pilotproject. The GI of the participant´s diet wa...

  9. First Clinical Experience with Retrospective Flash Glucose Monitoring (FGM) Analysis in South Africa: Characterizing Glycemic Control with Ambulatory Glucose Profile.

    Science.gov (United States)

    Distiller, Larry A; Cranston, Iain; Mazze, Roger

    2016-11-01

    In 2014, an innovative blinded continuous glucose monitoring system was introduced with automated ambulatory glucose profile (AGP) reporting. The clinical use and interpretation of this new technology has not previously been described. Therefore we wanted to understand its use in characterizing key factors related to glycemic control: glucose exposure, variability, and stability, and risk of hypoglycemia in clinical practice. Clinicians representing affiliated diabetes centers throughout South Africa were trained and subsequently were given flash glucose monitoring readers and 2-week glucose sensors to use at their discretion. After patient use, sensor data were collected and uploaded for AGP reporting. Complete data (sensor AGP with corresponding clinical information) were obtained for 50 patients with type 1 (70%) and type 2 diabetes (30%), irrespective of therapy. Aggregated analysis of AGP data comparing patients with type 1 versus type 2 diabetes, revealed that despite similar HbA1c values between both groups (8.4 ± 2 vs 8.6 ± 1.7%, respectively), those with type 2 diabetes had lower mean glucose levels (9.2 ± 3 vs 10.3 mmol/l [166 ± 54 vs 185 mg/dl]) and lower indices of glucose variability (3.0 ± 1.5 vs 5.0 ± 1.9 mmol/l [54 ± 27 vs 90 ± 34.2 mg/dl]). This highlights key areas for future focus. Using AGP, the characteristics of glucose exposure, variability, stability, and hypoglycemia risk and occurrence were obtained within a short time and with minimal provider and patient input. In a survey at the time of the follow-up visit, clinicians indicated that aggregated AGP data analysis provided important new clinical information and insights. © 2016 Diabetes Technology Society.

  10. Use of an insulin bolus advisor improves glycemic control in multiple daily insulin injection (MDI) therapy patients with suboptimal glycemic control: first results from the ABACUS trial.

    Science.gov (United States)

    Ziegler, Ralph; Cavan, David A; Cranston, Iain; Barnard, Katharine; Ryder, Jacqueline; Vogel, Claudia; Parkin, Christopher G; Koehler, Walter; Vesper, Iris; Petersen, Bettina; Schweitzer, Matthias A; Wagner, Robin S

    2013-11-01

    Use of automated bolus advisors is associated with improved glycemic control in patients treated with insulin pump therapy. We conducted a study to assess the impact of using an insulin bolus advisor embedded in a blood glucose (BG) meter on glycemic control and treatment satisfaction in patients treated with multiple daily insulin injection (MDI) therapy. The study goal was to achieve >0.5% A1C reduction in most patients. This was a 26-week, prospective, randomized, controlled, multinational study that enrolled 218 MDI-treated patients with poorly controlled diabetes (202 with type 1 diabetes, 16 with type 2 diabetes) who were 18 years of age or older. Participants had mean baseline A1C of 8.9% (SD, 1.2 [74 mmol/mol]), mean age of 42.4 years (SD, 14.0), mean BMI of 26.5 kg/m(2) (SD, 4.2), and mean diabetes duration of 17.7 years (SD, 11.1). Control group (CNL) patients used a standard BG meter and manual bolus calculation; intervention group (EXP) patients used the Accu-Chek Aviva Expert meter with an integrated bolus advisor to calculate insulin dosages. Glucose data were downloaded and used for therapy parameter adjustments in both groups. A total of 193 patients (CNL, n = 93; EXP, n = 100) completed the study. Significantly more EXP than CNL patients achieved >0.5% A1C reduction (56.0% vs. 34.4%; P < 0.01). Improvement in treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire scale) was significantly greater in EXP patients (11.4 [SD, 6.0] vs. 9.0 [SD, 6.3]; P < 0.01). Percentage of BG values <50 mg/dL was <2% in both groups during the study. Use of an automated bolus advisor resulted in improved glycemic control and treatment satisfaction without increasing severe hypoglycemia.

  11. Effect of meal glycemic load and caffeine consumption on prolonged monotonous driving performance.

    Science.gov (United States)

    Bragg, Christopher; Desbrow, Ben; Hall, Susan; Irwin, Christopher

    2017-11-01

    Monotonous driving involves low levels of stimulation and high levels of repetition and is essentially an exercise in sustained attention and vigilance. The aim of this study was to determine the effects of consuming a high or low glycemic load meal on prolonged monotonous driving performance. The effect of consuming caffeine with a high glycemic load meal was also examined. Ten healthy, non-diabetic participants (7 males, age 51±7yrs, mean±SD) completed a repeated measures investigation involving 3 experimental trials. On separate occasions, participants were provided one of three treatments prior to undertaking a 90min computer-based simulated drive. The 3 treatment conditions involved consuming: (1) a low glycemic load meal+placebo capsules (LGL), (2) a high glycemic load meal+placebo capsules (HGL) and (3) a high glycemic load meal+caffeine capsules (3mgkg -1 body weight) (CAF). Measures of driving performance included lateral (standard deviation of lane position (SDLP), average lane position (AVLP), total number of lane crossings (LC)) and longitudinal (average speed (AVSP) and standard deviation of speed (SDSP)) vehicle control parameters. Blood glucose levels, plasma caffeine concentrations and subjective ratings of sleepiness, alertness, mood, hunger and simulator sickness were also collected throughout each trial. No difference in either lateral or longitudinal vehicle control parameters or subjective ratings were observed between HGL and LGL treatments. A significant reduction in SDLP (0.36±0.20m vs 0.41±0.19m, p=0.004) and LC (34.4±31.4 vs 56.7±31.5, p=0.018) was observed in the CAF trial compared to the HGL trial. However, no differences in AVLP, AVSP and SDSP or subjective ratings were detected between these two trials (p>0.05). Altering the glycemic load of a breakfast meal had no effect on measures of monotonous driving performance in non-diabetic adults. Individuals planning to undertake a prolonged monotonous drive following consumption of a

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

    Directory of Open Access Journals (Sweden)

    Powell DR

    2015-02-01

    Full Text Available David R Powell, Deon Doree, Sabrina Jeter-Jones, Zhi-Ming Ding, Brian Zambrowicz, Arthur Sands Lexicon Pharmaceuticals, The Woodlands, TX, USA Purpose: Oral agents are needed that improve glycemic control without increasing hypoglycemic events in patients with type 1 diabetes (T1D. Sotagliflozin may meet this need, because this compound lowers blood glucose through the insulin-independent mechanisms of inhibiting kidney SGLT2 and intestinal SGLT1. We examined the effect of sotagliflozin on glycemic control and rate of hypoglycemia measurements in T1D mice maintained on a low daily insulin dose, and compared these results to those from mice maintained in better glycemic control with a higher daily insulin dose alone. Materials and methods: Nonobese diabetes-prone mice with cyclophosphamide-induced T1D were randomized to receive one of four daily treatments: 0.2 U insulin/vehicle, 0.05 U insulin/vehicle, 0.05 U insulin/2 mg/kg sotagliflozin or 0.05 U insulin/30 mg/kg sotagliflozin. Insulin was delivered subcutaneously by micro-osmotic pump; the day after pump implantation, mice received their first of 22 once-daily oral doses of sotagliflozin or vehicle. Glycemic control was monitored by measuring fed blood glucose and hemoglobin A1c levels. Results: Blood glucose levels decreased rapidly and comparably in the 0.05 U insulin/sotagliflozin-treated groups and the 0.2 U insulin/vehicle group compared to the 0.05 U insulin/vehicle group, which had significantly higher levels than the other three groups from day 2 through day 23. A1c levels were also significantly higher in the 0.05 U insulin/vehicle group compared to the other three groups on day 23. Importantly, the 0.2 U insulin/vehicle group had, out of 100 blood glucose measurements, 13 that were <70 mg/dL compared to one of 290 for the other three groups combined. Conclusion: Sotagliflozin significantly improved glycemic control, without increasing the rate of hypoglycemia measurements, in

  13. Timing of Peak Blood Glucose after Breakfast Meals of Different Glycemic Index in Women with Gestational Diabetes

    Directory of Open Access Journals (Sweden)

    Deborah Foote

    2012-12-01

    Full Text Available This study aims to determine the peak timing of postprandial blood glucose level (PBGL of two breakfasts with different glycemic index (GI in gestational diabetes mellitus (GDM. Ten women with diet-controlled GDM who were between 30 and 32 weeks of gestation were enrolled in the study. They consumed two carbohydrate controlled, macronutrient matched bread-based breakfasts with different GI (low vs. high on two separate occasions in a random order after an overnight fast. PBGLs were assessed using a portable blood analyser. Subjects were asked to indicate their satiety rating at each blood sample collection. Overall the consumption of a high GI breakfast resulted in a greater rise in PBGL (mean ± SEM peak PBGL: low GI 6.7 ± 0.3 mmol/L vs. high GI 8.6 ± 0.3 mmol/L; p < 0.001 and an earlier peak PBGL time (16.9 ± 4.9 min earlier; p = 0.015, with high variability in PBGL time between subjects. There was no significant difference in subjective satiety throughout the test period. In conclusion, the low GI breakfast produced lower postprandial glycemia, and the peak PBGL occurred closer to the time recommended for PBGL monitoring (i.e., 1 h postprandial in GDM than a macronutrient matched high GI breakfast.

  14. Glycemic Excursions in Type 1 Diabetes in Pregnancy: A Semiparametric Statistical Approach to Identify Sensitive Time Points during Gestation

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    Resmi Gupta

    2017-01-01

    Full Text Available Aim. To examine the gestational glycemic profile and identify specific times during pregnancy that variability in glucose levels, measured by change in velocity and acceleration/deceleration of blood glucose fluctuations, is associated with delivery of a large-for-gestational-age (LGA baby, in women with type 1 diabetes. Methods. Retrospective analysis of capillary blood glucose levels measured multiple times daily throughout gestation in women with type 1 diabetes was performed using semiparametric mixed models. Results. Velocity and acceleration/deceleration in glucose levels varied across gestation regardless of delivery outcome. Compared to women delivering LGA babies, those delivering babies appropriate for gestational age exhibited significantly smaller rates of change and less variation in glucose levels between 180 days of gestation and birth. Conclusions. Use of innovative statistical methods enabled detection of gestational intervals in which blood glucose fluctuation parameters might influence the likelihood of delivering LGA baby in mothers with type 1 diabetes. Understanding dynamics and being able to visualize gestational changes in blood glucose are a potentially useful tool to assist care providers in determining the optimal timing to initiate continuous glucose monitoring.

  15. Glycemic Excursions in Type 1 Diabetes in Pregnancy: A Semiparametric Statistical Approach to Identify Sensitive Time Points during Gestation

    Science.gov (United States)

    Gupta, Resmi; Khoury, Jane; Altaye, Mekibib; Dolan, Lawrence

    2017-01-01

    Aim. To examine the gestational glycemic profile and identify specific times during pregnancy that variability in glucose levels, measured by change in velocity and acceleration/deceleration of blood glucose fluctuations, is associated with delivery of a large-for-gestational-age (LGA) baby, in women with type 1 diabetes. Methods. Retrospective analysis of capillary blood glucose levels measured multiple times daily throughout gestation in women with type 1 diabetes was performed using semiparametric mixed models. Results. Velocity and acceleration/deceleration in glucose levels varied across gestation regardless of delivery outcome. Compared to women delivering LGA babies, those delivering babies appropriate for gestational age exhibited significantly smaller rates of change and less variation in glucose levels between 180 days of gestation and birth. Conclusions. Use of innovative statistical methods enabled detection of gestational intervals in which blood glucose fluctuation parameters might influence the likelihood of delivering LGA baby in mothers with type 1 diabetes. Understanding dynamics and being able to visualize gestational changes in blood glucose are a potentially useful tool to assist care providers in determining the optimal timing to initiate continuous glucose monitoring. PMID:28280744

  16. Study of Adiponectin Level in Diabetic Adolescent Girls in Relation to Glycemic Control and Complication of Diabetes

    Directory of Open Access Journals (Sweden)

    Soha M. Abd El Dayem

    2015-10-01

    CONCLUSION: Serum adiponectin level is high in adolescent type 1 diabetic girls. It can be used as a predictor of diabetes complications rather than a sensitive biochemical marker for glycemic control.

  17. Pomegranate juice, but not an extract, confers a lower glycemic response on a high-glycemic index food: randomized, crossover, controlled trials in healthy subjects.

    Science.gov (United States)

    Kerimi, Asimina; Nyambe-Silavwe, Hilda; Gauer, Julia S; Tomás-Barberán, Francisco A; Williamson, Gary

    2017-12-01

    Background: Low-glycemic index diets have demonstrated health benefits associated with a reduced risk of developing type 2 diabetes. Objectives: We tested whether pomegranate polyphenols could lower the glycemic response of a high-glycemic index food when consumed together and the mechanism by which this might occur. Design: We compared the acute effect of a pomegranate juice and a polyphenol-rich extract from pomegranate (supplement) on the bread-derived postprandial blood glucose concentration in 2 randomized, crossover, controlled studies (double-blinded for the supplements), each on 16 healthy volunteers. An additional randomized, crossover, controlled study on 16 volunteers consuming constituent fruit acids in a pH-balanced solution (same pH as pomegranate) and bread was conducted to determine any contributions to postprandial responses caused by acidic beverages. Results: As primary outcome, the incremental area under the curve for bread-derived blood glucose (-33.1% ± 18.1%, P = 0.000005) and peak blood glucose (25.4% ± 19.3%, P = 0.0004) were attenuated by pomegranate juice, compared with a control solution containing the equivalent amount of sugars. In contrast, the pomegranate supplement, or a solution containing the malic and citric acid components of the juice, was ineffective. The pomegranate polyphenol punicalagin was a very effective inhibitor of human α-amylase in vitro, comparable to the drug acarbose. Neither the pomegranate extract nor the individual component polyphenols inhibited 14 C-D-glucose transport across differentiated Caco-2/TC7 cell monolayers, but they inhibited uptake of 14 C-glucose into Xenopus oocytes expressing the human glucose transporter type 2. Further, some of the predicted pomegranate gut microbiota metabolites modulated 14 C-D-glucose and 14 C-deoxy-D-glucose uptake into hepatic HepG2 cells. Conclusions: These data indicate that pomegranate polyphenols, when present in a beverage but not in a supplement, can reduce the

  18. STUDY OF THE EFFECTS OF THE EDUCATIONAL HOSPITALIZATION FOR DIABETES IMPLEMENTING CRITICAL PATHWAY ON LONG-TERM GLYCEMIC CONTROL

    OpenAIRE

    Kaga, Midori; Narita, Takuma; Yamada, Yuichiro

    2013-01-01

    We evaluated the effect of diabetes educational hospitalization utilizing the critical pathway (CP) on long-term glycemic control after discharge in type 2 diabetic patients by comparing changes in HbA1c in 18 patients admitted before CP introduction with those in 18 patients admitted after CP introduction. We also investigated the factors related to worsening of glycemic control after discharge from diabetes educational hospitalization. In the patients admitted before CP introduction, HbA1c ...

  19. Application of BASNEF educational model for nutritional education among elderly patients with type 2 diabetes: improving the glycemic control

    OpenAIRE

    Gholamreza Sharifirad; Arash Najimi; Akbar Hassanzadeh; Leila Azadbakht

    2011-01-01

    Background: The objective of this study was to determine the effects of nutritional educational program on glycemic control of elderly patients with type 2 diabetes. Methods: In this parallel randomized controlled educational trial, 100 diabetic elderly patients (≥60 years) were chosen (50 in control and 50 in test group). Nutrition education based on beliefs, attitudes, subjective norms and enabling factors (BASNEF model) was conducted. Dietary intake and glycemic indices as well as the ...

  20. Body image mediates negative family climate and deteriorating glycemic control for single adolescents with type 1 diabetes.

    Science.gov (United States)

    Hartl, Amy C; Seiffge-Krenke, Inge; Laursen, Brett

    2015-12-01

    Glycemic control declines during adolescence, as youth with diabetes struggle with pubertal changes and a changing social world. The present study tests whether body image mediates longitudinal links between family climate and changes in adolescent glycemic control. Mediation was hypothesized for nondating adolescents but not for dating adolescents, because the former are thought to remain more family oriented than the latter. Participants were German adolescents with Type 1 diabetes (51 girls, 58 boys; M = 15.84 years, SD = 1.44). Participants reported body image and family climate. Physicians assayed blood HbA1c levels (M = 8.22%, SD = 1.80%) to measure glycemic control. For nondating adolescents, body image mediated associations between family climate and longitudinal changes in glycemic control. Poorer family climate was associated with poorer body image, which predicted deteriorating glycemic control. For dating adolescents, family climate was unassociated with changes in glycemic control. Nondating adolescents may look to parents for feedback on body image, which affects how they manage the challenges of diabetes. Parents and practitioners alike should be alert to the fact that family climate continues to be an important determinant of adolescent adjustment, particularly for those who have not moved into romantic relationships. We know that body image matters to adolescents, but for some youth, body image may be the difference between health and serious physical problems. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

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

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    Fatih Canan

    2011-06-01

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

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

    Science.gov (United States)

    Cheng, Alice Y Y

    2014-04-01

    Achieving and maintaining glycemic control in patients with diabetes admitted to hospital is challenging because of the many competing factors of nutrition, pharmacotherapy and other patient-related and systemic factors. For patients receiving enteral or parenteral feeding, eating irregularly or receiving glucocorticoid therapy, the challenges are even greater. The basic principles to follow when managing glycemia in these populations are as follows: 1) Recognition of those at risk for hyperglycemia; 2) frequent bedside glucose monitoring; 3) a proactive approach with routine insulin administration based on the predicted glucose patterns; 4) constant reassessment of the glycemic status and titration of the routine insulin accordingly. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  3. Glycemic Memory as a Pathogenic Basis for Modern Antidiabetic Therapy Algorithm Forming

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    V.V. Poltorak

    2014-04-01

    Full Text Available Prevention/delay of the development of vascular complications remains one of major challenges in treatment of diabetes mellitus. Epidemiological studies have shown lack of efficacy of stable glycemic control in patients with long-existing diabetes. This phenomenon, confirmed in animal models and analyzed at the molecular genetic level, is called metabolic/glycemic memory and associated with epigenetic modifications of gene expression. On the other hand, it has been proven that early intensive intervention in type 1 and 2 diabetes mellitus reduces the risk of micro- and macrovascular complications development and progression, forming the basis for long-term favorable effects that persist beyond normoglycemia. The foregoing justifies change of therapeutic approach in diabetes mellitus since the moment of establishing diagnosis for the early and maximum safely achievement of blood glucose and glycosylated hemoglobin levels close to normal ones.

  4. The Nigeria high glycemic index starchy foods, obesity, and the environment.

    Science.gov (United States)

    Osagie, A U; Omoregie, E S

    2011-01-01

    Glycemic index has generated a lot of debate for nearly 30 years, especially as it relates to the control for the treatment of diabetes. This study determined the glycemic index (GI) of ten processed Nigerian foods and revealed their similarity in the release of glucose on consumption. The food items tested were made from yam tubers, cassava tubers and local cereals. These foods were served to human volunteers in several processed forms which resulted in viscous pastes. The GI results are related to the increased incidence of overweight and obesity in the middle class Nigerians. It is suggested that these processed foods should be discouraged in the regular dietary plan if Nigerians desire to stay slim and save the planet by reducing carbon emission and climate change.

  5. Glycemic Response to Corn Starch Modified with Cyclodextrin Glycosyltransferase and its Relationship to Physical Properties.

    Science.gov (United States)

    Dura, A; Yokoyama, W; Rosell, C M

    2016-09-01

    Corn starch was modified with cyclodextrin glycosyltransferase (CGTase) below the gelatinization temperature. The porous granules with or without CGTase hydrolysis products may be used as an alternative to modified corn starches in foods applications. The amount and type of hydrolysis products were determined, containing mainly β-cyclodextrin (CD), which will influence pasting behavior and glycemic response in mice. Irregular surface and small holes were observed by microscopic analysis and differences in pasting properties were observed in the presence of hydrolysis products. Postprandial blood glucose in mice fed gelatinized enzymatically modified starch peaked earlier than their ungelatinized counterparts. However, in ungelatinized enzymatically modified starches, the presence of β- CD may inhibit the orientation of amylases slowing hydrolysis, which may help to maintain lower blood glucose levels. Significant correlations were found between glycemic curves and viscosity pattern of starches.

  6. Diabetes self-management education interventions and glycemic control among hispanics: a literature review.

    Science.gov (United States)

    Gonzalez, Lisanna Stamos; Berry, Diane C; Davison, Jean Ann

    2013-01-01

    Diabetes self-management education interventions have been shown to improve glycemic control in Whites and African Americans with type 2 diabetes. Hispanic women and men, however, sometimes have barriers to management including lack of access to care, low English proficiency, low literacy, and cultural differences. This review examined the state of the science related to the effects of diabetes self-management education interventions on glycemic control in Hispanics. The 8 of 9 studies showed a significant decrease in glycated hemoglobin in experimental patients. The interventions also demonstrated the success of using community health workers, bilingual interventionists, culturally sensitive designs, and accessible interventions. Limitations included weak study designs, high attrition rates, and short duration of studies.

  7. Association among individual deprivation, glycemic control, and diabetes complications: the EPICES score.

    Science.gov (United States)

    Bihan, Hélène; Laurent, Silvana; Sass, Catherine; Nguyen, Gérard; Huot, Caroline; Moulin, Jean Jacques; Guegen, René; Le Toumelin, Philippe; Le Clésiau, Hervé; La Rosa, Emilio; Reach, Gérard; Cohen, Régis

    2005-11-01

    Previous studies have related poor glycemic control and/or some diabetes complications to low socioeconomic status. Some aspects of socioeconomic status have not been assessed in these studies. In the present study, we used an individual index of deprivation, the Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé (Evaluation of Precarity and Inequalities in Health Examination Centers [EPICES]) score, to determine the relationship among glycemic control, diabetes complications, and individual conditions of deprivation. We conducted a cross-sectional prevalence study in 135 consecutive diabetic patients (age 59.41 +/- 13.2 years [mean +/- SD]) admitted in the hospitalization unit of a French endocrine department. Individual deprivation was assessed by the EPICES score, calculated from 11 socioeconomic questions. Glycemic control, lipid levels, blood pressure, retinopathy, neuropathy, and nephropathy were assessed. HbA(1c) level was significantly correlated with the EPICES score (r = 0.366, P < 0.001). The more deprived patients were more likely than the less deprived patients to have poor glycemic control (beta = 1.984 [SE 0.477], P < 0.001), neuropathy (odds ratio 2.39 [95% CI 1.05-5.43], P = 0.037), retinopathy (3.66 [1.39-9.64], P = 0.009), and being less often admitted for 1-day hospitalization (0.32 [0.14-0.74], P = 0.008). No significant relationship was observed with either nephropathy or cardiovascular risk factors. Deprivation status is associated with poor metabolic control and more frequent microvascular complications, i.e., retinopathy and neuropathy. The medical and economic burden of deprived patients is high.

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

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    Ivan Sergeevich Kuznetsov

    2013-11-01

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

  9. Safety and Efficacy of D-Tagatose in Glycemic Control in Subjects with Type 2 Diabetes

    OpenAIRE

    Ensor, Mark; Banfield, Amy B.; Smith, Rebecca R.; Williams, Jarrod; Lodder, Robert A.

    2014-01-01

    The primary objectives of this study were to evaluate the treatment effect of D-tagatose on glycemic control, determined by a statistically significant decrease in hemoglobin A1c (HbA1c), and safety profile of D-tagatose compared to placebo. The secondary objectives were to evaluate the treatment effects on fasting blood glucose, insulin, lipid profiles, changes in BMI, and the proportion of subjects achieving HbA1c targets of

  10. Metabolic response to different glycemic indexes of pre-exercise meal

    OpenAIRE

    Faria, Valéria Cristina de; Marins, João Carlos Bouzas; Oliveira, Gustavo Antônio de; Sales, Samuel de Souza; Reis, Fernando Fonseca dos; Pereira, Juscélia Cristina; Lima, Luciana Moreira

    2015-01-01

    INTRODUCTION: To ensure performance and health, the type of food and the time of pre-exercise ingestion should be considered by practitioners of morning physical activity. Objective: This study assessed the metabolic response after pre-exercise meals with different glycemic indexes (GI) and in the fasting state adopting different types of hydration.METHODS: Twelve men performed four experimental tests; two with pre-exercise meals of high GI (HGI) and low GI (LGI), and two were performed in th...

  11. Impact of Glycemic Control on Risk of Infections in Patients With Type 2 Diabetes

    DEFF Research Database (Denmark)

    Mor, Anil; Dekkers, Olaf M.; Nielsen, Jens S.

    2017-01-01

    Infections are a major clinical challenge for type 2 diabetes patients, but little is known about the impact of glycemic control. We used Cox regression analyses to examine the association between baseline and time-varying HbA1c values and development of community antiinfective-treated and hospital.......51, 1.79) for the latest updated HbA1c. Our findings provide evidence for an association of current hyperglycemia with infection risk in type 2 diabetes patients....

  12. Glycemic Status and Predictors of Relapse for Diabetic Cats in Remission

    OpenAIRE

    Gottlieb, S.; Rand, J.S.; Marshall, R.; Morton, J.

    2014-01-01

    Background It is unknown if diabetic cats in remission have persistent abnormalities of glucose metabolism and should be considered prediabetic, or have normal glucose tolerance. Objective To characterize glycemic status of diabetic cats in remission and to determine predictors of relapse. Animals A total of 21 cats in diabetic remission and 28 healthy control cats. Methods At a median of 107?days after remission, screening blood glucose concentration was measured on entry to the clinic. Afte...

  13. EFFECT OF CHRONIC INGESTION OF WINE ON THE GLYCEMIC, LIPID AND BODY WEIGHT HOMEOSTASIS IN MICE

    OpenAIRE

    de BRITO-FILHO, Sebasti?o Barreto; de MOURA, Egberto Gaspar; dos SANTOS, Orlando Jos?; SAUAIA-FILHO, Euler Nicolau; AMORIM, Elias; SANTANA, Ewaldo Eder Carvalho; BARROS-FILHO, Allan Kardec Dualibe; SANTOS, Rennan Abud Pinheiro

    2016-01-01

    ABSTRACT Background: The health benefits associated with moderate wine consumption, as with ethanol and phenolic compounds, include different mechanisms still little understandable. Aim: Evaluate glycemic and weight variations, and the deposit of triglycerides, cholesterol and liver glycogen with red wine consumption. Methods: 60 ApoE knockout mice were divided into three groups of 20: Wine Group (WG), Ethanol Group (EG) and Water Group (WAG). They received daily: WG 50 ml of wine and 50...

  14. The Influence of Diabetes, Glycemic Control, and Diabetes-Related Comorbidities on Pulmonary Tuberculosis

    Science.gov (United States)

    Chiang, Chen Yuan; Bai, Kuan Jen; Lin, Hsien Ho; Chien, Shun Tien; Lee, Jen Jyh; Enarson, Donald A.; Lee, Ting-I; Yu, Ming-Chih

    2015-01-01

    Background To assess the influence of diabetes mellitus (DM), glycemic control, and diabetes-related comorbidities on manifestations and outcome of treatment of pulmonary tuberculosis (TB). Methodology/Principal Findings Culture positive pulmonary TB patients notified to health authorities in three hospitals in Taiwan from 2005–2010 were investigated. Glycemic control was assessed by glycated haemoglobin A1C (HbA1C) and diabetic patients were categorized into 3 groups: HbA1C9%. 1,473 (705 with DM and 768 without DM) patients were enrolled. Of the 705 diabetic patients, 82 (11.6%) had pretreatment HbA1C9%, and 195 (27.7%) had no information of HbA1C. The proportions of patients with any symptom, cough, hemoptysis, tiredness and weight loss were all highest in diabetic patients with HbA1C>9%. In multivariate analysis adjusted for age, sex, smoking, and drug resistance, diabetic patients with HbA1C>9% (adjOR 3.55, 95% CI 2.40–5.25) and HbA1C 7–9% (adjOR 1.62, 95% CI 1.07–2.44) were significantly more likely to be smear positive as compared with non-diabetic patients, but not those with HbA1Cdiabetes-related comorbidities. Patients with diabetes-related comorbidities had an increased risk of unfavorable outcome (adjOR 3.38, 95% CI 2.19–5.22, pdiabetes was not associated with amplification of resistance to isoniazid (p = 0.363) or to rifampicin (p = 0.344). Conclusions/Significance Poor glycemic control is associated with poor TB treatment outcome and improved glycemic control may reduce the influence of diabetes on TB. PMID:25822974

  15. Evaluation of a novel artificial pancreas: closed loop glycemic control system with continuous blood glucose monitoring.

    Science.gov (United States)

    Tsukamoto, Yuuki; Kinoshita, Yoshihiko; Kitagawa, Hiroyuki; Munekage, Masaya; Munekage, Eri; Takezaki, Yuka; Yatabe, Tomoaki; Yamashita, Koichi; Yamazaki, Rie; Okabayashi, Takehiro; Tarumi, Masatoshi; Kobayashi, Masaki; Mishina, Suguru; Hanazaki, Kazuhiro

    2013-04-01

    A closed-loop glycemic control system using an artificial pancreas has been applied with many clinical benefits in Japan since 1987. To update this system incorporating user-friendly features, we developed a novel artificial pancreas (STG-55). The purpose of this study was to evaluate STG-55 for device usability, performance of blood glucose measurement, glycemic control characteristics in vivo in animal experiments, and evaluate its clinical feasibility. There are several features for usability improvement based on the design concepts, such as compactness, display monitor, batteries, guidance function, and reduction of the preparation time. All animal study data were compared with a clinically available artificial pancreas system in Japan (control device: STG-22). We examined correlations of both blood glucose levels between two groups (STG-55 vs. control) using Clarke's error grid analysis, and also compared mean glucose infusion rate (GIR) during glucose clamp. The results showed strong correlation in blood glucose concentrations (Pearson's product-moment correlation coefficient: 0.97; n = 1636). Clarke's error grid analysis showed that 98.4% of the data fell in Zones A and B, which represent clinically accurate or benign errors, respectively. The difference in mean GIRs was less than 0.2 mg/kg/min, which was considered not significant. Clinical feasibility study demonstrated sufficient glycemic control maintaining target glucose range between 80 and 110 (mg/dL), and between 140 and 160 without any hypoglycemia. In conclusion, STG-55 was a clinically acceptable artificial pancreas with improved interface and usability. A closed-loop glycemic control system with STG-55 would be a useful tool for surgical and critical patients in intensive care units, as well as diabetic patients. © 2013, Copyright the Authors. Artificial Organs © 2013, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  16. Glycated Albumin versus Glycated Hemoglobin as a Glycemic Indicator in Diabetic Patients on Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Hiroki Kobayashi

    2016-04-01

    Full Text Available Compared with glycated hemoglobin (HbA1c, glycated albumin (GA is superior in estimating glycemic control in diabetic patients on hemodialysis (HD. However, the better index for assessment of glycemic control in diabetic patients on peritoneal dialysis (PD and the impact of protein loss on GA are unknown. Twenty diabetic patients on HD were matched by age, sex, and baseline postprandial plasma glucose (PG levels to 20 PD patients. PG, HbA1c, GA, and serum albumin levels were measured for six months. Protein loss in PD patients was estimated by measuring the protein concentration in the peritoneal dialysate and by 24 h urine collection. Although PG and HbA1c did not differ significantly between the groups, the PD group had significantly lower GA (17.8% versus 20.8%, p < 0.001 and GA/HbA1c ratio (2.95% versus 3.45%, p < 0.0001 than the HD group. Although the PG level correlated significantly with the GA levels in both groups, it was not correlated with the HbA1c levels in both groups. HbA1c level was negatively associated with erythropoiesis-stimulating agent (ESA dose in both groups, whereas GA was not significantly associated with serum albumin, hemoglobin concentration, ESA dose, and protein loss. Multiple regression analysis identified GA as the only independent factor associated with PG in PD patients. Our results suggested that GA was not significantly associated with protein loss, hemoglobin, serum albumin, and ESA dose. Although GA might underestimate glycemic status, it provided a significantly better measure for estimating glycemic control than HbA1c, even in PD patients.

  17. Dietary fibre: influence on body weight, glycemic control and plasma cholesterol profile

    OpenAIRE

    N. Babio; R. Balanza; J. Basulto; M. Bulló; J. Salas-Salvadó

    2010-01-01

    Dietary fibre: influence on body weight, glycemic control and plasma cholesterol profile FIBRA DIETÉTICA: INFLUENCIA SOBRE EL PESO CORPORAL, EL CONTROL GLICÉMICO Y EL PERFIL DEL COLESTEROL PLASMÁTICO There have been several studies on the effects of dietary fibre on the metabolism. Epidemiologic studies have consistently reported an inverse relationship between dietary fibre and type 2 diabetes mellitus or cardiovascular mortality. This review focuses on observational and experimental s...

  18. Predictors of glycemic control among patients with Type 2 diabetes: A longitudinal study

    Directory of Open Access Journals (Sweden)

    Philis-Tsimikas Athena

    2005-04-01

    Full Text Available Abstract Background Diabetes is the sixth leading cause of death and results in significant morbidity. The purpose of this study is to determine what demographic, health status, treatment, access/quality of care, and behavioral factors are associated with poor glycemic control in a Type 2 diabetic, low-income, minority, San Diego population. Methods Longitudinal observational data was collected on patients with Type 2 diabetes from Project Dulce, a program in San Diego County designed to care for an underserved diabetic population. The study sample included 573 patients with a racial/ethnic mix of 53% Hispanic, 7% black, 18% Asian, 20% white, and 2% other. We utilized mixed effects models to determine the factors associated with poor glycemic control using hemoglobin A1C (A1C as the outcome of interest. A multi-step model building process was used resulting in a final parsimonious model with main effects and interaction terms. Results Patients had a mean age of 55 years, 69% were female, the mean duration of diabetes was 7.1 years, 31% were treated with insulin, and 57% were obese. American Diabetes Association (ADA recommendations for blood pressure and total cholesterol were met by 71% and 68%, respectively. Results of the mixed effects model showed that patients who were uninsured, had diabetes for a longer period of time, used insulin or multiple oral agents, or had high cholesterol had higher A1C values over time indicating poorer glycemic control. The younger subjects also had poorer control. Conclusion This study provides factors that predict glycemic control in a specific low-income, multiethnic, Type 2 diabetic population. With this information, subgroups with high risk of disease morbidity were identified. Barriers that prevent these patients from meeting their goals must be explored to improve health outcomes.

  19. Effect of Algerian Varieties Dates on Glycemic, Arterial Blood Pressure and Satiety Responses

    OpenAIRE

    Gourchala Freha, Mihoub Fatma, Derradj Meriem, Henchiri Cherifa

    2016-01-01

    The purpose of our study is to determine the Glycemic Indexes (GIs)of three Algerians varieties of dates in healthy subjects, evaluate the satiety and effect on arterial pressure after their consumption. We have first documented the chemical composition of the dates. 10 healthy subjects consumed the dates (carbohydrates content of 50 g) in order to determine the GIs. The responses of glycaemia were monitored during two hours after the dates taking and compared to the reference glucose. In a r...

  20. Seasonal variations in glycemic control of type 2 diabetes in Korean women.

    Science.gov (United States)

    Ryu, Ohk-Hyun; Lee, Sungwha; Yoo, Hyung Joon; Choi, Moon-Gi

    2014-06-01

    Seasonal variations in lifestyle, such as food intake and physical activity, have been reported. Glycemic control in type 2 diabetes mellitus (T2DM) may be affected by such changes. We investigated seasonal variations in glycemic control, food intake, and physical activity in type 2 diabetic patients. This prospective observational study included 37 Korean female patients who had food intake (kcal/day), HbA1c, and anthropometry every 3 months (August, November, February, May, and August in the Northern Hemisphere) over 1 year. When anti-diabetic drugs were changed, we analyzed the data just before the changes. The mean HbA1c levels (%) of August and November in 2008, and February, May, and August in 2009 were 7.0 ± 0.1, 6.9 ± 0.1, 7.2 ± 0.2, 7.4 ± 0.2, and 7.2 ± 0.2, respectively (P = 0.018). The change of HbA1c was nearly 0.5 % for the 1-year period. From August to May of the following year, there were also seasonal variations in food intake (1,872 ± 143, 1,739 ± 97, 1,673 ± 86, 1,561 ± 132, respectively; P = 0.013), and total physical activity [7.7 (3.7-14.6), 6.3 (2.8-10.4), 5.1 (2.7-12.6), and 11.2 (4.7-20.5), respectively; P = 0.048]. However, the seasonal variations of HbA1c and total physical activity became non-significant when farmers were excluded. These data suggested that glycemic control, total physical activity, and food intake varied seasonally in Korean T2DM patients. These seasonal variations should be considered in education for glycemic control.

  1. [Association between smoking/smoking cessation and glycemic control in male patients with type 2 diabetes].

    Science.gov (United States)

    Su, J; Qin, Y; Shen, C; Gao, Y; Pan, E C; Pan, X Q; Tao, R; Zhang, Y Q; Wu, M

    2017-11-10

    Objective: To explore the association of smoking and smoking cessation with glycemic control in male patients with type 2 diabetes. Methods: From December 2013 to January 2014, a total of 7 763 male patients with type 2 diabetes, who received national basic public health service in Changshu county of Suzhou city, Huai'an and Qinghe districts of Huai'an city, Jiangsu province, were recruited by cluster sampling. Questionnaire survey and anthropometric measurements were conducted, and fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were measured. Multiple linear regression model was used to evaluate the association of smoking and smoking cessation with glycemic control. Results: The prevalence of current smoking was 45.5% in male patients with type 2 diabetes. The levels of FPG and HbA1c increased with number of cigarettes smoked per day compared with non-smokers ( P smoking duration ≥30 years and smoking index ≥40 pack-years were 0.27% (95 %CI : 0.05%-0.49%) and 0.38% (95 %CI : 0.23%-0.53%), respectively. FPG and HbA1c level decreased obviously with smoking cessation years among former smokers ( P smoking duration, smoking cessation years and levels of FPG and HbA1c. Conclusion: Cigarette smoking was negatively related with glycemic control in male type 2 diabetes patients, especially in patients with drug treatment. Smoking cessation may be beneficial for glycemic control. Smoking cessation should be encouraged for diabetes patients as early as possible.

  2. Basal (18)F-FDG PET/CT in follicular lymphoma: A comparison of metabolic and clinical variables in the prognostic assessment.

    Science.gov (United States)

    Jiménez Londoño, G A; García Vicente, A M; Poblete García, V M; Amo-Salas, M; Calle Primo, C; Ibañez García, Á; Martínez Sanchís, B; López-Fidalgo, J F; Solano Ramos, F; Martínez Hellín, A; Díaz Morfa, M; Soriano Castrejón, Á

    2016-01-01

    To analyze the relationship of clinical variables related to prognosis and tumor burden, with metabolic variables obtained in the staging (18)F-FDG PET/CT, and their value in the prognosis in follicular lymphoma (FL). 82 patients with FL, a (18)F-FDG PET/CT at diagnosis and a follow-up for a minimum of 12 months, were retrospectively enrolled in the present study. Clinical variables (Tumor grade, Follicular Lymphoma International Prognostic Index (FLIPI) and Tumor burden) were evaluated. Metabolic variables such as SUVmax in the highest hypermetabolic lesion, extralymphatic locations, number of involved lymph node locations, bone marrow (BM) involvement, PET stage and diameter of the biggest hypermetabolic lesion, were analyzed in order to establish a PET score and classify the studies in low, intermediate and high metabolic risk. Clinical and metabolic variables (included metabolic risk) were compared. The relation among all variables and disease-free survival (DFS) was studied. The 28% of patients had a high-grade tumor. The 30.5% had FLIPI risk low, 29.3% intermediate y 40.2% high. The 42.7% presented a high tumor burden. The PET/CT was positive in 94% of patients. The tumor grade did not show significant relation with metabolic variable. FLIPI risk and tumor burden showed statistical relations with the SUV max and the PET score (p<0.008 and p=0.003 respectively). With respect to DFS, significant differences were detected for the PET stage and FLIPI risk (p=0.015 and p=0.047 respectively). FLIPI risk was the only significant predictor in Cox regression analysis, with a Hazard Ratio of 5.13 between high risk and low risk. The present research highlights the significant relation between metabolic variables obtained with FDG PET/CT and clinical variables although their goal as an independent factor of prognosis was not demonstrated in the present work. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  3. Randomised Double-Blind Comparison of Placebo and Active Drugs for Effects on Risks Associated with Blood Pressure Variability in the Systolic Hypertension in Europe Trial

    Science.gov (United States)

    Hara, Azusa; Thijs, Lutgarde; Asayama, Kei; Jacobs, Lotte; Wang, Ji-Guang; Staessen, Jan A.

    2014-01-01

    Background In the Systolic Hypertension in Europe trial (NCT02088450), we investigated whether systolic blood pressure variability determines prognosis over and beyond level. Methods Using a computerised random function and a double-blind design, we randomly allocated 4695 patients (≥60 years) with isolated systolic hypertension (160–219/blood pressure level (SBP), visit-to-visit variability independent of the mean (VIM) or within-visit variability (WVV) predicted total (n = 286) or cardiovascular (n = 150) mortality or cardiovascular (n = 347), cerebrovascular (n = 133) or cardiac (n = 217) endpoints. Findings At 2 years, mean between-group differences were 10.5 mm Hg (pblood pressure readings within 6 months after randomisation, 6 months prior to an event or both were confirmatory. Conclusions The double-blind placebo-controlled Syst-Eur trial demonstrated that blood-pressure lowering treatment reduces cardiovascular complications by decreasing level but not variability of SBP. Higher blood pressure level, but not higher variability, predicted risk. Trial Registration ClinicalTrials.gov NCT02088450 PMID:25090617

  4. Self-Rated Health and Glycemic Control in Type 2 Diabetes: Race by Gender Differences.

    Science.gov (United States)

    Assari, Shervin; Lankarani, Maryam Moghani; Piette, John D; Aikens, James E

    2017-08-04

    Although some studies have shown a link between self-rated health (SRH) and glycemic control in type 2 diabetes (DM), other studies have failed to support this association. The purpose of this study was to determine whether these equivocal findings can be explained by specific interactions between gender, race, and SRH, as suggested by the intersectionality literature. This cross-sectional study included 287 patients with DM (85 Black men, 78 Black women, 64 White men, and 60 White women). After adjusting for demographic and medical factors, we regressed HbA1c on SRH with and without interactions between gender, race, and SRH. We conducted additional subgroup analyses to further characterize gender by race group differences. Although there was no main effect of SRH upon HbA1c (b = .16, 95% CI: .08-.39), we found a significant interaction between gender and SRH on HbA1c (b = -.50, 95% CI: -.97 to -.03). In race by gender-stratified models, SRH (b = .53, 95% CI: .00-1.07) was associated with HbA1c in Black men. SRH was not associated with HbA1c in White men, White women, or Black women. Combined race and gender differences may exist in the link between SRH and glycemic control in DM. Specifically, Black men with DM may be more attuned to the relationship between their overall health and their glycemic control.

  5. Effect of Added Carbohydrates on Glycemic and Insulin Responses to Children’s Milk Products

    Directory of Open Access Journals (Sweden)

    Jennie Brand-Miller

    2013-01-01

    Full Text Available Powdered milk products for children (Growing Up Milk Powders or GUMPs containing added carbohydrates such as glucose and sucrose are now well established in parts of Asia. We surveyed GUMPs in Malaysia and Indonesia to determine the content of added carbohydrates. The ingredient lists and nutrition information panels were used to calculate the percentage of declared carbohydrates contributed by added carbohydrates and a subset of seven products was tested for their glycemic index (GI and insulin responses in healthy adults. The glycemic load for each product was calculated. In total, 58 products (n = 24 in Malaysia and n = 34 in Indonesia were surveyed. Added carbohydrate content (excluding fibre ranged from 0 to 21.5 g per serve. Milk powders without added sources of carbohydrate had similar GI values to standard liquid whole milk. Products containing maltodextrins, corn or glucose syrups increased the GI by more than 2-fold, and glycemic load (GL by 7-fold compared to milk powders with no added carbohydrates. Insulin responses were significantly but not strongly correlated with glucose responses (r = 0.32, p < 0.006. Children’s milk powders containing higher levels of added carbohydrate ingredients elicit higher glucose and insulin responses than liquid or powdered whole milk.

  6. Starch digestibility and predicted glycemic index in the bread fortified with pomelo (Citrus maxima) fruit segments.

    Science.gov (United States)

    Reshmi, S K; Sudha, M L; Shashirekha, M N

    2017-12-15

    The aim of this study was to evaluate the starch digestibility and predicted glycemic index in breads incorporated with pomelo fruit (Citrus maxima) segments. Volume of the white and brown breads supplemented with pomelo fresh segments increased, while the crumb firmness decreased. Bread with 20% fresh and 5% dry pomelo segments were sensorily acceptable. Bioactive components such as phenolics, flavonoids, naringin and carotenoids were retained to a greater extent in bread containing dry pomelo segments. The pomelo incorporated bread had higher levels of resistant starch fractions (3.87-10.96%) with low predicted glycemic index (62.97-53.13%), despite their higher total starch (69.87-75.47%) content compared to control bread. Thus pomelo segments in the product formulations lowered the glycemic index probably by inhibiting carbohydrate hydrolyzing enzyme activity which could be attributed to naringin. Hence fortified bread prepared from pomelo fruit segment is recommended to gain nutritional value and to decrease the risk of diabetes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. [Glycemic response to consumption of a cereals and legume (Phaseolus vulgaris) bar on healthy individuals].

    Science.gov (United States)

    Zambrano, Rosaura; Granito, Marisela; Valero, Yolmar

    2013-06-01

    The objective of this work was to formulate a cereals and legume (Phaseolus vulgaris) bar and assess its impact on the glycemic response of healthy individuals, in order to contribute to the healthy food supply beneficial to consumers. A mixture of cereals (corn and oats) and different percentages (20 and 30%) of Phaseolus vulgaris was used to formulate the bar. Additionally, a legume cereal bar without legumes (bar control) was prepared. The bar with 30% of Phaseolus vulgaris was selected through sensory evaluation, being scored with better flavor and texture. This combination of cereals and legumes aminoacid improves complementation and reaches the formulation criteria previously established. Chemical characterization indicated a higher protein content in the bar with 30% of Phaseolus vulgaris (13.55%) relative to the bar control (8.5%). The contents of fat, ash and dietary fiber did not differ between the two bars evaluated. However, the soluble fiber and resistant starch of the selected bar was a 32.05% and 18.67%, respectively, than in the control bar; this may contribute to decreasing the rate of glucose uptake. The selected bar presented a low glycemic index (49) and intermediate glycemic load (12.0) in healthy volunteers, which could lead to a possible reduction in the rate of absorption of glucose into the bloodstream, associated with a carbohydrate content of slow absorption. This bar represents a proposal of a healthy snack for the consumer.

  8. Hemorheological and Glycemic Parameters and HDL Cholesterol for the Prediction of Cardiovascular Events

    International Nuclear Information System (INIS)

    Cho, Sung Woo; Kim, Byung Gyu; Kim, Byung Ok; Byun, Young Sup; Goh, Choong Won; Rhee, Kun Joo; Kwon, Hyuck Moon; Lee, Byoung Kwon

    2016-01-01

    Hemorheological and glycemic parameters and high density lipoprotein (HDL) cholesterol are used as biomarkers of atherosclerosis and thrombosis. To investigate the association and clinical relevance of erythrocyte sedimentation rate (ESR), fibrinogen, fasting glucose, glycated hemoglobin (HbA1c), and HDL cholesterol in the prediction of major adverse cardiovascular events (MACE) and coronary heart disease (CHD) in an outpatient population. 708 stable patients who visited the outpatient department were enrolled and followed for a mean period of 28.5 months. Patients were divided into two groups, patients without MACE and patients with MACE, which included cardiac death, acute myocardial infarction, newly diagnosed CHD, and cerebral vascular accident. We compared hemorheological and glycemic parameters and lipid profiles between the groups. Patients with MACE had significantly higher ESR, fibrinogen, fasting glucose, and HbA1c, while lower HDL cholesterol compared with patients without MACE. High ESR and fibrinogen and low HDL cholesterol significantly increased the risk of MACE in multivariate regression analysis. In patients with MACE, high fibrinogen and HbA1c levels increased the risk of multivessel CHD. Furthermore, ESR and fibrinogen were significantly positively correlated with HbA1c and negatively correlated with HDL cholesterol, however not correlated with fasting glucose. Hemorheological abnormalities, poor glycemic control, and low HDL cholesterol are correlated with each other and could serve as simple and useful surrogate markers and predictors for MACE and CHD in outpatients

  9. Hemorheological and Glycemic Parameters and HDL Cholesterol for the Prediction of Cardiovascular Events

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sung Woo [Division of Cardiology - Department of Internal Medicine - Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Division of Cardiology - Department of Medicine - Samsung Medical Center, Seoul (Korea, Republic of); Kim, Byung Gyu; Kim, Byung Ok; Byun, Young Sup; Goh, Choong Won; Rhee, Kun Joo [Division of Cardiology - Department of Internal Medicine - Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Kwon, Hyuck Moon; Lee, Byoung Kwon, E-mail: cardiobk@yuhs.ac [Division of Cardiology - Department of Internal Medicine - Gangnam Severance Hospital - Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-01-15

    Hemorheological and glycemic parameters and high density lipoprotein (HDL) cholesterol are used as biomarkers of atherosclerosis and thrombosis. To investigate the association and clinical relevance of erythrocyte sedimentation rate (ESR), fibrinogen, fasting glucose, glycated hemoglobin (HbA1c), and HDL cholesterol in the prediction of major adverse cardiovascular events (MACE) and coronary heart disease (CHD) in an outpatient population. 708 stable patients who visited the outpatient department were enrolled and followed for a mean period of 28.5 months. Patients were divided into two groups, patients without MACE and patients with MACE, which included cardiac death, acute myocardial infarction, newly diagnosed CHD, and cerebral vascular accident. We compared hemorheological and glycemic parameters and lipid profiles between the groups. Patients with MACE had significantly higher ESR, fibrinogen, fasting glucose, and HbA1c, while lower HDL cholesterol compared with patients without MACE. High ESR and fibrinogen and low HDL cholesterol significantly increased the risk of MACE in multivariate regression analysis. In patients with MACE, high fibrinogen and HbA1c levels increased the risk of multivessel CHD. Furthermore, ESR and fibrinogen were significantly positively correlated with HbA1c and negatively correlated with HDL cholesterol, however not correlated with fasting glucose. Hemorheological abnormalities, poor glycemic control, and low HDL cholesterol are correlated with each other and could serve as simple and useful surrogate markers and predictors for MACE and CHD in outpatients.

  10. Leukocyte peroxidase and leptin: an associated link of glycemic tolerance and bronchial asthma?

    Directory of Open Access Journals (Sweden)

    Parco S

    2010-05-01

    Full Text Available Sergio ParcoImmunopathology Unit, Laboratory of the Department of Medicine, Children’s Hospital, IRCCS Burlo Garofolo, Trieste, ItalyAbstract: Recent observations suggest the presence of an interaction between leptin and the inflammatory system during bronchial asthma. Although there is evidence of a positive association between asthma and obesity in adults and children, little is yet known about the role of serum leptin, as a potential mediator for bronchial epithelial homeostasis, and intraleukocyte myeloperoxidase (MPO, a hemoprotein with a molecular weight of 140 kDa, expression of the inflammatory system, in asthmatic children. Glycemic tolerance is an important pathogenetic element in developing type 2 mellitus diabetes and a confirmed predictor of incident asthma-like symptoms in adults. This work is aimed at assessing a possible correlation between basal leukocyte myeloperoxidase levels, basal leptin and insulin-glycemic tolerance in obese children. Thirty obese children aged between 7 and 15 years were examined. The analyzed data showed a normal response to the insulinemic stimulus in children of both sexes whose basal leptin and MPO values, expressed as MPO intracellular index, werewithin the normal range.Keywords: leptin, myeloperoxidase, glycemic tolerance, asthma

  11. Glycemic control and associated factors among type 2 diabetic patients at Shanan Gibe Hospital, Southwest Ethiopia.

    Science.gov (United States)

    Yigazu, Daniel Miteku; Desse, Tigestu Alemu

    2017-11-15

    The aim of this study was to assess the rate of glycemic control and factors affecting glycemic control in type 2 diabetic patients. A total of 174 type 2 diabetic patients were interviewed and were studied. Mean age of the patients was 48.98 ± 14.96 years (range 18-80 years). More than half (51.7%) of the patients were males. About a third of patients, 53 (30.5%), were on antidiabetic medications for less than 5 years. The most common prescribed antidiabetic medications were insulin, 48 (27.6%), and metformin 15 (8.6%). One hundred seven (61.5%) patients were on combination therapy (two drug treatment) and the remaining patients were on monotherapy. The majority, 103 (59.2%), of patients had uncontrolled blood glucose. A larger proportion of female patients, 54 (52.4%), had uncontrolled blood glucose than males. Level of education (p diabetes treatment (p patients to regular follow up (Adjusted Odds Ratio (AOR) = 2.42, 95% CI 1.08-5.44, p = 0.03) and diabetes treatment for 5-10 years (AOR = 4.64, 95% CI 1.79-12.06, p = 0.002) are found to be independent predictors of glycemic control among type 2 diabetes patients.

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

    Science.gov (United States)

    Maranda, Louise; Gupta, Olga T

    2016-01-01

    Type 1 diabetes mellitus (T1DM) a chronic characterized by an absolute insulin deficiency requires conscientious patient self-management to maintain glucose control within a normal range. Family cohesion and adaptability, positive coping strategies, social support and adequate self-regulatory behavior are found to favorably influence glycemic control. Our hypothesis was that the responsible care of a companion animal is associated with these positive attributes and correlated with the successful management of a chronic illness such as type 1 diabetes. We recruited 223 youths between 9 and 19 years of age from the Pediatric Diabetes clinic at the University of Massachusetts Medical School, reviewed the status of their glycemic control (using three consecutive A1c values) and asked them questions about the presence of a pet at home, and their level of involvement with its care. Multivariate analyses show that children who care actively for one or more pets at home are 2.5 times more likely to have control over their glycemic levels than children who do not care for a pet, adjusting for duration of disease, socio-economic status, age and self-management [1.1 to 5.8], pWald = 0.032. A separate model involving the care of a petdog only yielded comparable results (ORa = 2.6 [1.1 to 5.9], pWald = 0.023).

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

    Directory of Open Access Journals (Sweden)

    Louise Maranda

    Full Text Available Type 1 diabetes mellitus (T1DM a chronic characterized by an absolute insulin deficiency requires conscientious patient self-management to maintain glucose control within a normal range. Family cohesion and adaptability, positive coping strategies, social support and adequate self-regulatory behavior are found to favorably influence glycemic control. Our hypothesis was that the responsible care of a companion animal is associated with these positive attributes and correlated with the successful management of a chronic illness such as type 1 diabetes. We recruited 223 youths between 9 and 19 years of age from the Pediatric Diabetes clinic at the University of Massachusetts Medical School, reviewed the status of their glycemic control (using three consecutive A1c values and asked them questions about the presence of a pet at home, and their level of involvement with its care. Multivariate analyses show that children who care actively for one or more pets at home are 2.5 times more likely to have control over their glycemic levels than children who do not care for a pet, adjusting for duration of disease, socio-economic status, age and self-management [1.1 to 5.8], pWald = 0.032. A separate model involving the care of a petdog only yielded comparable results (ORa = 2.6 [1.1 to 5.9], pWald = 0.023.

  14. Glycemic control and periodontal disease in type 2 diabetes mellitus patients: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Vaibhav Tandon

    2015-01-01

    Full Text Available Introduction: Diabetes mellitus (DM is a chronic, noncommunicable disease with concomitant oral manifestations that impact on dental care. Aim: To determine the correlation between glycemic control and periodontitis among 35-45 years aged patients with DM type 2 (DM2. Materials and Methods: A convenient sample of 40 subjects aged 35-45 years with DM2 on oral medication were recruited for the study. Glycosylated, hemoglobin(HbA1c, probing pocket depth (PPD, gingival index (GI, plaque index (PI, and the relevant drug history were recorded. The data were analyzed using unpaired student t-test to compare the means of PPD, GI, PI between different HbA1c levels, gender, and duration of drug, and the Pearson correlation was used to find correlation between HbA1c and PPD, GI, PI, duration of drug. Results: With the increase in HbA1c values there was a significant rise in PPD, PI scores, and GI scores (P < 0.001. Diabetic males had a higher PPD, PI, and GI score as compared to females. With the increase in duration of the drug, there was an increase in PPD, which was found to be statistically nonsignificant. Conclusion: Patients are having poor glycemic level had more severe periodontitis as compared to patients having a fair glycemic level.

  15. Association Between Cardiorespiratory Fitness and the Determinants of Glycemic Control Across the Entire Glucose Tolerance Continuum

    DEFF Research Database (Denmark)

    Solomon, Thomas P. J.; Malin, Steven K.; Karstoft, Kristian

    2015-01-01

    OBJECTIVE: Cardiorespiratory fitness (VO2max) is associated with glycemic control, yet the relationship between VO2max and the underlying determinants of glycemic control is less clear. Our aim was to determine whether VO2max is associated with insulin sensitivity, insulin secretion...... underwent measurements of body composition, HbA1c, fasting glucose, oral glucose tolerance (OGTT), and VO2max. OGTT-derived insulin sensitivity (SiOGTT), glucose-stimulated insulin secretion (GSISOGTT), and the disposition index (DIOGTT) (the product of SiOGTT and GSISOGTT) were measured, and associations...... between VO2max and these determinants of glycemic control were examined. RESULTS: A low VO2max was associated with high HbA1c (r = -0.33), high fasting glucose (r = -0.34), high 2-h OGTT glucose (r = -0.33), low SiOGTT (r = 0.73), and high early-phase (r = -0.34) and late-phase (r = -0.36) GSISOGTT...

  16. IN SITU COMPARISON OF TREE-RING RESPONSES TO CLIMATE AND POPULATION GENETICS: THE NEED TO CONTROL FOR LOCAL CLIMATE AND SITE VARIABLES

    Directory of Open Access Journals (Sweden)

    Johann Mathias Housset

    2016-10-01

    Full Text Available Tree species responses to climate change will be greatly influenced by their evolutionary potential and their phenotypic plasticity. Investigating tree-rings responses to climate and population genetics at the regional scale is therefore crucial in assessing the tree behaviour to climate change. This study combined in situ dendroclimatology and population genetics over a latitudinal gradient and compared the variations between the two at the intra- and inter-population levels. This approach was applied on the northern marginal populations of Thuja occidentalis (eastern white-cedar in the Canadian boreal forest. We aimed first to assess the radial growth variability (response functional trait within populations across the gradient and to compare it with the genetic diversity (microsatellites. Second, we investigated the variability in the growth response to climate at the regional scale through the radial growth-climate relationships, and tested its correlation with environmental variables and population genetic structure. Model selection based on the Akaike Information Criteria revealed that the growth synchronicity between pairs of trees of a population covariates with both the genetic diversity of this population and the amount of precipitation (inverse correlation, although these variables only explained a small fraction of the observed variance. At the regional scale, variance partitioning and partial redundancy analysis indicate that the growth response to climate was greatly modulated by stand environmental variables, suggesting predominant plastic variations in growth-response to climate. Combining in situ dendroclimatology and population genetics is a promising way to investigate species’ response capacity to climate change in natural stands. We stress the need to control for local climate and site conditions effects on dendroclimatic response to climate to avoid misleading conclusions regarding the associations with genetic variables.

  17. Glycemic responses to sweetened dried and raw cranberries in humans with type 2 diabetes.

    Science.gov (United States)

    Wilson, Ted; Luebke, Justin L; Morcomb, Erin F; Carrell, Emily J; Leveranz, Megan C; Kobs, Lisa; Schmidt, Travis P; Limburg, Paul J; Vorsa, Nicholi; Singh, Ajay P

    2010-10-01

    This study assessed the metabolic response to sweetened dried cranberries (SDC), raw cranberries (RC), and white bread (WB) in humans with type 2 diabetes. Development of palatable cranberry preparations associated with lower glycemic responses may be useful for improving fruit consumption and glycemic control among those with diabetes. In this trial, type 2 diabetics (n= 13) received WB (57 g, 160 cal, 1 g fiber), RC (55 g, 21 cal, 1 g fiber), SDC (40 g, 138 cal, 2.1 g fiber), and SDC containing less sugar (SDC-LS, 40 g, 113 cal, 1.8 g fiber + 10 g polydextrose). Plasma glucose (mmol/L) peaked significantly at 60 min for WB, and at 30 min for RC, SDC, and SDC-LS at 9.6 ± 0.4, 7.0 ± 0.4, 9.6 ± 0.5, and 8.7 ± 0.5, respectively, WB remained significantly elevated from the other treatments at 120 min. Plasma insulin (pmol/mL) peaked at 60 min for WB and SDC and at 30 min for RC and SDC-LS at 157 ± 15, 142 ± 27, 61 ± 8, and 97 ± 11, respectively. Plasma insulin for SDC-LS was significantly lower at 60 min than either WB or SDC. Insulin area under the curve (AUC) values for RC and SDC-LS were both significantly lower than WB or SDC. Phenolic content of SDC and SDC-LS was determined following extraction with 80% acetone prior to high-performance liquid chromatography (HPLC) and electronspray ionization-mass spectrometry (ESI-MS) and found to be rich in 5-caffeoylquinic cid, quercetin-3-galactoside, and quercetin-3-galactoside, and the proanthocyanidin dimer epicatechin. In conclusion, SDC-LS was associated with a favorable glycemic and insulinemic response in type 2 diabetics. Practical Application: This study compares phenolic content and glycemic responses among different cranberry products. The study seeks to expand the palatable and portable healthy food choices for persons with type 2 diabetes. The novel use of polydextrose as a bulking agent making possible a reduction in caloric content and potential glycemic response is also characterized in this study.

  18. Glucometer use and glycemic control among Hispanic patients with diabetes in southern Florida.

    Science.gov (United States)

    Kenya, Sonjia; Lebron, Cynthia; Reyes Arrechea, Ernesto; Li, Hua

    2014-04-01

    Self-monitoring of blood glucose (SMBG) has been deemed a critical component of diabetes care in the United States. To be effective, patients must have some diabetes knowledge, glucometer proficiency, and an ability to take appropriate actions when certain readings are obtained. However, most patients take no action in response to out-of-range glucometer readings, and in many populations, SMBG practices are not associated with improved glycemic control. Thus, SMBG utilization is being reconsidered in other countries. Nonetheless, SMBG behaviors are increasingly recommended in the United States, where the Hispanic population represents the fastest-growing minority group and is disproportionately affected by suboptimal diabetes outcomes. Because a growing number of interventions aim to reduce diabetes disparities by improving glycemic control among minorities, it is essential to determine whether efforts should focus on SMBG practices. We present data on SMBG behaviors and glycemic control among participants from the Miami Healthy Heart Initiative (MHHI), a National Institutes of Health/National Heart, Lung, and Blood Institute-sponsored trial assessing a community health worker (CHW) intervention among Hispanic patients with poorly controlled diabetes. This study examined the effects of a CHW intervention on SMBG practices, glycosylated hemoglobin (HbA1c), and knowledge of appropriate responses to glucometer readings among Hispanic patients with diabetes. This study was an ancillary investigation within MHHI, a randomized, controlled trial in 300 Hispanic patients. Participants were intervention-group members who received 12 months of CHW support. Assessments were administered at baseline and poststudy to determine potential barriers to optimal health. Items from validated instruments were used to determine knowledge of appropriate responses to different glucose readings. These data were linked to HbA1c values. Means and frequencies were used to describe population

  19. Zùsto: A new sweetening agent with low glycemic index.

    Science.gov (United States)

    Pen, Joeri Jan; Khorosheva, Galina; Van de Velde, Ursule; Debroye, Corinne; Huyghebaert, André; Rottiers, Raoul; Keymeulen, Bart

    2018-02-01

    Sweetening agents are sugar substitutes with a low glycemic index, used to obtain a better glycemic control in diabetes patients. However, they also may have a role in other subjects, as a high glycemic index is thought to cause many pathological conditions. Unfortunately, not all artificial sweeteners are perceived as sweet as sugar by patients. Consumers refer often to an after taste present in foods sweetened with intensive sweeteners. The objective of this study was to explore whether Zùsto ® had a low glycemic index, to replace glucose as a sweetener. In this study, the glycemic index (GI) of a new sweetening agent, Zùsto ® , is compared to that of glucose 25 g, a standard sugar-loaded drink used in the oral glucose tolerance test to detect diabetes, as primary endpoint. Zùsto ® is composed of non-digestible, water soluble fibers and sweeteners. 10 healthy, female non-obese volunteers received glucose and Zùsto ® , albeit by an interval of a week. Evolution of glycemia, C-peptide and insulin release was measured at different time-points after intake. The results show that, when calculating the mean incremental Area Under the Curve (AUC), the AUC of glucose was around five times as high as that of Zùsto ® ; a GI of 22 for Zùsto ® was calculated. Furthermore, Zùsto ® had no significant effect on the glycemia, contrary to glucose, for at least 60'. This was also the case concerning C-peptide and insulin release, but the difference lasted even for 180'. Moreover, Zùsto ® was perceived as sweet by all volunteers, with no particular aftertaste. Zùsto ® could be a viable alternative for fast sugars and other sweetening agents, both for diabetic patients and other subjects, requiring however a larger trial to confirm these results. CLINICALTRIALS.GOV: NCT02607345. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  20. Incidence of sleep apnea in patients with various types of glycemic disturbances

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    A V Dreval'

    2013-03-01

    Full Text Available Aims. To assess the risk for sleep apnea in patients with various types of glycemic disorders by means of Epworth Sleepiness Scale andSleep Apnea Screening Questionnaire.Materials and Methods. We examined 744 residents of Mozhaisk Region, that were considered to have high risk for development of type2 diabetes mellitus (T2DM, as estimated by FINDRISK Questionnaire. Patients, who scored 12+ were cleared for participation in this study. Combined score from Epworth Sleepiness Scale and Sleep Apnea Screening Questionnaire was applied for diagnosis of sleep apnea, supplemented with specific questions about snoring and episodes of apnea. Glycemic disorders were diagnosed with standard glucose tolerance test.Results. 42.7% of examined patients (n=318 were diagnosed with various types of glucose disorders. Prevalence of abdominal obe- sity (according to waist circumference measurement comprised 59.3% in male patients and 54.1% in females. We observed positive correlation between body mass index (BMI and snoring – 0.3 (p=0.0001, BMI and apnea – 0.2 (p=0.0001, BMI and daytime sleepiness – 0.1 (p=0.007; we also observed direct correlation between age and snoring – 0.2 (p=0.0001, as well as age and sleep apnea – 0.1 (p=0.028. Risk for sleep apnea was found to be 4.7 times higher in patients with arterial hypertension. After adjustment71Диагностика, контроль и лечениеСахарный диабет. 2013;(1:71–77Сахар ный диабетfor age risk of apnea remained 2.8 times higher in patients with T2DM, 1.9 times higher in subjects with impaired glucose tolerance and1.6 times higher in subjects with impaired fasting glycaemia. Relative risk for snoring in patients with various types of glycemic disorders was 1.1-1.2 against normoglycemic controls. We estimated that all types of glycemic disorders increase risk for apnea 1.2–1.6 times. Conclusion. Glycemic disorders, body weight excess, obesity and arterial

  1. INTERRELATIONSHIP OF OUTCOME MEASURES AND PROCESS VARIABLES IN EARLY RHEUMATOID-ARTHRITIS - A COMPARISON OF RADIOLOGIC DAMAGE, PHYSICAL-DISABILITY, JOINT COUNTS, AND ACUTE-PHASE REACTANTS

    NARCIS (Netherlands)

    VANLEEUWEN, MA; VANDERHEIJDE, DMFM; VANRIJSWIJK, MH; HOUTMAN, PM; VANRIEL, PLCM; VANDEPUTTE, LBA; LIMBURG, PC

    Objective. To investigate the relationship between different outcome and process measures in early rheumatoid arthritis (RA). Methods. A 5-year prospective study of 149 patients with early RA (symptoms <1 year at entry). Results of serial measurements of process variables were transformed into time

  2. Comparison of genetic variability between Czech and foreign isolates of phytopathogenic bacteria Clavibacter michiganensis subsp. sepedonicus by Rep-PCR technique

    Czech Academy of Sciences Publication Activity Database

    Fousek, Jan; Mráz, Ivan; Petrzik, Karel

    2002-01-01

    Roč. 47, - (2002), s. 450-454 ISSN 0015-5632 R&D Projects: GA ČR GA522/00/0887 Keywords : Clavibacter michiganensis * genetic variability Subject RIV: EE - Microbiology, Virology Impact factor: 0.979, year: 2002

  3. Comparison of different degrees of variability in tidal volume to prevent deterioration of respiratory system elastance in experimental acute lung inflammation.

    Science.gov (United States)

    Kiss, T; Silva, P L; Huhle, R; Moraes, L; Santos, R S; Felix, N S; Santos, C L; Morales, M M; Capelozzi, V L; Kasper, M; Pelosi, P; Gama de Abreu, M; Rocco, P R M

    2016-05-01

    Variable ventilation improves respiratory function, but it is not known whether the amount of variability in tidal volume (VT) can be reduced in recruited lungs without a deterioration of respiratory system elastance. Acute lung inflammation was induced by intratracheal instillation of lipopolysaccharide in 35 Wistar rats. Twenty-eight animals were anaesthetized and ventilated in volume-controlled mode. Lungs were recruited by random variation of VT (mean 6 ml kg(-1), coefficient of variation 30%, normal distribution) for 30 min. Animals were randomly assigned to different amounts of VT variability (n=7 for 90 min per group): 30, 15, 7.5, or 0%. Lung function, diffuse alveolar damage, and gene expression of biological markers associated with cell mechanical stress, inflammation, and fibrogenesis were assessed. Seven animals were not ventilated and served as controls for post-mortem analyses. A VT variability of 30%, but not 15, 7.5, or 0%, prevented deterioration of respiratory system elastance [Mean (SD) -7.5 (8.7%), Prespiratory system elastance and was not associated with lung histological damage. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Reconsideration of the Listening Skill Scale: Comparison of the Listening Skills of the Students of Psychological Counseling and Guidance in Accordance with Various Variables

    Science.gov (United States)

    Cihangir-Cankaya, Zeynep

    2012-01-01

    There are two main objectives of this study: The first is to reconsider the Listening Skill Scale and the second is to compare the levels of students of counseling and guidance according to the situations of whether they took the courses including the listening skills and to gender variable. In accordance with these objectives, the data obtained…

  5. A Comparison of the Effects of Organismic and Setting Variables on the Social Interaction Behavior of Children with Developmental Disabilities and Autism.

    Science.gov (United States)

    Sasso, Gary M.; Mundschenk, Nancy A.; Melloy, Kristine J.; Casey, Sean D.

    1998-01-01

    Two studies examined effects of four setting events and two organismic variables on the social behavior of children (ages 9 and 10) with developmental disabilities and autism. Results indicated that peer dyads; cooperative peer intervention; and triads, which included two high-status nondisabled peers, were most effective in promoting positive…

  6. Association between nighttime sleep duration, midday naps, and glycemic levels in Japanese patients with type 2 diabetes.

    Science.gov (United States)

    Makino, Shinya; Hirose, Sachie; Kakutani, Miki; Fujiwara, Masayoshi; Nishiyama, Mitsuru; Terada, Yoshio; Ninomiya, Hitoshi

    2018-04-01

    To clarify the relationship between nighttime sleep duration, midday naps, and glycemic control in Japanese patients diagnosed with type 2 diabetes (n = 355) or impaired glucose tolerance (n = 43). A total of 398 patients completed a self-administered questionnaire on sleep duration/quality and were divided into five groups according to their self-reported nighttime sleep duration: 8 h. Each group was further divided into two subgroups each according to the presence or absence of midday naps. Poor glycemic control was defined as HbA1c ≥ 7.0%. Short nighttime sleep (<5 h), poor sleep induction, daytime sleepiness, and low sleep satisfaction were associated with high HbA1c levels. HbA1c was higher in the short nighttime sleep/no nap group than in non-nappers with different nighttime sleep duration, whereas the short nighttime sleep/nap group showed similar HbA1c levels to the other nap subgroups. In multivariate logistic regression models, after adjusting for a number of potential confounders, short (<5 h) nighttime sleep without nap was significantly associated with poor glycemic control compared with 6-7 h nighttime sleep without nap (OR [95% CI]: 7.14 [2.20-23.20]). However, taking naps reduced this risk for poor glycemic control in short sleepers. Other risk factors for poor glycemic control were low sleep satisfaction (1.73 [1.10-2.70]) and poor sleep induction (1.69 [1.14-2.50]). Poor sleep quality and quantity could aggravate glycemic control in type 2 diabetes. Midday naps could mitigate the deleterious effects of short nighttime sleep on glycemic control. UMIN 000017887. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Once Daily Self-Monitoring of Blood Glucose (SMBG) Improves Glycemic Control in Oral Hypoglycemic Agents (OHA)-Treated Diabetes: SMBG-OHA Follow-Up Study.

    Science.gov (United States)

    Harashima, Shin-Ichi; Nishimura, Akiko; Ikeda, Kaori; Wang, Yu; Liu, Yanyan; Inagaki, Nobuya

    2015-10-01

    The aim of this study was to compare glycemic control between SMBG-continued and -discontinued subjects with type 2 diabetes in the SMBG-OHA study. Of the 96 subjects from the SMBG-OHA study, 59 were recruited for the 24-week, comparison follow-up study. The study outcomes were the differences in change in HbA1c levels at 24 weeks between the 2 groups, and change in SMBG frequency in SMBG-continued subjects. Although health insurance does not cover the cost of SMBG, 22.0% of subjects continued SMBG of their own will after the SMBG-OHA study was completed. HbA1c levels were maintained from 6.81 ± 0.55% to 6.64 ± 0.53% in SMBG-continued subjects. Conversely, HbA1c levels were increased from 7.18 ± 0.63% to 7.48 ± 0.84% in SMBG-discontinued subjects. HbA1c levels were significantly different by 0.83 ± 0.25% (95% CI: -1.33 to -0.36). The difference in change in HbA1c between the groups was -0.46% (95% CI: -0.78 to -0.15). SMBG frequency was decreased from 2.02 ± 1.06 to 1.53 ± 0.86 times a day. HbA1c levels were maintained in SMBG-continued subjects but increased in SMBG-discontinued subjects. The study implied that almost once daily SMBG is helpful to maintain glycemic control in non-insulin-treated type 2 diabetes. © 2015 Diabetes Technology Society.

  8. Effects of a Multispecies Probiotic Mixture on Glycemic Control and Inflammatory Status in Women with Gestational Diabetes: A Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Sadegh Jafarnejad

    2016-01-01

    Full Text Available Objective. This trial aims to examine the effects of a Probiotic Mixture (VSL#3 on glycemic status and inflammatory markers, in women with GDM. Materials and Methods. Over a period of 8 weeks, 82 women with gestational diabetes were randomly assigned to either an intervention group (n=41 which were given VSL#3 capsule or to a control group which were given placebo capsule (n=41. Fasting plasma glucose, homeostatic model assessment of insulin resistance, glycosylated hemoglobin, high-sensitivity C-reactive protein, tumor necrosis factor-α, interleukin-6, Interferon gamma, and interleukin-10 were measured before and after the intervention. Results. After 8 wk of supplementation FPG, HbA1c, HOMA-IR, and insulin levels remained unchanged in the probiotic and placebo groups. The comparison between the two groups showed no significant differences with FPG and HbA1c, but there were significant differences in insulin levels and HOMA-IR (16.6±5.9; 3.7±1.5, resp.. Unlike the levels of IFN-g (19.21±16.6, there was a significant decrease in levels of IL-6 (3.81±0.7, TNF-α (3.10±1.1, and hs-CRP (4927.4±924.6. No significant increase was observed in IL-10 (3.11±5.7 in the intervention group as compared with the control group. Conclusions. In women with GDM, supplementation with probiotics (VSL#3 may help to modulate some inflammatory markers and may have benefits on glycemic control.

  9. Impact of Alcohol on Glycemic Control and Insulin Action

    Directory of Open Access Journals (Sweden)

    Jennifer L. Steiner

    2015-09-01

    Full Text Available Alcohol has profound effects on tissue and whole-body fuel metabolism which contribute to the increased morbidity and mortality in individuals with alcohol use disorder. This review focuses on the glucose metabolic effects of alcohol, primarily in the muscle, liver and adipose tissue, under basal postabsorptive conditions and in response to insulin stimulation. While there is a relatively extensive literature in this area, results are often discordant and extrapolating between models and tissues is fraught with uncertainty. Comparisons between data generated in experimental cell and animals systems will be contrasted with that obtained from human subjects as often times results differ. Further, the nutritional status is also an important component of the sometimes divergent findings pertaining to the effects of alcohol on the regulation of insulin and glucose metabolism. This work is relevant as the contribution of alcohol intake to the development or exacerbation of type 2 diabetes remains ill-defined and a multi-systems approach is likely needed as both alcohol and diabetes affect multiple targets within the body.

  10. Three monoclonal antibodies to the VHS virus glycoprotein: comparison of reactivity in relation to differences in immunoglobulin variable domain gene sequences

    DEFF Research Database (Denmark)

    Lorenzen, Niels; Cupit, P.M.; Secombes, C.J.

    2000-01-01

    and their neutralising activity was evident. Binding kinetic analyses by plasmon resonance identified differences in the dissociation rate constant (kd) as a possible explanation for the different reactivity levels of the MAbs. The Ig variable heavy (VH) and light (V kappa) domain gene sequences of the three hybridomas...... were compared. The inferred amino acid sequence of the two neutralising antibody VH domains differed by three amino acid residues (97% identity) and only one residue difference was evident in the Vk. domains. In contrast, IP1H3 shared only 38 and 39% identity with the 3F1A2 and 3F1H10 VH domains...... respectively and 49 and 50% identity with the 3F1A2 and 3F1H10 VK domains respectively. The neutralising antibodies were produced by hybridomas originating from the same fusion and the high nucleotide sequence homology of the variable Ig gene regions indicated that the plasma cell partners of the hybridomas...

  11. Variability of Extreme Events in East Asia and their Dynamical Control: A Comparison Between Observation and Two High-Resolution Global Climate Models.

    Science.gov (United States)

    Freychet, N.; Duchez, A.; Wu, C. H.; Chen, C. A.; Hsu, H. H.; Hirschi, J.; New, A.

    2015-12-01

    East Asia is submitted to a strong seasonal monsoon system, with dry winters and wet summers. Each season can be submitted to extreme weather events such as long drought spells or extreme daily rainfall. Because this region is densely populated, the understanding and predictability of such events is a major subject of concern in the framework of global warming scenario. In this study we investigate the occurrence of the two (above mentioned) extreme events. We focus on their variability and the large-scale atmospheric (+ STT) patterns associated with these events. We use APHRODITE and PERSIANN observation, along with outputs from 2 high resolution (0.5 degree) global climate model (GCM): HadGEM3-GC2 (MetOffice, UK; fully coupled with ORCA025) and HiRAM-C192 (GFDL, USA; forced by prescribed SST). We use different approaches (composites and correlation fields) to highlight the main patterns and mechanisms that control the variability of extremes. We focus on the 1975-2005 historical period. Despite some biases, models can reproduce the signal of extreme events and their dynamical control. Results show a strong control of the land-sea heat contrast along with a significant impact of the monsoon winds system. The SST (which translate the moisture source) does not have a significant impact when considering short terms (monthly) variability but has stronger impact in terms of internannual variability. This work is then extend to end of century projection with the two GCM to investigate the major changes in the large scale dynamics and how it can impact extreme weather events.

  12. Evaluation of therapy for dilated cardiomyopathy with heart failure by iodine-123 metaiodobenzyl-guanidine imaging. Comparison with heart rate variability power spectral analysis

    International Nuclear Information System (INIS)

    Li, Shou-lin; Ikeda, Jun; Takita, Tamotsu; Sekiguchi, Yohei; Demachi, Jun; Chikama, Hisao; Goto, Atsushi; Shirato, Kunio

    1998-01-01

    The relationship between the myocardial uptake of iodine-123 metaiodobenzylguanidine ( 123 I-MIBG) and heart rate variability parameters has not been determined. This study determined the relationship between the change in myocardial uptake of 123 I-MIBG and improvement in left ventricular function after treatment, to determine the usefulness of 123 I-MIBG imaging to assess the effect of therapy on heart failure due to dilated cardiomyopathy (DCM). 123 I-MIBG imaging and power spectral analysis of heart rate variability were performed before and after treatment in 17 patients with heart failure due to DCM. The following parameters were compared before and after treatment: New York Heart Association (NYHA) functional class, radiographic cardiothoracic ratio (CTR), blood pressure, echocardiographic data (left ventricular end-systolic (LVDs) and end-diastolic (LVDd) diameters, left ventricular ejection fraction (LVEF)), plasma concentrations of norepinephrine and epinephrine, heart rate variability power spectral analysis data (mean low frequency (MLF) and high frequency power (MHF)) and the myocardium to mediastinum activity ratio (MYO/M) obtained in early and late images, and washout rate calculated by anterior planar imaging of 123 I-MIBG. The NYHA functional class, LVEF, LVDs, CTR, MLF and MHF improved after treatment. Early MYO/M and late MYO/M improved after treatment. The rate of increase in late MYO/M was positively correlated with the rate of improvement of LVEF after treatment. Furthermore, the late MYO/M was negatively correlated with MLF. Washout rate revealed no correlation with hemodynamic parameters. These findings suggest that late MYO/M is more useful than washout rate to assess the effect of treatment on heart failure due to DCM. Furthermore, the 123 I-MIBG imaging and heart rate variability parameters are useful to assess the autonomic tone in DCM with heart failure. (author)

  13. Glycemic index, glycemic load and glycemic response

    DEFF Research Database (Denmark)

    Augustin, Livia S A; Kendall, Cyril W C; Jenkins, David J A

    2015-01-01

    BACKGROUND AND AIMS: The positive and negative health effects of dietary carbohydrates are of interest to both researchers and consumers. METHODS: International experts on carbohydrate research held a scientific summit in Stresa, Italy, in June 2013 to discuss controversies surrounding the utilit...

  14. Comparison of the Spatiotemporal Variability of Temperature, Precipitation, and Maximum Daily Spring Flows in Two Watersheds in Quebec Characterized by Different Land Use

    Directory of Open Access Journals (Sweden)

    Ali A. Assani

    2016-01-01

    Full Text Available We compared the spatiotemporal variability of temperatures and precipitation with that of the magnitude and timing of maximum daily spring flows in the geographically adjacent L’Assomption River (agricultural and Matawin River (forested watersheds during the period from 1932 to 2013. With regard to spatial variability, fall, winter, and spring temperatures as well as total precipitation are higher in the agricultural watershed than in the forested one. The magnitude of maximum daily spring flows is also higher in the first watershed as compared with the second, owing to substantial runoff, given that the amount of snow that gives rise to these flows is not significantly different in the two watersheds. These flows occur early in the season in the agricultural watershed because of the relatively high temperatures. With regard to temporal variability, minimum temperatures increased over time in both watersheds. Maximum temperatures in the fall only increased in the agricultural watershed. The amount of spring rain increased over time in both watersheds, whereas total precipitation increased significantly in the agricultural watershed only. However, the amount of snow decreased in the forested watershed. The magnitude of maximum daily spring flows increased over time in the forested watershed.

  15. An Analysis of Interannual Variabilities in High Cloud Cover from AIRS Data: Imprints of the El Niño-Southern Oscillation and Comparison to Models

    Science.gov (United States)

    Yung, Y. L.; Antilla, K.; Mak, S. N.; Chang, T. M.; Li, K. F.; Su, H.; Wong, S.; Jiang, J. H.

    2014-12-01

    Using data from the Atmospheric Infrared Sounder (AIRS), we examine how global high cloud cover varies over time in the decade from 2003 to 2012, with a focus on identifying dominant modes of variabilities and associated spatial patterns, and relate them to sea surface temperature (SST). By performing Empirical Orthogonal Function (EOF) analysis on satellite observations of high cloud cover, the El Niño-Southern Oscillation (ENSO) — including both EP-ENSO (canonical ENSO) and CP-ENSO (ENSO Modoki) — is found to be the leading source of variability in high cloud cover. High cloud distributions are further shown to be closely associated with SST variations. The observations are compared to simulations from 20 AMIP5 models. In general, the models are able to simulate the first EOF, the EP-ENSO, in the data. However, only about half of the AMIP5 models could realistically reproduce the second EOF, the CP-ENSO. Improved understanding of high cloud variabilities will advance climate model simulations and facilitate more accurate predictions of future climate, specifically the climate response to increasing greenhouse gases such as CO2.

  16. Molecular Typing of Mycobacterium intracellulare Using Pulsed-Field Gel Electrophoresis, Variable-Number Tandem-Repeat Analysis, Mycobacteria Interspersed Repetitive-Unit-Variable-Number Tandem Repeat Typing, and Multilocus Sequence Typing: Molecular Characterization and Comparison of Each Typing Methods.

    Science.gov (United States)

    Jeon, Semi; Lim, Nara; Kwon, Seungjik; Shim, Taesun; Park, Misun; Kim, Bum-Joon; Kim, Seonghan

    2014-06-01

    Mycobacterium intracellulare is the major causative agent of nontuberculous mycobacteria-related pulmonary infections. The strain typing of M. intracellulare is important for the treatment and control of its infections. We compared the discrimination capacity and effective value of four different molecular typing methods. Antibiotic susceptibility testing, hsp65 and rpoB sequencing, pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), mycobacteria interspersed repetitive-unit-variable-number tandem-repeat analysis (MIRU-VNTR), and VNTR assay targeting 44 M. intracellulare isolates obtained from patients with pulmonary infections were performed. All the antibiotic susceptibility patterns had no association with the molecular and sequence types tested in this study; however, the molecular and sequence types were related with each other. PFGE gave best results for discriminatory capacity, followed by VNTR, MLST, and MIRU-VNTR. The high discriminatory power of PFGE, VNTR, and MLST is enough for differentiating between reinfection and relapse, as well as for other molecular epidemiological usages. The MLST could be regarded as a representative classification method, because it showed the clearest relation with the sequence types.