WorldWideScience

Sample records for glycemic variability comparison

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

    Science.gov (United States)

    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. Skin Autofluorescence and Glycemic Variability

    NARCIS (Netherlands)

    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

  3. Does glycemic variability impact mood and quality of life?

    Science.gov (United States)

    Penckofer, Sue; Quinn, Lauretta; Byrn, Mary; Ferrans, Carol; Miller, Michael; Strange, Poul

    2012-04-01

    Diabetes is a chronic condition that significantly impacts quality of life. Poor glycemic control is associated with more diabetes complications, depression, and worse quality of life. The impact of glycemic variability on mood and quality of life has not been studied. A descriptive exploratory design was used. Twenty-three women with type 2 diabetes wore a continuous glucose monitoring system for 72 h and completed a series of questionnaires. Measurements included (1) glycemic control shown by glycated hemoglobin and 24-h mean glucose, (2) glycemic variability shown by 24-h SD of the glucose readings, continuous overall net glycemic action (CONGA), and Fourier statistical models to generate smoothed curves to assess rate of change defined as "energy," and (3) mood (depression, anxiety, anger) and quality of life by questionnaires. Women with diabetes and co-morbid depression had higher anxiety, more anger, and lower quality of life than those without depression. Certain glycemic variability measures were associated with mood and quality of life. The 24-h SD of the glucose readings and the CONGA measures were significantly associated with health-related quality of life after adjusting for age and weight. Fourier models indicated that certain energy components were significantly associated with depression, trait anxiety, and overall quality of life. Finally, subjects with higher trait anxiety tended to have steeper glucose excursions. Data suggest that greater glycemic variability may be associated with lower quality of life and negative moods. Implications include replication of the study in a larger sample for the assessment of blood glucose fluctuations as they impact mood and quality of life.

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

    Science.gov (United States)

    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

  5. Impact of Glucose Meter Error on Glycemic Variability and Time in Target Range During Glycemic Control After Cardiovascular Surgery.

    Science.gov (United States)

    Karon, Brad S; Meeusen, Jeffrey W; Bryant, Sandra C

    2015-08-25

    We retrospectively studied the impact of glucose meter error on the efficacy of glycemic control after cardiovascular surgery. Adult patients undergoing intravenous insulin glycemic control therapy after cardiovascular surgery, with 12-24 consecutive glucose meter measurements used to make insulin dosing decisions, had glucose values analyzed to determine glycemic variability by both standard deviation (SD) and continuous overall net glycemic action (CONGA), and percentage glucose values in target glucose range (110-150 mg/dL). Information was recorded for 70 patients during each of 2 periods, with different glucose meters used to measure glucose and dose insulin during each period but no other changes to the glycemic control protocol. Accuracy and precision of each meter were also compared using whole blood specimens from ICU patients. Glucose meter 1 (GM1) had median bias of 11 mg/dL compared to a laboratory reference method, while glucose meter 2 (GM2) had a median bias of 1 mg/dL. GM1 and GM2 differed little in precision (CV = 2.0% and 2.7%, respectively). Compared to the period when GM1 was used to make insulin dosing decisions, patients whose insulin dose was managed by GM2 demonstrated reduced glycemic variability as measured by both SD (13.7 vs 21.6 mg/dL, P meter error (bias) was associated with decreased glycemic variability and increased percentage of values in target glucose range for patients placed on intravenous insulin therapy following cardiovascular surgery. © 2015 Diabetes Technology Society.

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

    NARCIS (Netherlands)

    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

  7. Effects of hypocaloric diets with different glycemic indexes on endothelial function and glycemic variability in overweight and in obese adult patients at increased cardiovascular risk.

    Science.gov (United States)

    Buscemi, Silvio; Cosentino, Loretta; Rosafio, Giuseppe; Morgana, Manuela; Mattina, Alessandro; Sprini, Delia; Verga, Salvatore; Rini, Giovam Battista

    2013-06-01

    The role of glycemic index of the diet in glucose control and cardiovascular prevention is still not clear. The aim of this study was to determine the effects of hypocaloric diets with different glycemic indexes and glycemic loads on endothelial function and glycemic variability in nondiabetic participants at increased cardiovascular risk. Forty nondiabetic obese participants were randomly assigned to a three-month treatment with either a low glycemic index (LGI; n=19) or high glycemic index (HGI; n=21) hypocaloric diet with similar macronutrient and fiber content. Endothelial function was measured as flow-mediated dilatation (FMD) of the brachial artery before and after dieting. In addition, 48-h continuous subcutaneous glucose monitoring was done before and after dieting in a subgroup of 24 participants. The amount of weight loss after dieting was similar in both groups. The glycemic index of the diet significantly influenced the FMD (Pdiet, and -0.9±3.6% after the HGI diet (Pdiet on results was observed. The glycemic index of the diet significantly influenced the 48-h glycemic variability measured as coefficient of variability (CV%; Pdiet (from 23.5 to 20.0%) and increased after the HGI diet (from 23.6 to 26.6%). The change in percentage of FMD was inversely correlated with the change in the 48-h glycemic CV% (r=-0.45; Phypocaloric diet in nondiabetic obese persons. ISRCTN56834511. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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

    Science.gov (United States)

    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.

    Science.gov (United States)

    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.

    Science.gov (United States)

    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. Variability in Glycemic Control with Temperature Transitions during Therapeutic Hypothermia

    Directory of Open Access Journals (Sweden)

    Krystal K. Haase

    2017-01-01

    Full Text Available Purpose. Patients treated with therapeutic hypothermia (TH and continuous insulin may be at increased risk of hyperglycemia or hypoglycemia, particularly during temperature transitions. This study aimed to evaluate frequency of glucose excursions during each phase of TH and to characterize glycemic control patterns in relation to survival. Methods. Patients admitted to a tertiary care hospital for circulatory arrest and treated with both therapeutic hypothermia and protocol-based continuous insulin between January 2010 and June 2013 were included. Glucose measures, insulin, and temperatures were collected through 24 hours after rewarming. Results. 24 of 26 patients experienced glycemic excursions. Hyperglycemic excursions were more frequent during initiation versus remaining phases (36.3%, 4.3%, 2.5%, and 4.0%, p=0.002. Hypoglycemia occurred most often during rewarming (0%, 7.7%, 23.1%, and 3.8%, p=0.02. Patients who experienced hypoglycemia had higher insulin doses prior to rewarming (16.2 versus 2.1 units/hr, p=0.03. Glucose variation was highest during hypothermia and trended higher in nonsurvivors compared to survivors (13.38 versus 9.16, p=0.09. Frequency of excursions was also higher in nonsurvivors (32.3% versus 19.8%, p=0.045. Conclusions. Glycemic excursions are common and occur more often in nonsurvivors. Excursions differ by phase but risk of hypoglycemia is increased during rewarming.

  12. Effect of Linagliptin Versus Metformin on Glycemic Variability in Patients with Impaired Glucose Tolerance.

    Science.gov (United States)

    González-Heredia, Tonatiuh; Hernández-Corona, Diana M; González-Ortiz, Manuel; Martínez-Abundis, Esperanza

    2017-08-01

    Impaired glucose tolerance (IGT) and glycemic variability may be associated with increased risk of micro- and macrovascular complications. The aim of this study was to assess the effect of linagliptin versus metformin on glycemic variability in patients with IGT. A randomized, double-blind clinical trial with parallel groups was carried out in 16 adult patients with IGT, overweight or obesity. All patients signed an informed consent. The therapies were randomly assigned: (a) metformin 500 mg bid (n = 8) or (b) linagliptin 5 mg a.m. and placebo p.m. (n = 8), both for 90 days. At the beginning of the trial and 3 months later, fasting glucose, glycated hemoglobin A1c, oral glucose tolerance test (OGTT), and glycemic variability [area under the curve (AUC) of glucose, mean amplitude of glycemic excursion (MAGE), standard deviation (SD) of glucose, coefficient of variation (CV) of glucose, and mean blood glucose (MBG)] were measured. Mann-Whitney U, Wilcoxon, and Fisher exact tests were used for statistical analyses. Both groups were similar in basal characteristics. After linagliptin administration, a significant decrease in glucose levels at 120 min of OGTT (9.0 ± 0.9 vs. 6.9 ± 2.2 mmol/L, P = 0.012) was observed. Glycemic variability showed a similar behavior and there were no significant differences in the AUC, MAGE, SD of glucose, CV of glucose, and MBG between groups. Linagliptin administration resulted in better glycemic control according to the decrease of glucose levels by the OGTT at 120 min in patients with IGT. Meanwhile, glycemic variability was not modified in any of the study groups.

  13. Gestational glucose intolerance modifies the association between magnesium and glycemic variables in mothers and daughters 15 years post-partum.

    Science.gov (United States)

    Del Gobbo, Liana C; Song, Yiqing; Elin, Ronald J; Meltzer, Sara J; Egeland, Grace M

    2012-07-01

    Gestational diabetes mellitus (GDM) and low magnesium (Mg) intake and status are associated with an increased risk of type 2 diabetes. However, Mg homeostasis may be modified by GDM. We sought to determine if a history of GDM prospectively modifies associations between Mg and glycemic variables in mothers and their offspring. Plasma and dietary Mg, anthropometric, lifestyle and glycemic variables were assessed in mothers affected by GDM during 1989-1990, a comparative group of normoglycemic women, pregnant during the same time period, and the 15-year-old, nondiabetic daughters of affected and unaffected pregnancies (n = 332). Multivariate regression analyses evaluated the cross-sectional association between plasma and dietary Mg with glycemic variables in mothers and daughters. Plasma Mg was lower in mothers with a history of GDM in comparison to control mothers after adjustment for current type 2 diabetes, race and body mass index (0.90 ± 0.01 versus 0.96 ± 0.01 mmol/L; p = 0.002). Plasma Mg was significantly associated with insulin sensitivity and was inversely associated with fasting insulin in GDM mothers only (pmothers and offspring with a history of GDM.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... and 39 women with non-insulin-treated type 2 diabetes and a known duration of diabetes ... by the standard deviation of normal-to-normal intervals (P = 0.001), the root mean square of successive differences (P = 0.018), LF (P power (P = 0.008), RS ratio (P = 0.027), and expiration-to-inspiration ratio (P = 0.006) was significantly associated with increased glycemic...

  15. Multiplicative surrogate standard deviation: a group metric for the glycemic variability of individual hospitalized patients.

    Science.gov (United States)

    Braithwaite, Susan S; Umpierrez, Guillermo E; Chase, J Geoffrey

    2013-09-01

    Group metrics are described to quantify blood glucose (BG) variability of hospitalized patients. The "multiplicative surrogate standard deviation" (MSSD) is the reverse-transformed group mean of the standard deviations (SDs) of the logarithmically transformed BG data set of each patient. The "geometric group mean" (GGM) is the reverse-transformed group mean of the means of the logarithmically transformed BG data set of each patient. Before reverse transformation is performed, the mean of means and mean of SDs each has its own SD, which becomes a multiplicative standard deviation (MSD) after reverse transformation. Statistical predictions and comparisons of parametric or nonparametric tests remain valid after reverse transformation. A subset of a previously published BG data set of 20 critically ill patients from the first 72 h of treatment under the SPRINT protocol was transformed logarithmically. After rank ordering according to the SD of the logarithmically transformed BG data of each patient, the cohort was divided into two equal groups, those having lower or higher variability. For the entire cohort, the GGM was 106 (÷/× 1.07) mg/dl, and MSSD was 1.24 (÷/× 1.07). For the subgroups having lower and higher variability, respectively, the GGM did not differ, 104 (÷/× 1.07) versus 109 (÷/× 1.07) mg/dl, but the MSSD differed, 1.17 (÷/× 1.03) versus 1.31 (÷/× 1.05), p = .00004. By using the MSSD with its MSD, groups can be characterized and compared according to glycemic variability of individual patient members. © 2013 Diabetes Technology Society.

  16. Serum bilirubin levels are positively associated with glycemic variability in women with type 2 diabetes.

    Science.gov (United States)

    Kim, Lee Kyung; Roh, Eun; Kim, Min Joo; Kim, Min Kyeong; Park, Kyeong Seon; Kwak, Soo Heon; Cho, Young Min; Park, Kyong Soo; Jang, Hak Chul; Jung, Hye Seung

    2016-11-01

    Glycemic variability is known to induce oxidative stress. We investigated the relationships between glycemic variability and serum bilirubin levels, an endogenous anti-oxidant, in patients with diabetes. A cross-sectional study was carried out with 77 patients with type 2 diabetes who had been recruited to two clinical studies from 2008 to 2014. There were no participants with diseases of the pancreas, liver, biliary tract and chronic renal insufficiency. Glycemic variation was calculated by a continuous glucose monitoring system, and correlation analyses were carried out to evaluate their association with bilirubin levels. Multiple linear regression was carried out to identify independent factors influencing bilirubin levels and glycemic variation. Among the participants, 42.3% were men. The mean (standard deviation) age was 61.5 years (10.4 years), body mass index was 24.2 kg/m 2 (2.8 kg/m 2 ), diabetes duration was 17.7 years (9.5 years), hemoglobin A 1c was 60.7 mmol/mol (7.1 mmol/mol; 7.7 [0.7]%) and bilirubin was 11.8 μmol/L (4.10 μmol/L). Serum bilirubin levels were not different according to age, body mass index and hemoglobin A 1c . However, the mean amplitude of glucose excursion was positively associated with bilirubin levels in women (r = 0.588, P bilirubin and mean amplitude of glucose excursion remained significant (r = 0.566, P bilirubin was an independent determinant for the mean amplitude of glucose excursion in women. 1,5-Anhydroglucitol was also associated with bilirubin levels in women. Bilirubin level within the physiological range might be an independent predictor for glycemic variability in women with type 2 diabetes. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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 showed longer period of esophageal acidification (17% [2?58]; p

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Individuals with Type 1 and Type 2 Diabetes Mellitus Trade Increased Hyperglycemia for Decreased Hypoglycemia When Glycemic Variability is not Improved.

    Science.gov (United States)

    Jangam, Sujit R; Hayter, Gary; Dunn, Timothy C

    2018-02-01

    Glycemic variability refers to oscillations in blood glucose within a day and differences in blood glucose at the same time on different days. Glycemic variability is linked to hypoglycemia and hyperglycemia. The relationship among these three important metrics is examined here, specifically to show how reduction in both hypo- and hyperglycemia risk is dependent on changes in variability. To understand the importance of glycemic variability in the simultaneous reduction of hypoglycemia and hyperglycemia risk, we introduce the glycemic risk plot-estimated HbA1c % (eA1c) vs. minutes below 70 mg/dl (MB70) with constant variability contours for predicting post-intervention risks in the absence of a change in glycemic variability. The glycemic risk plot illustrates that individuals who do not reduce glycemic variability improve one of the two metrics (hypoglycemia risk or hyperglycemia risk) at the cost of the other. It is important to reduce variability to improve both risks. These results were confirmed by data collected in a randomized controlled trial consisting of individuals with type 1 and type 2 diabetes on insulin therapy. For type 1, a total of 28 individuals out of 35 (80%) showed improvement in at least one of the risks (hypo and/or hyper) during the 100-day course of the study. Seven individuals (20%) showed improvement in both. Similar data were observed for type 2 where a total of 36 individuals out of 43 (84%) showed improvement in at least one risk and 8 individuals (19%) showed improvement in both. All individuals in the study who showed improvement in both hypoglycemia and hyperglycemia risk also showed a reduction in variability. Therapy changes intended to improve an individual's hypoglycemia or hyperglycemia risk often result in the reduction of one risk at the expense of another. It is important to improve glucose variability to reduce both risks or at least maintain one risk while reducing the other. Abbott Diabetes Care.

  3. Relative contributions of preprandial and postprandial glucose exposures, glycemic variability, and non-glycemic factors to HbA in individuals with and without diabetes

    DEFF Research Database (Denmark)

    Færch, Kristine; Alssema, Marjan; Mela, David J

    2018-01-01

    BACKGROUND/OBJECTIVE: There is substantial interest in dietary approaches to reducing postprandial glucose (PPG) responses, but the quantitative contribution of PPG to longer-term glycemic control (reflected in glycated hemoglobin, HbA1c) in the general population is not known. This study quantif...

  4. Glycemic variability is an independent predictive factor for development of hepatic fibrosis in nonalcoholic fatty liver disease.

    Directory of Open Access Journals (Sweden)

    Motoi Hashiba

    Full Text Available Patients with nonalcoholic fatty liver disease (NAFLD and nonalcoholic steatohepatitis (NASH often have metabolic disorders including insulin resistance and type 2 diabetes mellitus (T2DM. We clarified the predictive factors in glucose metabolism for progression of hepatic fibrosis in patients with NAFLD by the 75-g oral glucose tolerance test (75gOGTT and a continuous glucose monitoring system (CGMS. One hundred sixty-nine patients (68 female and 101 male patients with biopsy-proven NAFLD with performance with 75gOGTT were enrolled and divided into four groups according to the stage of hepatic fibrosis (F0-3. The proportion of patients with T2DM significantly gradually increased, HbA1c and the homeostasis model assessment of insulin resistance were significantly elevated, and 1,5-anhydroglucitol (1,5-AG was remarkably decreased with the progression of fibrosis. In the 75gOGTT, both plasma glucose and insulin secretion were remarkably increased with the progression of fibrosis. The only factor significantly associated with advanced fibrosis was 1,5-AG (P = 0.008 as determined by multivariate logistic regression analysis. We next evaluated the changes in blood glucose during 24 hours by monitoring with the CGMS to confirm the relationship between glycemic variability and progression of fibrosis. Variability of median glucose, standard deviation of median glucose (P = 0.0022, maximum blood glucose (P = 0.0019, and ΔMin-max blood glucose (P = 0.0029 were remarkably higher in severe fibrosis than in mild fibrosis.Hyperinsulinemia and hyperglycemia, especially glycemic variability, are important predictive factors in glucose impairment for the progression of hepatic fibrosis in NAFLD.

  5. Increased glycemic variability and decrease of the postprandial glucose contribution to HbA1c in obese subjects across the glycemic continuum from normal glycemia to first time diagnosed diabetes.

    Science.gov (United States)

    Fysekidis, Marinos; Cosson, Emmanuel; Banu, Isabela; Duteil, Régine; Cyrille, Chantal; Valensi, Paul

    2014-12-01

    The contribution of postprandial glycemia (PPG) to hyperglycemia has been shown to decrease as HbA1c increased in type 2 diabetic patients. This study aimed at examining, in a series of overweight/obese patients without known glycemic disorder, the contribution of PPG to a "relative" hyperglycemia (glucose values≥5.5 mmol/L) and the presence of glycemic variability according to HbA1c levels. Seventy overweight/obese inpatients (body mass index 35.2±6.8 kg/m2) without known glycemic disorder were included. Participants were classified according to an oral glucose tolerance test (according to the American Diabetes Association criteria) as patients with normoglycemia (n=33), with intermediate hyperglycemia (n=24) or diabetes (n=13). They were separated into HbA1c quartiles (Q1 to Q4). A 24 hour continuous glucose monitoring was used under a 1800 kcal diet and minimal physical activity. We assessed PPG contribution (3 hour period after each meal) to the "relative" 24 hour hyperglycemia (glucose values ≥5.5 mmol/L); the remaining time was considered as the fasting/post-absorptive period. HbA1c range was from 5.1% to 7.4% (32 to 57 mmol/mmol). From the lowest to the highest HbA1c quartile, the area under the curve (AUC) for the "relative" hyperglycemia presented a 17-fold increase for the fasting/post-absorptive (pAUC-3 h AUC for a constant 5.5 mmol/L glycemia)/(total 24 h AUC-24 h AUC for constant 5. 5 mmol/L glycemia)] and decreased from Q1 to Q4 of HbA1c (81.2%, 66%, 65.8%, 57%; pblood glucose level (pglucose variability indices, including mean amplitude of glycemic excursions (p<0.01). In overweight/obese patients, HbA1c was associated with lower PPG contribution to "relative" hyperglycemia and greater glycemic variability. The present findings support the importance of postprandial period in glycemic exposure even before the appearance of diabetes. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Four-Point Preprandial Self-Monitoring of Blood Glucose for the Assessment of Glycemic Control and Variability in Patients with Type 2 Diabetes Treated with Insulin and Vildagliptin

    Directory of Open Access Journals (Sweden)

    Andrea Tura

    2015-01-01

    Full Text Available The study explored the utility of four-point preprandial glucose self-monitoring to calculate several indices of glycemic control and variability in a study adding the DPP-4 inhibitor vildagliptin to ongoing insulin therapy. This analysis utilized data from a double-blind, randomized, placebo-controlled crossover study in 29 patients with type 2 diabetes treated with vildagliptin or placebo on top of stable insulin dose. During two 4-week treatment periods, self-monitoring of plasma glucose was undertaken at 4 occasions every day. Glucose values were used to assess several indices of glycemic control quality, such as glucose mean, GRADE, M-VALUE, hypoglycemia and hyperglycemia index, and indices of glycemic variability, such as standard deviation, CONGA, J-INDEX, and MAGE. We found that vildagliptin improved the glycemic condition compared to placebo: mean glycemic levels, and both GRADE and M-VALUE, were reduced by vildagliptin (P<0.01. Indices also showed that vildagliptin reduced glycemia without increasing the risk for hypoglycemia. Almost all indices of glycemic variability showed an improvement of the glycemic condition with vildagliptin (P<0.02, though more marked differences were shown by the more complex indices. In conclusion, the study shows that four-sample preprandial glucose self-monitoring is sufficient to yield information on the vildagliptin effects on glycemic control and variability.

  7. 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...

  8. Alternative Assessment of Glycemic Control

    NARCIS (Netherlands)

    Greven, W.L.

    2015-01-01

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

  9. 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.

  10. High glycemic variability assessed by continuous glucose monitoring after surgical treatment of obesity by gastric bypass.

    Science.gov (United States)

    Hanaire, Helene; Bertrand, Monelle; Guerci, Bruno; Anduze, Yves; Guillaume, Eric; Ritz, Patrick

    2011-06-01

    Obesity surgery elicits complex changes in glucose metabolism that are difficult to observe with discontinuous glucose measurements. We aimed to evaluate glucose variability after gastric bypass by continuous glucose monitoring (CGM) in a real-life setting. CGM was performed for 4.2 ± 1.3 days in three groups of 10 subjects each: patients who had undergone gastric bypass and who were referred for postprandial symptoms compatible with mild hypoglycemia, nonoperated diabetes controls, and healthy controls. The maximum interstitial glucose (IG), SD of IG values, and mean amplitude of glucose excursions (MAGE) were significantly higher in operated patients and in diabetes controls than in healthy controls. The time to the postprandial peak IG was significantly shorter in operated patients (42.8 ± 6.0 min) than in diabetes controls (82.2 ± 11.1 min, P = 0.0002), as were the rates of glucose increase to the peak (2.4 ± 1.6 vs. 1.2 ± 0.3 mg/mL/min; P = 0.041). True hypoglycemia (glucose fasting state and 2 h postmeal. Glucose variability is exaggerated after gastric bypass, combining unusually high and early hyperglycemic peaks and rapid IG decreases. This might account for postprandial symptoms mimicking hypoglycemia but often seen without true hypoglycemia. Early postprandial hyperglycemia might be underestimated if glucose measurements are done 2 h postmeal.

  11. Study of Glycemic Variability Through Time Series Analyses (Detrended Fluctuation Analysis and Poincaré Plot) in Children and Adolescents with Type 1 Diabetes.

    Science.gov (United States)

    García Maset, Leonor; González, Lidia Blasco; Furquet, Gonzalo Llop; Suay, Francisco Montes; Marco, Roberto Hernández

    2016-11-01

    Time series analysis provides information on blood glucose dynamics that is unattainable with conventional glycemic variability (GV) indices. To date, no studies have been published on these parameters in pediatric patients with type 1 diabetes. Our aim is to evaluate the relationship between time series analysis and conventional GV indices, and glycosylated hemoglobin (HbA1c) levels. This is a transversal study of 41 children and adolescents with type 1 diabetes. Glucose monitoring was carried out continuously for 72 h to study the following GV indices: standard deviation (SD) of glucose levels (mg/dL), coefficient of variation (%), interquartile range (IQR; mg/dL), mean amplitude of the largest glycemic excursions (MAGE), and continuous overlapping net glycemic action (CONGA). The time series analysis was conducted by means of detrended fluctuation analysis (DFA) and Poincaré plot. Time series parameters (DFA alpha coefficient and elements of the ellipse of the Poincaré plot) correlated well with the more conventional GV indices. Patients were grouped according to the terciles of these indices, to the terciles of eccentricity (1: 12.56-16.98, 2: 16.99-21.91, 3: 21.92-41.03), and to the value of the DFA alpha coefficient (> or ≤1.5). No differences were observed in the HbA1c of patients grouped by GV index criteria; however, significant differences were found in patients grouped by alpha coefficient and eccentricity, not only in terms of HbA1c, but also in SD glucose, IQR, and CONGA index. The loss of complexity in glycemic homeostasis is accompanied by an increase in variability.

  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. Impact of glycemic variability on the occurrence of periprocedural myocardial infarction and major adverse cardiovascular events (MACE) after coronary intervention in patients with stable angina pectoris at 6months follow-up.

    Science.gov (United States)

    Xia, Jinggang; Xu, Ji; Hu, Shaodong; Hao, Hengjian; Yin, Chunlin; Xu, Dong

    2017-08-01

    We explored the impact of glycemic variability on the occurrence of periprocedural myocardial infarction and major adverse cardiovascular events (MACE) after coronary intervention in patients with stable angina pectoris (SAP) at 6months follow-up. From May 2015 to April 2016, a total of 746 patients with SAP were divided to high glycemic variability group (H group) (n=261) and low glycemic variability group (L group) (n=485). The primary end point was incidence of periprocedural myocardial infarction and MACE at 6months follow-up. The occurrence of periprocedural myocardial infarction occurred in 18.8% of patients in H group and in 12.4% in L group (P=0.03). The incidence of MACE at 6months follow-up was 9.6% in H group and 4.5% in L group (P=0.01). Multivariable analysis suggested that high glycemic variability conferred a 53% risk increment of 6months follow-up MACE (odds ratio 2.13, 95% confidence interval 1.85-5.38; P=0.01). The trial shows that higher blood glucose variability was correlated with higher incidence of periprocedural myocardial infarction and MACE at 6months follow-up. Copyright © 2017. Published by Elsevier B.V.

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

    Science.gov (United States)

    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.

  15. Effects of Vildagliptin or Pioglitazone on Glycemic Variability and Oxidative Stress in Patients with Type 2 Diabetes Inadequately Controlled with Metformin Monotherapy: A 16-Week, Randomised, Open Label, Pilot Study

    Directory of Open Access Journals (Sweden)

    Nam Hoon Kim

    2017-06-01

    Full Text Available BackgroundGlycemic variability is associated with the development of diabetic complications through the activation of oxidative stress. This study aimed to evaluate the effects of a dipeptidyl peptidase 4 inhibitor, vildagliptin, or a thiazolidinedione, pioglitazone, on glycemic variability and oxidative stress in patients with type 2 diabetes.MethodsIn this open label, randomised, active-controlled, pilot trial, individuals who were inadequately controlled with metformin monotherapy were assigned to either vildagliptin (50 mg twice daily, n=17 or pioglitazone (15 mg once daily, n=14 treatment groups for 16 weeks. Glycemic variability was assessed by calculating the mean amplitude of glycemic excursions (MAGE, which was obtained from continuous glucose monitoring. Urinary 8-iso prostaglandin F2α, serum oxidised low density lipoprotein, and high-sensitivity C-reactive protein were used as markers of oxidative stress or inflammation.ResultsBoth vildagliptin and pioglitazone significantly reduced glycated hemoglobin and mean plasma glucose levels during the 16-week treatment. Vildagliptin also significantly reduced the MAGE (from 93.8±38.0 to 70.8±19.2 mg/dL, P=0.046, and mean standard deviation of 24 hours glucose (from 38±17.3 to 27.7±6.9, P=0.026; however, pioglitazone did not, although the magnitude of decline was similar in both groups. Markers of oxidative stress or inflammation including urinary 8-iso prostaglandin F2α did not change after treatment in both groups.ConclusionIn this 16-week treatment trial, vildagliptin, but not pioglitazone, reduced glycemic variability in individuals with type 2 diabetes who was inadequately controlled with metformin monotherapy, although a reduction of oxidative stress markers was not observed.

  16. 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.

  17. [Diabetes type 1 in young adults: The relationship between psycho-social variables, glycemic control, depression and anxiety].

    Science.gov (United States)

    Steinsdottir, Fjola Katrin; Halldorsdottir, Hildur; Gudmundsdottir, Arna; Arnardottir, Steinunn; Smari, Jakop; Arnarson, Eirikur Orn

    2008-12-01

    The aim of the present study was to investigate whether psycho-social variables, for example social support and task- and emotion-oriented coping would predict psychological and physical well being among young adults with diabetes. Participants were 56 individuals in their twenties suffering from type 1 diabetes. Response rate was 78%. The participants came from the whole of Iceland, 64.3% from the Greater Reykjavík area and 33.9% from rural areas. One participant did not indicate his place of residence. Self-assessment scales were used to assess depression, anxiety, task-, avoidance- and emotion-oriented coping, social support and problems relating to diabetes. Additional information was obtained from patients' records concerning the results of blood glucose measurements (HbA1c). Good social support was related to less anxiety and depression and to less self-reported problems related to having diabetes. Emotion-oriented coping was related to not feeling well and task- oriented coping to feeling better. No relationship was found between psychosocial variables and blood glucose measurements and a limited relationship between self-reported problems related to having diabetes and these measurements. Social support and coping are strongly related to measurements of depression, anxiety and problems related to having diabetes in the present age group. The results indicate that it is very important to teach and strengthen usage, as possible, of task-oriented coping instead of emotion-oriented coping. The results also indicate that social support is highly important for young adults with diabetes type 1. It is clear that friends and family have to be more involved in the treatment and also more educated about the disease and the importance of giving the right kind of support.

  18. Comparison of selected variables of gaming performance in football

    OpenAIRE

    Parachin, Jiří

    2014-01-01

    Title: Comparison of selected variables of gaming performance in football Objectives: Analysis of selected variables of gaming performance in the matches of professional Czech football teams in the Champions League and UEFA Europa League in 2013. During the observation to register set variables, then evaluate obtained results and compare them. Methods: The use of observational analysis and comparison of selected variables of gaming performance in competitive matches of professional football. ...

  19. A randomized controlled trial to compare the effects of sulphonylurea gliclazide MR (modified release) and the DPP-4 inhibitor vildagliptin on glycemic variability and control measured by continuous glucose monitoring (CGM) in Brazilian women with type 2 diabetes.

    Science.gov (United States)

    Vianna, Andre Gustavo Daher; Lacerda, Claudio Silva; Pechmann, Luciana Muniz; Polesel, Michelle Garcia; Marino, Emerson Cestari; Faria-Neto, Jose Rocha

    2018-05-01

    This study aims to evaluate whether there is a difference between the effects of vildagliptin and gliclazide MR (modified release) on glycemic variability (GV) in women with type 2 diabetes (T2DM) as evaluated by continuous glucose monitoring (CGM). An open-label, randomized study was conducted in T2DM women on steady-dose metformin monotherapy which were treated with 50 mg vildagliptin twice daily or 60-120 mg of gliclazide MR once daily. CGM and GV indices calculation were performed at baseline and after 24 weeks. In total, 42 patients (age: 61.9 ± 5.9 years, baseline glycated hemoglobin (HbA1c): 7.3 ± 0.56) were selected and 37 completed the 24-week protocol. Vildagliptin and gliclazide MR reduced GV, as measured by the mean amplitude of glycemic excursions (MAGE, p = 0.007 and 0.034, respectively). The difference between the groups did not reach statistical significance. Vildagliptin also significantly decreased the standard deviation of the mean glucose (SD) and the mean of the daily differences (MODD) (p = 0.007 and 0.030). Vildagliptin and gliclazide MR similarly reduced the MAGE in women with T2DM after 24 weeks of treatment. Further studies are required to attest differences between vildagliptin and gliclazide MR regarding glycemic variability. Copyright © 2018 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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.

  2. Glycemic index and diabetes

    Science.gov (United States)

    ... Most snack foods Potatoes White rice Watermelon Meal Planning with the Glycemic Index When planning your meals: ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  3. Islet Transplantation Provides Superior Glycemic Control With Less Hypoglycemia Compared With Continuous Subcutaneous Insulin Infusion or Multiple Daily Insulin Injections.

    Science.gov (United States)

    Holmes-Walker, Deborah Jane; Gunton, Jenny E; Hawthorne, Wayne; Payk, Marlene; Anderson, Patricia; Donath, Susan; Loudovaris, Tom; Ward, Glenn M; Kay, Thomas Wh; OʼConnell, Philip J

    2017-06-01

    The aim was to compare efficacy of multiple daily injections (MDI), continuous subcutaneous insulin infusion (CSII) and islet transplantation to reduce hypoglycemia and glycemic variability in type 1 diabetes subjects with severe hypoglycemia. This was a within-subject, paired comparison of MDI and CSII and CSII with 12 months postislet transplantation in 10 type 1 diabetes subjects referred with severe hypoglycemia, suitable for islet transplantation. Individuals were assessed with HbA1c, Edmonton Hypoglycemia Score (HYPOscore), continuous glucose monitoring (CGM) and in 8 subjects measurements of glucose variability using standard deviation of glucose (SD glucose) from CGM and continuous overlapping net glycemic action using a 4 hour interval (CONGA4). After changing from MDI to CSII before transplantation, 10 subjects reduced median HYPOscore from 2028 to 1085 (P transplantation, there were significant reductions in all baseline parameters versus CSII, respectively, HbA1c (6.4% cf 8.2%), median HYPOscore (0 cf 1085), mean glucose (7.1 cf 8.6 mmol L), SD glucose (1.7 cf 3.2 mmol/L), and CONGA4 (1.6 cf 3.0). In subjects with severe hypoglycemia suitable for islet transplantation, CSII decreased hypoglycemia frequency and glycemic variability compared with MDI whereas islet transplantation resolved hypoglycemia and further improved glycemic variability regardless of insulin independence.

  4. 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.

  5. 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.

  6. Electromyographic Comparison of Squats Using Constant or Variable Resistance.

    Science.gov (United States)

    Andersen, Vidar; Steiro Fimland, Marius; Knutson Kolnes, Maria; Jensen, Susanne; Laume, Martine; Hole Saeterbakken, Atle

    2016-12-01

    Andersen, V, Fimland, MS, Kolnes, MK, Jensen, S, Laume, M and Saeterbakken, AH. Electromyographic comparison of squats using constant or variable resistance. J Strength Cond Res 30(12): 3456-3463, 2016-The aim of the study was to compare the electromyographic (EMG) activity of vastus lateralis, vastus medialis, rectus femoris, and biceps femoris when performing the squat with constant resistance or variable resistance with 2 or 4 elastic bands, respectively, contributing with a mean of 39 and 73% of the total loads. Nineteen resistance-trained women performed 6 repetition maximum using 3 different experimental conditions: free weights (FW), free weights + 2 elastic bands (FW + 2EB), and free weights + 4 elastic bands (FW + 4EB). During analyses, each repetition was divided into 6 phases: upper (more extended knee), middle, and lower phase of the descending and ascending movements. Increased activation in the upper parts of the movement was observed for both variable resistance conditions compared with constant resistance (9-51%, p squat using free weights in combination with elastic bands seems to be preferable compared with free weights alone and more so with a high contribution from variable resistance to the total load.

  7. Comparison of appetite responses to high- and low-glycemic index postexercise meals under matched insulinemia and fiber in type 1 diabetes.

    Science.gov (United States)

    Campbell, Matthew D; Gonzalez, Javier T; Rumbold, Penny L S; Walker, Mark; Shaw, James A; Stevenson, Emma J; West, Daniel J

    2015-03-01

    Patients with type 1 diabetes face heightened risk of hypoglycemia after exercise. Subsequent overfeeding, as a preventative measure against hypoglycemia, negates the energy deficit after exercise. Patients are also required to reduce the insulin dose administered with postexercise foods to further combat hypoglycemia. However, the insulin dose is dictated solely by the carbohydrate content, even though postprandial glycemia is vastly influenced by glycemic index (GI). With a need to control the postexercise energy balance, appetite responses after meals differing in GI are of particular interest. We assessed the appetite response to low-glycemic index (LGI) and high-glycemic index (HGI) postexercise meals in type 1 diabetes patients. This assessment also offered us the opportunity to evaluate the influence of GI on appetite responses independently of insulinemia, which confounds findings in individuals without diabetes. Ten physically active men with type 1 diabetes completed 2 trials in a randomized crossover design. After 45 min of treadmill exercise at 70% of the peak oxygen uptake, participants consumed an LGI (GI ∼37) or HGI (GI ∼92) meal with a matched macronutrient composition, negligible fiber content, and standardized insulin-dose administration. The postprandial appetite response was determined for 180 min postmeal. During this time, circulating glucose, insulin, glucagon, and glucagon-like peptide-1 (GLP-1) concentrations and subjective appetite ratings were determined. The HGI meal produced an ∼60% greater postprandial glucose area under the curve (AUC) than did the LGI meal (P = 0.008). Insulin, glucagon, and GLP-1 did not significantly differ between trials (P > 0.05). The fullness AUC was ∼25% greater after the HGI meal than after the LGI meal (P < 0.001), whereas hunger sensations were ∼9% lower after the HGI meal than after the LGI meal (P = 0.001). Under conditions of matched insulinemia and fiber, an HGI postexercise meal suppresses

  8. 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.)

  9. Counting Carbs? Understanding Glycemic Index and Glycemic Load

    Science.gov (United States)

    ... compare how single servings of different foods affect blood sugar. It takes into account both the quality and quantity of carbs in a serving. . Some studies suggest that sticking to foods with a low glycemic index may help prevent ...

  10. 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 <110mg/dl. The primary endpoints were the change in HbA1c from baseline to 24weeks of treatment, as well as the standard deviation (SD) and coefficient of variation (CV) of FBG from 8 to 12weeks and from 20 to 24weeks. Secondary endpoints included the QOL evaluated by the Diabetes Therapy-Related QOL questionnaire. After 24weeks, HbA1c was decreased by 1.6% in the IDeg group and 1.7% in the IGlar at the same insulin dosage. At 24weeks, FBG was significantly lower in the IDeg group than in the IGlar group and the CV of FBG was significantly smaller in the IDeg group. The frequency of total and severe hypoglycemic episodes did not differ between the groups. In the IDeg group, QOL showed significant improvement regarding anxiety and dissatisfaction with treatment. Treatment with IDeg or IGlar achieved similar improvement in glycemic control in insulin-naïve patients with type 2 diabetes. The day-to-day variation of FBG was smaller in patients receiving IDeg. Copyright © 2017. Published by Elsevier B.V.

  11. 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.

  12. 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

    , 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......, total energy intake, BMI, and waist circumference. RESULTS - intake of lactose was positively associated with HOMA-IR (P < 0.0001), whereas daily glycemic load and intake of glucose, fructose, dietary fiber, total carbohydrate, fruit, and vegetables were inversely associated with HOMA-IR (P < 0...

  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. 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.

  15. Glycemic indices, glycemic load and glycemic response for seventeen varieties of dates grown in Saudi Arabia.

    Science.gov (United States)

    AlGeffari, Metab Ali; Almogbel, Ebtehal Solaiman; Alhomaidan, Homaidan Turki; El-Mergawi, Ragab; Barrimah, Issam Alsaed

    2016-01-01

    Dates are consumed worldwide, and are an important fruit for many individuals in Saudi Arabia. Currently, limited information is available on the glycemic indices of different date varieties. To determine the glycemic index (GI), glycemic load (GL) and glycemic response for 17 common date varieties in Saudi Arabia. Prospective clinical trial on healthy subjects. College of Medicine, Qassim University, Buraydah, Saudi Arabia. The available carbohydrate content of Tamer stage dates was determined using standard laboratory methods. Healthy subjects (ten males and nine females) received 50 g of glucose (on three separate occasions) and 50 g equivalent of available carbohydrates from the seventeen varieties of date (each once). The GI and GL were then calculated. GI, GL, and glycemic response. The mean (SEM) GI of the date samples was 55.2 (7.7) (range, 42.8-74.6). Sellaj and Maktoomi exhibited the highest GI (74.6 [10.1] and 71.0 [11.1]), respectively, whereas Shaqra, Sukkary, and Sag'ai had the lowest GI (42.8 [5.5], 43.4 [4.7] and 44.6 [6]), respectively. The GL of the date samples ranged from 8.5 to 24. Sellaj had a high GL (24), whereas Ajwah and Shaqra had a low GL (8.5 and 9.2). The analyses suggested no significant difference in GI between the date varieties. However, the GL values differed significantly between the 17 date varieties (P Saudi Arabia. The identification of date varieties with lower glycemic responses may help lower the GI of the diet of both healthy and diabetic Saudi individuals. We used dates at the Tamer stage, which may not be translatable to all types of dates.

  16. Comparison of variance estimators for metaanalysis of instrumental variable estimates

    NARCIS (Netherlands)

    Schmidt, A. F.; Hingorani, A. D.; Jefferis, B. J.; White, J.; Groenwold, R. H H; Dudbridge, F.; Ben-Shlomo, Y.; Chaturvedi, N.; Engmann, J.; Hughes, A.; Humphries, S.; Hypponen, E.; Kivimaki, M.; Kuh, D.; Kumari, M.; Menon, U.; Morris, R.; Power, C.; Price, J.; Wannamethee, G.; Whincup, P.

    2016-01-01

    Background: Mendelian randomization studies perform instrumental variable (IV) analysis using genetic IVs. Results of individual Mendelian randomization studies can be pooled through meta-analysis. We explored how different variance estimators influence the meta-analysed IV estimate. Methods: Two

  17. Comparison of the spatial and temporal variability of drought indices ...

    African Journals Online (AJOL)

    Churchill

    variability of regional water resources. Lake Chad for ... and water resources management question in drought prone regions of Africa .... implementation of contingency plans during the drought .... management (IWRM) by the Lake Chad Basin.

  18. 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.

  19. Bet-hedging response to environmental variability, an intraspecific comparison.

    Science.gov (United States)

    Nevoux, Marie; Forcada, Jaume; Barbraud, Christophe; Croxall, John; Weimerskirchi, Henri

    2010-08-01

    A major challenge in ecology is to understand the impact of increased environmental variability on populations and ecosystems. To maximize their fitness in a variable environment, life history theory states that individuals should favor a bet-hedging strategy, involving a reduction of annual breeding performance and an increase in adult survival so that reproduction can be attempted over more years. As a result, evolution toward longer life span is expected to reduce the deleterious effects of extra variability on population growth, and consequently on the trait contributing the most to it (e.g., adult survival in long-lived species). To investigate this, we compared the life histories of two Black-browed Albatross (Thalassarche melanophrys) populations breeding at South Georgia (Atlantic Ocean) and Kerguelen (Indian Ocean), the former in an environment nearly three times more variable climatically (e.g., in sea surface temperature) than the latter. As predicted, individuals from South Georgia (in the more variable environment) showed significantly higher annual adult survival (0.959, SE = 0.003) but lower annual reproductive success (0.285 chick per pair, SE = 0.039) than birds from Kerguelen (survival = 0.925, SE = 0.004; breeding success = 0.694, SE = 0.027). In both populations, climatic conditions affected the breeding success and the survival of inexperienced breeders, whereas the survival of experienced breeders was unaffected. The strength of the climatic impact on survival of inexperienced breeders was very similar between the two populations, but the effect on breeding success was positively related to environmental variability. These results provide rare and compelling evidence to support bet-hedging underlying changes in life history traits as an adaptive response to environmental variability.

  20. 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.

  1. Comparison between OpenFOAM CFD & BEM theory for variable speed – variable pitch HAWT

    Directory of Open Access Journals (Sweden)

    ElQatary Islam

    2014-01-01

    Full Text Available OpenFoam is used to compare computational fluid dynamics (CFD with blade element momentum theory (BEM for a variable speed - variable pitch HAWT (Horizontal Axis Wind Turbine. The wind turbine is first designed using the BEM to determine the blade chord, twist and operating conditions. The wind turbine blade has an outer diameter of 14 m, uses a NACA 63–415 profile for the entire blade and root to tip twist distribution of 15deg (Figure 3. The RPM varies from 20–75 for freestream velocities varying between 3–10.5 m/s (variable speed and a constant RPM of 78.78 for velocities ranging between 11–25 m/s (variable pitch. OpenFOAM is used to investigate the wind turbine performance at several operating points including cut-in wind speed (3 m/s, rated wind speed (10.5 m/s and in the variable pitch zone. Simulation results show that in the variable-speed operating range, both CFD and BEM compare reasonably well. This agreement can be attributed to the fact that the complex three-dimensional flow around the turbine blades can be split into two radial segments. For radii less than the mid-span, the flow is three-dimensional, whereas for radii greater than the mid-span, the flow is approximately two-dimensional. Since the majority of the power is produced from sections beyond the mid-span, the agreement between CFD and BEM is reasonable. For the variable-pitch operating range the CFD results and BEM deviate considerably. In this case the majority of the power is produced from the inner sections in which the flow is three-dimensional and can no longer be predicted by the BEM. The results show that differences in pitch angles up to 10deg can result to regulate the power for high wind speeds in the variable-pitch operation zone.

  2. 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.

  3. 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.

  4. 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 ...

  5. A Review of the Relationship between Dietary Glycemic Index and Glycemic Load and Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Fahime Zeinali

    2016-10-01

    Full Text Available Background: In recent decades, studies on type 2 diabetes (T2D, have adopted a new approach to the field of a more complete collection of variables related to the lifestyles and diet of people. Diet is an important factor in increasing the rate of T2D among individuals. Considering the consumption of a high-carbohydrate diet, little attention has been paid to the type of carbohydrates consumed in the incidence of T2D. The present study aimed to review the literature on the relationship between the glycemic index (GI, the glycemic load, (GL and T2D, it also targets at evaluating and comparing the results of similar studies in other countries Methods: Using search engines, including PubMed, Science Direct, Embase and Scopus, and key words such as GI, GL, diabetes; articles with cross-sectional, clinical trial, Prospective and retrospective cohort designs between 2000 to 2016 were selected. Moreover, non-English language articles were not investigate. Results: The results of these studies showed that a diet containing low GI and GL has beneficial effects on the metabolism of glucose in the body and is also considered as a factor to protect the body against T2D and its complications. Conclusions: Monitoring eating habits of people with T2D can have beneficial effects on T2D and its associated risk factors.

  6. Effect of macronutrients and fiber on postprandial glycemic responses and meal glycemic index and glycemic load value determinations123

    Science.gov (United States)

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

    2017-01-01

    Background: The potential confounding effect of different amounts and proportions of macronutrients across eating patterns on meal or dietary glycemic index (GI) and glycemic load (GL) value determinations has remained partially unaddressed. Objective: The study aimed to determine the effects of different amounts of macronutrients and fiber on measured meal GI and GL values. Design: Four studies were conducted during which participants [n = 20–22; women: 50%; age: 50–80 y; body mass index (in kg/m2): 25–30)] received food challenges containing different amounts of the variable nutrient in a random order. Added to the standard 50 g available carbohydrate from white bread was 12.5, 25, or 50 g carbohydrate; 12.5, 25, or 50 g protein; and 5.6, 11.1, or 22.2 g fat from rice cereal, tuna, and unsalted butter, respectively, and 4.8 or 9.6 g fiber from oat cereal. Arterialized venous blood was sampled for 2 h, and measured meal GI and GL and insulin index (II) values were calculated by using the incremental area under the curve (AUCi) method. Results: Adding carbohydrate to the standard white-bread challenge increased glucose AUCi (P < 0.0001), measured meal GI (P = 0.0066), and mean GL (P < 0.0001). Adding protein (50 g only) decreased glucose AUCi (P = 0.0026), measured meal GI (P = 0.0139), and meal GL (P = 0.0140). Adding fat or fiber had no significant effect on these variables. Adding carbohydrate (50 g), protein (50 g), and fat (11.1 g) increased the insulin AUCi or II; fiber had no effect. Conclusions: These data indicate that uncertainty in the determination of meal GI and GL values is introduced when carbohydrate-containing foods are consumed concurrently with protein (equal amount of carbohydrate challenge) but not with carbohydrate-, fat-, or fiber-containing foods. Future studies are needed to evaluate whether this uncertainty also influences the prediction of average dietary GI and GL values for eating patterns. This trial was registered at

  7. Effect of macronutrients and fiber on postprandial glycemic responses and meal glycemic index and glycemic load value determinations.

    Science.gov (United States)

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

    2017-04-01

    Background: The potential confounding effect of different amounts and proportions of macronutrients across eating patterns on meal or dietary glycemic index (GI) and glycemic load (GL) value determinations has remained partially unaddressed. Objective: The study aimed to determine the effects of different amounts of macronutrients and fiber on measured meal GI and GL values. Design: Four studies were conducted during which participants [ n = 20-22; women: 50%; age: 50-80 y; body mass index (in kg/m 2 ): 25-30)] received food challenges containing different amounts of the variable nutrient in a random order. Added to the standard 50 g available carbohydrate from white bread was 12.5, 25, or 50 g carbohydrate; 12.5, 25, or 50 g protein; and 5.6, 11.1, or 22.2 g fat from rice cereal, tuna, and unsalted butter, respectively, and 4.8 or 9.6 g fiber from oat cereal. Arterialized venous blood was sampled for 2 h, and measured meal GI and GL and insulin index (II) values were calculated by using the incremental area under the curve (AUC i ) method. Results: Adding carbohydrate to the standard white-bread challenge increased glucose AUC i ( P < 0.0001), measured meal GI ( P = 0.0066), and mean GL ( P < 0.0001). Adding protein (50 g only) decreased glucose AUC i ( P = 0.0026), measured meal GI ( P = 0.0139), and meal GL ( P = 0.0140). Adding fat or fiber had no significant effect on these variables. Adding carbohydrate (50 g), protein (50 g), and fat (11.1 g) increased the insulin AUC i or II; fiber had no effect. Conclusions: These data indicate that uncertainty in the determination of meal GI and GL values is introduced when carbohydrate-containing foods are consumed concurrently with protein (equal amount of carbohydrate challenge) but not with carbohydrate-, fat-, or fiber-containing foods. Future studies are needed to evaluate whether this uncertainty also influences the prediction of average dietary GI and GL values for eating patterns. This trial was registered at

  8. The Effects of Variability and Risk in Selection Utility Analysis: An Empirical Comparison.

    Science.gov (United States)

    Rich, Joseph R.; Boudreau, John W.

    1987-01-01

    Investigated utility estimate variability for the selection utility of using the Programmer Aptitude Test to select computer programmers. Comparison of Monte Carlo results to other risk assessment approaches (sensitivity analysis, break-even analysis, algebraic derivation of the distribtion) suggests that distribution information provided by Monte…

  9. 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.

  10. 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.

  11. PISA 2012 Analysis of School Variables Affecting Problem-Solving Competency: Turkey-Serbia Comparison

    Directory of Open Access Journals (Sweden)

    Emine YAVUZ

    2017-12-01

    Full Text Available According to the OECD's PISA 2012 Turkey problem-solving report, Turkey and Serbia are at the same mathematical literacy level. However, Serbia's average of problem-solving competency is said to be higher than Turkey's. In this study, school variables that affect problem-solving competency of the two countries were examined and compared. The method of the study was causal comparison method, and HLM analysis was performed on data of 4494 students from 147 schools in Turkey sample and 4059 students from 132 schools in Serbia sample separately. As a result of HLM analysis, "obstacle and family donation" variable for Serbia and "abandon, teacher morale and mathematics competition" variable for Turkey were statistically significant. Although it was found that for each countries different variables influence the problem-solving competency, it was quite remarkable that these variables are in common in that they are components of the school climate concept.

  12. 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

  13. 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.

  14. 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.

  15. 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.

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

    Science.gov (United States)

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

    2009-01-01

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

  17. Model-based analysis of postprandial glycemic response dynamics for different types of food

    Directory of Open Access Journals (Sweden)

    Yvonne J. Rozendaal

    2018-06-01

    Full Text Available Summary: Background & aims: Knowledge of postprandial glycemic response (PPGR dynamics is important in nutrition management and diabetes research, care and (selfmanagement. In daily life, food intake is the most important factor influencing the occurrence of hyperglycemia. However, the large variability in PPGR dynamics to different types of food is inadequately predicted by existing glycemic measures. The objective of this study was therefore to quantitatively describe PPGR dynamics using a systems approach. Methods: Postprandial glucose and insulin data were collected from literature for many different food products and mixed meals. The predictive value of existing measures, such as the Glycemic Index, was evaluated. A physiology-based dynamic model was used to reconstruct the full postprandial response profiles of both glucose and insulin simultaneously. Results: We collected a large range of postprandial glucose and insulin dynamics for 53 common food products and mixed meals. Currently available glycemic measures were found to be inadequate to describe the heterogeneity in postprandial dynamics. By estimating model parameters from glucose and insulin data, the physiology-based dynamic model accurately describes the measured data whilst adhering to physiological constraints. Conclusions: The physiology-based dynamic model provides a systematic framework to analyze postprandial glucose and insulin profiles. By changing parameter values the model can be adjusted to simulate impaired glucose tolerance and insulin resistance. Keywords: Postprandial glycemic response, Physiology-based dynamic model, Food intake, Computational modeling, Glucose, Insulin

  18. Utility of different glycemic control metrics for optimizing management of diabetes.

    Science.gov (United States)

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

    2015-02-15

    The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin (HbA1c). Despite its importance as an indicator for the development of diabetic complications, recent studies have revealed that this metric has some limitations; it conveys a rather complex message, which has to be taken into consideration for diabetes screening and treatment. On the basis of recent clinical trials, the relationship between HbA1c and cardiovascular outcomes in long-standing diabetes has been called into question. It becomes obvious that other surrogate and biomarkers are needed to better predict cardiovascular diabetes complications and assess efficiency of therapy. Glycated albumin, fructosamin, and 1,5-anhydroglucitol have received growing interest as alternative markers of glycemic control. In addition to measures of hyperglycemia, advanced glucose monitoring methods became available. An indispensible adjunct to HbA1c in routine diabetes care is self-monitoring of blood glucose. This monitoring method is now widely used, as it provides immediate feedback to patients on short-term changes, involving fasting, preprandial, and postprandial glucose levels. Beyond the traditional metrics, glycemic variability has been identified as a predictor of hypoglycemia, and it might also be implicated in the pathogenesis of vascular diabetes complications. Assessment of glycemic variability is thus important, but exact quantification requires frequently sampled glucose measurements. In order to optimize diabetes treatment, there is a need for both key metrics of glycemic control on a day-to-day basis and for more advanced, user-friendly monitoring methods. In addition to traditional discontinuous glucose testing, continuous glucose sensing has become a useful tool to reveal insufficient glycemic management. This new technology is particularly effective in patients with complicated diabetes and provides the opportunity to characterize

  19. 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)

  20. Effect of glycemic control on diabetic dyslipidemia

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, W [Military Hospital Rawalpindi, Rawalpindi (Pakistan); Arshad, A R [Combined Military Hospital, Lahore (Pakistan)

    2010-03-15

    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)

  1. Automatic variable selection method and a comparison for quantitative analysis in laser-induced breakdown spectroscopy

    Science.gov (United States)

    Duan, Fajie; Fu, Xiao; Jiang, Jiajia; Huang, Tingting; Ma, Ling; Zhang, Cong

    2018-05-01

    In this work, an automatic variable selection method for quantitative analysis of soil samples using laser-induced breakdown spectroscopy (LIBS) is proposed, which is based on full spectrum correction (FSC) and modified iterative predictor weighting-partial least squares (mIPW-PLS). The method features automatic selection without artificial processes. To illustrate the feasibility and effectiveness of the method, a comparison with genetic algorithm (GA) and successive projections algorithm (SPA) for different elements (copper, barium and chromium) detection in soil was implemented. The experimental results showed that all the three methods could accomplish variable selection effectively, among which FSC-mIPW-PLS required significantly shorter computation time (12 s approximately for 40,000 initial variables) than the others. Moreover, improved quantification models were got with variable selection approaches. The root mean square errors of prediction (RMSEP) of models utilizing the new method were 27.47 (copper), 37.15 (barium) and 39.70 (chromium) mg/kg, which showed comparable prediction effect with GA and SPA.

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

    OpenAIRE

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

    2011-01-01

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

  3. Comparison of the variability of apricot seedlings obtained from irradiated and non irradiated seeds of the same origin

    International Nuclear Information System (INIS)

    Legave, J.M.

    1985-01-01

    Results of experiences of low intensity gamma-ray irradiation on apricot seedlings and comparison of the variability to the variability of a control population. The characteristics studied were: flowering, fructification, growth and vegetative spreading. Favourable and unfavourable results are observed (earlier ripening time, or low fruitfulness), meanwhile, for higher intensity irradiation, only unfavourable results are obtained [fr

  4. 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

  5. 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.

  6. Relationships Between Glycemic Control and Cardiovascular Fitness.

    Science.gov (United States)

    Moxley, Elizabeth W; Smith, Donald; Quinn, Lauretta; Park, Chang

    2018-07-01

    Diabetes is a serious health problem affecting approximately 29.1 million individuals in the United States. Another 86 million have prediabetes. The development and implementation of lifestyle modifications such as physical activity for these persons are among the most effective methods for prevention and treatment. The aim of this study was to examine relationships between glycemic control (HbA1c) and cardiovascular fitness (peak maximal oxygen uptake [VO 2 peak] and ventilatory threshold [VT]) in overweight/obese subjects with and without type 2 diabetes (T2DM). In addition, the influences of body mass index (BMI) and insulin sensitivity (homeostasis model assessment [HOMA %S]) on the relationship between glycemic control and cardiovascular fitness were explored. Data were abstracted from a completed study that included 51 overweight or obese subjects with T2DM ( n = 18), impaired glucose tolerance ( n = 8), or normal glucose tolerance ( n = 25). Relationships between glycemic control (HbA1c) and cardiovascular fitness (VO 2 peak and VT) were determined using correlational analysis and multiple linear regression analyses. A statistically significant relationship was observed between HbA1c and cardiovascular fitness. However, BMI and HOMA %S did not influence the relationship between glycemic control and cardiovascular fitness. HbA1c contributes to VO 2 peak and VT in obese and overweight subjects across glucose tolerance categories. Significant results were achieved despite the fact that there was a limited range of HbA1c based on the study inclusion criteria. This finding suggests that even a mild decrease in glycemic control can negatively influence cardiovascular fitness.

  7. 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

  8. Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt

    Directory of Open Access Journals (Sweden)

    Hanaa A Mohammad

    2012-01-01

    Full Text Available Background : Type 1 diabetes mellitus (T1DM may lead to severe long-term health consequences, such as renal failure, blindness, as well as heart and cerebrovascular disease. Although a direct relationship between blood glucose control and diabetes complications remains to be established beyond doubt, most diabetologists aim to achieve the best possible glucose control in their patients with T1DM. The aim of this study was to detect the predictors of glycemic control among children with T1DM in Assiut Governorate-Egypt. Materials and Methods : We enrolled 415 children aged 2 to 18 years with type 1 diabetes of >1-year duration. They were subjected to full history including demographic factors and disease-related factors. Examination was done with determination of the body mass index, and assessment of stage of maturity. Investigations included hemoglobin A1c (HbA1c and lipid profile. Patients with HbA1c above the recommended values for age by the American Diabetes Association were considered as poor glycemic control group. Results : Of the studied cases, 190 cases (45.8% were of poor glycemic control. Patients with poor control had significantly higher mean age (16.83 ± 3.3 vs 9.77 ± 3.7, P<0.000. Girls aged 15 years or more had significantly higher prevalence of poor glycemic control than males of the same age group. As regard the disease-related factors, patients with poor control had significantly longer duration of disease (7.94 ± 2.6 vs 2.40 ± 2.0, P<0.000 and were older in age at onset of disease. Insulin regimen which consists of basal bolus insulin plus three injections of regular insulin was associated with more frequency of good glycemic control than other regimens. Patients with poor control had significantly higher mean of cholesterol, triglyceride (TG, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol than patients with good control. Adjusting for other variables, age of the patients, duration of

  9. Alignment-free Transcriptomic and Metatranscriptomic Comparison Using Sequencing Signatures with Variable Length Markov Chains.

    Science.gov (United States)

    Liao, Weinan; Ren, Jie; Wang, Kun; Wang, Shun; Zeng, Feng; Wang, Ying; Sun, Fengzhu

    2016-11-23

    The comparison between microbial sequencing data is critical to understand the dynamics of microbial communities. The alignment-based tools analyzing metagenomic datasets require reference sequences and read alignments. The available alignment-free dissimilarity approaches model the background sequences with Fixed Order Markov Chain (FOMC) yielding promising results for the comparison of microbial communities. However, in FOMC, the number of parameters grows exponentially with the increase of the order of Markov Chain (MC). Under a fixed high order of MC, the parameters might not be accurately estimated owing to the limitation of sequencing depth. In our study, we investigate an alternative to FOMC to model background sequences with the data-driven Variable Length Markov Chain (VLMC) in metatranscriptomic data. The VLMC originally designed for long sequences was extended to apply to high-throughput sequencing reads and the strategies to estimate the corresponding parameters were developed. The flexible number of parameters in VLMC avoids estimating the vast number of parameters of high-order MC under limited sequencing depth. Different from the manual selection in FOMC, VLMC determines the MC order adaptively. Several beta diversity measures based on VLMC were applied to compare the bacterial RNA-Seq and metatranscriptomic datasets. Experiments show that VLMC outperforms FOMC to model the background sequences in transcriptomic and metatranscriptomic samples. A software pipeline is available at https://d2vlmc.codeplex.com.

  10. A Prospective Comparison Study of Heart Rate Variability During Menses in Young Women With Dysmenorrhea.

    Science.gov (United States)

    Wang, Yu-Jen; Wang, Yi-Zen; Yeh, Mei-Ling

    2016-07-01

    Numerous studies have demonstrated autonomic abnormalities in various pain conditions. However, few have investigated heart rate variability (HRV) in young women with primary dysmenorrhea, and the conclusions have been inconsistent. More evidence is required to confirm the reported trend for consistent fluctuation of HRV parameters in dysmenorrhea. The study's aim was to determine whether significant differences exist between young women with and without dysmenorrhea for heart rate (HR), blood pressure (BP), and HRV parameters during menses. A prospective comparison design with repeated measures was used. Sixty-six women aged 18-25 with dysmenorrhea and 54 eumenorrheic women were recruited from a university in northern Taiwan. High-frequency and low-frequency HRV parameters (HF and LF), LF/HF ratio, BP, and HR were measured daily between 8 p.m. and 10 p.m. from Day 1 to Day 6 during menses. The generalized estimating equation was used to analyze the effects of group, time, and Group × Time interaction on these variables. HF values were significantly lower in the dysmenorrhea than in the eumenorrhea group, but there were no differences in BP, HR, LF, or LF/HF ratio. Reduced HF values reflect reduced parasympathetic activity and autonomic instability in young women with dysmenorrhea. Future longitudinal studies are warranted to examine autonomic regulation in menstrual pain of varying intensities associated with dysmenorrhea-related symptoms and to clarify the causal relationship between dysmenorrhea and HRV fluctuations. © The Author(s) 2016.

  11. Association between Social Relationship and Glycemic Control among Older Japanese: JAGES Cross-Sectional Study

    Science.gov (United States)

    Kawachi, Ichiro; Kondo, Katsunori; Kondo, Naoki; Nagamine, Yuiko; Tani, Yukako; Shirai, Kokoro; Tazuma, Susumu

    2017-01-01

    Aim The present study examined whether social support, informal socializing and social participation are associated with glycemic control in older people. Methods Data for this population-based cross-sectional study was obtained from the Japan Gerontological Evaluation Study (JAGES) 2010 linked to the annual health check-up data in Japan. We analyzed 9,554 individuals aged ≥65 years without the certification of needed long-term care. Multivariate logistic regression models were used to assess the effect of social support, informal socializing and social participations on glycemic control. The outcome measure was HbA1c ≥8.4%. Results 1.3% of the participants had a level of HbA1c over 8.4%. Better glycemic control was significantly associated with meeting with friends one to four times per month (odds ratio [OR] 0.51, 95% confidence interval [CI]0.30–0.89, compared to meeting with friends a few times per year or less) and participation in sports groups (OR 0.50, 95% CI 0.26–0.97) even after adjusting for other variables. Meeting with friends more than twice per week, receiving social support, and being married were not associated with better control of diabetes. Conclusions Meeting with friends occasionally is associated with better glycemic control among older people. PMID:28060887

  12. Association between Social Relationship and Glycemic Control among Older Japanese: JAGES Cross-Sectional Study.

    Science.gov (United States)

    Yokobayashi, Kenichi; Kawachi, Ichiro; Kondo, Katsunori; Kondo, Naoki; Nagamine, Yuiko; Tani, Yukako; Shirai, Kokoro; Tazuma, Susumu

    2017-01-01

    The present study examined whether social support, informal socializing and social participation are associated with glycemic control in older people. Data for this population-based cross-sectional study was obtained from the Japan Gerontological Evaluation Study (JAGES) 2010 linked to the annual health check-up data in Japan. We analyzed 9,554 individuals aged ≥65 years without the certification of needed long-term care. Multivariate logistic regression models were used to assess the effect of social support, informal socializing and social participations on glycemic control. The outcome measure was HbA1c ≥8.4%. 1.3% of the participants had a level of HbA1c over 8.4%. Better glycemic control was significantly associated with meeting with friends one to four times per month (odds ratio [OR] 0.51, 95% confidence interval [CI]0.30-0.89, compared to meeting with friends a few times per year or less) and participation in sports groups (OR 0.50, 95% CI 0.26-0.97) even after adjusting for other variables. Meeting with friends more than twice per week, receiving social support, and being married were not associated with better control of diabetes. Meeting with friends occasionally is associated with better glycemic control among older people.

  13. 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.

  14. Antithyroid Therapy Improves Glycemic Control in Hyperthyroid Type 1 Diabetes Mellitus Patients

    Directory of Open Access Journals (Sweden)

    Vlad Mihaela

    2015-12-01

    Full Text Available Background and aims. Thyroid disorders are more frequently met in patients with diabetes mellitus than in general population. Thyroid hormones increase glycemia by several mechanisms, but the effect of antithyroid treatment on glucose control in type 1 diabetes mellitus (T1DM cases is not well studied. The aim of our work was to analyze the evolution of glycemic control of T1DM patients submitted to specific therapy when hyperthyroidism was diagnosed. Material and method. The study group comprised by 37 patients, 35 women (94.6% and 2 men (5.4%, known as having T1DM and diagnosed with hyperthyroidism during a 10-years interval. They were treated with antithyroid medication and reassessed after 6 months regarding thyroid function and glycemic control. Results. In the whole group, there was a significant decrease in mean HbA1c level (with 0.41% and a significant increase in the percentage of patients being in the glycemic target (from 10.8% to 35.1%. The better glycemic control was obtained with a lower mean insulin dose. Patients who became euthyroid had a better evolution regarding glucose control in comparison to those who remained hyperthyroid. Changes in other cardiovascular risk factors were noted: systolic blood pressure decreased; diastolic blood pressure, HDL cholesterol, LDL cholesterol, non-HDL cholesterol, triglycerides and body weight increased. TSH and HbA1c values were inversely correlated. Conclusions. The therapeutic control of excessive thyroid function significantly contributes to the improvement of glycemic control in patients with T1DM and induces changes in the cardiovascular risk factors profile.

  15. 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.

  16. 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.

  17. Studies on the glycemic response of wheat at various level of ...

    African Journals Online (AJOL)

    CLEMENT O BEWAJI

    estimating the glycemic index of various processing effect subjected to wheat ... Over-consumption of milled cereals is sometimes blamed for obesity ... Glycemic index (GI) is a measure of the glycemic effect of carbohydrate in a particular food,.

  18. On Thermally Interacting Multiple Boreholes with Variable Heating Strength: Comparison between Analytical and Numerical Approaches

    Directory of Open Access Journals (Sweden)

    Marc A. Rosen

    2012-08-01

    Full Text Available The temperature response in the soil surrounding multiple boreholes is evaluated analytically and numerically. The assumption of constant heat flux along the borehole wall is examined by coupling the problem to the heat transfer problem inside the borehole and presenting a model with variable heat flux along the borehole length. In the analytical approach, a line source of heat with a finite length is used to model the conduction of heat in the soil surrounding the boreholes. In the numerical method, a finite volume method in a three dimensional meshed domain is used. In order to determine the heat flux boundary condition, the analytical quasi-three-dimensional solution to the heat transfer problem of the U-tube configuration inside the borehole is used. This solution takes into account the variation in heating strength along the borehole length due to the temperature variation of the fluid running in the U-tube. Thus, critical depths at which thermal interaction occurs can be determined. Finally, in order to examine the validity of the numerical method, a comparison is made with the results of line source method.

  19. Blood glucose monitoring and glycemic control in adolescents with type 1 diabetes: meter downloads versus self-report.

    Science.gov (United States)

    Guilfoyle, Shanna M; Crimmins, Nancy A; Hood, Korey K

    2011-09-01

    Reported frequencies of blood glucose monitoring (BGM) by both adolescents and their caregivers serve as adherence proxies when meter downloads are not available. Yet, correlates of reported BGM frequencies and their predictive utility are understudied. To identify sociodemographic, psychological, and disease-specific correlates of reported BGM frequencies in adolescents with type 1 diabetes and to explore the predictive utility of BGM indices on glycemic control. Study participants included caregivers and adolescents with type 1 diabetes (N=143, 13-18 yr) receiving diabetes treatment at a tertiary care setting. At the initial visit, adolescents and caregivers reported on daily BGM frequencies. A sub-sample provided meter downloads. Adolescents also completed a depression inventory. Three months later, adolescents provided blood sampling for A1c assessment. Multivariate general linear modeling identified that older adolescent age and more depressive symptoms were associated with reports of less frequent BGM. Two stepwise multivariate regression models examined the predictive utility of BGM indices (i.e., adolescent-reported BGM, caregiver-reported BGM, meter download) on glycemic control. Caregiver-reported BGM frequency predicted glycemic control in the absence of meter download data (pmeter download data were the most robust predictor of glycemic control (pMeter downloads have the most robust association with glycemic control when contextual variables are considered. Caregiver-reported BGM frequencies can serve as reliable substitutes in the absence of meter download, but they may not be as reliable in adolescents with depressive symptoms. © 2011 John Wiley & Sons A/S.

  20. Clinical Implications of Glucose Variability: Chronic Complications of Diabetes

    Directory of Open Access Journals (Sweden)

    Hye Seung Jung

    2015-06-01

    Full Text Available Glucose variability has been identified as a potential risk factor for diabetic complications; oxidative stress is widely regarded as the mechanism by which glycemic variability induces diabetic complications. However, there remains no generally accepted gold standard for assessing glucose variability. Representative indices for measuring intraday variability include calculation of the standard deviation along with the mean amplitude of glycemic excursions (MAGE. MAGE is used to measure major intraday excursions and is easily measured using continuous glucose monitoring systems. Despite a lack of randomized controlled trials, recent clinical data suggest that long-term glycemic variability, as determined by variability in hemoglobin A1c, may contribute to the development of microvascular complications. Intraday glycemic variability is also suggested to accelerate coronary artery disease in high-risk patients.

  1. Initial sociometric impressions of attention-deficit hyperactivity disorder and comparison boys: predictions from social behaviors and from nonbehavioral variables.

    Science.gov (United States)

    Erhardt, Drew; Hinshaw, Stephen P

    1994-08-01

    This study systematically compared the influence of naturalistic social behaviors and nonbehavioral variables on the development of peer status in 49 previously unfamiliar boys, aged 6-12 years, who attended a summer research program. Twenty-five boys with attention-deficit hyperactivity disorder (ADHD) and 24 comparison boys participated. Physical attractiveness, motor competence, intelligence, and academic achievement constituted the nonbehavioral variables; social behaviors included noncompliance, aggression, prosocial actions, and isolation, measured by live observations of classroom and playground interactions. As early as the first day of interaction, ADHD and comparison boys displayed clear differences in social behaviors, and the ADHD youngsters were overwhelmingly rejected. Whereas prosocial behavior independently predicted friendship ratings during the first week, the magnitude of prediction was small. In contrast, the boys' aggression (or noncompliance) strongly predicted negative nominations, even with nonbehavioral factors, group status (ADHD versus comparison), and other social behaviors controlled statistically. Implications for understanding and remediating negative peer reputations are discussed.

  2. 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

  3. 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.

  4. Comparison of foE and M(3000)F2 variability at Ibadan, Singapore and Slough

    Science.gov (United States)

    Somoye, E. O.; Onori, E. O.; Akala, A. O.

    2013-01-01

    The variability, VR, of critical frequency of E-layer, foE, and ionospheric propagation factor, M(3000)F2 at Ibadan (7.4°N, 3.9°E, 6°S dip) is investigated for local time, seasonal and solar cycle variations. Latitudinal influence of these characteristics is sought by comparison with foE VR and M(3000)F2 VR of Slough ( 51.5°N, 359.4°E, 66.5°N dip) in the European sector, and Singapore (1.3°N,103.8°E, 17.6°S dip) in the Asian sector. While the pattern of foE VR is similar to those of other F2 characteristics with characteristic peaks around dawn and dusk, M(3000)F2 VR shows no clear diurnal trend.A lower bound of foE VR is usually 3% while the maximum VR ranges between 8% and13% at post-sunrise and pre-sunset hours at all the epochs, M(3000)F2 VR is however lower during MSA (about 9%) than during LSA and HSA when it is 4% to about 12-14%. Generally, daytime M(3000)F2 VR is greater than that of foE VR by between 5% and 10%. Furthermore, no latitudinal difference is observed in both characteristics during both HSA and MSA. While nighttime M(3000)F2 VR is about half that of nighttime foF2 VR (the critical frequency of F2-layer ) VR, daytime VR of both characteristics are about equal during the three epochs at Ibadan. For Slough, nighttime M(3000)F2 VR and nighttime foF2 VR as well as the daytime VR of both characteristics are about equal. This difference is most likely due to latitudinal effect.

  5. 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 ...

  6. [Glycemic targets and cardiovascular morbi-mortality].

    Science.gov (United States)

    Bordier, Lyse; Bauduceau, Bernard

    2013-05-01

    The 2008-year was full of learning experience and suspense in diabetologia. The past studies, UKPDS in type 2 diabetic patients and DCCT in type 1 diabetic patients have shown that intensive treatment during a short period did reduce the incidence of microvascular events and in the long term, the incidence of macrovascular events linked to diabetes. The conclusions of recent studies quote, from ACCORD, an increased mortality in the type 2 diabetic patients using intensive therapy, from ADVANCE, a reduction of microvascular complications and from VADT, no effect. The analysis of studies published since 2008 brings lessons for the clinical practice: presence of glycemic memory, absence of tensional memory, usefulness of control of every cardiovascular risk factors, need of early treatment of diabetes. Moreover, to define HbA1c objective, age, duration of diabetes, presence of cardiovascular risk factors, former HbA1c level and potential undesirable effects, such hypoglycaemia, must be considered. The management of type 2 diabetic patients requires an early, not to quick intensive treatment, which avoids hypoglycaemia and is combined with a strict control of cardiovascular risk factors. So, the recent position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) consideres needs and preferences of each patient and individualizes glycemic targets and treatments. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  7. 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.

  8. 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.

  9. The Fallacy of Average: How Using HbA1c Alone to Assess Glycemic Control Can Be Misleading.

    Science.gov (United States)

    Beck, Roy W; Connor, Crystal G; Mullen, Deborah M; Wesley, David M; Bergenstal, Richard M

    2017-08-01

    HbA 1c is a v aluable metric for comparing treatment groups in a randomized trial, for assessing glycemic trends in a population over time, or for cross-sectional comparisons of glycemic control in different populations. However, what is not widely appreciated is that HbA 1c may not be a good indicator of an individual patient's glycemic control because of the wide range of mean glucose concentrations and glucose profiles that can be associated with a given HbA 1c level. To illustrate this point, we plotted mean glucose measured with continuous glucose monitoring (CGM) versus central laboratory-measured HbA 1c in 387 participants in three randomized trials, showing that not infrequently HbA 1c may underestimate or overestimate mean glucose, sometimes substantially. Thus, if HbA 1c is to be used to assess glycemic control, it is imperative to know the patient's actual mean glucose to understand how well HbA 1c is an indicator of the patient's glycemic control. With knowledge of the mean glucose, an estimated HbA 1c (eA1C) can be calculated with the formula provided in this article to compare with the measured HbA 1c . Estimating glycemic control from HbA 1c alone is in essence applying a population average to an individual, which can be misleading. Thus, a patient's CGM glucose profile has considerable value for optimizing his or her diabetes management. In this era of personalized, precision medicine, there are few better examples with respect to the fallacy of applying a population average to a specific patient rather than using specific information about the patient to determine the optimal approach to treatment. © 2017 by the American Diabetes Association.

  10. 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

    . The aim of the metabolomics study was to investigate the metabolic profile in pigs fed various cereal fractions with special attention to the metabolism of lignans using LC-MS based metabolomic approach. References 1. Lê Cao KA, Rossouw D, Robert-Granié C, Besse P: A Sparse PLS for Variable Selection when...... integrated approach. Due to the high number of variables in data sets (both raw data and after peak picking) the selection of important variables in an explorative analysis is difficult, especially when different data sets of metabolomics data need to be related. Variable selection (or removal of irrelevant...... different strategies for variable selection on PLSR method were considered and compared with respect to selected subset of variables and the possibility for biological validation. Sparse PLSR [1] as well as PLSR with Jack-knifing [2] was applied to data in order to achieve variable selection prior...

  11. The effect of ginger (Zingiber officinale) on glycemic markers in patients with type 2 diabetes.

    Science.gov (United States)

    Shidfar, Farzad; Rajab, Asadollah; Rahideh, Tayebeh; Khandouzi, Nafiseh; Hosseini, Sharieh; Shidfar, Shahrzad

    2015-06-01

    Ginger (Zingiber officinale) is one of the functional foods which contains biological compounds including gingerol, shogaol, paradol and zingerone. Ginger has been proposed to have anti-cancer, anti-thrombotic, anti-inflammatory, anti-arthritic, hypolipidemic and analgesic properties. Here, we report the effect of ginger supplementation on glycemic indices in Iranian patients with type 2 diabetes. A double-blind, placebo-controlled, randomized clinical trial was conducted on 20-60 -year-old patients with type 2 diabetes who did not receive insulin. Participants in the intervention and control groups were received 3 g of powdered ginger or placebo (lactose) (in capsules) daily for 3 months. Glycemic indices, total antioxidant capacity (TAC), malondialdehyde (MDA), C-reactive protein (CRP), serum paraoxonase, dietary intake and physical activity were measured at the beginning and end of the study, and after 12 h fasting. Comparison of the indices after 3 months showed that the differences between the ginger and placebo groups were statistically significant as follows: serum glucose (-19.41 ± 18.83 vs. 1.63 ± 4.28 mg/dL, p ginger improved glycemic indices, TAC and PON-1 activity in patients with type 2 diabetes.

  12. 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.

  13. 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

    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 PL...

  14. 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

  15. COMPARISON OF EXPERIMENTAL-DESIGNS COMBINING PROCESS AND MIXTURE VARIABLES .1. DESIGN CONSTRUCTION AND THEORETICAL EVALUATION

    NARCIS (Netherlands)

    DUINEVELD, CAA; SMILDE, AK; DOORNBOS, DA

    The combination of process variables and mixture variables in experimental design is a problem which has not yet been solved. It is examined here whether a set of designs can be found which can be used for a series of models of reasonable complexity. The proposed designs are compared with known

  16. COMPARISON OF EXPERIMENTAL-DESIGNS COMBINING PROCESS AND MIXTURE VARIABLES .1. DESIGN CONSTRUCTION AND THEORETICAL EVALUATION

    NARCIS (Netherlands)

    DUINEVELD, C. A. A.; Smilde, A. K.; Doornbos, D. A.

    1993-01-01

    The combination of process variables and mixture variables in experimental design is a problem which has not yet been solved. It is examined here whether a set of designs can be found which can be used for a series of models of reasonable complexity. The proposed designs are compared with known

  17. 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

  18. 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.

  19. 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)

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

    Energy Technology Data Exchange (ETDEWEB)

    Parvez, A; Ihsanullah,; Rafiq, A; Ahmad, N; Khan, E H [Khyber Teaching Hospital, Peshawar (Pakistan). Department of Pathology

    2010-04-15

    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)

  1. Parametric methods outperformed non-parametric methods in comparisons of discrete numerical variables

    Directory of Open Access Journals (Sweden)

    Sandvik Leiv

    2011-04-01

    Full Text Available Abstract Background The number of events per individual is a widely reported variable in medical research papers. Such variables are the most common representation of the general variable type called discrete numerical. There is currently no consensus on how to compare and present such variables, and recommendations are lacking. The objective of this paper is to present recommendations for analysis and presentation of results for discrete numerical variables. Methods Two simulation studies were used to investigate the performance of hypothesis tests and confidence interval methods for variables with outcomes {0, 1, 2}, {0, 1, 2, 3}, {0, 1, 2, 3, 4}, and {0, 1, 2, 3, 4, 5}, using the difference between the means as an effect measure. Results The Welch U test (the T test with adjustment for unequal variances and its associated confidence interval performed well for almost all situations considered. The Brunner-Munzel test also performed well, except for small sample sizes (10 in each group. The ordinary T test, the Wilcoxon-Mann-Whitney test, the percentile bootstrap interval, and the bootstrap-t interval did not perform satisfactorily. Conclusions The difference between the means is an appropriate effect measure for comparing two independent discrete numerical variables that has both lower and upper bounds. To analyze this problem, we encourage more frequent use of parametric hypothesis tests and confidence intervals.

  2. 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...

  3. 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

  4. Intraindividual variability as a marker of neurological dysfunction: a comparison of Alzheimer's disease and Parkinson's disease.

    Science.gov (United States)

    Burton, Catherine L; Strauss, Esther; Hultsch, David F; Moll, Alex; Hunter, Michael A

    2006-01-01

    Individuals with certain neurological conditions may demonstrate greater inconsistency (i.e., intraindividual variability) on cognitive tasks compared to healthy controls. Several researchers have suggested that intraindividual variability may be a behavioral marker of compromised neurobiological mechanisms associated with aging, disease, or injury. The present study sought to investigate whether intraindividual variability is associated with general nervous system compromise, or rather, with certain types of neurological disturbances by comparing healthy adults, adults with Alzheimer's disease (AD), and Parkinson's disease (PD). Participants were assessed on four separate occasions using measures of reaction time and memory. Results indicated that inconsistency was correlated with indices of severity of impairment suggesting a dose-response relationship between cognitive disturbance and intraindividual variability: the more severe the cognitive disturbance, the greater the inconsistency. However, participants with AD were more inconsistent than those with PD, with both groups being more variable than the healthy group, even when controlling for group differences in overall severity of cognitive impairment or cognitive decline. Consequently, intraindividual variability may index both the severity of cognitive impairment and the nature of the neurological disturbance.

  5. Transcriptome profiling from adipose tissue during a low-calorie diet reveals predictors of weight and glycemic outcomes in obese, nondiabetic subjects

    DEFF Research Database (Denmark)

    Armenise, Claudia; Lefebvre, Gregory C; Carayol, Jérôme

    2017-01-01

    and glycemic outcomes both at LCD termination and 6 mo after the LCD.Design: Using RNA sequencing (RNAseq), we analyzed transcriptome changes in AT from 191 obese, nondiabetic patients within a multicenter, controlled dietary intervention. Expression changes were associated with outcomes after an 8-wk LCD (800......-1000 kcal/d) and 6 mo after the LCD. Results were validated by using quantitative reverse transcriptase-polymerase chain reaction in 350 subjects from the same cohort. Statistical models were constructed to classify weight maintainers or glycemic improvers.Results: With RNAseq analyses, we identified 1173...... expression combined with clinical variables enabled us to distinguish weight and glycemic responders from nonresponders. These potential biomarkers may help clinicians understand intersubject variability and better predict the success of dietary interventions. This trial was registered at clinicaltrials...

  6. Quantifying direct effects of social determinants of health on glycemic control in adults with type 2 diabetes.

    Science.gov (United States)

    Walker, Rebekah J; Gebregziabher, Mulugeta; Martin-Harris, Bonnie; Egede, Leonard E

    2015-02-01

    The aim of this study was to investigate if self-care is the pathway through which social determinants of health impact diabetes outcomes by analyzing the direct and indirect effects of socioeconomic and psychosocial factors on self-care and glycemic control. Six hundred fifteen adults were recruited from two primary care clinics in the southeastern United States. A series of confirmatory factor analyses identified the latent factors underlying social status, psychosocial determinants (psychological distress, self-efficacy, and social support), and self-care (diet, exercise, foot care, glucose testing, and medication adherence). Structured equation modeling investigated the relationship among social determinants, self-care and glycemic control. Latent variables were created for diabetes self-care, psychological distress, self-efficacy, social support, and social status. The final model [χ(2)(275)=450.07, Psocial support (r=0.14, P=0.01), and higher self-efficacy (r=0.47, Psocial support (r=0.10, P=0.02), and higher self-efficacy (r=-0.37, Psocial determinants of health variables were included in the model, self-care was no longer significantly associated with glycemic control (r=0.01, P=0.83). This study suggests a direct relationship between psychosocial determinants of health and glycemic control. Although associated with self-care, the relationship between social determinants of health and glycemic control is not mediated by self-care. Development of interventions should take psychosocial factors into account as independent influences on diabetes outcomes, rather than as indirect influences via self-care behavior.

  7. Brewer's Yeast Improves Glycemic Indices in Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Hosseinzadeh, Payam; Javanbakht, Mohammad Hassan; Mostafavi, Seyed-Ali; Djalali, Mahmoud; Derakhshanian, Hoda; Hajianfar, Hossein; Bahonar, Ahmad; Djazayery, Abolghassem

    2013-10-01

    Brewer's yeast may have beneficial effects on insulin receptors because of itsglucose tolerance factor in diabetic patients. This study was conducted to investigate the effects of brewer's yeast supplementation on glycemic indices in patients with type 2 diabetes mellitus. In a randomized double-blind controlled clinical trial, 84 adults (21 men and 63 women) aged 46.3 ± 6.1 years old with type 2 diabetes mellitus were recruited and divided randomly into two groups: Supplement group receiving brewer's yeast (six 300mg tablets/day, total 1800 mg) and control group receiving placebo (six 300mg tablets/day) for 12 weeks. Body weight, height, body mass index, food consumption (based on 24h food record), fasting blood sugar (FBS), glycosylated hemoglobin, insulin sensitivity, and insulin resistance were measured before and after the intervention. Data analysis was performed using the Statistical Package for Social Sciences (version 18.0). The changes in FBS, glycosylated hemoglobin, and insulin sensitivity were significantly different between the two groups during the study (respectively P brewer›s yeast besides the usual treatment of diabetes can ameliorate blood glucose variables in type 2 diabetes mellitus.

  8. Postural hypotension in type 1 diabetes: The influence of glycemic ...

    African Journals Online (AJOL)

    2013-06-04

    saharan ... Key words: Diabetes mellitus, duration, glycemic control, postural hypotension. Date of ... or older) provided informed consent before enrolment in the study. .... asymptomatic despite significant falls in blood pressure.[26].

  9. 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 ( ham traits. Overall, traits associated with carcass fatness, including

  10. Comparison of climate envelope models developed using expert-selected variables versus statistical selection

    Science.gov (United States)

    Brandt, Laura A.; Benscoter, Allison; Harvey, Rebecca G.; Speroterra, Carolina; Bucklin, David N.; Romañach, Stephanie; Watling, James I.; Mazzotti, Frank J.

    2017-01-01

    Climate envelope models are widely used to describe potential future distribution of species under different climate change scenarios. It is broadly recognized that there are both strengths and limitations to using climate envelope models and that outcomes are sensitive to initial assumptions, inputs, and modeling methods Selection of predictor variables, a central step in modeling, is one of the areas where different techniques can yield varying results. Selection of climate variables to use as predictors is often done using statistical approaches that develop correlations between occurrences and climate data. These approaches have received criticism in that they rely on the statistical properties of the data rather than directly incorporating biological information about species responses to temperature and precipitation. We evaluated and compared models and prediction maps for 15 threatened or endangered species in Florida based on two variable selection techniques: expert opinion and a statistical method. We compared model performance between these two approaches for contemporary predictions, and the spatial correlation, spatial overlap and area predicted for contemporary and future climate predictions. In general, experts identified more variables as being important than the statistical method and there was low overlap in the variable sets (0.9 for area under the curve (AUC) and >0.7 for true skill statistic (TSS). Spatial overlap, which compares the spatial configuration between maps constructed using the different variable selection techniques, was only moderate overall (about 60%), with a great deal of variability across species. Difference in spatial overlap was even greater under future climate projections, indicating additional divergence of model outputs from different variable selection techniques. Our work is in agreement with other studies which have found that for broad-scale species distribution modeling, using statistical methods of variable

  11. Area vs. density: influence of visual variables and cardinality knowledge in early number comparison.

    Science.gov (United States)

    Abreu-Mendoza, Roberto A; Soto-Alba, Elia E; Arias-Trejo, Natalia

    2013-01-01

    Current research in the number development field has focused in individual differences regarding the acuity of children's approximate number system (ANS). The most common task to evaluate children's acuity is through non-symbolic numerical comparison. Efforts have been made to prevent children from using perceptual cues by controlling the visual properties of the stimuli (e.g., density, contour length, and area); nevertheless, researchers have used these visual controls interchangeably. Studies have also tried to understand the relation between children's cardinality knowledge and their performance in a number comparison task; divergent results may in fact be rooted in the use of different visual controls. The main goal of the present study is to explore how the usage of different visual controls (density, total filled area, and correlated and anti-correlated area) affects children's performance in a number comparison task, and its relationship to children's cardinality knowledge. For that purpose, 77 preschoolers participated in three tasks: (1) counting list elicitation to test whether children could recite the counting list up to ten, (2) give a number to evaluate children's cardinality knowledge, and (3) number comparison to evaluate their ability to compare two quantities. During this last task, children were asked to point at the set with more geometric figures when two sets were displayed on a screen. Children were exposed only to one of the three visual controls. Results showed that overall, children performed above chance in the number comparison task; nonetheless, density was the easiest control, while correlated and anti-correlated area was the most difficult in most cases. Only total filled area was sensitive to discriminate cardinal principal knowers from non-cardinal principal knowers. How this finding helps to explain conflicting evidence from previous research, and how the present outcome relates to children's number word knowledge is discussed.

  12. 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)

  13. 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.

  14. 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....

  15. 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.

  16. Collinear Latent Variables in Multilevel Confirmatory Factor Analysis : A Comparison of Maximum Likelihood and Bayesian Estimation

    NARCIS (Netherlands)

    Can, Seda; van de Schoot, Rens|info:eu-repo/dai/nl/304833207; Hox, Joop|info:eu-repo/dai/nl/073351431

    2015-01-01

    Because variables may be correlated in the social and behavioral sciences, multicollinearity might be problematic. This study investigates the effect of collinearity manipulated in within and between levels of a two-level confirmatory factor analysis by Monte Carlo simulation. Furthermore, the

  17. COMPARISON OF KEPLER PHOTOMETRIC VARIABILITY WITH THE SUN ON DIFFERENT TIMESCALES

    International Nuclear Information System (INIS)

    Basri, Gibor; Walkowicz, Lucianne M.; Reiners, Ansgar

    2013-01-01

    We utilize Kepler data to study the precision differential photometric variability of solar-type and cooler stars at different timescales, ranging from half an hour to three months. We define a diagnostic that characterizes the median differential intensity change between data bins of a given timescale. We apply the same diagnostics to Solar and Heliospheric Observatory data that has been rendered comparable to Kepler. The Sun exhibits similar photometric variability on all timescales as comparable solar-type stars in the Kepler field. The previously defined photometric ''range'' serves as our activity proxy (driven by starspot coverage). We revisit the fraction of comparable stars in the Kepler field that are more active than the Sun. The exact active fraction depends on what is meant by ''more active than the Sun'' and on the magnitude limit of the sample of stars considered. This active fraction is between a quarter and a third (depending on the timescale). We argue that a reliable result requires timescales of half a day or longer and stars brighter than M Kep of 14, otherwise non-stellar noise distorts it. We also analyze main sequence stars grouped by temperature from 6500 to 3500 K. As one moves to cooler stars, the active fraction of stars becomes steadily larger (greater than 90% for early M dwarfs). The Sun is a good photometric model at all timescales for those cooler stars that have long-term variability within the span of solar variability.

  18. COMPARISON OF EXPERIMENTAL-DESIGNS COMBINING PROCESS AND MIXTURE VARIABLES .2. DESIGN EVALUATION ON MEASURED DATA

    NARCIS (Netherlands)

    DUINEVELD, C. A. A.; Smilde, A. K.; Doornbos, D. A.

    1993-01-01

    The construction of a small experimental design for a combination of process and mixture variables is a problem which has not been solved completely by now. In a previous paper we evaluated some designs with theoretical measures. This second paper evaluates the capabilities of the best of these

  19. COMPARISON OF EXPERIMENTAL-DESIGNS COMBINING PROCESS AND MIXTURE VARIABLES .2. DESIGN EVALUATION ON MEASURED DATA

    NARCIS (Netherlands)

    DUINEVELD, CAA; SMILDE, AK; DOORNBOS, DA

    The construction of a small experimental design for a combination of process and mixture variables is a problem which has not been solved completely by now. In a previous paper we evaluated some designs with theoretical measures. This second paper evaluates the capabilities of the best of these

  20. 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.)

  1. Accuracy of Continuous Glucose Monitoring Measurements in Normo-Glycemic Individuals

    DEFF Research Database (Denmark)

    Akintola, Abimbola A; Noordam, Raymond; Jansen, Steffy W

    2015-01-01

    a 24-hour period. Validity of CGM-derived individual glucose measurements, calculated measures of glycemia over daytime (09:00h-23:00h) and nighttime (23:00h-09:00h), and calculated measures of glycemic variability (e.g. 24h standard deviation [SD]) were assessed by Pearson correlation coefficients......, mean absolute relative difference (MARD) and paired t-tests. RESULTS: The median correlation coefficient between CGM and venous glucose measurements per participant was 0.68 (interquartile range: 0.40-0.78), and the MARD was 17.6% (SD = 17%). Compared with venous sampling, the calculated measure...

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Comparison of spontaneous vs. metronome-guided breathing on assessment of vagal modulation using RR variability.

    Science.gov (United States)

    Bloomfield, D M; Magnano, A; Bigger, J T; Rivadeneira, H; Parides, M; Steinman, R C

    2001-03-01

    R-R interval variability (RR variability) is increasingly being used as an index of autonomic activity. High-frequency (HF) power reflects vagal modulation of the sinus node. Since vagal modulation occurs at the respiratory frequency, some investigators have suggested that HF power cannot be interpreted unless the breathing rate is controlled. We hypothesized that HF power during spontaneous breathing would not differ significantly from HF power during metronome-guided breathing. We measured HF power during spontaneous breathing in 20 healthy subjects and 19 patients with heart disease. Each subject's spontaneous breathing rate was determined, and the calculation of HF power was repeated with a metronome set to his or her average spontaneous breathing rate. There was no significant difference between the logarithm of HF power measured during spontaneous and metronome-guided breathing [4.88 +/- 0.29 vs. 5.29 +/- 0.30 ln(ms(2)), P = 0.32] in the group as a whole and when patients and healthy subjects were examined separately. We did observe a small (9.9%) decrease in HF power with increasing metronome-guided breathing rates (from 9 to 20 breaths/min). These data indicate that HF power during spontaneous and metronome-guided breathing differs at most by very small amounts. This variability is several logarithmic units less than the wide discrepancies observed between healthy subjects and cardiac patients with a heterogeneous group of cardiovascular disorders. In addition, HF power is relatively constant across the range of typical breathing rates. These data indicate that there is no need to control breathing rate to interpret HF power when RR variability (and specifically HF power) is used to identify high-risk cardiac patients.

  7. 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

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. Overall glycemic index and glycemic load of vegan diets in relation to plasma lipoproteins and triacylglycerols.

    Science.gov (United States)

    Waldmann, Annika; Ströhle, Alexander; Koschizke, Jochen W; Leitzmann, Claus; Hahn, Andreas

    2007-01-01

    To investigate the overall glycemic index (GI), glycemic load (GL), and intake of dietary fiber, and to examine the associations between these factors and plasma lipoproteins and triacylglycerols in adult vegans in the German Vegan Study (GVS). Cross-sectional study, Germany. Healthy men (n = 67) and women (n = 87), who fulfilled the study criteria (vegan diet for >or=1 year prior to study start; minimum age of 18 years; no pregnancy/childbirth during the last 12 months) and who participated in all study segments. The average dietary GL of the GVS population was 144, and the average GI was 51.4. The adjusted geometric mean total, HDL, and LDL cholesterol concentrations decreased across the increasing quartiles of GL, carbohydrate and dietary fiber intake. The associations between total cholesterol, HDL cholesterol, LDL cholesterol and GL density and GI were inconsistent. Also, associations between GI, GL, the intake of carbohydrates, and triacylglycerol concentration were not observed. Fiber-rich vegan diets are characterized by a low GI and a low to moderate GL. The data do not support the hypothesis that a carbohydrate-rich diet per se is associated with unfavorable effects on triaclyglycerols that would be predicted to increase the risk of coronary heart disease. Copyright (c) 2007 S. Karger AG, Basel.

  13. 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

  14. 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

  15. 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.

  16. Mechanisms driving recruitment variability in fish: comparisons between the Laurentian Great Lakes and marine systems

    Science.gov (United States)

    Pritt, Jeremy J.; Roseman, Edward F.; O'Brien, Timothy P.

    2014-01-01

    In his seminal work, Hjort (in Fluctuations in the great fisheries of Northern Europe. Conseil Parmanent International Pour L'Exploration De La Mar. Rapports et Proces-Verbaux, 20: 1–228, 1914) observed that fish population levels fluctuated widely, year-class strength was set early in life, and egg production by adults could not alone explain variability in year-class strength. These observations laid the foundation for hypotheses on mechanisms driving recruitment variability in marine systems. More recently, researchers have sought to explain year-class strength of important fish in the Laurentian Great Lakes and some of the hypotheses developed for marine fisheries have been transferred to Great Lakes fish. We conducted a literature review to determine the applicability of marine recruitment hypotheses to Great Lakes fish. We found that temperature, interspecific interactions, and spawner effects (abundance, age, and condition of adults) were the most important factors in explaining recruitment variability in Great Lakes fish, whereas relatively fewer studies identified bottom-up trophodynamic factors or hydrodynamic factors as important. Next, we compared recruitment between Great Lakes and Baltic Sea fish populations and found no statistical difference in factors driving recruitment between the two systems, indicating that recruitment hypotheses may often be transferable between Great Lakes and marine systems. Many recruitment hypotheses developed for marine fish have yet to be applied to Great Lakes fish. We suggest that future research on recruitment in the Great Lakes should focus on forecasting the effects of climate change and invasive species. Further, because the Great Lakes are smaller and more enclosed than marine systems, and have abundant fishery-independent data, they are excellent candidates for future hypothesis testing on recruitment in fish.

  17. 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.

  18. Comparison of winter wheat yield sensitivity to climate variables under irrigated and rain-fed conditions

    Science.gov (United States)

    Xiao, Dengpan; Shen, Yanjun; Zhang, He; Moiwo, Juana P.; Qi, Yongqing; Wang, Rende; Pei, Hongwei; Zhang, Yucui; Shen, Huitao

    2016-09-01

    Crop simulation models provide alternative, less time-consuming, and cost-effective means of determining the sensitivity of crop yield to climate change. In this study, two dynamic mechanistic models, CERES (Crop Environment Resource Synthesis) and APSIM (Agricultural Production Systems Simulator), were used to simulate the yield of wheat ( Triticum aestivum L.) under well irrigated (CFG) and rain-fed (YY) conditions in relation to different climate variables in the North China Plain (NCP). The study tested winter wheat yield sensitivity to different levels of temperature, radiation, precipitation, and atmospheric carbon dioxide (CO2) concentration under CFG and YY conditions at Luancheng Agro-ecosystem Experimental Stations in the NCP. The results from the CERES and APSIM wheat crop models were largely consistent and suggested that changes in climate variables influenced wheat grain yield in the NCP. There was also significant variation in the sensitivity of winter wheat yield to climate variables under different water (CFG and YY) conditions. While a temperature increase of 2°C was the threshold beyond which temperature negatively influenced wheat yield under CFG, a temperature rise exceeding 1°C decreased winter wheat grain yield under YY. A decrease in solar radiation decreased wheat grain yield under both CFG and YY conditions. Although the sensitivity of winter wheat yield to precipitation was small under the CFG, yield decreased significantly with decreasing precipitation under the rainfed YY treatment. The results also suggest that wheat yield under CFG linearly increased by ≈3.5% per 60 ppm (parts per million) increase in CO2 concentration from 380 to 560 ppm, and yield under YY increased linearly by ≈7.0% for the same increase in CO2 concentration.

  19. Comparison of valsartan and amlodipine on ambulatory blood pressure variability in hypertensive patients.

    Science.gov (United States)

    Eguchi, Kazuo; Imaizumi, Yuki; Kaihara, Toshiki; Hoshide, Satoshi; Kario, Kazuomi

    We tested the hypothesis that calcium channel blockers (CCBs: amlodipine group, n = 38)) are superior to angiotensin receptor blockers (ARBs: valsartan group, n = 38) against ambulatory blood pressure variability (BPV) in untreated Japanese hypertensive patients. Both drugs significantly reduced ambulatory systolic and diastolic BP values. With regard to BPV, standard deviation (SD) in SBP did not change with the administration of either drug, but the ARB significantly increased SD in awake DBP (12 ± 4-14 ± 4 mmHg). The ARB also significantly increased the coefficients of variation (CVs)in awake and 24-h SBP/DBP (all P valsartan, especially in reducing maximum BP levels.

  20. 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.

  1. 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

  2. Comparison of variable geometry turbocharging (VGT) over conventional wastegated machines to achieve lower emissions

    Energy Technology Data Exchange (ETDEWEB)

    Hawley, J.G.; Wallace, F.J.; Pease, A.C.; Cox, A. [University of Bath (United Kingdom). School of Mechanical Engineering; Horrocks, R.W.; Bird, G.L. [Ford Motor Co. Ltd., Basildon (United Kingdom)

    1997-07-01

    This paper represents the results of an extensive testing programme conducted at the University of Bath on behalf of the Ford Motor Company on a prototype 1.8 litre direct injection (DI) diesel engine. The testing compared the effects of a standard wastegate controlled fixed geometry turbocharger (FGT) with a variable geometry turbocharger (VGT) at discrete part-load operating points. The object being to evaluate the NOx reduction potential at these points due to the VGT and varying exhaust gas recirculation schedules. A reduction in NOx of up to 45 percent was observed without compromising fuel consumption or smoke levels. (author)

  3. TEC variability near northern EIA crest and comparison with IRI model

    Science.gov (United States)

    Aggarwal, Malini

    2011-10-01

    Monthly median values of hourly total electron content (TEC) is obtained with GPS at a station near northern anomaly crest, Rajkot (geog. 22.29°N, 70.74°E; geomag. 14.21°N, 144.9°E) to study the variability of low latitude ionospheric behavior during low solar activity period (April 2005 to March 2006). The TEC exhibit characteristic features like day-to-day variability, semiannual anomaly and noon bite out. The observed TEC is compared with latest International Reference Ionosphere (IRI) - 2007 model using options of topside electron density, NeQuick, IRI01-corr and IRI-2001 by using both URSI and CCIR coefficients. A good agreement of observed and predicted TEC is found during the daytime with underestimation at other times. The predicted TEC by NeQuick and IRI01-corr is closer to the observed TEC during the daytime whereas during nighttime and morning hours, IRI-2001 shows lesser discrepancy in all seasons by both URSI and CCIR coefficients.

  4. [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.

  5. Intensive glycemic control and cardiovascular disease: an update.

    Science.gov (United States)

    Brown, Aparna; Reynolds, L Raymond; Bruemmer, Dennis

    2010-07-01

    Cardiovascular complications constitute the major cause of morbidity and mortality in patients with diabetes. The Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) provided consistent evidence that intensive glycemic control prevents the development and progression of microvascular complications in patients with type 1 or type 2 diabetes. However, whether intensive glucose lowering also prevents macrovascular disease and major cardiovascular events remains unclear. Extended follow-up of participants in these studies demonstrated that intensive glycemic control reduced the long-term incidence of myocardial infarction and death from cardiovascular disease. By contrast, the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial, and Veterans Affairs Diabetes Trial (VADT) results suggested that intensive glycemic control to near normoglycemia had either no, or potentially even a detrimental, effect on cardiovascular outcomes. This article discusses the effects of intensive glycemic control on cardiovascular disease, and examines key differences in the design of these trials that might have contributed to their disparate findings. Recommendations from the current joint ADA, AHA, and ACCF position statement on intensive glycemic control and prevention of cardiovascular disease are highlighted.

  6. Retrieving Tract Variables From Acoustics: A Comparison of Different Machine Learning Strategies.

    Science.gov (United States)

    Mitra, Vikramjit; Nam, Hosung; Espy-Wilson, Carol Y; Saltzman, Elliot; Goldstein, Louis

    2010-09-13

    Many different studies have claimed that articulatory information can be used to improve the performance of automatic speech recognition systems. Unfortunately, such articulatory information is not readily available in typical speaker-listener situations. Consequently, such information has to be estimated from the acoustic signal in a process which is usually termed "speech-inversion." This study aims to propose and compare various machine learning strategies for speech inversion: Trajectory mixture density networks (TMDNs), feedforward artificial neural networks (FF-ANN), support vector regression (SVR), autoregressive artificial neural network (AR-ANN), and distal supervised learning (DSL). Further, using a database generated by the Haskins Laboratories speech production model, we test the claim that information regarding constrictions produced by the distinct organs of the vocal tract (vocal tract variables) is superior to flesh-point information (articulatory pellet trajectories) for the inversion process.

  7. 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

  8. 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

  9. Moderate glycemic control safe in critically ill adult burn patients: A 15 year cohort study.

    Science.gov (United States)

    Stoecklin, Patricia; Delodder, Frederik; Pantet, Olivier; Berger, Mette M

    2016-02-01

    Hyperglycemia is a metabolic alteration in major burn patients associated with complications. The study aimed at evaluating the safety of general ICU glucose control protocols applied in major burns receiving prolonged ICU treatment. 15 year retrospective analysis of consecutive, adult burn patients admitted to a single specialized centre. death or length of stay burned surface (TBSA), severity scores, infections, ICU stay, outcome. Metabolic variables: total energy, carbohydrate and insulin delivery/24h, arterial blood glucose and CRP values. Analysis of 4 periods: 1, before protocol; 2, tight doctor driven; 3, tight nurse driven; 4, moderate nurse driven. 229 patients, aged 45 ± 20 years (mean ± SD), burned 32 ± 20% TBSA were analyzed. SAPSII was 35 ± 13. TBSA, Ryan and ABSI remained stable. Inhalation injury increased. A total of 28,690 blood glucose samples were analyzed: the median value remained unchanged with a narrower distribution over time. After the protocol initiation, the normoglycemic values increased from 34.7% to 65.9%, with a reduction of hypoglycaemic events (no extreme hypoglycemia in period 4). Severe hyperglycemia persisted throughout with a decrease in period 4 (9.25% in period 4). Energy and glucose deliveries decreased in periods 3 and 4 (pprotocol improved the glycemic control in adult burn patients, reducing glucose variability. Moderate glycemic control in burns was safe specifically related to hypoglycemia, reducing the incidence of hypoglycaemic events compared to the period before. Hyperglycemia persisted at a lower level. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  10. Work-related psychosocial stress and glycemic control among working adults with diabetes mellitus.

    Science.gov (United States)

    Annor, Francis B; Roblin, Douglas W; Okosun, Ike S; Goodman, Michael

    2015-01-01

    To examine the association between glycosylated hemoglobin (HbA1c) and four subscales of work-related psychosocial stress at study baseline and over time. We used survey data from a major HMO located in the Southeastern part of the US on health and healthy behaviors linked with patients' clinical, pharmacy and laboratory records for the period between 2005 and 2009. Study participants (n=537) consisted of working adults aged 25-59 years, diagnosed with diabetes mellitus (DM) but without advanced micro or macrovascular complications at the time of the survey. We estimated the baseline (2005) association between HbA1c and work-related psychosocial stress and their interactions using linear regression analysis. Using individual growth model approach, we estimated the association between HbA1c over time and work-related psychosocial stress. Each of the models controlled for socio-demographic variables, diet and physical activity factor, laboratory factor, physical examinations variables and medication use in a hierarchical fashion. After adjusting for all study covariates, we did not find a significant association between work-related psychosocial stress and glycemic control either at baseline or over time. Among fairly healthy middle aged working adults with DM, work-related psychosocial stress was not directly associated with glycemic control. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  11. 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.

  12. Metabolic changes after a hypocaloric, low-glycemic-index diet in obese children.

    Science.gov (United States)

    Parillo, M; Licenziati, M R; Vacca, M; De Marco, D; Iannuzzi, A

    2012-07-01

    A low glycemic index (LGI) diet has been proposed as a treatment for obesity in adults; few studies have evaluated LGI diets in obese children. The purpose of the study was to compare the effects of two diets, with similar energy intakes, but different glycemic indexes in a pediatric outpatient setting. A parallel- group, randomized controlled trial was conducted, and 22 obese outpatient children with a body mass index (BMI) Z-score >2 (11 females and 11 males, BMI 28.9±2.9 kg/m²) were included in the study. Patients were randomly allocated to a hypocaloric LGI (GI:60), or to a hypocaloric high glycemic index (HGI) diet (GI:90). The LGI and HGI diets were almost equivalent for macronutrient composition. Anthropometric and biochemical parameters were measured at baseline and after 6 months. In both groups there were significant decreases in BMI, BMI Z-score, blood pressure, and high-sensitivity C-reactive protein. Only LGI diets produced a significant decrease in waist circumference and homeostasis model assessment. Analysis of variance demonstrated that the BMI Z-score decrease from baseline values was significantly greater after the LGI diet than after the HGI diet [-0.20 (95% confidence interval (CI) -0.29 to -0.10) vs -0.34 (95%CI -0.43 to -0.24)], mean difference between groups -0.14 (95%CI -0.27 to -0.01), pdiet (phypocaloric LGI diet has beneficial metabolic effects in comparison to a hypocaloric HGI diet in obese children.

  13. 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

    lung density measurements, i.e. densitometry. Methods – In a pilot study 60 CT scans were selected from a sample of 3980 CT scans from The Danish Lung Cancer Screening Trial (DLCST). The amount of emphysema in these scans was scored independently by two observers, who were blinded regarding clinical...... 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...... in emphysema grading. However, the agreement with the CT lung density measurement was poor, indicating that the two types of evaluation represent different aspects of emphysema. Most likely, they should be seen as complementary rather than competitive evaluations. Future comparison with physiological tests...

  14. Comparison of pharmacokinetic variables for creatinine and iohexol in dogs with various degrees of renal function.

    Science.gov (United States)

    Collignon, Cécile M; Heiene, Reidun; Queau, Yann; Reynolds, Brice S; Craig, Amanda J; Concordet, Didier; Harran, Nathaniel X; Risøen, Unni; Balouka, David; Faucher, Mathieu R; Eliassen, Knut A; Biourge, Vincent; Lefebvre, Hervé P

    2012-11-01

    To compare pharmacokinetics and clearances of creatinine and iohexol as estimates of glomerular filtration rate (GFR) in dogs with various degrees of renal function. 50 Great Anglo-Francais Tricolor Hounds with various degrees of renal function. Boluses of iohexol (40 mg/kg) and creatinine (647 mg/kg) were injected IV. Blood samples were collected before administration and 5 and 10 minutes and 1, 2, 4, 6, and 8 hours after administration. Plasma creatinine and iohexol concentrations were assayed via an enzymatic method and high-performance liquid chromatography, respectively. A noncompartmental approach was used for pharmacokinetic analysis. Pharmacokinetic variables were compared via a Bland-Altman plot and an ANOVA. Compared with results for creatinine, iohexol had a significantly higher mean ± SD plasma clearance (3.4 ± 0.8 mL/min/kg vs 3.0 ± 0.7 mL/min/kg) and a significantly lower mean volume of distribution at steady state (250 ± 37 mL/kg vs 539 ± 73 mL/kg), mean residence time (80 ± 31 minutes vs 195 ± 73 minutes), and mean elimination half-life (74 ± 20 minutes vs 173 ± 53 minutes). Despite discrepancies between clearances, especially for high values, the difference was dogs. Three dogs with a low GFR (dogs with a GFR within or above the reference range.

  15. Comparison of maternal omentin-1 levels and genetic variability between spontaneous term and preterm births.

    Science.gov (United States)

    Šplíchal, Zbyněk; Zlámal, Filip; Máchal, Jan; Lipková, Jolana; Pavlová, Tereza; Hodická, Zuzana; Ventruba, Pavel; Vašků, Anna; Bienertová-Vašků, Julie

    2018-07-01

    To determine maternal omentin-1 levels and genetic variability in the omentin-1 gene in women with spontaneous term and preterm births (PTBs). Maternal serum omentin-1 levels and the role of the omentin-1 Val109Asp (rs2274907) polymorphism were evaluated in 32 women with spontaneous term birth (sTB) and 30 women with spontaneous preterm birth (sPTB) including women with (n = 16) and without (n = 14) preterm premature rupture of membranes (PPROM). Maternal omentin-1 levels were significantly lower in women with sPTBs compared to term births during the hospitalization period (p = .015). However, maternal omentin-1 levels were similar in women with sPTBs with and without PPROM (p = .990). Furthermore, the omentin-1 Val109Asp polymorphism was found to have no significant effect on omentin-1 serum levels. In addition, no significant differences in genotype distributions and allelic frequencies between sTB and sPTB were established. High omentin-1 levels in normal sTBs compared to PTBs without significant differences between cases with and without PPROM suggest that omentin-1 plays a potential role in the pathophysiology of PTB but not in the PPROM mechanism itself.

  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 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.

  18. Experimental verification and comparison of the rubber V- belt continuously variable transmission models

    Science.gov (United States)

    Grzegożek, W.; Dobaj, K.; Kot, A.

    2016-09-01

    The paper includes the analysis of the rubber V-belt cooperation with the CVT transmission pulleys. The analysis of the forces and torques acting in the CVT transmission was conducted basing on calculated characteristics of the centrifugal regulator and the torque regulator. The accurate estimation of the regulator surface curvature allowed for calculation of the relation between the driving wheel axial force, the engine rotational speed and the gear ratio of the CVT transmission. Simplified analytical models of the rubber V-belt- pulley cooperation are based on three basic approaches. The Dittrich model assumes two contact regions on the driven and driving wheel. The Kim-Kim model considers, in addition to the previous model, also the radial friction. The radial friction results in the lack of the developed friction area on the driving pulley. The third approach, formulated in the Cammalleri model, assumes variable sliding angle along the wrap arch and describes it as a result the belt longitudinal and cross flexibility. Theoretical torque on the driven and driving wheel was calculated on the basis of the known regulators characteristics. The calculated torque was compared to the measured loading torque. The best accordance, referring to the centrifugal regulator range of work, was obtained for the Kim-Kim model.

  19. 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)

  20. 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.

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

    International Nuclear Information System (INIS)

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

    2016-01-01

    The latest generation of optical atomic clocks is approaching the level of one part in 10 18 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 m 2 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 10 18 . 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 m 2 s -2 for the potential and a range (maximum-to-minimum) of up to 1.3 and 10.0 m 2 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 m 2 s -2 , while the range of the potential between specific laboratories is 0.3 and 1.1 m 2 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. (authors)

  2. Impact of night sleep duration on glycemic and triglyceride levels in Chinese with different glycemic status.

    Science.gov (United States)

    Zheng, Yu; Wang, Anping; Pan, Changyu; Lu, Juming; Dou, Jingtao; Lu, Zhaohui; Ba, Jianming; Wang, Baoan; Mu, Yiming

    2015-01-01

    The aim of the present study was to assess the relationship between night sleep duration and glycemic and triglyceride (TG) levels among people with different glycemic status. In all, 18,121 subjects aged ≥40 years were enrolled in this cross-sectional study, including 4318 with impaired glucose regulation (IGR), 4225 with diabetes, and 9578 with normal glucose regulation (NGR). The IGR + diabetes and NGR groups were divided into three subgroups according to self-reported night sleep duration as follows: (i) 9 h. The associations of sleep duration with HbA1c, fasting plasma glucose (FPG), 2-h post-load plasma glucose (PPG), and TG levels were examined. Long night sleep duration (>9 h) was associated with higher HbA1c, FPG, PPG, and TG levels compared with sleep duration of 6-9 h (P index and depressive symptoms, and remained significant even after adjusting for snoring. A significant interaction between sleep duration and TG or snoring was observed for HbA1c levels, which attenuated the sleep-HbA1c association in the IGR + diabetes group. However, no significant association was observed between short night sleep duration and HbA1c levels. Long night sleep duration is associated with higher HbA1c, FPG, PPG, and TG levels in IGR and diabetes patients, independent of potential confounders. This may be important in clinical management of IGR and diabetes patients. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  3. 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 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.

  4. A comparison of VO2max and metabolic variables between treadmill running and treadmill skating.

    Science.gov (United States)

    Koepp, Kriston K; Janot, Jeffrey M

    2008-03-01

    The purpose of this study was to determine differences in VO2max and metabolic variables between treadmill running and treadmill skating. This study also examined VO2max responses during a continuous skating treadmill protocol and a discontinuous skating treadmill protocol. Sixteen male high school hockey players, who had a mean age of 16 +/- 1 years and were of an above-average fitness level, participated in this study. All subjects completed 4 exercise trials: a 1-hour skating treadmill familiarization trial, a treadmill running trial, and 2 randomized skating treadmill trials. Minute ventilation (VE), oxygen consumption VO2), carbon dioxide production VCO2), respiratory exchange ratio (RER), and heart rate were averaged every 15 seconds up to VO2max for each exercise test. The results showed that there was a significant difference (P skating treadmill protocol. There was also a significant difference for maximal RER between the discontinuous and continuous skating treadmill protocol and between the discontinuous skating treadmill protocol and running treadmill protocol. In conclusion, the running treadmill elicited a greater VO2max (mL.kg.min) than the skating treadmill did, but when it comes to specificity of ice skating, the skating treadmill may be ideal. Also, there was no significant difference between the discontinuous and continuous skating treadmill protocols. Therefore, a continuous protocol is possible on the skating treadmill without compromising correct skating position and physiologic responses. However, the continuous skating treadmill protocol should undergo validation before other scientists, coaches, and strength and conditioning professionals can apply it correctly.

  5. The relationship between breakfast skipping, chronotype, and glycemic control in type 2 diabetes.

    Science.gov (United States)

    Reutrakul, Sirimon; Hood, Megan M; Crowley, Stephanie J; Morgan, Mary K; Teodori, Marsha; Knutson, Kristen L

    2014-02-01

    Breakfast skipping is associated with obesity and an increased risk of type 2 diabetes. Later chronotypes, individuals who have a preference for later bed and wake times, often skip breakfast. The aim of the study was to explore the relationships among breakfast skipping, chronotype, and glycemic control in type 2 diabetes patients. We collected sleep timing and 24-h dietary recall from 194 non-shift-working type 2 diabetes patients who were being followed in outpatient clinics. Mid-sleep time on free days (MSF) was used as an indicator of chronotype. Hemoglobin A1C (HbA1C) values were obtained from medical records. Hierarchical linear regression analyses controlling for demographic, sleep, and dietary variables were computed to determine whether breakfast skipping was associated with HbA1C. Additional regression analyses were performed to test if this association was mediated by chronotype. There were 22 participants (11.3%) who self-reported missing breakfast. Breakfast skippers had significantly higher HbA1C levels, higher body mass indices (BMI), and later MSF than breakfast eaters. Breakfast skipping was significantly associated with higher HbA1C values (B = 0.108, p = 0.01), even after adjusting for age, sex, race, BMI, number of diabetes complications, insulin use, depressive symptoms, perceived sleep debt, and percentage of daily caloric intake at dinner. The relationship between breakfast skipping and HbA1C was partially mediated by chronotype. In summary, breakfast skipping is associated with a later chronotype. Later chronotype and breakfast skipping both contribute to poorer glycemic control, as indicated by higher HbA1C levels. Future studies are needed to confirm these findings and determine whether behavioral interventions targeting breakfast eating or sleep timing may improve glycemic control in patients with type 2 diabetes.

  6. 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.

  7. Current topics in glycemic control by wearable artificial pancreas or bedside artificial pancreas with closed-loop system.

    Science.gov (United States)

    Hanazaki, Kazuhiro; Munekage, Masaya; Kitagawa, Hiroyuki; Yatabe, Tomoaki; Munekage, Eri; Shiga, Mai; Maeda, Hiromichi; Namikawa, Tsutomu

    2016-09-01

    The incidence of diabetes is increasing at an unprecedented pace and has become a serious health concern worldwide during the last two decades. Despite this, adequate glycemic control using an artificial pancreas has not been established, although the 21st century has seen rapid developments in this area. Herein, we review current topics in glycemic control for both the wearable artificial pancreas for type 1 and type 2 diabetic patients and the bedside artificial pancreas for surgical diabetic patients. In type 1 diabetic patients, nocturnal hypoglycemia associated with insulin therapy remains a serious problem that could be addressed by the recent development of a wearable artificial pancreas. This smart phone-like device, comprising a real-time, continuous glucose monitoring system and insulin pump system, could potentially significantly reduce nocturnal hypoglycemia compared with conventional glycemic control. Of particular interest in this space are the recent inventions of a low-glucose suspend feature in the portable systems that automatically stops insulin delivery 2 h following a glucose sensor value <70 mg/dL and a bio-hormonal pump system consisting of insulin and glucagon pumps. Perioperative tight glycemic control using a bedside artificial pancreas with the closed-loop system has also proved safe and effective for not only avoiding hypoglycemia, but also for reducing blood glucose level variability resulting in good surgical outcomes. We hope that a more sophisticated artificial pancreas with closed-loop system will now be taken up for routine use worldwide, providing enormous relief for patients suffering from uncontrolled hyperglycemia, hypoglycemia, and/or variability in blood glucose concentrations.

  8. [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.

  9. High-Intensity Interval Exercises' Acute Impact on Heart Rate Variability: Comparison Between Whole-Body and Cycle Ergometer Protocols.

    Science.gov (United States)

    Schaun, Gustavo Z; Del Vecchio, Fabrício B

    2018-01-01

    Schaun, GZ and Del Vecchio, FB. High-intensity interval exercises' acute impact on heart rate variability: comparison between whole-body and cycle ergometer protocols. J Strength Cond Res 32(1): 223-229, 2018-Study aimed to compare the effects of 2 high-intensity interval training (HIIT) protocols on heart rate variability. Twelve young adult males (23.3 ± 3.9 years, 177.8 ± 7.4 cm, 76.9 ± 12.9 kg) volunteered to participate. In a randomized cross-over design, subjects performed 2 HIIT protocols, 1 on a cycle ergometer (Tabata protocol [TBT]; eight 20-second bouts at 170% Pmax interspersed by 10-second rest) and another with whole-body calisthenic exercises (McRae protocol; eight 20-second all-out intervals interspersed by 10-second rest). Heart rate variability outcomes in the time, frequency, and nonlinear domains were assessed on 3 moments: (a) presession; (b) immediately postsession; and (c) 24 hours postsession. Results revealed that RRmean, Ln rMSSD, Ln high frequency (HF), and Ln low frequency (LF) were significantly reduced immediately postsession (p ≤ 0.001) and returned to baseline 24 h after both protocols. In addition, LF/HF ratio was reduced 24 h postsession (p ≤ 0.01) and SD2 was significantly lower immediately postsession only in TBT. Our main finding was that responses from heart rate autonomic control were similar in both protocols, despite different modes of exercise performed. Specifically, exercises resulted in a high parasympathetic inhibition immediately after session with subsequent recovery within 1 day. These results suggest that subjects were already recovered the day after and can help coaches to better program training sessions with such protocols.

  10. Endocrinology Telehealth Consultation Improved Glycemic Control Similar to Face-to-Face Visits in Veterans.

    Science.gov (United States)

    Liu, Winnie; Saxon, David R; McNair, Bryan; Sanagorski, Rebecca; Rasouli, Neda

    2016-09-01

    Rates of diabetes for veterans who receive health care through the Veterans Health Administration are higher than rates in the general population. Furthermore, many veterans live in rural locations, far from Veterans Affairs (VA) hospitals, thus limiting their ability to readily seek face-to-face endocrinology care for diabetes. Telehealth (TH) technologies present an opportunity to improve access to specialty diabetes care for such patients; however, there is a lack of evidence regarding the ability of TH to improve glycemic control in comparison to traditional face-to-face consultations. This was a retrospective cohort study of all new endocrinology diabetes consultations at the Denver VA Medical Center over a 1-year period. A total of 189 patients were included in the analysis. In all, 85 patients had received face-to-face (FTF) endocrinology consultation for diabetes and 104 patients had received TH consultation. Subjects were mostly males (94.7%) and the mean age was 62.8 ± 10.1 years old. HbA1c improved from 9.76% (9.40% to 10.11%) to 8.55% (8.20% to 8.91%) (P Endocrinology TH consultations improved short-term glycemic control as effectively as traditional FTF visits in a veteran population with diabetes. © 2016 Diabetes Technology Society.

  11. Lowering the glycemic index of white bread using a white bean extract

    Directory of Open Access Journals (Sweden)

    Singh Betsy B

    2009-10-01

    Full Text Available Abstract Background Phase 2® is a dietary supplement derived from the common white kidney bean (Phaseolus vulgaris. Phase 2 has been shown to inhibit alpha-amylase, the complex carbohydrate digesting enzyme, in vitro. The inhibition of alpha-amylase may result in the lowering of the effective Glycemic Index (GI of certain foods. The objective of this study was to determine whether the addition of Phase 2 would lower the GI of a commercially available high glycemic food (white bread. Methods An open-label 6-arm crossover study was conducted with 13 randomized subjects. Standardized GI testing was performed on white bread with and without the addition of Phase 2 in capsule and powder form, each in dosages of 1500 mg, 2000 mg, and 3000 mg. Statistical analysis was performed by one-way ANOVA of all seven treatment groups using unadjusted multiple comparisons (t tests to the white bread control. Results For the capsule formulation, the 1500 mg dose had no effect on the GI and the 2000 mg and 3000 mg capsule doses caused insignificant reductions in GI. For the powder, the 1500 mg and 2000 mg doses caused insignificant reductions in the GI, and the 3000 mg dose had a significant effect (-20.23 or 34.11%, p = 0.023 Conclusion Phase 2 white bean extract appears to be a novel and potentially effective method for reducing the GI of existing foods without modifying their ingredient profile. Trial Registration Trial Registration: ISRCTN50347345

  12. Lowering the glycemic index of white bread using a white bean extract.

    Science.gov (United States)

    Udani, Jay K; Singh, Betsy B; Barrett, Marilyn L; Preuss, Harry G

    2009-10-28

    Phase 2((R)) is a dietary supplement derived from the common white kidney bean (Phaseolus vulgaris). Phase 2 has been shown to inhibit alpha-amylase, the complex carbohydrate digesting enzyme, in vitro. The inhibition of alpha-amylase may result in the lowering of the effective Glycemic Index (GI) of certain foods. The objective of this study was to determine whether the addition of Phase 2 would lower the GI of a commercially available high glycemic food (white bread). An open-label 6-arm crossover study was conducted with 13 randomized subjects. Standardized GI testing was performed on white bread with and without the addition of Phase 2 in capsule and powder form, each in dosages of 1500 mg, 2000 mg, and 3000 mg. Statistical analysis was performed by one-way ANOVA of all seven treatment groups using unadjusted multiple comparisons (t tests) to the white bread control. For the capsule formulation, the 1500 mg dose had no effect on the GI and the 2000 mg and 3000 mg capsule doses caused insignificant reductions in GI. For the powder, the 1500 mg and 2000 mg doses caused insignificant reductions in the GI, and the 3000 mg dose had a significant effect (-20.23 or 34.11%, p = 0.023) Phase 2 white bean extract appears to be a novel and potentially effective method for reducing the GI of existing foods without modifying their ingredient profile. Trial Registration: ISRCTN50347345.

  13. 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.

  14. Association between depression and glycemic control among type 2 diabetes patients in Lima, Peru.

    Science.gov (United States)

    Crispín-Trebejo, Brenda; Robles-Cuadros, María Cristina; Bernabé-Ortiz, Antonio

    2015-12-01

    There is limited and controversial information regarding the potential impact of depression on glycemic control. This study aims to evaluate the association between depression and poor glycemic control. In addition, the prevalence of depression and rates of poor glycemic control were determined. Cross-sectional study performed in the endocrinology unit of two hospitals of ESSALUD in Peru. The outcome of interest was poor glycemic control, evaluated by glycated hemoglobin (HbA1c: diabetes patients. Our results suggest that early detection of depression might be important to facilitate appropriate glycemic control and avoid further metabolic complications. © 2015 Wiley Publishing Asia Pty Ltd.

  15. Evaluation of the utility of a glycemic pattern identification system.

    Science.gov (United States)

    Otto, Erik A; Tannan, Vinay

    2014-07-01

    With the increasing prevalence of systems allowing automated, real-time transmission of blood glucose data there is a need for pattern recognition techniques that can inform of deleterious patterns in glycemic control when people test. We evaluated the utility of pattern identification with a novel pattern identification system named Vigilant™ and compared it to standard pattern identification methods in diabetes. To characterize the importance of an identified pattern we evaluated the relative risk of future hypoglycemic and hyperglycemic events in diurnal periods following identification of a pattern in a data set of 536 patients with diabetes. We evaluated events 2 days, 7 days, 30 days, and 61-90 days from pattern identification, across diabetes types and cohorts of glycemic control, and also compared the system to 6 pattern identification methods consisting of deleterious event counts and percentages over 5-, 14-, and 30-day windows. Episodes of hypoglycemia, hyperglycemia, severe hypoglycemia, and severe hyperglycemia were 120%, 46%, 123%, and 76% more likely after pattern identification, respectively, compared to periods when no pattern was identified. The system was also significantly more predictive of deleterious events than other pattern identification methods evaluated, and was persistently predictive up to 3 months after pattern identification. The system identified patterns that are significantly predictive of deleterious glycemic events, and more so relative to many pattern identification methods used in diabetes management today. Further study will inform how improved pattern identification can lead to improved glycemic control. © 2014 Diabetes Technology Society.

  16. 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.

  17. 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

  18. Pancreatic beta-cell function is a stronger predictor of changes in glycemic control after an aerobic exercise intervention than insulin sensitivity

    DEFF Research Database (Denmark)

    Solomon, Thomas; Malin, Steven K; Karstoft, Kristian

    2013-01-01

    glucose-stimulated insulin secretion (GSIS), and disposition index (DI) were measured following 12-16-weeks of aerobic exercise training. Regression analyses were used to identify relationships between variables.ResultsFollowing training, 86% of subjects increased VO2max and lost weight. HbA1c, fasting......ContextUnderstanding inter-subject variability in glycemic control following exercise training will help individualize treatment.ObjectiveTo determine whether this variability is related to training-induced changes in insulin sensitivity or pancreatic beta-cell function.Design, Setting....... Training increased first- and second-phase DI in 83% and 74% of subjects. Training-induced changes in glycemic control were related to changes in GSIS (P...

  19. 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

  20. 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

  1. Statistical variability comparison in MODIS and AERONET derived aerosol optical depth over Indo-Gangetic Plains using time series modeling.

    Science.gov (United States)

    Soni, Kirti; Parmar, Kulwinder Singh; Kapoor, Sangeeta; Kumar, Nishant

    2016-05-15

    A lot of studies in the literature of Aerosol Optical Depth (AOD) done by using Moderate Resolution Imaging Spectroradiometer (MODIS) derived data, but the accuracy of satellite data in comparison to ground data derived from ARrosol Robotic NETwork (AERONET) has been always questionable. So to overcome from this situation, comparative study of a comprehensive ground based and satellite data for the period of 2001-2012 is modeled. The time series model is used for the accurate prediction of AOD and statistical variability is compared to assess the performance of the model in both cases. Root mean square error (RMSE), mean absolute percentage error (MAPE), stationary R-squared, R-squared, maximum absolute percentage error (MAPE), normalized Bayesian information criterion (NBIC) and Ljung-Box methods are used to check the applicability and validity of the developed ARIMA models revealing significant precision in the model performance. It was found that, it is possible to predict the AOD by statistical modeling using time series obtained from past data of MODIS and AERONET as input data. Moreover, the result shows that MODIS data can be formed from AERONET data by adding 0.251627 ± 0.133589 and vice-versa by subtracting. From the forecast available for AODs for the next four years (2013-2017) by using the developed ARIMA model, it is concluded that the forecasted ground AOD has increased trend. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. A comparison study on detection of key geochemical variables and factors through three different types of factor analysis

    Science.gov (United States)

    Hoseinzade, Zohre; Mokhtari, Ahmad Reza

    2017-10-01

    Large numbers of variables have been measured to explain different phenomena. Factor analysis has widely been used in order to reduce the dimension of datasets. Additionally, the technique has been employed to highlight underlying factors hidden in a complex system. As geochemical studies benefit from multivariate assays, application of this method is widespread in geochemistry. However, the conventional protocols in implementing factor analysis have some drawbacks in spite of their advantages. In the present study, a geochemical dataset including 804 soil samples collected from a mining area in central Iran in order to search for MVT type Pb-Zn deposits was considered to outline geochemical analysis through various fractal methods. Routine factor analysis, sequential factor analysis, and staged factor analysis were applied to the dataset after opening the data with (additive logratio) alr-transformation to extract mineralization factor in the dataset. A comparison between these methods indicated that sequential factor analysis has more clearly revealed MVT paragenesis elements in surface samples with nearly 50% variation in F1. In addition, staged factor analysis has given acceptable results while it is easy to practice. It could detect mineralization related elements while larger factor loadings are given to these elements resulting in better pronunciation of mineralization.

  3. 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.

  4. 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.

  5. Psychological aspects of glycemic control in young patients with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Oleg Gennad'evich Motovilin

    2010-03-01

    Full Text Available Aim. To elucidate the relationship between glycemic control (assessed by the level of HbA1c and psychological status of the patients. Materials and methods. The study included 115 patients with type 1 diabetes aged 13-27 years. The following tests were used to assess the psychological statusof the patients status (emotional state, social relations, attitude toward disease: State-trait-anxiety Inventory (Spielberger C.D., Hanin Y.L, Center for EpidemiologicStudies Depression Scale (CES-D, Social ajustment scale by A.K. Osnizkiy based on Q-Sort Adjustment Scale developed by R. Dymond andC.R. Rogers (1954, Lusher colour test , Colour attitudes test, A.M. Etkind original technique, method for the assessment of attitude toward disease developedin V.M. Bekhterev Research Psychoneurologic Institute, Sankt-Peterburg. The patients were allocated to 3 groups differing in terms of 33.3% percentile ofHbA1c levels. Results. Patients with good glycemic control (mean HbA1c level 7.4% show the lowest level of social adaptation and emotional well-being. The reason for thisphenomenon is the excessive focus of patient on the disease and narrow scope of interests, which suggest psychological dependence on diabetes. Patients withpoor glycemic control (mean HbA1c level 13.1% also experience emotional discomfort due to increased anxiety. Despite the fact they exhibit a higher degreeof social adaptation than the patients of the above group, the main concern is the low level of communicative autonomy and the feeling of being unable to copewith the disease. Such personal characteristics also create a psychological dependence on diabetes, although of a different type than in the first group of patients.Patients with average glycemic control (mean HbA1c level 9.5% in the sample have the most favorable psychological state in comparison with the other twogroups. Their emotional state and social adaptation are significantly better than in the other two groups. These patients

  6. The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial.

    Science.gov (United States)

    Karstoft, Kristian; Winding, Kamilla; Knudsen, Sine H; Nielsen, Jens S; Thomsen, Carsten; Pedersen, Bente K; Solomon, Thomas P J

    2013-02-01

    To evaluate the feasibility of free-living walking training in type 2 diabetic patients and to investigate the effects of interval-walking training versus continuous-walking training upon physical fitness, body composition, and glycemic control. Subjects with type 2 diabetes were randomized to a control (n = 8), continuous-walking (n = 12), or interval-walking group (n = 12). Training groups were prescribed five sessions per week (60 min/session) and were controlled with an accelerometer and a heart-rate monitor. Continuous walkers performed all training 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]). Training 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 Body mass and adiposity (fat mass and visceral fat) decreased in the interval-walking group only (P interval-walking group. The continuous walkers showed no changes in glycemic control. Free-living walking training is feasible in type 2 diabetic patients. Continuous walking offsets the deterioration in glycemia seen in the control group, and interval walking is superior to energy expenditure-matched continuous walking for improving physical fitness, body composition, and glycemic control.

  7. 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.

  8. 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

    2018-05-01

    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.

  9. 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

  10. Salivary function and glycemic control in older persons with diabetes.

    Science.gov (United States)

    Chavez, E M; Taylor, G W; Borrell, L N; Ship, J A

    2000-03-01

    There is no consensus on the possible association between diabetes and salivary dysfunction in older persons with diabetes. This study's purpose was to investigate the effect of diabetes and glycemic control on salivary function in an older population. Twenty nine persons with type 2 diabetes and 23 nondiabetic control subjects participated (age range, 54-90 years). Diabetic status was determined by a glycosylated hemoglobin (HbA(1c)) test and a 2-hour glucose tolerance test. Poor glycemic control was defined as HbA(1c) >9%. Unstimulated whole saliva, unstimulated parotid, and stimulated parotid flow rates were measured, and subjects completed a standardized xerostomia questionnaire. Persons with poorly controlled diabetes had lower (P =.01) stimulated parotid flow rates than persons with well-controlled diabetes and nondiabetic control subjects. There were no significant differences in xerostomic complaints based on diabetic or glycemic control status or salivary flow rates. These results provide some evidence that poorly controlled diabetes may be associated with salivary dysfunction in older adults who have no concomitant complaints of xerostomia.

  11. Chemical compositions and glycemic responses to banana varieties.

    Science.gov (United States)

    Hettiaratchi, U P K; Ekanayake, S; Welihinda, J

    2011-06-01

    Chemical compositions and glycemic indices of four varieties of banana (Musa spp.) (kolikuttu-Silk AAB, embul-Mysore AAB, anamalu-Gros Michel AAA, seeni kesel-Pisang Awak ABB) were determined. Silk, Gros Michel, Pisang Awak and Mysore contained the highest percentages of starch (14%), sucrose (38%), free glucose (29%) and fructose (58%) as a percentage of the total available carbohydrate content respectively. Total dietary fiber contents of four varieties ranged from 2.7 to 5.3%. Glycemic indices of Silk, Mysore, Gros Michel and Pisang Awak were 61 ± 5, 61 ± 6, 67 ± 7, 69 ± 9 and can be categorized as low against white bread as the standard. A single banana of the four varieties elicited a low glycemic load. Thus, consumption of a banana from any of these varieties can be recommended as a snack for healthy or diabetic patients who are under dietary management or pharmacological drugs to regulate blood glucose responses in between meals.

  12. Diabetic status and the relation of the three domains of glycemic control to mortality in critically ill patients: an international multicenter cohort study.

    Science.gov (United States)

    Krinsley, James S; Egi, Moritoki; Kiss, Alex; Devendra, Amin N; Schuetz, Philipp; Maurer, Paula M; Schultz, Marcus J; van Hooijdonk, Roosmarijn T M; Kiyoshi, Morita; Mackenzie, Iain M J; Annane, Djillali; Stow, Peter; Nasraway, Stanley A; Holewinski, Sharon; Holzinger, Ulrike; Preiser, Jean-Charles; Vincent, Jean-Louis; Bellomo, Rinaldo

    2013-03-01

    Hyperglycemia, hypoglycemia, and increased glycemic variability have each been independently associated with increased risk of mortality in critically ill patients. The role of diabetic status on modulating the relation of these three domains of glycemic control with mortality remains uncertain. The purpose of this investigation was to determine how diabetic status affects the relation of hyperglycemia, hypoglycemia, and increased glycemic variability with the risk of mortality in critically ill patients. This is a retrospective analysis of prospectively collected data involving 44,964 patients admitted to 23 intensive care units (ICUs) from nine countries, between February 2001 and May 2012. We analyzed mean blood glucose concentration (BG), coefficient of variation (CV), and minimal BG and created multivariable models to analyze their independent association with mortality. Patients were stratified according to the diagnosis of diabetes. Among patients without diabetes, mean BG bands between 80 and 140 mg/dl were independently associated with decreased risk of mortality, and mean BG bands>or=140 mg/dl, with increased risk of mortality. Among patients with diabetes, mean BG from 80 to 110 mg/dl was associated with increased risk of mortality and mean BG from 110 to 180 mg/dl with decreased risk of mortality. An effect of center was noted on the relation between mean BG and mortality. Hypoglycemia, defined as minimum BGor=20%, was independently associated with increased risk of mortality only among patients without diabetes. Derangements of more than one domain of glycemic control had a cumulative association with mortality, especially for patients without diabetes. Although hyperglycemia, hypoglycemia, and increased glycemic variability is each independently associated with mortality in critically ill patients, diabetic status modulates these relations in clinically important ways. Our findings suggest that patients with diabetes may benefit from higher glucose

  13. Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial.

    Science.gov (United States)

    Ebbeling, Cara B; Leidig, Michael M; Feldman, Henry A; Lovesky, Margaret M; Ludwig, David S

    2007-05-16

    concentration improved more on the low-fat diet. Variability in dietary weight loss trials may be partially attributable to differences in hormonal response. Reducing glycemic load may be especially important to achieve weight loss among individuals with high insulin secretion. Regardless of insulin secretion, a low-glycemic load diet has beneficial effects on high-density lipoprotein cholesterol and triglyceride concentrations but not on low-density lipoprotein cholesterol concentration. clinicaltrials.gov Identifier: NCT00130299.

  14. 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

  15. Comparison of gas spring designs with adjustable spring characteristic for a free-piston engine; Vergleich von Gasfedervarianten mit variabler Kennlinie fuer einen Freikolbenmotor

    Energy Technology Data Exchange (ETDEWEB)

    Pohl, S.E.; Ferrari, C. [Deutsches Zentrum fuer Luft- und Raumfahrt (DLR), Stuttgart (Germany). Inst. fuer Fahrzeugkonzepte

    2007-12-15

    In this paper two different gas spring designs for a free-piston application are introduced. On the basis of thermodynamic calculations the spring characteristics of a mass-variable and a volume-variable gas spring are analyzed for different operating points. A comparison of the spring performances indicates that the spring characteristics of the two designs only match at one operation point. Therefore, a calculation method minimizing the difference between the two spring characteristics over the entire operating range of a free piston engine is introduced. The theoretical examination is confirmed by measurements on a gas spring test stand. (orig.)

  16. Intraindividual variability in physical and emotional functioning: comparison of adults with traumatic brain injuries and healthy adults.

    Science.gov (United States)

    Burton, Catherine L; Hultsch, David F; Strauss, Esther; Hunter, Michael A

    2002-08-01

    Recent research has shown that individuals with certain neurological conditions demonstrate greater intraindividual variability on cognitive tasks compared to healthy controls. The present study investigated intraindividual variability in the domains of physical functioning and affect/stress in three groups: adults with mild head injuries, adults with moderate/severe head injuries, and healthy adults. Participants were assessed on 10 occasions and results indicated that (a) individuals with head injuries demonstrated greater variability in dominant finger dexterity and right grip strength than the healthy controls; (b) increased variability tended to be associated with poorer performance/report both within and across tasks; and (c) increased variability on one task was associated with increased variability on other tasks. The findings suggest that increased variability in physical function, as well as cognitive function, represents an indicator of neurological compromise.

  17. Effect of an educational Inpatient Diabetes Management Program on medical resident knowledge and measures of glycemic control: a randomized controlled trial.

    Science.gov (United States)

    Desimone, Marisa E; Blank, Gary E; Virji, Mohamed; Donihi, Amy; DiNardo, Monica; Simak, Deborah M; Buranosky, Raquel; Korytkowski, Mary T

    2012-01-01

    To investigate the effectiveness of an Inpatient Diabetes Management Program (IDMP) on physician knowledge and inpatient glycemic control. Residents assigned to General Internal Medicine inpatient services were randomized to receive the IDMP (IDMP group) or usual education only (non-IDMP group). Both groups received an overview of inpatient diabetes management in conjunction with reminders of existing order sets on the hospital Web site. The IDMP group received print copies of the program and access to an electronic version for a personal digital assistant (PDA). A Diabetes Knowledge Test (DKT) was administered at baseline and at the end of the 1-month rotation. The frequency of hyperglycemia among patients under surveillance by each group was compared by using capillary blood glucose values and a dispersion index of glycemic variability. IDMP users completed a questionnaire related to the program. Twenty-two residents participated (11 in the IDMP group and 11 in the non-IDMP group). Overall Diabetes Knowledge Test scores improved in both groups (IDMP: 69% ± 1.7% versus 83% ± 2.1%, P = .003; non-IDMP: 76% ± 1.2% versus 84% ± 1.4%, P = .02). The percentage of correct responses for management of corticosteroid-associated hyperglycemia (P = .004) and preoperative glycemic management (P = .006) improved in only the IDMP group. The frequency of hyperglycemia (blood glucose level >180 mg/dL) and the dispersion index (5.3 ± 7.6 versus 3.7 ± 5.6; P = .2) were similar between the 2 groups. An IDMP was effective at improving physician knowledge for managing hyperglycemia in hospitalized patients treated with corticosteroids or in preparation for surgical procedures. Educational programs directed at improving overall health care provider knowledge for inpatient glycemic management may be beneficial; however, improvements in knowledge do not necessarily result in improved glycemic outcomes.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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

  20. First trimester prediction of maternal glycemic status.

    Science.gov (United States)

    Gabbay-Benziv, Rinat; Doyle, Lauren E; Blitzer, Miriam; Baschat, Ahmet A

    2015-05-01

    To predict gestational diabetes mellitus (GDM) or normoglycemic status using first trimester maternal characteristics. We used data from a prospective cohort study. First trimester maternal characteristics were compared between women with and without GDM. Association of these variables with sugar values at glucose challenge test (GCT) and subsequent GDM was tested to identify key parameters. A predictive algorithm for GDM was developed and receiver operating characteristics (ROC) statistics was used to derive the optimal risk score. We defined normoglycemic state, when GCT and all four sugar values at oral glucose tolerance test, whenever obtained, were normal. Using same statistical approach, we developed an algorithm to predict the normoglycemic state. Maternal age, race, prior GDM, first trimester BMI, and systolic blood pressure (SBP) were all significantly associated with GDM. Age, BMI, and SBP were also associated with GCT values. The logistic regression analysis constructed equation and the calculated risk score yielded sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 62%, 13.8%, and 98.3% for a cut-off value of 0.042, respectively (ROC-AUC - area under the curve 0.819, CI - confidence interval 0.769-0.868). The model constructed for normoglycemia prediction demonstrated lower performance (ROC-AUC 0.707, CI 0.668-0.746). GDM prediction can be achieved during the first trimester encounter by integration of maternal characteristics and basic measurements while normoglycemic status prediction is less effective.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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

    Directory of Open Access Journals (Sweden)

    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.

  4. A Comparison of Approaches for the Analysis of Interaction Effects between Latent Variables Using Partial Least Squares Path Modeling

    Science.gov (United States)

    Henseler, Jorg; Chin, Wynne W.

    2010-01-01

    In social and business sciences, the importance of the analysis of interaction effects between manifest as well as latent variables steadily increases. Researchers using partial least squares (PLS) to analyze interaction effects between latent variables need an overview of the available approaches as well as their suitability. This article…

  5. Universal, Developmental, and Variable Aspects of Young Children's Play: A Cross-Cultural Comparison of Pretending at Home.

    Science.gov (United States)

    Haight, Wendy L.; Wang, Xiao-lei; Fung, Heidi Han-tih; Williams, Kimberley; Mintz, Judith

    1999-01-01

    This study used longitudinal data from five Irish American families and nine Chinese families in Taiwan, in conjunction with cultural psychology research evidence, to propose universal, culturally variable, and developmental dimensions of children's pretend play. Findings raise the theoretical issue of how universal and variable dimensions of…

  6. Intraindividual variability in cognitive performance in older adults: comparison of adults with mild dementia, adults with arthritis, and healthy adults.

    Science.gov (United States)

    Hultsch, D F; MacDonald, S W; Hunter, M A; Levy-Bencheton, J; Strauss, E

    2000-10-01

    Intraindividual variability in latency and accuracy of cognitive performance across both trials and occasions was examined in 3 groups of older adults: healthy adults, adults with arthritis, and adults diagnosed with mild dementia. Participants completed 2 reaction-time and 2 episodic-memory tasks on 4 occasions. Results indicated that intraindividual variability in latency was greater in individuals diagnosed with mild dementia than in adults who were neurologically intact, regardless of their health status. Individual differences in variability were stable over time and across cognitive domains. Intraindividual variability was also related to level of performance and was uniquely predictive of neurological status, independent of level of performance. Results suggest that intraindividual variability may be a behavioral indicator of compromised neurological mechanisms.

  7. Yogurt Is a Low-Glycemic Index Food.

    Science.gov (United States)

    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.

  8. Vasculogenesis and Diabetic Erectile Dysfunction: How Relevant Is Glycemic Control?

    Science.gov (United States)

    Castela, Angela; Gomes, Pedro; Silvestre, Ricardo; Guardão, Luísa; Leite, Liliana; Chilro, Rui; Rodrigues, Ilda; Vendeira, Pedro; Virag, Ronald; Costa, Carla

    2017-01-01

    Erectile dysfunction (ED) is a complication of diabetes, condition responsible for causing endothelial dysfunction (EDys) and hampering repair mechanisms. However, scarce information is available linking vasculogenesis mediated by Endothelial Progenitor Cells (EPCs) and diabetes-associated ED. Furthermore, it remains to be elucidated if glycemic control plays a role on EPCs functions, EPCs modulators, and penile vascular health. We evaluated the effects of diabetes and insulin therapy on bone marrow (BM) and circulating EPCs, testosterone, and systemic/penile Stromal Derived Factor-1 alpha (SDF-1α) expression. Male Wistar rats were divided into groups: age-matched controls, 8-weeks streptozotocin-induced type 1 diabetics, and insulin-treated 8-weeks diabetics. EPCs were identified by flow cytometry for CD34/CD133/VEGFR2/CXCR4 antigens. Systemic SDF-1α and testosterone levels were evaluated by ELISA. Penile SDF-1α protein expression was assessed, in experimental and human diabetic cavernosal samples, by immunohistochemical techniques. Diabetic animals presented a reduction of BM-derived EPCs and an increase in putative circulating endothelial cells (CECs) sloughed from vessels wall. These alterations were rescued by insulin therapy. In addition, glycemic control promoted an increase in systemic testosterone and SDF-1α levels, which were significantly decreased in animals with diabetes. SDF-1α protein expression was reduced in experimental and human cavernosal diabetic samples, an effect prevented by insulin in treated animals. Insulin administration rescued the effects of diabetes on BM function, CECs levels, testosterone, and plasmatic/penile SDF-1α protein expression. This emphasizes the importance of glycemic control in the prevention of diabetes-induced systemic and penile EDys, by the amelioration of endothelial damage, and increase in protective pathways. J. Cell. Biochem. 118: 82-91, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  9. Propensity-score matching in economic analyses: comparison with regression models, instrumental variables, residual inclusion, differences-in-differences, and decomposition methods.

    Science.gov (United States)

    Crown, William H

    2014-02-01

    This paper examines the use of propensity score matching in economic analyses of observational data. Several excellent papers have previously reviewed practical aspects of propensity score estimation and other aspects of the propensity score literature. The purpose of this paper is to compare the conceptual foundation of propensity score models with alternative estimators of treatment effects. References are provided to empirical comparisons among methods that have appeared in the literature. These comparisons are available for a subset of the methods considered in this paper. However, in some cases, no pairwise comparisons of particular methods are yet available, and there are no examples of comparisons across all of the methods surveyed here. Irrespective of the availability of empirical comparisons, the goal of this paper is to provide some intuition about the relative merits of alternative estimators in health economic evaluations where nonlinearity, sample size, availability of pre/post data, heterogeneity, and missing variables can have important implications for choice of methodology. Also considered is the potential combination of propensity score matching with alternative methods such as differences-in-differences and decomposition methods that have not yet appeared in the empirical literature.

  10. 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

  11. 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.

  12. Analysis of the relationships between type 2 diabetes status, glycemic control, and neuroimaging measures in the Diabetes Heart Study Mind.

    Science.gov (United States)

    Raffield, Laura M; Cox, Amanda J; Freedman, Barry I; Hugenschmidt, Christina E; Hsu, Fang-Chi; Wagner, Benjamin C; Xu, Jianzhao; Maldjian, Joseph A; Bowden, Donald W

    2016-06-01

    To examine the relationships between type 2 diabetes (T2D) status, glycemic control, and T2D duration with magnetic resonance imaging (MRI)-derived neuroimaging measures in European Americans from the Diabetes Heart Study (DHS) Mind cohort. Relationships were examined using marginal models with generalized estimating equations in 784 participants from 514 DHS Mind families. Fasting plasma glucose, glycated hemoglobin, and diabetes duration were analyzed in 682 participants with T2D. Models were adjusted for potential confounders, including age, sex, history of cardiovascular disease, smoking, educational attainment, and use of statins or blood pressure medications. Association was tested with gray and white matter volume, white matter lesion volume, gray matter cerebral blood flow, and white and gray matter fractional anisotropy and mean diffusivity. Adjusting for multiple comparisons, T2D status was associated with reduced white matter volume (p = 2.48 × 10(-6)) and reduced gray and white matter fractional anisotropy (p ≤ 0.001) in fully adjusted models, with a trend toward increased white matter lesion volume (p = 0.008) and increased gray and white matter mean diffusivity (p ≤ 0.031). Among T2D-affected participants, neither fasting glucose, glycated hemoglobin, nor diabetes duration were associated with the neuroimaging measures assessed (p > 0.05). While T2D was significantly associated with MRI-derived neuroimaging measures, differences in glycemic control in T2D-affected individuals in the DHS Mind study do not appear to significantly contribute to variation in these measures. This supports the idea that the presence or absence of T2D, not fine gradations of glycemic control, may be more significantly associated with age-related changes in the brain.

  13. 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.

  14. 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 t...

  15. 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....

  16. ASHP therapeutic position statement on strict glycemic control in patients with diabetes.

    Science.gov (United States)

    2003-11-15

    The deleterious effects of hyperglycemia have been documented from the biochemical to the pathophysiologic level. Given the research findings and the guidelines for glycemic control established by ADA and ACE, ASHP supports and encourages strict glycemic control in all appropriate patients with diabetes mellitus to reduce the progression of chronic complications.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. The Effect of Financial and Non-Financial Variables to Firm Performance: Comparison Between Indonesia and Thailand

    Directory of Open Access Journals (Sweden)

    Hasni Yusrianti

    2016-04-01

    Full Text Available The purpose of this research is to test the effect of financial and non-financial variables to firm performances between Indonesia and Thailand. The observation data used in this study is manufacturing companies from several sectors.  Secondary data was used, collected from Indonesia Stock Exchange and Stock Exchange of Thailand during 2011 - 2013. By combining 3 years research, there are 55 Indonesian companies and 50 Thailand companies that meet predetermined criteria.  Multiple Regression was used to analyze. This study uses Return on Equity, Earnings per Share, Market Value Added as financial variables and Earnings Quality, Institutional Ownership, Independent Commissioner, Audit Committee, Corporate Social Responsibility as non-financial variables. Test results show that both financial and non-financial variables can effect to firm performance.

  19. Use of telemedicine improves glycemic control and quality of life in type 1 diabetes children on insulin pump therapy

    Directory of Open Access Journals (Sweden)

    Dmitry N. Laptev

    2018-02-01

    Full Text Available Rationale: Healthcare access plays a significant role in the improvement and maintaining of glycemic control and quality of life in type 1 diabetes mellitus (T1DM patients on continuous subcutaneous insulin infusion (CSII. Aims: The aim of the study was to evaluate the feasibility of remote support in children and adolescents with type 1 diabetes mellitus (T1DM and its effect on glycemic control and quality of life. Materials and methods: In 40 children and adolescents (13±2,7 years, 18/22 m/f on CSII with inadequately controlled T1DM (HbA1c≥7,5% we evaluated the effectiveness of telemedical support (TS, as compared with conventional support (CS. Parameters of glycemic control (HbA1c, average glycemia, SD, etc. and quality of a life were obtained on follow-up visits. Patients and their parents in ТМ group twice a month sent their insulin pump data using to CSII center and diabetologists sent back their advice via e-mail, phone or Skype. The primary end point was the change from the baseline HbA1c level and the proportion of patients achieving HbA1c of less than 7.5%. Results: At 24 weeks, the baseline mean HbA1c (8.7% in the two study groups had decreased to 7.7% in the TS group, as compared with 8.4% in the CS group (P0,05. Conclusion: In children with inadequately controlled T1DM, telemedical support proved to be feasible and resulted in significant improvement in glucose control (HbA1c, glucose variability and quality of life without the increase in the incidence of DKA and severe glycemia.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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…

  4. Comparison of Two- and Three-Dimensional Methods for Analysis of Trunk Kinematic Variables in the Golf Swing.

    Science.gov (United States)

    Smith, Aimée C; Roberts, Jonathan R; Wallace, Eric S; Kong, Pui; Forrester, Stephanie E

    2016-02-01

    Two-dimensional methods have been used to compute trunk kinematic variables (flexion/extension, lateral bend, axial rotation) and X-factor (difference in axial rotation between trunk and pelvis) during the golf swing. Recent X-factor studies advocated three-dimensional (3D) analysis due to the errors associated with two-dimensional (2D) methods, but this has not been investigated for all trunk kinematic variables. The purpose of this study was to compare trunk kinematic variables and X-factor calculated by 2D and 3D methods to examine how different approaches influenced their profiles during the swing. Trunk kinematic variables and X-factor were calculated for golfers from vectors projected onto the global laboratory planes and from 3D segment angles. Trunk kinematic variable profiles were similar in shape; however, there were statistically significant differences in trunk flexion (-6.5 ± 3.6°) at top of backswing and trunk right-side lateral bend (8.7 ± 2.9°) at impact. Differences between 2D and 3D X-factor (approximately 16°) could largely be explained by projection errors introduced to the 2D analysis through flexion and lateral bend of the trunk and pelvis segments. The results support the need to use a 3D method for kinematic data calculation to accurately analyze the golf swing.

  5. Speech production accuracy and variability in young cochlear implant recipients: comparisons with typically developing age-peers.

    Science.gov (United States)

    Ertmer, David J; Goffman, Lisa

    2011-02-01

    The speech production accuracy and variability scores of 6 young cochlear implant (CI) recipients with 2 years of device experience were compared with those of typically developing (TD) age-peers. Words from the First Words Speech Test (FWST; Ertmer, 1999) were imitated 3 times to assess the accuracy and variability of initial consonants, vowels, and words. The initial consonants in the 4 sets of the FWST followed a typical order of development. The TD group produced targets with high accuracy and low variability. Their scores across FWST sets reflected the expected order of development. The CI group produced most targets less accurately and with more variability than the TD children. Relatively high accuracy for the consonants of Sets 1 and 2 indicated that these phonemes were acquired early and in a typical developmental order. A trend toward greater accuracy for Set 4 as compared with Set 3 suggested that later-emerging consonants were not acquired in the expected order. Variability was greatest for later-emerging initial consonants and whole words. Although considerable speech production proficiency was evident, age-level performance was not attained after 2 years of CI experience. Factors that might influence the order of consonant acquisition are discussed.

  6. Universal, developmental, and variable aspects of young children's play: a cross-cultural comparison of pretending at home.

    Science.gov (United States)

    Haight, W L; Wang, X L; Fung, H H; Williams, K; Mintz, J

    1999-01-01

    Using longitudinal data from five Irish American families in the United States and nine Chinese families in Taiwan, in conjunction with an emerging body of evidence in the cultural psychology literature, we propose universal, culturally variable, and developmental dimensions of young children's pretend play. Possible universal dimensions include the use of objects, and the predominantly social nature of pretend play. Developmental dimensions include increases in the proportion of social pretend play initiated by the child, the proportion of partner initiations elaborated upon by the child, and caregivers' use of pretend play initiations to serve other, nonplay social functions. Culturally variable dimensions include the centrality of objects, the participation of specific play partners, the extent of child initiations of social pretend play with caregivers, the various functions of social pretend play in interaction, and specific themes. These findings raise the theoretical issue of how universal and variable dimensions of pretend play interact in specific communities to create distinctive development pathways.

  7. A comparison of methods to estimate daily global solar irradiation from other climatic variables on the Canadian prairies

    International Nuclear Information System (INIS)

    Barr, A.G.; McGinn, S.M.; Cheng, S.B.

    1996-01-01

    Historic estimates of daily global solar irradiation are often required for climatic impact studies. Regression equations with daily global solar irradiation, H, as the dependent variable and other climatic variables as the independent variables provide a practical way to estimate H at locations where it is not measured. They may also have potential to estimate H before 1953, the year of the first routine H measurements in Canada. This study compares several regression equations for calculating H on the Canadian prairies. Simple linear regression with daily bright sunshine duration as the dependent variable accounted for 90% of the variation of H in summer and 75% of the variation of H in winter. Linear regression with the daily air temperature range as the dependent variable accounted for 45% of the variation of H in summer and only 6% of the variation of H in winter. Linear regression with precipitation status (wet or dry) as the dependent variable accounted for only 35% of the summer-time variation in H, but stratifying other regression analyses into wet and dry days reduced their root-mean-squared errors. For periods with sufficiently dense bright sunshine observations (i.e. after 1960), however, H was more accurately estimated from spatially interpolated bright sunshine duration than from locally observed air temperature range or precipitation status. The daily air temperature range and precipitation status may have utility for estimating H for periods before 1953, when they are the only widely available climatic data on the Canadian prairies. Between 1953 and 1989, a period of large climatic variation, the regression coefficients did not vary significantly between contrasting years with cool-wet, intermediate and warm-dry summers. They should apply equally well earlier in the century. (author)

  8. 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.

  9. Glycemic Index and Glycemic Load and Their Association with C-Reactive Protein and Incident Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Geertruida J. van Woudenbergh

    2011-01-01

    Full Text Available Objective. To investigate whether the Glycemic Index (GI or Glycemic Load (GL of a diet is associated with C-reactive Protein (CRP and risk of type 2 diabetes in a prospective study. Materials and Methods. Our analysis included 4,366 participants who did not have diabetes at baseline. During follow-up 456 diabetes cases were confirmed. Dietary GI and GL were derived from a food-frequency questionnaire and its association with CRP was examined cross-sectionally using linear regression models. The association of GI and GL with diabetes incidence was examined using Cox proportional hazard models. Results. GL, but not GI, was associated with lnCRP at baseline (bGL=0.11 per 50 units; P=.01. When comparing the highest to the lowest tertile of GI with respect to diabetes incidence, a Relative Risk (RR of 0.95 [95%CI 0.75, 1.21] was found after adjustment for lifestyle and nutritional factors. For GL the RR for diabetes incidence was 1.00 [95%CI 0.74, 1.36]. Additional adjustment for CRP did not change RRs. Conclusion. Since GI was not associated with CRP and risk of type 2 diabetes, it is unlikely that a high GI diet induces the previously shown positive association between CRP and risk of type 2 diabetes by increasing CRP concentrations.

  10. 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

  11. Continuous glucose monitoring with Humalog Mix 25 versus Humalog Mix 50, twice daily: A comparative pilot study -Results from the Jikei-EValuation of insulin Lispro mixture on pharmacodynamics and glycemic VariancE (J-EVOLVE study

    Directory of Open Access Journals (Sweden)

    Morimoto Aya

    2010-05-01

    Full Text Available Abstract Objective To evaluate glycemic variability associated with two different premixed insulin analogue formulations when used in a twice-daily regimen. Patients and Methods Subjects comprised type 2 diabetic patients aged 20-79 years, treated with twice daily premixed insulin or insulin analogue formulations. All subjects were hospitalized for 6 days and randomized to receive either Humalog Mix 25 (Mix 25 or Humalog Mix 50 (Mix 50. They were then crossed over to the other arm between day 3 and day 4 of the study. Continuous glucose monitoring (CGM was performed on all subjects to examine the differences in glycemic variability. Results Eleven type 2 diabetic patients were enrolled. No significant difference was found in 24-hour mean glucose values and their SDs, pre-meal glucose values, increases from pre-meal to peak glucose values, or time to peak glucose levels between either group. However, the mean glucose values observed during 0-8 hrs were significantly lower with Mix 25 compared to Mix 50 (128 vs. 147 mg/dL; p = 0.024. Conclusions The twice-daily Mix 25 regimen provided superior overnight glycemic control compared to the Mix 50 regimen in Japanese patients with type 2 diabetes. However, both twice-daily regimens with either Mix 25 or Mix 50 provided inadequate post-lunch glycemic control. Trial Registration Current Controlled Trials UMIN000001327

  12. The Impact of Mindfulness-Based Stress Reduction on Emotional Wellbeing and Glycemic Control of Patients with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    A. Armani Kian

    2018-01-01

    Full Text Available Objective. The aim of the study was to determine the effect of mindfulness-based stress reduction (MBSR intervention on emotion regulation and glycemic control of patients with type 2 diabetes. Materials and Methods. Sixty patients with type 2 diabetes were recruited for this randomized controlled trial from an outpatient clinic at Imam Hospital in Iran. The intervention group participated in 8 sessions of MBSR, and the control group continued the treatment as usual. Fasting blood sugar and HbA1c were measured as two indices of glycemic control. Overall mental health, depression, and anxiety were measured using the General Health Questionnaire (GHQ-28, Hamilton Depression Rating Scale (HDRS, and Hamilton Anxiety Rating Scale (HARS, respectively. All the assessments were performed at baseline and after 8 weeks and 3 months as follow-up. Results. In comparison with the control group, the MBSR intervention group showed a significant reduction on all outcome measures including FBS, HbA1C, HARS, and HDRS scores (p<0/05. Conclusion. MBSR had a remarkable improvement on emotional wellbeing and glycemic control of patients with type 2 diabetes.

  13. [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.

  14. Comparison of Sex-Role Orientation and Personality Variables in Traditional Women and College Re-Entry Women.

    Science.gov (United States)

    Pierce, Norma F.

    Studies have indicated that mature women maintain a permanent role identity along two dimensions, i.e., traditional women or nontraditional women. However, the lifeset of many mature adult women may be on the continuum between these two positions, i.e., in the position of "deferred achiever." The personality variables and sex-role orientations of…

  15. Comparison of two systems for long-term heart rate variability monitoring in free-living conditions - a pilot study

    DEFF Research Database (Denmark)

    Kristiansen, Jesper; Korshoj, Mette; Skotte, Jorgen H

    2011-01-01

    Actiheart and Holter recorders, and signals were processed to RR-interval time series. Segments of 5-minute duration were sampled every 30 minutes, and spectral components of the heart rate variability were calculated. Actiheart and Holter values were compared using Deming regression analysis and Bland...

  16. 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

  17. 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

  18. Patterns of glycemic control using glycosylated hemoglobin in diabetics

    Directory of Open Access Journals (Sweden)

    Arunpreet Singh Kahlon

    2011-01-01

    Full Text Available Aim : Till now estimation of blood glucose is the highly effective method for diagnosing diabetes mellitus but it provides a short-term picture of control. More evidence is required to prove that plasma glucose and glycosylated hemoglobin levels together gives a better estimate of glycemic control and compliance with treatment. Indian diabetes risk score (IDRS is a simplified screening tool for identifying undiagnosed diabetic subjects, requires minimum time, and effort and can help to considerably reduce the costs of screening. Objective : To study patterns of glycemic control using glycosylated hemoglobin in diabetic patients. To find out correlation between levels of plasma glucose and glycosylated hemoglobin in diabetics and to calculate IDRS of the study population. Materials and Methods : A cross sectional study was conducted among 300 known diabetic patients attending outpatient department of a rural medical college in Haryana, India. Following standard procedures and protocols FPG and glycosylated hemoglobin were measured to find out a pattern of glycemic control in them after taking their written and informed consent. A correlation between the levels of glycosylated hemoglobin and fasting blood glucose was also calculated. These patients were made to fill a performa and their demographic and clinical risk factors were noted and based on this, their IDRS was calculated. This was done to validate the IDRS in Indian rural population. Results : Fifty-two percent of the population had fasting plasma glucose level between 125-150 mg/dl, 21% had this level between 151-175 mg/dl. Thirteen percent of the study subjects had HbA1C between 6.5-7.5, more than half (57.3% had this value between 7.5-8.5, 12% and 18% had values between 8.5-9.5 and 9.5-10.5, respectively. Twelve percent of the participants had HbA1C level higher than 10.5. Correlation of fasting plasma glucose level and HbA1C was also studied and found that correlation coefficient came

  19. Patterns of glycemic control using glycosylated hemoglobin in diabetics.

    Science.gov (United States)

    Kahlon, Arunpreet Singh; Pathak, Rambha

    2011-07-01

    Till now estimation of blood glucose is the highly effective method for diagnosing diabetes mellitus but it provides a short-term picture of control. More evidence is required to prove that plasma glucose and glycosylated hemoglobin levels together gives a better estimate of glycemic control and compliance with treatment. Indian diabetes risk score (IDRS) is a simplified screening tool for identifying undiagnosed diabetic subjects, requires minimum time, and effort and can help to considerably reduce the costs of screening. To study patterns of glycemic control using glycosylated hemoglobin in diabetic patients. To find out correlation between levels of plasma glucose and glycosylated hemoglobin in diabetics and to calculate IDRS of the study population. A cross sectional study was conducted among 300 known diabetic patients attending outpatient department of a rural medical college in Haryana, India. Following standard procedures and protocols FPG and glycosylated hemoglobin were measured to find out a pattern of glycemic control in them after taking their written and informed consent. A correlation between the levels of glycosylated hemoglobin and fasting blood glucose was also calculated. These patients were made to fill a performa and their demographic and clinical risk factors were noted and based on this, their IDRS was calculated. This was done to validate the IDRS in Indian rural population. Fifty-two percent of the population had fasting plasma glucose level between 125-150 mg/dl, 21% had this level between 151-175 mg/dl. Thirteen percent of the study subjects had HbA1C between 6.5-7.5, more than half (57.3%) had this value between 7.5-8.5, 12% and 18% had values between 8.5-9.5 and 9.5-10.5, respectively. Twelve percent of the participants had HbA1C level higher than 10.5. Correlation of fasting plasma glucose level and HbA1C was also studied and found that correlation coefficient came out to be .311. This correlation was found to be statistically

  20. 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.

  1. Factors associated with glycemic control among diabetic adult out-patients in Northeast Ethiopia.

    Science.gov (United States)

    Fiseha, Temesgen; Alemayehu, Ermiyas; Kassahun, Wongelawit; Adamu, Aderaw; Gebreweld, Angesom

    2018-05-18

    The aim of this study was to determine the status of glycemic control and identify factors associated with poor glycemic control among diabetic out-patients. A hospital based cross-sectional study was conducted among randomly selected 384 (126 type 1 and 258 type 2) diabetic adults attending a hospital in Northeast Ethiopia from January 1 to April 30, 2017. Of the total participants, 70.8% had poor status of glycemic control (defined as mean fasting blood glucose level above 130 mg/dl). In the multivariate analysis, rural residence (AOR = 2.61, 95% CI 1.37-4.96), low educational level (AOR = 7.10, 95% CI 2.94-17.17) and longer duration of diabetes (AOR = 2.20, 95% CI 1.18-4.08) were significantly associated with increased odds of poor glycemic control. Moreover, merchants (AOR = 3.39, 95% CI 1.16-9.96) were significantly more likely to have poor glycemic control compared to government employee. Diabetic patients receiving oral anti-diabetics (AOR = 5.12, 95% CI 2.10-12.52) or insulin (AOR = 3.26, 95% CI 1.26-8.48) were more likely to be poorly controlled. These results highlight the needed for appropriate management of patients focusing on associated factors identified for poor glycemic control to maintain good glycemic control and improve adverse outcomes of the disease in this study setting.

  2. FACTORS ASSOCIATED WITH POOR GLYCEMIC CONTROL AMONG TYPE 2 DIABETES MELLITUS IN INDONESIA

    Directory of Open Access Journals (Sweden)

    Rian Adi Pamungkas

    2017-07-01

    Full Text Available Background: Type 2 Diabetes mellitus becomes the public health problem in the wide world. Reasons for poor glycemic control in Type 2 diabetes are complex. Objective: To determine factors contributed to poor glycemic control among Indonesian patients with Type 2 Diabetes Methods: This was a cross sectional regression study. There were 70 respondents selected using purposive sampling. Pre-structured questionnaires were used to measure socio demographic, clinical characteristics, self-care management behaviors, medication adherence, barriers to adherence, and family support. Data were analyzed using chi-square and binary logistic regression. Results: Poor glycemic control was defined as HbA1c ≥7% or FBG ≥200 mg/dl. Findings of this study reported that 83% patients had or FBG ≥200 mg/dl, which confirmed as poor glycemic control. Logistic regression showed that increasing duration of diabetes (> 5 years, non-adherence to dietary behaviors recommendation through selecting healthy diet, arranging a meal plan, recognizing the amount calorie needs, managing dietary behaviors challenges, medication adherence, and family support were significantly influence poor glycemic control with increased odds ratio scores. Conclusion: The proportion of patients with poor glycemic control was raised. Increasing duration of diabetes, non- adherence to medication and dietary behaviors management, and lack of family support were associated with poor glycemic control. Thus, integration of diabetes self-management program with social support is needed to deal with patients’ need to achieve the great benefits in diabetes care.

  3. 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 1.345, 95 % CI 1.022-1.769; P = 0.034), higher levels of fasting blood glucose (OR 1.954, 95 % CI 1.778-2.147; P 1), and low-density lipoprotein cholesterol (OR 1.181, 95 % CI 1.020-1.367; P = 0.026) were significantly associated with poor glycemic control. The complexity of antidiabetics was also associated with poor glycemic control (P insulin injection was most strongly associated with poor glycemic control (OR 6.210, 95 % CI 4.054-9.514; P 1). Male patients with higher levels of total cholesterol, lower levels of high-density lipoprotein cholesterol, or longer 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.

  4. Comparison of small-footprint discrete return and full waveform airborne lidar data for estimating multiple forest variables

    OpenAIRE

    Sumnall, Matthew J.; Hill, Ross A.; Hinsley, Shelley A.

    2016-01-01

    The quantification of forest ecosystems is important for a variety of purposes, including the assessment of wildlife habitat, nutrient cycles, timber yield and fire propagation. This research assesses the estimation of forest structure, composition and deadwood variables from small-footprint airborne lidar data, both discrete return (DR) and full waveform (FW), acquired under leaf-on and leaf-off conditions. The field site, in the New Forest, UK, includes managed plantation and ancient, se...

  5. Low-frequency variability of the atmospheric circulation: a comparison of statistical properties in both hemispheres and extreme seasons

    International Nuclear Information System (INIS)

    Buzzi, A.; Tosi, E.

    1988-01-01

    A statistical investigation is presented of the main variables characterizing the tropospheric general circulation in both hemispheres and extreme season, Winter and Summer. This gives up the opportunity of comparing four distinct realizations of the planetary circulation, as function of different orographic and thermal forcing conditions. Our approach is made possible by the availability of 6 years of global daily analyses prepared by ECMWF (European Centre for Medium-range Weather Forecast). The variables taken into account are the zonal geostrophic wind, the zonal thermal wind and various large-scala wave components, averaged over the tropospheric depth between 1000 and 200 hPa. The mean properties of the analysed quantities in each hemisphere and season are compared and their principal characteristics are discussed. The probability density estimates for the same variables, filtered in order to eliminate the seasonal cycle and the high frequency 'noise', are then presented. The distributions are examined, in particular, with respect of their unimodal or multimodal nature and with reference to the recent discussion in the literature on the bimodality which has been found for some indicators of planetary wave activity in the Nothern Hemisphere Winter. Our results indicate the presence of nonunimodally distributed wave and zonal flow components in both hemispheres and extreme season. The most frequent occurrence of nonunimodal behaviour is found for those wave components which exhibit an almost vanishing zonal phase speed and a larger 'response' to orographic forcing

  6. 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.

    1978-01-01

    The variable modulus-cracking model is capable of predicting the behavior of reinforced concrete structures (such as the reinforced plate under transverse pressure described previously) well into the range of nonlinear behavior including the prediction of the ultimate load. For unreinforced thick-walled concrete vessels under internal pressure the use of elastic--plastic concrete models in finite element codes enhances the apparent ductility of the vessels in contrast to variable modulus-cracking models that predict nearly instantaneous rupture whenever the tensile strength at the inner wall is exceeded. For unreinforced thick-walled end slabs representative of PCRV heads, the behavior predicted by finite element codes using variable modulus-cracking models is much stiffer in the nonlinear range than that observed experimentally. Although the shear type failures and crack patterns that are observed experimentally are predicted by such concrete models, the ultimate load carrying capacity and vessel-ductility are significantly underestimated. It appears that such models do not adequately model such features as aggregate interlock that could lead to an enhanced vessel reserve strength and ductility

  7. 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.)

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

    Science.gov (United States)

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

    2016-09-01

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

  9. 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

    , 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......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...... perfluorooctane sulfonic acid/mL plasma was associated with 16.2% (95% confidence interval [CI], 5.2%-28.3%) higher insulin concentration, 12.0% (95% CI, 2.4%-22.4%) higher β-cell activity, 17.6% (95% CI, 5.8%-30.8%) higher insulin resistance, and 8.6% (95% CI, 1.2%-16.5%) higher triglyceride concentrations...

  10. Abscisic Acid: A Novel Nutraceutical for Glycemic Control

    Science.gov (United States)

    Zocchi, Elena; Hontecillas, Raquel; Leber, Andrew; Einerhand, Alexandra; Carbo, Adria; Bruzzone, Santina; Tubau-Juni, Nuria; Philipson, Noah; Zoccoli-Rodriguez, Victoria; Sturla, Laura; Bassaganya-Riera, Josep

    2017-01-01

    Abscisic acid is naturally present in fruits and vegetables, and it plays an important role in managing glucose homeostasis in humans. According to the latest U.S. dietary survey, about 92% of the population might have a deficient intake of ABA due to their deficient intake of fruits and vegetables. This review summarizes the in vitro, preclinical, mechanistic, and human translational findings obtained over the past 15 years in the study of the role of ABA in glycemic control. In 2007, dietary ABA was first reported to ameliorate glucose tolerance and obesity-related inflammation in mice. The most recent findings regarding the topic of ABA and its proposed receptor lanthionine synthetase C-like 2 in glycemic control and their interplay with insulin and glucagon-like peptide-1 suggest a major role for ABA in the physiological response to a glucose load in humans. Moreover, emerging evidence suggests that the ABA response might be dysfunctional in diabetic subjects. Follow on intervention studies in healthy individuals show that low-dose dietary ABA administration exerts a beneficial effect on the glycemia and insulinemia profiles after oral glucose load. These recent findings showing benefits in humans, together with extensive efficacy data in mouse models of diabetes and inflammatory disease, suggest the need for reference ABA values and its possible exploitation of the glycemia-lowering effects of ABA for preventative purposes. Larger clinical studies on healthy, prediabetic, and diabetic subjects are needed to determine whether addressing the widespread dietary ABA deficiency improves glucose control in humans. PMID:28660193

  11. Glycemic Variation in Tumor Patients with Total Parenteral Nutrition

    Directory of Open Access Journals (Sweden)

    Jin-Cheng Yang

    2015-01-01

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

  12. Human glycemic response and phenolic content of unsweetened cranberry juice.

    Science.gov (United States)

    Wilson, Ted; Singh, Ajay P; Vorsa, Nicholi; Goettl, Christopher D; Kittleson, Katrina M; Roe, Cindy M; Kastello, Gary M; Ragsdale, Frances R

    2008-03-01

    This cross-sectional study determined the phenolic composition of an over-the-counter cranberry juice (CBJ) with high-performance liquid chromatography and examined the effects of low- and normal-calorie CBJ formulations on the postprandial glycemic response in healthy humans. The CBJ used in this study contained seven phenolic acids, with 3- and 5-caffeoylquinic acid being the primary components, and 15 flavonol glycosides, with myricetin-3-galactoside and quercetin-3-galactoside being the most prevalent. CBJ proanthocyanidins consisted of three different tetramers and a heptamer, which were confirmed with matrix-assisted laser desorption ionization-time of flight-mass spectrometry analysis. Participants received one of the following six treatments: nothing (no water/beverage), water (480 mL), unsweetened low-calorie CBJ (38 Cal/480 mL), normal-calorie CBJ (280 Cal/480 mL), isocaloric normal calorie (high fructose corn syrup [HFCS]), or isocaloric low-calorie beverages. No significant differences in postprandial blood glucose or insulin were observed in the groups receiving nothing, water, or low-calorie treatments. In contrast, the ingestion of normal-calorie CBJ and normal-calorie control beverage resulted in significantly higher blood glucose concentrations 30 minutes postprandially, although the differences were no longer significant after 180 minutes. Plasma insulin of normal-calorie CBJ and control (HFCS) recipients was significantly higher 60 minutes postprandially, but not significantly different 120 minutes postprandially. CBJ ingestion did not affect heart rate or blood pressure. This study suggests that the consumption of a low-calorie CBJ rich in previously uncharacterized trimer and heptamer proanthocyanidins is associated with a favorable glycemic response and may be beneficial for persons with impaired glucose tolerance.

  13. 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

  14. 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.

  15. High Amylose White Rice Reduces Post-Prandial Glycemic Response but Not Appetite in Humans

    Directory of Open Access Journals (Sweden)

    Alison M. Zenel

    2015-07-01

    Full Text Available The present study compared the effects of three rice cultivars on postprandial glycemic control and appetite. A single-blind, randomized, crossover clinical trial was performed with 18 healthy subjects, nine males and nine females. Three treatments were administered at three separate study visits: commercially available conventional white rice (short grain, specialty high amylose white rice 1 (Dixiebelle, and specialty high amylose white rice 2 (Rondo. Postprandial capillary blood glucose, venous blood glucose and insulin measurements, and appetite visual analog scale (VAS surveys were done over the course of two hours. The capillary blood glucose concentrations were significantly lower for Rondo compared to short grain rice at 30 min, and for Dixiebelle and Rondo compared to short grain rice at 45, 60, and 120 min. Capillary blood glucose area under the curve (AUC was significantly lower for Dixiebelle and Rondo compared to short grain rice. Subjects were significantly more hungry at 30 min after Dixiebelle intake than Rondo intake, but there were no other significant effects in appetite ratings. The present study determined that intake of high amylose rice with resistant starch (RS can attenuate postprandial blood glucose and insulin response in comparison to short grain rice.

  16. 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.

  17. Comparison of semen variables, sperm DNA damage and sperm membrane proteins in two male layer breeder lines.

    Science.gov (United States)

    M, Shanmugam; T R, Kannaki; A, Vinoth

    2016-09-01

    Semen variables are affected by the breed and strain of chicken. The present study was undertaken to compare the semen quality in two lines of adult chickens with particular reference to sperm chromatin condensation, sperm DNA damage and sperm membrane proteins. Semen from a PD3 and White Leghorn control line was collected at 46 and 47 weeks and 55 weeks of age. The semen was evaluated for gross variables and sperm chromatin condensation by aniline blue staining. Sperm DNA damage was assessed by using the comet assay at 47 weeks of age and sperm membrane proteins were assessed at 55 weeks of age. The duration of fertility was studied by inseminating 100 million sperm once into the hens of the same line as well as another line. The eggs were collected after insemination for 15days and incubated. The eggs were candled on 18th day of incubation for observing embryonic development. The White Leghorn control line had a greater sperm concentration and lesser percentage of morphologically abnormal sperm at the different ages where assessments occurred. There was no difference in sperm chromatin condensation, DNA damage and membrane proteins between the lines. Only low molecular weight protein bands of less than 95kDa were observed in samples of both lines. The line from which semen was used had no effect on the duration over which fertility was sustained after insemination either when used in the same line or another line. Thus, from the results of the present study it may be concluded that there was a difference in gross semen variables between the lines that were studied, however, the sperm chromatin condensation, DNA damage, membrane proteins and duration over which fertility was sustained after insemination did not differ between the lines. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Low- and high-anxious hypermobile Ehlers-Danlos syndrome patients: comparison of psychosocial and health variables.

    Science.gov (United States)

    Baeza-Velasco, Carolina; Bourdon, Caroline; Montalescot, Lucile; de Cazotte, Cécile; Pailhez, Guillem; Bulbena, Antonio; Hamonet, Claude

    2018-05-01

    Despite the frequent co-ocurrence of hypermobile Ehler-Danlos syndrome (hEDS) and pathological anxiety, little is known about the psychosocial and health implications of such comorbidity. Our aim was to explore the association between high levels of anxiety and psychosocial (catastrophizing, kinesiophobia, somatosensory amplification, social support and functioning), health (pain, fatigue, BMI, tobacco/alcohol use, depression, diagnosis delay, general health), and sociodemographic factors in people with hEDS. In this cross-sectional study, 80 hEDS patients were divided into two groups according to self-reported anxiety levels: low and high. Psychosocial, sociodemographic and health variables were compared between the groups. Forty-one participants reported a high level of anxiety (51.2%). No differences were found in the sociodemographic variables between high-anxious and low-anxious patients. The percentage of participants with severe fatigue and high depressive symptomatology was significantly higher in the high-anxious group (80.5 vs 56.4; 26.8 vs 12.8%, respectively). High-anxious hEDS patients also showed significantly higher levels of pain catastrophizing, somatosensory amplification as well as a poorer social functioning and general health. Multivariate analyses showed that somatosensory amplification, pain catastrophizing and poor social functioning are variables that increase the probability of belonging to the high-anxious group. Despite limitations, this first study comparing high-anxious versus low-anxious hEDS patients with respect to health aspects, highlight the importance of considering the psychosocial factors (many susceptible to modification), to improve the adjustment to this chronic condition and provide support to those affected through a biopsychosocial approach.

  19. Comparison of ground-based and Viking Orbiter measurements of Martian water vapor - Variability of the seasonal cycle

    Science.gov (United States)

    Jakosky, B. M.; Barker, E. S.

    1984-01-01

    Earth-based observations of Mars atmospheric water vapor are presented for the 1975-1976, 1977-1978, and 1983 apparitions. Comparisons are made with near-simultaneous spacecraft measurements made from the Viking Orbiter Mars Atmospheric Water Detection experiment during 1976-1978 and with previous earth-based measurements. Differences occur between the behavior in the different years, and may be related to the Mars climate. Measurements during the southern summer in 1969 indicate a factor of three times as much water as is present at this same season in other years. This difference may have resulted from the sublimation of water from the south polar residual cap upon removal of most or all of the CO2 ice present; sublimation of all of the CO2 ice during some years could be a result of a greater thermal load being placed on the cap due to the presence of differing amounts of atmospheric dust.

  20. 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 1%, 26.16 %, 36.71 % and 45.06% respectively in chamomile group compared with these variables in control group at the end of the intervention (all P 16 Elsevier Inc. All rights reserved.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. Alterations in hemostasis associated with pregnancy in patients with glycemic disorders

    Directory of Open Access Journals (Sweden)

    Irina Arkad'evna Bondar'

    2013-06-01

    Full Text Available In this review we present a comparative analysis of alterations in hemostasis and blood coagulation during normal pregnancy with those in pregnant women with glycemic disorders (diabetes mellitus type 1 and 2, gestational diabetes.

  6. 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

  7. 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.

  8. 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....

  9. Early Glycemic Control in Critically Ill Emergency Department Patients: Pilot Trial

    Directory of Open Access Journals (Sweden)

    Cohen, Jason

    2010-02-01

    Full Text Available Objective: Glycemic control in the critically ill intensive care unit (ICU patient has been shown to improve morbidity and mortality. We sought to investigate the effect of early glycemic control in critically ill emergency department (ED patients in a small pilot trial.Methods: Adult non-trauma, non-pregnant ED patients presenting to a university tertiary referral center and identified as critically ill were eligible for enrollment on a convenience basis. Critical illness was determined upon assignment for ICU admission. Patients were randomized to either ED standard care or glycemic control. Glycemic control involved use of an insulin drip to maintain blood glucose levels between 80-140 mg/dL. Glycemic control continued until ED discharge. Standard patients were managed at ED attending physician discretion. We assessed severity of illness by calculation of APACHE II score. The primary endpoint was in-hospital mortality. Secondary endpoints included vasopressor requirement, hospital length of stay, and mechanical ventilation requirement.Results: Fifty patients were randomized, 24 to the glycemic group and 26 to the standard care cohort. Four of the 24 patients (17% in the treatment arm did not receive insulin despite protocol requirements. While receiving insulin, three of 24 patients (13% had an episode of hypoglycemia. By chance, the patients in the treatment group had a trend toward higher acuity by APACHE II scores. Patient mortality and morbidity were similar despite the acuity difference.Conclusion: There was no difference in morbidity and mortality between the two groups. The benefit of glycemic control may be subject to source of illness and to degree of glycemic control, or have no effect. Such questions bear future investigation. [West J Emerg Med. 2010; 11(1:20-23].

  10. Evaluation of the glycemic indices of three commonly eaten mixed meals in Okada, Edo State

    OpenAIRE

    Omage, Kingsley; Omage, Sylvia O.

    2017-01-01

    Abstract People do not generally eat single or individual meals; rather they eat mixed meals, consisting of two or more individual meals. These mixed meals usually have glycemic indices which differ from that of the individual food type. This study was aimed at evaluating the glycemic indices of three commonly consumed mixed meals eaten in Okada; rice and beans (test food 1), rice and plantain (test food 2), beans and plantain (test food 3). Two hundred and forty healthy subjects aged between...

  11. Linagliptin increases incretin levels, lowers glucagon, and improves glycemic control in type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Rauch, Thomas; Graefe-Mody, Ulrike; Deacon, Carolyn F

    2012-01-01

    Linagliptin is a xanthine-based dipeptidyl peptidase (DPP)-4 inhibitor that is now available in numerous countries worldwide for the treatment of type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate further the mechanisms underlying the improvements in glycemic control observed...... with linagliptin. The effects of linagliptin on DPP-4, pharmacodynamic parameters, and glycemic control versus placebo were assessed in patients with inadequately controlled T2DM....

  12. 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...

  13. The association between dietary glycemic index, glycemic load and diet quality indices in Iranian adults: results from Isfahan Healthy Heart Program.

    Science.gov (United States)

    Azadbakht, Leila; Mohammadifard, Noushin; Akhavanzanjani, Mohsen; Taheri, Marzieh; Golshahi, Jafar; Haghighatdoost, Fahimeh

    2016-01-01

    To assess the association between dietary glycemic index (GI), glycemic load (GL) and dietary quality indices in Iranian adults. This cross section was conducted among 1571 Iranian adults aged  ≥19 years. GI, GL and diet quality indices were estimated by 24-h recall and DDS was calculated using a validated 48-item food frequency questionnaire. Participants who were in the top tertile of GI had lower healthy eating index (HEI) (57.2 ± 7.8 versus 55.6 ± 8.7; p diet quality indices may suggest the relevance of carbohydrate source in determining the diet quality indices.

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

    International Nuclear Information System (INIS)

    Khan, A.U.; Fakhr, A.; Khan, Z.A.; Nadeem, M.; Bangash, R.Y.

    2013-01-01

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

  15. Inpatient glycemic management in internal medicine: an observational multicenter study in Nanjing, China.

    Science.gov (United States)

    Hao, Shujie; Zhang, Ning; Fish, Anne Folta; Yuan, Xiaodan; Liu, Lin; Li, Fan; Fang, Zhaohui; Lou, Qingqing

    2017-08-01

    To evaluate the prevalence of hyperglycemia among inpatients in internal medicine, and specifically, to assess the glycemic management of inpatients in non-endocrinology departments in three large urban hospitals in China. A multicenter observational study was conducted using electronic health records, and a survey of 1939 patients who were admitted to internal medicine units and followed until discharge. Those with previously diagnosed diabetes, newly diagnosed diabetes, or impaired fasting glucose were included. Aspects of glycemic management examined were (a) hyperglycemia, (b) endocrinology consultation for hyperglycemia and (c) hypoglycemia. The prevalence of hyperglycemia in internal medicine was 45.7% (886 out of 1939). A total of 741 (83.6%) patients were treated by non-endocrinology departments; of those, 230 (31.1%) were in poor glycemic control and needed an endocrinology consultation. Yet only 57 (24.8%) received one. In 4 cases, the physician did not follow the consultants' advice. Among the remaining 53 consulted patients, 35 (66.1%) were still in poor glycemic control, yet only about half received a second consultation. Finally, among patients treated in non-endocrinology departments, 58 (7.8%) had hypoglycemia; less than half retested their blood glucose after treatment. The majority of patients with hyperglycemia were in non-endocrinology departments. Their glycemic management was poor; the endocrinology consultation rate was low and the result was suboptimal. Also, the management of hypoglycemia was not ideal. Therefore, improving glycemic management is urgently needed in Chinese hospitals.

  16. 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

  17. A comparison of weather variables linked to infectious disease patterns using laboratory addresses and patient residence addresses.

    Science.gov (United States)

    Djennad, Abdelmajid; Lo Iacono, Giovanni; Sarran, Christophe; Fleming, Lora E; Kessel, Anthony; Haines, Andy; Nichols, Gordon L

    2018-04-27

    To understand the impact of weather on infectious diseases, information on weather parameters at patient locations is needed, but this is not always accessible due to confidentiality or data availability. Weather parameters at nearby locations are often used as a proxy, but the accuracy of this practice is not known. Daily Campylobacter and Cryptosporidium cases across England and Wales were linked to local temperature and rainfall at the residence postcodes of the patients and at the corresponding postcodes of the laboratory where the patient's specimen was tested. The paired values of daily rainfall and temperature for the laboratory versus residence postcodes were interpolated from weather station data, and the results were analysed for agreement using linear regression. We also assessed potential dependency of the findings on the relative geographic distance between the patient's residence and the laboratory. There was significant and strong agreement between the daily values of rainfall and temperature at diagnostic laboratories with the values at the patient residence postcodes for samples containing the pathogens Campylobacter or Cryptosporidium. For rainfall, the R-squared was 0.96 for the former and 0.97 for the latter, and for maximum daily temperature, the R-squared was 0.99 for both. The overall mean distance between the patient residence and the laboratory was 11.9 km; however, the distribution of these distances exhibited a heavy tail, with some rare situations where the distance between the patient residence and the laboratory was larger than 500 km. These large distances impact the distributions of the weather variable discrepancies (i.e. the differences between weather parameters estimated at patient residence postcodes and those at laboratory postcodes), with discrepancies up to ±10 °C for the minimum and maximum temperature and 20 mm for rainfall. Nevertheless, the distributions of discrepancies (estimated separately for minimum and maximum

  18. 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

  19. 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.

  20. Glycemic screening and recurrent carbohydrate metabolism disorders with endocrine pathology

    Directory of Open Access Journals (Sweden)

    L.А. Lutsenko

    2018-03-01

    analytical sensitivity of test system for thyroid-stimulating hormone. Screening for hyperparathyroidism is the detection of blood ionized calcium level. This examination is particularly relevant for patients from risk group for initial hyperparathyroidism — patients with gallstone disease, urolithiasis, stomach ulcer and/or duodenal ulcer, essential hypertension, etc. Free metanephrines of blood plasma and conjugated urine metanephrines are the screening tests for pheochromocytoma diagnosis. The level of methylated secondary catecholamines (metanephrines, normetanephrines shows the daily tumor activity of pheochromocytoma. Thus, glycemic screening and endocrynopathies screening with hypersecretion of counterregulatory hormones should be conducted together. This will allow detecting secondary forms of diabetes mellitus and compensating glycemic state of the patient.

  1. 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

  2. Factors associated with glycemic status and ability to adapt to changing demands in people with and without type 2 diabetes mellitus: A cross-sectional study.

    Science.gov (United States)

    Salazar-González, Bertha Cecilia; Gallegos-Cabriales, Esther C; Rivera-Castillo, Alicia; González-Cantú, Arnulfo; Gómez-Meza, Marco Vinicio; Villarreal-Pérez, Jesús Zacarías

    2018-01-01

    Type 2 diabetes mellitus studies focus on metabolic indicators and different self-reported lifestyle or care behaviors. Self-reported instruments involve conscious process therefore responses might not reflect reality. Meanwhile implicit responses involve automatic, unconscious processes underlying social judgments and behavior. No studies have explored the combined influence of both metabolic indicators and implicit responses on lifestyle practices in type 2 diabetes mellitus patients. The purpose was to investigate the explained variance of socio-demographic, metabolic, anthropometric, clinical, psychosocial, cognitive, and lifestyle variables on glycemic status and on the ability to adapt to changing demands in people with and without type 2 diabetes mellitus in Monterrey, Mexico. Adults with (n = 30, mean age 46.90 years old, 33.33% male) and without (n = 32, mean age: 41.69 years old, 21.87% male) type 2 diabetes mellitus were studied. Glycemic status was assessed using Bio-Rad D-10 Hemoglobin A1c Program, which uses ion-exchange high-performance chromatography. Stroop 2 test was used to assess the ability to changing demands. In participants with type 2 diabetes mellitus, less years of education, negative self-actualization, and higher levels of cholesterol and triglycerides explained more than 50% of the variance in glycemic status. In participants without type 2 diabetes mellitus, the variance (38.7%) was explained by total cholesterol, metabolic syndrome, high-density lipoprotein, and self-actualization scores; the latter in opposite direction. The ability to adapt to changing demands was explained by total cholesterol, malondialdehyde, insulin resistance, and triglycerides. In participants without type 2 diabetes mellitus, the contributing variables were metabolic syndrome and nutrition scores. Results showed significant effect on at least one of the following variables (socio-demographic, metabolic, or lifestyle subscale) on glycemic status

  3. 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

  4. 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.

  5. Clinical variables related to small bowel obstruction: comparison of patients with and without Crohn’s disease

    Directory of Open Access Journals (Sweden)

    Awad Al Qahtani

    2012-06-01

    Full Text Available Small bowel obstruction is a known complication of Crohn’s disease. Determining need for operation is a demanding task. The aim of this study was to fine tune the decision-making process by evaluating standard clinical and laboratory parameters in small bowel obstruction of any cause and compare etiologies. Consecutive patients with Crohn’s disease and small bowel obstruction were selected retrospectively and compared to a randomly selected group of non Crohn’s patients with obstruction over a 9 year period. Twenty-two clinical, laboratory and radiological variables were assessed for the following outcomes: i diagnosis of Crohn’s; ii operative or non operative treatment in Crohn’s; iii operative or non operative treatment without Crohn’s; iv exacerbation or adhesions causing obstruction among Crohn’s patients. Multivariable models were developed for each outcome using logistic regression. Age less than 50, history of smoking, Jewish ethnicity, white count >11x10E9, neutrophils >7.5x10E9 and platelet volume <9.9 fL, supported the diagnosis of Crohn’s disease. Operation in Crohn’s disease within the same admission was associated with a history of smoking, temperature >38˚, high pulse >100, leukocytosis (>11x10E9 and obstruction on abdominal scan, while operation in patients without Crohn’s in the sentinel admission, was associated with temperature >38˚, tachycardia, leukocytosis (>11x10E9 and previous operation. Confirmation of these predictive patterns in a validation group could help in clinical decisions regarding therapeutic options in an emergency setting.

  6. 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.

  7. The impact of a low glycemic index (GI) breakfast and snack on daily blood glucose profiles and food intake in young Chinese adult males.

    Science.gov (United States)

    Kaur, Bhupinder; Ranawana, Viren; Teh, Ai-Ling; Henry, C Jeya K

    2015-09-01

    Low glycemic index (GI) foods have been suggested to minimize large fluctuations in blood glucose levels and reduce food intake. However, the majority of studies have been conducted on Caucasian populations with limited data on Asians. The objective of this study was to investigate how the provision of a low GI breakfast and afternoon snack affected daily blood glucose profiles and food intake. In a randomized, controlled crossover non blind design, 11 healthy Chinese male adults (body mass index 22.4 ± 1.3 kg m -2 ) attended two sessions where they consumed either a high or low GI breakfast and afternoon snack, and a standardized buffet lunch. Daily changes in glycemic response (GR) were measured using the Medtronic MiniMed (Northridge, CA) iPro™2 continuous glucose monitoring system (CGMS). The GR was further calculated to obtain the incremental area under the curve (IAUC). Glycemic variability was calculated as mean amplitude of glycemic excursion (MAGE) and energy intake (kcal) was measured quantitatively at the buffet lunch. Compared to the high GI intervention, the low GI intervention significantly reduced the GR following breakfast ( p  = 0.02), lunch ( p  = 0.02) and dinner ( p  = 0.05). The low GI treatment showed a reduction in daily AUC ( p  = 0.03). There was a significant reduction in IAUC after a low GI breakfast compared to the high GI breakfast ( p  = 0.03). The low GI breakfast resulted in a significantly lower food intake at lunch and a resulting decreased energy intake of 285 kcal ( p  = 0.02). The MAGE was significantly lower during the entire low GI treatment ( p  = 0.03). Consumption of a low GI breakfast and afternoon snack was capable of attenuating 24-h blood glucose profiles, minimize glycemic excursions and reduce food intake in healthy Asian males. This simple dietary intervention may be an acceptable approach in improving overall glycemia and energy balance in Asians. NCT02340507.

  8. Effect of symbiotic supplementation on glycemic control, lipid profiles and microalbuminuria in patients with non-obese type 2 diabetes: a randomized, double-blind, clinical trial.

    Science.gov (United States)

    Ebrahimi, Zarin Sadat; Nasli-Esfahani, Ensieh; Nadjarzade, Azadeh; Mozaffari-Khosravi, Hassan

    2017-01-01

    The prevalent raise of type 2 diabetes (T2D) around the globe, are creating higher risk for cardiovascular diseases (CVDs) and increasing strain on each country's health care budget in the world. Microalbuminuria has appeared as a key parameter in diabetic patients. Microalbuminuria is also related to increased cardiovascular morbidity in people who are non-obese diabetic. Some studies have suggested that consumption of symbiotic foods might help improve the metabolic profile, inflammatory factors and biomarkers of oxidative stress. The aim of trial was to determine the effect of symbiotic supplementation on glycemic control, lipid profiles and microalbuminuria in non-obese T2D. In this randomized, double-blind, clinically controlled trial, 70 patients with T2D (28 females, 42 males) were randomly divided into two groups ( n  = 35 for each group). The symbiotic group (SG) consumed 500 mg/d of symbiotic supplementations containing probiotics (Lactobacillus family, Bifidobacterium family, Streptococus thermophilus), Prebiotics (Fructo oligosaccharide) and B group vitamins (1 mg), lactose (0.5 mg), malt-dextrin, magnesium saturate and the placebo group (PG) consumed capsules filled with row starch and also B group vitamins (1 mg), lactose (0.5 mg), malt-dextrin, magnesium saturate for 9 weeks. Fasting blood glucose (FBG), hemoglobin A1c (HbA1c), blood lipid profiles, 24-h dietary recalls, and anthropometric measurements were measured at the baseline and at the end of trial. SPSS software, version 16 was used to test the data and the results were expressed as mean ± standard deviation. Paired samples T-Test were used to compare continuous variables within groups. Comparison between different groups was performed through two independent samples T-Test. In the absence of normal distribution, the comparison between the groups was made using non-parametric Wilcoxon on signed ranks and Mann-Whitney tests. P values Symbiotic supplementation decreased

  9. Runoff Variability in the Scott River (SW Spitsbergen in Summer Seasons 2012–2013 in Comparison with the Period 1986–2009

    Directory of Open Access Journals (Sweden)

    Franczak Łukasz

    2016-09-01

    Full Text Available River runoff variability in the Scott River catchment in the summer seasons 2012 and 2013 has been presented in comparison to the multiannual river runoff in 1986–2009. Both in particular seasons and in the analysed multiannual, high variability of discharge rate was recorded. In the research periods 2012–2013, a total of 11 952 water stages and 20 flow rates were measured in the analysed cross-section for the determination of 83 daylong discharges. The mean multiannual discharge of the Scott River amounted to 0.96 m3·s−1. The value corresponds to a specific runoff of 94.6 dm3·s−1·km2, and the runoff layer 937 mm. The maximum values of daily discharge amounted to 5.07 m3·s−1, and the minimum values to 0.002 m3·s−1. The highest runoff occurs in the second and third decade of July, and in the first and second decade of August. The regime of the river is determined by a group of factors, and particularly meteorological conditions affecting the intensity of ablation, and consequently river runoff volume. We found a significant correlation (0.60 in 2012 and 0.67 in 2013 between the air temperature and the Scott River discharge related to the Scott Glacier ice melt.

  10. 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.

  11. 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.

  12. A Comparison of Somatic Variables of Elite Ice Hockey Players from the Czech ELH and Russian KHL

    Directory of Open Access Journals (Sweden)

    Kutáč Petr

    2015-03-01

    Full Text Available The goals of this study were to evaluate the basic morphological variables of contemporary elite ice hockey players, compare the parameters of players in the top Russian ice hockey league (KHL with those of the top Czech ice hockey league (ELH, and to evaluate the parameters of players according to their position in the game. The research participants included 30 KHL players (mean age: 27.1 ± 5.1 years and 25 ELH players (mean age: 26.4 ± 5.8 years. We determined body height, body mass, and body composition (body fat, fat-free mass, segmental fat analysis. All measurements were performed at the end of preseason training. The KHL players had the following anthropometric characteristics: body height 182.97 ± 5.61 cm (forward and 185.72 ± 3.57 cm (defenseman, body mass 89.70 ± 5.28 kg (forward and 92.52 ± 4.01 kg (defenseman, body fat 10.76 ± 0.63 kg (forward and 11.10 ± 0.48 kg (defenseman, fatfree mass 78.94 ± 4.65 kg (forward and 81.42 ± 3.52 kg (defenseman. The values for ELH players were as follows: body height 182.06 ± 5.93 cm (forward and 185.88 ± 7.13 cm (defenseman, body mass 88.47 ± 7.06 kg (forward and 89.36 ± 10.91 kg (defenseman, body fat 12.57 ± 2.89 kg (forward and 11.91 ± 3.10 kg (defenseman, fat-free mass 75.93 ± 6.54 kg (forward and 77.46 ± 7.89 kg (defenseman. The results indicate that it is beneficial to ice hockey players to have increased body mass and lower body fat, which leads to higher muscle mass, thus enabling a player to perform at the highest level and meet the specific challenges of the game.

  13. Modeling actual evapotranspiration with routine meteorological variables in the data-scarce region of the Tibetan Plateau: Comparisons and implications

    Science.gov (United States)

    Ma, Ning; Zhang, Yinsheng; Xu, Chong-Yu; Szilagyi, Jozsef

    2015-08-01

    Quantitative estimation of actual evapotranspiration (ETa) by in situ measurements and mathematical modeling is a fundamental task for physical understanding of ETa as well as the feedback mechanisms between land and the ambient atmosphere. However, the ETa information in the Tibetan Plateau (TP) has been greatly impeded by the extremely sparse ground observation network in the region. Approaches for estimating ETa solely from routine meteorological variables are therefore important for investigating spatiotemporal variations of ETa in the data-scarce region of the TP. Motivated by this need, the complementary relationship (CR) and Penman-Monteith approaches were evaluated against in situ measurements of ETa on a daily basis in an alpine steppe region of the TP. The former includes the Nonlinear Complementary Relationship (Nonlinear-CR) as well as the Complementary Relationship Areal Evapotranspiration (CRAE) models, while the latter involves the Katerji-Perrier and the Todorovic models. Results indicate that the Nonlinear-CR, CRAE, and Katerji-Perrier models are all capable of efficiently simulating daily ETa, provided their parameter values were appropriately calibrated. The Katerji-Perrier model performed best since its site-specific parameters take the soil water status into account. The Nonlinear-CR model also performed well with the advantage of not requiring the user to choose between a symmetric and asymmetric CR. The CRAE model, even with a relatively low Nash-Sutcliffe efficiency (NSE) value, is also an acceptable approach in this data-scarce region as it does not need information of wind speed and ground surface conditions. In contrast, application of the Todorovic model was found to be inappropriate in the dry regions of the TP due to its significant overestimation of ETa as it neglects the effect of water stress on the bulk surface resistance. Sensitivity analysis of the parameter values demonstrated the relative importance of each parameter in the

  14. 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)

  15. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  17. A Comparison of Seasonal and Interannual Variability of Soil Dust Aerosols Over the Atlantic Ocean as Inferred by the Toms AI and AVHRR AOT Retrievals

    Science.gov (United States)

    Cakmur, R. V.; Miller, R. L.; Tegen, Ina; Hansen, James E. (Technical Monitor)

    2001-01-01

    The seasonal cycle and interannual variability of two estimates of soil (or 'mineral') dust aerosols are compared: Advanced Very High Resolution Radiometer (AVHRR) aerosol optical thickness (AOT) and Total Ozone Mapping Spectrometer (TOMS) aerosol index (AI), Both data sets, comprising more than a decade of global, daily images, are commonly used to evaluate aerosol transport models. The present comparison is based upon monthly averages, constructed from daily images of each data set for the period between 1984 and 1990, a period that excludes contamination from volcanic eruptions. The comparison focuses upon the Northern Hemisphere subtropical Atlantic Ocean, where soil dust aerosols make the largest contribution to the aerosol load, and are assumed to dominate the variability of each data set. While each retrieval is sensitive to a different aerosol radiative property - absorption for the TOMS AI versus reflectance for the AVHRR AOT - the seasonal cycles of dust loading implied by each retrieval are consistent, if seasonal variations in the height of the aerosol layer are taken into account when interpreting the TOMS AI. On interannual time scales, the correlation is low at most locations. It is suggested that the poor interannual correlation is at least partly a consequence of data availability. When the monthly averages are constructed using only days common to both data sets, the correlation is substantially increased: this consistency suggests that both TOMS and AVHRR accurately measure the aerosol load in any given scene. However, the two retrievals have only a few days in common per month so that these restricted monthly averages have a large uncertainty. Calculations suggest that at least 7 to 10 daily images are needed to estimate reliably the average dust load during any particular month, a threshold that is rarely satisfied by the AVHRR AOT due to the presence of clouds in the domain. By rebinning each data set onto a coarser grid, the availability of

  18. A high-glycemic diet is associated with cerebral amyloid burden in cognitively normal older adults.

    Science.gov (United States)

    Taylor, Matthew K; Sullivan, Debra K; Swerdlow, Russell H; Vidoni, Eric D; Morris, Jill K; Mahnken, Jonathan D; Burns, Jeffrey M

    2017-12-01

    Background: Little is known about the relation between dietary intake and cerebral amyloid accumulation in aging. Objective: We assessed the association of dietary glycemic measures with cerebral amyloid burden and cognitive performance in cognitively normal older adults. Design: We performed cross-sectional analyses relating dietary glycemic measures [adherence to a high-glycemic-load diet (HGLDiet) pattern, intakes of sugar and carbohydrates, and glycemic load] with cerebral amyloid burden (measured by florbetapir F-18 positron emission tomography) and cognitive performance in 128 cognitively normal older adults who provided eligibility screening data for the University of Kansas's Alzheimer's Prevention through Exercise (APEX) Study. The study began in November 2013 and is currently ongoing. Results: Amyloid was elevated in 26% ( n = 33) of participants. HGLDiet pattern adherence ( P = 0.01), sugar intake ( P = 0.03), and carbohydrate intake ( P = 0.05) were significantly higher in participants with elevated amyloid burden. The HGLDiet pattern was positively associated with amyloid burden both globally and in all regions of interest independently of age, sex, and education (all P ≤ 0.001). Individual dietary glycemic measures (sugar intake, carbohydrate intake, and glycemic load) were also positively associated with global amyloid load and nearly all regions of interest independently of age, sex, and educational level ( P ≤ 0.05). Cognitive performance was associated only with daily sugar intake, with higher sugar consumption associated with poorer global cognitive performance (global composite measure and Mini-Mental State Examination) and performance on subtests of Digit Symbol, Trail Making Test B, and Block Design, controlling for age, sex, and education. Conclusion: A high-glycemic diet was associated with greater cerebral amyloid burden, which suggests diet as a potential modifiable behavior for cerebral amyloid accumulation and subsequent Alzheimer

  19. Association between glycemic control and morning blood surge with vascular endothelial dysfunction in type 2 diabetes mellitus patients

    Directory of Open Access Journals (Sweden)

    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

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. [Influence on glycemic control of improved diabetic gastroparesis by long-term cisapride therapy].

    Science.gov (United States)

    Ishii, K; Tanabe, S; Mitsuhashi, T; Saigenji, K

    1995-10-01

    To investigate the effect on glycemic control of improving diabetic gastroparesis, we evaluated symptoms (scored), gastric motor functions (solid and liquid gastric emptying studies and electrogastrography), and glycemic control in 11 patients with diabetic gastroparesis (5 men, 6 women, 50.4 +/- 4.5 years old) before and after treatment with cisapride (15 mg/day p.o., 12 weeks). None of the patients had organic abnormalities on gastrointestinal endoscopy. The dysmotility symptom score (maximum: 18) on cisapride significantly improved from 13.1 to 4.0 (p instant noodles labeled with 37 MBq (1 mCi) technetium-99m (both p < 0.05). Liquid gastric emptying, evaluated using a sulfamethizole technique, also improved but not significantly. Electrogastrography revealed no significant changes after treatment, but the postprandial rate of normal frequency waves tended to increase. Glycemic control was assessed based on HbA1C, fructosamine and M value. There were no significant changes in glycemic control after treatment with cisapride. We conclude that long-term administration of cisapride reduced dysmotility symptoms and improved solid and liquid gastric emptying without adversely affecting glycemic control.

  5. 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 yeast induces milder postprandial glycemic response to bread without the necessity of high fiber amounts, providing with another strategy for the management of glycemic control.

  6. Cushing's syndrome in type 2 diabetes patients with poor glycemic control.

    Science.gov (United States)

    Gungunes, Askin; Sahin, Mustafa; Demirci, Taner; Ucan, Bekir; Cakir, Evrim; Arslan, Muyesser Sayki; Unsal, Ilknur Ozturk; Karbek, Basak; Calıskan, Mustafa; Ozbek, Mustafa; Cakal, Erman; Delibasi, Tuncay

    2014-12-01

    Cushing's syndrome may be more frequent in some specific patient groups such as type 2 diabetes and obesity. The aim of this study was to investigate the prevalence of Cushing's syndrome in outpatients with type 2 diabetes with poor glycemic control despite at least 3-months insulin therapy. Outpatients with type 2 diabetes whose glycemic control is poor (Hb Alc value >7 %) despite receiving at least 3-months long insulin treatment (insulin alone or insulin with oral antidiabetics) were included. Patients with classic features of Cushing's syndrome were excluded. Overnight 1 mg dexamethasone suppression test (DST) was performed as a screening test. A total of 277 patients with type 2 diabetes whose glycemic control is poor (Hb Alc value >7 %) despite insulin therapy were included. Two of the 277 patients with type 2 diabetes were diagnosed with Cushing's syndrome (0.72 %). Hypertension was statistically more frequent in the patients with cortisol levels ≥1.8 μg/dL than the patients with cortisol levels Cushing's syndrome among patients with type 2 diabetes with poor glycemic control despite insulin therapy is much higher than in the general population. The patients with type 2 diabetes with poor glycemic control despite at least three months of insulin therapy should be additionally tested for Cushing's syndrome if they have high dose insülin requirements.

  7. 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.

  8. Metabolic effects of resistance or high-intensity interval training among glycemic control-nonresponsive children with insulin resistance.

    Science.gov (United States)

    Álvarez, C; Ramírez-Campillo, R; Ramírez-Vélez, R; Martínez, C; Castro-Sepúlveda, M; Alonso-Martínez, A; Izquierdo, M

    2018-01-01

    Little evidence exists on which variables of body composition or muscular strength mediates more glucose control improvements taking into account inter-individual metabolic variability to different modes of exercise training. We examined 'mediators' to the effects of 6-weeks of resistance training (RT) or high-intensity interval training (HIT) on glucose control parameters in physically inactive schoolchildren with insulin resistance (IR). Second, we also determined both training-induce changes and the prevalence of responders (R) and non-responders (NR) to decrease the IR level. Fifty-six physically inactive children diagnosed with IR followed a RT or supervised HIT program for 6 weeks. Participants were classified based on ΔHOMA-IR into glycemic control R (decrease in homeostasis model assessment-IR (HOMA-IR) training-induced changes to glucose control parameters; and third the report of R and NR to improve body composition, cardiovascular, metabolic and performance variables. Mediation analysis revealed that improvements (decreases) in abdominal fat by the waist circumference can explain more the effects (decreases) of HOMA-IR in physically inactive schoolchildren under RT or HIT regimes. The same analysis showed that increased one-maximum repetition leg-extension was correlated with the change in HOMA-IR (β=-0.058; P=0.049). Furthermore, a change in the waist circumference fully mediated the dose-response relationship between changes in the leg-extension strength and HOMA-IR (β'=-0.004; P=0.178). RT or HIT were associated with significant improvements in body composition, muscular strength, blood pressure and cardiometabolic parameters irrespective of improvement in glycemic control response. Both glucose control RT-R and HIT-R (respectively), had significant improvements in mean HOMA-IR, mean muscular strength leg-extension and mean measures of adiposity. The improvements in the lower body strength and the decreases in waist circumference can explain more

  9. Technology Use for Diabetes Problem Solving in Adolescents with Type 1 Diabetes: Relationship to Glycemic Control.

    Science.gov (United States)

    Kumah-Crystal, Yaa A; Hood, Korey K; Ho, Yu-Xian; Lybarger, Cindy K; O'Connor, Brendan H; Rothman, Russell L; Mulvaney, Shelagh A

    2015-07-01

    This study examines technology use for problem solving in diabetes and its relationship to hemoglobin A1C (A1C). A sample of 112 adolescents with type 1 diabetes completed measures assessing use of technologies for diabetes problem solving, including mobile applications, social technologies, and glucose software. Hierarchical regression was performed to identify the contribution of a new nine-item Technology Use for Problem Solving in Type 1 Diabetes (TUPS) scale to A1C, considering known clinical contributors to A1C. Mean age for the sample was 14.5 (SD 1.7) years, mean A1C was 8.9% (SD 1.8%), 50% were female, and diabetes duration was 5.5 (SD 3.5) years. Cronbach's α reliability for TUPS was 0.78. In regression analyses, variables significantly associated with A1C were the socioeconomic status (β = -0.26, P Problem Solving Questionnaire (β = -0.26, P = 0.01), and TUPS (β = 0.26, P = 0.01). Aside from the Diabetes Self-Care Inventory--Revised, each block added significantly to the model R(2). The final model R(2) was 0.22 for modeling A1C (P problem solving and higher A1C. Adolescents with poorer glycemic control may use technology in a reactive, as opposed to preventive, manner. Better understanding of the nature of technology use for self-management over time is needed to guide the development of technology-mediated problem solving tools for youth with type 1 diabetes.

  10. Glycemic control and alveolar bone loss progression in type 2 diabetes.

    Science.gov (United States)

    Taylor, G W; Burt, B A; Becker, M P; Genco, R J; Shlossman, M

    1998-07-01

    This study tested the hypothesis that the risk for alveolar bone loss is greater, and bone loss progression more severe, for subjects with poorly controlled (PC) type 2 diabetes mellitus (type 2 DM) compared to those without type 2 DM or with better controlled (BC) type 2 DM. The PC group had glycosylated hemoglobin (HbA1) > or = 9%; the BC group had HbA1 or = 75% were used to identify the worst bone score (WBS) in the dentition. Change in worst bone score at follow-up, the outcome, was specified on a 4-category ordinal scale as no change, or a 1-, 2-, 3-, or 4-category increase over baseline WBS (WBS1). Poorly controlled diabetes, age, calculus, time to follow-up examination, and WBS1 were statistically significant explanatory variables in ordinal logistic regression models. Poorly controlled type 2 DM was positively associated with greater risk for a change in bone score (compared to subjects without type 2 DM) when the covariates were included in the model. The cumulative odds ratio (COR) at each threshold of the ordered response was 11.4 (95% CI = 2.5, 53.3). When contrasted with subjects with BC type 2 DM, the COR for those in the PC group was 5.3 (95% CI = 0.8, 53.3). The COR for subjects with BC type 2 DM was 2.2 (95% CI = 0.7, 6.5), when contrasted to those without type 2 DM. These results suggest that poorer glycemic control leads to both an increased risk for alveolar bone loss and more severe progression over those without type 2 DM, and that there may be a gradient, with the risk for bone loss progression for those with better controlled type 2 DM intermediate to the other 2 groups.

  11. 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.

  12. Quantitative Comparison of Effects of Dofetilide, Sotalol, Quinidine, and Verapamil between Human Ex vivo Trabeculae and In silico Ventricular Models Incorporating Inter-Individual Action Potential Variability

    Directory of Open Access Journals (Sweden)

    Oliver J. Britton

    2017-08-01

    Full Text Available Background:In silico modeling could soon become a mainstream method of pro-arrhythmic risk assessment in drug development. However, a lack of human-specific data and appropriate modeling techniques has previously prevented quantitative comparison of drug effects between in silico models and recordings from human cardiac preparations. Here, we directly compare changes in repolarization biomarkers caused by dofetilide, dl-sotalol, quinidine, and verapamil, between in silico populations of human ventricular cell models and ex vivo human ventricular trabeculae.Methods and Results:Ex vivo recordings from human ventricular trabeculae in control conditions were used to develop populations of in silico human ventricular cell models that integrated intra- and inter-individual variability in action potential (AP biomarker values. Models were based on the O'Hara-Rudy ventricular cardiomyocyte model, but integrated experimental AP variability through variation in underlying ionic conductances. Changes to AP duration, triangulation and early after-depolarization occurrence from application of the four drugs at multiple concentrations and pacing frequencies were compared between simulations and experiments. To assess the impact of variability in IC50 measurements, and the effects of including state-dependent drug binding dynamics, each drug simulation was repeated with two different IC50 datasets, and with both the original O'Hara-Rudy hERG model and a recently published state-dependent model of hERG and hERG block. For the selective hERG blockers dofetilide and sotalol, simulation predictions of AP prolongation and repolarization abnormality occurrence showed overall good agreement with experiments. However, for multichannel blockers quinidine and verapamil, simulations were not in agreement with experiments across all IC50 datasets and IKr block models tested. Quinidine simulations resulted in overprolonged APs and high incidence of repolarization

  13. 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.

  14. Breaking down patient and physician barriers to optimize glycemic control in type 2 diabetes.

    Science.gov (United States)

    Ross, Stuart A

    2013-09-01

    Approximately half of patients with type 2 diabetes (T2D) do not achieve globally recognized blood glucose targets, despite the availability of a wide range of effective glucose-lowering therapies. Failure to maintain good glycemic control increases the risk of diabetes-related complications and long-term health care costs. Patients must be brought under glycemic control to improve treatment outcomes, but existing barriers to optimizing glycemic control must first be overcome, including patient nonadherence to treatment, the failure of physicians to intensify therapy in a timely manner, and inadequacies in the health care system itself. The reasons for such barriers include treatment side effects, complex treatment regimens, needle anxiety, poor patient education, and the absence of an adequate patient care plan; however, newer therapies and devices, combined with comprehensive care plans involving adequate patient education, can help to minimize barriers and improve treatment outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. 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

  16. Calculating meal glycemic index by using measured and published food values compared with directly measured meal glycemic index.

    Science.gov (United States)

    Dodd, Hayley; Williams, Sheila; Brown, Rachel; Venn, Bernard

    2011-10-01

    Glycemic index (GI) testing is normally based on individual foods, whereas GIs for meals or diets are based on a formula using a weighted sum of the constituents. The accuracy with which the formula can predict a meal or diet GI is questionable. Our objective was to compare the GI of meals, obtained by using the formula and by using both measured food GI and published values, with directly measured meal GIs. The GIs of 7 foods were tested in 30 healthy people. The foods were combined into 3 meals, each of which provided 50 g available carbohydrate, including a staple (potato, rice, or spaghetti), vegetables, sauce, and pan-fried chicken. The mean (95% CI) meal GIs determined from individual food GI values and by direct measurement were as follows: potato meal [predicted, 63 (56, 70); measured, 53 (46, 62)], rice meal [predicted, 51 (45, 56); measured, 38 (33, 45)], and spaghetti meal [predicted, 54 (49, 60); measured, 38 (33, 44)]. The predicted meal GIs were all higher than the measured GIs (P < 0.001). The extent of the overestimation depended on the particular food, ie, 12, 15, and 19 GI units (or 22%, 40%, and 50%) for the potato, rice, and spaghetti meals, respectively. The formula overestimated the GI of the meals by between 22% and 50%. The use of published food values also overestimated the measured meal GIs. Investigators using the formula to calculate a meal or diet GI should be aware of limitations in the method. This trial is registered with the Australian and New Zealand Clinical Trials Registry as ACTRN12611000210976.

  17. 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

  18. Comparison of variable region 3 sequences of human immunodeficiency virus type 1 from infected children with the RNA and DNA sequences of the virus populations of their mothers.

    Science.gov (United States)

    Scarlatti, G; Leitner, T; Halapi, E; Wahlberg, J; Marchisio, P; Clerici-Schoeller, M A; Wigzell, H; Fenyö, E M; Albert, J; Uhlén, M

    1993-01-01

    We have compared the variable region 3 sequences from 10 human immunodeficiency virus type 1 (HIV-1)-infected infants to virus sequences from the corresponding mothers. The sequences were derived from DNA of uncultured peripheral blood mononuclear cells (PBMC), DNA of cultured PBMC, and RNA from serum collected at or shortly after delivery. The infected infants, in contrast to the mothers, harbored homogeneous virus populations. Comparison of sequences from the children and clones derived from DNA of the corresponding mothers showed that the transmitted virus represented either a minor or a major virus population of the mother. In contrast to an earlier study, we found no evidence of selection of minor virus variants during transmission. Furthermore, the transmitted virus variant did not show any characteristic molecular features. In some cases the transmitted virus was more related to the virus RNA population of the mother and in other cases it was more related to the virus DNA population. This suggests that either cell-free or cell-associated virus may be transmitted. These data will help AIDS researchers to understand the mechanism of transmission and to plan strategies for prevention of transmission. PMID:8446584

  19. 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.

  20. Visit-to-visit blood pressure variability as a prognostic marker in patients with cardiovascular and cerebrovascular diseases--relationships and comparisons with vascular markers of atherosclerosis.

    Science.gov (United States)

    Lau, Kui Kai; Wong, Yuen Kwun; Chan, Yap Hang; Teo, Kay Cheong; Chan, Koon Ho; Wai Li, Leonard Sheung; Cheung, Raymond Tak Fai; Siu, Chung Wah; Ho, Shu Leong; Tse, Hung Fat

    2014-07-01

    Visit-to-visit blood pressure variability (BPV) is a simple surrogate marker for the development of atherosclerotic diseases, cardiovascular and all-cause mortality. Nevertheless, the relative prognostic value of BPV in comparison with other established vascular assessments remain uncertain. We prospectively followed-up 656 high-risk patients with diabetes or established cardiovascular or cerebrovascular diseases for the occurrence of major adverse cardiovascular events (MACEs). Baseline brachial endothelial function, carotid intima-media thickness (IMT) and plaque burden, ankle-brachial index and arterial stiffness were determined. Visit-to-visit BPV were recorded during a mean 18 ± 9 outpatient clinic visits. After a mean 81 ± 12 month's follow-up, 123 patients (19%) developed MACEs. Patients who developed a MACE had significantly higher systolic BPV, more severe endothelial function, arterial stiffness and systemic atherosclerotic burden compared to patients who did not develop a MACE (all Parea under receiver operating characteristic curve (AUC) 0.69 ± 0.03, PAUC 0.65 ± 0.03, P<0.01). After adjustment of confounding factors, a high BPV remained a significant independent predictor of MACE (hazards ratio 1.67, 95% confidence interval 1.14-2.43, P<0.01). Compared with established surrogate markers of atherosclerosis, visit-to-visit BPV provides similar prognostic information and may represent a new and simple marker for adverse outcomes in patients with vascular diseases. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. 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....

  2. 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…

  3. Glycemic control and all-cause mortality risk in type 1 diabetes patients: the EURODIAB prospective complications study

    NARCIS (Netherlands)

    Schoenaker, D.A.J.M.; Simon, D.; Chaturvedi, N.; Fuller, J.H.; Soedamah-Muthu, S.S.

    2014-01-01

    Context: Glycemic targets and the benefit of intensive glucose control are currently under debate because intensive glycemic control has been suggested to have negative effects on mortality risk in type 2 diabetes patients. Objective: We examined the association between glycated hemoglobin (HbA1c)

  4. Effects of diabetes-related family stress on glycemic control in young patients with type 1 diabetes: Systematic review.

    Science.gov (United States)

    Tsiouli, Elina; Alexopoulos, Evangelos C; Stefanaki, Charikleia; Darviri, Christina; Chrousos, George P

    2013-02-01

    To investigate the way that family stress influences glycemic control among patients with diabetes who are younger than 18 years of age. PubMed and Scopus were searched for relevant studies published since 1990 using the following key words: diabetes type 1, glycemic control, family stress, family conflict, and family function. In total, 1478 papers were identified in the initial search. The final review included 6 cohort studies, 3 cross-sectional studies, and 1 qualitative review in which family stress was assessed using specific diabetes-related conflict measurement instruments, and glycemic control was evaluated by glycosylated hemoglobin measurement. In most studies family stress was negatively correlated with patients' glycemic control. Family function was strongly related to patients' glycemic control, while family conflict was adversely associated with glycemic control. Families of low socioeconomic status, those of adolescents with diabetes, and those of single parents were more prone to diabetes-related stress and thus more susceptible to worse glycemic control. Therapeutic psychological interventions and educational programs can help alleviate family diabetes-related stress and will likely improve glycemic control.

  5. 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

  6. 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...

  7. The effects of glycemic control on seizures and seizure-induced excitotoxic cell death

    Directory of Open Access Journals (Sweden)

    Schauwecker Paula

    2012-08-01

    Full Text Available Abstract Background Epilepsy is the most common neurological disorder after stroke, affecting more than 50 million persons worldwide. Metabolic disturbances are often associated with epileptic seizures, but the pathogenesis of this relationship is poorly understood. It is known that seizures result in altered glucose metabolism, the reduction of intracellular energy metabolites such as ATP, ADP and phosphocreatine and the accumulation of metabolic intermediates, such as lactate and adenosine. In particular, it has been suggested that the duration and extent of glucose dysregulation may be a predictor of the pathological outcome of status. However, little is known about neither the effects of glycemic control on brain metabolism nor the effects of managing systemic glucose concentrations in epilepsy. Results In this study, we examined glycemic modulation of kainate-induced seizure sensitivity and its neuropathological consequences. To investigate the relationship between glycemic modulation, seizure susceptibility and its neuropathological consequences, C57BL/6 mice (excitotoxin cell death resistant were subjected to hypoglycemia or hyperglycemia, followed by systemic administration of kainic acid to induce seizures. Glycemic modulation resulted in minimal consequences with regard to seizure severity but increased hippocampal pathology, irrespective of whether mice were hypoglycemic or hyperglycemic prior to kainate administration. Moreover, we found that exogenous administration of glucose following kainic acid seizures significantly reduced the extent of hippocampal pathology in FVB/N mice (excitotoxin cell death susceptible following systemic administration of kainic acid. Conclusion These findings demonstrate that modulation of the glycemic index can modify the outcome of brain injury in the kainate model of seizure induction. Moreover, modulation of the glycemic index through glucose rescue greatly diminishes the extent of seizure

  8. Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy.

    Science.gov (United States)

    Shi, Hao-Jun; Jin, Chen; Fu, De-Liang

    2017-01-14

    To evaluate the impact of glycemic control and nutritional status after total pancreatectomy (TP) on complications, tumor recurrence and overall survival. Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined. Risk factors for postoperative glycemic control and nutritional status were identified. High early postoperative fasting blood glucose (FBG) levels (OR = 4.074, 95%CI: 1.188-13.965, P = 0.025) and low early postoperative prealbumin levels (OR = 3.816, 95%CI: 1.110-13.122, P = 0.034) were significantly associated with complications after TP. Postoperative HbA1c levels over 7% (HR = 2.655, 95%CI: 1.299-5.425, P = 0.007) were identified as one of the independent risk factors for tumor recurrence. Patients with postoperative HbA1c levels over 7% had much poorer overall survival than those with HbA1c levels less than 7% (9.3 mo vs 27.6 mo, HR = 3.212, 95%CI: 1.147-8.999, P = 0.026). Patients with long-term diabetes mellitus (HR = 15.019, 95%CI: 1.278-176.211, P = 0.031) and alcohol history (B = 1.985, SE = 0.860, P = 0.025) tended to have poor glycemic control and lower body mass index levels after TP, respectively. At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on long-term outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival.

  9. Glycemic control in type 2 diabetes mellitus prevents coronary arterial wall infection

    Directory of Open Access Journals (Sweden)

    Morteza Izadi

    2014-05-01

    Full Text Available BACKGROUND: Diabetes mellitus (DM is a very well-known risk factor for development of atherosclerosis, and it has been hypothesized that poor glycemic control and hyperglycemia plays a major role in this process. In the current study, we aimed to evaluate the associates of poor glycemic control in Iranian patients who have already undergone coronary artery bypass grafting (CABG, with especial focus on the inhabitation of infectious agents within the coronary arterial wall. METHODS: In January 2010, 52 consecutive patients with type 2 DM who undergone CABG at the Department of Cardiovascular Surgery of Baqiyatallah University of Medical Sciences (Tehran, Iran were included into this cross-sectional study and biopsy specimens from their coronary plaques were taken and analyzed by polymerase chain reaction (PCR methods for detecting Helicobacter species, cytomegalovirus (CMV and Chlamydia pneumoniae, and their potential relation to the glycemic control status in these patients. RESULTS: Compared to that in diabetic patients with mean fasting blood sugar (FBS levels FBS < 126, atherosclerotic lesions in type 2 diabetic patients with poor glycemic control (FBS > 126 were significantly more likely to be positive for CMV PCR test (41% vs. 9%, respectively; P = 0.05. In laboratorial test results, mean triglyceride level was significantly higher among patients of poor glycemic control (168 ± 89 vs. 222 ± 125 mg/dl, respectively; P = 0.033. Hypertension was also significantly more prevalent in this population (73% vs. 36%, respectively; P = 0.034. CONCLUSION: Type 2 diabetic patients with poor glycemic control can be at higher risk for developing CMV infection in their coronary arterial wall, which can promote atherosclerosis formation process in this patient population. According to the findings of this study, we recommend better control of serum glucose levels in type 2 diabetic patients to prevent formation/progression of atherosclerosis.   Keywords

  10. 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.

  11. 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, and the disp...... fitness and compromised pancreatic β-cell compensation across the entire glucose tolerance continuum provides additional evidence highlighting the importance of fitness in protection against the onset of a fundamental pathophysiological event that leads to type 2 diabetes....

  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. Effects of High Performance Inulin Supplementation on Glycemic Status and Lipid Profile in Women with Type 2 Diabetes: A Randomized, Placebo-Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    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.

  14. Translating glucose variability metrics into the clinic via Continuous Glucose Monitoring: a Graphical User Interface for Diabetes Evaluation (CGM-GUIDE©).

    Science.gov (United States)

    Rawlings, Renata A; Shi, Hang; Yuan, Lo-Hua; Brehm, William; Pop-Busui, Rodica; Nelson, Patrick W

    2011-12-01

    Several metrics of glucose variability have been proposed to date, but an integrated approach that provides a complete and consistent assessment of glycemic variation is missing. As a consequence, and because of the tedious coding necessary during quantification, most investigators and clinicians have not yet adopted the use of multiple glucose variability metrics to evaluate glycemic variation. We compiled the most extensively used statistical techniques and glucose variability metrics, with adjustable hyper- and hypoglycemic limits and metric parameters, to create a user-friendly Continuous Glucose Monitoring Graphical User Interface for Diabetes Evaluation (CGM-GUIDE©). In addition, we introduce and demonstrate a novel transition density profile that emphasizes the dynamics of transitions between defined glucose states. Our combined dashboard of numerical statistics and graphical plots support the task of providing an integrated approach to describing glycemic variability. We integrated existing metrics, such as SD, area under the curve, and mean amplitude of glycemic excursion, with novel metrics such as the slopes across critical transitions and the transition density profile to assess the severity and frequency of glucose transitions per day as they move between critical glycemic zones. By presenting the above-mentioned metrics and graphics in a concise aggregate format, CGM-GUIDE provides an easy to use tool to compare quantitative measures of glucose variability. This tool can be used by researchers and clinicians to develop new algorithms of insulin delivery for patients with diabetes and to better explore the link between glucose variability and chronic diabetes complications.

  15. Measuring the glycemic index of foods: interlaboratory study.

    Science.gov (United States)

    Wolever, Thomas M S; Brand-Miller, Jennie C; Abernethy, John; Astrup, Arne; Atkinson, Fiona; Axelsen, Mette; Björck, Inger; Brighenti, Furio; Brown, Rachel; Brynes, Audrey; Casiraghi, M Cristina; Cazaubiel, Murielle; Dahlqvist, Linda; Delport, Elizabeth; Denyer, Gareth S; Erba, Daniela; Frost, Gary; Granfeldt, Yvonne; Hampton, Shelagh; Hart, Valerie A; Hätönen, Katja A; Henry, C Jeya; Hertzler, Steve; Hull, Sarah; Jerling, Johann; Johnston, Kelly L; Lightowler, Helen; Mann, Neil; Morgan, Linda; Panlasigui, Leonora N; Pelkman, Christine; Perry, Tracy; Pfeiffer, Andreas F H; Pieters, Marlien; Ramdath, D Dan; Ramsingh, Rayna T; Robert, S Daniel; Robinson, Carol; Sarkkinen, Essi; Scazzina, Francesca; Sison, Dave Clark D; Sloth, Birgitte; Staniforth, Jane; Tapola, Niina; Valsta, Liisa M; Verkooijen, Inge; Weickert, Martin O; Weseler, Antje R; Wilkie, Paul; Zhang, Jian

    2008-01-01

    Many laboratories offer glycemic index (GI) services. We assessed the performance of the method used to measure GI. The GI of cheese-puffs and fruit-leather (centrally provided) was measured in 28 laboratories (n=311 subjects) by using the FAO/WHO method. The laboratories reported the results of their calculations and sent the raw data for recalculation centrally. Values for the incremental area under the curve (AUC) reported by 54% of the laboratories differed from central calculations. Because of this and other differences in data analysis, 19% of reported food GI values differed by >5 units from those calculated centrally. GI values in individual subjects were unrelated to age, sex, ethnicity, body mass index, or AUC but were negatively related to within-individual variation (P=0.033) expressed as the CV of the AUC for repeated reference food tests (refCV). The between-laboratory GI values (mean+/-SD) for cheese-puffs and fruit-leather were 74.3+/-10.5 and 33.2+/-7.2, respectively. The mean laboratory GI was related to refCV (P=0.003) and the type of restrictions on alcohol consumption before the test (P=0.006, r2=0.509 for model). The within-laboratory SD of GI was related to refCV (P<0.001), the glucose analysis method (P=0.010), whether glucose measures were duplicated (P=0.008), and restrictions on dinner the night before (P=0.013, r2=0.810 for model). The between-laboratory SD of the GI values is approximately 9. Standardized data analysis and low within-subject variation (refCV<30%) are required for accuracy. The results suggest that common misconceptions exist about which factors do and do not need to be controlled to improve precision. Controlled studies and cost-benefit analyses are needed to optimize GI methodology. The trial was registered at clinicaltrials.gov as NCT00260858.

  16. Low-glycemic load decreases postprandial insulin and glucose and increases postprandial ghrelin in white but not black women.

    Science.gov (United States)

    Brownley, Kimberly A; Heymen, Steve; Hinderliter, Alan L; Galanko, Joseph; Macintosh, Beth

    2012-07-01

    Alterations in appetite hormones favoring increased postprandial satiety have been implicated in both the glycemic control and potential weight-loss benefits of a low-glycemic diet. Racial differences exist in dietary glycemic load and appetite hormone concentrations. This study examined the impact of glycemic load on appetite hormones in 20 black women [10 normal weight, BMI = 22.8 ± 1.42 (mean ± SD); 10 obese, BMI = 35.1 ± 2.77] and 20 white women (10 normal weight, BMI = 22.9 ± 1.45; 10 obese, BMI = 34.3 ± 2.77). Each woman completed two 4.5-d weight-maintenance, mixed-macronutrient, high-glycemic vs. low-glycemic load diets that concluded with a test meal of identical composition. Blood samples collected before and serially for 3 h after each test meal were assayed for plasma ghrelin and serum insulin and glucose concentrations. Compared with the high-glycemic load meal, the low-glycemic load meal was associated with lower insulin(AUC) (P = 0.02), glucose(AUC) (P = 0.01), and urge to eat ratings (P = 0.05) but with higher ghrelin(AUC) (P = 0.008). These results suggest the satiating effect of a low-glycemic load meal is not directly linked to enhanced postprandial suppression of ghrelin. Notably, these effects were significant among white but not black women, suggesting that black women may be less sensitive than white women to the glucoregulatory effects of a low-glycemic load. These findings add to a growing literature demonstrating racial differences in postprandial appetite hormone responses. If reproducible, these findings have implications for individualized diet prescription for the purposes of glucose or weight control in women.

  17. Variability and budget of CO2 in Europe: analysis of the CAATER airborne campaigns – Part 2: Comparison of CO2 vertical variability and fluxes between observations and a modeling framework

    Directory of Open Access Journals (Sweden)

    P. Ciais

    2011-06-01

    Full Text Available Our ability to predict future climate change relies on our understanding of current and future CO2 fluxes, particularly on a regional scale (100–1000 km. CO2 regional sources and sinks are still poorly understood. Inverse transport modeling, a method often used to quantify these fluxes, relies on atmospheric CO2 measurements. One of the main challenges for the transport models used in the inversions is to properly reproduce CO2 vertical gradients between the boundary layer and the free troposphere, as these gradients impact on the partitioning of the calculated fluxes between the different model regions. Vertical CO2 profiles are very well suited to assess the performances of the models. In this paper, we conduct a comparison between observed and modeled CO2 profiles recorded during two CAATER campaigns that occurred in May 2001 and October 2002 over Western Europe, as described in a companion paper. We test different combinations between a global transport model (LMDZt, a mesoscale transport model (CHIMERE, and different sets of biospheric fluxes, all chosen with a diurnal cycle (CASA, SiB2 and ORCHIDEE. The vertical profile comparison shows that: 1 in most cases the influence of the biospheric flux is small but sometimes not negligible, ORCHIDEE giving the best results in the present study; 2 LMDZt is most of the time too diffuse, as it simulates a too high boundary layer height; 3 CHIMERE better reproduces the observed gradients between the boundary layer and the free troposphere, but is sometimes too variable and gives rise to incoherent structures. We conclude there is a need for more vertical profiles to conduct further studies to improve the parameterization of vertical transport in the models used for CO2 flux inversions. Furthermore, we use a modeling method to quantify CO2 fluxes at the regional scale from a chosen observing point, coupling influence functions from the transport model LMDZt (that works quite well at the synoptic

  18. Variability and budget of CO2 in Europe: analysis of the CAATER airborne campaigns - Part 2: Comparison of CO2 vertical variability and fluxes between observations and a modeling framework

    International Nuclear Information System (INIS)

    Xueref-Remy, I.; Bousquet, P.; Rivier, L.; Ciais, P.; Carouge, C.

    2011-01-01

    Our ability to predict future climate change relies on our understanding of current and future CO 2 fluxes, particularly on a regional scale (100-1000 km). CO 2 regional sources and sinks are still poorly understood. Inverse transport modeling, a method often used to quantify these fluxes, relies on atmospheric CO 2 measurements. One of the main challenges for the transport models used in the inversions is to properly reproduce CO 2 vertical gradients between the boundary layer and the free troposphere, as these gradients impact on the partitioning of the calculated fluxes between the different model regions. Vertical CO 2 profiles are very well suited to assess the performances of the models. In this paper, we conduct a comparison between observed and modeled CO 2 profiles recorded during two CAATER campaigns that occurred in May 2001 and October 2002 over Western Europe, as described in a companion paper. We test different combinations between a global transport model (LMDZt), a mesoscale transport model (CHIMERE), and different sets of biospheric fluxes, all chosen with a diurnal cycle (CASA, SiB2 and ORCHIDEE). The vertical profile comparison shows that: 1) in most cases the influence of the biospheric flux is small but sometimes not negligible, ORCHIDEE giving the best results in the present study; 2) LMDZt is most of the time too diffuse, as it simulates a too high boundary layer height; 3) CHIMERE better reproduces the observed gradients between the boundary layer and the free troposphere, but is sometimes too variable and gives rise to incoherent structures. We conclude there is a need for more vertical profiles to conduct further studies to improve the parameterization of vertical transport in the models used for CO 2 flux inversions. Furthermore, we use a modeling method to quantify CO 2 fluxes at the regional scale from a chosen observing point, coupling influence functions from the transport model LMDZt (that works quite well at the synoptic scale) with

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

    Science.gov (United States)

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

    2014-12-10

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

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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,…

  7. 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,

  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. 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].

  10. The influence of carbohydrate consumption on glycemic control in pregnant women with type 1 diabetes

    DEFF Research Database (Denmark)

    Asbjörnsdóttir, Björg; Akueson, Cecelia E.; Ronneby, Helle

    2017-01-01

    , 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). Results At least two days of diet recording were available in 75...

  11. 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...

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

    DEFF Research Database (Denmark)

    Jensen, Lotte

    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...... 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...... and antigen levels in overweight women. Methods 45 healthy overweight women (BMI 27.6 ± 0.2 kg/m2) were randomly assigned to a parallel 10 week intervention with a low GI (n=23) or high GI (n=22) diet. Fasting blood samples were obtained before and after the 10 weeks. To study the postprandial effect of LGI...

  13. Dietary hyperglycemia, glycemic index and age-related metabolic retinal diseases

    Science.gov (United States)

    The glycemic index (GI) indicates how fast blood glucose is raised after consuming a carbohydrate-containing food. Human metabolic studies indicate that GI is related to patho-physiological responses after meals. Compared with a low-GI meal, a high-GI meal is characterized with hyperglycemia during ...

  14. 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…

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    Objective: To determine the influence of dietary glycemic index on exercise training-induced adaptations in substrate oxidation in obesity. Design and Methods: Twenty older, obese individuals undertook 3 months of fully supervised aerobic exercise and were randomized to low- (LoGIX) or high-glyce...

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  17. 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.

  18. 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.

  19. Effect of Glycemic Index of a Pre-exercise Meal on Endurance Exercise Performance

    NARCIS (Netherlands)

    Burdon, Catriona A.; Spronk, Inge; Cheng, Hoi Lun; O’Connor, Helen T.

    2017-01-01

    Background: Low glycemic index (GI) pre-exercise meals may enhance endurance performance by maintaining euglycemia and altering fuel utilization. However, evidence for performance benefits is equivocal. Objective: To evaluate the effect of a low GI (LGI) versus a high GI (HGI) pre-exercise meal on

  20. 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

  1. Calculating the Mean Amplitude of Glycemic Excursions from Continuous Glucose Data Using an Open-Code Programmable Algorithm Based on the Integer Nonlinear Method.

    Science.gov (United States)

    Yu, Xuefei; Lin, Liangzhuo; Shen, Jie; Chen, Zhi; Jian, Jun; Li, Bin; Xin, Sherman Xuegang

    2018-01-01

    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.

  2. [Moderate exercise and intake of either high or low glycemic index carbohydrates in sedentary women].

    Science.gov (United States)

    Ortiz-Rodríguez, Briseidy; De León, Lidia G; Esparza-Romero, Julián; Carrasco-Legleu, Claudia E; Candia-Luján, Ramón

    2018-05-25

    To analyze changes in blood glucose, insulin and triglyceride concentrations in relation to a moderate aerobic exercise in sedentary women of different body weight, exposed to either a high or low glycemic index carbohydrates diet. DISEñO: Cross-over type. SITE: Research was performed in the Exercise Physiology Laboratory at Facultad de Ciencias de la Cultura Física, Universidad Autónoma de Chihuahua, México. Twenty-six young sedentary women who did not exercise in the last year participated in the study. Four of adequate weight (AW) and 2 with obesity (OB) were excluded for not consuming the suggested carbohydrates (1gr/kg of weight) nor completed the programed exercise. There were n=10 in each group (AW/OB). Two treatments of 55minutes of aerobic exercise each were applied one day after consuming either high or low glycemic index carbohydrates. Plasmatic glucose, insulin, and triglycerides were determined before and after the scheduled exercise. Glucose, insulin, and triglycerides were higher in OB than in AW at baseline. Glucose was normalized in OB from 5.8±0.35 to 5.3±0.23 mmol/L (P=.001), only by eating foods with low glycemic index; triglycerides increased from 139.5±66.0 to 150.8±67.2mg/dl (P=.004) at the end of the exercise, after consumption of low glycemic index carbohydrates. Elevation of triglycerides secondary to exercise after consumption of low glycemic index seems to indicate an increase of lipid oxidation in OB. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. 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.

  4. Diurnal glycemic profile in obese and normal weight nondiabetic pregnant women.

    Science.gov (United States)

    Yogev, Yariv; Ben-Haroush, Avi; Chen, Rony; Rosenn, Barak; Hod, Moshe; Langer, Oded

    2004-09-01

    A paucity of data exists concerning the normal glycemic profile in nondiabetic pregnancies. Using a novel approach that provides continuous measurement of blood glucose, we sought to evaluate the ambulatory daily glycemic profile in the second half of pregnancy in nondiabetic women. Fifty-seven obese and normal weight nondiabetic subjects were evaluated for 72 consecutive hours with continuous glucose monitoring by measurement interstitial glucose levels in subcutaneous tissue every 5 minutes. Subjects were instructed not to modify their lifestyle or to follow any dietary restriction. For each woman, mean and fasting blood glucose values were determined; for each meal during the study period, the first 180 minutes were analyzed. For the study group, the fasting blood glucose level was 75 +/- 12 mg/dL; the mean blood glucose level was 83.7 +/- 18 mg/dL; the postprandial peak glucose value level was 110 +/- 16 mg/dL, and the time interval that was needed to reach peak postprandial glucose level was 70 +/- 13 minutes. A similar postprandial glycemic profile was obtained for breakfast, lunch, and dinner. Obese women were characterized by a significantly higher postprandial glucose peak value, increased 1- and 2-hour postprandial glucose levels, increased time interval for glucose peak, and significantly lower mean blood glucose during the night. No difference was found in fasting and mean blood glucose between obese and nonobese subjects. Glycemic profile characterization in both obese and normal weight nondiabetic subjects provide a measure for the desired level of glycemic control in pregnancy that is complicated with diabetes mellitus.

  5. Plasma adiponectin concentrations are associated with dietary glycemic index in Malaysian patients with type 2 diabetes.

    Science.gov (United States)

    Loh, Beng-In; Sathyasuryan, Daniel Robert; Mohamed, Hamid Jan Jan

    2013-01-01

    Adiponectin, an adipocyte-derived hormone has been implicated in the control of blood glucose and chronic inflammation in type 2 diabetes. However, limited studies have evaluated dietary factors on plasma adiponectin levels, especially among type 2 diabetic patients in Malaysia. The aim of this study was to investigate the influence of dietary glycemic index on plasma adiponectin concentrations in patients with type 2 diabetes. A cross-sectional study was conducted in 305 type 2 diabetic patients aged 19-75 years from the Penang General Hospital, Malaysia. Socio-demographic information was collected using a standard questionnaire while dietary details were determined by using a pre-validated semi-quantitative food frequency questionnaire. Anthropometry measurement included weight, height, BMI and waist circumference. Plasma adiponectin concentrations were measured using a commercial ELISA kit. Data were analyzed using multiple linear regression. After multivariate adjustment, dietary glycemic index was inversely associated with plasma adiponectin concentrations (β =-0.272, 95% CI -0.262, - 0.094; pfoods containing high dietary glycemic index that plasma adiponectin level reduced by 0.3 μg/mL. Thirty two percent (31.9%) of the variation in adiponectin concentrations was explained by age, sex, race, smoking status, BMI, waist circumference, HDL-C, triglycerides, magnesium, fiber and dietary glycemic index according to the multiple linear regression model (R2=0.319). These results support the hypothesis that dietary glycemic index influences plasma adiponectin concentrations in patients with type 2 diabetes. Controlled clinical trials are required to confirm our findings and to elucidate the underlying mechanism.

  6. Climate variability in Andalusia (southern Spain during the period 1701–1850 based on documentary sources: evaluation and comparison with climate model simulations

    Directory of Open Access Journals (Sweden)

    J. P. Montávez Gómez

    2012-01-01

    Full Text Available In this work, a reconstruction of climatic conditions in Andalusia (southern Iberian Peninsula during the period 1701–1850, as well as an evaluation of its associated uncertainties, is presented. This period is interesting because it is characterized by a minimum in solar irradiance (Dalton Minimum, around 1800, as well as intense volcanic activity (for instance, the eruption of Tambora in 1815, at a time when any increase in atmospheric CO2 concentrations was of minor importance. The reconstruction is based on the analysis of a wide variety of documentary data. The reconstruction methodology is based on counting the number of extreme events in the past, and inferring mean value and standard deviation using the assumption of normal distribution for the seasonal means of climate variables. This reconstruction methodology is tested within the pseudoreality of a high-resolution paleoclimate simulation performed with the regional climate model MM5 coupled to the global model ECHO-G. The results show that the reconstructions are influenced by the reference period chosen and the threshold values used to define extreme values. This creates uncertainties which are assessed within the context of climate simulation. An ensemble of reconstructions was obtained using two different reference periods (1885–1915 and 1960–1990 and two pairs of percentiles as threshold values (10–90 and 25–75. The results correspond to winter temperature, and winter, spring and autumn rainfall, and they are compared with simulations of the climate model for the considered period. The mean value of winter temperature for the period 1781–1850 was 10.6 ± 0.1 °C (11.0 °C for the reference period 1960–1990. The mean value of winter rainfall for the period 1701–1850 was 267 ± 18 mm (224 mm for 1960–1990. The mean values of spring and autumn rainfall were 164 ± 11 and 194 ± 16 mm (129 and 162 mm for 1960–1990, respectively. Comparison of the distribution

  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. 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

  9. 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

  10. 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.

  11. 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

  12. Glycemic Excursions in Type 1 Diabetes in Pregnancy: A Semiparametric Statistical Approach to Identify Sensitive Time Points during Gestation

    Directory of Open Access Journals (Sweden)

    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.

  13. Weight loss maintenance in overweight subjects on ad libitum diets with high or low protein content and glycemic index

    DEFF Research Database (Denmark)

    Aller, E E J G; Larsen, Thomas Meinert; Holst, Claus

    2014-01-01

    Background:A high dietary protein (P) content and low glycemic index (GI) have been suggested to be beneficial for weight management, but long-term studies are scarce.Objective:The DIOGENES randomized clinical trial investigated the effect of P and GI on weight loss maintenance in overweight...... or obese adults in 8 centers across Europe. This study reports the 1-year results in 2 of the centers that extended the intervention to 1 year.Method:After an 8-week low calorie diet (LCD), 256 adults (BMI>27 kg/m(2)) were randomized to 5 ad libitum diets for 12 months: high P/low GI (HP/LGI), high P/high...... GI (HP/HGI), low P/low GI (LP/LGI), low P/high GI (LP/HGI) and a control diet. During the first 6 months foods were provided for free through a shop system, during the whole 12-month period subjects received guidance by a dietician. Primary outcome variable was the change in body weight over the 12...

  14. Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control

    OpenAIRE

    Di Pierro, Francesco; Villanova,Nicola; Agostini,Federica; Soverini,Valentina; Marchesini,Giulio; Marzocchi,Rebecca

    2012-01-01

    Francesco Di Pierro,1 Nicola Villanova,2 Federica Agostini,2 Rebecca Marzocchi,2 Valentina Soverini,2 Giulio Marchesini21Scientific Department, Velleja Research, Milano, 2Diseases of Metabolism, S Orsola Malpighi Hospital, Bologna, ItalyBackground: Suboptimal glycemic control is a common situation in diabetes, regardless of the wide range of drugs available to reach glycemic targets. Basic research in diabetes is endeavoring to identify new actives working as insulin savers, use of which coul...

  15. 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…

  16. Identification of solid state fermentation degree with FT-NIR spectroscopy: Comparison of wavelength variable selection methods of CARS and SCARS

    Science.gov (United States)

    Jiang, Hui; Zhang, Hang; Chen, Quansheng; Mei, Congli; Liu, Guohai

    2015-10-01

    The use of wavelength variable selection before partial least squares discriminant analysis (PLS-DA) for qualitative identification of solid state fermentation degree by FT-NIR spectroscopy technique was investigated in this study. Two wavelength variable selection methods including competitive adaptive reweighted sampling (CARS) and stability competitive adaptive reweighted sampling (SCARS) were employed to select the important wavelengths. PLS-DA was applied to calibrate identified model using selected wavelength variables by CARS and SCARS for identification of solid state fermentation degree. Experimental results showed that the number of selected wavelength variables by CARS and SCARS were 58 and 47, respectively, from the 1557 original wavelength variables. Compared with the results of full-spectrum PLS-DA, the two wavelength variable selection methods both could enhance the performance of identified models. Meanwhile, compared with CARS-PLS-DA model, the SCARS-PLS-DA model achieved better results with the identification rate of 91.43% in the validation process. The overall results sufficiently demonstrate the PLS-DA model constructed using selected wavelength variables by a proper wavelength variable method can be more accurate identification of solid state fermentation degree.

  17. Limited Documentation and Treatment Quality of Glycemic Inpatient Care in Relation to Structural Deficits of Heterogeneous Insulin Charts at a Large University Hospital.

    Science.gov (United States)

    Kopanz, Julia; Lichtenegger, Katharina M; Sendlhofer, Gerald; Semlitsch, Barbara; Cuder, Gerald; Pak, Andreas; Pieber, Thomas R; Tax, Christa; Brunner, Gernot; Plank, Johannes

    2018-02-09

    Insulin charts represent a key component in the inpatient glycemic management process. The aim was to evaluate the quality of structure, documentation, and treatment of diabetic inpatient care to design a new standardized insulin chart for a large university hospital setting. Historically grown blank insulin charts in use at 39 general wards were collected and evaluated for quality structure features. Documentation and treatment quality were evaluated in a consecutive snapshot audit of filled-in charts. The primary end point was the percentage of charts with any medication error. Overall, 20 different blank insulin charts with variable designs and significant structural deficits were identified. A medication error occurred in 55% of the 102 audited filled-in insulin charts, consisting of prescription and management errors in 48% and 16%, respectively. Charts of insulin-treated patients had more medication errors relative to patients treated with oral medication (P international standards, a new insulin chart was developed to overcome these quality hurdles.

  18. In vitro and in vivo assessment of the glycemic index of bakery products: influence of the reformulation of ingredients.

    Science.gov (United States)

    Ferrer-Mairal, A; Peñalva-Lapuente, C; Iglesia, I; Urtasun, L; De Miguel-Etayo, P; Remón, S; Cortés, E; Moreno, L A

    2012-12-01

    To evaluate whether the modification of ingredients of two bakery products, muffins and bread, reduces their glycemic index, by means of in vitro and in vivo procedures. In vitro and in vivo glycemic index were evaluated for two types of bread and two types of muffins including one standard product for each category. For the in vitro determination, kinetics of starch digestion method was used. For the in vivo procedure, postprandial glucose measured as IAUC was obtained in a group of eighteen healthy volunteers (ten did the test with muffins and eight with breads). In in vitro, a reduction in the expected glycemic index regarding the control muffin was achieved with the partial substitution of wheat flour by a mixture of resistant starch, dextrin and lentil flour. In breads, with the partial substitution of wheat flour by a mixture of resistant starch and dextrins, a decrease in the expected glycemic index was also observed. In in vivo, a reduction in GI was also achieved both in muffin and in bread. All the obtained GI was higher in in vitro method. Despite the fact that in vitro overestimate in vivo method, the trend in the reduction in GI seems to be similar in both methods. With the substitution assayed, a reduction in the expected glycemic index and the glycemic index were obtained both in muffins and in breads.

  19. 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.

  20. 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.

  1. Role of glycemic elements of Cynodon dactylon and Musa paradisiaca in diabetes management.

    Science.gov (United States)

    Rai, Prashant Kumar; Jaiswal, Dolly; Rai, Nilesh K; Pandhija, Shiwani; Rai, A K; Watal, Geeta

    2009-09-01

    The study defined the scientific evaluation of glycemic elements of extracts of Cynodon dactylon and Musa paradisiaca. A dose of 500 mg/kg body weight (bw) of C. dactylon produced maximum falls of 23.2% and 22.8% in blood glucose levels of normoglycemic rats during studies of fasting blood glucose and glucose tolerance, respectively, whereas the same dose of M. paradisiaca produced a rise of 34.9% and 18.4%. In diabetic rats during glucose tolerance tests, a fall of 27.8% and a rise of 17.5% were observed with the same dose of C. dactylon and M. paradisiaca, respectively. Laser-induced breakdown spectroscopy used for detection of glycemic elements present in both the extracts indicated that C. dactylon was rich in magnesium (Mg), whereas M. paradisiaca was rich in potassium (K) and sodium (Na), comparatively, suggesting thereby the defined roles of these elements in diabetes management.

  2. Glycemic Memory as a Pathogenic Basis for Modern Antidiabetic Therapy Algorithm Forming

    Directory of Open Access Journals (Sweden)

    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.

  3. Hope matters to the glycemic control of adolescents and young adults with type 1 diabetes.

    Science.gov (United States)

    Santos, Fábio R M; Sigulem, Daniel; Areco, Kelsy C N; Gabbay, Monica A L; Dib, Sergio A; Bernardo, Viviane

    2015-05-01

    This study investigated the association of hope and its factors with depression and glycemic control in adolescents and young adults with type 1 diabetes. A total of 113 patients were invited to participate. Significant negative correlations were found between hope and HbA1c and also between hope and depression. Hope showed a significant association with HbA1c and depression in the stepwise regression model. Among the hope factors, "inner positive expectancy" was significantly associated with HbA1c and depression. This study supports that hope matters to glycemic control and depression. Intervention strategies focusing on hope should be further explored. © The Author(s) 2015.

  4. [The optimal blood glucose target in critically ill patient: comparison of two intensive insulin therapy protocols].

    Science.gov (United States)

    Raurell Torredà, Marta; del Llano Serrano, César; Almirall Solsona, Dolors; Catalan Ibars, Rosa María; Nicolás Arfelis, José María

    2014-03-04

    Recent studies in critically ill patients receiving insulin intravenous therapy (IIT) have shown an increased incidence of severe hypoglycemia, while intermittent subcutaneous insulin «sliding scales» (conventional insulin therapy [CIT]) is associated with hyperglycemia. The objective of this study is to assess whether glycemic control range IIT can affect glucose levels and their variability and to compare it with CIT. Prospective comparative cohort study in intensive care unit, with 2 study periods: Period 1, IIT with glycemic target range 110-140 mg/dL, and Period 2, IIT of 140-180 mg/dL. In both periods CIT glycemic target was 110-180 mg/dL. We assessed severe hypoglycemia ( 216 mg/L) and the variability of blood glucose. We studied 221 patients with 12.825 blood glucose determinations. Twenty-six and 17% of patients required IIT for glycemic control in Period 1 and 2, respectively. Hypoglycemia was associated with a discontinuous nutritional intake, glycemic target 110-140 mg/dL and low body mass index (BMI) (P = .002). Hyperglycemia was exclusively associated with a history of diabetes mellitus (OR 2.6 [95% CI 1.6 to 4.5]). Glycemic variability was associated with a discontinuous nutritional intake, low BMI, CIT insulinization, diabetes mellitus, elderly and high APACHE II (P < .001). The use of IIT is useful to reduce the variability of blood glucose. Although the 140-180 mg/dL range would be more secure as to presenting greater variability and hyperglycemia, the 110-140 mg/dL range is most suitable. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  5. Comparison of the Effects of Environmental Parameters on the Growth Variability of Vibrio parahaemolyticus Coupled with Strain Sources and Genotypes Analyses.

    Science.gov (United States)

    Liu, Bingxuan; Liu, Haiquan; Pan, Yingjie; Xie, Jing; Zhao, Yong

    2016-01-01

    Microbial growth variability plays an important role on food safety risk assessment. In this study, the growth kinetic characteristics corresponding to maximum specific growth rate (μmax) of 50 V. parahaemolyticus isolates from different sources and genotypes were evaluated at different temperatures (10, 20, 30, and 37°C) and salinity (0.5, 3, 5, 7, and 9%) using the automated turbidimetric system Bioscreen C. The results demonstrated that strain growth variability increased as the growth conditions became more stressful both in terms of temperature and salinity. The coefficient of variation (CV) of μmax for temperature was larger than that for salinity, indicating that the impact of temperature on strain growth variability was greater than that of salinity. The strains isolated from freshwater aquatic products had more conspicuous growth variations than those from seawater. Moreover, the strains with tlh (+) /tdh (+) /trh (-) exhibited higher growth variability than tlh (+) /tdh (-) /trh (-) or tlh (+) /tdh (-) /trh (+), revealing that gene heterogeneity might have possible relations with the growth variability. This research illustrates that the growth environments, strain sources as well as genotypes have impacts on strain growth variability of V. parahaemolyticus, which can be helpful for incorporating strain variability in predictive microbiology and microbial risk assessment.

  6. [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.

  7. Glycemic Control: A Combination of Lifestyle Management and the Use of Drugs

    OpenAIRE

    Standl, Eberhard; Erbach, Michael; Schnell, Oliver

    2012-01-01

    Some 30% of contemporary cardiology patients have coexisting known diabetes, and another 40% have either undiagnosed diabetes or prediabetes. There is still no final conclusive evidence of cardiovascular benefit by good glycemic control in type 2 diabetes, although studies like the United Kingdom Prospective Diabetes Study (UKPDS) and the Prospective Pioglitazone Clinical Trial in Macrovascular Events, and meta-analyses based on these and other randomized controlled trials of blood glucose-lo...

  8. The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients.

    Science.gov (United States)

    Eray, Şafak; Uçar, Halit Necmi; Çetinkaya, Fatma; Eren, Erdal; Vural, Pınar

    2017-09-01

    Type 1 diabetes mellitus (T1DM) is a chronic disease which ranks third in children under age 16 years. Expressed emotion (EE) is a term that indicates a specific family climate including lack of emotional support (LES), irritability, and emotional over-involvement. It is known that the family environment is highly important for glycemic control in diabetic adolescents. In this study, the relationship between perceived EE and glycemic control in adolescents diagnosed with T1DM not accompanied by psychopathology were investigated. The study included 49 adolescents with T1DM and 50 adolescents as a control group. Adolescents with psychopathology and intellectual disability were excluded from the study. Perceived EE was measured by the Shortened Level of Expressed Emotion Scale (SLEES) and blood sugar regulation was assessed by HbA1c levels. The adolescents with T1DM showed a significant difference in perceived EE (p=0.020) and LES (p=0.014) when compared with the control group. When diabetic adolescents were compared among themselves, the diabetic adolescents with poor glycemic control perceived greater EE (p=0.033) and less emotional support (p=0.049). In regression analyses, the predictive power of mother's educational level, the employment status of mothers and the subscale "LES" of SLEES combined to explain HbA1c level was determined to be 37.8%. The strong relationship between perceived EE and glycemic control showed us that perceived EE can hinder treatment compliance without causing psychopathology. For this reason, it is recommended that not only patients with psychopathology, but all diabetic adolescents receive psychosocial support and family interventions.

  9. EFFECTS OF COOKED LENTILS ON GLYCEMIC CONTROL AND BLOOD LIPIDS OF PATIENTS WITH TYPE 2 DIABETES

    Directory of Open Access Journals (Sweden)

    Hamidreza Shams

    2010-12-01

    Full Text Available Abstract    INTRODUCTION: Diabetes control is one of the main conflict issues in diabetes management. Scientists, recently, recommend [increasing low glycemic index (LGI foods in dietary regimen. The effects of cooked lentil as a low glycemic index food on serum blood glucose and lipid profile among type 2 diabetic patients has been investigated in this study.    METHODS: In a randomized cross-over clinical trial which was performed on 30 patients with type II diabetes mellitus, subjects were randomly divided into 2 groups. Group A followed the normal diet and Group B followed normal diet with 50gm cooked lentil and 6gm canula oil substitute of 30gm bread and 20gm cheese. After  6 weeks, groups stopped their diets and put on wash out period for 3 weeks and later the  diets where switched between the them. Diet continued for another 6 weeks. Anthropometric measurements, dietary intakes, serum lipids and glucose levels were determined at the beginning and the end of each test period. Data were analyzed by Food Processor II and SPSS-13.    RESULTS: BMI, LDL_C, HDL_C, TG and serum Fructozamine were not significantly affected by dietary regimens. But Total cholesterol and fasting blood glucose decreased significantly in regimen containing lentil (P<0.05.    CONCLUSION: Consumption of cooked lentil as a LGI food in breakfast led to reduction of FBS and TC and improvement of glycemic control in type 2 diabetic patients.      Keywords: Diabetes Mellitus, Lentil, Lipid profiles, Blood glucose, Glycemic index, Clinical Trial.

  10. Associations of Glycemic Control With Cardiovascular Outcomes Among US Hemodialysis Patients With Diabetes Mellitus.

    Science.gov (United States)

    Rhee, Jinnie J; Zheng, Yuanchao; Montez-Rath, Maria E; Chang, Tara I; Winkelmayer, Wolfgang C

    2017-06-07

    There is a lack of data on the relationship between glycemic control and cardiovascular end points in hemodialysis patients with diabetes mellitus. We included adult Medicare-insured patients with diabetes mellitus who initiated in-center hemodialysis treatment from 2006 to 2008 and survived for >90 days. Quarterly mean time-averaged glycated hemoglobin (HbA 1c ) values were categorized into diabetes mellitus. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  11. IMPACT OF GLYCEMIC CONTROL ON OXIDATIVE STRESS AND ANTIOXIDANT STATUS IN DIABETIC NEUROPATHY

    Directory of Open Access Journals (Sweden)

    Shilpashree

    2015-01-01

    Full Text Available INTRODUCTION: Oxidative stress due to enhanced free - radical generation and/or a decrease in antioxidant defense mechanisms has been implicated in the pathogenesis of diabetic neuropathy. This study was conducted to study the impact of glycemic control on oxidative stress and antioxidant balance in diab etic neuropathy. METHOD S : fifty patients with diabetic neuropathy and fifty age matched healthy controls were included in the study. Glycosylated hemoglobin (HbA1c was estimated to assess the severity of diabetes and the glycemic control. Serum malondiaal dehyde (MDA levels were assessed as a marker of lipid peroxidation and hence oxidative stress. Superoxide Dismutase (SOD levels were assessed for antioxidant status. RESULTS: Significant positive correlation was found between serum MDA levels and hba1c ( r = 0.276, p < 0.0001 in patients with diabetic neuropathy. There was statistically significant reduction in the Glutathione peroxidase levels. Further, SOD levels were inversely correlated with HbA1c (r= - 0.603, p<0.0001 levels. CONCLUSION AND SUMMARY: oxidative stress is greatly increased in patients suffering from diabetic neuropathy and is inversely related to glycemic control. This may be due to depressed antioxidant enzyme levels and may also be responsible for further depletion of antioxidant enzym e GPx. This worsens the oxidative stress and creates a vicious cycle of imbalance of free radical generation and deficit of antioxidant status in these patients which may lead to nervous system damage causing diabetic neuropathy. A good glycemic control is essential for prevention of diabetic neuropathy.

  12. 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

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

    Directory of Open Access Journals (Sweden)

    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-naive 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.

  14. 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.

  15. Factors Related to the Glycemic Control in Lithuanian Adolescents with Type 1 Diabetes Mellitus

    OpenAIRE

    Kassem, Salem

    2017-01-01

    1) Adolescent female patients with type 1 diabetes mellitus have better glycemic control and higher levels of diabetes distress than male patients. 2) Parents of adolescents using insulin pumps experience higher diabetes distress than parents of adolescents using multiple daily injections. 3) No differences in diabetes-related factors, emotional state, diabetes-related distress (in adolescent patients and in their primary care-givers) and social factors in groups of adolescent patients ...

  16. 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.

  17. 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.

  18. Association of reduced zinc status with poor glycemic control in individuals with type 2 diabetes mellitus.

    Science.gov (United States)

    Bandeira, Verônica da Silva; Pires, Liliane Viana; Hashimoto, Leila Leiko; Alencar, Luciane Luca de; Almondes, Kaluce Gonçalves Sousa; Lottenberg, Simão Augusto; Cozzolino, Silvia Maria Franciscato

    2017-12-01

    This study evaluated the relationship between the zinc-related nutritional status and glycemic and insulinemic markers in individuals with type 2 diabetes mellitus (T2DM). A total of 82 individuals with T2DM aged between 29 and 59 years were evaluated. The concentration of zinc in the plasma, erythrocytes, and urine was determined by the flame atomic absorption spectrometry method. Dietary intake was assessed using a 3-day 24-h recall. In addition, concentrations of serum glucose, glycated hemoglobin percentage, total cholesterol and fractions, triglycerides, and serum insulin were determined. The insulin resistance index (HOMA-IR) and β-cell function (HOMA- β) were calculated. The markers of zinc status (plasma: 83.3±11.9μg/dL, erythrocytes: 30.1±4.6μg/g Hb, urine: 899.1±622.4μg Zn/24h, and dietary: 9.9±0.8mg/day) were classified in tertiles and compared to insulinemic and glycemic markers. The results showed that lower zinc concentrations in plasma and erythrocytes, as well as its high urinary excretion, were associated with higher percentages of glycated hemoglobin, reflecting a worse glycemic control in individuals with T2DM (pzinc levels and glycated hemoglobin percentage (r=-0.325, p=0.003), and a positive correlation between urinary zinc excretion and glycemia (r=0.269, p=0.016), glycated hemoglobin percentage (r=0.318, p=0.004) and HOMA-IR (r=0.289, p=0.009). According to our study results, conclude that T2DM individuals with reduced zinc status exhibited poor glycemic control. Copyright © 2017 Elsevier GmbH. All rights reserved.

  19. 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.

  20. [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.

  1. 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

  2. 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

  3. 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.

  4. In vitro colonic fermentation and glycemic response of different kinds of unripe banana flour.

    Science.gov (United States)

    Menezes, Elizabete Wenzel; Dan, Milana C T; Cardenette, Giselli H L; Goñi, Isabel; Bello-Pérez, Luis Arturo; Lajolo, Franco M

    2010-12-01

    This work aimed to study the in vitro colonic fermentation profile of unavailable carbohydrates of two different kinds of unripe banana flour and to evaluate their postprandial glycemic responses. The unripe banana mass (UBM), obtained from the cooked pulp of unripe bananas (Musa acuminata, Nanicão variety), and the unripe banana starch (UBS), obtained from isolated starch of unripe banana, plantain type (Musa paradisiaca) in natura, were studied. The fermentability of the flours was evaluated by different parameters, using rat inoculum, as well as the glycemic response produced after the ingestion by healthy volunteers. The flours presented high concentration of unavailable carbohydrates, which varied in the content of resistant starch, dietary fiber and indigestible fraction (IF). The in vitro colonic fermentation of the flours was high, 98% for the UBS and 75% for the UBM when expressed by the total amount of SCFA such as acetate, butyrate and propionate in relation to lactulose. The increase in the area under the glycemic curve after ingestion of the flours was 90% lower for the UBS and 40% lower for the UBM than the increase produced after bread intake. These characteristics highlight the potential of UBM and UBS as functional ingredients. However, in vivo studies are necessary in order to evaluate the possible benefit effects of the fermentation on intestinal health.

  5. 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.

  6. The glycemic index: methodological aspects related to the interpretation of health effects and to regulatory labeling.

    Science.gov (United States)

    Aziz, Alfred

    2009-01-01

    The glycemic index (GI) is an experimental system that classifies carbohydrates (CHO) and CHO-containing foods according to their blood glucose-raising potential. It is based on the glycemic response following the ingestion of a test food containing a defined amount of available CHO relative to that of an equi-carbohydrate portion of either white bread or glucose. The concept has been extended to mixed meals and whole diets where the GI of the meal/diet is expressed as the weighted average of the GI of each food, based on the percentage of the total mealldiet CHO provided by each food. Over the last few decades, a substantial number of epidemiological and interventional studies have reported beneficial associationsleffects of lower GI diets across a wide spectrum of pathophysiological conditions, including diabetes, cardiovascular disease, obesity, and certain forms of cancer. This has prompted proponents of the GI to recommend its use for dietary planning and labeling purposes. However, the currently recommended GI methodology is not well standardized and has several flaws, which brings into question the strength of evidence attributed to the health effects of low-GI diets. This review focuses exclusively on the methodological aspects of the GI, how they might impact the interpretation of data related to the purported health benefits of low GI diets, and the considerations for the use of the GI in food labeling. In addition, alternative systems for classifying the glycemic effects of CHO-containing foods are briefly discussed.

  7. 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.

  8. The effect of ginseng (the genus panax on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials.

    Directory of Open Access Journals (Sweden)

    Esra' Shishtar

    Full Text Available Despite the widespread use of ginseng in the management of diabetes, supporting evidence of its anti-hyperglycemic efficacy is limited, necessitating the need for evidence-based recommendations for the potential inclusion of ginseng in diabetes management.To elucidate the effect of ginseng on glycemic control in a systematic review and meta-analysis of randomized controlled trials in people with and without diabetes.MEDLINE, EMBASE, CINAHL and the Cochrane Library (through July 3, 2013.Randomized controlled trials ≥30 days assessing the glycemic effects of ginseng in people with and without diabetes.Relevant data were extracted by 2 independent reviewers. Discrepancies were resolved by consensus. The Heyland Methodological Quality Score and the Cochrane risk of bias tool were used to assess study quality and risk of bias respectively.Sixteen trials were included, in which 16 fasting blood glucose (n = 770, 10 fasting plasma insulin (n = 349, 9 glycated hemoglobin (n = 264, and 7 homeostasis model assessment of insulin resistance (n = 305 comparisons were reported. Ginseng significantly reduced fasting blood glucose compared to control (MD =  -0.31 mmol/L [95% CI: -0.59 to -0.03], P = 0.03. Although there was no significant effect on fasting plasma insulin, glycated hemoglobin, or homeostasis model assessment of insulin resistance, a priori subgroup analyses did show significant reductions in glycated hemoglobin in parallel compared to crossover trials (MD = 0.22% [95%CI: 0.06 to 0.37], P = 0.01.Most trials were of short duration (67% trials<12wks, and included participants with a relatively good glycemic control (median HbA1c non-diabetes = 5.4% [2 trials]; median HbA1c diabetes = 7.1% [7 trials].Ginseng modestly yet significantly improved fasting blood glucose in people with and without diabetes. In order to address the uncertainty in our effect estimates and provide better assessments of ginseng's anti

  9. 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.

  10. 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.

  11. Comparison of the variability of the onset and recovery from neuromuscular blockade with cisatracurium versus rocuronium in elderly patients under total intravenous anesthesia

    Science.gov (United States)

    Xiaobo, Feng; Jianjuan, Ke; Yanlin, Wang

    2012-01-01

    This study was designed to compare the variability of the onset and offset of the effect of two neuromuscular blocking drugs with different elimination pathways in adult and elderly patients during total intravenous anesthesia (TIVA). After Ethics Committee approval and patients' informed consent, the drugs were compared in 40 adult and 40 elderly patients scheduled for elective surgery under TIVA with tracheal intubation who were randomized to receive a single bolus dose of 0.15 mg/kg cisatracurium or 0.9 mg/kg rocuronium. The time of onset of maximum depression, duration of action, and recovery index time were measured and recorded for each patient and variability is reported as means ± standard deviation. Time of onset was significantly shorter for rocuronium than cisatracurium for the adult and elderly groups (P = 0.000), but the variability of cisatracurium was significantly greater compared with rocuronium for the same age groups (93.25 vs 37.01 s in the adult group and 64.56 vs 33.75 s in the elderly group; P = 0.000). The duration of the effect in the elderly group receiving rocuronium was significantly longer than in the elderly group receiving cisatracurium, and the variability of the duration was significantly greater in the rocuronium group than in the cisatracurium group. Mean time of recovery was significantly longer for the elderly group receiving rocuronium than for the elderly group receiving cisatracurium (P = 0.022), and variability was also greater (P = 0.002). Both drugs favored good intubating conditions. In conclusion, cisatracurium showed less variability in these parameters than rocuronium, especially in the elderly, a fact that may be of particular clinical interest. PMID:22584638

  12. Comparison of the variability of the onset and recovery from neuromuscular blockade with cisatracurium versus rocuronium in elderly patients under total intravenous anesthesia

    Directory of Open Access Journals (Sweden)

    Feng Xiaobo

    2012-07-01

    Full Text Available This study was designed to compare the variability of the onset and offset of the effect of two neuromuscular blocking drugs with different elimination pathways in adult and elderly patients during total intravenous anesthesia (TIVA. After Ethics Committee approval and patients’ informed consent, the drugs were compared in 40 adult and 40 elderly patients scheduled for elective surgery under TIVA with tracheal intubation who were randomized to receive a single bolus dose of 0.15 mg/kg cisatracurium or 0.9 mg/kg rocuronium. The time of onset of maximum depression, duration of action, and recovery index time were measured and recorded for each patient and variability is reported as means ± standard deviation. Time of onset was significantly shorter for rocuronium than cisatracurium for the adult and elderly groups (P = 0.000, but the variability of cisatracurium was significantly greater compared with rocuronium for the same age groups (93.25 vs 37.01 s in the adult group and 64.56 vs 33.75 s in the elderly group; P = 0.000. The duration of the effect in the elderly group receiving rocuronium was significantly longer than in the elderly group receiving cisatracurium, and the variability of the duration was significantly greater in the rocuronium group than in the cisatracurium group. Mean time of recovery was significantly longer for the elderly group receiving rocuronium than for the elderly group receiving cisatracurium (P = 0.022, and variability was also greater (P = 0.002. Both drugs favored good intubating conditions. In conclusion, cisatracurium showed less variability in these parameters than rocuronium, especially in the elderly, a fact that may be of particular clinical interest.

  13. Variability Bugs:

    DEFF Research Database (Denmark)

    Melo, Jean

    . Although many researchers suggest that preprocessor-based variability amplifies maintenance problems, there is little to no hard evidence on how actually variability affects programs and programmers. Specifically, how does variability affect programmers during maintenance tasks (bug finding in particular......)? How much harder is it to debug a program as variability increases? How do developers debug programs with variability? In what ways does variability affect bugs? In this Ph.D. thesis, I set off to address such issues through different perspectives using empirical research (based on controlled...... experiments) in order to understand quantitatively and qualitatively the impact of variability on programmers at bug finding and on buggy programs. From the program (and bug) perspective, the results show that variability is ubiquitous. There appears to be no specific nature of variability bugs that could...

  14. 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.

  15. 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...

  16. Variable Omission of "ne" in Real-Time French Chat: A Corpus-Driven Comparison of Educational and Non-Educational Contexts

    Science.gov (United States)

    van Compernolle, Remi A.; Williams, Lawrence

    2009-01-01

    This article reports on the variable omission of the French negative particle "ne" (the first marker of verbal negation) in synchronous (i.e., real-time) electronic communication environments. Patterns of variation in a corpus of non-educational chat (i.e., free, public-access Internet chat) are analyzed and compared to data produced by first-,…

  17. 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

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    born in 1922, 1932, 1942, or 1952. A baseline health examination and a dietary history interview were carried out in 1987 and 1988; a follow-up health examination was performed in 1993 and 1994. Results: Positive associations between GI and changes in bodyweight (¿BW), percentage body fat (%BF......), and waist circumference (¿WC) were observed in women after adjustment for covariates.Significant GI X sex X physical activity interactions for ABSTRACTBackground: A diet with a high glycemic index (GI) and glycemicload (GL) may promote overconsumption of energy and increase therisk of weight gain...... of the Monitoring Trendsand Determinants in Cardiovascular Disease study. The subsamplecomprised 185 men and 191 women born in 1922, 1932, 1942, or1952. A baseline health examination and a dietary history interviewwere carried out in 1987 and 1988; a follow-up health examinationwas performed in 1993 and 1994...

  19. Risk stratification in middle-aged patients with congestive heart failure: prospective comparison of the Heart Failure Survival Score (HFSS) and a simplified two-variable model.

    Science.gov (United States)

    Zugck, C; Krüger, C; Kell, R; Körber, S; Schellberg, D; Kübler, W; Haass, M

    2001-10-01

    The performance of a US-American scoring system (Heart Failure Survival Score, HFSS) was prospectively evaluated in a sample of ambulatory patients with congestive heart failure (CHF). Additionally, it was investigated whether the HFSS might be simplified by assessment of the distance ambulated during a 6-min walk test (6'WT) instead of determination of peak oxygen uptake (peak VO(2)). In 208 middle-aged CHF patients (age 54+/-10 years, 82% male, NYHA class 2.3+/-0.7; follow-up 28+/-14 months) the seven variables of the HFSS: CHF aetiology; heart rate; mean arterial pressure; serum sodium concentration; intraventricular conduction time; left ventricular ejection fraction (LVEF); and peak VO(2), were determined. Additionally, a 6'WT was performed. The HFSS allowed discrimination between patients at low, medium and high risk, with mortality rates of 16, 39 and 50%, respectively. However, the prognostic power of the HFSS was not superior to a two-variable model consisting only of LVEF and peak VO(2). The areas under the receiver operating curves (AUC) for prediction of 1-year survival were even higher for the two-variable model (0.84 vs. 0.74, P<0.05). Replacing peak VO(2) with 6'WT resulted in a similar AUC (0.83). The HFSS continued to predict survival when applied to this patient sample. However, the HFSS was inferior to a two-variable model containing only LVEF and either peak VO(2) or 6'WT. As the 6'WT requires no sophisticated equipment, a simplified two-variable model containing only LVEF and 6'WT may be more widely applicable, and is therefore recommended.

  20. The prevalence and determinants of poor glycemic control among adults with type 2 diabetes mellitus in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Alzaheb RA

    2018-01-01

    Full Text Available Riyadh A Alzaheb,1 Abdullah H Altemani2 1Department of Clinical Nutrition, Faculty of Applied Medical Sciences, 2Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia Background: Although the prevalence of type 2 diabetes mellitus (T2DM is rising sharply in Saudi Arabia, data on glycemic control, crucial to reducing diabetes mellitus complications, remain scarce. This study therefore investigated glycemic control status and the factors influencing poor glycemic control among adult T2DM patients in Saudi Arabia.Methods: This cross-sectional study examined 423 T2DM patients at a diabetic center in Tabuk, Saudi Arabia between September 2016 and July 2017. Glycemic levels were measured via fasting blood glucose (FBG levels, and “poor glycemic control” was defined as FBG >130 mg/dL. Poor glycemic control’s risk factors were identified using a logistic regression.Results: In the sample, 74.9% of the patients had poor blood glycemic control. Logistic regression revealed that T2DM patients had an increased chance of poorly controlled diabetes if they had family histories of diabetes (adjusted odds ratio [AOR] =7.38, 95% CI 4.09–13.31, longer diabetic durations (AOR =2.33, 95% CI 1.14–4.78 for 5–10 years and AOR =5.19, 95% CI 2.50–10.69 for >10 years, insufficient physical exercise (AOR =19.02, 95% CI 6.23–58.06, or were overweight (AOR =3.79, 95% CI 2.00–7.18, or obese (AOR =5.35, 95% CI 2.72–12.59.Conclusion: A high proportion of the sampled patients had poor glycemic control, therefore, health care professionals should manage the associated risk factors to limit disease complications and improve the health of patients with diabetes. Keywords: type 2 diabetes, glycemic control, Saudi Arabia

  1. The effect of consumption of low-glycemic-index and low-glycemic-load desserts on anthropometric parameters and inflammatory markers in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Argiana, Vasiliki; Kanellos, Panagiotis Τ; Makrilakis, Konstantinos; Eleftheriadou, Ioanna; Tsitsinakis, Georgios; Kokkinos, Alexander; Perrea, Despina; Tentolouris, Nikolaos

    2015-10-01

    The aim of the present study was to examine the effects of consumption of desserts with low glycemic index (GI) and low glycemic load (GL), as part of a balanced hypo-caloric diet, on anthropometric and biochemical parameters in patients with type 2 diabetes mellitus (T2DM). A total of 61 subjects with T2DM were randomly assigned to the intervention (n = 30) or to the control group (n = 31). Both groups followed the same hypo-caloric (-500 kcal) diet for 12 weeks. Consumption of four portions of low-GI/low-GL desserts/week was included in the diet in the intervention group while one portion of a favorite usual sweet/week was allowed to be consumed in the control group. Thirty subjects in the control and 28 subjects in the intervention group completed the trial. Body weight, body mass index, and waist circumference were reduced significantly in both groups. Arterial blood pressure, fasting blood glucose, glycosylated hemoglobin, insulin, and γ-GT were reduced significantly only in the intervention group; however, there were no significant differences between the two groups at endpoint. C-reactive protein was reduced in the intervention, and HDL cholesterol was also reduced in the control group; the reductions were significantly different at the end of the trial. No significant changes were observed in the other plasma lipids, uric acid, leptin, adiponectin, and interleukin-6 in either study group. Consumption of desserts with low GI/GL in a balanced hypo-caloric diet has a positive impact on anthropometric and metabolic parameters of patients with T2DM.

  2. Dietary glycemic load and glycemic index and risk of coronary heart disease and stroke in Dutch men and women: the EPIC-MORGEN study.

    Directory of Open Access Journals (Sweden)

    Koert N J Burger

    Full Text Available BACKGROUND: The associations of glycemic load (GL and glycemic index (GI with the risk of cardiovascular diseases (CVD are not well-established, particularly in men, and may be modified by gender. OBJECTIVE: To assess whether high dietary GL and GI increase the risk of CVD in men and women. METHODS: A large prospective cohort study (EPIC-MORGEN was conducted within the general Dutch population among 8,855 men and 10,753 women, aged 21-64 years at baseline (1993-1997 and free of diabetes and CVD. Dietary intake was assessed with a validated food-frequency questionnaire and GI and GL were calculated using Foster-Powell's international table of GI. Information on morbidity and mortality was obtained through linkage with national registries. Cox proportional hazards analysis was performed to estimate hazard ratios (HRs for incident coronary heart disease (CHD and stroke, while adjusting for age, CVD risk factors, and dietary factors. RESULTS: During a mean follow-up of 11.9 years, 581 CHD cases and 120 stroke cases occurred among men, and 300 CHD cases and 109 stroke cases occurred among women. In men, GL was associated with an increased CHD risk (adjusted HR per SD increase, 1.17 [95% CI, 1.02-1.35], while no significant association was found in women (1.09 [0.89-1.33]. GI was not associated with CHD risk in both genders, while it was associated with increased stroke risk in men (1.27 [1.02-1.58] but not in women (0.96 [0.75-1.22]. Similarly, total carbohydrate intake and starch intake were associated with a higher CHD risk in men (1.23 [1.04-1.46]; and 1.24 [1.07-1.45], but not in women. CONCLUSION: Among men, high GL and GI, and high carbohydrate and starch intake, were associated with increased risk of CVD.

  3. Effect of scaling and root planing on serum interleukin-10 levels and glycemic control in chronic periodontitis and type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Anirudh Balakrishna Acharya

    2015-01-01

    Full Text Available Aim: Chronic periodontal disease (CPD and type 2 diabetes mellitus (T2DM share common pathogenic pathways involving the cytokine network resulting in increased susceptibility to both diseases, leading to increased inflammatory destruction, insulin resistance, and poor glycemic control. Periodontal treatment may improve glycemic control. The aim of this study was to evaluate the effect of scaling and root planing (SRP of T2DM patients with CPD on hyperglycemia and the levels of serum interleukin-10 (IL-10. Materials and Methods: Forty-five subjects were divided into three groups comprising 15 subjects each as Group 1 (healthy controls, Group 2 (CPD patients, and Group 3 (T2DM patients with CPD. Plaque index, gingival index (GI, probing pocket depths (PPD, clinical attachment loss (AL, bleeding on probing (BoP, random blood sugar, glycosylated hemoglobin (HbA1C, and serum IL-10 were measured at baseline; SRP was performed on Groups 2 and 3 and the selected parameters recorded again at 6 months. Results: Statistically significant (P < 0.05 differences were observed in the variables at baseline and 6 months after SRP between the three groups using one-way ANOVA. The paired samples t-test for PPD and AL in Group 3 was statistically significant. Group 3 revealed positive correlations between PPD and HbA1C, BoP and IL-10, respectively, at 6 months and a predictable association of HbA1C with PPD and GI, and IL-10 levels with BoP, respectively, at 6 months. Conclusion: Scaling and root planing is effective in reducing blood glucose levels in T2DM patient with pocket depths and effective in elevating systemic IL-10 levels in CPD patients and CPD patients with T2DM.

  4. 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...

  5. A comparison of logistic regression analysis and an artificial neural network using the BI-RADS lexicon for ultrasonography in conjunction with introbserver variability.

    Science.gov (United States)

    Kim, Sun Mi; Han, Heon; Park, Jeong Mi; Choi, Yoon Jung; Yoon, Hoi Soo; Sohn, Jung Hee; Baek, Moon Hee; Kim, Yoon Nam; Chae, Young Moon; June, Jeon Jong; Lee, Jiwon; Jeon, Yong Hwan

    2012-10-01

    To determine which Breast Imaging Reporting and Data System (BI-RADS) descriptors for ultrasound are predictors for breast cancer using logistic regression (LR) analysis in conjunction with interobserver variability between breast radiologists, and to compare the performance of artificial neural network (ANN) and LR models in differentiation of benign and malignant breast masses. Five breast radiologists retrospectively reviewed 140 breast masses and described each lesion using BI-RADS lexicon and categorized final assessments. Interobserver agreements between the observers were measured by kappa statistics. The radiologists' responses for BI-RADS were pooled. The data were divided randomly into train (n = 70) and test sets (n = 70). Using train set, optimal independent variables were determined by using LR analysis with forward stepwise selection. The LR and ANN models were constructed with the optimal independent variables and the biopsy results as dependent variable. Performances of the models and radiologists were evaluated on the test set using receiver-operating characteristic (ROC) analysis. Among BI-RADS descriptors, margin and boundary were determined as the predictors according to stepwise LR showing moderate interobserver agreement. Area under the ROC curves (AUC) for both of LR and ANN were 0.87 (95% CI, 0.77-0.94). AUCs for the five radiologists ranged 0.79-0.91. There was no significant difference in AUC values among the LR, ANN, and radiologists (p > 0.05). Margin and boundary were found as statistically significant predictors with good interobserver agreement. Use of the LR and ANN showed similar performance to that of the radiologists for differentiation of benign and malignant breast masses.

  6. Evaluation of therapy for dilated cardiomyopathy with heart failure by iodine-123 metaiodobenzyl-guanidine imaging. Comparison with heart rate variability power spectral analysis

    Energy Technology Data Exchange (ETDEWEB)

    Li, Shou-lin; Ikeda, Jun; Takita, Tamotsu; Sekiguchi, Yohei; Demachi, Jun; Chikama, Hisao; Goto, Atsushi; Shirato, Kunio [Tohoku Univ., Sendai (Japan). School of Medicine

    1998-11-01

    The relationship between the myocardial uptake of iodine-123 metaiodobenzylguanidine ({sup 123}I-MIBG) and heart rate variability parameters has not been determined. This study determined the relationship between the change in myocardial uptake of {sup 123}I-MIBG and improvement in left ventricular function after treatment, to determine the usefulness of {sup 123}I-MIBG imaging to assess the effect of therapy on heart failure due to dilated cardiomyopathy (DCM). {sup 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 {sup 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 {sup 123}I-MIBG imaging and heart rate variability parameters are useful to assess the autonomic tone in DCM with heart failure. (author)

  7. Comparison of the CBA-H and SF-36 for the screening of the psychological and behavioural variables in chronic dialysis patients.

    Science.gov (United States)

    De Pasquale, Concetta; Conti, Daniela; Pistorio, Maria Luisa; Fatuzzo, Pasquale; Veroux, Massimiliano; Di Nuovo, Santo

    2017-01-01

    The aim of the study was to perform an analysis of the emotional reactions, perception of stressful life and behavioural changes related to Haemodialysis (HD) in order to identify those variables that can improve lifestyle and the adherence to treatment. Some psychometric assessment, such as the Cognitive Behavioural Assessment, Hospital Form, (CBA-H) and the Health Survey (SF-36), which provides two indexes: the Physical Component Score (PCS) and the Mental Component Score (MCS), are suitable to assess a patient's psychological and behavioural style and their health-related quality of life. The study involved 37 Italian out-patients with end-stage renal disease under HD therapy. We calculated the Spearman correlation between variables of CBA-H, SF-36, age and time on HD. We also performed a multivariate linear regression using the CBA-H variables as predictors and PCS and MCS as dependent variables. From the CBA-H, 95% of participants self-reported psychological characteristics comparable to Type A personality, which identifies an anxious, hyperactive and hostile subject. Physical limitations were found to be directly proportional to the time on dialysis (rs = -0.42). The condition of perceived stress worsens the state of mental health (rs = -0.68) and general health perception (rs = -0.44). The condition of vital exhaustion correlates both the PCS and the MCS (ppsychological wellbeing of a dialyzed patient could be due to the combination of several factors, including life parameters, the positive perception of psychosocial outcomes, and the perceived quality of life. A multidisciplinary team (neurologists, psychiatrists, psychologists, and nurses) is essential to plan effective psychological and psychotherapeutic interventions to improve a mind-body integration.

  8. 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)

  9. 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.

  10. A Journey to Improved Inpatient Glycemic Control by Redesigning Meal Delivery and Insulin Administration.

    Science.gov (United States)

    Engle, Martha; Ferguson, Allison; Fields, Willa

    2016-01-01

    The purpose of this quality improvement project was to redesign a hospital meal delivery process in order to shorten the time between blood glucose monitoring and corresponding insulin administration and improve glycemic control. This process change redesigned the workflow of the dietary and nursing departments. Modifications included nursing, rather than dietary, delivering meal trays to patients receiving insulin. Dietary marked the appropriate meal trays and phoned each unit prior to arrival on the unit. The process change was trialed on 2 acute care units prior to implementation hospital wide. Elapsed time between blood glucose monitoring and insulin administration was analyzed before and after process change as well as evaluation of glucometrics: percentage of patients with blood glucose between 70 and 180 mg/dL (percent perfect), blood glucose greater than 300 mg/dL (extreme hyperglycemia), and blood glucose less than 70 mg/dL (hypoglycemia). Percent perfect glucose results improved from 45% to 53%, extreme hyperglycemia (blood glucose >300 mg/dL) fell from 11.7% to 5%. Hypoglycemia demonstrated a downward trend line, demonstrating that with improving glycemic control hypoglycemia rates did not increase. Percentage of patients receiving meal insulin within 30 minutes of blood glucose check increased from 35% to 73%. In the hospital, numerous obstacles were present that interfered with on-time meal insulin delivery. Establishing a meal delivery process with the nurse performing the premeal blood glucose check, delivering the meal, and administering the insulin improves overall blood glucose control. Nurse-led process improvement of blood glucose monitoring, meal tray delivery, and insulin administration does lead to improved glycemic control for the inpatient population.

  11. Starch digestibility and predicted glycemic index of fried sweet potato cultivars

    Directory of Open Access Journals (Sweden)

    Amaka Odenigbo

    2012-07-01

    Full Text Available Background: Sweet potato (Ipomoea batatas L. is a very rich source of starch. There is increased interest in starch digestibility and the prevention and management of metabolic diseases.Objective: The aim of this study was to evaluate the levels of starch fractions and predicted glycemic index of different cultivars of sweet potato. Material and Method: French fries produced from five cultivars of sweet potato (‘Ginseng Red’, ‘Beauregard’, ‘White Travis’, ‘Georgia Jet clone #2010’ and ‘Georgia Jet’ were used. The level of total starch (TS, resistant starch (RS, digestible starch (DS, and starch digestion index starch digestion index in the samples were evaluated. In vitro starch hydrolysis at 30, 90, and 120 min were determined enzymatically for calculation of rapidly digestible starch (RDS, predicted glycemic index (pGI and slowly digestible starch (SDS respectively. Results: The RS content in all samples had an inversely significant correlation with pGI (-0.52; P<0.05 while RDS had positive and significant influence on both pGI (r=0.55; P<0.05 and SDI (r= 0.94; P<0.01. ‘White Travis’ and ‘Ginseng Red’ had higher levels of beneficial starch fractions (RS and SDS with low pGI and starch digestion Index (SDI, despite their higher TS content. Generally, all the cultivars had products with low to moderate GI values. Conclusion: The glycemic index of these food products highlights the health promoting characteristics of sweet potato cultivars.

  12. Frozen desserts and glycemic response in well-controlled NIDDM patients.

    Science.gov (United States)

    Bukar, J; Mezitis, N H; Saitas, V; Pi-Sunyer, F X

    1990-04-01

    Fructose is known to elicit a lower glycemic response than sucrose, and high-fructose desserts have been recommended for a diabetic diet. We compared a cholesterol-free tofu-based frozen dessert (TFD) containing high-fructose corn syrups with a dairy-based sucrose-sweetened ice cream (IC). Six male and six female non-insulin-dependent diabetic patients (mean age 51 yr, mean ideal body weight 143%, fasting blood glucose less than 160 mg/dl) with well-controlled diabetes and managed on oral hypoglycemic agents were studied. Subjects underwent three trials. In the first trial they ingested 50 g glucose, and in the next two trials they ingested 50-g carbohydrate equivalents of either TFD or IC in random sequence. Venous blood was drawn at intervals during the 3-h trials for glucose and insulin determinations. Fasting plasma glucose was not statistically different between IC and TFD trials (130 vs. 121 mg/dl). Peak glucose responses were at 120 min in both trials (190 mg/dl for IC and 222 mg/dl for TFD), with those for TFD being significantly higher (P less than 0.01). Mean glucose area and glycemic index for TFD were significantly greater than for IC (P less than 0.01 and P less than 0.03, respectively). There was no significant difference between mean insulin areas. In summary, the TFD, which contains soybean curd and high-fructose corn syrup, might have been expected to produce more satisfactory postprandial blood glucose levels than IC, which contains sucrose, yet a higher glycemic response was elicited. This is related to the substantial amount of total glucose in this "fructose" dessert.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Evaluation of the glycemic indices of three commonly eaten mixed meals in Okada, Edo State.

    Science.gov (United States)

    Omage, Kingsley; Omage, Sylvia O

    2018-01-01

    People do not generally eat single or individual meals; rather they eat mixed meals, consisting of two or more individual meals. These mixed meals usually have glycemic indices which differ from that of the individual food type. This study was aimed at evaluating the glycemic indices of three commonly consumed mixed meals eaten in Okada; rice and beans (test food 1), rice and plantain (test food 2), beans and plantain (test food 3). Two hundred and forty healthy subjects aged between 18 and 30 participated in this study. They were randomized into three groups of eighty persons each, and fed with the standard food (50 g glucose) on day one and one of the test foods on day two, after an overnight fast. Blood samples were taken at 0, 30, 60, 90, and 120 min after the food had been eaten. The results showed that the Glycemic Index (GI) values for the test foods were high: 86.60 (test food 1), 89.74 (test food 2), 86.93(test food 3). The incremental increase in blood glucose was monitored and calculated for each food and when compared with that of the standard food (glucose), there was significant differences ( p   .05). The results from this study indicated that the GI of the mixed meals was affected by the constituent nutrient and the response is also affected by the proportion of each nutrient. Our findings show that the selected test foods (mixed meals) consumed in Okada have high GI values.

  14. Glycemic Effects of Rebaudioside A and Erythritol in People with Glucose Intolerance

    Directory of Open Access Journals (Sweden)

    Dong Hee Shin

    2016-06-01

    Full Text Available BackgroundRebaudioside A and erythritol are nonnutritive sweeteners. There have been several studies of their glycemic effects, but the outcomes remain controversial. The purpose of this study was to evaluate the glycemic effects of rebaudioside A and erythritol as a sweetener in people with glucose intolerance.MethodsThis trial evaluated the glycemic effect after 2 weeks of consumption of rebaudioside A and erythritol as sweeteners in a pre-diabetic population. The patients were evaluated for fructosamine, fasting plasma glucose, C-peptide, insulin, and 2-hour plasma glucose before and after consumption of sweetener. The primary outcome was a change in fructosamine levels from the baseline to the end of treatment. Secondary outcomes were the changes in levels of fasting plasma glucose and 2-hour plasma glucose.ResultsFrom the baseline to the end of experiment, the changes in fructosamine levels after consumption of rebaudioside A and erythritol, did not differ significantly (244.00±19.57 vs. 241.68±23.39 µmol/L, P=0.366. The change in levels from the baseline to end of the study for rebaudioside A and erythritol were fasting plasma glucose (102.56±10.72 vs. 101.32±9.20 mg/dL, 2-hour plasma glucose (154.92±54.53 vs. 141.92±42.22 mg/dL, insulin (7.56±4.29 vs. 7.20±5.12 IU/mL, and C-peptide (2.92±1.61 vs. 2.73±1.31 ng/mL, respectively, and also did not differ significantly (P>0.05 for all.ConclusionOur study suggests that consumption of rebaudioside A and erythritol does not alter the glucose homeostasis in people with glucose intolerance.

  15. Gestational diabetes mellitus: glycemic control during pregnancy and neonatal outcomes of twin and singleton pregnancies.

    Science.gov (United States)

    Guillén-Sacoto, María Augusta; Barquiel, Beatriz; Hillman, Natalia; Burgos, María Ángeles; Herranz, Lucrecia

    2018-04-20

    To assess the impact of glycemic control in gestational on neonatal weight and metabolic complications of twin and singleton pregnancies. An observational, retrospective study to monitor 120 twin and 240 singleton pregnancies in women with GDM. Maternal glycemic parameters during pregnancy (oral glucose tolerance test results, treatment, insulinization rate, mean HbA1c in the third trimester), and neonatal complications and weight were recorded. A higher infant birth weight ratio (IBWR 1.02±0.12 vs. 0.88±0.12, P<.001) and a lower rate of newborns small for gestational age (severe SGA 2.5% vs. 8.3%, P=.012) were seen after singleton pregnancies as compared to twin pregnancies. The rates of newborns large for gestational age (LGA 12.6% vs. 12.5%, P=.989); macrosomic (6.7% vs. 7.5%, P=.777); or small for gestational age (SGA 6.7% vs. 10.8%, P=.175) were similar in both groups. Neonates from twin pregnancies had a higher risk of hypoglycemia (adjusted OR 4.71; 1.38-16.07, P=.013) and polycythemia (adjusted OR 10.05; 1.82-55.42, P=0.008). A linear relationship was seen between third trimester HbA1c levels and IBWR in singleton (r=.199, P=.003), but not in twin pregnancies (r=0.049, P=0.610). Risk of severe SGA, hypoglycemia, and polycythemia was significantly higher in twin pregnancies of women with GDM. Neonatal weight outcomes and metabolic complications in twin pregnancies of women with GDM were not related to glycemic control. Moreover, in our study population, fasting glucose at diagnosis and mean HbA1c in the third trimester showed a linear relationship with higher birth weights in singleton, but not in twin pregnancies. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Intensive gestational glycemic management and childhood obesity: a systematic review and meta-analysis.

    Science.gov (United States)

    Guillemette, L; Durksen, A; Rabbani, R; Zarychanski, R; Abou-Setta, A M; Duhamel, T A; McGavock, J M; Wicklow, B

    2017-07-01

    Hyperglycemia in pregnancy is associated with increased risk of offspring childhood obesity. Treatment reduces macrosomia; however, it is unclear if this effect translates into a reduced risk of childhood obesity. We performed a systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy and safety of intensive glycemic management in pregnancy in preventing childhood obesity. We searched MEDLINE, EMBASE, CENTRAL and ClinicalTrials.gov up to February 2016 and conference abstracts from 2010 to 2015. Two reviewers independently identified randomized controlled trials evaluating intensive glycemic management interventions for hyperglycemia in pregnancy and included four of the 383 citations initially identified. Two reviewers independently extracted study data and evaluated internal validity of the studies using the Cochrane Collaboration's Risk of Bias tool. Data were pooled using random-effects models. Statistical heterogeneity was quantified using the I 2 test. The primary outcome was age- and sex-adjusted childhood obesity. Secondary outcomes included childhood weight and waist circumference and maternal hypoglycemia during the trial (safety outcome). The four eligible trials (n=767 children) similarly used lifestyle and insulin to manage gestational hyperglycemia, but only two measured offspring obesity and waist circumference and could be pooled for these outcomes. We found no association between intensive gestational glucose management and childhood obesity at 7-10 years of age (relative risk 0.89, 95% confidence interval (CI) 0.65 to 1.22; two trials; n=568 children). Waist circumference also did not differ between treatment and control arms (mean difference, -2.68 cm; 95% CI, -8.17 to 2.81 cm; two trials; n=568 children). Intensive gestational glycemic management is not associated with reduced childhood obesity in offspring, but randomized data is scarce. Long-term follow-up of trials should be prioritized and comprehensive

  17. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Itandehui Castro-Quezada

    Full Text Available OBJECTIVE: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI and glycemic load (GL are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ. We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS: We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths. As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04; P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS: High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

  18. Using a mentoring approach to implement an inpatient glycemic control program in United States hospitals.

    Science.gov (United States)

    Rushakoff, Robert J; Sullivan, Mary M; Seley, Jane Jeffrie; Sadhu, Archana; O'Malley, Cheryl W; Manchester, Carol; Peterson, Eric; Rogers, Kendall M

    2014-09-01

    establishing an inpatient glycemic control program is challenging, requires years of work, significant education and coordination of medical, nursing, dietary, and pharmacy staff, and support from administration and Performance Improvement departments. We undertook a 2 year quality improvement project assisting 10 medical centers (academic and community) across the US to implement inpatient glycemic control programs. the project was comprised of 3 interventions. (1) One day site visit with a faculty team (MD and CDE) to meet with key personnel, identify deficiencies and barriers to change, set site specific goals and develop strategies and timelines for performance improvement. (2) Three webinar follow-up sessions. (3) Web site for educational resources. Updates, challenges, and accomplishments for each site were reviewed at the time of each webinar and progress measured at the completion of the project with an evaluation questionnaire. as a result of our intervention, institutions revised and simplified formularies and insulin order sets (with CHO counting options); implemented glucometrics and CDE monitoring of inpatient glucoses (assisting providers with orders); added new protocols for DKA and perinatal treatment; and implemented nursing, physician and patient education initiatives. Changes were institution specific, fitting the local needs and cultures. As to the extent to which Institution׳s goals were satisfied: 2 reported "completely", 4 "mostly," 3 "partially," and 1 "marginally". Institutions continue to move toward fulfilling their goals. an individualized, structured, performance improvement approach with expert faculty mentors can help facilitate change in an institution dedicated to implementing an inpatient glycemic control program. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Short-term effects of a low glycemic index carob-containing snack on energy intake, satiety, and glycemic response in normal-weight, healthy adults: Results from two randomized trials.

    Science.gov (United States)

    Papakonstantinou, Emilia; Orfanakos, Nickolaos; Farajian, Paul; Kapetanakou, Anastasia E; Makariti, Ifigenia P; Grivokostopoulos, Nikolaos; Ha, Marie-Ann; Skandamis, Panagiotis N

    2017-10-01

    The potential positive health effects of carob-containing snacks are largely unknown. Therefore, the aims of these studies were to determine the glycemic index (GI) of a carob snack compared with chocolate cookie containing equal amounts of available carbohydrates and to compare the effects of a carob versus chocolate cookie preload consumed as snack before a meal on (a) short-term satiety response measured by subsequent ad libitum meal intake, (b) subjective satiety as assessed by visual analog scales and (c) postprandial glycemic response. Ten healthy, normal-weight volunteers participated in GI investigation. Then, 50 healthy, normal-weight individuals consumed, crossover, in random order, the preloads as snack, with 1-wk washout period. Ad libitum meal (lunch and dessert) was offered. Capillary blood glucose samples were collected at baseline, 2 h after breakfast, just before preload consumption, 2 h after preload, 3 h after preload, just before meal (lunch and dessert), 1 h after meal, and 2 h after meal consumption. The carob snack was a low GI food, whereas the chocolate cookie was a high GI food (40 versus 78, respectively, on glucose scale). Consumption of the carob preload decreased the glycemic response to a following meal and to the individual's feelings of hunger, desire to eat, preoccupation with food, and thirst between snack and meal, as assessed with the use of visual analog scales. Subsequently, participants consumed less amounts of food (g) and had lower total energy intake at mealtimes. The carob snack led to increased satiety, lower energy intake at meal, and decreased postmeal glycemic response possibly due to its low GI value. Identifying foods that promote satiety and decrease glycemic response without increasing the overall energy intake may offer advantages to body weight and glycemic control. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Dietary glycemic load and risk of cognitive impairment in women: findings from the EPIC-Naples cohort.

    Science.gov (United States)

    Simeon, Vittorio; Chiodini, Paolo; Mattiello, Amalia; Sieri, Sabina; Panico, Camilla; Brighenti, Furio; Krogh, Vittorio; Panico, Salvatore

    2015-05-01

    Cognitive impairment is a common cause of morbidity in the elderly. The relationship between dietary habits and cognitive impairment in a female population living in the metropolitan area of Naples, in the Mediterranean part of Italy, has been evaluated in the Naples EPIC prospective cohort study. The study cohort, enrolled between 1993 and 1997, is composed of 5062 women aged 30-69 years. At time of enrolment anthropometric measures were performed and information about socio-demographic details, clinical data, lifestyle and dietary habits were collected. During 2008 and 2009, women 65 years of age or older received a telephone interview to evaluate cognitive status (TICS); the derived score was used as proxy of cognitive impairment. Analyses were carried out on 1514 participants. Linear regression model showed negative association between TICS score and, respectively, age at baseline (β = -.31, 95% CI -.34, -.24), body mass index (BMI) (β = -.08, 95% CI -.16, -.01), and glycemic load (GL) (β = -.02, 95% CI -.03, -.01), whereas education level (β = 0.62, 95% CI .56, .69) showed positive association. A logistic regression model, used to evaluate determinants of the low cognitive score (TICS score ≤ 15, 1st tertile), confirmed association for previous variables [age (OR 1.1, 95% CI 1.08, 1.15); BMI (OR 1.03, 95% CI 1.001, 1.07); GL (OR 1.005, 95% CI 1.001, 1.011); education level (OR .82, 95% CI .79, .84)] with, in addition, type II diabetes (OR 1.85, 95% CI 1.014, 3.4). This study indicates that GL may play a role in determining risk of cognitive impairment, besides age, BMI, education and diabetes.

  1. Thermoeconomic analysis of storage systems for solar heating and cooling systems: A comparison between variable-volume and fixed-volume tanks

    International Nuclear Information System (INIS)

    Buonomano, Annamaria; Calise, Francesco; Ferruzzi, Gabriele

    2013-01-01

    The paper investigates different control strategies for the thermal storage management in SHC (Solar Heating and Cooling) systems. The SHC system under investigation is based on a field of evacuated solar collectors coupled with a single-stage LiBr–H 2 O absorption chiller; auxiliary thermal energy is supplied by a gas-fired boiler. The SHC is also equipped with a novel thermal storage system, consisting in a variable volume storage tank. It includes three separate tanks and a number of mixers and diverters managed by novel control strategies, based on combinations of series/parallel charging and discharging approaches. The aim of this component is to vary the thermal storage capacity as a function of the combinations of solar radiation availability and user thermal/cooling energy demands. The system allows one to increase the number of active tanks when the time shift between solar energy and user demand is high. Conversely, when this time shift is low, the number of active tanks is automatically reduced. In addition, when the solar energy in excess cannot be stored in such tanks, a heat exchanger is also used in the solar loop for producing DHW (Domestic Hot Water). The analysis is carried out by means of a zero-dimensional transient simulation model, developed by using the TRNSYS software. In order to assess the operating and capital costs of the systems under analysis, an economic model is also proposed. In addition, in order to determine the set of the synthesis/design variables which maximize the system profitability, a parametric analysis was implemented. The novel variable-volume storage system, in both the proposed configurations, was also compared with a constant-volume storage system from the energy and economic points of view. The results showed that the presented storage system allows one to save up to 20% of the natural gas used by the auxiliary boiler only for very high solar fractions. In all the other cases, marginal savings are achieved by the

  2. Variability among the Most Rapidly Evolving Plastid Genomic Regions is Lineage-Specific: Implications of Pairwise Genome Comparisons in Pyrus (Rosaceae) and Other Angiosperms for Marker Choice

    Science.gov (United States)

    Ter-Voskanyan, Hasmik; Allgaier, Martin; Borsch, Thomas

    2014-01-01

    Plastid genomes exhibit different levels of variability in their sequences, depending on the respective kinds of genomic regions. Genes are usually more conserved while noncoding introns and spacers evolve at a faster pace. While a set of about thirty maximum variable noncoding genomic regions has been suggested to provide universally promising phylogenetic markers throughout angiosperms, applications often require several regions to be sequenced for many individuals. Our project aims to illuminate evolutionary relationships and species-limits in the genus Pyrus (Rosaceae)—a typical case with very low genetic distances between taxa. In this study, we have sequenced the plastid genome of Pyrus spinosa and aligned it to the already available P. pyrifolia sequence. The overall p-distance of the two Pyrus genomes was 0.00145. The intergenic spacers between ndhC–trnV, trnR–atpA, ndhF–rpl32, psbM–trnD, and trnQ–rps16 were the most variable regions, also comprising the highest total numbers of substitutions, indels and inversions (potentially informative characters). Our comparative analysis of further plastid genome pairs with similar low p-distances from Oenothera (representing another rosid), Olea (asterids) and Cymbidium (monocots) showed in each case a different ranking of genomic regions in terms of variability and potentially informative characters. Only two intergenic spacers (ndhF–rpl32 and trnK–rps16) were consistently found among the 30 top-ranked regions. We have mapped the occurrence of substitutions and microstructural mutations in the four genome pairs. High AT content in specific sequence elements seems to foster frequent mutations. We conclude that the variability among the fastest evolving plastid genomic regions is lineage-specific and thus cannot be precisely predicted across angiosperms. The often lineage-specific occurrence of stem-loop elements in the sequences of introns and spacers also governs lineage-specific mutations

  3. Variability among the most rapidly evolving plastid genomic regions is lineage-specific: implications of pairwise genome comparisons in Pyrus (Rosaceae and other angiosperms for marker choice.

    Directory of Open Access Journals (Sweden)

    Nadja Korotkova

    Full Text Available Plastid genomes exhibit different levels of variability in their sequences, depending on the respective kinds of genomic regions. Genes are usually more conserved while noncoding introns and spacers evolve at a faster pace. While a set of about thirty maximum variable noncoding genomic regions has been suggested to provide universally promising phylogenetic markers throughout angiosperms, applications often require several regions to be sequenced for many individuals. Our project aims to illuminate evolutionary relationships and species-limits in the genus Pyrus (Rosaceae-a typical case with very low genetic distances between taxa. In this study, we have sequenced the plastid genome of Pyrus spinosa and aligned it to the already available P. pyrifolia sequence. The overall p-distance of the two Pyrus genomes was 0.00145. The intergenic spacers between ndhC-trnV, trnR-atpA, ndhF-rpl32, psbM-trnD, and trnQ-rps16 were the most variable regions, also comprising the highest total numbers of substitutions, indels and inversions (potentially informative characters. Our comparative analysis of further plastid genome pairs with similar low p-distances from Oenothera (representing another rosid, Olea (asterids and Cymbidium (monocots showed in each case a different ranking of genomic regions in terms of variability and potentially informative characters. Only two intergenic spacers (ndhF-rpl32 and trnK-rps16 were consistently found among the 30 top-ranked regions. We have mapped the occurrence of substitutions and microstructural mutations in the four genome pairs. High AT content in specific sequence elements seems to foster frequent mutations. We conclude that the variability among the fastest evolving plastid genomic regions is lineage-specific and thus cannot be precisely predicted across angiosperms. The often lineage-specific occurrence of stem-loop elements in the sequences of introns and spacers also governs lineage-specific mutations. Sequencing

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    markers of glycemic control (glucose, insulin, glycerol, free fatty acids, HbA1c), inflammation and endothelial function (hsCRP, orosomucoid, interleukin 6, TNF-alpha, urine-orosomucoid and -albumin/creatinin), lipid metabolism, NT-proBNP or other regulatory hormones (cortisol, epinephrine and IGF-1......). There were no changes in quality of life. Conclusions. The effect of exercise training in these older CHF-patients was not as impressive as reported in younger and more selected patients. More studies on the efficiency of exercise training that reflect the age- and co-morbidity of the majority of CHF...

  5. Serum glycated albumin as a new glycemic marker in pediatric diabetes

    Directory of Open Access Journals (Sweden)

    Ji Woo Lee

    2013-12-01

    Full Text Available PurposeSerum glycated albumin (GA has been recently used as another glycemic marker that reflects shorter term glycemic control than glycated hemoglobin (HbA1c. Insulin secretory function and glycemic fluctuation might be correlated with the ratio of GA to HbA1c (GA/HbA1c in diabetic adult patients. This study investigated the association of GA and GA/HbA1c ratio with the levels of fasting C-peptide, fasting plasma glucose in type 1 and type 2 pediatric diabetes.MethodsTotal 50 cases from 42 patients were included. The subjects were classified into type 1 diabetes mellitus (T1DM (n=30 and type 2 diabetes mellitus (T2DM (n=20 group. The associations among HbA1c, GA, and GA/HbA1c ratio were examined. The relationship between the three glycemic indices and fasting glucose, fasting C-peptide were analyzed.ResultsMean values of GA, the GA/HbA1c ratio were significantly higher in T1DM than T2DM. GA (r=0.532, P=0.001, HbA1c (r=0.519, P=0.002 and the GA/HbA1c ratio (r=0.409, P=0.016 were correlated with the fasting plasma glucose. Fasting C-peptide level arranged 4.22±3.22 ng/mL in T2DM, which was significantly above the values in T1DM (0.26±0.49 ng/mL. There were no significant correlation between HbA1c and fasting C-peptide level. However, GA and the GA/HbA1c ratio exhibited inverse correlations with fasting C-peptide level (r=-0.214, P=0.002; r=-0.516, P<0.001.ConclusionGA seems to more accurately reflects fasting plasma glucose level than HbA1c. GA, GA/HbA1c ratio appear to reflect insulin secretory function.

  6. IMPROVING GLYCEMIC CONTROL SAFELY IN CRITICAL CARE PATIENTS: A COLLABORATIVE SYSTEMS APPROACH IN NINE HOSPITALS.

    Science.gov (United States)

    Maynard, Gregory A; Holdych, Janet; Kendall, Heat