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Sample records for superior glycaemic control

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-10-01

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

  3. Preconception optimization of glycaemic control in diabetes.

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    Islam, Najmul

    2016-09-01

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

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

    DEFF Research Database (Denmark)

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

    2003-01-01

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2017-05-05

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

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

    Directory of Open Access Journals (Sweden)

    Oladele V. Adeniyi

    2015-02-01

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

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

    Science.gov (United States)

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

    2017-08-02

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

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

    Directory of Open Access Journals (Sweden)

    Janes R

    2013-06-01

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

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

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    J. N. Seheult

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    1994-01-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Danielle Creme

    2015-01-01

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

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

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    Amy Kennedy

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

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

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    Emmanuel Mwila Musenge

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2004-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2011-12-01

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

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

    Science.gov (United States)

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

    2014-03-01

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

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

    NARCIS (Netherlands)

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

    2006-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

    Pouwer, F; Snoek, Frank J

    2001-01-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

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

    DEFF Research Database (Denmark)

    Madsbad, Sten

    2002-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

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

    OpenAIRE

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Anne L Harrison

    2016-10-01

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

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

    Directory of Open Access Journals (Sweden)

    N.H. Shiluban

    2009-09-01

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

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

    Directory of Open Access Journals (Sweden)

    N. H. Shilubane,

    2010-06-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2012-05-01

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

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

    Science.gov (United States)

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

    2015-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Akinola Dada

    2015-09-01

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

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

    OpenAIRE

    Noorani, Mariam; Ramaiya, Kaushik; Manji, Karim

    2016-01-01

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

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

    Science.gov (United States)

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

    2011-11-01

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

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

    Science.gov (United States)

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

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Science.gov (United States)

    Gabbay, Mônica de A Lima

    2008-03-01

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

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

    Science.gov (United States)

    Kelly, Peter

    2017-02-02

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

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

    Science.gov (United States)

    Zenari, L; Marangoni, A

    2013-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Sana Taher Ashur

    2016-03-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2009-12-01

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    MA Harris

    2014-11-01

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

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

    Science.gov (United States)

    Suksomboon, N; Poolsup, N; Punthanitisarn, S

    2016-04-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2017-03-08

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    John Joseph Valletta

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

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

    OpenAIRE

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Yathish TR.

    2010-01-01

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

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

    Science.gov (United States)

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

    2015-11-06

    Glycaemic control is a key issue in the care of people with diabetes mellitus (DM). Periodontal disease is the inflammation and destruction of the underlying supporting tissues of the teeth. Some studies have suggested a bidirectional relationship between glycaemic control and periodontal disease. This review updates the previous version published in 2010. The objective is to investigate the effect of periodontal therapy on glycaemic control in people with diabetes mellitus. We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 31 December 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library 2014, Issue 11), MEDLINE via OVID (1946 to 31 December 2014), EMBASE via OVID (1980 to 31 December 2014), LILACS via BIREME (1982 to 31 December 2014), and CINAHL via EBSCO (1937 to 31 December 2014). ZETOC (1993 to 31 December 2014) and Web of Knowledge (1990 to 31 December 2014) were searched for conference proceedings. Additionally, two periodontology journals were handsearched for completeness, Annals of Periodontology (1996 to 2003) and Periodontology 2000 (1993 to 2003). We searched the US National Institutes of Health Trials Registry (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. We searched for randomised controlled trials (RCTs) of people with type 1 or type 2 DM (T1DM/T2DM) with a diagnosis of periodontitis. Interventions included periodontal treatments such as mechanical debridement, surgical treatment and antimicrobial therapy. Two broad comparisons were proposed:1. periodontal therapy versus no active intervention/usual care;2. periodontal therapy versus alternative periodontal therapy. For this review update, at least two review authors independently examined the titles and abstracts retrieved by the search, selected the included

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Bou Christophe

    2009-08-01

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

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

    Science.gov (United States)

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

    2015-11-28

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

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

    Science.gov (United States)

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

    2013-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Andreas Schmitt

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

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

    Science.gov (United States)

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

    2012-05-01

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

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

    Science.gov (United States)

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

    2017-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2015-02-01

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

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

    Science.gov (United States)

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

    2014-02-12

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

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

    OpenAIRE

    2014-01-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    Science.gov (United States)

    Noorani, Mariam; Ramaiya, Kaushik; Manji, Karim

    2016-05-31

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Søren Møller Madsen

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

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

    Directory of Open Access Journals (Sweden)

    Søren Søgaard Lund

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    LENUS (Irish Health Repository)

    Walsh, Jennifer

    2010-04-23

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2007-12-01

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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2016-10-15

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

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

    Directory of Open Access Journals (Sweden)

    Mary K. Horan

    2014-07-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Iraklis Avramopoulos; Alexandros Moulis; Nikos Nikas

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Anna Lih

    2015-01-01

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

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

    Science.gov (United States)

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

    2017-08-31

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

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

    Science.gov (United States)

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

    2016-01-14

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    OpenAIRE

    Aris, Aishairma

    2016-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2017-10-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Stephen A Myers

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

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

    Directory of Open Access Journals (Sweden)

    Senthilnathan

    2016-03-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Science.gov (United States)

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

    2016-10-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2016-08-17

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

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

    OpenAIRE

    Senthilnathan; Muthumani,; Nehru

    2016-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2010-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Plavšić Ljiljana

    2014-01-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2000-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2017-09-09

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

  17. Glycaemic index methodology.

    Science.gov (United States)

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

    2005-06-01

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

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

    Science.gov (United States)

    Cincotta; Meier; Cincotta Jr

    1999-10-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Sun, Jing; Buys, Nicholas J

    2016-04-14

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

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

    Science.gov (United States)

    Smith, Michael A; Foster, Jonathan K

    2008-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Daniel Panarotto

    2008-08-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2014-07-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

    DEFF Research Database (Denmark)

    Tarnow, L; Kjeld, T; Knudsen, E

    2000-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2017-04-01

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

  12. Superior Valley photovoltaic power processing and system controller evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Bonn, R.; Ginn, J.; Zirzow, J.; Sittler, G.

    1995-11-01

    Sandia National Laboratories, sponsored by the US Department of Energy`s Office of Energy Management, conducts the photovoltaic balance-of-system program. Under this program, Sandia supports the Department of Defense Strategic Environmental Research Development Plan, SERDP, which is advancing the use of photovoltaics in operational DoD facilities. This report details the acceptance testing of the first of these photovoltaic hybrid systems: the Superior Valley photovoltaic-diesel hybrid system. This is the first of several photovoltaic installations for the Department of Defense. The system hardware tested at Sandia included an inverter, maximum power trackers, and a system controller.

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

    Science.gov (United States)

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

    2014-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Cavan David A

    2012-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Mary K. Horan

    2016-01-01

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

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

    LENUS (Irish Health Repository)

    Horan, Mary K

    2016-01-04

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

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

    LENUS (Irish Health Repository)

    Ferriss, J B

    2012-02-03

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-02-07

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

  20. Metabolic effects of low glycaemic index diets

    Directory of Open Access Journals (Sweden)

    Rusu Emilia

    2009-01-01

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

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

    Science.gov (United States)

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

    2017-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Saraheimo Markku

    2010-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Esbensen Bente

    2011-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Amandeep Singh

    2016-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Majid Mobasseri

    2012-04-01

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

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Sarah E Bennett

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

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

    Science.gov (United States)

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

    2010-05-01

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

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

    Science.gov (United States)

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

    2017-02-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-03-01

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

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

    LENUS (Irish Health Repository)

    O'Sullivan, J B

    2012-02-01

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

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

    Science.gov (United States)

    Ranawana, Viren; Henry, C Jeya K

    2013-03-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2012-03-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  20. Dietary glycaemic index from an epidemiological point of view

    NARCIS (Netherlands)

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

    2006-01-01

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

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

    African Journals Online (AJOL)

    2015-06-30

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

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

    LENUS (Irish Health Repository)

    Walsh, Jennifer

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Goyder Elizabeth

    2005-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Pereira LRL

    2005-12-01

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

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

    Science.gov (United States)

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

    2015-08-25

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

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

    Science.gov (United States)

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

    2015-03-14

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

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

    Science.gov (United States)

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

    2016-02-28

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

  8. Glycaemic Response to Quality Protein Maize Grits

    Directory of Open Access Journals (Sweden)

    Leonora N. Panlasigui

    2010-01-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2006-08-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jane McEneny

    2015-01-01

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

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

    Science.gov (United States)

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

    2009-04-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  17. Investigation on Superior Performance by Fractional Controller for Cart-Servo Laboratory Set-Up

    Directory of Open Access Journals (Sweden)

    Ameya Anil Kesarkar

    2014-01-01

    Full Text Available In this paper, an investigation is made on the superiority of fractional PID controller (PI^alpha D^beta over conventional PID for the cart-servo laboratory set-up. The designed controllers are optimum in the sense of Integral Absolute Error (IAE and Integral Square Error (ISE. The paper contributes in three aspects: 1 Acquiring nonlinear mathematical model for the cart-servo laboratory set-up, 2 Designing fractional and integer order PID for minimizing IAE, ISE, 3 Analyzing the performance of designed controllers for simulated plant model as well as real plant. The results show a significantly superior performance by PI^alpha D^beta as compared to the conventional PID controller.

  18. Can bread processing conditions alter glycaemic response?

    Science.gov (United States)

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

    2015-04-15

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

  19. Superior Inhibitory Control and Resistance to Mental Fatigue in Professional Road Cyclists.

    Directory of Open Access Journals (Sweden)

    Kristy Martin

    Full Text Available Given the important role of the brain in regulating endurance performance, this comparative study sought to determine whether professional road cyclists have superior inhibitory control and resistance to mental fatigue compared to recreational road cyclists.After preliminary testing and familiarization, eleven professional and nine recreational road cyclists visited the lab on two occasions to complete a modified incongruent colour-word Stroop task (a cognitive task requiring inhibitory control for 30 min (mental exertion condition, or an easy cognitive task for 10 min (control condition in a randomized, counterbalanced cross-over order. After each cognitive task, participants completed a 20-min time trial on a cycle ergometer. During the time trial, heart rate, blood lactate concentration, and rating of perceived exertion (RPE were recorded.The professional cyclists completed more correct responses during the Stroop task than the recreational cyclists (705±68 vs 576±74, p = 0.001. During the time trial, the recreational cyclists produced a lower mean power output in the mental exertion condition compared to the control condition (216±33 vs 226±25 W, p = 0.014. There was no difference between conditions for the professional cyclists (323±42 vs 326±35 W, p = 0.502. Heart rate, blood lactate concentration, and RPE were not significantly different between the mental exertion and control conditions in both groups.The professional cyclists exhibited superior performance during the Stroop task which is indicative of stronger inhibitory control than the recreational cyclists. The professional cyclists also displayed a greater resistance to the negative effects of mental fatigue as demonstrated by no significant differences in perception of effort and time trial performance between the mental exertion and control conditions. These findings suggest that inhibitory control and resistance to mental fatigue may contribute to successful road cycling

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

    Directory of Open Access Journals (Sweden)

    Christiani Jeyakumar Henry

    2017-05-01

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

  1. Glycaemic and insulinemic response to dietary carbohydrates in horses

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  5. The Right Superior Frontal Gyrus and Individual Variation in Proactive Control of Impulsive Response.

    Science.gov (United States)

    Hu, Sien; Ide, Jaime S; Zhang, Sheng; Li, Chiang-Shan R

    2016-12-14

    A hallmark of cognitive control is the ability to rein in impulsive responses. Previously, we used a Bayesian model to describe trial-by-trial likelihood of the stop signal or p(Stop) and related regional activations to p(Stop) to response slowing in a stop signal task. Here, we characterized the regional processes of conflict anticipation in association with intersubject variation in impulse control in 114 young adults. We computed the stop signal reaction time (SSRT) and a measure of motor urgency, indexed by the reaction time (RT) difference between go and stop error trials or "GoRT - SERT," where GoRT is the go trial RT and SERT is the stop error RT. Motor urgency and SSRT were positively correlated across subjects. A linear regression identified regional activations to p(Stop), each in correlation with SSRT and motor urgency. We hypothesized that shared neural activities mediate the correlation between motor urgency and SSRT in proactive control of impulsivity. Activation of the ventromedial prefrontal cortex, posterior cingulate cortex and right superior frontal gyrus (SFG) during conflict anticipation correlated negatively with the SSRT. Activation of the right SFG also correlated negatively with GoRT - SERT. Therefore, activation of the right SFG was associated with more efficient response inhibition and less motor urgency. A mediation analysis showed that right SFG activation to conflict anticipation mediates the correlation between SSRT and motor urgency bidirectionally. The current results highlight a specific role of the right SFG in translating conflict anticipation to the control of impulsive response, which is consistent with earlier studies suggesting its function in action restraint.

  6. The effects of corn silk on glycaemic metabolism

    Directory of Open Access Journals (Sweden)

    Han Linna

    2009-11-01

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

  7. Selection of Superior Genotypes of Coffea Canephora Pierre on ControlledHybrid Population Using Cluster Analysis Method

    Directory of Open Access Journals (Sweden)

    Ucu Sumirat

    2007-05-01

    Full Text Available Selection of superior genotypes of robusta coffee (Coffea canephora to improve its important agronomic characters should be conducted continuously to get better planting productivity. The aim of this research was to select superior genotypes of Robusta coffee for high yield and high proportion of large bean. Selection was conducted on controlled hybrid populations, developed from three crossing parental clones, i.e. BP 961 x Q 121 (A, BP 409 x Q 121 (B and BP 961 x BP 409 (C. Selection was done by applying cluster analysis with complete linkage and Euclidean distance as the clustering method. The result of the research showed that the selection was successful to identify superior genotypes of Robusta coffee for high yield and high proportion of large bean. The parameters used (cherries weight/tree, bean weight/tree, bean size percentage > 6.5 mm and 100 cherries weight were effective in clustering the superior genotypes, indicated by increased minimum and average value of population. Yield potential and percentage of bean size > 6.5 mm of those genotypes were having better performance than the control genotype and its parent. The selection code A 95, B 28, B 62, B 66, B 74 and C 38 were considered  as promising superior genotypes of Robusta coffee, respectively. Key words: Coffea canephora, selection, bean size, yield, cluster analysis

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  10. Posterior superior alveolar nerve blocks: a randomised controlled, double blind trial.

    Science.gov (United States)

    Singla, Himanshi; Alexander, Mohan

    2015-06-01

    Local anesthesia has been a boon for dentistry to allay the most common fear of pain among dental patients. Several techniques to achieve anesthesia for posterior maxillae have been advocated albeit with minor differences. We compared two techniques of posterior superior alveolar nerve block (PSANB), the one claimed to be "most accurate" to the one "most commonly used." This study was conducted to assess and compare the efficacy as well as complications of "the straight needle technique" to that of "the bent needle technique" for PSANB. We conducted a prospective, randomised, double blind study on 120 patients divided into two groups, using a 26-gauge, 38 mm long needle with 2 ml of 2 % lignocaine hydrochloride with 1:200,000 adrenaline solution. Objective symptoms were evaluated by a single investigator. Cold test using ice was used to evaluate the status of pulpal anesthesia. Data thus obtained was subjected to statistical analysis. Out of the 120 blocks, 19 blocks failed. Statistical analysis found straight needle technique to be more successful than the bent needle technique (p = 0.002). Both the techniques were equally effective for the first molar region on both right and left side (p = 0.66 on right side and p = 0.20 on left side). However, in the second and third molar region technique A was more effective than B (p = 0.01) on right side only. On Left side, both techniques were equally effective (p = 0.08). Sensitivity of the cold test was 82 % which is quite high but the specificity was 68 % which seems to be falling in the above average range only. Positive predictive value of 75 and negative predictive value of 76 was observed. We did not encounter any complications in this study. To the best of our knowledge, this is the first randomised controlled clinical study on PSANB techniques. This study suggests that the PSANB using the straight needle technique as advocated by Malamed [1] can be routinely and safely used to achieve anesthesia in

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2010-02-01

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

  17. Evidence for superior neurobiological and behavioral inhibitory control abilities in non-offending as compared to offending pedophiles.

    Science.gov (United States)

    Kärgel, Christian; Massau, Claudia; Weiß, Simone; Walter, Martin; Borchardt, Viola; Krueger, Tillmann H C; Tenbergen, Gilian; Kneer, Jonas; Wittfoth, Matthias; Pohl, Alexander; Gerwinn, Hannah; Ponseti, Jorge; Amelung, Till; Beier, Klaus M; Mohnke, Sebastian; Walter, Henrik; Schiffer, Boris

    2017-02-01

    Neurobehavioral models of pedophilia and child sexual offending suggest a pattern of temporal and in particular prefrontal disturbances leading to inappropriate behavioral control and subsequently an increased propensity to sexually offend against children. However, clear empirical evidence for such mechanisms is still missing. Using a go/nogo paradigm in combination with functional magnetic resonance imaging (fMRI) we compared behavioral performance and neural response patterns among three groups of men matched for age and IQ: pedophiles with (N = 40) and without (N = 37) a history of hands-on sexual offences against children as well as healthy non-offending controls (N = 40). As compared to offending pedophiles, non-offending pedophiles exhibited superior inhibitory control as reflected by significantly lower rate of commission errors. Group-by-condition interaction analysis also revealed inhibition-related activation in the left posterior cingulate and the left superior frontal cortex that distinguished between offending and non-offending pedophiles, while no significant differences were found between pedophiles and healthy controls. Both areas showing distinct activation pattern among pedophiles play a critical role in linking neural networks that relate to effective cognitive functioning. Data therefore suggest that heightened inhibition-related recruitment of these areas as well as decreased amount of commission errors is related to better inhibitory control in pedophiles who successfully avoid committing hands-on sexual offences against children. Hum Brain Mapp 38:1092-1104, 2017. © 2016 Wiley Periodicals, Inc.

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

    Institute of Scientific and Technical Information of China (English)

    刘彩云; 孙剑; 孟杨; 曾宪涛; 周静; 庞光明

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    周岩; 吴大方; 杨瑜莹

    2013-01-01

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

  20. How music alters a kiss: superior temporal gyrus controls fusiform–amygdalar effective connectivity

    Science.gov (United States)

    Deserno, Lorenz; Bakels, Jan-Hendrik; Schlochtermeier, Lorna H.; Kappelhoff, Hermann; Jacobs, Arthur M.; Fritz, Thomas Hans; Koelsch, Stefan; Kuchinke, Lars

    2014-01-01

    While watching movies, the brain integrates the visual information and the musical soundtrack into a coherent percept. Multisensory integration can lead to emotion elicitation on which soundtrack valences may have a modulatory impact. Here, dynamic kissing scenes from romantic comedies were presented to 22 participants (13 females) during functional magnetic resonance imaging scanning. The kissing scenes were either accompanied by happy music, sad music or no music. Evidence from cross-modal studies motivated a predefined three-region network for multisensory integration of emotion, consisting of fusiform gyrus (FG), amygdala (AMY) and anterior superior temporal gyrus (aSTG). The interactions in this network were investigated using dynamic causal models of effective connectivity. This revealed bilinear modulations by happy and sad music with suppression effects on the connectivity from FG and AMY to aSTG. Non-linear dynamic causal modeling showed a suppressive gating effect of aSTG on fusiform–amygdalar connectivity. In conclusion, fusiform to amygdala coupling strength is modulated via feedback through aSTG as region for multisensory integration of emotional material. This mechanism was emotion-specific and more pronounced for sad music. Therefore, soundtrack valences may modulate emotion elicitation in movies by differentially changing preprocessed visual information to the amygdala. PMID:24298171

  1. How music alters a kiss: superior temporal gyrus controls fusiform-amygdalar effective connectivity.

    Science.gov (United States)

    Pehrs, Corinna; Deserno, Lorenz; Bakels, Jan-Hendrik; Schlochtermeier, Lorna H; Kappelhoff, Hermann; Jacobs, Arthur M; Fritz, Thomas Hans; Koelsch, Stefan; Kuchinke, Lars

    2014-11-01

    While watching movies, the brain integrates the visual information and the musical soundtrack into a coherent percept. Multisensory integration can lead to emotion elicitation on which soundtrack valences may have a modulatory impact. Here, dynamic kissing scenes from romantic comedies were presented to 22 participants (13 females) during functional magnetic resonance imaging scanning. The kissing scenes were either accompanied by happy music, sad music or no music. Evidence from cross-modal studies motivated a predefined three-region network for multisensory integration of emotion, consisting of fusiform gyrus (FG), amygdala (AMY) and anterior superior temporal gyrus (aSTG). The interactions in this network were investigated using dynamic causal models of effective connectivity. This revealed bilinear modulations by happy and sad music with suppression effects on the connectivity from FG and AMY to aSTG. Non-linear dynamic causal modeling showed a suppressive gating effect of aSTG on fusiform-amygdalar connectivity. In conclusion, fusiform to amygdala coupling strength is modulated via feedback through aSTG as region for multisensory integration of emotional material. This mechanism was emotion-specific and more pronounced for sad music. Therefore, soundtrack valences may modulate emotion elicitation in movies by differentially changing preprocessed visual information to the amygdala.

  2. The Neuroanatomical Basis for Posterior Superior Parietal Lobule Control Lateralization of Visuospatial Attention.

    Science.gov (United States)

    Wu, Yan; Wang, Jiaojian; Zhang, Yun; Zheng, Dingchen; Zhang, Jinfeng; Rong, Menglin; Wu, Huawang; Wang, Yinyan; Zhou, Ke; Jiang, Tianzi

    2016-01-01

    The right hemispheric dominance in visuospatial attention in human brain has been well established. Converging evidence has documented that ventral posterior parietal cortex (PPC) plays an important role in visuospatial attention. The role of dorsal PPC subregions, especially the superior parietal lobule (SPL) in visuospatial attention is still controversial. In the current study, we used repetitive transcranial magnetic stimulation (rTMS) and diffusion magnetic resonance imaging (MRI) techniques to test the role of posterior SPL in visuospatial attention and to investigate the potential neuroanatomical basis for right hemisphere dominance in visuospatial function. Transcranial magnetic stimulation (TMS) results unraveled that the right SPL predominantly mediated visuospatial attention compared to left SPL. Anatomical connections analyses between the posterior SPL and the intrahemispheric frontal subregions and the contralateral PPC revealed that right posterior SPL has stronger anatomical connections with the ipsilateral middle frontal gyrus (MFG), with the ipsilateral inferior frontal gyrus (IFG), and with contralateral PPC than that of the left posterior SPL. Furthermore, these asymmetric anatomical connections were closely related to behavioral performances. Our findings indicate that SPL plays a crucial role in regulating visuospatial attention, and dominance of visuospatial attention results from unbalanced interactions between the bilateral fronto-parietal networks and the interhemispheric parietal network.

  3. 可编程控制器的上位链接实验研究%Study on Superior Chaining Experiment of Programmable Logic Controller

    Institute of Scientific and Technical Information of China (English)

    王秀琴; 赵金宪; 桑玉军

    2000-01-01

    This article introduced the wire-splicing method of superior chaining between pro-grammable logic controller and computer, control command style of superior machine andstyle of response to superior machine's control command of inferior one.%介绍了可编程控制器与计算机进行上位链接的接线方法,上位机的控制命令格式,下位机对上位机控制命令的响应格式。

  4. Glycaemic and insulinemic response to dietary carbohydrates in horses

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Science.gov (United States)

    Li, Dongmei

    2015-01-01

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

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

    Science.gov (United States)

    Li, Dongmei

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-04-14

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

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

    Science.gov (United States)

    Livesey, Geoffrey

    2003-12-01

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

  9. Control Deficit Subjects are Superior for Man-Made Objects on a Verbal Semantic Task

    Directory of Open Access Journals (Sweden)

    Carlos Roncero

    2014-04-01

    Full Text Available When semantic deficits occur following brain damage, the subjects generally show anomia as well as deficits on semantic matching tasks such as the Camels and Cactus test. Such individuals can be further characterized as demonstrating either a semantic control deficit or a storage deficit (Jeffries & Lambon Ralph, 2006. Semantic control subjects show improved performance when responses are constrained, but storage subjects do not. In the present study, we categorized 17 subjects with neurodegenerative diseases – Alzheimer’s disease and Primary Progressive Aphasia - as Semantic Storage or Semantic Control patterns of deficit, based on their performance on three semantic tasks—Naming, Cued Naming, and Word-to-Picture Matching. This was done independent of both the subject’s localization of brain damage and clinical diagnosis. Subjects who demonstrated impaired performance on the Naming task, but showed normal performance on Cued Naming and Word-to-Picture Matching, were classified as showing a control deficit (N = 8, while subjects who were impaired on all three semantic tasks were classified as anomic subjects with a storage deficit (N = 9. Despite only using these three semantic tasks, the identified sub-groups demonstrated different patterns of semantic knowledge consistent with either a control deficit or a storage deficit. The identified sub-groups, for example, were comparable for letter fluency, but subjects with a storage deficit were significantly worse for animal fluency. Accessing subjects’ semantic knowledge with the word and picture versions of the Camels and Cactus test, we also found that storage deficit subjects’ performance was equally poor on both versions compared to normal elderly participants, whereas control deficit subjects were relatively impaired only in the word version. Finally, comparing FDG PET scans for these subjects, we noted storage deficit subjects typically had bilateral temporal damage—all but one

  10. Solution Coating of Superior Large-Area Flexible Perovskite Thin Films with Controlled Crystal Packing

    KAUST Repository

    Li, Jianbo

    2017-05-08

    Solution coating of organohalide lead perovskites offers great potential for achieving low-cost manufacturing of large-area flexible optoelectronics. However, the rapid coating speed needed for industrial-scale production poses challenges to the control of crystal packing. Herein, this study reports using solution shearing to confine crystal nucleation and growth in large-area printed MAPbI3 thin films. Near single-crystalline perovskite microarrays are demonstrated with a high degree of controlled macroscopic alignment and crystal orientation, which exhibit significant improvements in optical and optoelectronic properties comparing with their random counterparts, spherulitic, and nanograined films. In particular, photodetectors based on the confined films showing intense anisotropy in charge transport are fabricated, and the device exhibits significantly improved performance in all aspects by one more orders of magnitude relative to their random counterparts. It is anticipated that perovskite films with controlled crystal packing may find applications in high-performance, large-area printed optoelectronics, and solar cells.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  12. Zolpidem is not superior to temazepam with respect to rebound insomnia: a controlled study.

    NARCIS (Netherlands)

    Oude Voshaar, R.C.; Balkom, A.J.L.M. van; Zitman, F.G.

    2004-01-01

    This randomised controlled trial was conducted to compare zolpidem to an equivalent dose of temazepam with respect to subjective rebound insomnia after cessation of 4 weeks of treatment in chronic insomnia (zolpidem 10 mg, n=79; temazepam 20 mg, n=84). Both agents improved total sleep time (TST) as

  13. Slow cryopreservation is not superior to vitrification in human spermatozoa; an experimental controlled study

    Directory of Open Access Journals (Sweden)

    Mohamed Shehata Ali Mohamed

    2015-10-01

    Full Text Available Background: Spermatozoa cryopreservation is used for the management of infertility and some other medical conditions. The routinely applied cryopreservation technique depends on permeating cryoprotectants, whose toxic effects have raised the attention towards permeating cryoprotectants-free vitrification technique. Objective: To compare between the application of slow cryopreservation and vitrification on human spermatozoa. Materials and Methods: This was an experimental controlled study involving 33 human semen samples, where each sample was divided into three equal parts; fresh control, conventional slow freezing, and permeating cryoprotectants-free vitrification. Viability and mitochondrial membrane potential (MMP of control and post-thawing spermatozoa were assessed with the sperm viability kit and the JC-1 kit, respectively, using fluorescence-activated cell sorting analysis. Results: Significant reduction of the progressive motility, viability and MMP was observed by the procedure of freezing and thawing, while there was not any significant difference between both cryopreservation techniques. Cryopreservation resulted in 48% reduction of the percentage of viable spermatozoa and 54.5% rise in the percentage of dead spermatozoa. In addition, high MMP was reduced by 24% and low MMP was increased by 34.75% in response to freezing and thawing. Progressive motility of spermatozoa was correlated significantly positive with high MMP and significantly negative with low MMP in control as well as post-thawing specimens (r=0.8881/ -0.8412, 0.7461/ -0.7510 and 0.7603/ -0.7839 for control, slow and vitrification respectively, p=0.0001. Conclusion: Although both cryopreservation techniques have similar results, vitrification is faster, easier and associated with less toxicity and costs. Thus, vitrification is recommended for the clinical application.

  14. Glycaemic and insulinemic response to dietary carbohydrates in horses

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  15. effect of low glycaemic index meals on insulin secretion

    African Journals Online (AJOL)

    DR. AMINU

    2012-12-02

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

  16. Superior Performance of Leagile Supply Networks by Application of Autonomous Control

    OpenAIRE

    Scholz-Reiter, Bernd; Mehrsai, Afshin

    2010-01-01

    International audience; In the paper, a special approach to supply networks' material flows is posed. The considered strategy is based on the both principles of Lean and agility, beside push and pull of materials. Here, the trade off between positioning of decoupling point throughout an exemplary network, and reduction of inventory level along throughput time is examined. Moreover, autonomous control for material routing and lot-sizes is taken into account. To do so, a discrete-event simulati...

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2014-01-30

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

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

    Science.gov (United States)

    Shehadeh, N; Maor, Y

    2015-11-01

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

  1. Autogenic-feedback training exercise is superior to promethazine for control of motion sickness symptoms

    Science.gov (United States)

    Cowings, P. S.; Toscano, W. B.

    2000-01-01

    Motion sickness symptoms affect approximately 50% of the crew during space travel and are commonly treated with intramuscular injections of promethazine. The purpose of this paper is to compare the effectiveness of three treatments for motion sickness: intramuscular injections (i.m.) of promethazine, a physiological training method (autogenic-feedback training exercise [AFTE]), and a no-treatment control. An earlier study tested the effects of promethazine on cognitive and psychomotor performance and motion sickness tolerance in a rotating chair. For the present paper, motion sickness tolerance, symptom reports, and physiological responses of these subjects were compared to matched subjects selected from an existing database who received either AFTE or no treatment. Three groups of 11 men, between the ages of 33 and 40 years, were matched on the number of rotations tolerated during their initial rotating-chair motion sickness test. The motion sickness test procedures and the 7-day interval between tests were the same for all subjects. The drug group was tested under four treatment conditions: baseline (no injections), a 25 mg dose of promethazine, a 50 mg dose of promethazine, and a placebo of sterile saline. AFTE subjects were given four 30-minute AFTE sessions before their second, third, and fourth motion sickness tests (6 hours total). The no-treatment control subjects were only given the four rotating-chair tests. Motion sickness tolerance was significantly increased after 4 hours of AFTE when compared to either 25 mg (p training.

  2. Modulation by Amino Acids: Toward Superior Control in the Synthesis of Zirconium Metal-Organic Frameworks.

    Science.gov (United States)

    Gutov, Oleksii V; Molina, Sonia; Escudero-Adán, Eduardo C; Shafir, Alexandr

    2016-09-12

    The synthesis of zirconium metal-organic frameworks (Zr MOFs) modulated by various amino acids, including l-proline, glycine, and l-phenylalanine, is shown to be a straightforward approach toward functional-group incorporation and particle-size control. High yields in Zr-MOF synthesis are achieved by employing 5 equivalents of the modulator at 120 °C. At lower temperatures, the method provides a series of Zr MOFs with increased particle size, including many suitable for single-crystal X-ray diffraction studies. Furthermore, amino acid modulators can be incorporated at defect sites in Zr MOFs with an amino acid/ligand ratio of up to 1:1, depending on the ligand structure and reaction conditions. The MOFs obtained through amino acid modulation exhibit an improved CO2 -capture capacity relative to nonfunctionalized materials. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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

    Science.gov (United States)

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

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Kate S. Steinbeck

    2012-04-01

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

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

    Science.gov (United States)

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

    2012-04-01

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

  6. Concepts for `superior process control` in the energy industry; Konzepte fuer die uebergeordnete Prozessfuehrung in der Energiewirtschaft

    Energy Technology Data Exchange (ETDEWEB)

    Doellen, U.C. von

    1996-12-01

    The work concerns the task of control described as dispatching of extensive energy supply and distribution networks. Due to the special contractual situation, there are special long-term targets in firms, which must be achieved in addition to the extensive operational tasks of control and monitoring of the networks. The concepts introduced in the work offer a framework for a target-orientated design of computer-aided menus for this superior process control in the energy industry. (orig./GL) [Deutsch] Die Arbeit betrachtet die als Dispatching bezeichnete Aufgabe der Fuehrung ausgedehnter Energieversorgungs- und verteilungsnetze. Aus den speziellen Vertragssituationen ergeben sich in den Unternehmen besondere, langfristige Zielvorgaben an die mit der Betriebsfuehrung beauftragen Operateure, die zusaetzlich zu den umfangreichen operativen Aufgaben der Fuehrung und Ueberwachung der Netze zu erreichen sind. Die in der Arbeit vorgestellten Konzepte bieten den Rahmen fuer einen zielgerichteten Entwurf rechnergestuetzter Hilfsmittel fuer diese uebergeordnete Prozessfuehrung in der Energiewirtschaft. Das erstellte Gesamtsystem wird abschliessend zur Loesung einer konkreten, energiewirtschaftlichen Problemstellung eingesetzt. Die entwickelte Anwendungsloesung wird als Hilfsmittel fuer die technische und vertragliche Optimierung im Dispatching eingesetzt. Wesentliche Zielsetzung ist ein technisch und wirtschaftlich optimaler Einsatz von Energiespeichern zur Deckung von Spitzenlasten. (orig./GL)

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

    Science.gov (United States)

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

    2012-03-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张会峰; 徐丹丹; 袁慧娟; 马跃华; 虎子颖; 赵志刚

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2008-12-01

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

  11. Robotic gait training is not superior to conventional treadmill training in parkinson disease: a single-blind randomized controlled trial.

    Science.gov (United States)

    Carda, Stefano; Invernizzi, Marco; Baricich, Alessio; Comi, Cristoforo; Croquelois, Alexandre; Cisari, Carlo

    2012-01-01

    The use of robots for gait training in Parkinson disease (PD) is growing, but no evidence points to an advantage over the standard treadmill. In this randomized, single-blind controlled trial, participants aged training on a treadmill or in the Lokomat for 3 d/wk for 4 weeks. Patients were evaluated by a physical therapist blinded to allocation before and at the end of treatment and then at the 3- and 6-month follow-up. The primary outcome measure was the 6-minute walk test. Of 334 screened patients, the authors randomly allocated 30 to receive gait training with treadmill or the Lokomat. At baseline, the 2 groups did not differ. At the 6-month follow-up, both groups had improved significantly in the primary outcome measure (treadmill: mean = 490.95 m, 95% confidence interval [CI] = 448.56-533.34, P = .0006; Lokomat: 458.6 m, 95% CI = 417.23-499.96, P = .01), but no significant differences were found between the 2 groups (P = .53). Robotic gait training with the Lokomat is not superior to treadmill training in improving gait performance in patients with PD. Both approaches are safe, with results maintained for up to 6 months.

  12. Adalimumab combined with ciprofloxacin is superior to adalimumab monotherapy in perianal fistula closure in Crohn's disease : a randomised, double-blind, placebo controlled trial (ADAFI)

    NARCIS (Netherlands)

    Dewint, Pieter; Hansen, Bettina E.; Verhey, Elke; Oldenburg, Bas; Hommes, Daniel W.; Pierik, Marieke; Ponsioen, Cyriel I. J.; van Dullemen, Hendrik M.; Russel, Maurice; van Bodegraven, Ad A.; van der Woude, C. Janneke

    2014-01-01

    Objective To assess whether a combination of adalimumab and ciprofloxacin is superior to adalimumab alone in the treatment of perianal fistulising Crohn's disease (CD). Design Randomised, double-blind, placebo controlled trial in eight Dutch hospitals. In total, 76 CD patients with active perianal f

  13. Adalimumab combined with ciprofloxacin is superior to adalimumab monotherapy in perianal fistula closure in Crohn's disease: A randomised, double-blind, placebo controlled trial (ADAFI)

    NARCIS (Netherlands)

    P. Dewint (Pieter); B.E. Hansen (Bettina); E. Verhey (Elke); B. Oldenburg (Bas); D.W.S. Hommes (Daniël); M. Pierik (Marieke); C.Y. Ponsioen (Cyril); H.M. van Dullemen (Hendrik); M. Russel (Maurice); A.A. van Bodegraven (Ad); C.J. van der Woude (Janneke)

    2014-01-01

    textabstractObjective: To assess whether a combination of adalimumab and ciprofloxacin is superior to adalimumab alone in the treatment of perianal fistulising Crohn's disease (CD). Design: Randomised, double-blind, placebo controlled trial in eight Dutch hospitals. In total, 76 CD patients with act

  14. Adalimumab combined with ciprofloxacin is superior to adalimumab monotherapy in perianal fistula closure in Crohn's disease : a randomised, double-blind, placebo controlled trial (ADAFI)

    NARCIS (Netherlands)

    Dewint, Pieter; Hansen, Bettina E.; Verhey, Elke; Oldenburg, Bas; Hommes, Daniel W.; Pierik, Marieke; Ponsioen, Cyriel I. J.; van Dullemen, Hendrik M.; Russel, Maurice; van Bodegraven, Ad A.; van der Woude, C. Janneke

    2014-01-01

    Objective To assess whether a combination of adalimumab and ciprofloxacin is superior to adalimumab alone in the treatment of perianal fistulising Crohn's disease (CD). Design Randomised, double-blind, placebo controlled trial in eight Dutch hospitals. In total, 76 CD patients with active perianal f

  15. Rumination-focused cognitive behaviour therapy vs. cognitive behaviour therapy for depression: study protocol for a randomised controlled superiority trial.

    Science.gov (United States)

    Hvenegaard, Morten; Watkins, Ed R; Poulsen, Stig; Rosenberg, Nicole K; Gondan, Matthias; Grafton, Ben; Austin, Stephen F; Howard, Henriette; Moeller, Stine B

    2015-08-11

    Cognitive behavioural therapy is an effective treatment for depression. However, one third of the patients do not respond satisfactorily, and relapse rates of around 30 % within the first post-treatment year were reported in a recent meta-analysis. In total, 30-50 % of remitted patients present with residual symptoms by the end of treatment. A common residual symptom is rumination, a process of recurrent negative thinking and dwelling on negative affect. Rumination has been demonstrated as a major factor in vulnerability to depression, predicting the onset, severity, and duration of future depression. Rumination-focused cognitive behavioural therapy is a psychotherapeutic treatment targeting rumination. Because rumination plays a major role in the initiation and maintenance of depression, targeting rumination with rumination-focused cognitive behavioural therapy may be more effective in treating depression and reducing relapse than standard cognitive behavioural therapy. This study is a two-arm pragmatic randomised controlled superiority trial comparing the effectiveness of group-based rumination-focused cognitive behaviour therapy with the effectiveness of group-based cognitive behavioural therapy for treatment of depression. One hundred twenty-eight patients with depression will be recruited from and given treatment in an outpatient service at a psychiatric hospital in Denmark. Our primary outcome will be severity of depressive symptoms (Hamilton Rating Scale for Depression) at completion of treatment. Secondary outcomes will be level of rumination, worry, anxiety, quality of life, behavioural activation, experimental measures of cognitive flexibility, and emotional attentional bias. A 6-month follow-up is planned and will include the primary outcome measure and assessment of relapse. The clinical outcome of this trial may guide clinicians to decide on the merits of including rumination-focused cognitive behavioural therapy in the treatment of depression in

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

    OpenAIRE

    Li, Dongmei

    2015-01-01

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

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

    Science.gov (United States)

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

    2010-08-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2016-12-24

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

    Uche

    2011-01-15

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

  4. Effect of bile acid sequestrants on glycaemic control

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Alexandra M. Johnstone

    2011-06-01

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

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

    Science.gov (United States)

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

    2015-04-28

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

  7. Athletic background is related to superior trunk proprioceptive ability, postural control, and neuromuscular responses to sudden perturbations.

    Science.gov (United States)

    Glofcheskie, Grace O; Brown, Stephen H M

    2017-01-28

    Trunk motor control is essential for athletic performance, and inadequate trunk motor control has been linked to an increased risk of developing low back and lower limb injury in athletes. Research is limited in comparing relationships between trunk neuromuscular control, postural control, and trunk proprioception in athletes from different sporting backgrounds. To test for these relationships, collegiate level long distance runners and golfers, along with non-athletic controls were recruited. Trunk postural control was investigated using a seated balance task. Neuromuscular control in response to sudden trunk loading perturbations was measured using electromyography and kinematics. Proprioceptive ability was examined using active trunk repositioning tasks. Both athlete groups demonstrated greater trunk postural control (less centre of pressure movement) during the seated task compared to controls. Athletes further demonstrated faster trunk muscle activation onsets, higher muscle activation amplitudes, and less lumbar spine angular displacement in response to sudden trunk loading perturbations when compared to controls. Golfers demonstrated less absolute error and variable error in trunk repositioning tasks compared to both runners and controls, suggestive of greater proprioceptive ability. This suggests an interactive relationship between neuromuscular control, postural control, and proprioception in athletes, and that differences exist between athletes of various training backgrounds.

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

    Science.gov (United States)

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

    2013-06-01

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

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

    Science.gov (United States)

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

    2006-08-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  11. Superior efficacy of fesoterodine over tolterodine extended release with rapid onset: a prospective, head-to-head, placebo-controlled trial.

    Science.gov (United States)

    Kaplan, Steven A; Schneider, Tim; Foote, Jenelle E; Guan, Zhonghong; Carlsson, Martin; Gong, Jason

    2011-05-01

    • To show the superior efficacy of fesoterodine over tolterodine extended release (ER) in a placebo-controlled overactive bladder (OAB) trial with predefined treatment comparisons for both diary measures and patient-reported outcomes. • In this 12-week, double-blind, double-dummy trial, subjects reporting >1 urgency urinary incontinence (UUI) episode and ≥8 micturitions per 24 h at baseline were randomized to fesoterodine (4 mg for 1 week, 8 mg for 11 weeks), tolterodine ER 4 mg, or placebo. • Subjects completed 3-day bladder diaries, the Patient Perception of Bladder Condition (PPBC) and the Urgency Perception Scale (UPS) at baseline and weeks 1, 4 and 12 and the OAB Questionnaire at baseline and week 12. • A total of 2417 subjects were randomized. At week 12, fesoterodine 8 mg showed superiority over tolterodine ER 4 mg and placebo on UUI episodes (primary endpoint), micturitions, urgency and most other diary endpoints, and on the PPBC, UPS and all OAB Questionnaire scales and domains (all P fesoterodine 8 mg over tolterodine ER 4 mg was seen as early as week 4 (3 weeks after escalation to fesoterodine 8 mg). At week 1, fesoterodine 4 mg was superior to placebo on most diary variables, the PPBC and the UPS (all P fesoterodine, 13% and 3% with tolterodine ER, and 5% and 2% with placebo. • Discontinuation rates as a result of adverse events were 5%, 3% and 2% for fesoterodine, tolterodine ER and placebo, respectively. • In this randomized study, which is the largest to compare antimuscarinic efficacy performed to date, fesoterodine 8 mg was superior to tolterodine ER 4 mg for UUI episodes, micturitions and urgency episodes, as well as for self-reported patient assessments of bladder-related problems, urgency, symptom bother and health-related quality of life. • The superiority of fesoterodine 8 mg over tolterodine ER 4 mg was observed as early as 3 weeks after escalation from fesoterodine 4 mg for most outcomes. These data may have important

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

    Directory of Open Access Journals (Sweden)

    Hasani S.H.

    2015-06-01

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

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

    Science.gov (United States)

    Wolever, T M S

    2013-05-01

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

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

    NARCIS (Netherlands)

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

    2001-01-01

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

  15. Cervical total disc replacement is superior to anterior cervical decompression and fusion: a meta-analysis of prospective randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Yujie Zhang

    Full Text Available Despite being considered the standard surgical procedure for symptomatic cervical disc disease, anterior cervical decompression and fusion invariably accelerates adjacent segment degeneration. Cervical total disc replacement is a motion-preserving procedure developed as a substitute to fusion. Whether cervical total disc replacement is superior to fusion remains unclear.We comprehensively searched PubMed, EMBASE, Medline, and the Cochrane Library in accordance with the inclusion criteria to identify possible studies. The retrieved results were last updated on December 12, 2014. We classified the studies as short-term and midterm follow-up.Nineteen randomized controlled trials involving 4516 cases were identified. Compared with anterior cervical decompression and fusion, cervical total disc replacement had better functional outcomes (neck disability index [NDI], NDI success, neurological success, neck pain scores reported on a numerical rating scale [NRS], visual analog scales scores and overall success, greater segmental motion at the index level, fewer adverse events and fewer secondary surgical procedures at the index and adjacent levels in short-term follow-up (P 0.05.Cervical total disc replacement presented favorable functional outcomes, fewer adverse events, and fewer secondary surgical procedures. The efficacy and safety of cervical total disc replacement are superior to those of fusion. Longer-term, multicenter studies are required for a better evaluation of the long-term efficacy and safety of the two procedures.

  16. Feeling safe in the plane: neural mechanisms underlying superior action control in airplane pilot trainees – a combined EEG/MRS study

    Science.gov (United States)

    Dharmadhikari, Shalmali; Chmielewski, Witold; Glaubitz, Benjamin; Schmidt-Wilcke, Tobias; Edden, Richard; Dydak, Ulrike; Beste, Christian

    2015-01-01

    In day-to-day life, we need to apply strategies to cascade different actions for efficient unfolding of behaviour. While deficits in action cascading are examined extensively, almost nothing is known about the neuronal mechanisms mediating superior performance above the normal level. To examine this question, we investigate action control in airplane pilot trainees. We use a stop-change paradigm that is able to estimate the efficiency of action cascading on the basis of mathematical constraints. Behavioural and EEG data is analyzed along these constraints and integrated with neurochemical data obtained using Magnetic Resonance Spectroscopy (MRS) from the striatal gamma-aminobutyric acid (GABA) -ergic system. We show that high performance in action cascading, as exemplified in airplane pilot trainees, can be driven by intensified attentional processes, circumventing response selection processes. The results indicate that the efficiency of action cascading and hence the speed of responding as well as attentional gating functions are modulated by striatal GABA and Glutamate + Glutamine concentrations. In superior performance in action cascading similar increases in the concentrations of GABA and Glutamate + Glutamine lead to stronger neurophysiological and behavioural effects as compared to subjects with normal performance in action cascading. PMID:24753040

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

    Science.gov (United States)

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

    2016-01-01

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

  18. As atitudes sexuais, contraceptivas, o lócus de controle da saúde e a autoestima em estudantes do ensino superior

    Directory of Open Access Journals (Sweden)

    José Manuel da Silva Vilelas Janeiro

    2013-12-01

    Full Text Available Objetivo: Analisar as relações entre as atitudes sexuais, contraceptivas, o lócus de controle da saúde e a autoestima nos estudantes de uma instituição de ensino superior privado. Métodos: Estudo descrito e correlacional, de abordagem quantitativa, realizado numa escola de ensino superior da região de Lisboa, com 152 estudantes do 1º e 4º anos dos cursos de licenciatura em Enfermagem, Fisioterapia, Cardiopneumologia e Radiologia. Utilizou-se como instrumento de pesquisa um questionário com as seguintes escalas de avaliação: “atitudes sexuais”, “atitudes contraceptivas”, “lócus de controle da saúde” e “autoestima”.Os dados obtidos foram submetidos à análise descritiva e inferencial. Resultados: A maioria dos estudantes (90,7%; n=138 já teve relações sexuais. As atitudes sexuais foram influenciadas pelo gênero (p=0,0035, e não pelo início da atividade sexual ou pelo ano de curso (p>0,05. As atitudes contraceptivas estavam relacionadas ao ano que os estudantes frequentavam (p=0,031 e ao gênero (p=0,029. O lócus de controle externo, em média, foi mais elevado nas raparigas (29,2 que nos rapazes (30,1. A autoestima aumentou com a idade dos estudantes (p=0,003. Conclusão: É necessário um investimento em educação sexual no ensino superior, pois os jovens vivem os seus dias inseridos no ambiente escolar, passando pouco tempo junto das famílias. A universidade deve assumir uma posição especial no desenvolvimento do conceito de sexualidade baseado na perspetiva holística do ser humano, promovendo a educação sexual como fundamental na construção da identidade humana e imprescindível na promoção da saúde.

  19. Algoritmo de control anticipatorio assisted-as-needed para neurorrehabilitación funcional de extremidad superior

    OpenAIRE

    Pérez Rodríguez, Rodrigo; Costa Boned, U.; Cáceres Taladriz, César; Tormos Muñoz, Josep M.; Medina Casanovas, J.; Gómez Aguilera, Enrique J.

    2012-01-01

    Los dispositivos robóticos se están convirtiendo en una alternativa muy extendida a las terapias de neurorrehabilitación funcional tradicionales al ofrecer una práctica más intensiva sin incrementar el tiempo empleado en la supervisión por parte de los terapeutas especialistas. Por ello, este trabajo de investigación propone un algoritmo de control anticipatorio que, bajo el paradigma 'assisted-as-needed', proporcione a una ortesis robótica las capacidades de actuación necesarias para ...

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

    NARCIS (Netherlands)

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

    2014-01-01

    Low-glycaemic index diets reduce glycated Hb (HbA1c) in patients with type 2 diabetes, but require intensive dietary support. Using a liquid meal replacement with a low glycaemic response (GR) may be an alternative dietary approach. In the present study, we investigated whether breakfast replacement

  1. Glycaemic load versus carbohydrate counting for insulin bolus calculation in patients with type 1 diabetes on insulin pump.

    Science.gov (United States)

    Bozzetto, L; Giorgini, M; Alderisio, A; Costagliola, L; Giacco, A; Riccardi, G; Rivellese, A A; Annuzzi, G

    2015-10-01

    To evaluate feasibility and effectiveness on short-term blood glucose control of using glycaemic load counting (GLC) versus carbohydrate counting (CC) for prandial insulin dosing in patients with type 1 diabetes (T1D). Nine T1D patients on insulin pump, aged 26-58 years, HbA1c 7.7 ± 0.8 % (61 ± 8.7 mmol/mol), participated in this real-life setting study. By a crossover design, patients were randomised to calculate their pre-meal insulin dose based on the insulin/glycaemic load ratio (GLC period) or the insulin/carbohydrate ratio (CC period) for 1 week, shifting to the alternate method for the next week, when participants duplicated their first week food plan. Over either week, a blind subcutaneous continuous glucose monitoring was performed, and a 7-day food record was filled in. Total daily insulin doses (45 ± 10 vs. 44 ± 9 I.U.; M ± SD, p = 0.386) and basal infusion (26 ± 7 vs. 26 ± 8 I.U., p = 0.516) were not different during GLC and CC periods, respectively. However, the range of insulin doses (difference between highest and lowest insulin dose) was wider during GLC, with statistical significance at dinner (8.4 ± 6.2 vs. 6.0 ± 3.9 I.U., p = 0.041). Blood glucose iAUC after lunch was lower, albeit not significantly, during GLC than CC period (0.6 ± 8.6 vs. 3.4 ± 8.2 mmol/l∙3 h, p = 0.059). Postprandial glucose variability, evaluated as the maximal amplitude after meal (highest minus lowest glucose value), was significantly lower during GLC than CC period at lunch (4.22 ± 0.28 vs. 5.47 ± 0.39 mmol/l, p = 0.002) and dinner (3.89 ± 0.33 vs. 4.89 ± 0.33, p = 0.026). Calculating prandial insulin bolus based on glycaemic load counting is feasible in a real-life setting and may improve postprandial glucose control in people with T1D.

  2. Active-control trials with binary data: a comparison of methods for testing superiority or non-inferiority using the odds ratio.

    Science.gov (United States)

    Siqueira, Arminda Lucia; Whitehead, Anne; Todd, Susan

    2008-02-10

    This paper considers methods for testing for superiority or non-inferiority in active-control trials with binary data, when the relative treatment effect is expressed as an odds ratio. Three asymptotic tests for the log-odds ratio based on the unconditional binary likelihood are presented, namely the likelihood ratio, Wald and score tests. All three tests can be implemented straightforwardly in standard statistical software packages, as can the corresponding confidence intervals. Simulations indicate that the three alternatives are similar in terms of the Type I error, with values close to the nominal level. However, when the non-inferiority margin becomes large, the score test slightly exceeds the nominal level. In general, the highest power is obtained from the score test, although all three tests are similar and the observed differences in power are not of practical importance.

  3. Superior control of HIV-1 replication by CD8+ T cells targeting conserved epitopes: implications for HIV vaccine design.

    Directory of Open Access Journals (Sweden)

    Pratima Kunwar

    Full Text Available A successful HIV vaccine will likely induce both humoral and cell-mediated immunity, however, the enormous diversity of HIV has hampered the development of a vaccine that effectively elicits both arms of the adaptive immune response. To tackle the problem of viral diversity, T cell-based vaccine approaches have focused on two main strategies (i increasing the breadth of vaccine-induced responses or (ii increasing vaccine-induced responses targeting only conserved regions of the virus. The relative extent to which set-point viremia is impacted by epitope-conservation of CD8(+ T cell responses elicited during early HIV-infection is unknown but has important implications for vaccine design. To address this question, we comprehensively mapped HIV-1 CD8(+ T cell epitope-specificities in 23 ART-naïve individuals during early infection and computed their conservation score (CS by three different methods (prevalence, entropy and conseq on clade-B and group-M sequence alignments. The majority of CD8(+ T cell responses were directed against variable epitopes (p<0.01. Interestingly, increasing breadth of CD8(+ T cell responses specifically recognizing conserved epitopes was associated with lower set-point viremia (r = - 0.65, p = 0.009. Moreover, subjects possessing CD8(+ T cells recognizing at least one conserved epitope had 1.4 log10 lower set-point viremia compared to those recognizing only variable epitopes (p = 0.021. The association between viral control and the breadth of conserved CD8(+ T cell responses may be influenced by the method of CS definition and sequences used to determine conservation levels. Strikingly, targeting variable versus conserved epitopes was independent of HLA type (p = 0.215. The associations with viral control were independent of functional avidity of CD8(+ T cell responses elicited during early infection. Taken together, these data suggest that the next-generation of T-cell based HIV-1 vaccines should focus

  4. Superior subconjunctival anesthesia versus retrobulbar anesthesia for manual small-incision cataract surgery in a residency training program: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kongsap P

    2012-11-01

    Full Text Available Pipat KongsapDepartment of Ophthalmology, Prapokklao Hospital, Chanthaburi, Thailand; Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandPurpose: To evaluate the effectiveness of subconjunctival anesthesia as compared to retrobulbar anesthesia for pain control during manual small-incision cataract surgery (MSICS performed by third-year residents.Design: A randomized, controlled trial.Patients and methods: A total of 150 patients undergoing routine cataract surgery were randomly assigned to receive either subconjunctival anesthesia (group 1, n = 75 or retrobulbar anesthesia (group 2, n = 75. Third-year residents performed MSICS using the modified Blumenthal technique. Subconjunctival anesthesia was administered by injecting 2% xylocaine with adrenalin into the superior conjunctiva, and retrobulbar anesthesia by injecting 2 mL of 2% xylocaine with adrenalin into the retrobulbar space. We studied the following variables: intraoperative pain score rated on a 100-point visual analog scale (VAS, operative time, and injection and operative complications.Results: A mean age of 69 vs 70 years, an operative time of 47.1 (SD, 9.9 min vs 47.7 (10.9 min, and a median (interquartile range pain score of 40 (range, 20–70 vs 40 (range, 20–50 were observed in the subconjunctival and the retrobulbar groups, respectively. The injection complication of subconjunctival hemorrhage was significantly higher in the subconjunctival group (25.3% compared to the retrobulbar group (1.3%. The operative complication rate between groups was not different (P > 0.05.Conclusion: Both, superior subconjunctival anesthesia and retrobulbar anesthesia were effective during MSICS when used in a residency training program.Keywords: subconjunctival anesthesia, retrobulbar anesthesia, cataract surgery, small-incision cataract surgery, visual analog scale, pain score

  5. Glycaemic & insulinaemic responses in men at rest following sago meal.

    Science.gov (United States)

    Ahmad, Hishamuddin; Singh, Rabindarjeet; Ghosh, Asok Kumar

    2009-08-01

    Sago (Metroxylin sagu) is one of the main sources of native starch. In Malaysia sago dishes are commonly eaten with sugar. However, other societies use sago as a staple food item instead of rice or potato. The study was undertaken to investigate the effect of ingestion of different physical forms of sago supplementation on plasma glucose and plasma insulin responses, as compared to the white bread supplementation in man, during resting condition. Twelve male subjects were given in random order with three different physical forms of a sago supplementation, viz., sago porridge (SR), sago paste (SP), sago gel (SG) and white bread (WB) which was repeated on separate days, at least, 1 wk apart after an overnight fast. Venous blood samples were collected at baseline and at 15, 30, 45, 60, 90, 120, 150 and 180 min after the start of each meal and were analyzed for plasma levels of glucose and insulin. Plasma glucose reached peak at 45 min after supplementation of various sago meals. Plasma glucose area under the curve (AUC) for WB was significantly lower than SG but not significantly different from SR and SP. No significant difference was observed in plasma glucose AUC among the three sago meals. Plasma insulin AUC for SG was significantly higher than WB and SR. All three sago meals tested were not significantly different in their glycaemic responses. However, the insulin response was significantly lower for SR compared to SP and SG. The present findings suggest that any one of the three sago meals tested in this study may be used to elucidate the effect of sago starch ingestion on exercise performance in the heat. Sago paste and sago porridge may be used for supplementation before and during exercise, whereas, sago gel may be used after endurance exercise during recovery process.

  6. Glycaemic index of four commercially available breads in Malaysia.

    Science.gov (United States)

    Yusof, Barakatun Nisak Mohd; Abd Talib, Ruzita; Karim, Norimah A; Kamarudin, Nor Azmi; Arshad, Fatimah

    2009-09-01

    This study was carried out to determine the blood glucose response and glycaemic index (GI) values of four types of commercially available breads in Malaysia. Twelve healthy volunteers (six men, six women; body mass index, 21.9±1.6 kg/m(2); age, 22.9±1.7 years) participated in this study. The breads tested were multi-grains bread (M-Grains), wholemeal bread (WM), wholemeal bread with oatmeal (WM-Oat) and white bread (WB). The subjects were studied on seven different occasions (four tests for the tested breads and three repeated tests of the reference food) after an overnight fast. Capillary blood samples were taken immediately before (0 min) and 15, 30, 45, 60, 90 and 120 min after consumption of the test foods. The blood glucose response was obtained by calculating the incremental area under the curve. The GI values were determined according to the standardized methodology. Our results showed that the M-Grains and WM-Oat could be categorized as intermediate GI while the WM and WB breads were high GI foods, respectively. The GI of M-Grains (56±6.2) and WM-Oat (67±6.9) were significantly lower than the reference food (glucose; GI = 100) (P food and the GI of WM (85±5.9) and WB (82±6.5) (P > 0.05). Among the tested breads, the GI values of M-Grains and WM-Oat were significantly lower (P foods.

  7. Non-glycaemic effects mediated via GLP-1 receptor agonists and the potential for exploiting these for therapeutic benefit

    DEFF Research Database (Denmark)

    Vilsbøll, T; Garber, A J

    2012-01-01

    The glucagon-like peptide-1 receptor agonists (GLP-1 RAs) liraglutide and exenatide can improve glycaemic control by stimulating insulin release through pancreatic β-cells in a glucose-dependent manner. GLP-1 receptors are not restricted to the pancreas; therefore, GLP-1 RAs cause additional non-...... for GLP-1 RAs in the cardiovascular and central nervous systems has been suggested from animal studies and short-term clinical trials. These effects and other safety aspects of GLP-1 therapy are currently being investigated in ongoing long-term clinical studies....... are affected by β-cell dysfunction, obesity and hypertension. Transient gastrointestinal adverse events, such as nausea and diarrhoea, are also common. To improve gastrointestinal tolerability, an incremental dosing approach is used with liraglutide and exenatide twice daily. A potential protective role...

  8. The OnControl bone marrow biopsy technique is superior to the standard manual technique for hematologists-in-training: a prospective, randomized comparison

    Directory of Open Access Journals (Sweden)

    Louis Juden Reed

    2011-10-01

    Full Text Available The purpose of this study was to compare a novel bone marrow device with the standard marrow needle in a prospective, randomized study in a teaching hospital employing hematologists- in-training. The new device, the OnControl Bone Marrow (OBM Biopsy System, utilizes a battery-powered drill to insert the needle. Fifty-four bone marrows (27 standard and 27 OBM were performed by 11 fellows under the observation and supervision of 3 attending hematologists and 1 research technologist. The primary endpoint of the study, the mean length of the marrow biopsy specimens, a surrogate for marrow quality, was determined by a pathologist in a blinded manner. The mean length of the marrow biopsy specimens was significantly longer (56% for the OBM group (15.3 mm than for the standard bone marrow (SBM group (9.8 mm, P<0.003. An objectively determined secondary endpoint; mean procedure time, skin-to-skin; also favored the OBM group (175 s versus the SBM group (292 s, P<0.007. Several subjective secondary endpoints also favored the OBM group. Only minor adverse events were encountered in the OBM and SBM study groups. It was concluded that bone marrow procedures (BMPs performed by hematologists- in-training were significantly faster and superior in quality when performed with the OBM compared to the SBM. These data suggest that the OBM may be considered a new standard of care for adult hematology patients. OBM also appears to be a superior method for training hematology fellows.

  9. The acute effects of a pulse-containing meal on glycaemic responses and measures of satiety and satiation within and at a later meal.

    Science.gov (United States)

    Mollard, R C; Zykus, A; Luhovyy, B L; Nunez, M F; Wong, C L; Anderson, G H

    2012-08-01

    Pulses are low glycaemic foods; however, their effect on satiation is unknown. The objective was to determine the effects of an ad libitum pulse meal on food intake (FI), appetite and blood glucose (BG) before and after a test meal (4 h later) and on FI at the test meal. Males (n 24, 22·8 kg/m2) received one of four treatments or control. The pulse treatments contained pasta and tomato sauce and 44 % of energy from: (1) chickpeas, (2) lentils, (3) navy beans or (4) yellow peas. The control was pasta and tomato sauce (pasta and sauce). FI (satiation) was measured at the treatment meal (0-20 min) and at an ad libitum pizza meal 4 h later. BG and appetite were measured from 0 to 340 min. At the treatment meal, lentils led to lower FI compared to chickpeas and pasta and sauce, whereas navy beans led to lower FI compared to chickpeas. Also, lentils led to lower cumulative FI compared to pasta and sauce. All pulses led to lower BG peak and cumulative area under the curve (AUC; 0-340 min); however, only chickpeas, lentils and navy beans reduced pre-pizza meal BG AUC (0-260 min) relative to pasta and sauce. Chickpeas led to lower post-pizza meal BG AUC (260-340 min) compared to navy beans and yellow peas. Consumption of pulses in a high-glycaemic meal contributes to earlier satiation, lower BG following the meal and after a later meal, but these effects are specific to pulse type and cannot be explained by their glycaemic properties alone.

  10. Rising methods and leavening agents used in the production of bread do not impact the glycaemic index.

    Science.gov (United States)

    Fredensborg, Monica Hardman; Perry, Tracy; Mann, Jim; Chisholm, Alex; Rose, Meredith

    2010-01-01

    The aim of this study was to compare the glycaemic index of breads produced using different rising methods and leavening agents. Eleven bread varieties were selected based on method of production, and divided between three groups of ten participants (mean +/- SD age 30.0 +/- 10.7 years and BMI 22.9 +/- 2.8). Standard glycaemic index testing protocol was implemented after an overnight fast, using glucose as the reference food, and collecting blood samples over a two-hour period. Glycemic index was calculated using the usual method. Additionally, incremental area under the curve data were log transformed and glycaemic index was calculated using regression analysis. Mean glycaemic index values of the breads in ascending order were as follows: Swiss Rye; 60, Long oat; 68, Sourdough+oats; 71, Long rye; 76, Short oat; 77, Short whole meal; 78, Long whole meal; 80, Sourdough; 82, Short rye; 82, Yeast; 88, and Desem; 92. There were significant differences in mean glycaemic index values between Swiss Rye and Yeast (p = 0.010), Swiss Rye and Desem (p = 0.007) and Sourdough+oats and Desem (p = 0.043). The rising method and leavening agents used in this study did not impact on the glycaemic index of the breads tested. Other factors, such as increased bread density, and the addition of whole grains may be required to produce bread with a low glycaemic index.

  11. Glycaemic threshold for diabetes-specific retinopathy among individuals from Saudi Arabia, Algeria and Portugal

    DEFF Research Database (Denmark)

    Almdal, Thomas Peter; Handlos, Line Neerup; Vistisen, Dorte

    2014-01-01

    We studied the glycaemic threshold and prevalence of diabetic retinopathy in screen-detected diabetes in Saudi Arabia, Algeria and Portugal. The prevalence of diabetes-specific retinopathy started to increase at an HbA1c level of 6-6.4% and in individuals with HbA1c >7.0% the prevalence was 6.0%....

  12. Glycaemic threshold for diabetes-specific retinopathy among individuals from Saudi Arabia, Algeria and Portugal

    DEFF Research Database (Denmark)

    Almdal, Thomas Peter; Handlos, Line Neerup; Vistisen, Dorte

    2014-01-01

    We studied the glycaemic threshold and prevalence of diabetic retinopathy in screen-detected diabetes in Saudi Arabia, Algeria and Portugal. The prevalence of diabetes-specific retinopathy started to increase at an HbA1c level of 6-6.4% and in individuals with HbA1c >7.0% the prevalence was 6.0%....

  13. Glycaemic index of parboiled rice depends on the severity of processing: study in type 2 diabetic subjects

    DEFF Research Database (Denmark)

    Larsen, H. N.; Rasmussen, O. W.; Rasmussen, Peter Have

    2000-01-01

    Objective: To study the influence of parboiling and the severity of the process on glycaemic and insulinaemic responses to rice in type 2 diabetes. Moreover, to examine changes in starch structure related to parboiling, which may affect the metabolic responses and digestibility. Design: Nine type...... subjects. There was no effect of TP on glycaemic index, whereas PP reduced the glycaemic index by almost 30% compared to NP....... diabetic subjects ingested four test meals: white bread (WB) and three meals of cooked polished rice of the same variety being non-parboiled (NP), mildly traditionally parboiled (TP) and severely pressure parboiled (PP). The participants ingested the test meals (50 g available carbohydrates) on separate...

  14. Superior electro-optical properties of electrically controlled birefringence mode using solution-derived La{sub 2}O{sub 3} films

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Hae-Chang; Park, Hong-Gyu; Lee, Ju Hwan; Seo, Dae-Shik, E-mail: dsseo@yonsei.ac.kr [Information Display Device Laboratory, Department of Electrical and Electronic Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-749 (Korea, Republic of); Oh, Byeong-Yun [ZeSHTech Co., Ltd., Business Incubator, Gwangju Institute of Science and Technology, 123, Cheomdangwagi-ro, Buk-gu, Gwangju 500-712 (Korea, Republic of)

    2015-11-15

    The authors demonstrate a high performance electrically controlled birefringence (ECB) mode with solution-derived La{sub 2}O{sub 3} films at various molar concentrations. Uniform and homogeneous liquid crystal (LC) alignment was spontaneously achieved on the La{sub 2}O{sub 3} films for lanthanum concentrations at ratios greater than and equal to 0.2. A preferred orientation of LC molecules appeared along the filling direction, and the LC alignment was maintained via van der Waals force by nanocrystals of the La{sub 2}O{sub 3} films. The LC alignment mechanism was confirmed by x-ray photoelectron spectroscopy and high-resolution transmission electron microscopy analysis. Superior electro-optical characteristics of the ECB cells constructed with solution-derived La{sub 2}O{sub 3} films were observed, which suggests that the proposed solution-derived La{sub 2}O{sub 3} films have strong potential for use in the production of advanced LC displays.

  15. RELN-expressing neuron density in layer I of the superior temporal lobe is similar in human brains with autism and in age-matched controls.

    Science.gov (United States)

    Camacho, Jasmin; Ejaz, Ehsan; Ariza, Jeanelle; Noctor, Stephen C; Martínez-Cerdeño, Verónica

    2014-09-05

    Reelin protein (RELN) level is reduced in the cerebral cortex and cerebellum of subjects with autism. RELN is synthesized and secreted by a subpopulation of neurons in the developing cerebral cortex termed Cajal-Retzius (CR) cells. These cells are abundant in the marginal zone during cortical development, many die after development is complete, but a small population persists into adulthood. In adult brains, RELN is secreted by the surviving CR cells, by a subset of GABAergic interneurons in layer I, and by pyramidal cells and GABAergic interneurons in deeper cortical layers. It is widely believed that decreased RELN in layer I of the cerebral cortex of subjects with autism may result from a decrease in the density of RELN expressing neurons in layer I; however, this hypothesis has not been tested. We examined RELN expression in layer I of the adult human cortex and found that 70% of cells express RELN in both control and autistic subjects. We quantified the density of neurons in layer I of the superior temporal cortex of subjects with autism and age-matched control subjects. Our data show that there is no change in the density of neurons in layer I of the cortex of subjects with autism, and therefore suggest that reduced RELN expression in the cerebral cortex of subjects with autism is not a consequence of decreased numbers of RELN-expressing neurons in layer I. Instead reduced RELN may result from abnormal RELN processing, or a decrease in the number of other RELN-expressing neuronal cell types. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. BST-CarGel® Treatment Maintains Cartilage Repair Superiority over Microfracture at 5 Years in a Multicenter Randomized Controlled Trial

    Science.gov (United States)

    Stanish, William D.; McCormack, Robert; Forriol, Francisco; Mohtadi, Nicholas; Pelet, Stéphane; Desnoyers, Jacques; Méthot, Stéphane; Vehik, Kendra; Restrepo, Alberto

    2015-01-01

    Objective The efficacy and safety of BST-CarGel®, a chitosan scaffold for cartilage repair was compared with microfracture alone at 1 year during a multicenter randomized controlled trial in the knee. This report was undertaken to investigate 5-year structural and clinical outcomes. Design The international randomized controlled trial enrolled 80 patients, aged 18 to 55 years, with grade III or IV focal lesions on the femoral condyles. Patients were randomized to receive BST-CarGel® treatment or microfracture alone, and followed standardized 12-week rehabilitation. Co-primary endpoints of repair tissue quantity and quality were evaluated by 3-dimensional MRI quantification of the degree of lesion filling (%) and T2 relaxation times. Secondary endpoints were clinical benefit measured with WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) questionnaires and safety. General estimating equations were used for longitudinal statistical analysis of repeated measures. Results Blinded MRI analysis demonstrated that BST-CarGel®-treated patients showed a significantly greater treatment effect for lesion filling (P = 0.017) over 5 years compared with microfracture alone. A significantly greater treatment effect for BST-CarGel® was also found for repair tissue T2 relaxation times (P = 0.026), which were closer to native cartilage compared to the microfracture group. BST-CarGel® and microfracture groups showed highly significant improvement at 5 years from pretreatment baseline for each WOMAC subscale (P < 0.0001), and there were no differences between the treatment groups. Safety was comparable for both groups. Conclusions BST-CarGel® was shown to be an effective mid-term cartilage repair treatment. At 5 years, BST-CarGel® treatment resulted in sustained and significantly superior repair tissue quantity and quality over microfracture alone. Clinical benefit following BST-CarGel® and microfracture treatment were highly significant over baseline

  17. Superior Hiking Trail

    Data.gov (United States)

    Minnesota Department of Natural Resources — Superior Hiking Trail main trail, spurs, and camp spurs for completed trail throughout Cook, Lake, St. Louis and Carlton counties. These data were collected with...

  18. Bathymetry of Lake Superior

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Bathymetry of Lake Superior has been compiled as a component of a NOAA project to rescue Great Lakes lake floor geological and geophysical data and make it more...

  19. Superior Hiking Trail Facilities

    Data.gov (United States)

    Minnesota Department of Natural Resources — Superior Hiking Trail main trail, spurs, and camp spurs for completed trail throughout Cook, Lake, St. Louis and Carlton counties. These data were collected with...

  20. Randomized, double-blind, placebo-controlled superiority trial of the Yiqigubiao pill for the treatment of patients with chronic obstructive pulmonary disease at a stable stage

    Science.gov (United States)

    Li, Feng-Sen; Zhang, Yan-Li; Li, Zheng; Xu, Dan; Liao, Chun-Yan; Ma, Huan; Gong, Li; Su, Jun; Sun, Qi; Xu, Qian; Gao, Zhen; Wang, Ling; Jing, Jing; Wang, Jing; Jiang, Min; Tian, Ge; Hasan, Bilal

    2016-01-01

    In traditional Chinese medicine (TCM), the Yiqigubiao pill is commonly used to enhance physical fitness. The current clinical trial was designed to evaluate the efficacy and safety of the Yiqigubiao pill as an adjuvant therapy for patients with stable chronic obstructive pulmonary disease (COPD). The current trial was a randomized, double-blind, placebo-controlled superiority trial. The participants were recruited from outpatients at the Traditional Chinese Medicine Hospital affiliated with Xinjiang Medical University (Ürümqi, China) between February and September 2012. All participants were patients with stable COPD that were randomized to the Yiqigubiao pill (YQGB; n=84) or placebo (Pb; n=87) groups. The occurrences of acute exacerbation (AE) of COPD during the trial were recorded. Lung function value assessments, scoring of life quality and exercise endurance, arterial blood gas analysis and serum inflammatory cytokines level determination were performed prior to and throughout the study. A total of 139 participants completed the intervention and 132 participants completed the study. The interval between the initial intervention and the first AECOPD was greater in the YQGB group compared with the Pb group (P<0.01). The incidence rate of AECOPD was lower in the YQGB group than in the Pb group (P<0.01). Subsequent to the intervention or at the end of the study, the 6-min walking distance difference was longer in the YQGB group compared with the Pb group (P<0.01). The scores reflecting life quality decline became lower in the YQGB group (P<0.01). The serum levels of proinflammatory factors were downregulated to a greater extent in the YQGB group compared with the Pb group. Thus, the Yiqigubiao pill is an efficient and safe adjuvant therapy for the treatment of stable patients with COPD. PMID:27698749

  1. Adalimumab combined with ciprofloxacin is superior to adalimumab monotherapy in perianal fistula closure in Crohn's disease: a randomised, double-blind, placebo controlled trial (ADAFI).

    Science.gov (United States)

    Dewint, Pieter; Hansen, Bettina E; Verhey, Elke; Oldenburg, Bas; Hommes, Daniel W; Pierik, Marieke; Ponsioen, Cyriel I J; van Dullemen, Hendrik M; Russel, Maurice; van Bodegraven, Ad A; van der Woude, C Janneke

    2014-02-01

    To assess whether a combination of adalimumab and ciprofloxacin is superior to adalimumab alone in the treatment of perianal fistulising Crohn's disease (CD). Randomised, double-blind, placebo controlled trial in eight Dutch hospitals. In total, 76 CD patients with active perianal fistulising disease were enrolled. After adalimumab induction therapy (160/80 mg week 0, 2), patients received 40 mg every other week together with ciprofloxacin 500 mg or placebo twice daily for 12 weeks. After 12 weeks, adalimumab was continued. Follow-up was 24 weeks. Primary endpoint (clinical response) was defined as 50% reduction of fistulas from baseline to week 12. Secondary endpoints included remission (closure of all fistulas), Perianal Crohn's Disease Activity Index, Crohn's Disease Activity Index (CDAI) and Inflammatory Bowel Disease Questionnaire (IBDQ). Clinical response was observed in 71% of patients treated with adalimumab plus ciprofloxacin and in 47% treated with adalimumab plus placebo (p=0.047). Likewise, remission rate at week 12 was significantly higher (p=0.009) in the combination group (65%) compared with adalimumab plus placebo (33%). Combination treatment was associated with a higher mean CDAI change and mean IBDQ change at week 12 (p=0.005 and p=0.009, respectively). At week 24, no difference in clinical response between the two treatment groups was observed (p=0.22). No difference in safety issues was observed. Combination therapy of adalimumab and ciprofloxacin is more effective than adalimumab monotherapy to achieve fistula closure in CD. However, after discontinuation of antibiotic therapy, the beneficial effect of initial coadministration is not maintained. ClinicalTrials.gov Identifier: NCT00736983.

  2. The effect of mixing and changing the order of feeding oats and chopped alfalfa to horses on: glycaemic and insulinaemic responses, and breath hydrogen and methane production.

    Science.gov (United States)

    Vervuert, I; Voigt, K; Hollands, T; Cuddeford, D; Coenen, M

    2009-10-01

    The aim of this study was to investigate the effects of feeding oats alone before or after feeding chopped alfalfa or, in admixture with the alfalfa on the glycaemic and insulinaemic responses of horses as well as post-prandial breath hydrogen and methane excretion. Horses were fed in a randomized order, chopped alfalfa as a source of dietary fibre and unprocessed oats as a source of starch. Chopped alfalfa intake was adjusted to a crude fibre intake of 0.5 g/kg bodyweight (BW) per meal and the oats intake was adjusted to a starch intake of 2 g/kg BW per meal. The feeds were offered in three different ways: (i) alfalfa followed by oats (A/O), (ii) oats followed by alfalfa (O/A) or (iii) a mixture of alfalfa and oats (A + O). Oats alone were used as a control. Blood and breath were collected after the test meal was fed at the end of a 11.5-h overnight fast following a 10-day acclimatization period. The highest glycaemic and insulinaemic responses were measured when the A/O and O/A diets orders were fed, whereas most hydrogen was produced after feeding oats alone. It was concluded that adding alfalfa chaff to a meal of oats prolonged the pre-caecal digestion of starch, but there was no evidence for any effect on pre-caecal starch digestibility.

  3. Methodology for adding and amending glycaemic index values to a nutrition analysis package.

    LENUS (Irish Health Repository)

    Levis, Sharon P

    2011-04-01

    Since its introduction in 1981, the glycaemic index (GI) has been a useful tool for classifying the glycaemic effects of carbohydrate foods. Consumption of a low-GI diet has been associated with a reduced risk of developing CVD, diabetes mellitus and certain cancers. WISP (Tinuviel Software, Llanfechell, Anglesey, UK) is a nutrition software package used for the analysis of food intake records and 24 h recalls. Within its database, WISP contains the GI values of foods based on the International Tables 2002. The aim of the present study is to describe in detail a methodology for adding and amending GI values to the WISP database in a clinical or research setting, using data from the updated International Tables 2008.

  4. Green tea catechins reduced the glycaemic potential of bread: an in vitro digestibility study.

    Science.gov (United States)

    Goh, Royston; Gao, Jing; Ananingsih, Victoria K; Ranawana, Viren; Henry, Christiani Jeyakumar; Zhou, Weibiao

    2015-08-01

    Green tea catechins are potent inhibitors of enzymes for carbohydrate digestion. However, the potential of developing low glycaemic index bakery food using green tea extract has not been investigated. Results of this study showed that addition of green tea extract (GTE) at 0.45%, 1%, and 2% concentration levels significantly reduced the glycaemic potential of baked and steamed bread. The average retention levels of catechins in the baked and steamed bread were 75.3-89.5% and 81.4-99.3%, respectively. Bread fortified with 2% GTE showed a significantly lower level of glucose release during the first 90 min of pancreatic digestion as well as a lower content of rapidly digested starch (RDS) content. A significantly negative correlation was found between the catechin retention level and the RDS content of bread. The potential of transforming bread into a low GI food using GTE fortification was proven to be promising. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Glycaemic indices of three Sri Lankan wheat bread varieties and a bread-lentil meal.

    Science.gov (United States)

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

    2009-01-01

    The glycaemic index (GI) concept ranks individual foods and mixed meals according to the blood glucose response. Low-GI foods with a slow and prolonged glycaemic response are beneficial for diabetic people, and several advantages have been suggested also for non-diabetic individuals. The recent investigations imply an increasing prevalence of diabetes mellitus in Sri Lanka. Thus, the present study was designed primarily to determine the glycaemic indices of some bread varieties in Sri Lanka as bread has become a staple diet among most of the urban people. A second objective was to observe the effects of macronutrients and physicochemical properties of starch on GI. Glycaemic responses were estimated according to FAO/WHO guidelines and both glucose and white bread were used as standards. Non-diabetic individuals aged 22-30 years (n=10) participated in the study. The test meals included white sliced bread, wholemeal bread, ordinary white bread and a mixed meal of wholemeal bread with lentil curry. The GI values (+/-standard error of the mean) of the meals were 77+/-6, 77+/-6, 80+/-4, 61+/-6, respectively (with glucose as the standard). The GI values of the bread varieties or the meal did not differ significantly (P >0.05). However, the meal can be categorized as a medium-GI food while the other bread varieties belong to the high-GI food group. A significant negative correlation was obtained with protein (P=0.042) and fat (P=0.039) contents of the food items and GI. Although the GI values of the foods are not significantly different, the inclusion of lentils caused the GI to decrease from a high-GI category to a medium-GI category. According to the present study, a ratio of 1.36 can be used to interconvert the GI values obtained with the two standards.

  6. Glycaemic threshold for diabetes-specific retinopathy among individuals from Saudi Arabia, Algeria and Portugal.

    Science.gov (United States)

    Almdal, T P; Handlos, L N; Valerius, M; Juul, E; Nielsen, K E; Vistisen, D; Nielsen, L B; Sheikh, A; Belhadj, M; Nadir, D; Zinai, S; Raposo, J; Lund-Andersen, H; Witte, D R

    2014-03-01

    We studied the glycaemic threshold and prevalence of diabetic retinopathy in screen-detected diabetes in Saudi Arabia, Algeria and Portugal. The prevalence of diabetes-specific retinopathy started to increase at an HbA1c level of 6-6.4% (42-47 mmol/mol) and in individuals with HbA(1c) >7.0% the prevalence was 6.0%.

  7. METABOLIC PROPERTIES OF RYE PRODUCTS Focusing on insulinaemia, glycaemic profile and appetite regulation in healthy subjects

    OpenAIRE

    Rosén, Liza

    2011-01-01

    The prevalence of metabolic disorders, such as type 2 diabetes, cardiovascular diseases and the insulin resistance syndrome (IRS) are increasing worldwide. However, disturbances in the metabolic status can be prevented by changing the daily diet towards more whole grains, vegetables, legumes and dairy products. Also the dietary glycaemic- and insulinaemic indices of foods may play a role. Rye products are interesting in this context as they are usually consumed in wholegrain form and have bee...

  8. The effect of dietary fibre on reducing the glycaemic index of bread.

    Science.gov (United States)

    Scazzina, Francesca; Siebenhandl-Ehn, Susanne; Pellegrini, Nicoletta

    2013-04-14

    As bread is the most relevant source of available carbohydrates in the diet and as lowering dietary glycaemic index (GI) is considered favourable to health, many studies have been carried out in order to decrease the GI of bread. The most relevant strategy that has been applied so far is the addition of fibre-rich flours or pure dietary fibre. However, the effectiveness of dietary fibre in bread in reducing the GI is controversial. The purpose of the present review was to discuss critically the effects obtained by adding different kinds of fibre to bread in order to modulate its glycaemic response. The studies were selected because they analysed in vivo whether or not dietary fibre, naturally present or added during bread making, could improve the glucose response. The reviewed literature suggests that the presence of intact structures not accessible to human amylases, as well as a reduced pH that may delay gastric emptying or create a barrier to starch digestion, seems to be more effective than dietary fibre per se in improving glucose metabolism, irrespective of the type of cereal. Moreover, the incorporation of technologically extracted cereal fibre fractions, the addition of fractions from legumes or of specifically developed viscous or non-viscous fibres also constitute effective strategies. However, when fibres or wholemeal is included in bread making to affect the glycaemic response, the manufacturing protocol needs to reconsider several technological parameters in order to obtain high-quality and consumer-acceptable breads.

  9. The influence of maternal glycaemia and dietary glycaemic index on pregnancy outcome in healthy mothers.

    LENUS (Irish Health Repository)

    McGowan, Ciara A

    2010-07-01

    Infant birth weight has increased in Ireland in recent years along with levels of childhood overweight and obesity. The present article reviews the current literature on maternal glycaemia and the role of the dietary glycaemic index (GI) and its impact on pregnancy outcomes. It is known that maternal weight and weight gain significantly influence infant birth weight. Fetal macrosomia (birth weight >4000 g) is associated with an increased risk of perinatal trauma to both mother and infant. Furthermore, macrosomic infants have greater risk of being obese in childhood, adolescence and adulthood compared to normal-sized infants. There is evidence that there is a direct relationship between maternal blood glucose levels during pregnancy and fetal growth and size at birth, even when maternal blood glucose levels are within their normal range. Thus, maintaining blood glucose concentrations within normal parameters during pregnancy may reduce the incidence of fetal macrosomia. Maternal diet, and particularly its carbohydrate (CHO) type and content, influences maternal blood glucose concentrations. However, different CHO foods produce different glycaemic responses. The GI was conceived by Jenkins in 1981 as a method for assessing the glycaemic responses of different CHO. Data from clinical studies in healthy pregnant women have documented that consuming a low-GI diet during pregnancy reduces peaks in postprandial glucose levels and normalises infant birth weight. Pregnancy is a physiological condition where the GI may be of particular relevance as glucose is the primary fuel for fetal growth.

  10. PERSISTENT LEFT SUPERIOR VENACAVA

    Directory of Open Access Journals (Sweden)

    Devinder Singh

    2014-05-01

    Full Text Available A Persistent Left Superior Venacava (PLSVC is the most common variation of the thoracic venous system and rare congenital vascular anomaly and is prevalent in 0.3% of the population. It may be associated with other cardiovascular abnormalities including atrial septal defect, bicuspid aortic valve, coarctation of aorta, coronary sinus ostial atresia, and cor triatriatum. Incidental rotation of a dilated coronary sinus on echocardiography should raise the suspicion of PLSVC. The diagnosis should be confirmed by saline contrast echocardiography. Condition is usually asymptomatic. Here we present a rare case of persistent left superior vena cava presented in OPD with dyspnoea & palpitations.

  11. Serum ferritin and glucose homeostasis: change in the association by glycaemic state.

    Science.gov (United States)

    Aregbesola, Alex; Virtanen, Jyrki K; Voutilainen, Sari; Mursu, Jaakko; Lagundoye, Ayodele; Kauhanen, Jussi; Tuomainen, Tomi-Pekka

    2015-07-01

    Data on the association between body iron and glucose homeostasis by the three glycaemic states are scarce. Thus, we investigated the association between body iron as assessed by a serum ferritin concentration and glucose homeostasis using homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR) and beta cell function (HOMA-BcF) in different glycaemic states. A cross-sectional analysis was conducted in 2541 men aged 42-60 years in 1984-1989 in the Kuopio Ischemic Heart Disease Risk Factor Study. Subjects were classified into the three glycaemic states, normoglycaemia, prediabetes and type 2 diabetes (T2D), by fasting plasma glucose measurements and the information collected at study visit. The association between serum ferritin quartiles and HOMA-IR and HOMA-BcF for each glycaemic state was examined by analysis of covariance and linear regression analysis. The mean age and serum ferritin concentrations were 53.1 years (standard deviation = 5.7, range = 42.0-61.3 years) and 166.2 µg/L (standard deviation = 141.7, range = 11-960 µg/L), respectively. After multivariable adjustments, a weak and direct association was observed between serum ferritin quartiles and HOMA-IR in normoglycaemia (P-trend = 0.001) but a direct association in prediabetes (P-trend = 0.007) and in T2D (P-trend = 0.078). In HOMA-BcF, the association was weak and direct in normoglycaemia (P-trend = 0.003), direct in prediabetes (P-trend = 0.005) and inverse in T2D (P-trend = 0.105). Strongest associations were observed in prediabetes (β = 0.25, 95% confidence interval = 0.14-0.36 and P = 0.004 in HOMA-IR; β = 0.23, 95% confidence interval = 0.15-0.31 and P = 0.008 in HOMA-BcF) after a 100-µg/L increase in serum ferritin (log-transformed). These data suggest that both the strength and the direction of the association between body iron stores and glucose homeostasis are dependent on the glycaemic state of the population

  12. Superior sulcus tumors (Pancoast tumors).

    Science.gov (United States)

    Marulli, Giuseppe; Battistella, Lucia; Mammana, Marco; Calabrese, Francesca; Rea, Federico

    2016-06-01

    Superior Sulcus Tumors, frequently termed as Pancoast tumors, are a wide range of tumors invading the apical chest wall. Due to its localization in the apex of the lung, with the potential invasion of the lower part of the brachial plexus, first ribs, vertebrae, subclavian vessels or stellate ganglion, the superior sulcus tumors cause characteristic symptoms, like arm or shoulder pain or Horner's syndrome. The management of superior sulcus tumors has dramatically evolved over the past 50 years. Originally deemed universally fatal, in 1956, Shaw and Paulson introduced a new treatment paradigm with combined radiotherapy and surgery ensuring 5-year survival of approximately 30%. During the 1990s, following the need to improve systemic as well as local control, a trimodality approach including induction concurrent chemoradiotherapy followed by surgical resection was introduced, reaching 5-year survival rates up to 44% and becoming the standard of care. Many efforts have been persecuted, also, to obtain higher complete resection rates using appropriate surgical approaches and involving multidisciplinary team including spine surgeon or vascular surgeon. Other potential treatment options are under consideration like prophylactic cranial irradiation or the addition of other chemotherapy agents or biologic agents to the trimodality approach.

  13. Is the lymph node ratio superior to the Union for International Cancer Control (UICC) TNM system in prognosis of colon cancer?

    OpenAIRE

    2013-01-01

    Background Decision making for adjuvant chemotherapy in stage III colon cancer is based on the TNM system. It is well known that prognosis worsens with higher pN classification, and several recent studies propose superiority of the lymph node ratio (ln ratio) to the TNM system. Therefore, we compared the prognosis of ln ratio to TNM system in our stage III colon cancer patients. Methods A total of 939 patients underwent radical surgery for colorectal cancer between January 2000 and December 2...

  14. Air Superiority Fighter Characteristics.

    Science.gov (United States)

    1998-06-05

    many a dispute could have been deflated into a single paragraph if the disputants had just dared to define their terms.7 Aristotle ...meaningful. This section will expand on some key ideology concepts. The phrase "air superiority fighter" may bring to mind visions of fighter... biographies are useful in garnering airpower advocate theories as well as identifying key characteristics. Air campaign results, starting with World

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

    Science.gov (United States)

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

    1995-03-01

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

  16. Estimation of glycaemic index of peach palm (Bactris gasipaes) cooked fruits and chips, and pitahaya (Hylocereus spp.) pulp.

    Science.gov (United States)

    Jiménez, Gin; Gómez, Georgina; Pérez, Ana M; Blanco-Metzler, Adriana

    2012-09-01

    The glycaemic index (GI) is a physiological measure of a food's potential to increase postprandial blood glucose, as compared to the effect produced by food taken as reference, such as glucose or white bread. Currently researchers and consumers are interested in low GI foods, since their consumption is associated with better weight control and reduced risk of incidence of chronic diseases, like diabetes. In the present study, the GI value for peach palm cooked fruit, peach palm chips and pitahaya pulp was estimated. The methodology established by the FAO/WHO for determining the GI of food was used. A total of 12 healthy, non-smoking volunteers were selected and they ingested the fore mentioned foods on different occasions, in 25 g portions of available carbohydrates, after 12-14 h overnight fast. Blood glucose levels were measured in 30 min intervals up to 120 min after ingestion. Average GI value was 48 +/- 11 for the pitahaya pulp and 35 +/- 6 for the peach palm cooked fruit, which may be classified as low glyceamic index foods. The GI of peach palm chips was 60 +/- 7, corresponding to a food with a moderate GI. The processing for producing the chips caused an increase in the GI value when compared to the cooked fruit, probably because the stages of miIling, moulding and baking promote availability of starch during hydrolysis by the digestive enzymes.

  17. Associations of dietary glycaemic index and glycaemic load with food and nutrient intake and general and central obesity in British adults.

    Science.gov (United States)

    Murakami, Kentaro; McCaffrey, Tracy A; Livingstone, M Barbara E

    2013-12-14

    Inconsistent associations between dietary glycaemic index (GI) and glycaemic load (GL) and body fatness may be partly due to differences in the underlying dietary patterns or energy under-reporting. In the present study, we examined the cross-sectional associations of dietary GI and GL with food and nutrient intake and general and central obesity, accounting for energy under-reporting. The subjects were 1487 British adults aged 19-64 years. Dietary intake was assessed using a 7 d weighed dietary record. Breads and potatoes were the positive predictive foods for dietary GI, while fruit, other cereals and dairy products were the negative predictors. These foods were similarly identified in the analysis of only acceptable reporters (AR; ratio of reported energy intake:estimated energy requirement within 0·665-1·335) and under-reporters (UR; ratio intake. Multiple linear regression analyses showed that dietary GI was independently associated with a higher risk of general obesity (BMI ≥ 30 kg/m²) and central obesity (waist circumference ≥ 102 cm in men and ≥ 88 cm in women). Dietary GL was also associated with general (only women) and central obesity. Similarly, in the analysis of AR, the GI showed positive associations with general and central obesity, and, only in women, the GL showed positive associations with general and central obesity. Conversely, in the analysis of UR, the associations were generally weaker and many of them failed to reach statistical significance. In conclusion, we found independent positive associations of dietary GI and GL with general and central obesity in British adults.

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

    Science.gov (United States)

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

    2014-02-01

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

  19. Contabilidad Financiera Superior

    OpenAIRE

    Ipiñazar Petralanda, Izaskun

    2013-01-01

    Duración (en horas): De 31 a 40 horas. Destinatario: Estudiante y Docente A través de este material se presentan las pautas necesarias para implementar un aprendizaje basado en problemas en la asignatura de Contabilidad Financiera Superior dentro de los temas “Constitución de S.A. y S.R.L.” (Tema 2), “Ampliaciones de Capital” (Tema 3) y “Reducciones de Capital” (Tema 4). En primer lugar se presentan las guías generales de la asignatura, y a continuación, las diferentes activida...

  20. Contabilidad Financiera Superior

    OpenAIRE

    Ipiñazar Petralanda, Izaskun

    2013-01-01

    Duración (en horas): De 31 a 40 horas. Destinatario: Estudiante y Docente A través de este material se presentan las pautas necesarias para implementar un aprendizaje basado en problemas en la asignatura de Contabilidad Financiera Superior dentro de los temas “Constitución de S.A. y S.R.L.” (Tema 2), “Ampliaciones de Capital” (Tema 3) y “Reducciones de Capital” (Tema 4). En primer lugar se presentan las guías generales de la asignatura, y a continuación, las diferentes activida...

  1. Influence of acute glycaemic level on measures of myocardial infarction in non-diabetic pigs

    DEFF Research Database (Denmark)

    Diemar, Sarah S; Sejling, Anne-Sophie; Iversen, Kasper K;

    2015-01-01

    OBJECTIVE: Patients with diabetes are at increased risk of experiencing myocardial infarction. The influence of the prevailing plasma glucose level on infarction and mortality after acute ischaemia is however unknown. The aim was to study the effect of the acute plasma glucose level on the myocar...... glycaemic level and measures of myocardial infarction, rates of ventricular fibrillation and subsequent premature death in the setting of acute ischaemia and reperfusion.......OBJECTIVE: Patients with diabetes are at increased risk of experiencing myocardial infarction. The influence of the prevailing plasma glucose level on infarction and mortality after acute ischaemia is however unknown. The aim was to study the effect of the acute plasma glucose level...

  2. Statistics of superior records

    Science.gov (United States)

    Ben-Naim, E.; Krapivsky, P. L.

    2013-08-01

    We study statistics of records in a sequence of random variables. These identical and independently distributed variables are drawn from the parent distribution ρ. The running record equals the maximum of all elements in the sequence up to a given point. We define a superior sequence as one where all running records are above the average record expected for the parent distribution ρ. We find that the fraction of superior sequences SN decays algebraically with sequence length N, SN˜N-β in the limit N→∞. Interestingly, the decay exponent β is nontrivial, being the root of an integral equation. For example, when ρ is a uniform distribution with compact support, we find β=0.450265. In general, the tail of the parent distribution governs the exponent β. We also consider the dual problem of inferior sequences, where all records are below average, and find that the fraction of inferior sequences IN decays algebraically, albeit with a different decay exponent, IN˜N-α. We use the above statistical measures to analyze earthquake data.

  3. Frenillo labial superior doble

    Directory of Open Access Journals (Sweden)

    Carlos Albornoz López del Castillo

    Full Text Available El frenillo labial superior doble no sindrómico es una anomalía del desarrollo que no hemos encontrado reportada en la revisión bibliográfica realizada. Se presenta una niña de 11 años de edad que fue remitida al servicio de Cirugía Maxilofacial del Hospital "Eduardo Agramonte Piña", de Camagüey, por presentar un frenillo labial superior doble de baja inserción. Se describen los síntomas clínicos asociados a esta anomalía y el tratamiento quirúrgico utilizado para su solución: una frenectomía y plastia sobre la banda muscular frénica anormal que provocaba exceso de tejido en la mucosa labial. Consideramos muy interesante la descripción de este caso, por no haber encontrado reporte similar en la literatura revisada.

  4. Discovery of a low-glycaemic index potato and relationship with starch digestion in vitro.

    Science.gov (United States)

    Ek, Kai Lin; Wang, Shujun; Copeland, Les; Brand-Miller, Jennie C

    2014-02-01

    Potatoes are usually a high-glycaemic index (GI) food. Finding a low-GI potato and developing a screening method for finding low-GI cultivars are both health and agricultural priorities. The aims of the present study were to screen the commonly used and newly introduced cultivars of potatoes, in a bid to discover a low-GI potato, and to describe the relationship between in vitro starch digestibility of cooked potatoes and their in vivo glycaemic response. According to International Standard Organisation (ISO) guidelines, seven different potato cultivars were tested for their GI. In vitro enzymatic starch hydrolysis and chemical analyses, including amylose content analysis, were carried out for each potato cultivar, and correlations with the respective GI values were sought. The potato cultivars had a wide range of GI values (53-103). The Carisma cultivar was classified as low GI and the Nicola cultivar (GI = 69) as medium GI and the other five cultivars were classified as high GI according to ISO guidelines. The GI values were strongly and positively correlated with the percentage of in vitro enzymatic hydrolysis of starch in the cooked potatoes, particularly with the hydrolysis percentage at 120 min (r 0·91 and P starch content was not correlated with either in vitro starch digestibility or GI. The findings suggest that low-GI potato cultivars can be identified by screening using a high-throughput in vitro digestion procedure, while chemical composition, including amylose and fibre content, is not indicative.

  5. Bioavailability of milk protein-derived bioactive peptides: a glycaemic management perspective.

    Science.gov (United States)

    Horner, Katy; Drummond, Elaine; Brennan, Lorraine

    2016-06-01

    Milk protein-derived peptides have been reported to have potential benefits for reducing the risk of type 2 diabetes. However, what the active components are and whether intact peptides exert this bioactivity has received little investigation in human subjects. Furthermore, potentially useful bioactive peptides can be limited by low bioavailability. Various peptides have been identified in the gastrointestinal tract and bloodstream after milk-protein ingestion, providing valuable insights into their potential bioavailability. However, these studies are currently limited and the structure and sequence of milk peptides exerting bioactivity for glycaemic management has received little investigation in human subjects. The present article reviews the bioavailability of milk protein-derived peptides in human studies to date, and examines the evidence on milk proteins and glycaemic management, including potential mechanisms of action. Areas in need of advancement are identified. Only by establishing the bioavailability of milk protein-derived peptides, the active components and the mechanistic pathways involved can the benefits of milk proteins for the prevention or management of type 2 diabetes be fully realised in future.

  6. Perceived Barriers to Application of Glycaemic Index: Valid Concerns or Lost in Translation?

    Directory of Open Access Journals (Sweden)

    Shannan M. Grant

    2011-02-01

    Full Text Available The term glycaemic-index (GI originally appeared in the literature in the early 1980s. GI categorizes carbohydrate according to glycaemic effect postprandially. Since its inception, GI has obtained and maintained interest of academics and clinicians globally. Upon review of GI literature, it becomes clear that the clinical utility of GI is a source of controversy. Can and should GI be applied clinically? There are academics and clinicians on both sides of the argument. Certainly, this controversy has been a stimulus for the evolution of GI methodology and application research, but may also negatively impact clinicians’ perception of GI if misunderstood. This article reviews two assessments of GI that are often listed as barriers to application; the GI concept is (1 too complex and (2 too difficult for clients to apply. The literature reviewed does not support the majority of purported barriers, but does indicate that there is a call from clinicians for more and improved GI education tools and clinician GI education. The literature indicates that the Registered Dietitian (RD can play a key role in GI knowledge translation; from research to application. Research is warranted to assess GI education tool and knowledge needs of clinicians and the clients they serve.

  7. Does a Low Glycaemic Index (GI Diet Cost More during Pregnancy?

    Directory of Open Access Journals (Sweden)

    Jennie Brand-Miller

    2012-11-01

    Full Text Available  The aim of this study was to examine the monetary cost of dietary change among pregnant women before and after receiving low glycaemic index (GI dietary advice. The pregnant women in this study were a subgroup of participants in the Pregnancy and Glycaemic Index Outcomes (PREGGIO study. Twenty women from the low GI dietary advice group, who had completed their pregnancies, were randomly chosen. All these women had completed three day food records at 12–16 weeks and again around 36 weeks of gestation. Consumer food prices were applied to recorded dietary intake data. The mean ± SD GI of the diet reduced from 55.1 ± 4.3 to 51.6 ± 3.9 (p = 0.003. The daily cost of the diet (AUD was 9.1 ± 2.7 at enrolment and 9.5 ± 2.1 prior to delivery was not significantly different (p = 0.52. There were also no significant differences in the daily energy intake (p = 0.2 or the daily cost per MJ (p = 0.16. Women were able to follow low GI dietary advice during pregnancy with no significant increase in the daily costs.

  8. Is the lymph node ratio superior to the Union for International Cancer Control (UICC) TNM system in prognosis of colon cancer?

    Science.gov (United States)

    Schiffmann, Leif; Eiken, Anne Karen; Gock, Michael; Klar, Ernst

    2013-03-23

    Decision making for adjuvant chemotherapy in stage III colon cancer is based on the TNM system. It is well known that prognosis worsens with higher pN classification, and several recent studies propose superiority of the lymph node ratio (ln ratio) to the TNM system. Therefore, we compared the prognosis of ln ratio to TNM system in our stage III colon cancer patients. A total of 939 patients underwent radical surgery for colorectal cancer between January 2000 and December 2009. From this pool of patients, 142 colon cancer stage III patients were identified and taken for this analysis. Using martingale residuals, this cohort could be separated into a group with a low ln ratio and one with a high ln ratio. These groups were compared to pN1 and pN2 of the TNM system. For ln ratio, the cutoff was calculated at 0.2. There was a good prognosis of disease-free and cancer-related survival for the N-category of the TNM system as well as for the lymph node ratio. There was no statistical difference between using the N-category of the TNM system and the ln ratio. There might not be a benefit in using the lymph node ratio rather than the N category of the TNM system as long as the number of subgroups is not increased. In our consideration, there is no need to change the N categorization of the TNM system to the ln ratio.

  9. Important differences in the durability of glycaemic response among second-line treatment options when added to metformin in type 2 diabetes: a retrospective cohort study.

    Science.gov (United States)

    Mamza, Jil; Mehta, Rajnikant; Donnelly, Richard; Idris, Iskandar

    2016-01-01

    There is limited information about the durability of glycaemic control when different oral glucose-lowering therapies (GLTs) are used as add-on treatments to metformin (MET) in patients with type 2 diabetes mellitus (T2DM). To compare time to treatment failure between different classes of oral GLT when used as second line (add-on) treatments to MET monotherapy at HbA1c ≥ 7.5%. A retrospective cohort study on 20,070 patients who were newly treated with a sulphonylurea (SU), dipeptidyl-peptidase-4 (DPP-4) inhibitor or thiazolidinedione (TZD) following MET therapy failure (2007-2014). Patients' data was sourced from UK General Practices via The Health Improvement Network (THIN) database. The risk of dual therapy failure was compared between three treatment groups: MET + SU (reference group, n = 15,508), MET + DPP-4 inhibitor (n = 3,080) and MET + TZD (n = 1,482). Follow-up was until treatment substitution or intensification with a 3rd GLT, or for up to 5 years (totalling 46,430 person-years). Propensity score weighting and Cox proportional hazard regression analyses were employed. Risk of dual therapy failure was compared between treatment groups while adjusting for baseline covariates. Unadjusted survival analysis showed the incidence of dual therapy failure at 1 year was 15% with SU, 23% with DPP-4 inhibitor and 8% with TZD. Corresponding failure rates at 2 years were 26, 38 and 12%, respectively. Adjusted multivariate models showed that, compared to the SU group, adding a DPP-4 inhibitor was associated with an increased risk of treatment failure (adjusted hazard ratio, aHR, 1.58; 95% CI: 1.48-1.68), while adding a TZD was associated with a reduced hazard (aHR, 0.45; 95% CI: 0.41-0.50). Baseline parameters associated with an increased hazard of intensification included HbA1c, diabetes duration, gender, smoking status and the use of statins. In routine clinical practice, adding a DPP-4 inhibitor to MET is associated with an increased

  10. Sobredentadura total superior implantosoportada

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  11. Bracing superior to neuromuscular training for the prevention of self-reported recurrent ankle sprains: a three-arm randomised controlled trial.

    Science.gov (United States)

    Janssen, Kasper W; van Mechelen, Willem; Verhagen, Evert A L M

    2014-08-01

    Ankle sprain is the most common sports-related injury with a high rate of recurrence and associated costs. Recent studies have emphasised the effectiveness of both neuromuscular training and bracing for the secondary prevention of ankle sprains. To evaluate the effectiveness of combined bracing and neuromuscular training, or bracing alone, against the use of neuromuscular training on recurrences of ankle sprain after usual care. 384 athletes, aged 18-70, who had sustained a lateral ankle sprain, were included (training group n=120; brace group n=126; combi group n=138). The training group received an 8-week home-based neuromuscular training programme, the brace group received a semirigid ankle brace to be worn during all sports activities for 12 months, and the combi group received both the training programme, as well as the ankle brace, to be worn during all sports activities for 8 weeks. The main outcome measure was self-reported recurrence of the ankle sprain. During the 1-year follow-up, 69 participants (20%) reported a recurrent ankle sprain: 29 (27%) in the training group, 17 (15%) in the brace group and 23 (19%) in the combi group. The relative risk for a recurrent ankle sprain in the brace group versus the training group was 0.53 (95% CI 0.29 to 0.97). No significant differences were found for time losses or costs due to ankle sprains between the intervention groups. Bracing was superior to neuromuscular training in reducing the incidence but not the severity of self-reported recurrent ankle sprains after usual care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. 通过创先争优活动更好地促进疾控工作%Better Promote Disease Prevention and Control Activities Through Creating and Struggling Activity in Superiorly First

    Institute of Scientific and Technical Information of China (English)

    黄钦; 黄文辉

    2014-01-01

    创先争优活动是实践科学发展观,扎实走群众路线的体现,通过创先争优活动可以更好地促进疾病控制工作。江西省的疾病预防控制工作近年来以快速、科学、和谐的势头稳步发展,与该省疾控中心深入贯彻科学发展观,落实深化医药卫生体制改革任务,创新工作机制,提升管理水平,积极深入开展创先争优活动密不可分。具体体现在疾控管理工作中,把以民为本当作根本,精细管理抓好各项工作,营造风清气正的工作氛围,形成和谐与发展良性互动。通过各种方式大力开展创先争优活动,进一步促进了党组织和广大党员更好地联系和服务群众,推动了疾控体系建设,加快了转变疾控发展方式,从而更好地服务公共卫生工作大局。%Creating and struggling activity in superiorly first can reflect practicing scientific concept of development and fol owing the mass line solidly, and bet er promote disease prevention and control job. Jiang xi province developed its disease prevention and control work steadily with rapid, scientific, harmonious momentum, which depended on that Jiangxi provincial center for disease prevention and control thoroughly implemented the scientific development concept, deepened medical and health system reform task, innovated work mechanism, enhanced the management level and developed creating and struggling activity in superiorly first. In disease management work Jiangxi provincial center for disease prevention and control taked the people as foundation, finely managed al kinds of jobs, create a fair working atmosphere and promote positive interaction between harmony and development. Through development of creating and struggling activity in superiorly first, it promoted party organizations and members bet er contacting and serving the masses, promoting the construction of disease control system, speeding up the transformation of development

  13. Identification of those most likely to benefit from a low-glycaemic index dietary intervention in pregnancy.

    LENUS (Irish Health Repository)

    Walsh, Jennifer M

    2014-08-28

    The present study is a secondary analysis of the ROLO study, a randomised control trial of a low-glycaemic index (GI) diet in pregnancy to prevent the recurrence of fetal macrosomia. The objectives of the present study were to identify which women are most likely to respond to a low-GI dietary intervention in pregnancy with respect to three outcome measures: birth weight; maternal glucose intolerance; gestational weight gain (GWG). In early pregnancy, 372 women had their mid-upper arm circumference recorded and BMI calculated. Concentrations of glucose, insulin and leptin were measured in early pregnancy and at 28 weeks. At delivery, infant birth weight was recorded and fetal glucose, C-peptide and leptin concentrations were measured in the cord blood. Women who benefited in terms of infant birth weight were shorter, with a lower education level. Those who maintained weight gain within the GWG guidelines were less overweight in both their first and second pregnancies, with no difference being observed in maternal height. Women who at 28 weeks of gestation developed glucose intolerance, despite the low-GI diet, had a higher BMI and higher glucose concentrations in early pregnancy with more insulin resistance. They also had significantly higher-interval pregnancy weight gain. For each analysis, women who responded to the intervention had lower leptin concentrations in early pregnancy than those who did not. These findings suggest that the maternal metabolic environment in early pregnancy is important in determining later risks of excessive weight gain and metabolic disturbance, whereas birth weight is mediated more by genetic factors. It highlights key areas, which warrant further interrogation before future pregnancy intervention studies, in particular, maternal education level and inter-pregnancy weight gain.

  14. Remote-controlled magnetic pulmonary vein isolation combined with superior vena cava isolation for paroxysmal atrial fibrillation: a prospective randomized study.

    Science.gov (United States)

    Da Costa, Antoine; Levallois, Marie; Romeyer-Bouchard, Cécile; Bisch, Laurence; Gate-Martinet, Alexis; Isaaz, Karl

    2015-03-01

    Radiofrequency ablation (RFA) of paroxysmal atrial fibrillation (PAF) has focused on pulmonary vein isolation (PVI). However, despite initial positive results, significant recurrences have occurred, partly because of pulmonary vein (PV) reconnection or non-PV ectopic foci, including the superior vena cava (SVC). This prospective, randomized study sought to investigate the efficacy of additional SVCI combined with PVI in symptomatic PAF patients referred for ablation. From November 2011 to May 2013, RFA was performed remotely using a CARTO(®) 3 System in patients randomized to undergo PVI for symptomatic drug-refractory PAF, with (PVI+SVCI group) or without (PVI alone group) SVCI. PVI and SVCI were confirmed by spiral catheter recording during ablation. Procedural data, complications and freedom from atrial tachycardia (AT) and atrial fibrillation (AF) were assessed. Over an 18-month period, 100 consecutive patients (56±9years; 17 women) with symptomatic PAF were included in the study (PVI+SVCI, n=51; PVI, n=49); the CHA2DS2-VASc score was 0.9±1. Median duration of procedure (±interquartile), 2.5±1hours; total X-ray exposure, 13.3±8minutes; transseptal puncture and catheter positioning, 8±5minutes; left atrium electroanatomical reconstruction, 3±2minutes; and catheter ablation, 3.7±3minutes. After a median follow-up of 15±8months, and having undergone a single procedure, 84% of patients were symptom free, while 86% remained asymptomatic after undergoing two procedures. The cumulative risks of atrial arrhythmias (AT or AF) were interpreted using Kaplan-Meier curves and compared using the log-rank test. Long-term follow-up revealed no significant difference between groups, with atrial arrhythmias occurring in six (12%) patients in the PVI+SVCI group and nine (18%) patients in the PVI alone group (P=0.6). One transient phrenic nerve palsy and one phrenic nerve injury with partial recovery occurred in the PVI+SVCI group. SVCI combined with PVI did not reduce

  15. Technological Superiority and Application of Real-Time Control Die Casting Machine%实时控制压铸机的技术优势及应用*

    Institute of Scientific and Technical Information of China (English)

    张新华; 孔晓武

    2013-01-01

    This article introduces the development of die casting machine controlling theory, concept and feature of die casting machine embedded real time operating system,with drawing conclusions that contain electro-hydraulic schematic diagram for die casting machine injection system, configuration scheme of embedded real time controlling, analysis of real time control curve and comparison with traditional controlling technique. The real time control die casting machine which referred in this article has been to the stage of application,and won quite considerable market share and high praise.%介绍了压铸机控制理论的发展和压铸机嵌入式实时控制技术的概念及其特点优势,给出了压铸机压射系统的电液原理图,嵌入式实时控制的配置方案,实时控制曲线的分析及与传统控制技术的对比。介绍的实时控制压铸机已经进入应用环节,并取得了较大的市场份额和较好的评价。

  16. Are newer, more expensive pharmacotherapy options associated with superior symptom control compared to less costly agents used in a collaborative practice setting?

    Science.gov (United States)

    Weschules, Douglas J; Maxwell, Terri; Reifsnyder, JoAnne; Knowlton, Calvin H

    2006-01-01

    previous value documented. A partial response was defined as any improvement in score that did not result in a 0 of 10. No improvement from baseline reflected a lack of overall change in score throughout the series of data points collected. A worsened response was any score found to be higher than the score documented at the time of dispense. The unknown category reflects any set of scores that had an "N/A " documented at the time of medication dispense or when documented for both attempts subsequent to dispensing the medication. A complete response was present in 14 of 50 (28 [corrected] percent) of the patients prescribed oral therapy [corrected] as compared with 12 of 50 (24 [corrected] percent) of those prescribed fentanyl [corrected] (p = .82). Responses defined as partial, no improvement over baseline, worsened, and unknown were also comparable between the two cohorts. A complete response was seen in 26 patients prescribed temazepam (52 percent), whereas only 11 (22 percent) of patients initially prescribed zolpidem achieved the same response (p = .0037). Both groups had a similar distribution of partial, no improvement over baseline, and worsened responses. For the nausea arm of the study, a difference was found in the number of complete responses, favoring prochlorperazine (22 of 45, 48.9 percent for prochlorperazine, 12 of 45, 26.7 percent for ondansetron, p = .0504), as well as an increased number of worse responses seen with ondansetron patients (p = .0513); however, neither difference was statistically significant. Newer pharmacotherapy options for the management of pain, insomnia, and nausea were not found to be superior when compared to older agents prescribed under CP.

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

    Science.gov (United States)

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

    2015-06-01

    The aim of this study was to evaluate the knowledge about GDM and its corresponding relation with glycaemic level in GDM patients. A cross-sectional study was conducted in antenatal clinic of Hospital Pulau Pinang, Malaysia from June 2013 to December 2013 using Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) on the sample of 175 GDM patients. Three most recent fasting plasma glucose (FPG) values (mmol/l) were taken from patients profiles and mean was calculated. A total of 166 patients were included in final analysis. A total mean knowledge score of 166 patients was 10.01±3.63 and total mean FPG value was 5.50±1.13. Knowledge had a significant negative association with FPG (r=- 0.306, Pliteracy. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  18. Glycaemic effects of bread and marmalade in insulin-dependent diabetes.

    Science.gov (United States)

    Lean, M E; Tennison, B R; Williams, D R

    1985-03-01

    The glycaemic responses of 12 C-peptide negative insulin-dependent diabetics were studied following four breakfasts with different carbohydrate sources. Total energy content of the meals was the usual for each subject, carbohydrate supplying 55% and fat 32%. The meals comprised: wholemeal bread with margarine; white bread with margarine; marmalade made with sucrose, and cheddar cheese; and marmalade (22% of total energy) on wholemeal bread with margarine. The study demonstrated powerfully that there were no statistically significant or clinically relevant differences between the meals in post-prandial glucose peak elevation, or in incremental area under the blood glucose curve to 120 mins. On these grounds, sucrose, in amounts considered acceptable to the general population, need not be prohibited from diabetic diets.

  19. Yellow mustard bran attenuates glycaemic response of a semi-solid food in young healthy men.

    Science.gov (United States)

    Lett, Aron M; Thondre, Pariyarath S; Rosenthal, Andrew J

    2013-03-01

    In a randomized, repeated-measures design, the glycaemic response and satiety ratings of a potato and leek soup were compared with and without the addition of 5 g of yellow mustard bran. Ten healthy, non-smoking, moderately active male subjects (mean age of 21.1 years and mean body mass index 23.2 kg/m(2)) were recruited to the study. Capillary blood glucose and satiety were measured at 0, 15, 30, 45, 60, 90 and 120 min, postprandial of each food. The incremental area under the blood glucose curve, blood glucose at each time point and satiety rating were calculated and compared via paired t-test. Mean blood glucose values at 15, 30 and 90 min (p soup.

  20. A low glycaemic index breakfast cereal preferentially prevents children's cognitive performance from declining throughout the morning.

    Science.gov (United States)

    Ingwersen, Jeanet; Defeyter, Margaret Anne; Kennedy, David O; Wesnes, Keith A; Scholey, Andrew B

    2007-07-01

    This study investigated whether the glycaemic index (GI) of breakfast cereal differentially affects children's attention and memory. Using a balanced cross-over design, on two consecutive mornings 64 children aged 6-11 years were given a high GI cereal and a low GI cereal in a counterbalanced order. They performed a series of computerised tests of attention and memory, once prior to breakfast and three times following breakfast at hourly intervals. The results indicate that children's performance declines throughout the morning and that this decline can be significantly reduced following the intake of a low GI cereal as compared with a high GI cereal on measures of accuracy of attention (M=-6.742 and -13.510, respectively, p<0.05) and secondary memory (M=-30.675 and -47.183, respectively, p<0.05).

  1. Demands on response inhibition processes determine modulations of theta band activity in superior frontal areas and correlations with pupillometry - Implications for the norepinephrine system during inhibitory control.

    Science.gov (United States)

    Dippel, Gabriel; Mückschel, Moritz; Ziemssen, Tjalf; Beste, Christian

    2017-08-15

    Response inhibition processes are important for goal-directed behavior and particularly demanded when it is unlikely to inhibit automatically executed responses. It has been suggested that the norepinephrine (NE) system is important to consider for such likelihood effects. As an indirect measure of the NE system activity we used the pupil diameter and integrated this data with neurophysiological (EEG) data and beamforming analyses. The study shows that inhibitory control processes reflected by theta oscillations are strongly modulated by the likelihood to employ these processes and that these mechanisms were related to neural processes in the SMA and SFG. Probably, the modulations observed for theta band activity may reflect modulations in the encoding of a surprise, or conflict signal. Interestingly, correlation analyses of neuronal activity at the sensor and the source level with pupil diameter data revealed strong correlations that were only seen in the condition where inhibitory control processes were rarely demanded. On the basis of findings and theoretical models suggesting that the pupil diameter can be interpreted as a proximate of NE system activity the results may be interpreted that the NE system modulates inhibitory control processes via theta band activity in the SFB when the likelihood to inhibit a prepotent response tendency is low. From this it may be speculated that the NE system dynamically gains and loses relevance to modulate inhibitory control depending on boundary conditions that determine the mode of responding. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Glycaemic index (GI) of an Indian branded thermally treated basmati rice variety: a multi centric study.

    Science.gov (United States)

    Srinivasa, Dinesh; Raman, Abhi; Meena, P; Chitale, Geetanjali; Marwahat, Ankita; Jainani, Kiran J

    2013-10-01

    Glycaemic Index (GI) is the classification of carbohydrates based on their ability to raise blood glucose levels and evidence shows that its usage has beneficial health implications. Rice forms a part of the Indian staple diet and one of the major energy contributors. Hence, it is important to establish the Glycaemic Index (GI) value of rice. However, due to availability of different varieties of rice it is important first to identify a lower GI variety and to make it available to the Indian population. Subjecting rice to thermal processing is also known to reduce the GI of rice. An Indian thermally treated basmati rice variety was hypothesised to be low in GI. This multi centric study was conducted to test this hypothesis in healthy volunteers. In this study, out of 83 participants, data points of 70 healthy volunteers were taken into consideration for arriving at the final GI value. The study procedure was similar to the recommendations by FAO/WHO. A multi centric trial was conducted to nullify any regional or genetic variability. It was observed that reference glucose curve had the maximum average peak of 166.37 mg/dL while the basmati sample had a lower peak (136.22 mg/dL). The mean blood glucose incremental area under the curve for reference food was 5969.64 mins.mg/dL (SEM 95.94) and for rice it was 3267.81 mins. mg/dL (SEM 76.21). In this studyThe GI of Indian branded basmati rice was found to GI category. The Indian basmati rice because of its lower GI can prove to be a healthier rice alternative.

  3. Synchronous BRAFV600E and MEK inhibition leads to superior control of murine melanoma by limiting MEK inhibitor induced skin toxicity

    Directory of Open Access Journals (Sweden)

    Gadiot J

    2013-11-01

    Full Text Available Jules Gadiot,1,* Anna I Hooijkaas,1,* Marcel A Deken,1 Christian U Blank1,21Department of Immunology, 2Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands* These authors contributed equally to this workAbstract: The BRAF inhibitor (BRAFi treatment has led to impressive responses in BRAFV600E mutation-positive melanomas, but responses are not durable in many patients. As most of the BRAFi escape mechanisms involve ERK reactivation, combinations with MEK inhibitors (MEKi are currently tested to improve BRAFi-mediated response durations. Additionally, such a combination is expected to reduce MEKi-induced skin toxicities, as these drugs are thought to have antagonistic effects on ERK activation in keratinocytes. However, preclinical in vivo data exploring the combination of BRAFi and MEKi to achieve improved tumor control in the absence of skin toxicities are limited. Using a murine Tyr::CreERT2;PtenLoxP/LoxP;BrafCA/+ melanoma model, we have determined the effect of BRAFi and MEKi treatment and their combination on melanoma control and occurrence of adverse events. We found that the MEKi dosed beyond the maximum tolerable dose (MTD led to stronger control of tumor growth than did the BRAFi, but mice had to be removed from treatment because of skin toxicity. The combination of BRAFi and MEKi reduced MEKi-associated skin toxicity. This allowed high and long-term dosing of the MEKi, resulting in long-term tumor control. In contrast to previous hypotheses, the addition of a BRAFi did not restore the MEKi-mediated downregulation of pErk1/2 in skin cells. Our data describe, for the first time, the alleviation of MEKi-mediated dose-limiting toxicity by addition of a BRAFi in a mouse melanoma model. Additional clinical Phase I studies should be implemented to explore MEKi dosing beyond the single drug MTD in combination with BRAFi.Keywords: melanoma, BRAF, MEK, skin toxicity, vemurafenib, trametinib

  4. Dispositivos de control físicos para la interacción con contenidos virtuales para neurorrehabilitación funcional de la extremidad superior

    OpenAIRE

    Ontiveros Ravell, J.; Almenara, M.; Molina Nájera, Fernando; Villán Villán, M.A.; Soriano, I.; Molleja, C.; Opisso, Eloy; Medina Casanovas, J.; Tormos Muñoz, José M.; Gómez Aguilera, Enrique J.

    2015-01-01

    La utilización de entornos y contenidos virtuales interactivos de rehabilitación han adquirido un gran interés en el área de neurorrehabilitación. El objetivo del presente trabajo es diseñar y desarrollar dispositivos de control específicos para la interacción con contenidos virtuales de rehabilitación de pacientes con Daño Cerebral Adquirido. Los dispositivos desarrollados en este trabajo han sido diseñados expresamente para servir de mecanismo de interacción en 2 contenidos virtuales de neu...

  5. Pancreaticogastrostomy is superior to pancreaticojejunostomy for prevention of pancreatic fistula after pancreaticoduodenectomy: an updated meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Menahem, Benjamin; Guittet, Lydia; Mulliri, Andrea; Alves, Arnaud; Lubrano, Jean

    2015-05-01

    To review prospective randomized controlled trials to determine whether pancreaticogastrostomy (PG) or pancreaticojejunostomy (PJ) is associated with lower risks of mortality and pancreatic fistula after pancreaticoduodenectomy (PD). Previous studies comparing reconstruction by PG and PJ reported conflicting results regarding the relative risks of mortality and pancreatic fistula after these procedures. MEDLINE, the Cochrane Trials Register, and EMBASE were searched for prospective randomized controlled trials comparing PG and PJ after PD, published up to November 2013. Meta-analysis was performed using Review Manager 5.0. Seven trials were selected, including 562 patients who underwent PG and 559 who underwent PJ. The pancreatic fistula rate was significantly lower in the PG group than in the PJ group (63/562, 11.2% vs 84/559, 18.7%; odds ratio = 0.53; 95% confidence interval, 0.38-0.75; P = 0.0003). The overall mortality rate was 3.7% (18/489) in the PG group and 3.9% (19/487) in the PJ group (P = 0.68). The biliary fistula rate was significantly lower in the PG group than in the PJ group (8/400, 2.0% vs 19/392, 4.8%; odds ratio = 0.42; 95% confidence interval, 0.18-0.93; P = 0.03). In PD, reconstruction by PG is associated with lower postoperative pancreatic and biliary fistula rates.

  6. Glycaemic control in patients with type 2 diabetes treated with oral antidiabetic drugs in urban areas of China%中国城市地区口服降糖药治疗的2型糖尿病患者血糖控制达标现状

    Institute of Scientific and Technical Information of China (English)

    陆菊明; 柳洁; 单忠艳; 杨玉芝; 胡仁明; 朱大龙; 杨立勇; 陈丽; 赵志刚; 李启富; 田浩明; 纪立农; 姬秋和; 刘静; 葛家璞; 时立新; 徐焱成; 郭晓蕙; 杨文英; 翁建平; 贾伟平; 邹大进; 周智广; 于德民

    2012-01-01

    目的 了解中国城市地区口服降糖药治疗的2型糖尿病(T2DM)患者的口服药治疗模式、血糖控制达标率及相关因素.方法 2010年7月至9月在全国30个省级行政区81个城市的414家医院,入选目前接受单纯口服降糖药治疗的门诊T2DM患者,收集患者的一般资料、糖尿病病史、实验室检查结果及治疗方案,以了解中国城市地区口服降糖药治疗的T2DM患者的口服药治疗模式、血糖控制达标率及相关因素.血糖达标的相关性分析采用逻辑回归模型分析.结果 共纳入97 315例T2DM患者,平均年龄(59±11)岁,病程(5±4)年,糖化血红蛋白(HbA1c)为7.7%±1.6%,HbA1c< 7.0%者34 154例(35.1%),HbA1c<6.5%者17 380例(17.9%).调查患者中12 748例(13.1%)合并有至少1种大血管病变,14 694例(15.1%)合并有至少1种微血管病变,合并有大或微血管并发症的患者血糖达标率分别为27.3%和25.2%,均低于未合并血管并发症组的36.3%和36.9%.口服药治疗方案中,双药(51.3%)、单药(34.5%)治疗较为常见,在单药、双药、3种药物和4种及以上药物联合治疗患者中,血糖达标率分别为40.6%、33.7%、27.0%和24.5%;单药治疗中,应用较多的为双胍类(30.8%)、磺脲类(24.6%)和格列奈类(21.1%);联合治疗中双胍类联合磺脲类者为23.7%,双胍类联合格列奈类者为13.6%.回归分析显示男性、糖尿病病程、口服药物种类数、体质指数、大血管病变、微血管病变与HbA1c达标率均呈显著负相关(OR=1.025、0.855、0.868、0.852、0.789、0.698,均P<0.01).结论 在中国应用口服药的T2DM患者中血糖控制达标率低,应进一步加强糖尿病管理,及时改变治疗方案,有效改善患者血糖控制状况.%Objective To investigate glycemic control,treatment regimen and other relevant characteristics in patients with type 2 diabetes mellitus( T2DM ) treated with oral antidiabetic drugs (OADs

  7. The use of dry Jerusalem artichoke as a functional nutrient in developing extruded food with low glycaemic index.

    Science.gov (United States)

    Radovanovic, Ana; Stojceska, Valentina; Plunkett, Andrew; Jankovic, Slobodan; Milovanovic, Dragan; Cupara, Snezana

    2015-06-15

    This study considers the use of dry Jerusalem artichoke (JA) as a functional nutrient in developing food products with enhanced nutritional characteristics and low glycaemic index (GI). Three different formulations based on buckwheat and JA were developed and processed using extrusion technology. Nutritional properties including the levels of total dietary fibre (TDF), protein, inulin, total carbohydrates and lipids were analysed. A clinical study was performed on ten healthy volunteers (aged between 21 and 56) to determine the level of GI and glycaemic load (GL). The results revealed that JA significantly (Pfood and extruded products, GI and GL. Samples containing 80% of Jerusalem artichoke were considered as a low GI food whilst samples containing 30% and 60% of Jerusalem artichoke as a medium GI food. A similar trend was seen in terms of GL.

  8. Glycaemic responses to different types of bread in insulin-dependent diabetic subjects (IDDM): studies at constant insulinaemia.

    Science.gov (United States)

    Rasmussen, O; Winther, E; Hermansen, K

    1991-02-01

    To study the glycaemic effect of various Danish bread types in insulin-dependent diabetic subjects (IDDM) we looked at the incremental blood glucose areas after isocaloric meals of grained wholemeal rye bread, wholemeal bread (graham bread) and white bread in seven C-peptide negative diabetic subjects. Furthermore, we evaluated the glycaemic potency of dried fruits by exchanging 40 per cent of the starch of grained wholemeal rye bread as dried figs. Prior to the meal intake the patients had attained normoglycaemia and isoinsulinaemia by means of the artificial pancreas. The four test meals containing 50 g of available carbohydrate were taken in random order. The postprandial blood glucose response areas after whole-meal bread (1037 +/- 113 mM X 180 min) and white bread (1021 +/- 100 mM X 180 min) were significantly higher than that to grained wholemeal rye bread (786 +/- 66 mM X 180 min, P less than 0.05). Exchange of 40 per cent of the complex carbohydrate as grained wholemeal rye bread with simple sugars, such as figs, had no influence on the blood glucose response (786 +/- 66 mM X 180 min vs. 766 +/- 56 mM X 180 min). Constant and identical serum-free insulin levels at 30 mU/l and similar amounts of glucose lost in the urine were found after the four test meals. In conclusion, the difference in extraction rate of wheat in the form of white flour (0, 7) and wholemeal flour (1, 0) was not reflected in the glycaemic responses in IDDM subjects. Grained wholemeal rye bread is a fibre-rich, cheap nutrient which elicits a significantly lower glycaemic response compared to wholemeal and white bread and can be recommended to diabetic subjects.

  9. Blood profiling of proteins and steroids during weight maintenance with manipulation of dietary protein level and glycaemic index

    DEFF Research Database (Denmark)

    Wang, Ping; Holst, Claus; Astrup, Arne

    2012-01-01

    Weight regain after weight loss is common. In the Diogenes dietary intervention study, a high-protein and low-glycaemic index (GI) diet improved weight maintenance. The objective of the present study was to identify (1) blood profiles associated with continued weight loss and weight regain (2) bl...... differences between continued weight losers and weight regainers. Increases in leptin (LEP) and C-reactive protein (CRP) were significantly associated with weight regain (P ...

  10. T'ain't what you say, it's the way that you say it--left insula and inferior frontal cortex work in interaction with superior temporal regions to control the performance of vocal impersonations.

    Science.gov (United States)

    McGettigan, Carolyn; Eisner, Frank; Agnew, Zarinah K; Manly, Tom; Wisbey, Duncan; Scott, Sophie K

    2013-11-01

    Historically, the study of human identity perception has focused on faces, but the voice is also central to our expressions and experiences of identity [Belin, P., Fecteau, S., & Bedard, C. Thinking the voice: Neural correlates of voice perception. Trends in Cognitive Sciences, 8, 129-135, 2004]. Our voices are highly flexible and dynamic; talkers speak differently, depending on their health, emotional state, and the social setting, as well as extrinsic factors such as background noise. However, to date, there have been no studies of the neural correlates of identity modulation in speech production. In the current fMRI experiment, we measured the neural activity supporting controlled voice change in adult participants performing spoken impressions. We reveal that deliberate modulation of vocal identity recruits the left anterior insula and inferior frontal gyrus, supporting the planning of novel articulations. Bilateral sites in posterior superior temporal/inferior parietal cortex and a region in right middle/anterior STS showed greater responses during the emulation of specific vocal identities than for impressions of generic accents. Using functional connectivity analyses, we describe roles for these three sites in their interactions with the brain regions supporting speech planning and production. Our findings mark a significant step toward understanding the neural control of vocal identity, with wider implications for the cognitive control of voluntary motor acts.

  11. Serum fructosamine and glycated haemoglobin measurements in diabetic control.

    Science.gov (United States)

    Hindle, E J; Rostron, G M; Clark, S A; Gatt, J A

    1986-01-01

    Serum fructosamine and glycated haemoglobin (HbA1) were measured in capillary samples from diabetic children and compared with samples from non-diabetic children. Glycaemic control was assessed clinically and by average daily glucose values recorded by home monitoring. Fructosamine correlated with HbA1 and with average glucose values measured over 30 days. HbA1 also correlated with average glucose values measured over 60 days. Changes in fructosamine with time tended to parallel those of HbA1, and advance indication of deteriorating or improving glycaemic control was possible by observing changes in these. Fructosamine has many advantages over HbA1 measurement such as speed, technical ease, and low cost, and is a reliable alternative to HbA1 estimation as an indication of glycaemic control. PMID:3954436

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

    DEFF Research Database (Denmark)

    Sørensen, V R; Mathiesen, E R; Clausen, P

    2005-01-01

    in Type 1 diabetic patients may disturb vascular function, possibly mediated through smooth muscle cell dysfunction as well as endothelial dysfunction. We suggest that prolonged and repeated episodes of hyperglycaemia could possibly lead to permanent vascular dysfunction and thereby development...

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    Aims To test whether patients with Type 1 diabetes would join support groups and benefit by improving psychosocial functioning, regardless of their HbA1c levels. Methods A pre-post test with follow-up after 6 and 12 months was conducted as a concurrent mixed-method study. The convenience sample...

  14. Improved glycaemic control decreases inner mitochondrial membrane leak in type 2 diabetes

    DEFF Research Database (Denmark)

    Rabøl, R; Højberg, P M V; Almdal, T;

    2009-01-01

    AIM: Several mechanisms have been targeted as culprits of weight gain during antihyperglycaemic treatment in type 2 diabetes (T2DM). These include reductions in glucosuria, increased food intake from fear of hypoglycaemia, the anabolic effect of insulin, decreased metabolic rate and increased...... efficiency in fuel usage. The purpose of the study was to test the hypothesis that mitochondrial efficiency increases as a result of insulin treatment in patients with type 2 diabetes. METHODS: We included ten patients with T2DM (eight males) on oral antidiabetic treatment, median age: 51.5 years (range: 39......-67) and body mass index (BMI): 30.1 +/- 1.2 kg/m2 (mean +/- s.e.). Muscle biopsies from m. vastus lateralis and m. deltoideus were obtained before and after seven weeks of intensive insulin treatment, and mitochondrial respiration was measured using high-resolution respirometry. State 3 respiration...

  15. Exercise-stimulated glucose uptake - regulation and implications for glycaemic control

    DEFF Research Database (Denmark)

    Sylow, Lykke; Kleinert, Maximilian; Richter, Erik

    2017-01-01

    -resistant muscle, emphasizing exercise as a therapeutic cornerstone among patients with metabolic diseases such as diabetes mellitus. Exercise increases uptake of glucose by up to 50-fold through the simultaneous stimulation of three key steps: delivery, transport across the muscle membrane and intracellular flux...... energy supply during physical activity. Here, we review the molecular mechanisms that regulate the movement of glucose from the capillary bed into the muscle cell and discuss what is known about their integrated regulation during exercise. Novel developments within the field of mass spectrometry...

  16. Investigating Endothelial Activation and Oxidative Stress in relation to Glycaemic Control in a Multiethnic Population

    Directory of Open Access Journals (Sweden)

    E. M. Brady

    2012-01-01

    Full Text Available Aim. An exploration of ethnic differences in measures of oxidative stress and endothelial activation in relation to known cardiovascular risk factors within South Asians (SA and White Europeans (WE residing in the UK. Methods. 202 participants within a UK multiethnic population provided biomedical and anthropometric data. Human urinary 2,3-dinor-8-iso-prostaglandin-F1α and plasma ICAM-1 were quantified as measures of oxidative stress and endothelial activation, respectively. Results. 2,3-Dinor-8-iso-prostaglandin-F1α levels were significantly higher in the SA group compared to WE group (10.36 (95% CI: 9.09, 11.79 versus 8.46 (7.71, 9.29, P=0.021 after adjustment for age, gender, smoking status, body weight, HbA1c, and medication. Oxidative stress was positively associated with HbA1c (β=1.08, 95% CI:1.02, 1.14, P=0.009, fasting (β=1.06, 95% CI: 1.02, 1.10, P=0.002, and 2 hr glucose (β=1.02, 95% CI: 1.00, 1.04, P=0.052. In each adjusted model, SA continued to have elevated levels of oxidative stress compared to WE. ICAM-1 levels were significantly higher in the composite IGR group compared to the normoglycaemic group (P<0.001. No ethnic differences in ICAM-1 were observed. Conclusion. These results suggest that SA are more susceptible to the detrimental effects of hyperglycaemia-induced oxidative stress at lower blood glucose thresholds than WE. Further research into the potential mechanisms involved is warranted.

  17. Investigating Endothelial Activation and Oxidative Stress in relation to Glycaemic Control in a Multiethnic Population

    Science.gov (United States)

    Brady, E. M.; Webb, D. R.; Morris, D. H.; Khunti, K.; Talbot, D. S. C.; Sattar, N.; Davies, M. J.

    2012-01-01

    Aim. An exploration of ethnic differences in measures of oxidative stress and endothelial activation in relation to known cardiovascular risk factors within South Asians (SA) and White Europeans (WE) residing in the UK. Methods. 202 participants within a UK multiethnic population provided biomedical and anthropometric data. Human urinary 2,3-dinor-8-iso-prostaglandin-F1α and plasma ICAM-1 were quantified as measures of oxidative stress and endothelial activation, respectively. Results. 2,3-Dinor-8-iso-prostaglandin-F1α levels were significantly higher in the SA group compared to WE group (10.36 (95% CI: 9.09, 11.79) versus 8.46 (7.71, 9.29), P = 0.021) after adjustment for age, gender, smoking status, body weight, HbA1c, and medication. Oxidative stress was positively associated with HbA1c (β = 1.08, 95% CI:1.02, 1.14, P = 0.009), fasting (β = 1.06, 95% CI: 1.02, 1.10, P = 0.002), and 2 hr glucose (β = 1.02, 95% CI: 1.00, 1.04, P = 0.052). In each adjusted model, SA continued to have elevated levels of oxidative stress compared to WE. ICAM-1 levels were significantly higher in the composite IGR group compared to the normoglycaemic group (P < 0.001). No ethnic differences in ICAM-1 were observed. Conclusion. These results suggest that SA are more susceptible to the detrimental effects of hyperglycaemia-induced oxidative stress at lower blood glucose thresholds than WE. Further research into the potential mechanisms involved is warranted. PMID:23304116

  18. Rosiglitazone use and post-discontinuation glycaemic control in two European countries, 2000-2010

    DEFF Research Database (Denmark)

    Ehrenstein, V; Hernandez, R K; Ulrichsen, Sinna Pilgaard

    2013-01-01

    ) in northern Denmark and from the General Practice Research Database (GPRD) in the UK. MAIN OUTCOME MEASURES: We examined the use of rosiglitazone during its entire period of availability on the European market (2000-2010) and evaluated changes in the glycated haemoglobin (HbA1c) and fasting plasma glucose...

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    included patients with Type 1 diabetes aged ≥ 21 years, having been diagnosed ≥ 1 year earlier. Primary outcome was diabetes-related distress (using the Problem Areas in Diabetes scale). Secondary outcomes were psychological distress and depressive symptoms (Symptom Check List -90-R/Global Severity Index...

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    included patients with Type 1 diabetes aged = 21 years, having been diagnosed = 1 year earlier. Primary outcome was diabetes-related distress (using the Problem Areas in Diabetes scale). Secondary outcomes were psychological distress and depressive symptoms (Symptom Check List -90-R/Global Severity Index...

  1. Is poor glycaemic control in diabetic patients a risk factor of myopia?

    DEFF Research Database (Denmark)

    Jacobsen, N.; Jensen, H.; Lund-Andersen, H.

    2008-01-01

    haemoglobin (HbA(1c)), insulin dosage and myopia in diabetic patients. Methods: All type 1 diabetic patients aged 16-26 years [mean age 22.0, standard deviation (SD) 2.9] attending the eye clinic at Steno Diabetes Center, Copenhagen, in 1995-1997 were included in the study (n = 393). The following data were...... collected from the medical records from baseline to 2005: age at diabetes onset, age at baseline, sex, weight, HbA(1c), insulin dosage, refractive error, visual acuity and ocular diabetes complications. Results: The prevalence of myopia [spherical equivalent (SE)

  2. Dietary cystine level affects metabolic rate and glycaemic control in adult mice.

    Science.gov (United States)

    Elshorbagy, Amany K; Church, Chris; Valdivia-Garcia, Maria; Smith, A David; Refsum, Helga; Cox, Roger

    2012-04-01

    Plasma total cysteine (tCys) is strongly and independently associated with obesity in large human cohorts, but whether the association is causal is unknown. Dietary cyst(e)ine increases weight gain in some rodent models. We investigated the body composition, metabolic rate and metabolic phenotype of mature C3H/HeH mice assigned to low-cystine (LC) or high-cystine (HC) diets for 12 weeks. Compared to LC mice, HC mice gained more weight (P=.004 for 12-week weight gain %), with increased fat mass and lean mass, and lowered O₂ consumption and CO₂ production by calorimetry. The HC mice had 30% increase in intestinal fat/body weight % (P=.003) and ∼twofold elevated hepatic triglycerides (P=.046), with increased expression of hepatic lipogenic factors, peroxisome proliferator-activated receptor-γ and sterol regulatory element binding protein-1. Gene expression of both basal and catecholamine-stimulated lipolytic enzymes, adipose triglyceride lipase and hormone-sensitive lipase was inhibited in HC mice adipose tissue. The HC mice also had elevated fasting glucose (7.0 vs. 4.5 mmol/L, Pcystine intake promotes adiposity and an adverse metabolic phenotype in mice, indicating that the positive association of plasma tCys with obesity in humans may be causal.

  3. quality of glycaemic control in ambulatory diabetics at the out-patient ...

    African Journals Online (AJOL)

    hi-tech

    2003-08-08

    Aug 8, 2003 ... Conclusion: The majority of ambulatory diabetic patients attending the out-patient diabetic ... with knowledge and resources to enhance their individual participation in .... complications of retinopathy, neuropathy (3, 4, 7).

  4. Retinal function in relation to improved glycaemic control in type 1 diabetes

    DEFF Research Database (Denmark)

    Holfort, S K; Nørgaard, K; Jackson, George

    2011-01-01

    To study long-term changes in retinal function in response to sustained glycaemia reduction in participants with type 1 diabetes.......To study long-term changes in retinal function in response to sustained glycaemia reduction in participants with type 1 diabetes....

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

    DEFF Research Database (Denmark)

    Madsbad, Sten

    2002-01-01

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

  6. Intramyocellular triglyceride content in man, influence of sex, obesity and glycaemic control

    DEFF Research Database (Denmark)

    Haugaard, Steen B; Mu, Huiling; Vaag, Allan

    2009-01-01

    It remains unknown whether sex impacts on intramyocellular triglyceride (IMTG) in obesity. as has been shown in non-obese subjects, and if so, whether this may have implications on the association between IMTG and insulin sensitivity. Subject and methods: A Muscle biopsy from vastus lateralis...

  7. Differential associations between depressive symptoms and glycaemic control in outpatients with diabetes

    NARCIS (Netherlands)

    Bot, M.; Pouwer, F.; Jonge, P. de; Tack, C.J.J.; Geelhoed-Duijvestijn, P.H.; Snoek, F.J.

    2013-01-01

    AIMS: Depression is common in people with diabetes, and related to higher HbA(1c) levels. Depression, however, is a heterogeneous construct that involves a variety of symptoms. As little is known about the associations of individual depressive symptoms with HbA(1c) , we explored these associations i

  8. Differential associations between depressive symptoms and glycaemic control in outpatients with diabetes

    DEFF Research Database (Denmark)

    Bot, M; Pouwer, F; De Jonge, P

    2013-01-01

    .001), appetite problems (β = 0.15, P suicidal ideation (β = 0.14, P = 0.001) were significantly related to higher baseline HbA(1c) values. Furthermore, depressed mood (β = 0.09, P = 0.03) sleeping difficulties (β = 0.12, P = 0.004), appetite problems (β = 0.11, P = 0.01) and psychomotor agitation....../retardation (β = 0.09, P = 0.04) were significantly related to higher HbA(1c) values at 1-year follow-up. Associations were more pronounced in Type 1 diabetes than in Type 2 diabetes. None of the depressive symptoms were related to change in HbA(1c) over time, except suicidal ideation. CONCLUSION: In people...

  9. Association of Serum Selenium, Zinc and Magnesium Levels with Glycaemic Indices and Insulin Resistance in Pre-diabetes: a Cross-Sectional Study from South India.

    Science.gov (United States)

    Yadav, Charu; Manjrekar, Poornima A; Agarwal, Ashish; Ahmad, Afzal; Hegde, Anupama; Srikantiah, Rukmini Mysore

    2017-01-01

    A growing understanding of antioxidant mechanisms and insulin-like actions of trace elements selenium and zinc has rekindled researchers' interest towards their role in diabetes mellitus, nutritional management of which concentrates predominantly on macronutrient intake. However, selenium studies limiting largely to diabetes have yielded inconsistent results with sparse knowledge in the pre-diabetes population. This hospital-based cross-sectional study screened 300 people who came to the institutional hospital laboratory with fasting plasma glucose and glycosylated haemoglobin requisition over a period of 6 months. Thirty-five pre-diabetes subjects aged 25-45 years and 35 age-matched healthy controls were selected as per inclusion criteria and clinical history. Serum selenium was estimated by inductively coupled plasma-mass spectrometry, zinc and magnesium by colorimetric end-point methods and insulin by enzyme-linked immunosorbent assay, and insulin resistance was calculated using a homeostasis model assessment (HOMA) 2 calculator. Data analysis was done using SPSS ver. 16 employing an independent sample t test for intergroup comparison of means and Pearson's correlation for correlation analysis. Serum mineral levels in the pre-diabetes group (selenium 63.01 ± 17.6 μg/L, zinc 55.78 ± 13.49 μg/dL, magnesium 1.37 ± 0.38 mg/dL) were significantly reduced (p zinc 94.53 ± 15.41 μg/dL, magnesium 2.12 ± 0.22 mg/dL). A significant negative correlation was seen with glycaemic indices and insulin resistance. This study conducted in pre-diabetes subjects highlights a considerable deficiency of serum selenium, zinc and magnesium observed at a much earlier pre-clinical phase. This coupled with the evidence of a strong inverse association with glycaemic indices and insulin resistance postulates the role of mineral alterations in the pathophysiology of hyperglycaemia and insulin resistance.

  10. Diet e ect on short- and long-term glycaemic response in adult healthy cats.

    Science.gov (United States)

    Musco, Nadia; Calabro, Serena; Tudisco, Raffaella; Grossi, Micaela; Addi, Laura; Moniello, Giuseppe; Lombardi, Pietro; Cutrignelli, Monica Isabella

    2016-08-03

    In the paper the short- and long-term glycaemic response after 4 diet programmes was evaluated. Each diet programme was alternatively administered to 6 healthy cats for 30 days. At the end of each period cats were weighed and underwent blood sampling for glucose and fructosamine determination. Glycaemia was measured every 2 hours for 24 hours using an automated glucometer. Very high protein level and low starch (VHP/LS) and high protein and moderate starch level (HP/LS) diets showed glucose (Mean and Peak) and fructosamine values signi cantly lower compared to the moderate protein and high starch diets (MP/HS). It is likely that these results are due to the contemporary e ect of the following nutritional characteristics: protein level, protein/starch ratio and dietary bre. All these parameters were higher in VHP/LS and HP/MS diets. These preliminary results suggest that the use of diets with high protein/starch ratio and soluble bre levels favours the carbohydrate metabolism of healthy cats.

  11. Política de avaliação da educação superior: controle e massificação Higher education assessment policy in Brasil: control and massification

    Directory of Open Access Journals (Sweden)

    Alfredo Macedo Gomes

    2002-09-01

    Full Text Available O artigo analisa a política de avaliação implantada pelo Ministério da Educação a partir de 1995, que se materializa por intermédio do Exame Nacional de Cursos (ENC e da Avaliação das Condições de Oferta de Cursos de Graduação. Argumenta-se que uma política de avaliação não deve caracterizar-se apenas pela contribuição que pode oferecer ao entendimento das características específicas de procedimentos avaliativos, mas deve, sobretudo, distinguir-se pela contribuição à compreensão crítica dos impactos e usos da avaliação e dos seus resultados como instrumento de exercício (e disputa do poder no campo educacional. Dessa forma, é argumentado que uma política de avaliação nunca é destituída de vínculos estratégicos com a organização do sistema de ensino, com a sua dinâmica funcional e, igualmente, com os objetivos principais do projeto político para a área de educação que o grupo no poder busca realizar. Este é o caso da atual política de avaliação para o ensino superior brasileiro, que, por um lado, desempenha papel central na lógica organizativo-funcional do atual sistema de educação superior e, por outro, tornou-se o instrumento por excelência da política oficial para promover a massificação da educação superior via financiamento privado e desenvolver um moderno mercado da educação superior no Brasil.This paper analyses the assessment policy the Department of Education (MEC implemented in Brazil since 1995. Such policies comprise the Exame Nacional de Cursos (Brazilian Examination of Courses and the Avaliação das Condições de Oferta dos Cursos de Graduação (Assessment of Adequacy of Conditions for Undergraduate Course Provision. It argues that an assessment policy should not merely be characterised by the contributions it can offer to understand specific evaluation procedures. It should, above all, distinguish itself by contributing to critically understand the impacts and uses of

  12. Improving mood with psychoanalytic and cognitive therapies (IMPACT: a pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depression: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Suckling John

    2011-07-01

    Full Text Available Abstract Background Up to 70% of adolescents with moderate to severe unipolar major depression respond to psychological treatment plus Fluoxetine (20-50 mg with symptom reduction and improved social function reported by 24 weeks after beginning treatment. Around 20% of non responders appear treatment resistant and 30% of responders relapse within 2 years. The specific efficacy of different psychological therapies and the moderators and mediators that influence risk for relapse are unclear. The cost-effectiveness and safety of psychological treatments remain poorly evaluated. Methods/Design Improving Mood with Psychoanalytic and Cognitive Therapies, the IMPACT Study, will determine whether Cognitive Behavioural Therapy or Short Term Psychoanalytic Therapy is superior in reducing relapse compared with Specialist Clinical Care. The study is a multicentre pragmatic effectiveness superiority randomised clinical trial: Cognitive Behavioural Therapy consists of 20 sessions over 30 weeks, Short Term Psychoanalytic Psychotherapy 30 sessions over 30 weeks and Specialist Clinical Care 12 sessions over 20 weeks. We will recruit 540 patients with 180 randomised to each arm. Patients will be reassessed at 6, 12, 36, 52 and 86 weeks. Methodological aspects of the study are systematic recruitment, explicit inclusion criteria, reliability checks of assessments with control for rater shift, research assessors independent of treatment team and blind to randomization, analysis by intention to treat, data management using remote data entry, measures of quality assurance, advanced statistical analysis, manualised treatment protocols, checks of adherence and competence of therapists and assessment of cost-effectiveness. We will also determine whether time to recovery and/or relapse are moderated by variations in brain structure and function and selected genetic and hormone biomarkers taken at entry. Discussion The objective of this clinical trial is to determine

  13. 75 FR 28542 - Superior Resource Advisory Committee

    Science.gov (United States)

    2010-05-21

    ... orient the new Superior Resource Advisory Committee members on their roles and responsibilities. DATES... of the roles and responsibilities of the Superior Resource Advisory Committee members; Election of... Forest Service Superior Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice...

  14. [The superior laryngeal nerve and the superior laryngeal artery].

    Science.gov (United States)

    Lang, J; Nachbaur, S; Fischer, K; Vogel, E

    1987-01-01

    Length, diameter and anastomoses of the nervus vagus and its ganglion inferius were measured 44 halved heads. On the average, 8.65 fiber bundles of the vagus nerve leave the retro-olivary area. In the area of the jugular foramen is the near superior ganglion of the 10th cranial nerve. In this area were found 1.48 (mean value) anastomoses with the 9th cranial nerve. 11.34 mm below the margo terminalis sigmoidea branches off the ramus internus of the accessory nerve which has a length of 9.75 mm. Further anastomoses with the 10th cranial nerve were found. The inferior ganglion of the 10th nerve had a length of 25.47 mm and a diameter of 3.46 mm. Five mm below the ganglion the 10th nerve had a width of 2.9 and a thickness of 1.5 mm. The mean length of the superior sympathetic ganglion was 26.6 mm, its width 7.2 and its thickness 3.4 mm. In nearly all specimens anastomoses of the superior sympathetic ganglion with the ansa cervicalis profunda and the inferior ganglion of the 10th cranial nerve were found. The superior laryngeal nerve branches off about 36 mm below the margo terminalis sigmoidea. The width of this nerve was 1.9 mm, its thickness 0.8 mm on the right and 1.0 mm on the left side. The division in the internal and external rami was found about 21 mm below its origin. Between the n. vagus and thyreohyoid membrane the ramus internus had a length of 64 mm, the length of external ramus between the vagal nerve and the inferior pharyngeal constrictor muscle was 89 mm. Its mean length below the thyreopharyngeal part was 10.7 mm, 8.6 branchlets to the cricothyroid muscle were counted. The superior laryngeal artery had its origin in 80% of cases in the superior thyroideal artery, in 6.8% this vessel was a branch of the external carotid artery. Its average outer diameter was 1.23 mm on the right side and 1.39 mm on the left. The length of this vessel between its origin and the thyreohyoid membrane was 34 mm. In 7% on the right side and in 13% on the left, the superior

  15. What are Millian Qualitative Superiorities?

    Directory of Open Access Journals (Sweden)

    Jonathan Riley

    2008-04-01

    Full Text Available In an article published in Prolegomena 2006, Christoph Schmidt-Petri has defended his interpretation and attacked mine of Mill’s idea that higher kinds of pleasure are superior in quality to lower kinds, regardless of quantity. Millian qualitative superiorities as I understand them are infinite superiorities. In this paper, I clarify my interpretation and show how Schmidt-Petri has misrepresented it and ignored the obvious textual support for it. As a result, he fails to understand how genuine Millian qualitative superiorities determine the novel structure of Mill’s pluralistic utilitarianism, in which a social code of justice that distributes equal rights and duties takes absolute priority over competing considerations. Schmidt-Petri’s own interpretation is a non-starter, because it does noteven recognize that Mill is talking about different kinds of pleasant feelings, such that the higher kinds are intrinsically more valuable than the lower. I conclude by outlining why my interpretation is free of any metaphysical commitment to the “essence” of pleasure.

  16. Isolated superior mesenteric artery dissection

    Directory of Open Access Journals (Sweden)

    Lalitha Palle

    2010-01-01

    Full Text Available Isolated superior mesenteric artery (SMA dissection without involvement of the aorta and the SMA origin is unusual. We present a case of an elderly gentleman who had chronic abdominal pain, worse after meals. CT angiography, performed on a 64-slice CT scanner, revealed SMA dissection with a thrombus. A large artery of Drummond was also seen. The patient was managed conservatively.

  17. A escrita no Ensino Superior

    Directory of Open Access Journals (Sweden)

    Maria Conceição Pillon Christofoli

    2013-01-01

    Full Text Available http://dx.doi.org/10.5902/198464445865 O presente artigo trata de apresentar resultados oriundos de pesquisa realizada no Ensino Superior, enfocando a escrita em contextos universitários. Depoimentos por parte dos acadêmicos evidenciam certa resistência ao ato de escrever, o que acaba muitas vezes distanciando o sujeito da produção de um texto. Assim sendo, mesmo que parciais, os resultados até então analisados dão conta de que: pressuposto 1 – há ruptura da ideia de coerência entre o que pensamos, o que conseguimos escrever, o que entende nosso interlocutor; pressuposto 2 – a autocorreção de textos como exercício de pesquisa é imprescindível para a qualificação da escrita; pressuposto 3 – os diários de aula representam rico instrumento para a qualificação da escrita no Ensino Superior; pressuposto 4 – há necessidade de que o aluno do Ensino Superior escreva variados tipos de escrita, ainda que a universidade cumpra com seu papel, enfatizando a escrita acadêmica; pressuposto 5 – o trabalho com a escrita no Ensino Superior deve enfatizar os componentes básicos da expressão escrita: o código escrito e a composição da escrita. Palavras-chave: Escrita; Ensino Superior; formação de professores.

  18. Superiority of fesoterodine 8 mg vs 4 mg in reducing urgency urinary incontinence episodes in patients with overactive bladder: results of the randomised, double-blind, placebo-controlled EIGHT trial.

    Science.gov (United States)

    Chapple, Christopher; Schneider, Tim; Haab, François; Sun, Franklin; Whelan, Laurence; Scholfield, David; Dragon, Erika; Mangan, Erin

    2014-09-01

    To assess the superiority of fesoterodine 8 mg vs 4 mg for improvement in urgency urinary incontinence (UUI) episodes and other diary variables, diary-dry rate (proportion of patients with >0 UUI episodes on baseline diary and 0 UUI episodes on post-baseline diary), and improvements in measures of symptom bother, health-related quality of life (HRQL), and other patient-reported outcomes (PROs). This was a 12-week, randomised, double-blind, placebo-controlled, multinational trial of men and women aged ≥18 years with overactive bladder (OAB) symptoms including UUI (ClinicalTrials.gov ID NCT01302067). Patients were randomised (2:2:1) to receive fesoterodine 8 mg, fesoterodine 4 mg, or placebo once daily; those randomised to fesoterodine 8 mg started with fesoterodine 4 mg once daily for 1 week, then 8 mg once daily for the remaining 11 weeks. Patients completed bladder diaries at baseline and weeks 4 and 12 and the Patient Perception of Bladder Condition (PPBC), Urgency Perception Scale (UPS), and Overactive Bladder Questionnaire (OAB-q) at baseline and week 12. The primary endpoint was change from baseline to week 12 in UUI episodes per 24 h. At week 12, patients receiving fesoterodine 8 mg (779 patients) had significantly greater reductions from baseline in UUI episodes, micturitions, and urgency episodes than patients receiving fesoterodine 4 mg (790) or placebo (386); diary-dry rate was significantly higher in the fesoterodine 8-mg group vs the fesoterodine 4-mg and placebo groups (all P fesoterodine 8 mg also had significantly greater improvements in scores on the PPBC, UPS, and all OAB-q scales and domains than patients receiving fesoterodine 4 mg or placebo (all P fesoterodine 4 mg had significantly greater improvements in UUI episodes, urgency episodes, and micturitions; significantly higher diary-dry rates; and significantly greater improvement in PPBC scores and OAB-q scores than patients receiving placebo (all P fesoterodine groups (placebo group, 3

  19. [Superior vena cava syndrome--surgical solution--case report].

    Science.gov (United States)

    Galie, N; Vasile, R; Savu, C; Petreanu, C; Grigorie, V; Tabacu, E

    2010-01-01

    The patient of 52-year-old smoker was admitted in emergency with headaches, dyspnea, oedema and cyanosis of the cephalic extremity and of the superior members. This signs and symptoms suggest a superior vena cava sindrom. Thoracic CT scan shows the thrombosis of the superior vena cava and a tumor localized in the Bariety's Lodge of about 30/40 mm witch is around the right lateral wall of the traheea.This tumor is also tangent to the superior the superior vena cava. The patient was operated by total median sternotomy. By this approach we performed a complete excision of the mediastinal tumor mass. After that we effected a longitudinal cavotomy, we took out the endoluminal clot and we sutured the superior vena cava. The histological diagnosis of the mediastinal tumor was adenocarcinoma tubular-papillary moderately differentiated. The evolution post operative period was favorable the superior vena cava sindrom was a complet remission. The thoracic CT scan control after 9 months later didn't show a local relapse and blood flow was normally throw the superior vena cava.

  20. The effect of food with different glycaemic index on the blood glucose level

    Directory of Open Access Journals (Sweden)

    Lenka Kouřimská

    2015-08-01

    Full Text Available Blood glucose levels are affected by many factors including the type of foods consumed, processing technology and cooking method. Hormone insulin lowers blood glucose to its constant level, while glucagon, growth hormone, adrenalin and glucocorticoids have the opposite effect. High steepness of the blood glucose level rise after meals may be unfavourable for the organism. Sugars are transferred into the blood at different speeds according to the type of food. Therefore the aim of this study was to confirm experimentally the effect of food on blood glucose levels in men and women of different ages. Two types of low, medium and high-glycaemic index (GI foods were given to 4 men and 4 women of different age (from 35 to 65 years. All volunteers were healthy, slightly overweight, and without any regular sporting activity. None of them had any idea about their daily carbohydrates consumption and what the term glycaemic index meant. The volunteers came to the GI determination fasted in the morning. Their rise in blood glucose level was monitored by glucometer before the meal and after 1 and 2 hours of the consumption of baked potatoes (GI 85, white bread bun (GI 70, boiled potatoes (GI 64, rye bread (GI 62, potato dumplings (GI 52 and white cooked spaghetti (GI 41. Fasting blood sugar levels of volunteers highly depended on their age (p <0.0001 and gender (p <0.0001. The blood glucose values increased with age and were higher in men than in women. Significant influence of food GI on blood glucose levels in both men and women in all the age categories was observed (p <0.0001. An interaction between age and gender was also statistically highly significant (p <0.0001. One hour after consuming food the blood glucose values were significantly different from the values of fasting (p = 0.0035. The differences of these values did not depend on the age (p = 0.0574 and sex (p = 0.8256 of volunteers, but there was a significant difference on the GI value of food

  1. Dietary carbohydrates, glycaemic load, food groups and newly detected type 2 diabetes among urban Asian Indian population in Chennai, India (Chennai Urban Rural Epidemiology Study 59).

    Science.gov (United States)

    Mohan, Viswanathan; Radhika, Ganesan; Sathya, Rangaswamy Mohan; Tamil, Selvi Ramjothi; Ganesan, Anbazhagan; Sudha, Vasudevan

    2009-11-01

    The aim of the study was to examine the association of dietary carbohydrates and glycaemic load with the risk of type 2 diabetes among an urban adult Asian Indian population. Adult subjects aged >20 years (n 1843) were randomly selected from the Chennai Urban Rural Epidemiology Study, in Chennai city in southern India. Dietary carbohydrates, glycaemic load and food groups were assessed using FFQ. Oral glucose tolerance tests were performed using 75 g glucose in all subjects. Diagnosis of diabetes was based on WHO Consulting Group criteria. OR for newly detected diabetes were calculated for carbohydrates, glycaemic load and specific food groups comparing subjects in the highest with those in the lowest quartiles, after adjustment for potential confounders such as age, sex, BMI, family history of diabetes, physical activity, current smoking, alcohol consumption and relevant dietary factors. We identified 156 (8.5 %) newly diagnosed cases of type 2 diabetes. Refined grain intake was positively associated with the risk of type 2 diabetes (OR 5.31 (95 % CI 2.98, 9.45); P < 0.001). In the multivariate model, after adjustment for potential confounders, total carbohydrate (OR 4.98 (95 % CI 2.69, 9.19), P < 0.001), glycaemic load (OR 4.25 (95 % CI 2.33, 7.77); P < 0.001) and glycaemic index (OR 2.51 (95 % CI 1.42, 4.43); P = 0.006) were associated with type 2 diabetes. Dietary fibre intake was inversely associated with diabetes (OR 0.31 (95 % CI 0.15, 0.62); P < 0.001). In urban south Indians, total dietary carbohydrate and glycaemic load are associated with increased, and dietary fibre with decreased, risk of type 2 diabetes.

  2. Glycaemic index values in the Finnish food composition database: an approach to standardised value documentation.

    Science.gov (United States)

    Kaartinen, N E; Similä, M E; Pakkala, H; Korhonen, T; Männistö, S; Valsta, L M

    2010-11-01

    The glycaemic index (GI) is used to describe the blood glucose-raising potential of carbohydrate-containing foods. Only a few descriptions of the addition of GI values to national food composition databases (FCDBs) exist. We tested whether the value documentation framework established within the European Food Information Resource (EuroFIR) Network could be used for GI values when adding them to the Finnish FCDB. The list of foods requiring GI values was based on the National FINDIET 2007 Survey data and extended with foods encoded in a food-frequency questionnaire used in other nationally representative studies. The minimum quality of GI measurements was verified when gathering values from various sources, using earlier defined criteria. If a measured GI value for a food was directly available, or could be imputed or estimated, the value was added to the Finnish FCDB and documented using core standard vocabularies of EuroFIR. The GI values of composite foods were calculated using recipe calculation software. A total of 2210 foods required a GI value. GI values for 1322 foods were available and added to the FCDB. The remaining 888 foods were composite foods and received a GI value through recipe calculation. The standard vocabularies describing the origin of the GI values, the methods used in their derivation and their qualitative characteristics were suitable for GI values. GI values can be added to FCDBs and documented using terms similar to those used for traditional food composition data. Standardised value documentation may provide transparency for GI database compilation processes.

  3. Use of sourdough lactobacilli and oat fibre to decrease the glycaemic index of white wheat bread.

    Science.gov (United States)

    De Angelis, Maria; Rizzello, Carlo G; Alfonsi, Giuditta; Arnault, Philip; Cappelle, Stefan; Di Cagno, Raffaella; Gobbetti, Marco

    2007-12-01

    This work was aimed at decreasing the glycaemic index (GI) of white wheat bread. Breads made with wheat flour (WF) or wholemeal flour (WMF) and fermented with baker's yeast had similar values of resistant starch (RS; 1.4-1.7 %, starch basis). Sourdough Lactobacillus plantarum P1 and Lactobacillus brevis P2 favoured the highest formation of RS (approximately 5 %) when fermented with WF and WMF. The mixture (1:1) of WF and WMF (WF/WMF) was selected. The effect of dietary fibres, chemical or sourdough acidification on the hydrolysis index (HI) of WF/WMF bread was determined. Among fibres, only the addition of oat fibre (5 %) decreased the HI to 90.84 %. Lactic acid determined the lowest HI, and the effect was related to the decrease of pH. For the same decrease of pH, breads fermented with L. plantarum P1 and L. brevis P2 (sourdough WF/WMF) showed values of HI lower than chemical acidification. The glucose response and GI of WF bread or sourdough WF/WMF bread enriched with oat fibre was determined by using fifteen healthy volunteers. Anhydrous glucose was used as reference. The area under the glucose response curve and the value of GI (72 %) of WF bread were significantly (P sourdough WF/WMF bread enriched with oat fibre (GI = 53.7 %). The decrease of GI of the sourdough WF/WMF bread may be due to both fibre content and decreased pH. Compared to WMF bread, sourdough WF/WMF bread, enriched with oat fibre, had higher specific volume, better cell crumb structure and more appreciated acidulous smell, taste and aroma.

  4. Enrichment of an Israeli ethnic food with fibres and their effects on the glycaemic and insulinaemic responses in subjects with non-insulin-dependent diabetes mellitus.

    Science.gov (United States)

    Feldman, N; Norenberg, C; Voet, H; Manor, E; Berner, Y; Madar, Z

    1995-11-01

    The effects of various sources of dietary fibre on the high glycaemic index of an Israeli ethnic food, melawach, were investigated in subjects with non-insulin-dependent diabetes mellitus (NIDDM). Locust-bean (Ceratonia siliqua) gum significantly decreased the glucose response to, and glycaemic index of, melawach in these diabetic subjects (P 30 kg/m2, whereas insulinaemic response decreased. The results indicate that foods containing the same nutrients in almost the same amounts, but differing in added dietary fibre, lead to different physiological responses in diabetic subjects. Furthermore, insulin response should be considered when fibre is incorporated into the diabetic's diet.

  5. Fermentation as a Means of Optimizing the Glycaemic Index - Food Mechanisms and Metabolic Merits with Emphasis on Lactic Acid in Cereal Products

    OpenAIRE

    Östman, Elin

    2003-01-01

    In current recommendations from FAO/WHO, foods that elicit low glycaemic responses and thus have low glycaemic indices (GIs) are advocated. The rationale for this recommendation is that low-GI diets have been shown to reduce risk factors for e.g. type II diabetes and cardiovascular disease. A major problem in this context is that most important starch rich staple foods in our diet, such as potato and bread products, have high GIs. One important task is, therefore, to identify food factors tha...

  6. Noise management to achieve superiority in quantum information systems

    Science.gov (United States)

    Nemoto, Kae; Devitt, Simon; Munro, William J.

    2017-06-01

    Quantum information systems are expected to exhibit superiority compared with their classical counterparts. This superiority arises from the quantum coherences present in these quantum systems, which are obviously absent in classical ones. To exploit such quantum coherences, it is essential to control the phase information in the quantum state. The phase is analogue in nature, rather than binary. This makes quantum information technology fundamentally different from our classical digital information technology. In this paper, we analyse error sources and illustrate how these errors must be managed for the system to achieve the required fidelity and a quantum superiority. This article is part of the themed issue 'Quantum technology for the 21st century'.

  7. Pensamiento Superior y Desarrollo Territorial

    Directory of Open Access Journals (Sweden)

    Víctor Manuel Racancoj Alonzo

    2015-04-01

    Full Text Available Esta reflexión pretende explicar el papel, fundamental, que juega el pensamiento superior, en la formulación y la práctica de modelos de desarrollo territorial local; para que contribuyan de forma sustantiva, en la transformación de las condiciones socioeconómicas adversas que hoy viven comunidades indígenas y rurales de muchos países, como Guatemala, situación que puede resumirse en altos índices de pobreza y desnutrición. Pero, el pensamiento superior, debe ser competencia de la población con pertenencia a lo local, pues si y solo si esta condición existe, se dará validez y viabilidad al desarrollo territorial. Para alcanzar competencias de pensamiento superior, en los espacios locales, se tiene que superar obstáculos en el modelo de universidad, que hoy estamos familiarizados a ver y pensar; modelos que tienen las características de: herencia colonial, disfunción con la problemática económica, cultural, social y política de la sociedad y la negación de los saberes ancestrales.

  8. Cognitive behavioural therapy and short-term psychoanalytical psychotherapy versus a brief psychosocial intervention in adolescents with unipolar major depressive disorder (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled superiority trial.

    Science.gov (United States)

    Goodyer, Ian M; Reynolds, Shirley; Barrett, Barbara; Byford, Sarah; Dubicka, Bernadka; Hill, Jonathan; Holland, Fiona; Kelvin, Raphael; Midgley, Nick; Roberts, Chris; Senior, Rob; Target, Mary; Widmer, Barry; Wilkinson, Paul; Fonagy, Peter

    2017-02-01

    Psychological treatments for adolescents with unipolar major depressive disorder are associated with diagnostic remission within 28 weeks in 65-70% of patients. We aimed to assess the medium-term effects and costs of psychological therapies on maintenance of reduced depression symptoms 12 months after treatment. We did this multicentre, pragmatic, observer-blind, randomised controlled superiority trial (IMPACT) at 15 National Health Service child and adolescent mental health service (CAMHS) clinics in three regions in England. Adolescent patients (aged 11-17 years) with a diagnosis of DSM IV major depressive disorder were randomly assigned (1:1:1), via a web-based randomisation service, to receive cognitive behavioural therapy (CBT) or short-term psychoanalytical therapy versus a reference brief psychological intervention. Randomisation was stochastically minimised by age, sex, self-reported depression sum score, and region. Patients and clinicians were aware of group allocation, but allocation was concealed from outcome assessors. Patients were followed up and reassessed at weeks 6, 12, 36, 52, and 86 post-randomisation. The primary outcome was self-reported depression symptoms at weeks 36, 52, and 86, as measured with the self-reported Mood and Feelings Questionnaire (MFQ). Because our aim was to compare the two psychological therapies with the brief psychosocial intervention, we first established whether CBT was inferior to short-term psychoanalytical psychotherapy for the same outcome. Primary analysis was by intention to treat. This trial is registered with Current Controlled Trials, number ISRCTN83033550. Between June 29, 2010, and Jan 17, 2013, we randomly assigned 470 patients to receive the brief psychosocial intervention (n=158), CBT (n=155), or short-term psychoanalytical therapy (n=157); 465 patients comprised the intention-to-treat population. 392 (84%) patients had available data for primary analysis by the end of follow-up. Treatment fidelity and

  9. Wear plates control rod guide tubes top internal reactor vessel C. N. VANDELLOS II; Desgaste placas tubos guia barras de control interno superior vasija del reactor C.N. Vandellos II

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    The guide tubes for control rods forming part of the upper internals of the reactor vessel, its function is to guide the control rod to permit its insertion in the reactor core. These guide tubes are suspended from the upper support plate which are fixed by bolts and extending to the upper core plate which is fastened by clamping bolts (split pin) to prevent lateral displacement of the guide tubes, while allowing axial expansion.

  10. Robot-assisted gait training is not superior to balance training for improving postural instability in patients with mild to moderate Parkinson's disease: a single-blind randomized controlled trial.

    Science.gov (United States)

    Picelli, Alessandro; Melotti, Camilla; Origano, Francesca; Neri, Roberta; Verzè, Elisa; Gandolfi, Marialuisa; Waldner, Andreas; Smania, Nicola

    2015-04-01

    The main aim was to compare robotic gait training vs. balance training for reducing postural instability in patients with Parkinson's disease. The secondary aim was to compare their effects on the level of confidence during activities of daily living requiring balance, functional mobility and severity of disease. Randomized controlled trial. University hospital. A total of 66 patients with Parkinson's disease at Hoehn and Yahr Stage 3. After balanced randomization, all patients received 12, 45-minute treatment sessions, three days a week, for four consecutive weeks. A group underwent robot-assisted gait training with progressive gait speed increasing and body-weight support decreasing. The other group underwent balance training aimed at improving postural reactions (self and externally induced destabilization, coordination, locomotor dexterity exercises). Patients were evaluated before, after and one month posttreatment. Berg Balance Scale. Activities-Specific Balance Confidence Scale; Timed Up and Go Test; Unified Parkinson's Disease Rating Scale. No significant differences were found between the groups for the Berg Balance Scale either immediately after intervention (mean score in the robotic training group 51.58 ±3.94; mean score in the balance training group 51.15 ±3.46), or one-month follow-up (mean score in the robotic training group 51.03 ±4.63; mean score in the balance training group 50.97 ±4.28). Similar results were found for all the secondary outcome measures. Our findings indicate that robotic gait training is not superior to balance training for improving postural instability in patients with mild to moderate Parkinson's disease. © The Author(s) 2014.

  11. No Superiority of Treatment With Osmotic Controlled-Release Oral Delivery System-Methylphenidate Over Short/Medium-Acting Methylphenidate Preparations in the Rate and Timing of Injuries in Children With Attention-Deficit/Hyperactivity Disorder.

    Science.gov (United States)

    Golubchik, Pavel; Kodesh, Arad; Weizman, Abraham

    Methylphenidate (MPH) treatment in patients with attention-deficit/hyperactivity disorder (ADHD) is reported to reduce the risk for injuries. In the present study, the rate and timing of injuries were compared among the various MPH preparations (4 and 6-8 vs 12 hour-acting) in children with ADHD. This real-world retrospective study covered the years 2011 to 2013. Participants included 2042 youngsters (aged 4-18 years, 13.01 ± 3.2 years; 71.8% males and 28.2% females) diagnosed with ADHD according to the International Statistical Classification of Diseases, 10th Revision criteria and treated with various MPH preparations. They were divided into 2 groups by their treatment preparation as follows: MPH-immediate release (MPH-IR)-4 hour-acting pooled with MPH-slow release/long-acting (MPH-SR/LA)- 6 to 8 hour-acting versus osmotic controlled-release oral delivery system-MPH (OROS-MPH; Concerta)-12 hour-acting that consisted of pooling of OROS-MPH only and OROS-MPH combined with the other MPH preparations. The monthly rates of injury, specifically, late injury (occurrence between 4:00 p.m. to midnight) and for multiple injuries, the time interval between injuries, were assessed. No significant differences in monthly rate of nonfatal injuries were found between OROS-MPH with or without 4/6 to 8 hour-acting MPH-formulations versus only 4/6 to 8 hour-acting MPH-preparations (P = 0.53). Neither were differences found in the between-injury time interval (P = 0.83) or in late-injury-rates (P = 0.37) between those groups. This real-world-naturalistic study in the community demonstrates that, in ADHD pediatric populations, OROS-MPH preparation is not superior to short/medium-acting (4/6-8 hours) MPH preparations regarding the rate and timing of injuries.

  12. Effect of coffee and tea on the glycaemic index of foods: no effect on mean but reduced variability.

    Science.gov (United States)

    Aldughpassi, Ahmed; Wolever, Thomas M S

    2009-05-01

    Coffee and tea may influence glycaemic responses but it is not clear whether they affect the glycaemic index (GI) value of foods. Therefore, to see if coffee and tea affected the mean and SEM of GI values, the GI of fruit leather (FL) and cheese puffs (CP) were determined twice in ten subjects using the FAO/WHO protocol with white bread as the reference food. In one series subjects chose to drink 250 ml of either coffee or tea with all test meals, while in the other series they drank 250 ml water. The tests for both series were conducted as a single experiment with the order of all tests being randomised. Coffee and tea increased the overall mean peak blood glucose increment compared with water by 0.25 (SEM 0.09) mmol/l (P=0.02), but did not significantly affect the incremental area under the glucose response curve. Mean GI values were not affected by coffee or tea but the SEM was reduced by about 30% (FL: 31 (SEM 4) v. 35 (SEM 7) and CP: 76 (SEM 6) v. 75 (SEM 8) for coffee or tea v. water, respectively). The error mean square term from the ANOVA of the GI values was significantly smaller for coffee or tea v. water (F(18, 18) = 2.31; P=0.04). We conclude that drinking coffee or tea with test meals does not affect the mean GI value obtained, but may reduce variability and, hence, improve precision.

  13. Entidades fiscalizadoras superiores y accountability

    OpenAIRE

    Estela Moreno, María

    2016-01-01

    OBJETIVOS DE LA TESIS: El objetivo general del trabajo es establecer el nivel de eficacia de las Entidades Fiscalizadoras Superiores (EFS) como agencia asignada y herramienta de accountability horizontal, a través de la valoración de su diseño institucional y de la calidad de sus productos finales, los informes de auditoría, estableciéndose los siguientes objetivos específicos: 1. Relevar las nociones de accountability, actualizando el Estado del Arte de la cuestión. 2. Analizar la ...

  14. Glycaemic and insulinaemic responses of adult healthy warm-blooded mares following feeding with Jerusalem artichoke meal.

    Science.gov (United States)

    Glatter, M; Bochnia, M; Goetz, F; Gottschalk, J; Koeller, G; Mielenz, N; Hillegeist, D; Greef, J M; Einspanier, A; Zeyner, A

    2017-06-01

    This study aimed to investigate the impact of the supplementation of a pre-biotic compound [Jerusalem artichoke meal (JAM)] on the glycaemic and insulinaemic response in healthy, non-obese warm-blooded horses. Six adult mares [mean body weight (bwt) 529 ± 38.7 kg; body condition score 5.1 ± 0.49/9] were used. In two equal meals per day, the horses received crushed oat grains (1 g starch/kg bwt per day) and meadow hay (2 kg/100 kg bwt per day) which together were likely to meet the energy recommendation for light work (GfE, ). Additionally, they received either 0.15 g fructo-oligosaccharides and inulin (FOS+INU)/kg bwt per day via commercial JAM or maize cob meal without grains as control (CON) in 2 × 3-week periods according to a crossover design. Blood was collected on d21 of the feeding period at different ante- and postprandial (PP) time points (-60, 0, 30, 60, 90, 120, 180, 240 and 300 min), and the plasma glucose and serum insulin levels were determined. Feeding JAM vs. CON did not change the PP peak of glucose or insulin (glucose: 6.3 ± 0.40 vs. 7.0 ± 0.87 mmol/l; insulin: 0.508 ± 0.087 vs. 0.476 ± 0.082 nmol/l) nor did it cause different AUCs until 120 and 300 min PP for glucose and insulin, respectively (AUC120 , glucose: 997 ± 41.6 vs. 1015 ± 41.63 mmol/l per minute, insulin: 49 ± 6.3 vs. 42 ± 6.3 nmol/l per minute; AUC300 , glucose: 1943 ± 142.3 vs. 2115 ± 142.3 mmol/l per minute, insulin: 94 ± 14.8 vs. 106 ± 14.8 nmol/l per minute; p > 0.05). Following JAM vs. CON feeding, glucose and insulin levels declined more rapidly until 240 min PP and tended to be lower (p = 0.053 and p = 0.056, respectively) at this time point. This result might be promising and should further be studied more detailed. Journal of Animal Physiology and Animal Nutrition © 2017 Blackwell Verlag GmbH.

  15. Dietary approach to hypertension based on low glycaemic index and principles of DASH (Dietary Approaches to Stop Hypertension): a randomised trial in a primary care service.

    Science.gov (United States)

    Lima, Sílvia Tereza Rodrigues Moreira; da Silva Nalin de Souza, Bárbara; França, Ana Karina Teixeira; Salgado Filho, Natalino; Sichieri, Rosely

    2013-10-01

    Hypertension is one of the leading causes of morbidity and mortality in Brazil. Diet may play an important role in reducing blood pressure (BP), as has been shown for diets high in fruits, vegetables and low-fat dairy products and low in salt (Dietary Approaches to Stop Hypertension (DASH)-Na). A low-glycaemic index Brazilian diet combined with the principles of the DASH-Na diet was evaluated in a randomised study of 206 individuals who were followed for 6 months. In the control group (CG), counselling was based on standard care and mainly focused on salt intake reduction. An intention-to-treat analysis showed that, after 6 months, systolic BP was reduced by 14·4 mmHg and diastolic BP by 9·7 mmHg in the experimental group (EG), compared with 6·7 and 4·6 mmHg, respectively, in the CG. After adjusting for body weight, BP at baseline and age, these changes were 12·1 and 7·9 mmHg, respectively. Urinary Na excretion was also reduced by 43·4 mEq/24 h in the EG. Food intake was modified accordingly during the intervention with an increase in the consumption of vegetables (2·97-5·85 frequency of consumption measured in three non-consecutive days), fruits (4·09-7·18), beans (1·94-3·13) and fish (1·80-2·74) by the EG. The present study showed the feasibility of a Brazilian dietary approach to treating hypertension by reducing urinary Na excretion and BP, changes that may have a great impact on public health and promote the benefits of controlling hypertension.

  16. Oral versus intubated feeding and the effect on glycaemic and insulinaemic responses, gastric emptying and satiety.

    Science.gov (United States)

    Morey, S; Shafat, A; Clegg, M E

    2016-01-01

    Cephalic phase responses (CPR) are important in early initiation of digestion and maximal absorption of nutrients prior to ingestion. Bypassing CPR has been shown to have consequences on metabolic responses that may influence satiety. The aim of this study was to investigate if using gastric intubation to bypass oro-pharyngeal and oesophageal exposure would reduce CPR including insulin and blood glucose and whether these impact on gastric emptying and satiety. Ten male subjects were tested on 2 occasions, 3-7 days apart after an overnight fast, in randomized order. Subjects were cannulated and intubated with a gastric tube for both tests. For test one, subjects ate 400 ml soup with a spoon and for test two the soup was infused into the stomach at an equivalent rate. Subsequently measurements of glycaemic (GR) and insulinaemic responses (IR) from cannula samples, breath samples for measurement of gastric emptying using the [(13)C] sodium acetate breath test and visual analogue scales (VAS) for satiety were taken over 180 min. There were differences in IR over the first 15 min (Oral: 169.0 ± 22.1; Gastric 124.1 ± 18.8; t(9) = 2.67; p = 0.028) but no difference in GR. There were differences in gastric emptying half time (Oral: 85.0 ± 2.7; Gastric 79.4 ± 3.3; t(9) = 2.40; p = 0.04) and ascension time (Oral: 68.2 ± 2.2; Gastric 64.0 ± 2.2; t(9) = 2.57; p = 0.03) with food taking longer to empty from the stomach on the Oral test day than on the Gastric test day. There was no significant difference in the satiety ratings. This study demonstrated that bypassing oro-pharyngeal and oesophageal exposure decreases the normal physiological CPR with detriment to IR and gastric emptying.

  17. The glycaemic index: importance of dietary fibre and other food properties.

    Science.gov (United States)

    Björck, Inger; Elmståhl, Helena Liljeberg

    2003-02-01

    An increasing body of evidence suggests that a low-glycaemic-index (GI) diet has a therapeutic as well as a preventive potential in relation to the insulin resistance syndrome. The implementation of a low-GI diet, however, will require an extended list of low-GI foods to be available on the market. The tailoring of low-GI bread products offers a particular challenge due to their generally high GI and abundance in the diet. Low-GI bread products can be tailored by, for example,enclosure of cereal kernels, sour dough fermentation and/or addition of organic acids, or use of cereal genotypes with elevated contents of amylose or f-glucans. Low-GI cereal foods appear to vary in effect on 'second-meal' glucose tolerance in healthy subjects. In addition to the slow-release properties of such foods, the content of dietary fibre appears to play a role. The low glycaemia to starch in a pasta breakfast (GI 54) promoted a higher glucose tolerance and lowered triacylglycerol levels at a standardized lunch ingested 4 h later, compared with a white-wheat-bread breakfast (GI 100). The metabolic benefits of the low GI properties per se have been demonstrated also in the longer term. Thus, a reduction in dietary GI improved glucose and lipid metabolism and normalized fibrinolytic activity in type 2 diabetics, while maintaining a similar amount and composition of dietary fibre. However, the higher dietary fibre content frequently associated with low-GI foods may add to the metabolic merits of a low-GI diet. Consequently, a low-GI barley meal rich in dietary fibre (GI 53) improved glucose tolerance from evening meal to breakfast, whereas an evening meal with pasta had no effect (GI 54). The exchange of common high-GI bread for low-GI high-fibre bread, as the only dietary modification, improved insulin economy in women at risk of type 2 diabetes. These results are in accordance with epidemiological evidence of a reduced risk of type 2 diabetes with a low-GI diet rich in cereal fibre. It

  18. The sentence superiority effect revisited.

    Science.gov (United States)

    Snell, Joshua; Grainger, Jonathan

    2017-11-01

    A sentence superiority effect was investigated using post-cued word-in-sequence identification with the rapid parallel visual presentation (RPVP) of four horizontally aligned words. The four words were presented for 200ms followed by a post-mask and cue for partial report. They could form a grammatically correct sentence or were formed of the same words in a scrambled agrammatical sequence. Word identification was higher in the syntactically correct sequences, and crucially, this sentence superiority effect did not vary as a function of the target's position in the sequence. Cloze probability measures for words at the final, arguably most predictable position, revealed overall low values that did not interact with the effects of sentence context, suggesting that these effects were not driven by word predictability. The results point to a level of parallel processing across multiple words that enables rapid extraction of their syntactic categories. These generate a sentence-level representation that constrains the recognition process for individual words, thus facilitating parallel word processing when the sequence is grammatically sound. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Scientific Opinion on the substantiation of health claims related to glycaemic carbohydrates and maintenance of normal brain function pursuant to Article 13(5) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Tetens, Inge

    an opinion on the scientific substantiation of health claims related to glycaemic carbohydrates and maintenance of normal brain function. The scope of the applications was proposed to fall under health claims based on newly developed scientific evidence. The Panel considers that the food constituent......, glycaemic carbohydrates, which is the subject of the health claims, is sufficiently characterised in relation to the claimed effect. Maintenance of normal brain function is a beneficial physiological effect. A claim on glycaemic carbohydrates and maintenance of normal brain function has already been...

  20. Superior efficacy of St John's wort extract WS® 5570 compared to placebo in patients with major depression: a randomized, double-blind, placebo-controlled, multi-center trial [ISRCTN77277298

    Directory of Open Access Journals (Sweden)

    Dienel Angelika

    2006-06-01

    Full Text Available Abstract Background The aim of the current study was to assess the antidepressant efficacy and safety of Hypericum perforatum (St. John's wort extract WS® 5570 at doses of 600 mg/day in a single dose and 1200 mg/day in two doses. Methods The participants in this double-blind, randomized, placebo-controlled, multi-center clinical trial were male and female adult out-patients with an episode of mild or moderate major depressive episode (single or recurrent episode, DSM-IV criteria. As specified by the relevant guideline, the study was preceded by a medication-free run-in phase. For the 6-week treatment, 332 patients were randomized: 123 to WS® 5570 600 mg/day, 127 to WS® 5570 1200 mg/day, and 82 to placebo. The primary outcome measure was the change in total score on the Hamilton Rating Scale for Depression (HAM-D, 17-item version between baseline and endpoint. Additional measures included the number of responders, the number of patients in remission, and several other standard rating scales. Efficacy and safety were assessed after 2 and 6 weeks. The design included an interim analysis performed after randomization with the option of early termination. Results After 6 weeks of treatment, mean ± standard deviation decreases in HAM-D total scores of 11.6 ± 6.4, 10.8 ± 7.3, and 6.0 ± 8.1 points were observed for the WS® 5570 600 mg/day, 1200 mg/day and placebo groups, respectively (endpoint analysis. Secondary measures of treatment efficacy also showed that both WS® 5570 groups were statistically superior to placebo. Significantly more patients in the WS® 5570 treatment groups than in the placebo group showed treatment response and remission. WS® 5570 was consistently more effective than placebo in patients with either less severe or more severe baseline impairment. The number of patients who experienced remission was higher in the WS® 5570 1200 mg/day group than the WS® 5570 600 mg/day group. The incidence of adverse events was low in

  1. 78 FR 21116 - Superior Supplier Incentive Program

    Science.gov (United States)

    2013-04-09

    ... Department of the Navy Superior Supplier Incentive Program AGENCY: Department of the Navy, DoD. ACTION... policy that will establish a Superior Supplier Incentive Program (SSIP). Under the SSIP, contractors that..., performance, quality, and business relations would be granted Superior Supplier Status (SSS). Contractors...

  2. superior en México

    Directory of Open Access Journals (Sweden)

    César Mureddu Torres

    2008-01-01

    Full Text Available El presente artículo desarrolla algunos de los retos que ha traído consigo el acceso a la información existente en la red de Internet y lo que ello supone. Se abordan principalmente las consecuencias de la presencia actual de una sociedad llamada del conocimiento, si se mantiene la confusión entre conocimiento e información. Por ello, la sola gestión de la información no puede ser tomada como definitoria respecto a la función de educación superior confiada a las universidades. Hacerlo sería cometer un error aún más grave que la confusión teórica entre los términos mencionados.

  3. Evaluación del cumplimiento del control interno de un departamento de registro de una entidad de estudios superiores basado en técnicas de auditoría interna

    OpenAIRE

    Cambier Marmolejos, Enrique Ernesto

    2015-01-01

    Las Instituciones de Educación Superior durante las últimas décadas, han modificando su rol social y su modelo académico-educativo. Estos cambios han permitido adecuar las estructuras organizacionales de las Universidades públicas y privadas, a alcanzar el cumplimiento de los objetivos institucionales y asegurar su funcionamiento de acuerdo a leyes, normas, reglamentos y políticas internas vigentes. Las evaluaciones internas, como iniciativa de las universidades se promueven para determinar s...

  4. Glycaemic and insulin responses of diabetic patients to traditional Malaysian meals and the effect of guar gum.

    Science.gov (United States)

    Khalid, B A; Lee, L F; Samad, A H; Ng, M L

    1996-12-01

    The aims of the project were to determine the glycaemic and insulin responses of non-insulin dependent diabetic patients (NIDDM) to 3 traditional Malaysian meals compared to oral glucose, and to determine whether guar gum would affect these responses. Patients with NIDDM were tested with 75 g oral glucose and three common breakfast meals of the three main ethnic groups of Malaysia. When compared with the oral glucose group, significantly by lower blood glucose responses were seen at 90 and 120 minutes post prandial for nasi lemak (pnasi lemak and between 15 and 30 minutes (p<0.03) for mee sup but not with roti telur. With addition of guar gum, there was no significant change of insulin responses with the three meals but a significant increase was seen at 30 minutes (p<0.02) after ingestion of glucose.

  5. Glycaemic Profiles of Children With Overweight and Obesity in Free-living Conditions in Association With Cardiometabolic Risk

    Science.gov (United States)

    Rijks, Jesse; Karnebeek, Kylie; van Dijk, Jan-Willem; Dorenbos, Elke; Gerver, Willem-Jan; Stouthart, Pauline; Plat, Jogchum; Vreugdenhil, Anita

    2016-01-01

    Insulin resistance is common among children with overweight and obesity. However, knowledge about glucose fluctuations in these children is scarce. This study aims to evaluate glycaemic profiles in children with overweight and obesity in free-living conditions, and to examine the association between glycaemic profiles with insulin resistance and cardiovascular risk parameters. One hundred eleven children with overweight and obesity were included. 48-hour sensor glucose concentrations in free-living conditions, fasting plasma and post-glucose load concentrations, serum lipid and lipoprotein concentrations, homeostatic model assessment of insulin resistance (HOMA-IR), and blood pressure were evaluated. Hyperglycaemic glucose excursions (≥7.8 mmol/L) were observed in 25% (n = 28) of the children. The median sensor glucose concentration was 5.0 (2.7–7.3) mmol/L, and correlated with fasting plasma glucose concentrations (rs = 0.190, p = 0.046), serum insulin concentrations (rs = 0.218, p = 0.021), and HOMA-IR (rs = 0.230, p = 0.015). The hyperglycaemic area under the curve (AUC) correlated with waist circumference z-score (rs = 0.455, p = 0.025), triacylglycerol concentrations (rs = 0.425, p = 0.024), and HOMA-IR (rs = 0.616, p obesity in free-living conditions. Children with insulin resistance had higher median sensor glucose concentrations and a larger hyperglycaemic sensor glucose AUC, which are both associated with specific parameters predicting cardiovascular disease risk. PMID:27534260

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

    Directory of Open Access Journals (Sweden)

    Momoko Horikoshi

    2015-07-01

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

  7. Escuela Superior de Palos Verdes

    Directory of Open Access Journals (Sweden)

    Neutra, Richard J.

    1965-02-01

    Full Text Available Before initiating the building operations for the «Palos Verdes» School, the site was divided into two large horizontal surfaces, at different levels. The lower one served to accommodate the playing fields, a car park, the physical training building, and shop and ancillary buildings. On the higher of these two surfaces, and to the West of the access road, there is a car park and also the building and plot of ground devoted to agricultural technology, as well as the literary studies and general purpose buildings. As a complement to these, there is a series of blocks, arranged in parallel rows, which house the administrative offices, the art school, the craft's school, the general classrooms, and those devoted to higher education. The fascinating aspect of this school is the outstanding penetration of the architect's mind into the essential function of the project. Its most evident merit is the sense of comradeship and harmony that permeates the whole architectural manifold.Antes de construir el complejo escolar «Palos Verdes» se comenzó por crear, en el terreno, dos grandes mesetas a niveles diferentes. Sobre el inferior se organizaron: los campos de juegos, de deportes, un aparcamiento, el edificio para educación física y los destinados a tiendas y servicios. Sobre la meseta superior, al oeste de la vía de acceso, se dispuso un aparcamiento y el edificio y campo para adiestramiento agrícola; al este, otro aparcamiento, el edificio dedicado a materias literarias, y el destinado a usos múltiples. Completan las instalaciones de la escuela una serie de bloques paralelos: la administración, la escuela de arte, las clases de trabajos manuales, las aulas de enseñanzas generales, y las de los cursos superiores. Lo fascinante de este complejo escolar es la perfecta y magistral compenetración del arquitecto con el tema proyectado, y su mayor mérito, la sensación de cordialidad y armonía con el ambiente.

  8. Sobredentadura total superior implantosoportada Superior total overdenture on implants

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.This is the case of a total maxilla edentulous patient seen in consultation of the "Pedro Ortíz" Clinic Implant of Habana del Este municipality in 2009 and con rehabilitation by prosthesis over osteointegration implants added to stomatology practice in Cuba as an alternative to conventional treatment in patients totally edentulous. We follow a protocol including a surgery or surgical phase, technique without or with flap creation and early or immediate load. This is a male patient aged 56 came to our multidisciplinary consultation worried because he had three prostheses in last two years and any fulfilled the requirements of retention to feel safe and comfortable with prostheses. The final result was the total satisfaction of rehabilitated patient improving its aesthetic and functional quality.

  9. Mnemonic Training Reshapes Brain Networks to Support Superior Memory

    NARCIS (Netherlands)

    Dresler, M.; Shirer, W.R.; Konrad, B.N.; Muller, N.C.J.; Wagner, I.; Fernandez, G.S.E.; Czisch, M.; Greicius, M.D.

    2017-01-01

    Memory skills strongly differ across the general population; however, little is known about the brain characteristics supporting superior memory performance. Here we assess functional brain network organization of 23 of the world's most successful memory athletes and matched controls with fMRI

  10. Noise management to achieve superiority in quantum information systems.

    Science.gov (United States)

    Nemoto, Kae; Devitt, Simon; Munro, William J

    2017-08-06

    Quantum information systems are expected to exhibit superiority compared with their classical counterparts. This superiority arises from the quantum coherences present in these quantum systems, which are obviously absent in classical ones. To exploit such quantum coherences, it is essential to control the phase information in the quantum state. The phase is analogue in nature, rather than binary. This makes quantum information technology fundamentally different from our classical digital information technology. In this paper, we analyse error sources and illustrate how these errors must be managed for the system to achieve the required fidelity and a quantum superiority.This article is part of the themed issue 'Quantum technology for the 21st century'. © 2017 The Author(s).

  11. False memories in highly superior autobiographical memory individuals.

    Science.gov (United States)

    Patihis, Lawrence; Frenda, Steven J; LePort, Aurora K R; Petersen, Nicole; Nichols, Rebecca M; Stark, Craig E L; McGaugh, James L; Loftus, Elizabeth F

    2013-12-24

    The recent identification of highly superior autobiographical memory (HSAM) raised the possibility that there may be individuals who are immune to memory distortions. We measured HSAM participants' and age- and sex-matched controls' susceptibility to false memories using several research paradigms. HSAM participants and controls were both susceptible to false recognition of nonpresented critical lure words in an associative word-list task. In a misinformation task, HSAM participants showed higher overall false memory compared with that of controls for details in a photographic slideshow. HSAM participants were equally as likely as controls to mistakenly report they had seen nonexistent footage of a plane crash. Finding false memories in a superior-memory group suggests that malleable reconstructive mechanisms may be fundamental to episodic remembering. Paradoxically, HSAM individuals may retrieve abundant and accurate autobiographical memories using fallible reconstructive processes.

  12. Improved metabolic response after 16 weeks of calorie-restricted low-glycaemic index diet and metformin in impaired glucose tolerance subjects

    Directory of Open Access Journals (Sweden)

    Teresa Helena Macedo da Costa

    2014-05-01

    Full Text Available Aim: This study analyzed the metabolic effects of dietary advice to follow calorie-restricted low-glycaemic index diet with metformin in overweight / obese impaired glucose tolerance subjects. Methods: Sixteen subjects with body mass index between 27-38 kg/m² were followed monthly for 16 weeks and treated with metformin (1 g/day and dietary prescription for low-glycaemic index diet with energy reduction of 25-30% their total energy expenditure. Glucose metabolism, lipid profile, anthropometric and body composition, and food intake parameters were measured before and after the treatment. Paired t-tests/Wilcoxon tests were used to compare differences from baseline, with a statistical significance criterion of p < 0.05. Results: There were significant reductions in anthropometric and body composition parameters, decrease in HOMA2-%β and triglycerides concentrations, and increase in Cederholm index. These results show enhanced peripheral insulin sensitivity and preservation of pancreatic beta-cell function. Conclusion: Calorie-restricted low-glycaemic index diet and metformin was benefit to metabolic and anthropometric parameters in overweight/obese subjects with impaired glucose tolerance.

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

    LENUS (Irish Health Repository)

    Murphy, Mark E

    2017-08-04

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

  14. Glucose control in non-critically ill inpatients with diabetes: towards closed-loop.

    Science.gov (United States)

    Thabit, H; Hovorka, R

    2014-06-01

    Inpatient glycaemic control remains an important issue due to the increasing number of patients with diabetes admitted to hospital. Morbidity and mortality in hospital are associated with poor glucose control, and cost of hospitalization is higher compared to non-diabetes patients. Guidelines for inpatient glycaemic control in the non-critical care setting have been published. Current recommendations include basal-bolus insulin therapy, regular glucose monitoring, as well as enhancing healthcare provider's role and knowledge. In spite of growing focus, implementation in practice is limited, mainly due to increasing workload burden on staff and fear of hypoglycaemia. Advances in healthcare technology may contribute to an improvement of inpatient diabetes care. Integration of glucose measurements with healthcare records and computerized glycaemic control protocols are currently being used in some institutions. Recent interests in continuous glucose monitoring have led to studies assessing its utilization in inpatients. Automation of glucose monitoring and insulin delivery may provide a safe and efficacious tool for hospital staff to manage inpatient hyperglycaemia, whilst reducing staff workload. This review summarizes the evidence on current approaches to managing inpatient glycaemic control; its utility and limitations. We conclude by discussing the evidence from feasibility studies to date, on the potential use of closed loop in the non-critical care setting and its implication for future studies.

  15. Paso superior en una ladera

    Directory of Open Access Journals (Sweden)

    Bender, O.

    1965-07-01

    Full Text Available The Redwood highway, through the Californian forest, runs on a viaduct, as it crosses a mountain slope of about 45° inclination. The firm ground is fairly deep, and as an additional constructional difficulty, it was necessary to respect the natural beauty of the countryside. A structure of portal frames were built, forming a number of short spans. These spans were bridged with metal girders, on which a 19 m wide deck was placed. The columns are hollow and have a transversal cross beam, to join each pair. There was difficulty in excavating the foundations for the columns, as it was necessary to dig through the soft top soil, and also prevent this soil from hurting the trunks of the forest trees. Another significant difficulty in the construction of this viaduct was the access to the working site, since there were no suitable platforms from which to operate the appropriate machinery. This made it necessary to do a lot of the work by manual operation. As one of the edges of the deck is very close to the mountain side, a supporting beam was erected on this side. It was made of concrete, on metal piles. The formwork for the deck structure was placed on the concrete stems of the supporting piles.La autopista denominada Redwood (California salva, con un paso superior, la ladera de un bosque cuya pendiente es del 1/1. El terreno firme se halla a bastante profundidad, añadiéndose, a los naturales problemas de la construcción, el imperativo de respetar la belleza agreste del paraje. La solución adoptada consiste en una estructura porticada, con varios tramos de pequeñas luces, salvados con vigas metálicas, sobre los que se coloca la losa del tablero, de 19 m de anchura total. Los soportes están constituidos por pórticos de dos montantes huecos (con bases de hormigón en masa por debajo del suelo, hasta el firme coronados por un cabezal. La perforación de pozos para el hormigonado de los montantes presentaba la dificultad de atravesar el terreno

  16. Superior efficacy of new medicines?

    NARCIS (Netherlands)

    Luijn, J.C.F. van; Gribnau, F.W.J.; Leufkens, H.G.M.

    2010-01-01

    PURPOSE: To provide an overview of and discuss newly authorised medicines with an improved efficacy. METHODS: This analysis focussed on new medicines with an improved efficacy based on the results of randomised active control trials. Information on comparative efficacy was obtained from the European

  17. Pseudodisplacements of superior vena cava catheter in the persistent left superior vena cava

    Energy Technology Data Exchange (ETDEWEB)

    Jantsch, H.; Draxler, V.; Muhar, U.; Schlemmer, M.; Waneck, R.

    1983-01-01

    Pseudodisplacement of a left sided superior vena cava catheter in a persistent superior vena cava may be expected in adults in 0,37% and in a group of children with congenital heart disease in 2,5%. Embryology, anatomy and clinical implications is discussed on the basis of our own cases. The vena cava superior sinistra persitents is depending on a sufficient calibre a suitable vessel for a superior cava catheter.

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

    Directory of Open Access Journals (Sweden)

    Madan Kumar Chapagai

    2016-08-01

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

  19. File list: InP.Neu.50.AllAg.Superior_Cervical_Ganglion [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  20. File list: InP.Neu.05.AllAg.Superior_Cervical_Ganglion [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  1. File list: InP.Neu.20.AllAg.Superior_Cervical_Ganglion [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  2. File list: InP.Neu.10.AllAg.Superior_Cervical_Ganglion [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Neu.10.AllAg.Superior_Cervical_Ganglion mm9 Input control Neural Superior Cervi...cal Ganglion SRX435085 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Neu.10.AllAg.Superior_Cervical_Ganglion.bed ...

  3. Superiority in value and the repugnant conclusion

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint

    2007-01-01

    James Griffin has considered a weak form of superiority in value a possible remedy to the Repugnant Conclusion. In this paper, I demonstrate that, in a context where value is additive, this weaker form collapses into a stronger form of superiority. And in a context where value is non-additive, weak...... superiority does not amount to a radical value difference at all. I then spell out the consequences of these results for different interpretations of Griffin's suggestion regarding population ethics. None of them comes out very successful, but perhaps they nevertheless retain some interest....

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

    Science.gov (United States)

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

    2006-09-01

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

  5. Millian superiorities and the repugnant conclusion

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint

    2008-01-01

    James Griffin has considered a form of superiority in value that is weaker than lexical priority as a possible remedy to the Repugnant Conclusion. In this article, I demonstrate that, in a context where value is additive, this weaker form collapses into the stronger form of superiority. And in a ......James Griffin has considered a form of superiority in value that is weaker than lexical priority as a possible remedy to the Repugnant Conclusion. In this article, I demonstrate that, in a context where value is additive, this weaker form collapses into the stronger form of superiority...... of these results for different interpretations of Griffin's suggestion regarding population ethics. None of them comes out very successful, but perhaps they nevertheless retain some interest....

  6. Measuring Financial Gains from Genetically Superior Trees

    Science.gov (United States)

    George Dutrow; Clark Row

    1976-01-01

    Planting genetically superior loblolly pines will probably yield high profits.Forest economists have made computer simulations that predict financial gains expected from a tree improvement program under actual field conditions.

  7. Superior mesenteric artery syndrome causing growth retardation

    Directory of Open Access Journals (Sweden)

    Halil İbrahim Taşcı

    2013-03-01

    Full Text Available Superior mesenteric artery syndrome is a rare and lifethreateningclinical condition caused by the compressionof the third portion of the duodenum between the aortaand the superior mesenteric artery’s proximal part. Thiscompression may lead to chronic intermittent, acute totalor partial obstruction. Sudden weight-loss and the relateddecrease in the fat tissue are considered to be the etiologicalreason of acute stenosis. Weight-loss accompaniedby nausea, vomiting, anorexia, epigastric pain, andbloating are the leading complaints. Barium radiographs,computerized tomography, conventional angiography,tomographic and magnetic resonance angiography areused in the diagnosis. There are medical and surgical approachesto treatment. We hereby present the case ofa patient with superior mesenteric artery syndrome withdelayed diagnosis.Key words: superior mesenteric artery syndrome, nausea-vomiting, anorexia

  8. Leiomyosarcoma of the superior vena cava.

    Science.gov (United States)

    de Chaumont, Arthus; Pierret, Charles; de Kerangal, Xavier; Le Moulec, Sylvestre; Laborde, François

    2014-08-01

    Leiomyosarcoma of the superior vena cava is a very rare tumor and only a few cases have been reported, with various techniques of vascular reconstruction. We describe a new case of leiomyosarcoma of the superior vena cava in a 61-year-old woman with extension to the brachiocephalic arterial trunk. Resection and vascular reconstruction were performed using, respectively, polytetrafluoroethylene and polyethylene terephtalate vascular grafts.

  9. Superior mesenteric artery compression syndrome - case report

    OpenAIRE

    Paulo Rocha França Neto; Rodrigo de Almeida Paiva; Antônio Lacerda Filho; Fábio Lopes de Queiroz; Teon Noronha

    2011-01-01

    Superior mesenteric artery syndrome is an entity generally caused by the loss of the intervening mesenteric fat pad, resulting in compression of the third portion of the duodenum by the superior mesenteric artery. This article reports the case of a patient with irremovable metastatic adenocarcinoma in the sigmoid colon, that evolved with intense vomiting. Intestinal transit was carried out, which showed important gastric dilation extended until the third portion of the duodenum, compatible wi...

  10. DESyne novolimus-eluting coronary stent is superior to Endeavor zotarolimus-eluting coronary stent at five-year follow-up: final results of the multicentre EXCELLA II randomised controlled trial.

    Science.gov (United States)

    Iqbal, Javaid; Verheye, Stefan; Abizaid, Alexandre; Ormiston, John; de Vries, Ton; Morrison, Lynn; Toyloy, Sara; Fitzgerald, Peter; Windecker, Stephan; Serruys, Patrick W

    2016-12-10

    Newer-generation drug-eluting stents (DES) have been shown to be superior to first-generation DES. Current-generation DES have zotarolimus, everolimus or biolimus as antiproliferative drugs. Novolimus, a metabolite of sirolimus, has been specifically developed to provide efficacy similar to currently available agents at a lower dose and thus requires a lower polymer load. We report the final five-year outcomes of the EXCELLA II trial comparing a zotarolimus-eluting stent (ZES) with a novolimus-eluting stent (NES). EXCELLA II is a prospective, multicentre, single-blind, non-inferiority clinical trial. Patients (n=210) with a maximum of two de novo lesions in two different epicardial vessels were randomised (2:1) to treatment with either NES (n=139) or ZES (n=71). At five-year follow-up, patients in the NES group had a significantly lower incidence of the patient-oriented (HR 0.53, 95% CI: 0.32-0.87, p=0.013) and device-oriented (HR 0.38, 95% CI: 0.17-0.83, p=0.011) composite endpoints. There was no difference in cardiac death and definite/probable stent thrombosis between the two groups; however, there was a trend towards reduction in myocardial infarction and repeat revascularisation in the NES group at five-year follow-up. At five-year follow-up, the incidence of device- and patient-oriented events was significantly lower in the NES group. Further studies, adequately powered for clinical outcomes, are warranted.

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

    Science.gov (United States)

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

    2009-09-01

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

  12. Pseudoaneurysm of the superior gluteal artery following polytrauma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dennis [Vancouver General Hospital, University of British Columbia and Department of Radiology, Vancouver, BC (Canada); Legiehn, Gerald M. [Vancouver General Hospital, Interventional Radiology, University of British Columbia and Department of Radiology, Vancouver, BC (Canada); Munk, Peter L. [Vancouver General Hospital, MSK Section, University of British Columbia and Department of Radiology, Vancouver, BC (Canada)

    2007-09-15

    Gluteal artery aneurysms are rare and often secondary to pelvic fractures, blunt or penetrating trauma. We describe a case of a superior gluteal artery pseudoaneurysm that presented as back pain with numbness and weakness of the lower extremities. Diagnosis was confirmed by color Doppler sonography and angiography. A proximal and distal control was obtained over the aneurysm neck via coil embolization with excellent hemostasis within the pseudoaneurysm and maintenance of perfusion to the left pelvis. (orig.)

  13. Pseudoaneurysm of the superior gluteal artery following polytrauma.

    Science.gov (United States)

    Lee, Dennis; Legiehn, Gerald M; Munk, Peter L

    2007-09-01

    Gluteal artery aneurysms are rare and often secondary to pelvic fractures, blunt or penetrating trauma. We describe a case of a superior gluteal artery pseudoaneurysm that presented as back pain with numbness and weakness of the lower extremities. Diagnosis was confirmed by color Doppler sonography and angiography. A proximal and distal control was obtained over the aneurysm neck via coil embolization with excellent hemostasis within the pseudoaneurysm and maintenance of perfusion to the left pelvis.

  14. Superior oblique surgery: when and how?

    Directory of Open Access Journals (Sweden)

    Taylan Şekeroğlu H

    2013-08-01

    Full Text Available Hande Taylan Şekeroğlu,1 Ali Sefik Sanac,1 Umut Arslan,2 Emin Cumhur Sener11Department of Ophthalmology, 2Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, TurkeyBackground: The purpose of this paper is to review different types of superior oblique muscle surgeries, to describe the main areas in clinical practice where superior oblique surgery is required or preferred, and to discuss the preferred types of superior oblique surgery with respect to their clinical outcomes.Methods: A consecutive nonrandomized retrospective series of patients who had undergone superior oblique muscle surgery as a single procedure were enrolled in the study. The diagnosis, clinical features, preoperative and postoperative vertical deviations in primary position, type of surgery, complications, and clinical outcomes were reviewed. The primary outcome measures were the type of strabismus and the type of superior oblique muscle surgery. The secondary outcome measure was the results of the surgeries.Results: The review identified 40 (20 male, 20 female patients with a median age of 6 (2–45 years. Nineteen patients (47.5% had Brown syndrome, eleven (27.5% had fourth nerve palsy, and ten (25.0% had horizontal deviations with A pattern. The most commonly performed surgery was superior oblique tenotomy in 29 (72.5% patients followed by superior oblique tuck in eleven (27.5% patients. The amount of vertical deviation in the fourth nerve palsy and Brown syndrome groups (P = 0.01 for both and the amount of A pattern in the A pattern group were significantly reduced postoperatively (P = 0.02.Conclusion: Surgery for the superior oblique muscle requires experience and appropriate preoperative evaluation in view of its challenging nature. The main indications are Brown syndrome, fourth nerve palsy, and A pattern deviations. Superior oblique surgery may be effective in terms of pattern collapse and correction of vertical deviations in primary

  15. THE HUMAN SUBJECTIVITY BETWEEN THE SUPERIOR AND INFERIOR TYPES A SUBJETIVIDADE HUMANA ENTRE OS TIPOS SUPERIORES E INFERIORES

    Directory of Open Access Journals (Sweden)

    Vagner Silva

    2011-12-01

    Full Text Available This article attempts to solve the following contradiction of Nietzsche's thought: man has a subjective drive constitution, these drives, however, are individuals, and its being (the being of the drives, is constituted for more power fight (the will to power. Nietzsche's superior man (educated and cultivated man is that one, in which there is harmony in the drives, who can give greater freedom to its most terrible drives, without, however, loses the control over them. That is the contradiction: if man has to control the drives, they are not harmonics. There is incompatibility between harmony and control. In other words, the superior man is indeed the man of culture and cultivated man of Nietzsche? If the answer to this question is yes, then, in this man, reigns the drives harmony. If, on the other hand, the answer is no, then, for this man does not become a barbarian destroyer, dangerous to himself and to others it is necessary that a drive dominates the others. However it is not possible to escape the contradiction: either there is harmony in human drive or control.Este artigo busca resolver a seguinte contradição do pensamento de Nietzsche: o homem possui uma constituição subjetiva pulsional, estas pulsões, porém, são individuais, e o seu ser, o das pulsões, constitui-se da luta por mais poder (vontade de poder. O homem superior de Nietzsche (homem culto e cultivado é aquele no qual há harmonia nas pulsões, aquele que pode dar mais liberdade às suas mais terríveis pulsões, sem, no entanto, perder o controle sobre elas. Eis a contradição: se o homem superior exerce controle sobre as pulsões então elas não são harmônicas. Há, aqui, a incompatibilidade entre harmonia e controle. Em outros termos: o homem superior é de fato o homem culto e cultivado de Nietzsche? Se a resposta para esta pergunta for sim, então neste homem reina a harmonia pulsional. Se, por outro lado, a resposta for não, então, para que este homem n

  16. Report of a 7 year case-control study of continuous intraperitoneal insulin infusion and subcutaneous insulin therapy among patients with poorly controlled type 1 diabetes mellitus : Favourable effects on hypoglycaemic episodes

    NARCIS (Netherlands)

    van Dijk, P. R.; Logtenberg, S. J. J.; Groenier, K. H.; Gans, R. O. B.; Bilo, H. J. G.; Kleefstra, N.

    2014-01-01

    Aims: Continuous intraperitoneal insulin infusion (CIPII) is a last-resort treatment option for patients with type 1 diabetes mellitus (T1DM) who fail to reach adequate glycaemic control with subcutaneous (SC) insulin therapy. Aim was to compare the long-term effects of CIPII and SC insulin therapy

  17. Report of a 7 year case-control study of continuous intraperitoneal insulin infusion and subcutaneous insulin therapy among patients with poorly controlled type 1 diabetes mellitus : Favourable effects on hypoglycaemic episodes

    NARCIS (Netherlands)

    van Dijk, P. R.; Logtenberg, S. J. J.; Groenier, K. H.; Gans, R. O. B.; Bilo, H. J. G.; Kleefstra, N.

    2014-01-01

    Aims: Continuous intraperitoneal insulin infusion (CIPII) is a last-resort treatment option for patients with type 1 diabetes mellitus (T1DM) who fail to reach adequate glycaemic control with subcutaneous (SC) insulin therapy. Aim was to compare the long-term effects of CIPII and SC insulin therapy

  18. Low-volume high-intensity swim training is superior to high-volume low-intensity training in relation to insulin sensitivity and glucose control in inactive middle-aged women

    DEFF Research Database (Denmark)

    Connolly, Luke J; Nordsborg, Nikolai Baastrup; Nyberg, Michael Permin

    2016-01-01

    to an inactive control (n = 20; CON), a high-intensity low-volume (n = 21; HIT) or a low-intensity high-volume (n = 21; LIT) training group. During the 15-week intervention period, HIT performed 3 weekly 6-10 × 30-s all-out swimming intervals (average heart rate (HR) = 86 ± 3 % HRmax) interspersed by 2-min...... adhesion molecule 1 had decreased (P training strategy for improving insulin sensitivity, glucose control and biomarkers of vascular function...

  19. Type 2 diabetes seems not to be a risk factor for the carpal tunnel syndrome : a case control study

    NARCIS (Netherlands)

    Hendriks, Steven H.; van Dijk, Peter R.; Groenier, Klaas H.; Houpt, Peter; Bilo, Henk J. G.; Kleefstra, Nanne

    2014-01-01

    BACKGROUND: Previous studies have shown that the carpal tunnel syndrome seems to occur more frequently in patients with diabetes mellitus and might be associated with the duration of diabetes mellitus, microvascular complications and degree of glycaemic control. Primary aim was to determine if type

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

    DEFF Research Database (Denmark)

    Vestergaard, H; Lund, S; Bjørbaek, C

    1995-01-01

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

  1. Addition of low-dose rosiglitazone to sulphonylurea therapy improves glycaemic control in Type 2 diabetic patients

    NARCIS (Netherlands)

    Wolffenbuttel, B H; Gomis, R; Squatrito, S; Jones, N P; Patwardhan, R N

    2000-01-01

    AIMS: This study was designed to test the efficacy and safety of low-dose rosiglitazone, a potent, insulin-sensitizing thiazolidinedione, in combination with sulphonylurea in Type 2 diabetic patients. METHODS: For the intention-to-treat analysis, 574 patients (59% male, mean age 61 years) were avail

  2. Addition of low-dose rosiglitazone to sulphonylurea therapy improves glycaemic control in Type 2 diabetic patients

    NARCIS (Netherlands)

    Wolffenbuttel, B H; Gomis, R; Squatrito, S; Jones, N P; Patwardhan, R N

    2000-01-01

    AIMS: This study was designed to test the efficacy and safety of low-dose rosiglitazone, a potent, insulin-sensitizing thiazolidinedione, in combination with sulphonylurea in Type 2 diabetic patients. METHODS: For the intention-to-treat analysis, 574 patients (59% male, mean age 61 years) were avail

  3. Impact of cancer diagnosis and treatment on glycaemic control among individuals with colorectal cancer using glucose lowering drugs

    NARCIS (Netherlands)

    Zanders, M.M.J.; van Herk-Sukel, M.P.P.; Herings, R.M.C.; van de Poll-Franse, L.V.; Haak, H.

    2016-01-01

    Aims This study aims to evaluate the impact of cancer and its treatment on HbA1c values among individuals with colorectal cancer (CRC) using glucose-lowering drugs (GLDs). Methods Patients with primary CRC (1998–2011) were selected from the Eindhoven Cancer Registry and linked to the PHARMO Database

  4. Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes

    National Research Council Canada - National Science Library

    Kapoor, D; Goodwin, E; Channer, K S; Jones, T H

    2006-01-01

    ... (Correspondence should be addressed to T H Jones; Email: hugh.jones{at}bdgh-tr.trent.nhs.uk ) Objective : Low levels of testosterone in men have been shown to be associated with type 2 diabetes, visceral adiposity, dyslipidaemia and metabolic syndrome...

  5. body mass (ID 1412), reduction of post-prandial glycaemic responses (ID 1414), and maintenance of a normal blood lipid profile (1421) pursuant to Article 13(1) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Tetens, Inge

    claims in relation to very low calorie diets (VLCDs) and reduction in body weight, reduction in the sense of hunger, reduction in body fat mass while maintaining lean body mass, reduction of post-prandial glycaemic responses, and maintenance of normal blood lipid profile. The scientific substantiation......), very low calorie diet is not sufficiently characterised in relation to: reduction of post-prandial glycaemic responses (ID 1414) and maintenance of normal blood lipid profile (ID 1421), mainly owing to the lack of standardisation of the type of available carbohydrates and of most of the fatty acids...... that formula foods for use in very low calorie diets should contain. The Panel concludes that a cause and effect relationship cannot be established between the consumption of a very low calorie diet and reduction of post-prandial glycaemic responses (ID 1414) and maintenance of normal blood lipid profile (ID...

  6. Whisker-related afferents in superior colliculus.

    Science.gov (United States)

    Castro-Alamancos, Manuel A; Favero, Morgana

    2016-05-01

    Rodents use their whiskers to explore the environment, and the superior colliculus is part of the neural circuits that process this sensorimotor information. Cells in the intermediate layers of the superior colliculus integrate trigeminotectal afferents from trigeminal complex and corticotectal afferents from barrel cortex. Using histological methods in mice, we found that trigeminotectal and corticotectal synapses overlap somewhat as they innervate the lower and upper portions of the intermediate granular layer, respectively. Using electrophysiological recordings and optogenetics in anesthetized mice in vivo, we showed that, similar to rats, whisker deflections produce two successive responses that are driven by trigeminotectal and corticotectal afferents. We then employed in vivo and slice experiments to characterize the response properties of these afferents. In vivo, corticotectal responses triggered by electrical stimulation of the barrel cortex evoke activity in the superior colliculus that increases with stimulus intensity and depresses with increasing frequency. In slices from adult mice, optogenetic activation of channelrhodopsin-expressing trigeminotectal and corticotectal fibers revealed that cells in the intermediate layers receive more efficacious trigeminotectal, than corticotectal, synaptic inputs. Moreover, the efficacy of trigeminotectal inputs depresses more strongly with increasing frequency than that of corticotectal inputs. The intermediate layers of superior colliculus appear to be tuned to process strong but infrequent trigeminal inputs and weak but more persistent cortical inputs, which explains features of sensory responsiveness, such as the robust rapid sensory adaptation of whisker responses in the superior colliculus. Copyright © 2016 the American Physiological Society.

  7. Glycaemic index of selected staples commonly eaten in the Caribbean and the effects of boiling v. crushing.

    Science.gov (United States)

    Ramdath, D Dan; Isaacs, Renée L C; Teelucksingh, Surujpal; Wolever, Thomas M S

    2004-06-01

    Integrating information about the glycaemic index (GI) of foods into the Caribbean diet is limited by the lack of data. Therefore, we determined the GI of eight staple foods eaten in the Caribbean and the effect on GI of crushing selected tubers. Groups of eight to ten healthy volunteers participated in three studies at two sites. GI was determined using a standard method with white bread and adjusted relative to glucose. The mean area under the glucose response curve elicited by white bread was similar for the different groups of subjects. In study 1, the GI of cassava (Manihot esculenta; 94 (sem 11)) was significantly higher than those of breadfruit (Artocarpus altilis; 60 (sem 9)), cooking 'green' banana (Musa spp.; 65 (sem 11)) and sadha roti (65 (sem 9)) (P=0.018). There was no significant difference in the GI of the foods in study 2: dasheen (Colocasia esculenta var. esculenta; 77 (sem 10)), eddoes (Colocasia esculenta var. antiquorum; 61 (sem 10)), Irish potato (Solanum tuberosum; 71 (sem 8)), tannia (Xanthosoma sagittifolium; 60 (sem 5)) and white yam (Dioscorea alata; 62 (sem 6)), and, in study 3, crushing did not significantly affect the GI of dasheen, tannia or Irish potato. However, when the results from studies 2 and 3 were pooled, the GI of dasheen (76 (sem 7)) was significantly greater than that of tannia (55 (sem 5); P=0.015) with potato being intermediate (69 (sem 6)). We conclude that dasheen and cassava are high-GI foods, whereas the other tubers studied and sadha roti are intermediate-GI foods. Given the regular usage of cassava and dasheen in Caribbean diets we speculate that these diets would tend to be high GI, although this could be reduced by foods such as sadha roti and white yam. The range of GI between the staples is sufficiently large that health benefits may be accrued by replacing high-GI staples with intermediate-GI staples in the Caribbean diet.

  8. A STUDY ON THE CLINICAL CORRELATION OF THE GLYCAEMIC STATUS AND STROKE EVENTS AMONG STROKE PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    K. Ghanachandra Singh

    2016-09-01

    Full Text Available BACKGROUND AND OBJECTIVES Stroke is a common cause of chronic debilitating disease as a result of the vascular related effect of certain part of the brain. Also the mortality due to the nature of stroke either Intracerebral Haemorrhage (ICH or Cerebral Infarction (Ischaemic stroke vary, the earlier causing more fatality. The risk factors of the ICH or the Ischaemic stroke vary to certain degree. Glycaemic state of stroke patients affects the outcome of them. It is of importance to establish clinical correlation of the glycaemic status of the stroke patients with the type and extent of the lesion documented by Computerised Tomography (CT scan of brain for development of preventive measures and clinical management of such patients for better outcome. Hence, this study was conducted among stroke patients who were admitted in Medicine wards, Jawaharlal Nehru Institute of Medical Sciences (JNIMS, Porompat, Manipur. DATA AND METHODS A study of stroke cases was undertaken in patients who were admitted to Medicine wards, Jawaharlal Nehru Institute of Medical Sciences (JNIMS, Porompat, Manipur from January 2011 till December 2014. All the patients were investigated with CT scan brain, Blood sugar along with Glycosylated Haemoglobin (HbA1C besides other routine tests and recorded. RESULT Out of the 200 stroke patients registered in 48 months, 120 patients were having hyperglycaemia. All the patients with stress hyperglycaemia were haemorrhagic. 85.71% of the cases among known diabetes were also haemorrhagic. CONCLUSION Glycaemic state of patients presented in stroke gives a picture of clinical difference. The size of the lesion measured by CT scan of brain also varies among different types of hyperglycaemia and the prognosis of the patients and showed that those patients with higher glucose level had haemorrhagic lesions with bigger size and had higher mortality rate. The deteriorating glucose tolerance with age also contributes to the increased incidence

  9. Superior-subordinate relations as organizational processes

    DEFF Research Database (Denmark)

    Asmuss, Birte; Aggerholm, Helle Kryger; Oshima, Sae

    Since the emergence of the practice turn in social sciences (Golsorkhi et al. 2010), studies have shown a number of institutionally relevant aspects as achievements across time and by means of various resources (human and non-human) (Taylor & van Every 2000, Cooren et al. 2006). Such a process view...... on organizational practices relates closely to an increased focus on communication as being constitutive of the organization in general and the superior-subordinate relationship in specific. The current study aims to contribute to this line of research by investigating micro-practices involved in establishing...... superior-subordinate relations in a specific institutionalized setting: performance appraisal interviews (PAIs). While one main task of PAIs is to manage and integrate organizational and employee performance (Fletcher, 2001:473), PAIs are also organizational practices where superior-subordinate relations...

  10. Lake Superior Aquatic Invasive Species Complete Prevention Plan

    Science.gov (United States)

    The Lake Superior Aquatic Invasive Species Complete Prevention Plan is an expression of the best professional judgment of the members of the Lake Superior Task Force as to what is necessary to protect Lake Superior from new aquatic invasive species.

  11. Endovascular treatment of superior vena cava syndrome

    DEFF Research Database (Denmark)

    Duvnjak, Stevo; Andersen, Poul Erik

    2011-01-01

    Abstract AIM: The aim of this study was to report our experience with palliative stent treatment of superior vena cava syndrome. METHODS: Between January 2008 and December 2009, 30 patients (mean age 60.7 years) were treated with stents because of stenosed superior vena cava. All patients presented...... there was an immediate clinical improvement with considerable reduction in the edema of upper extremities and head. There was, however, continous dyspnea in five patients (17%) and two patients (7%) had persistent visible collateral venous circulations on the upper chest. There were no stent associated complications...

  12. Low-volume high-intensity swim training is superior to high-volume low-intensity training in relation to insulin sensitivity and glucose control in inactive middle-aged women.

    Science.gov (United States)

    Connolly, Luke J; Nordsborg, Nikolai B; Nyberg, Michael; Weihe, Pál; Krustrup, Peter; Mohr, Magni

    2016-10-01

    We tested the hypothesis that low-volume high-intensity swimming has a larger impact on insulin sensitivity and glucose control than high-volume low-intensity swimming in inactive premenopausal women with mild hypertension. Sixty-two untrained premenopausal women were randomised to an inactive control (n = 20; CON), a high-intensity low-volume (n = 21; HIT) or a low-intensity high-volume (n = 21; LIT) training group. During the 15-week intervention period, HIT performed 3 weekly 6-10 × 30-s all-out swimming intervals (average heart rate (HR) = 86 ± 3 % HRmax) interspersed by 2-min recovery periods and LIT swam continuously for 1 h at low intensity (average HR = 73 ± 3 % HRmax). Fasting blood samples were taken and an oral glucose tolerance test (OGTT) was conducted pre- and post-intervention. After HIT, resting plasma [insulin] was lowered (17 ± 34 %; P training strategy for improving insulin sensitivity, glucose control and biomarkers of vascular function in inactive, middle-aged mildly hypertensive women.

  13. Magnetic resonance imaging evaluation of meniscoid superior labrum: normal variant or superior labral tear*

    Science.gov (United States)

    Simão, Marcelo Novelino; Vinson, Emily N.; Spritzer, Charles E.

    2016-01-01

    Objective The objective of this study was to determine the incidence of a "meniscoid" superior labrum. Materials and Methods This was a retrospective analysis of 582 magnetic resonance imaging examinations of shoulders. Of those 582 examinations, 110 were excluded, for a variety of reasons, and the final analysis therefore included 472 cases. Consensus readings were performed by three musculoskeletal radiologists using specific criteria to diagnose meniscoid labra. Results A meniscoid superior labrum was identified in 48 (10.2%) of the 472 cases evaluated. Arthroscopic proof was available in 21 cases (43.8%). In 10 (47.6%) of those 21 cases, the operative report did not include the mention a superior labral tear, thus suggesting the presence of a meniscoid labrum. In only one of those cases were there specific comments about a mobile superior labrum (i.e., meniscoid labrum). In the remaining 11 (52.4%), surgical correlation demonstrated superior labral tears. Conclusion A meniscoid superior labrum is not an infrequent finding. Depending upon assumptions and the requirement of surgical proof, the prevalence of a meniscoid superior labrum in this study was between 2.1% (surgically proven) and 4.8% (projected). However, superior labral tears are just as common and are often confused with meniscoid labra. PMID:27777474

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    For decades, it has been debated whether high protein intake compromises bone mineralisation, but no long-term randomised trial has investigated this in children. In the family-based, randomised controlled trial DiOGenes (Diet, Obesity and Genes), we examined the effects of dietary protein and gl...... group after 6 months of intervention (95 % CI 2·2, 56·1 ng/ml, P= 0·034). The dietary intervention did not affect U-NTx (P= 0·96) or height (P= 0·80). Baseline levels of U-NTx and osteocalcin correlated with changes in height at month 6 across the dietary groups (P......For decades, it has been debated whether high protein intake compromises bone mineralisation, but no long-term randomised trial has investigated this in children. In the family-based, randomised controlled trial DiOGenes (Diet, Obesity and Genes), we examined the effects of dietary protein....../low GI; high protein/high GI; control. They received dietary instructions and were provided all foods for free. Children, who were eligible and willing to participate, were included in the study. In the present analyses, we included children with data on plasma osteocalcin or urinary N...

  15. The association of mindful parenting with glycemic control and quality of life in adolescents with Type 1 Diabetes : Results from Diabetes MILES—The Netherlands

    NARCIS (Netherlands)

    Serkel-Schrama, Inge; de Vries, J.; Nieuwesteeg, A.M.; Pouwer, F.; Nyklicek, I.; Speight, Jane; de Bruin, Esther; Bogels, Susan; Hartman, E.E.

    2016-01-01

    The objective of this study was to examine associations between the mindful parenting style of parents of adolescents (aged 12–18) with type 1 diabetes mellitus (T1DM), and the glycaemic control and quality of life (QoL) of the adolescents. Chronic health conditions, such as T1DM, that require deman

  16. The association of mindful parenting with glycemic control and quality of life in adolescents with Type 1 Diabetes : Results from Diabetes MILES—The Netherlands

    NARCIS (Netherlands)

    Serkel-Schrama, Inge; de Vries, J.; Nieuwesteeg, A.M.; Pouwer, F.; Nyklicek, I.; Speight, Jane; de Bruin, Esther; Bogels, Susan; Hartman, E.E.

    2016-01-01

    The objective of this study was to examine associations between the mindful parenting style of parents of adolescents (aged 12–18) with type 1 diabetes mellitus (T1DM), and the glycaemic control and quality of life (QoL) of the adolescents. Chronic health conditions, such as T1DM, that require

  17. The Association of Mindful Parenting with Glycemic Control and Quality of Life in Adolescents with Type 1 Diabetes : Results from Diabetes MILES—The Netherlands

    NARCIS (Netherlands)

    Serkel-Schrama, I.J.P.; de Vries, J.; Nieuwesteeg, A.M.; Pouwer, F.; Nyklíček, I.; Speight, J.; de Bruin, E.I.; Bögels, S.M.; Hartman, E.E.

    2016-01-01

    The objective of this study was to examine associations between the mindful parenting style of parents of adolescents (aged 12–18) with type 1 diabetes mellitus (T1DM), and the glycaemic control and quality of life (QoL) of the adolescents. Chronic health conditions, such as T1DM, that require

  18. The association of mindful parenting with glycemic control and quality of life in adolescents with Type 1 Diabetes: : Results from Diabetes MILES—The Netherlands

    NARCIS (Netherlands)

    Serkel-Schrama, Inge; de Vries, J.; Nieuwesteeg, A.M.; Pouwer, F.; Nyklicek, I.; Speight, Jane; de Bruin, Esther; Bogels, Susan; Hartman, E.E.

    2016-01-01

    The objective of this study was to examine associations between the mindful parenting style of parents of adolescents (aged 12–18) with type 1 diabetes mellitus (T1DM), and the glycaemic control and quality of life (QoL) of the adolescents. Chronic health conditions, such as T1DM, that require deman

  19. Effect of a low glycaemic index diet in gestational diabetes mellitus on post-natal outcomes after 3 months of birth: a pilot follow-up study.

    Science.gov (United States)

    Louie, Jimmy Chun Yu; Markovic, Tania P; Ross, Glynis P; Foote, Deborah; Brand-Miller, Jennie C

    2015-07-01

    A low glycaemic index (LGI) diet during pregnancy complicated by gestational diabetes mellitus (GDM) may offer benefits to the mother and infant pair beyond those during pregnancy. We aimed to investigate the effect of an LGI diet during pregnancy complicated with GDM on early post-natal outcomes. Fifty-eight women (age: 23-41 years; mean ± SD pre-pregnancy body mass index: 24.5 ± 5.6 kg m(-2) ) who had GDM and followed either an LGI diet (n = 33) or a conventional high-fibre diet (HF; n = 25) during pregnancy had a 75-g oral glucose tolerance test and blood lipid tests at 3 months post-partum. Anthropometric assessments were conducted for 55 mother-infant pairs. The glycaemic index of the antenatal diets differed modestly (mean ± SD: 46.8 ± 5.4 vs. 52.4 ± 4.4; P diet during pregnancy complicated by GDM has outcomes similar to those of a conventional healthy diet. Adequately powered studies should explore the potential beneficial effects of LGI diet on risk factors for chronic disease.

  20. Glycaemic index and load values tested in normoglycemic adults for five staple foodstuffs: pounded yam, pounded cassava-plantain, placali, attieke and maize meal stiff porridge.

    Science.gov (United States)

    Kouamé, Adam C; Kouassi, Kouakou N; N'dri, Yao D; Amani, N'guessan G

    2015-02-16

    There is currently an increased global interest in the published glycaemic index (GI) and glycaemic load (GL) values of foods. However, data on the GI and GL values of different varieties of foods within Côte d'Ivoire are very limited. The study therefore aimed at finding the GI and GL of the main food staples in Côte d'Ivoire. Following the International Standard Organisation's protocol (ISO/FDI 26642:2010), a selection of five staple foodstuffs were tested for their GI and GL. Fasted healthy subjects were given 50 g of available carbohydrate servings of a glucose reference, which was tested twice, and test foods which were tested once, on separate occasions. Excepted attieke (GI 63), the majority of foods tested have a high GI (GI>70). Attieke (agbodjama) had a high GL (GL 29) while placali (GL 17) and maize meal stiff porridge (GL 16) had medium GLs. The GLs of pounded cassava-plantain and pounded yam are 26 and 22. Consumption of attieke could minimize postprandial blood glucose spikes, in spite of high GL and potentially have benefit in the management and prevention of some chronic diseases.

  1. Glycaemic Index and Load Values Tested in Normoglycemic Adults for Five Staple Foodstuffs: Pounded Yam, Pounded Cassava-Plantain, Placali, Attieke and Maize Meal Stiff Porridge

    Directory of Open Access Journals (Sweden)

    Adam C. Kouamé

    2015-02-01

    Full Text Available There is currently an increased global interest in the published glycaemic index (GI and glycaemic load (GL values of foods. However, data on the GI and GL values of different varieties of foods within Côte d’Ivoire are very limited. The study therefore aimed at finding the GI and GL of the main food staples in Côte d’Ivoire. Following the International Standard Organisation’s protocol (ISO/FDI 26642:2010, a selection of five staple foodstuffs were tested for their GI and GL. Fasted healthy subjects were given 50 g of available carbohydrate servings of a glucose reference, which was tested twice, and test foods which were tested once, on separate occasions. Excepted attieke (GI 63, the majority of foods tested have a high GI (GI > 70. Attieke (agbodjama had a high GL (GL 29 while placali (GL 17 and maize meal stiff porridge (GL 16 had medium GLs. The GLs of pounded cassava-plantain and pounded yam are 26 and 22. Consumption of attieke could minimize postprandial blood glucose spikes, in spite of high GL and potentially have benefit in the management and prevention of some chronic diseases.

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

    Science.gov (United States)

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

    2014-09-01

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

  3. Superior metallic alloys through rapid solidification processing (RSP) by design

    Energy Technology Data Exchange (ETDEWEB)

    Flinn, J.E. [Idaho National Engineering Laboratory, Idaho Falls, ID (United States)

    1995-05-01

    Rapid solidification processing using powder atomization methods and the control of minor elements such as oxygen, nitrogen, and carbon can provide metallic alloys with superior properties and performance compared to conventionally processing alloys. Previous studies on nickel- and iron-base superalloys have provided the baseline information to properly couple RSP with alloy composition, and, therefore, enable alloys to be designed for performance improvements. The RSP approach produces powders, which need to be consolidated into suitable monolithic forms. This normally involves canning, consolidation, and decanning of the powders. Canning/decanning is expensive and raises the fabrication cost significantly above that of conventional, ingot metallurgy production methods. The cost differential can be offset by the superior performance of the RSP metallic alloys. However, without the performance database, it is difficult to convince potential users to adopt the RSP approach. Spray casting of the atomized molten droplets into suitable preforms for subsequent fabrication can be cost competitive with conventional processing. If the fine and stable microstructural features observed for the RSP approach are preserved during spray casing, a cost competitive product can be obtained that has superior properties and performance that cannot be obtained by conventional methods.

  4. Superior-subordinate relations as organizational processes

    DEFF Research Database (Denmark)

    Asmuss, Birte; Aggerholm, Helle Kryger; Oshima, Sae

    Since the emergence of the practice turn in social sciences (Golsorkhi et al. 2010), studies have shown a number of institutionally relevant aspects as achievements across time and by means of various resources (human and non-human) (Taylor & van Every 2000, Cooren et al. 2006). Such a process view...... superior-subordinate relations in a specific institutionalized setting: performance appraisal interviews (PAIs). While one main task of PAIs is to manage and integrate organizational and employee performance (Fletcher, 2001:473), PAIs are also organizational practices where superior-subordinate relations...... are shaped, (re)confirmed and re-evaluated. This paper pursues the better understanding of the latter aspect by looking at one substantial and recurrent activity in PAIs: the evaluation of employee performance. One resource for doing the evaluation work is making assessments (e.g. Goodwin & Goodwin, 1987...

  5. Exploring the word superiority effect using TVA

    DEFF Research Database (Denmark)

    Starrfelt, Randi

    Words are made of letters, and yet sometimes it is easier to identify a word than a single letter. This word superiority effect (WSE) has been observed when written stimuli are presented very briefly or degraded by visual noise. It is unclear, however, if this is due to a lower threshold...... for perception of words, or a higher speed of processing for words than letters. We have investigated the WSE using methods based on a Theory of Visual Attention. In an experiment using single stimuli (words or letters) presented centrally, we show that the classical WSE is specifically reflected in perceptual...... processing speed: words are simply processed faster than single letters. It is also clear from this experiment, that the word superiority effect can be observed at a large range of exposure durations, from the perceptual threshold to ceiling performance. Intriguingly, when multiple stimuli are presented...

  6. Superior digit memory of abacus experts: an event-related functional MRI study.

    Science.gov (United States)

    Tanaka, Satoshi; Michimata, Chikashi; Kaminaga, Tatsuro; Honda, Manabu; Sadato, Norihiro

    2002-12-01

    Abacus experts exhibit superior short-term memory for digits, but the underlying neurophysiological mechanism remains unknown. Using event-related fMRI, we examined the brain activity of abacus experts and non-experts during the memory retention period of a delayed match-to-sample task using digits as stimuli. In controls, activity was greater in cortical areas related to verbal working memory, including Broca's area. In contrast, in experts, activity was greater in cortical areas related to visuo-spatial working memory, including the bilateral superior frontal sulcus and superior parietal lobule. This provides neurophysiological evidence that abacus experts utilize a visuo-spatial representation for digit memory.

  7. Resolution of superior oblique myokymia with memantine.

    Science.gov (United States)

    Jain, Saurabh; Farooq, Shegufta J; Gottlob, Irene

    2008-02-01

    We describe a novel treatment of superior oblique myokymia. A 40-year-old woman was treated with gabapentin for this disorder with partial success and reported significant side effects including loss of libido and weight gain. After a drug holiday, memantine therapy was initiated resulting in a substantial improvement in her symptoms with far fewer side effects and stability on long-term maintenance therapy.

  8. Locked Superior Dislocation of the Acromioclavicular Joint

    Directory of Open Access Journals (Sweden)

    Salma Eltoum Elamin

    2013-01-01

    Full Text Available Acromioclavicular (AC joint injuries account for approximately 3–5% of shoulder girdle injuries (Rockwood et al., 1998. Depending on severity of injury and direction of displacement these are classified using Rockwood classification system for AC joint dislocation. We present an unusual case presenting with locked superior dislocation of the AC joint highlighting the presentation and subsequent successful surgical management of such case. To our knowledge this has not been reported previously in literature.

  9. Reperfusion hemorrhage following superior mesenteric artery stenting.

    LENUS (Irish Health Repository)

    Moore, Michael

    2012-02-03

    Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

  10. Do institutional investors have superior stock selection ability in China?

    Institute of Scientific and Technical Information of China (English)

    Yihong; Deng; Yongxing; Xu

    2011-01-01

    This paper uses unique data on the shareholdings of both institutional and individual investors to directly investigate whether institutional investors have better stock selection ability than individual investors in China.Controlling for other factors,we find that institutional investors increase(decrease)their shareholdings in stocks that subsequently exhibit positive(negative)short-and long-term cumulative abnormal returns.In contrast individual investors decrease(increase)their shareholdings in stocks that subsequently exhibit positive(negative)short-and long-term cumulative abnormal returns.These findings indicate that institutional investors have superior stock selection ability in China.

  11. [Mitral surgery by superior biatrial septotomy].

    Science.gov (United States)

    Saade, A; Delepine, G; Lemaitre, C; Baehrel, B

    1995-01-01

    The superior biatrial septotomy approach consists of two semicircular right atrial and septal incisions joined at the superior end of the interatrial septum and extended across the dome of the left atrium, allowing exposure of the mitral valve by reflecting the ventricular side using stay sutures. From 1991 to 1993, 81 patients underwent mitral valve surgery by this technic. Mitral valve operation was combined with other cardiac procedures in 30 patients (37%) and was performed as a second operation in 21 patients (25.9%). Duration of cardiopulmonary bypass and aortic occlusion was not significantly different from that of patients operated via a conventional left atrial approach. The five hospital deaths (6.2%) were not related to this operative approach. Only 2 patients (3.3%) with preoperative in sinus rythm were discharged in atrial fibrillation after operation. In one patient (1.6%), atrioventricular block appeared at late follow-up. There were no cases of bleeding, atrioventricular nodal dysfunction or intra-atrial shunting related to the approach. This approach provides excellent exposure of the mitral valve even in unfavorable situations such as a small left atrium, dense adhesions from previous procedures or a previously implanted aortic prosthesis, without damage to various cardiac structures due to excessive traction. No retractor or vena cava repair are required. These data support a wide application of the superior biatrial septotomy approach in mitral valve surgery.

  12. Mnemonic Training Reshapes Brain Networks to Support Superior Memory.

    Science.gov (United States)

    Dresler, Martin; Shirer, William R; Konrad, Boris N; Müller, Nils C J; Wagner, Isabella C; Fernández, Guillén; Czisch, Michael; Greicius, Michael D

    2017-03-08

    Memory skills strongly differ across the general population; however, little is known about the brain characteristics supporting superior memory performance. Here we assess functional brain network organization of 23 of the world's most successful memory athletes and matched controls with fMRI during both task-free resting state baseline and active memory encoding. We demonstrate that, in a group of naive controls, functional connectivity changes induced by 6 weeks of mnemonic training were correlated with the network organization that distinguishes athletes from controls. During rest, this effect was mainly driven by connections between rather than within the visual, medial temporal lobe and default mode networks, whereas during task it was driven by connectivity within these networks. Similarity with memory athlete connectivity patterns predicted memory improvements up to 4 months after training. In conclusion, mnemonic training drives distributed rather than regional changes, reorganizing the brain's functional network organization to enable superior memory performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Superior mesenteric artery compression syndrome - case report

    Directory of Open Access Journals (Sweden)

    Paulo Rocha França Neto

    2011-12-01

    Full Text Available Superior mesenteric artery syndrome is an entity generally caused by the loss of the intervening mesenteric fat pad, resulting in compression of the third portion of the duodenum by the superior mesenteric artery. This article reports the case of a patient with irremovable metastatic adenocarcinoma in the sigmoid colon, that evolved with intense vomiting. Intestinal transit was carried out, which showed important gastric dilation extended until the third portion of the duodenum, compatible with superior mesenteric artery syndrome. Considering the patient's nutritional condition, the medical team opted for the conservative treatment. Four months after the surgery and conservative measures, the patient did not present vomiting after eating, maintaining previous weight. Superior mesenteric artery syndrome is uncommon and can have unspecific symptoms. Thus, high suspicion is required for the appropriate clinical adjustment. A barium examination is required to make the diagnosis. The treatment can initially require gastric decompression and hydration, besides reversal of weight loss through adequate nutrition. Surgery should be adopted only in case of clinical treatment failure.A síndrome da artéria mesentérica superior é uma entidade clínica causada geralmente pela perda do tecido adiposo mesentérico, resultando na compressão da terceira porção do duodeno pela artéria mesentérica superior. Esse artigo relata o caso clínico de uma paciente portadora de adenocarcinoma de cólon sigmoide metastático irressecável, que evoluiu com vômitos incoercíveis. Realizou-se, então, trânsito intestinal que evidenciou dilatação gástrica importante, que se prolongava até a terceira porção duodenal, quadro radiológico compatível com pinçamento da artéria mesentérica superior. Diante da condição nutricional da paciente, foi optado por iniciar medidas conservadoras (porções alimentares pequenas e mais frequentes, além de dec

  14. Once-daily basal insulin glargine versus thrice-daily prandial insulin lispro in people with type 2 diabetes on oral hypoglycaemic agents (APOLLO): an open randomised controlled trial

    DEFF Research Database (Denmark)

    Bretzel, R.G.; Nuber, U.; Landgraf, W.

    2008-01-01

    BACKGROUND: As type 2 diabetes mellitus progresses, oral hypoglycaemic agents often fail to maintain blood glucose control and insulin is needed. We investigated whether the addition of once-daily insulin glargine is non-inferior to three-times daily prandial insulin lispro in overall glycaemic c...

  15. Cognitive abilities and superior decision making under risk

    Directory of Open Access Journals (Sweden)

    Edward T. Cokely

    2009-02-01

    Full Text Available Individual differences in cognitive abilities and skills can predict normatively superior and logically consistent judgments and decisions. The current experiment investigates the processes that mediate individual differences in risky choices. We assessed working memory span, numeracy, and cognitive impulsivity and conducted a protocol analysis to trace variations in conscious deliberative processes. People higher in cognitive abilities made more choices consistent with expected values; however, expected-value choices rarely resulted from expected-value calculations. Instead, the cognitive ability and choice relationship was mediated by the number of simple considerations made during decision making --- e.g., transforming probabilities and considering the relative size of gains. Results imply that, even in simple lotteries, superior risky decisions associated with cognitive abilities and controlled cognition can reflect metacognitive dynamics and elaborative heuristic search processes, rather than normative calculations. Modes of cognitive control (e.g., dual process dynamics and implications for process models of risky decision-making (e.g., priority heuristic are discussed.

  16. Exploring the word superiority effect using TVA

    DEFF Research Database (Denmark)

    Starrfelt, Randi

    Words are made of letters, and yet sometimes it is easier to identify a word than a single letter. This word superiority effect (WSE) has been observed when written stimuli are presented very briefly or degraded by visual noise. It is unclear, however, if this is due to a lower threshold for perc...... simultaneously we find a different pattern: In a whole report experiment with six stimuli (letters or words), letters are perceived more easily than words, and this is reflected both in perceptual processing speed and short term memory capacity....

  17. de educación media superior

    Directory of Open Access Journals (Sweden)

    Enrique Cerón Ferrer

    2007-01-01

    Full Text Available El trabajo presenta los resultados obtenidos en relación al conocimiento y manejo que sobre matemáticas tienen los estudiantes de educación media superior, de los Centros de Estudios Tecnológicos y de Servicios del Distrito Federal, de diferentes carreras que se imparten en estos centros escolares, durante el año 2005. El instrumento de análisis es un cuestionario que contestaron los alumnos, la metodología utilizada es de tipo longitudinal y comparativa.

  18. Intermittent screening and treatment or intermittent preventive treatment with dihydroartemisinin-piperaquine versus intermittent preventive treatment with sulfadoxine-pyrimethamine for the control of malaria during pregnancy in western Kenya: an open-label, three-group, randomised controlled superiority trial.

    Science.gov (United States)

    Desai, Meghna; Gutman, Julie; L'lanziva, Anne; Otieno, Kephas; Juma, Elizabeth; Kariuki, Simon; Ouma, Peter; Were, Vincent; Laserson, Kayla; Katana, Abraham; Williamson, John; ter Kuile, Feiko O

    2015-12-19

    Every year, more than 32 million pregnancies in sub-Saharan Africa are at risk of malaria infection and its adverse consequences. The effectiveness of the intermittent preventive treatment with sulfadoxine-pyrimethamine strategy recommended by WHO is threatened by high levels of parasite resistance. We aimed to assess the efficacy and safety of two alternative strategies: intermittent screening with malaria rapid diagnostic tests and treatment of women who test positive with dihydroartemisinin-piperaquine, and intermittent preventive treatment with dihydroartemisinin-piperaquine. We did this open-label, three-group, randomised controlled superiority trial at four sites in western Kenya with high malaria transmission and sulfadoxine-pyrimethamine resistance. HIV-negative pregnant women between 16 and 32 weeks' gestation were randomly assigned (1:1:1), via computer-generated permuted-block randomisation (block sizes of three, six, and nine), to receive intermittent screening and treatment with dihydroartemisinin-piperaquine, intermittent preventive treatment with dihydroartemisinin-piperaquine, or intermittent preventive treatment with sulfadoxine-pyrimethamine. Study participants, study clinic nurses, and the study coordinator were aware of treatment allocation, but allocation was concealed from study investigators, delivery unit nurses, and laboratory staff. The primary outcome was malaria infection at delivery, defined as a composite of peripheral or placental parasitaemia detected by placental histology, microscopy, or rapid diagnostic test. The primary analysis was by modified intention to treat. This study is registered with ClinicalTrials.gov, number NCT01669941. Between Aug 21, 2012, and June 19, 2014, we randomly assigned 1546 women to receive intermittent screening and treatment with dihydroartemisinin-piperaquine (n=515), intermittent preventive treatment with dihydroartemisinin-piperaquine (n=516), or intermittent preventive treatment with sulfadoxine

  19. Prospective, multicenter randomized GITMO/IIL trial comparing intensive (R-HDS) versus conventional (CHOP-R) chemoimmunotherapy in high-risk follicular lymphoma at diagnosis: the superior disease control of R-HDS does not translate into an overall survival advantage.

    Science.gov (United States)

    Ladetto, Marco; De Marco, Federica; Benedetti, Fabio; Vitolo, Umberto; Patti, Caterina; Rambaldi, Alessandro; Pulsoni, Alessandro; Musso, Maurizio; Liberati, Anna M; Olivieri, Attilio; Gallamini, Andrea; Pogliani, Enrico; Rota Scalabrini, Delia; Callea, Vincenzo; Di Raimondo, Francesco; Pavone, Vincenzo; Tucci, Alessandra; Cortelazzo, Sergio; Levis, Alessandro; Boccadoro, Mario; Majolino, Ignazio; Pileri, Alessandro; Gianni, Alessandro M; Passera, Roberto; Corradini, Paolo; Tarella, Corrado

    2008-04-15

    In this randomized multicenter study of 136 patients, 6 courses of CHOP (cyclo-phosphamide/doxorubicin/vincristine/prednisone) followed by rituximab (CHOP-R) were compared with rituximab-supplemented high-dose sequential chemotherapy with autografting (R-HDS) to assess the value of intensified chemo-therapy as a first-line treatment for high-risk follicular lymphoma (FL) after the introduction of monoclonal antibodies. The analysis was intention to treat with event-free survival (EFS) as the primary endpoint. Complete remission (CR) was 62% with CHOP-R and 85% with R-HDS (P HDS patients (P HDS in 71% of cases. Salvage R-HDS had an 85% CR rate and a 68% 3-year EFS (MFU, 30 months). We conclude that (1) achieving MR is critical for effective disease control, regardless of which treatment is used; (2) R-HDS ensures superior disease control and molecular outcome than CHOP-R, but no OS improvement; and (3) CHOP-R failures have a good outcome after salvage R-HDS, suggesting that relapsed/refractory FL could be the most appropriate setting for R-HDS-like treatments. This trial was registered at www.clinicaltrials.gov as no. NCT00435955.

  20. Differences in superior thyroid artery and inferior thyroid artery blood flow spectrum parameters in subacute thyroiditis

    Institute of Scientific and Technical Information of China (English)

    Jin-Bo Li

    2016-01-01

    Objective:To study the differences in superior thyroid artery and inferior thyroid artery blood flow spectrum parameters in subacute thyroiditis. Methods:A Total of 40 cases of patients with subacute thyroiditis and 40 cases of healthy volunteers were selected for study and enrolled in pathology group and control group respectively, color Doppler ultrasonography was conducted to detect peak blood flow velocities (Vmax) of superior thyroid artery and inferior thyroid artery as well as resistance index (RI), and serum was collected to detect thyroid hormone contents, infection indexes and oxidative stress indexes. Results:Peak blood flow velocities Vmax of superior thyroid artery and inferior thyroid artery of pathology group were significantly higher than those of control group, and resistance index RI was not different from that of control group;FT3, FT4, TT3, TT4, ESR, CRP, PCT and MDA of pathology group were significantly higher than those of control group, and SOD and TAOC were significantly lower than those of control group;Vmax of superior thyroid artery and inferior thyroid artery were positively correlated with FT3, FT4, TT3, TT4, ESR, CRP, PCT and MDA, and negatively correlated with SOD and TAOC. Conclusion:Peak blood flow velocities (Vmax) of superior thyroid artery and inferior thyroid artery in subacute thyroiditis are significantly accelerated, Vmax has good consistency with thyroid hormone contents, infection indexes and oxidative stress indexes, and it can accurately assess the severity of the disease.

  1. The effect of beverages varying in glycaemic load on postprandial glucose responses, appetite and cognition in 10-12-year-old school children.

    Science.gov (United States)

    Brindal, Emily; Baird, Danielle; Slater, Amy; Danthiir, Vanessa; Wilson, Carlene; Bowen, Jane; Noakes, Manny

    2013-08-28

    Reducing glycaemic index (GI) and glycaemic load (GL) inconsistently improves aspects of cognitive function and appetite in children. Whether altering the GL by lowering carbohydrate relative to protein and fat has a role in these effects is unknown. Therefore, we assessed the differential effects of beverages varying in GL and dairy composition on appetite, energy intake and cognitive function in children. A total of forty children (10–12 years) completed a double-blind, randomised, crossover trial, receiving three isoenergetic drinks (approximately 1100 kJ): a glucose beverage (GI 100, GL 65), a full milk beverage (GI 27, GL 5) and a half milk/glucose beverage (GI 84, GL 35). For 3 h post-consumption, subjective appetite and cognitive performance (speed of processing, memory, attention and perceptual speed) were measured hourly. At completion, each child was provided a buffet-style lunch and energy intake was calculated. Blood glucose was objectively measured using the Continuous Glucose Monitoring System. Blood glucose AUC values were significantly different between the drinks (P,0·001), but did not sustain above the baseline for 3 h for any drink. Mixed modelling revealed no effect of beverage on subjective appetite or energy intake. Participant sex and drink GL significantly interacted for short-term memory (P,0·001). When girls consumed either milk-containing beverage, they recalled 0·7–0·8 more words compared with 0·5 less words after the glucose drink (P#0·014). Altering GL of drinks by reducing carbohydrate and increasing protein did not affect appetite or cognition in children. Girls may demonstrate improved short-term memory after consuming beverages with higher protein and lower GL.

  2. Pancreaticoduodenectomy with early superior mesenteric artery dissection

    Institute of Scientific and Technical Information of China (English)

    Yu-Fei Xu; Zuo-Jin Liu; Jian-Ping Gong

    2010-01-01

    BACKGROUND: Pancreatic adenocarcinoma remains the fourth leading cause of cancer-related death and is one of the most aggressive human tumors. At present, surgical resection is the only potentially curative treatment. Early neck division is inadequate when invasion of the superior mesenteric artery (SMA) is suspected or in cases of replaced or accessory right hepatic artery. Malignant periampullary tumors often invade retroperitoneal peripancreatic tissues and a positive resection margin is associated with a poor long-term survival. DATA SOURCES: English-language medical databases, PubMed, ELSEVIER and SPRINGERLINK, were searched for articles on"posterior approach pancreaticoduodenectomy","superior mesenteric artery ifrst approach", "retroperitoneal tissue","hanging maneuver", and related topics. RESULTS:The modiifcation allowed the surgeon to early identify the nonresectability of a replaced right hepatic artery if present, enabling complete dissection of the right side of the SMA and portal vein as well as complete excision of the retroportal pancreatic lamina. CONCLUSION: Pancreaticoduodenectomy with early retro-pancreatic dissection is a useful and safe technical variant, which is indicated for the improvement of the safety and curative effect of the procedure.

  3. Radiation treatment of superior sulcus lung carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Millar, J.; Ball, D.; Worotniuk, V.; Smith, J.; Crennan, E.; Bishop, M. [Peter MacCallum Cancer Inst., East Melbourne, VIC (Australia)

    1996-02-01

    The survival of patients with superior sulcus lung carcinoma and the effects of treatment were reviewed. From a prospective database of 4123 consecutive new patients with lung carcinoma, 131 (3.2%) cases of superior sulcus lung carcinoma were identified. Seventy-four patients were planned to receive radiation with palliative intent, 53 radical radiotherapy and one was observed only. The remaining three patients, with small-cell carcinoma, were treated with chemotherapy with or without radiotherapy. Of the 53 radically treated patients, nine were treated with pre-operative radiation prior to intended radical resection. Analysis was carried out on the effect on survival of performance status, nodal involvement, weight loss, vertebral body or rib involvement, treatment intent and radical combined modality treatment compared with radical radiation alone. The estimated median survival for the whole group was 7.6 months; for those treated radically it was 18.3 months, while for the palliatively treated patients it was 3.7 months. Radically treated patients with no initial nodal involvement had an estimated median survival of 22 months, while radically treated patients with nodal involvement had an estimated median survival of 8.4 months (P = 0.003). There were no statistically significant differences in survival between radically treated patients grouped according to initial weight loss, performance status, or vertebral body and rib involvement. Patients treated with pre-operative radiation did not survive significantly longer than patients treated with radiation alone, although the numbers are small. 33 refs., 2 tabs., 4 figs.

  4. Studies on zooplankton of Lago Paione Superiore

    Directory of Open Access Journals (Sweden)

    Patrizia COMOLI

    1999-08-01

    Full Text Available We report here the results of a three year study on the zooplankton of Lago Paione Superiore, an acid sensitive lake above the tree line in the Italian Alps. The research was carried out within MOLAR, an EC-founded Project on “Measuring and Modeling the dynamic response of remote mountain lakes ecosystems to environmental change”. This study comes after a series of investigations on the effects of acidification, in which we documented the changes occurred with decreasing water pHs, by comparing the recent situation with that in the literature of the 40s, and reconstructed the beginning of anthropogenic disturbance through an analysis of the past cladocera assemblages archived in the lake sediments. A characteristic pattern in seasonal periodicity is a transition from a community dominated by small zooplankton (August to a community where the large particle-feeder Daphnia longispina dominates. This is a typical pattern observed in fishless, copepod-cladocera lakes. Regardless from which food is able to exploit, Daphnia population of Lago Paione Superiore is composed by well-fed organisms, visually rich in lipids, able to produce more than one generation/ year of parthenogenetic females at density levels which are rather high in an oligotrophic high mountain lake.

  5. Lipid peroxidation following superior mesenteric artery occlusion in rat intestine

    Directory of Open Access Journals (Sweden)

    P. Pasbakhsh

    2006-07-01

    Full Text Available Background: The aim of this study was to determine the level of lipid peroxidation and tissue protein after superior mesenteric artery occlusion tissue damage. The effect of melatonin as anti oxidant and free radical scavenger in prevention of tissue damage, were also evaluated. Methods: Thity six young male Wisatr-Albino rats (weight: 80-120 gr, were divided equally in 6 group with different concentrations of melatonin (10,20,30 mg/kg treatment. Group 1was control, group 2 the sham that surgical process was applied until superior mesenteric artery dissection and received vehicle solution only in equally volume by intra muscular route. Group 3 was ischemia- reperfusion (I/R, group 4 was I/R plus melatonin 10 mg/kg, group 5 I/R plus melatonin 20 mg/kg and finally group 6 I/R plus melatonin 30 mg/kg. After laparatomy, a microvascular atraumatic clip was placed across the superior mesenteric artery under general anaesthesia and itbremoved after ischemia for 30 minutes. The first dose of melatonin was applied just beforereperfusion, second dose, after reperfusion and third dose on the second day .On third day rats were killed and their bowels were removed. The level of tissue melandialdehyde (MDA as index of lipid peroxidation and tissue protein was determined. Results: The level of tissue MDA were significantly lower in group 4, 5, 6 than group 3 (p0, 05. Conclusion: These results suggest that melatonin 10 mg/kg has antioxidant effect in prevention of inducing tissue damage during SMA occlusion in rat intestine.

  6. Cochlear implant outcomes in patients with superior canal dehiscence

    NARCIS (Netherlands)

    Puram, Sidharth V.; Roberts, Daniel S.; Niesten, Marlien E F; Dilger, Amanda E.; Lee, Daniel J.

    2015-01-01

    Objective: To determine whether adult cochlear implant (CI) users with superior canal dehiscence syndrome (SCDS) or asymptomatic superior semicircular canal dehiscence (SCD) have different surgical, vestibular, and audiologic outcomes when compared to CI users with normal temporal bone anatomy. Meth

  7. The Superior Transvelar Approach to the Fourth Ventricle and Brainstem

    OpenAIRE

    Ezer, Haim; Banerjee, Anirban Deep; Bollam, Papireddy; Guthikonda, Bharat; Nanda, Anil

    2012-01-01

    Objective The superior transvelar approach is used to access pathologies located in the fourth ventricle and brainstem. The surgical path is below the venous structures, through the superior medullary velum. Following splitting the tentorial edge, near the tentorial apex, the superior medullary velum is split in the cerebello-mesencephalic fissure. Using the supracerebellar infratentorial, transtentorial or parietal interhemispheric routes, the superior medullary velum is approached. Splittin...

  8. 14 CFR 385.7 - Exercise of authority by superiors.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Exercise of authority by superiors. 385.7... Exercise of authority by superiors. Any assignment of authority to a staff member other than the Chief... Department's principle of management responsibility, the superior may choose to exercise the assigned power...

  9. Sustained attention is associated with right superior longitudinal fasciculus and superior parietal white matter microstructure in children.

    Science.gov (United States)

    Klarborg, Brith; Skak Madsen, Kathrine; Vestergaard, Martin; Skimminge, Arnold; Jernigan, Terry L; Baaré, William F C

    2013-12-01

    Sustained attention develops during childhood and has been linked to the right fronto-parietal cortices in functional imaging studies; however, less is known about its relation to white matter (WM) characteristics. Here we investigated whether the microstructure of the WM underlying and connecting the right fronto-parietal cortices was associated with sustained attention performance in a group of 76 typically developing children aged 7-13 years. Sustained attention was assessed using a rapid visual information processing paradigm. The two behavioral measures of interest were the sensitivity index d' and the coefficient of variation in reaction times (RTCV ). Diffusion-weighted imaging was performed. Mean fractional anisotropy (FA) was extracted from the WM underlying right dorsolateral prefrontal (DLPFC) and parietal cortex (PC), and the right superior longitudinal fasciculus (SLF), as well as equivalent anatomical regions-of-interest (ROIs) in the left hemisphere and mean global WM FA. When analyzed collectively, right hemisphere ROIs FA was significantly associated with d' independently of age. Follow-up analyses revealed that only FA of right SLF and the superior part of the right PC contributed significantly to this association. RTCV was significantly associated with right superior PC FA, but not with right SLF FA. Observed associations remained significant after controlling for FA of equivalent left hemisphere ROIs or global mean FA. In conclusion, better sustained attention performance was associated with higher FA of WM in regions connecting right frontal and parietal cortices. Further studies are needed to clarify to which extent these associations are driven by maturational processes, stable characteristics and/or experience.

  10. Fish community change in Lake Superior, 1970-2000

    Science.gov (United States)

    Bronte, Charles R.; Ebener, Mark P.; Schreiner, Donald R.; DeVault, David S.; Petzold, Michael M.; Jensen, Douglas A.; Richards, Carl; Lozano, Steven J.

    2003-01-01

    Changes in Lake Superior's fish community are reviewed from 1970 to 2000. Lake trout (Salvelinus namaycush) and lake whitefish (Coregonus clupeaformis) stocks have increased substantially and may be approaching ancestral states. Lake herring (Coregonus artedi) have also recovered, but under sporadic recruitment. Contaminant levels have declined and are in equilibrium with inputs, but toxaphene levels are higher than in all other Great Lakes. Sea lamprey (Petromyzon marinus) control, harvest limits, and stocking fostered recoveries of lake trout and allowed establishment of small nonnative salmonine populations. Natural reproduction supports most salmonine populations, therefore further stocking is not required. Nonnative salmonines will likely remain minor components of the fish community. Forage biomass has shifted from exotic rainbow smelt (Osmerus mordax) to native species, and high predation may prevent their recovery. Introductions of exotics have increased and threaten the recovering fish community. Agencies have little influence on the abundance of forage fish or the major predator, siscowet lake trout, and must now focus on habitat protection and enhancement in nearshore areas and prevent additional species introductions to further restoration. Persistence of Lake Superior's native deepwater species is in contrast to other Great Lakes where restoration will be difficult in the absence of these ecologically important fishes.

  11. Superiority: China Mobile in the competition

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The market share between China Mobile and China Unicom has stabilized since 2002.It is found that China Mobile has the superiority in the competition, for example, the scissors movement between its revenue and cost indicates that it has a strong profit generating ability and there is enough room for it to reduce the price.The ratio between its price (marginal income) and marginal cost indicates that there is a very distant limit for it to reduce the price.Its demand is obviously flexible with the price, but it does not use the price weapon abundantly.The reason for the stabilization of the market is that China Mobile withdrew from the competition.

  12. MRI manifestations of enlarged superior ophthalmic vein

    Institute of Scientific and Technical Information of China (English)

    WEI Rui-li; MA Xiao-ye; CAI Ji-ping; ZHU Huang

    2002-01-01

    Objective:To assess MRI in the evaluation of enlarged superior ophthalmic vein (SOV). Methods: MRI manifestations and etiology of forty-six patients with enlarged SOV were analyzed. Results: SOV enlargement was noted to occur in carotid-cavernous fistula, ophthalmic Graves'disease, Tolosa-Hunt syndrome, inflammation at the apex of the orbit, orbital pseudotumor and thrombosis of cavernous sinus. The dilated vein appeared as signal void tubular shadows on both T1 and T2 weighted images. The diameter of the enlarged vein was 3.5-6.0 mm. Extraocular muscle enlargement, orbital pathologies, enlarged carotid cavernous sinus etc were also revealed by MRI. Conclusion: The dilated SOV may be well demonstrated by MRI. The etiological diagnosis of enlarged SOV can be made in combination with the associated findings.

  13. Lightning activity during the 1999 Superior derecho

    Science.gov (United States)

    Price, Colin G.; Murphy, Brian P.

    2002-12-01

    On 4 July 1999, a severe convective windstorm, known as a derecho, caused extensive damage to forested regions along the United States/Canada border, west of Lake Superior. There were 665,000 acres of forest destroyed in the Boundary Waters Canoe Area Wilderness (BWCAW) in Minnesota and Quetico Provincial Park in Canada, with approximately 12.5 million trees blown down. This storm resulted in additional severe weather before and after the occurrence of the derecho, with continuous cloud-to-ground (CG) lightning occurring for more than 34 hours during its path across North America. At the time of the derecho the percentage of positive cloud-to-ground (+CG) lightning measured by the Canadian Lightning Detection Network (CLDN) was greater than 70% for more than three hours, with peak values reaching 97% positive CG lightning. Such high ratios of +CG are rare, and may be useful indicators of severe weather.

  14. Analgesia em modelo animal superior para ortopedia

    OpenAIRE

    Oliveira MT, Maria Teresa; Potes, José Alberto; Queiroga, Cristina; Castro, José António; Pereira, Alfredo; Reis, Joana

    2015-01-01

    O teste de novos biomateriais para aplicações clínicas em ortopedia, ou noutras áreas da medicina, em modelos animais vivos e sencientes, em prol do benefício humano, deve ser objecto de planeamento cuidado e ponderado, dado o conflito ético que se coloca. Compete-nos a nós, enquanto investigadores, garantir que as condições de vida, saúde e bem-estar são asseguradas. O uso de ovinos como modelo superior pré-clínico, para investigação em Ortopedia, tem-se evidenciado devido às suas caracterís...

  15. Superior vena cava syndrome in hemodialysis patient

    Directory of Open Access Journals (Sweden)

    Azeb Molhem

    2011-01-01

    Full Text Available Obstruction of blood flow in the superior vena cava (SVC results in symptoms and signs of SVC syndrome. SVC obstruction can be caused either by invasion or external compression of the SVC by contagious pathologic processes involving the right lung, lymph nodes, and other mediastinal structures, or by thrombosis of blood within the SVC. Occasionally, both mechanisms co-exist. We hereby report a case of a 28-year-old male, Saudi patient who was diagnosed with end-stage renal disease and was maintained on regular hemodiaysis via right jugular vein dual lumen catheter for ten months. Three years later, the patient presented with signs and symptoms suggestive of SVC obstruction that was successfully managed with SVC stenting.

  16. [Surgical treatment of superior thoracic outlet syndrome].

    Science.gov (United States)

    Gaibov, A D; Kakhorov, A Z; Sadriev, O N; Yunusov, Kh A

    2015-01-01

    The authors present immediate and long-term results of treatment of 117 patients with superior thoracic outlet syndrome (STOS). There were different reasons for compression of neu- rovascular fascicle in outlet of the thorax. The costaclavicular syndrome was a reason in 48 patients, additional cervical ribs had 36 patients. Skalenus syndrome was noted in 26 cases, rudimentary cervical ribs or hypertrophy of cervical vertebrae C7 had 7 patients. Raynaud's syndrome took place in 19 cases. The required volume of diagnostic procedures and surgical treatment of STOS were determined according to the cause of the syndrome. Differentiated approach to the different forms of STOS was used in relation to dominant symptoms of the disease and reasons for compression of neurovascular fascicle. This allowed getting positive results in majority of patients (90,4%) in long- term period.

  17. ANATOMIC RESEARCH OF SUPERIOR CLUNIAL NERVE TRAUMA

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    In order to find the mechanism of superior clunial nerve (SCN) trauma, we dissected and revealed SCN from 12 corpses (24 sides). Combining 100 sides of SCN trauma, we inspected the course of SCN, the relation between SCN and it's neighbour tissues with the situation of SCN when being subjected to force. We found that the following special anatomic characteristics and mechanical elements such as the course of SCN, it's turning angles, the bony fibrous tube at the iliac crest, the posterior layer of the lumbodorsal fascia and SCN neighbour adipose tissue, are the causes of external force inducing SCN trauma. The anatomic revealment is the guidance of SCN trauma treatment with edged needle.

  18. Superiorization: An optimization heuristic for medical physics

    CERN Document Server

    Herman, G T; Davidi, R; Censor, Y

    2012-01-01

    Purpose: To describe and mathematically validate the superiorization methodology, which is a recently-developed heuristic approach to optimization, and to discuss its applicability to medical physics problem formulations that specify the desired solution (of physically given or otherwise obtained constraints) by an optimization criterion. Methods: The underlying idea is that many iterative algorithms for finding such a solution are perturbation resilient in the sense that, even if certain kinds of changes are made at the end of each iterative step, the algorithm still produces a constraints-compatible solution. This property is exploited by using permitted changes to steer the algorithm to a solution that is not only constraints-compatible, but is also desirable according to a specified optimization criterion. The approach is very general, it is applicable to many iterative procedures and optimization criteria used in medical physics. Results: The main practical contribution is a procedure for automatically p...

  19. Superior calcium homeostasis of extraocular muscles.

    Science.gov (United States)

    Zeiger, Ulrike; Mitchell, Claire H; Khurana, Tejvir S

    2010-11-01

    Extraocular muscles (EOMs) are a unique group of skeletal muscles with unusual physiological properties such as being able to undergo rapid twitch contractions over extended periods and escape damage in the presence of excess intracellular calcium (Ca(2+)) in Duchenne's muscular dystrophy (DMD). Enhanced Ca(2+) buffering has been proposed as a contributory mechanism to explain these properties; however, the mechanisms are not well understood. We investigated mechanisms modulating Ca(2+) levels in EOM and tibialis anterior (TA) limb muscles. Using Fura-2 based ratiometric Ca(2+) imaging of primary myotubes we found that EOM myotubes reduced elevated Ca(2+) ˜2-fold faster than TA myotubes, demonstrating more efficient Ca(2+) buffering. Quantitative PCR (qPCR) and western blotting revealed higher expression of key components of the Ca(2+) regulation system in EOM, such as the cardiac/slow isoforms sarcoplasmic Ca(2+)-ATPase 2 (Serca2) and calsequestrin 2 (Casq2). Interestingly EOM expressed monomeric rather than multimeric forms of phospholamban (Pln), which was phosphorylated at threonine 17 (Thr17) but not at the serine 16 (Ser16) residue. EOM Pln remained monomeric and unphosphorylated at Ser16 despite protein kinase A (PKA) treatment, suggesting differential signalling and modulation cascades involving Pln-mediated Ca(2+) regulation in EOM. Increased expression of Ca(2+)/SR mRNA, proteins, differential post-translational modification of Pln and superior Ca(2+) buffering is consistent with the improved ability of EOM to handle elevated intracellular Ca(2+) levels. These characteristics provide mechanistic insight for the potential role of superior Ca(2+) buffering in the unusual physiology of EOM and their sparing in DMD.

  20. The management of superior sulcus tumors

    Energy Technology Data Exchange (ETDEWEB)

    Komaki, Ritsuko; Cox, J.D.; Putnam, J.B. Jr [Texas Univ., Houston, TX (United States). Anderson Cancer Center] (and others)

    2001-09-01

    Superior sulcus tumors are a rare type of lung cancer arising in the apex of the lung above the sulcus and cause specific symptoms and signs depending on the location and whether the tumor extends into the surrounding structures. Because of the closeness of critical structures to the tumor (e.g., the subclavian artery for anterior lesions, the brachial plexus for lesions in the middle location, and the sympathetic stellate ganglion causing Horner's syndrome [Pancoast's tumor], the vertebral bodies, nerve foramen, and spinal cord for posterior lesions), superior sulcus tumors were often considered marginally respectable or unresectable. Therefore, for many years, preoperative radiation therapy was considered routine treatment for those tumors. However, with the evolution in our understanding of these tumors and modern imaging techniques such as computerized tomography (CT) and magnetic resonant imaging (MRI) and surgical techniques, there is now considerable debate about the roles and timing of surgical resection, radiation therapy, and chemotherapy in the treatment of patients with these tumors. If mediastinoscopy reveals microscopic mediastinal lymph node involvement, the patient can be treated with preoperative concurrent chemoradiotherapy followed by surgery. If there was a gross mediastinal lymph node involvement (N2) on CT, N3 or T4 lesions, the patient can be treated with concurrent chemoradiotherapy with a curative intent; the outcome of such treatment appears to be better than that of sequential chemotherapy followed by radiation therapy. Whenever possible, without compromising the patient's quality of life, surgery should be considered to improve outcome. (author)

  1. STEREO Superior Solar Conjunction Mission Phase

    Science.gov (United States)

    Ossing, Daniel A.; Wilson, Daniel; Balon, Kevin; Hunt, Jack; Dudley, Owen; Chiu, George; Coulter, Timothy; Reese, Angel; Cox, Matthew; Srinivasan, Dipak; hide

    2017-01-01

    With its long duration and high gain antenna (HGA) feed thermal constraint; the NASA Solar-TErestrial RElations Observatory (STEREO) solar conjunction mission phase is quite unique to deep space operations. Originally designed for a two year heliocentric orbit mission to primarily study coronal mass ejection propagation, after 8 years of continuous science data collection, the twin STEREO observatories entered the solar conjunction mission phase, for which they were not designed. Nine months before entering conjunction, an unforeseen thermal constraint threatened to stop daily communications and science data collection for 15months. With a 3.5 month long communication blackout from the superior solar conjunction, without ground commands, each observatory will reset every 3 days, resulting in 35 system resets at an Earth range of 2 AU. As the observatories will be conjoined for the first time in 8 years, a unique opportunity for calibrating the same instruments on identical spacecraft will occur. As each observatory has lost redundancy, and with only a limited fidelity hardware simulator, how can the new observatory configuration be adequately and safely tested on each spacecraft? Without ground commands, how would a 3-axis stabilized spacecraft safely manage the ever accumulating system momentum without using propellant for thrusters? Could science data still be collected for the duration of the solar conjunction mission phase? Would the observatories survive? In its second extended mission, operational resources were limited at best. This paper discusses the solutions to the STEREO superior solar conjunction operational challenges, science data impact, testing, mission operations, results, and lessons learned while implementing.

  2. Scientific Opinion on the substantiation of health claims related to glycaemic carbohydrates and maintenance of normal brain function pursuant to Article 13(5) of Regulation (EC) No 1924/2006

    OpenAIRE

    Tetens, Inge

    2015-01-01

    Following applications from Dextro Energy GmbH & Co. KG, submitted for the authorisation of health claims pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of Germany, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of health claims related to glycaemic carbohydrates and maintenance of normal brain function. The scope of the applications was proposed to fall under health...

  3. Quadrilobed superior gluteal artery perforator flap for sacrococcygeal defects

    Institute of Scientific and Technical Information of China (English)

    HAI Heng-lin; SHEN Chuan-an; CHAI Jia-ke; LI Hua-tao; YU Yong-ming; LI Da-wei

    2013-01-01

    Background Perforator flaps are used extensively in repairing soft tissue defects.Superior gluteal artery perforatorflaps are used for repairing sacral defects,but the tension required for direct closure of the donor area after harvesting ofrelatively large flaps carries a risk of postoperative dehiscence.This research was to investigate a modified superiorgluteal artery perforator flap for repairing sacrococcygeal soft tissue defects.Methods From June 2003 to April 2010,we used our newly designed superior gluteal artery perforator flap for repair of sacrococcygeal soft tissue defects in 10 patients (study group).The wound and donor areas were measured,and the flaps were designed accordingly.Wound healing was assessed over a follow-up period of 6-38 months.From January 1998 to February 2003,twelve patients with sacrococcygeal pressure sores were treated with traditional methods,VY advancement flaps or oblong flaps,as control group.Results After debridement,the soft tissue defects ranged from 12 cm × 10 cm to 26 cm × 22 cm (mean 16.3 cm x 13.5cm).Four patients were treated using right-sided flaps ranging from 15 cm × 11 cm to 25 cm × 20 cm (mean 18.2 cm × 14cm).Four patients were treated using left-sided flaps,and two were treated using both right-and left-sided flaps.Suction drains were removed on postoperative Days 3-21 (mean 5.9) and sutures were removed on postoperative Days 12-14.Each flap included 1-2 perforators for each of the donor and recipient sites.Donor sites were closed directly.All flaps survived.In eight patients,the wounds healed after single-stage surgery.After further debridement,the wounds of the remaining two patients were considered healed on postoperative Days 26 and 33,respectively.The rate of first intention in the study group (80%,8/10) significantly increased than that of control group ((25%,3/12),X2=4.583,P=-0.032).Follow-up examinations found that the flaps had a soft texture without ulceration.In the two patients without

  4. Lake Superior Coastal Wetland Fish Assemblages and ...

    Science.gov (United States)

    The role of the coastal margin and the watershed context in defining the ecology of even very large lakes is increasingly being recognized and examined. Coastal wetlands are both important contributors to the biodiversity and productivity of large lakes and important mediators of the lake-basin connection. We explored wetland-watershed connections and their relationship to wetland function and condition using data collected from 37 Lake Superior wetlands spanning a substantial geographic and geomorphic gradient. While none of these wetlands are particularly disturbed, there were nevertheless clear relationships between watershed landuse and wetland habitat and biota, and these varied consistently across wetland type categories that reflected the strength of connection to the watershed. For example, water clarity and vegetation structure complexity declined with decreasing percent natural land cover, and these effects were strongest in riverine wetlands (having generally large watersheds and tributary-dominated hydrology) and weakest in lagoon wetlands (having generally small watersheds and lake-dominate hydrology). Fish abundance and species richness both increased with decreasing percent natural land cover while species diversity decreased, and again the effect was strongest in riverine wetlands. Lagoonal wetlands, which lack any substantial tributary, consistently harbored the fewest species of fish and a composition different from the more watershed-lin

  5. EFFECTS OF INDIVIDUAL CHARACTERISTICS AND ORGANIZATIONAL CONTEXT ON SUPERIORS' USE OF CONFLICT STYLES AND SUBORDINATES' SATISFACTION WITH SUPERVISION

    Directory of Open Access Journals (Sweden)

    Lee Kim Lian

    2008-01-01

    Full Text Available Data from 139 respondents from major industries showed that subordinates were more satisfied with their superiors' supervision through the exercise of integrating, compromising and obliging styles. On the contrary, subordinates who perceived their superiors as primarily using dominating and avoiding styles viewed them as incompetent in supervision and thus lowering their level of satisfaction with supervision. Among the conflict handling styles, integrating was most correlated with organic structure. The organic structure was found to be positively correlated with subordinates' satisfaction. These results implied that organic structure can be a potent force in maintaining organizational stability. The exercise of dominating style was found to be only marginally correlated with superior's age. Superior rank in lower hierarchy level was found to have a negative impact, albeit marginally on the exercise of dominating style. The present results also seemed to suggest that subordinates tend to be less satisfied with superiors with wider span of control.

  6. Carbon phosphide monolayers with superior carrier mobility

    Science.gov (United States)

    Wang, Gaoxue; Pandey, Ravindra; Karna, Shashi P.

    2016-04-01

    Two dimensional (2D) materials with a finite band gap and high carrier mobility are sought after materials from both fundamental and technological perspectives. In this paper, we present the results based on the particle swarm optimization method and density functional theory which predict three geometrically different phases of the carbon phosphide (CP) monolayer consisting of sp2 hybridized C atoms and sp3 hybridized P atoms in hexagonal networks. Two of the phases, referred to as α-CP and β-CP with puckered or buckled surfaces are semiconducting with highly anisotropic electronic and mechanical properties. More remarkably, they have the lightest electrons and holes among the known 2D semiconductors, yielding superior carrier mobility. The γ-CP has a distorted hexagonal network and exhibits a semi-metallic behavior with Dirac cones. These theoretical findings suggest that the binary CP monolayer is a yet unexplored 2D material holding great promise for applications in high-performance electronics and optoelectronics.Two dimensional (2D) materials with a finite band gap and high carrier mobility are sought after materials from both fundamental and technological perspectives. In this paper, we present the results based on the particle swarm optimization method and density functional theory which predict three geometrically different phases of the carbon phosphide (CP) monolayer consisting of sp2 hybridized C atoms and sp3 hybridized P atoms in hexagonal networks. Two of the phases, referred to as α-CP and β-CP with puckered or buckled surfaces are semiconducting with highly anisotropic electronic and mechanical properties. More remarkably, they have the lightest electrons and holes among the known 2D semiconductors, yielding superior carrier mobility. The γ-CP has a distorted hexagonal network and exhibits a semi-metallic behavior with Dirac cones. These theoretical findings suggest that the binary CP monolayer is a yet unexplored 2D material holding great

  7. Smaller superior temporal gyrus volume specificity in schizotypal personality disorder

    Science.gov (United States)

    Goldstein, Kim E.; Hazlett, Erin A.; New, Antonia S.; Haznedar, M. Mehmet; Newmark, Randall E.; Zelmanova, Yuliya; Passarelli, Vincent; Weinstein, Shauna R.; Canfield, Emily L.; Meyerson, David A.; Tang, Cheuk Y.; Buchsbaum, Monte S.; Siever, Larry J.

    2009-01-01

    Background Superior temporal gyrus (STG/BA22) volume is reduced in schizophrenia and to a milder degree in schizotypal personality disorder (SPD), representing a less severe disorder in the schizophrenia-spectrum. SPD and Borderline personality disorder (BPD) are severe personality disorders characterized by social and cognitive dysfunction. However, while SPD is characterized by social withdrawal/anhedonia, BPD is marked by hyper-reactivity to interpersonal stimuli and hyper-emotionality. This is the first morphometric study to directly compare SPD and BPD patients in temporal volume. Methods We compared three age-gender- and education-matched groups: 27 unmedicated SPD individuals with no BPD traits, 52 unmedicated BPD individuals with no SPD traits, and 45 healthy controls. We examined gray matter volume of frontal and temporal lobe Brodmann areas (BAs), and dorsal/ventral amygdala from 3T magnetic resonance imaging. Results In the STG, an auditory association area reported to be dysfunctional in SPD and BPD, the SPD patients had significantly smaller volume than healthy controls and BPD patients. No group differences were found between BPD patients and controls. Smaller BA22 volume was associated with greater symptom severity in SPD patients. Reduced STG volume may be an important endophenotype for schizophrenia-spectrum disorders. SPD is distinct from BPD in terms of STG volume abnormalities which may reflect different underlying pathophysiological mechanisms and could help discriminate between them. PMID:19473820

  8. Absent right superior caval vein in situs solitus

    DEFF Research Database (Denmark)

    Lytzen, Rebekka; Sundberg, Karin; Vejlstrup, Niels

    2015-01-01

    no postnatal complications. All children were found to have healthy hearts at follow-up. CONCLUSIONS: In all cases, the findings proved to be a benign condition with no clinical manifestations or complications. Although isolated absent right superior caval vein does not seem to affect the outcome, associated......Introduction In up to 0.07% of the general population, the right anterior cardinal vein obliterates and the left remains open, creating an absent right superior caval vein and a persistent left superior caval vein. Absent right superior caval vein is associated with additional congenital heart...... disease in about half the patients. We wished to study the consequences of absent right superior caval vein as an incidental finding on prenatal ultrasonic malformation screening. Material and methods This is a retrospective case series study of all foetuses diagnosed with absent right superior caval vein...

  9. The Business Value of Superior Energy Performance

    Energy Technology Data Exchange (ETDEWEB)

    McKane, Aimee; Scheihing, Paul; Evans, Tracy; Glatt, Sandy; Meffert, William

    2015-08-04

    Industrial facilities participating in the U.S. Department of Energy’s (US DOE) Superior Energy Performance (SEP) program are finding that it provides them with significant business value. This value starts with the implementation of ISO 50001-Energy management system standard, which provides an internationally-relevant framework for integration of energy management into an organization’s business processes. The resulting structure emphasizes effective use of available data and supports continual improvement of energy performance. International relevance is particularly important for companies with a global presence or trading interests, providing them with access to supporting ISO standards and a growing body of certified companies representing the collective knowledge of communities of practice. This paper examines the business value of SEP, a voluntary program that builds on ISO 50001, inviting industry to demonstrate an even greater commitment through third-party verification of energy performance improvement to a specified level of achievement. Information from 28 facilities that have already achieved SEP certification will illustrate key findings concerning both the value and the challenges from SEP/ISO 50001 implementation. These include the facilities’ experience with implementation, internal and external value of third-party verification of energy performance improvement; attractive payback periods and the importance of SEP tools and guidance. US DOE is working to bring the program to scale, including the Enterprise-Wide Accelerator (SEP for multiple facilities in a company), the Ratepayer-Funded Program Accelerator (supporting tools for utilities and program administrators to include SEP in their program offerings), and expansion of the program to other sectors and industry supply chains.

  10. Coronary artery bypass and superior vena cava syndrome.

    OpenAIRE

    Thomas, T V; Masrani, K; Thomas, J.L.

    1999-01-01

    Superior vena cava syndrome is the obstruction of the superior vena cava or its main tributaries by benign or malignant lesions. The syndrome causes edema and engorgement of the vessels on the face, neck, and arms, nonproductive cough, and dyspnea. We discuss the case of a 48-year-old obese diabetic woman who was admitted with unstable angina. She had previously been diagnosed with superior vena cava syndrome. Urgent coronary artery bypass grafting was necessary Although thousands of coronary...

  11. Superiorization of incremental optimization algorithms for statistical tomographic image reconstruction

    Science.gov (United States)

    Helou, E. S.; Zibetti, M. V. W.; Miqueles, E. X.

    2017-04-01

    We propose the superiorization of incremental algorithms for tomographic image reconstruction. The resulting methods follow a better path in its way to finding the optimal solution for the maximum likelihood problem in the sense that they are closer to the Pareto optimal curve than the non-superiorized techniques. A new scaled gradient iteration is proposed and three superiorization schemes are evaluated. Theoretical analysis of the methods as well as computational experiments with both synthetic and real data are provided.

  12. 77 FR 48856 - Safety Zone; Superior Bay, Duluth, MN

    Science.gov (United States)

    2012-08-15

    ... spectators during the Superior Man Triathlon. DATES: This rule is effective from 6 a.m. to 8:30 a.m. on... Triathlon, which are discussed further below. Under 5 U.S.C. 553(d)(3), the Coast Guard finds that good... inaugural Superior Man Triathlon will occur along the Bay of Lake Superior. The 1.2 mile swim leg of...

  13. Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery

    Directory of Open Access Journals (Sweden)

    Metin Keskin

    2014-01-01

    Full Text Available Superior mesenteric artery syndrome is a rare condition that causes a proximal small intestinal obstruction due to contraction of the angle between the superior mesenteric artery and the aorta. Scoliosis surgery is one of the 15 reasons for superior mesenteric artery syndrome, which can present with acute or chronic manifestations. Although conservative treatment is usually possible, surgical treatment is required in certain cases that cannot be treated using conservative methods. In this paper, we describe a patient who developed superior mesenteric artery syndrome after scoliosis surgery and was treated with duodenojejunostomy due to failure and complications of conservative treatment.

  14. Superior Vena Cava Thrombosis in a Case of Lung Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Santanu Ghosh

    2013-01-01

    Full Text Available Superior vena cava syndrome is a common presentation of bronchogenic carcinoma. The mechanism of obstruction is by compression of superior vena cava by the bronchogenic tumor itself or enlarged mediastinal lymph nodes. However obstruction due to intravascular thrombosis is extremely uncommon. Here, we report a rare case of a 65-year-old male smoker who presented with superior vena cava syndrome and bilateral pleural and pericardial effusion with thrombotic occlusion of the superior vena cava in adenocarcinoma of the lung. He was given chemotherapy with carboplatin and gemcitabine with anticoagulant therapy.

  15. [Catheter in the superior vena cava for hemodialysis as a last resort in superior hemithorax].

    Science.gov (United States)

    Restrepo Valencia, C A; Buritica Barragán, C M; Arango, A

    2010-01-01

    We report four patients with chronic kidney disease undergoing haemodialysis therapy, which had exhausted conventional venous access (internal jugular, subclavian) and non-conventional access (axillary, innominate) in the upper hemithorax for haemodialysis. This was primarily due to thrombosis of these veins caused by previous catheterisation. These patients did not qualify for peritoneal dialysis. Using the technique recommended by Archundia et al., 4 indwelling catheters were implanted directly in the superior vena cava in each of the patients with subsequent subcutaneous tunneling. The catheters operated correctly and are currently permeable after being used for an average of 19 months.

  16. Influence of superior cervical ganglionectomy on hippocampal neurogenesis and learning and memory in adult rats

    Institute of Scientific and Technical Information of China (English)

    Yanping Ding; Baoping Shao; Shiyuan Yu; Shanting Zhao; Jianlin Wang

    2009-01-01

    BACKGROUND: Studies have shown that neurogenesis in the dentate gyrus plays an important role in learning and memory. However, studies have not determined whether the superior cervical ganglion or the sympathetic nerve system influences hippocampal neurogenesis or learning and memory in adult rats. OBJECTIVE: To observe differences in dentate gyrus neurogenesis, as well as learning and memory, in adult rats following superior cervical ganglionectomy. DESIGN, TIME AND SETTING: A randomized, controlled, animal study was performed at the Immunohistochemistry Laboratory of the School of Life Sciences in Lanzhou University from July 2006 to July 2007.MATERIALS: Doublecortin polyclonal antibody was provided by Santa Cruz Biotechnology, USA;avidin-biotin-peroxidase complex was purchased from Zhongshan Goldenbride Biotechnology, China;Morris water maze was bought from Taimeng Technology, China. METHODS: A total of 20 adult, male, Wistar rats were randomly divided into surgery and control groups, with 10 rats in each group. In the surgery group, the bilateral superior cervical ganglions were transected. In the control group, the superior cervical ganglions were only exposed, but no ganglionectomy was performed. MAIN OUTCOME MEASURES: To examine distribution, morphology, and number of newborn neurons in the dentate gyrus using doublecortin immunohistochemistry at 36 days following surgical procedures. To examine ability of learning and memory in adult rats using the Morris water maze at 30 days following surgical procedures. RESULTS: Doublecortin immunohistochemical results showed that a reduction in the number of doublecortin-positive neurons in the surgery group compared to the control group (P<0.05), while the distribution of doublecortin-positive neurons was identical in the two groups. The surgery group exhibited significantly worse performance in learning and spatial memory tasks compared to the control group (P<0.05). CONCLUSION: Superior cervical ganglionectomy

  17. Short-term effects of a low carbohydrate diet on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Ranjan, Ajenthen; Schmidt, Signe; Damm-Frydenberg, Camilla

    2017-01-01

    The aim of the present study was to assess the effects of a high carbohydrate diet (HCD) vs a low carbohydrate diet (LCD) on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes. Ten patients (4 women, insulin pump-treated, median ± standard deviation [s.d.] age 48...... (225 ± 30 vs 47 ± 10 g carbohydrates/d; P levels were similar in the two diets (7.3 ± 1.1 vs 7.4 ± 0.6 mmol/L; P = .99). The LCD resulted in more time with glucose values in the range of 3.9 to 10.0 mmol/L (83% ± 9% vs 72% ± 11%; P = .02), less time with values ≤3.9 mmol....../L (3.3% ± 2.8% vs 8.0% ± 6.3%; P = .03), and less glucose variability (s.d. 1.9 ± 0.4 vs 2.6 ± 0.4 mmol/L; P = .02) than the HCD. Cardiovascular markers were unaffected, while fasting glucagon, ketone and free fatty acid levels were higher at end of the LCD week than the HCD week. In conclusion...

  18. Social vigilantism: measuring individual differences in belief superiority and resistance to persuasion.

    Science.gov (United States)

    Saucier, Donald A; Webster, Russell J

    2010-01-01

    Social vigilantism (SV) is an enduring individual difference that assesses the tendency of individuals to impress and propagate their "superior" beliefs onto others to correct others' more "ignorant" opinions. After establishing a reliable measure of SV, three studies showed that SV was associated with greater expressions of belief superiority (whether reacting to others holding dissimilar or similar beliefs) and greater resistance to persuasion (via increased rates of counterarguing and greater attitude stability after persuasion appeals) even after controlling for relevant individual differences (narcissism, dogmatism, psychological reactance, and need for cognition), as well as attitude importance and extremity. Thus, SV predicts expressions of belief superiority and resistance to persuasion above and beyond characteristics of the attitude and individual difference variables previously studied in the attitude literature. SV is a meaningful construct in increasing the understanding of persuasion, attitude resistance, and attitude dissemination that can be applied in a variety of psychological domains.

  19. Mediating the effect of self-care management intervention in type 2 diabetes: A meta-analysis of 47 randomised controlled trials

    DEFF Research Database (Denmark)

    Minet, Lisbeth; Møller, Sine; Vach, Werner;

    2010-01-01

    to November 2007 included original studies of randomised controlled trials involving adult patients diagnosed with type 2 diabetes and evaluating a self-care management intervention. RESULTS: The 47 included studies yielded 7677 participants. The analysis showed a 0.36% (95% CI 0.21-0.51) improvement......OBJECTIVE: To perform a meta-analysis assessing the effects of self-care management interventions in improving glycaemic control in type 2 diabetes by analysing the impact of different study characteristics on the effect size. METHODS: A literature search in eight scientific databases up......-up. For type of intervention and duration of intervention there was a non-significant effect on effect size in favour of educational techniques and short interventions. CONCLUSION: In type 2 diabetes, there are improvements in glycaemic control in people who receive self-care management treatment with a small...

  20. Reproductive success of herring gulls breeding on Lake Superior

    Energy Technology Data Exchange (ETDEWEB)

    Shutt, J.L. [Canadian Wildlife Service, Hull, Quebec (Canada)

    1994-12-31

    Herring gulls breed in the vicinity of three pulp mills located on the north shore of Lake Superior. The impacts of exposure to effluents produced by these mills on various aspects of the reproductive biology of this species have been monitored since 1992. Reproductive success at these sites has been either zero or below the level necessary to maintain a stable population. Levels of dioxins and furans in the eggs and tissues of herring gulls did not show any consistent trends between the exposed and control sites and were generally low. Additionally, TCDD TEQs calculated for the same colonies, with the inclusion of several non ortho-substituted PCBs, were well below levels thought to result in reproductive impairment of herring gulls. However, plasma and liver concentrations of retinol were depressed and variable at several colonies, indicating potential diet differences between the study sites. Further determination of food types consumed at the control and exposed sites revealed that fish, the traditional diet of this species, was a small or insignificant component of the diet. Food type was also correlated with contaminant burden and reproductive output. Previously collected data as well as current results will be discussed.