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1

Subjective Assessment of Diabetes Self-Care Correlates with Perceived Glycemic Control but not with Actual Glycemic Control  

PubMed Central

Background We investigated whether patients' perceived glycemic control and self-reported diabetes self-care correlated with their actual glycemic control. Methods A survey was administered among patients with diabetes mellitus at an outpatient clinic with structured self-report questionnaires regarding perceived glycemic control and diabetes self-management. Actual glycemic control was defined as a change in glycated hemoglobin (A1C) or fasting plasma glucose (FPG) since the last clinic visit. Results Patients who perceived their glycemic control as "improved" actually showed a mild but significant decrease in the mean A1C (-0.1%, P=0.02), and those who perceived glycemic control as "aggravated" had a significant increase in the mean FPG (10.5 mg/dL or 0.59 mmol/L, P=0.04) compared to the "stationary" group. However, one-half of patients falsely predicted their actual glycemic control status. Subjective assessment of diabetes self-care efforts, such as adherence to a diet regimen or physical activity, correlated positively with perceived glycemic control but showed no association with actual glycemic control. Conclusion Patients should be encouraged to assess and monitor diabetes self-care more objectively to motivate behavioral modifications and improve their actual glycemic control. PMID:25729710

Ohn, Jung Hun; Lee, Ju Hee; Hong, Eun Shil; Koo, Bo Kyung; Kim, Sang Wan; Yi, Ka Hee

2015-01-01

2

Glycemic goals in diabetes: trade-off between glycemic control and iatrogenic hypoglycemia.  

PubMed

The selection of a glycemic goal in a person with diabetes is a compromise between the documented upside of glycemic control-the partial prevention or delay of microvascular complications-and the documented downside of glycemic control-the recurrent morbidity and potential mortality of iatrogenic hypoglycemia. The latter is not an issue if glycemic control is accomplished with drugs that do not cause hypoglycemia or with substantial weight loss. However, hypoglycemia becomes an issue if glycemic control is accomplished with a sulfonylurea, a glinide, or insulin, particularly in the setting of absolute endogenous insulin deficiency with loss of the normal decrease in circulating insulin and increase in glucagon secretion and attenuation of the sympathoadrenal response as plasma glucose concentrations fall. Then the selection of a glycemic goal should be linked to the risk of hypoglycemia. A reasonable individualized glycemic goal is the lowest A1C that does not cause severe hypoglycemia and preserves awareness of hypoglycemia, preferably with little or no symptomatic or even asymptomatic hypoglycemia, at a given stage in the evolution of the individual's diabetes. PMID:24962915

Cryer, Philip E

2014-07-01

3

Glycemic control in critically ill: A moving target  

PubMed Central

Glycemic control targets in intensive care units (ICUs) have three distinct domains. Firstly, excessive hyperglycemia needs to be avoided. The upper limit of this varies depending on the patient population studied and diabetic status of the patients. Surgical patients particularly cardiac surgery patients tend to benefit from a lower upper limit of glycemic control, which is not evident in medically ill patient. Patient with premorbid diabetic status tends to tolerate higher blood sugar level better than normoglycemics. Secondly, hypoglycemia is clearly detrimental in all groups of critically ill patient and all measures to avoid this catastrophe need to be a part of any glycemic control protocol. Thirdly, glycemic variability has increasingly been shown to be detrimental in this patient population. Glycemic control protocols need to take this into consideration and target to reduce any of the available metrics of glycemic variability. Newer technologies including continuous glucose monitoring techniques will help in titrating all these three domains within a desirable range. PMID:24872652

Todi, Subhash

2014-01-01

4

Glycemic control and heart disease.  

PubMed

The leading cause of death among patients with diabetes is cardiovascular disease with approximately 80% of all deaths being attributed to coronary heart disease. Acute myocardial infarctions (AMIs) in patients with diabetes are associated with an increased rate of reinfarction than those without diabetes. Following AMI, patients with diabetes are more likely to develop severe heart failure. The Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) clinical trial examined the relationship between intensive insulin and conventional therapy following AMI. Results of the DIGAMI study clearly identify the need for tight glucose control following AMI in improving clinical outcomes and mortality. PMID:11382566

Colwell, L; Quinn, L

2001-06-01

5

Motivation and glycemic control in diabetes mellitus.  

PubMed

Although adherence to treatment regimes is clinically important in diabetes mellitus, the best way to improve it is unclear. As a precursor to evaluating the place of a brief intervention (motivational interviewing) in the treatment of diabetes, this study investigated the relation between motivation and glycemic control in 361 diabetic out-patients. Outcome measures were the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) and HbA1C level--a measure of glycemic control. The majority of patients (86.7%) could be allocated to a single motivational stage, indicating that this concept is applicable in the study of diabetes. There were significant associations between HbA1C level and motivational stage, but not in the direction predicted. That is, patients at an earlier motivational stage had lower HbA1C levels than those at later stages. The results suggest that feedback of HbA1C level may partly determine the patient's motivation to control their diabetes, although the effect is quite weak. PMID:9304556

Trigwell, P; Grant, P J; House, A

1997-09-01

6

Glycemic control indicators in patients with neonatal diabetes mellitus  

PubMed Central

Neonatal diabetes mellitus (NDM) is a type of diabetes mellitus caused by genetic abnormality which develops in insulin dependent state within 6 mo after birth. HbA1c is widely used in clinical practice for diabetes mellitus as the gold standard glycemic control indicator; however, fetal hemoglobin (HbF) is the main hemoglobin in neonates and so HbA1c cannot be used as a glycemic control indicator in NDM. Glycated albumin (GA), another glycemic control indicator, is not affected by HbF. We reported that GA can be used as a glycemic control indicator in NDM. However, it was later found that because of increased metabolism of albumin, GA shows an apparently lower level in relation to plasma glucose in NDM; measures to solve this problem were needed. In this review, we outlined the most recent findings concerning glycemic control indicators in neonates or NDM. PMID:24748932

Suzuki, Shigeru; Koga, Masafumi

2014-01-01

7

Use of the glycemic index for weight loss and glycemic control: A review of recent evidence  

Microsoft Academic Search

This article summarizes current findings regarding the use of low-glycemic index (GI) diets for weight loss and type 2 diabetes\\u000a control. Results from cross-sectional studies evaluating the association between dietary GI and body mass index had equivocal\\u000a results, especially when dietary fiber was included in the model. Of five prospective cohort studies, two reported increased\\u000a risk of type 2 diabetes

Sonia Vega-López; Sandra N. Mayol-Kreiser

2009-01-01

8

A longitudinal study of coping, anxiety and glycemic control in adults with type 1 diabetes  

Microsoft Academic Search

Diabetes is a unique disorder in how much it requires a high degree of individual self management strategies. Anxiety and stress can affect glycemic control, and thus management of emotions may be key to good glycemic control. This study is the first to examine how anxiety and coping style, and their interaction, can affect long-term glycemic control. We measured anxiety,

Serge Sultan; Elissa Epel; Claude Sachon; Genevieve Vaillant; Agnes Hartemann-Heurtier

2008-01-01

9

Is There a "July Effect" for Inpatient Glycemic Control?  

PubMed

Objective: The period of resident turnover in teaching hospitals has been believed by some to lead to worsening of health outcomes or the so-called "July Effect". We sought to study glycemic control in patients admitted to medical floors looking for any adverse outcomes related to a"July effect".Methods: This is a single-center retrospective cohort study comparing inpatient glycemic control at the start and end of a single academic year (July 2009 to June 2010). A total of 100 inpatients with a diagnosis of diabetes mellitus were included in the first group (Group 1: July to September 2009) and 118 in the second group (Group 2: April to June 2010). Four capillary blood glucose measurements per day from Day 2 to Day 6 of hospitalization, as well as clinical data pertinent to glycemic management were collected.Results: Data analysis showed no significant difference in the overall inpatient glycemic control between the two groups. Mean glucose for Group 1 was 168.67 mg/dL and 168.59 mg/dl for Group 2. 67% of patients in Group 1 and 72.9% in Group 2 were within blood glucose range of 70 - 179 mg/dl, 32% of patients in Group 1 and 52% of patients in Group 2 were within the range of 140 - 179 mg/dL. Hypoglycemia occurred in 17% and 18.6% of patients for Group 1 and 2 respectively. No difference in diabetes treatment ordering practices of residents was detected.Conclusion: This study did not show any evidence to support the "July Effect" on overall inpatient glycemic control. PMID:25100361

Nicolas, Kristine; Raroque, Sabrina; Rowland, Douglas Y; Chaiban, Joumana T

2014-08-01

10

Performance improvement measures in achieving glycemic control in the acute brain injury population.  

PubMed

Glycemic control is becoming a standard practice in the intensive care environment because it has been shown to produce positive patient outcomes and benefits. A 14-bed neurointensive care unit initiated a strict glycemic protocol and evaluated the results over a 1-year period through a performance improvement initiative. Results indicated that tight glycemic control could be achieved safely by adhering to an evidence-based established protocol. The average blood glucose level for all patients was between 90 and 130 mg/dl by Day 2 after the implementation of the glycemic control protocol. The purpose of this article was to explain how a strict glycemic protocol was safely implemented. Further research is necessary to determine long-term benefits of glycemic control in the population with neurocritical illness. PMID:19361123

Moyer, Megan T

2009-04-01

11

Effect of Fructose on Glycemic Control in Diabetes  

PubMed Central

OBJECTIVE The effect of fructose on cardiometabolic risk in humans is controversial. We conducted a systematic review and meta-analysis of controlled feeding trials to clarify the effect of fructose on glycemic control in individuals with diabetes. RESEARCH DESIGN AND METHODS We searched MEDLINE, EMBASE, and the Cochrane Library (through 22 March 2012) for relevant trials lasting ?7 days. Data were aggregated by the generic inverse variance method (random-effects models) and expressed as mean difference (MD) for fasting glucose and insulin and standardized MD (SMD) with 95% CI for glycated hemoglobin (HbA1c) and glycated albumin. Heterogeneity was assessed by the Cochran Q statistic and quantified by the I2 statistic. Trial quality was assessed by the Heyland methodological quality score (MQS). RESULTS Eighteen trials (n = 209) met the eligibility criteria. Isocaloric exchange of fructose for carbohydrate reduced glycated blood proteins (SMD ?0.25 [95% CI ?0.46 to ?0.04]; P = 0.02) with significant intertrial heterogeneity (I2 = 63%; P = 0.001). This reduction is equivalent to a ?0.53% reduction in HbA1c. Fructose consumption did not significantly affect fasting glucose or insulin. A priori subgroup analyses showed no evidence of effect modification on any end point. CONCLUSIONS Isocaloric exchange of fructose for other carbohydrate improves long-term glycemic control, as assessed by glycated blood proteins, without affecting insulin in people with diabetes. Generalizability may be limited because most of the trials were <12 weeks and had relatively low MQS (<8). To confirm these findings, larger and longer fructose feeding trials assessing both possible glycemic benefit and adverse metabolic effects are required. PMID:22723585

Cozma, Adrian I.; Sievenpiper, John L.; de Souza, Russell J.; Chiavaroli, Laura; Ha, Vanessa; Wang, D. David; Mirrahimi, Arash; Yu, Matt E.; Carleton, Amanda J.; Di Buono, Marco; Jenkins, Alexandra L.; Leiter, Lawrence A.; Wolever, Thomas M.S.; Beyene, Joseph; Kendall, Cyril W.C.; Jenkins, David J.A.

2012-01-01

12

Predictors of glycemic control and short-term adverse outcomes in youth with type 1 diabetes  

Microsoft Academic Search

Objectives: To examine predictors of glycemic control and to assess how glycemic control affects the incidence of short-term adverse outcomes in a pediatric population with type 1 diabetes. Study design: Three hundred youth, aged 7 to 16 years, with type 1 diabetes who were receiving diabetes specialty care were followed up prospectively for 1 year. Treatment plans and frequency of

Bat-Sheva Levine; Barbara J. Anderson; Deborah A. Butler; Jeanne E. Antisdel; Julienne Brackett; Lori M. B. Laffel

2001-01-01

13

Trace elements, oxidative stress and glycemic control in young people with type 1 diabetes mellitus.  

PubMed

Trace elements and oxidative stress are associated with glycemic control and diabetic complications in type 1 diabetes mellitus. In this study, we analyzed the levels of serum copper, zinc, superoxide dismutase (SOD) activity, and malondialdehyde (MDA) and urinary MDA and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in 33 type 1 diabetic patients with optimal and suboptimal glycemic control (HbA1C<9.0%) and 40 patients with poor glycemic control (HbA1C?9%) and 27 age- and sex-matched non-diabetic controls to evaluate the differences between these markers in different glycemic control states. Diabetic patients, especially poor-glycemic-control subjects (HbA1C?9%), exhibited significantly lower levels of serum zinc and increased levels of serum copper (and, therefore, increased serum copper-to-zinc ratios), serum SOD, blood MDA, and urinary MDA and 8-OHdG, relative to non-diabetic subjects. Furthermore, significant correlations existed in these patients between the serum copper, serum copper-to-zinc ratio, and urinary MDA (all p<0.001) and the levels of urinary 8-OHdG (p=0.007) and HbA1C. Our results suggest that high serum copper levels and oxidative stress correlate with glycemic control. Therefore, strict glycemic control, decreased oxidative stress, and a lower copper concentration might prevent diabetic complications in patients with type 1 diabetes mellitus. PMID:24315963

Lin, Ching-Chiang; Huang, Hsiu-Hua; Hu, Chiung-Wen; Chen, Bai-Hsiun; Chong, Inn-Wen; Chao, Yu-Ying; Huang, Yeou-Lih

2014-01-01

14

Glycemic control and diabetes management in hospitalized patients in Brazil  

PubMed Central

Background The importance of tight blood glucose control among outpatients with diabetes mellitus is well established, however, the management of diabetes in the hospital setting is generally considered secondary in importance. This study sought to assess glycemic control and diabetes management in adult patients admitted to hospitals in Brazil. Methods A cross-sectional and nationwide survey was conducted from July 2010 to January 2012. Eligible cases were 18 years of age or older, had a diagnosis of diabetes and a hospitalization length of stay ?72 hours. Socio-demographic information, hospitalization details, and data on diabetes diagnosis, management and treatment were collected for all patients by chart review. Information on all blood glucose (BG) readings for a maximum of 20 consecutive days of hospitalization was recorded for each patient. Results Overall, 2,399 patients were surveyed in 24 hospitals located in 13 cities from all five Brazilian regions. The prevalence of patients presenting hyperglycemic (BG >180 mg/dL) or hypoglycemic (BG <70 mg/dL) events was 89.4% and 30.9% in patients in general wards, and 88.2% and 27.7% in those in Intensive Care Units (ICUs), respectively. In addition, a BG measure >180 mg/dL was recorded in two-thirds of the patient-days. A high proportion of patients were treated with sliding-scale insulin regimen alone in the general wards (52.0%) and in the ICUs (69.2%), and only 35.7% and 3.9% received appropriate insulin therapy in general wards (basal + bolus insulin) and in ICUs (continuous IV insulin), respectively. Conclusions Inpatient glycemic control and diabetes management needs improvement. Opportunities to improve care in Brazilian hospitals include expanded use of intravenous insulin and subcutaneous basal-bolus insulin protocols, avoiding use of sliding-scale insulin alone, increased frequency of blood glucose monitoring, and institution wide quality improvement efforts targeting both physician and nursing behavior. PMID:24499564

2013-01-01

15

A Critical Review of Diabetes, Glycemic Control and Dental Implant Therapy  

PubMed Central

Objectives To systematically examine the evidence guiding the use of implant therapy relative to glycemic control for patients with diabetes and to consider the potential for both implant therapy to support diabetes management and hyperglycemia to compromise implant integration. Material and Methods A systematic approach was used to identify and review clinical investigations directly assessing implant survival or failure for patients with diabetes. A MEDLINE (PubMED) database search identified potential articles for inclusion using the search strategy: (dental implants OR oral implants) AND (diabetes OR diabetic). Inclusion in this review required longitudinal assessments including at least 10 patients, with included articles assessed relative to documentation of glycemic status for patients. Results The initial search identified 129 publications, reduced to 16 for inclusion. Reported implant failures rates for diabetic patients ranged from 0–14.3%. The identification and reporting of glycemic control was insufficient or lacking in 13 of the 16 studies with 11 of these enrolling only patients deemed as having acceptable glycemic control, limiting interpretation of findings relative to glycemic control. Three of the 16 studies having interpretable information on glycemic control failed to demonstrate a significant relationship between glycemic control and implant failure, with failure rates ranging from 0–2.9%. Conclusions Clinical evidence is lacking for the association of glycemic control with implant failure while support is emerging for implant therapy in diabetes patients with appropriate accommodations for delays in implant integration based on glycemic control. The role for implants to improve oral function in diabetes management and the effects of hyperglycemia on implant integration remains to be determined. PMID:22111901

Oates, Thomas W.; Huynh-Ba, Guy; Vargas, Adriana; Alexander, Peggy; Feine, Jocelyne

2011-01-01

16

Clinical review: Strict or loose glycemic control in critically ill patients - implementing best available evidence from randomized controlled trials  

Microsoft Academic Search

ABSTRACT: Glycemic control aiming at normoglycemia, frequently referred to as 'strict glycemic control' (SGC), decreased mortality and morbidity of adult critically ill patients in two randomized controlled trials (RCTs). Five successive RCTs, however, failed to show benefit of SGC with one trial even reporting an unexpected higher mortality. Consequently, enthusiasm for the implementation of SGC has declined, hampering translation of

Marcus J Schultz; Robin E Harmsen; Peter E Spronk

2010-01-01

17

Poor glycemic control is associated with increased diastolic blood pressure and heart rate in children with Type 1 diabetes  

Microsoft Academic Search

Although higher levels of hemoglobin A1c (HbA1c) and blood pressure precede the development of nephropathy in Type 1 diabetes (T1DM), the relationship between glycemic control and cardiovascular factors early in the course of diabetes is not clear. We conducted a retrospective study from clinic data for a 1-year period in 148 children with T1DM aged 12.5±4.4 years who had average

Michael Y Torchinsky; Ricardo Gomez; Jay Rao; Alfonso Vargas; Donald E Mercante; Stuart A Chalew

2004-01-01

18

Veganism is a viable alternative to conventional diet therapy for improving blood lipids and glycemic control.  

PubMed

Abstract The American Diabetes Association (ADA) and the National Cholesterol Education Program (NCEP) have each outlined a set of dietary recommendations aimed at improving glycemic control and blood lipids, respectively. However, traditional vegan diets (low-fat diets that proscribe animal product consumption) are also effective at improving glycemic control, and dietary portfolios (vegan diets that contain prescribed amounts of plant sterols, viscous fibers, soy protein, and nuts) are also effective at improving blood lipids. The purpose of this review was to compare the effects of traditional vegan diets and dietary portfolios with ADA and NCEP diets on body weight, blood lipids, blood pressure, and glycemic control. The main findings are that traditional vegan diets appear to improve glycemic control better than ADA diets in individuals with type 2 diabetes mellitus (T2DM), while dietary portfolios have been consistently shown to improve blood lipids better than NCEP diets in hypercholesterolemic individuals. PMID:24922183

Trepanowski, John F; Varady, Krista A

2014-06-12

19

Almond consumption improved glycemic control and lipid profiles in patients with type 2 diabetes mellitus  

Technology Transfer Automated Retrieval System (TEKTRAN)

Almond consumption is associated with ameliorations in obesity, hyperlipidemia, hypertension, and hyperglycemia. The hypothesis of this 12-wk randomized crossover clinical trial was that almond consumption would improve glycemic control and decrease risk to cardiovascular disease in 20 Chinese type ...

20

Self-Efficacy Links Health Literacy and Numeracy to Glycemic Control  

Microsoft Academic Search

The mechanisms underlying the relationship between health literacy, numeracy, and glycemic control are unclear. We explored the role of diabetes self-efficacy in the predicted pathway linking health literacy and numeracy to glycemic control (A1C). Adults with type 1 or type 2 diabetes mellitus (N = 383) were enrolled in a cross-sectional study at primary care and diabetes clinics at three medical centers.

Chandra Y. Osborn; Kerri Cavanaugh; Kenneth A. Wallston; Russell L. Rothman

2010-01-01

21

Glycemic control and major depression in patients with type 1 and type 2 diabetes mellitus  

Microsoft Academic Search

The current study evaluated the association of glycemic control and major depression in 33 type 1 and 39 type 2 diabetes mellitus patients. Type 1 patients with a lifetime history of major depression showed significantly worse glycemic control than patients without a history of psychiatric illness (t=2.09; df=31, p<0.05). Type 2 diabetes patients with a lifetime history of major depression

Mary de Groot; ALAN M. JACOBSON; JACQUELINE A. SAMSON; Garry Welch

1999-01-01

22

?-2-Macroglobulin in Saliva Is Associated with Glycemic Control in Patients with Type 2 Diabetes Mellitus  

PubMed Central

Background. Subjects with type 2 diabetes mellitus (DM2) require an adequate glycemic control to avoid diabetic complications. Currently, saliva biomarkers are used as a diagnostic tool and can be indicative of the degree of progression and control of various diseases. Several studies indicate that ?-2-macroglobulin levels are elevated in diabetic patients. Methods. 120 subjects with DM2 were enrolled and classified into two groups according to their glycemic control (percentage of glycated hemoglobin-A1c (HbA1c), <7% adequate glycemic control group; >7% inadequate glycemic control group). The relationship between ?-2-macroglobulin levels from saliva samples and HbA1c was subsequently evaluated. Results. We found a positive correlation between ?-2-macroglobulin and HbA1c (r = 0.778 and P < 0.0001). Area under the receivers operating characteristic (ROC) curve of ?-2-macroglobulin indicated a positive discrimination threshold of ?-2-macroglobulin (AUC = 0.903, CI 95%: 0.847–0.959, P < 0.0001) to diagnose glycemic control. Conclusions. Our data strongly suggest that the level of saliva ?-2-macroglobulin is an indicator for the degree of glycemic control in diabetic patients and represents a promising alternative method to evaluate this parameter.

Aitken, Juan Pablo; Ortiz, Carolina; Morales-Bozo, Irene; Rojas-Alcayaga, Gonzalo; Baeza, Mauricio; Beltran, Caroll

2015-01-01

23

?-2-Macroglobulin in Saliva Is Associated with Glycemic Control in Patients with Type 2 Diabetes Mellitus.  

PubMed

Background. Subjects with type 2 diabetes mellitus (DM2) require an adequate glycemic control to avoid diabetic complications. Currently, saliva biomarkers are used as a diagnostic tool and can be indicative of the degree of progression and control of various diseases. Several studies indicate that ?-2-macroglobulin levels are elevated in diabetic patients. Methods. 120 subjects with DM2 were enrolled and classified into two groups according to their glycemic control (percentage of glycated hemoglobin-A1c (HbA1c), <7% adequate glycemic control group; >7% inadequate glycemic control group). The relationship between ?-2-macroglobulin levels from saliva samples and HbA1c was subsequently evaluated. Results. We found a positive correlation between ?-2-macroglobulin and HbA1c (r = 0.778 and P < 0.0001). Area under the receivers operating characteristic (ROC) curve of ?-2-macroglobulin indicated a positive discrimination threshold of ?-2-macroglobulin (AUC = 0.903, CI 95%: 0.847-0.959, P < 0.0001) to diagnose glycemic control. Conclusions. Our data strongly suggest that the level of saliva ?-2-macroglobulin is an indicator for the degree of glycemic control in diabetic patients and represents a promising alternative method to evaluate this parameter. PMID:25821337

Aitken, Juan Pablo; Ortiz, Carolina; Morales-Bozo, Irene; Rojas-Alcayaga, Gonzalo; Baeza, Mauricio; Beltran, Caroll; Escobar, Alejandro

2015-01-01

24

Update in Diabetes and CVD: Synthesizing the Evidence from Recent Trials of Glycemic Control to Prevent Cardiovascular Disease  

PubMed Central

Purpose of review To review the recent studies on intensive glucose control and the risk of cardiovascular disease (CVD) in type 2 diabetes, to discuss potential reasons for discordant results among recent trials, and to comment on implications for clinical practice. Recent findings Three large randomized controlled trials on the effect of tight glycemic control (TGC) on CVD in patients with type 2 diabetes have been published within the last year, along with the cardiovascular outcomes from the long-term follow-up of the UKPDS study. This narrative review of the methods and results of these trials reveals cardiovascular benefit from early institution of TGC, and lack of benefit or potential harm with intensification of glucose control late in the course of type 2 diabetes or after CVD has developed. Also, the benefits of TGC may be outweighed by weight gain and hypoglycemia. All trials had fewer cardiovascular events than anticipated due to improvements in other cardiovascular risk factors. Summary In addition to controlling cardiovascular risk factors, patients with type diabetes should aim for good glycemic control (HbA1c<7%) soon after the diagnosis of diabetes to prevent macrovascular as well as microvascular complications. Glycemic targets should be individualized as diabetes progresses, comorbidities develop, and to avoid having the side effects of therapy (hypoglycemia and weight gain) predominate. PMID:19829110

Park, Lee; Wexler, Deborah

2010-01-01

25

Impact of pancreatic cancer and subsequent resection on glycemic control in diabetic and nondiabetic patients.  

PubMed

The incidence of new onset or worsening diabetes is surprisingly low in patients after partial pancreatectomy for cancer, leading us to question what factors predict diminished glycemic control in those undergoing resection. All patients undergoing pancreatectomy for cancer at a large, rural university teaching hospital between 1996 and 2010 were identified. The incidence of new onset, or worsening, existing diabetes was determined based on pre and postoperative medication requirement. Univariate analysis was undertaken to identify factors that predict worsened glycemic control. One hundred and one (1 total, 79 Whipple, 21 distal) patients were identified, 41 per cent of which had preexisting diabetes. Nearly half of existing diabetics manifested an increased medication requirement prior to their cancer diagnosis. New onset diabetes occurred in 20 per cent of postoperative patients. Of established diabetics, 34 per cent had either improved glycemic control (9/41) or were cured (5/41) despite the reduction of islet cell mass that occurred with surgery. On univariate analysis, only prolonged hospitalization was associated with worsened glycemic control. Diminished glycemic control is a frequent presenting symptom of pancreatic cancer. Worsened or new onset diabetes is associated with length of stay, which can be influenced by a number of factors including complications and comorbidities. PMID:21944519

White, Michael A; Agle, Steven C; Fuhr, Hannah M; Mehaffey, James H; Waibel, Brett H; Zervos, Emmanuel E

2011-08-01

26

Teneligliptin improves glycemic control with the reduction of postprandial insulin requirement in Japanese diabetic patients.  

PubMed

Teneligliptin is a novel peptidomimetic-chemotype prolylthiazolidine-based inhibitor of dipeptidyl peptidase-4 (DPP-4). The aim of this study was to evaluate the effects of teneligliptin on 24 h blood glucose control and gastrointestinal hormone responses to a meal tolerance test, and to investigate the glucose-lowering mechanisms of teneligliptin. Ten patients with type 2 diabetes mellitus (T2DM) were treated for 3 days with teneligliptin (20 mg/day). Postprandial profiles for glucose, insulin, glucagon, active glucagon-like peptide-1 (GLP-1), active glucose-dependent insulinotropic polypeptide (GIP), ghrelin, des-acyl ghrelin, and 24 h glycemic fluctuations were measured via continuous glucose monitoring for 4 days. Once daily teneligliptin administration for 3 days significantly lowered postprandial and fasting glucose levels. Significant elevations of fasting and postprandial active GLP-1 and postprandial active GIP levels were observed. Teneligliptin lowered postprandial glucose elevations, 24 h mean blood glucose levels, standard deviation of 24 h glucose levels and mean amplitude of glycemic excursions (MAGE) without hypoglycemia. Serum insulin levels in the fasting state and 30 min after a meal were similar before and after teneligliptin treatment; however significant reductions at 60 to 180 min after treatment were observed. A significant elevation in early-phase insulin secretion estimated by insulinogenic and oral disposition indices, and a significant reduction in postprandial glucagon AUC were observed. Both plasma ghrelin and des-acyl ghrelin levels were unaltered following teneligliptin treatment. Teneligliptin improved 24 h blood glucose levels by increasing active incretin levels and early-phase insulin secretion, reducing the postprandial insulin requirement, and reducing glucagon secretion. Even short-term teneligliptin treatment may offer benefits for patients with T2DM. PMID:25252844

Tsuchimochi, Wakaba; Ueno, Hiroaki; Yamashita, Eiichiro; Tsubouchi, Chikako; Sakoda, Hideyuki; Nakamura, Shuji; Nakazato, Masamitsu

2015-01-30

27

Erectile function in men with diabetes type 2: correlation with glycemic control  

Microsoft Academic Search

Men with diabetes have an increased risk for erectile dysfunction (ED) than those without diabetes. The diabetes control and complications trial clearly showed that better long-term control of blood glucose in diabetes type 1 is associated with decreased frequency and delayed the onset of microvascular complications. The aim of this study is to explore the role of glycemic control, and

H Awad; A Salem; A Gadalla; N Abou El Wafa; O A Mohamed

2010-01-01

28

Acute effects of dietary glycemic index on antioxidant capacity in nutrient-controlled feeding study  

Technology Transfer Automated Retrieval System (TEKTRAN)

Oxidative stress, caused by an imbalance between antioxidant capacity and reactive oxygen species, may be an early event in a metabolic cascade elicited by a high glycemic index (GI) diet, ultimately increasing the risk for cardiovascular disease and diabetes. We conducted a feeding study to evalua...

29

Template to improve glycemic control without reducing adiposity or dietary fat  

PubMed Central

Drugs that improve chronic hyperglycemia independently of insulin signaling or reduction of adiposity or dietary fat intake may be highly desirable. Ad36, a human adenovirus, promotes glucose uptake in vitro independently of adiposity or proximal insulin signaling. We tested the ability of Ad36 to improve glycemic control in vivo and determined if the natural Ad36 infection in humans is associated with better glycemic control. C57BL/6J mice fed a chow diet or made diabetic with a high-fat (HF) diet were mock infected or infected with Ad36 or adenovirus Ad2 as a control for infection. Postinfection (pi), systemic glycemic control, hepatic lipid content, and cell signaling in tissues pertinent to glucose metabolism were determined. Next, sera of 1,507 adults and children were screened for Ad36 antibodies as an indicator of past natural infection. In chow-fed mice, Ad36 significantly improved glycemic control for 12 wk pi. In HF-fed mice, Ad36 improved glycemic control and hepatic steatosis up to 20 wk pi. In adipose tissue (AT), skeletal muscle (SM), and liver, Ad36 upregulated distal insulin signaling without recruiting the proximal insulin signaling. Cell signaling suggested that Ad36 increases AT and SM glucose uptake and reduces hepatic glucose release. In humans, Ad36 infection predicted better glycemic control and lower hepatic lipid content independently of age, sex, or adiposity. We conclude that Ad36 offers a novel tool to understand the pathways to improve hyperglycemia and hepatic steatosis independently of proximal insulin signaling, and despite a HF diet. This metabolic engineering by Ad36 appears relevant to humans for developing more practical and effective antidiabetic approaches. PMID:21266671

Krishnapuram, R.; Dhurandhar, E. J.; Dubuisson, O.; Kirk-Ballard, H.; Bajpeyi, S.; Butte, N.; Sothern, M. S.; Larsen-Meyer, E.; Chalew, S.; Bennett, B.; Gupta, A. K.; Greenway, F. L.; Johnson, W.; Brashear, M.; Reinhart, G.; Rankinen, T.; Bouchard, C.; Cefalu, W. T.; Ye, J.; Javier, R.; Zuberi, A.

2011-01-01

30

Patient perception of understanding health education and instructions has moderating effect on glycemic control  

PubMed Central

Background Whether health literacy is independently associated with processes or outcomes of diabetes-related care is controversial. We tried to demonstrate the interaction of health literacy and understanding of health education and instructions in achieving glycemic control. Methods Five hundred and one consecutive patients with type 2 diabetes mellitus (DM) in the outpatient clinic of the metabolism department were recruited into this pilot study. The demographic data were collected from patients’ self-reports. The clinical background information was collected through electronic medical records. A questionnaire derived from part of the Mandarin Health Literacy Scale was used to measure numeracy and functional health literacy of people with diabetes. Health literacy levels were categorized into inadequate, marginal and adequate. Patient self-ratings of their perceived understanding of the health education information and instructions provided by their case manager in the past were categorized into two subgroups: better and poor. Patients with an HbA1c level equal to or below 7% were considered to have good glycemic control. Multivariate logistic regression was used to find associated factors of health literacy and understanding of health education and instructions. GENMOD procedures were used to analyze repeated outcome measurements of glycemic control. Results Higher educational attainment and higher household income (odds ratios were 2.23 and 2.22, respectively) were significantly associated with patients who had adequate health literacy. Higher educational attainment and patients with a family history of DM (odds ratios were 4.99 and 1.85, respectively) were significantly associated with better understanding of health education and instructions. Adequate health literacy is not the only factor associated with good glycemic control. The effect of adequate health literacy in achieving good glycemic control might be masked by patients with better understanding of health education and instructions. Conclusions Our results revealed that not only were patients with adequate health literacy associated with good glycemic control but patients with marginal health literacy were also able to achieve good glycemic control. Adequate health literacy and better understanding of health education is highly correlated. The role of adequate health literacy on glycemic control could be suppressed if variables are over-controlled during analysis. PMID:24996669

2014-01-01

31

Taking a Low Glycemic Index Multi-Nutrient Supplement as Breakfast Improves Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial  

PubMed Central

Dietary therapy is the mainstay of treatment for diabetes. This study examined the effect of a low glycemic index (GI) multi-nutrient supplement, consumed in place of breakfast, on glycemic control in patients with type 2 diabetes mellitus (T2DM). A total of 71 participants were randomized at a 2:1 ratio into either a breakfast replacement group or a normal breakfast group for a 12-week interventional study. The primary outcome measure was change in hemoglobin A1c (HbA1c). Nutrition status and somatometry were studied as secondary outcomes. The breakfast replacement group displayed a ?0.2% absolute reduction in HbA1c (95% CI (confidence interval), ?0.38% to ?0.07%, p = 0.004), while the HbA1c of the control group increased 0.3% (95% CI, 0.1% to 0.5%, p = 0.005). The baseline Mini Nutritional Assessment score for both groups was 26.0 and no significant changes occurred following intervention. However, there was a statistically significant difference in body mass index between the treatment and control groups (p = 0.032) due to the weight gain in the control group (increased 0.5 kg, 95% CI was 0.2 to 0.9, p = 0.007). These data suggest that breakfast replacement with a low GI multi-nutrient supplement can improve glycemic and weight control in T2DM. PMID:25514391

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

2014-01-01

32

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

Microsoft Academic Search

Objective  Dietary carbohydrate is the major determinant of postprandial glucose levels, and several clinical studies have shown that\\u000a low-carbohydrate diets improve glycemic control. In this study, we tested the hypothesis that a diet lower in carbohydrate\\u000a would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and type 2 diabetes mellitus.\\u000a \\u000a \\u000a \\u000a \\u000a Research design and methods  Eighty-four

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

2008-01-01

33

Glycemic Control in the Pediatric Intensive Care Unit of Leuven: Two Years of Experience  

E-print Network

patients have a severe dysregulation of their glucose homeostasis. Observational studies have shown, (PICU) pediatric intensive care unit, (TGC) tight glycemic control Keywords: blood glucose, children controlling blood glucose levels within age-adjusted narrow limits by applying intensive insulin therapy

34

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

PubMed

The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin (HbA1c). Despite its importance as an indicator for the development of diabetic complications, recent studies have revealed that this metric has some limitations; it conveys a rather complex message, which has to be taken into consideration for diabetes screening and treatment. On the basis of recent clinical trials, the relationship between HbA1c and cardiovascular outcomes in long-standing diabetes has been called into question. It becomes obvious that other surrogate and biomarkers are needed to better predict cardiovascular diabetes complications and assess efficiency of therapy. Glycated albumin, fructosamin, and 1,5-anhydroglucitol have received growing interest as alternative markers of glycemic control. In addition to measures of hyperglycemia, advanced glucose monitoring methods became available. An indispensible adjunct to HbA1c in routine diabetes care is self-monitoring of blood glucose. This monitoring method is now widely used, as it provides immediate feedback to patients on short-term changes, involving fasting, preprandial, and postprandial glucose levels. Beyond the traditional metrics, glycemic variability has been identified as a predictor of hypoglycemia, and it might also be implicated in the pathogenesis of vascular diabetes complications. Assessment of glycemic variability is thus important, but exact quantification requires frequently sampled glucose measurements. In order to optimize diabetes treatment, there is a need for both key metrics of glycemic control on a day-to-day basis and for more advanced, user-friendly monitoring methods. In addition to traditional discontinuous glucose testing, continuous glucose sensing has become a useful tool to reveal insufficient glycemic management. This new technology is particularly effective in patients with complicated diabetes and provides the opportunity to characterize glucose dynamics. Several continuous glucose monitoring (CGM) systems, which have shown usefulness in clinical practice, are presently on the market. They can broadly be divided into systems providing retrospective or real-time information on glucose patterns. The widespread clinical application of CGM is still hampered by the lack of generally accepted measures for assessment of glucose profiles and standardized reporting of glucose data. In this article, we will discuss advantages and limitations of various metrics for glycemic control as well as possibilities for evaluation of glucose data with the special focus on glycemic variability and application of CGM to improve individual diabetes management. PMID:25685275

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

2015-02-15

35

Utility of different glycemic control metrics for optimizing management of diabetes  

PubMed Central

The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin (HbA1c). Despite its importance as an indicator for the development of diabetic complications, recent studies have revealed that this metric has some limitations; it conveys a rather complex message, which has to be taken into consideration for diabetes screening and treatment. On the basis of recent clinical trials, the relationship between HbA1c and cardiovascular outcomes in long-standing diabetes has been called into question. It becomes obvious that other surrogate and biomarkers are needed to better predict cardiovascular diabetes complications and assess efficiency of therapy. Glycated albumin, fructosamin, and 1,5-anhydroglucitol have received growing interest as alternative markers of glycemic control. In addition to measures of hyperglycemia, advanced glucose monitoring methods became available. An indispensible adjunct to HbA1c in routine diabetes care is self-monitoring of blood glucose. This monitoring method is now widely used, as it provides immediate feedback to patients on short-term changes, involving fasting, preprandial, and postprandial glucose levels. Beyond the traditional metrics, glycemic variability has been identified as a predictor of hypoglycemia, and it might also be implicated in the pathogenesis of vascular diabetes complications. Assessment of glycemic variability is thus important, but exact quantification requires frequently sampled glucose measurements. In order to optimize diabetes treatment, there is a need for both key metrics of glycemic control on a day-to-day basis and for more advanced, user-friendly monitoring methods. In addition to traditional discontinuous glucose testing, continuous glucose sensing has become a useful tool to reveal insufficient glycemic management. This new technology is particularly effective in patients with complicated diabetes and provides the opportunity to characterize glucose dynamics. Several continuous glucose monitoring (CGM) systems, which have shown usefulness in clinical practice, are presently on the market. They can broadly be divided into systems providing retrospective or real-time information on glucose patterns. The widespread clinical application of CGM is still hampered by the lack of generally accepted measures for assessment of glucose profiles and standardized reporting of glucose data. In this article, we will discuss advantages and limitations of various metrics for glycemic control as well as possibilities for evaluation of glucose data with the special focus on glycemic variability and application of CGM to improve individual diabetes management. PMID:25685275

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

2015-01-01

36

Serum phospholipid monounsaturated fatty acid composition and ?-9-desaturase activity are associated with early alteration of fasting glycemic status.  

PubMed

Because alterations in blood fatty acid (FA) composition by dietary lipids are associated with insulin resistance and related metabolic disorders, we hypothesized that serum phospholipid FA composition would reflect the early alteration of fasting glycemic status, even in people without metabolic syndrome (MetS). To examine this hypothesis, serum phospholipid FA, desaturase activities, fasting glycemic status, and cardiometabolic parameters were measured in study participants (n = 1022; 30-69 years; male, n = 527; female, n = 495; nondiabetics without disease) who were stratified into normal fasting glucose (NFG) and impaired fasting glucose (IFG) groups. Total monounsaturated FA (MUFA), oleic acid (OA; 18:1n-9), dihomo-?-linolenic acid (DGLA; 20:3n-6), ?-9-desaturase activity (D9D; 18:1n-9/18:0), and DGLA/linoleic acid (20:3n-6/18:2n-6) in serum phospholipids were significantly higher in IFG subjects than NFG controls. Study subjects were subdivided into 4 groups, based on fasting glucose levels and MetS status. Palmitoleic acid (16:1n-7) was highest in IFG-MetS and lowest in NFG-non-MetS subjects. Oleic acid and D9D were higher in IFG-MetS than in the other 3 groups. Dihomo-?-linolenic acid and DGLA/linoleic acid were higher in MetS than in non-MetS, regardless of fasting glucose levels. The high-sensitivity C-reactive proteins (hs-CRPs) and 8-epi-prostaglandin-F2? were higher in IFG than in NFG, regardless of MetS status. Oxidized low-density lipoproteins were higher in IFG-MetS than in the other 3 groups. Total MUFAs, OA, and D9D were positively correlated with homeostasis model assessment of insulin resistance, fasting glucose, triglyceride, hs-CRP, and 8-epi-prostaglandin-F2?. Palmitoleic acid was positively correlated with triglyceride and hs-CRP. Lastly, total MUFA, OA, palmitoleic acid, and D9D were associated with early alteration of fasting glycemic status, therefore suggesting that these may be useful markers for predicting the risk of type 2 diabetes and cardiometabolic diseases. PMID:25236425

Cho, Jae Sun; Baek, Seung Han; Kim, Ji Young; Lee, Jong Ho; Kim, Oh Yoen

2014-09-01

37

Physician and patient management of type 2 diabetes and factors related to glycemic control in Spain  

PubMed Central

The objective of this study was to assess current treatment patterns, blood glucose test strip usage, and treatment compliance in patients with type 2 diabetes mellitus (T2DM) in primary care centers in Spain, and to assess factors related to glycemic control. We conducted a retrospective chart review of patients with T2DM and measured treatment compliance using the Morisky-Green questionnaire. 294 patients were included in the study from a population of patients attending 30 primary care centers throughout Spain. Results showed that the majority of patients were treated with oral monotherapy (36%) and oral combination therapy (35%). Less than half of the patients had good glycemic control (HbA1c ? 6.5%). Half of the patients treated pharmacologically reported good compliance with treatment. Logistic regression analyses performed to identify factors associated with glycemic control showed that high body mass index (BMI) and poor compliance were the strongest predictors of poor HbA1c control (OR: 2.198 and 1.789, respectively, p < 0.05). In conclusion, in the course of managing diabetes, physicians and patients should attempt to improve compliance and lower BMI, which could lead to better glycemic control. PMID:19920948

Yurgin, Nicole Rae; Boye, Kristina Secnik; Dilla, Tatiana; Suriñach, Núria Lara; Llach, Xavier Badia

2008-01-01

38

Blood Glucose Measurements in Arterial Blood of Intensive Care Unit Patients Submitted to Tight Glycemic Control  

E-print Network

932 Blood Glucose Measurements in Arterial Blood of Intensive Care Unit Patients Submitted to Tight University of Leuven, Leuven, Belgium Abbreviations: (BG) blood glucose, (EGA) error grid analysis, (ICU: Implementing tight glycemic control (TGC) in intensive care unit (ICU) patients requires accurate blood glucose

39

Alternative Medicine for Glycemic Control in Type 2 Diabetes Mellitus: What's the Evidence?  

Microsoft Academic Search

B Y J EANNETTE G OGUEN ,M D This issue of Endocrinology Rounds reviews the best available evidence about the impact of alternative medications on glycemic control. Alternative medicine has been used to treat diabetes mellitus (DM) for thousands of years. For example, there are traditions in China, Tibet, and India (Ayurvedic medicine) that are still in use to this

ENDOCRINOLOGY ROUNDS; GILLIAN BOOTH; M D ALICE CHENG; M D PHILIP CONNELLY; CHRISTINE DERZKO; M D JEANNETTE GOGUEN; LOREN GROSSMAN; M D AMIR HANNA; M D SOPHIE JAMAL; DAVID JENKINS; ROBERT JOSSE; M D TIM MURRAY; M D DOMINIC NG; LETICIA RAO; M D WILLIAM SINGER; M D VLAD VUKSAN; QINGHUA WANG; TOM WOLEVER

40

Improvement in Glycemic Control and Outcome Corresponding to Intensive Insulin Therapy Protocol Development  

Microsoft Academic Search

Background: Intensive insulin therapy (IIT) has been shown to reduce mortality and morbidity in longer stay, critically ill patients. However, this has been demonstrated in a single site, whereas two multicentric studies have been terminated prematurely mainly due to hypoglycemia. Other difficulties with IIT include efficacy of glycemic control. This report describes how IIT can be improved by protocol simplification

Rob Shulman; Simon J. Finney; Neelam Shah; M. Pharm; Russell Greene; Paul A. Glynne

41

Low Glycemic Index Carbohydrates versus All Types of Carbohydrates for Treating Diabetes in Pregnancy: A Randomized Clinical Trial to Evaluate the Effect of Glycemic Control  

PubMed Central

Background. Due to the higher prevalence of obesity and diabetes mellitus (DM), more pregnant women complicated with diabetes are in need of clinical care. Purpose. Compare the effect of including only low glycemic index (GI) carbohydrates (CHO) against all types of CHO on maternal glycemic control and on the maternal and newborn's nutritional status of women with type 2 DM and gestational diabetes mellitus (GDM). Methods. Women (n = 107, ?29 weeks of gestation) were randomly assigned to one of two nutrition intervention groups: moderate energy and CHO restriction (Group 1: all types of CHO, Group 2: low GI foods). Results. No baseline differences in clinical data were observed. Capillary glucose concentrations throughout pregnancy were similar between groups. Fewer women in Group 2 exceeded weight gain recommendations. Higher risk of prematurity was observed in women in Group 2. No differences in glycemic control were observed between women with type 2 DM and those with GDM. Conclusions. Inclusion of low GI CHO as part of a comprehensive nutrition intervention is equally effective in improving glycemic control as compared to all types of CHO. This strategy had a positive effect in preventing excessive maternal weight gain but increased the risk of prematurity. PMID:23251152

Perichart-Perera, Otilia; Balas-Nakash, Margie; Rodríguez-Cano, Ameyalli; Legorreta-Legorreta, Jennifer; Parra-Covarrubias, Adalberto; Vadillo-Ortega, Felipe

2012-01-01

42

Effect of aerobic and anaerobic exercises on glycemic control in type 1 diabetic youths  

PubMed Central

AIM: To evaluate the long-term effect of aerobic and/or anaerobic exercise on glycemic control in youths with type 1 diabetes. METHODS: Literature review was performed in spring and summer 2014 using PubMed/MEDLINE, Google Scholar, Scopus, and ScienceDirect with the following terms: aerobic, anaerobic, high-intensity, resistance, exercise/training, combined with glycemic/metabolic control, glycated haemoglobin A1c (HbA1c) and type 1 diabetes. Only peer-reviewed articles in English were included published in the last 15 years. It was selected from 1999 to 2014. Glycemic control was measured with HbA1c. Studies with an intervention lasting at least 12 wk were included if the HbA1c was measured before and after the intervention. RESULTS: A total of nine articles were found, and they were published between the years of 2002-2011. The sample size was 401 diabetic youths (166 males and 235 females) with an age range of 10-19 years except one study, in which the age range was 13-30 years. Study participants were from Australia, Tunisia, Lithuania, Taiwan, Turkey, Brazilia, Belgium, Egypt and France. Four studies were aerobic-based, four were combined aerobic and anaerobic programs, and one compared aerobic exercise to anaerobic one. Available studies had insufficient evidence that any type of exercise or combined training would clearly improve the glycemic control in type 1 diabetic youth. Only three (two aerobic-based and one combined) studies could provide a significant positive change in glycemic control. CONCLUSION: The regular physical exercise has several other valuable physiological and health benefits that justify the inclusion of exercise in pediatric diabetes treatment and care. PMID:25897363

Lukács, Andrea; Barkai, László

2015-01-01

43

Prevalence of Asthma and Its Association With Glycemic Control Among Youth With Diabetes  

PubMed Central

OBJECTIVE: To estimate the prevalence of asthma among youth with types 1 and 2 diabetes and examine associations between asthma and glycemic control. METHODS: This was a cross-sectional analysis of data from the SEARCH for Diabetes in Youth study, which included youth diagnosed with type 1 (n = 1683) and type 2 (n = 311) diabetes from 2002 through 2005. Asthma status and medications were ascertained from medical records and self-administered questionnaires, and glycemic control was assessed from hemoglobin A1c measured at the study visit. RESULTS: Prevalence of asthma among all youth with diabetes was 10.9% (95% confidence interval [CI]: 9.6%–12.3%). The prevalence was 10.0% (95% CI: 8.6%–11.4%) among youth with type 1 and 16.1% (95% CI: 12.0%–20.2%) among youth with type 2 diabetes and differed according to race/ethnicity. Among youth with type 1 diabetes, those with asthma had higher mean A1c levels than those without asthma, after adjustment for age, gender, race/ethnicity, and BMI (7.77% vs 7.49%; P = .034). Youth with asthma were more likely to have poor glycemic control, particularly those with type 1 diabetes whose asthma was not treated with pharmacotherapy, although this association was attenuated by adjustment for race/ethnicity. CONCLUSIONS: Prevalence of asthma may be elevated among youth with diabetes relative to the general US population. Among youth with type 1 diabetes, asthma is associated with poor glycemic control, especially if asthma is untreated. Specific asthma medications may decrease systemic inflammation, which underlies the complex relationship between pulmonary function, BMI, and glycemic control among youth with diabetes. PMID:21949144

Black, Mary Helen; Anderson, Andrea; Bell, Ronny A.; Dabelea, Dana; Pihoker, Catherine; Saydah, Sharon; Seid, Michael; Standiford, Debra A.; Waitzfelder, Beth; Marcovina, Santica M.

2011-01-01

44

Optimal glycemic control in neurocritical care patients: a systematic review and meta-analysis  

PubMed Central

Introduction Hyper- and hypoglycemia are strongly associated with adverse outcomes in critical care. Neurologically injured patients are a unique subgroup, where optimal glycemic targets may differ, such that the findings of clinical trials involving heterogeneous critically ill patients may not apply. Methods We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing intensive insulin therapy with conventional glycemic control among patients with traumatic brain injury, ischemic or hemorrhagic stroke, anoxic encephalopathy, central nervous system infections or spinal cord injury. Results Sixteen RCTs, involving 1248 neurocritical care patients, were included. Glycemic targets with intensive insulin ranged from 70-140 mg/dl (3.9-7.8 mmol/L), while conventional protocols aimed to keep glucose levels below 144-300 mg/dl (8.0-16.7 mmol/L). Tight glycemic control had no impact on mortality (RR 0.99; 95% CI 0.83-1.17; p = 0.88), but did result in fewer unfavorable neurological outcomes (RR 0.91; 95% CI 0.84-1.00; p = 0.04). However, improved outcomes were only observed when glucose levels in the conventional glycemic control group were permitted to be relatively high [threshold for insulin administration > 200 mg/dl (> 11.1 mmol/L)], but not with more intermediate glycemic targets [threshold for insulin administration 140-180 mg/dl (7.8-10.0 mmol/L)]. Hypoglycemia was far more common with intensive therapy (RR 3.10; 95% CI 1.54-6.23; p = 0.002), but there was a large degree of heterogeneity in the results of individual trials (Q = 47.9; p<0.0001; I2 = 75%). Mortality was non-significantly higher with intensive insulin in studies where the proportion of patients developing hypoglycemia was large (> 33%) (RR 1.17; 95% CI 0.79-1.75; p = 0.44). Conclusions Intensive insulin therapy significantly increases the risk of hypoglycemia and does not influence mortality among neurocritical care patients. Very loose glucose control is associated with worse neurological recovery and should be avoided. These results suggest that intermediate glycemic goals may be most appropriate. PMID:23082798

2012-01-01

45

Use of an Insulin Bolus Advisor Improves Glycemic Control in Multiple Daily Insulin Injection (MDI) Therapy Patients With Suboptimal Glycemic Control  

PubMed Central

OBJECTIVE Use of automated bolus advisors is associated with improved glycemic control in patients treated with insulin pump therapy. We conducted a study to assess the impact of using an insulin bolus advisor embedded in a blood glucose (BG) meter on glycemic control and treatment satisfaction in patients treated with multiple daily insulin injection (MDI) therapy. The study goal was to achieve >0.5% A1C reduction in most patients. RESEARCH DESIGN AND METHODS This was a 26-week, prospective, randomized, controlled, multinational study that enrolled 218 MDI-treated patients with poorly controlled diabetes (202 with type 1 diabetes, 16 with type 2 diabetes) who were 18 years of age or older. Participants had mean baseline A1C of 8.9% (SD, 1.2 [74 mmol/mol]), mean age of 42.4 years (SD, 14.0), mean BMI of 26.5 kg/m2 (SD, 4.2), and mean diabetes duration of 17.7 years (SD, 11.1). Control group (CNL) patients used a standard BG meter and manual bolus calculation; intervention group (EXP) patients used the Accu-Chek Aviva Expert meter with an integrated bolus advisor to calculate insulin dosages. Glucose data were downloaded and used for therapy parameter adjustments in both groups. RESULTS A total of 193 patients (CNL, n = 93; EXP, n = 100) completed the study. Significantly more EXP than CNL patients achieved >0.5% A1C reduction (56.0% vs. 34.4%; P < 0.01). Improvement in treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire scale) was significantly greater in EXP patients (11.4 [SD, 6.0] vs. 9.0 [SD, 6.3]; P < 0.01). Percentage of BG values <50 mg/dL was <2% in both groups during the study. CONCLUSIONS Use of an automated bolus advisor resulted in improved glycemic control and treatment satisfaction without increasing severe hypoglycemia. PMID:23900590

Ziegler, Ralph; Cavan, David A.; Cranston, Iain; Barnard, Katharine; Ryder, Jacqueline; Vogel, Claudia; Parkin, Christopher G.; Koehler, Walter; Vesper, Iris; Petersen, Bettina; Schweitzer, Matthias A.; Wagner, Robin S.

2013-01-01

46

Sotagliflozin improves glycemic control in nonobese diabetes-prone mice with type 1 diabetes  

PubMed Central

Purpose Oral agents are needed that improve glycemic control without increasing hypoglycemic events in patients with type 1 diabetes (T1D). Sotagliflozin may meet this need, because this compound lowers blood glucose through the insulin-independent mechanisms of inhibiting kidney SGLT2 and intestinal SGLT1. We examined the effect of sotagliflozin on glycemic control and rate of hypoglycemia measurements in T1D mice maintained on a low daily insulin dose, and compared these results to those from mice maintained in better glycemic control with a higher daily insulin dose alone. Materials and methods Nonobese diabetes-prone mice with cyclophosphamide-induced T1D were randomized to receive one of four daily treatments: 0.2 U insulin/vehicle, 0.05 U insulin/vehicle, 0.05 U insulin/2 mg/kg sotagliflozin or 0.05 U insulin/30 mg/kg sotagliflozin. Insulin was delivered subcutaneously by micro-osmotic pump; the day after pump implantation, mice received their first of 22 once-daily oral doses of sotagliflozin or vehicle. Glycemic control was monitored by measuring fed blood glucose and hemoglobin A1c levels. Results Blood glucose levels decreased rapidly and comparably in the 0.05 U insulin/sotagliflozin-treated groups and the 0.2 U insulin/vehicle group compared to the 0.05 U insulin/vehicle group, which had significantly higher levels than the other three groups from day 2 through day 23. A1c levels were also significantly higher in the 0.05 U insulin/vehicle group compared to the other three groups on day 23. Importantly, the 0.2 U insulin/vehicle group had, out of 100 blood glucose measurements, 13 that were <70 mg/dL compared to one of 290 for the other three groups combined. Conclusion Sotagliflozin significantly improved glycemic control, without increasing the rate of hypoglycemia measurements, in diabetic mice maintained on a low insulin dose. This sotagliflozin-mediated improvement in glycemic control was comparable to that achieved by raising the insulin dose alone, but was not accompanied by the increased rate of hypoglycemia measurements observed with the higher insulin dose.

Powell, David R; Doree, Deon; Jeter-Jones, Sabrina; Ding, Zhi-Ming; Zambrowicz, Brian; Sands, Arthur

2015-01-01

47

Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.  

PubMed

Even with the best health care available, patients with chronic illnesses typically spend no more than a few hours a year in a health care setting, while their outcomes are largely determined by their activities during the remaining 5,000 waking hours of the year. As a widely available, low-cost technology, mobile phones are a promising tool to use in engaging patients in behavior change and facilitating self-care between visits. We examined the impact of a six-month mobile health (mHealth) demonstration project among adults with diabetes who belonged to an academic medical center's employee health plan. In addition to pre-post improvements in glycemic control (p=0.01) and patients' satisfaction with overall care (p=0.04), we observed a net cost savings of 8.8 percent. Those early results suggest that mHealth programs can support health care organizations' pursuit of the triple aim of improving patients' experiences with care, improving population health, and reducing the per capita cost of health care PMID:24493770

Nundy, Shantanu; Dick, Jonathan J; Chou, Chia-Hung; Nocon, Robert S; Chin, Marshall H; Peek, Monica E

2014-02-01

48

A RANDOMIZED CONTROLLED TRIAL OF RESISTANCE EXERCISE TRAINING TO IMPROVE GLYCEMIC CONTROL IN OLDER ADULTS WITH TYPE 2 DIABETES  

Technology Transfer Automated Retrieval System (TEKTRAN)

OBJECTIVE-To determine the efficacy of high-intensity progressive resistance training (PRT) on glycemic control in older adults with type 2 diabetes. RESEARCH DESIGN AND METHODS-We performed a 16-week randomized controlled trial in 62 Latino older adults (40 women and 22 men; mean +/- SE age 66 +/...

49

Diabetes, glycemic control and risk of medical glaucoma treatment: A population-based case-control study  

PubMed Central

Purpose: To examine the association between diabetes and risk of medical glaucoma treatment and to assess the role of long-term glycemic control in the putative association. Design: Population-based case-control study. Methods: Cases of treated glaucoma were all persons filling at least three prescriptions for glaucoma medication for the first time within one year between 2001 and 2006 in Northern Jutland, Denmark. We used risk set sampling to select 10 gender- and age-matched general population controls per case using the Danish Civil Registration System. Data on diabetes, comorbidities, and laboratory tests, including glycosylated hemoglobin (as a measure of glycemic control) were obtained from population-based medical registries. We calculated odds ratio (OR) as an estimate of relative risk for treated glaucoma comparing patients with and without diabetes, adjusted for comorbid conditions and medication use. Results: We included 5,991 persons with incident medical glaucoma treatment and 59,910 population controls. The adjusted OR for treated glaucoma for patients with diabetes was 1.81 (95% confidence interval: 1.65–1.98). The strength of the association between diabetes and glaucoma risk did not vary by diabetes duration or by the level of glycemic control. Conclusions: Regardless of glycemic control, diabetes is associated with a substantially increased risk for medical glaucoma treatment. PMID:20865094

Welinder, Lotte G; Riis, Anders H; Knudsen, Lars L; Thomsen, Reimar W

2009-01-01

50

Tight Glycemic Control and Cardiovascular Effects in Type 2 Diabetic Patients  

PubMed Central

Diabetes Mellitus (DM) with poor glycemic control is one of the leading causes for cardiovascular mortality in diabetic patients. Tight glycemic control with glycosylated haemoglobin of <7 gms% is recommended as a routine and < 6.5 gms% is recommended for young and newly diagnosed diabetics. Treatment goal aims at achieving near normal blood glucose level, and directed at management of other co morbid conditions such as obesity, hypertension and dyslipidemia. Oral hypoglycemic agents are the preferred drugs, alone or in combination. Preference for glitazones is declining due to the increasing evidences of associated adverse events. Gliptins appear as promising agents with lesser tendency to cause hypoglycemia, but their long term safety and efficacy is yet to be established. We emphasize the role of preventive measures in prediabetics and in established DM, treatment should be individualized and customized to minimize hypoglycemic effects and to retain quality of life.

Moodahadu, Latha Subramanya; Dhall, Ruchi; Zargar, Abdul Hamid; Bangera, Sudhakar; Ramani, Lalitha; Katipally, Ramesh

2014-01-01

51

[Health literacy in type 2 diabetics: associated factors and glycemic control].  

PubMed

Diabetes mellitus patients must concentrate on self-care, with complex treatments and adequate health behavior in which such habits are a key factor. Due to the complexity of this issue, the importance of literacy in health arises. The goal of the study was to analyze factors associated with literacy in health and its relation with glycemic control in diabetic patients. It involved a study with 82 type 2 diabetic patients of both sexes and aged between 19 and 59 attended in the outpatient endocrinology ward of a public hospital, who filled out an abbreviated and translated version of the Test of Functional Health Literacy in Adults (b-TOFHLA). Fasting glycaemia values and glycated hemoglobin were collected from the clinical history of the participants. Correlations, mean comparisons and linear regression models were tested. Inadequate literacy in health was encountered in 65.9% of the patients. The issues involved factors associated with the b-TOFHLA point scores were age and years of schooling. Global literacy did not explain the glycemic control, but the level of numeracy presented an association with this control. The results point to the need to improve the numeracy in health of the patients to obtain enhanced glycemic control, mainly in those with more advanced age and less years of schooling. PMID:25760126

Sampaio, Helena Alves de Carvalho; Carioca, Antônio Augusto Ferreira; Sabry, Maria Olganê Dantas; Santos, Patrícia Mariano Dos; Coelho, Maria Auristela Magalhães; Passamai, Maria da Penha Baião

2015-03-01

52

Overcoming barriers to glycemic control in African Americans with type-2 diabetes: benefits of insulin therapy.  

PubMed Central

A disproportionate number of African-American men and women are affected by obesity and diabetes. The documented rate of poor glycemic control in the African-American population may contribute to the high rate of morbidity and mortality due to diabetes observed in these patients. Since the benefits of strict glycemic control have been demonstrated in multiple large trials, the aim of treatment should be to achieve the goals set forth by the American Diabetes Association. Insulin remains an essential therapeutic agent for helping patients achieve glycemic control and preventing long-term comorbidities. However, barriers to insulin therapy exist for both the physician and patient. Strategies to counter this resistance include identifying barriers to treatment, restoring the patient's sense of control, utilizing simple regimens, and reviewing the benefits of insulin and the risk of hypoglycemia. In treating African-American patients with diabetes, providers of various racial and ethnic backgrounds may maximize treatment efficacy by attempting to understand and practice culturally competent care. PMID:17722663

Marshall, Merville C.

2007-01-01

53

GI symptoms in diabetes mellitus are associated with both poor glycemic control and diabetic complications  

Microsoft Academic Search

OBJECTIVE:Diabetes mellitus is associated with an increased prevalence of GI symptoms, but the mechanisms underlying symptoms are poorly defined and controversial. We aimed to determine whether there is a relationship between GI symptoms and both diabetic complications and glycemic control.METHODS:We performed a cross-sectional questionnaire study of 1101 subjects with diabetes mellitus recruited from outpatient clinics (n = 209) and the

Peter Bytzer; Nicholas J. Talley; Johann Hammer; Lisa J. Young; Michael P. Jones; Michael Horowitz

2002-01-01

54

Patient complexity in quality comparisons for glycemic control: An observational study  

Microsoft Academic Search

BACKGROUND: Patient complexity is not incorporated into quality of care comparisons for glycemic control. We developed a method to adjust hemoglobin A1c levels for patient characteristics that reflect complexity, and examined the effect of using adjusted A1c values on quality comparisons. METHODS: This cross-sectional observational study used 1999 national VA (US Department of Veterans Affairs) pharmacy, inpatient and outpatient utilization,

Monika M Safford; Michael Brimacombe; Quanwu Zhang; Mangala Rajan; Minge Xie; Wesley Thompson; John Kolassa; Miriam Maney; Leonard Pogach

2009-01-01

55

Sputum Glucose and Glycemic Control in Cystic Fibrosis-Related Diabetes: A Cross-Sectional Study  

PubMed Central

Cystic fibrosis-related diabetes affects up to half of cystic fibrosis patients and is associated with increased mortality and more frequent pulmonary exacerbations. However, it is unclear to what degree good glycemic control might mitigate these risks and clinical outcomes have not previously been studied in relation to glucose from the lower airways, the site of infection and CF disease progression. We initially hypothesized that diabetic cystic fibrosis patients with glycosylated hemoglobin (HbA1c) > 6.5% have worse pulmonary function, longer and more frequent exacerbations and also higher sputum glucose levels than patients with HbA1c ? 6.5% or cystic fibrosis patients without diabetes. To test this, we analyzed spontaneously expectorated sputum samples from 88 cystic fibrosis patients. The median sputum glucose concentration was 0.70 mM (mean, 4.75 mM; range, 0-64.6 mM). Sputum glucose was not correlated with age, sex, body mass index, diabetes diagnosis, glycemic control, exacerbation frequency or length, or pulmonary function. Surprisingly, sputum glucose was highest in subjects with normal glucose tolerance, suggesting the dynamics of glycemic control, sputum glucose and pulmonary infections are more complex than previously thought. Two-year mean HbA1c was positively correlated with the length of exacerbation admission (p < 0.01), and negatively correlated with measures of pulmonary function (p < 0.01). While total number of hospitalizations for exacerbations were not significantly different, subjects with an HbA1c > 6.5% were hospitalized on average 6 days longer than those with HbA1c ? 6.5% (p < 0.01). Current clinical care guidelines for cystic fibrosis-related diabetes target HbA1c ? 7% to limit long-term microvascular damage, but more stringent glycemic control (HbA1c ? 6.5%) may further reduce the short-term pulmonary complications. PMID:25803537

Van Sambeek, Lindsey; Cowley, Elise S.; Newman, Dianne K.; Kato, Roberta

2015-01-01

56

Oxidative stress and nitric oxide related parameters in type II diabetes mellitus: effects of glycemic control  

Microsoft Academic Search

Objectives: The aim of this study is to investigate the status of oxidative stress and nitric oxide related parameters in type II diabetes mellitus (DM) patients in which heart disease, atherosclerosis, retinopathy, and nephropathy commonly occur, and also to determine the effect of glycemic control on these parameters.Design and methods: Erythrocyte copper zinc-superoxide dismutase (CuZn-SOD), erythrocyte and plasma selenium dependent

Ahmet Ayd?n; Hilmi Orhan; Ahmet Sayal; Metin Özata; Gönül ?ahin; A?k?n I??mer

2001-01-01

57

Improvement in Glycemic Control and Outcome Corresponding to Intensive Insulin Therapy Protocol Development  

PubMed Central

Background Intensive insulin therapy (IIT) has been shown to reduce mortality and morbidity in longer stay, critically ill patients. However, this has been demonstrated in a single site, whereas two multicentric studies have been terminated prematurely mainly due to hypoglycemia. Other difficulties with IIT include efficacy of glycemic control. This report describes how IIT can be improved by protocol simplification and removal of glucose supplementation. Methods A clinical information system established at each bedspace guided staff through the IIT algorithms. Time spent within predefined glycemic ranges was calculated assuming a linear trend between successive measurements. Three groups were investigated retrospectively: IIT1 protocol,1 an updated IIT2 version, and intuitive nurse dosing of conventional insulin therapy (CIT). Results Fifty consecutive, critically ill patients were included in each study group. Patient characteristics were similar in each group. The frequency of CIT and IIT2 blood glucose measurements were 11.6 and 11.5 measurements per day, respectively, while the IIT1 measurements were more frequent (14.5 measurements per day). The mean proportion of time spent in the target glycemic range (4.4–6.1 mmol/liter) was highest in the IIT2 group (34.9%), as compared to the IIT1 (22.9%) and CIT groups (20.3%) (p <.001). Survival at 28 days was 74.5% for IIT2 (highest), 68% for IIT1, and 48% for CIT (p = .02). There were a similar number of those experiencing a severe hypoglycemic event in each group. Conclusions IIT protocol optimization was associated with increased glycemic control and improved 28-day survival. The better optimized IIT2 protocol provided tighter control than either the IIT1 or CIT protocol, without increased sampling or incidence of hypoglycemia. The clinical effectiveness of the IIT algorithm appeared to be improved by simplifying the protocol to meet the needs of the critical care unit. PMID:19885203

Shulman, Rob; Finney, Simon J.; Shah, Neelam; Ali, Md Shawkat; Greene, Russell; Glynne, Paul A.

2008-01-01

58

Benefits of Renin-Angiotensin Blockade on Retinopathy in Type 1 Diabetes Vary With Glycemic Control  

PubMed Central

OBJECTIVE Optimal glycemic control slows diabetic retinopathy (DR) development and progression and is the standard of care for type 1 diabetes. However, these glycemic goals are difficult to achieve and sustain in clinical practice. The Renin Angiotensin System Study (RASS) showed that renin-angiotensin system (RAS) blockade can slow DR progression. In the current study, we evaluate whether glycemic control influenced the benefit of RAS blockade on DR progression in type 1 diabetic patients. RESEARCH DESIGN AND METHODS We used RASS data to analyze the relationships between two-steps or more DR progression and baseline glycemic levels in 223 normotensive, normoalbuminuric type 1 diabetic patients randomized to receive 5 years of enalapril or losartan compared with placebo. RESULTS A total of 147 of 223 patients (65.9%) had DR at baseline (47 of 74 patients [63.5%] in placebo and 100 of 149 patients [67.1%] in the combined treatment groups [P = 0.67]). Patients with two-steps or more DR progression had higher baseline A1C than those without progression (9.4 vs. 8.2%, P < 0.001). There was no beneficial effect of RAS blockade (P = 0.92) in patients with baseline A1C ?7.5%. In contrast, 30 of 112 (27%) patients on the active treatment arms with A1C >7.5% had two-steps or more DR progression compared with 26 of 56 patients (46%) in the placebo group (P = 0.03). CONCLUSIONS RAS blockade reduces DR progression in normotensive, normoalbuminuric type 1 diabetic patients with A1C >7.5%. Whether this therapy could benefit patients with A1C ?7.5% will require long-term studies of much larger cohorts. PMID:21715517

Harindhanavudhi, Tasma; Mauer, Michael; Klein, Ronald; Zinman, Bernard; Sinaiko, Alan; Caramori, M. Luiza

2011-01-01

59

Outpatient Glycemic Control with a Bionic Pancreas in Type 1 Diabetes  

PubMed Central

BACKGROUND The safety and effectiveness of automated glycemic management have not been tested in multiday studies under unrestricted outpatient conditions. METHODS In two random-order, crossover studies with similar but distinct designs, we compared glycemic control with a wearable, bihormonal, automated, “bionic” pancreas (bionic-pancreas period) with glycemic control with an insulin pump (control period) for 5 days in 20 adults and 32 adolescents with type 1 diabetes mellitus. The automatically adaptive algorithm of the bionic pancreas received data from a continuous glucose monitor to control subcutaneous delivery of insulin and glucagon. RESULTS Among the adults, the mean plasma glucose level over the 5-day bionic-pancreas period was 138 mg per deciliter (7.7 mmol per liter), and the mean percentage of time with a low glucose level (<70 mg per deciliter [3.9 mmol per liter]) was 4.8%. After 1 day of automatic adaptation by the bionic pancreas, the mean (±SD) glucose level on continuous monitoring was lower than the mean level during the control period (133±13 vs. 159±30 mg per deciliter [7.4±0.7 vs. 8.8±1.7 mmol per liter], P<0.001) and the percentage of time with a low glucose reading was lower (4.1% vs. 7.3%, P = 0.01). Among the adolescents, the mean plasma glucose level was also lower during the bionic-pancreas period than during the control period (138±18 vs. 157±27 mg per deciliter [7.7±1.0 vs. 8.7±1.5 mmol per liter], P = 0.004), but the percentage of time with a low plasma glucose reading was similar during the two periods (6.1% and 7.6%, respectively; P = 0.23). The mean frequency of interventions for hypoglycemia among the adolescents was lower during the bionic-pancreas period than during the control period (one per 1.6 days vs. one per 0.8 days, P<0.001). CONCLUSIONS As compared with an insulin pump, a wearable, automated, bihormonal, bionic pancreas improved mean glycemic levels, with less frequent hypoglycemic episodes, among both adults and adolescents with type 1 diabetes mellitus. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; ClinicalTrials.gov numbers, NCT01762059 and NCT01833988.) PMID:24931572

Sinha, Manasi; Magyar, Kendra L.; McKeon, Katherine; Goergen, Laura G.; Balliro, Courtney; Hillard, Mallory A.; Nathan, David M.; Damiano, Edward R.

2014-01-01

60

Extended-release niacin/laropiprant significantly improves lipid levels in type 2 diabetes mellitus irrespective of baseline glycemic control  

PubMed Central

Background The degree of glycemic control in patients with type 2 diabetes mellitus (T2DM) may alter lipid levels and may alter the efficacy of lipid-modifying agents. Objective Evaluate the lipid-modifying efficacy of extended-release niacin/laropiprant (ERN/LRPT) in subgroups of patients with T2DM with better or poorer glycemic control. Methods Post hoc analysis of clinical trial data from patients with T2DM who were randomized 4:3 to double-blind ERN/LRPT or placebo (n=796), examining the lipid-modifying effects of ERN/LRPT in patients with glycosylated hemoglobin or fasting plasma glucose levels above and below median baseline levels. Results At Week 12 of treatment, ERN/LRPT significantly improved low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), non-high-density lipoprotein cholesterol, triglycerides, and lipoprotein (a), compared with placebo, with equal efficacy in patients above or below median baseline glycemic control. Compared with placebo, over 36 weeks of treatment more patients treated with ERN/LRPT had worsening of their diabetes and required intensification of antihyperglycemic medication, irrespective of baseline glycemic control. Incidences of other adverse experiences were generally low in all treatment groups. Conclusion The lipid-modifying effects of ERN/LRPT are independent of the degree of baseline glycemic control in patients with T2DM (NCT00485758).

Bays, Harold E; Brinton, Eliot A; Triscari, Joseph; Chen, Erluo; Maccubbin, Darbie; MacLean, Alexandra A; Gibson, Kendra L; Ruck, Rae Ann; Johnson-Levonas, Amy O; O’Neill, Edward A; Mitchel, Yale B

2015-01-01

61

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

PubMed

Breakfast skipping is associated with obesity and an increased risk of type 2 diabetes. Later chronotypes, individuals who have a preference for later bed and wake times, often skip breakfast. The aim of the study was to explore the relationships among breakfast skipping, chronotype, and glycemic control in type 2 diabetes patients. We collected sleep timing and 24-h dietary recall from 194 non-shift-working type 2 diabetes patients who were being followed in outpatient clinics. Mid-sleep time on free days (MSF) was used as an indicator of chronotype. Hemoglobin A1C (HbA1C) values were obtained from medical records. Hierarchical linear regression analyses controlling for demographic, sleep, and dietary variables were computed to determine whether breakfast skipping was associated with HbA1C. Additional regression analyses were performed to test if this association was mediated by chronotype. There were 22 participants (11.3%) who self-reported missing breakfast. Breakfast skippers had significantly higher HbA1C levels, higher body mass indices (BMI), and later MSF than breakfast eaters. Breakfast skipping was significantly associated with higher HbA1C values (B?=?0.108, p?=?0.01), even after adjusting for age, sex, race, BMI, number of diabetes complications, insulin use, depressive symptoms, perceived sleep debt, and percentage of daily caloric intake at dinner. The relationship between breakfast skipping and HbA1C was partially mediated by chronotype. In summary, breakfast skipping is associated with a later chronotype. Later chronotype and breakfast skipping both contribute to poorer glycemic control, as indicated by higher HbA1C levels. Future studies are needed to confirm these findings and determine whether behavioral interventions targeting breakfast eating or sleep timing may improve glycemic control in patients with type 2 diabetes. PMID:24094031

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

2014-02-01

62

Assessing Glycemic Control in Diabetes: From Self Monitoring of Blood Glucose to Continuous Glucose Monitoring System  

Microsoft Academic Search

\\u000a The incidence of diabetes is increasing at an alarming rate. Maintaining tight glycemic control is essential to prevent microvascular\\u000a and macrovascular complications as demonstrated by many studies. Current recommendation for HbA1c is less then 7% and even\\u000a 6.5% in special individuals. HbA1c measurement is considered the gold standard of diabetes care and serves as a surrogate\\u000a of diabetes-related complications, but

M. Gribovschi; A. Fodor; G. Grosu; N. Hancu

63

The Influence of Diabetes, Glycemic Control, and Diabetes-Related Comorbidities on Pulmonary Tuberculosis  

PubMed Central

Background To assess the influence of diabetes mellitus (DM), glycemic control, and diabetes-related comorbidities on manifestations and outcome of treatment of pulmonary tuberculosis (TB). Methodology/Principal Findings Culture positive pulmonary TB patients notified to health authorities in three hospitals in Taiwan from 2005–2010 were investigated. Glycemic control was assessed by glycated haemoglobin A1C (HbA1C) and diabetic patients were categorized into 3 groups: HbA1C<7%, HbA1C 7–9%, HbA1C>9%. 1,473 (705 with DM and 768 without DM) patients were enrolled. Of the 705 diabetic patients, 82 (11.6%) had pretreatment HbA1C<7%, 152 (21.6%) 7%–9%, 276 (39.2%) >9%, and 195 (27.7%) had no information of HbA1C. The proportions of patients with any symptom, cough, hemoptysis, tiredness and weight loss were all highest in diabetic patients with HbA1C>9%. In multivariate analysis adjusted for age, sex, smoking, and drug resistance, diabetic patients with HbA1C>9% (adjOR 3.55, 95% CI 2.40–5.25) and HbA1C 7–9% (adjOR 1.62, 95% CI 1.07–2.44) were significantly more likely to be smear positive as compared with non-diabetic patients, but not those with HbA1C<7% (adjOR 1.16, 95% CI 0.70–1.92). The influence of DM on outcome of TB treatment was not proportionately related to HbA1C, but mainly mediated through diabetes-related comorbidities. Patients with diabetes-related comorbidities had an increased risk of unfavorable outcome (adjOR 3.38, 95% CI 2.19–5.22, p<0.001) and one year mortality (adjOR 2.80, 95% CI 1.89–4.16). However, diabetes was not associated with amplification of resistance to isoniazid (p = 0.363) or to rifampicin (p = 0.344). Conclusions/Significance Poor glycemic control is associated with poor TB treatment outcome and improved glycemic control may reduce the influence of diabetes on TB. PMID:25822974

Chiang, Chen Yuan; Bai, Kuan Jen; Lin, Hsien Ho; Chien, Shun Tien; Lee, Jen Jyh; Enarson, Donald A.; Lee, Ting-I; Yu, Ming-Chih

2015-01-01

64

Poor glycemic control is associated with low BMD detected in premenopausal women with type 1 diabetes  

Microsoft Academic Search

Summary  The etiology of bone fragility in individuals with type 1 diabetes is unknown. This study demonstrated that bone turnover\\u000a favors resorption and that poor glycemic control is associated with low bone mineral density (BMD) and low bone turnover,\\u000a in premenopausal women with type 1 diabetes. The results could inform future interventions.\\u000a \\u000a \\u000a \\u000a Introduction  Low BMD and fracture may be complications of type

K. K. Danielson; M. E. Elliott; T. LeCaire; N. Binkley; M. Palta

2009-01-01

65

Differentiating Approaches to Diabetes Self-Management of Multi-ethnic Rural Older Adults at the Extremes of Glycemic Control  

PubMed Central

Purpose of the Study:?This study identified approaches to diabetes self-management that differentiate persons with well-controlled from poorly controlled diabetes. Previous research has focused largely on persons participating in self-management interventions.?Design and Methods:?In-depth qualitative interviews were conducted with 48 adults, drawn from a population-based sample aged 65 years or older with diabetes. The sample was stratified by sex and ethnic group (African American, American Indian, and White) from the low (A1C <6%) and high (A1C >8%) extremes of the glycemic control distribution. Case-based text analysis was guided by a model, including six self-management domains and four resource types (self-care, informal support, formal services, and medical care).?Results:?A “structured” approach to self-management differentiated respondents in good glycemic control from those in poor glycemic control. Those in good glycemic control were more likely to practice specific food behaviors to limit food consumption and practice regular blood glucose monitoring with specific target values. This approach was facilitated by a greater use of home aides to assist with diabetes care. Respondents in poor glycemic control demonstrated less structure, naming general food categories and checking blood glucose in reaction to symptoms.?Implications:?Results provide evidence that degree of structure differentiates self-management approaches of persons with good and poor glycemic control. Findings should provide a foundation for further research to develop effective self-management programs for older adults with diabetes. PMID:20110333

Brewer-Lowry, Aleshia Nichol; Arcury, Thomas A.; Bell, Ronny A.; Quandt, Sara A.

2010-01-01

66

Dietary glycemic index and carbohydrate in relation to early age-related macular degeneration  

Technology Transfer Automated Retrieval System (TEKTRAN)

Little is known about the association between dietary carbohydrates and cataract in nondiabetic persons. The aim was to test whether recent dietary carbohydrate intakes or glycemic index (GI; a measure of carbohydrate intake quality) was associated with the presence of cortical or nuclear opacities....

67

Response to Acute Psychophysical Stress and 24-Hour Glycemic Control in Healthy Older People  

PubMed Central

We examined the relation between stress reactivity and 24?h glycemic control in 17 inactive, healthy older people (?60 years) under both a novel psychophysical stress and a seated control condition. Plasma cortisol was measured over the course of the stress and recovery periods. Glycemic control was determined over the subsequent 3?h from an oral glucose tolerance test (OGTT) and over 24?h via continuous glucose monitoring (CGM). We observed significant (P < 0.05) elevations in perceived stress, cardiovascular activity, and peak cortisol response at 30?min (10.6 ± 3.1 versus 8.6 ± 2.6??g·dL?1, resp.) during the stress compared with the control condition; however, 3?h OGTT glucose and insulin responses were similar between conditions. The CGM data suggested a 30–40?min postchallenge delay in peak glucose response and attenuated glucose clearance over the 6?h following the stress condition, but these alterations were not statistically significant. Healthy older people may demonstrate minimal disruption in metabolic resiliency following everyday psychological stress. PMID:22830023

DiPietro, Loretta; Yeckel, Catherine W.; Gribok, Andrei

2012-01-01

68

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

PubMed Central

Background Suboptimal glycemic control is a common situation in diabetes, regardless of the wide range of drugs available to reach glycemic targets. Basic research in diabetes is endeavoring to identify new actives working as insulin savers, use of which could delay the introduction of injectable insulin or reduce the insulin dose needed. Commonly available as a nutraceutical, berberine is a potential candidate. Methods and results Because its low oral bioavailability can be overcome by P-glycoprotein inhibitors like herbal polyphenols, we have tested the nutraceutical combination of Berberis aristata extract and Silybum marianum extract (Berberol®) in type 2 diabetes in terms of its additive effect when combined with a conventional oral regimen for patients with suboptimal glycemic control. After 90 days of treatment, the nutraceutical association had a positive effect on glycemic and lipid parameters, significantly reducing glycosylated hemoglobin, basal insulin, homeostatic model assessment of insulin resistance, total and low-density lipoprotein cholesterol, and triglycerides. A relevant effect was also observed in terms of liver function by measuring aspartate transaminase and alanine transaminase. The product had a good safety profile, with distinctive gastrointestinal side effects likely due to its acarbose-like action. Conclusion Although further studies should be carried out to confirm our data, Berberol could be considered a good candidate as an adjunctive treatment option in diabetes, especially in patients with suboptimal glycemic control. PMID:22924000

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

2012-01-01

69

Mother-father informant discrepancies regarding diabetes management: Associations with diabetes-specific family conflict and glycemic control  

PubMed Central

Objective To examine the relationship of mother-father informant discrepancies regarding diabetes management to diabetes-specific family conflict and glycemic control. Methods 136 mothers and fathers of youth with type 1 diabetes reported on the youth's diabetes management, diabetes-specific family conflict, and amount of paternal involvement in diabetes care. Glycosylated hemoglobin A1c (HbA1c) was used to measure glycemic control. Results As hypothesized, mother-father discrepancies regarding diabetes management were positively associated with frequency of diabetes-specific family conflict. Contrary to hypotheses, mother-father discrepancies regarding diabetes management predicted poorer glycemic control for youth with less involved fathers only. Conclusions Results highlight the importance of caregivers being consistent about pediatric illness management and support the idea that informant discrepancies represent an important window into the functioning of the family system. PMID:22823070

Sood, Erica D.; Pendley, Jennifer Shroff; Delamater, Alan; Rohan, Jennifer M.; Pulgaron, Elizabeth; Drotar, Dennis

2014-01-01

70

Lifestyle and glycemic control in Japanese adults receiving diabetes treatment: an analysis of the 2009 Japan Society of Ningen Dock database.  

PubMed

We investigated the level of glycemic control in 7020 patients treated with diabetes medications. We found that the overall mean HbA1c was 7.3% (56 mmol/mol). Over half had HbA1c levels ?7.0% (53 mmol/mol) and poorer glycemic control was associated with unhealthy lifestyle habits. PMID:24598264

Takahashi, Eiko; Moriyama, Kengo; Yamakado, Minoru

2014-05-01

71

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

PubMed

Fructose is known to elicit a lower glycemic response than sucrose, and high-fructose desserts have been recommended for a diabetic diet. We compared a cholesterol-free tofu-based frozen dessert (TFD) containing high-fructose corn syrups with a dairy-based sucrose-sweetened ice cream (IC). Six male and six female non-insulin-dependent diabetic patients (mean age 51 yr, mean ideal body weight 143%, fasting blood glucose less than 160 mg/dl) with well-controlled diabetes and managed on oral hypoglycemic agents were studied. Subjects underwent three trials. In the first trial they ingested 50 g glucose, and in the next two trials they ingested 50-g carbohydrate equivalents of either TFD or IC in random sequence. Venous blood was drawn at intervals during the 3-h trials for glucose and insulin determinations. Fasting plasma glucose was not statistically different between IC and TFD trials (130 vs. 121 mg/dl). Peak glucose responses were at 120 min in both trials (190 mg/dl for IC and 222 mg/dl for TFD), with those for TFD being significantly higher (P less than 0.01). Mean glucose area and glycemic index for TFD were significantly greater than for IC (P less than 0.01 and P less than 0.03, respectively). There was no significant difference between mean insulin areas. In summary, the TFD, which contains soybean curd and high-fructose corn syrup, might have been expected to produce more satisfactory postprandial blood glucose levels than IC, which contains sucrose, yet a higher glycemic response was elicited. This is related to the substantial amount of total glucose in this "fructose" dessert.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2180658

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

1990-04-01

72

Everolimus dramatically improves glycemic control in unresectable metastatic insulinoma: a case report.  

PubMed

Hypoglycemia poses a significant management challenge in patients with unresectable metastatic insulinoma. A 57-year-old woman with pancreatic neuroendocrine tumor with multiple liver metastases was referred to our institution. During the clinical course of pancreatic neuroendocrine tumor, she had experienced palpitations, cold sweats and faintness between meals that indicated her tumors had attained the characteristics of an insulinoma, and her quality of life was impacted by frequent hypoglycemic episodes which could not be prevented by conventional therapies. Shortly after the approval of everolimus for pancreatic neuroendocrine tumor in Japan, we began oral administration at 10 mg per day, which produced a rapid and substantial improvement in glycemic control. The serum insulin level decreased dramatically despite the tumor size remaining stable on computed tomography evaluation. Despite a dose reduction of everolimus to 5 mg per day in response to the adverse reaction of interstitial pneumonitis and a subsequent moderate increase in the serum insulin level, the patient has maintained normoglycemia for a year. Everolimus might represent the treatment of choice for unresectable insulinoma in terms of not only tumor stabilization but also glycemic control. PMID:24367043

Asayama, Masako; Yamada-Murano, Toko; Hara, Hiroki; Ooki, Akira; Kurosumi, Masafumi; Yamaguchi, Kensei

2014-02-01

73

Defining the Role of Medication Adherence in Poor Glycemic Control among a General Adult Population with Diabetes  

PubMed Central

Aims This study assesses the attributable impact of adherence to oral glucose medications as a risk factor for poor glycemic control in population subgroups of a large general population, using an objective medication adherence measure. Methods Using electronic health records data, adherence to diabetes medications over a two-year period was calculated by prescription-based Medication Possession Ratios for adults with diabetes diagnosed before January 1, 2010. Glycemic control was determined by the HbA1c test closest to the last drug prescription during 2010–2012. Poor control was defined as HbA1c>75 mmol/mol (9.0%). Medication adherence was categorized as “good” (>80%), “moderate” (50–80%), or “poor” (<50%). Logistic regression models assessed the role medication adherence plays in the association between disease duration, age, and poor glycemic control. We calculated the change in the attributable fraction of glucose control if the non-adherent diabetic medication population would become adherent by age-groups. Results Among 228,846 diabetes patients treated by oral antiglycemic medication, 46.4% had good, 28.8% had moderate, and 24.8% had poor adherence. Good adherence rates increased with increasing disease duration, while glycemic control became worse. There was a strong inverse association between adherence level and poor control (OR?=?2.50; CI?=?2.43–2.58), and adherence was a significant mediator between age and poor control. Conclusions A large portion of the diabetes population is reported to have poor adherence to oral diabetes medications, which is strongly associated with poor glycemic control in all disease durations. While poor adherence does not mediate the poorer glycemic control seen in patients with longer-standing disease, it is a significant mediator of poor glycemic control among younger diabetes patients. A greater fraction of poorly controlled younger patients, compared to older patients, could be prevented if at least 80% adherence to their medications was achieved. Therefore, our results suggest that interventions to improve adherence should focus on this younger sub-group. PMID:25259843

Feldman, Becca S.; Cohen-Stavi, Chandra J.; Leibowitz, Morton; Hoshen, Moshe B.; Singer, Shepherd R.; Bitterman, Haim; Lieberman, Nicky; Balicer, Ran D.

2014-01-01

74

Relationship between Postoperative Infectious Complications and Glycemic Control for Diabetic Patients in an Orthopedic Hospital in Kuwait  

Microsoft Academic Search

Objective: To study the relationship between postoperative infectious complications and glycemic control for diabetic patients in an orthopedic hospital in Kuwait. Subjects and Methods: Patients who underwent surgical orthopedic procedures between 2006 and 2007 were identified to provide demographic and clinical informations including age, gender, type of surgery, length of operation, HbA1c values, nature of specimens and species of the

S. M. Lamloum; L. A. Mobasher; A. H. Karar; L. Basiony; T. H. Abdallah; A. I. Al-Saleh; N. A. Al-Shamali

2009-01-01

75

Sleep Duration and Glycemic Control in Patients with Diabetes Mellitus: Korea National Health and Nutrition Examination Survey 2007-2010  

PubMed Central

Short sleep duration has been reported to increase the risk of diabetes. However, the influence of sleep duration on glycemic control in diabetic patients has not been clarified. In this study we evaluated the association between sleep duration and glycemic control in diabetic patients. We analyzed the data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2010. Sleep duration was classified into five groups: <6, 6, 7, 8, and ?9 h/day. Fasting blood glucose and HbA1c showed a U-shaped trend according to sleep duration. Sleep duration of 7 h/day had the lowest HbA1c (7.26%) among the subjects (P=0.026). In the older age group (?65 yr), a sleep duration of 6 h/day was associated with the lowest HbA1c (7.26%). The adjusted odds ratio (OR) with a 95% confidence interval (CI) of worse glycemic control (HbA1c ?7.0%) in group of sleep duration of ?9 h/day was 1.48 (1.04-2.13) compared with the group of 7 h/day. This relationship disappeared after adjusting duration of diabetes (OR, 1.38; 95% CI, 0.93-2.03). Our results suggest that sleep duration and glycemic control in diabetic patients has U-shaped relationship which was mainly affected by duration of diabetes. PMID:24015039

Kim, Bu Kyung; Kim, Bong Sun; An, So-Yeon; Lee, Min Suk; Choi, Yong Jun; Han, Seung Jin; Chung, Yoon-sok; Lee, Kwan-Woo

2013-01-01

76

Acculturation and glycemic control of Asian Indian adults with type 2 diabetes.  

PubMed

The prevalence of type 2 diabetes is disproportionately high among Asian Indians (AI), one of the fastest growing immigrant groups in the United States (US). Poorly controlled diabetes associated with inadequate self-management increases complications and thus medical costs. Acculturation may be an important determinant of diabetes self-management and hence control. This study examined the association between the degree of acculturation and glycemic control as measured by Hemoglobin A1c in AI adults with type 2 diabetes. A mixed method (quantitative and qualitative) study was conducted among 30 AI adults with type 2 diabetes. Acculturation assessment using the Suinn-Lew Asian Self-identity Instrument was followed by socio-demographic questions, self-reported anthropometric measures, and open ended diabetes self-care questions. A two-step multiple regression analysis and content analysis of verbatim interview transcriptions were conducted. Interactions of acculturation with body mass index (interaction b = 1.11; p = 0.01), annual household income (interaction b = 7.19; p = .01), and diabetes duration (interaction b = .30; p = .02) significantly predicted higher HbA1c levels (R(2) change = .368; F change = 4.21; p = .02). From the qualitative interviews, the following were regarded as US specific facilitators for glycemic control: excellent health care system and facilities, availability of healthy food choices and self-monitoring devices, medical insurance benefits, good quality medications, and improved health awareness. Cultural orientation might be important for patient tailored interventions targeting AI with type 2 diabetes. Therefore, interventions targeted at Asian Indians with diabetes should include culture specific adaptations to nutrition education and support. PMID:22744164

Venkatesh, Sumathi; Weatherspoon, Lorraine J; Kaplowitz, Stan A; Song, Won O

2013-02-01

77

A Clinical Trial to Maintain Glycemic Control in Youth with Type 2 Diabetes  

PubMed Central

BACKGROUND Despite the increasing prevalence of type 2 diabetes in youth, there are few data to guide treatment. We compared the efficacy of three treatment regimens to achieve durable glycemic control in children and adolescents with recent-onset type 2 diabetes. METHODS Eligible patients 10 to 17 years of age were treated with metformin (at a dose of 1000 mg twice daily) to attain a glycated hemoglobin level of less than 8% and were randomly assigned to continued treatment with metformin alone or to metformin combined with rosiglitazone (4 mg twice a day) or a lifestyle-intervention program focusing on weight loss through eating and activity behaviors. The primary outcome was loss of glycemic control, defined as a glycated hemoglobin level of at least 8% for 6 months or sustained metabolic decompensation requiring insulin. RESULTS Of the 699 randomly assigned participants (mean duration of diagnosed type 2 diabetes, 7.8 months), 319 (45.6%) reached the primary outcome over an average follow-up of 3.86 years. Rates of failure were 51.7% (120 of 232 participants), 38.6% (90 of 233), and 46.6% (109 of 234) for metformin alone, metformin plus rosiglitazone, and metformin plus lifestyle intervention, respectively. Metformin plus rosiglitazone was superior to metformin alone (P = 0.006); metformin plus lifestyle intervention was intermediate but not significantly different from metformin alone or metformin plus rosiglitazone. Prespecified analyses according to sex and race or ethnic group showed differences in sustained effectiveness, with metformin alone least effective in non-Hispanic black participants and metformin plus rosiglitazone most effective in girls. Serious adverse events were reported in 19.2% of participants. CONCLUSIONS Monotherapy with metformin was associated with durable glycemic control in approximately half of children and adolescents with type 2 diabetes. The addition of rosiglitazone, but not an intensive lifestyle intervention, was superior to metformin alone. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; TODAY ClinicalTrials.gov number, NCT00081328.) PMID:22540912

2012-01-01

78

Nutritional status, glycemic control and its associated risk factors among a sample of type 2 diabetic individuals, a pilot study  

PubMed Central

Background: The prevalence of type 2 diabetes is increasing in Malaysia, with most patients poorly controlled. Hence, this study aimed to determine nutritional and metabolic status as well as blood pressure of Malaysian patients with type 2 diabetes mellitus and identify associated risk factors for poor glycemic control. Materials and Methods: A total of 104 type 2 diabetic patients were recruited and completed a questionnaire covering socio-demographic status, 3-day diet records, and physical activity. Anthropometry and glycemic control parameters, lipid profile and blood pressure were also measured. Results: Subjects were on average 56.7±9.9 years old with a mean duration of diabetes of 6.5 ± 5.0 years. The mean hemoglobin A1c of the subjects was 7.6% ± 1.4%, with only 20.2% achieving the target goal of <6.5% with no significant differences between genders. The mean body mass index was 26.9 ± 4.7 kg/m2, with 86.5% either were overweight or obese. Only 10.6% of the subjects exercised daily. The proportions of macronutrients relative to total energy intake were consistent with the recommendations of most diabetes associations. The adjusted odds of having poor glycemic control were 3.235 (1.043-10.397) (P < 0.05) higher among those who had high density lipoprotein cholesterol levels below the normal range. Those taking one or two types of oral anti-diabetic drugs had 19.9 (2.959-87.391) (P < 0.01) and 14.3 (2.647-77.500) (P < 0.01) higher odds of poor glycemic control respectively compared to those who were being treated by diet alone. Conclusion: Poor glycemic control was prevalent among Malaysian diabetic patients, and this could be associated with low levels of HDL and being treated with oral anti-diabetes agents.

Firouzi, Somayyeh; Barakatun-Nisak, Mohd Yusof; Azmi, Kamaruddin Nor

2015-01-01

79

Behavioral and technological interventions targeting glycemic control in a racially/ethnically diverse population: a randomized controlled trial  

PubMed Central

Background Diabetes self-care by patients has been shown to assist in the reduction of disease severity and associated medical costs. We compared the effectiveness of two different diabetes self-care interventions on glycemic control in a racially/ethnically diverse population. We also explored whether reductions in glycated hemoglobin (HbA1c) will be more marked in minority persons. Methods We conducted an open-label randomized controlled trial of 376 patients with type 2 diabetes aged ?18 years and whose last measured HbA1c was ?7.5% (?58 mmol/mol). Participants were randomized to: 1) a Chronic Disease Self-Management Program (CDSMP; n = 101); 2) a diabetes self-care software on a personal digital assistant (PDA; n = 81); 3) a combination of interventions (CDSMP + PDA; n = 99); or 4) usual care (control; n = 95). Enrollment occurred January 2009-June 2011 at seven regional clinics of a university-affiliated multi-specialty group practice. The primary outcome was change in HbA1c from randomization to 12 months. Data were analyzed using a multilevel statistical model. Results Average baseline HbA1c in the CDSMP, PDA, CDSMP + PDA, and control arms were 9.4%, 9.3%, 9.2%, and 9.2%, respectively. HbA1c reductions at 12 months for the groups averaged 1.1%, 0.7%, 1.1%, and 0.7%, respectively and did not differ significantly from baseline based on the model (P = .771). Besides the participants in the PDA group reporting eating more high-fat foods compared to their counterparts (P < .004), no other significant differences were observed in participants’ diabetes self-care activities. Exploratory sub-analysis did not reveal any marked reductions in HbA1c for minority persons but rather modest reductions for all racial/ethnic groups. Conclusions Although behavioral and technological interventions can result in some modest improvements in glycemic control, these interventions did not fare significantly better than usual care in achieving glycemic control. More research is needed to understand how these interventions can be most effective in clinical practice. The reduction in HbA1c levels found in our control group that received usual care also suggests that good routine care in an integrated healthcare system can lead to better glycemic control. Trial registration Clinicaltrials.gov Identifier: NCT01221090. PMID:24450992

2014-01-01

80

Level of sustained glycemic control and associated factors among patients with diabetes mellitus in Ethiopia: a hospital-based cross-sectional study  

PubMed Central

Background The level of sustained glycemic control in patients with diabetes mellitus (DM) is a major determinant of the occurrence of both acute and chronic complications. However, information about the level of glycemic control among patients in the follow-up care at the University of Gondar Referral Hospital is scanty. The study assessed the degree of glycemic control and associated factors among diabetic patients in the study area. Method A hospital-based cross-sectional study was conducted at the University of Gondar Referral Hospital. All diabetic patients aged ?18 years who visited the Diabetes Clinic in January and February 2013 for follow-up medical evaluation and medication participated in the study. Patients with glycosylated hemoglobin test (HbA1c) of ?7% were classified as having a poor level of glycemic control. Propensity score was used to estimate the treatment effect. Multivariable logistic regression analysis was applied to determine the associated factors. Result Two hundred and fifty three (64.7%) of the 391 diabetic patients included in the study had a poor level of glycemic control, as evidenced by HbA1c ?7%. Poor glycemic control was much higher among Type 1 patients (82.9%) compared with Type 2 patients (57.5%). Being on insulin treatment (AOR =2.51; 95% CI =1.25, 5.04) and reporting poor medication adherence (AOR =3.19; 95% CI =1.76, 5.80) were found to be associated with poor glycemic control among Type 2 DM patients. High waist circumference was inversely associated with a poor level of glycemic control in Type 1 DM patients (AOR =0.05; 95% CI =0.01, 0.85). Conclusion The proportion of diabetic patients with a poor level of glycemic control is high. We recommend a comprehensive intervention to improve the overall treatment adherence with special attention to DM patients receiving insulin. PMID:25657591

Abebe, Solomon Mekonnen; Berhane, Yemane; Worku, Alemayehu; Alemu, Shitaye; Mesfin, Nebiyu

2015-01-01

81

Serum lipid profiles and glycemic control in adolescents and young adults with type 1 diabetes mellitus  

PubMed Central

Purpose We aimed to investigate serum lipid profiles and glycemic control in adolescents and young adults with type 1diabetes mellitus (T1DM). Methods This cross-sectional study included 29 Korean young adults and adolescents with T1DM. The median age was 17 years (range, 10-25 years) and 18 (62.1%) were female. We compared the lipid profiles of patients with dyslipidemia and those without dyslipidemia. Correlations between glycosylated hemoglobin (HbA1c) and lipid profiles (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglyceride [TG]) were determined by linear regression analysis. Results Of the 29 patients with T1DM, 11 (37.9%) were classified as having dyslipidemia due to the following lipid abnormality: TC?200 mg/dL in 8 patients, LDL-C?130 mg/dL in 4 patients, TG?150 mg/dL in 2 patients, and HDL-C?35 mg/dL in 2 patients. Compared to patients without dyslipidemia, patients with dyslipidemia were more likely to have higher values of HbA1c (median, 10.6%; range, 7.5%-12.3% vs. median, 8.0%; range, 6.6%-10.0%; P=0.002) and a higher body mass index z score (median, 0.7; range, -0.57 to 2.6 vs. median, -0.4; range, -2.5 to 2.2; P=0.02). HbA1c levels were positively correlated with TC (P=0.03, R2=0.156) and TG (P=0.005, R2=0.261). Conclusion A substantial proportion of adolescents and young adults with T1DM had dyslipidemia. We found a correlation between poor glycemic control and poor lipid profiles in those patients. PMID:25654064

Kim, Shin-Hee; Jung, In-Ah; Jeon, Yeon Jin; Cho, Won Kyoung; Cho, Kyoung Soon; Park, So Hyun; Suh, Byoung Kyu

2014-01-01

82

Closed-Loop Insulin Therapy Improves Glycemic Control in Children Aged <7 Years  

PubMed Central

OBJECTIVE To assess the possibility of improving nocturnal glycemic control as well as meal glycemic response using closed-loop therapy in children aged <7 years. RESEARCH DESIGN AND METHODS This was a randomized controlled crossover trial comparing closed-loop with standard open-loop insulin pump therapy performed in an inpatient clinical research center. Ten subjects aged <7 years with type 1 diabetes for >6 months treated with insulin pump therapy were studied. Closed-loop therapy and standard open-loop therapy were compared from 10:00 p.m. to 12:00 p.m. on 2 consecutive days. The primary outcome was plasma glucose time in range (110–200 mg/dL) during the night (10:00 p.m.–8:00 a.m.). Secondary outcomes included peak postprandial glucose levels, incidence of hypoglycemia, degree of hyperglycemia, and prelunch glucose levels. RESULTS A trend toward a higher mean nocturnal time within target range was noted for closed- versus open-loop therapy, although not reaching statistical significance (5.3 vs. 3.2 h, P = 0.12). There was no difference in peak postprandial glucose or number of episodes of hypoglycemia. There was significant improvement in time spent >300 mg/dL overnight with closed-loop therapy (0.18 vs. 1.3 h, P = 0.035) and the total area under the curve of glucose >200 mg/dL (P = 0.049). Closed-loop therapy returned prelunch blood glucose closer to target (189 vs. 273 mg/dL on open loop, P = 0.009). CONCLUSIONS Closed-loop insulin delivery decreases the severity of overnight hyperglycemia without increasing the incidence of hypoglycemia. The therapy is better able to reestablish target glucose levels in advance of a subsequent meal. Younger children with type 1 diabetes may reap significant benefits from closed-loop therapy. PMID:23033237

Dauber, Andrew; Corcia, Liat; Safer, Jason; Agus, Michael S.D.; Einis, Sara; Steil, Garry M.

2013-01-01

83

Glucose-regulated insulin production in the liver improves glycemic control in type 1 diabetic micea  

PubMed Central

Objective Type 1 diabetes results from autoimmune destruction of beta-cells in the pancreas. Our objective is to reconstitute a glucose-responsive system in the liver to regulate hepatic insulin production for improving glycemic control in type 1 diabetes. Methods We have cloned the glucose-responsive element (GRE) from the promoter of acetyl-CoA carboxylase (ACC), an enzyme that catalyzes the rate-limiting step in fatty acid synthesis in the liver in response to glucose. To increase the amplitude of glucose induction, we quadruplicated the GRE DNA by gene duplication. The resulting GRE multimer (4×GRE) was tested for its ability to drive rat proinsulin cDNA expression in hepatocytes and insulin-deficient diabetic mice. Results We showed that this GRE multimer-directed glucose-responsive system produced insulin in hepatocytes in a glucose-dependent manner. When delivered into the liver by adenovirus-mediated gene transfer, this glucose-responsive insulin production system was able to reverse hyperglycemia to a normal range without causing hypoglycemia after glucose challenge or overnight fasting. Insulin vector-treated diabetic mice exhibited significantly improved blood glucose profiles in response to glucose tolerance, correlating with insulin production in the liver. We recapitulated these findings in streptozotocin-induced diabetic CD1 mice and autoimmune non-obese diabetic mice. Conclusion Our data characterized the GRE motif from the ACC promoter as a potent glucose-responsive element, and provided proof-of-concept that the 4×GRE-mediated hepatic insulin production is capable of correcting insulin deficiency and improving glycemic control in type 1 diabetes. PMID:25685692

Zhang, Ting; Dong, H. Henry

2014-01-01

84

Prevalence of diabetic peripheral neuropathy and relation to glycemic control therapies at baseline in the BARI 2D cohort  

PubMed Central

We evaluated the associations between glycemic therapies and prevalence of diabetic peripheral neuropathy (DPN) at baseline among participants in the Bypass-Angioplasty-Revascularization-Investigation-2-Diabetes (BARI 2D) trial on medical and revascularization therapies for coronary artery disease (CAD) and on insulin-sensitizing versus insulin-providing treatments for diabetes. 2368 patients with type 2 diabetes and CAD were evaluated. DPN was defined as clinical examination score >2 using the Michigan Neuropathy Screening Instrument (MNSI). DPN odds ratios across different groups of glycemic therapy were evaluated by multiple logistic regression, adjusted for multiple covariates including age, sex, HbA1c, diabetes duration. 51% BARI 2D subjects with valid baseline characteristics and MNSI scores had DPN. After adjusting for all variables, use of insulin was significantly associated with DPN (OR1.57, 1.15, 2.13). Patients on sulfonylurea or combination of sulfonylurea/metformin/TZD had marginally higher rates of DPN than the metformin/TZD group. This cross-sectional study in a cohort of patients with type 2 diabetes and CAD showed association of insulin use with higher DPN prevalence, independent of disease duration, glycemic control and other characteristics. The causality between a glycemic control strategy and DPN cannot be evaluated in this cross-sectional study, but continued assessment of DPN and randomized therapies in BARI 2D trial may provide further explanations on the development of DPN. PMID:19335534

Pop-Busui, Rodica; Lu, Jiang; Lopes, Neuza; Jones, Teresa L. Z.

2009-01-01

85

Glycemic Variability in Abdominally Obese Men With Normal Glucose Tolerance as Assessed by Continuous Glucose Monitoring System  

Microsoft Academic Search

The purpose of this study was to observe both the glycemic variability in abdominally obese men with normal glucose tolerance (NGT) and the relationship between glycemic variability and early atherosclerosis. This case–control study included 23 abdominally obese men (waist circumference (WC) ?90 cm) and 23 nonabdominally obese men (WC <90 cm) with NGT who were between 20 and 50 years

Chun-Ming Ma; Fu-Zai Yin; Rui Wang; Chun-Mei Qin; Bo Liu; Dong-Hui Lou; Qiang Lu

2011-01-01

86

A study of sociodemographic clinical and glycemic control factors associated with co-morbid depression in type 2 diabetes mellitus  

PubMed Central

Context: Diabetes affects 9.2% of adults in India. About 8–16% of its population also suffer from depression. Both diseases pose a serious health challenge at individual and system level. The prevalence of depression in diabetes is much higher than in the general population. Undiagnosed and untreated depression puts people at higher morbidity and mortality risk. Aim: To study the prevalence of depression in diabetes and to identify associated risk factors. Settings and Design: Case control study carried out in an outpatient setting of a tertiary hospital in central India. Materials and Methods: One hundred and nine type 2 diabetes patients and 91 healthy controls formed the subjects of the study. Sociodemographic data were obtained on seven parameters. Comprehensive clinical data were obtained by means of standard procedures. Blood sugar levels and glycosylated hemoglobin levels were measured to assess glycemic control. Data of diabetic patients and controls as well as that of depressed and nondepressed diabetics were subjected to statistical analysis. Results: About 42.2% of diabetes patients and only 4.39% of controls had depression. About 19% of diabetics had peripheral neuropathy but had much higher neuropathic symptoms. Depression was not related to any sociodemographic or clinical factors but was strongly associated with poor glycemic control. Conclusion: Depression is highly prevalent in diabetes. Physical symptoms mask depression. Special attention needs to be paid to diagnose depression in diabetes and treat it appropriately along with effective glycemic control. Diabetes patients need to be treated collaboratively by physicians and psychiatrists. PMID:25788803

Singh, Hritu; Raju, M. S. V. K.; Dubey, Vaibhav; Kurrey, Ravindra; Bansal, Shaifali; Malik, Mustafa

2014-01-01

87

Role of community pharmacists in improving knowledge and glycemic control of type 2 diabetes  

PubMed Central

Objective: To study the role of the community pharmacists in improving knowledge and glycemic control in patients with type 2 diabetes residing in villages of Coimbatore district, Tamil Nadu. Materials and Methods: Fifty patients were interviewed, of whom 39 subjects were included in the study. The literate and chronic diabetic patients were included in the study and illiterate, children below 12 years of age, pregnant women, nursing mothers and subjects with any other chronic disorders were excluded from the study. The subjects were interviewed and divided randomly into two groups. There were 20 subjects in the control group and 19 in the intervention group. The study protocol was explained to all the participants, and written informed consent was obtained from them. Before the initiation of the study, the subjects were interviewedfor 20–40 min to educate them about diabetes. Subjects in the intervention group received continuous counselling and medical advice to improve their awareness about the disease and drugs. During the study period, the Diabetes Care Profile (a questionnaire developed by J.J. Fitzgerald of the Michigan Diabetes Research and Training Center, University of Michigan Medical School, Michigan) was performed to each subject. The interval between visits was 2 months. All the values are expressed in mean ± standard deviation. Results: The intervention group showed better progress in the recovery of diabetics because of the continuous counselling and monitoring. There were significant changes in Diabetes Care Profile subscale scores in both the control and the intervention groups at the end of the study, viz. 1.8 ± 4.52 to 2.75 ± 6.62 and 3.10 ± 3.23 to 1.53 ± 2.66. Similarly, the knowledge test score was found to be increased in the intervention group compared with the baseline values (8.53 ± 1.81 to 12.16 ± 1.34). Conclusions: At the end of the study period, the patients of the intervention group had very good glycemic control. Their health status and understanding of diabetes and its management were better, and they had fewer problems such as episodes of hyperglycemia or hypoglycemia. PMID:22347699

Venkatesan, R.; Devi, A. S. Manjula; Parasuraman, S.; Sriram, S.

2012-01-01

88

Effects of a pharmaceutical care model on medication adherence and glycemic control of people with type 2 diabetes  

PubMed Central

Background Diabetes mellitus is a lifelong chronic condition that requires self-management. Lifestyle modification and adherence to antidiabetes medications are the major determinants of therapeutic success in the management of diabetes. Purpose To assess the effects of a pharmaceutical care (PC) model on medication adherence and glycemic levels of people with type 2 diabetes mellitus. Patients and methods A total of 241 people with type 2 diabetes were recruited from a major teaching hospital in Malaysia and allocated at random to the control (n=121) or intervention (n=120) groups. Participants in the intervention group received PC from an experienced pharmacist, whereas those in the control group were provided the standard pharmacy service. Medication adherence was assessed using the Malaysian Medication Adherence Scale, and glycemic levels (glycated hemoglobin values and fasting blood glucose [FBG]) of participants were obtained at baseline and after 4, 8, and 12 months. Results At baseline, there were no significant differences in demographic data, medication adherence, and glycemic levels between participants in the control and intervention groups. However, statistically significant differences in FBG and glycated hemoglobin values were observed between the control and intervention groups at months 4, 8, and 12 after the provision of PC (median FBG, 9.0 versus 7.2 mmol/L [P<0.001]; median glycated hemoglobin level, 9.1% versus 8.0% [P<0.001] at 12 months). Medication adherence was also significantly associated with the provision of PC, with a higher proportion in the intervention group than in the control group achieving it (75.0% versus 58.7%; P=0.007). Conclusion The provision of PC has positive effects on medication adherence as well as the glycemic control of people with type 2 diabetes. Therefore, the PC model used in this study should be duplicated in other health care settings for the benefit of more patients with type 2 diabetes. PMID:25214772

Chung, Wen Wei; Chua, Siew Siang; Lai, Pauline Siew Mei; Chan, Siew Pheng

2014-01-01

89

The impact of diabetes mellitus and glycemic control on clinical outcomes following liver transplant for hepatitis C.  

PubMed

Hepatitis C is the leading indication for liver transplantation in the USA and recurrence is universal. The impact of preexisting diabetes, new-onset diabetes after transplant (NODAT), and glycemic control on fibrosis progression has not been studied. This retrospective longitudinal cohort study included adult liver recipients with hepatitis C transplanted between 2000 and 2011. Patients were divided into three groups: preexisting diabetes (n = 41), NODAT (n = 59), and no diabetes (n = 103). Patients with preexisting diabetes (70%) or NODAT (59%) were more likely to develop hepatitis C recurrence (?stage 1 fibrosis), as compared to non-diabetics (36%, p = 0.006). There was also a trend toward a higher incidence of at least Stage 2 fibrosis (36% and 48% vs. 23%, respectively; p = 0.063). Patients with tight glycemic control had a lower rate of Stage 2 fibrosis development (78% vs. 60%, p = 0.027), while those with good control (<150 mg/dL) also had lower rates of Stage 2 fibrosis (84% vs. 62%, p = 0.004). Multivariable analysis verified a decreased rate of recurrence for patients with blood glucose <138 mg/dL (p = 0.021), after controlling for confounders. These results demonstrate that diabetes is strongly associated with an increased risk of hepatitis C virus-related fibrosis development and glycemic control may reduce the risk and severity of recurrence. PMID:24893750

Morbitzer, Kathryn A; Taber, David J; Pilch, Nicole A; Meadows, Holly B; Fleming, James N; Bratton, Charles F; McGillicuddy, John W; Baliga, Prabhakar K; Chavin, Kenneth D

2014-08-01

90

Effects of intensive glycemic control in ocular complications in patients with type 2 diabetes: a meta-analysis of randomized clinical trials.  

PubMed

Whether intensive glycemic control can reduce incidence of diabetic retinopathy or other diabetes-associated ocular complications remains undefined. In this meta-analysis, we assessed the effects of intensive versus conventional glycemic control in ocular complications in patients with type 2 diabetes. A systematic literature search of PubMed, Web of Knowledge, and Scopus (until December 12, 2013) was conducted. Randomized controlled trials which compared intensive glycemic control with conventional glycemic control in ocular events in patients with type 2 diabetes were included. Random-effects models were used to measure the pooled odds ratio (OR) with 95 % confidence interval (CI). Seven trials involving 32,523 patients were included. Intensive glycemic control reduced the risks of retinal photocoagulation or vitrectomy (OR 0.86; 95 % CI 0.75-0.98), macular edema (OR 0.65; 95 % CI 0.43-0.99), and progression of retinopathy (OR 0.69; 95 % CI 0.55-0.87). No significant risk reduction was shown in incidence of retinopathy (OR 0.67; 95 % CI 0.26-1.73), cataract surgery (OR 0.88; 95 % CI 0.76-1.03), or severe loss of vision or blindness (OR 0.99; 95 % CI 0.86-1.13). Intensive glycemic control reduces the risk of most retinopathy-related events. But no beneficial effect was shown in ocular endpoint as severe loss of vision or blindness. PMID:25355306

Zhang, Xiaodan; Zhao, Jiangpei; Zhao, Tongfeng; Liu, Huanliang

2015-05-01

91

Glycemic control after initiating basal insulin therapy in patients with type 2 diabetes: a primary care database analysis  

PubMed Central

Background When target glycated hemoglobin (HbA1c) levels are not reached, basal insulin therapy should be considered in type 2 diabetes. The objective of this report was to describe the predictors of glycemic control (strict criterion: HbA1c ?6.5%) during the first year after initiating basal insulin therapy in primary care. Methods The study applied a retrospective approach using a nationwide database in Germany (Disease Analyzer, IMS Health, January 2008 to December 2011, including 1,024 general and internal medicine practices). Potential predictors of glycemic control considered were age, sex, duration of diabetes, type of basal insulin, comedication with short-acting insulin, baseline HbA1c, previous oral antidiabetic drugs, diabetologist care, private health insurance, macrovascular and microvascular comorbidity, and concomitant medication. Multivariable logistic regression models were fitted with glycemic control as the dependent variable. Results A total of 4,062 type 2 diabetes patients started basal insulin (mean age 66 years, males 53%, diabetes duration 4.8 years, mean HbA1c 8.8%), of whom 295 (7.2%) achieved an HbA1c ?6.5% during the one-year follow-up. Factors positively associated with HbA1c ?6.5% in logistic regression were male sex (odds ratio 1.59, 95% confidence interval 1.23–2.04), insulin glargine (reference neutral protamine Hagedorn; odds ratio 1.43, 95% confidence interval 1.09–1.88), short-acting insulin (odds ratio 1.33, 95% confidence interval 1.01–1.76), and prior treatment with metformin, dipeptidyl peptidase-4 inhibitors, and diuretics. Lipid-lowering drugs were associated with a lower odds of reaching the glycemic target. Conclusion Few type 2 diabetes patients (7%) reached the glycemic target (HbA1c ?6.5%) after one year of basal insulin therapy. Achievement of the glycemic target was associated with type of basal insulin, additional short-acting insulins, previous antidiabetic medication, and other comedication, eg, diuretics or lipid-lowering drugs. PMID:25609990

Kostev, Karel; Dippel, Franz W; Rathmann, Wolfgang

2015-01-01

92

Self-monitoring of blood glucose levels and glycemic control: the Northern California Kaiser Permanente Diabetes registry?  

Microsoft Academic Search

PURPOSE: We sought to evaluate the effectiveness of self-monitoring blood glucose levels to improve glycemic control.SUBJECTS AND METHODS: A cohort design was used to assess the relation between self-monitoring frequency (1996 average daily glucometer strip utilization) and the first glycosylated hemoglobin (HbA1c) level measured in 1997. The study sample included 24,312 adult patients with diabetes who were members of a

Andrew J Karter; Lynn M Ackerson; Jeanne A Darbinian; Ralph B D’Agostino; Assiamira Ferrara; Jennifer Liu; Joe V Selby

2001-01-01

93

Impact of ambulatory, family-focused teamwork intervention on glycemic control in youth with type 1 diabetes  

Microsoft Academic Search

Objective To evaluate an ambulatory, family-focused intervention aimed at optimizing glycemic control, minimizing diabetes-related family conflict (DFC), and maintaining quality of life in youth with type 1 diabetes (T1DM). Study design We randomly assigned 105 children and adolescents, 8 to 17 years of age, with T1DM for ?6 years, to a family-focused teamwork (TW) intervention or to standard multidisciplinary diabetes

Lori M. B. Laffel; Laura Vangsness; Alexa Connell; Ann Goebel-Fabbri; Deborah Butler; Barbara J. Anderson

2003-01-01

94

First pilot trial of the STAR-Liege protocol for tight glycemic control in critically ill patients  

Microsoft Academic Search

Tight glycemic control (TGC) has shown benefits in ICU patients, but been difficult to achieve consistently due to inter- and intra- patient variability that requires more adaptive, patient-specific solutions. STAR (Stochastic TARgeted) is a flexible model-based TGC framework accounting for patient variability with a stochastically derived maximum 5% risk of blood glucose (BG) below 72mg\\/dL. This research describes the first

Sophie Penning; Aaron J. Le Compte; Katherine T. Moorhead; Thomas Desaive; Paul Massion; Jean-Charles Preiser; Geoffrey M. Shaw; J. Geoffrey Chase

95

Helicobacter pylori Prevalence in Diabetes Mellitus Patients with Dyspeptic Symptoms and its Relationship to Glycemic Control and Late Complications  

Microsoft Academic Search

Background There are contradictory reports on Helicobacter pylori prevalence and its relationship to late complications of diabetes mellitus (DM). The aim of this study was to determine the\\u000a prevalence of H. pylori infection in type 2 DM patients and to evaluate the relationship between H. pylori infection and the glycemic control, late complications. Material and Method A total of 141 type 2

Mehmet Demir; Huseyin Savas Gokturk; Nevin Akcaer Ozturk; Mustafa Kulaksizoglu; Ender Serin; Ugur Yilmaz

2008-01-01

96

Psychological Functioning, Support for Self-Management, and Glycemic Control Among Rural African American Adults With Diabetes Mellitus Type 2  

Microsoft Academic Search

Objective: To test a contextual-ecological model of factors relevant for glycemic control in an under-studied and vulnerable population of persons with diabetes mellitus Type 2. Design: Rural African American adults (40–65 years old, n = 200) with Type 2 diabetes and 200 adult support persons whom the adults with diabetes nominated were interviewed in their homes. Adults with diabetes and

Gene H. Brody; Steven M. Kogan; Velma McBride Murry; Yi-fu Chen; Anita C. Brown

2008-01-01

97

Glycemic Control and Blood Glucose Monitoring Over Time in a Sample of Young Australians With Type 1 Diabetes  

PubMed Central

OBJECTIVE To determine whether personality traits (conscientiousness, agreeableness, emotional regulation, extraversion, and openness to experience) are associated with glycemic control and blood glucose monitoring behavior, and change or stability of these outcomes over time, in young people with type 1 diabetes. RESEARCH DESIGN AND METHODS A 3-year longitudinal study was conducted using data from 142 individuals with type 1 diabetes, 8–19 years of age. Personality was assessed at baseline using the Five-Factor Personality Inventory for Children. Data relating to glycemic control (HbA1c) and frequency of blood glucose monitoring (based on meter memory) were collected annually. Relationships between personality traits and HbA1c and monitoring frequency were examined using regression models and mixed-design ANOVA. RESULTS Three of the Five-Factor domains were independently associated with glycemic control. Individuals high in conscientiousness and agreeableness had a lower and more stable HbA1c across the 3-year study period. In contrast, the HbA1c of individuals scoring low on these traits was either consistently worse or deteriorated over time. Low or high emotional regulation scores were also associated with worse glycemic control. By the third year, these domains, together with initial HbA1c, accounted for 39% of HbA1c variance. Conscientiousness was the only personality factor associated with blood glucose monitoring behavior. CONCLUSIONS Results of this study underline the importance of personality in contributing to diabetes outcomes. Attention to a young person’s personality, and appropriate tailoring of diabetes management to ensure an individualized approach, may help to optimize diabetes outcomes. PMID:23835696

Waller, Daniel; Johnston, Christine; Molyneaux, Lynda; Brown-Singh, Lin; Hatherly, Kristy; Smith, Lorraine; Overland, Jane

2013-01-01

98

Computer decision support software safely improves glycemic control in the burn intensive care unit: a randomized controlled clinical study  

PubMed Central

Objective The optimal method for glycemic control in the critically burned patient is unknown. The purpose of this randomized controlled study was to determine the safety and efficacy of computer decision support software (CDSS) to control serum glucose concentration in a burn intensive care unit. Methods Eighteen adult burn/trauma patients receiving continuous insulin infusion were initially randomized to receive glucose management via a traditional paper-based protocol (PP) or a computer protocol (CP) for 72 hours, then crossed over to the alternate method for an additional 72 hours. Results Time in target glucose range (80-110 mg/dl) was higher in the CP group (47 ± 17% versus 41 ± 16.6%; p ? 0.05); time over target range was not significantly reduced in the CP group (49 ± 17.8% versus 54 ± 17.1; p = 0.08); and no difference was noted in time under target range of 80 mg/dl (CP 4.5 ± 2.8, PP 4.8 ± 3.3%; p = 0.8), under 60 mg/dl (p = 0.7), and under 40 mg/dl (p = 1.0). Severe hypoglycemic events (< 40 mg/dl) did not differ from the CP group compared to historical controls for patients receiving no insulin (p = 0.6). More glucose measurements were performed in the CP group (p = 0.0003), and nursing staff compliance with CP recommendations was greater (p < 0.0001). Conclusions Glycemic control using CDSS is safe and effective for the critically burned patient. Time in target range improved without increase in hypoglycemic events. CDSS enhanced consistency in practice, providing standardization among nursing staff. PMID:21240001

Mann, Elizabeth A.; Jones, John A.; Wolf, Steven E.; Wade, Charles E.

2011-01-01

99

PERCEIVED WEIGHT DISCRIMINATION AMPLIFIES THE LINK BETWEEN CENTRAL ADIPOSITY AND NONDIABETIC GLYCEMIC CONTROL (HBA1C)  

PubMed Central

Background While the preclinical development of type 2 diabetes is partly explained by obesity and central adiposity, psychosocial research has shown that chronic stressors such as discrimination have health consequences as well. Purpose We investigated the extent to which the well-established effects of obesity and central adiposity on nondiabetic glycemic control (indexed by HbA1c) were moderated by a targeted psychosocial stressor linked to weight: perceived weight discrimination. Methods Data came from the nondiabetic subsample (n=938) of the Midlife in the United States (MIDUS II) survey. Results Body mass index (BMI), waist-to-hip ratio, and waist circumference were linked to significantly higher HbA1c (p < .001). Multivariate-adjusted models showed that weight discrimination exacerbated the effects of waist-to-hip ratio on HbA1c ( p < .05), such that people who had higher WHR and reported weight discrimination had the highest HbA1c levels. Conclusions Understanding how biological and psychosocial factors interact at nondiabetic levels to increase vulnerability could have important implications for public health and education strategies. Effective strategies may include targeting sources of discrimination, rather than solely targeting health behaviors and practices of overweight and obese persons. PMID:21136227

Tsenkova, Vera K.; Carr, Deborah; Schoeller, Dale A.; Ryff, Carol D.

2010-01-01

100

Beyond Glycemic Control in Diabetes Mellitus: Effects of Incretin-Based Therapies on Bone Metabolism  

PubMed Central

Diabetes mellitus (DM) and osteoporosis (OP) are common disorders with a significant health burden, and an increase in fracture risk has been described both in type 1 (T1DM) and in type 2 (T2DM) diabetes. The pathogenic mechanisms of impaired skeletal strength in diabetes remain to be clarified in details and they are only in part reflected by a variation in bone mineral density. In T2DM, the occurrence of low bone turnover together with a decreased osteoblast activity and compromised bone quality has been shown. Of note, some antidiabetic drugs (e.g., thiazolidinediones, insulin) may deeply affect bone metabolism. In addition, the recently introduced class of incretin-based drugs (i.e., GLP-1 receptor agonists and DPP-4 inhibitors) is expected to exert potentially beneficial effects on bone health, possibly due to a bone anabolic activity of GLP-1, that can be either direct or indirect through the involvement of thyroid C cells. Here we will review the established as well as the putative effects of incretin hormones and of incretin-based drugs on bone metabolism, both in preclinical models and in man, taking into account that such therapeutic strategy may be effective not only to achieve a good glycemic control, but also to improve bone health in diabetic patients. PMID:23785355

Ceccarelli, Elena; Guarino, Elisa G.; Merlotti, Daniela; Patti, Aurora; Gennari, Luigi; Nuti, Ranuccio; Dotta, Francesco

2013-01-01

101

Preserving Mafa Expression in Diabetic Islet ?-Cells Improves Glycemic Control in Vivo.  

PubMed

The murine Mafa transcription factor is a key regulator of postnatal islet ?-cell activity, affecting insulin transcription, insulin secretion, and ?-cell mass. Human MAFA expression is also markedly decreased in islet ?-cells of type 2 diabetes mellitus (T2DM) patients. Moreover, levels are profoundly reduced in db/db islet ?-cells, a mouse model of T2DM. To examine the significance of this key islet ?-cell-enriched protein to glycemic control under diabetic conditions, we generated transgenic mice that conditionally and specifically produced Mafa in db/db islet ?-cells. Sustained expression of Mafa resulted in significantly lower plasma glucose levels, higher plasma insulin, and augmented islet ?-cell mass. In addition, there was increased expression of insulin, Slc2a2, and newly identified Mafa-regulated genes involved in reducing ?-cell stress, like Gsta1 and Gckr. Importantly, the levels of human GSTA1 were also compromised in T2DM islets. Collectively, these results illustrate how consequential the reduction in Mafa activity is to islet ?-cell function under pathophysiological conditions. PMID:25645923

Matsuoka, Taka-Aki; Kaneto, Hideaki; Kawashima, Satoshi; Miyatsuka, Takeshi; Tochino, Yoshihiro; Yoshikawa, Atsushi; Imagawa, Akihisa; Miyazaki, Jun-Ichi; Gannon, Maureen; Stein, Roland; Shimomura, Iichiro

2015-03-20

102

Influences of The Great Hanshin-Awaji Earthquake on glycemic control in diabetic patients.  

PubMed

We investigated influences on glycemic control in 177 diabetic patients after The Great Hanshin-Awaji Earthquake which occurred on January 17, 1995. Changes in serum HbA(1c) level were studied according to the worsen rate of dietary and living conditions. A significant temporary increase in the mean value of HbA(1c) level was found after the earthquake (8.34 +/- 2.07% in March, 1995 vs. 7.74 +/- 1.82% in December, 1994, P < 0.01). Ninety nine of them showed more than 0.5% in the rate of increase. Multiple regression analysis was applied to the following factors: inappropriate diet, discontinuation of drug uptake, reduction of exercise, destruction of house, long stay at shelter, sex, age, and pre-earthquake therapy. Among them, inappropriate diet demonstrated the highest partial regression coefficient to raise the mean value of the HbA(1c) level. The increased level of HbA(1c) declined gradually to the pre-earthquake level in September, 1995. This study emphasizes the importance of appropriate diet for diabetic patients during a natural disaster. To fulfil it, medical staff have to educate diabetic patients of their disorders tediously in ordinary time. In addition, it seems quite useful to supply a medical information card and a small medical bag containing essential drugs to each patient. PMID:9237786

Kirizuka, K; Nishizaki, H; Kohriyama, K; Nukata, O; Arioka, Y; Motobuchi, M; Yoshiki, K; Tatezumi, K; Kondo, T; Tsuboi, S

1997-06-01

103

Effects of zinc and multimineral vitamin supplementation on glycemic and lipid control in adult diabetes  

PubMed Central

Aims: To evaluate the effects of zinc with or without other antioxidants on blood glucose, lipid profile, and serum creatinine in adult diabetics on long-term follow-up. Materials and methods: Patients (n = 96) were randomly allocated to three groups: group A (n = 29) was supplemented with oral zinc sulfate (22 mg/day) and multivitamin/mineral (zinc+MVM) preparation; group B (n = 31) was given the same preparation without zinc (MVM); and group C (n = 36) was given a matching placebo for a period of 4 months in a single-blinded study. Blood samples were taken at baseline and after 4 months of supplementation to assess blood glucose (fasting and postprandial) and glycosylated hemoglobin (HbA1C%) and serum levels of zinc, creatinine, and lipids. Results: The zinc+MVM group had a mean change of fasting blood sugar ?0.33 mmol/L (standard error of the mean 0.21 mmol/L) and was significant (P = 0.05) when compared with the other two groups (mean change in the MVM group +0.19 (0.31) mmol/L and +0.43 (0.23) mmol/L in the control group, respectively). The HbA1C% level reduced significantly, irrespective of the baseline level, in zinc+MVM-supplemented individuals. In the other two groups, the change of HbA1C% level was not significant. Serum lipid levels reduced significantly in the zinc+MVM and MVM groups. Conclusions: Zinc+MVM supplementation showed beneficial effects in the metabolic control of adult diabetics in addition to elevating their serum zinc level. Zinc supplementation improved glycemic control measured by HbA1C% and fasting and postprandial glucose. Furthermore, zinc supplementation lowered serum cholesterol and cholesterol/high-density lipoprotein ratio. PMID:21448322

Gunasekara, Priyanka; Hettiarachchi, Manjula; Liyanage, Chandrani; Lekamwasam, Sarath

2011-01-01

104

Plasma Lipopolysaccharide Is Closely Associated With Glycemic Control and Abdominal Obesity  

PubMed Central

OBJECTIVE It is of vital importance to elucidate the triggering factors of obesity and type 2 diabetes to improve patient care. Bariatric surgery has been shown to prevent and even cure diabetes, but the mechanism is unknown. Elevated levels of lipopolysaccharide (LPS) predict incident diabetes, but the sources of LPS are not clarified. The objective of the current study was to evaluate the potential impact of plasma LPS on abdominal obesity and glycemic control in subjects undergoing bariatric surgery. RESEARCH DESIGN AND METHODS This was a prospective observational study involving a consecutive sample of 49 obese subjects undergoing bariatric surgery and 17 controls. Main assessments were plasma LPS, HbA1c, adipose tissue volumes (computed tomography), and quantified bacterial DNA in adipose tissue compartments. RESULTS Plasma levels of LPS were elevated in obese individuals compared with controls (P < 0.001) and were reduced after bariatric surgery (P = 0.010). LPS levels were closely correlated with HbA1c (r = 0.56; P = 0.001) and intra-abdominal fat volumes (r = 0.61; P < 0.001), but only moderately correlated with subcutaneous fat volumes (r = 0.33; P = 0.038). Moreover, there was a decreasing gradient (twofold) in bacterial DNA levels going from mesenteric via omental to subcutaneous adipose tissue compartments (P = 0.041). Finally, reduced LPS levels after bariatric surgery were directly correlated with a reduction in HbA1c (r = 0.85; P < 0.001). CONCLUSIONS Our findings support a hypothesis of translocated gut bacteria as a potential trigger of obesity and diabetes, and suggest that the antidiabetic effects of bariatric surgery might be mechanistically linked to, and even the result of, a reduction in plasma levels of LPS. PMID:23835694

Trøseid, Marius; Nestvold, Torunn K.; Rudi, Knut; Thoresen, Hanne; Nielsen, Erik W.; Lappegård, Knut T.

2013-01-01

105

Patient Assessment of Chronic Illness Care, Glycemic Control and the Utilization of Community Health Care among the Patients with Type 2 Diabetes in Shanghai, China  

PubMed Central

Objectives To evaluate the relationship between Patient Assessment of Chronic Illness Care in community health centers and self-management behaviors and glycemic control and to examine the relationship between Patient Assessment of Chronic Illness Care in community health centers and the utilization of community health centers for monitoring and treating diabetes among the patients with type 2 diabetes. Methods A questionnaire including self-management behaviors, glycemic control, Patient Assessment of Chronic Illness Care in community health centers and the most often utilized medical institutions for monitoring and treating diabetes (community health centers vs. hospitals) was administered to 960 patients with type 2 diabetes in Shanghai, China. The relationships between Patient Assessment of Chronic Illness Care and self-management behaviors, self-management behaviors and glycemic control, Patient Assessment of Chronic Illness Care and glycemic control, Patient Assessment of Chronic Illness Care and the most often utilized medical institutions for monitoring and treating diabetes were examined. Results Wilcoxon rank sum tests showed that the high scores of total Patient Assessment of Chronic Illness Care and five subscales in community health centers were positively related to almost all the proper self-management behaviors and good glycemic control (p<0.05). Almost all of the proper self-management behaviors were positively related to good glycemic control (p<0.01). High summary score of the Patient Assessment of Chronic Illness Care was positively associated with the utilization of community health centers for monitoring and treating diabetes (p<0.001). Conclusions Patient Assessment of Chronic Illness Care (implementation of the Chronic Care Model) in community health centers was associated with patients' self-management behaviors and glycemic control, and finally was associated with the utilization of community health centers for monitoring and treating diabetes. PMID:24039847

Liu, Li-Juan; Li, Yun; Sha, Kun; Wang, Yue; He, Xiang

2013-01-01

106

Counting Carbs? Understanding Glycemic Index and Glycemic Load  

MedlinePLUS

... to know. The glycemic index and load concern carbohydrates, or carbs—one of the main types of ... to support the concept that the more complex carbohydrates will lead to better blood sugar control than ...

107

The benefits of tight glycemic control in critical illness: Sweeter than assumed?  

PubMed

Hyperglycemia has long been observed amongst critically ill patients and associated with increased mortality and morbidity. Tight glycemic control (TGC) is the clinical practice of controlling blood glucose (BG) down to the "normal" 4.4-6.1 mmol/L range of a healthy adult, aiming to avoid any potential deleterious effects of hyperglycemia. The ground-breaking Leuven trials reported a mortality benefit of approximately 10% when using this technique, which led many to endorse its benefits. In stark contrast, the multi-center normoglycemia in intensive care evaluation-survival using glucose algorithm regulation (NICE-SUGAR) trial, not only failed to replicate this outcome, but showed TGC appeared to be harmful. This review attempts to re-analyze the current literature and suggests that hope for a benefit from TGC should not be so hastily abandoned. Inconsistencies in study design make a like-for-like comparison of the Leuven and NICE-SUGAR trials challenging. Inadequate measures preventing hypoglycemic events are likely to have contributed to the increased mortality observed in the NICE-SUGAR treatment group. New technologies, including predictive models, are being developed to improve the safety of TGC, primarily by minimizing hypoglycemia. Intensive Care Units which are unequipped in trained staff and monitoring capacity would be unwise to attempt TGC, especially considering its yet undefined benefit and the deleterious nature of hypoglycemia. International recommendations now advise clinicians to ensure critically ill patients maintain a BG of <10 mmol/L. Despite encouraging evidence, currently we can only speculate and remain optimistic that the benefit of TGC in clinical practice is sweeter than assumed. PMID:25538415

Gardner, Andrew John

2014-12-01

108

The benefits of tight glycemic control in critical illness: Sweeter than assumed?  

PubMed Central

Hyperglycemia has long been observed amongst critically ill patients and associated with increased mortality and morbidity. Tight glycemic control (TGC) is the clinical practice of controlling blood glucose (BG) down to the “normal” 4.4–6.1 mmol/L range of a healthy adult, aiming to avoid any potential deleterious effects of hyperglycemia. The ground-breaking Leuven trials reported a mortality benefit of approximately 10% when using this technique, which led many to endorse its benefits. In stark contrast, the multi-center normoglycemia in intensive care evaluation–survival using glucose algorithm regulation (NICE-SUGAR) trial, not only failed to replicate this outcome, but showed TGC appeared to be harmful. This review attempts to re-analyze the current literature and suggests that hope for a benefit from TGC should not be so hastily abandoned. Inconsistencies in study design make a like-for-like comparison of the Leuven and NICE-SUGAR trials challenging. Inadequate measures preventing hypoglycemic events are likely to have contributed to the increased mortality observed in the NICE-SUGAR treatment group. New technologies, including predictive models, are being developed to improve the safety of TGC, primarily by minimizing hypoglycemia. Intensive Care Units which are unequipped in trained staff and monitoring capacity would be unwise to attempt TGC, especially considering its yet undefined benefit and the deleterious nature of hypoglycemia. International recommendations now advise clinicians to ensure critically ill patients maintain a BG of <10 mmol/L. Despite encouraging evidence, currently we can only speculate and remain optimistic that the benefit of TGC in clinical practice is sweeter than assumed. PMID:25538415

Gardner, Andrew John

2014-01-01

109

Family Physician Clinical Inertia in Glycemic Control among Patients with Type 2 Diabetes  

PubMed Central

Background Many patients with diabetes do not achieve target values. One of the reasons for this is clinical inertia. The correct explanation of clinical inertia requires a conjunction of patient with physician and health care system factors. Our aim was to determine the rate of clinical inertia in treating diabetes in primary care and association of patient, physician, and health care setting factors with clinical inertia. Material/Methods This was a national, multicenter, observational, cross-sectional study in primary care in Croatia. Each family physician (FP) provided professional data and collected clinical data on 15–25 type 2 diabetes (T2DM) patients. Clinical inertia was defined as a consultation in which treatment change based on glycated hemoglobin (HbA1c) levels was indicated but did not occur. Results A total of 449 FPs (response rate 89.8%) collected data on 10275 patients. Mean clinical inertia per FP was 55.6% (SD ±26.17) of consultations. All of the FPs were clinically inert with some patients, and 9% of the FPs were clinically inert with all patients. The main factors associated with clinical inertia were: higher percentage of HbA1c, oral anti-diabetic drug initiated by diabetologist, increased postprandial glycemia and total cholesterol, physical inactivity of patient, and administration of drugs other than oral antidiabetics. Conclusions Clinical inertia in treating patients with T2DM is a serious problem. Patients with worse glycemic control and those whose therapy was initiated by a diabetologist experience more clinical inertia. More research on causes of clinical inertia in treating patients with T2DM should be conducted to help achieve more effective diabetes control. PMID:25652941

Lang, Valerija Brali?; Markovi?, Biserka Bergman; Kranj?evi?, Ksenija

2015-01-01

110

Vagal Blocking Improves Glycemic Control and Elevated Blood Pressure in Obese Subjects with Type 2 Diabetes Mellitus  

PubMed Central

Background. An active device that downregulates abdominal vagal signalling has resulted in significant weight loss in feasibility studies. Objective. To prospectively evaluate the effect of intermittent vagal blocking (VBLOC) on weight loss, glycemic control, and blood pressure (BP) in obese subjects with DM2. Methods. Twenty-eight subjects were implanted with a VBLOC device (Maestro Rechargeable System) at 5 centers in an open-label study. Effects on weight loss, HbA1c, fasting blood glucose, and BP were evaluated at 1 week to 12 months. Results. 26 subjects (17 females/9 males, 51 ± 2 years, BMI 37 ± 1?kg/m2, mean?±?SEM) completed 12 months followup. One serious adverse event (pain at implant site) was easily resolved. At 1 week and 12 months, mean excess weight loss percentages (% EWL) were 9 ± 1% and 25 ± 4% (P < 0.0001), and HbA1c declined by 0.3 ± 0.1% and 1.0 ± 0.2% (P = 0.02, baseline 7.8 ± 0.2%). In DM2 subjects with elevated BP (n = 15), mean arterial pressure reduced by 7 ± 3?mmHg and 8 ± 3?mmHg (P = 0.04, baseline 100 ± 2?mmHg) at 1 week and 12 months. All subjects MAP decreased by 3 ± 2?mmHg (baseline 95 ± 2?mmHg) at 12 months. Conclusions. VBLOC was safe in obese DM2 subjects and associated with meaningful weight loss, early and sustained improvements in HbA1c, and reductions in BP in hypertensive DM2 subjects. This trial is registered with ClinicalTrials.gov NCT00555958. PMID:23984050

Shikora, S.; Toouli, J.; Herrera, M. F.; Kulseng, B.; Zulewski, H.; Brancatisano, R.; Kow, L.; Pantoja, J. P.; Johnsen, G.; Brancatisano, A.; Tweden, K. S.; Knudson, M. B.; Billington, C. J.

2013-01-01

111

Effects of diets differing in glycemic index and glycemic load on cardiovascular risk factors: review of randomized controlled-feeing trials  

Technology Transfer Automated Retrieval System (TEKTRAN)

Despite a considerable amount of data available on the relationship between dietary glycemic index (GI) or load (GL) and cardiovascular disease (CVD) risk factors, in aggregate, the area remains unsettled. The aim of the present review was to summarize the effect of diets differing in GI/GL on CVD r...

112

The Association of English Ability and Glycemic Control among Latinos with Diabetes  

PubMed Central

Objective Language barriers may be significant contributors to diabetes disparities. We sought to assess the association of English speaking ability with glycemic control among Latinos with diabetes. Methods We analyzed 167 Latinos from a cross-sectional survey of adults with type 2 diabetes. The main outcome was HbA1c ?7.0%. The main predictor was self-reported English speaking ability. Adjusted analyses accounted for age, gender, education, annual income, health insurance status, duration of diabetes, birth in the U.S., and years in the U.S. Results In unadjusted analyses, point estimates for the odds of having a high HbA1c revealed a U-shaped curve with English speaking ability. Those who spoke English very well (OR=2.32, 95% CI, 1.00–5.41) or not at all (OR=4.11, 95% CI 1.35–12.54) had higher odds of having an elevated HbA1c than those who spoke English well, although this was only statistically significant for those who spoke no English. In adjusted analyses, the U-shaped curve persisted with the highest odds among those who spoke English very well (OR=3.20, 95% CI 1.05–9.79) or not at all (OR 4.95, 95% CI 1.29–18.92). Conclusions The relationship between English speaking ability and diabetes management is more complex than previously described. Interventions aimed at improving diabetes outcomes may need to be tailored to specific subgroups within the Latino population. PMID:24620445

Baig, Arshiya A.; Locklin, Cara A.; Foley, Edward; Ewigman, Bernard; Meltzer, David O.; Huang, Elbert S.

2014-01-01

113

Estimation of the Glycation Gap in Diabetic Patients With Stable Glycemic Control  

PubMed Central

OBJECTIVE The glycation gap (the difference between measured A1C and the value predicted by regression on fructosamine) is stable and is associated with microvascular complications of diabetes but has not hitherto been estimated within a clinically useful time frame. We investigated whether two determinations 30 days apart suffice for a reasonably reliable estimate if both A1C and fructosamine exhibit stability. RESEARCH DESIGN AND METHODS We studied 311 patients with type 1 or type 2 diabetes for whom simultaneous measurements of A1C and serum fructosamine had been made on at least two occasions separated by 1 month (t0 and t1). Glycemia was deemed stable if A1C(t1) – A1C(t0) and fructosamine(t1) ? fructosamine(t0) were both less than their reference change values (RCVs). Instantaneous glycation gaps [gg(t0) and gg(t1)] and their mean (GG), were calculated using the data from all stable patients for the required regression. RESULTS Stable glycemia was shown by 144 patients. In 90% of unstable case subjects, a change in medication was identified as the cause of instability. Among 129 stable patients with an average of eight gg determinations prior to t0, GG correlated closely with the mean of these prior determinations (r2 = 0.902, slope 1.025, intercept ?0.038). CONCLUSIONS The glycation gap can be calculated reliably from pairs of A1C and fructosamine measurements taken 1 month apart if these measurements satisfy the RCV criteria for glycemic control. PMID:22961579

Rodríguez-Segade, Santiago; Rodríguez, Javier; García Lopez, José M.; Casanueva, Felipe F.; Camiña, Félix

2012-01-01

114

The impact of knowledge about diabetes, resilience and depression on glycemic control: a cross-sectional study among adolescents and young adults with type 1 diabetes  

PubMed Central

Background The purpose of this study is to evaluate the relationship between glycemic control and the factors of knowledge about diabetes, resilience, depression and anxiety among Brazilian adolescents and young adults with type 1 diabetes. Methods This cross-sectional study included 85 adolescents and young adults with type 1 diabetes, aged between 11–22 years, with an average age of 17.7?±?3.72 years. Glycemic control degree was evaluated through HbA1c. To assess psychosocial factors, the following questionnaires were used: resilience (Resilience Scale, RS) and anxiety and depression (Hospital Anxiety and Depression Scale, HADS). The Diabetes Knowledge Assessment Scale (DKNA) was used to assess knowledge about diabetes. Results Significant correlations were found between HbA1c and resilience, anxiety and depression. Multiple linear regression analysis revealed that the only variable which presented significant association with the value of HbA1c was depression. Conclusions Depression has a significant association with higher HbA1c levels, as demonstrated in a regression analysis. The results suggest that depression, anxiety and resilience should be considered in the design of a multidisciplinary approach to type 1 diabetes, as these factors were significantly correlated with glycemic control. Glycemic control was not correlated with knowledge of diabetes, suggesting that theoretical or practical understanding of this disease is not by itself significantly associated with appropriate glycemic control (HbA1c???7.5%). PMID:24289093

2013-01-01

115

Does tight glycemic control improve outcomes in pediatric patients undergoing surgery and/or those with critical illness?  

PubMed Central

This literature review examines the current evidence regarding the potential usefulness of tight glycemic control in pediatric surgical patients. In adults, fluctuations in glucose levels and/or prolonged hyperglycemia have been shown to be associated with poor outcomes with respect to morbidity and mortality. This review begins by summarizing the findings of key papers in adult patients and continues by investigating whether or not similar results have been seen in pediatric patients by performing a comprehensive literature review using Medline (OVID). A database search using the OVID interface and including the search terms (exp glucose) AND (exp surgery) AND (exp Paediatric/pediatric) AND (exp Hypoglycaemia/hypoglycemia) AND (exp Hyperglycaemia/hyperglycemia) yielded a total of 150+ papers, of which 24 fulfilled our criteria. We isolated papers utilizing pediatric patients who were hospitalized due to illness and/or surgery. Our review highlights several difficulties encountered in addressing this potentially useful clinical intervention. An absence of scientifically robust and randomized trials and the existence of several small-powered trials yielding conflicting results mean we cannot recommend tight glycemic control in these patients. Differences in study design and disagreements concerning the crucial stage of surgery where hyperglycemia becomes important are compounded by an over-reliance on the discretion of clinicians in the absence of well described treatment protocols. Closer inspection of key papers in adult patients identified fundamental discrepancies between exact definitions of both hyperglycemia and hypoglycemia. This lack of consensus, along with a fear of inducing iatrogenic hypoglycemia in pediatric patients, has resulted in professional bodies advising against this form of intervention. In conclusion, we cannot recommend use of tight glycemic control in pediatric surgical patients due to unclear glucose definitions, unclear thresholds for treatment, and the unknown long-term effects of iatrogenic hypoglycemia on the developing body and brain. PMID:24353435

Forbes, Neil Christopher; Anders, Nicola

2014-01-01

116

Association between Poor Glycemic Control, Impaired Sleep Quality, and Increased Arterial Thickening in Type 2 Diabetic Patients  

PubMed Central

Objective Poor sleep quality is an independent predictor of cardiovascular events. However, little is known about the association between glycemic control and objective sleep architecture and its influence on arteriosclerosis in patients with type-2 diabetes mellitus (DM). The present study examined the association of objective sleep architecture with both glycemic control and arteriosclerosis in type-2 DM patients. Design Cross-sectional study in vascular laboratory. Methods The subjects were 63 type-2 DM inpatients (M/F, 32/31; age, 57.5±13.1) without taking any sleeping promoting drug and chronic kidney disease. We examined objective sleep architecture by single-channel electroencephalography and arteriosclerosis by carotid-artery intima-media thickness (CA-IMT). Results HbA1c was associated significantly in a negative manner with REM sleep latency (interval between sleep-onset and the first REM period) (?=-0.280, p=0.033), but not with other measurements of sleep quality. REM sleep latency associated significantly in a positive manner with log delta power (the marker of deep sleep) during that period (?=0.544, p=0.001). In the model including variables univariately correlated with CA-IMT (REM sleep latency, age, DM duration, systolic blood pressure, and HbA1c) as independent variables, REM sleep latency (?=-0.232, p=0.038), but not HbA1c were significantly associated with CA-IMT. When log delta power was included in place of REM sleep latency, log delta power (?=-0.257, p=0.023) emerged as a significant factor associated with CA-IMT. Conclusions In type-2 DM patients, poor glycemic control was independently associated with poor quality of sleep as represented by decrease of REM sleep latency which might be responsible for increased CA-IMT, a relevant marker for arterial wall thickening. PMID:25875738

Yoda, Koichiro; Inaba, Masaaki; Hamamoto, Kae; Yoda, Maki; Tsuda, Akihiro; Mori, Katsuhito; Imanishi, Yasuo; Emoto, Masanori; Yamada, Shinsuke

2015-01-01

117

Glycemic control, complications, and associated autoimmune diseases in children and adolescents with type 1 diabetes in Jeddah, Saudi Arabia  

PubMed Central

Objectives: To investigate the relationship between metabolic control, acute and long-term complications, the coexistence of autoimmune diseases, and to assess the different factors that can affect the glycemic control level among children with type 1 diabetes mellitus (T1DM). Methods: This is a cross-sectional study that included 228 T1DM children and adolescents visiting the pediatric diabetes clinic at the King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia from January 2013 to January 2014. The clinical and laboratory characteristics of the patients were recorded. Metabolic control, complications, and associated autoimmune diseases were evaluated. Results: The mean age of patients was 10.99 years, and the glycated hemoglobin (HbA1c) level was 8.8%. Acute complications included ketoacidosis in 65.4% of patients, and hypoglycemic attacks in 68.9%. Long-term complications were detected in patients including retinopathy (4.4%), microalbuminuria (16.2%), and dyslipidemia (8.3%). Autoimmune thyroiditis was noted in 14%, and celiac disease was found in 19.7% of patients. A significant difference was found in pubertal and pre-pubertal age groups in terms of glycemic control (p=0.01). Conclusion: The level of HbA1c was found to be higher among the pubertal age group. A relationship between autoimmune diseases and gender was determined. PMID:25630001

Al-Agha, Abdulmoein E.; Alafif, Maram; Abd-Elhameed, Ihab A.

2015-01-01

118

Effects of pioglitazone and glimepiride on glycemic control and insulin sensitivity in Mexican patients with type 2 diabetes mellitus: A multicenter, randomized, double-blind, parallel-group trial  

Microsoft Academic Search

Background: Pioglitazone and glimepiride improve glycemic control in patients with type 2 diabetes mellitus by different mechanisms. Pioglitazone is a thiazolidinedione that reduces insulin resistance, and glimepiride is a sulfonylurea insulin secretagogue.Objective: The goals of this study were to compare changes in measures of glycemic control and insulin sensitivity in Mexican patients with type 2 diabetes who received pioglitazone or

Meng Tan; Don Johns; Guillermo González Gálvez; Oscar Antúnez; Guadalupe Fabián; Fernando Flores-Lozano; Sergio Zúñiga Guajardo; Eduardo Garza; Hector Morales; Christopher Konkoy; Matthias Herz

2004-01-01

119

CARBOHYDRATE INTAKE AND GLYCEMIC INDEX IN RELATION TO THE ODDS OF EARLY CORTICAL AND NUCLEAR LENS OPACITIES  

Technology Transfer Automated Retrieval System (TEKTRAN)

Animal studies suggest a role for dietary carbohydrate in cataractogenesis. However, few published human studies have evaluated associations between carbohydrate nutrition and lens opacification. Our objective was to test the hypothesis that long-term carbohydrate intake and dietary glycemic index (...

120

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

Microsoft Academic Search

BACKGROUND: To reduce the likelihood of complications in persons with type 2 diabetes, it is critical to control hyperglycaemia. Monotherapy with metformin or insulin secretagogues may fail to sustain control after an initial reduction in glycemic levels. Thus, combining metformin with other agents is frequently necessary. These analyses model the potential long-term economic and health impact of using combination therapy

Alexandra J Ward; Maribel Salas; J Jaime Caro; David Owens

2004-01-01

121

Continuous vs interval training on glycemic control and macro- and microvascular reactivity in type 2 diabetic patients.  

PubMed

To determine the effects of continuous aerobic exercise training (CON) vs interval aerobic exercise training (INT) on glycemic control and endothelium-dependent vasodilatation, 43 participants with type 2 diabetes were randomly allocated to the sedentary, CON, and INT groups. The CON and INT exercise training programs were designed to yield the same energy expenditure/exercise session and included walking on treadmill for 30 and 40 min/day, 3 times/week for 12 weeks. Body fatness and heart rate at rest decreased and leg muscle strength increased (all P < 0.05) in both the CON and INT groups. Fasting blood glucose levels decreased (P < 0.05) in both exercise groups but glycosylated hemoglobin levels decreased (P < 0.05) only in the INT group. Maximal aerobic capacity, flow-mediated dilation, and cutaneous reactive hyperemia increased significantly in both exercise groups; however, the magnitude of improvements was greater in the INT group. Only the INT group experienced reductions in erythrocyte malondialdehyde and serum von Willebrand factor and increases in plasma glutathione peroxidase and nitric oxide (all P < 0.05). We concluded that both continuous and interval training were effective in improving glycemic control, aerobic fitness, and endothelium-dependent vasodilation, but the interval training program appears to confer greater improvements than the continuous training program. PMID:24102912

Mitranun, W; Deerochanawong, C; Tanaka, H; Suksom, D

2014-04-01

122

Effect of combination therapy with alogliptin and lansoprazole on glycemic control in patients with type 2 diabetes.  

PubMed

The main purpose of the current study was to investigate the effect of a combination of alogliptin [a dipeptydil peptidase (DPP)-4 inhibitor] and lansoprazole [a proton pump inhibitor (PPI)] compared with alogliptin mono-therapy on glycemic control in patients with type 2 diabetes. This study was a multicenter randomized open-label study. One hundred type 2 diabetic patients were randomly assigned to either the alogliptin with lansoprazole group or the alogliptin mono-therapy group. After 3 months of treatment, the changes in hemoglobin (Hb)A1c, fasting plasma glucose (FPG), serum gastrin, homeostasis model assessment (HOMA)-?, and HOMA-insulin resistance (IR) were evaluated. A significant decrease in HbA1c and FPG, and a significant increase in HOMA-? were observed in both groups (all with P <0.0001). However, there were no significant differences in changes in HbA1c, FPG, or HOMA-? before and after therapy between the combination and alogliptin mono-therapy group (P =0.2945, P =0.1901, P =0.3042, respectively). There was a significant elevation of serum gastrin in the combination group compared with the alogliptin mono-therapy group (P =0.0004). This study showed that, although combination therapy with alogliptin and lansoprazole more effectively elevated serum gastrin levels compared with alogliptin mono-therapy, the effect of the combination therapy on glycemic control was equal to that of alogliptin mono-therapy during a 3-month study period. PMID:25185672

Takebayashi, Kohzo; Sakurai, Shintaro; Suzuki, Tatsuhiko; Hori, Kenichiro; Terasawa, Tomoko; Naruse, Rika; Hara, Kenji; Suetsugu, Mariko; Tsuchiya, Takafumi; Aoki, Hiromi; Hamasaki, Takashi; Shuutou, Hiroshi; Inukai, Toshihiko

2014-01-01

123

Evaluation of Glycemic Control in Type 2 Diabetes Mellitus using Cytomorphometry of Buccal Cells and Correlation with Glycosylated Hemoglobin  

PubMed Central

Background: To study cytological alterations in the exfoliated buccal cells of diabetic patients. To analyze the cytomorphometric findings in the smears of uncontrolled and controlled diabetic patients and compare it with that of normal healthy controls. To establish a correlation between cytomorphometric changes and glycosylated hemoglobin (HbA1c) in diabetics and normal controls, for evaluation of glycemic control. Materials and Methods: The study was carried out in 40 confirmed diabetic patients from a hospital out-patient diabetic ward and 20 healthy individuals as controls (Group A: n = 20), in Chennai. Specific exclusion criteria were used to select the study group from a larger group of subjects. Based on HbA1c values, the diabetic patients were categorized into Group B = Controlled diabetics (n = 20) (HbA1c <7%) and Group C = Uncontrolled diabetics (n = 20) (HbA1c >9%). After informed consent, buccal smear was collected from clinically normal appearing mucosa and stained with papanicoloau (PAP) stain. Cytomorphometric analysis of selective PAP stained cells was done using image analysis software, Image Pro Plus 5.5 (Olympus) and parameters determined were average cytoplasmic area (CA), average nuclear area (NA) and cytoplasmic:nuclear (C: N) ratio for an average of 50 cells/patient. Results: Comparing the average NA among three groups, an increase through Group A, B, C, with a maximum significance between Group C and A was seen. The average C: N ratio showed a statistically significant difference between all three groups. Significant correlation existed between the HbA1c values and both the C: N ratio and average NA in all the three groups. Conclusions: Cytomorphometric analysis of buccal smears using the C: N ratio alteration as a reliable criteria, may serve as yet another non-invasive tool for screening programs for diabetic detection. And the technique may possibly be used also for evaluation of glycemic control in known diabetics.

Karthik, K Raghavendhar; Malathi, N; Poornima, K; Prakash, Sunil; Kadhiresan, R; Arunmozhi, U

2015-01-01

124

Diet Is Critical for Prolonged Glycemic Control after Short-Term Insulin Treatment in High-Fat Diet-Induced Type 2 Diabetic Male Mice  

PubMed Central

Background Clinical studies suggest that short-term insulin treatment in new-onset type 2 diabetes (T2DM) can promote prolonged glycemic control. The purpose of this study was to establish an animal model to examine such a “legacy” effect of early insulin therapy (EIT) in long-term glycemic control in new-onset T2DM. The objective of the study was to investigate the role of diet following onset of diabetes in the favorable outcomes of EIT. Methodology As such, C57BL6/J male mice were fed a high-fat diet (HFD) for 21 weeks to induce diabetes and then received 4 weeks of daily insulin glargine or sham subcutaneous injections. Subsequently, mice were either kept on the HFD or switched to a low-fat diet (LFD) for 4 additional weeks. Principal Findings Mice fed a HFD gained significant fat mass and displayed increased leptin levels, increasing insulin resistance (poor HOMA-IR) and worse glucose tolerance test (GTT) performance in comparison to mice fed a LFD, as expected. Insulin-treated diabetic mice but maintained on the HFD demonstrated even greater weight gain and insulin resistance compared to sham-treated mice. However, insulin-treated mice switched to the LFD exhibited a better HOMA-IR compared to those mice left on a HFD. Further, between the insulin-treated and sham control mice, in spite of similar HOMA-IR values, the insulin-treated mice switched to a LFD following insulin therapy did demonstrate significantly better HOMA-B% values than sham control and insulin-treated HFD mice. Conclusion/Interpretation Early insulin treatment in HFD-induced T2DM in C57BL6/J mice was only beneficial in animals that were switched to a LFD after insulin treatment which may explain why a similar legacy effect in humans is achieved clinically in only a portion of cases studied, emphasizing a vital role for diet adherence in diabetes control. PMID:25633992

Guo, Aili; Daniels, Nigel A.; Thuma, Jean; McCall, Kelly D.; Malgor, Ramiro; Schwartz, Frank L.

2015-01-01

125

Training, detraining, and retraining effects on glycemic control and physical fitness in women with type 2 diabetes.  

PubMed

Little is known about the detraining and retraining effects of exercise in patients with diabetes. The purpose of the present study was to investigate the effects of training, detraining, and retraining, using a combined strength and aerobic exercise program on glycemic control in women with type 2 diabetes. Thirteen postmenopausal women with type 2 diabetes (n = 13, age: 55.8 ± 5.1 years) followed a supervised aerobic and strength training program for 9 months, which was interrupted for 3 months (detraining) and resumed again for a period of 9 months (retraining). Anthropometric characteristics, glycemic control, and physical fitness were determined at baseline and after 9, 12, and 21 months. Training induced a small reduction in body mass index (BMI: -3.3%, 95% CI -5.1 to -1.5%), a moderate decrease in fasting plasma glucose (FPG: -12.0%, 95% CI -20.70 to -3.2%), glycosylated hemoglobin (HbA1c: -4.7%, 95% CI -12.1 to 2.7%), and a large decrease in postprandial glucose (PPG: - 12.1%, 95% CI -20.2 to -4.1%). In addition, there was an increase in power output (20.2%, 95% CI 6.9 to 33.6%) and total muscle strength (33.8%, 95% CI 21.4 to 46.1%). Detraining reversed PPG, HbA1c, and physical fitness. Resumption of training, however, led to a moderate decrease in BMI (-5.4%, 95% CI -8.1 to -2.7%), PPG (-9.5%, 95% CI -19.4 to 0.3%), and HbA1c (-6.8%, 95% CI -14.1 to 0.5%), and to large changes in FPG (-20.9%, 95% CI -31.9 to -9.9%), power output (33.1%, 95% CI 17.9 to 48.4%) and total muscle strength (48.2%, 95% CI 34.0 to 62.4%) compared to baseline. Thus, systematic training improves body composition, glycemic control and physical fitness in patients with type 2 diabetes. The cessation of exercise brings about negative alterations, while retraining restores all beneficial adaptations and improves them even more. Therefore, diabetic patients should follow a regular and an uninterrupted exercise program throughout life in order to control glucose metabolism and improve health. PMID:25369073

Tokmakidis, S P; Touvra, A-M; Douda, H T; Smilios, I; Kotsa, K; Volaklis, K A

2014-12-01

126

Should guidelines for glycemic control of the critically ill be individualized?: Weighing the evidence from randomized and observational investigations.  

PubMed

The monitoring of blood glucose and treatment of hyperglycemia has been a standard of care in intensive care units since the publication of a single-center randomized controlled trial (RCT) of intensive insulin therapy in 2001 that demonstrated marked improvements in mortality. Professional societies created guidelines based on the results of this investigation, and revised them based on the results of a very small group of RCTs that followed. This commentary reviews the weight of evidence provided by the RCTs in comparison to the large body of evidence from observational studies regarding glycemic control of the critically ill, and suggests that the totality of evidence should be considered in the formulation of clinical practice paradigms. PMID:24769780

Krinsley, James S

2014-04-01

127

Four-year change in cardiorespiratory fitness and influence on glycemic control in adults with Type 2 diabetes in a randomized trial  

Technology Transfer Automated Retrieval System (TEKTRAN)

OBJECTIVE To examine an intensive lifestyle intervention (ILI) compared with diabetes support and education (DSE) on 4-year change in fitness and physical activity (PA), and to examine the effect of change in fitness and PA, adjusting for potential confounders, on glycemic control in the Look AHEAD ...

128

Glycemic control with Glyburide\\/Metformin tablets in combination with rosiglitazone in patients with type 2 diabetes: a randomized, double-blind trial  

Microsoft Academic Search

PurposeTo assess the efficacy and safety of adding rosiglitazone to an established regimen of glyburide\\/metformin in patients with type 2 diabetes who had not achieved adequate glycemic control (glycosylated hemoglobin [HbA1C] levels >7.0% and ?10.0%).

George E Dailey; Mustafa A Noor; Jong-Soon Park; Simon Bruce; Fred T Fiedorek

2004-01-01

129

Effects of Pioglitazone and rosiglitazone on blood lipid levels and glycemic control in patients with type 2 diabetes mellitus: A retrospective review of randomly selected medical records  

Microsoft Academic Search

Background: The antihyperglycemic effects of pioglitazone hydrochloride and rosiglitazone maleate are well documented. The results of clinical trials and observational studies have suggested, however, that there are individual differences in the effects of these drugs on blood lipid levels.Objective: The present study evaluated the effects of pioglitazone and rosiglitazone on blood lipid levels and glycemic control in patients with type

Patrick J. Boyle; Allen Bennett King; Leann Olansky; Albert Marchetti; Helen Lau; Raf Magar; John Martin

2002-01-01

130

Glycated albumin as an improved indicator of glycemic control in hemodialysis patients with type 2 diabetes based on fasting plasma glucose and oral glucose tolerance test  

Microsoft Academic Search

AimsTo compare glycated albumin (GA) with glycated hemoglobin (HbA1c) as an indicator of glycemic control in hemodialysis patients with diabetes mellitus (DM), based on relationships with plasma glucose (PG) after overnight fasting and during 75g oral glucose tolerance test (OGTT).

Harumi Nagayama; Masaaki Inaba; Reiko Okabe; Masanori Emoto; Eiji Ishimura; Shuji Okazaki; Yoshiki Nishizawa

2009-01-01

131

Asymmetric dimethylarginine and long-term adverse cardiovascular events in patients with type 2 diabetes: relation with the glycemic control.  

PubMed

Background and aimsElevated plasma asymmetric dimethylarginine (ADMA) levels have been observed in patients with insulin resistance and diabetes, and have been reported to predict adverse cardiovascular events in type 2 diabetic patients. However, the relationship between ADMA and glycemic control in patients with type 2 diabetes remained controversial.Methods and resultsWe evaluated 270 patients with type 2 diabetes and measured their plasma ADMA and hemoglobin A1c (HbA1c) levels by high performance liquid chromatography. The mean age was 67¿±¿12 years. The mean plasma ADMA and HbA1c level were 0.46¿±¿0.09 ¿mol/l and 7.8¿±¿1.6%, respectively. There was no significant correlation between plasma ADMA level and HbA1c level (r¿=¿¿0.09, p¿=¿0.13). During the median follow-up period of 5.7 years (inter-quartile range: 5.0¿¿¿7.3 years), major adverse cardiovascular event (MACE, including cardiovascular death, myocardial infarction and stroke) was observed in 55 patients (20.4%). Multivariate Cox regression analysis revealed that the ADMA tertile was an independent risk factor for MACE (ADMA tertile III versus ADMA tertile I: p¿=¿0.026, HR: 2.31, 95% CI: 1.10¿¿¿4.81). The prognosis predictive power of ADMA disappeared in patients with well glycemic control (HbA1c ¿6.5%), and the ADMA-HbA1c interaction p value was 0.01.ConclusionsIn patients with type 2 diabetes, ADMA might be an independent risk factor for long-term adverse cardiovascular events. However, ADMA was not correlated with serum HbA1c level, and in diabetic patients with HbA1c ¿6.5%, elevated ADMA level was no longer associated with increased risk of long-term prognosis. Our findings suggested that the prognosis predictive value of ADMA in type 2 diabetes might be modified by the glycemic control. PMID:25467091

Hsu, Chiao-Po; Hsu, Pai-Feng; Chung, Ming-Yi; Lin, Shing-Jong; Lu, Tse-Min

2014-12-01

132

Effect of Intensive Glycemic Control and Diabetes Complications on Lower Urinary Tract Symptoms in Men With Type 1 Diabetes  

PubMed Central

OBJECTIVE Although diabetes is known to result in lower urinary tract symptoms (LUTS) in men, it remains unclear if glycemic control can mitigate urinary symptoms. We studied how diabetic characteristics are related to LUTS in the men who completed the urological assessment component (UroEDIC) of the Epidemiology of Diabetes Interventions and Complications (EDIC) follow-up study of the Diabetes Control and Complications Trial (DCCT) participants. RESEARCH DESIGN AND METHODS Study participants were men who completed the UroEDIC questionnaire at the year 10 DCCT/EDIC follow-up examination, which included data on genitourinary tract function and the American Urological Association Symptom Index (AUASI). Analyses were conducted to assess how treatment arm and diabetes characteristics were associated with LUTS using logistic regression. RESULTS Of the 591 men who completed the AUASI questions, nearly 20% (n = 115) had AUASI scores in the moderate to severe category for LUTS (AUASI score ?8). No associations were observed between LUTS and treatment arm, or A1C levels at the DCCT baseline or end-of-study or at the year 10 EDIC (UroEDIC) examination. Of the diabetes complications studied, only erectile dysfunction at the UroEDIC examination was associated with LUTS. CONCLUSIONS These data from the UroEDIC cohort do not support the assumption that intensive glycemic control results in decreased lower urinary tract symptom severity in men with type 1 diabetes. This result may be due to a true lack of effect, or it may be due to other factors, for example, the relatively young age of the cohort. PMID:19171725

Van Den Eeden, Stephen K.; Sarma, Aruna V.; Rutledge, Brandy N.; Cleary, Patricia A.; Kusek, John W.; Nyberg, Leroy M.; McVary, Kevin T.; Wessells, Hunter

2009-01-01

133

Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma  

PubMed Central

Although the evidence strongly supports perioperative glycemic control among cardiac surgical patients, there is scant literature to describe the practical application of such a protocol in the complex ICU environment. This paper describes the use of the Lean Six Sigma methodology to implement a perioperative insulin protocol in a cardiac surgical intensive care unit (CSICU) in a large academic hospital. A preintervention chart audit revealed that fewer than 10% of patients were admitted to the CSICU with glucose <200?mg/dL, prompting the initiation of the quality improvement project. Following protocol implementation, more than 90% of patients were admitted with a glucose <200?mg/dL. Key elements to success include barrier analysis and intervention, provider education, and broadening the project scope to address the intraoperative period. PMID:22091218

Martinez, Elizabeth A.; Chavez-Valdez, Raul; Holt, Natalie F.; Grogan, Kelly L.; Khalifeh, Katherine W.; Slater, Tammy; Winner, Laura E.; Moyer, Jennifer; Lehmann, Christoph U.

2011-01-01

134

Impact of Peer Health Coaching on Glycemic Control in Low-Income Patients With Diabetes: A Randomized Controlled Trial  

PubMed Central

PURPOSE Peer health coaches offer a potential model for extending the capacity of primary care practices to provide self-management support for patients with diabetes. We conducted a randomized controlled trial to test whether clinic-based peer health coaching, compared with usual care, improves glycemic control for low-income patients who have poorly controlled diabetes. METHOD We undertook a randomized controlled trial enrolling patients from 6 public health clinics in San Francisco. Twenty-three patients with a glycated hemoglobin (HbA1C) level of less than 8.5%, who completed a 36-hour health coach training class, acted as peer coaches. Patients from the same clinics with HbA1C levels of 8.0% or more were recruited and randomized to receive health coaching (n = 148) or usual care (n = 151). The primary outcome was the difference in change in HbA1C levels at 6 months. Secondary outcomes were proportion of patients with a decrease in HbA1C level of 1.0% or more and proportion of patients with an HbA1C level of less than 7.5% at 6 months. Data were analyzed using a linear mixed model with and without adjustment for differences in baseline variables. RESULTS At 6 months, HbA1C levels had decreased by 1.07% in the coached group and 0.3% in the usual care group, a difference of 0.77% in favor of coaching (P = .01, adjusted). HbA1C levels decreased 1.0% or more in 49.6% of coached patients vs 31.5% of usual care patients (P = .001, adjusted), and levels at 6 months were less than 7.5% for 22.0% of coached vs 14.9% of usual care patients (P = .04, adjusted). CONCLUSIONS Peer health coaching significantly improved diabetes control in this group of low-income primary care patients. PMID:23508600

Thom, David H.; Ghorob, Amireh; Hessler, Danielle; De Vore, Diana; Chen, Ellen; Bodenheimer, Thomas A.

2013-01-01

135

Depression, Coping Strategies, Glycemic Control and Patient Compliance in Type 2 Diabetic Patients in an endocrine Outpatient Clinic  

PubMed Central

Objective: Diabetes is a multifactorial disorder posing a great challenge to public health. In this study, we aimed to evaluate the relationship between depression, coping strategies, glycemic control and patient compliance in type 2 diabetic patients. Methods: Total 110 outpatients (mean (SD) age: 57.9 years (10.5), 56.4% were females) with type 2 diabetes mellitus were included in this descriptive and cross-sectional study. They were followed-up in the endocrinology outpatient clinic at Baskent University Istanbul Hospital Turkey. A questionnaire including items on sociodemographics, patient compliance, Beck Depression Inventory (BDI) and Ways of Coping Questionnaire (WCQ) were used. Glycemic control was measured by HbA1c levels. Results: Mean depression score was 12.6(9.2) with moderate to severe depression in 30.9% of study participants. Overall scores for BDI, fatalism and helplessness approaches were significantly higher among females compared with male patients. Depression scores were correlated positively to duration of disease (r=0.190, p=0.047), fatalistic (r=0.247, p=0.009), helplessness (r=0.543, p=0.000) and avoidance (r=0.261, p=0.006) approaches, and negatively to educational status (r=-0.311, p=0.001) and problem solving-optimistic approach (r=-0.381, p=0.000). Conclusions: Likelihood of depression was frequent, consistent with literature and was associated with gender, educational status, coping strategies, duration of diabetes and patient compliance with treatment in our study. Screening for depression and patient education may improve the quality of life in diabetic patients.

Parildar, Hulya; Cigerli, Ozlem; Demirag, Nilgun Guvener

2015-01-01

136

Zinc transporter gene expression and glycemic control in post-menopausal women with Type 2 diabetes mellitus.  

PubMed

Type 2 diabetes mellitus (DM) is associated often with underlying zinc deficiency and nutritional supplements such as zinc may be of therapeutic benefit in the disease. In a randomized, double-blind, placebo-controlled, 12-week trial in postmenopausal women (n=48) with Type 2 DM we investigated the effects of supplementation with zinc (40mg/d) and flaxseed oil (FSO; 2g/d) on the gene expression of zinc transporters (ZnT1, ZnT5, ZnT6, ZnT7, ZnT8, Zip1, Zip3, Zip7, and Zip10) and metallothionein (MT-1A, and MT-2A), and markers of glycemic control (glucose, insulin, glycosylated hemoglobin [HbA1c]). The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. No significant effects of zinc or FSO supplementation were observed on glycemic marker concentrations, HOMA-IR or fold change over 12 weeks in zinc transporter and metallothionein gene expression. In multivariate analysis, the change over 12 weeks in serum glucose concentrations (P=0.001) and HOMA-IR (P=0.001) predicted the fold change in Zip10. In secondary analysis, marginal statistical significance was observed with the change in both serum glucose concentrations (P=0.003) and HOMA-IR (P=0.007) being predictive of the fold change in ZnT6. ZnT8 mRNA expression was variable; HbA1c levels were higher (P=0.006) in participants who exhibited ZnT8 expression compared to those who did not. The significant predictive relationships between Zip10, ZnT6, serum glucose and HOMA-IR are preliminary, as is the relationship between HbA1c and ZnT8; nevertheless the observations support an association between Type 2 DM and zinc homeostasis that requires further exploration. PMID:25156968

Foster, Meika; Chu, Anna; Petocz, Peter; Samman, Samir

2014-10-01

137

Impact of inpatient diabetes management, education, and improved discharge transition on glycemic control 12 months after discharge  

PubMed Central

Aim To determine whether inpatient diabetes management and education with improved transition to outpatient care (IDMET) improves glycemic control after hospital discharge in patients with uncontrolled type 2 diabetes (T2DM). Methods Adult inpatients with T2DM and HbA1c?7.5% (11 mmol/mol) admitted for reasons other than diabetes to an academic medical center were randomly assigned to IDMET vs. usual care (UC). Linear mixed models estimated treatment-dependent differences in the change in HbA1c (measured at 3, 6, and 12 months) from baseline to 1 year follow-up. Results Thirty-one subjects had mean age 55 ± 12.6 years, with mean HbA1c of 9.7 ± 1.6% (82 ± 18 mmol/mol). Mean inpatient glucose was lower in the IDMET than in the UC group (176 ± 66 vs. 195 ± 74 mg/dl [9.7 vs. 10.8 mmol/l]), p=0.001. In the year after discharge, the average HbA1c reduction was greater in the IDMET compared to the UC group by 0.6% (SE 0.5%, [7 (SE 5) mmol/mol], p=0.3). Among patients newly discharged on insulin, the average HbA1c reduction was greater in the in the IDMET than in the UC group by 2.4% (SE 1.0%, [25 (SE 11) mmol/mol] p=0.04). Conclusions Inpatient diabetes management (IDMET) substantially improved glycemic control one year after discharge in patients newly discharged on insulin; patients previously treated with insulin did not benefit. PMID:23036785

Wexler, Deborah J.; Beauharnais, Catherine C.; Regan, Susan; Nathan, David M.; Cagliero, Enrico; Larkin, Mary E.

2012-01-01

138

Poor Glycemic Control Is Related to Increased Nitric Oxide Activity Within the Renal Circulation of Patients With Type 2 Diabetes  

PubMed Central

OBJECTIVE Experimental studies have shown that glucose releases endothelial nitric oxide (NO) and that NO contributes to renal hyperperfusion in models of diabetes. To examine whether this translates into the human condition, we studied the relationship between glycemic control and renal NO activity in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 113 patients with type 2 diabetes and a wide range of HbA1c concentrations were included. Renal plasma flow (RPF) and glomerular filtration rate (GFR) were determined by constant infusion input clearance. Functional NO activity in the renal circulation was determined as change of RPF to infusion of the NO synthase (NOS) inhibitor N(G)-monomethyl-l-arginine (l-NMMA) (4.25 mg/kg). As additional markers, we measured urinary excretion of NO (UNOx) and l-arginine–to–asymmetrical dimethylarginine (ADMA) ratio in plasma. RESULTS Subjects within the highest tertile of HbA1c concentration had increased RPF (low, medium, and high tertiles 576 ± 17 vs. 585 ± 22 vs. 627 ± 33 mL/min/m2, P = 0.05 by one-way ANOVA), while GFR was similar across tertiles. The response of RPF to NOS blockade was augmented in subjects with higher HbA1c levels (?55 ± 7 vs. ?64 ± 8 vs. ?86 ± 8 mL/min, P = 0.04 by one-way ANOVA). Further, l-arginine–to–ADMA ratio and UNOx were increased in subjects with higher HbA1c levels. CONCLUSIONS In line with experimental evidence, we could demonstrate in humans that poor glycemic control is related to higher NO activity and hyperperfusion of the kidney. The renal NO system may thus be a novel therapeutic target for improving renal hemodynamics in patients with diabetes. PMID:24130344

Schneider, Markus P.; Ott, Christian; Schmidt, Stephanie; Kistner, Iris; Friedrich, Stefanie; Schmieder, Roland E.

2013-01-01

139

Achieving glycemic control in elderly patients with type 2 diabetes: a critical comparison of current options  

PubMed Central

The prevalence of type 2 diabetes mellitus (T2DM) is increasing in the elderly. Because of the unique characteristics of elderly people with T2DM, therapeutic strategy and focus should be tailored to suit this population. This article reviews the guidelines and studies related to older people with T2DM worldwide. A few important themes are generalized: 1) the functional and cognitive status is critical for older people with T2DM considering their life expectancy compared to younger counterparts; 2) both severe hypoglycemia and persistent hyperglycemia are deleterious to older adults with T2DM, and both conditions should be avoided when determining therapeutic goals; 3) recently developed guidelines emphasize the avoidance of hypoglycemic episodes in older people, even in the absence of symptoms. In addition, we raise the concern of glycemic variability, and discuss the rationale for the selection of current options in managing this patient population. PMID:25429208

Du, Ye-Fong; Ou, Horng-Yih; Beverly, Elizabeth A; Chiu, Ching-Ju

2014-01-01

140

Effects of subtracting sitting versus adding exercise on glycemic control and variability in sedentary office workers.  

PubMed

Recent evidence suggests that, like adding exercise, reducing sitting time may improve cardiometabolic health. There has not been a direct comparison of the 2 strategies with energy expenditure held constant. The purpose of this study was to compare fasting and postmeal glucose and insulin concentrations in response to a day with frequent breaks from sitting but no exercise versus considerable sitting plus moderate exercise. Ten sedentary overweight/obese office workers were tested in 3 conditions: (i) walking per activity guidelines (AGW): sitting for majority of workday with a 30 min pre-lunch walk; (ii) frequent long breaks (FLB): no structured exercise but frequent breaks from sitting during workday with energy expenditure matched to AGW; and (iii) frequent short breaks (FSB): number of breaks matched to FLB, but duration of breaks were shorter. Plasma glucose and insulin areas under the curve were measured in response to a meal tolerance test (MTT) at the end of the workday and interstitial glucose was evaluated throughout the day and overnight using continuous glucose monitoring. Using repeated-measures linear mixed models, area under the curve of plasma glucose or insulin after the MTT was not different between conditions. Glycemic variability was lower in FLB compared with AGW (p < 0.05), and nocturnal duration of elevated glucose (>7.8 mmol/L) was shorter after FLB (2.5 ± 2.5 min) than AGW (32.7 ± 16.4 min) or FSB (45.6 ± 29.6 min, p = 0.05). When energy expenditure was matched, breaks from sitting approximated the effects of moderate-intensity exercise on postmeal glucose and insulin responses and more effectively constrained glycemic variability. PMID:25166626

Blankenship, Jennifer M; Granados, Kirsten; Braun, Barry

2014-11-01

141

Design and rationale of Safe Pediatric Euglycemia after Cardiac Surgery (SPECS): a randomized controlled trial of tight glycemic control after pediatric cardiac surgery  

PubMed Central

Objective To describe the design of a clinical trial testing the hypothesis that children randomized to tight glycemic control with intensive insulin therapy after cardiac surgery will have improved clinical outcomes compared to children randomized to conventional blood glucose management Design Two-center, randomized controlled trial Setting Cardiac intensive care units (CICUs) at two large academic pediatric centers Patients Children from birth-36 months recovering in the CICU after surgery with cardiopulmonary bypass Interventions Subjects in the tight glycemic control (intervention) group receive an intravenous insulin infusion titrated to achieve normoglycemia (target blood glucose range of 80–110 mg/dL; 4.4–6.1 mmol/L). The intervention begins upon admission to the CICU from the operating room and terminates when the patient is ready for discharge from the intensive care unit. Continuous glucose monitoring is performed for the duration of insulin infusion to minimize the risks of hypoglycemia. The standard care group has no target blood glucose range. Measurements and Main Results The primary outcome is the development of any nosocomial infection (bloodstream, urinary tract, and surgical site infection, or nosocomial pneumonia). Secondary outcomes include mortality, measures of cardiorespiratory function and recovery, laboratory indices of nutritional balance, immunologic, endocrinologic, and neurologic function, CICU and hospital length of stay, and neurodevelopmental outcome at 1 and 3 years of age. A total of 980 subjects will be enrolled (490 in each treatment arm) for sufficient power to show a 50% reduction in the incidence of the primary outcome. Conclusions Pediatric cardiac surgical patients may recognize great benefit from tight glycemic control in the postoperative period, particularly in regard to reduction of nosocomial infections. The SPECS trial is designed to provide an unbiased answer to the question of whether this therapy is indeed beneficial and to define the associated risks of therapy. PMID:22805161

Gaies, Michael G.; Langer, Monica; Alexander, Jamin; Steil, Garry M.; Ware, Janice; Wypij, David; Laussen, Peter C.; Newburger, Jane W.; Goldberg, Caren S.; Pigula, Frank A.; Shukla, Avinash C.; Duggan, Christopher P.; Agus, Michael S.D.

2012-01-01

142

Withdrawal of sulfonylureas from patients with type 2 diabetes receiving long-term sulfonylurea and insulin combination therapy results in deterioration of glycemic control: a randomized controlled trial  

PubMed Central

Background The benefit of sulfonylureas (SUs) to patients with type 2 diabetes mellitus receiving long-term insulin treatment is unclear. This study evaluated glycemic control and beta-cell function after SU withdrawal in these patients. Methods In this 8-week randomized controlled study, patients with type 2 diabetes who had been treated with insulin for at least 3 years plus moderate to high doses of SUs were randomly assigned to withdrawal (n=16) or continuation (n=16) of SUs. Clinical characteristics, glycemic control, hypoglycemic events, and insulin secretion, including homeostasis model assessment of beta-cell function (HOMA-B) score, C-peptide concentration, and Matsuda index, were evaluated at baseline and after 2 and 8 weeks. Results Thirty patients (16 in the SU withdrawal group and 14 in the SU continuation group) completed the study. Median duration of diabetes was 17 (range 5–40) years. Baseline clinical characteristics, glycemic control, and HOMA-B were similar in the two groups, but the mean fasting C-peptide concentration was higher in the SU withdrawal group. After 8 weeks, the SU withdrawal group showed a significant increase in mean glycosylated hemoglobin levels from 7.8%±0.5% (62±5 mmol/mol) to 8.6%±1.2% (71±13 mmol/mol; P=0.002), whereas the SU continuation group showed a slight but not significant increase from 7.7%±0.5% (61±5 mmol/mol) to 7.9%±1.2% (63±13 mmol/mol; P=0.37). Insulin secretion, as measured by C-peptide and HOMA-B, decreased by 18% and 36%, respectively, in the SU withdrawal group. Hypoglycemic events were significantly more frequent in the SU continuation group whereas body weight did not change significantly in either group. Conclusion Withdrawal of SU from patients with type 2 diabetes receiving long-term combination treatment with SU and insulin resulted in deterioration of glycemic control and insulin secretion. PMID:25767401

Srivanichakorn, Weerachai; Sriwijitkamol, Apiradee; Kongchoo, Aroon; Sriussadaporn, Sutin; Plengvidhya, Nattachet; Lertwattanarak, Raweewan; Vannasaeng, Sathit; Thongtang, Nuntakorn

2015-01-01

143

Bone Turnover and Insulin-like Growth Factor I Levels Increase After Improved Glycemic Control in Noninsulin-dependent Diabetes Mellitus  

Microsoft Academic Search

.   It is unclear whether both bone resorption and formation are affected by glycemic control, and contribute to diabetic osteopenia.\\u000a In this study, 20 patients with noninsulin-dependent diabetes mellitus (12 men and 8 postmenopausal women) and 20 healthy\\u000a control subjects (10 men and 10 postmenopausal women) were examined at baseline and 2 months. The diabetic patients showed\\u000a an improvement of

M. T. Rosato; S. H. Schneider; S. A. Shapses

1998-01-01

144

How does autoimmune thyroiditis in children with type 1 diabetes mellitus influence glycemic control, lipid profile and thyroid volume?  

PubMed

Abstract Aim: To investigate whether autoimmune thyroiditis (AIT) in children with type 1 diabetes mellitus (DM1) has any influence on glycemic control, lipid profile or thyroid volume. Methods: A total of 330 patients with DM1 and AIT (DM1+AIT group) were compared with 309 children with DM1 without AIT (control group). Patients were treated in four Polish academic pediatric diabetes centers from 2008 to 2012: Warsaw, Lodz, Katowice and Gdansk. All patients underwent measurements of thyroid-stimulating hormone (TSH), free thyroxine, anti-thyroid peroxidase (anti-TPO) antibody, anti-thyroglobulin (anti-TG) antibody and HbA1c levels, and thyroid ultrasound examination. Results: Among AIT+DM1 patients, 62% (n=205) were female, whereas in the control group 60.8% (n=188) were male (p<0.0001). Children with AIT+DM1 had lower a BMI-SDS (mean difference of -0.5, 95% CI -0.68 to -0.33; p<0.0001), had a higher SDS thyroid volume (0.27, 95% CI 0.03-0.51; p=0.014) and needed less insulin (-0.15, 95% CI -0.20 to -0.11 U/kg body weight per day; p<0.0001) in comparison with the control group. AIT patients had higher HbA1c levels (0.66, 95% CI 0.36%-0.96%, p<0.0001), lower HDL-cholesterol levels (-3.68, 95% CI -1.41 to -5.94 mg/dL, p=0.002) and higher triglyceride levels (7.16, 95% CI 1.22-13.10 mg/dL, p=0.02). Patients with positive anti-TPO and anti-TG antibodies were older (by 1.95 years, 95% CI 0.98-2.92 years, p=0.006) and had longer DM1 duration (by 1.64 years, 95% CI 0.76-2.52 years, p=0.006). Presence of anti-TPO antibodies was associated with higher TSH levels (odds ratio 2.34, 95% CI 1.36-4.04; p=0.007). Conclusion: AIT accompanying DM1 is associated with worse glycemic control and lipid profile as well as a lower daily insulin requirement. The female gender is more likely to develop AIT and hypothyroidism. PMID:25210750

Korzeniowska, Katarzyna; Ramotowska, Anna; Szypowska, Agnieszka; Szadkowska, Agnieszka; Fendler, Wojciech; Kalina-Faska, Barbara; M?ynarski, Wojciech; Jarosz-Chobot, Przemyslawa; My?liwiec, Malgorzata

2014-09-11

145

Accelerated Insulin Pharmacokinetics and Improved Postprandial Glycemic Control in Patients With Type 1 Diabetes After Coadministration of Prandial Insulins With Hyaluronidase  

PubMed Central

OBJECTIVE To compare the pharmacokinetics, pharmacodynamics, and safety of insulin lispro or regular human insulin (RHI) with or without recombinant human hyaluronidase (rHuPH20) administered before a standardized meal. RESEARCH DESIGN AND METHODS In this four-way, crossover study, 22 patients with type 1 diabetes received injections of individually optimized doses of lispro or RHI with and without rHuPH20 before a liquid meal. RESULTS With rHuPH20 coadministration, early insulin exposure (0–60 min) increased by 54% (P = 0.0011) for lispro and 206% (P < 0.0001) for RHI compared with the respective insulin alone. Peak blood glucose decreased 26 mg/dL for lispro (P = 0.002) and 24 mg/dL for RHI (P = 0.017), reducing hyperglycemic excursions (area under the curve for blood glucose >140 mg/dL) by 79% (P = 0.09) and 85% (P = 0.049), respectively. Rates of hypoglycemia were comparable for lispro with or without rHuPH20, whereas coadministration of RHI and rHuPH20 reduced hypoglycemia. CONCLUSIONS Lispro or RHI with rHuPH20 produced earlier and greater peak insulin concentrations and improved postprandial glycemic control. PMID:21273493

Hompesch, Marcus; Muchmore, Douglas B.; Morrow, Linda; Vaughn, Daniel E.

2011-01-01

146

Permanent neonatal diabetes mellitus: same mutation, different glycemic control with sulfonylurea therapy on long-term follow-up.  

PubMed

Permanent neonatal diabetes mellitus (PNDM) is a rare condition presenting before six months of age. Mutations in the genes encoding the ATP-sensitive potassium (KATP) channel are the most common causes. Sulfonylurea (SU) therapy leads to dramatic improvement in diabetes control and quality of life in most patients who carry these mutations. Here, we report the long-term follow-up results of two siblings with PNDM who were treated with insulin until ABCC8 gene mutation was identified, and were successfully transferred to oral SU therapy. After 3.5 years of follow-up on SU, one patient had a very good response, while the other one had a poor response. Bad compliance to diet was thought to be the most probable reason for poor glycemic control in this patient. In conclusion, molecular genetic diagnosis in all patients with PNDM is recommended. Compliance to treatment should be an important aspect of the follow-up of these patients. PMID:22672870

Aydin, Banu Kücükemre; Bundak, Rüveyde; Ba?, Firdevs; Mara?, Hülya; Saka, Nurçin; Günöz, Hülya; Darendeliler, Feyza

2012-06-01

147

Effect of two dietary fibers on satiety and glycemic parameters: a randomized, double-blind, placebo-controlled, exploratory study  

PubMed Central

Background Dietary carbohydrates may affect metabolic and physiologic parameters. The present study evaluated whether a combination of two dietary fibers, oligofructose (OFS) and pectin (P), altered satiety and glycemic parameters. The primary objective of this study was to determine whether dietary supplementation for 3 weeks with OFS?+?P would produce a greater reduction in energy intake of an ad libitum test meal compared to control. Methods This was a single center, randomized, double-blind, placebo-controlled, parallel group study in overweight and obese, otherwise healthy, subjects (N?=?96). There were two OFS?+?P treatment groups: high-dose (30 g/d), low-dose (15 g/d), and a control group (maltodextrin 15 g/d). Energy intake, appetite measures based on Satiety Labeled Intensity Magnitude (SLIM) scale, fasting and post-prandial glucose, and insulin levels and body weight were measured at baseline and at the end of 3 weeks. Adverse events and gastrointestinal tolerability of the treatments were also assessed. Results An analysis of covariance (ANCOVA) performed on the primary endpoint change from baseline in energy intake, showed no statistically significant difference in energy intake among the three treatment groups (p?=?0.5387). The LS mean changes (SE) in energy intake from baseline to week 3 were ?58.3 (42.4) kilocalories (kcal) for the high dose group, ?74.2 (43.6) kcal for the low dose group, and ?9.0 (42.9) kcal for the control group. For the pairwise comparisons of OFS?+?P doses and control, confidence intervals were constructed around the difference in LS mean changes. All study products were generally well tolerated. Conclusion There was a directional benefit in ad libitum energy intake for both OFS?+?P doses compared to control, with a greater reduction in kilocalories in the low dose comparison, but the reductions were not significant. Further studies are warranted. Clinical trial registration GSK Clinical Study Register # W7781293 PMID:24886409

2014-01-01

148

Add-On Treatment with Teneligliptin Ameliorates Glucose Fluctuations and Improves Glycemic Control Index in Japanese Patients with Type 2 Diabetes on Insulin Therapy  

PubMed Central

Abstract Background: This study investigated whether teneligliptin, a novel dipeptidyl peptidase-4 inhibitor, ameliorated glucose fluctuations in hospitalized Japanese patients with type 2 diabetes receiving insulin therapy, with or without other antidiabetes drugs, and using continuous glucose monitoring (CGM). Patients and Methods: Twenty-six patients with type 2 diabetes were admitted for glycemic control. After admission, patients continued to be treated with optimal dietary therapy plus insulin therapy, with or without other antidiabetes drugs, until they achieved stable glycemic control. CGM measurements were made for 7 consecutive days. On Days 1–3, patients received insulin with or without other antidiabetes drugs, and on Days 4–7, teneligliptin 20?mg once daily at breakfast was added to ongoing therapy. Doses of insulin were fixed during the study. Levels of serum glycated albumin (GA), 1,5-anhydro-d-glucitol (1,5-AG), and high-sensitivity C-reactive protein (hsCRP) were measured. Results: Add-on treatment with teneligliptin led to significant improvements in 24-h mean glucose levels, the proportion of time in normoglycemia, mean amplitude of glycemic excursions, and total area under the curve within 2?h after each meal. The proportion of time in hypoglycemia and hsCRP levels did not increase significantly compared with before teneligliptin. Values of 1,5-AG and GA were significantly improved by treatment with teneligliptin. Conclusions: Addition of teneligliptin to insulin therapy led to a significant improvement in diurnal glycemic control and significant reductions in glucose fluctuations in 24-h periods without increasing hypoglycemia in Japanese patients with type 2 diabetes on insulin therapy, with or without other antidiabetes agents. PMID:25144424

Tanaka, Seiichi; Aoki, Chie; Niitani, Mai; Kato, Kanako; Tomotsune, Takanori; Aso, Yoshimasa

2014-01-01

149

Family-based Psychoeducation and Care Ambassador Intervention to Improve Glycemic Control in Youth with Type 1 Diabetes: A Randomized Trial  

PubMed Central

Objective Youth with type 1 diabetes frequently do not achieve glycemic targets. We aimed to improve glycemic control with a Care Ambassador (CA) and family-focused psychoeducational intervention. Research Design and Methods In a 2-year, randomized, clinical trial, we compared 3 groups: 1) standard care, 2) monthly outreach by a CA, and 3) monthly outreach by a CA plus a quarterly clinic-based psychoeducational intervention. The psychoeducational intervention provided realistic expectations and problem-solving strategies related to family diabetes management. Data on diabetes management and A1c were collected, and participants completed surveys assessing parental involvement in management, diabetes-specific family conflict, and youth quality of life. The primary outcome was A1c at 2 years; secondary outcomes included maintaining parent involvement and avoiding deterioration in glycemic control. Results We studied 153 youth (56% female, median age 12.9 years) with type 1 diabetes (mean A1c 8.4±1.4%). There were no differences in A1c across treatment groups. Among youth with suboptimal baseline A1c ?8%, more youth in the psychoeducation group maintained or improved their A1c and maintained or increased parent involvement than youth in the other 2 groups combined (77% vs. 52%, p=.03; 36% vs. 11%, p=.01, respectively) without negative impact on youth quality of life or increased diabetes-specific family conflict. Conclusions No differences in A1c were detected among the 3 groups at 2 years. The psychoeducational intervention was effective in maintaining or improving A1c and parent involvement in youth with suboptimal baseline glycemic control. PMID:23914987

Katz, Michelle L.; Volkening, Lisa K.; Butler, Deborah A.; Anderson, Barbara J.; Laffel, Lori M.

2013-01-01

150

The Effect of Ginseng (The Genus Panax) on Glycemic Control: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials  

PubMed Central

Importance Despite the widespread use of ginseng in the management of diabetes, supporting evidence of its anti-hyperglycemic efficacy is limited, necessitating the need for evidence-based recommendations for the potential inclusion of ginseng in diabetes management. Objective To elucidate the effect of ginseng on glycemic control in a systematic review and meta-analysis of randomized controlled trials in people with and without diabetes. Data sources MEDLINE, EMBASE, CINAHL and the Cochrane Library (through July 3, 2013). Study selection Randomized controlled trials ?30 days assessing the glycemic effects of ginseng in people with and without diabetes. Data extraction Relevant data were extracted by 2 independent reviewers. Discrepancies were resolved by consensus. The Heyland Methodological Quality Score and the Cochrane risk of bias tool were used to assess study quality and risk of bias respectively. Data synthesis Sixteen trials were included, in which 16 fasting blood glucose (n?=?770), 10 fasting plasma insulin (n?=?349), 9 glycated hemoglobin (n?=?264), and 7 homeostasis model assessment of insulin resistance (n?=?305) comparisons were reported. Ginseng significantly reduced fasting blood glucose compared to control (MD?=? ?0.31 mmol/L [95% CI: ?0.59 to ?0.03], P?=?0.03). Although there was no significant effect on fasting plasma insulin, glycated hemoglobin, or homeostasis model assessment of insulin resistance, a priori subgroup analyses did show significant reductions in glycated hemoglobin in parallel compared to crossover trials (MD?=?0.22% [95%CI: 0.06 to 0.37], P?=?0.01). Limitations Most trials were of short duration (67% trials<12wks), and included participants with a relatively good glycemic control (median HbA1c non-diabetes?=?5.4% [2 trials]; median HbA1c diabetes?=?7.1% [7 trials]). Conclusions Ginseng modestly yet significantly improved fasting blood glucose in people with and without diabetes. In order to address the uncertainty in our effect estimates and provide better assessments of ginseng's anti-diabetic efficacy, larger and longer randomized controlled trials using standardized ginseng preparations are warranted. Trial Registration ClinicalTrials.gov NCT01841229 PMID:25265315

Shishtar, Esra'; Sievenpiper, John L.; Djedovic, Vladimir; Cozma, Adrian I.; Ha, Vanessa; Jayalath, Viranda H.; Jenkins, David J. A.; Meija, Sonia Blanco; de Souza, Russell J.; Jovanovski, Elena; Vuksan, Vladimir

2014-01-01

151

Salacia reticulata improves serum lipid profiles and glycemic control in patients with prediabetes and mild to moderate hyperlipidemia: a double-blind, placebo-controlled, randomized trial.  

PubMed

The present randomized, double-blind, placebo-controlled study evaluated the efficacy and safety of Salacia reticulata leaves and root bark extracts in 29 patients with prediabetes and mild to moderate hyperlipidemia. Patients received either Salacia extracts (500?mg/day) or placebo along with therapeutic lifestyle changes for a period of 6 weeks. Efficacy was evaluated in terms of change in lipid profile and glycemic levels. The safety and tolerability was evaluated by a physical examination and clinical laboratory evaluations. Improvements in lipid profiles and glycemic levels were observed in Salacia extract-treated groups when compared to placebo at week 6. A statistical significant reduction was observed in low-density lipoprotein cholesterol and fasting blood sugar (FBS) levels at week 3 and 6 when treated with root bark extract. The leaves extract-treated group showed statistically significant reduction in FBS levels at week 6 only. No adverse events occurred and all safety parameters were within normal ranges during the study. This study revealed that treatment with S. reticulata was safe and well-tolerated and may be beneficial in the management of prediabetes and mild to moderate hyperlipidemia. PMID:23767865

Shivaprasad, H N; Bhanumathy, M; Sushma, G; Midhun, T; Raveendra, K R; Sushma, K R; Venkateshwarlu, K

2013-06-01

152

A Prospective Study of Variability in Glycemic Control during Different Phases of the Menstrual Cycle in Type 2 Diabetic Women Using High Sensitivity C – Reactive Protein  

PubMed Central

Introduction: Diabetes mellitus (DM) is one of the metabolic syndromes prevalent worldwide, with more concentration in the Asian region. Many studies have been conducted in order to understand the complex pathogenesis of this disease. Yet, there exists a lacuna in our knowledge about DM. This study aims at establishing the reason for glycemic variation in menstruating Type-2 diabetic women by estimation of C-reactive protein, an inflammatory marker that exhibits significant association with changes in blood glucose levels. Methodology: A prospective study was undertaken in Type-2 diabetic women of reproductive age group to assess the variability of glycemic control during different phases of menstrual cycle using high sensitivity C reactive protein (hs-CRP) as the biomarker. Fifty women were enrolled after satisfying a set of inclusion and exclusion criteria. The fasting blood glucose, hs-CRP concentration and endogenous female hormones were assayed in follicular and luteal phases of the cycle. The observed parameters were analyzed statistically for significant correlation. Observation and Result: The result showed that hs-CRP level significantly correlates with increasing levels of fasting blood glucose level in both the phases of menstrual cycle in Type-2 diabetic women. The significance is statistically stronger during luteal phase of the cycle (r = 0.807; p<0.05). The correlation observed between hs-CRP and Estrodiol in follicular phase (r = –0.311; p < 0.05) was not statistically significant. The hs-CRP level increased significantly with progesterone level during luteal phase (r = 0.826; p <0.05). Conclusion: This study concludes that Type-2 diabetic women of reproductive age group encounter a period of poor glycemic control during luteal phase, as shown by statistically high hs-CRP level mediated by endogenous progesterone hormone. Therefore, this study advocates careful monitoring, life style adjustments and drug regime to reduce the fluctuation in glycemic level experienced by Type-2 diabetic premenopausal women in the luteal phase. PMID:24959437

Karthick, S.; Nagarjuna, B.

2014-01-01

153

Impact of Glycemic Control on Healthcare Resource Utilization and Costs of Type 2 Diabetes: Current and Future Pharmacologic Approaches to Improving Outcomes  

PubMed Central

Background The incidence and prevalence of type 2 diabetes continue to grow in the United States and worldwide, along with the growing prevalence of obesity. Patients with type 2 diabetes are at greater risk for comorbid cardiovascular (CV) disease (CVD), which dramatically affects overall healthcare costs. Objectives To review the impact of glycemic control and medication adherence on morbidity, mortality, and healthcare costs of patients with type 2 diabetes, and to highlight the need for new drug therapies to improve outcomes in this patient population. Methods This comprehensive literature search was conducted for the period between 2000 and 2013, using MEDLINE, to identify published articles that report the associations between glycemic control, medication adherence, CV morbidity and mortality, and healthcare utilization and costs. Search terms included “type 2 diabetes,” “adherence,” “compliance,” “nonadherence,” “drug therapy,” “resource use,” “cost,” and “cost-effectiveness.” Discussion Despite improvements in the management of CV risk factors in patients with type 2 diabetes, outcomes remain poor. The costs associated with the management of type 2 diabetes are increasing dramatically as the prevalence of the disease increases. Medication adherence to long-term drug therapy remains poor in patients with type 2 diabetes and contributes to poor glycemic control in this patient population, increased healthcare resource utilization and increased costs, as well as increased rates of comorbid CVD and mortality. Furthermore, poor adherence to established evidence-based guidelines for type 2 diabetes, including underdiagnosis and undertreatment, contributes to poor outcomes. New approaches to the treatment of patients with type 2 diabetes currently in development have the potential to improve medication adherence and consequently glycemic control, which in turn will help to reduce associated costs and healthcare utilization. Conclusions As the prevalence of type 2 diabetes and its associated comorbidities grows, healthcare costs will continue to increase, indicating a need for better approaches to achieve glycemic control and manage comorbid conditions. Drug therapies are needed that enhance patient adherence and persistence levels far above levels reported with currently available drugs. Improvements in adherence to treatment guidelines and greater rates of lifestyle modifications also are needed. A serious unmet need exists for greatly improved patient outcomes, more effective and more tolerable drugs, as well as marked improvements in adherence to treatment guidelines and drug therapy to positively impact healthcare costs and resource use. PMID:24991370

Banerji, Mary Ann; Dunn, Jeffrey D.

2013-01-01

154

Mechanism of action of pre-meal consumption of whey protein on glycemic control in young adults.  

PubMed

Whey protein (WP), when consumed in small amounts prior to a meal, improves post-meal glycemic control more than can be explained by insulin-dependent mechanisms alone. The objective of the study was to identify the mechanism of action of WP beyond insulin on the reduction of post-meal glycemia. In a randomized crossover study, healthy young men received preloads (300 ml) of WP (10 and 20 g), glucose (10 and 20 g) or water (control). Paracetamol (1.5 g) was added to the preloads to measure gastric emptying. Plasma concentrations of paracetamol, glucose, and ?-cell and gastrointestinal hormones were measured before preloads (baseline) and at intervals before (0-30 min) and after (50-230 min) a preset pizza meal (12 kcal/kg). Whey protein slowed pre-meal gastric emptying rate compared to the control and 10 g glucose (P<.0001), and induced lower pre-meal insulin and C-peptide than the glucose preloads (P<.0001). Glucose, but not WP, increased pre-meal plasma glucose concentrations (P<.0001). Both WP and glucose reduced post-meal glycemia (P=.0006) and resulted in similar CCK, amylin, ghrelin and GIP responses (P<.05). However, compared with glucose, WP resulted in higher post-meal GLP-1 and peptide tyrosine-tyrosine (PYY) and lower insulin concentrations, without altering insulin secretion and extraction rates. For the total duration of this study (0-230 min), WP resulted in lower mean plasma glucose, insulin and C-peptide, but higher GLP-1 and PYY concentrations than the glucose preloads. In conclusion, pre-meal consumption of WP lowers post-meal glycemia by both insulin-dependent and insulin-independent mechanisms. PMID:24314863

Akhavan, Tina; Luhovyy, Bohdan L; Panahi, Shirin; Kubant, Ruslan; Brown, Peter H; Anderson, G Harvey

2014-01-01

155

POOR GLYCEMIC CONTROL IS ASSOCIATED WITH REDUCED PROSTATE-SPECIFIC ANTIGEN CONCENTRATIONS IN MEN WITH TYPE 1 DIABETES  

PubMed Central

PURPOSE Previous studies have demonstrated lower prostate-specific antigen (PSA) concentrations in men with type 2 diabetes (T2DM), paralleling the reported lower prevalence of prostate cancer among diabetic men. Data on PSA in men with type 1 diabetes (T1DM), in whom insulin and obesity profiles differ from those in T2DM, are lacking. The objective of this study was to examine the relationship between long-term glycemic control and PSA in men with T1DM. MATERIALS & METHODS Total PSA was measured at one time in 639 men in the Epidemiology of Diabetes Interventions and Complications (EDIC) study, the observational follow up of participants in the Diabetes Control and Complications Trial (DCCT). The relationship between DCCT/EDIC weighted mean HbA1c and log PSA was assessed using linear regression modeling after adjusting for age, body mass index (BMI), total testosterone, statin and thiazide medication use, diabetes duration, and DCCT randomization arm and cohort. RESULTS The subjects had a median age of 52 years, BMI of 28.4 kg/m2 and DCCT/EDIC time weighted HbA1c of 7.9%. Total median (interquartile range) for PSA levels was 0.64 (0.43, 1.05). PSA levels increased significantly with age (p<0.0001) and with lower time weighted HbA1c (p<0.0001). Each 10% increase in HbA1c was accompanied by an 11% reduction in PSA (p=0.0001). CONCLUSIONS PSA levels decrease as HbA1c increases in men with T1DM. This relationship is independent of age, BMI, androgen levels, medication use and measures of diabetes severity, which suggest that factors related to glycemia may be directly affecting PSA levels. PMID:25218922

Sarma, Aruna V.; Hotaling, James; Dunn, Rodney L.; Cleary, Patricia A.; Braffett, Barbara H.; Kim, Catherine; Martin, Catherine; Herman, William; Gatcomb, Patricia; Jacobson, Alan M.; Holt, Sarah K.; Wessells, Hunter

2015-01-01

156

Low-dose glimepiride with sitagliptin improves glycemic control without dose-dependency in patients with type 2 diabetes inadequately controlled on high-dose glimepiride.  

PubMed

This randomized, prospective study was conducted in 76 subjects to assess whether low-dose (0.5-2 mg/day) glimepiride, in combination therapy with sitagliptin, improves glycemic control in a dose-dependent manner in Japanese patients with type 2 diabetes. Eligible subjects had been treated with glimepiride at doses of 3-6 mg/day for at least 3 months and had a HbA1c level of ?6.9%. Subjects were randomly assigned to three treatment groups of reduced doses of glimepiride (0.5 mg/day, 1 mg/day, or 2 mg/day) in addition to sitagliptin for 24 weeks. The primary efficacy analysis evaluated the change in HbA1c from baseline to week 24. Secondary efficacy endpoints included the changes in fasting plasma glucose, insulin secretion capacity, and ?-cell function. Safety endpoints included hypoglycemia and any adverse event. Despite dose reduction of glimepiride, combination therapy with sitagliptin induced significant improvements in HbA1c levels (-0.8%, p < 0.001). Insulin secretion parameters (CPI, SUIT) also increased significantly. There were no significant differences between groups in changes from baseline HbA1c, insulin secretion capacity, and ?-cell function (proinsulin/insulin) at 24 weeks of combination therapy. Multivariate analysis showed that baseline HbA1c was the only predictor for efficacy of combination therapy with sitagliptin and low-dose glimeripide. No changes in body weight were noted and no symptomatic hypoglycemia was documented. These findings indicate that combination therapy with sitagliptin and low-dose glimepiride (0.5 mg/day) is both effective for glycemic control and safe in Japanese patients with type 2 diabetes inadequately controlled with high-dose glimepiride. PMID:25168659

Umayahara, Rieko; Yonemoto, Takako; Kyou, Chika; Morishita, Kae; Ogawa, Tatsuo; Taguchi, Yoshitaka; Inoue, Tatsuhide

2014-12-25

157

Addition of sitagliptin to ongoing glimepiride therapy in Japanese patients with type 2 diabetes over 52 weeks leads to improved glycemic control  

Microsoft Academic Search

The efficacy and safety of sitagliptin as an add-on therapy to glimepiride were evaluated in a multicenter, randomized, double-blind,\\u000a placebo-controlled study, followed by an uncontrolled open-label period, in Japanese patients with type 2 diabetes who had\\u000a inadequate glycemic control on diet\\/exercise therapy and glimepiride monotherapy. During the initial double-blind period,\\u000a sitagliptin (50 mg q.d.) or placebo was added to ongoing glimepiride

Naoko Tajima; Takashi Kadowaki; Masato Odawara; Mikio Nishii; Tadaaki Taniguchi; Juan Camilo Arjona Ferreira

2011-01-01

158

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

PubMed Central

Background: Type 2 diabetes mellitus, as a noncommunicable disease, is the main public health challenge in the 21st century. The prevalence of diabetes mellitus adjusted for the world population in Iran was 8% until the year 2010.Lipid levels are considered as important parameters to be evaluated, as high serum lipid levels are often reported as a complication in patients with diabetes mellitus.It is claimed that functional foods may improve complications of diabetes mellitus, so this study was designed to evaluate the effects of high performance inulin on glycemic status and lipid profile of women with type 2 diabetes. Methods: The study was a randomized controlled clinical trial. Forty-nine type 2 diabetic females (fiber intake <30g/d, 25control group (n=25) received 10g/d maltodextrin for 8 weeks.Glycemic status and lipid profile indices were measured pre and post intervention. Data were analyzed using SPSS software (verision11.5). Paired, unpaired t-test and ANCOVA were used to compare quantitative variables. Results: Supplementation with inulin caused a significant reduction in FBS (8.50%), HbA1c (10.40%), total cholesterol (12.90%), triglyceride (23.60 %), LDL-c (35.30 %), LDL-c/HDL-c ratio (16.25%) and TC/HDL-c ratio (25.20%) and increased HDL-c (19.90%). The changes for the control group parameters were not significant at the end of study. Conclusion: Inulin may help to control diabetes and its complications via improving glycemic and lipid parameters. PMID:24688953

Dehghan, Parvin; Pourghassem Gargari, Bahram; Asgharijafarabadi, Mohammad

2013-01-01

159

The association of depression and anxiety with glycemic control among Mexican Americans with diabetes living near the U.S.-Mexico border  

PubMed Central

Background The prevalence of diabetes is alarmingly high among Mexican American adults residing near the U.S.-Mexico border. Depression is also common among Mexican Americans with diabetes, and may have a negative influence on diabetes management. Thus, the purpose of the current study was to evaluate the associations of depression and anxiety with the behavioral management of diabetes and glycemic control among Mexican American adults living near the border. Methods The characteristics of Mexican Americans with diabetes living in Brownsville, TX (N?=?492) were compared by depression/anxiety status. Linear regression models were conducted to evaluate the associations of depression and anxiety with BMI, waist circumference, physical activity, fasting glucose, and glycated hemoglobin (HbA1c). Results Participants with clinically significant depression and/or anxiety were of greater age, predominantly female, less educated, more likely to have been diagnosed with diabetes, and more likely to be taking diabetes medications than those without depression or anxiety. In addition, anxious participants were more likely than those without anxiety to have been born in Mexico and to prefer study assessments in Spanish rather than English. Greater depression and anxiety were associated with poorer behavioral management of diabetes (i.e., greater BMI and waist circumference; engaging in less physical activity) and poorer glycemic control (i.e., higher fasting glucose, HbA1c). Conclusions Overall, depression and anxiety appear to be linked with poorer behavioral management of diabetes and glycemic control. Findings highlight the need for comprehensive interventions along the border which target depression and anxiety in conjunction with diabetes management. PMID:24548487

2014-01-01

160

Correlation between ? cell mass and glycemic control in type 1 diabetic recipients of islet cell graft  

PubMed Central

Islet grafts can induce insulin independence in type 1 diabetic patients, but their function is variable with only 10% insulin indepence after 5 years. We investigated whether cultured grafts with defined ? cell number help standardize metabolic outcome. Nonuremic C-peptide-negative patients received an intraportal graft with 0.5–5.0 × 106 ? cells per kilogram of body weight (kgBW) under antithymocyte globulin and mycophenolate mofetil plus tacrolimus. Metabolic outcome at posttransplant (PT) month 2 was used to decide on a second graft under maintenance mycophenolate mofetil/tacrolimus. Graft function was defined by C-peptide >0.5 ng/ml and reduced insulin needs, metabolic control by reductions in HbA1c, glycemia coefficient of variation, and hypoglycemia. At PT month 2, graft function was present in 16 of 17 recipients of >2 × 106 ? cells per kgBW versus 0 of 5 with lower number. The nine patients with C-peptide >1 ng/ml and glycemia coefficient of variation of <25% did not receive a second graft; five of them were insulin-independent until PT month 12. The 12 others received a second implant; it achieved insulin-independence at PT month 12 when the first and second graft contained >2 × 106 ? cells per kgBW. Of the 20 recipients of at least one graft with >2 × 106 ? cells per kgBW, 17 maintained graft function and metabolic control up to PT month 12. At PT month 12, ? cell function in insulin-independent patients ranged around 25% of age-matched control values. Thus, 1-year metabolic control can be reproducibly achieved and standardized by cultured islet cell grafts with defined ? cell number. PMID:17090674

Keymeulen, Bart; Gillard, Pieter; Mathieu, Chantal; Movahedi, Babak; Maleux, Geert; Delvaux, Georges; Ysebaert, Dirk; Roep, Bart; Vandemeulebroucke, Evy; Marichal, Miriam; In 't Veld, Peter; Bogdani, Marika; Hendrieckx, Christel; Gorus, Frans; Ling, Zhidong; van Rood, Jon; Pipeleers, Daniel

2006-01-01

161

Effect of bariatric surgery combined with medical therapy versus intensive medical therapy or calorie restriction and weight loss on glycemic control in Zucker diabetic fatty rats.  

PubMed

Bariatric surgery rapidly improves Type 2 diabetes mellitus (T2DM). Our objective was to profile and compare the extent and duration of improved glycemic control following Roux-en-Y gastric (RYGB) bypass surgery and vertical sleeve gastrectomy (SG) and compare against calorie restriction/weight loss and medical combination therapy-based approaches using the Zucker diabetic fatty rat (ZDF) rodent model of advanced T2DM. Male ZDF rats underwent RYGB (n = 15) or SG surgery (n = 10) at 18 wk of age and received postsurgical insulin treatment, as required to maintain mid-light-phase glycemia within a predefined range (10-15 mmol/l). In parallel, other groups of animals underwent sham surgery with ad libitum feeding (n = 6), with body weight (n = 8), or glycemic matching (n = 8) to the RYGB group, using food restriction or a combination of insulin, metformin, and liraglutide, respectively. Both bariatric procedures decreased the daily insulin dose required to maintain mid-light-phase blood glucose levels below 15 mmol/l, compared with those required by body weight or glycemia-matched rats (P < 0.001). No difference was noted between RYGB and SG with regard to initial efficacy. SG was, however, associated with higher food intake, weight regain, and higher insulin requirements vs. RYGB at study end (P < 0.05). Severe hypoglycemia occurred in several rats after RYGB. RYGB and SG significantly improved glycemic control in a rodent model of advanced T2DM. While short-term outcomes are similar, long-term efficacy appears marginally better after RYGB, although this is tempered by the increased risk of hypoglycemia. PMID:25540099

Abegg, Kathrin; Corteville, Caroline; Docherty, Neil G; Boza, Camilo; Lutz, Thomas A; Muñoz, Rodrigo; le Roux, Carel W

2015-02-15

162

Glucose monitoring as an impediment to Improving glycemic control: a case report.  

PubMed

Diabetes mellitus is increasing in frequency and is associated with disabling acute and chronic complications. There is evidence to indicate that excellent glucose control may retard the development and/or progression of these complications. In order to optimize diabetic control, patients are encouraged to monitor their glucose frequently We describe a patient who provided inaccurate glucose monitoring results, delaying effective management of his progressively increasing glycosylated hemoglobin level. The diagnostic clue to his erroneous glucose monitoring results was the lack of intra-day variation in this patient on insulin therapy. Moreover, glucose records within the patient's glucometer pointed to a much less frequent glucose monitoring than the written data provided by the patient. The glucometer was accurate when used by the patient under direct observation. It remains unclear whether this patient deliberately misled his providers or if the erroneous data reflected underlying cognitive dysfunction. Providers are encouraged to approximate average blood sugars based on glycosylated hemoglobin values and compare this to home monitoring results provided by the patient. Primary providers should also expect a certain degree of variability when reviewing home blood sugar values with their patients (on insulin therapy) and consider further investigation should the numbers lack such variation. Clinicians are urged to inspect the actual glucose readings on the patient's glucometer as well as inspecting written glucose records. Observing the patient's technique and accuracy when using their personal glucometer should also be considered. PMID:24592619

Russell, Aimee G; Chen, Lei; Jones, Kelli; Peiris, Alan N

2014-01-01

163

The Role of Genetic Factors and Kidney and Liver Function in Glycemic Control in Type 2 Diabetes Patients on Long-Term Metformin and Sulphonylurea Cotreatment  

PubMed Central

This study investigated the influence of genetic polymorphisms of metformin transporters on long-term glycemic control and lipid status in type 2 diabetes patients in the everyday clinical setting. In total 135 patients treated with combination of metformin and sulphonylurea for at least 6 months were genotyped for SLC22A1 rs628031 and SLC47A1 rs2289669 polymorphisms. Relatively good blood glucose control with median HbA1c 6.9 (6.4–7.6) % was achieved on prescribed metformin dosage of 2550 (2000–2550)?mg per day. Only 28 (20.7%) patients experienced mild hypoglycemia events, while no severe hypoglycemia events were observed. Most patients had normal or mildly impaired renal function. Parameters indicating renal function were not correlated with fasting glucose, HbA1c, or lipid parameters. Rs628031 and rs2289669 had minor allele frequencies of 0.385 and 0.355, respectively, and were not associated with HbA1c levels. Rs628031 was marginally associated with risk for hypoglycemia events (P = 0.046; OR?=?0.51; 95% CI 0.26–0.99), while significant correlation was observed between rs2289669 and total cholesterol levels (P = 0.018). In conclusion, in patients on long-term metformin and sulphonylurea combination treatment, metformin transporters polymorphisms do not play a major role in glycemic control; however, they may influence lipid status. PMID:25025077

Klen, Jasna; Janež, Andrej; Dolžan, Vita

2014-01-01

164

Long-term study of patients with type 2 diabetes and moderate renal impairment shows that dapagliflozin reduces weight and blood pressure but does not improve glycemic control  

PubMed Central

In patients with diabetes, glycemic improvement by sodium-glucose cotransporter-2 inhibition depends on the kidney's ability to filter glucose. Dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, reduces hyperglycemia in patients with diabetes and normal or mildly impaired renal function. In this randomized, double-blind, placebo-controlled study we assessed daily treatment with dapagliflozin in 252 patients with inadequately controlled type 2 diabetes and moderate renal impairment. The primary endpoint, the mean change in HbA1c, was not statistically different from placebo after 24 weeks (?0.41% and ?0.44% for 5- and 10-mg doses, respectively, and ?0.32% for placebo). The mean weight change from baseline was ?1.54 and ?1.89?kg for the 5- and 10-mg doses, respectively, and +0.21?kg for placebo. The mean systolic and diastolic blood pressure decreased in the dapagliflozin groups compared to placebo. Through 104 weeks, 13 patients receiving dapagliflozin and no patients receiving placebo experienced bone fracture. At 1 week, the mean serum creatinine increased with dapagliflozin 5?mg (+0.13?mg/dl) and 10?mg (+0.18?mg/dl) and did not change further after 104 weeks. Mean serum electrolytes did not change in any group, and there were fewer episodes of hyperkalemia with dapagliflozin than placebo. Thus, in patients with moderate renal impairment, dapagliflozin did not improve glycemic control, but reduced weight and blood pressure. PMID:24067431

Kohan, Donald E; Fioretto, Paola; Tang, Weihua; List, James F

2014-01-01

165

Mechanism of action of whole milk and its components on glycemic control in healthy young men.  

PubMed

Milk reduces post-meal glycemia when consumed either before or within an ad libitum meal. The objective of this study was to compare the effect of each of the macronutrient components and their combination with whole milk on postprandial glycemia, glucoregulatory and gastrointestinal hormones and gastric emptying in healthy young men. In a randomized, crossover study, 12 males consumed beverages (500 ml) of whole milk (3.25% M.F.) (control), a simulated milk beverage based on milk macronutrients, complete milk protein (16 g), lactose (24 g) or milk fat (16 g). Whole and simulated milk was similar in lowering postprandial glycemia and slowing gastric emptying while increasing insulin, C-peptide, peptide tyrosine tyrosine (PYY) and cholecystokinin (CCK), but simulated milk resulted in higher (41%) glucagon-like peptide-1 (GLP-1) and lower (43%) ghrelin areas under the curve (AUC) than whole milk (P=.01 and P=.04, respectively). Whole and simulated milk lowered glucose (P=.0005) more than predicted by the sum of AUCs for their components. Adjusted for energy content, milks produced lower glucose and hormone responses than predicted from the sum of their components. The effect of protein/kcal on the AUCs was higher than fat/kcal for insulin, C-peptide, insulin secretion rate, GLP-1, CCK and paracetamol (P<.0001), but similar to lactose except for CCK and paracetamol, which were lower. The response in PYY and ghrelin was similar per unit of energy for each macronutrient. In conclusion, milk lowers postprandial glycemia by both insulin and insulin-independent mechanisms arising from interactions among its macronutrient components and energy content. PMID:25167977

Panahi, Shirin; El Khoury, Dalia; Kubant, Ruslan; Akhavan, Tina; Luhovyy, Bohdan L; Goff, H Douglas; Anderson, G Harvey

2014-11-01

166

Inpatient Diabetes Education Is Associated With Less Frequent Hospital Readmission Among Patients With Poor Glycemic Control  

PubMed Central

OBJECTIVE To explore the relationship between inpatient diabetes education (IDE) and hospital readmissions in patients with poorly controlled diabetes. RESEARCH DESIGN AND METHODS Patients with a discharge diagnosis of diabetes (ICD-9 code 250.x) and HbA1c >9% who were hospitalized between 2008 and 2010 were retrospectively identified. All-cause first readmissions were determined within 30 days and 180 days after discharge. IDE was conducted by a certified diabetes educator or trainee. Relationships between IDE and hospital readmission were analyzed with stepwise backward logistic regression models. RESULTS In all, 2,265 patients were included in the 30-day analysis and 2,069 patients were included in the 180-day analysis. Patients who received IDE had a lower frequency of readmission within 30 days than did those who did not (11 vs. 16%; P = 0.0001). This relationship persisted after adjustment for sociodemographic and illness-related factors (odds ratio 0.66 [95% CI 0.51–0.85]; P = 0.001). Medicaid insurance and longer stay were also independent predictors in this model. IDE was also associated with reduced readmissions within 180 days, although the relationship was attenuated. In the final 180-day model, no IDE, African American race, Medicaid or Medicare insurance, longer stay, and lower HbA1c were independently associated with increased hospital readmission. Further analysis determined that higher HbA1c was associated with lower frequency of readmission only among patients who received a diabetes education consult. CONCLUSIONS Formal IDE was independently associated with a lower frequency of all-cause hospital readmission within 30 days; this relationship was attenuated by 180 days. Prospective studies are needed to confirm this association. PMID:23835695

Healy, Sara J.; Black, Dawn; Harris, Cara; Lorenz, Andrew; Dungan, Kathleen M.

2013-01-01

167

Improvement in inpatient glycemic care: pathways to quality.  

PubMed

The management of inpatient hyperglycemia is a focus of quality improvement projects across many hospital systems while remaining a point of controversy among clinicians. The association of inpatient hyperglycemia with suboptimal hospital outcomes is accepted by clinical care teams; however, the clear benefits of targeting hyperglycemia as a mechanism to improve hospital outcomes remain contentious. Glycemic management is also frequently confused with efforts aimed at intensive glucose control, further adding to the confusion. Nonetheless, several regulatory agencies assign quality rankings based on attaining specified glycemic targets for selected groups of patients (Surgical Care Improvement Project (SCIP) measures). The current paper reviews the data supporting the benefits associated with inpatient glycemic control projects, the components of a successful glycemic control intervention, and utilization of the electronic medical record in implementing an inpatient glycemic control project. PMID:25715828

Aloi, Joseph A; Mulla, Christopher; Ullal, Jagdeesh; Lieb, David C

2015-04-01

168

Effects of an aquatic physical exercise program on glycemic control and perinatal outcomes of gestational diabetes: study protocol for a randomized controlled trial  

PubMed Central

Background Gestational diabetes mellitus (GDM) is increasing worldwide and has been associated with adverse perinatal outcomes and high risk for chronic disease both for the mother and for the child. Physical exercise is feasible for diabetic pregnant women and contributes to better glycemic control and to a decrease in adverse perinatal outcomes. However, there are no randomized controlled trials (RCT) assessing the effects of aquatic physical exercise on GDM control and adverse maternal and fetal outcomes. Methods/Design An RCT will be conducted at Instituto de Medicina Integral Prof Fernando Figueira (IMIP), Brazil. A total of 72 pregnant women will be studied; 36 gestational diabetics will undergo an aquatic physical exercise program in a thermal pool, 3 times per week over 2 months. The primary endpoint will be glucose level control and use of insulin; secondary endpoints will be the following maternal and fetal outcomes: weight gain during pregnancy, blood pressure, pre-eclampsia diagnosis, intrauterus growth restriction, preterm birth, Cesarean section, macrosomia and maternal or neonatal intensive care admission. Endpoints between intervention and control group will analyzed by t test for unpaired data and ?2 test, and the level of significance will set at <0.05. Discussion The physical proprieties of water make aquatic exercises ideal for pregnant women. An aquatic physical exercise program developed for GDM women will be trialed in a thermal pool and under the supervision of physiotherapist to ensure compliance. It is expected that this study will provide evidence as to the effect of aquatic physical exercise on GDM control. Trial registration ClinicalTrial.gov, NCT01940003. PMID:24245914

2013-01-01

169

Impact of intensive glycemic control on the incidence of atrial fibrillation and associated cardiovascular outcomes in patients with type 2 diabetes mellitus (from the Action to Control Cardiovascular Risk in Diabetes Study).  

PubMed

Atrial fibrillation (AF) is prevalent in patients with type 2 diabetes mellitus (DM) and is associated with markers of poor glycemic control; however, the impact of glycemic control on incident AF and outcomes is unknown. The aims of this study were to prospectively evaluate if intensive glycemic control in patients with DM affects incident AF and to evaluate morbidity and mortality in patients with DM and incident AF. A total of 10,082 patients with DM from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) cohort were studied in a randomized, double-blind fashion. Participants were randomized to an intensive therapeutic strategy targeting a glycated hemoglobin level of <6.0% or a standard strategy targeting a glycated hemoglobin level of 7.0% to 7.9%. Incident AF occurred in 159 patients (1.58%) over the follow-up period, at a rate of 5.9 per 1,000 patient-years in the intensive-therapy group and a rate of 6.37 per 1,000 patient-years in the standard-therapy group (p = 0.52). In a multivariate model, predictors of incident AF were age, weight, diastolic blood pressure, heart rate, and heart failure history. Patients with DM and new-onset AF had a hazard ratio of 2.65 for all-cause mortality (95% confidence interval 1.8 to 3.86, p <0.0001), a hazard ratio of 2.1 for myocardial infarction (95% confidence interval 1.33 to 3.31, p = 0.0015), and a hazard ratio of 3.80 for the development of heart failure (95% confidence interval 2.48 to 5.84, p <0.0001). In conclusion, intensive glycemic control did not affect the rate of new-onset AF. Patients with DM and incident AF had an increased risk for morbidity and mortality compared with those without AF. PMID:25159234

Fatemi, Omid; Yuriditsky, Eugene; Tsioufis, Costas; Tsachris, Demetrios; Morgan, Timothy; Basile, Jan; Bigger, Thomas; Cushman, William; Goff, David; Soliman, Elsayed Z; Thomas, Abraham; Papademetriou, Vasilios

2014-10-15

170

The effects of different doses of atorvastatin on serum lipid profile, glycemic control, and liver enzymes in patients with ischemic cerebrovascular accident  

PubMed Central

BACKGROUND Despite established effects of atorvastatin on level of serum lipid profile in patients with different underlying clinical conditions, the effects of this drug on other serum biomarkers remain uncertain. We examined the effects of atorvastatin therapy on lipid profile, glycemic control, and liver enzymes in patients with ischemic cerebrovascular accident without any history or clinical evidences of diabetes, heart failure, renal failure, or hepatic disease. METHODS In a randomized double-blinded controlled trial, 140 hospitalized patients with an ischemic cerebrovascular accident were included and randomly assigned to receive either atorvastatin 40 mg (n = 70) or atorvastatin 20 mg daily (n = 70) for 3 months. The levels of biomarkers were measured at the time of administrating drugs as well as at the time of completing the treatment. RESULTS A significant reduction was revealed in serum triglyceride, total cholesterol, low-density lipoprotein, non-high-density lipoprotein (HDL) cholesterol, and also aspartate aminotransferase levels as well as a significant increase in serum HDL level following administration of atorvastatin in both case and control groups who received the atorvastatin 40 mg/day and 20 mg/day, respectively (all P < 0.050). Although a significant increase in fasting blood sugar and hemoglobin A1c was observed in the case group received atorvastatin 40 mg/day (both P < 0.001), but this elevation was not occurred in another group treated with lower dose of the drug (both P > 0.050). CONCLUSION Daily administration of 20 mg and 40 mg doses of atorvastatin for 3 months provides improvement in serum lipid profiles; however, because of interfering effect of high-dose atorvastatin on glycemic control status, the use of the former dose may be preferred. This is very important in these patients because the positive effects of high-dose atorvastatin in stroke patients are not confirmed.

Sadeghi, Roxana; Asadpour-Piranfar, Mohammad; Asadollahi, Marjan; Taherkhani, Maryam; Baseri, Fariba

2014-01-01

171

The Impact of a Decision Support Tool Linked to an Electronic Medical Record on Glycemic Control in People with Type 2 Diabetes  

PubMed Central

Aims We retrospectively compared glycemic control and glycemic burden in type 2 diabetes patients treated by general physicians with access to decision support with those treated by general physicians without access to decision support. Methods A total of 875 patients [471 (53.8%) males] aged 54.3 [standard deviation (SD) 13.1] years followed up over 84 months. A total of 342 patients (39%) were managed with decision support, and effects on glycosylated hemoglobin (HbA1c) were assessed. Results There was no difference between groups in starting HbA1c [7.6 (SD 1.8) versus 7.5 (SD 1.5); p = not significant] at baseline. Patients treated with decision support were more likely to have planned review of HbA1c, adjustment of medication, prescription of statins, dietetic and nurse educator inputs (71.3% versus 58.5%; Chi squared = 14.7; p =.001). The mean HbA1c in the group treated with decision support was not significantly reduced within the first year [7.5% (SD 1.8) versus 7.6% (SD 1.5); p = not significant; 95% confidence interval (CI) ?0.33 to 0.17], but statistically significant differences were apparent at year 2 [7.2% (SD 2.0) versus 8% (SD 3.4); p = .0001; 95% CI ?1.3 to ?0.5] and sustained through year 3 [7.2% (SD 2.0) versus 8.0% (SD 2.0); p = .0001; 95% CI ?1.2 to ?0.6], year 4 [7.2% (SD 2.3) versus 8.2% (SD 2.5); p = .0001; 95% CI ?1.2 to ?0.6], year 5 [7.0% (SD 2.3) versus 8.3% (SD 2.6); p = .001; 95% CI ?1.5 to ?0.8], year 6 [7.0% (SD 2.0) versus 8.2% (SD 2.4); p = .001; 95% CI ?1.5 to ?0.9], and year 7 [6.9% (SD 1.2) versus 8% (SD 1.8); p = .001; 95% CI ?1.4 to ?1.0]. Conclusion Use of a decision support system showed benefits in adherence to clinical care pathways and achieving significant improvements in glycemic control. PMID:23759398

Gunathilake, Waruna; Gunawardena, Sajith; Fernando, Ranga; Thomson, George; Fernando, Devaka

2013-01-01

172

The hypoglycemic effect of pumpkin seeds, Trigonelline (TRG), Nicotinic acid (NA), and D-Chiro-inositol (DCI) in controlling glycemic levels in diabetes mellitus.  

PubMed

In the contemporary society, diabetes mellitus is considered as a common, growing, serious, costly, and potentially preventable public health problem. It is forecasted that in 2030, the number of people with diabetes will go up from 117 million in 2000 to 366 million in 2030. The prevalence of diabetes will place a huge burden on health and financial structures of countries, and these will impact on individuals, as well as families and nations. Polysaccharides, para-aminobenzoic acid, fixed oils, sterol, proteins, and peptides are biologically active ingredients, which are found in pumpkins. The chemicals within pumpkins such as the fruit pulp, oil from ungerminated seeds, and protein from germinated seeds have hypoglycemic properties. Preliminary investigation showed that pumpkin seeds, and the macromolecules, therein, such as Trigonelline (TRG), Nicotinic acid (NA), and D-chiro-inositol (DCI), possess hypoglycemic properties and could assist in maintaining glycemic control. PMID:24564589

Adams, Gary G; Imran, Shahwar; Wang, Sheng; Mohammad, Abubaker; Kok, M Samil; Gray, David A; Channell, Guy A; Harding, Stephen E

2014-01-01

173

Four-Year Change in Cardiorespiratory Fitness and Influence on Glycemic Control in Adults With Type 2 Diabetes in a Randomized Trial  

PubMed Central

OBJECTIVE To examine an intensive lifestyle intervention (ILI) compared with diabetes support and education (DSE) on 4-year change in fitness and physical activity (PA), and to examine the effect of change in fitness and PA, adjusting for potential confounders, on glycemic control in the Look AHEAD Trial. RESEARCH DESIGN AND METHODS Subjects were overweight/obese adults with type 2 diabetes mellitus (T2DM) with available fitness data at 4 years (n = 3,942).This clinical trial randomized subjects to DSE or ILI. DSE subjects received standard care plus information related to diet, PA, and social support three times per year. ILI subjects received weekly intervention contact for 6 months, which was reduced over the 4-year period, and were prescribed diet and PA. Measures included weight, fitness, PA, and HbA1c. RESULTS The difference in percent fitness change between ILI and DSE at 4 years was significant after adjustment for baseline fitness and change in weight (3.70 vs. 0.94%; P < 0.01). At 4 years, PA increased by 348 (1,562) kcal/week in ILI vs. 105 (1,309) kcal/week in DSE (P < 0.01). Fitness change at 4 years was inversely related to change in HbA1c after adjustment for clinical site, treatment, baseline HbA1c, prescribed diabetes medication, baseline fitness, and weight change (P < 0.01). Change in PA was not related to change in HbA1c. CONCLUSIONS A 4-year ILI increased fitness and PA in overweight/obese individuals with T2DM. Change in fitness was associated with improvements in glycemic control, which provides support for interventions to improve fitness in adults with T2DM. PMID:23223405

Jakicic, John M.; Egan, Caitlin M.; Fabricatore, Anthony N.; Gaussoin, Sarah A.; Glasser, Stephen P.; Hesson, Louise A.; Knowler, William C.; Lang, Wei; Regensteiner, Judith G.; Ribisl, Paul M.; Ryan, Donna H.

2013-01-01

174

Effect of Pramlintide on Prandial Glycemic Excursions During Closed-Loop Control in Adolescents and Young Adults With Type 1 Diabetes  

PubMed Central

OBJECTIVE Even under closed-loop (CL) conditions, meal-related blood glucose (BG) excursions frequently exceed target levels as a result of delays in absorption of insulin from the subcutaneous site of infusion. We hypothesized that delaying gastric emptying with preprandial injections of pramlintide would improve postprandial glycemia by allowing a better match between carbohydrate and insulin absorptions. RESEARCH DESIGN AND METHODS Eight subjects (4 female; age, 15–28 years; A1C, 7.5 ± 0.7%) were studied for 48 h on a CL insulin-delivery system with a proportional integral derivative algorithm with insulin feedback: 24 h on CL control alone (CL) and 24 h on CL control plus 30-?g premeal injections of pramlintide (CLP). Target glucose was set at 120 mg/dL; timing and contents of meals were identical on both study days. No premeal manual boluses were given. Differences in reference BG excursions, defined as the incremental glucose rise from premeal to peak, were compared between conditions for each meal. RESULTS CLP was associated with overall delayed time to peak BG (2.5 ± 0.9 vs. 1.5 ± 0.5 h; P < 0.0001) and reduced magnitude of glycemic excursion (88 ± 42 vs. 113 ± 32 mg/dL; P = 0.006) compared with CL alone. Pramlintide effects on glycemic excursions were particularly evident at lunch and dinner, in association with higher premeal insulin concentrations at those mealtimes. CONCLUSIONS Pramlintide delayed the time to peak postprandial BG and reduced the magnitude of prandial BG excursions. Beneficial effects of pramlintide on CL may in part be related to higher premeal insulin levels at lunch and dinner compared with breakfast. PMID:22815298

Weinzimer, Stuart A.; Sherr, Jennifer L.; Cengiz, Eda; Kim, Grace; Ruiz, Jessica L.; Carria, Lori; Voskanyan, Gayane; Roy, Anirban; Tamborlane, William V.

2012-01-01

175

THE ROLE OF AMYLIN AND GLUCAGON IN THE DAMPENING OF GLYCEMIC EXCURSIONS IN CHILDREN WITH TYPE 1 DIABETES.  

Technology Transfer Automated Retrieval System (TEKTRAN)

Postprandial hyperglycemia and preprandial hypoglycemia contribute to poor glycemic control in type 1 diabetes. We hypothesized that postprandial glycemic excursions could be normalized in type 1 diabetes by suppressing glucagon with pramlintide acetate in the immediate postprandial period and suppl...

176

Glycemic Index Values Database  

Cancer.gov

NCI has developed a listing of Glycemic Index (GI) values for individual foods. Food codes from the USDA Continuing Survey of Food Intakes of Individuals (CSFII) are used as a reference. This file provides GI values for those foods consumed by adults and queried on the DHQ or other FFQs used at NCI.

177

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

PubMed

In-intensive care unit (ICU) glucose variability (GV) is associated with increased mortality. However, the impact of GV on hospital survivors' morbidity and associated changes in destination at time of hospital discharge are unknown. We studied a retrospective patient cohort in a medical/surgical ICU, requiring insulin infusion, using computer-guided insulin dosing software. Standard deviation (GluSD) and coefficient of variation (GluCV) were used as GV measures. We examined rates of home discharge (H) in the whole cohort and selected subgroups across GV quartiles, between patients with and without H, determinants of H, and determinants of GV and its association with patients' ICU length of stay (LOS). A total of 351 patients met study criteria. The association of GV and H varied among examined subgroups. H increased with GV quartile (GluSD; P = .004). GV was higher in patients with H than non-H (GluSD 36.1 vs 30.0 mg/dl, respectively; P = .002). Increased GV was not a predictor of reduced H on multivariate analysis. GV was inversely associated with patients' ICU LOS in all examined subgroups. Increased number of hypoglycemic events and time to attain target glycemia were independent predictors of reduced H. GV was not associated with adverse impact on H in the present cohort, and its prognostic impact should be considered in the context of ICU LOS of examined patient populations. Further studies are needed to examine the morbidity effects of GV and other glycemia-related measures among hospital survivors of critical illness across varying ICU populations, glycemic control approaches, and glycemic targets. PMID:24876579

Oud, Lavi; Spellman, Craig

2014-02-01

178

Glycemic index, glycemic load and childhood obesity: A systematic review  

PubMed Central

Background: Several evidences have been reported so far in terms of the relationship between obesity and glycemic index and glycemic load in children. However, the number of review studies that have dealt with recent findings is quite low. The purpose of present study is to review the existing evidences in this regard. Materials and Methods: First of all, the phrases: “Glycaemic index”, “Glycaemic load”, “Glycemic index” OR “Glycemic load” accompanied by one of the words: “Adolescent”, “Young”, “Youth” “Children” OR “Child” were searched in texts of articles existing in ISI and PUBMED databases which were obtained out of 1001 articles. Among these, some articles, which reviewed the relationship of obesity with glycemic index and glycemic load, were selected. Finally, 20 articles were studied in current review study. Results: The majority of cross-sectional studies have found children's obesity directly linked with glycemic index and glycemic load; however, cohort studies found controversial results. Also, the intervention studies indicate the negative effect of glycemic index and glycemic load on obesity in children. Conclusion: Published evidences reported inconsistent results. It seems that existing studies are not sufficient and more studies are needed in this regard. PMID:24627855

Rouhani, Mohammad Hossein; Kelishadi, Roya; Hashemipour, Mahin; Esmaillzadeh, Ahmad; Azadbakht, Leila

2014-01-01

179

Comparison of Ranolazine and Trimetazidine on Glycemic Status in Diabetic Patients with Coronary Artery Disease – A Randomized Controlled Trial  

PubMed Central

Introduction: Cardiovascular diseases have become the leading cause of death around the globe and diabetes mellitus (DM) is considered to be a coronary artery disease (CAD) risk equivalent. Ranolazine, an anti anginal drug has been found to reduce Glycated haemoglobin (HbA1c) in diabetes patients with chronic angina. However the effect of another antianginal drug trimetazidine, on glycemic status is not clear. Aim: To compare the effect of ranolazine and trimetazidine on glycemic status in diabetic patients with CAD. Settings and Design: Patients diagnosed with CAD and diabetes mellitus attending Cardiology Out Patient Department (OPD), Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India were recruited for this randomized open label parallel arm trial. Materials and Methods: The study conducted from January-2012 to April-2013 had 47 eligible patients diagnosed with CAD and diabetes mellitus. They were randomized to receive either ranolazine 500 mg BD or trimetazidine 35 mg BD for 12 weeks. HbA1c levels, fasting blood glucose (FBG), lipid profile, QT and QTc intervals were measured at baseline and after 12 weeks. Statistical Analysis: Unpaired t-test was used to compare the baseline characteristics of between the groups while comparison within the groups were done using Paired t-test. Wilcoxon and Mann Whitney U-tests were used for non parametric data. Graph pad instat version-3 was used for statistical analysis. Values were expressed as mean ± SD. A p < 0.05 was considered statistically significant. Results: The study could not find any change in HbA1c levels in both ranolazine and trimetazidine groups. The adverse effects reported from patients on ranolazine include angina, constipation, postural hypotension, headache, dizziness, nausea and weakness while patients on trimetazidine complained of constipation, weakness, palpitations, angina, dizziness, nausea, dyspepsia, headache, gastric discomfort, joint pain, etc. Conclusion: In patients with chronic angina and diabetes mellitus Ranolazine 500mg BD and Trimetazidine 35mg BD did not show any effect on HbA1c and fasting blood glucose lebel. PMID:25738014

Dkhar, Steven Aibor; Pillai, Ajith Ananthakrishna; George, Melvin; Jayaraman, Balachander; Chandrasekaran, Adithan

2015-01-01

180

The emerging role of telemedicine in managing glycemic control and psychobehavioral aspects of pregnancy complicated by diabetes.  

PubMed

There is a gradual decline in concern of specialists who follow up the care of pregnant women with diabetes. In addition, due to the dwindling economic resources allocated to health services, access to specialized healthcare facilities is becoming more difficult. Telemedicine, or medicine practiced at a distance, is inserted in this context with applications differing for type of interaction (real-time or deferred, i.e., videoconferencing versus store-and-forward data transmission), type of monitoring (automatic versus requesting cooperation from the patient), and type of devices used (web connections and use of mobile phones or smartphones). Telemedicine can cope with the current lack of ability to ensure these patients frequent direct contact with their caregivers. This approach may have an impact not only on the classical maternal-fetal outcome, but also on some underestimated aspects of patients with diabetes in pregnancy, in this case their quality of life, the perception of "diabetes self-efficacy," and the glycemic variability. In this paper, we will analyze the current evidence regarding the use of telemedicine in pregnancies complicated by diabetes, trying to highlight the main limitations of these studies and possible strategies to overcome them in order to improve the effectiveness of future clinical interventions with these medical applications. PMID:25295059

Chilelli, Nino Cristiano; Dalfrà, Maria Grazia; Lapolla, Annunziata

2014-01-01

181

The Emerging Role of Telemedicine in Managing Glycemic Control and Psychobehavioral Aspects of Pregnancy Complicated by Diabetes  

PubMed Central

There is a gradual decline in concern of specialists who follow up the care of pregnant women with diabetes. In addition, due to the dwindling economic resources allocated to health services, access to specialized healthcare facilities is becoming more difficult. Telemedicine, or medicine practiced at a distance, is inserted in this context with applications differing for type of interaction (real-time or deferred, i.e., videoconferencing versus store-and-forward data transmission), type of monitoring (automatic versus requesting cooperation from the patient), and type of devices used (web connections and use of mobile phones or smartphones). Telemedicine can cope with the current lack of ability to ensure these patients frequent direct contact with their caregivers. This approach may have an impact not only on the classical maternal-fetal outcome, but also on some underestimated aspects of patients with diabetes in pregnancy, in this case their quality of life, the perception of “diabetes self-efficacy,” and the glycemic variability. In this paper, we will analyze the current evidence regarding the use of telemedicine in pregnancies complicated by diabetes, trying to highlight the main limitations of these studies and possible strategies to overcome them in order to improve the effectiveness of future clinical interventions with these medical applications. PMID:25295059

Chilelli, Nino Cristiano; Dalfrà, Maria Grazia; Lapolla, Annunziata

2014-01-01

182

Evaluation of the Long-Term Durability and Glycemic Control of Fasting Plasma Glucose and Glycosylated Hemoglobin for Pioglitazone in Japanese Patients with Type 2 Diabetes  

PubMed Central

Abstract Background: This study applied a pharmacodynamic model-based approach to evaluate the long-term durability and glycemic control of pioglitazone in comparison with other oral glucose-lowering drugs in Japanese type 2 diabetes mellitus (T2DM) patients. Subjects and Methods: Japanese T2DM patients were enrolled in a prospective, randomized, open-label, blinded-end point study and received pioglitazone with or without other oral glucose-lowering drugs (excluding another thiazolidinedione [TZD]) (n=293) or oral glucose-lowering drugs excluding TZD (n=294). Treatment was adjusted to achieve glycosylated hemoglobin (HbA1c) <6.9%, and samples for fasting plasma glucose (FPG) and HbA1c were collected over 2.5–4 years. A simultaneous cascading indirect response model structure was applied to describe the time course of FPG and HbA1c. HbA1c levels were described using both an FPG-dependent and an FPG-independent function. To account for titration, drug effects for both treatment groups were implemented using a time-dependent Emax model. Results: Pioglitazone was superior in both time to maximum effect and the magnitude of reduction achieved in FPG and HbA1c. A greater reduction in median FPG (–21?mg/dL vs. ?9?mg/dL) was observed with pioglitazone (P<0.05). Maximum drug effect for FPG was predicted to occur earlier (11 months) for pioglitazone than for the control group (14 months). The simulated additional reduction in FPG and HbA1c achieved with pioglitazone was predicted to be maintained beyond the currently observed study duration. Conclusions: Pioglitazone was found to result in improved glycemic control and durability compared with control treatment. This model-based approach enabled the quantification of differences in FPG and HbA1c for both treatment groups and simulation to evaluate longer-term durability on FPG and HbA1c. PMID:25531677

Stringer, Frances; DeJongh, Joost; Koumura, Emiko; Danhof, Meindert; Kaku, Kohei

2015-01-01

183

Effect of varying glycemic index meals on blood glucose control assessed with continuous glucose monitoring in youth with type 1 diabetes on basal-bolus insulin regimens  

Microsoft Academic Search

OBJECTIVE: The purpose of this study was to test the effect of high glycemic index (HGI) and low glycemic index (LGI) meals on blood glucose levels using continuous blood glucose monitoring in youths with type 1 diabetes.\\u000aRESEARCH DESIGN AND METHODS: A total of 20 youths on basal-bolus regimens consumed macronutrient-matched HGI and LGI meals 1 day each in a

Tonja R. Nansel; Lauren A. Gellar; Adrienne McGill

2008-01-01

184

Targeting Dietary Fat or Glycemic Load in the Treatment of Obesity and Type 2 Diabetes: A Randomized Controlled Trial  

PubMed Central

Aims To compare the effects of lifestyle modification programs that prescribe low-glycemic load (GL) vs. low-fat diets in a randomized trial. Methods Seventy-nine obese adults with type 2 diabetes received low-fat or low-GL dietary instruction, delivered in 40-week lifestyle modification programs with identical goals for calorie intake and physical activity. Changes in weight, HbA1c, and other metabolic parameters were compared at weeks 20 and 40. Results Weight loss did not differ between groups at week 20 (low-fat: ?5.7 ± 3.7%, low-GL: ?6.7 ± 4.4%, p = .26) or week 40 (low-fat: ?4.5 ± 7.5%, low-GL: ?6.4 ± 8.2%, p = .28). Adjusting for changes in antidiabetic medications, subjects on the low-GL diet had larger reductions in HbA1c than those on the low-fat diet at week 20 (low-fat: ?0.3 ± 0.6%, low-GL: ?0.7 ± 0.6%, p = .01), and week 40 (low-fat: ?0.1 ± 1.2%, low-GL: ?0.8 ± 1.3%, p = .01). Groups did not differ significantly on any other metabolic outcomes (p ? .06). Conclusions Results suggest that targeting GL, rather than dietary fat, in a low-calorie diet can significantly enhance the effect of weight loss on HbA1c in patients with type 2 diabetes. PMID:21208675

Fabricatore, AN; Wadden, TA; Ebbeling, CB; Thomas, JG; Stallings, VA; Schwartz, S; Ludwig, DS

2011-01-01

185

Efficacy of Continuous Glucose Monitoring in Improving Glycemic Control and Reducing Hypoglycemia: A Systematic Review and Meta-Analysis of Randomized Trials  

PubMed Central

Objective We conducted a systematic review and meta-analysis to assess the efficacy of continuous glucose monitoring (CGM) in improving glycemic control and reducing hypoglycemia compared to self-monitored blood glucose (SMBG). Methods We searched MEDLINE, EMBASE, Cochrane Central, Web of Science, and Scopus for randomized trials of adults and children with type 1 or type 2 diabetes mellitus (T1DM or T2DM). Pairs of reviewers independently selected studies, assessed methodological quality, and extracted data. Meta-analytic estimates of treatment effects were generated using a random-effects model. Results Nineteen trials were eligible and provided data for meta-analysis. Overall, CGM was associated with a significant reduction in mean hemoglobin A1c [HbA1c; weighted mean difference (WMD) of -0.27% (95% confidence interval [CI] -0.44 to -0.10)]. This was true for adults with T1DM as well as T2DM [WMD -0.50% (95% CI -0.69 to -0.30) and -0.70 (95% CI, -1.14 to -0.27), respectively]. No significant effect was noted in children and adolescents. There was no significant difference in HbA1c reduction between studies of real-time versus non-realtime devices (WMD -0.22%, 95% CI, -0.59 to 0.15 versus -0.30%, 95% CI, -0.49 to -0.10; p for interaction 0.71). The quality of evidence was moderate due to imprecision, suggesting increased risk for bias. Data for the incidence of severe or nocturnal hypoglycemia were sparse and imprecise. In studies that reported patient satisfaction, users felt confident about the device and gave positive reviews. Conclusion Continuous glucose monitoring seems to help improve glycemic control in adults with T1DM and T2DM. The effect on hypoglycemia incidence is imprecise and unclear. Larger trials with longer follow-up are needed to assess the efficacy of CGM in reducing patient-important complications without significantly increasing the burden of care for patients with diabetes. PMID:21880239

Gandhi, Gunjan Y; Kovalaske, Michelle; Kudva, Yogish; Walsh, Kristin; Elamin, Mohamed B; Beers, Melody; Coyle, Cathy; Goalen, Melissa; Murad, Mohammad Safwan; Erwin, Patricia J; Corpus, Joshua; Montori, Victor M; Murad, M. Hassan

2011-01-01

186

Glycemic control, growth and complications in children with insulin-dependent diabetes mellitus — a study of children enrolled in a Summer camp program for diabetics in Kinki district, Japan  

Microsoft Academic Search

The influence of glycemic control on growth and on the development of complications in diabetic children was studied. The subjects of the study were 107 children with insulin-dependent diabetes mellitus (IDDM), who were enrolled in a Summer camp program for diabetic children in Kinki District, Japan from 1972 to 1990, and who had at least three determinations of HbA1 during

Kanji Izumi; Mitsuru Hoshi; Shotaro Kuno; Giichi Okuno; Yoshimitsu Yamazaki; Gen Isshiki; Akira Sasaki

1995-01-01

187

Metformin powder formulation compared to metformin tablets on glycemic control and on treatment satisfaction in subjects with type 2 diabetes mellitus.  

PubMed

The aim of this study was to evaluate if the new metformin powder formulation improves the treatment satisfaction in patients with type 2 diabetes, in a case-control clinical trial. We enrolled 602 subjects in therapy with metformin in tablets formulation and instructed them to take the same dose of metformin in the new powder formulation. At baseline, and after 6 months since the assumption of metformin powder, each patient answered the following questionnaires: the SF-36 Health Survey, the Diabetes Quality Of Life questionnaire Modified (DQOL/Mod), and the Diabetes Treatment Satisfaction Questionnaire (DTSQ). We also assessed the following at baseline, at 3 and 6 months: fasting plasma glucose (FPG) and postprandial glucose (PPG), glycated hemoglobin (HbA1c ), fasting plasma insulin (FPI), and homeostasis model assessment index of insulin resistance (HOMA-IR). We observed a statistically significant reduction in HbA1c , FPG, PPG, FPI, and HOMA-IR (P?glycemic control suggests a better adherence to the powder formulation. PMID:25328091

Derosa, Giuseppe; Romano, Davide; Bianchi, Lucio; D'Angelo, Angela; Maffioli, Pamela

2015-04-01

188

Dose- and Time-Dependent Association of Smoking and Its Cessation with Glycemic Control and Insulin Resistance in Male Patients with Type 2 Diabetes Mellitus: The Fukuoka Diabetes Registry  

PubMed Central

Objective Cigarette smoking is an important modifiable risk factor for cardiovascular diseases. However, the effect of smoking and its cessation on glycemic control in diabetic patients has not been fully examined yet. The aim of the present study was to examine the association of smoking status with glycemic level and markers of insulin resistance and secretion in patients with type 2 diabetes mellitus. Research Design and Methods A total of 2,490 Japanese male patients with type 2 diabetes mellitus aged ?20 years were divided according to smoking status, amount of cigarettes smoked and years since quitting. The associations with glycemic level and markers of insulin resistance and secretion were examined cross-sectionally. Results HbA1c levels increased progressively with increases in both number of cigarettes per day and pack-years of cigarette smoking compared with never smokers (P for trend = 0.001 and <0.001, respectively), whereas fasting plasma glucose did not. On the other hand, HbA1c, but not fasting plasma glucose, decreased linearly with increase in years after smoking cessation (P for trend <0.001). These graded relationships persisted significantly after controlling for the confounders, including total energy intake, current drinking, regular exercise, depressive symptoms, and BMI. In addition, a homeostasis model assessment of insulin resistance and high-sensitivity C-reactive protein also showed similar trends. Conclusions Smoking and its cessation showed dose- and time-dependent relationship with glycemic control and insulin resistance in patients with type 2 diabetes mellitus. These findings may highlight the importance of smoking cessation in the clinical management of diabetes mellitus. PMID:25822499

Ohkuma, Toshiaki; Iwase, Masanori; Fujii, Hiroki; Kaizu, Shinako; Ide, Hitoshi; Jodai, Tamaki; Kikuchi, Yohei; Idewaki, Yasuhiro; Hirakawa, Yoichiro; Nakamura, Udai; Kitazono, Takanari

2015-01-01

189

A randomized controlled trial to investigate the impact of a low glycemic index (GI) diet on body mass index in obese adolescents  

PubMed Central

Background The role of a low glycemic index (GI) diet in the management of adolescent obesity remains controversial. In this study, we aim to evaluate the impact of low GI diet versus a conventional Chinese diet on the body mass index (BMI) and other obesity indices of obese adolescents. Methods Obese adolescents aged 15–18 years were identified from population-recruited, territory-wide surveys. Obesity was defined as BMI ?95th percentile of Hong Kong local age- and sex-specific references. Eligible subjects were randomized to either an intervention with low GI diet (consisting of 45-50% carbohydrate, 30-35% fat and 15-20% protein) or conventional Chinese diet as control (consisting of 55-60% carbohydrate, 25-30% fat and 10-15% protein). We used random intercept mixed effects model to compare the differential changes across the time points from baseline to month 6 between the 2 groups. Results 104 obese adolescents were recruited (52 in low GI group and 52 in control group; 43.3% boys). Mean age was 16.7?±?1.0 years and 16.8 ±1.0 years in low GI and control group respectively. 58.7% subjects completed the study at 6 months (65.4% in low GI group and 51.9% in control group). After adjustment for age and sex, subjects in the low GI group had a significantly greater reduction in obesity indices including BMI, body weight and waist circumference (WC) compared to subjects in the control group (all p <0.05). After further adjustment for physical activity levels, WC was found to be significantly lower in the low GI group compared to the conventional group (p?=?0.018). Conclusion Low GI diet in the context of a comprehensive lifestyle modification program may be an alternative to conventional diet in the management of obese adolescents. Trial registration number ClinicalTrials.gov Ref. No: NCT01278563 PMID:24552366

2014-01-01

190

Super long-term glycemic control in diabetic rats by glucose-sensitive LbL films constructed of supramolecular insulin assembly.  

PubMed

The supramolecular assembly of porcine insulin (P-SIA) is prepared at moderate condition and monitored by Thioflavin T fluorescence to avoid the formation of mature amyloid fibrils with ?-sheet rich structure. P-SIA is characterized in terms of structure, morphology and the capability of sustained insulin release in vitro. Then, a glucose-sensitive layer-by-layer (LbL) film is fabricated with star poly[2-(dimethylamino)ethyl methacrylate] (star-PDMAEMA), glucose oxidase (GOD), catalase (CAT) and P-SIA in the form of {(Star-PDMAEMA/P-SIA)(2) + (Star-PDMAEMA/CAT)(1) + (Star-PDMAEMA/GOD)(2)}(2) + Star-PDMAEMA, in which the CAT is introduced to eliminate the aggregated H(2)O(2) and maintain the activity of GOD in the long release time. Within the scope of the investigation, a single dose administration could provide effective glycemic control in diabetic rats for up to 295 days without hypoglycemia. The striking result is contributed both by the inherent property of P-SIA and the glucose-sensitive regulation capability of the LbL film, for which the mechanism was thoroughly investigated both in vitro and in vivo. These findings are valuable to inspire more researches to combine supramolecular insulin assembly with various functional drug delivery systems, biochemical additives, biomaterials and biomedical devices for diabetic therapy. PMID:22954517

Luo, Jun; Cao, Shuqin; Chen, Xingyu; Liu, Shuning; Tan, Hong; Wu, Wei; Li, Jianshu

2012-11-01

191

Glycemic Control Outcomes by Gender in the Pay-for-Performance System: A Retrospective Database Analysis in Patients with Type 2 Diabetes Mellitus.  

PubMed

Background. The purpose of this study was to investigate how the degree of glycemic control in patients with type 2 diabetes associated with lifestyle interventions as well as sociodemographic factors and further examine the differences by gender. Methods. This was a retrospective study using data collected from a diabetes quality improvement plan that began in 2002 in a medical center in Taiwan. Statistic analysis was used to determine the associations of sociodemographic data, lifestyle intervention, and treatment regimens with changes in HbA1c levels (between the initial visit and the latest follow-up measured level), and the differences were then sorted by the sex of the patients. Results. Our results showed that HbA1c averaged 7.50% for males and 7.80% for females at the initial visit, compared to levels averaging 7.50% for males and 7.70% for females at the most recent follow-up visit. There was no significant change (P = 0.541) in HbA1c in males, but there was a 0.10% (P = 0.384) reduction in females. The duration of the diabetes and medication regimen was associated with the decrease seen in the females. Conclusions. The results of these analyses provide important insights for policy makers to formulate healthcare policies related to chronic diseases or illnesses. PMID:25202328

Yuan, Shao-Ping; Huang, Chien-Ning; Liao, Hung-Chang; Lin, Yu-Tzu; Wang, Ya-Huei

2014-01-01

192

DNA Aptamer Raised Against Advanced Glycation End Products (AGEs) Improves Glycemic Control and Decreases Adipocyte Size in Fructose-Fed Rats by Suppressing AGE-RAGE Axis.  

PubMed

Advanced glycation end products (AGEs) decrease adiponectin expression and suppress insulin signaling in cultured adipocytes through the interaction with a receptor for AGEs (RAGE) via oxidative stress generation. We have recently found that high-affinity DNA aptamer directed against AGE (AGE-aptamer) prevents the progression of experimental diabetic nephropathy by blocking the harmful actions of AGEs in the kidney. This study examined the effects of AGE-aptamer on adipocyte remodeling, AGE-RAGE-oxidative stress axis, and adiponectin expression in fructose-fed rats. Although AGE-aptamer treatment by an osmotic mini pump for 8 weeks did not affect serum insulin levels, it significantly decreased average fasting blood glucose and had a tendency to inhibit body weight gain in fructose-fed rats. Furthermore, AGE-aptamer significantly suppressed the increase in adipocyte size and prevented the elevation in AGEs, RAGE, and an oxidative stress marker, 8-hydroxydeoxyguanosine (8-OHdG), levels in adipose tissues of fructose-fed rats at 14-week-old, while it restored the decrease in adiponectin mRNA levels. Our present study suggests that AGE-aptamer could improve glycemic control and prevent adipocyte remodeling in fructose-fed rats partly by suppressing the AGE-RAGE-mediated oxidative stress generation. AGE-aptamer might be a novel therapeutic strategy for fructose-induced metabolic derangements. PMID:25105541

Ojima, A; Matsui, T; Nakamura, N; Higashimoto, Y; Ueda, S; Fukami, K; Okuda, S; Yamagishi, S

2015-04-01

193

Dietary Glycemic Index of Human Immunodeficiency Virus–Positive Men with and without Fat Deposition  

Microsoft Academic Search

This study focused on dietary glycemic index because insulin resistance can be important in the pathogenesis of fat deposition in human immunodeficiency virus (HIV). We evaluated differences in past dietary glycemic intake between men with HIV who developed fat deposition and those who did not. This was a nested case-control study consisting of 37 cases and 37 controls from the

Kimberly R. Dong; Christine A. Wanke; Alice M. Tang; Bei Ding; Kristy M. Hendricks

2006-01-01

194

Glycemic management of diabetes by insulin therapy.  

PubMed

Recent technological innovations as insulin analogue formulation, devices for insulin delivery and glucose monitoring have allowed diabetic patients to improve their glycemic control and decrease their level of burden due to diabetes. Intensive insulin therapy via insulin pens, subcutaneous or intraperitoneal insulin infusions using pumps instead of vials and syringes, are associated with improved absorption reproducibility, HbA1c levels, reduced risk of hypo- or hyperglycemia, and increased quality of patient's life. These currently used systems are discussed in this review as well as the future of exogenous insulin therapy: closed loop system, the artificial pancreas, and oral insulin delivery. Glucose homeostasis is directly linked to glycemic regulated by portal insulin administration, thus endogenous insulin therapy might be the most promising treatment to "cure" diabetes. Consequently, pancreas and islet transplantation, and the bioartificial pancreas are described. PMID:23435441

Reix, N; Sigrist, S; Heurtault, B; Agin, A; Moreau, F; Pinget, M; Jeandidier, N

2013-03-01

195

Low-Glycemic Diets May Not Improve Cardiovascular Outcomes When Compared to High-Glycemic Diets  

MedlinePLUS

... 4 p.m. EST Low-glycemic diets may not improve cardiovascular outcomes when compared to high-glycemic ... using the glycemic index to select foods may not improve insulin sensitivity, lower HDL or LDL lipid ...

196

Glycemic variability and outcome in critically ill  

PubMed Central

Background: Acute hyperglycemia, hypoglycemia and glycemic variability (GV) have been found to be the three principal domains of glycemic control, which can adversely affect patient outcome. GV may be the confounding factor in tight glycemic control trials in surgical and medical patient. Objective: This study was conducted to establish if there was any relationship between GV and intensive care unit (ICU) mortality in the Indian context. Study Design: A retrospective review of a large cohort of prospectively collected database. Setting: Adult Medical/Surgical/Trauma/Neuro ICU of a tertiary care hospital. Patient Population: All patients who had four or more blood glucose measured during the ICU stay. Outcome: ICU mortality. Result: 2208 patients with a total of 11,335 blood glucose values were analyzed. GV measured by the standard deviation (SD) of mean blood glucose and glycemic lability index (GLI), both were significantly (P < 0.001) associated with ICU mortality. This relationship was maintained (odds ratio (OR): 2.023, 95% confidence interval (CI): 1.483-2.758) even after excluding patients with hypoglycemia (<60 mg/dl). Patients with blood glucose values in the euglycemic range but highest SD had higher mortality (54%) compared to mortality (24%) in patients above the euglycemic range. Similarly patients with blood sugar values below the average for study cohort and high GLI, another marker of GV had higher mortality (OR: 5.62, CI: 3.865-8.198) than compared to patients in the hyperglycemic range, reflecting the importance of GV as a prognostic marker in patients with blood sugar in the euglycemic range. Conclusion: This study demonstrated that high glucose variability is associated with increased ICU mortality in a large heterogeneous cohort of ICU patients. This effect was particularly evident among patients in the euglycemic range. PMID:24914256

Todi, Subhash; Bhattacharya, Mahuya

2014-01-01

197

Improved Glycemic Control through Continuous Glucose Sensor-Augmented Insulin Pump Therapy: Prospective Results from a Community and Academic Practice Patient Registry  

PubMed Central

Background Conducted by highly experienced investigators with abundant time and resources, phase III studies of continuous glucose sensing (CGS) may lack generalizability to everyday clinical practice. Method Community or academic practices in six Central and Eastern European or Mediterranean countries prospectively established an anonymized registry of consecutive patients with type 1 insulin-dependent diabetes mellitus starting CGS-augmented insulin pump therapy with the Paradigm® X22 (Medtronic MiniMed, Northridge, CA) under everyday conditions, without prior CGS with another device. We compared glycosylated hemoglobin (GHb) values before and after 3 months of CGS and assessed relationships between insulin therapy variables and glycemia-related variables at weeks 1, 4, and 12 of CGS. Results Of 102 enrolled patients, 85 (83%) with complete weeks 1, 4, and 12 sensor data and baseline/3-month GHb data were evaluable. Evaluable patients were ?54% male and ?75% adult (mean age, 33.2 ± 16.9 years) with longstanding diabetes and high personal/family education levels. Mean GHb declined significantly after 3 months of CGS (7.55 ± 1.33% at baseline to 6.81 ± 1.08% after 12 weeks, 0.74% absolute decrease, P < 0.001). The absolute GHb reduction correlated significantly (P < 0.0005) with baseline GHb: larger absolute reductions tended to occur when baseline levels were higher. An increased basal insulin dose as a percentage of the total daily insulin dose and a decreased daily bolus count from week 1 to week 12 of CGS predicted GHb improvement from baseline to week 12. Conclusions CGS-augmented insulin pump therapy appears to improve glycemic control in type 1 diabetes in varied everyday practice settings. PMID:20144331

Cohen, Ohad; Körner, Anna; Chlup, Rudolf; Zoupas, Christos S.; Ragozin, Anton K.; Wudi, Krisztina; Bartaskova, Dagmar; Pappas, Aggelos; Niederland, Tamás; Taybani, Zoltán; Barák, Lubomir; Vazeou, Andriani

2009-01-01

198

A Comparison of Food-grade Folium mori (?? S?ng Yè) Extract and 1-Deoxynojirimycin for Glycemic Control and Renal Function in Streptozotocin-induced Diabetic Rats  

PubMed Central

Folium mori (?? S?ng Yè, leaf of Morus alba L.; FM) is known to possess hypoglycemic effects, and 1-deoxynojirimycin (1-DNJ) has been proposed as an important functional compound in FM. However, the hypoglycemic activity of purified 1-DNJ has been rarely studied. It is also not known how FM and 1-DNJ affect the development of DM nephropathy. This study compared the antidiabetic effect of a commercial FM product with that of purified 1-DNJ in streptozotocin-induced diabetic rats. Seven days after induction, the diabetic rats were gavaged with FM (1, 3, 10, and 30 mg/kg/day), 1-DNJ (30 mg/kg/day), or vehicle (distilled deionized water; 2 ml/kg/day) for 7 days. All doses of FM ameliorated fasting and post-prandial blood glucose concomitantly with an increase in peripheral and pancreatic levels of insulin and improved homeostasis model assessment (HOMA-IR) in diabetic rats in a dose-dependent manner. Increased thiobarbituric acid reactive substances (TBARS) and nitrate/nitrite levels in the kidney, liver, and muscle of diabetic rats were reversed by all doses of FM. The renal function of the diabetic rats was normalized by all doses of FM, while blood pressure changes were reversed by FM at doses of 3 mg/kg and above. Moreover, most of the above-mentioned parameters were improved by FM at doses of 3 mg/kg and above to a similar extent as that of 1-DNJ. The results showed superior antidiabetic potential of the commercial FM product for glycemic control and protection against the development of diabetic nephropathy. PMID:25161921

Huang, Shiang-Suo; Yan, Yi-Hui; Ko, Chien-Hui; Chen, Ke-Ming; Lee, Shih-Chieh; Liu, Cheng-Tzu

2014-01-01

199

Insulin pump use and glycemic control in adolescents with type 1 diabetes: Predictors of change in method of insulin delivery across two years.  

PubMed

Few studies have explored durability of insulin pump use, and none have explored the link between depression and pump discontinuation. To examine the relationship between depressive symptoms [measured by the Children's Depression Inventory (CDI)], method of insulin delivery, and hemoglobin A1c (A1c), mixed models were used with data from 150 adolescents with type 1 diabetes (T1D) and visits every 6?months for 2?years. Of the 63% who used a pump, compared with multiple daily injections (MDI) at baseline, there were higher proportions who were non-minorities, had caregivers with a college degree, private insurance, and two caregivers in the home (p???0.01). After adjusting for time, sex, age, T1D duration, frequency of blood glucose monitoring, ethnicity, insurance, and caregiver number and education, baseline pump use was associated with -0.79% lower mean A1c [95% confidence interval (CI): -1.48, -0.096; p?=?0.03]. For those using a pump at baseline, but switching to MDI during the study (n?=?9), mean A1c was 1.38% higher (95% CI: 0.68, 2.08; p?glycemic control. PMID:25387433

Wong, Jenise C; Dolan, Lawrence M; Yang, Tony T; Hood, Korey K

2014-11-10

200

Differentiating Approaches to Diabetes Self-Management of Multi-Ethnic Rural Older Adults at the Extremes of Glycemic Control  

ERIC Educational Resources Information Center

Purpose of the Study: This study identified approaches to diabetes self-management that differentiate persons with well-controlled from poorly controlled diabetes. Previous research has focused largely on persons participating in self-management interventions. Design and Methods: In-depth qualitative interviews were conducted with 48 adults, drawn…

Brewer-Lowry, Aleshia Nichol; Arcury, Thomas A.; Bell, Ronny A.; Quandt, Sara A.

2010-01-01

201

Blood Glucose Monitoring and Glycemic Control in Adolescence: Contribution of Diabetes-Specific Responsibility and Family Conflict  

Microsoft Academic Search

PurposeTo examine age and time trends in responsibility for diabetes management tasks and diabetes-specific family conflict and their relationship to blood glucose monitoring (BGM) frequency and blood glucose control (HbA1c).

Lisa M. Ingerski; Barbara J. Anderson; Lawrence M. Dolan; Korey K. Hood

2010-01-01

202

[Improvement in glycemic control, cardiovascular risk factors and anthropometric data in type 2 diabetic patients after the switch from biphasic human insulin to biphasic premix analog insulin aspart].  

PubMed

Long-term studies involving large number of type 2 diabetic patients supplied evidence that constant adequate metabolic control may prevent the late (micro- and macrovascular) diabetic complications. In the present non-interventional, retrospective study, authors performed an analysis of type 2 diabetic patients who had been previously treated with biphasic human insulin (BHI) and their therapy was changed to biphasic analog insulin aspart 30/70 (BIAsp = NovoMix 30). The switch of the insulin therapy was carried out in years 2007 and 2008 with the cooperation of 50 accredited diabetes centers. Data were obtained at the time of therapeutical change and six months later. The number of suitable patients was 2898 with an age of 66.20 +/- 10.10 year, and the duration of diabetes was >10 years in 43% of the patients. After the six-month therapy with NovoMix 30, the mean HbA 1c level decreased statistically significantly from the initial value of 9.10 +/- 1.44% to 7.62 +/- 1.00% ( p < 0.001). The lipid profile also improved although target values were not always attained. A reduction was also observed in both systolic and diastolic blood pressure. Mean body weight decreased from 84.2 +/- 14.9 kg to 82.6 +/- 13.9 kg ( p < 0.01). All these changes occurred in spite of a significantly reduced daily insulin dose (48.4 +/- 17.6 IU) as compared with the initial value (49.0 +/- 17.4 IU, p < 0.001). A marked decrement was also observed in the frequency of hypoglycemic reactions. These results confirm that treatment with NovoMix 30 insulin leads to a significant amelioration of glycemic control as reflected by the decreased level of HbA 1c and the higher proportion of patients attaining the target value, as well as the lower frequency of hypoglycemic episodes. The significant improvements in cardiovascular risk factors are also important, but the explanation is still missing and would require the accomplishment of prospective, controlled studies. PMID:19692308

Gero, László; Gyimesi, András; Hidvégi, Tibor; Jánosi, István

2009-08-30

203

Grapefruit juice improves glycemic control but exacerbates metformin-induced lactic acidosis in non-diabetic rats.  

PubMed

Recent clinical studies have indicated that grapefruit juice (GFJ) improves insulin resistance and reduces weight gain in humans. The effect of GFJ on glucose tolerance and metformin-induced lactic acidosis in normal, non-diabetic in rats is hereby investigated. Three groups (A, B, C) of 20 male Wistar rats each, were treated with stepwise, escalated oral doses of 0, 1.0, 2.0, 3.0 (group A), and 3.0 ml/kg body weight (groups B and C) of GFJ. Group C rats additionally received 250 mg/kg body weight of metformin. All the animals were sacrificed after 14 days of treatment. Fasting blood glucose levels were significantly (P < 0.0001) lower in GFJ-treated test (2.9 +/- 0.4 mmol/L) compared with control (3.7 +/- 0.39 mmol/L) rats, but 1.5-hr plasma insulin levels were similar. GFJ alone or in combination with metformin, significantly (P < 0.05) lowered blood glucose levels compared with control animals. Blood lactic acid levels were similar in GFJ-treated test (2.81 +/- 1.4 mmol/L) and control (2.54 +/- 0.7 mmol/L) rats, respectively, but were significantly increased (P = 0.0079) in rats that were treated with either metformin alone (5.38 +/- 2.53 mmol/L) or in combination with GFJ (8.31 +/- 3.48 mmol/L). Metformin concentration in liver tissue was significantly higher (P < 0.05) in GFJ-treated (397 +/- 19 microg/g) than in control (280 +/- 15 microg/g) rats, respectively. Plasma metformin levels were comparable between the control (95 +/- 8.1 microg/ml) and GFJ-treated test (108 +/- 20 microg/ml) rats, respectively. Liver tissue metformin concentrations and plasma lactic acid levels showed significant correlation in both control (P = 0.0122; r(2) = 0.9080) and GFJ-treated test rats (P = 0.0005; r(2) = 0.9893). Although GFJ may be beneficial to diabetic patients, it may exacerbate lactic acidosis in diabetic patients taking metformin concurrently. PMID:20094639

Owira, P M O; Ojewole, J A O

2009-11-01

204

The effect of purslane seeds on glycemic status and lipid profiles of persons with type 2 diabetes: A randomized controlled cross-over clinical trial  

PubMed Central

Background: We are aware of limited data about the effects of purslane on diabetes. Earlier studies have mostly indicated the beneficial effects in animal models. This study aimed to evaluate the effect of purslane seeds on glycemic status and lipid profiles of persons with type 2 diabetes. Materials and Methods: This cross-over randomized controlled clinical trial was conducted on 48 persons with type 2 diabetes. Participants were randomly assigned to receive either 10 g/day purslane seeds with 240 cc low-fat yogurt (intervention group) or only 240 cc low-fat yogurt (as a control group) for 5 weeks. After a 2-week washout period, subjects were moved to the alternate arm for an additional 5 weeks. At baseline and end of each phase of the study, fasting blood samples were collected to quantify plasma glucose levels, as well as serum insulin and lipid profiles. Within-group and between-group changes in anthropometric measures, as well as biochemical indicators, were compared using a paired-samples t-test. Results: Mean age of study participants was 51.4 ± 6.0 year. We found a significant reduction in weight (?0.57 vs. 0.09 kg, P = 0.003) and body mass index (?0.23 vs. 0.02 kg/m2, P = 0.004) following purslane seeds consumption. Despite a slight reduction in fasting plasma glucose levels (?2.10 vs. ?2.77 mg/dL, P = 0.90), we failed to find any significant effect on serum insulin levels and homeostatic model of assessment of insulin resistance score. Furthermore, purslane consumption decreased serum triglyceride levels (?25.5 vs. ?1.8 mg/dL, P = 0.04) but could not affect serum high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol levels. We observed a significant reduction in systolic blood pressure (?3.33 vs. 0.5 mmHg, P = 0.01) and a borderline significant decrease in diastolic blood pressure (?3.12 vs. ?0.93 mmHg, P = 0.09) after purslane seeds intake. Conclusion: In summary, consumption of purslane seeds for 5 weeks in persons with type 2 diabetes might improve their anthropometric measures, serum triglyceride levels, and blood pressure. Further studies are required to determine the appropriate dosage for these patients.

Esmaillzadeh, Ahmad; Zakizadeh, Elahe; Faghihimani, Elham; Gohari, Mahmoodreza; Jazayeri, Shima

2015-01-01

205

[Acute glycemic control in critically ill perioperative patients; the impact of parenteral nutrition on the effect of intensive insulin therapy].  

PubMed

Hyperglycemia is common in critically ill patients. Recently the international multicentre NICE-SUGAR study reported increased mortality with this approach and recent meta-analyses do not support adopting intensive glucose control for critically ill patients. One possible explanation of the different effect of intensive insulin therapy between Leuven study and NICE-SUGAR study is how aggressively parenteral nutrition was applied. In Leuven study, parenteral nutrition was applied aggressively (total intravenous intake of non-protein calorie; 12-18 kcal x kg(-1) day(-1)), while in NICE-SUGAR study, "permissive hypo-nutrition" (total intravenous intake of non-protein calorie; 1-1.5 kcal x kg(-1) x day(-1)) was applied. As recent meta-analysis showed that the percentage of calories given intravenously was significantly associated with a treatment effect of intensive insulin therapy, this difference might be relevant. Recently, EPaNC trial showed that aggressive parenteral nutrition may increase infection rate and worsen outcomes, even though they apply intensive insulin therapy in all participating patients. The results of the NICE-SUGAR study and EPaNIC trial have resulted in the more moderate recommendation to target a blood glucose concentration between 144 and 180 mg x dl(-1) and less aggressive parenteral nutrition. Until another level I evidence is available, clinicians would be well advised to abide by the age-old adage, "First, do no harm". PMID:22702088

Egi, Moritoki

2012-05-01

206

Glycemic load effect on fasting and post-prandial serum glucose, insulin, IGF-1 and IGFBP-3 in a randomized, controlled feeding study  

PubMed Central

Background/Objectives The effect of a low glycemic load (GL) diet on insulin-like growth factor-1 (IGF-1) concentration is still unknown but may contribute to lower chronic disease risk. We aimed to assess the impact of GL on concentrations of IGF-1 and IGFBP-3. Subjects/Methods We conducted a randomized, controlled crossover feeding trial in 84 overweight-obese and normal weight healthy individuals using two 28-day weight-maintaining high- and low-GL diets. Measures were fasting and post-prandial concentrations of insulin, glucose, IGF-1 and IGFBP-3. 20 participants completed post-prandial testing by consuming a test breakfast at the end of each feeding period. We used paired t-tests for diet-component and linear mixed models for biomarker analyses. Results The 28-day low-GL diet led to 4% lower fasting concentrations of IGF-1 (10.6 ng/mL, p=0.04) and a 4% lower ratio of IGF-1/IGFBP-3 (0.24, p=0.01) compared to the high-GL diet. The low-GL test breakfast led to 43% and 27% lower mean post-prandial glucose and insulin responses, respectively; mean incremental areas under the curve for glucose and insulin, respectively, were 64.3±21.8 (mmol/L/240min) (p<0.01) and 2253±539 (?U/mL/240min) (p<0.01) lower following the low- compared to the high-GL test meal. There was no effect of GL on mean HOMA-IR or on mean integrated post-prandial concentrations of glucose-adjusted insulin, IGF-1 or IGFBP-3. We did not observe modification of the dietary effect by adiposity. Conclusions Low-GL diets resulted in 43% and 27% lower post-prandial responses of glucose and insulin, respectively, and modestly lower fasting IGF-1 concentrations. Further intervention studies are needed to weigh the impact of dietary GL on risk for chronic disease. PMID:22892437

Runchey, Shauna S.; Pollak, Michael N.; Valsta, Liisa M.; Coronado, Gloria D.; Schwarz, Yvonne; Breymeyer, Kara L.; Wang, Chiachi; Wang, Ching-Yun; Lampe, Johanna W.; Neuhouser, Marian L.

2012-01-01

207

Relationship between adherence to diet, glycemic control and cardiovascular risk factors in patients with type 1 diabetes: a nationwide survey in Brazil  

PubMed Central

Background To determine the relationship between adherence to the diet reported by patients with type 1 diabetes under routine clinical care in Brazil, and demographic, socioeconomic status, glycemic control and cardiovascular risk factors. Methods This was a cross-sectional, multicenter study conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. The data was obtained from 3,180 patients, aged 22?±?11.8 years (56.3% females, 57.4% Caucasians and 43.6% non-Caucasians). The mean time since diabetes diagnosis was 11.7?±?8.1 years. Results Overall, 1,722 (54.2%) of the patients reported to be adherent to the diet without difference in gender, duration of diabetes and socioeconomic status. Patients who reported adherence to the diet had lower BMI, HbA1c, triglycerides, LDL-cholesterol, non HDL-cholesterol and diastolic blood pressure and had more HbA1c at goal, performed more frequently self-monitoring of blood glucose (p?

2014-01-01

208

Glycemic and insulinemic responses to carbohydrate rich whole foods.  

PubMed

Glycemic and insulinemic responses to food may depend on several intrinsic factors such as the type of sugar, molecular arrangement, size of starch granules, co-components in the whole food like moisture, fat, protein, fiber, as well as external factors like processing technique and total amount consumed. The postprandial glycemic response to equivalent quantities of test food and standard food is compared using Glycemic Index food (GI food). The incremental area under the curve for blood glucose and insulin at fasting, 30, 60, 90 and 120 min after consumption of different doses (50 and 100 g) of carbohydrate rich foods like rice and chapatti were compared with standard food, white bread. The GI food value for 50 g of chapatti and rice was 44 and 11 respectively. The Insulinemic Index food (II food) values, calculated similarly, for 50 g portion of chapatti and rice were 39 and 6 respectively. Glycemic and insulinemic response showed a dose dependent increase from 50 to 100 g. Both glycemic and insulinemic impact of chapatti were found to be significantly higher than that of rice (p?control. PMID:24493894

Ray, Kasturi Sen; Singhania, Pooja Ratan

2014-02-01

209

Glycemic index in chronic disease: a review  

Microsoft Academic Search

Aim: The intent of this review is to critically analyze the scientific evidence on the role of the glycemic index in chronic Western disease and to discuss the utility of the glycemic index in the prevention and management of these disease states.Background: The glycemic index ranks foods based on their postprandial blood glucose response. Hyperinsulinemia and insulin resistance, as well

LS Augustin; S Franceschi; DJA Jenkins; CWC Kendall; C La Vecchia

2002-01-01

210

Glycemic memory associated epigenetic changes.  

PubMed

It is evident that metabolic memory, whereby diabetic complications continue to develop and progress in individuals who returned to normal glycemic control after a period of transient hyperglycemia, can have long lasting effects. We have primary findings that transient hyperglycemia causes profound transcriptional changes in vascular endothelial cells. We hypothesized that ambient hyperglycemia triggers gene-activating events of the NF?B p65 promoter that are mediated by changes in epigenetic modifications. In a follow-up study we identified two histone-specific writing and erasing enzymes involved in the underlying regulation of gene expression during transient hyperglycemia and subsequent return to normoglycemia. Experimental evidence indicates that previous hyperglycemia is associated with persistent expression of the NF?B p65 gene, which activates NF?B-dependent proteins, such as MCP-1, which are implicated in diabetes-associated vascular injury. Increased gene transcription is correspondent with H3K4m1, but not H3K4m2 and H3K4m3, on the NF?B p65 gene. In vascular endothelial cells the histone methyltransferase Set7 can write the mono-methylation mark H3K4m1 and this methyl-writing enzyme is recruited as a gene co-activator in response to glucose. Furthermore, Set7 knockdown prevents glucose-induced p65 expression. We hypothesize that these molecular events represent an integrated response of the epigenome that lead to changes in the expression of genes and proteins that regulate the development and progression of diabetic vascular complications. Further characterisation of these glucose-induced epigenetic events and the identification of key enzymes involved will improve our understanding of the pathways implicated in diabetic vascular injury. PMID:20599797

Siebel, Andrew L; Fernandez, Ana Z; El-Osta, Assam

2010-12-15

211

Relations between Long-term Glycemic Control and Postoperative Wound and Infectious Complications after Total Knee Arthroplasty in Type 2 Diabetics  

PubMed Central

Background The authors examined whether poor preoperative glucose control, as indicated by the hemoglobin A1c (HbA1c) level of more than 8%, is associated with postoperative wound and infectious complications in diabetic patients that have undergone total knee arthroplasty (TKA). Methods One hundred and sixty-seven TKAs performed in 115 patients with type 2 diabetes mellitus, from January 2001 through March 2007, were retrospectively reviewed. Logistic regression was used to identify the variables that had a significant effect on the risk of wound complications or early deep infection. The variables considered were age, gender, body mass index, comorbidities, operation time, antibiotic-impregnated cement use, amount of blood transfusion, close suction drain use, duration of diabetes, method of diabetes treatment, diabetes complications, and preoperative HbA1c level. Results The overall incidence of wound complications was 6.6% (n = 11) and there were seven cases (4.2%) of early postoperative deep infection. Logistic regression revealed that the independent risk factors of wound complications were preoperative HbA1C ? 8% (odds ratio [OR], 6.07; 95% confidence interval [CI], 1.12 to 33.0) and operation time (OR, 1.01; 95% CI, 1.00 to 1.03). No variable examined was found to be significantly associated with the risk of early postoperative deep infection. Conclusions Poorly controlled hyperglycemia before surgery may increase the incidence of wound complications among diabetic patients after TKA. PMID:23730475

Han, Hyuk-Soo

2013-01-01

212

Effects of switching from prandial premixed insulin therapy to basal plus two times bolus insulin therapy on glycemic control and quality of life in patients with type 2 diabetes mellitus  

PubMed Central

Background The effects of switching from prandial premixed insulin therapy (PPT) injected three times a day to basal plus two times bolus insulin therapy (B2B) on glycemic control and quality of life were investigated in patients with type 2 diabetes mellitus. Methods The clinical course was prospectively observed during the first 16 weeks after switching to B2B (insulin glargine plus insulin glulisine before breakfast and dinner) in 27 subjects previously treated with PPT using 50/50 premixed insulin. The Diabetes Treatment Satisfaction Questionnaire (DTSQ) was administered at the start and end of the study. Results The glycated hemoglobin (HbA1c) level (8.3%±1.8% to 8.2%±1.1%) and the DTSQ score did not change between the start and end of the study. An improvement in HbA1c level was found in nine (33%) subjects. The change in HbA1c showed a significant negative correlation with baseline HbA1c, and was significantly better in patients with a baseline HbA1c >8.0% than in those with an HbA1c ?8.0% (?0.9±2.0 versus 0.3±0.6, respectively, P=0.02). The change in DTSQ score representing treatment satisfaction was significantly greater in patients whose HbA1c level was improved than in those in whom it was not (2.7±3.6 versus ?0.8±3.5, P=0.04). Conclusion B2B was noninferior to PPT with regard to HbA1c levels in patients with type 2 diabetes mellitus. B2B should be considered particularly for subjects whose glycemic control is poor despite PPT. PMID:24790413

Ito, Hiroyuki; Abe, Mariko; Antoku, Shinichi; Omoto, Takashi; Shinozaki, Masahiro; Nishio, Shinya; Mifune, Mizuo; Togane, Michiko

2014-01-01

213

Effects of a low glycemic load or a low-fat dietary intervention on body weight in obese Hispanic American children and adolescents: a randomized controlled trial1234  

PubMed Central

Background: In Hispanic children and adolescents, the prevalence of obesity and insulin resistance is considerably greater than in non-Hispanic white children. A low–glycemic load diet (LGD) has been proposed as an effective dietary intervention for pediatric obesity, but to our knowledge, no published study has examined the effects of an LGD in obese Hispanic children. Objective: We compared the effects of an LGD and a low-fat diet (LFD) on body composition and components of metabolic syndrome in obese Hispanic youth. Design: Obese Hispanic children (7–15 y of age) were randomly assigned to consume an LGD or an LFD in a 2-y intervention program. Body composition and laboratory assessments were obtained at baseline and 3, 12, and 24 mo after intervention. Results: In 113 children who were randomly assigned, 79% of both groups completed 3 mo of treatment; 58% of LGD and 55% of LFD subjects attended 24-mo follow-up. Compared with the LFD, the LGD decreased the glycemic load per kilocalories of reported food intakes in participants at 3 mo (P = 0.02). Both groups had a decreased BMI z score (P < 0.003), which was expressed as a standard z score relative to CDC age- and sex-specific norms, and improved waist circumference and systolic blood pressure (P < 0.05) at 3, 12, and 24 mo after intervention. However, there were no significant differences between groups for changes in BMI, insulin resistance, or components of metabolic syndrome (all P > 0.5). Conclusions: We showed no evidence that an LGD and an LFD differ in efficacy for the reduction of BMI or aspects of metabolic syndrome in obese Hispanic youth. Both diets decreased the BMI z score when prescribed in the context of a culturally adapted, comprehensive weight-reduction program. This trial was registered at clinicaltrials.gov as NCT01068197. PMID:23255569

Mirza, Nazrat M; Palmer, Matilde G; Sinclair, Kelly B; McCarter, Robert; He, Jianping; Ebbeling, Cara B; Ludwig, David S; Yanovski, Jack A

2013-01-01

214

Neural circulatory control during exercise: early insights.  

PubMed

During exercise, the cardiovascular response is rapidly and appropriately matched to the intensity of the physical activity. The autonomic nervous system plays an important role in achieving this closely matched circulatory response by an increase in the sympathetic nerve activity to the heart, blood vessels and adrenal medulla and a decrease in the parasympathetic nerve activity to the heart. Early insights into the mechanisms that controlled these cardiovascular changes during exercise were reported in the 19th century. At that time, two mechanisms were hypothesized to be responsible for these changes. In one mechanism, a signal arising in a central area of the brain causes a parallel activation of skeletal muscle contraction and of autonomic nervous system changes (now termed 'central command'). In the other mechanism, a signal arising in the contracting skeletal muscle causes a reflex activation of the autonomic nervous system changes (now termed 'exercise pressor reflex'). Some important investigators involved in early studies include Johan Johansson, August Krogh, Johannes Lindhard and Horace Smirk. Also, Florence Buchanan and Louis Fridericia should be recognized for their contributions. In more recent years, the important involvement of a third mechanism, the arterial baroreflex, has been elucidated. Since those early insights, experiments in both animals and humans have added important findings that strongly support these early hypotheses. PMID:23261851

Mitchell, Jere H

2013-04-01

215

Dietary glycemic index, glycemic load and incidence of type 2 diabetes in Japanese men and women: the Japan public health center-based prospective study  

PubMed Central

Background Japanese diets contain a relatively high amount of carbohydrates, and its high dietary glycemic index and glycemic load may raise the risk of diabetes in the Japanese population. The current study evaluated the associations between the dietary glycemic index, glycemic load, and the risk of type 2 diabetes in a population based cohort in Japan. Methods We observed 27,769 men and 36,864 women (45–75 y) who participated in the second survey of the Japan Public Health Center-based Prospective Study. The dietary glycemic index and glycemic load were estimated using a food-frequency questionnaire. The development of diabetes was reported in a questionnaire administered five years later, and the associations were analyzed using logistic regression after controlling for age, area, total energy intake, smoking status, family history of diabetes, physical activity, hypertension, BMI, alcohol intake, magnesium, calcium, dietary fiber and coffee intake, and occupation. Results The dietary glycemic load was positively associated with the risk of diabetes among women: the multivariable-adjusted odds ratio comparing the highest vs. the lowest quartile was 1.52 (95% CI, 1.13-2.04; P-trend?=?0.01). The association was implied to be stronger among women with BMI?glycemic index was positively associated with the risk of diabetes among men with a high intake of total fat: the multivariable-adjusted odds ratio comparing the highest vs. the lowest quartile was 1.46 (95% CI, 0.94-2.28; P-trend?=?0.04). Among women with a high total fat intake, those in the first and second quartiles of the dietary glycemic index had a significant reduced risk of diabetes, compared with those in the first quartile who had a lower total fat level (multivariable-adjusted odds ratio?=?0.59 with 95% CI, 0.37-0.94, and odds ratio?=?0.63 with 95% CI, 0.40-0.998 respectively). Conclusions The population-based cohort study in Japan indicated that diets with a high dietary glycemic load increase the risk of type 2 diabetes among women. Total fat intake may modify the association between the dietary glycemic index and the risk of type 2 diabetes among men and women. PMID:24370346

2013-01-01

216

Genetics and early disturbances of breathing control.  

PubMed

Early disturbances in breathing control, including apneas of prematurity and apparently life-threatening events, account for some cases of sudden infant death syndrome and for a rare disorder called congenital central hypoventilation syndrome (CCHS). Data suggesting a genetic basis for CCHS have been obtained. Recently, we found heterozygous de novo mutations of the PHOX2B gene in 18 of 29 individuals with CCHS. Most mutations consisted of five to nine alanine expansions within a 20-residue polyalanine tract, probably resulting from nonhomologous recombination. Other mutations, generally inherited from one of the parents, in the coding regions of genes involved in the endothelin and RET signaling pathways and in the brain-derived-neurotrophic factor (BDNF) gene have been found in a few CCHS patients. Interestingly, all these genes are involved in the development of neural crest cells. Targeted disruption of these genes in mice has provided information on the pathophysiological mechanisms underlying CCHS. Despite the identification of these genes involved in breathing control, none of the genetically engineered mice developed to date replicate the full human CCHS respiratory phenotype. Recent insights into the genetic basis for CCHS may shed light on the genetics of other early disturbances in breathing control, such as apnea of prematurity and sudden infant death syndrome. PMID:14739359

Gaultier, Claude; Amiel, Jeanne; Dauger, Stéphane; Trang, Ha; Lyonnet, Stanislas; Gallego, Jorge; Simonneau, Michel

2004-05-01

217

A randomized controlled trial of the efficacy and safety of twice-daily saxagliptin plus metformin combination therapy in patients with type 2 diabetes and inadequate glycemic control on metformin monotherapy  

PubMed Central

Background To compare the safety and efficacy of saxagliptin 2.5 mg twice daily (BID) versus placebo add-on therapy to metformin immediate release (IR) in patients with type 2 diabetes and inadequate glycemic control with metformin alone. Methods This multicenter, 12-week, double-blind, parallel-group trial enrolled adult outpatients with type 2 diabetes (glycated hemoglobin [HbA1c] 7.0%–10.0%) on stable metformin IR monotherapy (?1500 mg, BID for ?8 weeks). Patients were randomized to double-blind saxagliptin 2.5 mg BID or placebo added on to metformin IR following a 2-week, single-blind, placebo add-on therapy lead-in period. The primary end point was the change from baseline to week 12 in HbA1c. Key secondary end points included change from baseline to week 12 in fasting plasma glucose (FPG) and the proportion of patients achieving HbA1c <7.0% or HbA1c???6.5% at week 12. Efficacy was analyzed in all patients who received randomized study drug with ?1 postbaseline assessment. Safety was assessed in all treated patients. Results In total, 74 patients were randomized to double-blind saxagliptin add-on therapy and 86 to placebo add-on therapy. At week 12, least-squares mean changes (95% CI) from baseline HbA1c (adjusted for baseline HbA1c) were significantly greater (P?=?0.006) in the saxagliptin?+?metformin group -0.56% (-0.74% to -0.38%) versus the placebo?+?metformin group -0.22% (-0.39% to -0.06%). Adjusted mean changes from baseline in FPG were numerically greater with saxagliptin versus placebo; the difference (95% CI) -9.5 mg/dL (-21.7 to 2.7) was not statistically significant (P?=?0.12). A numerically greater proportion of patients in the saxagliptin group than the placebo group achieved HbA1c?glycemic control on metformin monotherapy reduced HbA1c compared with placebo added to metformin, with an adverse events profile similar to placebo and no unexpected safety findings. Trial registration ClinicalTrials.gov NCT00885378 PMID:24565221

2014-01-01

218

Effects of Three Low-Doses of D-Tagatose on Glycemic Control Over Six Months in Subjects with Mild Type 2 Diabetes Mellitus Under Control with Diet and Exercise  

PubMed Central

The primary objective of this study was to evaluate the safety and the effect of D-tagatose on the glycemic control of subjects with type 2 diabetes as determined by HbA1c levels at the end of 6 months of therapy using the subject’s own baseline HbA1c level as a comparator. The determination of the minimal dose required to cause a statistically significant reduction in HbA1c was of particular interest. Eight weeks after screening, the qualifying subjects were randomized to receive one of three doses of D-tagatose: 2.5 g TID, 5.0 g TID or 7.5 g TID. Blood levels of HbA1c, fasting blood glucose concentrations, plasma lipids, changes in body weight, changes in body mass index, and change in insulin levels were checked at each study visit and at the end of the study. Treatment success, as measured by the reduction of HbA1c, was greatest for the 7.5 g D-tagatose dose group, although the difference between the treatments was not statistically significant. For fasting glucose, only the 7.5 g dosage group exhibited reductions from baseline at the 3- and 6-month time points. Mean body weights reduced in a dose-response fashion, with the 5.0 g and the 7.5 g D-tagatose doses providing the greatest reductions. D-tagatose at dosages of 2.5 g, 5.0 g, and 7.5 g TID for six months were well tolerated by this subject population. D-tagatose at 5.0 g TID was the minimal dose required to reduce HbA1c. D-tagatose at 7.5 g TID provided the greatest effect in most measured efficacy parameters. PMID:25580449

Ensor, Mark; Williams, Jarrod; Smith, Rebecca; Banfield, Amy; Lodder, Robert A.

2014-01-01

219

Today`s control systems evolved from early pioneers` dreams  

Microsoft Academic Search

In the last 100 years, power plant controls have evolved from manual operation and simple instruments to automatic state-of-the-art computerized control systems using smart instruments. This article traces the evolution of controls. The topics of the article include early control systems, developments in the early 20th century, Bailey controls, and developments in the late 20th century.

1996-01-01

220

Today`s control systems evolved from early pioneers` dreams  

SciTech Connect

In the last 100 years, power plant controls have evolved from manual operation and simple instruments to automatic state-of-the-art computerized control systems using smart instruments. This article traces the evolution of controls. The topics of the article include early control systems, developments in the early 20th century, Bailey controls, and developments in the late 20th century.

Smith, D.J.

1996-04-01

221

Effect of Probiotic Fermented Milk (Kefir) on Glycemic Control and Lipid Profile In Type 2 Diabetic Patients: A Randomized Double-Blind Placebo-Controlled Clinical Trial  

PubMed Central

Background: Diabetes is a global health problem in the world. Probiotic food has anti-diabetic property. The aim of this trial was to determine the effect of probiotic fermented milk (kefir) on glucose and lipid profile control in patients with type 2 diabetes mellitus. Methods: This randomized double-blind placebo-controlled clinical trial was conducted on 60 diabetic patients aged 35 to 65 years.Patients were randomly and equally (n=30) assigned to consume either probiotic fermented milk (kefir) or conventional fermented milk (dough) for 8 weeks. Probiotic group consumed 600 ml/day probiotic fermented milk containing Lactobacillus casei, Lactobacillus acidophilus and Bifidobacteria and control group consumed 600 ml/day conventional fermented milk.Blood samples tested for fasting blood glucose, HbA1C, triglyceride (TG), total cholesterol, HDL-C and LDL-C at the baseline and end of the study. Results: The comparison of fasting blood glucose between two groups after intervention was statistically significant (P=0.01). After intervention, reduced HbA1C compared with the baseline value in probiotic fermented milk group was statistically significant (P=0.001), also the HbA1C level significantly decreased in probiotic group in comparison with control group (P=0.02) adjusting for serum levels of glucose, baseline values of HbA1c and energy intake according to ANCOVA model. Serum triglyceride, total cholesterol, LDL-cholesterol and HDL- cholesterol levels were not shown significant differences between and within the groups after intervention. Conclusion: Probiotic fermented milk can be useful as a complementary or adjuvant therapy in the treatment of diabetes.

OSTADRAHIMI, Alireza; TAGHIZADEH, Akbar; MOBASSERI, Majid; FARRIN, Nazila; PAYAHOO, Laleh; BEYRAMALIPOOR GHESHLAGHI, Zahra; VAHEDJABBARI, Morteza

2015-01-01

222

Nigella sativa Improves Glycemic Control and Ameliorates Oxidative Stress in Patients with Type 2 Diabetes Mellitus: Placebo Controlled Participant Blinded Clinical Trial  

PubMed Central

Background and Objective Oxidative stress plays an important role in pathogenesis of diabetes mellitus and its complications. Our previous study has shown glucose lowering effect produced by 3 months supplementation of Nigella sativa (NS) in combination with oral hypoglycemic drugs among type 2 diabetics. This study explored the long term glucose lowering effect (over one year) of NS in patients with type 2 diabetes mellitus on oral hypoglycemic drugs and to study its effect on redox status of such patients. Methods 114 type 2 diabetic patients on standard oral hypoglycemic drugs were assigned into 2 groups by convenience. The control group (n = 57) received activated charcoal as placebo and NS group (n = 57) received 2g NS, daily, for one year in addition to their standard medications. Fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), C- peptide, total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase (CAT), glutathione and thiobarbituric acid reactive substances (TBARS) at the baseline, and every 3 months thereafter were determined. Insulin resistance and ?-cell activity were calculated using HOMA 2 calculator. Results Comparison between the two groups showed a significant drop in FBG (from 180±5.75 to 180±5.59 in control Vs from 195±6.57 to 172 ±5.83 in NS group), HbA1c (from 8.2±0.12 to 8.5±0.14 in control VS from 8.6±0.13 to 8.2±0.14 in NS group), and TBARS (from 48.3±6.89 to 52.9 ±5.82 in control VS from 54.1±4.64 to 41.9 ±3.16 in NS group), in addition to a significant elevation in TAC, SOD and glutathione in NS patients compared to controls. In NS group, insulin resistance was significantly lower, while ?-cell activity was significantly higher than the baseline values during the whole treatment period. Conclusion Long term supplementation with Nigella sativa improves glucose homeostasis and enhances antioxidant defense system in type 2 diabetic patients treated with oral hypoglycemic drugs. Trial Registration Clinical Trials Registry-India (CTRI) CTRI/2013/06/003781 PMID:25706772

Kaatabi, Huda; Bamosa, Abdullah Omar; Badar, Ahmed; Al-Elq, Abdulmohsen; Abou-Hozaifa, Bodour; Lebda, Fatma; Al-Khadra, Akram; Al-Almaie, Sameeh

2015-01-01

223

Metabolic effects of a low-glycemic-index diet13  

Microsoft Academic Search

ABSTRACF Six healthy male volunteers underwent 2-wk metabolically controlled high- glycemic-index (GI) and low-GI diets in random order. Over the low-UI diet significant reductions were seen in serum fructosamine (7.0 ± 1.0%, p < 0.01), 12-h blood glucose profile (37 ± 7%, p < 0.01), and total serum cholesterol (1 5 ± 3%, p < 0.01). As a measure of

David JA Jenkins; Gregory R Collier; Anthony Ocana; Gloria Buckley; Yun Lam; Amnon Mayer; Lilian U Thompson

224

The Effects of Berberis vulgaris Fruit Extract on Serum Lipoproteins, apoB, apoA-I, Homocysteine, Glycemic Control and Total Antioxidant Capacity in Type 2 Diabetic Patients.  

PubMed

Type 2 diabetes is a well-known endocrine and metabolic disorder which has reached epidemic proportions worldwide and represents a serious public health concern. Hyperglycemia and dyslipidemia are two major abnormalities which are major cardiovascular risk factors. Berberine is a major alkaloid in Berberis vulgaris fruit extract (BVFE) which have important role in regulation of serum glucose and fat metabolism in-vivo and in-vitro but its role in type 2 diabetes have not been extensively examined. The aim of this study was the effect of BVFE on serum lipoproteins, apoB, apoA-I, homocysteine, glycemic control and total antioxidant capacity in type 2 diabetic patients. In a double-blind randomised clinical trial, 31 diabetic patients were randomly assigned to 3 g/d BVFE or placebo for 3 months. Serum glucose, lipoproteins, apoB, apoA-I, insulin, homocysteine and HbA1c were measured at the baseline and also at the end of the 3(rd) month. At the beginning and end of 1(st), 2(nd) and 3(rd) months, a 24-h dietary recall questionnaire about each patients was completed. Data were analyzed by SPSS version 16. There were significant decreases in serum TG, TC, LDL-c, apo B, glucose, and insulin and also a significant increase in TAC at the end of the study in BVFE group compared to the control group (p = 0.001, p = 0.001, p = 0.001, p = 0.001, p = 0.002, p = 0.01 and p = 0.0001 respectively). There were significant differences in serum TG (p = 0.0001), TC (p = 0.001), LDL-c (p = 0.001), apoB (p = 0.001), glucose (p = 0.002), insulin (p = 0.01), TAC (p = 0.005), and insulin resistance (p = 0.01) between the two groups at the end of the study; but homocysteine, HbA1c and HDL-c showed no significant changes between the two groups at the end of study. The intake of 3 g/d BVFE for 3 months may have benefical effects on lipoproteins, apoproteins, glycemic control and TAC in type 2 diabetic patients. PMID:24250489

Shidfar, Farzad; Ebrahimi, Shima Seyyed; Hosseini, Sharieh; Heydari, Iraj; Shidfar, Shahrzad; Hajhassani, Giti

2012-01-01

225

The Effects of Berberis vulgaris Fruit Extract on Serum Lipoproteins, apoB, apoA-I, Homocysteine, Glycemic Control and Total Antioxidant Capacity in Type 2 Diabetic Patients  

PubMed Central

Type 2 diabetes is a well-known endocrine and metabolic disorder which has reached epidemic proportions worldwide and represents a serious public health concern. Hyperglycemia and dyslipidemia are two major abnormalities which are major cardiovascular risk factors. Berberine is a major alkaloid in Berberis vulgaris fruit extract (BVFE) which have important role in regulation of serum glucose and fat metabolism in-vivo and in-vitro but its role in type 2 diabetes have not been extensively examined. The aim of this study was the effect of BVFE on serum lipoproteins, apoB, apoA-I, homocysteine, glycemic control and total antioxidant capacity in type 2 diabetic patients. In a double-blind randomised clinical trial, 31 diabetic patients were randomly assigned to 3 g/d BVFE or placebo for 3 months. Serum glucose, lipoproteins, apoB, apoA-I, insulin, homocysteine and HbA1c were measured at the baseline and also at the end of the 3rd month. At the beginning and end of 1st, 2nd and 3rd months, a 24-h dietary recall questionnaire about each patients was completed. Data were analyzed by SPSS version 16. There were significant decreases in serum TG, TC, LDL-c, apo B, glucose, and insulin and also a significant increase in TAC at the end of the study in BVFE group compared to the control group (p = 0.001, p = 0.001, p = 0.001, p = 0.001, p = 0.002, p = 0.01 and p = 0.0001 respectively). There were significant differences in serum TG (p = 0.0001), TC (p = 0.001), LDL-c (p = 0.001), apoB (p = 0.001), glucose (p = 0.002), insulin (p = 0.01), TAC (p = 0.005), and insulin resistance (p = 0.01) between the two groups at the end of the study; but homocysteine, HbA1c and HDL-c showed no significant changes between the two groups at the end of study. The intake of 3 g/d BVFE for 3 months may have benefical effects on lipoproteins, apoproteins, glycemic control and TAC in type 2 diabetic patients. PMID:24250489

Shidfar, Farzad; Ebrahimi, Shima Seyyed; Hosseini, Sharieh; Heydari, Iraj; Shidfar, Shahrzad; Hajhassani, Giti

2012-01-01

226

EFFECTS OF DIETARY GLYCEMIC LOAD ON MOOD DURING CALORIC RESTRICTION  

Technology Transfer Automated Retrieval System (TEKTRAN)

A 1-yr randomized hypocaloric trial tested the effects of high glycemic load (HG: 60% high glycemic index carbohydrate, 20% fat, 20% protein) and low glycemic load (LG: 40% lower glycemic index carbohydrate, 30% fat, 30% protein) diets on mood parameters in 28 healthy men and women (mean+/-SD, age 3...

227

Glycemic Index, Glycemic Load, Carbohydrates, and Type 2 Diabetes  

PubMed Central

OBJECTIVE Diets with high glycemic index (GI), with high glycemic load (GL), or high in all carbohydrates may predispose to higher blood glucose and insulin concentrations, glucose intolerance, and risk of type 2 diabetes. We aimed to conduct a systematic literature review and dose–response meta-analysis of evidence from prospective cohorts. RESEARCH DESIGN AND METHODS We searched the Cochrane Library, MEDLINE, MEDLINE in-process, Embase, CAB Abstracts, ISI Web of Science, and BIOSIS for prospective studies of GI, GL, and total carbohydrates in relation to risk of type 2 diabetes up to 17 July 2012. Data were extracted from 24 publications on 21 cohort studies. Studies using different exposure categories were combined on the same scale using linear and nonlinear dose–response trends. Summary relative risks (RRs) were estimated using random-effects meta-analysis. RESULTS The summary RR was 1.08 per 5 GI units (95% CI 1.02–1.15; P = 0.01), 1.03 per 20 GL units (95% CI 1.00–1.05; P = 0.02), and 0.97 per 50 g/day of carbohydrate (95% CI 0.90–1.06; P = 0.5). Dose–response trends were linear for GI and GL but more complex for total carbohydrate intake. Heterogeneity was high for all exposures (I2 >50%), partly accounted for by different covariate adjustment and length of follow-up. CONCLUSIONS Included studies were observational and should be interpreted cautiously. However, our findings are consistent with protective effects of low dietary GI and GL, quantifying the range of intakes associated with lower risk. Future research could focus on the type of sugars and other carbohydrates associated with greatest risk. PMID:24265366

Greenwood, Darren C.; Threapleton, Diane E.; Evans, Charlotte E.L.; Cleghorn, Christine L.; Nykjaer, Camilla; Woodhead, Charlotte; Burley, Victoria J.

2013-01-01

228

Effect of Low- and High-Glycemic Load on Circulating Incretins in a Randomized Clinical Trial  

PubMed Central

Objective Low-glycemic load diets lower post-prandial glucose and insulin responses; however, the effect of glycemic load on circulating incretin concentrations is unclear. We aimed assess effects of dietary glycemic load on fasting and post-prandial glucose, insulin and incretin (i.e., glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1)) concentrations and to examine for effect modification by adiposity. Materials and Methods We conducted a single-center, randomized controlled crossover feeding trial in which a subset of participants had post-prandial testing. Participants were recruited from the local Seattle area. We enrolled 89 overweight-obese (BMI 28.0–39.9 kg/m2) and lean (BMI 18.5–25.0 kg/m2) healthy adults. Participants consumed two 28-day, weight-maintaining high- and low-glycemic load controlled diets in random order. Primary outcome measures were post-prandial circulating concentrations of glucose, insulin, GIP and GLP-1, following a test breakfast. Results Of the 80 participants completing both diet interventions, 16 had incretin testing and comprise the group for analyses. Following each 28-day high- and low-glycemic load diet, mean fasting concentrations of insulin, glucose, GIP and GLP-1 were not significantly different. Mean integrated post-prandial concentrations of glucose, insulin and GIP were higher (1504±476 mg/dL/min, p<0.01; 2012±644 µU/mL/min, p<0.01 and 15517±4062 pg/ml/min, p<0.01, respectively) and GLP-1 was lower (?81.6±38.5 pmol/L/min, p<0.03) following the high-glycemic load breakfast as compared to the low-glycemic load breakfast. Body fat did not significantly modify the effect of glycemic load on metabolic outcomes. Conclusions High-glycemic load diets in weight-maintained healthy individuals leads to higher post-prandial GIP and lower post-prandial GLP-1 concentrations. Future studies evaluating dietary glycemic load manipulation of incretin effects would be helpful for establishing diabetes nutrition guidelines. PMID:22959497

Runchey, Shauna S.; Valsta, Liisa M.; Schwarz, Yvonne; Wang, Chiachi; Song, Xiaoling; Lampe, Johanna W.; Neuhouser, Marian L.

2012-01-01

229

Combined Insulin Pump Therapy with Real-Time Continuous Glucose Monitoring Significantly Improves Glycemic Control Compared to Multiple Daily Injection Therapy in Pump Naïve Patients with Type 1 Diabetes; Single Center Pilot Study Experience  

PubMed Central

Objectives This study assessed the safety and clinical effectiveness of the training protocol for initiating insulin pump therapy with real-time continuous glucose monitoring (MiniMed Paradigm REAL-Time System) in a stepwise approach on pump naive subjects with type 1 diabetes compared to a control group who remained on multiple daily injection (MDI) therapy. Methods This was a 15-week treat-to-target pilot study of 16 adult subjects (n = 50% male, age 45.9 ± 16 years) with type 1 diabetes (duration of diabetes 21.9 ± 11 years) on MDI therapy with hemoglobin A1c levels at or above 7.5% at baseline. Subjects were randomized to either the study arm (using a combined insulin pump and real-time continuous glucose monitoring system) or the control arm [which continued on MDI therapy with self-monitored blood glucose (SMBG) only]. All subjects dosed insulin according to results of SMBG by finger stick and uploaded data into the CareLink data management software. Results Significant improvements in glycemic control were observed from baseline in both study groups—study arm: pre-A1c 9.45 ± 0.55 and post-A1c 7.4 ± 0.66 (p = 0.00037); control arm: pre-A1c 8.58 ± 1.30 and post-A1c 7.5 ±1.01 (p = 0.04). Both arms had no incidence of severe hypoglycemia. Conclusion In this pilot study, the Paradigm REAL-Time System was initiated safely and effectively in type 1 diabetes patients who were pump naïve using a stepwise educational protocol. PMID:19885096

Lee, Scott W.; Sweeney, Tom; Clausen, Debbie; Kolbach, Celia; Hassen, Allen; Firek, Anthony; Brinegar, Charles; Petrofsky, Jerrold

2007-01-01

230

Dietary glycemic load and atherothrombotic risk  

Microsoft Academic Search

Hyperglycemia and hyperinsulinemia are central features of the metabolic syndrome and type 2 diabetes mellitus, which contribute\\u000a to the pathogenesis of coronary heart disease (CHD). Recent data indicate that increased dietary glycemic load (GL) due to\\u000a replacing fats with carbohydrates or increasing intake of rapidly absorbed carbohydrates (ie, high glycemic index [GI]) can create a self-perpetuating insulin resistance state and

Simin Liu; Walter C. Willett

2002-01-01

231

Overall Glycemic Index and Glycemic Load of Vegan Diets in Relation to Plasma Lipoproteins and Triacylglycerols  

Microsoft Academic Search

Background: To investigate the overall glycemic index (GI), glycemic load (GL), and intake of dietary fiber, and to examine the associations between these factors and plasma lipoproteins and triacylglycerols in adult vegans in the German Vegan Study (GVS). Methods: Cross-sectional study, Germany. Healthy men (n = 67) and women (n = 87), who fulfilled the study criteria (vegan diet for

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

2007-01-01

232

Understanding the Glycemic Index and Glycemic Load and Their Practical Applications  

ERIC Educational Resources Information Center

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

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

2009-01-01

233

Multi-Scale Glycemic Variability: A Link to Gray Matter Atrophy and Cognitive Decline in Type 2 Diabetes  

PubMed Central

Objective Type 2 diabetes mellitus (DM) accelerates brain aging and cognitive decline. Complex interactions between hyperglycemia, glycemic variability and brain aging remain unresolved. This study investigated the relationship between glycemic variability at multiple time scales, brain volumes and cognition in type 2 DM. Research Design and Methods Forty-three older adults with and 26 without type 2 DM completed 72-hour continuous glucose monitoring, cognitive tests and anatomical MRI. We described a new analysis of continuous glucose monitoring, termed Multi-Scale glycemic variability (Multi-Scale GV), to examine glycemic variability at multiple time scales. Specifically, Ensemble Empirical Mode Decomposition was used to identify five unique ultradian glycemic variability cycles (GVC1–5) that modulate serum glucose with periods ranging from 0.5–12 hrs. Results Type 2 DM subjects demonstrated greater variability in GVC3–5 (period 2.0–12 hrs) than controls (P<0.0001), during the day as well as during the night. Multi-Scale GV was related to conventional markers of glycemic variability (e.g. standard deviation and mean glycemic excursions), but demonstrated greater sensitivity and specificity to conventional markers, and was associated with worse long-term glycemic control (e.g. fasting glucose and HbA1c). Across all subjects, those with greater glycemic variability within higher frequency cycles (GVC1–3; 0.5–2.0 hrs) had less gray matter within the limbic system and temporo-parietal lobes (e.g. cingulum, insular, hippocampus), and exhibited worse cognitive performance. Specifically within those with type 2 DM, greater glycemic variability in GVC2–3 was associated with worse learning and memory scores. Greater variability in GVC5 was associated with longer DM duration and more depression. These relationships were independent of HbA1c and hypoglycemic episodes. Conclusions Type 2 DM is associated with dysregulation of glycemic variability over multiple scales of time. These time-scale-dependent glycemic fluctuations might contribute to brain atrophy and cognitive outcomes within this vulnerable population. PMID:24475100

Cui, Xingran; Abduljalil, Amir; Manor, Brad D.; Peng, Chung-Kang; Novak, Vera

2014-01-01

234

Progressive zinc-induced changes in glycemic responses in lean and obese LAIN-cp rats  

SciTech Connect

The effect of diet and phenotype on glycemic status was studied in 9-17 week (wk) old female LAIN-cp rats fed isoenergetic diets containing 0, 20 (control), or 100 ppm Zn. At 9, 13 and 17 wks of age, fasting glucose (FG) of obese > lean. At age 13 wks, Fg of obese + 0 ppm Zn < control obese, and by 17 weeks, lean + 0 ppm Zn < controls, consistent with both diet and phenotype effects on FG. Four point glucose tolerance tests were determined via both intraperitoneal (ipGTT) and oral (OGT) routes at periodic intervals. ipGTT glycemic responses of control obese > lean at all ages, and at both 13 and 17 weeks, obese rats fed both 0 ppm and 100 ppm Zn diets had greater glycemic excursions at +30, +60, and +120 minutes than obese controls, and the glycemic excursions became progressively more impaired as the dietary regimens progressed. In contrast, the corresponding plasma glucoses following ipGTT in lean rats fed 0 or 100 ppm Zn diets and the OGT responses of all rats of both phenotypes remained similar to lean controls at those point. Plasma insulin concentrations of obese 0 ppm Zn < controls following ipGTT, and became progressively more impaired in obese rats fed 0 ppm Zn diet as the duration of treatment continued. These observations suggest that the progressive deterioration of glucose homeostasis when fed diets deficient or excessive in Zn content may be due to impaired pancreatic secretion and/or release of insulin.

Zwick, D.; Frimpong, N.A.; Tulp, O.L. (Drexel Univ., Philadelphia, PA (United States))

1991-03-15

235

Mindfulness and Inhibitory Control in Early Adolescence  

ERIC Educational Resources Information Center

This study examined the relationship between the executive control process of inhibition and self-reported dispositional mindfulness, controlling for gender, grade, and cortisol levels in 99 (43% female) fourth- and fifth-graders ([X-bar] = 10.23 years, SD = 0.53). Students completed a measure of mindful attention awareness and a computerized…

Oberle, Eva; Schonert-Reichl, Kimberly A.; Lawlor, Molly Stewart; Thomson, Kimberly C.

2012-01-01

236

One-Year Glycemic Control With a Sulfonylurea Plus Pioglitazone Versus a Sulfonylurea Plus Metformin in Patients With Type 2 Diabetes  

Microsoft Academic Search

OBJECTIVE — The goal was to assess the 1-year efficacy and safety of the addition of pio- glitazone or metformin to existing sulfonylurea (SU) therapy in patients with inadequately controlled type 2 diabetes. RESEARCH DESIGN AND METHODS — In this multicenter, double-blind study, patients were randomized to receive either pioglitazone 15 mg (n 319) or metformin 850 mg (n 320)

MARKOLF HANEFELD; PAOLO BRUNETTI; GUNTRAM H. SCHERNTHANER; DAVID R. MATTHEWS; BERNARD H. CHARBONNEL

2004-01-01

237

Myocardial perfusion imaging for evaluation of suspected ischemia and its relationship with glycemic control in South African subjects with diabetes mellitus  

PubMed Central

Background The relationship between myocardial perfusion imaging (MPI) abnormalities, diabetes mellitus, and glucose control in South African populations is unknown. It was hypothesized that in subjects undergoing MPI for suspected coronary artery disease (CAD), those with diabetes would have more extensive perfusion defects and that diabetes control would influence MPI abnormalities. The aim of this study was to examine the relationship between the severity of CAD diagnosed with MPI in subjects with and without diabetes and to determine the relationship between diabetes control and extent of CAD. Methods This study was a retrospective chart review of 340 subjects in whom MPI scans were performed over a 12-month period. Results Subjects with diabetes had a higher prevalence of abnormal MPI, with more extensive ischemia, compared with subjects without diabetes (85.6% versus 68%; odds ratio 2.81, P<0.01). Glycated hemoglobin ?7.0% was associated with a higher risk of abnormal MPI, with more extensive ischemia, compared with subjects having diabetes and glycated hemoglobin <7.0% (odds ratio 2.46, P=0.03) and those without diabetes (odds ratio 4.55, P=0.0001). Conclusion Subjects with diabetes have more extensive myocardial ischemia when compared with subjects without diabetes. Furthermore, poorer diabetes control is associated with more abnormalities on MPI scanning. PMID:25484596

Shmendi, Akram; Pirie, Fraser; Naidoo, Datshana P; Tlou, Boikhutso; Pilloy, Wilfred; Motala, Ayesha A

2014-01-01

238

Effects of Exenatide (Exendin-4) on Glycemic Control Over 30 Weeks in Patients With Type 2 Diabetes Treated With Metformin and a Sulfonylurea  

Microsoft Academic Search

controlled study was performed in 733 subjects (aged 55 10 years, BMI 33.6 5.7 kg\\/m 2 , A1C 8.5 1.0%; means SD) randomized to 5 g subcutaneous exenatide b.i.d. (arms A and B) or placebo for 4 weeks. Thereafter, arm A remained at 5 g b.i.d. and arm B escalated to 10 g b.i.d. Subjects continued taking their dose of

DAVID M. KENDALL; MATTHEW C. RIDDLE; JULIO ROSENSTOCK; DONGLIANG ZHUANG; DENNIS D. KIM; MARK S. FINEMAN; ALAIN D. BARON

2005-01-01

239

Low-Volume Insulin Degludec 200 Units/mL Once Daily Improves Glycemic Control Similarly to Insulin Glargine With a Low Risk of Hypoglycemia in Insulin-Naïve Patients With Type 2 Diabetes  

PubMed Central

OBJECTIVE The 200 units/mL formulation of insulin degludec (IDeg 200 units/mL) contains equal units of insulin in half the volume compared with the 100 units/mL formulation. We compared the efficacy and safety of IDeg 200 units/mL once daily with 100 units/mL insulin glargine (IGlar) in insulin-naïve subjects with type 2 diabetes (T2DM) inadequately controlled with oral antidiabetic drugs. RESEARCH DESIGN AND METHODS In this 26-week, open-label, treat-to-target trial, subjects (n = 457; mean HbA1c 8.3% [67 mmol/mol], BMI 32.4 kg/m2, and fasting plasma glucose [FPG] 9.6 mmol/L [173.2 mg/dL]) were randomized to IDeg 200 units/mL or IGlar, both given once daily in combination with metformin with or without a dipeptidyl peptidase-4 inhibitor. Basal insulin was initiated at 10 units/day and titrated weekly to an FPG target of <5 mmol/L (<90 mg/dL) according to mean prebreakfast self-measured blood glucose values from the preceding 3 days. RESULTS By 26 weeks, IDeg reduced HbA1c by 1.30% and was not inferior to IGlar. Mean observed FPG reductions were significantly greater with IDeg than IGlar (?3.7 vs. ?3.4 mmol/L [–67 vs. –61 mg/dL]; estimated treatment difference: ?0.42 [95% CI ?0.78 to ?0.06], P = 0.02). Despite this difference, rates of overall confirmed hypoglycemia were not higher with IDeg than with IGlar (1.22 and 1.42 episodes/patient-year, respectively), as were rates of nocturnal confirmed hypoglycemia (0.18 and 0.28 episodes/patient-year, respectively). Mean daily basal insulin dose was significantly lower by 11% with IDeg 200 units/mL compared with IGlar. IDeg was well-tolerated, and the rate of treatment-emergent adverse events was similar across groups. CONCLUSIONS In this treat-to-target trial in insulin-naïve patients with T2DM, IDeg 200 units/mL improved glycemic control similarly to IGlar with a low risk of hypoglycemia. PMID:23715753

Gough, Stephen C.L.; Bhargava, Anuj; Jain, Rajeev; Mersebach, Henriette; Rasmussen, Søren; Bergenstal, Richard M.

2013-01-01

240

Dietary carbohydrate intake, glycemic index, and glycemic load and endometrial cancer risk: a prospective cohort study.  

PubMed

Endometrial cancer risk has been directly associated with glycemic load. However, few studies have investigated this link, and the etiological role of specific dietary carbohydrate components remains unclear. Our aim was to investigate associations of carbohydrate intake, glycemic index, and glycemic load with endometrial cancer risk in the US Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Recruitment took place in 1993-2001. Over a median of 9.0 years of follow-up through 2009, 386 women developed endometrial cancer among 36,115 considered in the analysis. Dietary intakes were assessed using a 124-item diet history questionnaire. Cox proportional hazards models were applied to calculate hazard ratios and 95% confidence intervals. Significant inverse associations were detected between endometrial cancer risk and total available carbohydrate intake (hazard ratio (HR) = 0.66, 95% confidence interval (CI): 0.49, 0.90), total sugars intake (HR = 0.71, 95% CI: 0.52, 0.96), and glycemic load (HR = 0.63, 95% CI: 0.46, 0.84) when women in the highest quartile of intake were compared with those in the lowest. These inverse associations were strongest among overweight and obese women. No associations with endometrial cancer risk were observed for glycemic index or dietary fiber. Our findings contrast with previous evidence and suggest that high carbohydrate intakes and glycemic loads are protective against endometrial cancer development. Further clarification of these associations is warranted. PMID:24091889

Coleman, Helen G; Kitahara, Cari M; Murray, Liam J; Dodd, Kevin W; Black, Amanda; Stolzenberg-Solomon, Rachael Z; Cantwell, Marie M

2014-01-01

241

High Glycemic Index Foods, Overeating, and Obesity  

Microsoft Academic Search

Objective. The prevalence of obesity has increased dramatically in recent years. However, the role of dietary composition in body weight regulation re- mains unclear. The purpose of this work was to investi- gate the acute effects of dietary glycemic index (GI) on energy metabolism and voluntary food intake in obese subjects. Methods. Twelve obese teenage boys were evaluated on three

David S. Ludwig; Joseph A. Majzoub; Ahmad Al-Zahrani; Gerard E. Dallal; Isaac Blanco; Susan B. Roberts

1999-01-01

242

Control Networks and Neuromodulators of Early Development  

ERIC Educational Resources Information Center

In adults, most cognitive and emotional self-regulation is carried out by a network of brain regions, including the anterior cingulate, insula, and areas of the basal ganglia, related to executive attention. We propose that during infancy, control systems depend primarily upon a brain network involved in orienting to sensory events that includes…

Posner, Michael I.; Rothbart, Mary K.; Sheese, Brad E.; Voelker, Pascale

2012-01-01

243

Effect of Probiotics on Lipid Profile, Glycemic Control, Insulin Action, Oxidative Stress, and Inflammatory Markers in Patients with Type 2 Diabetes: A Clinical Trial  

PubMed Central

Background: The dramatic increase in the incidence of diabetes and its associated complications require a natural and safe solution to control and delay such complications. The present study tested the hypothesis that probiotics may affect biochemical indices of diabetic patients Methods: Thirty four types 2 diabetic patients aged between 25 to 65 years, and diagnosed with diabetes for less than 15 years were selected for this single- blinded clinical trial. Using balanced block random sampling, the patients were divided into two groups of intervention (probiotics) and placebo. Blood samples tested for baseline glucose, insulin, TG, total cholesterol, LDL-C, HDL-C, malondialdehyde, high sensitive CRP (hs-CRP) and IL-6. After six weeks of experiment, fasting blood samples were re-tested and the data obtained were analyzed using SPSS software. Results: There were no significant differences between anthropometric data including body mass index and waist to hip ratio in placebo and treatment groups. There was no significant difference in FBS, Serum TG concentration total cholesterol and LDL-C levels between placebo and treatment groups. HDL-C levels were slightly elevated after probiotic treatment, which were not statistically significant. Insulin, MDA and IL-6 levels were reduced and high sensitive CRP hs.CRP levels were elevated, although, not statistically significant. Conclusion: The result of this study indicates a non- significant declining trend in the level of TG, MDA and IL-6 and insulin resistance after consumption of probiotics. PMID:23645956

Mazloom, Zohreh; Yousefinejad, Abbas; Dabbaghmanesh, Mohammad Hossein

2013-01-01

244

77 FR 66469 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)  

Federal Register 2010, 2011, 2012, 2013, 2014

...Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control...aforementioned committee: Name: Breast and Cervical Cancer Early Detection and Control...detection and control of breast and cervical cancer. The committee makes...

2012-11-05

245

Glycemic index of traditional Indian carbohydrate foods.  

PubMed

The glycemic index (GI) was determined in 36 non-insulin-dependent diabetes mellitus patients who were fed 50 g carbohydrate portions of six Indian conventional foods, including rice, a combination of rice-legume (Bengalgram, peas, and greengram), and a combination of rice-dal (greengram dal and redgram dal -- dal is dehusked and split legume). In addition to the GI, triglyceride (TG) responses of these foods were also determined. A higher GI was obtained for rice and for rice with peas; all other combinations yielded lower glycemic indices. However, all the foods produced significantly lower blood glucose response 2 hours postprandially as compared with blood glucose responses to a 50 g glucose load for the same group. No significant difference was observed for TG responses to the different foods. PMID:2273190

Mani, U V; Bhatt, S; Mehta, N C; Pradhan, S N; Shah, V; Mani, I

1990-12-01

246

Metabolic Control and Diabetic Retinopathy  

Microsoft Academic Search

The Early Treatment Diabetic Retinopathy Study (ETDRS) identified important risk factors for progression to high risk proliferative diabetic retinopathy (PDR) including retinopathy severity, decreased visual acuity, and high levels of hemoglobin A1C (HbA1c). Additional risk factors for progression to PDR are decreased hematocrit and increased se- rum lipids. The long-term benefit of improving glycemic control was evaluated by three large

Monica Rodriguez-Fontal; John B. Kerrison; D. Virgil Alfaro; Eric P. Jablon

2009-01-01

247

Effect of the Glycemic Index of Carbohydrates on Acne vulgaris  

PubMed Central

Acne vulgaris may be improved by dietary factors that increase insulin sensitivity. We hypothesized that a low-glycemic index diet would improve facial acne severity and insulin sensitivity. Fifty-eight adolescent males (mean age ± standard deviation 16.5 ± 1.0 y and body mass index 23.1 ± 3.5 kg/m2) were alternately allocated to high or low glycemic index diets. Severity of inflammatory lesions on the face, insulin sensitivity (homeostasis modeling assessment of insulin resistance), androgens and insulin-like growth factor-1 and its binding proteins were assessed at baseline and at eight weeks, a period corresponding to the school term. Forty-three subjects (n = 23 low glycemic index and n = 20 high glycemic index) completed the study. Diets differed significantly in glycemic index (mean ± standard error of the mean, low glycemic index 51 ± 1 vs. high glycemic index 61 ± 2, p = 0.0002), but not in macronutrient distribution or fiber content. Facial acne improved on both diets (low glycemic index ?26 ± 6%, p = 0.0004 and high glycemic index ?16 ± 7%, p = 0.01), but differences between diets did not reach significance. Change in insulin sensitivity was not different between diets (low glycemic index 0.2 ± 0.1 and high glycemic index 0.1 ± 0.1, p = 0.60) and did not correlate with change in acne severity (Pearson correlation r = ?0.196, p = 0.244). Longer time frames, greater reductions in glycemic load or/and weight loss may be necessary to detect improvements in acne among adolescent boys. PMID:22253996

Reynolds, Rebecca C.; Lee, Stephen; Choi, James Y. J.; Atkinson, Fiona S.; Stockmann, Karola S.; Petocz, Peter; Brand-Miller, Jennie C.

2010-01-01

248

Case-Control Study of Early Childhood Caries in Australia  

Microsoft Academic Search

The aim of this case-control study of 617 children was to investigate early childhood caries (ECC) risk indicators in a non-fluoridated region in Australia. ECC cases were recruited from childcare facilities, public hospitals and private specialist clinics to source children from different socioeconomic backgrounds. Non-ECC controls were recruited from the same childcare facilities. A multinomial logistic modelling approach was used

W. K. Seow; H. Clifford; D. Battistutta; A. Morawska; T. Holcombe

2009-01-01

249

Glucose sensor evaluation of glycemic instability in pediatric type 1 diabetes mellitus.  

PubMed

Maintaining blood glucose (BG) levels within the target range can be an elusive goal in children with type 1 diabetes mellitus (DM). To identify factor(s) that may contribute to glycemic instability, we analyzed the Continuous Glucose Monitoring System (CGMS) (Medtronic MiniMed, Northridge, CA) profiles of a group of children with type 1 DM and a history of frequent BG fluctuations and hypoglycemia. A total of 30 (17 girls, 13 boys) pediatric patients with a history of frequent BG fluctuations and hypoglycemia (mean age, 10.5 +/- 0.7 years; duration, 5.0 +/- 0.6 years), on three to four injections of insulin daily or insulin pump therapy, were evaluated by the CGMS. The mean BG (MBG), absolute means of daily differences (MODD), mean amplitude of glycemic excursion (MAGE), and number of hypoglycemic events (BG <60 mg/dL) for 48 h were calculated in each patient. There was a significant correlation between MBG and glycosylated hemoglobin (HbA1c) (r(2) = 0.22, p < 0.009). There was also a significant correlation between severity of lipohypertrophy and glycemic control (HbA1c) (r(2) = 0.20, p < 0.01). The MODD values had a positive correlation with the severity of injection site lipohypertrophy (r(2) = 0.37, p < 0.0003). The MAGE values had a positive correlation with bolus:basal insulin ratio (r(2) = 0.22, p < 0.009) and number of hypoglycemic events (r(2) = 0.21, p < 0.008), independent of age, MBG, and glycemic control. The 48-h CGMS profile can help characterize day-to-day and within-day BG variability and identify factors influencing glycemic instability in pediatric type 1 DM. PMID:12871606

Alemzadeh, Ramin; Loppnow, Cindy; Parton, Elaine; Kirby, Midge

2003-01-01

250

Sustained Attention and Age Predict Inhibitory Control during Early Childhood  

ERIC Educational Resources Information Center

Executive functioning skills develop rapidly during early childhood. Recent research has focused on specifying this development, particularly predictors of executive functioning skills. Here we focus on sustained attention as a predictor of inhibitory control, one key executive functioning component. Although sustained attention and inhibitory…

Reck, Sarah G.; Hund, Alycia M.

2011-01-01

251

Life Stress Impairs Self-Control in Early Adolescence  

PubMed Central

The importance of self-control to a wide range of developmental outcomes prompted the current investigation of negative life events and self-control in early adolescence. In three prospective, longitudinal studies, negative life events reported by the mother (in Study 1) or child (in Studies 2 and 3) predicted rank-order decreases in self-control over time. In all studies, self-control was measured at two different time points using questionnaires completed by three separate raters, including a classroom teacher who knew the child well and two other raters (parents, caregivers, and/or the child himself/herself). Psychological distress measured in Studies 2 and 3 mediated the deleterious effects of negative life events on self-control. These findings extend prior experimental laboratory research documenting the acute effects of stress on self-control. PMID:23443890

Duckworth, Angela L.; Kim, Betty; Tsukayama, Eli

2013-01-01

252

Charting early trajectories of executive control with the shape school.  

PubMed

Despite acknowledgement of the importance of executive control for learning and behavior, there is a dearth of research charting its developmental trajectory as it unfolds against the background of children's sociofamilial milieus. Using a prospective, cohort-sequential design, this study describes growth trajectories for inhibitory control and cognitive flexibility across the preschool period in relation to child sex and sociofamilial resources. At ages 3, 3.75, 4.5, and 5.25 years, children (N = 388) from a broad range of social backgrounds were assessed using the Shape School, a graduated measure of executive control incorporating baseline, inhibitory control, and cognitive flexibility conditions. Measures of children's proximal access to learning resources and social network supports were collected at study entry. Findings revealed substantial gains in accuracy and speed for all Shape School conditions, these gains being particularly accelerated between ages 3 and 3.75 years. Improvements in inhibitory control were more rapid than those in flexible switching. Age-related differences in error and self-correction patterns on the Shape School also suggest qualitative changes in the underlying processes supporting executive performance across early childhood. Children from homes with fewer learning resources showed a subtle lag in inhibition and cognitive flexibility performance that persisted at kindergarten entry age, despite exhibiting gradual catch up to their more advantaged peers for the nonexecutive, baseline task condition. The study provides a unique characterization of the early developmental pathways for inhibitory control and cognitive flexibility and highlights the critical role of stimulating early educational resources for shaping the dynamic ontogeny of executive control. PMID:23106846

Clark, Caron A C; Sheffield, Tiffany D; Chevalier, Nicolas; Nelson, Jennifer Mize; Wiebe, Sandra A; Espy, Kimberly Andrews

2013-08-01

253

Internet blood glucose monitoring systems provide lasting glycemic benefit in type 1 and 2 diabetes: a systematic review.  

PubMed

Internet blood glucose monitoring systems (IBGMS) are associated with improved glycemic control in patients with type 2 diabetes (T2D) who are pharmacologically managed, using oral agents or insulin. IBGMS improves glycemic levels in patients with type 1 diabetes (T1D). IBGMS has not led to increased hypoglycemia. Mechanisms underlying IBGMS-associated glycemic improvement extend beyond optimizing insulin dose titration. The most important effects seem to be associated with increased patient self-motivation and improved patient-physician communication. IBGMS have been recommended in clinical practice guidelines, and their effectiveness and safety in trials suggest that this approach is appropriate for patients with T1D or T2D. PMID:25456641

Tildesley, Hugh D; Po, Michelle D; Ross, Stuart A

2015-01-01

254

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

ERIC Educational Resources Information Center

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

Miller, Carla K.; Gutschall, Melissa

2009-01-01

255

Kiwifruit, carbohydrate availability, and the glycemic response.  

PubMed

An appreciable proportion, about 10%, of the dry weight of kiwifruit consists of primary cell walls. About 80% of dry matter is available carbohydrate consisting of glucose, fructose, and sucrose, and about 10% is digestible protein. The cell wall component, being nonstarch polysaccharide, is undigested in the stomach and small intestine, so the component increases in relative concentration in the gut lumen where its physicochemical properties may be important in modulating carbohydrate digestion and absorption. Released from the constraint of fruit structure, the dietary fiber swells to four times its original volume during in vitro digestion. When the digested remnants are allowed to settle into a packed but uncompressed state, as in the gut, they reduce the rate of glucose diffusion by about 40% and profoundly reduce digesta mixing, especially in the presence of a low background of soluble viscous polysaccharide. An in vitro estimation of the glycemic index (GI) of carbohydrate in kiwifruit, and in vivo estimates show the carbohydrate to be of low GI. On a whole fruit basis because of the high water content of kiwifruit, a 100g kiwifruit would be equivalent to about 5g (1 teaspoon) of glucose in its effect on blood glucose; thus, kiwifruit have low glycemic impact and are suitable for those with diabetes. PMID:23394992

Monro, John A

2013-01-01

256

Archean komatiite volcanism controlled by the evolution of early continents  

PubMed Central

The generation and evolution of Earth’s continental crust has played a fundamental role in the development of the planet. Its formation modified the composition of the mantle, contributed to the establishment of the atmosphere, and led to the creation of ecological niches important for early life. Here we show that in the Archean, the formation and stabilization of continents also controlled the location, geochemistry, and volcanology of the hottest preserved lavas on Earth: komatiites. These magmas typically represent 50–30% partial melting of the mantle and subsequently record important information on the thermal and chemical evolution of the Archean–Proterozoic Earth. As a result, it is vital to constrain and understand the processes that govern their localization and emplacement. Here, we combined Lu-Hf isotopes and U-Pb geochronology to map the four-dimensional evolution of the Yilgarn Craton, Western Australia, and reveal the progressive development of an Archean microcontinent. Our results show that in the early Earth, relatively small crustal blocks, analogous to modern microplates, progressively amalgamated to form larger continental masses, and eventually the first cratons. This cratonization process drove the hottest and most voluminous komatiite eruptions to the edge of established continental blocks. The dynamic evolution of the early continents thus directly influenced the addition of deep mantle material to the Archean crust, oceans, and atmosphere, while also providing a fundamental control on the distribution of major magmatic ore deposits. PMID:24958873

Mole, David R.; Fiorentini, Marco L.; Thebaud, Nicolas; Cassidy, Kevin F.; McCuaig, T. Campbell; Kirkland, Christopher L.; Romano, Sandra S.; Doublier, Michael P.; Belousova, Elena A.; Barnes, Stephen J.; Miller, John

2014-01-01

257

Archean komatiite volcanism controlled by the evolution of early continents.  

PubMed

The generation and evolution of Earth's continental crust has played a fundamental role in the development of the planet. Its formation modified the composition of the mantle, contributed to the establishment of the atmosphere, and led to the creation of ecological niches important for early life. Here we show that in the Archean, the formation and stabilization of continents also controlled the location, geochemistry, and volcanology of the hottest preserved lavas on Earth: komatiites. These magmas typically represent 50-30% partial melting of the mantle and subsequently record important information on the thermal and chemical evolution of the Archean-Proterozoic Earth. As a result, it is vital to constrain and understand the processes that govern their localization and emplacement. Here, we combined Lu-Hf isotopes and U-Pb geochronology to map the four-dimensional evolution of the Yilgarn Craton, Western Australia, and reveal the progressive development of an Archean microcontinent. Our results show that in the early Earth, relatively small crustal blocks, analogous to modern microplates, progressively amalgamated to form larger continental masses, and eventually the first cratons. This cratonization process drove the hottest and most voluminous komatiite eruptions to the edge of established continental blocks. The dynamic evolution of the early continents thus directly influenced the addition of deep mantle material to the Archean crust, oceans, and atmosphere, while also providing a fundamental control on the distribution of major magmatic ore deposits. PMID:24958873

Mole, David R; Fiorentini, Marco L; Thebaud, Nicolas; Cassidy, Kevin F; McCuaig, T Campbell; Kirkland, Christopher L; Romano, Sandra S; Doublier, Michael P; Belousova, Elena A; Barnes, Stephen J; Miller, John

2014-07-15

258

DIETARY HYPERGLYCEMIA, GLYCEMIC INDEX AND METABOLIC RETINAL DISEASES  

PubMed Central

The glycemic index (GI) indicates how fast blood glucose is raised after consuming a carbohydrate-containing food. Human metabolic studies indicate that GI is related to patho-physiological responses after meals. Compared with a low-GI meal, a high-GI meal is characterized with hyperglycemia during the early postprandial stage (0~2 h) and a compensatory hyperlipidemia associated with counter-regulatory hormone responses during late postprandial stage (4~6 h). Over the past three decades, several human health disorders have been related to GI. The strongest relationship suggests that consuming low-GI foods prevents diabetic complications. Diabetic retinopathy (DR) is a complication of diabetes. In this aspect, GI appears to be useful as a practical guideline to help diabetic people choose foods. Abundant epidemiological evidence also indicates positive associations between GI and risk for type 2 diabetes, cardiovascular disease, and more recently, age-related macular degeneration (AMD) in people without diabetes. Although data from randomized controlled intervention trials are scanty, these observations are strongly supported by evolving molecular mechanisms which explain the pathogenesis of hyperglycemia. This wide range of evidence implies that dietary hyperglycemia is etiologically related to human aging and diseases, including DR and AMD. In this context, these diseases can be considered metabolic retinal diseases. Molecular theories that explain hyperglycemic pathogenesis involve a mitochondria-associated pathway and four glycolysis-associated pathways, including advanced glycation end products formation, protein kinase C activation, polyol pathway, and hexosamine pathway. While the four glycolysis-associated pathways appear to be universal for both normoxic and hypoxic conditions, the mitochondria-associated mechanism appears to be most relevant to the hyperglycemic, normoxic pathogenesis. For diseases that affect tissues with highly active metabolism and that frequently face challenge from low oxygen tension, such as retina in which metabolism is determined by both glucose and oxygen homeostases, these theories appear to be insufficient. Several lines of evidence indicate that the retina is particularly vulnerable when hypoxia coincides with hyperglycemia. We propose a novel hyperglycemic, hypoxia-inducible factor (HIF) pathway, to complement the current theories regarding hyperglycemic pathogenesis. HIF is a transcription complex that responds to decreases in oxygen in the cellular environment. In addition to playing a significant role in the regulation of glucose metabolism, under hyperglycemia HIF has been shown to increase the expression of HIF-inducible genes, such as vascular endothelial growth factor (VEGF) leading to angiogenesis. To this extent, we suggest that HIF can also be described as a hyperglycemia-inducible factor. In summary, while management of dietary GI appears to be an effective intervention for the prevention of metabolic diseases, specifically AMD and DR, more interventional data is needed to evaluate the efficacy of GI management. There is an urgent need to develop reliable biomarkers of exposure, surrogate endpoints, as well as susceptibility for GI. These insights would also be helpful in deciphering the detailed hyperglycemia-related biochemical mechanisms for the development of new therapeutic agents. PMID:20868767

Chiu, Chung-Jung; Taylor, Allen

2014-01-01

259

24-Hour Glucose Profiles on Diets Varying in Protein Content and Glycemic Index  

PubMed Central

Evidence is increasing that the postprandial state is an important factor contributing to the risk of chronic diseases. Not only mean glycemia, but also glycemic variability has been implicated in this effect. In this exploratory study, we measured 24-h glucose profiles in 25 overweight participants in a long-term diet intervention study (DIOGENES study on Diet, Obesity and Genes), which had been randomized to four different diet groups consuming diets varying in protein content and glycemic index. In addition, we compared 24-h glucose profiles in a more controlled fashion, where nine other subjects followed in random order the same four diets differing in carbohydrate content by 10 energy% and glycemic index by 20 units during three days. Meals were provided in the lab and had to be eaten at fixed times during the day. No differences in mean glucose concentration or glucose variability (SD) were found between diet groups in the DIOGENES study. In the more controlled lab study, mean 24-h glucose concentrations were also not different. Glucose variability (SD and CONGA1), however, was lower on the diet combining a lower carbohydrate content and GI compared to the diet combining a higher carbohydrate content and GI. These data suggest that diets with moderate differences in carbohydrate content and GI do not affect mean 24-h or daytime glucose concentrations, but may result in differences in the variability of the glucose level in healthy normal weight and overweight individuals. PMID:25093276

van Baak, Marleen A.

2014-01-01

260

High hydrostatic pressure processing reduces the glycemic index of fresh mango puree in healthy subjects.  

PubMed

Dietary guidelines recommend the daily consumption of fruits; however, healthy and type 2 diabetes mellitus (T2DM) subjects receive conflicting messages regarding ingestion of fruits, such as mango, because of its sugar content. We investigated the effects of high hydrostatic pressure (HHP) processing of fresh mango puree (MP) on the glycemic indexes (GIs) and postprandial glycemic responses of 38 healthy Mexican subjects in a randomized cross-over clinical trial. Physicochemical characterization of MP included sugar profiles by HPLC-ELSD, starch, fibers, moisture, viscosity, swelling capacity and solubility properties of alcohol insoluble residue (AIR). The mean GI for HHP-MP was significantly lower (32.7 ± 13.4) than that of unprocessed-MP (42.7 ± 19.5). A significantly higher proportion of subjects showed a low GI following the consumption of HHP-MP compared to unprocessed-MP and none of them showed a high GI for the HHP-MP, compared to a significantly higher proportion for the unprocessed-MP. The viscosity and AIR solubility values of HHP-MP samples were significantly higher, which influenced glucose peaking later (Tmax) at 45 minutes and induced 20% lower AUC values than unprocessed-MP, corresponding to greater retardation indexes. The study findings support data stating that low GI fruits are appropriate for glycemic control and that mango may be included as part of healthy subjects' diets and potentially T2DM subjects' diets. Furthermore, HHP processing of mango may offer additional benefits for glycemic control, as its performance regarding GI, AUC and Tmax was significantly better than that of the unprocessed-MP. To our knowledge, this is the first report on the impact of this commercial non-thermal pasteurization technology on glucose metabolism. PMID:25797308

Elizondo-Montemayor, Leticia; Hernández-Brenes, Carmen; Ramos-Parra, Perla A; Moreno-Sánchez, Diana; Nieblas, Bianca; Rosas-Pérez, Aratza M; Lamadrid-Zertuche, Ana C

2015-04-01

261

Enhanced glycemic responsiveness to epinephrine in insulin-dependent diabetes mellitus is the result of the inability to secrete insulin. Augmented insulin secretion normally limits the glycemic, but not the lipolytic or ketogenic, response to epinephrine in humans.  

PubMed Central

To determine if the enhanced glycemic response to epinephrine in patients with insulin-dependent diabetes mellitus (IDDM) is the result of increased adrenergic sensitivity per se, increased glucagon secretion, decreased insulin secretion, or a combination of these, plasma epinephrine concentration-response curves were determined in insulin-infused (initially euglycemic) patients with IDDM and nondiabetic subjects on two occasions: once when insulin and glucagon were free to change (control study), and again when insulin and glucagon were held constant (islet clamp study). During the control study, plasma C-peptide doubled, and glucagon did not change in the nondiabetic subjects, whereas plasma C-peptide did not change but glucagon increased in the patients. The patients with IDDM exhibited threefold greater increments in plasma glucose, largely the result of greater increments in glucose production. This enhanced glycemic response was apparent with 30-min increments in epinephrine to plasma concentrations as low as 100-200 pg/ml, levels that occur commonly under physiologic conditions. During the islet clamp study (somatostatin infusion with insulin and glucagon replacement at fixed rates), the heightened glycemic response was unaltered in the patients with IDDM, but the nondiabetic subjects exhibited an enhanced glycemic response to epinephrine indistinguishable from that of patients with IDDM. In contrast, the FFA, glycerol, and beta-hydroxybutyrate responses were unaltered. Thus, we conclude the following: Short, physiologic increments in plasma epinephrine cause greater increments in plasma glucose in patients with IDDM than in nondiabetic subjects, a finding likely to be relevant to glycemic control during the daily lives of such patients as well as during the stress of intercurrent illness. Enhanced glycemic responsiveness of patients with IDDM to epinephrine is not the result of increased sensitivity of adrenergic receptor-effector mechanisms per se nor of their increased glucagon secretory response; rather, it is the result of their inability to augment insulin secretion. Augmented insulin secretion, albeit restrained, normally limits the glycemic response, but not the lipolytic or ketogenic responses, to epinephrine in humans. Images PMID:3891786

Berk, M A; Clutter, W E; Skor, D; Shah, S D; Gingerich, R P; Parvin, C A; Cryer, P E

1985-01-01

262

Carbohydrate Intake, Glycemic Index, Glycemic Load, and Dietary Fiber in Relation to Risk of Stroke in Women  

Microsoft Academic Search

The associations of dietary carbohydrate, glycemic index, and glycemic load with stroke risk were examined among 78,779 US women who were free of cardiovascular disease and diabetes in 1980 and completed a food frequency questionnaire. During an 18-year follow-up, 1,020 stroke cases were documented (including 515 ischemic and 279 hemorrhagic). In analyses adjusting for nondietary risk factors and cereal fiber,

Kyungwon Oh; Frank B. Hu; Eunyoung Cho; Kathryn M. Rexrode; Meir J. Stampfer; JoAnn E. Manson; Simin Liu; Walter C. Willett

2005-01-01

263

Mesulergine in early Parkinson's disease: a double blind controlled trial.  

PubMed Central

The efficacy and tolerance of treatment with an 8-alpha-amino-ergoline derivative CU32-o85, Mesulergine, were compared with levodopa/benserazide (Madopar) in a 3 month double-blind controlled trial in 31 patients with Parkinson's disease, not previously treated with levodopa. The two treatments were equally well tolerated, and neither dyskinesias nor dose-related fluctuations developed. In 90% of the patients treated with Mesulergine, Parkinsonian symptoms improved, and at the dose given the overall therapeutical response was two-thirds that of levodopa. During further 9 months of open study the beneficial effect was maintained equally well in both groups. Compared with other dopamine agonists Mesulergine has a considerable antiparkinsonian effect. Unfortunately, further clinical evaluation of the compound recently has been stopped owing to sex and species specific histological alterations in rats. It is suggested that Mesulergine derivatives might well be of value in future treatment of early Parkinson's disease and of late incompensated stages. PMID:3517235

Dupont, E; Mikkelsen, B; Jakobsen, J

1986-01-01

264

Landslide Geohazard Monitoring, Early Warning and Stabilization Control Methods  

NASA Astrophysics Data System (ADS)

This paper is a presentation of landslide monitoring, early warning and remediation methods recommended for the Polish Carpathians. Instrumentation included standard and automatic on-line measurements with the real-time transfer of data to an Internet web server. The research was funded through EU Innovative Economy Programme and also by the SOPO Landslide Counteraction Project. The landslides investigated were characterized by relatively low rates of the displacements. These ranged from a few millimetres to several centimetres per year. Colluviums of clayey flysch deposits were of a soil-rock type with a very high plasticity and moisture content. The instrumentation consisted of 23 standard inclinometers set to depths of 5-21 m. The starting point of monitoring measurements was in January 2006. These were performed every 1-2 months over the period of 8 years. The measurements taken detected displacements from several millimetres to 40 cm set at a depth of 1-17 m. The modern, on-line monitoring and early warning system was installed in May 2010. The system is the first of its kind in Poland and only one of several such real-time systems in the world. The installation was working with the Local Road Authority in Gorlice. It contained three automatic field stations for investigation of landslide parameters to depths of 12-16 m and weather station. In-place tilt transducers and innovative 3D continuous inclinometer systems with sensors located every 0.5 m were used. It has the possibility of measuring a much greater range of movements compared to standard systems. The conventional and real-time data obtained provided a better recognition of the triggering parameters and the control of geohazard stabilizations. The monitoring methods chosen supplemented by numerical modelling could lead to more reliable forecasting of such landslides and could thus provide better control and landslide remediation possibilities also to stabilization works which prevent landslides.

Bednarczyk, Zbigniew

2014-03-01

265

76 FR 30723 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)  

Federal Register 2010, 2011, 2012, 2013, 2014

...Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control...detection and control of breast and cervical cancer. The committee makes recommendations...Reform and its impact for breast and cervical cancer screening; updates on...

2011-05-26

266

75 FR 7282 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)  

Federal Register 2010, 2011, 2012, 2013, 2014

...Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control...detection and control of breast and cervical cancer. The committee makes recommendations...Task Force guidelines for breast and cervical cancer screening; Impact of...

2010-02-18

267

CBL CONTROLS EGF RECEPTOR FATE BY REGULATING EARLY ENDOSOME FUSION#  

PubMed Central

Residues 1-434 of the ubiquitin ligase Cbl control epidermal growth factor receptor (EGF-R) signaling by enhancing receptor ubiquitination, downregulation, and lysosomal degradation. Cbl 1-434 comprises a tyrosine kinase-binding domain, linker region, RING finger (RF), and a subset of the RF tail amino acids 420-436. Using full-length alanine substitution mutants, we demonstrate that the Cbl RF tail regulates biochemically distinct EGF-R endocytosis checkpoints: 1) Cbl- and ubiquitin-dependent degradation of hSprouty2 upstream of EGF-R ubiquitination (compromised by Cbl V431A); and 2) Cbl- and EGF-R-dependent dephosphorylation or degradation of the endosomal trafficking regulator Hrs (compromised by Cbl F434A). Deregulated Hrs phosphorylation correlates with the inhibition of both early endosome fusion and EGF-R degradation. This is the first evidence that Cbl can regulate receptor fate by controlling the fusion of sorting endosomes. We postulate that it does so by modulating the generation and loss of tyrosine phosphorylated Hrs. PMID:20029031

Visser Smit, Gina D.; Place, Trenton L.; Cole, Sara L.; Clausen, Kathryn A.; Vemuganti, Soumya; Zhang, Guojuan; Koland, John G.; Lill, Nancy L.

2010-01-01

268

NPY signalling in early osteoblasts controls glucose homeostasis  

PubMed Central

Objective The skeleton has recently emerged as an additional player in the control of whole-body glucose metabolism; however, the mechanism behind this is not clear. Methods Here we employ mice lacking neuropeptide Y, Y1 receptors solely in cells of the early osteoblastic lineage (Y1f3.6Cre), to examine the role of osteoblastic Y1 signalling in glycaemic control. Results Y1f3.6Cre mice not only have a high bone mass phenotype, but importantly also display altered glucose homeostasis; significantly decreased pancreas weight, islet number and pancreatic insulin content leading to elevated glucose levels and reduced glucose tolerance, but with no effect on insulin induced glucose clearance. The reduced glucose tolerance and elevated bone mass was corrected in Y1f3.6Cre mice by bone marrow transplant from wildtype animals, reinforcing the osteoblastic nature of this pathway. Importantly, when fed a high fat diet, Y1f3.6Cre mice, while equally gaining body weight and fat mass compared to controls, showed significantly improved glucose and insulin tolerance. Conditioned media from Y1f3.6Cre osteoblastic cultures was unable to stimulate insulin expression in MIN6 cells compared to conditioned media from wildtype osteoblast, indicating a direct signalling pathway. Importantly, osteocalcin a secreted osteoblastic factor previously identified as a modulator of insulin secretion was not altered in the Y1f3.6Cre model. Conclusion This study identifies the existence of other osteoblast-derived regulators of pancreas function and insulin secretion and illustrates a mechanism by which NPY signalling in bone tissue is capable of regulating pancreatic function and glucose homeostasis. PMID:25737952

Lee, Nicola J.; Nguyen, Amy D.; Enriquez, Ronaldo F.; Luzuriaga, Jude; Bensellam, Mohammed; Laybutt, Ross; Baldock, Paul A.; Herzog, Herbert

2015-01-01

269

Dietary Glycemic Index, Dietary Glycemic Load, Blood Lipids, and Coronary Heart Disease  

PubMed Central

Objective. To examine the associations of dietary glycemic index (GI) and dietary glycemic load (GL) with blood lipid concentrations and coronary heart disease (CHD) in nondiabetic participants in the Health Worker Cohort Study (HWCS). Materials and Methods. A cross-sectional analysis was performed, using data from adults who participated in the HWCS baseline assessment. We collected information on participants' socio-demographic conditions, dietary patterns and physical activity via self-administered questionnaires. Dietary GI and dietary GL were measured using a validated food frequency questionnaire. Anthropometric and clinical measurements were assessed with standardized procedures. CHD risk was estimated according to the sex-specific Framingham prediction algorithms. Results. IIn the 5,830 individuals aged 20 to 70 who were evaluated, dietary GI and GL were significantly associated with HDL-C, LDL-C, LDL-C/HDL-C ratio, and triglycerides serum levels. Subjects with high dietary GI have a relative risk of 1.56 (CI 95%; 1.13–2.14), and those with high dietary GL have a relative risk of 2.64 (CI 95%; 1.15–6.58) of having an elevated CHD risk than those who had low dietary GI and GL. Conclusions. Our results suggest that high dietary GI and dietary GL could have an unfavorable effect on serum lipid levels, which are in turn associated with a higher CHD risk. PMID:20700407

Denova-Gutiérrez, Edgar; Huitrón-Bravo, Gerardo; Talavera, Juan O.; Castañón, Susana; Gallegos-Carrillo, Katia; Flores, Yvonne; Salmerón, Jorge

2010-01-01

270

The glycemic index (GI) and glycemic load (GL) of five commonly consumed foods of the South Pacific.  

PubMed

Glycemic index (GI) has been widely used in the management of blood sugar levels among diabetes however; in the South Pacific very little information regarding the GI of local foods is made available. The objectives of this research were to determine the glycemic index and the glycemic load of 5 South Pacific foods, which have not been studied. The foods tested were plantain (Musa AAB), tannia (Xanthosoma sagittifolium), roti or chappati, homemade pancake and Lees cabin crackers. Glucose powder mixed in 200 mL of water was used as reference food. Eight apparently healthy indigenous Fijian males from the Fiji Military Forces aged 25-36 years old were recruited for this study. Participants were given a 50 g carbohydrate portion of the test foods to ingest after a 10-12 hour fast the night before the test and the standard reference food were administered to participants on different days for comparison. In the morning, capillary blood samples were drawn from the fingers at 0 min, 15, 30, 45, 60, 90 and 120 minutes postprandially and the blood glucose level was determined. The equation of Wolever using computer software was used to calculate the glycemic index and the glycemic load was calculated using the formular provided in the Harvard Health Online. The results showed that individuals respond to foods differently thus affecting the GI average values. The glycemic index has been categorized by Miller as low GI is pounds 55, moderate GI is between 56-69 and high GI is > or = 70. All the five carbohydrate foods understudy have moderate GI values ranging from 59 to 68. The Glycemic Load (GL) for cabin biscuit was the highest. PMID:18181442

Lako, Jimaima; Sotheeswaran, Subramania; Aalbersberg, William; Sreekumar, K P

2004-03-01

271

Structured SMBG in early management of T2DM: Contributions from the St Carlos study  

PubMed Central

Diabetes mellitus type 2 (T2DM) is a global pandemic that will affect 300 million people in the next decade. It has been shown that early and aggressive treatment of T2DM from the onset decreases complications, and the patient’s active role is necessary to achieve better glycemic control. In order to achieve glycemic control targets, an active attitude in patients is needed, and self-monitoring of blood glucose (SMBG) plays a significant role. Nowadays, SMBG has become an important component of modern therapy for diabetes mellitus, and is even more useful if it is performed in a structured way. SMBG aids physicians and patients to achieve a specific level of glycemic control and to prevent hypoglycemia. In addition, SMBG empowers patients to achieve nutritional and physical activity goals, and helps physicians to optimize the different hypoglycemic therapies as demonstrated in the St Carlos study. This article describes the different ways of using this educational and therapeutic tool from the medical point of view as well as from the patient’s perspective. PMID:25126393

Ruiz Gracia, Teresa; García de la Torre Lobo, Nuria; Durán Rodríguez Hervada, Alejandra; Calle Pascual, Alfonso L

2014-01-01

272

75 FR 57472 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC): Notice of...  

Federal Register 2010, 2011, 2012, 2013, 2014

...DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC): Notice of Charter Renewal This gives notice...

2010-09-21

273

77 FR 60703 - Breast and Cervical Cancer Early Detection and Control Advisory Committee: Notice of Charter Renewal  

Federal Register 2010, 2011, 2012, 2013, 2014

...SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control Advisory Committee...L. 92-463) of October 6, 1972, that the Breast and Cervical Cancer Early Detection and Control Advisory...

2012-10-04

274

Dietary glycemic index, dietary glycemic load, and mortality among men with established cardiovascular disease  

PubMed Central

Background/Objectives In men with established cardiovascular disease, the effect of diets with high glycemic index (GI) and glycemic load (GL) is unknown. We tested the hypothesis that diets with higher GI and GL are associated with increased mortality in men with established cardiovascular disease. Subjects/Methods We measured dietary GI and GL using food-frequency questionnaires in 4 617 men, 45–79 years old, with a history of cardiovascular disease. The men were followed for cardiovascular mortality (6 year follow-up, 608 cases) and all-cause mortality (8 year follow-up, 1 303 cases) using the Swedish cause-of-death and death registers. We used Cox models with age as the time scale and adjusted for body mass index, physical activity, history of hypertension and diabetes, family history of myocardial infarction, aspirin use, cigarette smoking, and dietary factors to estimate incidence rate ratios (RR). Results Comparing top to bottom quartiles of dietary GI, the RR for cardiovascular mortality was 0.86 (95% confidence interval (CI) 0.67–1.10, p for linear trend = 0.21), and the RR for all-cause mortality was 1.00 (95% CI 0.85–1.19, p for linear trend = 0.87). Compared to quartile 1, the RR for men with dietary GL in quartile 4 was 1.02 (95% CI 0.70–1.49, p for linear trend = 0.81) for cardiovascular and 1.15 (95% CI 0.89–1.49, p for linear trend = 0.20) for all-cause mortality. Conclusions In this population of men with prior cardiovascular disease, dietary GI and GL were not associated with cardiovascular or all-cause mortality. PMID:18091767

Levitan, Emily B.; Mittleman, Murray A.; Wolk, Alicja

2015-01-01

275

Effects of formulation and surfactant on control of early leaf spot of peanut with tebuconazole  

Technology Transfer Automated Retrieval System (TEKTRAN)

Prior to 1997, control of early leaf spot with the DMI fungicide tebuconazole, applied in a block of 4 mid-season applications scheduled between 2 applications of chlorothalonil, was similar to a full-season program with chlorothalonil. Periodically since 1997, control of early leaf spot with tebuc...

276

Controls on development and diversity of Early Archean stromatolites  

E-print Network

that covary with stromatolite morphology, linking morphologic diversity to changes in sedimentation, sea adapted to shifting environmental conditions in early oceans. microbe paleontology biosignature carbonate.43-Ga Strelley Pool For- mation, based on their morphology (1), morphological associations

Grotzinger, John P.

277

Automatic Detection of Excessive Glycemic Variability for Diabetes Management  

E-print Network

in blood glucose levels, is a significant factor in diabetes management. Excessive glycemic variability, blindness, and strokes [2]. Patients are routinely monitored for hyperglycemia, or high blood glucose levels, as well as for hypoglycemia, or low blood glucose levels. There is a recent growing awareness

Bunescu, Razvan C.

278

Slowly Digestible Starch: Concept, Mechanism, and Proposed Extended Glycemic Index  

Microsoft Academic Search

Starch is the major glycemic carbohydrate in foods, and its nutritional property is related to its rate and extent of digestion and absorption in the small intestine. A classification of starch into rapidly digestible starch (RDS), slowly digestible starch (SDS), and resistant starch (RS) based on the in vitro Englyst test is used to specify the nutritional quality of starch.

Genyi Zhang; Bruce R. Hamaker

2009-01-01

279

Glycemic Impact and Health: New Horizons in White Bread Formulations  

Microsoft Academic Search

The challenge of provision of a much wider range of foods of relatively low glycemic response than is currently available, especially in terms of cereal products, has been highlighted in recent years and this has particular relevance to bread consumption. Although there has been some transition to brown bread consumption, white bread remains a firm feature in the typical average

Pat M. Burton; John A. Monro; Laura Alvarez; Eimear Gallagher

2011-01-01

280

Glycemic Index and Chemical Composition of Traditional Omani Breads  

Microsoft Academic Search

This study evaluated the chemical composition and glycemic index (GI) of eight different types of traditional Omani breads made from wheat flour. Significant (P < 0.05) differences were observed in the proximate chemical composition, dietary fibre content, and gross energy value of these breads. The moisture, crude protein, total fat, ash, crude fibre and nitrogen free extract (NFE) contents ranged

Amanat Ali; Hussain Ali S Al-Nassri; Buthaina Al-Rasasi; Mohammad Shoaib Akhtar; Buthaina Saleh Al-Belushi

2010-01-01

281

Large-scale association analyses identify new loci influencing glycemic traits and provide insight into the underlying biological pathways  

PubMed Central

Through genome-wide association meta-analyses of up to 133,010 individuals of European ancestry without diabetes, including individuals newly genotyped using the Metabochip, we have raised the number of confirmed loci influencing glycemic traits to 53, of which 33 also increase type 2 diabetes risk (q < 0.05). Loci influencing fasting insulin showed association with lipid levels and fat distribution, suggesting impact on insulin resistance. Gene-based analyses identified further biologically plausible loci, suggesting that additional loci beyond those reaching genome-wide significance are likely to represent real associations. This conclusion is supported by an excess of directionally consistent and nominally significant signals between discovery and follow-up studies. Functional follow-up of these newly discovered loci will further improve our understanding of glycemic control. PMID:22885924

Scott, Robert A; Lagou, Vasiliki; Welch, Ryan P; Wheeler, Eleanor; Montasser, May E; Luan, Jian’an; Mägi, Reedik; Strawbridge, Rona J; Rehnberg, Emil; Gustafsson, Stefan; Kanoni, Stavroula; Rasmussen-Torvik, Laura J; Yengo, Loïc; Lecoeur, Cecile; Shungin, Dmitry; Sanna, Serena; Sidore, Carlo; Johnson, Paul C D; Jukema, J Wouter; Johnson, Toby; Mahajan, Anubha; Verweij, Niek; Thorleifsson, Gudmar; Hottenga, Jouke-Jan; Shah, Sonia; Smith, Albert V; Sennblad, Bengt; Gieger, Christian; Salo, Perttu; Perola, Markus; Timpson, Nicholas J; Evans, David M; Pourcain, Beate St; Wu, Ying; Andrews, Jeanette S; Hui, Jennie; Bielak, Lawrence F; Zhao, Wei; Horikoshi, Momoko; Navarro, Pau; Isaacs, Aaron; O’Connell, Jeffrey R; Stirrups, Kathleen; Vitart, Veronique; Hayward, Caroline; Esko, Tönu; Mihailov, Evelin; Fraser, Ross M; Fall, Tove; Voight, Benjamin F; Raychaudhuri, Soumya; Chen, Han; Lindgren, Cecilia M; Morris, Andrew P; Rayner, Nigel W; Robertson, Neil; Rybin, Denis; Liu, Ching-Ti; Beckmann, Jacques S; Willems, Sara M; Chines, Peter S; Jackson, Anne U; Kang, Hyun Min; Stringham, Heather M; Song, Kijoung; Tanaka, Toshiko; Peden, John F; Goel, Anuj; Hicks, Andrew A; An, Ping; Müller-Nurasyid, Martina; Franco-Cereceda, Anders; Folkersen, Lasse; Marullo, Letizia; Jansen, Hanneke; Oldehinkel, Albertine J; Bruinenberg, Marcel; Pankow, James S; North, Kari E; Forouhi, Nita G; Loos, Ruth J F; Edkins, Sarah; Varga, Tibor V; Hallmans, Göran; Oksa, Heikki; Antonella, Mulas; Nagaraja, Ramaiah; Trompet, Stella; Ford, Ian; Bakker, Stephan J L; Kong, Augustine; Kumari, Meena; Gigante, Bruna; Herder, Christian; Munroe, Patricia B; Caulfield, Mark; Antti, Jula; Mangino, Massimo; Small, Kerrin; Miljkovic, Iva; Liu, Yongmei; Atalay, Mustafa; Kiess, Wieland; James, Alan L; Rivadeneira, Fernando; Uitterlinden, Andre G; Palmer, Colin N A; Doney, Alex S F; Willemsen, Gonneke; Smit, Johannes H; Campbell, Susan; Polasek, Ozren; Bonnycastle, Lori L; Hercberg, Serge; Dimitriou, Maria; Bolton, Jennifer L; Fowkes, Gerard R; Kovacs, Peter; Lindström, Jaana; Zemunik, Tatijana; Bandinelli, Stefania; Wild, Sarah H; Basart, Hanneke V; Rathmann, Wolfgang; Grallert, Harald; Maerz, Winfried; Kleber, Marcus E; Boehm, Bernhard O; Peters, Annette; Pramstaller, Peter P; Province, Michael A; Borecki, Ingrid B; Hastie, Nicholas D; Rudan, Igor; Campbell, Harry; Watkins, Hugh; Farrall, Martin; Stumvoll, Michael; Ferrucci, Luigi; Waterworth, Dawn M; Bergman, Richard N; Collins, Francis S; Tuomilehto, Jaakko; Watanabe, Richard M; de Geus, Eco J C; Penninx, Brenda W; Hofman, Albert; Oostra, Ben A; Psaty, Bruce M; Vollenweider, Peter; Wilson, James F; Wright, Alan F; Hovingh, G Kees; Metspalu, Andres; Uusitupa, Matti; Magnusson, Patrik K E; Kyvik, Kirsten O; Kaprio, Jaakko; Price, Jackie F; Dedoussis, George V; Deloukas, Panos; Meneton, Pierre; Lind, Lars; Boehnke, Michael; Shuldiner, Alan R; van Duijn, Cornelia M; Morris, Andrew D; Toenjes, Anke; Peyser, Patricia A; Beilby, John P; Körner, Antje; Kuusisto, Johanna; Laakso, Markku; Bornstein, Stefan R; Schwarz, Peter E H; Lakka, Timo A; Rauramaa, Rainer; Adair, Linda S; Smith, George Davey; Spector, Tim D; Illig, Thomas; de Faire, Ulf; Hamsten, Anders; Gudnason, Vilmundur; Kivimaki, Mika; Hingorani, Aroon; Keinanen-Kiukaanniemi, Sirkka M; Saaristo, Timo E; Boomsma, Dorret I; Stefansson, Kari; van der Harst, Pim; Dupuis, Josée; Pedersen, Nancy L; Sattar, Naveed; Harris, Tamara B; Cucca, Francesco; Ripatti, Samuli; Salomaa, Veikko; Mohlke, Karen L; Balkau, Beverley; Froguel, Philippe; Pouta, Anneli; Jarvelin, Marjo-Riitta; Wareham, Nicholas J; Bouatia-Naji, Nabila; McCarthy, Mark I; Franks, Paul W; Meigs, James B; Teslovich, Tanya M; Florez, Jose C; Langenberg, Claudia; Ingelsson, Erik; Prokopenko, Inga; Barroso, Inês

2012-01-01

282

Large-scale association analyses identify new loci influencing glycemic traits and provide insight into the underlying biological pathways.  

PubMed

Through genome-wide association meta-analyses of up to 133,010 individuals of European ancestry without diabetes, including individuals newly genotyped using the Metabochip, we have increased the number of confirmed loci influencing glycemic traits to 53, of which 33 also increase type 2 diabetes risk (q < 0.05). Loci influencing fasting insulin concentration showed association with lipid levels and fat distribution, suggesting impact on insulin resistance. Gene-based analyses identified further biologically plausible loci, suggesting that additional loci beyond those reaching genome-wide significance are likely to represent real associations. This conclusion is supported by an excess of directionally consistent and nominally significant signals between discovery and follow-up studies. Functional analysis of these newly discovered loci will further improve our understanding of glycemic control. PMID:22885924

Scott, Robert A; Lagou, Vasiliki; Welch, Ryan P; Wheeler, Eleanor; Montasser, May E; Luan, Jian'an; Mägi, Reedik; Strawbridge, Rona J; Rehnberg, Emil; Gustafsson, Stefan; Kanoni, Stavroula; Rasmussen-Torvik, Laura J; Yengo, Loïc; Lecoeur, Cecile; Shungin, Dmitry; Sanna, Serena; Sidore, Carlo; Johnson, Paul C D; Jukema, J Wouter; Johnson, Toby; Mahajan, Anubha; Verweij, Niek; Thorleifsson, Gudmar; Hottenga, Jouke-Jan; Shah, Sonia; Smith, Albert V; Sennblad, Bengt; Gieger, Christian; Salo, Perttu; Perola, Markus; Timpson, Nicholas J; Evans, David M; Pourcain, Beate St; Wu, Ying; Andrews, Jeanette S; Hui, Jennie; Bielak, Lawrence F; Zhao, Wei; Horikoshi, Momoko; Navarro, Pau; Isaacs, Aaron; O'Connell, Jeffrey R; Stirrups, Kathleen; Vitart, Veronique; Hayward, Caroline; Esko, Tõnu; Mihailov, Evelin; Fraser, Ross M; Fall, Tove; Voight, Benjamin F; Raychaudhuri, Soumya; Chen, Han; Lindgren, Cecilia M; Morris, Andrew P; Rayner, Nigel W; Robertson, Neil; Rybin, Denis; Liu, Ching-Ti; Beckmann, Jacques S; Willems, Sara M; Chines, Peter S; Jackson, Anne U; Kang, Hyun Min; Stringham, Heather M; Song, Kijoung; Tanaka, Toshiko; Peden, John F; Goel, Anuj; Hicks, Andrew A; An, Ping; Müller-Nurasyid, Martina; Franco-Cereceda, Anders; Folkersen, Lasse; Marullo, Letizia; Jansen, Hanneke; Oldehinkel, Albertine J; Bruinenberg, Marcel; Pankow, James S; North, Kari E; Forouhi, Nita G; Loos, Ruth J F; Edkins, Sarah; Varga, Tibor V; Hallmans, Göran; Oksa, Heikki; Antonella, Mulas; Nagaraja, Ramaiah; Trompet, Stella; Ford, Ian; Bakker, Stephan J L; Kong, Augustine; Kumari, Meena; Gigante, Bruna; Herder, Christian; Munroe, Patricia B; Caulfield, Mark; Antti, Jula; Mangino, Massimo; Small, Kerrin; Miljkovic, Iva; Liu, Yongmei; Atalay, Mustafa; Kiess, Wieland; James, Alan L; Rivadeneira, Fernando; Uitterlinden, Andre G; Palmer, Colin N A; Doney, Alex S F; Willemsen, Gonneke; Smit, Johannes H; Campbell, Susan; Polasek, Ozren; Bonnycastle, Lori L; Hercberg, Serge; Dimitriou, Maria; Bolton, Jennifer L; Fowkes, Gerard R; Kovacs, Peter; Lindström, Jaana; Zemunik, Tatijana; Bandinelli, Stefania; Wild, Sarah H; Basart, Hanneke V; Rathmann, Wolfgang; Grallert, Harald; Maerz, Winfried; Kleber, Marcus E; Boehm, Bernhard O; Peters, Annette; Pramstaller, Peter P; Province, Michael A; Borecki, Ingrid B; Hastie, Nicholas D; Rudan, Igor; Campbell, Harry; Watkins, Hugh; Farrall, Martin; Stumvoll, Michael; Ferrucci, Luigi; Waterworth, Dawn M; Bergman, Richard N; Collins, Francis S; Tuomilehto, Jaakko; Watanabe, Richard M; de Geus, Eco J C; Penninx, Brenda W; Hofman, Albert; Oostra, Ben A; Psaty, Bruce M; Vollenweider, Peter; Wilson, James F; Wright, Alan F; Hovingh, G Kees; Metspalu, Andres; Uusitupa, Matti; Magnusson, Patrik K E; Kyvik, Kirsten O; Kaprio, Jaakko; Price, Jackie F; Dedoussis, George V; Deloukas, Panos; Meneton, Pierre; Lind, Lars; Boehnke, Michael; Shuldiner, Alan R; van Duijn, Cornelia M; Morris, Andrew D; Toenjes, Anke; Peyser, Patricia A; Beilby, John P; Körner, Antje; Kuusisto, Johanna; Laakso, Markku; Bornstein, Stefan R; Schwarz, Peter E H; Lakka, Timo A; Rauramaa, Rainer; Adair, Linda S; Smith, George Davey; Spector, Tim D; Illig, Thomas; de Faire, Ulf; Hamsten, Anders; Gudnason, Vilmundur; Kivimaki, Mika; Hingorani, Aroon; Keinanen-Kiukaanniemi, Sirkka M; Saaristo, Timo E; Boomsma, Dorret I; Stefansson, Kari; van der Harst, Pim; Dupuis, Josée; Pedersen, Nancy L; Sattar, Naveed; Harris, Tamara B; Cucca, Francesco; Ripatti, Samuli; Salomaa, Veikko; Mohlke, Karen L; Balkau, Beverley; Froguel, Philippe; Pouta, Anneli; Jarvelin, Marjo-Riitta; Wareham, Nicholas J; Bouatia-Naji, Nabila; McCarthy, Mark I; Franks, Paul W; Meigs, James B; Teslovich, Tanya M; Florez, Jose C; Langenberg, Claudia; Ingelsson, Erik; Prokopenko, Inga; Barroso, Inês

2012-09-01

283

Effects of Cinnamon Consumption on Glycemic Status, Lipid Profile and Body Composition in Type 2 Diabetic Patients  

PubMed Central

Objective: Type 2 diabetes is the most common metabolic disorder worldwide. Traditional herbs and spices can be used to control blood glucose concentrations. The objective of this study was to evaluate the effects of the daily intake of three grams cinnamon over eight weeks on glycemic status, lipid profiles and body composition in type 2 diabetic patients. Methods: A double blind, randomized, placebo controlled clinical trial was conducted on 44 patients with type 2 diabetes. Participants were randomly assigned to take either a three g/day cinnamon supplement (n=22) or a placebo (n=22) for eight weeks. Weight, height, body fat mass and systolic and diastolic blood pressure were measured at baseline and after intervention. The fasting blood glucose, insulin, HbA1c, total cholesterol, LDL C, HDL C, Apo lipoprotein A I and B were measured at baseline and endpoint. Results: From 44 subjects participated in this study 37 completed the study. There were no significant differences in baseline characteristics, dietary intake and physical activity between groups. In the treatment group, the levels of fasting blood glucose, HbA1c, triglyceride, weight, BMI and body fat mass decreased significantly compared to baseline, but not in placebo group. No significant differences were observed in glycemic status indicators, lipid profile and anthropometric indicators between the groups at the end of intervention. Conclusion: These data suggest that cinnamon may have a moderate effect in improving glycemic status indicators. PMID:22973482

Vafa, Mohammadreza; Mohammadi, Farhad; Shidfar, Farzad; Sormaghi, Mohammadhossein Salehi; Heidari, Iraj; Golestan, Banafshe; Amiri, Fatemehsadat

2012-01-01

284

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

Microsoft Academic Search

OBJECTIVE: Foods with contrasting glycemic index when incorporated into a meal, are able to differentially modify glycemia and insulinemia. However, little is known about whether this is dependent on the size of the meal. The purposes of this study were: i) to determine if the differential impact on blood glucose and insulin responses induced by contrasting GI foods is similar

José Galgani; Carolina Aguirre; Erik Díaz

2006-01-01

285

Chronic treatment with the dipeptidyl peptidase-4 inhibitor BI 1356 [(R)-8-(3-amino-piperidin-1-yl)-7-but-2-ynyl-3-methyl-1-(4-methyl-quinazolin-2-ylmethyl)-3,7-dihydro-purine-2,6-dione] increases basal glucagon-like peptide-1 and improves glycemic control in diabetic rodent models.  

PubMed

Antidiabetic effects of dipeptidyl peptidase-4 (DPP-4) inhibitors are exerted by potentiation of the biological activity of incretin hormones like glucagon-like peptide (GLP)-1. BI 1356 [proposed trade name Ondero; (R)-8-(3-amino-piperidin-1-yl)-7-but-2-ynyl-3-methyl-1-(4-methyl-quinazolin-2-ylmethyl)-3,7-dihydro-purine-2,6-dione] is a novel competitive, selective, potent, and long-acting DPP-4 inhibitor under clinical development for the treatment of type 2 diabetes. The effect of 1 to 2 months of chronic dosing of BI 1356 in two different animal models was investigated. The first is a primarily genetic model (Zucker diabetic fatty rats), and the second is a nongenetic model (mice with diabetes induced by a combination of high-fat diet and low-dose streptozotocin). BI 1356 was shown to lower HbA1c after multiple dosing in both models. The improvement of glycemic control achieved in disease models of different etiology suggests that BI 1356 would also be efficacious in treating a broad spectrum of type 2 diabetic patients. In addition, multiple dosing of BI 1356 leads to a sustained increase in basal levels of active GLP-1 in the systemic circulation, with expected long-term benefits on pancreatic alpha- and beta-cells. The effects on HbA1c and GLP-1 were superior to the short-acting DPP-4 inhibitor vildagliptin, demonstrating the potential of BI 1356 as a once daily treatment for type 2 diabetes at low therapeutic doses. PMID:18971371

Thomas, Leo; Tadayyon, Moh; Mark, Michael

2009-02-01

286

LETTER TO THE EDITOR IN REBUTTAL TO "INFLUENCE OF GLYCEMIC INEX/LOAD ON GLYCEMIC RESPONSE, APPETITE, AND FOOD INTAKE IN HEALTHY HUMANS"  

Technology Transfer Automated Retrieval System (TEKTRAN)

In their recent article, Alfenas and Mattes(1) conclude that the glycemic index values (GI) of individual foods do not predict glycemic response (GR) to mixed meals, nor influence measures of hunger. Because the observed GR did not differ between diets, the lack of effect on appetite is not surprisi...

287

Prevention and early intervention for anxiety disorders: a controlled trial.  

PubMed

The Queensland Early Intervention and Prevention of Anxiety Project evaluated the effectiveness of a cognitive-behavioral and family-based group intervention for preventing the onset and development of anxiety problems in children. A total of 1,786 7- to 14-year-olds were screened for anxiety problems using teacher nominations and children's self-report. After recruitment and diagnostic interviews, 128 children were selected and assigned to a 10-week school-based child- and parent-focused psychosocial intervention or to a monitoring group. Both groups showed improvements immediately postintervention. At 6 months follow-up, the improvement maintained in the intervention group only, reducing the rate of existing anxiety disorder and preventing the onset of new anxiety disorders. Overall, the results showed that anxiety problems and disorders identified using child and teacher reports can be successfully targeted through an early intervention school-based program. PMID:9256564

Dadds, M R; Spence, S H; Holland, D E; Barrett, P M; Laurens, K R

1997-08-01

288

Milestones:Early Developments in Remote-Control, 1901  

NSDL National Science Digital Library

This site provides a brief history of the development of remote control devices by Spanish engineer Leonardo Torres-Quevedo. He was the first person to lay down the modern remote control operation principles, which he expressed in a prototype that he patented in 1903 under the name Telekine.

289

Charting Early Trajectories of Executive Control with the Shape School  

ERIC Educational Resources Information Center

Despite acknowledgement of the importance of executive control for learning and behavior, there is a dearth of research charting its developmental trajectory as it unfolds against the background of children's sociofamilial milieus. Using a prospective, cohort-sequential design, this study describes growth trajectories for inhibitory control

Clark, Caron A. C.; Sheffield, Tiffany D.; Chevalier, Nicolas; Nelson, Jennifer Mize; Wiebe, Sandra A.; Espy, Kimberly Andrews

2013-01-01

290

Familial liability, obstetric complications and childhood development abnormalities in early onset schizophrenia: a case control study  

Microsoft Academic Search

Background  Genetic and environmental risk factors and gene-environment interactions are linked to higher likelihood of developing schizophrenia\\u000a in accordance with the neurodevelopmental model of disease; little is known about risk factors and early development in early-onset\\u000a schizophrenia (EOS) and very early-onset schizophrenia (VEOS).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We present a case-control study of a sample of 21 patients with EOS\\/VEOS and a control group of

Francesco Margari; Maria G Petruzzelli; Paola A Lecce; Orlando Todarello; Andrea De Giacomo; Elisabetta Lucarelli; Domenico Martinelli; Lucia Margari

2011-01-01

291

THE EFFECTS OF HIGH AND LOW GLYCEMIC INDEX MEALS ON METABOLISM AND ENDURANCE PERFORMANCE  

Microsoft Academic Search

Thomas, G.J. and Moore, L.J. The effects of high and low glycemic index meals on metabolism and performance. Journal of Undergraduate Kinesiology Research 2008;3(2):89-104. Purpose: The ingestion of carbohydrate rich pre-exercise meals alters the glycemic and insulinemic responses during subsequent exercise and can impact substrate utilisation and hence performance, especially during prolonged exercise. As a result, the glycemic index (GI)

Thomas Gemma; Moore Laura

292

Protein, Carbohydrates and Weight Control  

MedlinePLUS Videos and Cool Tools

... Control HealthDay April 16, 2015 Related MedlinePlus Pages Diets Weight Control Transcript Eat this. Don’t eat ... their protein consumption, carbohydrate habits and where their diet registered on the glycemic index, which indicates its ...

293

Early risk stratification in pediatric type 1 diabetes.  

PubMed

In the late 1980s all Danish children with type 1 diabetes were invited for a nationwide evaluation of glycemic control. Approximately 75% (n = 720) participated and have later been referred to as The Danish Cohort of Pediatric Diabetes 1987 (DCPD1987). The results were surprisingly poor glycemic control among these young patients which lead to a great emphasis on glycemic control in the Danish Pediatric Departments. In 1995 the participants were invited for yet another evaluation but this time with main focus on early signs of microvascular complications - 339 participated. The mean HbA1c had remained at high levels (9.6%) and 60% of the participants had some level of Diabetic Retinopathy (DR). However, as the patients with DR mostly had the very milder forms it was believed that stricter glycemic control would reverse or at least stop progression of the disease in accordance with results from the large intervention study DCCT. This was investigated further at follow-up in 2011. The first study in the present thesis aimed to describe the 16-year incidence, progression and regression of DR in 185 participants from the DCPD1987 cohort. The 16-year incidence of proliferative retinopathy (PDR), 2-step progression and regression of DR was 31.0, 64.4, and 0.0%, respectively. As expected, the participants with PDR at follow-up had significantly higher HbA1c-values at both baseline and follow-up than those without PDR. However; a significantly larger decrease in HbA1c was also observed in the group with PDR over the study period, which in accordance with DCCT should have prevented the development of PDR to some extent. A surprisingly high incidence of proliferative retinopathy amongst young patients with type 1 diabetes in Denmark was found despite improvements in HbA1c over time. The improvement in HbA1c was either too small or happened too late. This study highlights that sight-threatening diabetic retinopathy remain a major concern in type 1 diabetes and the importance of early glycemic control. Identifying high-risk patients at a very early stage is not only desired for prevention of diabetic retinopathy - neuropathy and nephropathy similarly remain frequent in type 1 diabetes. Early risk stratification will allow for timely implementation of effective interventions and for individualized screening and diabetes care. The second and third studies of this thesis provide the longest prospective studies to date on both retinal vessel calibers and retinal fractal dimensions and their predictive value on diabetic microvascular complications. Semi-automated computer software has been developed to measure smaller changes in the retinal vessels on retinal photographs. Two of the first parameters to be reliably estimated by these programs were retinal vessel calibers and retinal vascular fractal dimensions (a quantitative measure on vascular complexity). There is very limited knowledge on their predictive value on diabetic complications thus far. In the second and third study, a consistent relation between narrower retinal arteriolar calibers, wider retinal venular calibers, lower fractal dimensions and the 16-year incidences of diabetic neuropathy, nephropathy and proliferative retinopathy was found. This has never been shown before. The results on vessel analyzes provides indications of a common pathogenic pathway for diabetic microvascular complications and therefore a possibility of universal risk estimation for development of neuropathy, nephropathy and retinopathy in type 1 diabetes. PMID:25703648

Broe, Rebecca

2015-03-01

294

Gain control network conditions in early sensory coding.  

PubMed

Gain control is essential for the proper function of any sensory system. However, the precise mechanisms for achieving effective gain control in the brain are unknown. Based on our understanding of the existence and strength of connections in the insect olfactory system, we analyze the conditions that lead to controlled gain in a randomly connected network of excitatory and inhibitory neurons. We consider two scenarios for the variation of input into the system. In the first case, the intensity of the sensory input controls the input currents to a fixed proportion of neurons of the excitatory and inhibitory populations. In the second case, increasing intensity of the sensory stimulus will both, recruit an increasing number of neurons that receive input and change the input current that they receive. Using a mean field approximation for the network activity we derive relationships between the parameters of the network that ensure that the overall level of activity of the excitatory population remains unchanged for increasing intensity of the external stimulation. We find that, first, the main parameters that regulate network gain are the probabilities of connections from the inhibitory population to the excitatory population and of the connections within the inhibitory population. Second, we show that strict gain control is not achievable in a random network in the second case, when the input recruits an increasing number of neurons. Finally, we confirm that the gain control conditions derived from the mean field approximation are valid in simulations of firing rate models and Hodgkin-Huxley conductance based models. PMID:23874176

Serrano, Eduardo; Nowotny, Thomas; Levi, Rafael; Smith, Brian H; Huerta, Ramón

2013-01-01

295

Gain Control Network Conditions in Early Sensory Coding  

PubMed Central

Gain control is essential for the proper function of any sensory system. However, the precise mechanisms for achieving effective gain control in the brain are unknown. Based on our understanding of the existence and strength of connections in the insect olfactory system, we analyze the conditions that lead to controlled gain in a randomly connected network of excitatory and inhibitory neurons. We consider two scenarios for the variation of input into the system. In the first case, the intensity of the sensory input controls the input currents to a fixed proportion of neurons of the excitatory and inhibitory populations. In the second case, increasing intensity of the sensory stimulus will both, recruit an increasing number of neurons that receive input and change the input current that they receive. Using a mean field approximation for the network activity we derive relationships between the parameters of the network that ensure that the overall level of activity of the excitatory population remains unchanged for increasing intensity of the external stimulation. We find that, first, the main parameters that regulate network gain are the probabilities of connections from the inhibitory population to the excitatory population and of the connections within the inhibitory population. Second, we show that strict gain control is not achievable in a random network in the second case, when the input recruits an increasing number of neurons. Finally, we confirm that the gain control conditions derived from the mean field approximation are valid in simulations of firing rate models and Hodgkin-Huxley conductance based models. PMID:23874176

Serrano, Eduardo; Nowotny, Thomas; Levi, Rafael; Smith, Brian H.; Huerta, Ramón

2013-01-01

296

Early Implementation of THAM for ICP Control: Therapeutic Hypothermia Avoidance and Reduction in Hypertonics/Hyperosmotics  

PubMed Central

Background. Tromethamine (THAM) has been demonstrated to reduce intracranial pressure (ICP). Early consideration for THAM may reduce the need for other measures for ICP control. Objective. To describe 4 cases of early THAM therapy for ICP control and highlight the potential to avoid TH and paralytics and achieve reduction in sedation and hypertonic/hyperosmotic agent requirements. Methods. We reviewed the charts of 4 patients treated with early THAM for ICP control. Results. We identified 2 patients with aneurysmal subarachnoid hemorrhage (SAH) and 2 with traumatic brain injury (TBI) receiving early THAM for ICP control. The mean time to initiation of THAM therapy was 1.8 days, with a mean duration of 5.3 days. In all patients, after 6 to 12 hours of THAM administration, ICP stability was achieved, with reduction in requirements for hypertonic saline and hyperosmotic agents. There was a relative reduction in mean hourly hypertonic saline requirements of 89.1%, 96.1%, 82.4%, and 97.0% for cases 1, 2, 3, and 4, respectively, comparing pre- to post-THAM administration. Mannitol, therapeutic hypothermia, and paralytics were avoided in all patients. Conclusions. Early administration of THAM for ICP control could potentially lead to the avoidance of other ICP directed therapies. Prospective studies of early THAM administration are warranted. PMID:25544901

Zeiler, F. A.; Gillman, L. M.; Teitelbaum, J.; West, M.

2014-01-01

297

Dimensions of Locus of Control: Impact of Early Educational Experiences.  

ERIC Educational Resources Information Center

A study was conducted to: (1) assess the equivalence of the Nowicki Strickland Locus of Control Scale for Children, the Stephens-Delys Reinforcement Contingency Interview, and the Gruen-Korte-Stephens test and the construct validity of each; and (2) investigate the impact on IE of the open classroom Follow Through program sponsored by the…

Stephens, Mark W.

298

Inhibitory Control during Emotional Distraction across Adolescence and Early Adulthood  

ERIC Educational Resources Information Center

This study investigated the changing relation between emotion and inhibitory control during adolescence. One hundred participants between 11 and 25 years of age performed a go-nogo task in which task-relevant stimuli (letters) were presented at the center of large task-irrelevant images depicting negative, positive, or neutral scenes selected from…

Cohen-Gilbert, Julia E.; Thomas, Kathleen M.

2013-01-01

299

Effect of Glycemic Treatment and Microvascular Complications on Menopause in Women With Type 1 Diabetes in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Cohort  

PubMed Central

OBJECTIVE We examined the impact of intensive versus conventional diabetes treatment upon menopause among women with type 1 diabetes in the Diabetes Control and Complications Trial (DCCT), a randomized controlled trial of intensive diabetes treatment, and its observational follow-up, the Epidemiology of Diabetes Interventions and Complications (EDIC) study. RESEARCH DESIGN AND METHODS In a secondary analysis of women in the DCCT/EDIC (n = 657), outcomes were the cumulative incidences of natural menopause and surgical menopause. Cox regression analyses were used to examine associations with treatment group, time-varying estimates of hemoglobin A1c (HbA1c), insulin dosage, BMI, and microvascular complications (retinopathy, nephropathy, and neuropathy). RESULTS By EDIC year 18, after an average of 28 years of follow-up, 240 (38%) women had experienced natural menopause and 115 (18%) women had experienced surgical menopause. Age at natural menopause was similar in the intensive versus conventional groups (49.9 vs. 49.0 years; P = 0.28), and age at surgical menopause was similar in the intensive versus conventional groups (40.8 vs. 42.0 years; P = 0.31). In multivariable models, treatment group, HbA1c, and microvascular complications were not associated with risk of natural or surgical menopause. Each 10 unit/day increase in insulin dosage decreased risk of natural menopause (hazard ratio [HR] 0.91, 95% CI 0.75–0.98) and each kg/m2 increase in BMI increased risk of surgical menopause (HR 1.08, 95% CI 1.00–1.16). CONCLUSIONS In the DCCT/EDIC, intensive versus conventional treatment group and HbA1c level were not associated with menopause risk. Greater insulin dose was associated with lower menopause risk. PMID:24170751

Kim, Catherine; Cleary, Patricia A.; Cowie, Catherine C.; Braffett, Barbara H.; Dunn, Rodney L.; Larkin, Mary E.; Gatcomb, Patricia M.; Wessells, Hunter B.; Nathan, David M.; Sarma, Aruna V.

2014-01-01

300

An early warning and security countermeasure (EWSC) system for electric power control centers  

Microsoft Academic Search

An early warning and security countermeasure (EWSC) system for electric power control centers is proposed in this paper. Taking advantage of real-time data from SCADA system in a control center, this system automatically tracks operation state of the electric power system, ranks and screens contingencies, determines security levels of current system and finally gives corresponding countermeasures according to the security

B. M. Zhang; S. N. Wu; B. Cai; W. C. Wu; H. B. Sun; Q. Guo

2005-01-01

301

Promoting Early Intervention Referral through a Randomized Controlled Home-Visiting Program  

ERIC Educational Resources Information Center

The MOM Program is a randomized, controlled trial of an intervention to promote mothers' care for the health and development of their children, including accessing early intervention (EI) services. Study aims were to determine whether, relative to controls, this intervention increased receipt of and referral to EI services. Mothers (N = 302)…

Schwarz, Donald F.; O'Sullivan, Ann L.; Guinn, Judith; Mautone, Jennifer A.; Carlson, Elyse C.; Zhao, Huaqing; Zhang, Xuemei; Esposito, Tara L.; Askew, Megan; Radcliffe, Jerilynn

2012-01-01

302

An Examination of Locus of Control, Epistemological Beliefs and Metacognitive Awareness in Preservice Early Childhood Teachers  

ERIC Educational Resources Information Center

This study aims to explore the locus of control, epistemological beliefs and metacognitive awareness levels of preservice early childhood education teachers and to determine the interrelations among these variables. 206 teacher candidates have been asked to fill out Rotter's Internal-External Locus of Control Scale, Central Epistemological Beliefs…

Bedel, Emine Ferda

2012-01-01

303

Relations among Peer Acceptance, Inhibitory Control, and Math Achievement in Early Adolescence  

ERIC Educational Resources Information Center

This study examined relations among peer acceptance, inhibitory control, and math achievement in ninety-nine 4th and 5th grade early adolescents. Teachers rated students on peer acceptance and students completed a computerized executive function task assessing inhibitory control. Math achievement was assessed via end of year math grades. Results…

Oberle, Eva; Schonert-Reichl, Kimberly A.

2013-01-01

304

Controls on development and diversity of Early Archean stromatolites  

PubMed Central

The ?3,450-million-year-old Strelley Pool Formation in Western Australia contains a reef-like assembly of laminated sedimentary accretion structures (stromatolites) that have macroscale characteristics suggestive of biological influence. However, direct microscale evidence of biology—namely, organic microbial remains or biosedimentary fabrics—has to date eluded discovery in the extensively-recrystallized rocks. Recently-identified outcrops with relatively good textural preservation record microscale evidence of primary sedimentary processes, including some that indicate probable microbial mat formation. Furthermore, we find relict fabrics and organic layers that covary with stromatolite morphology, linking morphologic diversity to changes in sedimentation, seafloor mineral precipitation, and inferred microbial mat development. Thus, the most direct and compelling signatures of life in the Strelley Pool Formation are those observed at the microscopic scale. By examining spatiotemporal changes in microscale characteristics it is possible not only to recognize the presence of probable microbial mats during stromatolite development, but also to infer aspects of the biological inputs to stromatolite morphogenesis. The persistence of an inferred biological signal through changing environmental circumstances and stromatolite types indicates that benthic microbial populations adapted to shifting environmental conditions in early oceans. PMID:19515817

Allwood, Abigail C.; Grotzinger, John P.; Knoll, Andrew H.; Burch, Ian W.; Anderson, Mark S.; Coleman, Max L.; Kanik, Isik

2009-01-01

305

The Effect of Intensive Glycemic Treatment on Coronary Artery Calcification in Type 1 Diabetic Participants of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study  

PubMed Central

The Epidemiology of Diabetes Interventions and Complications (EDIC) study, an observational follow-up of the Diabetes Control and Complications Trial (DCCT) type 1 diabetes cohort, measured coronary artery calcification (CAC), an index of atherosclerosis, with computed tomography (CT) in 1,205 EDIC patients at ~7–9 years after the end of the DCCT. We examined the influence of the 6.5 years of prior conventional versus intensive diabetes treatment during the DCCT, as well as the effects of cardiovascular disease risk factors, on CAC. The prevalences of CAC >0 and >200 Agatston units were 31.0 and 8.5%, respectively. Compared with the conventional treatment group, the intensive group had significantly lower geometric mean CAC scores and a lower prevalence of CAC >0 in the primary retinopathy prevention cohort, but not in the secondary intervention cohort, and a lower prevalence of CAC >200 in the combined cohorts. Waist-to-hip ratio, smoking, hypertension, and hypercholesterolemia, before or at the time of CT, were significantly associated with CAC in univariate and multivariate analyses. CAC was associated with mean HbA1c (A1C) levels before enrollment, during the DCCT, and during the EDIC study. Prior intensive diabetes treatment during the DCCT was associated with less atherosclerosis, largely because of reduced levels of A1C during the DCCT. PMID:17130504

Cleary, Patricia A.; Orchard, Trevor J.; Genuth, Saul; Wong, Nathan D.; Detrano, Robert; Backlund, Jye-Yu C.; Zinman, Bernard; Jacobson, Alan; Sun, Wanjie; Lachin, John M.; Nathan, David M.

2008-01-01

306

Bean and rice meals reduce postprandial glycemic response in adults with type 2 diabetes: a cross-over study  

PubMed Central

Background Around the world, beans and rice are commonly consumed together as a meal. With type 2 diabetes increasing, the effect of this traditional diet pattern on glycemic response has not been studied fully. Methods We evaluated the glycemic response of bean and rice traditional meals compared to rice alone in adults with type 2 diabetes. Seventeen men and women with type 2 diabetes controlled by metformin (n?=?14) or diet/exercise (n?=?3) aged 35–70?years participated in the randomized 4?×?4 crossover trial. The white long grain rice control, pinto beans/rice, black beans/rice, red kidney beans/rice test meals, matched for 50 grams of available carbohydrate, were consumed at breakfast after a 12 hour fast. Capillary blood glucose concentrations at baseline and at 30 minute intervals up to 180 minutes postprandial were collected. MANOVA for repeated measures established glucose differences between treatments. Paired t tests identified differences between bean types and the rice control following a significant MANOVA. Results Postprandial net glucose values were significantly lower for the three bean/rice treatments in contrast to the rice control at 90, 120 and 150 minutes. Incremental area under the curve values were significantly lower for the pinto and black bean/rice meals compared to rice alone, but not for kidney beans. Conclusions Pinto, dark red kidney and black beans with rice attenuate the glycemic response compared to rice alone. Promotion of traditional foods may provide non-pharmaceutical management of type 2 diabetes and improve dietary adherence with cultural groups. Trial registration Clinical Trials number NCT01241253 PMID:22494488

2012-01-01

307

Extended insulin boluses cannot control postprandial glycemia as well as a standard bolus in children and adults using insulin pump therapy  

PubMed Central

Introduction Insulin pumps are able to deliver bolus insulin as a standard, extended or combination bolus. There is minimal research to determine which bolus is preferable in different settings. Anecdotally, many patients utilizes only the standard bolus (SB) due to uncertainty regarding when and how to program the different bolus types. We compared postprandial glycemia when five different extended boluses (EBs) and an SB were used following a test meal. We sought to determine the impact of varying rates of insulin delivery from an EB on early postprandial glycemia. Methods We conducted a randomized, repeated measures trial of 20 children and adults comparing postprandial glycemic excursions following EBs given at five different rates with SB as a control. All EBs were delivered over 2?h. Rates of EBs were chosen to reflect EBs used in clinical practice: EB1HR=100% of insulin:carbohydrate ratio (ICR) per hour (200% ICR total dose); EB2HR=50% of ICR per hour; EB3HR=33% of ICR per hour; EB4HR=25% of ICR per hour; EB6HR=16% ICR per hour. A standardized breakfast was given and activity was standardized. Continuous glucose monitoring was used to assess glycemia for 2?h after the meal. Results The mean postprandial glycemic excursions were lower at 30, 60, and 90?min (p<0.05) for SB compared with all EBs. The mean peak postprandial glycemic excursion and the area under the curve was lower for SB compared with all EBs (p<0.05). Discussion EBs resulted in higher postprandial glycemic excursions than SB for 2?h after the meal. For a moderate glycemic index meal EBs are unable to control glycemia for 2?h after a meal as well as SB. Further studies with different meal types are required to determine the impact of differential delivery of the EB on postprandial glycemia. Trial registration number ACTRN12612000609853. PMID:25489486

Lopez, Prudence; Smart, Carmel; Morbey, Claire; McElduff, Patrick; Paterson, Megan; King, Bruce R

2014-01-01

308

Mandibular Motor Control During the Early Development of Speech and Nonspeech Behaviors  

PubMed Central

Purpose The mandible is often portrayed as a primary structure of early babble production, but empiricists still need to specify (a) how mandibular motor control and kinematics vary among different types of multisyllabic babble, (b) whether chewing or jaw oscillation relies on a coordinative infrastructure that can be exploited for early types of multisyllables, and (c) whether the organization of motor control and associated kinematics varies across the nonspeech behaviors that are candidate motor stereotypies for speech. Method Electromyographic signals were obtained from mandibular muscle groups, and associated kinematics were measured longitudinally from a typically developing infant from 9 to 22 months during jaw oscillation, chewing, and several types of early multisyllabic babble. Results Measures of early motor control and mandibular kinematics for multisyllabic productions indicated task-dependent changes across syllable types and significant differences across babble and nonspeech behaviors. Differences in motor control were also observed across nonspeech behaviors. Conclusions Motor control for babble appears to be influenced by the balanced interaction between developing motor and linguistic systems, such that variation in linguistic complexity systematically evinces changes in motor organization apparently to meet these demands. This same effect was noted among chewing and jaw oscillation; task-dependent changes in mandibular control were noted across behaviors. PMID:19717649

Steeve, Roger W.; Moore, Christopher A.

2014-01-01

309

TRC210258, a novel TGR5 agonist, reduces glycemic and dyslipidemic cardiovascular risk in animal models of diabesity  

PubMed Central

Background Patients with diabesity have a significantly increased risk of developing cardiovascular disease. Therefore, therapy addressing the multiple metabolic abnormalities linked with diabesity and leading to further reduction of cardiovascular risk is highly desirable. Activation of the TGR5 receptor holds therapeutic potential for diabesity. In the present study, we evaluated the efficacy of TRC210258, a novel TGR5 agonist, in clinically relevant animal models of diabesity. Methods A novel small molecule, TRC210258 (N-(4-chlorophenyl)-2-(4-fluorophenoxy)-N-methylimidazo (1, 2-a) pyrimidine-3-carboxamide), was synthesized. The in vitro TGR5 receptor activation potential of TRC210258 was assessed by cyclic adenosine monophosphate (cAMP) assay and cAMP-responsive element reporter assay using cells overexpressing the human TGR5 receptor. The effect of TRC210258 on glucagon-like peptide-1 release was evaluated in vitro using a human enteroendocrine cell line. The effect of TRC210258 on energy expenditure and glycemic control was evaluated in high-fat diet-induced obese mice. Additionally, the effect of TRC210258 on dyslipidemic parameters was determined in high fat-fed hamsters. Results TRC210258 demonstrated potent TGR5 agonist activity, with enhanced glucagon-like peptide-1 release and energy expenditure. Treatment with TRC210258 resulted in better glycemic control and improved parameters of dyslipidemia such as plasma triglyceride, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol levels. Treatment with TRC210258 also improved emerging dyslipidemic cardiovascular risk parameters, including remnant cholesterol and triglyceride clearance. Conclusion This study highlights the potential of TRC210258, a novel TGR5 agonist, to improve dyslipidemic cardiovascular risk beyond glycemic control in patients with type 2 diabetes. PMID:24379686

Zambad, Shitalkumar P; Tuli, Davinder; Mathur, Anoop; Ghalsasi, Sameer A; Chaudhary, Anita R; Deshpande, Shailesh; Gupta, Ramesh C; Chauthaiwale, Vijay; Dutt, Chaitanya

2014-01-01

310

Automated Computation of Glycemic Index for Foodstuffs Using Continuous Glucose Monitoring  

Microsoft Academic Search

Background: The glycemic index (GI) is a measure of the ability of a food to raise glucose levels after it is eaten. Continuous glucose monitoring (CGM) has been shown to give identical values of GI when compared to traditional methods. However, there has been no standardized protocol for measuring GI that takes into account interindividual variability and chronophysiological glycemic response

Rudolf Chlup; Pavel Se?ka?; Karolina Chlupová; Josef Bartek; Daniela Jelenová

2008-01-01

311

Mild traumatic brain injuries: the impact of early intervention on late sequelae. A randomized controlled trial  

Microsoft Academic Search

Summary  \\u000a Background. Positive results from early clinical intervention of mild traumatic brain injury (MTBI) patients by rehabilitation specialists\\u000a have been reported. Various treatments have been used, but few controlled studies are published. We hypothesised that early\\u000a rehabilitation of selected MTBI patients would reduce long term sequelae.\\u000a \\u000a \\u000a Method. A randomised controlled trial with one year follow-up. Among 1719 consecutive patients with

E. Elgmark Andersson; I. Emanuelson; R. Björklund; D. A. Stålhammar

2007-01-01

312

Nursing, social contexts, and ideologies in the early United States birth control movement.  

PubMed

Using historical discourse analysis, this study provides a thematic analysis of writings of nursing and birth control as found in The Birth Control Review from 1917 to 1927. The author contrasts this publication with the official journal of the American Nurses Association, the American Journal of Nursing from the same years to explore nursing voices and silences in early birth control stories. In dialogue with social contexts, nursing endeavors and inactivity have played important yet conflicting roles in the birth control movement in the United States. Nursing writings from the early twentieth century reflect eugenic beliefs, national fears of immigrants, and ambivalence about women's roles in society and the home. Nurses simultaneously empowered women to choose when to become pregnant and reinforced nativist and paternalistic views of the poor. PMID:10696211

Lagerwey, M D

1999-12-01

313

Effectiveness of lifestyle change plus dental care (LCDC) program on improving glycemic and periodontal status in the elderly with type 2 diabetes  

PubMed Central

Background Currently, there is an increased prevalence of diabetes mellitus among the elderly. To minimize adverse effects on glycemic control, prevention and management of general and oral complications in diabetic patients is essential. The purpose of the present study is to assess the effectiveness of a Lifestyle Change plus Dental Care (LCDC) program to improve glycemic and periodontal status in the elderly with type 2 diabetes. Methods A quasi-experimental study was conducted in Health Centers 54 (intervention) and 59 (control) from October 2013 to January 2014. 66 diabetic patients per health center were included. At baseline, the intervention group attended a 20 minute lifestyle and oral health education program, individual lifestyle counseling using motivational interviewing (MI), application of self regulation manual, and individual oral hygiene instruction. The intervention group received booster education every visit by viewing a 15 minute educational video. The control group received a routine program. Participants were assessed at baseline and 3 month follow up for glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI), periodontal status, knowledge, attitude and practice of oral health and diabetes mellitus. Data were analyzed by using descriptive statistic, Chi-square test, Fisher’s exact test, t-test, and multiple linear regression. Results After the 3 month follow up, a multiple linear regression analysis showed that the intervention group was significantly negatively correlated in both glycemic and periodontal status. Participants in the intervention group had significantly lower glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), plaque index score, gingival index score, pocket depth, clinical attachment level (CAL), and percentage of bleeding on probing (BOP) when compared to the control group. Conclusions The combination of lifestyle change and dental care in one program improved both glycemic and periodontal status in the elderly with type 2 diabetes. Trial registration ClinicalTrials.in.th: TCTR20140602001. PMID:24934646

2014-01-01

314

In an early branching metazoan, bacterial colonization of the embryo is controlled by maternal antimicrobial peptides.  

PubMed

Early embryos of many organisms develop outside the mother and are immediately confronted with myriads of potential colonizers. How these naive developmental stages control and shape the bacterial colonization is largely unknown. Here we show that early embryonic stages of the basal metazoan Hydra are able to control bacterial colonization by using maternal antimicrobial peptides. Antimicrobial peptides of the periculin family selecting for a specific bacterial colonization during embryogenesis are produced in the oocyte and in early embryos. If overexpressed in hydra ectodermal epithelial cells, periculin1a drastically reduces the bacterial load, indicating potent antimicrobial activity. Unexpectedly, transgenic polyps also revealed that periculin, in addition to bactericidal activity, changes the structure of the bacterial community. These findings delineate a role for antimicrobial peptides both in selecting particular bacterial partners during development and as important components of a "be prepared" strategy providing transgenerational protection. PMID:20921390

Fraune, Sebastian; Augustin, René; Anton-Erxleben, Friederike; Wittlieb, Jörg; Gelhaus, Christoph; Klimovich, Vladimir B; Samoilovich, Marina P; Bosch, Thomas C G

2010-10-19

315

In an early branching metazoan, bacterial colonization of the embryo is controlled by maternal antimicrobial peptides  

PubMed Central

Early embryos of many organisms develop outside the mother and are immediately confronted with myriads of potential colonizers. How these naive developmental stages control and shape the bacterial colonization is largely unknown. Here we show that early embryonic stages of the basal metazoan Hydra are able to control bacterial colonization by using maternal antimicrobial peptides. Antimicrobial peptides of the periculin family selecting for a specific bacterial colonization during embryogenesis are produced in the oocyte and in early embryos. If overexpressed in hydra ectodermal epithelial cells, periculin1a drastically reduces the bacterial load, indicating potent antimicrobial activity. Unexpectedly, transgenic polyps also revealed that periculin, in addition to bactericidal activity, changes the structure of the bacterial community. These findings delineate a role for antimicrobial peptides both in selecting particular bacterial partners during development and as important components of a “be prepared” strategy providing transgenerational protection. PMID:20921390

Fraune, Sebastian; Augustin, René; Anton-Erxleben, Friederike; Wittlieb, Jörg; Gelhaus, Christoph; Klimovich, Vladimir B.; Samoilovich, Marina P.; Bosch, Thomas C. G.

2010-01-01

316

Early Life Environmental Control Effect on Symptoms, Sensitization, and Lung Function at Age 3 Years  

Microsoft Academic Search

We investigated whether environmental control during pregnancy and early life affects sensitization and lung function at the age of 3 years. High-risk children (n 251) were prenatally randomized to stringent environmental control (active) or no intervention (con- trol). Questionnaires, skin testing, IgE, and specific airway resistance (sRaw) measurement were completed at the age of 3 years. Children in the active

Ashley Woodcock; Lesley A. Lowe; Clare S. Murray; Bridget M. Simpson; Spyros D. Pipis; Patricia Kissen; Angela Simpson; Adnan Custovic

317

Mobile phone base stations and early childhood cancers: case-control study  

Microsoft Academic Search

Objective To investigate the risk of early childhood cancers associated with the mother’s exposure to radiofrequency from and proximity to macrocell mobile phone base stations (masts) during pregnancy.Design Case-control study.Setting Cancer registry and national birth register data in Great Britain.Participants 1397 cases of cancer in children aged 0-4 from national cancer registry 1999-2001 and 5588 birth controls from national birth

Paul Elliott; Mireille B Toledano; J. Bennett; L. Beale; K. de Hoogh; N. Best; D. J. Briggs

2010-01-01

318

Developmental Changes in the Relations between Inhibitory Control and Externalizing Problems during Early Childhood  

ERIC Educational Resources Information Center

Deficits in executive function, and in particular, reduced capacity to inhibit a dominant action, are a risk factor for externalizing problems (EP). Inhibitory control (IC) develops in the later preschool and early childhood periods, such that IC might not regulate EP in toddlers and younger preschoolers. Aggression was observed during peer play…

Utendale, William T.; Hastings, Paul D.

2011-01-01

319

Improved age control on early Homo fossils from the upper Burgi Member at Koobi Fora, Kenya  

E-print Network

the evolutionary origin, radiation and dispersal of the genus Homo, it is crucial to be able to place substantial fossil record of the genus Homo is first found. Here we combine magnetostratigraphy and strontiumImproved age control on early Homo fossils from the upper Burgi Member at Koobi Fora, Kenya

Utrecht, Universiteit

320

The Chromosomal Control of Leaf Characteristics of Early-Stage Plants in Wheat ( Triticum aestivum L.)  

Microsoft Academic Search

Rapid expansion of leaves of early-stage plants in wheat produced by chromosomal control of characteristics related to rapid expansion of the first six leaves of wheat were investigated using a set of single chromosome substitution lines under two different temperature regimes (TRs). Results from this study indicated that several chromosomes could be responsible for each of the four characteristics studied

Cun-dong LI; Zhi-ying BAI; G Ye; M Miyagi; S Chapman; SM Reader; Chun-ji LIU

2011-01-01

321

The Control of Sexuality in the Early British Boy Scouts Movement  

ERIC Educational Resources Information Center

This article looks at the way in which the early (1907-1922) British Boy Scouts movement attempted to control sexuality through archival examination of the organization's preoccupation with preventing masturbation or, as it was generally referred to, "self abuse". Having briefly outlined the origination and nature of the Scouts, it considers why…

Pryke, Sam

2005-01-01

322

Anger and Approach Motivation in Infancy: Relations to Early Childhood Inhibitory Control and Behavior Problems  

ERIC Educational Resources Information Center

The relations among infant anger reactivity, approach behavior, and frontal electroencephalogram (EEG) asymmetry, and their relations to inhibitory control and behavior problems in early childhood were examined within the context of a longitudinal study of temperament. Two hundred nine infants' anger expressions to arm restraint were observed at 4…

He, Jie; Degnan, Kathryn Amey; McDermott, Jennifer Martin; Henderson, Heather A.; Hane, Amie Ashley; Xu, Qinmei; Fox, Nathan A.

2010-01-01

323

Zebrafish Pou5f1-dependent transcriptional networks in temporal control of early development  

E-print Network

Zebrafish Pou5f1-dependent transcriptional networks in temporal control of early development Daria of zebrafish pou5f1 MZspg mutant embryos to identify genes regulated by Pou5f1. Comparison to mammalian systems timing. The temporospatial structure of the zebrafish Pou5f1 target networks may explain aspects

Timmer, Jens

324

The argument against glycemic index: what are the other options?  

PubMed

There is debate among professionals regarding the use of the glycemic index (GI) for meal planning. In type-1 diabetes, there are 4 studies (average duration approximately 4 weeks) comparing high versus low GI diets; none reported improvements in HbA1c, and although 2 reported improvements in fructosamine, 2 reported no differences. In type-2 diabetes, there are 12 studies (average duration approximately 5 weeks); 3 reported improvements in HbA1c and fructosamine, 5 reported no differences in HBA1c, and 3 reported no differences in fructosamine. In adults, there is limited evidence that a low GI diet is beneficial for weight loss or satiety. Three epidemiologic studies reported that a low GI/glycemic load (GL) is associated with a reduced risk of developing diabetes or prevalence of insulin resistance; however, 5 studies report no association between GI/GL and the risk of developing diabetes, fasting insulin or insulin resistance, or adiposity. In general, the total amount of carbohydrate in a meal is the primary meal-planning strategy for people with diabetes. The GI can be used as an adjunct for the fine tuning of postprandial blood glucose responses. Other food/meal-planning interventions have been shown to be more effective than the use of the GI. PMID:16820731

Franz, Marion J

2006-01-01

325

Impaired Replication Capacity of Acute/Early Viruses in Persons Who Become HIV Controllers?  

PubMed Central

Human immunodeficiency virus type 1 (HIV-1) controllers maintain viremia at <2,000 RNA copies/ml without antiretroviral therapy. Viruses from controllers with chronic infection were shown to exhibit impaired replication capacities, in part associated with escape mutations from cytotoxic-T-lymphocyte (CTL) responses. In contrast, little is known about viruses during acute/early infection in individuals who subsequently become HIV controllers. Here, we examine the viral replication capacities, HLA types, and virus sequences from 18 HIV-1 controllers identified during primary infection. gag-protease chimeric viruses constructed using the earliest postinfection samples displayed significantly lower replication capacities than isolates from persons who failed to control viremia (P = 0.0003). Protective HLA class I alleles were not enriched in these early HIV controllers, but viral sequencing revealed a significantly higher prevalence of drug resistance mutations associated with impaired viral fitness in controllers than in noncontrollers (6/15 [40.0%] versus 10/80 [12.5%], P = 0.018). Moreover, of two HLA-B57-positive (B57+) controllers identified, both harbored, at the earliest time point tested, signature escape mutations within Gag that likewise impair viral replication capacity. Only five controllers did not express “protective” alleles or harbor viruses with drug resistance mutations; intriguingly, two of them displayed typical B57 signature mutations (T242N), suggesting the acquisition of attenuated viruses from B57+ donors. These data indicate that acute/early stage viruses from persons who become controllers have evidence of reduced replication capacity during the initial stages of infection which is likely associated with transmitted or acquired CTL escape mutations or transmitted drug resistance mutations. These data suggest that viral dynamics during acute infection have a major impact on HIV disease outcome. PMID:20504921

Miura, Toshiyuki; Brumme, Zabrina L.; Brockman, Mark A.; Rosato, Pamela; Sela, Jennifer; Brumme, Chanson J.; Pereyra, Florencia; Kaufmann, Daniel E.; Trocha, Alicja; Block, Brian L.; Daar, Eric S.; Connick, Elizabeth; Jessen, Heiko; Kelleher, Anthony D.; Rosenberg, Eric; Markowitz, Martin; Schafer, Kim; Vaida, Florin; Iwamoto, Aikichi; Little, Susan; Walker, Bruce D.

2010-01-01

326

Control of the papillomavirus early-to-late switch by differentially expressed SRp20.  

PubMed

The viral early-to-late switch of papillomavirus infection is tightly linked to keratinocyte differentiation and is mediated in part by alternative mRNA splicing. Here, we report that SRp20, a cellular splicing factor, controls the early-to-late switch via interactions with A/C-rich RNA elements. An A/C-rich SE4 element regulates the selection of a bovine papillomavirus type 1 (BPV-1) late-specific splice site, and binding of SRp20 to SE4 suppresses this selection. Expression of late BPV-1 L1 or human papillomavirus (HPV) L1, the major capsid protein, inversely correlates with SRp20 levels in the terminally differentiated keratinocytes. In HPV type 16, a similar SRp20-interacting element also controls the viral early-to-late switch. Keratinocytes in raft cultures, which support L1 expression, make considerably less SRp20 than keratinocytes in monolayer cultures, which do not support L1 expression. Conversely, abundant SRp20 in cancer cells or undifferentiated keratinocytes is important for the expression of the viral early E6 and E7 by promoting the expression of cellular transcription factor SP1 for transactivation of viral early promoters. PMID:18945760

Jia, Rong; Liu, Xuefeng; Tao, Mingfang; Kruhlak, Michael; Guo, Ming; Meyers, Craig; Baker, Carl C; Zheng, Zhi-Ming

2009-01-01

327

Effect of Education through Support ­Group on Early Symptoms of Menopause: a Randomized Controlled Trial  

PubMed Central

Introduction: Menopause is one of the most important crises in the life of women. The control of menopause symptoms is a main challenge in providing care to this population. So, the aim of present study was to investigate the effect of education through support ­group on early symptoms of menopause. Methods: In this randomized controlled clinical trial 124 postmenopausal women who had a health records in Valiasr participatory health center of Eslamshahr city were participated. These women were allocated by block randomization method into support group (62 women) and control group (62 women).Women in support group was assigned into 6 groups. Three 60-minutes educational sessions were conducted in 3 sequential weekly sessions. Early menopausal symptoms were measured before and 4 weeks after the intervention by using Greene scale (score ranged from 0 to 63). Data analysis was performed by ANCOVA statistical test. Results: There were no statistical differences between two groups in demographic characteristics and the total score of the Greene scale before intervention. The mean score of the Greene scale in support group was statistically less than control group 4 weeks after intervention. The number of hot flashes in the support group was significantly lower than control group, 4 weeks after intervention.Conclusion: Education through support group was effective in reducing the early symptoms of menopause. Thus, this educational method can be used as an appropriate strategy for enhancing women’ health and their dealing with annoying symptoms of menopause. PMID:25709980

Sehhatie Shafaie, Fahimeh; Mirghafourvand, Mozhgan; Jafari, Maryam

2014-01-01

328

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

PubMed Central

High-density lipoprotein (HDL) is a lipoprotein which has anti-atherogenic property by reverse cholesterol transport from the peripheral tissues to liver. Low HDL-cholesterol (HDL-C) levels are associated with the development of coronary artery diseases (CADs). Various epidemiological studies have suggested that the development of CAD increase in individuals with less than 40 mg/dL of HDL-C. In spite of accumulation of evidences which suggest a significant association between low HDL-C and cardiovascular diseases, effects of dietary factors on HDL metabolism remained largely unknown. There may be interracial differences in effects of dietary factors on HDL metabolism. Here we reviewed published articles about effects of carbohydrate and dietary fiber intake, glycemic index (GI) and glycemic load (GL), on HDL-C metabolism, regarding meta-analyses and clinical studies performed in Asian population as important articles. Low carbohydrate intake, GI and GL may be beneficially associated with HDL metabolism. Dietary fiber intake may be favorably associated with HDL metabolism in Asian populations. PMID:25110535

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

2014-01-01

329

Dietary glycemic load, glycemic index, and carbohydrates on the risk of primary liver cancer among Chinese women and men  

PubMed Central

Background Dietary glycemic index (GI) and glycemic load (GL) typically have a positive relationship with obesity and diabetes, which are risk factors for liver cancer. However, studies on their association with liver cancer have yielded inconsistent results. Therefore, we assessed the association of GI, GL, and carbohydrates with liver cancer risk. Patients and methods A total of 72 966 women and 60 207 men from the Shanghai Women's Health Study (SWHS) and the Shanghai Men's Health Study (SMHS) were included for analysis. Food frequency questionnaire (FFQ) data were used to calculate daily dietary GI, GL, and carbohydrate intake. These values were energy adjusted and categorized into quintiles. The hazard ratios (HRs) and 95% confidence intervals (CI) were calculated with adjustment for potential confounders. Results After a median follow-up time of 11.2 years for the SWHS and 5.3 years for the SMHS, 139 and 208 incident liver cancer cases were identified in the SWHS and SMHS, respectively. In multivariable Cox regression models, no statistically significant trends by quintile of GI, GL, or carbohydrate intake were observed. Stratification by chronic liver disease/hepatitis, diabetes, or body mass index (BMI) did not alter the findings. Conclusions There is little evidence that dietary GI, GL, or carbohydrates affect the incidence of liver cancer in this Asian population. PMID:22898034

Vogtmann, E.; Li, H. L.; Shu, X. O.; Chow, W. H.; Ji, B. T.; Cai, H.; Gao, J.; Zhang, W.; Gao, Y. T.; Zheng, W.; Xiang, Y. B.

2013-01-01

330

Genome-Wide Association Study Identifies Two Novel Loci with Sex-Specific Effects for Type 2 Diabetes Mellitus and Glycemic Traits in a Korean Population  

PubMed Central

Background Until recently, genome-wide association study (GWAS)-based findings have provided a substantial genetic contribution to type 2 diabetes mellitus (T2DM) or related glycemic traits. However, identification of allelic heterogeneity and population-specific genetic variants under consideration of potential confounding factors will be very valuable for clinical applicability. To identify novel susceptibility loci for T2DM and glycemic traits, we performed a two-stage genetic association study in a Korean population. Methods We performed a logistic analysis for T2DM, and the first discovery GWAS was analyzed for 1,042 cases and 2,943 controls recruited from a population-based cohort (KARE, n=8,842). The second stage, de novo replication analysis, was performed in 1,216 cases and 1,352 controls selected from an independent population-based cohort (Health 2, n=8,500). A multiple linear regression analysis for glycemic traits was further performed in a total of 14,232 nondiabetic individuals consisting of 7,696 GWAS and 6,536 replication study participants. A meta-analysis was performed on the combined results using effect size and standard errors estimated for stage 1 and 2, respectively. Results A combined meta-analysis for T2DM identified two new (rs11065756 and rs2074356) loci reaching genome-wide significance in CCDC63 and C12orf51 on the 12q24 region. In addition, these variants were significantly associated with fasting plasma glucose and homeostasis model assessment of ?-cell function. Interestingly, two independent single nucleotide polymorphisms were associated with sex-specific stratification in this study. Conclusion Our study showed a strong association between T2DM and glycemic traits. We further observed that two novel loci with multiple diverse effects were highly specific to males. Taken together, these findings may provide additional insights into the clinical assessment or subclassification of disease risk in a Korean population. PMID:25349825

Go, Min Jin; Hwang, Joo-Yeon; Park, Tae-Joon; Kim, Young Jin; Oh, Ji Hee; Kim, Yeon-Jung; Han, Bok-Ghee

2014-01-01

331

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

PubMed Central

Background Glucose variability is one of components of the dysglycemia in diabetes and may play an important role in development of diabetic vascular complications. The objective of this study was to assess the relationship between glycemic variability determined by a continuous glucose monitoring (CGM) system and the presence and severity of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM). Methods In 344 T2DM patients with chest pain, coronary angiography revealed CAD (coronary stenosis ? 50% luminal diameter narrowing) in 252 patients and 92 patients without CAD. Gensini score was used to assess the severity of CAD. All participants' CGM parameters and biochemical characteristics were measured at baseline. Results Diabetic patients with CAD were older, and more were male and cigarette smokers compared with the controls. Levels of the mean amplitude of glycemic excursions (MAGE) (3.7 ± 1.4 mmol/L vs. 3.2 ± 1.2 mmol/L, p < 0.001), postprandial glucose excursion (PPGE) (3.9 ± 1.6 mmol/L vs. 3.6 ± 1.4 mmol/L, p = 0.036), serum high-sensitive C-reactive protein (hs-CRP) (10.7 ± 12.4 mg/L vs. 5.8 ± 6.7 mg/L, p < 0.001) and creatinine (Cr) (87 ± 23 mmol/L vs. 77 ± 14 mmol/L, p < 0.001) were significantly higher in patients with CAD than in patients without CAD. Gensini score closely correlated with age, MAGE, PPGE, hemoglobin A1c (HbA1c), hs-CRP and total cholesterol (TC). Multivariate analysis indicated that age (p < 0.001), MAGE (p < 0.001), serum levels of HbA1c (p = 0.022) and hs-CRP (p = 0.005) were independent determinants for Gensini score. Logistic regression analysis revealed that MAGE ? 3.4 mmol/L was an independent predictor for CAD. The area under the receiver-operating characteristic curve for MAGE (0.618, p = 0.001) was superior to that for HbA1c (0.554, p = 0.129). Conclusions The intraday glycemic variability is associated with the presence and severity of CAD in patients with T2DM. Effects of glycemic excursions on vascular complications should not be neglected in diabetes. PMID:21349201

2011-01-01

332

Inhibitory Control in Preschool Predicts Early Math Skills in First Grade: Evidence from an Ethnically Diverse Sample  

ERIC Educational Resources Information Center

Preschoolers' inhibitory control and early math skills were concurrently and longitudinally examined in 255 Chinese, African American, Dominican, and Mexican 4-year-olds in the United States. Inhibitory control at age 4, assessed with a peg-tapping task, was associated with early math skills at age 4 and predicted growth in such skills from…

Ng, Florrie Fei-Yin; Tamis-LeMonda, Catherine; Yoshikawa, Hirokazu; Sze, Irene Nga-Lam

2015-01-01

333

Clinical Article Mild traumatic brain injuries: the impact of early intervention on late sequelae. A randomized controlled trial  

Microsoft Academic Search

Summary Background. Positive results from early clinical inter- vention of mild traumatic brain injury (MTBI) patients by rehabilitation specialists have been reported. Various treatments have been used, but few controlled studies are published. We hypothesised that early rehabilitation of selected MTBI patients would reduce long term sequelae. Method. A randomised controlled trial with one year follow-up. Among 1719 consecutive patients

E. Elgmark Andersson; I. Emanuelson; R. Bjorklund

334

An occupational health intervention programme for workers at risk for early retirement; a randomised controlled trial  

PubMed Central

Aims: To evaluate an occupational health intervention programme for workers at risk for early retirement. Methods: Between April 1997 and May 1998, 116 employees of a large company who were older than 50 years indicated that they would not be able to work up to their retirement. They were randomly assigned to an intervention (n = 61) or control group (n = 55). The intervention programme lasted six months and was executed by an occupational physician. Job position and number of sick leave days after two years were collected from the company's computer database. A questionnaire was sent to the employees at baseline, after six months, and after two years; it included the Work Ability Index, the Utrecht Burn Out Scale, and the Nottingham Health Profile measuring quality of life. Results: Fewer employees (11%) in the intervention group retired early than in the control group (28%). The total average number of sick leave days in two years was 82.3 for the intervention group and 107.8 for the control group. Six months after baseline, employees in the intervention group had better work ability, less burnout, and better quality of life than employees in the control group. Two years after randomisation no differences between the two groups were found. Conclusions: This occupational health intervention programme proved to be a promising intervention in the prevention of early retirement. PMID:15477286

de Boer, A G E M; van Beek, J-C; Durinck, J; Verbeek, J; van Dijk, F J H

2004-01-01

335

Insulin Use and Weight Maintenance in Well-controlled Type 2 Diabetes: A Prospective Cohort Study  

Microsoft Academic Search

Intensification of glycemic control is associated with weight gain, however, less is known about weight change during the maintenance phase of glycemic management. On the basis of current models of energy homeostasis, we hypothesize that insulin use will result in less weight gain than oral antidiabetic agents in patients with well-controlled diabetes. This is a prospective cohort nested within a

Mary Margaret Huizinga; Kevin D. Niswender; Tebeb Gebretsadik; Russell L. Rothman; Ayumi K. Shintani; Tom A. Elasy

2008-01-01

336

Early depolarizing GABA controls critical-period plasticity in the rat visual cortex.  

PubMed

Hyperpolarizing and inhibitory GABA regulates critical periods for plasticity in sensory cortices. Here we examine the role of early, depolarizing GABA in the control of plasticity mechanisms. We report that brief interference with depolarizing GABA during early development prolonged critical-period plasticity in visual cortical circuits without affecting the overall development of the visual system. The effects on plasticity were accompanied by dampened inhibitory neurotransmission, downregulation of brain-derived neurotrophic factor (BDNF) expression and reduced density of extracellular matrix perineuronal nets. Early interference with depolarizing GABA decreased perinatal BDNF signaling, and a pharmacological increase of BDNF signaling during GABA interference rescued the effects on plasticity and its regulators later in life. We conclude that depolarizing GABA exerts a long-lasting, selective modulation of plasticity of cortical circuits by a strong crosstalk with BDNF. PMID:25485756

Deidda, Gabriele; Allegra, Manuela; Cerri, Chiara; Naskar, Shovan; Bony, Guillaume; Zunino, Giulia; Bozzi, Yuri; Caleo, Matteo; Cancedda, Laura

2015-01-01

337

Early stage second-language learning improves executive control: Evidence from ERP.  

PubMed

A growing body of research has reported a bilingual advantage in performance on executive control tasks, but it is not known at what point in emerging bilingualism these advantages first appear. The present study investigated the effect of early stage second-language training on executive control. Monolingual English-speaking students were tested on a go-nogo task, sentence judgment task, and verbal fluency, before and after 6months of Spanish instruction. The training group (n=25) consisted of students enrolled in introductory Spanish and the control group (n=30) consisted of students enrolled in introductory Psychology. After training, the Spanish group showed larger P3 amplitude on the go-nogo task and smaller P600 amplitude on the judgment task, indicating enhanced performance, with no changes for the control group and no differences between groups on behavioral measures. Results are discussed in terms of neural changes underlying executive control after brief second-language learning. PMID:25463819

Sullivan, Margot D; Janus, Monika; Moreno, Sylvain; Astheimer, Lori; Bialystok, Ellen

2014-12-01

338

Automated Glycemic Pattern Analysis: Overcoming Diabetes Clinical Inertia  

PubMed Central

The OneTouch® Verio™ IQ Meter with PatternAlert™ Technology has been approved by the U.S. Food and Drug Administration as the first self-glucose monitor that can automatically determine glycemic patterns [high and low pre-meal blood glucose (BG)] for health care providers (HCPs) and patients. In this issue of Journal of Diabetes Science and Technology, Katz and coauthors demonstrate that this device was more accurate and quicker in detecting abnormal glucose patterns than the review by HCPs of 30-day handwritten BG logs and that its interpretations were positively accepted by the HCPs. Continued development of automated pattern analysis and decision-support software to overcome the “data-overload” associated with intensive glucose monitoring and diabetes management will reduce clinical inertia and could dramatically improve diabetes outcomes. PMID:23439174

Schwartz, Frank L.; Marling, Cynthia R.; Shubrook, Jay

2013-01-01

339

Growth and Survival of Early Juveniles of the Marine Sponge Hymeniacidon perlevis (Demospongiae) Under Controlled Conditions  

Microsoft Academic Search

To resolve “the supply problem” in sponge-derived drug development and other biotechnological applications, current research\\u000a is exploring the possibility of obtaining an alternative sustainable supply of sponge biomass through intensive aquaculture\\u000a of sponges utilizing artificial seed rearing. This study aimed to investigate the technology of early juvenile sponge cultivation\\u000a under controlled conditions. The effects of food, temperature, water flow, and

Lingyun Xue; Wei Zhang

2009-01-01

340

Controlled early feed restriction as a potential means of reducing the incidence of ascites in broilers.  

PubMed

Male broiler chicks were grown at cold temperatures to enhance susceptibility to the ascites syndrome. Various feeding regimens were used to determine whether they could influence mortality due to ascites. It was found that a precisely controlled early feed-restriction regimen at the age of 6 to 11 days significantly reduced mortality from all causes and mortality due to ascites, while maintaining optimum body weight and feed conversion at marketing age. PMID:1785999

Shlosberg, A; Berman, E; Bendheim, U; Plavnik, I

1991-01-01

341

Cognitive-Behavioral Group Therapy as an Early Intervention for Insomnia: A Randomized Controlled Trial  

Microsoft Academic Search

A randomized controlled design was used with a 1-yr follow-up. The purpose was to compare the effects of two early interventions, a cognitive-behavioral group intervention and a self-help information package, in patients with insomnia. In sum, 165 individuals seeking care for insomnia of 3–12 months duration were randomized to either a group receiving a CBT intervention or a group receiving

Markus Jansson; Steven J. Linton

2005-01-01

342

Glycemic response to tortilla consumption: Influence of physical activity and insulin resistance  

E-print Network

Insulin resistance (IR) reduces glucose uptake and leads to elevated glucose levels (EGL). Foods that limit postprandial glycemic response (PPGR) and exercising can help limit these EGL. 25 subjects consumed 6 different types of tortillas. Bean...

Fletcher, Justin Andrew

2010-07-26

343

Study on an advanced early rehabilitation training system for postural control using a tilting bed  

NASA Astrophysics Data System (ADS)

It proposed a new early rehabilitation training system for postural control using a tilting bed, a visual display and a force plate. The conventional rehabilitation systems for postural control can't be applied to the patients lying in bed because the rehabilitation training using those systems is only possible when the patient can stand up by himself or herself. Moreover, there did not exist any device that could provide the sense of balance or the sensation of walking to the patients in bed. The software for the system consists of the training program and the analysis program. The training program was designed to improve the ability of postural control of the subjects by repeated training of moving the center of pressure (COP) applied to the forceplate. The training program consists of the COP maintaining training and the COP movement training in horizontal, vertical, 45° and -45° directions. The analysis program consists of the COP moving time analysis modules, the COP maintaining time analysis module. Through the experiments with real people, it verified the effectiveness of the new early rehabilitation training system. The results showe that this system is an effective system for early rehabilitation training and that our system might be useful as clinical equipment.

Yu, Chang-Ho; Kim, Kyong; Kwon, Tae-Kyu; Hong, Chul-Un; Kim, Nam-Gyun

2005-12-01

344

Dietary glycemic index and risk of type 2 diabetes mellitus in middle-aged Japanese men  

Microsoft Academic Search

This cohort study investigated the association between dietary glycemic index (GI), glycemic load (GL), and the incidence of type 2 diabetes mellitus in middle-aged Japanese men, and the effect of insulin resistance and pancreatic B-cell function on the association. Participants were 1995 male employees of a metal products factory in Japan. Dietary GI and GL were assessed using a self-administered

Masaru Sakurai; Koshi Nakamura; Katsuyuki Miura; Toshinari Takamura; Katsushi Yoshita; Yuko Morikawa; Masao Ishizaki; Teruhiko Kido; Yuchi Naruse; Yasushi Suwazono; Shuichi Kaneko; Satoshi Sasaki; Hideaki Nakagawa

345

Early seasonal development of brain song control nuclei in male blue tits  

PubMed Central

In songbirds, the seasonal growth of the song system is generally thought to be controlled by the spring increase in plasma levels of testosterone and/or related changes in singing activity. Here we report an extremely early seasonal growth (before February) of the song control nuclei HVC and RA in Corsican blue tits (Parus caeruleus) indicating that the vernal development of these nuclei occurs well before the vernal increase in plasma testosterone, testes size and song activity. The development of HVC and RA occurred simultaneously in two populations that are known to breed consistently one month apart as an adaptation to heterogeneous landscapes (predominance of broad-leaved deciduous versus evergreen oak trees). The unidentified environmental and/or physiological cues controlling the plasticity in the song system must therefore differ, at least in part, from those affecting other morphological and physiological traits controlling reproduction. PMID:16051436

Caro, Samuel P.; Lambrechts, Marcel M.; Balthazart, Jacques

2007-01-01

346

Dietary glycemic index and glycemic load and risk of colorectal cancer: results from the EPIC-Italy study.  

PubMed

A carbohydrate-rich diet, resulting in high blood glucose and insulin, has been hypothesized as involved in colorectal cancer etiology. We investigated dietary glycemic index (GI) and glycemic load (GL), in relation to colorectal cancer, in the prospectively recruited EPIC-Italy cohort. After a median 11.7 years, 421 colorectal cancers were diagnosed among 47,749 recruited adults. GI and GL were estimated from validated food frequency questionnaires. Multivariable Cox modeling estimated hazard ratios (HRs) for associations between colorectal cancer and intakes of total, high GI and low GI carbohydrate and GI and GL. The adjusted HR of colorectal cancer for highest versus lowest GI quartile was 1.35; 95% confidence interval (CI) 1.03-1.78; p trend 0.031. Increasing high GI carbohydrate intake was also significantly associated with increasing colorectal cancer risk (HR 1.45; 95% CI 1.04-2.03; p trend 0.034), whereas increasing low GI carbohydrate was associated with reducing risk (HR 0.73; 95% CI 0.54-0.98; p trend 0.033). High dietary GI and high GI carbohydrate were associated with increased risks of cancer at all colon sites (HR 1.37; 95% CI 1.00-1.88, HR 1.80; 95% CI 1.22-2.65, respectively), whereas high GI carbohydrate and high GL were associated with increased risk of proximal colon cancer (HR 1.94; 95% CI 1.18-3.16, HR 2.01; 95% CI 1.08-3.74, respectively). After stratification for waist-to-hip ratio (WHR), cancer was significantly associated with GI, and high GI carbohydrate, in those with high WHR. These findings suggest that high dietary GI and high carbohydrate intake from high GI foods are associated with increased risk of colorectal cancer. PMID:25403784

Sieri, S; Krogh, V; Agnoli, C; Ricceri, F; Palli, D; Masala, G; Panico, S; Mattiello, A; Tumino, R; Giurdanella, M C; Brighenti, F; Scazzina, F; Vineis, P; Sacerdote, C

2015-06-15

347

Dietary glycemic index, dietary glycemic load, and cardiovascular disease in middle-aged and older Swedish men1–3  

PubMed Central

Background In women, dietary glycemic index (GI) and dietary glycemic load (GL) have been associated with cardiovascular disease; in men, however, the evidence for an association is weaker. Objective We tested the hypothesis that men consuming diets high in GI or GL have a greater risk of cardiovascular disease. Design At baseline, we assessed dietary GI and dietary GL by using food-frequency questionnaires in 36 246 Swedish men aged 45–79 y without diabetes or prior cardiovascular disease. Participants were followed through inpatient, cause-of-death, and death registries from 1 January 1998 until 31 December 2003 for myocardial infarction, ischemic stroke, hemorrhagic stroke, and cardiovascular mortality and until 31 December 2005 for all-cause mortality. We used Cox models with age as the time scale to estimate relative risks adjusted for cigarette smoking, body mass index, physical activity, demographic characteristics, and nutritional factors. Results Dietary GI and dietary GL were not associated with myocardial infarction (n = 1324), ischemic stroke (n = 692), cardiovascular mortality (n = 785), or all-cause mortality (n = 2959). Dietary GL was associated with hemorrhagic stroke [n = 165; relative risk = 1.44 comparing extreme quartiles (95% CI: 0.91, 2.27); P for trend = 0.047]. Conclusions Dietary GI and dietary GL were not associated with ischemic cardiovascular disease or mortality, but dietary GL was associated with a greater risk of hemorrhagic stroke. Discrepancies between these findings and those of previous studies may be due to variations in the associations by sex or to differences in dietary contributions to GI and GL. PMID:17556687

Levitan, Emily B; Mittleman, Murray A; Håkansson, Niclas; Wolk, Alicja

2015-01-01

348

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

PubMed Central

Background Dietary intake of fiber, carbohydrate, glycemic index (GI), and glycemic load (GL) may influence breast cancer survival, but consistent and convincing evidence is lacking. Methods We investigated associations of dietary fiber, carbohydrates, GI, and GL with breast cancer prognosis among n=688 stage 0 to IIIA breast cancer survivors in the Health, Eating, Activity, and Lifestyle (HEAL) study. Pre- and postmenopausal women from Western Washington State, Los Angeles County, and New Mexico participated. Usual diet was assessed with a food frequency questionnaire. Total mortality, breast cancer mortality, non-fatal recurrence and second occurrence data were obtained from SEER registries and medical records. Cox proportional hazards regression estimated multivariate-adjusted hazard ratios and 95% CIs. Results During a median of 6.7 years follow-up after diagnosis, n= 106 total deaths, n=83 breast cancer-specific deaths and n=82 non-fatal recurrences were confirmed. We observed an inverse association between fiber intake and mortality. Multivariate-adjusted HRRs comparing high to low intake were 0.53 (95% CI 0.23-1.23) and 0.75 (95% CI 0.43-1.31). A threshold effect was observed whereby no additional benefit was observed for intakes >9 g/day. Fiber intake was suggestively inversely associated with breast-cancer specific mortality (HRR=0.68, 95% CI 0.27-1.70) and risk of non-fatal recurrence or second occurrence (HRR=0.68, 95% CI 0.27-1.70), but results were not statistically significant. Conclusion Dietary fiber was associated with a non-significant inverse association with breast cancer events and total mortality. Further studies to assess and confirm this relationship are needed in order to offer effective dietary strategies for breast cancer patients. Impact Increasing dietary fiber may an effective lifestyle modification strategy for breast cancer survivors. PMID:21430298

Belle, Fabiën N.; Kampman, Ellen; McTiernan, Anne; Bernstein, Leslie; Baumgartner, Kathy; Baumgartner, Richard; Ambs, Anita; Ballard-Barbash, Rachel; Neuhouser, Marian L.

2011-01-01

349

Rationale and current perspective for early rhythm control therapy in atrial fibrillation  

PubMed Central

Atrial fibrillation (AF) is the most common sustained arrhythmia and an important source for mortality and morbidity on a population level. Despite the clear association between AF and death, stroke, and other cardiovascular events, there is no evidence that rhythm control treatment improves outcome in AF patients. The poor outcome of rhythm control relates to the severity of the atrial substrate for AF not only due to the underlying atrial remodelling process but also due to the poor efficacy and adverse events of the currently available ion-channel antiarrhythmic drugs and ablation techniques. Data suggest, however, an association between sinus rhythm maintenance and improved survival. Hypothetically, sinus rhythm may also lead to a lower risk of stroke and heart failure. The presence of AF, thus, seems one of the modifiable factors associated with death and cardiovascular morbidity in AF patients. Patients with a short history of AF and the underlying heart disease have not been studied before. It is fair to assume that abolishment of AF in these patients is more successful and possibly also safer, which could translate into a prognostic benefit of early rhythm control therapy. Several trials are now investigating whether aggressive early rhythm control therapy can reduce cardiovascular morbidity and mortality and increase maintenance of sinus rhythm. In the present paper we describe the background of these studies and provide some information on their design. PMID:21784740

Van Gelder, Isabelle C.; Haegeli, Laurent M.; Brandes, Axel; Heidbuchel, Hein; Aliot, Etienne; Kautzner, Josef; Szumowski, Lukasz; Mont, Lluis; Morgan, John; Willems, Stephan; Themistoclakis, Sakis; Gulizia, Michele; Elvan, Arif; Smit, Marcelle D.; Kirchhof, Paulus

2011-01-01

350

Differentiating Processes of Control and Understanding in the Early Development of Emotion and Cognition  

PubMed Central

In this study we examined the hypothesis that preschoolers’ performance on emotion and cognitive tasks is organized into discrete processes of control and understanding within the domains of emotion and cognition. Additionally, we examined the relations among component processes using mother report, behavioral observation, and physiological measures of emotion control. Participants were 263 children (42% non-White) and their mothers. Results indicated that the three approaches of measuring emotion control were unrelated. Regardless of the measurement method, a four-factor solution differentiating emotion control and understanding and cognitive control and understanding fit the data better than did either of two 2-factor models, one based on domains of emotion and cognition across processes, and one based on processes of control and understanding across domains. Results of this research replicate those of Leerkes et al. (2008) in describing a differentiated underlying structure of emotion and cognition processes in early childhood while also extending these conclusions across samples and across measurement approaches for assessing emotion control. PMID:22328805

Blankson, A. Nayena; O’Brien, Marion; Leerkes, Esther M.; Marcovitch, Stuart; Calkins, Susan D.

2011-01-01

351

The Contribution of Adolescent Effortful Control to Early Adult Educational Attainment  

PubMed Central

Effortful control has been proposed as a set of neurocognitive competencies that is relevant to self-regulation and educational attainment (Posner & Rothbart, 2007). This study tested the hypothesis that a multiagent report of adolescents’ effortful control (age 17) would be predictive of academic persistence and educational attainment (age 23–25), after controlling for other established predictors (family factors, problem behavior, grade point average, and substance use). Participants were 997 students recruited in 6th grade from 3 urban public middle schools (53% males; 42.4% European American; 29.2% African American). Consistent with the hypothesis, the unique association of effortful control with future educational attainment was comparable in strength to that of parental education and students’ past grade point average, suggesting that effortful control contributes to this outcome above and beyond well-established predictors. Path coefficients were equivalent across gender and ethnicity (European Americans and African Americans). Effortful control appears to be a core feature of the self-regulatory competencies associated with achievement of educational success in early adulthood. These findings suggest that the promotion of self-regulation in general and effortful control in particular may be an important focus not only for resilience to stress and avoidance of problem behavior, but also for growth in academic competence. PMID:25308996

Véronneau, Marie-Hélène; Racer, Kristina Hiatt; Fosco, Gregory M.; Dishion, Thomas J.

2014-01-01

352

Randomised controlled trial of early discharge for inguinal hernia and varicose veins.  

PubMed Central

A randomised controlled trial has been conducted into the effects of discharging patients from hospital either 48 hours or six to seven days after operations for inguinal hernia and varicose veins. There was no statistically significant difference in major postoperative complications between the two lengths of stay for either of the two conditions. Similarly there was no difference between the two groups of hernia patients in relation to eventual recurrences. There was no significant difference in length of convalescence between long-stay and short-stay patients in full-time occupations. The savings to the statutory services of discharging patients early were estimated at 25.72 pounds per patient. Patients appeared to approve of the type of care they experienced, regardless of length of stay. However, the families of short-stay patients were significantly less enthusiastic in their attitudes towards the policy of early discharge than the families of long-stay patients. PMID:98548

Adler, M W; Waller, J J; Creese, A; Thorne, S C

1978-01-01

353

A Randomized Controlled Trial of Early Postoperative Feeding in Gynecologic Oncology Patients Undergoing Intra-abdominal Surgery  

Microsoft Academic Search

Objective: To evaluate the safety and efficacy of early oral feeding after intra-abdominal surgery in gynecologic oncology patients.Methods: During a 1-year period, 200 gynecologic oncology patients undergoing intra-abdominal surgery were enrolled in a randomized controlled trial of early compared with traditional oral postoperative feeding. Patients allocated to early postoperative oral feeding began a clear liquid diet on the first postoperative

Michael L Pearl; Fidel A Valea; Margaret Fischer; Linda Mahler; Eva Chalas

1998-01-01

354

How early studies on secreted and membrane protein quality control gave rise to the ER associated degradation (ERAD) pathway: The early history of ERAD  

PubMed Central

All newly synthesized proteins are subject to quality control check-points, which prevent aberrant polypeptides from harming the cell. For proteins that ultimately reside in the cytoplasm, components that also reside in the cytoplasm were known for many years to mediate quality control. Early biochemical and genetic data indicated that misfolded proteins were selected by molecular chaperones and then targeted to the proteasome (in eukaryotes) or to proteasome-like particles (in bacteria) for degradation. What was less clear was how secreted and integral membrane proteins, which in eukaryotes enter the endoplasmic reticulum (ER), were subject to quality control decisions. In this review, we highlight early studies that ultimately led to the discovery that secreted and integral membrane proteins also utilize several components that constitute the cytoplasmic quality machinery. This component of the cellular quality control pathway is known as ER associated degradation, or ERAD. PMID:23557783

Needham, Patrick G.; Brodsky, Jeffrey L.

2013-01-01

355

Early diagnostic suggestions improve accuracy of GPs: a randomised controlled trial using computer-simulated patients  

PubMed Central

Background Designers of computerised diagnostic support systems (CDSSs) expect physicians to notice when they need advice and enter into the CDSS all information that they have gathered about the patient. The poor use of CDSSs and the tendency not to follow advice once a leading diagnosis emerges would question this expectation. Aim To determine whether providing GPs with diagnoses to consider before they start testing hypotheses improves accuracy. Design and setting Mixed factorial design, where 297 GPs diagnosed nine patient cases, differing in difficulty, in one of three experimental conditions: control, early support, or late support. Method Data were collected over the internet. After reading some initial information about the patient and the reason for encounter, GPs requested further information for diagnosis and management. Those receiving early support were shown a list of possible diagnoses before gathering further information. In late support, GPs first gave a diagnosis and were then shown which other diagnoses they could still not discount. Results Early support significantly improved diagnostic accuracy over control (odds ratio [OR] 1.31; 95% confidence interval [95%CI] = 1.03 to 1.66, P = 0.027), while late support did not (OR 1.10; 95% CI = 0.88 to 1.37). An absolute improvement of 6% with early support was obtained. There was no significant interaction with case difficulty and no effect of GP experience on accuracy. No differences in information search were detected between experimental conditions. Conclusion Reminding GPs of diagnoses to consider before they start testing hypotheses can improve diagnostic accuracy irrespective of case difficulty, without lengthening information search. PMID:25548316

Kostopoulou, Olga; Rosen, Andrea; Round, Thomas; Wright, Ellen; Douiri, Abdel; Delaney, Brendan

2015-01-01

356

Early Concurrent and Longitudinal Symptoms of ADHD and ODD: Relations to Different Types of Inhibitory Control and Working Memory  

ERIC Educational Resources Information Center

Background: The aim of the present study was to investigate how three different types of inhibitory control--interference control within task, interference control outside task, and prepotent response inhibition--and two types of working memory--verbal and spatial--would relate to early symptoms of attention deficit/hyperactivity disorder (ADHD)…

Brocki, Karin C.; Nyberg, Lilianne; Thorell, Lisa B.; Bohlin, Gunilla

2007-01-01

357

The Impact of a School-Based Obesity Prevention Trial on Disordered Weight-Control Behaviors in Early Adolescent Girls  

Microsoft Academic Search

Objective: To assess the impact of an obesity preven- tion intervention on use of self-induced vomiting\\/ laxatives (purging) and diet pills to control weight in girls in early adolescence. Design: We matched and randomly assigned 10 middle schools to an intervention or a control condition in a ran- domized controlled trial. Longitudinal multivariable analy- ses using generalized estimating equations were

S. Bryn Austin; Alison E. Field; Jean Wiecha; Karen E. Peterson; Steven L. Gortmaker

2005-01-01

358

Marked changes in olfactory perception during early pregnancy: a prospective case-control study.  

PubMed

Pregnancy seems to be related with a significant change in olfaction. Here, we investigate this theory by testing the odor identification abilities of uncomplicated pregnant women and compare the results with non-pregnant controls. The study included 31 healthy pregnant women in the first trimester (Group 1), 30 in the second trimester (Group 2), 31 in the third trimester, and 30 non-pregnant healthy controls (Group 4). In order to measure odor identification abilities, each subject completed the 12-item Brief Smell Identification Test (BSIT). Next, the demographic characteristics and BSIT scores of the groups were compared. The total BSIT scores of the subjects in Group 1 were found to be significantly lower than those of the other groups (p < 0.001). This reduction in odor identification abilities was particularly noticeable for leather, pine, and soot. Pregnant women in the second and third trimesters had similar odor identification abilities to the healthy controls (p > 0.05). Early pregnancy might be related to significant changes in olfactory performance. The distortion of odor identification in the first trimester might be a causative factor for the development of pregnancy-specific conditions, such as morning sickness and hyperemesis gravidarum, which are both common complaints during the early phase of parturition. PMID:24972540

Simsek, Gokce; Bayar Muluk, Nuray; Arikan, Osman Kursat; Ozcan Dag, Zeynep; Simsek, Yavuz; Dag, Ersel

2015-03-01

359

Substance Use Progression from Adolescence to Early Adulthood: Effortful Control in the Context of Friendship Influence and Early-Onset Use  

ERIC Educational Resources Information Center

In a sample of 998 ethnically diverse adolescents, a multiagent, multimethod approach to the measurement of adolescent effortful control, adolescent substance use, and friendship influence was used to predict escalations to early-adult tobacco, alcohol, and marijuana use by ages 22-23. Structural equation modeling revealed that adolescent…

Piehler, Timothy F.; Veronneau, Marie-Helene; Dishion, Thomas J.

2012-01-01

360

A Novel Early Intervention for Preschool Depression: Findings from a Pilot Randomized Controlled Trial  

PubMed Central

Background Validation for depression in preschool children has been established; however, to date no empirical investigations of interventions for the early onset disorder have been conducted. Based on this and the modest efficacy of available treatments for childhood depression, the need for novel early interventions has been emphasized. Large effect sizes for preschool psychotherapies for several Axis I disorders suggest that earlier intervention in depression may also be promising. Therefore, a novel form of treatment for preschool depression, Parent Child Interaction Therapy Emotion Development (PCIT-ED) was developed and tested. Methods A preliminary randomized controlled trial (RCT) was conducted comparing PCIT-ED to psycho-education in depressed 3-7 year olds and their caregivers. N=54 subjects met symptom criteria for DSM-IV MDD and were randomized, N=19 subjects completed the active treatment (N=8 drop-outs) and N=10 completed psycho-education (N=17 drop-outs). Results Both groups showed significant improvement in several domains, with PCIT-ED showing significance in a greater number of domains. An Intent-to-Treat analysis suggested that PCIT-ED was significantly more effective than psycho-education on executive functioning (p=0.011, ES=0.12) and emotion recognition skills (p=0.002, ES=0.83). Conclusions The RCT proved feasible and suggests an individual control condition should be used in future trials to minimize differential drop-out. These pilot data, although limited by power, suggest that PCIT-ED may be a promising early intervention for depression. Larger scale randomized controlled trials of PCIT-ED for depressed preschoolers are now warranted. PMID:22040016

Luby, Joan; Lenze, Shannon; Tillman, Rebecca

2012-01-01

361

Temporally Dissociable Mechanisms of Self-Control: Early Attentional Filtering Versus Late Value Modulation  

PubMed Central

Optimal decision-making often requires exercising self-control. A growing fMRI literature has implicated the dorsolateral prefrontal cortex (dlPFC) in successful self-control, but due to the limitations inherent in BOLD measures of brain activity, the neurocomputational role of this region has not been resolved. Here we exploit the high temporal resolution and whole-brain coverage of event-related potentials (ERPs) to test the hypothesis that dlPFC affects dietary self-control through two different mechanisms: attentional filtering and value modulation. Whereas attentional filtering of sensory input should occur early in the decision process, value modulation should occur later on, after the computation of stimulus values begins. Hungry human subjects were asked to make food choices while we measured neural activity using ERP in a natural condition, in which they responded freely and did not exhibit a tendency to regulate their diet, and in a self-control condition, in which they were given a financial incentive to lose weight. We then measured various neural markers associated with the attentional filtering and value modulation mechanisms across the decision period to test for changes in neural activity during the exercise of self-control. Consistent with the hypothesis, we found evidence for top-down attentional filtering early on in the decision period (150–200 ms poststimulus onset) as well as evidence for value modulation later in the process (450–650 ms poststimulus onset). We also found evidence that dlPFC plays a role in the deployment of both mechanisms. PMID:24285897

Hare, Todd; Rangel, Antonio

2013-01-01

362

Structural dynamics and attitude control study of early manned capability space station configurations  

NASA Technical Reports Server (NTRS)

A study was performed to determine the vibration and attitude control characteristics of critical space station configurations featuring early manned capability during buildup from initial user support through the operations capability reference station. Five configurations were selected and were examined thus determining the changes that are likely to occur in the characteristics of the system as the station progresses from a single boom structure to a mature, dual keel, operations capability reference station. Both 9 foot and 5 meter truss bay sizes were investigated. All configurations analyzed were stable; however, the 5 meter truss bay size structure exhibited superior stability characteristics.

Ayers, J. Kirk; Cirillo, William M.; Giesy, Daniel P.; Hitchcock, Jay C.; Kaszubowski, Martin J.; Raney, J. Philip

1987-01-01

363

Interlocking detachable platinum coils, a controlled embolization device: Early clinical experience  

Microsoft Academic Search

Purpose  To present the early clinical experience of a new mechanically controlled-release embolization device—the interlocking detachable\\u000a coil (IDC)—in complex embolization outside the head.\\u000a \\u000a \\u000a \\u000a Methods  IDCs were used only when conventional embolization techniques were considered too risky or unsafe. The soils consist of unfibered\\u000a coiled platinum (0.012 inch), mechanically connected to a pusher wire and deployed through a Tracker 18 catheter. IDCs come

John F. Reidy; Shakeel A. Qureshi

1996-01-01

364

A randomized controlled trial of early oral analgesia in gynecologic oncology patients undergoing intra-abdominal surgery  

Microsoft Academic Search

OBJECTIVE:To evaluate the safety and efficacy of early oral analgesia after intra-abdominal surgery in gynecologic oncology patients.METHODS:Over a 2.5-year period, 227 gynecologic oncology patients undergoing intra-abdominal surgery were enrolled in a randomized controlled trial of early oral versus traditional parenteral analgesia. All patients initially received parenteral morphine via a patient-controlled analgesia (PCA) pump with a basal dose of 0.5 mg\\/h

Michael L Pearl; Dayna L McCauley; Jill Thompson; Linda Mahler; Fidel A Valea; Eva Chalas

2002-01-01

365

Treating anemia early in renal failure patients slows the decline of renal function: A randomized controlled trial  

Microsoft Academic Search

Treating anemia early in renal failure patients slows the decline of renal function: A randomized controlled trial.BackgroundErythropoietin is known to improve outcomes in patients with anemia from chronic renal disease. However, there is uncertainty about the optimal timing of initiation of erythropoietin treatment in predialysis patients with non-severe anemia.MethodsWe conducted a randomized controlled trial of early versus deferred initiation of

CHARICLIA GOUVA; PETROS NIKOLOPOULOS; JOHN P A IOANNIDIS; KOSTAS C SIAMOPOULOS

2004-01-01

366

Pouteria ramiflora extract inhibits salivary amylolytic activity and decreases glycemic level in mice.  

PubMed

In this study, extracts of plant species from the Cerrado biome were assessed in order to find potential inhibitors of human salivary alpha-amylase. The plants were collected and extracts were obtained from leaves, bark, and roots. We performed a preliminary phytochemical analysis and a screening for salivar alpha-amylase inhibitory activity. Only three botanical families (Sapotaceae, Sapindaceae and Flacourtiaceae) and 16 extracts showed a substantial inhibition (>75%) of alpha-amylase. The ethanolic extracts of Pouteria ramiflora obtained from stem barks and root barks decreased amylolytic activity above 95% at a final concentration of 20 µg/mL. Thus, adult male Swiss mice were treated orally with P. ramiflora in acute toxicity and glycemic control studies. Daily administration with 25, 50 and 100 mg/kg of aqueous extract of P. ramiflora for eight days can reduce significantly body weight and blood glucose level in mice. These data suggest that the crude polar extract of P. ramiflora decreases salivary amylolytic activity while lowering the blood levels of glucose. PMID:24068095

De Gouveia, Neire M; De Albuquerque, Cibele L; Espindola, Laila S; Espindola, Foued S

2013-09-01

367

Glycemic index and phenolics of partially-baked frozen bread with sourdough.  

PubMed

Different lactic acid bacteria starters were used to prepare sourdough to make partially-baked frozen wholemeal wheat bread. The sourdough was prepared with a pure culture of Lactobacillus plantarum or with commercial starters containing Lactobacillus brevis combined with Saccharomyces cerevisiae var. chevalieri (LV4), Lactobacillus fermentum (PL1), or Lactobacillus fermentum with phytase (PL3). We determined the acetic and lactic acid concentrations in sourdough, bread chemical composition, total phenolics content and glycemic index (GI) in vivo. Depending on the starter, the lactic to acetic acid ratio in the sourdough was significantly different. The GI of control bread without sourdough (70) was significantly higher than that of bread containing sourdough prepared with LV4 starter (50), PL1 starter (56) or PL3 starter (56), but not from bread with L. plantarum sourdough (60). The addition of 10% sourdough with a lower molar ratio of lactic to acetic acid ( ? 4) and higher total phenolics content is preferable for generating bread with medium and low GI. PMID:20715901

Novotni, Dubravka; Curi?, Duška; Bituh, Martina; Coli? Bari?, Irena; Skevin, Dubravka; Cukelj, Nikolina

2011-02-01

368

WT1 controls antagonistic FGF and BMP-pSMAD pathways in early renal progenitors.  

PubMed

Kidney organogenesis requires the tight control of proliferation, differentiation and apoptosis of renal progenitor cells. How the balance between these cellular decisions is achieved remains elusive. The Wilms' tumour suppressor Wt1 is required for progenitor survival, but the molecular cause for renal agenesis in mutants is poorly understood. Here we demonstrate that lack of Wt1 abolishes fibroblast growth factor (FGF) and induces BMP/pSMAD signalling within the metanephric mesenchyme. Addition of recombinant FGFs or inhibition of pSMAD signalling rescues progenitor cell apoptosis induced by the loss of Wt1. We further show that recombinant BMP4, but not BMP7, induces an apoptotic response within the early kidney that can be suppressed by simultaneous addition of FGFs. These data reveal a hitherto unknown sensitivity of early renal progenitors to pSMAD signalling, establishes FGF and pSMAD signalling as antagonistic forces in early kidney development and places WT1 as a key regulator of pro-survival FGF signalling pathway genes. PMID:25031030

Motamedi, Fariba Jian; Badro, Danielle A; Clarkson, Michael; Lecca, M Rita; Bradford, Stephen T; Buske, Fabian A; Saar, Kathrin; Hübner, Norbert; Brändli, André W; Schedl, Andreas

2014-01-01

369

Organoleptic and glycemic properties of chickpea-wheat composite breads.  

PubMed

Prevalence of obesity and type-2-diabetes requires dietary manipulation. It was hypothesized that wheat-legume-composite breads will reduce the spike of blood glucose and increase satiety. Four pan bread samples were prepared: White bread (WB) as standard, Whole-wheat bread (WWB), WWB supplemented with chickpea flour at 25 % (25%ChB) and 35 % (35%ChB) levels. These breads were tested in healthy female subjects for acceptability and for effect on appetite, blood glucose, and physical discomfort in digestion. The breads were rated >5.6 on a 9-point hedonic scale with WB significantly higher than all other breads. No difference in area under the curve (AUC) for appetite was found, but blood glucose AUC was reduced as follows: 35%ChB < WB and WWB, WB >25%ChB = WWB or 35%ChB. We conclude that addition of chickpea flour at 35 % to whole wheat produces a bread that is acceptable to eat, causing no physical discomfort and lowers the glycemic response. PMID:25829607

Zafar, Tasleem A; Al-Hassawi, Fatima; Al-Khulaifi, Fatima; Al-Rayyes, Ghanima; Waslien, Carol; Huffman, Fatma G

2015-04-01

370

Variable Classifications of Glycemic Index Determined by Glucose Meters  

PubMed Central

The study evaluated and compared the differences of glucose responses, incremental area under curve (IAUC), glycemic index (GI) and the classification of GI values between measured by biochemical analyzer (Fuji automatic biochemistry analyzer (FAA)) and three glucose meters: Accue Chek Advantage (AGM), BREEZE 2 (BGM), and Optimum Xceed (OGM). Ten healthy subjects were recruited for the study. The results showed OGM yield highest postprandial glucose responses of 119.6 ± 1.5, followed by FAA, 118.4 ± 1.2, BGM, 117.4 ± 1.4 and AGM, 112.6 ± 1.3 mg/dl respectively. FAA reached highest mean IAUC of 4156 ± 208 mg × min/dl, followed by OGM (3835 ± 270 mg × min/dl), BGM (3730 ± 241 mg × min/dl) and AGM (3394 ± 253 mg × min/dl). Among four methods, OGM produced highest mean GI value than FAA (87 ± 5) than FAA, followed by BGM and AGM (77 ± 1, 68 ± 4 and 63 ± 5, p<0.05). The results suggested that the AGM, BGM and OGM are more variable methods to determine IAUC, GI and rank GI value of food than FAA. The present result does not necessarily apply to other glucose meters. The performance of glucose meter to determine GI value of food should be evaluated and calibrated before use. PMID:20664730

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

2010-01-01

371

Variable classifications of glycemic index determined by glucose meters.  

PubMed

THE STUDY EVALUATED AND COMPARED THE DIFFERENCES OF GLUCOSE RESPONSES, INCREMENTAL AREA UNDER CURVE (IAUC), GLYCEMIC INDEX (GI) AND THE CLASSIFICATION OF GI VALUES BETWEEN MEASURED BY BIOCHEMICAL ANALYZER (FUJI AUTOMATIC BIOCHEMISTRY ANALYZER (FAA)) AND THREE GLUCOSE METERS: Accue Chek Advantage (AGM), BREEZE 2 (BGM), and Optimum Xceed (OGM). Ten healthy subjects were recruited for the study. The results showed OGM yield highest postprandial glucose responses of 119.6 +/- 1.5, followed by FAA, 118.4 +/- 1.2, BGM, 117.4 +/- 1.4 and AGM, 112.6 +/- 1.3 mg/dl respectively. FAA reached highest mean IAUC of 4156 +/- 208 mg x min/dl, followed by OGM (3835 +/- 270 mg x min/dl), BGM (3730 +/- 241 mg x min/dl) and AGM (3394 +/- 253 mg x min/dl). Among four methods, OGM produced highest mean GI value than FAA (87 +/- 5) than FAA, followed by BGM and AGM (77 +/- 1, 68 +/- 4 and 63 +/- 5, p<0.05). The results suggested that the AGM, BGM and OGM are more variable methods to determine IAUC, GI and rank GI value of food than FAA. The present result does not necessarily apply to other glucose meters. The performance of glucose meter to determine GI value of food should be evaluated and calibrated before use. PMID:20664730

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

2010-07-01

372

Post-translational control of Cdc25 degradation terminates Drosophila’s early cell cycle program  

PubMed Central

SUMMARY In most metazoans, early embryonic development is characterized by rapid mitotic divisions that are controlled by maternal mRNAs and proteins that accumulate during oogenesis [1]. These rapid divisions pause at the Mid-Blastula Transition (MBT), coinciding with a dramatic increase in gene transcription and the degradation of a subset of maternal mRNAs [2, 3]. In Drosophila, the cell cycle pause is controlled by inhibitory phosphorylation of Cdk1, which in turn is driven by down-regulation of the activating Cdc25 phosphatases [4, 5]. Here, we show that the two Drosophila Cdc25 homologues, String and Twine, differ in their dynamics and that, contrary to current models [4], their down-regulations are not controlled by mRNA degradation but through different post-translational mechanisms. The degradation rate of String protein gradually increases during the late syncytial cycles in a manner dependent on the nuclear-to-cytoplasmic ratio and on the DNA replication checkpoints. Twine, on the other hand, is targeted for degradation at the onset of the MBT through a switch-like mechanism controlled like String by the nuclear-to-cytoplasmic ratio, but not requiring the DNA replication checkpoints. We demonstrate that post-translational control of Twine degradation ensures that the proper number of mitoses precede the MBT. PMID:23290553

Talia, Stefano Di; She, Richard; Blythe, Shelby A.; Lu, Xuemin; Zhang, Qi Fan; Wieschaus, Eric F.

2013-01-01

373

Diesel engine smoke reduction by controlling early thermal cracking process and activation later stage combustion  

SciTech Connect

In this investigation, extensive soot reduction was attempted with two parallel approaches: blending of oxygenated fuel and generation of strong turbulence during the combustion process. In the early stage of usual diesel combustion, the droplets in the spray are thermally cracked to low boiling point components as C2 to C5 due to the shortage of oxygen, and these components result in the formation of soot. To control the thermal cracking process, the addition of oxygenated additives to the fuel was attempted. As a result, remarkable soot reduction was obtained by adding small amounts of oxygen to the fuel. To generate strong turbulence, a small chamber connected to the main combustion chamber was added and small amount of fuel were injected into the chamber, resulting in significant soot reduction. Additionally, a clearly apparent NO{sub x}reduction was obtained by the mixing control.

Murayama, T. [Hokkaido Automotive Engineering Coll., Sapporo (Japan); Chikahisa, T. [Hokkaido Univ., Sapporo (Japan); Fujiwara, Y. [Hokkaido Inst. of Tech., Sapporo (Japan)

1998-07-01

374

Diesel engine smoke reduction by controlling early thermal cracking process and activating later stage combustion  

SciTech Connect

In this investigation, extensive soot reduction was attempted with two parallel approaches: blending of oxygenated fuel and generation of strong turbulence during the combustion process. In the early stage of usual diesel combustion, the droplets in the spray are thermally cracked to low boiling point components as C{sub 2} to C{sub 5} due to the shortage of oxygen, and these components result in the formation of soot. To control the thermal cracking process, the addition of oxygenated additives to the fuel was attempted. As a result, remarkable soot reduction was obtained by adding small amounts of oxygen to the fuel. To generate strong turbulence, a small chamber connected to the main combustion chamber was added and small amounts of fuel were injected into the chamber, resulting in significant soot reduction. Additionally, a clearly apparent NOx reduction was obtained by the mixing control.

Murayama, Tadashi [Hokkaido Automotive Engineering Coll., Sapporo (Japan); Chikahisa, Takemi [Hokkaido Univ., Sapporo (Japan); Fujiwara, Yasuhiro [Hokkaido Inst. of Tech., Sapporo (Japan)

1996-12-31

375

Genetic control of identity and growth in the early Arabidopsis embryo.  

PubMed

Plants can grow complex and elaborate structures, in some species for thousands of years. Despite the diversity in form and shape, plants are built from a limited number of fundamental tissue types, and their arrangement is deeply conserved in the plant kingdom. A key question in biology is how these fundamental tissues, i.e. epidermal, ground and vascular tissue, are specified and organized in time and space. In the present paper, I discuss the use of the early Arabidopsis embryo as a model system to dissect the control of tissue formation and patterning, as well as the specification of the stem cells that sustain post-embryonic growth. I present recent insights into the molecules and mechanisms that control both the specification and the subsequent growth of the different cell types within the embryonic root. Finally, I discuss major unanswered questions and future challenges in using the embryo as a model to decipher the regulatory logic of plant development. PMID:24646242

Weijers, Dolf

2014-04-01

376

Substance Use Progression from Adolescence to Early Adulthood: Effortful Control in the Context of Friendship Influence and Early-Onset Use  

PubMed Central

In a sample of 998 ethnically diverse adolescents, a multiagent, multimethod approach to the measurement of adolescent effortful control, adolescent substance use, and friendship influence was used to predict escalations to early-adult tobacco, alcohol, and marijuana use by ages 22–23. Structural equation modeling revealed that adolescent substance use and friends’ substance use tended to be highly correlated and together were robust predictors of a problematic pattern of usage for all substances in early adulthood. In addition, the adolescent effortful control construct directly predicted progressions to problematic use of tobacco and marijuana, but not for alcohol. In the alcohol model, effortful control interacted with the construct of substance use lifestyle (based on adolescent alcohol use and friends’ substance use) when predicting problematic alcohol use in early adulthood. Results held when comparing across genders and across ethnic groups. These findings emphasize the importance of addressing adolescent self-regulation in interventions designed to treat and prevent early-adult substance abuse. PMID:22527607

Piehler, Timothy F.; Véronneau, Marie-Hélène; Dishion, Thomas J.

2012-01-01

377

The p66Shc Adaptor Protein Controls Oxidative Stress Response in Early Bovine Embryos  

PubMed Central

The in vitro production of mammalian embryos suffers from high frequencies of developmental failure due to excessive levels of permanent embryo arrest and apoptosis caused by oxidative stress. The p66Shc stress adaptor protein controls oxidative stress response of somatic cells by regulating intracellular ROS levels through multiple pathways, including mitochondrial ROS generation and the repression of antioxidant gene expression. We have previously demonstrated a strong relationship with elevated p66Shc levels, reduced antioxidant levels and greater intracellular ROS generation with the high incidence of permanent cell cycle arrest of 2–4 cell embryos cultured under high oxygen tensions or after oxidant treatment. The main objective of this study was to establish a functional role for p66Shc in regulating the oxidative stress response during early embryo development. Using RNA interference in bovine zygotes we show that p66Shc knockdown embryos exhibited increased MnSOD levels, reduced intracellular ROS and DNA damage that resulted in a greater propensity for development to the blastocyst stage. P66Shc knockdown embryos were stress resistant exhibiting significantly reduced intracellular ROS levels, DNA damage, permanent 2–4 cell embryo arrest and diminished apoptosis frequencies after oxidant treatment. The results of this study demonstrate that p66Shc controls the oxidative stress response in early mammalian embryos. Small molecule inhibition of p66Shc may be a viable clinical therapy to increase the developmental potential of in vitro produced mammalian embryos. PMID:24475205

Betts, Dean H.; Bain, Nathan T.; Madan, Pavneesh

2014-01-01

378

Early psychological intervention in accidentally injured children ages 2–16: a randomized controlled trial  

PubMed Central

Background Road traffic accidents (RTA) and burns are frequent events in children. Although many children recover spontaneously, a considerable number develop long-term psychological sequelae. Evidence on early psychological interventions to prevent such long-term problems is still scarce for school-age children and completely lacking for pre-school children. Objectives To evaluate the efficacy of an early two-session cognitive-behavioral intervention in 108 children ages 2–16 after RTAs and burns. Methods Children assessed at risk for the development of posttraumatic stress disorder (PTSD) were randomly assigned to either a control group offered treatment as usual or an intervention group. Primary outcomes were PTSD, behavioral problems, and depression symptoms. Baseline and blinded 3- and 6-month follow-up assessments were conducted. Results In pre-school children, no intervention effects were found. School-age children in the intervention group exhibited significantly fewer internalizing problems at 3-month follow-up relative to controls and a borderline significant time-by-group effect for PTSD intrusion symptoms was found (p=0.06). Conclusions This is the first study examining the efficacy of an indicated, early psychological intervention among both school-age and pre-school-age children. Because the intervention was ineffective for young children, no evidence-based practice can currently be suggested. Given that parents of pre-school children perceived the intervention as helpful, brief counseling of parents in terms of psychoeducation and training in coping skills still should be provided by clinicians, despite the current lack of evidence. To prevent trauma-related disorders in school-age children, the intervention might be used in a step-wise manner, where only children at risk for long-term psychological maladjustment are provided with psychological support. PMID:24987498

Kramer, Didier N.; Landolt, Markus A.

2014-01-01

379

Effect of trestatin, an amylase inhibitor, incorporated into bread, on glycemic responses in normal and diabetic patients.  

PubMed

The effect of incorporating the pancreatic alpha-amylase inhibitor trestatin into bread on postprandial plasma glucose and insulin excursions was tested in healthy volunteers and non-insulin-dependent diabetic patients. At both dose levels of trestatin (3 and 6 mg/75 g starch) the peak values of plasma glucose and insulin were reduced markedly (compared with placebo) after the ingestion of 75 g starch in the form of bread. In healthy control subjects as well as in diabetic patients, trestatin produced significantly lower insulin excretions but also significant reductions in incremental plasma glucose areas in a dose-dependent fashion. It is concluded that it is technologically feasible to incorporate trestatin into starchy foods without loss of activity or impairment of taste. Furthermore, the positive effect of trestatin on glycemic and insulinemic responses in diabetics and the lack of serious side effects offer a great potential in the dietary treatment of diabetic patients. PMID:1701612

Golay, A; Schneider, H; Temler, E; Felber, J P

1991-01-01

380

Early Adversity, RSA, and Inhibitory Control: Evidence of Children’s Neurobiological Sensitivity to Social Context  

PubMed Central

This study examined parasympathetic physiology as a moderator of the effects of early adversity (i.e., child abuse and neglect) on children’s inhibitory control. Children’s respiratory sinus arrhythmia (RSA) was assessed during a resting baseline, two joint challenge tasks with mother, and an individual frustration task. RSA assessed during each of the joint parent–child challenge tasks moderated the effects of child maltreatment (CM) status on children’s independently-assessed inhibitory control. No moderation effect was found for RSA assessed at baseline or in the child-alone challenge task. Among CM-exposed children, lower RSA levels during the joint task predicted the lowest inhibitory control, whereas higher joint task RSA was linked to higher inhibitory control scores that were indistinguishable from those of non-CM children. Results are discussed with regard to the importance of considering context specificity (i.e., individual and caregiver contexts) in how biomarkers inform our understanding of individual differences in vulnerability among at-risk children. PMID:24142832

Skowron, Elizabeth A.; Cipriano-Essel, Elizabeth; Gatzke-Kopp, Lisa M.; Teti, Douglas M.; Ammerman, Robert T.

2014-01-01

381

Deficit irrigation strategies combined with controlled atmosphere preserve quality in early peaches.  

PubMed

Due to the water scarcity in the Mediterranean countries, irrigation must be optimized while keeping fruit quality. The effect of deficit irrigation strategies on changes in quality parameters of the early "Flordastar" peaches was studied. The deficit irrigation was programmed according to signal intensity of the maximum daily trunk shrinkage; deficit irrigation plants were irrigated to maintain maximum daily trunk shrinkage signal intensity values close to 1.4 or 1.3 in the case of DI1 or DI2 plants, respectively. Results were compared to a control watered at 150% crop evapotranspiration. Fruits were stored up to 14 days at 0?? and 95% Relative Humidity (RH) in air or in controlled atmosphere (controlled atmosphere; 3-4?kPa O2 and 12-14?kPa CO2), followed by a retail sale period of 4 days at 15?? and 90-95% Relative Humidity in air. Weight losses were lower in controlled atmosphere stored peaches from deficit irrigation. Air-stored fruits developed a more intense red color due to a faster ripening, which was not affected by the type of watering. At harvest, deficit irrigation peaches showed higher soluble solids content, which provided a better sensory evaluation. The soluble phenolic content was initially higher (55.26?±?0.18?mg gallic acid equivalents/100?g fresh weight) and more stable throughout postharvest life in DI1 fruits than in those from the other irrigation treatments. Concerning vitamin C, control fruits at harvest showed higher ascorbic acid than dehydroascorbic acid content (5.43 versus 2.43?mg/100?g fresh weight, respectively), while water stressed peaches showed the opposite results. The combination of DI2 and controlled atmosphere storage allowed saving a significant amount of water and provided peaches with good overall quality, maintaining the bioactive compounds analyzed. PMID:25280939

Falagán, Natalia; Artés, Francisco; Gómez, Perla A; Artés-Hernández, Francisco; Conejero, Wenceslao; Aguayo, Encarna

2014-10-01

382

Glypican-1 controls brain size through regulation of fibroblast growth factor signaling in early neurogenesis  

PubMed Central

Background Cell surface heparan sulfate proteoglycans (HSPGs) act as co-receptors for multiple families of growth factors that regulate animal cell proliferation, differentiation and patterning. Elimination of heparan sulfate during brain development is known to produce severe structural abnormalities. Here we investigate the developmental role played by one particular HSPG, glypican-1 (Gpc1), which is especially abundant on neuronal cell membranes, and is the major HSPG of the adult rodent brain. Results Mice with a null mutation in Gpc1 were generated and found to be viable and fertile. The major phenotype associated with Gpc1 loss is a highly significant reduction in brain size, with only subtle effects on brain patterning (confined to the anterior cerebellum). The brain size difference emerges very early during neurogenesis (between embryonic days 8.5 and 9.5), and remains roughly constant throughout development and adulthood. By examining markers of different signaling pathways, and the differentiation behaviors of cells in the early embryonic brain, we infer that Gpc1-/- phenotypes most likely result from a transient reduction in fibroblast growth factor (FGF) signaling. Through the analysis of compound mutants, we provide strong evidence that Fgf17 is the FGF family member through which Gpc1 controls brain size. Conclusion These data add to a growing literature that implicates the glypican family of HSPGs in organ size control. They also argue that, among heparan sulfate-dependent signaling molecules, FGFs are disproportionately sensitive to loss of HSPGs. Finally, because heterozygous Gpc1 mutant mice were found to have brain sizes half-way between homozygous and wild type, the data imply that endogenous HSPG levels quantitatively control growth factor signaling, a finding that is both novel and relevant to the general question of how the activities of co-receptors are exploited during development. PMID:19732411

Jen, Yi-Huei Linda; Musacchio, Michele; Lander, Arthur D

2009-01-01

383

Early-Life Stress Is Associated with Impairment in Cognitive Control in Adolescence: An fMRI Study  

ERIC Educational Resources Information Center

Early-life stress (ES) has been associated with diverse forms of psychopathology. Some investigators suggest that these associations reflect the effects of stress on the neural circuits that support cognitive control. However, very few prior studies have examined the associations between ES, cognitive control, and underlying neural architecture.…

Mueller, Sven C.; Maheu, Francoise S.; Dozier, Mary; Peloso, Elizabeth; Mandell, Darcy; Leibenluft, Ellen; Pine, Daniel S.; Ernst, Monique

2010-01-01

384

Maternal Over-Control Moderates the Association between Early Childhood Behavioral Inhibition and Adolescent Social Anxiety Symptoms  

ERIC Educational Resources Information Center

Behavioral inhibition (BI) and maternal over-control are early risk factors for later childhood internalizing problems, particularly social anxiety disorder (SAD). Consistently high BI across childhood appears to confer risk for the onset of SAD by adolescence. However, no prior studies have prospectively examined observed maternal over-control as…

Lewis-Morrarty, Erin; Degnan, Kathryn A.; Chronis-Tuscano, Andrea; Rubin, Kenneth H.; Cheah, Charissa S. L.; Pine, Daniel S.; Henderon, Heather A.; Fox, Nathan A.

2012-01-01

385