Sample records for early glycemic control

  1. Pharmacologic Factors Affecting Glycemic Control

    Microsoft Academic Search

    Lillian F. Lien

    Among many challenges to achieving and maintaining glycemic control, the impact of pharmacologic agents on glycemia is a significant,\\u000a but often overlooked factor. Numerous medications have been implicated in the development of drug-induced hyperglycemia and\\u000a type 2 diabetes mellitus. Of these, the atypical antipsychotics (for the management of depression and psychosis), the protease-inhibitor\\u000a anti retroviral agents (for the management of

  2. Criteria of Glycemic Control in Type 2 Diabetes Mellitus.

    PubMed

    Sharafetdinov, Kh Kh; Lapik, I A; Vorozhko, I V; Tutelyan, V A

    2015-05-01

    The paper presents the basic criteria for glycemic control in type 2 diabetes mellitus, the data on the relationship between postprandial glycemia and the development of the late vascular complications, and methods for evaluating the glycemic index of foodstuffs and dishes in order to optimize the diets and improve the efficiency of therapeutic measures in this disease. PMID:26041260

  3. Alternative biomarkers for assessing glycemic control in diabetes: fructosamine, glycated albumin, and 1,5-anhydroglucitol

    PubMed Central

    2015-01-01

    The growing attention to alternative glycemic biomarkers including fructosamine, glycated albumin (GA), 1,5-anhydroglucitol (1,5-AG), is attributable to the limitations of the glycated hemoglobin (HbA1c) assay. It is important to recognize the conditions in which HbA1c levels may be difficult to interpret. Serum fructosamine and GA have been proposed useful tools for monitoring of short-term glycemic control. These biomarkers not only reflect well glycemic control in hematologic disorder, but also represent postprandial glucose fluctuation. Serum 1,5-AG may be useful for estimating within-day glucose variation. Use of these nontraditional tests can be more helpful in the management of diabetes as complement traditional measures. Further larger cohort studies are warranted to determine whether nontraditional biomarkers have potential utility for early diagnosis, management of diabetes, and prevention of diabetic complications.

  4. Predictors of glycemic control in children with Type 1 diabetes

    Microsoft Academic Search

    Stuart A Chalew; Ricardo Gomez; Ashley Butler; James Hempe; Terry Compton; Donald Mercante; Jayashree Rao; Alfonso Vargas

    2000-01-01

    Diabetes is a common cause of kidney failure and blindness among young adults, particularly of African-American descent. Since glycemic control is a predictor of diabetes complications, we evaluated the impact of multiple factors including a special multidisciplinary management program on glycosylated hemoglobin in children with Type 1 diabetes.Data was collected from pediatric diabetes clinics in New Orleans, LA and Baltimore,

  5. Closed-loop glycemic control with a wearable artificial endocrine pancreas. Variations in daily insulin requirements to glycemic response.

    PubMed

    Shichiri, M; Kawamori, R; Hakui, N; Yamasaki, Y; Abe, H

    1984-12-01

    We succeeded in miniaturizing a needle-type glucose monitoring system with characteristics suitable for application in a wearable, closed-loop control system. A wearable artificial endocrine pancreas (12 X 15 X 6 cm, 400 g) consisting of a sensor, a microcomputer system that calculates insulin and glucagon infusion rates, and two roller pumps was developed. Continuous glucose monitoring by a glucose sensor inserted in the subcutaneous tissue of the forearm or abdomen of healthy and diabetic volunteers revealed that glucose concentrations in subcutaneous tissue were 10% lower than, but were highly correlated with, blood glucose concentrations in the range of 49-388 mg/dl. Glycemic control was established in diabetic patients by intravenously infusing insulin in response to measured glucose concentrations on a moment-to-moment basis for a period of several days. By comparing the glycemic control obtained in each patient treated with multiple insulin injections or open-loop subcutaneous insulin infusion, the superiority of feedback control with the system was clearly demonstrated. During continuous glycemic regulation, day-to-day variations of insulin requirements were recognized in both basal insulin infusion and postprandial insulin infusion rates in response to identical meals and exercise. These data suggest the feasibility of long-term glycemic control in diabetic subjects with a wearable artificial endocrine pancreas, and indicate that to overcome changes in individual metabolic characteristics on a moment-to-moment basis, a closed-loop glycemic control system may be essential for ambulatory diabetic patients. PMID:6389235

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

    PubMed Central

    2014-01-01

    Tight glycemic control in the ICU has been shown to reduce mortality in some but not all prospective randomized control trials. Confounding the interpretation of these studies are differences in how the control was achieved and underlying incidence of hypoglycemia, which can be expected to be affected by the introduction of continuous glucose monitoring (CGM). In this issue of Critical Care, a consensus panel provides a list of the research priorities they believe are needed for CGM to become routine practice in the ICU. We reflect on these recommendations and consider the implications for using CGM today. PMID:25041720

  7. Glycemic Control in Pediatric Patients on Extracorporeal Membrane Oxygenation

    PubMed Central

    Wierer, Kathryn L.; Pagryzinski, Rachel A.; Xiang, Qun

    2013-01-01

    OBJECTIVES To determine whether glycemic control has an effect on outcomes for pediatric patients on extracorporeal membrane oxygenation (ECMO) therapy, while controlling for multiple factors. METHODS A single-center retrospective chart review was performed on 82 patients who required ECMO from January 1, 2008, to December 31, 2010. All glucose concentrations collected while patients were on ECMO were analyzed; multiple other factors that may have affected mortality were also recorded. Primary outcome was mortality, and secondary outcomes were length of time on ECMO and length of time until death or discharge from the hospital. RESULTS Of 82 patients, 53 patients survived ECMO (64.6%). Glucose control had no effect on survival of patients on ECMO (p=0.56), even when controlling for multiple factors (p=0.48). Similarly, statistical evaluation showed no differences for hospital mortality in relationship to controlled serum glucose (p=0.50). Patients with controlled glucose spent an average of 31.5% more time on ECMO than non-controlled patients (p=0.048). CONCLUSIONS In this study, glycemic control, defined as serum glucose concentration between 60 mg/dL and 250 mg/dL for >95% of the time on ECMO, had no statistically significant effect on mortality for patients on ECMO. Future studies could focus on tighter glucose control or specific dextrose/glucose protocols to evaluate whether improved glucose control would have an effect on morbidity and mortality. PMID:24052786

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

    E-print Network

    15 Glycemic Control in the Pediatric Intensive Care Unit of Leuven: Two Years of Experience Tom Van, (PICU) pediatric intensive care unit, (TGC) tight glycemic control Keywords: blood glucose, children ill patients. Three randomized controlled trials, in the surgical, medical, and pediatric intensive

  9. Effect of Fructose on Glycemic Control in Diabetes

    PubMed Central

    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

    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

  10. Glycemic Control during Coronary Artery Bypass Graft Surgery

    PubMed Central

    Lazar, Harold L.

    2012-01-01

    Hyperglycemia, which occurs in the perioperative period during cardiac surgery, has been shown to be associated with increased morbidity and mortality. The management of perioperative hyperglycemia during coronary artery bypass graft surgery and all cardiac surgical procedures has been the focus of intensive study in recent years. This report will paper the pathophysiology responsible for the detrimental effects of perioperative hyperglycemia during cardiac surgery, show how continuous insulin infusions in the perioperative period have improved outcomes, and discuss the results of trials designed to determine what level of a glycemic control is necessary to achieve optimal clinical outcomes. PMID:23209941

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

    Microsoft Academic Search

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

    2001-01-01

    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

  12. Stochastic Targeted (STAR) Glycemic Control: Design, Safety, and Performance

    PubMed Central

    Evans, Alicia; Le Compte, Aaron; Tan, Chia-Siong; Ward, Logan; Steel, James; Pretty, Christopher G; Penning, Sophie; Suhaimi, Fatanah; Shaw, Geoffrey M; Desaive, Thomas; Chase, J Geoffrey

    2012-01-01

    Introduction Tight glycemic control (TGC) has shown benefits but has been difficult to achieve consistently. STAR (Stochastic TARgeted) is a flexible, model-based TGC approach that directly accounts for intra- and interpatient variability with a stochastically derived maximum 5% risk of blood glucose (BG) below 72 mg/dl. This research assesses the safety, efficacy, and clinical burden of a STAR TGC controller modulating both insulin and nutrition inputs in virtual and clinical pilot trials. Methods Clinically validated virtual trials using data from 370 patients in the SPRINT (Specialized Relative Insulin and Nutrition Titration) study were used to design the STAR protocol and test its safety, performance, and required clinical effort prior to clinical pilot trials. Insulin and nutrition interventions were given every 1–3 h as chosen by the nurse to allow them to manage workload. Interventions were designed to maximize the overlap of the model-predicted (5–95th percentile) range of BG outcomes with the 72–117 mg/dl band and thus provide a maximum 5% risk of BG <72 mg/dl. Interventions were calculated using clinically validated computer models of human metabolism and its variability in critical illness. Carbohydrate intake (all sources) was selected to maximize intake up to 100% of the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) goal (25 kg/kcal/h). Insulin doses were limited (8 U/h maximum), with limited increases based on current rate (0.5–2.0 U/h). Initial clinical pilot trials involved 3 patients covering ?450 h. Approval was granted by the Upper South A Regional Ethics Committee. Results Virtual trials indicate that STAR provides similar glycemic control performance to SPRINT with 2–3 h (maximum) measurement intervals. Time in the 72–126 mg/dl and 72–145 mg/dl bands was equivalent for all controllers, indicating that glycemic outcome differences between protocols were only shifted in this range. Safety from hypoglycemia was improved. Importantly, STAR using 2–3 h (maximum) intervention intervals reduced clinical burden up to 30%, which is clinically very significant. Initial clinical trials showed glycemic performance, safety, and management of inter- and intrapatient variability that matched or exceeded the virtual trial results. Conclusions In virtual trials, STAR TGC provided tight control that maximized the likelihood of BG in a clinically specified glycemic band and reduced hypoglycemia with a maximum 5% (or lower) expected risk of light hypoglycemia (BG <72 mg/dl) via model-based management of intra- and interpatient variability. Clinical workload was self-managed and reduced up to 30% compared with SPRINT. Initial pilot clinical trials matched or exceeded these virtual results. PMID:22401328

  13. Designing mobile support for glycemic control in patients with diabetes.

    PubMed

    Harris, Lynne T; Tufano, James; Le, Tung; Rees, Courtney; Lewis, Ginny A; Evert, Alison B; Flowers, Jan; Collins, Carol; Hoath, James; Hirsch, Irl B; Goldberg, Harold I; Ralston, James D

    2010-10-01

    We assessed the feasibility and acceptability of using mobile phones as part of an existing Web-based system for collaboration between patients with diabetes and a primary care team. In design sessions, we tested mobile wireless glucose meter uploads and two approaches to mobile phone-based feedback on glycemic control. Mobile glucose meter uploads combined with graphical and tabular data feedback were the most desirable system features tested. Participants had a mixture of positive and negative reactions to an automated and tailored messaging feedback system for self-management support. Participants saw value in the mobile system as an adjunct to the Web-based program and traditional office-based care. Mobile diabetes management systems may represent one strategy to improve the quality of diabetes care. PMID:20937484

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

    PubMed

    Trepanowski, John F; Varady, Krista A

    2015-12-01

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

  15. Point of care testing to improve glycemic control

    PubMed Central

    Rust, George; Gailor, Morna; Daniels, Elvan; McMillan-Persaud, Barbara; Strothers, Harry; Mayberry, Robert

    2013-01-01

    Purpose The purpose of this paper is to pilot-test the feasibility and impact of protocol-driven point-of-care HbA1c testing on levels of glycemic control and on rates of diabetic regimen intensification in an urban community health center serving low-income patients. Design/methodology/approach The paper suggests a primary care process re-design, using point of care finger-stick HbA1c testing under a standing order protocol that provided test results to the provider at patient visit. Findings The paper finds that the protocol was well received by both nurses and physicians. HbA1c testing rates increased from 73.6 percent to 86.8 percent (p = 0:40, n = 106). For the 69 patients who had both pre- and post-intervention results, HbA1c levels decreased significantly from 8.55 to 7.84 (p = 0:004, n = 69). At baseline, the health center as a system was relatively ineffective in responding to elevated HbA1c levels. An opportunity to intensify, i.e. a face-to-face visit with lab results available, occurred for only 68.6 percent of elevated HbA1c levels before the intervention, vs. 100 percent post-intervention (p < 0:001). Only 28.6 percent of patients with HbA1c levels >8.0 had their regimens intensified in the pre-intervention phase, compared with 53.8 percent in the post-intervention phase (p = 0:03). Research limitations/implications This was a pilot-study in one urban health center. Larger group-randomized controlled trials are needed. Practical implications The health center’s performance as a system, improved significantly as a way of intensifying diabetic regimens thereby achieving improved glycemic control. Originality/value This intervention is feasible, replicable and scalable and does not rely on changing physician behaviors to improve primary care diabetic outcomes. PMID:18578216

  16. Health Literacy, Diabetes Self-Care, and Glycemic Control in Adults with Type 2 Diabetes

    PubMed Central

    Osborn, Chandra Y.; Bains, Sujeev S.

    2010-01-01

    Abstract Background Although limited health literacy is a barrier to disease management and has been associated with poor glycemic control, the mechanisms underlying the relationships between health literacy and diabetes outcomes are unknown. We examined the relationships between health literacy, determinants of diabetes self-care, and glycemic control in adults with type 2 diabetes. Methods Patients with diabetes were recruited from an outpatient primary care clinic. We collected information on demographics, health literacy, diabetes knowledge, diabetes fatalism, social support, and diabetes self-care, and hemoglobin A1c values were extracted from the medical record. Structural equation models tested the predicted pathways linking health literacy to diabetes self-care and glycemic control. Results No direct relationship was observed between health literacy and diabetes self-care or glycemic control. Health literacy had a direct effect on social support (r?=??0.20, P?glycemic control (r?=??0.01). More diabetes knowledge (r?=?0.22, P?glycemic control (r?=??0.20, P?glycemic control through its association with social support. This suggests that for patients with limited health literacy, enhancing social support would facilitate diabetes self-care and improved glycemic control. PMID:20879964

  17. Glycemic Control Rate of T2DM Outpatients in China: A Multi-Center Survey

    PubMed Central

    Chen, Rong; Ji, Linong; Chen, Liming; Chen, Li; Cai, Dehong; Feng, Bo; Kuang, Hongyu; Li, Hong; Li, Yiming; Liu, Jing; Shan, Zhongyan; Sun, Zilin; Tian, Haoming; Xu, Zhangrong; Xu, Yancheng; Yang, Yuzhi; Yang, Liyong; Yu, Xuefeng; Zhu, Dalong; Zou, Dajin

    2015-01-01

    Background Type 2 diabetes mellitus (T2DM)-associated mortality and morbidity are strongly dependent on glycemic control. With T2DM prevalence increasing in China, we aimed to assess glycemic control rates in Chinese T2DM outpatients. Material/Methods A total of 9065 adult T2DM outpatients (5035 men) were assessed in 26 Chinese medical centers between August 2010 and April 2012. Patients were stratified according to BMI (kg/m2): <24, 24–28, and >28. Successful glycemic control was defined as glycated hemoglobin A1c (HbA1c) ?7% or fasting plasma glucose (FPG) <7.0 mmol/L. Results Among the participants included in this study, 2939 had BMI <24, 3361 had BMI of 24–28, and 2764 had BMI >28. The glycemic control rate was only 32.6%, and the triple control rate for glycemia, blood pressure, and lipidemia was only 11.2%. Glycemic control rates by BMI group were 33.7% (<24), 33.8% (24–28), and 30.2% (>28) (p=0.005), and corresponding incidences of cardiovascular diseases (CVD) were 12.2%, 15.7%, and 15.9% (p<0.001). Multivariate logistic regression analysis demonstrated that older age (p<0.001), higher BMI (p=0.026), larger waist circumference (p<0.001), less education (p<0.001), and recent diagnosis (p<0.001) were independent risk factors for poor glycemic control. Conclusions The T2DM glycemic control rate in China is currently low, especially in older obese patients with poor education and recent diagnosis. PMID:25986070

  18. Motor Vehicle Crashes in Diabetic Patients with Tight Glycemic Control: A Population-based Case Control Analysis

    Microsoft Academic Search

    Donald A. Redelmeier; Anne B. Kenshole; Joel G. Ray

    2009-01-01

    Using a population-based case control analysis, Donald Redelmeier and colleagues found that tighter glycemic control, as measured by the HbA1c, is associated with an increased risk of a motor vehicle crash.

  19. Update on glycemic control for the treatment of diabetic kidney disease.

    PubMed

    Nadkarni, Girish N; Yacoub, Rabi; Coca, Steven G

    2015-07-01

    Diabetic kidney disease (DKD) is a common, complex condition that has become a significant public health problem. The beneficial effects of intensive glycemic control in type 1 diabetes mellitus on development of DKD are proven; however, the evidence for nephroprotection in patients with type 2 diabetes is conflicting. Moreover, a strategy of intensive glycemic control increases the risk for adverse effects (hypoglycemic episodes) with no obvious impact on macrovascular events or mortality in recent large randomized controlled trials. The risk for hypoglycemia with intensive therapy is heightened in patients with significant renal dysfunction, due to decreased renal clearance of insulin. Establishing an ideal level of glycemic control in patients requires an individualized approach taking into account duration of diabetes and presence of coexisting comorbidities and pre-existing DKD. In this article, we review the available evidence from both observational studies and randomized controlled trials and provide suggestions about evaluating the potential benefits and harm from intensive glycemic control in patients. We also discuss how in the future, a personalized approach using biomarkers might help identify patients most likely to respond as well as those most susceptible to harm. We believe that using the optimal level of glycemic control in diabetic patients using a multi-pronged strategy will improve individual patient outcomes and decrease the overall burden of morbidity and mortality. PMID:25971619

  20. Colesevelam improves glycemic control and lipid management in inadequately controlled type 2 diabetes mellitus

    Microsoft Academic Search

    Konstantinos Tziomalos; Vasilios G Athyros; Dimitri P Mikhailidis

    2008-01-01

    Colesevelam has been suggested as a promising alternative treatment for patients with type 2 diabetes mellitus (T2DM) who are intolerant to statins or who have an elevated LDL cholesterol level despite statin treatment. In this Practice Point commentary, we discuss a randomized, controlled, double-blind trial that assessed the effect of colesevelam treatment on glycemic control in patients with T2DM that

  1. Association of Exercise Stages of Change with Glycemic Control in Individuals with Type 2 Diabetes.

    ERIC Educational Resources Information Center

    Natarajan, Sundar; Clyburn, Ernest B.; Brown, Ronald T.

    2002-01-01

    Investigated the distribution of diabetic patients' stages of change to follow an exercise regimen, examining whether later stages of change were associated with better glycemic control. Data on participants from a primary care clinic (who were predominantly black, female, and indigent) indicated that over half of were in pre-contemplation,…

  2. 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

  3. Link between Hypoglycemia and Cardiac Arrhythmias: An Answer to Why Tight Glycemic Control May Increase Mortality in ...

    MedlinePLUS

    ... Answer to Why Tight Glycemic Control May Increase Mortality in People with Diabetes and a Possible Explanation ... the subgroup that experienced a higher than expected mortality rate in the Action to Control Cardiovascular Risk ...

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

    PubMed

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

    2014-02-01

    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

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

    PubMed Central

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

    2015-01-01

    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. PMID:25759591

  6. Extremes of Glycemic Control (HbA1c) Increase Hospitalization Risk in Diabetic Hemodialysis Patients in the USA

    Microsoft Academic Search

    M. E. Williams; M. Teng; R. M. Hakim; J. M. Lazarus

    2009-01-01

    Background\\/Aims: Because the relation between glycemic control and clinical outcomes found in the general diabetic population has not been established in diabetic hemodialysis patients, we evaluated the association between glycemic control and hospitalization risk. Methods: We performed a primary retrospective data analysis on 23,829 hemodialysis patients with diabetes mellitus. Hemoglobin A1c at baseline and hospitalization events over the subsequent 12

  7. Tight Glycemic Control and Cardiovascular Effects in Type 2 Diabetic Patients

    PubMed Central

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

    2014-01-01

    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. PMID:25774253

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

    PubMed Central

    Marshall, Merville C.

    2007-01-01

    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

  9. Chronotype Is Independently Associated With Glycemic Control in Type 2 Diabetes

    PubMed Central

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

    2013-01-01

    OBJECTIVE To examine whether chronotype and daily caloric distribution are associated with glycemic control in patients with type 2 diabetes independently of sleep disturbances. RESEARCH DESIGN AND METHODS Patients with type 2 diabetes had a structured interview and completed questionnaires to collect information on diabetes history and habitual sleep duration, quality, and timing. Shift workers were excluded. A recently validated construct derived from mid-sleep time on weekends was used as an indicator of chronotype. One-day food recall was used to compute the temporal distribution of caloric intake. Hierarchical linear regression analyses controlling for demographic and sleep variables were computed to determine whether chronotype was associated with HbA1c values and whether this association was mediated by a higher proportion of caloric intake at dinner. RESULTS We analyzed 194 completed questionnaires. Multiple regression analyses adjusting for age, sex, race, BMI, insulin use, depressed mood, diabetes complications, and perceived sleep debt found that chronotype was significantly associated with glycemic control (P = 0.001). This association was partially mediated by a greater percentage of total daily calories consumed at dinner. CONCLUSIONS Later chronotype and larger dinner were associated with poorer glycemic control in patients with type 2 diabetes independently of sleep disturbances. These results suggest that chronotype may be predictive of disease outcomes and lend further support to the role of the circadian system in metabolic regulation. PMID:23637357

  10. Perioperative glycemic control using an artificial endocrine pancreas in patients undergoing total pancreatectomy: tight glycemic control may be justified in order to avoid brittle diabetes.

    PubMed

    Hanazaki, Kazuhiro; Yatabe, Tomoaki; Kobayashi, Masaki; Tsukamoto, Yuuki; Kinoshita, Yoshihiko; Munekage, Masaya; Kitagawa, Hiroyuki

    2013-01-01

    I dedicate this paper to the late Prof. Yukihiko Nosé with all my heart. In 2001, under the direction of Prof. Nosé and Prof. Brunicardi at Baylor College of Medicine, we published a review article entitled "Artificial endocrine pancreas" in JACS. Subsequently, we reported that perioperative tight glycemic control (TGC) using an artificial pancreas (AP) with a closed-loop system could stably maintain near-normoglycemia in total-pancreatectomized dogs. Based on this experimental study in Houston, since 2006, we have introduced perioperative TGC using an AP into clinical use in Kochi. As of 2011, this novel TGC method has provided safe and stable blood glucose levels in more than 400 surgical patients. In this paper, we report new clinical findings regarding perioperative TGC using an AP in total-pancreatectomized patients. TGC using an AP enables us to achieve stable glycemic control not only without hypoglycemia and hyperglycemia but also with less variation in blood glucose concentration from the target blood glucose range, even in patients with the most serious form of diabetes, so-called "brittle diabetes", undergoing total pancreatectomy. To the best of our knowledge, this is the first clinical report of TGC using an AP in patients undergoing total pancreatic resection. PMID:23442241

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

    PubMed Central

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

    2015-01-01

    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

  12. Recent progress in analytical instrumentation for glycemic control in diabetic and critically ill patients

    Microsoft Academic Search

    Venkata Radhakrishna Kondepati; H. Michael Heise

    2007-01-01

    Implementing strict glycemic control can reduce the risk of serious complications in both diabetic and critically ill patients.\\u000a For this reason, many different analytical, mainly electrochemical and optical sensor approaches for glucose measurements\\u000a have been developed. Self-monitoring of blood glucose (SMBG) has been recognised as being an indispensable tool for intensive\\u000a diabetes therapy. Recent progress in analytical instrumentation, allowing submicroliter

  13. Influences of The Great Hanshin-Awaji Earthquake on Glycemic Control in Diabetic Patients

    Microsoft Academic Search

    Keiji Kirizuka; Hiroshi Nishizaki; Kenji Kohriyama; Osamu Nukata; Yasutaka Arioka; Masako Motobuchi; Keiko Yoshiki; Kayako Tatezumi; Toshiko Kondo; Shuhei Tsuboi

    1997-01-01

    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 HbA1c level were studied according to the worsen rate of dietary and living conditions. A significant temporary increase in the mean value of HbA1c level was found after the earthquake (8.34±2.07% in March, 1995 vs. 7.74±1.82%

  14. Duodenal-jejunal bypass liner implantation provokes rapid weight loss and improved glycemic control, accompanied by elevated fasting ghrelin levels

    PubMed Central

    Koehestanie, Parweez; Dogan, Kemal; Berends, Frits; Janssen, Ignace; Wahab, Peter; Groenen, Marcel; Müller, Michael; de Wit, Nicole

    2014-01-01

    Background and study aims: Endoscopic implantation of a duodenal-jejunal bypass liner (DJBL) is a novel bariatric technique to induce weight loss and remission of type 2 diabetes mellitus. Placement of the DJBL mimics the bypass component of the Roux-en-Y gastric bypass (RYGB) procedure. In this observational study, we evaluated improvement of glycemic control and weight loss in the course of the treatment (0?–?24 weeks after DJBL implantation) and analyzed accompanying gut hormone responses. Patients and methods: 12 obese individuals with type 2 diabetes were selected for DJBL implantation. Body weight, fat mass, and fasting plasma levels of glucose, insulin, C-peptide, and glycated hemoglobin (HbA1c), were analyzed at 0, 1, 4 and 24 weeks post-implant. Fasting ghrelin, gastric inhibitory peptide (GIP), and glucagon-like peptide (GLP-1) were determined at 0, 1 and 4 weeks post-implant. Results: Besides significant weight loss, fat mass, fasting insulin, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) index were also significantly decreased after DJBL implantation and a 42?% reduction was found in diabetes medication (P?early remission of type 2 diabetes, comparable to results seen after RYGB surgery. Gut hormone analyses revealed a potential role of fasting GLP-1 in early remission of type 2 diabetes. Interestingly, the DJBL-induced elevation of ghrelin contradicts the suggested role of reduced ghrelin levels after RYGB in improvement of glycemic control.

  15. Outpatient Glycemic Control with a Bionic Pancreas in Type 1 Diabetes

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

    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

    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). PMID:25750540

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

    PubMed Central

    He, Jie; Chen, Fangyao; Chen, Rongping; Chen, Hong

    2015-01-01

    Background Previous clinical trials indicate that probiotic consumption may improve blood glucose control, however, results from randomized trials on glycemic control have been inconsistent. Objective To investigate the effects of probiotics on glycemic control in a systematic review and meta-analysis of randomized controlled trials. Data Sources PubMed, Embase, Cochrane Library, and Clinicaltrial.gov through October 2014. Data Extraction and Synthesis Two independent reviewers extracted relevant data and assessed study quality and risk of bias. Data were pooled using a random-effects model and expressed as mean differences (MD) with 95% CI. Heterogeneity was assessed (Cochran Q-statistic) and quantified (I2). Results Seventeen randomized controlled trials were included, in which 17 fasting blood glucose (n = 1105), 11 fasting plasma insulin (n = 788), 8 homeostasis model assessment of insulin resistance (n = 635) comparisons were reported. Probiotic consumption, compared with placebo, significantly reduced fasting glucose (MD = -0.31 mmol/L; 95% CI 0.56, 0.06; p = 0.02), fasting plasma insulin (MD = -1.29 ?U/mL; 95% CI -2.17, -0.41; p = 0.004), and HOMA-IR (MD = 0.48; 95% CI -0.83, -0.13; p = 0.007). Conclusions Probiotic consumption may improve glycemic control modestly. Modification of gut microbiota by probiotic supplementation may be a method for preventing and control hyperglycemia in clinical practice. PMID:26161741

  18. The combination of colesevelam with sitagliptin enhances glycemic control in diabetic ZDF rat model.

    PubMed

    Shang, Quan; Liu, Matthew K; Saumoy, Monica; Holst, Jens Juul; Salen, Gerald; Xu, Guorong

    2012-04-15

    Bile acid sequestrants have been shown to reduce glucose levels in patients with type 2 diabetes. We previously reported that the bile acid sequestrant colesevelam HCl (Welchol) (COL) induced the release of glucagon-like peptide (GLP)-1 and improved glycemic control in insulin-resistant rats. In the present study, we tested whether adding sitagliptin (Januvia) (SIT), which prolongs bioactive GLP-1 half life, to COL would further enhance glycemic control. Male Zucker diabetic fatty (ZDF) rats were assigned to four groups: diabetic model without treatment (the model), the model treated with 2% COL or 0.4% (120 mg/day) SIT alone, or with the combination (COL+SIT). After 4 wk of treatment, the glucose area under the curve (AUC) was reduced more in the COL+SIT than the COL although both groups showed decreased glucose AUC with increased AUC of bioactive GLP-1 (GLP-1A) compared with the model group. The above changes were not observed after 8 wk. Increasing the SIT dose by 50% (180 mg SIT/day) in the diet reduced the glucose AUC in the COL+SIT group even after 8 wk but still not in the SIT alone group compared with the model. It was noteworthy that, after 8 wk, insulin levels in the SIT group declined to levels similar to the model. Histological examination of the pancreatic ?-cell islets showed that islet sizes were larger, proliferation enhanced, and cell apoptosis reduced in the COL+SIT but not the SIT alone group compared with the model. We hypothesize that the combination of COL with SIT extends the half life of COL-induced GLP-1A and benefits preservation of the islets that delay the development of diabetes and improve glycemic control. This study suggests that the combined therapy (COL+SIT) is more effective than either drug alone for reducing glucose levels in diabetes. PMID:22281473

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

    PubMed Central

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

    2012-01-01

    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

  20. Effect of Hospital Admission on Glycemic Control One Year after Discharge

    PubMed Central

    Wei, Nancy J.; Grant, Richard W.; Nathan, David M.; Wexler, Deborah J.

    2013-01-01

    Objective We assessed the effect of hospital admission on glycemic control in patients with diabetes up to 1 year after discharge. Methods We retrospectively studied 826 adults with diabetes admitted to a tertiary care medical center and with available hemoglobin A1c (A1C) values prior to admission and 1 year after discharge. We compared them to 826 age-, sex-, race-, co-morbidity- and baseline A1C-matched non-hospitalized adults with diabetes. We determined change in A1C relative to hospitalization and baseline A1C using multivariate random effects models for repeated measures. Logistic regression was used to determine predictors of achieving recommended A1C levels at 1 year. Results Patients with baseline A1C?9% (adjusted mean A1C 9.90% [95% CI 9.25, 10.55]) had an adjusted change in A1C of ?0.10% per month ([95% CI ?0.18, ?0.022], p<0.01) over the course of 1 year without differences between hospitalized and non-hospitalized patients in the mean rate of change. However, hospitalized patients were less likely to achieve an A1C ?7% at one year (OR 0.68 [95% CI 0.55, 0.86], p<0.01) or A1C <8% at one year (OR 0.62 [95% CI 0.48, 0.81], p<0.01) compared to non-hospitalized patients. Conclusions Despite an overall trend towards improved glycemia over time, hospitalized patients with uncontrolled diabetes were less likely to achieve glycemic targets at 1 year compared to matched non-hospitalized patients. These results suggest a missed opportunity to improve long-term glycemic control in hospitalized patients with diabetes. PMID:22805110

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

    PubMed Central

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

    2012-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  3. Recent progress in analytical instrumentation for glycemic control in diabetic and critically ill patients.

    PubMed

    Kondepati, Venkata Radhakrishna; Heise, H Michael

    2007-06-01

    Implementing strict glycemic control can reduce the risk of serious complications in both diabetic and critically ill patients. For this reason, many different analytical, mainly electrochemical and optical sensor approaches for glucose measurements have been developed. Self-monitoring of blood glucose (SMBG) has been recognised as being an indispensable tool for intensive diabetes therapy. Recent progress in analytical instrumentation, allowing submicroliter samples of blood, alternative site testing, reduced test time, autocalibration, and improved precision, is comprehensively described in this review. Continuous blood glucose monitoring techniques and insulin infusion strategies, developmental steps towards the realization of the dream of an artificial pancreas under closed loop control, are presented. Progress in glucose sensing and glycemic control for both patient groups is discussed by assessing recent published literature (up to 2006). The state-of-the-art and trends in analytical techniques (either episodic, intermittent or continuous, minimal-invasive, or noninvasive) detailed in this review will provide researchers, health professionals and the diabetic community with a comprehensive overview of the potential of next-generation instrumentation suited to either short- and long-term implantation or ex vivo measurement in combination with appropriate body interfaces such as microdialysis catheters. PMID:17431594

  4. Diet, Inflammation, and Glycemic Control in Type 2 Diabetes: An Integrative Review of the Literature

    PubMed Central

    Nowlin, Sarah Y.; Hammer, Marilyn J.; D'Eramo Melkus, Gail

    2012-01-01

    Type 2 diabetes (T2D) is a growing national health problem affecting 35% of adults ?20 years of age in the United States. Recently, diabetes has been categorized as an inflammatory disease, sharing many of the adverse outcomes as those reported from cardiovascular disease. Medical nutrition therapy is recommended for the treatment of diabetes; however, these recommendations have not been updated to target the inflammatory component, which can be affected by diet and lifestyle. To assess the current state of evidence for which dietary programs contain the most anti-inflammatory and glycemic control properties for patients with T2D, we conducted an integrative review of the literature. A comprehensive search of the PubMed, CINAHL, Scopus, and Web of Science databases from January 2000 to May 2012 yielded 786 articles. The final 16 studies met the selection criteria including randomized control trials, quasiexperimental, or cross-sectional studies that compared varying diets and measured inflammatory markers. The Mediterranean and DASH diets along with several low-fat diets were associated with lower inflammatory markers. The Mediterranean diet demonstrated the most clinically significant reduction in glycosylated hemoglobin (HbA1c). Information on best dietary guidelines for inflammation and glycemic control in individuals with T2D is lacking. Continued research is warranted. PMID:23316349

  5. Analysis of alternatives for insulinizing patients to achieve glycemic control and avoid accompanying risks of hypoglycemia

    PubMed Central

    GAO, JIALIN; XIONG, QIANYIN; MIAO, JUN; ZHANG, YAO; XIA, LIBING; LU, MEIQIN; ZHANG, BINHUA; CHEN, YUEPING; ZHANG, ANSU; YU, CUI; WANG, LI-ZHUO

    2015-01-01

    The aims of the present study were to explore the efficacy of glycemic control and the risks of hypoglycemia with different methods of insulin therapy, and to provide reference data for the clinical treatment of diabetes. In this retrospective study, hospitalized patients diagnosed with type 2 diabetes between March and December 2014, in the Department of Endocrinology in the First Affiliated Hospital of Wannan Medical College, were divided into three groups, including an intensive insulin analogue therapy group, a premixed insulin analogue treatment group and a premixed human insulin therapy group. The efficacy of glycemic control and the incidence of hypoglycemia were determined in each of the insulin treatment groups. Compared with the other treatment groups, the intensive insulin analogue therapy group was associated with superior blood glucose control, shorter time to reach standard insulin regimen, shorter hospitalization time, fewer fluctuations in blood glucose levels and lower insulin dosage on discharge from hospital. However, this treatment was also associated with a high risk of hypoglycemia. In conclusion, when combined with the effective prevention of hypoglycemia and appropriate nursing care (especially in hospital care), intensive insulin analogue therapy may provide the greatest benefit to patients. PMID:26137223

  6. Efficiency of vibration exercise for glycemic control in type 2 diabetes patients

    PubMed Central

    Baum, Klaus; Votteler, Tim; Schiab, Jürgen

    2007-01-01

    Although it is well documented that persons suffering from diabetes type 2 profit from muscular activities, just a negligible amount of patients take advantage of physical exercises. During the last decade, vibration exercise (VE) could be established as an effective measure to prevent muscular atrophy and osteoporosis with low expenditure of overall exercise-time. Unfortunately, little is known about the metabolic effects of VE. In the present study we compared VE with the influence of strength training and a control group (flexibility training) on glycemic control in type 2 diabetes patients. Forty adult non-insulin dependent patients participated in the intervention. Fasting glucose concentration, an oral glucose tolerance test (OGTT), haemoglobin A1c (HbA1c), the isometric maximal torque of quadriceps muscles, and endurance capacity were evaluated at baseline and after 12 weeks of training with three training sessions per week. The main findings are: Fasting glucose concentrations remind unchanged after training. The area under curve and maximal glucose concentration of OGTT were reduced in the vibration and strength training group. HbA1c values tended to decrease below baseline date in the vibration training group while it increased in the two other intervention groups. Theses findings suggest that vibration exercise may be an effective and low time consuming tool to enhance glycemic control in type 2 diabetes patients. PMID:17554399

  7. Friends or Foes? A Review of Peer Influence on Self-Care and Glycemic Control in Adolescents With Type 1 Diabetes

    E-print Network

    Creswell, J. David

    Friends or Foes? A Review of Peer Influence on Self-Care and Glycemic Control in Adolescents for adolescents with type 1 diabetes. Methods We searched PsychInfo and MedLine databases and personal archives between person and social context. Key words adherence; adolescent; friends; glycemic control; peers; self

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

    PubMed

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

    1990-04-01

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

  9. Glycemic Control in the Burn Intensive Care Unit: Focus on the Role of Anemia in Glucose Measurement

    PubMed Central

    Mann, Elizabeth A.; Mora, Alejandra G.; Pidcoke, Heather F.; Wolf, Steven E.; Wade, Charles E.

    2009-01-01

    Glycemic control with intensive insulin therapy (IIT) has received widespread adoption secondary to findings of improved clinical outcomes and survival in the burn population. Severe burn as a model for trauma is characterized by a hypermetabolic state, hyperglycemia, and insulin resistance. In this article, we review the findings of a burn center research facility in terms of understanding glucose management. The conferred benefits from IIT, our findings of poor outcomes associated with glycemic variability, advantages from preserved diurnal variation of glucose and insulin, and impacts of glucometer error and hematocrit correction factor are discussed. We conclude with direction for further study and the need for a reliable continuous glucose monitoring system. Such efforts will further the endeavor for achieving adequate glycemic control in order to assess the efficacy of target ranges and use of IIT. PMID:20144386

  10. Physical activity, glycemic control, and diabetic peripheral neuropathy: a national sample.

    PubMed

    Loprinzi, Paul D; Hager, Kathy K; Ramulu, Pradeep Y

    2014-01-01

    To determine if physical activity and/or blood glycohemoglobin (HbA1c) are associated with the prevalence of peripheral neuropathy (PN) in a representative population of diabetics. Three hundred thirty-nine diabetic participants (40-85 yrs) taking part in 2003-2004 National Health and Nutrition Examination Survey were studied. Participants were defined as having peripheral neuropathy if examination determined ?1 insensate area in either foot. Moderate-to-vigorous physical activity (MVPA) was objectively-measured using accelerometry. After adjustments, MVPA was not significantly associated with PN (OR=1.16; 95% CI: 0.48-2.78), nor was HbA1c (OR=0.55; 95% CI: 0.28-1.04). However, there was evidence of statistical interaction (OR=0.24; 95% CI: 0.06-0.87) between MVPA and HbA1c status, showing that diabetics engaging in higher levels of MVPA and having normal HgbA1c levels were less likely to have PN than what would be expected based on the individual effects of MVPA and HbA1c alone. Although MVPA was not directly associated with PN, these findings suggest that proper physical activity, coupled with good glycemic control, is associated with less neuropathy. Future longitudinal studies are required to evaluate whether physical activity and improved glycemic control may help prevent or slow the progression of diabetic end-organ damage, particularly diabetic neuropathy. PMID:24090951

  11. Glycemic control, dyslipidemia and endothelial dysfunction in coexisted diabetes, hypertension and nephropathy.

    PubMed

    Shahid, Syed Muhammad; Nawab, Syeda Nuzhat; Shaikh, Rozeena; Mahboob, Tabassum

    2012-01-01

    Diabetes mellitus is a chronic metabolic disorder that can lead to serious cardiovascular, renal, neurologic and retinal complications. Diabetes clustered with hypertension and nephropathy has become the leading cause of end-stage renal disease globally. This study describes diabetes, hypertension and nephropathy with reference to glycemic control, dyslipidemia and endothelial dysfunction indicating the foremost basis of morbidity and mortality world wide and rapidly progressing in Pakistan. Study subjects selected and divided in four groups (60 each) followed by institutional ethical approval and informed consent. Group 1: non-diabetic, normotensive control subjects; Group 2: diabetic, normotensive patients; Group 3: diabetic, hypertensive patients and Group 4: diabetic, hypertensive patients with nephropathy. Their fasting blood samples analyzed for the estimations of blood glucose, HbA1c, serum triglyceride, cholesterol, LDL-cholesterol, HDL-cholesterol, urea, creatinine, nitric oxide and sialic acid levels. Results showed that all the groups showed significant rise in fasting blood glucose. Similarly HbA1c levels were also significantly high in all the patients as compared to controls. Group 2 showed significantly high serum cholesterol and LDL levels and low HDL levels. Group 3 and 4 showed significantly high serum triglyceride, cholesterol and LDL levels where as low HDL levels as compared to controls. Group 3 showed significantly high serum creatinine. Group 4 showed a significantly high serum urea and creatinine as compared to controls. Persistent albuminuria was characteristic in Group 4 patients. Significantly low production of serum nitric oxide with high concentration of serum sialic acid was observed in Group 3 and 4 as compared to controls. Results indicate a clear relationship of declining renal function with poor glycemic control, abnormal lipid metabolism, endothelial dysfunction and initiation of acute phase response in tissues affected from the microvascular complications of diabetes like hypertension and nephropathy. It must be taken into account while screening diabetic patients to get them rid of progressive renal impairment leading to end stage renal disease. PMID:22186319

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

    PubMed Central

    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

    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

  13. Diabetes and tuberculosis: a review of the role of optimal glycemic control

    PubMed Central

    2012-01-01

    Developing countries shoulder most of the burden of diabetes and tuberculosis. These diseases often coexist. Suboptimal control of diabetes predisposes the patient to tuberculosis, and is one of the common causes of poor response to anti-tubercular treatment. Tuberculosis also affects diabetes by causing hyperglycemia and causing impaired glucose tolerance. Impaired glucose tolerance is one of the major risk factors for developing diabetes. The drugs used to treat tuberculosis (especially rifampicin and isoniazid) interact with oral anti-diabetic drugs and may lead to suboptimal glycemic control. Similarly some of the newer oral anti-diabetic drugs may interact with anti-tuberculosis drugs and lower their efficacy. Therefore diabetes and tuberculosis interact with each other at multiple levels – each exacerbating the other. Management of patients with concomitant tuberculosis and diabetes differs from that of either disease alone. This article reviews the association between diabetes and tuberculosis and suggests appropriate management for these conditions. PMID:23497638

  14. Determinants of Glycemic control in Youth with Type 2 diabetes at randomization in the TODAY study

    PubMed Central

    2011-01-01

    Objective To investigate insulin sensitivity and secretion indices and determinants of glycemic control in youth with recent-onset type 2 diabetes at randomization in the TODAY study, the largest study of youth with type 2 diabetes to date. Research Design and Methods We examined estimates of insulin sensitivity [1/fasting insulin (1/IF), fasting glucose/insulin (GF/IF), 1/fasting C-peptide (1/CF), GF/CF], ?-cell function [insulinogenic index (?I30/?G30), and ?C30/?G30], and disposition index (DI) in the TODAY cohort of 704 youth (14.0±2.0 yr; diabetes duration 7.8±5.8 mo; 64.9% female; 41.1% Hispanic, 31.5% Black, 19.6% White, 6.1% American Indian, and 1.7% Asian) according to HbA1c quartiles at study randomization. The randomization visit followed a run-in period (median 71 days) during which glycemic control (HbA1c? 8% for at least 2 months) was achieved with metformin alone. These measures were also examined in relation to screening HbA1c levels prior to run-in. Results Insulin secretion indices declined with increasing HbA1c quartiles, at randomization and screening, (at randomization: ?C30/?G30: 0.11±0.09, 0.10±0.19, 0.07±0.06, and 0.03±0.03 ng/ml per mg/dl, p<0.0001; DI: 0.03±0.03, 0.03±0.05, 0.02±0.02, and 0.01±0.01 mg/dl?1, p<0.0001) with no significant difference in insulin sensitivity. There were no significant differences in estimates of insulin sensitivity or secretion between genders or across the different racial groups. At randomization and screening, HbA1C correlated with DI (r=?0.3, p<0.001), with ?C30/?G30, but not with insulin sensitivity estimates. Conclusions In youth with recent-onset type 2 diabetes treated with metformin, glycemic control, as measured by HbA1c, appears to be associated with residual ?-cell function, and not insulin sensitivity. PMID:22332798

  15. Intensive Glycemic Control Is Not Associated With Fractures or Falls in the ACCORD Randomized Trial

    PubMed Central

    Schwartz, Ann V.; Margolis, Karen L.; Sellmeyer, Deborah E.; Vittinghoff, Eric; Ambrosius, Walter T.; Bonds, Denise E.; Josse, Robert G.; Schnall, Adrian M.; Simmons, Debra L.; Hue, Trisha F.; Palermo, Lisa; Hamilton, Bruce P.; Green, Jennifer B.; Atkinson, Hal H.; O’Connor, Patrick J.; Force, Rex W.; Bauer, Douglas C.

    2012-01-01

    OBJECTIVE Older adults with type 2 diabetes are at high risk of fractures and falls, but the effect of glycemic control on these outcomes is unknown. To determine the effect of intensive versus standard glycemic control, we assessed fractures and falls as outcomes in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) randomized trial. RESEARCH DESIGN AND METHODS ACCORD participants were randomized to intensive or standard glycemia strategies, with an achieved median A1C of 6.4 and 7.5%, respectively. In the ACCORD BONE ancillary study, fractures were assessed at 54 of the 77 ACCORD clinical sites that included 7,287 of the 10,251 ACCORD participants. At annual visits, 6,782 participants were asked about falls in the previous year. RESULTS During an average follow-up of 3.8 (SD 1.3) years, 198 of 3,655 participants in the intensive glycemia and 189 of 3,632 participants in the standard glycemia group experienced at least one nonspine fracture. The average rate of first nonspine fracture was 13.9 and 13.3 per 1,000 person-years in the intensive and standard groups, respectively (hazard ratio 1.04 [95% CI 0.86–1.27]). During an average follow-up of 2.0 years, 1,122 of 3,364 intensive- and 1,133 of 3,418 standard-therapy participants reported at least one fall. The average rate of falls was 60.8 and 55.3 per 100 person-years in the intensive and standard glycemia groups, respectively (1.10 [0.84–1.43]). CONCLUSIONS Compared with standard glycemia, intensive glycemia did not increase or decrease fracture or fall risk in ACCORD. PMID:22723583

  16. Glycemic control in diabetic dialysis patients and the burnt-out diabetes phenomenon.

    PubMed

    Park, Jongha; Lertdumrongluk, Paungpaga; Molnar, Miklos Z; Kovesdy, Csaba P; Kalantar-Zadeh, Kamyar

    2012-08-01

    Diabetes mellitus (DM) is the most common cause of end-stage kidney disease and a major risk of morbidity and mortality. It is not clear whether medical management of DM has any significant beneficial effect on clinical outcomes at the end-stage of diabetic nephropathy with full-blown micro- and macro-angiopathic complications. Both loss of kidney function and dialysis treatment interfere with glucose homeostasis and confound glycemic control. Given the unique nature of uremic milieu and dialysis therapy related alterations, there have been some debates about reliance on the conventional measures of glycemic control, in particular the clinical relevance of hemoglobin A1c and its recommended target range of <7 % in diabetic dialysis patients. Moreover, a so-called burnt-out diabetes phenomenon has been described, in that many diabetic dialysis patients experience frequent hypoglycemic episodes prompting cessation of their anti-diabetic therapies transiently or even permanently. By reviewing the recent literature we argue that the use of A1c for management of diabetic dialysis patients should be encouraged if appropriate target ranges specific for these patients (e.g. 6 to 8 %) are used. We also argue that "burnt-out diabetes" is a true biologic phenomenon and highly prevalent in dialysis patients with established history and end-stage diabetic nephropathy and explore the role of protein-energy wasting to this end. Similarly, the J- or U-shaped associations between A1c or blood glucose concentrations and mortality are likely biologically plausible phenomena that should be taken into consideration in the management of diabetic dialysis patients to avoid hypoglycemia and its fatal consequences in diabetic dialysis patients. PMID:22638938

  17. Glycemic control among patients in China with type 2 diabetes mellitus receiving oral drugs or injectables

    PubMed Central

    2013-01-01

    Background The prevalence of type 2 diabetes mellitus (T2DM) is increasing rapidly among Chinese adults, and limited data are available on T2DM management and the status of glycemic control in China. We assessed the efficacy of oral antidiabetes drugs (OADs), glucagon-like peptide-1 (GLP-1) receptor agonists, and insulin for treatment of T2DM across multiple regions in China. Methods This was a multicenter, cross-sectional survey of outpatients conducted in 606 hospitals across China. Data from all the patients were collected between April and June, 2011. Results A total of 238,639 patients were included in the survey. Eligible patients were treated with either OADs alone (n=157,212 [65.88%]), OADs plus insulin (n=80,973 [33.93%]), or OADs plus GLP-1 receptor agonists (n=454 [0.19%]). The OAD monotherapy, OAD + insulin, and OAD + GLP-1 receptor agonist groups had mean glycosylated hemoglobin (HbA1c) levels (±SD) of 7.67% (±1.58%), 8.21% (±1.91%), and 7.80% (±1.76%), respectively. Among those three groups, 34.63%, 26.21%, and 36.12% met the goal of HbA1c <7.0%, respectively. Mean HbA1c and achievement of A1c <7.0% was related to the duration of T2DM. Conclusions Less than one third of the patients had achieved the goal of HbA1c <7.0%. Glycemic control decreased and insulin use increased with the duration of diabetes. PMID:23800082

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    2009-01-01

    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

  20. A Randomized Controlled Trial of an Internet-Based Mentoring Program for Type 1 Diabetes Patients with Inadequate Glycemic Control

    PubMed Central

    Suh, Sunghwan; Jean, Cheol; Koo, Mihyun; Lee, Sun Young; Cho, Min Ja; Sim, Kang-Hee; Jin, Sang-Man; Bae, Ji Cheol

    2014-01-01

    Background To determine whether an internet-based mentoring program can improve glycemic control in subjects with type 1 diabetes mellitus (T1DM). Methods Subjects with T1DM on intensive insulin therapy and with hemoglobin A1c (HbA1c) ?8.0% were randomized to mentored (glucometer transmission with feedback from mentors) or control (glucometer transmission without feedback) groups and were examined for 12 weeks. Five mentors were interviewed and selected, of which two were T1DM patients themselves and three were parents with at least one child diagnosed with T1DM since more than 5 years ago. Results A total of 57 T1DM adult subjects with a mean duration after being diagnosed with diabetes of 7.4 years were recruited from Samsung Medical Center. Unfortunately, the mentored group failed to show significant improvements in HbA1c levels or other outcomes, including the quality of life, after completion of the study. However, the mentored group monitored their blood glucose (1.41 vs. 0.30) and logged into our website (http://ubisens.co.kr/) more frequently (20.59 times vs. 5.07 times) than the control group. Conclusion A 12-week internet-based mentoring program for T1DM patients with inadequate glycemic control did not prove to be superior to the usual follow-up. However, the noted increase in the subjects' frequency of blood glucose monitoring may lead to clinical benefits. PMID:24851207

  1. Efficacy and Safety of Colesevelam in Patients With Type 2 Diabetes Mellitus and Inadequate Glycemic Control Receiving Insulin-Based Therapy

    Microsoft Academic Search

    Ronald B. Goldberg; Vivian A. Fonseca; Kenneth E. Truitt; Michael R. Jones

    2008-01-01

    Background: Poor glycemic control is a risk factor for microvascular complications in patients with type 2 dia- betes mellitus. Achieving glycemic control safely with in- sulin therapy can be challenging. Methods: A prospective, 16-week, multicenter, ran- domized, double-blind, placebo-controlled, parallel- group study conducted at 50 sites in the United States and 1 site in Mexico between August 12, 2004, and

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

    PubMed Central

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

    2014-01-01

    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

  3. Poor Glycemic Control of Diabetes Mellitus Is Associated with Higher Risk of Prostate Cancer Detection in a Biopsy Population

    PubMed Central

    Park, Juhyun; Cho, Sung Yong; Lee, Young Ju; Lee, Seung Bae; Son, Hwancheol; Jeong, Hyeon

    2014-01-01

    Objectives To evaluate the impact of glycemic control of diabetes mellitus (DM) on prostate cancer detection in a biopsy population. Patients and Methods We retrospectively reviewed the records of 1,368 men who underwent prostate biopsy at our institution. We divided our biopsy population into three groups according to their history of DM, and their Hemoglobin A1c (HbA1c) level: a no-DM (DM?) group; a good glycemic control (DM+GC) group (HbA1c <6.5%); and a poor glycemic control (DM+PC) group (HbA1c ?6.5%). For sub-analyses, the DM+PC group was divided into a moderately poor glycemic control (DM+mPC) group (6.5? HbA1c <7.5%) and a severely poor glycemic control (DM+sPC) group (HbA1c ?7.5%). Results Among 1,368 men, 338 (24.7%) had a history of DM, and 393 (28.7%) had a positive biopsy. There was a significant difference in prostatic specific antigen density (PSAD) (P?=?0.037) and the frequency of abnormal DRE findings (P?=?0.031) among three groups. The occurrence rate of overall prostate cancer (P<0.001) and high-grade prostate cancer (P?=?0.016) also presented with a significantly difference. In the multivariate analysis, the DM+PC group was significantly associated with a higher rate of overall prostate cancer detection in biopsy subjects compared to the DM? group (OR?=?2.313, P?=?0.001) but the DM+PC group was not associated with a higher rate of high-grade (Gleason score ?7) diseases detected during the biopsy (OR?=?1.297, P?=?0.376). However, in subgroup analysis, DM+sPC group was significantly related to a higher risk of high-grade diseases compared to the DM? group (OR?=?2.446, P?=?0.048). Conclusions Poor glycemic control of DM was associated with a higher risk of prostate cancer detection, including high-grade disease, in the biopsy population. PMID:25198675

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

    PubMed Central

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

    2012-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  6. In search of quality evidence for lifestyle management and glycemic control in children and adolescents with type 2 diabetes: A systematic review

    Microsoft Academic Search

    Steven T Johnson; Amanda S Newton; Meera Chopra; Jeanette Buckingham; Terry TK Huang; Paul W Franks; Mary M Jetha; Geoff DC Ball

    2010-01-01

    BACKGROUND: Our purpose was to evaluate the impact of lifestyle behavior modification on glycemic control among children and youth with clinically defined Type 2 Diabetes (T2D). METHODS: We conducted a systematic review of studies (randomized trials, quasi-experimental studies) evaluating lifestyle (diet and\\/or physical activity) modification and glycemic control (HbA1c). Our data sources included bibliographic databases (EMBASE, CINAHL®, Cochrane Library, Medline®,

  7. Nasogastric Aspiration as an Indicator for Feed Absorption in Model-Based Glycemic Control in Neonatal Intensive Care

    PubMed Central

    Gunn, Cameron A.; Dickson, Jennifer L.; Hewett, James N.; Lynn, Adrienne; Rose, Hamish J.; Clarkson, Sooji H.; Shaw, Geoffrey M.; Geoffrey Chase, J.

    2013-01-01

    Background STAR (stochastic targeted) is a glycemic control model-based framework for critically ill neonates that has shown benefits in reducing hypoglycemia and hyperglycemia. STAR uses a stochastic matrix method to forecast future changes in a patient’s insulin sensitivity and then applies this result to a physiological model to select an optimal insulin treatment. Nasogastric aspiration may be used as an indicator to suggest periods of care when enteral feed absorption is compromised, improving the performance of glycemic control. An analysis has been carried out to investigate the effect of poorly absorbed feeds on glycemic control. Method Clinical data were collected from eight patients on insulin therapy and enteral feed, which included large or significantly milky aspirates. Patients had a median gestational age of 25 weeks and postnatal age of 5.5 days. Virtual patients were created using the NICING model, and insulin sensitivity (SI) profiles were fit. Alternative feed profiles were generated whereby enteral feed absorption was redistributed with time to account for poor feed absorption. The effect of poor feed absorption, as indicated by aspirates, is investigated. Results The average percentage change of SI 4 h before a significant aspirate was 1.16%, and 1.49% in the 4 h following the aspirate. No distinct relationship was found between the fractional change in SI and the volume of the aspirate. Accounting for aspirates had a clinically negligible impact on glycemic control in virtual trials. Conclusion Accounting for aspirates by manipulating enteral feed profiles had a minimal influence on both modeling and controlling glycemia in neonates. The impact of this method is clinically insignificant, suggesting that a population constant for the rate of glucose absorption in the gut adequately models feed absorption within the STAR framework. J Diabetes Sci Technol 2013;7(3):717–726 PMID:23759405

  8. A systematic review and meta-analysis of beta-glucan consumption on glycemic control in hypercholesterolemic individuals.

    PubMed

    Zou, Ying; Liao, Dan; Huang, Haohai; Li, Tao; Chi, Honggang

    2015-06-01

    Evidence from animal and observational studies has supported the beneficial effects of beta-glucan intake on glycemic control, but intervention studies in hypercholesterolemic crowd have generated mixed results and have not been systematically examined. In the present study, we aimed to quantitatively evaluate the relation between beta-glucan consumption from oats or barley on glycemic control in hypercholesterolemic individuals. A systematic literature review was conducted for relevant published randomized controlled trials studies (RCTs) in electronic databases through July 2014. Twelve trials with a total of 603 subjects were included in the meta-analysis. Beta-glucan consumption did not significantly affect measures of glycemic control. Summary estimates of weighted mean differences (WMD) and 95% confidence interval was 0.05?mmol/L (-0.11, 0.02) for fasting glucose concentration and 0.75?pmol/L (-1.82, 3.32) for fasting insulin concentrations. In conclusion, there was not a significant overall effect of beta-glucan intake on improvements of fasting glucose and insulin concentrations in hypercholesterolemic subjects. PMID:26001090

  9. Exploring the relationship between diabetes self-efficacy, depressive symptoms, and glycemic control among men and women with type 2 diabetes.

    PubMed

    Cherrington, Andrea; Wallston, Kenneth A; Rothman, Russell L

    2010-02-01

    Depression and low self-efficacy are both associated with worse glycemic control in adults with diabetes, but the relationship between these variables is poorly understood. We conducted a cross-sectional study examining associations between depressive symptoms, self-efficacy, and glycemic control among men (n = 64) and women (n = 98) with type 2 diabetes to see if self-efficacy mediates the relationship between depression and glycemic control. Correlational and mediational analyses examined the relationship between these three variables for the sample as a whole and separately by sex. A significant association between depressive symptoms and glycemic control was found for men (0.34, P < 0.01) but not for women (0.05, P = 0.59). Path analysis suggested that, among men, self-efficacy mediates the relationship between depressive symptoms and glycemic control. We conclude that men with depressive symptoms and type 2 diabetes may need tailored interventions that improve their self-efficacy in order to achieve glycemic control. PMID:20128112

  10. HOMA-IR Values are Associated With Glycemic Control in Japanese Subjects Without Diabetes or Obesity: The KOBE Study

    PubMed Central

    Hirata, Takumi; Higashiyama, Aya; Kubota, Yoshimi; Nishimura, Kunihiro; Sugiyama, Daisuke; Kadota, Aya; Nishida, Yoko; Imano, Hironori; Nishikawa, Tomofumi; Miyamatsu, Naomi; Miyamoto, Yoshihiro; Okamura, Tomonori

    2015-01-01

    Background Several studies have reported that insulin resistance was a major risk factor for the onset of type 2 diabetes mellitus in individuals without diabetes or obesity. We aimed to clarify the association between insulin resistance and glycemic control in Japanese subjects without diabetes or obesity. Methods We conducted a community-based cross-sectional study including 1083 healthy subjects (323 men and 760 women) in an urban area. We performed multivariate regression analyses to estimate the association between the homeostasis model assessment of insulin resistance (HOMA-IR) values and markers of glycemic control, including glycated haemoglobin (HbA1c), 1,5-anhydroglucitol (1,5-AG), and fasting plasma glucose (FPG) levels, after adjustment for potential confounders. Results Compared with the lowest tertile of HOMA-IR values, the highest tertile was significantly associated with HbA1c and FPG levels after adjustment for potential confounders, both in men (HbA1c: ? = 1.83, P = 0.001; FPG: ? = 0.49, P < 0.001) and women (HbA1c: ? = 0.82, P = 0.008; FPG: ? = 0.39, P < 0.001). The highest tertile of HOMA-IR values was inversely associated with 1,5-AG levels compared with the lowest tertile (? = ?18.42, P = 0.009) only in men. Conclusions HOMA-IR values were associated with markers of glycemic control in Japanese subjects without diabetes or obesity. Insulin resistance may influence glycemic control even in a lean, non-diabetic Asian population. PMID:26005064

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

    Microsoft Academic Search

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

    2003-01-01

    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

  12. Inflammatory biomarkers in type 2 diabetic patients: effect of glycemic control and impact of ldl subfraction phenotype

    PubMed Central

    2014-01-01

    Background Type 2 diabetes mellitus (T2D) is associated with higher cardiovascular risk partly related to an increase in inflammatory parameters. The aim of this study was to determine the association of inflammatory biomarkers with low-density lipoprotein (LDL) subfraction phenotype and glycemic control in subjects with T2D and poor glycemic control. Methods A cross-sectional study was performed comparing 122 subjects with T2D (59 ± 11 years old, body mass index 30.2 ± 5.6 kg/m2) with 54 control subjects. Patients with T2D were classified according to their LDL subfraction phenotype and inflammatory biomarkers (C-reactive protein, Interleukin-6, Interleukin-8, Transforming growth factor ?1, Monocyte chemotactic protein 1, Leptin, Adiponectin) were evaluated according to the degree of glycemic control, LDL phenotype and other clinical characteristics. Forty-two subjects with T2D were studied before and after 3 months of improving glycemic control by different strategies. Results Patients with T2D had higher C-reactive protein (CRP) and monocyte chemotactic protein-1 (MCP1) levels and lower adiponectin concentration, compared to controls. T2D subjects with body mass index???30 kg/m2 had higher CRP levels (5.2?±?4.8 mg/l vs 3.7?±?4.3 mg/l; p?glycemic control reduces TGF-?1 levels, which may contribute partly to its renoprotective role. PMID:24495560

  13. Improving glycemic and cholesterol control through an integrated approach incorporating colesevelam – a clinical perspective

    PubMed Central

    Goldberg, Ronald B

    2009-01-01

    Bile sequestrants have been used for almost 50 years to lower low density lipoprotein cholesterol (LDL-C). The advent of colesevelam in 2000 provided a more tolerable add-on LDL-C-lowering agent with an excellent safety record and with likely benefit for coronary heart disease events. Colesevelam lowers LDL-C approximately 15%, and has an additive effect when combined with statin or non-statin lipid-modifying agents. It also tends to increase triglyceride levels. The discovery that bile sequestrants also lower glucose levels led to definitive large-scale clinical trials testing the effect of colesevelam as a dual antihyperglycemic agent with LDL-C-lowering properties in type 2 diabetic subjects on metformin-, sulfonylurea- or insulin-based therapy with inadequate glycemic control. Colesevelam was found to lower hemoglobin A1c (HbA1c) by approximately 0.5% compared to placebo over the 16- to 26-week period, and had similar effects on the lipid profile in these diabetic subjects, as had previously been demonstrated in non-diabetic individuals. Colesevelam was well tolerated, with constipation being the most common adverse effect, and did not cause weight gain or excessive hypoglycemia. Colesevelam thus combines antihyperglycemic action with LDL-C-lowering properties, and should be useful in the management of type 2 diabetes. PMID:21437115

  14. Niclosamide ethanolamine improves blood glycemic control and reduces hepatic steatosis in mice

    PubMed Central

    Tao, Hanlin; Zhang, Yong; Zeng, Xiangang; Shulman, Gerald I.; Jin, Shengkan

    2014-01-01

    Type 2 diabetes (T2D) has reached an epidemic level globally. Most current treatments ameliorate the hyperglycemic symptom but are not effective in correcting the underlying cause. One important causal factor of T2D is ectopic accumulation of lipid in organs such as liver and muscle. Mitochondrial uncoupling, which reduces cellular energy efficiency and increases lipid oxidation, represents an appealing therapeutic strategy. The challenge, however, is to discover safe mitochondrial uncouplers for practical use. Niclosamide is an FDA approved anthelmintic drug that uncouples mitochondria of parasitic worms. Here we show that niclosamide ethanolamine salt (NEN) uncouples mammalian mitochondria at upper nanomolar concentrations. Oral NEN increases energy expenditure and lipid metabolism in mice. It is efficacious in preventing and treating high-fat diet (HFD) induced hepatic steatosis and insulin resistance. Moreover, it improves glycemic control and delays disease progression of the db/db mice. Given the well- documented safety profile of NEN, our study provides a potentially practical pharmacological embodiment of a new strategy for treating T2D. PMID:25282357

  15. Effect of Mobile Phone Short Text Messages on Glycemic Control in Type 2 Diabetes

    PubMed Central

    Bin Abbas, Bassam; Al Fares, Abdullah; Jabbari, Musleh; El Dali, Abdelmoneim; Al Orifi, Fahad

    2015-01-01

    Background: Mobile phone text messaging has rapidly become a socially popular form of communication. Several studies showed that mobile phone might offer a useful means of providing information between clinic visits and might increase adherence to diabetes therapy regimens. Objectives: We conducted a study to evaluate the effect of mobile phone short message service (SMS) on glycemic control in Saudi patients with type 2 diabetes. Patients and Methods: One hundred patients (mean age, 41 ± 9.5 years) were selected at the Security Forces Hospital, Riyadh, Saudi Arabia, and provided with daily educational, reminding SMS messages for four months. Glycosylated hemoglobin (HbA1c) level, frequency of hypoglycemic and hyperglycemic attacks, and compliance with blood glucose monitoring were recorded before and after the trial. Results: In addition to significant improvement in patients’ knowledge, mean fasting blood glucose level improved from 8.60 ± 3.16 to 7.77 ± 3.11 mmol/L and mean HbA1c decreased from 9.9% ± 1.8% to 9.5% ± 1.7%. Conclusions: Mobile phone text messaging increased adherence to diabetes therapy and improved the clinical outcome in Saudi patients with type 2 diabetes. PMID:25745493

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed

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

    1997-06-01

    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

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

    PubMed

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

    2009-03-01

    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 vs. insulin-providing treatments for diabetes. A total of 2,368 patients with type 2 diabetes and CAD was 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, hemoglobin A1c (HbA1c), and diabetes duration. Fifty-one percent of 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 (OR = 1.57, 95% CI: 1.15-2.13). Patients on sulfonylurea (SU) or combination of SU/metformin (Met)/thiazolidinediones (TZD) had marginally higher rates of DPN than the Met/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

  19. Diabetes and hyperglycemia in the critical care setting: has the evidence for glycemic control vanished? (Or … is going away?).

    PubMed

    Wagstaff, Amy E; Cheung, N Wah

    2014-01-01

    Hyperglycemia is associated with increased mortality and other complications amongst hospitalized patients. However, the studies of tight glycemic control in a range of critical illness settings, including intensive care, acute myocardial infarction, and stroke, have produced inconsistent and divergent results. We examine some of the factors that may have contributed to the differing results, and their implications for targeting tight glucose control in critical illness. With these in mind, most clinical guidelines now recommend moderate glucose control with an upper glucose target of <10 mmol/L (180 mg/dL) in critical illness while avoiding hypoglycemia. PMID:24277672

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

    PubMed Central

    Gardner, Andrew John

    2014-01-01

    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

  1. 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...

  2. Interface Design and Human Factors Considerations for Model-Based Tight Glycemic Control in Critical Care

    PubMed Central

    Ward, Logan; Steel, James; Le Compte, Aaron; Evans, Alicia; Tan, Chia-Siong; Penning, Sophie; Shaw, Geoffrey M; Desaive, Thomas; Chase, J Geoffrey

    2012-01-01

    Introduction Tight glycemic control (TGC) has shown benefits but has been difficult to implement. Model-based methods and computerized protocols offer the opportunity to improve TGC quality and compliance. This research presents an interface design to maximize compliance, minimize real and perceived clinical effort, and minimize error based on simple human factors and end user input. Method The graphical user interface (GUI) design is presented by construction based on a series of simple, short design criteria based on fundamental human factors engineering and includes the use of user feedback and focus groups comprising nursing staff at Christchurch Hospital. The overall design maximizes ease of use and minimizes (unnecessary) interaction and use. It is coupled to a protocol that allows nurse staff to select measurement intervals and thus self-manage workload. Results The overall GUI design is presented and requires only one data entry point per intervention cycle. The design and main interface are heavily focused on the nurse end users who are the predominant users, while additional detailed and longitudinal data, which are of interest to doctors guiding overall patient care, are available via tabs. This dichotomy of needs and interests based on the end user's immediate focus and goals shows how interfaces must adapt to offer different information to multiple types of users. Conclusions The interface is designed to minimize real and perceived clinical effort, and ongoing pilot trials have reported high levels of acceptance. The overall design principles, approach, and testing methods are based on fundamental human factors principles designed to reduce user effort and error and are readily generalizable. PMID:22401330

  3. Data Entry Errors and Design for Model-Based Tight Glycemic Control in Critical Care

    PubMed Central

    Ward, Logan; Steel, James; Le Compte, Aaron; Evans, Alicia; Tan, Chia-Siong; Penning, Sophie; Shaw, Geoffrey M; Desaive, Thomas; Chase, J Geoffrey

    2012-01-01

    Introduction Tight glycemic control (TGC) has shown benefits but has been difficult to achieve consistently. Model-based methods and computerized protocols offer the opportunity to improve TGC quality but require human data entry, particularly of blood glucose (BG) values, which can be significantly prone to error. This study presents the design and optimization of data entry methods to minimize error for a computerized and model-based TGC method prior to pilot clinical trials. Method To minimize data entry error, two tests were carried out to optimize a method with errors less than the 5%-plus reported in other studies. Four initial methods were tested on 40 subjects in random order, and the best two were tested more rigorously on 34 subjects. The tests measured entry speed and accuracy. Errors were reported as corrected and uncorrected errors, with the sum comprising a total error rate. The first set of tests used randomly selected values, while the second set used the same values for all subjects to allow comparisons across users and direct assessment of the magnitude of errors. These research tests were approved by the University of Canterbury Ethics Committee. Results The final data entry method tested reduced errors to less than 1–2%, a 60–80% reduction from reported values. The magnitude of errors was clinically significant and was typically by 10.0 mmol/liter or an order of magnitude but only for extreme values of BG < 2.0 mmol/liter or BG > 15.0–20.0 mmol/liter, both of which could be easily corrected with automated checking of extreme values for safety. Conclusions The data entry method selected significantly reduced data entry errors in the limited design tests presented, and is in use on a clinical pilot TGC study. The overall approach and testing methods are easily performed and generalizable to other applications and protocols. PMID:22401331

  4. Benefits of Low Glycemic and High Satiety Index Foods for Obesity and Diabetes Control and Management

    Microsoft Academic Search

    Pankaj Modi

    \\u000a \\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a \\u000a Cardiovascular disease risk may be reduced by consuming a low glycemic index diet.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a \\u000a Studies have shown clients can successfully incorporate the glycemic index in their dietary ­routine with positive outcomes.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a \\u000a Weight loss may be another benefit found with choosing low glycemic index foods.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a \\u000a Diets with high glycemic impact have been postulated to increase risk of obesity,

  5. Impact of Walking on Glycemic Control and Other Cardiovascular Risk Factors in Type 2 Diabetes: A Meta-Analysis

    PubMed Central

    Qiu, Shanhu; Cai, Xue; Schumann, Uwe; Velders, Martina; Sun, Zilin; Steinacker, Jürgen Michael

    2014-01-01

    Background Walking is the most popular and most preferred exercise among type 2 diabetes patients, yet compelling evidence regarding its beneficial effects on cardiovascular risk factors is still lacking. The aim of this meta-analysis of randomized controlled trials (RCTs) was to evaluate the association between walking and glycemic control and other cardiovascular risk factors in type 2 diabetes patients. Methods Three databases were searched up to August 2014. English-language RCTs were eligible for inclusion if they had assessed the walking effects (duration ?8 weeks) on glycemic control or other cardiovascular risk factors among type 2 diabetes patients. Data were pooled using a random-effects model. Subgroup analyses based on supervision status and meta-regression analyses of variables regarding characteristics of participants and walking were performed to investigate their association with glycemic control. Results Eighteen studies involving 20 RCTs (866 participants) were included. Walking significantly decreased glycosylated haemoglobin A1c (HbA1c) by 0.50% (95% confidence intervals [CI]: ?0.78% to ?0.21%). Supervised walking was associated with a pronounced decrease in HbA1c (WMD ?0.58%, 95% CI: ?0.93% to ?0.23%), whereas non-supervised walking was not. Further subgroup analysis suggested non-supervised walking using motivational strategies is also effective in decreasing HbA1c (WMD ?0.53%, 95% CI: ?1.05% to ?0.02%). Effects of covariates on HbA1c change were generally unclear. For other cardiovascular risk factors, walking significantly reduced body mass index (BMI) and lowered diastolic blood pressure (DBP), but non-significantly lowered systolic blood pressure (SBP), or changed high-density or low-density lipoprotein cholesterol levels. Conclusions This meta-analysis supports that walking decreases HbA1c among type 2 diabetes patients. Supervision or the use of motivational strategies should be suggested when prescribed walking to ensure optimal glycemic control. Walking also reduces BMI and lowers DBP, however, it remains insufficient regarding the association of walking with lowered SBP or improved lipoprotein profiles. Trial Registration PROSPERO CRD42014009515 PMID:25329391

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

    PubMed Central

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

    2015-01-01

    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

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

    PubMed Central

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

    2015-01-01

    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

  8. Beneficial Effects of Resistance Exercise on Glycemic Control Are Not Further Improved by Protein Ingestion

    PubMed Central

    Breen, Leigh; Philp, Andrew; Shaw, Christopher S.; Jeukendrup, Asker E.; Baar, Keith; Tipton, Kevin D.

    2011-01-01

    Purpose To investigate the mechanisms underpinning modifications in glucose homeostasis and insulin sensitivity 24 h after a bout of resistance exercise (RE) with or without protein ingestion. Methods Twenty-four healthy males were assigned to a control (CON; n?=?8), exercise (EX; n?=?8) or exercise plus protein condition (EX+PRO; n?=?8). Muscle biopsy and blood samples were obtained at rest for all groups and immediately post-RE (75% 1RM, 8×10 repetitions of leg-press and extension exercise) for EX and EX+PRO only. At 24 h post-RE (or post-resting biopsy for CON), a further muscle biopsy was obtained. Participants then consumed an oral glucose load (OGTT) containing 2 g of [U-13C] glucose during an infusion of 6, 6-[2H2] glucose. Blood samples were obtained every 10 min for 2 h to determine glucose kinetics. EX+PRO ingested an additional 25 g of intact whey protein with the OGTT. A final biopsy sample was obtained at the end of the OGTT. Results Fasted plasma glucose and insulin were similar for all groups and were not different immediately post- and 24 h post-RE. Following RE, muscle glycogen was 26±8 and 19±6% lower in EX and EX+PRO, respectively. During OGTT, plasma glucose AUC was lower for EX and EX+PRO (75.1±2.7 and 75.3±2.8 mmol·L?1?120 min, respectively) compared with CON (90.6±4.1 mmol·L?1?120 min). Plasma insulin response was 13±2 and 21±4% lower for EX and CON, respectively, compared with EX+PRO. Glucose disappearance from the circulation was ?12% greater in EX and EX+PRO compared with CON. Basal 24 h post-RE and insulin-stimulated PAS-AS160/TBC1D4 phosphorylation was greater for EX and EX+PRO. Conclusions Prior RE improves glycemic control and insulin sensitivity through an increase in the rate at which glucose is disposed from the circulation. However, co-ingesting protein during a high-glucose load does not augment this response at 24 h post-exercise in healthy, insulin-sensitive individuals. PMID:21701685

  9. Value of Continuous Glucose Monitoring For Minimizing Severe Hypoglycemia during Tight Glycemic Control

    PubMed Central

    Steil, Garry M.; Langer, Monica; Jaeger, Karen; Alexander, Jamin; Gaies, Michael; Agus, Michael SD

    2013-01-01

    Objective Tight glycemic control (TGC) can potentially reduce morbidity and mortality in the ICU but increases the risk of hypoglycemia. The most effective means to avoid hypoglycemia is to obtain frequent blood glucose (BG) samples, but this increases the burden to nursing staff. The objective of this study was to assess the ability of a real-time continuous glucose monitor (CGM-RT) to reduce hypoglycemia (BG<60 mg/dL [3.3 mmol/L]) during standard care (STD) or TGC effected with a proportional integral derivative (PID) insulin titration algorithm. Design CGM-RT profiles obtained from an ongoing prospective randomized trial of TGC were retrospectively analyzed to determine if the continuous glucose measure had prevented instances of hypoglycemia. Setting Cardiac ICU. Patients Children 3 years of age or less undergoing cardiac surgery were studied. Interventions Intravenous insulin infusion and rescue glucose with guided by CGM-RT and the PID algorithm in the TGC arm (N=155; target glucose 80–110 mg/dL [4.4–6.1 mmol/L); CGM-RT in the STD care arm (N=156). Measurements and Main Results No reduction in hypoglycemia was observed with CGM-RT alarms set at 60 mg/dL [3.3 mmol/L] (0 of 19 occurrences of BG<60 mg/dL [3.3 mmol/L] detected); 18 of 40 subsequent incidences of hypoglycemia were detected after increasing the alarm threshold to 70 mg/dL [3.9 mmol/L]. In the TGC arm, 8 incidences were reduced in duration and an additional 8 events were prevented with intravenous glucose. In the STD arm, 3 of 9 occurrences of hypoglycemia were detected with the duration reduced in all cases. On average, one to two false hypoglycemia alarms were observed in each patient. Conclusions CGM-RT in combination with PID control can reduce hypoglycemia during TGC. CGM-RT can also reduce hypoglycemia during STD. However, false alarms increase the overall nursing workload. PMID:21499183

  10. Effect of Tree Nuts on Glycemic Control in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Dietary Trials

    PubMed Central

    Viguiliouk, Effie; Kendall, Cyril W. C.; Blanco Mejia, Sonia; Cozma, Adrian I.; Ha, Vanessa; Mirrahimi, Arash; Jayalath, Viranda H.; Augustin, Livia S. A.; Chiavaroli, Laura; Leiter, Lawrence A.; de Souza, Russell J.; Jenkins, David J. A.; Sievenpiper, John L.

    2014-01-01

    Background Tree nut consumption has been associated with reduced diabetes risk, however, results from randomized trials on glycemic control have been inconsistent. Objective To provide better evidence for diabetes guidelines development, we conducted a systematic review and meta-analysis of randomized controlled trials to assess the effects of tree nuts on markers of glycemic control in individuals with diabetes. Data Sources MEDLINE, EMBASE, CINAHL, and Cochrane databases through 6 April 2014. Study Selection Randomized controlled trials ?3 weeks conducted in individuals with diabetes that compare the effect of diets emphasizing tree nuts to isocaloric diets without tree nuts on HbA1c, fasting glucose, fasting insulin, and HOMA-IR. Data Extraction and Synthesis Two independent reviewer’s extracted relevant data and assessed study quality and risk of bias. Data were pooled by the generic inverse variance method and expressed as mean differences (MD) with 95% CI’s. Heterogeneity was assessed (Cochran Q-statistic) and quantified (I2). Results Twelve trials (n?=?450) were included. Diets emphasizing tree nuts at a median dose of 56 g/d significantly lowered HbA1c (MD?=??0.07% [95% CI:?0.10, ?0.03%]; P?=?0.0003) and fasting glucose (MD?=??0.15 mmol/L [95% CI: ?0.27, ?0.02 mmol/L]; P?=?0.03) compared with control diets. No significant treatment effects were observed for fasting insulin and HOMA-IR, however the direction of effect favoured tree nuts. Limitations Majority of trials were of short duration and poor quality. Conclusions Pooled analyses show that tree nuts improve glycemic control in individuals with type 2 diabetes, supporting their inclusion in a healthy diet. Owing to the uncertainties in our analyses there is a need for longer, higher quality trials with a focus on using nuts to displace high-glycemic index carbohydrates. Trial Registration ClinicalTrials.gov NCT01630980 PMID:25076495

  11. Epigenetic Changes in Endothelial Progenitors as a Possible Cellular Basis for Glycemic Memory in Diabetic Vascular Complications

    PubMed Central

    Rajasekar, Poojitha; O'Neill, Christina L.; Eeles, Lydia; Stitt, Alan W.; Medina, Reinhold J.

    2015-01-01

    The vascular complications of diabetes significantly impact the quality of life and mortality in diabetic patients. Extensive evidence from various human clinical trials has clearly established that a period of poor glycemic control early in the disease process carries negative consequences, such as an increase in the development and progression of vascular complications that becomes evident many years later. Importantly, intensive glycemic control established later in the disease process cannot reverse or slow down the onset or progression of diabetic vasculopathy. This has been named the glycemic memory phenomenon. Scientists have successfully modelled glycemic memory using various in vitro and in vivo systems. This review emphasizes that oxidative stress and accumulation of advanced glycation end products are key factors driving glycemic memory in endothelial cells. Furthermore, various epigenetic marks have been proposed to closely associate with vascular glycemic memory. In addition, we comment on the importance of endothelial progenitors and their role as endogenous vasoreparative cells that are negatively impacted by the diabetic milieu and may constitute a “carrier” of glycemic memory. Considering the potential of endothelial progenitor-based cytotherapies, future studies on their glycemic memory are warranted to develop epigenetics-based therapeutics targeting diabetic vascular complications. PMID:26106624

  12. Night eating in patients with type 2 diabetes. Associations with glycemic control, eating patterns, sleep, and mood.

    PubMed

    Hood, Megan M; Reutrakul, Sirimon; Crowley, Stephanie J

    2014-08-01

    Night eating is a complex behavior associated with disruptions in eating, sleep, and mood regulation. While night eating has been associated with alterations in neuroendocrine functioning, night eating and Night Eating Syndrome (NES) are not well understood in patients with prevalent metabolic conditions, such as diabetes. In this study, 194 adults with Type 2 diabetes completed questionnaires assessing night eating symptoms as well as eating, sleep, and depressive symptoms. Glycemic control data, as measured by hemoglobin A1c (HbA1c), were gathered from patient medical charts. Results indicated that 7% of participants met criteria for NES. Increased symptoms of night eating were associated with poorer glycemic control and disruptions in eating, sleep, and mood, including significantly increased likelihood of having HbA1c levels >7% and endorsing clinical levels of depressive symptoms. Increasing understanding of the relationship between night eating and metabolic and psychosocial functioning in patients with diabetes may provide new avenues for treatment of these patients. PMID:24751916

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

    PubMed Central

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

    2015-01-01

    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

  14. Preliminary Study Characterizing the Use of Sitagliptin for Glycemic Control in Healthy Beagle Dogs with Normal Gluco-Homeostasis

    PubMed Central

    ODA, Hitomi; MORI, Akihiro; LEE, Peter; SAEKI, Kaori; ARAI, Toshiro; SAKO, Toshinori

    2014-01-01

    ABSTRACT Sitagliptin is a dipeptidyl peptidase-4 inhibitor aimed at treating Type 2 diabetes mellitus (T2DM) and T1DM, by increasing blood levels of Glucagon-like peptide 1 (GLP-1) and insulin. The objective of this preliminary study is to characterize Sitagliptin’s ability for glycemic control, in healthy dogs under an oral glucose tolerance test (OGTT) environment. Overall, Sitagliptin did not result in any significant changes to temporal glucose and insulin concentrations. However, a ~55% increase in median total GLP-1 AUC0–120min was observed, as compared to baseline control in healthy dogs (n=5), thus indicating a similar mode of action of Sitagliptin between healthy dogs and humans. Future studies to validate the use of Sitagliptin with dogs suffering from insulin independent diabetes are warranted. PMID:24931645

  15. Preliminary study characterizing the use of sitagliptin for glycemic control in healthy Beagle dogs with normal gluco-homeostasis.

    PubMed

    Oda, Hitomi; Mori, Akihiro; Lee, Peter; Saeki, Kaori; Arai, Toshiro; Sako, Toshinori

    2014-10-01

    Sitagliptin is a dipeptidyl peptidase-4 inhibitor aimed at treating Type 2 diabetes mellitus (T2DM) and T1DM, by increasing blood levels of Glucagon-like peptide 1 (GLP-1) and insulin. The objective of this preliminary study is to characterize Sitagliptin's ability for glycemic control, in healthy dogs under an oral glucose tolerance test (OGTT) environment. Overall, Sitagliptin did not result in any significant changes to temporal glucose and insulin concentrations. However, a ~55% increase in median total GLP-1 AUC0-120 min was observed, as compared to baseline control in healthy dogs (n=5), thus indicating a similar mode of action of Sitagliptin between healthy dogs and humans. Future studies to validate the use of Sitagliptin with dogs suffering from insulin independent diabetes are warranted. PMID:24931645

  16. 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

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

    2002-01-01

    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

  17. [Indicators of glycemic control --hemoglobin A1c (HbA1c), glycated albumin (GA), and 1,5-anhydroglucitol (1,5-AG)].

    PubMed

    Sato, Asako

    2014-01-01

    The clinical goal of diabetes management is a good quality of life that is not different from that of a healthy subjects. To fulfill the goal, prevention of complications is needed under good glycemic control. Although blood glucose measurement is essential for glycemic control, there are diurnal variations in blood glucose levels. An indicator of long-term glycemic control is necessary. HbA1c is the gold standard measurement for the assessment of glycemic control, and worldwide large scale clinical studies of diabetes complications have greatly valued HbA1c as an indicator of glycemic control. In addition, recently, HbA1c was recommended for use in the diagnosis of diabetes in Japan and in the United States. Although HbA1c is used widely and internationally, international standardization of the HbA1c value has not been achieved. In Japan, from April 2014, it has been decided to adopt the National Glycohemoglobin Standardization Program (NGSP) value, which is used by many countries globally, as the first step toward internationalization. Recently, cardiovascular disease in diabetic patients has been increasing in Japan. Relationships between postprandial hyperglycemia and cardiovascular disease have been noted. Therefore, the correction of postprandial hyperglycemia is one of the important goals of glycemic control to prevent cardiovascular disease. HbA1c or glycated albumin (GA) results from the glycation of hemoglobin or serum albumin and represents 2-month or 2-week glycemia, respectively. In addition, the glycation speed of GA is ten times faster than HbA1c, so GA is likely to reflect the variation in blood glucose and postprandial hyperglycemia in combination with HbA1c and its value. 1,5-anhydroglucitol (AG) is a marker of glycemia-induced glycosuria, since reabsorption of filtered 1,5-AG in the proximal tubule is competitively inhibited by glucose. It is an indicator to identify rapid changes in hyperglycemia. Understanding the characteristics of the indicators above, it is important to use them suitably for each diabetes subject and to recognize glycemic control conditions more accurately. PMID:24724426

  18. Adenovirus 36 Attenuates Weight Loss from Exercise but Improves Glycemic Control by Increasing Mitochondrial Activity in the Liver

    PubMed Central

    Ye, Michael B.; Park, Sooho; Kim, In-Beom; Nam, Jae-Hwan

    2014-01-01

    Human adenovirus type 36 (Ad36) as an obesity agent induces adiposity by increasing glucose uptake and promoting chronic inflammation in fat tissues; in contrast, exercise reduces total body fat and inflammation. Our objective was to determine the association between Ad36 and the effects of exercise on inflammation and glycemic control. In the human trials (n?=?54), Korean children (aged 12–14 years) exercised for 60 min on three occasions each week for 2 months. We compared the body mass index (BMI) Z-scores before and after exercise. C57BL/6 mice were infected with Ad36 and Ad2 as a control, and these mice exercised for 12 weeks postinfection. After the exercise period, we determined the serum parameters and assessed the presence of inflammation and the mitochondrial function in the organs. Ad36-seropositive children who were subjected to a supervised exercise regimen had high BMI Z-scores whereas Ad36-seronegative children had lower scores. Similarly, Ad36-infected mice were resistant to weight loss and exhibited chronic inflammation of their adipose tissues despite frequent exercise. However, Ad36 combined with exercise reduced the levels of serum glucose, nonesterified fatty acids, total cholesterol, and insulin in virus-infected mice. Interestingly, virus infection increased the mitochondrial function in the liver, as demonstrated by the numbers of mitochondria, cytochrome c oxidase activity, and transcription of key mitochondrial genes. Therefore Ad36 counteracts the weight-loss effect of exercise and maintains the chronic inflammatory state, but glycemic control is improved by exercise synergistically because of increased mitochondrial activity in the liver. PMID:25479564

  19. On the Problem of Patient-Specific Endogenous Glucose Production in Neonates on Stochastic Targeted Glycemic Control

    PubMed Central

    Dickson, Jennifer L.; Hewett, James N.; Gunn, Cameron A.; Lynn, Adrienne; Shaw, Geoffrey M.; Chase, Geoffrey

    2013-01-01

    Background: Both stress and prematurity can induce hyperglycemia in the neonatal intensive care unit, which, in turn, is associated with worsened outcomes. Endogenous glucose production (EGP) is the formation of glucose by the body from substrates and contributes to blood glucose (BG) levels. Due to the inherent fragility of the extremely low birth weight (ELBW) neonates, true fasting EGP cannot be explicitly determined, introducing uncertainty into glycemic models that rely on quantifying glucose sources. Stochastic targeting, or STAR, is one such glycemic control framework. Methods: A literature review was carried out to gather metabolic and EGP values on preterm infants with a gestational age (GA) <32 weeks and a birth weight (BW) <2 kg. The data were analyzed for EGP trends with BW, GA, BG, plasma insulin, and glucose infusion (GI) rates. Trends were modeled and compared with a literature-derived range of population constant EGP models using clinically validated virtual trials on retrospective clinical data. Results: No clear relationship was found for EGP and BW, GA, or plasma insulin. Some evidence of suppression of EGP with increasing GI or BG was seen. Virtual trial results showed that population-constant EGP models fit clinical data best and gave tighter control performance to a target band in virtual trials. Conclusions: Variation in EGP cannot easily be quantified, and EGP is sufficiently modeled as a population constant in the neonatal intensive care insulin–nutrition–glucose model. Analysis of the clinical data and fitting error suggests that ELBW hyperglycemic preterm neonates have unsuppressed EGP in the higher range than that seen in literature. PMID:23911173

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

    PubMed Central

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

    2015-01-01

    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. PMID:25878608

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

    PubMed Central

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

    2012-01-01

    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

  2. Trajectories in Glycemic Control over Time Are Associated with Cognitive Performance in Elderly Subjects with Type 2 Diabetes

    PubMed Central

    Ravona-Springer, Ramit; Heymann, Anthony; Schmeidler, James; Moshier, Erin; Godbold, James; Sano, Mary; Leroith, Derek; Johnson, Sterling; Preiss, Rachel; Koifman, Keren; Hoffman, Hadas; Silverman, Jeremy M.; Beeri, Michal Schnaider

    2014-01-01

    Objective To study the relationships of long-term trajectories of glycemic control with cognitive performance in cognitively normal elderly with type 2 diabetes (T2D). Methods Subjects (n?=?835) pertain to a diabetes registry (DR) established in 1998 with an average of 18 HbA1c measurements per subject, permitting identification of distinctive trajectory groups of HbA1c and examining their association with cognitive function in five domains: episodic memory, semantic categorization, attention/working memory, executive function, and overall cognition. Analyses of covariance compared cognitive function among the trajectory groups adjusting for sociodemographic, cardiovascular, diabetes-related covariates and depression. Results Subjects averaged 72.8 years of age. Six trajectories of HbA1c were identified, characterized by HbA1c level at entry into the DR (Higher/Lower), and trend over time (Stable/Decreasing/Increasing). Both groups with a trajectory of decreasing HbA1c levels had high HbA1c levels at entry into the DR (9.2%, 10.7%), and high, though decreasing, HbA1c levels over time. They had the worst cognitive performance, particularly in overall cognition (p<0.02) and semantic categorization (p<0.01), followed by that of subjects whose HbA1c at entry into the DR was relatively high (7.2%, 7.8%) and increased over time. Subjects with stable HbA1c over time had the lowest HbA1c levels at entry (6.0%, 6.8%) and performed best in cognitive tests. Conclusion Glycemic control trajectories, which better reflect chronicity of T2D than a single HbA1c measurement, predict cognitive performance. A trajectory of stable HbA1c levels over time is associated with better cognitive function. PMID:24887092

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

    PubMed

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

    2014-11-01

    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

  4. Weight Loss, Glycemic Control, and Cardiovascular Disease Risk Factors in Response to Differential Diet Composition in a Weight Loss Program in Type 2 Diabetes: A Randomized Controlled Trial

    PubMed Central

    Rock, Cheryl L.; Flatt, Shirley W.; Pakiz, Bilge; Taylor, Kenneth S.; Leone, Angela F.; Brelje, Kerrin; Heath, Dennis D.; Quintana, Elizabeth L.; Sherwood, Nancy E.

    2014-01-01

    OBJECTIVE To test whether a weight loss program promotes greater weight loss, glycemic control, and improved cardiovascular disease risk factors compared with control conditions and whether there is a differential response to higher versus lower carbohydrate intake. RESEARCH DESIGN AND METHODS This randomized controlled trial at two university medical centers enrolled 227 overweight or obese adults with type 2 diabetes and assigned them to parallel in-person diet and exercise counseling, with prepackaged foods in a planned menu during the initial phase, or to usual care (UC; two weight loss counseling sessions and monthly contacts). RESULTS Relative weight loss was 7.4% (95% CI 5.7–9.2%), 9.0% (7.1–10.9%), and 2.5% (1.3–3.8%) for the lower fat, lower carbohydrate, and UC groups (P < 0.001 intervention effect). Glycemic control markers and triglyceride levels were lower in the intervention groups compared with UC group at 1 year (fasting glucose 141 [95% CI 133–149] vs. 159 [144–174] mg/dL, P = 0.023; hemoglobin A1c 6.9% [6.6–7.1%] vs. 7.5% [7.1–7.9%] or 52 [49–54] vs. 58 [54–63] mmol/mol, P = 0.001; triglycerides 148 [134–163] vs. 204 [173–234] mg/dL, P < 0.001). The lower versus higher carbohydrate groups maintained lower hemoglobin A1c (6.6% [95% CI 6.3–6.8%] vs. 7.2% [6.8–7.5%] or 49 [45–51] vs. 55 [51–58] mmol/mol) at 1 year (P = 0.008). CONCLUSIONS The weight loss program resulted in greater weight loss and improved glycemic control in type 2 diabetes. PMID:24760261

  5. The effects of the king oyster mushroom Pleurotus eryngii (higher Basidiomycetes) on glycemic control in alloxan-induced diabetic mice.

    PubMed

    Li, Jian-Ping; Lei, Ya-li; Zhan, Huan

    2014-01-01

    The purpose of this study is to investigate the effects of Pleurotus eryngii on glycemic metabolism. Alloxan-induced hyperglycemic mice were used to study the effects of P. eryngii on blood glucose, glycohemoglobin, insulin secretion, damaged pancreatic ?-cells, total antioxidant status (TAOS), and hepatic glycogen in hyperglycemic mice. Sixty diabetic mice were divided equally into 5 groups: the alloxan (AX)-induced hyperglycemic group, the AX and glibenclamide (GLI)-treated group, the AX and P. eryngii extracts (PEEs) 50-treated group (PEE 50 mg/kg), the AX and PEE100-treated group (PEE 100 mg/kg), and the AX and PEE200-treated group (PEE 200 mg/kg). The other 12 normal mice were injected intravenously with the normal saline and used as the control group. After PEE (100 and 200 mg/kg) was orally administered to the mice over 5 weeks, blood glucose and HbAlc were significantly decreased in AX-induced hyperglycemic mice (P < 0.05 and P < 0.01, respectively), whereas the level of insulin secretion was markedly elevated in (P < 0.05). The pancreatic ?-cells damaged by AX partially and gradually recovered after PPE extract was administered to the hyperglycemic mice for 35 days. In addition, PEE treatment gradually increased the body weight and significantly increased the concentration of hepatic glycogen in hyperglycemic mice (P < 0.05). The results suggest that the action of PPE on glycemic metabolism occurs via increasing glycogen and insulin concentrations as well as recovering injured ?-cells and reducing free radical damage. PPE may become a new potential hypoglycemic food for hyperglycemic people. PMID:24941163

  6. A Novel Behavioral Intervention in Adolescents with Type 1 Diabetes Mellitus Improves Glycemic Control: Preliminary Results from a Pilot Randomized Control Trial

    PubMed Central

    Maranda, Louise; Lau, May; Stewart, Sunita M; Gupta, Olga T

    2015-01-01

    Purpose The purpose of this study is to develop and pilot an innovative behavioral intervention in adolescents with type 1 diabetes mellitus (T1DM) incorporating structured care of a pet to improve glycemic control. Methods Twenty-eight adolescents with A1C > 8.5% (69 mmol/mol) were randomly assigned to either the intervention group (care of a Betta splendens pet fish) or the control group (usual care). Adolescents in the intervention group were given instructions to associate daily and weekly fish care duties with diabetes self-management tasks including blood glucose testing and parent-adolescent communication. Results After 3 months the participants in the intervention group exhibited a statistically significant decrease in A1C levels (?0.5%) compared to their peers in the control group who had an increase in A1C levels (0.8%)(p = 0.04). The younger adolescents (ages 10–13) demonstrated a greater response to the intervention which was statistically significant (?1.5% vs. 0.6%, p = 0.04) compared with the older adolescents (ages 14–17). Conclusions Structured care of a pet fish can improve glycemic control in adolescents with T1DM, likely by providing cues to perform diabetes self-management behaviors. PMID:25614529

  7. Glycemic control in a medical intensive care setting: revision of an intensive care unit nurse-driven hyperglycemia protocol.

    PubMed

    Dodson, Crystal H; Simpson, Jenny; Feinstein, Daniel

    2014-01-01

    The purpose of this study was to determine whether the addition of rapid-acting insulin bolus for enteral feed coverage and a reduction in basal insulin improve glycemic control and decrease hypoglycemia in a medical intensive care unit. A quasi-experimental posttest design assessing glucose control postimplementation of a revised nurse-driven ICU hyperglycemia protocol was conducted on a 16-bed medical intensive care unit at a multicenter hospital system. A daily report of all patients on the ICU hyperglycemia protocol was automated for the inpatient diabetes management team, and pertinent data were collected. Univariate statistics were conducted for all variables. The variability in blood glucose based on different clinical variables was compared using t tests. The hypoglycemic rate was only 0.72%, and no glucose value was less than 40 mg/dL. In addition, the mean glucose value throughout the study was 160.9 ± 35.6 mg/dL. Findings from this study will hopefully provide insight on an effective way to control glucose within a medical intensive care unit as well as reduce hypoglycemia rates within this setting. PMID:24595254

  8. Dietary glycemic index and glycemic load in relation to HbA1c in Japanese obese adults: a cross-sectional analysis of the Saku Control Obesity Program

    PubMed Central

    2012-01-01

    Background Dietary glycemic index or load is thought to play an important role in glucose metabolism. However, few studies have investigated the relation between glycemic index (GI) or load (GL) and glycemia in Asian populations. In this cross-sectional analysis of a randomized controlled trial, the Saku Control Obesity Program, we examined the relation between the baseline GI or GL and glycemia (HbA1c and fasting plasma glucose [FPG] levels), insulin resistance (HOMA-IR), ?-cell function (HOMA-?), and other metabolic risk factors (lipid levels, diastolic and systolic blood pressure, and adiposity measures). Methods The participants were 227 obese Japanese women and men. We used multiple linear regression models and logistic regression models to adjust for potential confounding factors such as age, sex, visceral fat area, total energy intake, and physical activity levels. Results After adjustments for potential confounding factors, GI was not associated with HbA1c, but GL was positively associated with HbA1c. For increasing quartiles of GI, the adjusted mean HbA1c were 6.3%, 6.7%, 6.4%, and 6.4% (P for trend?=?0.991). For increasing quartiles of GL, the adjusted mean HbA1c were 6.2%, 6.2%, 6.6%, and 6.5% (P for trend?=?0.044). In addition, among participants with HbA1c???7.0%, 20 out of 28 (71%) had a high GL (? median); the adjusted odds ratio for HbA1c???7.0% among participants with higher GL was 3.1 (95% confidence interval [CI]?=?1.2 to 8.1) compared to the participants with a lower GL (glycemic control tend to have a higher GL in an obese Japanese population. PMID:22963077

  9. Evaluation of the regional ventricular systolic function by two-dimensional strain echocardiography in gestational diabetes mellitus (GDM) fetuses with good glycemic control.

    PubMed

    Wang, Hongying; Xu, Yi; Fu, Jing; Huang, Lan

    2014-11-28

    Abstract Objective: The aim is to quantitatively assess regional ventricular systolic function by two-dimensional strain (2DS) echocardiography in gestational diabetes mellitus (GDM) fetuses with good glycemic control. Methods: We studied 60 consecutive normal fetuses and 35 fetuses of GDM mothers with good glycemic control by echocardiography. M-mode and two-dimensional echocardiography were used to measure ejection fraction and wall dimensions of left ventricle and right ventricle. Both left and right ventricle peak systolic myocardial strain values were obtained by 2DS echocardiography. Results: Compared with normal fetuses, the thickness of the interventricular septum (IVS) and the thickness of right ventricular wall were significantly increased in GDM fetuses (p?glycemic control. PMID:25367553

  10. The effect of Ginkgo biloba and Camellia sinensis extracts on psychological state and glycemic control in patients with type 2 diabetes mellitus.

    PubMed

    Lasaite, Lina; Spadiene, Asta; Savickiene, Nijole; Skesters, Andrejs; Silova, Alise

    2014-09-01

    Interest in finding natural antioxidants for use in food or medical materials to prevent free radical imbalance has increased considerably over the past years. The aim of this research was to evaluate changes in glycemic control and psychological state of patients with type 2 diabetes mellitus (T2DM) after use of antioxidant plant preparations. Fifty-six patients with T2DM were randomly allocated to receive standardized Ginkgo biloba L. leaves dry extract, green tea dry extract, or placebo capsules. Diabetes glycemic control measured as glycated hemoglobin (HbA1c) level, antioxidant state and psychological data were evaluated at baseline, after 9 and 18 months of using either antioxidant preparations or placebo. The level of perceived stress lowered significantly after 9 months (p = 0.038) and 18 months (p = 0.030), and the psychological aspect of quality of life significantly improved after 18 months (p = 0.019) of use of G. biloba extrac. No significant differences were detected after using green tea extract. In patients using placebo, significant lowering of HbA1c level was observed after 18 months (p = 0.017). In conclusion, antioxidant G. biloba leaf extract exhibited a mild effect on psychological state and a trend of improving glycemic control in patients with type 2 diabetes mellitus. PMID:25918808

  11. Ileal Interposition in Rats with Experimental Type 2 Like Diabetes Improves Glycemic Control Independently of Glucose Absorption

    PubMed Central

    Jurowich, Christian Ferdinand; Otto, Christoph; Rikkala, Prashanth Reddy; Wagner, Nicole; Vrhovac, Ivana; Saboli?, Ivan; Germer, Christoph-Thomas; Koepsell, Hermann

    2015-01-01

    Bariatric operations in obese patients with type 2 diabetes often improve diabetes before weight loss is observed. In patients mainly Roux-en-Y-gastric bypass with partial stomach resection is performed. Duodenojejunal bypass (DJB) and ileal interposition (IIP) are employed in animal experiments. Due to increased glucose exposition of L-cells located in distal ileum, all bariatric surgery procedures lead to higher secretion of antidiabetic glucagon like peptide-1 (GLP-1) after glucose gavage. After DJB also downregulation of Na+-d-glucose cotransporter SGLT1 was observed. This suggested a direct contribution of decreased glucose absorption to the antidiabetic effect of bariatric surgery. To investigate whether glucose absorption is also decreased after IIP, we induced diabetes with decreased glucose tolerance and insulin sensitivity in male rats and investigated effects of IIP on diabetes and SGLT1. After IIP, we observed weight-independent improvement of glucose tolerance, increased insulin sensitivity, and increased plasma GLP-1 after glucose gavage. The interposed ileum was increased in diameter and showed increased length of villi, hyperplasia of the epithelial layer, and increased number of L-cells. The amount of SGLT1-mediated glucose uptake in interposed ileum was increased 2-fold reaching the same level as in jejunum. Thus, improvement of glycemic control by bariatric surgery does not require decreased glucose absorption. PMID:26185767

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

    PubMed Central

    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

    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

  13. 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

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

    2013-06-01

    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

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

    PubMed Central

    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

    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

  15. Development of a patient decision aid for type 2 diabetes mellitus for patients not achieving glycemic control on metformin alone

    PubMed Central

    Shillington, Alicia C; Col, Nananda; Bailey, Robert A; Jewell, Mark A

    2015-01-01

    Purpose To describe the process used to develop an evidence-based patient decision aid (PDA) that facilitates shared decision-making for treatment intensification in inadequately controlled type 2 diabetes mellitus (T2DM) consistent with International Patient Decision Aids Standards. Methods A PDA was developed by a multidisciplinary steering committee of clinicians, patient advocate, nurse, certified diabetes educators, and decision scientist, using a systematic development process. The process included defining the PDA scope and purpose, outlining the framework, content creation, and designing for integration into clinical practice. This was accomplished through a review of the literature and publically available educational materials and input from practicing clinicians and patients during development and iteratively refining content based on input. Patients with poorly controlled T2DM on metformin considering additional medication assessed the PDA during a pilot. Results Testing identified six preference-sensitive domains important for choosing T2DM treatment: degree of glycemic response, avoiding weight gain, hypoglycemia risk and other adverse events, avoiding injections, convenience of dose administration, blood glucose monitoring, and cost of therapy. Patient feedback guided content revision. Treatment options were offered after presenting medication class risk–benefit information and eliciting patient values, goals, and preferences. The PDA received the highest International Patient Decision Aids Standards global score to date, 88/100, with 100% of criteria fully met for the following dimensions: development process, disclosures, evaluation process, evidence quality, guidance for users, information quality, language/readability, testing, and eliciting patient values. Conclusion A PDA was developed to help T2DM patients make decisions regarding medication choice. This approach may be applicable to other chronic conditions. PMID:25995622

  16. Glycemic control after brain injury: boon and bane for the brain.

    PubMed

    Jauch-Chara, K; Oltmanns, K M

    2014-12-26

    Hyperglycemia is a common phenomenon in the early phase of brain injury (BI). The management of blood glucose levels after BI, however, is subject of a growing debate. The occurrence of elevated blood glucose concentrations is linked to increased mortality and worse neurologic outcomes indicating the necessity for therapeutic glucose-lowering. Intensive glucose-lowering therapy, on the other hand, inevitably results in an increased rate of hypoglycemic episodes with detrimental effects on the injured brain. In this review, we give an overview on the current knowledge about causes and pathophysiological consequences of dysglycemia in patients with BI and offer some suggestions for clinical glucose management. PMID:24814022

  17. Low glycemic index foods should play a role in improving overall glycemic control in type-1 and type-2 diabetic patients and, more specifically, in correcting excessive postprandial hyperglycemia.

    PubMed

    Slama, Gérard; Elgrably, Fabienne; Kabir, Morvarid; Rizkalla, Salwa

    2006-01-01

    There is a large bulk of evidence that using low glycemic index (GI) foods has a very significant impact on the amelioration of metabolic disturbances observed in diabetic and/or hyperlipidemic patients and in subjects affected by the metabolic syndrome. Studies bringing convincing evidence against this concept are very rare if any. Improvement is observed not only in postprandial blood glucose and insulin variations but also in circulating plasma lipid levels and the morphology and function of adipocytes. Using the concept of low GI foods in diet counseling of diabetic patients is not exclusive of other measures to improve postprandial and overall blood glucose control. On the contrary, the use of low GI foods should be considered as one of other means and tools available to improve diabetes control (such as other dietary modifications, use of specific and nonspecific drug therapy altering postprandial blood glucose). Among these therapies, the most promising ones are alpha-glucosidase inhibitors, glynides, rapid insulin analogues and in the near future the GLP1 analogue. Again, all these classes of drugs could be associated with one another in order to obtain a postprandial delta excursion target of not below 20 and not above 40-50 mg/dl blood glucose. PMID:16820732

  18. Effects of regular exercise on obesity and type 2 diabete mellitus in Korean children: improvements glycemic control and serum adipokines level

    PubMed Central

    Lee, Sung Soo; Kang, Sunghwun

    2015-01-01

    [Purpose] The aim of the study was to clarify the effects of regular exercise on lipid profiles and serum adipokines in Korean children. [Subjects and Methods] Subjects were divided into controls (n=10), children who were obese (n=10), and children with type 2 diabetes mellitus (n=10). Maximal oxygen uptake (VO2max), body composition, lipid profiles, glucagon, insulin and adipokines (leptin, resistin, visfatin and retinol binding protein 4) were measured before to and after a 12-week exercise program. [Results] Body weight, body mass index, and percentage body fat were significantly higher in the obese and diabetes groups compared with the control group. Total cholesterol, triglycerides, low-density lipoprotein cholesterol and glycemic control levels were significantly decreased after the exercise program in the obese and diabetes groups, while high-density lipoprotein cholesterol levels were significantly increased. Adipokines were higher in the obese and diabetes groups compared with the control group prior to the exercise program, and were significantly lower following completion. [Conclusion] These results suggest that regular exercise has positive effects on obesity and type 2 diabetes mellitus in Korean children by improving glycemic control and reducing body weight, thereby lowering cardiovascular risk factors and adipokine levels. PMID:26180345

  19. Glycemic control and anti-osteopathic effect of propolis in diabetic rats

    PubMed Central

    Al-Hariri, M; Eldin, T Gamal; Abu-Hozaifa, B; Elnour, A

    2011-01-01

    The aim of the study was to explore the possibility that propolis can control diabetes mellitus and prevent diabetic osteopathy in rats. The study compared 60 streptozotocin (STZ)-induced diabetic rats, with ten nondiabetic rats used as a negative control. The experimental design comprised seven groups (n = 10 rats per group): (1) nondiabetic, used as a negative control; (2) nontreated, used as a positive control; (3) treated with insulin alone; (4) treated with a single dose of propolis alone; (5) treated with a double dose of propolis; (6) treated with insulin and a single dose of propolis; and (7) treated with insulin and a double dose of propolis. After 6 weeks of treatment, the rats were sacrificed. Ratios of femur ash to femur weight and of femur weight to body weight (FW/BW) were calculated and calcium (Ca), phosphorus (P), and magnesium (Mg) concentrations in femur ash were estimated and analyzed. Fasting blood glucose (FBG), plasma insulin and glucagon, serum thiobarbituric acid reactive substances (TBARS), plasma parathyroid hormone (PTH), and calcitonin levels were also estimated and analyzed. There was significant reduction in FBG in all diabetic treated rats. Similarly, higher plasma insulin levels were observed in diabetic rats treated with propolis and insulin than in nontreated diabetic rats, although plasma insulin was not comparatively higher in diabetic rats treated with insulin alone. Serum TBARS was significantly lower in the propolis treated rats than the diabetic nontreated rats. No differences in PTH and calcitonin levels were observed among treatment groups. The FW/BW ratio was significantly higher in diabetic treated groups than in control groups. Furthermore, diabetic rats treated with propolis and insulin had significantly higher Ca, P, and Mg concentrations in femoral ash than nontreated diabetic rats and diabetic rats treated with insulin alone. In conclusion, propolis has a remarkable effect on glucose homeostasis and bone mineralization. PMID:22253535

  20. Impact of Leisure-Time Physical Activity on Glycemic Control and Cardiovascular Risk Factors in Japanese Patients with Type 2 Diabetes Mellitus: The Fukuoka Diabetes Registry

    PubMed Central

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

    2014-01-01

    Aims/hypothesis The effects of leisure-time physical activity (LTPA) on glycemia and cardiovascular risk factors are not fully understood in Asian type 2 diabetic patients, who are typically non-obese. We studied associations between LTPA and glycemia and cardiovascular risk factors in Japanese type 2 diabetic patients. Methods A total of 4,870 Japanese type 2 diabetic patients aged ?20 years were divided into eight groups according to their LTPA. We investigated associations between the amount and intensity levels of physical activity (PA) and glycemic control, insulin sensitivity, cardiovascular risk factors, and low-grade systemic inflammation in a cross-sectional study. Results LTPA was dose-dependently associated with body mass index (BMI), waist circumference, hemoglobin A1c (HbA1c), fasting plasma glucose, homeostasis model assessment of insulin resistance, triglyceride, high density lipoprotein cholesterol, high sensitivity C-reactive protein, and prevalence of metabolic syndrome, but not with blood pressure, low density lipoprotein cholesterol or adiponectin. The amount of PA required to lower HbA1c was greater than that required to improve cardiovascular risk factors. LTPA was inversely associated with HbA1c in non-obese participants but not in obese participants after multivariate adjustments for age, sex, duration of diabetes, current smoking, current drinking, energy intake, cardiovascular diseases, depressive symptoms, and treatment of diabetes. Higher-intensity LTPA, not lower-intensity LTPA was associated with HbA1c after multivariate adjustments with further adjustment including BMI. Conclusions/interpretation LTPA was dose-dependently associated with better glycemic control and amelioration of some cardiovascular risk factors in Japanese type 2 diabetic patients. In addition, increased higher-intensity LTPA may be appropriate for glycemic control. PMID:24897110

  1. Boc5, a Non-Peptidic Glucagon-Like Peptide-1 Receptor Agonist, Invokes Sustained Glycemic Control and Weight Loss in Diabetic Mice

    PubMed Central

    Li, Hongmei; Liu, Qing; Wang, Jia; Wang, Yiqian; Gao, Weiwei; Zhou, Ling; Liao, Jiayu; Young, Andrew A.; Wang, Ming-Wei

    2008-01-01

    Background Our recent discovery of the substituted cyclobutane Boc5, one of the first non-peptidic agonists at glucagon-like peptide-1 receptors, offers the potential of combining oral availability with full agonism capable of eliciting antidiabetic and antiobesity effects. The present study was aimed at determining the in vivo pharmacologic properties of Boc5 in both normal and diabetic mice following chronic administration, with emphasis on glycemic control and weight loss. Methodology/Principal Findings C57BL/6J and db/db mice were treated daily with Boc5 for 4 weeks and a range of pharmacologic parameters, including hemoglobin A1c, intraperitoneal glucose tolerance, insulin tolerance, fasting insulin and leptin levels, food intake, body weight and fat mass, were assessed before and after the treatment. Effects on food intake, gastric emptying, and insulinogenic index were also investigated in animals acutely administered with Boc5. Boc5 (3 mg) was able to induce a durable restoration of glycemic control (normalization of both hemoglobin A1c and intraperitoneal glucose tolerance) in db/db mice, following 4 weeks of daily administration. As with peptidic glucagon-like peptide-1 receptor agonists, its glycemic benefit and weight (fat) loss were associated with dose-dependent effects that included reduction in food intake, slowing of gastric emptying (both of which reduce nutrient-drive at ?-cells), stimulation of insulin secretion (which was glucose-dependent), and elevation in insulin sensitivity. There was little effect on normal mice treated in the same manner. Conclusions/Significance Our findings suggest that Boc5 is the only non-peptidic molecule reported thus far to simultaneously activate this spectrum of antidiabetic effects. PMID:18682834

  2. Consumption of a high glycemic load but not a high glycemic index diet is marginally associated with oxidative stress in young women.

    PubMed

    Arikawa, Andrea Y; Jakits, Holly E; Flood, Andrew; Thomas, William; Gross, Myron; Schmitz, Kathryn H; Kurzer, Mindy S

    2015-01-01

    Research studies have suggested that chronic consumption of high glycemic index foods may lead to chronically high oxidative stress. This is important because oxidative stress is suspected to be an early event in the etiology of many disease processes. We hypothesized that dietary glycemic index and glycemic load were positively associated with oxidative stress assessed by plasma F2-isoprostanes in healthy, premenopausal women (body mass index [BMI] = 24.7 ± 4.8 kg/m(2) and age 25.3 ± 3.5 years, mean ± SD). We measured plasma F2-isoprostanes in 306 healthy premenopausal women at the baseline visit for the Women In Steady Exercise Research study, using gas chromatography-mass spectrometry. Dietary glycemic index and load were calculated from the National Cancer Institute Diet History Questionnaire, and participants were divided into quartiles of dietary glycemic index and of glycemic load. Plasma F2-isoprostanes were compared across quartile groups of dietary glycemic index and glycemic load using linear regression models. Plasma F2-isoprostanes (pg/mL) increased with quartile of glycemic load (test for linear trend, P = .033), and also increased with quartile of glycemic index in participants with BMI ? 25 (P = .035) but not in those with BMI <25 (P = .924). After adjustment for BMI, alcohol consumption and total energy intake, both these positive trends remained marginally significant (P = .123 for quartiles of glycemic index and P = .065 for quartiles of glycemic load). PMID:25453541

  3. 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

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

    2014-01-01

    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

  4. Glycemic Responses, Appetite Ratings and Gastrointestinal Hormone Responses of Most Common Breads Consumed in Spain. A Randomized Control Trial in Healthy Humans

    PubMed Central

    Gonzalez-Anton, Carolina; Rico, Maria C.; Sanchez-Rodriguez, Estefania; Ruiz-Lopez, Maria D.; Gil, Angel; Mesa, Maria D.

    2015-01-01

    The present study was carried out to determine the glycemic index (GI), glycemic load (GL), insulinemic index (InI), appetite ratings and postprandial plasma concentrations of gastrointestinal hormones related to the control of food intake after the ingestion of the five most common breads consumed in Spain with different compositions and manufacturing processes. Twenty-two healthy adults participated in a randomized crossover study. The breads tested were Ordinary, Precooked-Frozen, Candeal-flour, Alfacar whites and Wholemeal. All breads portions were calculated to supply 50 g of available carbohydrates. In addition, 50 g of glucose was used as a reference. A linear mixed-effects model was used to compare data calculated for all breads with glucose load. The GI value varied from 61 for the Wholemeal, to Alfacar 68, Ordinary 76, and 78 and 86 for the Precooked-Frozen and Candeal-flour breads, respectively. Wholemeal and Alfacar had lower GI than glucose. All tested breads had a lower GL (ranged 9 to 18) compared with glucose. Wholemeal GL was similar to Alfacar, but lower than the other white breads. InI were significantly lower for all breads (ranged 68 to 73) compared with glucose, and similar among them. The intake of the Wholemeal bread led to a higher release of gastric inhibitory polypeptide compared with the Ordinary and Precooked breads and to a higher release of pancreatic polypeptide compared with the Precooked-Frozen bread. All breads affected appetite ratings similarly. In conclusion, based on GL, the Wholemeal bread would be expected to exert a favorable glycemic response. PMID:26024293

  5. Glycemic responses, appetite ratings and gastrointestinal hormone responses of most common breads consumed in Spain. A randomized control trial in healthy humans.

    PubMed

    Gonzalez-Anton, Carolina; Rico, Maria C; Sanchez-Rodriguez, Estefania; Ruiz-Lopez, Maria D; Gil, Angel; Mesa, Maria D

    2015-01-01

    The present study was carried out to determine the glycemic index (GI), glycemic load (GL), insulinemic index (InI), appetite ratings and postprandial plasma concentrations of gastrointestinal hormones related to the control of food intake after the ingestion of the five most common breads consumed in Spain with different compositions and manufacturing processes. Twenty-two healthy adults participated in a randomized crossover study. The breads tested were Ordinary, Precooked-Frozen, Candeal-flour, Alfacar whites and Wholemeal. All breads portions were calculated to supply 50 g of available carbohydrates. In addition, 50 g of glucose was used as a reference. A linear mixed-effects model was used to compare data calculated for all breads with glucose load. The GI value varied from 61 for the Wholemeal, to Alfacar 68, Ordinary 76, and 78 and 86 for the Precooked-Frozen and Candeal-flour breads, respectively. Wholemeal and Alfacar had lower GI than glucose. All tested breads had a lower GL (ranged 9 to 18) compared with glucose. Wholemeal GL was similar to Alfacar, but lower than the other white breads. InI were significantly lower for all breads (ranged 68 to 73) compared with glucose, and similar among them. The intake of the Wholemeal bread led to a higher release of gastric inhibitory polypeptide compared with the Ordinary and Precooked breads and to a higher release of pancreatic polypeptide compared with the Precooked-Frozen bread. All breads affected appetite ratings similarly. In conclusion, based on GL, the Wholemeal bread would be expected to exert a favorable glycemic response. PMID:26024293

  6. Characteristics associated with poor glycemic control among adults with self-reported diagnosed diabetes--National Health and Nutrition Examination Survey, United States, 2007-2010.

    PubMed

    Ali, Mohammed K; McKeever Bullard, Kai; Imperatore, Giuseppina; Barker, Lawrence; Gregg, Edward W

    2012-06-15

    Nationally representative estimates indicate that 18.8 million adults in the United States have received a diagnosis with diabetes mellitus. When glycemic control is not optimized, diabetes imposes additional burdensome care requirements, health-care costs, and high risk of disabling complications, and this has been especially evident in socioeconomically disadvantaged and minority populations. For example, higher levels of glycated hemoglobin (A1c) have been associated with increased risk of diabetic retinopathy, increased risk of chronic kidney disease, and increased risk of cardiovascular disease. Reducing A1c levels through combined clinical and effective self-management has demonstrated reduced risk for microvascular complications. Although the most appropriate target A1c levels to achieve optimal health impact might vary among persons, the majority of adults with diabetes will benefit from reduction of A1c levels to ?7%; targets for patients with a history of severe hypoglycemia, or with limited life expectancy, or with advanced complications, or with certain comorbid conditions might be higher. Nevertheless, an A1c level of 9% constitutes a clearly modifiable, high level of risk that few, if any, persons with diabetes should be exposed to. Accordingly, the Healthy People 2020 objectives include a 10% reduction in the proportion of the diabetes population that has poor glycemic control (A1c >9%) as a target. PMID:22695461

  7. Improvement in inpatient glycemic care: pathways to quality.

    PubMed

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

    2015-04-01

    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

  8. Treatment with the ?-glucosidase inhibitor miglitol from the preonset stage in Otsuka Long-Evans Tokushima Fatty rats improves glycemic control and reduces the expression of inflammatory cytokine genes in peripheral leukocytes

    Microsoft Academic Search

    Kazuki Mochizuki; Nanae Fukaya; Yutaro Tanaka; Masahiro Fuchigami; Toshinao Goda

    2011-01-01

    Otsuka Long-Evans Tokushima Fatty (OLETF) rats, an animal model of type 2 diabetes mellitus, exhibit chronic and slowly progressive hyperglycemia with obesity. In this study, we examined whether dietary supplementation with the ?-glucosidase inhibitor miglitol from the preonset stage improves glycemic control and reduces the gene expression of inflammatory cytokines in peripheral leukocytes. The OLETF rats were fed a control

  9. Survey of the Effect of Biotin on Glycemic Control and Plasma Lipid Concentrations in Type 1 Diabetic Patients in Kermanshah in Iran (2008-2009)

    PubMed Central

    Hemmati, Mitra; Babaei, Homa; Abdolsalehei, Mohammadreza

    2013-01-01

    Objective: Diabetes mellitus is the most common chronic endocrine disease worldwide. Intensive glycemic control plays an important role in decreasing morbidity and mortality rate of the disease. Preclinical studies have shown that biotin has an essential role in regulating blood glucose and serum lipid metabolism. This study aims to evaluate the effect of biotin on glycemic control and plasma lipids concentrations in type 1diabetic patients. Methods: This randomized double-blind placebo-controlled clinical trial study was conducted 70 type 1 diabetic patients with an age range 5-25 years old with poorly controlled (glycosylated hemoglobin ?8%). Subjects were randomly allocated into two groups. In the intervention group biotin (40 microgram/kg) was administered plus daily insulin, while the control group received placebo plus daily insulin regimen for three months. Laboratory tests including glycosylated hemoglobin (HbA1c), fasting blood sugar and plasma lipids were measured at the base and after 3 months. Results: In this study, seventy patients were evaluated, 35 were allocated to each group. There were no statistically significant differences between age, gender, duration of diabetes, BMI and BP between the two groups (p>0.05). HbA1c in the intervention (biotin) group was 9.84±1.80 at base and after 3 months treatment, it declined to 8.88±1.73 (p<0.001). In the control group HbA1c at base was 9.39±1.58, after 3 months it increased to10.11± 1.68. There were statistically significant differences in the mean of HbA1c in both the biotin and the control groups (p<0.001). FBS in the biotin group at base was 275±65.76 mg/dl and after 3 months it had reduced to 226± 41.31 (p<0.001). There were statistically significant differences in the mean of total cholesterol, low density lipoprotein cholesterol and triglyceride between the two groups at the end of 3 months (p<0.05). Conclusion: Results of this study showed that biotin administration as an adjuvant in addition to insulin regimen can improve glycemic management and decrease plasma lipids concentrations in poorly controlled type 1 diabetic patients. PMID:23772286

  10. Randomized, double-blind, placebo-controlled, clinical study on the effect of Diabetinol® on glycemic control of subjects with impaired fasting glucose

    PubMed Central

    Evans, Malkanthi; Judy, William V; Wilson, Dale; Rumberger, John A; Guthrie, Najla

    2015-01-01

    Background This study investigated the efficacy of Diabetinol® in people with diabetes on medication but not meeting the American Association of Clinical Endocrinologists and American Diabetes Association glycemic, blood pressure, and lipid targets. Subjects and methods Fifty subjects, aged 18–75 years, with fasting blood glucose ?15.4 mmol/L, hemoglobin A1c levels ?12%, and a body mass index between 25 and 40 kg/m2, were enrolled in a 24-week, randomized, double-blind, placebo-controlled, parallel study. Diabetinol® or placebo was administered as 2×525 mg capsules/day. Results In the Diabetinol® group, 14.3% versus 0% in the placebo group, 33.3% versus 15.4% in placebo, 20.0% versus 12.5% in placebo, and 83.3% versus 60% in placebo achieved the American Association of Clinical Endocrinologists and American Diabetes Association targets for hemoglobin A1c, low-density lipoprotein, total cholesterol, and systolic blood pressure, respectively. There was no difference in the maximum concentration (Cmax) of serum glucose or area under the curve (AUC)0–240 minutes. The time to Cmax was longer for participants on Diabetinol® than placebo group at week 12 (P=0.01). Fasting blood glucose increased from baseline to week 24 in both groups; however, this increase was 14.3 mg/dL lower in the Diabetinol® group versus placebo. The Diabetinol® group showed an increase of 5.53 mg/dL in fasting insulin at week 12 (P=0.09) and 3.2 mg/dL at week 24 (P=0.41) over and above the placebo group. A decrease of 1.5% in total cholesterol, 5.8% in low-density lipoprotein, and a 1.6% increase in high-density lipoprotein concentrations were seen in the Diabetinol® group. Diabetinol® improved 6-month oral glucose tolerance test and 2-hour postprandial glucose profiles in participants between 40 and 60 years of age. Conclusion The current study suggests a role for Diabetinol® as an adjunctive therapy for glycemic maintenance and for decreasing the risk of diabetes-associated comorbidities in type 2 diabetic patients on conventional therapies. PMID:26150732

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

    PubMed Central

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

    2014-01-01

    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. PMID:25815019

  12. Effects of a low-fat diet compared with those of a high-monounsaturated fat diet on body weight, plasma lipids and lipoproteins, and glycemic control in type 2 diabetes1-3

    Microsoft Academic Search

    Glenn T Gerhard; Andrew Ahmann; Kaatje Meeuws; Martha P McMurry; P Barton Duell; William E Connor

    Background: An important therapeutic goal for patients with type 2 diabetes is weight loss, which improves metabolic abnormalities. Ad libitum low-fat diets cause weight loss in nondiabetic popula- tions. Compared with diets higher in monounsaturated fat, however, eucaloric low-fat diets may increase plasma triacylglycerol concen- trations and worsen glycemic control in persons with type 2 diabetes. Objective: We investigated whether,

  13. Insulin glargine maintains equivalent glycemic control and better lipometabolic control than NPH insulin in type 1 diabetes patients who missed a meal.

    PubMed

    Rosak, C; Jung, R; Hofmann, U

    2008-08-01

    Our goal was to investigate blood glucose and lipometabolism control in type 1 diabetes patients who missed breakfast and the accompanying insulin injection of NPH insulin (NPH) or insulin glargine (glargine) as part of a basal-bolus regimen. This was a multi-center, open-label, controlled study in adults (> or =18 years) with HbA (1c)< or =11.5% on insulin therapy with NPH as basal insulin. Patients were randomized to receive prandial insulin plus either bedtime glargine (n=28) or NPH (n=32). Insulin was titrated to target fasting blood glucose levels 80-130 mg/dl at 06:00-07:00. Patients had no intake of insulin or food between 22:00 and 12:00 the next day. The change in blood glucose levels (07:00-11:00) was similar (27.5 mg/dl vs. 35.4 mg/dl), but the mean blood glucose level was higher with glargine vs. NPH at 22:00 (158.2 mg/dl vs. 130.2 mg/dl). During the period without insulin or food intake, blood glucose decreased with glargine (-25.8 mg/dl) and increased with NPH (+9.1 mg/dl; p=0.0284). Nonesterified fatty acid (07:00 and 09:00-12:00) and beta-hydroxybutyrate (07:00 and 10:00-12:00) levels were lower with glargine vs. NPH (both p<0.05). For patients who miss a morning meal, glargine is associated with maintained glycemic and lipometabolic control compared with NPH insulin. PMID:18493882

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed

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

    2014-01-01

    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

  16. Weight Loss, Glycemic Control, and Changes in Cardiovascular Biomarkers in Patients With Type 2 Diabetes Receiving Incretin Therapies or Insulin in a Large Cohort Database

    PubMed Central

    Horton, Edward S.; Silberman, Cheryl; Davis, Keith L.; Berria, Rachele

    2010-01-01

    OBJECTIVE Weight loss in patients with type 2 diabetes can improve glycemic control, lower blood pressure, and improve dyslipidemia. Glucagon-like peptide (GLP-1) receptor agonists are associated with weight loss and have potentially beneficial effects on cardiovascular risk biomarkers; however, there is limited information to indicate whether these effects remain outside of clinical trials. RESEARCH DESIGN AND METHODS Medical records from the General Electric Centricity research database were analyzed retrospectively to evaluate the relationship between weight loss and glycemic control and changes in blood pressure and lipids in patients with type 2 diabetes initiating therapy with exenatide, sitagliptin, or insulin. Baseline and follow-up (90–365 days after the index date) for weight, A1C, fasting blood glucose (FBG), blood pressure, triglycerides, and LDL, HDL, and total cholesterol were assessed. RESULTS A total of 6,280, 5,861, and 32,398 patients receiving exenatide, sitagliptin, or insulin, respectively, were included in the analysis. Exenatide-treated patients lost a mean ± SD of 3.0 ± 7.33 kg, sitagliptin-treated patients lost 1.1 ± 5.39 kg, and insulin-treated patients gained 0.6 ± 9.49 kg. There was a significant association between weight loss and a reduction in A1C and FBG with exenatide only and a reduction in blood pressure for all therapies. Weight loss was associated with some improvements in lipids, primarily in the GLP-1 receptor agonist group, with little association in the insulin group. CONCLUSIONS Weight reduction with GLP-1 receptor agonists was associated with a shift toward a more favorable cardiovascular risk profile. Outcome trials are needed to determine whether improvement in biomarkers translates into a reduction in cardiovascular events in patients with type 2 diabetes. PMID:20460445

  17. 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...

  18. Clinical significance of barriers to blood glucose control in type 2 diabetes patients with insufficient glycemic control

    PubMed Central

    Suzuki, Takeo; Takei, Ryoko; Inoguchi, Toyoshi; Sonoda, Noriyuki; Sasaki, Shuji; Kaise, Toshihiko; Takayanagi, Ryoichi

    2015-01-01

    Background The purpose of this study was to assess actual barriers to blood glucose control in patients with type 2 diabetes mellitus and to investigate barrier-related factors in an exploratory manner. Methods This cross-sectional study assessed patients with type 2 diabetes mellitus treated as outpatients at medical institutions within Fukuoka Prefecture, Japan. Barriers to blood glucose control were examined in patients with glycated hemoglobin ?6.9% using a nine-item questionnaire. Answers were also obtained from physicians in charge of the patients for seven of nine questions. Results Seven hundred and thirteen patients answered the questionnaire. Many physicians and patients described barriers that involved difficulty in complying with diet therapy. For six of the seven barriers, patient awareness was lower than physician awareness. Patient-reported lack of concern for diabetes mellitus was more prevalent among patients with macrovascular complications. Patients who reported difficulty in compliance with exercise therapy and fear of hypoglycemia were more likely to suffer from microvascular complications. Conclusion For many of the barriers to blood glucose control, patients were less aware than physicians, suggesting that we need to take action to raise patient awareness. Of interest are the observations that the relevant barriers differed for macrovascular and microvascular complications and that the relationship between presence of macrovascular complications and lack of concern about diabetes mellitus. PMID:26170633

  19. 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

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

    2015-01-01

    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

  20. Glycemic index, glycemic load and risk of gastric cancer

    Microsoft Academic Search

    L. S. A. Augustin; S. Gallus; E. Negri; C. La Vecchia

    2004-01-01

    Background: Dietary carbohydrates have been directly associated with gastric cancer risk and have been considered general indicators of a poor diet. However, elevated levels of glucose and insulin elicited by con- sumption of high amounts of refined carbohydrates may stimulate mitogenic and cancer-promoting insulin-like growth factors (IGF). Glycemic index (GI) and glycemic load (GL), which represent indirect measures of dietary

  1. Effect of conjugated linoleic acid and vitamin E on glycemic control, body composition, and inflammatory markers in overweight type2 diabetics

    PubMed Central

    2013-01-01

    Background The healthy properties of conjugated linoleic acid (CLA) such as weight loss, reducing cardiovascular risk factors and inflammation have been reported. The trans-10, cis-12 CLA isomer is related to increasing insulin resistance, but the effects of cis-9, trans-11 isomer is not clear. The aim of this study was to investigate the effects of CLA with and without Vitamin E on body weight, body composition, glycemic index, inflammatory and coagulation factors, lipid profile, serum leptin and adiponectin, malondialdehyde (MDA), and blood pressure in type2 diabetes. Methods 56 patients with type2 diabetes were included in 8 week double-blind control trial that used metformin. They randomly divided into three groups: CLA + VitE, CLA + VitE placebo, CLA placebo + VitE placebo. All variables, anthropometric measurements, and body composition were evaluated at the beginning and the end of study. Statistical analysis and analysis of dietary data were performed using SPSS and nutritionist IV software, respectively. Results There were not any significant differences in variable changes among three groups. However, there was a trend to increase in MDA and decrease in apoB100 among CLA consumers. Conclusion The results of this study showed that administration of CLA supplementation for 8 weeks does not affect any indicators of metabolic control in overweight type2 diabetic patients. PMID:23870044

  2. Glycemic management in diabetes and the associated cardiovascular risk: are we helping or hurting our patients?

    PubMed

    Koshizaka, Masaya; Green, Jennifer B; Alexander, John H

    2012-01-01

    Diabetes, which is a metabolic disorder with multiple comorbidities, increases the risk of cardiovascular disease. Although it was once assumed that controlling plasma glucose levels would reduce diabetes-related morbidity and mortality, recent trials have demonstrated that this is not consistently the case. Data from large, well-designed trials suggest that intensive glycemic therapy may be useful in preventing cardiovascular events if initiated early in the disease course, but may be harmful or not useful if applied to high-risk patients with a longer history of diabetes. Furthermore, the cardiovascular safety of existing individual antihyperglycemic agents remains largely unknown. We review the relationship between glycemic control targets and cardiovascular outcomes, as well as the current understanding of the cardiovascular effects of existing glucose-lowering therapies. This information has affected recommendations for diabetes care in Japan and the United States differently, and supports a more comprehensive and prospective approach to cardiovascular safety assessments of diabetes therapies in the future. Results from ongoing cardiovascular outcomes trials of diabetes medications may help to define optimal glucose-lowering strategies for patients at high risk of cardiovascular complications. Until then, glycemic control targets and the medications used to achieve them should be individualized according to each patient's age, duration of diabetes, risk of hypoglycemia, risk of cardiovascular complications, and life expectancy. PMID:22789974

  3. Streptozotocin-Induced Early Thermal Hyperalgesia is independent of Glycemic State of Rats: Role of Transient Receptor Potential Vanilloid 1(TRPV1) and Inflammatory mediators

    PubMed Central

    2011-01-01

    Background Streptozotocin (STZ) is used as a common tool to induce diabetes and to study diabetes-induced complications including diabetic peripheral neuropathy (DPN). Previously, we have reported that STZ induces a direct effect on neurons through expression and function of the Transient receptor potential vanilloid 1 (TRPV1) channel in sensory neurons resulting in thermal hyperalgesia, even in non-diabetic STZ-treated mice. In the present study, we investigated the role of expression and function of TRPV1 in the central sensory nerve terminals in the spinal cord in STZ-induced hyperalgesia in rats. Results We found that a proportion of STZ-treated rats were normoglycemic but still exhibited thermal hyperalgesia and mechanical allodynia. Immunohistochemical data show that STZ treatment, irrespective of glycemic state of the animal, caused microglial activation and increased expression of TRPV1 in spinal dorsal horn. Further, there was a significant increase in the levels of pro-inflammatory mediators (IL-1?, IL-6 and TNF-?) in spinal cord tissue, irrespective of the glycemic state. Capsaicin-stimulated release of calcitonin gene related peptide (CGRP) was significantly higher in the spinal cord of STZ-treated animals. Intrathecal administration of resiniferatoxin (RTX), a potent TRPV1 agonist, significantly attenuated STZ-induced thermal hyperalgesia, but not mechanical allodynia. RTX treatment also prevented the increase in TRPV1-mediated neuropeptide release in the spinal cord tissue. Conclusions From these results, it is concluded that TRPV1 is an integral component of initiating and maintaining inflammatory thermal hyperalgesia, which can be alleviated by intrathecal administration of RTX. Further, the results suggest that enhanced expression and inflammation-induced sensitization of TRPV1 at the spinal cord may play a role in central sensitization in STZ-induced neuropathy. PMID:21794120

  4. 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

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

    2015-04-01

    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

  5. Improvement of glycemic control in streptozotocin-induced diabetic rats by Atlantic salmon skin gelatin hydrolysate as the dipeptidyl-peptidase IV inhibitor.

    PubMed

    Hsieh, C H; Wang, T Y; Hung, C C; Chen, M C; Hsu, K C

    2015-06-10

    In our previous study, Atlantic salmon skin gelatin hydrolysed with flavourzyme possessed 42.5% dipeptidyl-peptidase (DPP)-IV inhibitory activity at a concentration of 5 mg mL(-1). The oral administration of the hydrolysate (FSGH) at a single dose of 300 mg per day in streptozotocin (STZ)-induced diabetic rats for 5 weeks was evaluated for its antidiabetic effect. During the 5-week experiment, body weight increased, and the food and water intake was reduced by FSGH in diabetic rats. The daily administration of FSGH for 5 weeks was effective for lowering the blood glucose levels of diabetic rats during an oral glucose tolerance test (OGTT). After the 5-week treatment, plasma DPP-IV activity was inhibited; the plasma activity of glucagon-like peptide-1 (GLP-1), insulin, and the insulin-to-glucagon ratio were increased by FSGH in diabetic rats. The results indicate that FSGH has the function of inhibiting GLP-1 degradation by DPP-IV, resulting in the enhancement of insulin secretion and improvement of glycemic control in STZ-induced diabetic rats. PMID:25946069

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

    PubMed

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

    2014-01-01

    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

  7. Genetic ablation of myelin protein zero-like 3 in mice increases energy expenditure, improves glycemic control, and reduces hepatic lipid synthesis.

    PubMed

    Czyzyk, Traci A; Andrews, Jessica L; Coskun, Tamer; Wade, Mark R; Hawkins, Eric D; Lockwood, John F; Varga, Gabor; Sahr, Allison E; Chen, Yanyun; Brozinick, Joseph T; Kikly, Kristine; Statnick, Michael A

    2013-07-15

    Obesity continues to be a global health problem, and thus it is imperative that new pathways regulating energy balance be identified. Recently, it was reported: (Hayashi K, Cao T, Passmore H, Jourdan-Le Saux C, Fogelgren B, Khan S, Hornstra I, Kim Y, Hayashi M, Csiszar K. J Invest Dermatol 123: 864-871, 2004) that mice carrying a missense mutation in myelin protein zero-like 3 (Mpzl3rc) have reduced body weight. To determine how Mpzl3 controls energy balance in vivo, we generated mice deficient in myelin protein zero-like 3 (Mpzl3-KO). Interestingly, KO mice were hyperphagic yet had reduced body weight and fat mass. Moreover, KO mice were highly resistant to body weight and fat mass gain after exposure to a high-fat, energy-dense diet. These effects on body weight and adiposity were driven, in part, by a pronounced increase in whole body energy expenditure levels in KO mice. KO mice also had reduced blood glucose levels during an intraperitoneal glucose challenge and significant reductions in circulating insulin levels suggesting an increase in insulin sensitivity. In addition, there was an overall increase in oxidative capacity and contractile force in skeletal muscle isolated from KO mice. Hepatic triglyceride levels were reduced by 92% in livers of KO mice, in part due to a reduction in de novo lipid synthesis. Interestingly, Mpzl3 mRNA expression in liver was increased in diet-induced obese mice. Moreover, KO mice exhibited an increase in insulin-stimulated Akt signaling in the liver, further demonstrating that Mpzl3 can regulate insulin sensitivity in this tissue. We have determined that Mpzl3 has a novel physiological role in controlling body weight regulation, energy expenditure, glycemic control, and hepatic triglyceride synthesis in mice. PMID:23715724

  8. Tight Glycemic Control after Pediatric Cardiac Surgery in High-Risk Patient Populations: A Secondary Analysis of the Safe Pediatric Euglycemia after Cardiac Surgery Trial

    PubMed Central

    Agus, Michael SD; Asaro, Lisa A; Steil, Garry M; Alexander, Jamin L; Silverman, Melanie; Wypij, David; Gaies, Michael G

    2014-01-01

    Background Our previous randomized clinical trial showed that post-operative tight glycemic control (TGC) for children undergoing cardiac surgery did not reduce the rate of healthcare-associated infections compared to standard care (STD). Heterogeneity of treatment effect may exist within this population. Methods and Results We performed a post-hoc exploratory analysis on 980 children from birth to 36 months at the time of cardiac surgery who were randomized to post-operative TGC or STD in the intensive care unit. Significant interactions were observed between treatment group and both neonate (age ?30 days, P=0.03) and intraoperative glucocorticoid exposure (P=0.03) on the risk of infection. The rate and incidence of infections in subjects ?60 days old were significantly increased in the TGC group compared to the STD group (rate 13.5 vs. 3.7 infections/1,000 CICU days, P=0.01; incidence 13% vs. 4%, P=0.02), while infections among those >60 days of age was significantly reduced in TGC compared to STD (rate 5.0 vs. 14.1 infections/1,000 CICU days, P=0.02; incidence 2% vs. 5%, P=0.03); the treatment group by age subgroup interaction was highly significant (P=0.001). Multivariable logistic regression controlling for the main effects revealed that previous cardiac surgery, chromosomal anomaly, and delayed sternal closure were independently associated with increased risk of infection. Conclusions This exploratory analysis demonstrated that TGC may lower the risk of infection in children >60 days old at the time of cardiac surgery compared to children receiving STD. Meta-analyses of past and ongoing clinical trials are necessary to confirm these findings before altering clinical practice. PMID:24671945

  9. Counting Carbs? Understanding Glycemic Index and Glycemic Load

    MedlinePLUS

    ... Many things affect the glycemic load, including food processing, how ripe a fruit is, how a food ... grain bread, whole-wheat pasta, brown or wild rice, barley, quinoa and bulgur. Eat more fresh fruits ...

  10. Glycemic management in the inpatient setting.

    PubMed

    Schmeltz, Lowell R; Ferrise, Carla

    2012-04-01

    Hyperglycemia occurs frequently in hospitalized patients and affects patient outcomes, including mortality, inpatient complications, hospital length of stay, and overall hospital costs. Various degrees of glycemic control have been studied and consensus statements from the American Diabetes Association/American Association of Clinical Endocrinologists and The Endocrine Society recommend a target blood glucose range of 140 to 180 mg/dL in most hospitalized patients. Insulin is the preferred modality for treating all hospitalized patients with hyperglycemia, as it is adaptable to changing patient physiology over the course of hospitalization. Critically ill patients should receive intravenous insulin infusion, and all noncritically ill patients with hyperglycemia (individuals with and without diabetes) should be managed using a subcutaneous insulin algorithm with basal, nutritional, and correctional dose components. Hypoglycemia remains a limiting factor to achieving optimal glycemic targets. Similar to hyperglycemia, hypoglycemia is an independent risk factor for poor outcomes in hospitalized patients. Improvement in glycemic control throughout the hospital includes efforts from all health care providers. Institutions can encourage safe insulin use by using insulin algorithms, preprinted order sets, and hypoglycemia protocols, as well as by supporting patient and health care provider education. PMID:22615078

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

    ERIC Educational Resources Information Center

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

    2010-01-01

    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…

  12. Activity of hydrolytic enzymes in fungi isolated from diabetic pregnant women: is there any relationship between fungal alkaline and acid phosphatase activity and glycemic control?

    PubMed

    Nowakowska, Dorota; Kurnatowska, Alicja; Stray-Pedersen, Babill; Wilczy?ski, Jan

    2004-06-01

    Ability to respond to environmental changes and secretion of hydrolases are considered to be important for Candida virulence. In this study we determined and compared the activities of 19 different hydrolases of the fungal strains isolated from diabetic and non-diabetic pregnant women. We also looked for the presence of a relationship between hydrolase activities and glycemic control, and, furthermore, evaluated the influence of gestational age on the activity of hydrolases. Mycological examinations were performed for 119 diabetic pregnant women: 47 with diabetes mellitus type I (DM), 72 with gestational diabetes (GDM), and for 132 healthy women (CON). Samples were collected from the vagina, rectum and oral cavity and cultured on Sabouraud media. The fungal hydrolase activities were evaluated using the API ZYM test (bioMerieux). For the 19 different fungal hydrolases tested, 13 activities were present in the isolated fungal strains. The activity of alkaline phosphatase (ALP) in vaginal strains (p=0.028) and acid phosphatase (ACP) in strains from the vagina (p=0.006) and rectum (p=0.049) was significantly lower in DM than in GDM and CON women. In conclusion, we describe for the first time that fungi isolated from pregnant diabetic women have lower activity of both phosphatases compared to fungi isolated from healthy women. Furthermore, similar differences of mean ALP and ACP activities were observed in the course of pregnancy in strains from the vagina and rectum of DM and CON women. However, strains from DM had lower activity at each stage of pregnancy. The highest activity of ALP and ACP was detected at the beginning, then declined, and had the lowest values between the 24(th) and 33(rd) week of gestation. After that period the activity of both phosphatases increased. PMID:15511275

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

    PubMed

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

    2014-11-10

    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

  14. 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

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

    2014-07-01

    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

  15. 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

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

    2014-01-01

    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

  16. Treatment with the ?-glucosidase inhibitor miglitol from the preonset stage in Otsuka Long-Evans Tokushima Fatty rats improves glycemic control and reduces the expression of inflammatory cytokine genes in peripheral leukocytes.

    PubMed

    Mochizuki, Kazuki; Fukaya, Nanae; Tanaka, Yutaro; Fuchigami, Masahiro; Goda, Toshinao

    2011-11-01

    Otsuka Long-Evans Tokushima Fatty (OLETF) rats, an animal model of type 2 diabetes mellitus, exhibit chronic and slowly progressive hyperglycemia with obesity. In this study, we examined whether dietary supplementation with the ?-glucosidase inhibitor miglitol from the preonset stage improves glycemic control and reduces the gene expression of inflammatory cytokines in peripheral leukocytes. The OLETF rats were fed a control diet or a diet containing 800 ppm miglitol (miglitol diet) for 40 weeks from 5 weeks of age (preonset stage). We determined nonfasting blood glucose, blood 1,5-anhydroglucitol, and messenger RNA levels of inflammatory cytokines in peripheral leukocytes in these rats. Nonfasting blood glucose concentrations gradually increased in OLETF rats fed the control diet, with significant increases at weeks 28 and 40 compared with week 0. In contrast, nonfasting blood glucose levels did not increase in miglitol-treated rats during the experimental period. Miglitol-treated rats had lower nonfasting blood glucose levels and higher 1,5-anhydroglucitol levels, a marker for glucose fluctuations, at week 40 than control rats. The gene expression of inflammatory cytokines including interleukin-6, tumor necrosis factor-?, and interferon-? in peripheral leukocytes gradually increased during the development of diabetes in control rats, but not in miglitol-treated rats. Our results suggest that dietary supplementation with miglitol from the preonset stage in OLETF rats improves glycemic control and reduces gene expression of cytokines related to inflammation in peripheral leukocytes. PMID:21550076

  17. Impact of Bromocriptine-QR Therapy on Glycemic Control and Daily Insulin Requirement in Type 2 Diabetes Mellitus Subjects Whose Dysglycemia Is Poorly Controlled on High-Dose Insulin: A Pilot Study

    PubMed Central

    Roe, Erin D.; Chamarthi, Bindu; Raskin, Philip

    2015-01-01

    Background. The concurrent use of a postprandial insulin sensitizing agent, such as bromocriptine-QR, a quick release formulation of bromocriptine, a dopamine D2 receptor agonist, may offer a strategy to improve glycemic control and limit/reduce insulin requirement in type 2 diabetes (T2DM) patients on high-dose insulin. This open label pilot study evaluated this potential utility of bromocriptine-QR. Methods. Ten T2DM subjects on metformin (1-2?gm/day) and high-dose (TDID ? 65?U/day) basal-bolus insulin were enrolled to receive once daily (morning) bromocriptine-QR (1.6–4.8?mg/day) for 24 weeks. Subjects with at least one postbaseline HbA1c measurement (N = 8) were analyzed for change from baseline HbA1c, TDID, and postprandial glucose area under the curve of a four-hour mixed meal tolerance test (MMTT). Results. Compared to the baseline, average HbA1c decreased 1.76% (9.74 ± 0.56 to 7.98 ± 0.36, P = 0.01), average TDID decreased 27% (199 ± 33 to 147 ± 31, P = 0.009), and MMTT AUC60–240 decreased 32% (P = 0.04) over the treatment period. The decline in HbA1c and TDID was observed at 8 weeks and sustained over the remaining 16-week study duration. Conclusion. In this study, bromocriptine-QR therapy improved glycemic control and meal tolerance while reducing insulin requirement in T2DM subjects poorly controlled on high-dose insulin therapy.

  18. Relationships among different glycemic variability indices obtained by continuous glucose monitoring.

    PubMed

    Saisho, Yoshifumi; Tanaka, Chihiro; Tanaka, Kumiko; Roberts, Rachel; Abe, Takayuki; Tanaka, Masami; Meguro, Shu; Irie, Junichiro; Kawai, Toshihide; Itoh, Hiroshi

    2015-08-01

    The aim of this study was to assess the relationships among indices of glycemic variability obtained by continuous glucose monitoring (CGM). CGM was performed in 88 patients with diabetes (20 type 1 and 68 type 2 diabetes, age 59±15 years) admitted to our hospital (Keio University Hospital, Tokyo, Japan) between 2010 and 2012. Mean glucose, glucose standard deviation (SDglu) and other glycemic indices such as index of glycemic control (ICG), J-index, mean of daily differences (MODD), continuous overlapping net glycemic action 1 (CONGA1), mean amplitude of glycemic excursions (MAGE) and M value were calculated from CGM data, and the correlations among these indices were assessed. There were strong correlations between SDglu and the indices MAGE, CONGA1, MODD and M value (all r>0.8, P<0.05). On the other hand, mean glucose was strongly correlated with J index and M value (both r>0.8, P<0.05). SDglu and other glycemic variability indices were more strongly correlated with hypoglycemia than was mean glucose, and the combination of mean glucose and SDglu was useful for predicting hypoglycemia in patients with diabetes. In this study, we demonstrated the characteristics of various glycemic variability indices in relation to mean glucose and SDglu. This information will help physicians to understand the characteristics of various glycemic variability indices and to select an appropriate index for their purpose. Our results also underpin the importance of glycemic variability in relation to risk of hypoglycemia in patients with diabetes. PMID:25456706

  19. Available Carbohydrate and Glycemic Index Combined in New Data Sets for Managing Glycemia and Diabetes

    Microsoft Academic Search

    J. A. Monro

    1999-01-01

    Available carbohydrate data have long been used as a basis for food exchanges in controlling glycemia, but are not entirely appropriate because the same quantity of available carbohydrate in different foods can induce very different degrees of glycemic response. As an additional aid to food selection the glycemic index (GI) is now being increasingly used in diabetes management. GI is

  20. Effect of telenursing (telephone follow-up) on glycemic control and body mass index (BMI) of type 2 diabetes patients

    PubMed Central

    Borhani, Fariba; Lashkari, Tahereh; Sabzevari, Sakineh; Abbaszadeh, Abbas

    2013-01-01

    Background: Telenursing includes every nursing and care-giving services conducted remotely. In telenursing, telephone as a device, which is available for most of the people, is being used increasingly. In a telephone-based system, patients are being contacted by health care providers on regular bases and they would be provided with some information about their illness and their treatment method. This study was conducted to determine the effect of phone-based follow-ups on diabetes patients’ metabolic control in the city of Kerman in Iran. Materials and Methods: This is a quasi-experimental study conducted on 50 type II diabetes patients in Kerman during 2011. Data were collected using a demographic questionnaire and also by taking physiological measurement of fasting blood suger (FBS), Glycated Hemoglobin (HbA1c), and postprandial glucose (PPG). Participants’ body mass index (BMI) was calculated by measuring height and weight. Patients completed the questionnaire at the beginning of the study and 12 weeks later. The patients were randomly divided into two groups of experiment and control. Patients in the experimental group received phone calls by the researcher for 12 weeks, and the follow-ups included instructions on self-care and advices to follow their diets, exercise, and insulin titration. Data analysis was done using descriptive and inferential statistical methods (chi-square, analysis of variance [ANOVA], independent t-test, and paired t-test). Results: The decrease of HbA1c and PPG was significantly more in the intervention group compared with the controls (P < 0.001). However, there was no significant difference between the mean of FBS (P = 0.42), and BMI (P = 0.31) in both groups after the intervention. Conclusions: According to the results of this study, telenursing was able to improve the metabolic indices of the patients. Therefore, using this method is recommended for patients with type II diabetes. PMID:24554942

  1. 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

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

    2015-01-01

    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. PMID:25767522

  2. Effect of Home Telemonitoring on Glycemic and Blood Pressure Control in Primary Care Clinic Patients with Diabetes

    PubMed Central

    Koopman, Richelle J.; Keplinger, Lynn E.; Bomar, Marilee; Bernt, Beth; Johanning, Jennifer L.; Kruse, Robin L.; Davis, J. Wade; Wakefield, Douglas S.; Mehr, David R.

    2014-01-01

    Abstract Objective: Patient self-management support may be augmented by using home-based technologies that generate data points that providers can potentially use to make more timely changes in the patients' care. The purpose of this study was to evaluate the effectiveness of short-term targeted use of remote data transmission on treatment outcomes in patients with diabetes who had either out-of-range hemoglobin A1c (A1c) and/or blood pressure (BP) measurements. Materials and Methods: A single-center randomized controlled clinical trial design compared in-home monitoring (n=55) and usual care (n=53) in patients with type 2 diabetes and hypertension being treated in primary care clinics. Primary outcomes were A1c and systolic BP after a 12-week intervention. Results: There were no significant differences between the intervention and control groups on either A1c or systolic BP following the intervention. Conclusions: The addition of technology alone is unlikely to lead to improvements in outcomes. Practices need to be selective in their use of telemonitoring with patients, limiting it to patients who have motivation or a significant change in care, such as starting insulin. Attention to the need for effective and responsive clinic processes to optimize the use of the additional data is also important when implementing these types of technology. PMID:24404819

  3. Updated Review: Improved Glycemic Control with Repaglinide-Metformin in Fixed Combination for Patients with Type 2 Diabetes

    PubMed Central

    Richard, John W.; Raskin, Philip

    2011-01-01

    As the prevalence of type 2 diabetes continues to rise, new drug therapies will need to be explored to prevent morbidity and mortality associated with diabetes as well as growing health care costs. Type 2 diabetes is characterized by decreased insulin secretion and sensitivity. Numerous oral medications are currently approved for the treatment of type 2 diabetes. A treat-to-failure approach has traditionally been adopted with step-wise additions of oral medications; however, a growing frequency of treatment failures with monotherapy has led to the use of combination therapies earlier in the treatment of type 2 diabetes. One such combination regimen is repaglinide (a prandial glucose optimizer that increases insulin release) plus metformin (an insulin sensitizer that inhibits hepatic glucose output and increases peripheral glucose uptake while minimizing weight gain). Findings from several clinical trials have shown repaglinide plus metformin combination therapy to be superior to either monotherapy with significant reductions in hemoglobin A1C and fasting glucose values. Repaglinide used in combination also has shown less incidence of hypoglycemia compared with other combination therapies such as sulphonylureas plus metformin. Repaglinide plus metformin combination therapy appears to be a valuable therapeutic option for type 2 diabetic patients seeking a less complex drug regimen while potentially achieving better glucose control if currently inadequately controlled on monotherapy. PMID:22879792

  4. Implementation of the chronic care model in small medical practices improves cardiovascular risk but not glycemic control.

    PubMed

    Frei, Anja; Senn, Oliver; Chmiel, Corinne; Reissner, Josiane; Held, Ulrike; Rosemann, Thomas

    2014-04-01

    OBJECTIVE To test whether the implementation of elements of the Chronic Care Model (CCM) via a specially trained practice nurse leads to an improved cardiovascular risk profile among type 2 diabetes patients. RESEARCH DESIGN AND METHODS This cluster randomized controlled trial with primary care physicians as the unit of randomization was conducted in the German part of Switzerland. Three hundred twenty-six type 2 diabetes patients (age >18 years; at least one glycosylated hemoglobin [HbA1c] level of ?7.0% [53 mmol/mol] in the preceding year) from 30 primary care practices participated. The intervention included implementation of CCM elements and involvement of practice nurses in the care of type 2 diabetes patients. Primary outcome was HbA1c levels. The secondary outcomes were blood pressure (BP), LDL cholesterol, accordance with CCM (assessed by Patient Assessment of Chronic Illness Care [PACIC] questionnaire), and quality of life (assessed by the 36-item short-form health survey [SF-36]). RESULTS After 1 year, HbA1c levels decreased significantly in both groups with no significant difference between groups (-0.05% [-0.60 mmol/mol]; P = 0.708). Among intervention group patients, systolic BP (-3.63; P = 0.050), diastolic BP (-4.01; P < 0.001), LDL cholesterol (-0.21; P = 0.033), and PACIC subscores (P < 0.001 to 0.048) significantly improved compared with control group patients. No differences between groups were shown in the SF-36 subscales. CONCLUSIONS A chronic care approach according to the CCM and involving practice nurses in diabetes care improved the cardiovascular risk profile and is experienced by patients as a better structured care. Our study showed that care according to the CCM can be implemented even in small primary care practices, which still represent the usual structure in most European health care systems. PMID:24513589

  5. Effects of nonsurgical periodontal therapy on clinical response, microbiological profile, and glycemic control in Malaysian subjects with type 1 diabetes.

    PubMed

    Buzinin, Samira Mukhtar; Alabsi, Aied Mohammed; Tan, Alexander Tong Boon; Vincent-Chong, Vui King; Swaminathan, Dasan

    2014-01-01

    The association between diabetes mellitus and chronic periodontal disease has long been established. Most of the researches linking these two very common chronic diseases were based on type 2 diabetes mellitus and chronic periodontal disease. However, this study was conducted to investigate the association between type 1 diabetes and chronic periodontal disease in Malaysian subjects. Forty-one Malaysian subjects, of which 20 subjects were type 1 diabetics and with chronic periodontal disease (test group) and 21 subjects with only chronic periodontal disease (control group), were included in the study. Periodontal parameters and plaque samples for microbiological evaluation were done at baseline, 2 and 3 months after nonsurgical periodontal therapy. Blood samples were taken from only the test group and evaluated for HbA1c at baseline and 3 months after periodontal therapy. There were no statistically significant difference in periodontal parameters between groups (P>0.05) and no significant improvement in the level of HbA1c in the test group. Microbiological studies indicated that there were significant reductions in the levels of the tested pathogens in both groups. The results of our study were similar to the findings of several other studies that had been done previously. PMID:25147841

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

    PubMed Central

    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

    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

  7. Glycemic index in chronic disease: a review

    Microsoft Academic Search

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

    2002-01-01

    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

  8. Glycemic index in chronic disease: a review

    Microsoft Academic Search

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

    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

  9. Dietary Glycemic Index, Glycemic Load, and Risk of Cancer: A Prospective Cohort Study

    PubMed Central

    George, Stephanie Materese; Mayne, Susan T.; Leitzmann, Michael F.; Park, Yikyung; Schatzkin, Arthur; Flood, Andrew; Hollenbeck, Albert

    2009-01-01

    Previous studies have provided limited evidence for a harmful effect of high glycemic index and dietary glycemic load on cancer. The authors analyzed associations among glycemic index, glycemic load, and risk of cancer in women and men in the National Institutes of Health–AARP Diet and Health Study. Published glycemic index values were assigned to 225 foods/food groups. Glycemic load was calculated by multiplying the glycemic index, carbohydrate content, and intake frequency of individual foods reported on a food frequency questionnaire. From 1995 through 2003, the authors identified 15,215 and 33,203 cancer cases in women and men, respectively. Cox proportional hazards models were used to estimate multivariate relative risks and 95% confidence intervals. For women and men, respectively, the relative risks for total cancer for high versus low glycemic index were 1.03 (Ptrend?=?0.217) and 1.04 (Ptrend?=?0.012) and, for glycemic load, were 0.90 (Ptrend?=?0.024) and 0.93 (Ptrend = 0.01). Associations with total cancer held only among the overweight for glycemic index and among those of healthy weight for glycemic load. These findings suggest that glycemic index and glycemic load are not strong predictors of cancer incidence. The direction and small magnitude of associations might be explained by the manner in which high glycemic index and glycemic load track with overall diet and lifestyle patterns. PMID:19095757

  10. Automatic Detection of Excessive Glycemic Variability for Diabetes Management

    E-print Network

    Bunescu, Razvan C.

    in blood glucose levels, is a significant factor in diabetes management. Excessive glycemic variability management is blood glucose control. By keeping blood glucose profiles as close to normal as possible, blindness, and strokes [2]. Patients are routinely monitored for hyperglycemia, or high blood glucose levels

  11. Glycemic Variability: Assessing Glycemia Differently and the Implications for Dietary Management of Diabetes.

    PubMed

    Tay, Jeannie; Thompson, Campbell H; Brinkworth, Grant D

    2015-07-17

    The primary therapeutic target for diabetes management is the achievement of good glycemic control, of which glycated hemoglobin (HbA1c) remains the standard clinical marker. However, glycemic variability (GV; the amplitude, frequency, and duration of glycemic fluctuations around mean blood glucose) is an emerging target for blood glucose control. A growing body of evidence supports GV as an independent risk factor for diabetes complications. Several techniques have been developed to assess and quantify intraday and interday GV. Additionally, GV can be influenced by several nutritional factors, including carbohydrate quality, quantity; and distribution; protein intake; and fiber intake. These factors have important implications for clinical nutrition practice and for optimizing blood glucose control for diabetes management. This review discusses the available evidence for GV as a marker of glycemic control and risk factor for diabetes complications. GV quantification techniques and the influence of nutritional considerations for diabetes management are also discussed. PMID:25974701

  12. A Randomized Controlled Trial Investigating the Effects of a Low–Glycemic Index Diet on Pregnancy Outcomes in Gestational Diabetes Mellitus

    PubMed Central

    Louie, Jimmy Chun Yu; Markovic, Tania P.; Perera, Nimalie; Foote, Deborah; Petocz, Peter; Ross, Glynis P.; Brand-Miller, Jennie C.

    2011-01-01

    OBJECTIVE The prevalence of gestational diabetes mellitus (GDM) is rising. There is little evidence to demonstrate the effectiveness of one dietary therapy over another. We aimed to investigate the effect of a low–glycemic index (LGI) versus a conventional high-fiber diet on pregnancy outcomes, neonatal anthropometry, and maternal metabolic profile in GDM. RESEARCH DESIGN AND METHODS Ninety-nine women (age 26–42 years; mean ± SD prepregnancy BMI 24 ± 5 kg/m2) diagnosed with GDM at 20–32 weeks’ gestation were randomized to follow either an LGI (n = 50; target glycemic index [GI] ~50) or a high-fiber moderate-GI diet (HF) (n = 49; target GI ~60). Dietary intake was assessed by 3-day food records. Pregnancy outcomes were collected from medical records. RESULTS The LGI group achieved a modestly lower GI than the HF group (mean ± SEM 47 ± 1 vs. 53 ± 1; P < 0.001). At birth, there was no significant difference in birth weight (LGI 3.3 ± 0.1 kg vs. HF 3.3 ± 0.1 kg; P = 0.619), birth weight centile (LGI 52.5 ± 4.3 vs. HF 52.2 ± 4.0; P = 0.969), prevalence of macrosomia (LGI 2.1% vs. HF 6.7%; P = 0.157), insulin treatment (LGI 53% vs. HF 65%; P = 0.251), or adverse pregnancy outcomes. CONCLUSIONS In intensively monitored women with GDM, an LGI diet and a conventional HF diet produce similar pregnancy outcomes. PMID:21900148

  13. Long–Term Effects of Energy-Restricted Diets Differing in Glycemic Load on Metabolic Adaptation and Body Composition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A randomized controlled trial of high glycemic load (HG) and low glycemic load (LG) diets with food provided for 6 months and self-administered for 6 additional months at 30% caloric restriction (CR) was performed in 29 overweight adults (mean+/-SD, age 35+/-5y; BMI 27.5+/-1.5 kg/m2). Total energy e...

  14. Today`s control systems evolved from early pioneers` dreams

    SciTech Connect

    Smith, D.J.

    1996-04-01

    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.

  15. The glycemic index: methodology and clinical implications\\

    Microsoft Academic Search

    David JA; Alexandra L Jenkins Jenkins; Robert G Josse

    There is controversy regarding the clinical utility ofclassifying foods according to their glycemic responses by using the glycemic index (GI). Part ofthe controversy is due to methodologic variables that can markedly affect the inter- pretation ofglycemic responses and the GI values obtained. Re- cent studies support the clinical utility of the GI. Within limits determined by the expected GI difference

  16. Glycemic index of foods in individual subjects.

    PubMed

    Wolever, T M; Jenkins, D J; Vuksan, V; Josse, R G; Wong, G S; Jenkins, A L

    1990-02-01

    We studied 12 subjects with diabetes to determine how well the glycemic index (GI) predicted the ranking of glycemic responses of different foods in individuals. All subjects ate three mixed meals (bread, rice, or spaghetti with GIs of 100, 79, and 61, respectively) four times in a randomized complete block design. The mean glycemic response areas of the different meals ranked according to the predicted GI in every individual. The observed mean +/- SD GI values of the meals were significantly different from each other (bread 100 +/- 7, rice 75 +/- 9, spaghetti 54 +/- 9), with no significant difference in response between subjects. It is concluded that individuals share common mean GI values for different foods. Within confidence limits determined by the variability of glycemic responses, the number of repeated tests conducted, and the expected GI difference, the GI can be used to predict the ranking of the mean glycemic responses of mixed meals taken by individuals. PMID:2351011

  17. 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

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

    2015-01-01

    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. PMID:25905057

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

    PubMed Central

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

    2015-01-01

    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

  19. Metabolic effects of a low-glycemic-index diet13

    Microsoft Academic Search

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

    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

  20. Application of glycemic index to mixed meals1'2

    Microsoft Academic Search

    Irene Chew; Janette C Brand; Anne W Thorburn

    glycemic indices correlated well with the predicted glycemic indices (r = 0.88, p < 0.01) and insulin responses paralleled the glycemic responses (r = 0.83, p < 0.05). These results suggest that the glycemic index approach will be useful in planning diets for diabetic people. Am J Clin Nutr l988;47:53-6.

  1. 1,5-Anhydroglucitol as a Useful Marker for Assessing Short-Term Glycemic Excursions in Type 1 Diabetes

    PubMed Central

    Seok, Hannah; Huh, Ji Hye; Kim, Hyun Min; Lee, Byung-Wan; Kang, Eun Seok; Lee, Hyun Chul

    2015-01-01

    Background Type 1 diabetes is associated with more severe glycemic variability and more frequent hypoglycemia than type 2 diabetes. Glycemic variability is associated with poor glycemic control and diabetic complications. In this study, we demonstrate the clinical usefulness of serum 1,5-anhydroglucitol (1,5-AG) for assessing changes in glycemic excursion in type 1 diabetes. Methods Seventeen patients with type 1 diabetes were enrolled in this study. A continuous glucose monitoring system (CGMS) was applied twice at a 2-week interval to evaluate changes in glycemic variability. The changes in serum glycemic assays, including 1,5-AG, glycated albumin and hemoglobin A1c (HbA1c), were also evaluated. Results Most subjects showed severe glycemic excursions, including hypoglycemia and hyperglycemia. The change in 1,5-AG level was significantly correlated with changes in the glycemic excursion indices of the standard deviation (SD), mean amplitude of glucose excursion (MAGE), lability index, mean postmeal maximum glucose, and area under the curve for glucose above 180 mg/dL (r=-0.576, -0.613, -0.600, -0.630, and -0.500, respectively; all P<0.05). Changes in glycated albumin were correlated with changes in SD and MAGE (r=0.495 and 0.517, respectively; all P<0.05). However, changes in HbA1c were not correlated with any changes in the CGMS variables. Conclusion 1,5-AG may be a useful marker for the assessment of short-term changes in glycemic variability. Furthermore, 1,5-AG may have clinical implications for the evaluation and treatment of glycemic excursions in type 1 diabetes. PMID:25922811

  2. Attentional control of early perceptual learning.

    PubMed Central

    Ahissar, M; Hochstein, S

    1993-01-01

    The performance of adult humans in simple visual tasks improves dramatically with practice. This improvement is highly specific to basic attributes of the trained stimulus, suggesting that the underlying changes occur at low-level processing stages in the brain, where different orientations and spatial frequencies are handled by separate channels. We asked whether these practice effects are determined solely by activity in stimulus-driven mechanisms or whether high-level attentional mechanisms, which are linked to the perceptual task, might control the learning process. We found that practicing one task did not improve performance in an alternative task, even though both tasks used exactly the same visual stimuli but depended on different stimulus attributes (either orientation of local elements or global shape). Moreover, even when the experiment was designed so that the same responses were associated with the same stimuli (although subjects were instructed to attend to the attribute underlying one task), learning did not transfer from one task to the other. These results suggest that specific high-level attentional mechanisms, controlling changes at early visual processing levels, are essential in perceptual learning. Images Fig. 3 PMID:8516322

  3. Effects of Glycemic Regulation on Chronic Postischemia Pain

    PubMed Central

    Ross-Huot, Marie-Christine; Laferrière, André; Gi, Cho Min; Khorashadi, Mina; Schricker, Thomas; Coderre, Terence J.

    2015-01-01

    Background Ischemia-reperfusion (I/R) injuries consist of enhanced oxidative and inflammatory responses along with microvascular dysfunction following prolonged ischemia and reperfusion. Since I/R injuries induce chronic postischemia pain (CPIP) in laboratory animals, it is possible that surgical procedures utilizing prolonged ischemia may result in chronic postoperative pain. Glycemic modulation during ischemia and reperfusion could impact pain following I/R injury, as glucose triggers oxidative, inflammatory and thrombotic reactions, whereas insulin has anti-oxidative, anti-inflammatory and vasodilatory properties. Methods 110 rats underwent a 3-h period of ischemia followed by reperfusion to produce CPIP. CPIP rats had previously been divided into 6 groups with differing glycemic-modulation paradigms: 1) normal feeding; 2) fasting; 3) fasting with normal saline administration; 4) fasting with dextrose administration; 5) normal feeding with insulin administration; and 6) normal feeding with dextrose and insulin administration. Blood glucose levels were assessed during ischemia and reperfusion in these separate groups of rats, and they were tested for mechanical and cold allodynia over the following 21 days (on days 2, 5, 7, 9, 12 and 21 post-I/R injury). Results I/R injury in rats with normoglycemia or relative hyperglycemia (groups 1, 4) led to significant mechanical and cold allodynia; conversely, relative hypoglycemia associated with insulin treatment or fasting (groups 2, 3, and 5) reduced allodynia induced by I/R injury. Importantly, insulin treatment did not reduce allodynia when administered to fed rats given dextrose (group 6). Conclusion Our results suggest that glycemic levels at the time of I/R injury significantly modulate postinjury pain thresholds in CPIP rats. Strict glycemic control during I/R injury significantly reduces CPIP pain and, and conversely, hyperglycemia significantly enhances it, which could have potential clinical applications especially in the surgical field. PMID:21795964

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

    PubMed Central

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

    2012-01-01

    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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  6. Early diabetic neuropathy: Triggers and mechanisms

    PubMed Central

    Dobretsov, Maxim; Romanovsky, Dmitry; Stimers, Joseph R

    2007-01-01

    Peripheral neuropathy, and specifically distal peripheral neuropathy (DPN), is one of the most frequent and troublesome complications of diabetes mellitus. It is the major reason for morbidity and mortality among diabetic patients. It is also frequently associated with debilitating pain. Unfortunately, our knowledge of the natural history and pathogenesis of this disease remains limited. For a long time hyperglycemia was viewed as a major, if not the sole factor, responsible for all symptomatic presentations of DPN. Multiple clinical observations and animal studies supported this view. The control of blood glucose as an obligatory step of therapy to delay or reverse DPN is no longer an arguable issue. However, while supporting evidence for the glycemic hypothesis has accumulated, multiple controversies accumulated as well. It is obvious now that DPN cannot be fully understood without considering factors besides hyperglycemia. Some symptoms of DPN may develop with little, if any, correlation with the glycemic status of a patient. It is also clear that identification of these putative non-glycemic mechanisms of DPN is of utmost importance for our understanding of failures with existing treatments and for the development of new approaches for diagnosis and therapy of DPN. In this work we will review the strengths and weaknesses of the glycemic hypothesis, focusing on clinical and animal data and on the pathogenesis of early stages and triggers of DPN other than hyperglycemia. PMID:17226897

  7. Quality Control and Early Diagnostics for cDNA Microarrays

    E-print Network

    Sawitzki, Günther

    Quality Control and Early Diagnostics for cDNA Microarrays by Günther Sawitzki1 We present a case in the finer issues, but these details can only be mentioned in passing. Quality Control for Microarrays it quality control. We use R for quality control of microarrays. We simplify and specialize the problem

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

    Microsoft Academic Search

    D. Zwick; N. A. Frimpong; O. L. Tulp

    1991-01-01

    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

  9. Beta Cell Protective Effects of Sodium Tungstate in Streptozotocin-Induced Diabetic Rats: Glycemic Control, Blockage of Oxidative Stress and Beta Cell Histochemistry

    Microsoft Academic Search

    Zahra Heidari; Mehdi Harati; Hamid Reza Mahmoudzadeh-Sagheb; Bita Moudi

    2008-01-01

    Background: Diabetes is a major public health problem. The development of new therapies that are able to improve glycemia management and even to cure diabetes is of great interest. In this study, protective effects of sodium tungstate against STZ-induced beta-cell damages were investigated. Methods: Sixty rats were divided into six groups: control, diabetic, sodium tungstate treated diabetic rats from one

  10. Reduction in Self-Monitoring of Blood Glucose in Persons with Type 2 Diabetes Results in Cost Savings and No Change in Glycemic Control

    Microsoft Academic Search

    Joy L. Meier; Arthur L. M. Swislocki; Julio R. Lopez; Robert H. Noth; Patricia Bartlebaugh; David Siegel

    2002-01-01

    Objective: Recent Veterans Affairs (VA) guidelines recom- mend that persons with stable type 2 diabetes controlled on oral agents or diet therapy perform self-monitoring of blood glucose (SMBG) twice weekly. We assessed the impact of a modification of these guidelines on hemoglobin A1c (HbA1c) and monitoring cost. Study Design: Retrospective, noncrossover clinical trial. Patients and Methods: We instructed persons with

  11. Genetic Variant in HK1 Is Associated With a Proanemic State and A1C but Not Other Glycemic Control–Related Traits

    PubMed Central

    Bonnefond, Amélie; Vaxillaire, Martine; Labrune, Yann; Lecoeur, Cécile; Chèvre, Jean-Claude; Bouatia-Naji, Nabila; Cauchi, Stéphane; Balkau, Beverley; Marre, Michel; Tichet, Jean; Riveline, Jean-Pierre; Hadjadj, Samy; Gallois, Yves; Czernichow, Sébastien; Hercberg, Serge; Kaakinen, Marika; Wiesner, Susanne; Charpentier, Guillaume; Lévy-Marchal, Claire; Elliott, Paul; Jarvelin, Marjo-Riitta; Horber, Fritz; Dina, Christian; Pedersen, Oluf; Sladek, Robert; Meyre, David; Froguel, Philippe

    2009-01-01

    OBJECTIVE A1C is widely considered the gold standard for monitoring effective blood glucose levels. Recently, a genome-wide association study reported an association between A1C and rs7072268 within HK1 (encoding hexokinase 1), which catalyzes the first step of glycolysis. HK1 deficiency in erythrocytes (red blood cells [RBCs]) causes severe nonspherocytic hemolytic anemia in both humans and mice. RESEARCH DESIGN AND METHODS The contribution of rs7072268 to A1C and the RBC-related traits was assessed in 6,953 nondiabetic European participants. We additionally analyzed the association with hematologic traits in 5,229 nondiabetic European individuals (in whom A1C was not measured) and 1,924 diabetic patients. Glucose control–related markers other than A1C were analyzed in 18,694 nondiabetic European individuals. A type 2 diabetes case-control study included 7,447 French diabetic patients. RESULTS Our study confirms a strong association between the rs7072268–T allele and increased A1C (? = 0.029%; P = 2.22 × 10?7). Surprisingly, despite adequate study power, rs7072268 showed no association with any other markers of glucose control (fasting- and 2-h post-OGTT–related parameters, n = 18,694). In contrast, rs7072268–T allele decreases hemoglobin levels (n = 13,416; ? = ?0.054 g/dl; P = 3.74 × 10?6) and hematocrit (n = 11,492; ? = ?0.13%; P = 2.26 × 10?4), suggesting a proanemic effect. The T allele also increases risk for anemia (836 cases; odds ratio 1.13; P = 0.018). CONCLUSIONS HK1 variation, although strongly associated with A1C, does not seem to be involved in blood glucose control. Since HK1 rs7072268 is associated with reduced hemoglobin levels and favors anemia, we propose that HK1 may influence A1C levels through its anemic effect or its effect on glucose metabolism in RBCs. These findings may have implications for type 2 diabetes diagnosis and clinical management because anemia is a frequent complication of the diabetes state. PMID:19651813

  12. Mindfulness and Inhibitory Control in Early Adolescence

    ERIC Educational Resources Information Center

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

    2012-01-01

    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…

  13. High Glycemic Index Foods, Overeating, and Obesity

    Microsoft Academic Search

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

    1999-01-01

    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

  14. Emerging Control and Disruptive Behavior Disorders During Early Childhood

    PubMed Central

    Martel, Michelle M.; Roberts, Bethan; Gremillion, Monica L.

    2015-01-01

    The current study evaluates associations between control processes and Oppositional Defiant Disorder (ODD) and attention deficit hyperactivity disorder (ADHD) during early childhood. Participants were 98 children between ages 3 and 6 and their primary caregivers. Diagnostic information on ODD and ADHD symptoms was available from parents and teachers/caregivers via standardized rating forms. Affective, effortful, and cognitive control processes were measured using parent and examiner ratings via standardized questionnaires, observational ratings, and child performance on laboratory tasks of cognitive control. Affective control, but not effortful control, was significantly associated with cognitive control. A latent factor of control was significantly associated with ADHD, but not ODD, symptoms. PMID:23573794

  15. Effect of Habitual Khat Chewing on Glycemic Control, Body Mass Index, and Age at Diagnosis of Diabetes in Patients with Type 2 Diabetes Mellitus in Yemen

    PubMed Central

    Al-Sharafi, Butheinah A; Gunaid, Abdallah A

    2015-01-01

    Khat chewing is common in Yemen. We conducted this study to see if it affected diabetes control in patients with type 2 diabetes mellitus (DM). We studied 1540 patients with type 2 DM attending an endocrinology clinic in Sana’a, Yemen, of which 997 were khat chewers (KC) and 543 were non-khat chewers (NKC). The patients answered a questionnaire regarding khat chewing. Hemoglobin A1c (HbA1c) and body mass index (BMI) were measured. KC had a higher mean HbA1c of 9.8 (95% confidence interval (95% CI) 9.6–10) than the NKC, with a mean of 9.1 (95% CI 8.9–9.4) (adjusted odds ratios (AOR) 1.74, P < 0.001) after multivariate regression analysis. KC also had a lower mean BMI, 26.9 (95% CI 26.6–27.2), than the NKC, mean BMI 27.6 (95% CI 27.1–28) (P < 0.01). The mean age at diagnosis of DM among the KC group was 43.3 (10.1) and among the NKC group was 45.9 (11.8) (AOR 1.4 P < 0.008) after multivariate regression analysis. KC patients had a higher mean HbA1c, a lower BMI, and a younger age at diagnosis of type 2 DM when compared with NKC.

  16. Acarbose improves glycemic control as add-on or monotherapy in Indian type-2 diabetes: Findings from the GlucoVIP multinational observational study

    PubMed Central

    Philip, Elizabeth; Sundaram, Meenakshi L.; Das, Rupam; Chauhan, Sushil Kumar; Deshpande, Sandeep; Ambhore, Sanjay; Rathod, Rahul; Manjrekar, Pravin

    2013-01-01

    Objective: To investigate the efficacy and tolerability of the anti-diabetic agent acarbose (Glucobay®) as add-on or monotherapy in a range of patients with type-2 diabetes mellitus (T2DM), including those with cardiovascular morbidities in India. Materials and Methods: This was a part of a prospective, non-interventional, non-controlled, multicentre, multinational, observational study. The study included patients of either gender if they were aged at least 18 years and had untreated or pre-treated type-2 diabetes mellitus (T2DM) or impaired glucose tolerance and no acarbose treatment within the 3 months before study inclusion. Results: In total, 1996 Indian patients were included in the effectiveness and 2010 in the safety analysis. Patients received acarbose (25-150 mg/day). The mean age of the patients was 50.1 years and the mean BMI was 27.2 kg/m2. Mean 2-h post-prandial plasma glucose (PPG) value and fasting blood glucose (FBG) decreased from 243.9 to 169.5 mg/dl and 158.3 to 120.4 mg/dl, respectively after the last follow-up of 12.4 weeks. The mean HbA1c value at initial visit was 8.4% and was 7.4% at the last follow-up visit. FBG, PPG and HbA1c deceased in 90.6%, 94.4% and 52.4% patients respectively, by the last follow-up visit. The mean decrease in weight and waist circumference was 1.4 kg and 1.6 cm, respectively by the last follow-up visit. Physicians assessed the efficacy of drug as positive response in “very good to good” in 91.08%, “sufficient” in 7.92% and “insufficient” in 0.90% of patients. Also, continuation of Acarbose was reported in 97.09% of patients. Adverse events were reported in 2.74% and drug-related adverse events were reported in 2.19% of patients. Majority of them were gastrointestinal adverse events but were not serious. Conclusion: Acarbose is effective and safe in Indian patients with T2DM. Further, it helps in weight reduction and has very good compliance in patients with T2DM. PMID:24910836

  17. Glycemic Index and Serum High-Density Lipoprotein Cholesterol Concentration Among US Adults

    Microsoft Academic Search

    Earl S. Ford; Simin Liu

    2001-01-01

    Background: Dietary glycemic index, an indicator of the ability of the carbohydrate to raise blood glucose lev- els, and glycemic load, the product of glycemic index and carbohydrate intake, have been positively related to risk of coronary heart disease. However, the relationships be- tween glycemic index and glycemic load and high- density lipoprotein cholesterol (HDL-C) concentration in the US population

  18. 77 FR 66469 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-05

    ...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...

  19. Determinants of diet glycemic index calculated retrospectively from diet records of 342 individuals with non-insulin-dependent diabetes mellitus?3

    Microsoft Academic Search

    Phu-My Nguyen; Jean-Louis Chiasson; John A Hunt; Robert G Josse; Carol Palmason; N Wilson Rodger; Stuart A Ross; Edmond A Ryan; Meng H Tan

    Controlled trials have shown that a diet with a low glycemic index improves blood glucose and lipid control in patients with diabetes. To study the distribution and determinants of diet glycemic index, we obtained two 3-d diet records from 342 free-living subjects with non-insulin-dependent diabetes. Mean ± SD 24-h intakes were as follows: energy, 7170 ± 1890 kJ; fat, 33.6

  20. Effect of the Glycemic Index of Carbohydrates on Acne vulgaris

    PubMed Central

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

    2010-01-01

    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

  1. Effect of the glycemic index of carbohydrates on Acne vulgaris.

    PubMed

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

    2010-10-01

    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/m(2)) 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

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

    PubMed

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

    2003-01-01

    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

  3. Spatially and temporally controlled electroporation of early chick embryos

    E-print Network

    Stern, Claudio

    Spatially and temporally controlled electroporation of early chick embryos Octavian Voiculescu helped the chick embryo to become a powerful system to study gene regulation and function during development. Although this is a simple procedure for embryos of 2-d incubation, earlier stages (from laying

  4. Abstract # 6851 Assessing the Role of Potatoes and Glycemic Index in Body Weight

    E-print Network

    Heller, Barbara

    -energy diet plus regular potato consumption on anthropometric measurements, independent of glycemic index, independent of glycemic index. Results: Anthropometric Measurements OGTT, DEXA, Anthropometric and metabolic

  5. Glycemic index and glycemic load: measurement issues and their effect on diet–disease relationships

    Microsoft Academic Search

    B J Venn; T J Green

    2007-01-01

    Glycemic index (GI) describes the blood glucose response after consumption of a carbohydrate containing test food relative to a carbohydrate containing reference food, typically glucose or white bread. GI was originally designed for people with diabetes as a guide to food selection, advice being given to select foods with a low GI. The amount of food consumed is a major

  6. Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity

    PubMed Central

    Sacks, Frank M.; Carey, Vincent J.; Anderson, Cheryl A. M.; Miller, Edgar R.; Copeland, Trisha; Charleston, Jeanne; Harshfield, Benjamin J.; Laranjo, Nancy; McCarron, Phyllis; Swain, Janis; White, Karen; Yee, Karen; Appel, Lawrence J.

    2015-01-01

    IMPORTANCE Foods that have similar carbohydrate content can differ in the amount they raise blood glucose. The effects of this property, called the glycemic index, on risk factors for cardiovascular disease and diabetes are not well understood. OBJECTIVE To determine the effect of glycemic index and amount of total dietary carbohydrate on risk factors for cardiovascular disease and diabetes. DESIGN, SETTING, AND PARTICIPANTS Randomized crossover-controlled feeding trial conducted in research units in academic medical centers, in which 163 overweight adults (systolic blood pressure, 120–159 mm Hg) were given 4 complete diets that contained all of their meals, snacks, and calorie-containing beverages, each for 5 weeks, and completed at least 2 study diets. The first participant was enrolled April 1, 2008; the last participant finished December 22, 2010. For any pair of the 4 diets, there were 135 to 150 participants contributing at least 1 primary outcome measure. INTERVENTIONS (1) A high–glycemic index (65% on the glucose scale), high-carbohydrate diet (58% energy); (2) a low–glycemic index (40%), high-carbohydrate diet; (3) a high–glycemic index, low-carbohydrate diet (40% energy); and (4) a low–glycemic index, low-carbohydrate diet. Each diet was based on a healthful DASH-type diet. MAIN OUTCOMES AND MEASURES The 5 primary outcomes were insulin sensitivity, determined from the areas under the curves of glucose and insulin levels during an oral glucose tolerance test; levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides; and systolic blood pressure. RESULTS At high dietary carbohydrate content, the low– compared with high–glycemic index level decreased insulin sensitivity from 8.9 to 7.1 units (?20%, P = .002); increased LDL cholesterol from 139 to 147 mg/dL (6%, P ? .001); and did not affect levels of HDL cholesterol, triglycerides, or blood pressure. At low carbohydrate content, the low– compared with high–glycemic index level did not affect the outcomes except for decreasing triglycerides from 91 to 86 mg/dL (?5%, P = .02). In the primary diet contrast, the low–glycemic index, low-carbohydrate diet, compared with the high–glycemic index, high-carbohydrate diet, did not affect insulin sensitivity, systolic blood pressure, LDL cholesterol, or HDL cholesterol but did lower triglycerides from 111 to 86 mg/dL (?23%, P ? .001). CONCLUSIONS AND RELEVANCE In this 5-week controlled feeding study, diets with low glycemic index of dietary carbohydrate, compared with high glycemic index of dietary carbohydrate, did not result in improvements in insulin sensitivity, lipid levels, or systolic blood pressure. In the context of an overall DASH-type diet, using glycemic index to select specific foods may not improve cardiovascular risk factors or insulin resistance. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00608049 PMID:25514303

  7. Charting early trajectories of executive control with the shape school.

    PubMed

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

    2013-08-01

    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

  8. Second-meal effect: low-glycemic-index foods eaten at dinner improve subsequent breakfast glycemic response13

    Microsoft Academic Search

    Anthony M Ocana; Venketeshwer A Rao; Gregory R Collier

    The effects of the glycemic index (GI) of carbohydrate eaten the previous night on the glycemic response to a standard test meal eaten subsequently in the morning (breakfast) was studied. On separate evenings normal subjects ate low- or high-GI test meals of the same nutrient composition. The dinners consisted of single foods in two experiments and mixed meals containing several

  9. Glycemic index, glycemic load, and chronic disease risk—a meta- analysis of observational studies1,2

    Microsoft Academic Search

    Alan W Barclay; Peter Petocz; Tania Prvan; Paul Mitchell; Jennie C Brand-Miller

    Background: Inconsistent findings from observational studies have prolonged the controversy over the effects of dietary glycemic index (GI) and glycemic load (GL) on the risk of certain chronic diseases. Objective: The objective was to evaluate the association between GI, GL, and chronic disease risk with the use of meta-analysis tech- niques. Design: A systematic review of published reports identified a

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

    PubMed

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

    2015-01-01

    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

  11. Archean komatiite volcanism controlled by the evolution of early continents

    PubMed Central

    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

    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

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

    PubMed

    Masala, Giovanna; Assedi, Melania; Bendinelli, Benedetta; Ermini, Ilaria; Occhini, Daniela; Sieri, Sabina; Brighenti, Furio; Del Turco, Marco Rosselli; Ambrogetti, Daniela; Palli, Domenico

    2013-01-01

    A few studies have evaluated the association between diet and mammographic breast density (MBD) and results are inconsistent. MBD, a well-recognized risk factor for breast cancer, has been proposed as a marker of cumulative exposure to hormones and growth factors. Diets with a high glycemic index (GI) or glycemic load (GL) may increase breast cancer risk, via an effect on the insulin-like growth factor axis. We have investigated the association between carbohydrate intake, GI, GL and MBD in a prospective study. We identified a large series of women, in the frame of the EPIC-Florence cohort, with a mammogram taken five years after enrolment, when detailed information on dietary and lifestyle habits and anthropometric measurements had been collected. Mammograms have been retrieved (1,668, 83%) and MBD assessed according to Wolfe's classification. We compared women with high MBD (P2+DY Wolfe's categories) with those with low MBD (N1+P1) through logistic models adjusted for age, education, body mass index, menopause, number of children, breast feeding, physical activity, non-alcohol energy, fibers, saturated fat and alcohol. A direct association between GL and high MBD emerged in the highest quintile of intake in comparison with the lowest quintile (OR = 1.73, 95%CI 1.13-2.67, p for trend = 0.048) while no association with glycemic index was evident. These results were confirmed after exclusion of women reporting to be on a diet or affected with diabetes, and when Hormone Replacement Therapy at the date of mammographic examination used to assess MBD was considered. The effect was particularly evident among leaner women, although no interaction was found. A positive association was suggested for increasing simple sugar and total carbohydrates intakes limited to the highest quintiles. In this Italian population we observed an association between glycemic load, total and rapidly absorbed carbohydrates and high MBD. These novel results warrant further investigations. PMID:23951047

  13. 24-Hour Glucose Profiles on Diets Varying in Protein Content and Glycemic Index

    PubMed Central

    van Baak, Marleen A.

    2014-01-01

    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

  14. Predicting the Glycemic Response to Gastric Bypass Surgery in Patients With Type 2 Diabetes

    PubMed Central

    Dixon, John B.; Chuang, Lee-Ming; Chong, Keong; Chen, Shu-Chun; Lambert, Gavin W.; Straznicky, Nora E.; Lambert, Elisabeth A.; Lee, Wei-Jei

    2013-01-01

    OBJECTIVE To find clinically meaningful preoperative predictors of diabetes remission and conversely inadequate glycemic control after gastric bypass surgery. Predicting the improvement in glycemic control in those with type 2 diabetes after bariatric surgery may help in patient selection. RESEARCH DESIGN AND METHODS Preoperative details of 154 ethnic Chinese subjects with type 2 diabetes were examined for their influence on glycemic outcomes at 1 year after gastric bypass. Remission was defined as HbA1c ?6%. Analysis involved binary logistic regression to identify predictors and provide regression equations and receiver operating characteristic curves to determine clinically useful cutoff values. RESULTS Remission was achieved in 107 subjects (69.5%) at 12 months. Diabetes duration <4 years, body mass >35 kg/m2, and fasting C-peptide concentration >2.9 ng/mL provided three independent preoperative predictors and three clinically useful cutoffs. The regression equation classification plot derived from continuous data correctly assigned 84% of participants. A combination of two or three of these predictors allows a sensitivity of 82% and specificity of 87% for remission. Duration of diabetes (with different cutoff points) and C-peptide also predicted those cases in which HbA1c ?7% was not attained. Percentage weight loss after surgery was also predictive of remission and of less satisfactory outcomes. CONCLUSIONS The glycemic response to gastric bypass is related to BMI, duration of diabetes, fasting C-peptide (influenced by insulin resistance and residual ?-cell function), and weight loss. These data support and refine previous findings in non-Asian populations. Specific ethnic and procedural regression equations and cutoff points may vary. PMID:23033249

  15. Genetic and epigenetic control of early mouse development.

    PubMed

    Albert, Mareike; Peters, Antoine H F M

    2009-04-01

    A decade after cloning the sheep Dolly, the induction of pluripotency by transcription factors has further revolutionized the possibilities of reprogramming a cell's identity, with exciting prospects for personalized medicine. Establishing totipotency during natural reproduction remains, however, exceedingly more efficient than in reproductive cloning or in transcription factor-based reprogramming. Understanding the molecular mechanisms directing acquisition of totipotency during early embryogenesis may enable optimization of protocols for induced reprogramming. Recent studies in mouse embryonic stem cells (ESCs) show that self-renewal and pluripotency are efficiently maintained by a core set of transcription factors when intrinsic differentiation inducing signals are blocked. In early embryos, the specification of the pluripotent epiblast and two differentiating lineages (trophectoderm and primitive endoderm) is controlled by transcription factors that are regulated by autoactivating and reciprocal repressive mechanisms as well as by ERK-mediated signaling. Chromatin-based regulatory mechanisms also contribute to the identity of ESCs and early embryos. During gametogenesis, genomes undergo extensive epigenetic reprogramming. This may underlie the efficient acquisition of totipotency during subsequent preimplantation development. PMID:19359161

  16. Results of the glucose-lowering effect of WelChol study (GLOWS): A randomized, double-blind, placebo-controlled pilot study evaluating the effect of colesevelam hydrochloride on glycemic control in subjects with type 2 diabetes

    Microsoft Academic Search

    Franklin J. Zieve; Marcia F. Kalin; Sherwyn L. Schwartz; Michael R. Jones; William L. Bailey

    2007-01-01

    Objective:This study evaluated the glycosylated hemoglobin (HbA1c-lowering effect of colesevelam hydrochloride, a bile acid sequestrant, in subjects with type 2 diabetes that was inadequately controlled by existing antihyperglycemic therapy.

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

    Microsoft Academic Search

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

    2005-01-01

    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,

  18. 75 FR 7282 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-18

    ...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...

  19. 76 FR 30723 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-26

    ...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...

  20. Adherence to glycemic monitoring in diabetes.

    PubMed

    Patton, Susana R

    2015-05-01

    Glucose monitoring either by self-monitoring of blood glucose (SMBG) or continuous glucose monitoring (CGM) plays an important role in diabetes management and in reducing risk for diabetes-related complications. However, despite evidence supporting the role of glucose monitoring in better patient health outcomes, studies also reveal relatively poor adherence rates to SMBG and CGM use and numerous patient-reported barriers. Fortunately, some promising intervention strategies have been identified that promote at least short-term improvements in patients' adherence to SMBG. These include education, problem solving, contingency management, goal setting, cognitive behavioral therapy, and motivational interviewing. Specific to CGM, interventions to promote greater use among patients are currently under way, yet one pilot study provides data suggesting better maintenance of CGM use in patients showing greater readiness for behavior change. The purpose of this review is to summarize the literature specific to glucose monitoring in patients with diabetes focusing specifically on current adherence rates, barriers to monitoring, and promising intervention strategies that may be ready to deploy now in the clinic setting to promote greater patient adherence to glucose monitoring. Yet, to continue to help patients with diabetes adhere to glucose monitoring, future research is needed to identify the treatment strategies and the intervention schedules that most likely lead to long-term maintenance of optimal glycemic monitoring levels. PMID:25591853

  1. Diabetic Autonomic Imbalance and Glycemic Variability

    PubMed Central

    Fleischer, Jesper

    2012-01-01

    Diabetic autonomic neural imbalance is a severe complication of long-term diabetes patients and may progress to diabetic autonomic neuropathy (DAN). The prevalence of DAN is reported to be between 20 and 70%, depending on the studies. The pathogenesis of DAN remains unresolved. However, emerging evidence suggests that glycemic variability (GV) may be associated with autonomic imbalance in patients with both type 1 and type 2 diabetes. As symptoms are initially weak and uncharacteristic, the condition often remains undiagnosed until late manifestations present themselves. Predominant symptoms may include nausea, vomiting, gastroparesis, involuntary diarrhea, postural hypotension, voiding difficulties, and sexual dysfunction. Analyzing the patterns of heart rate variability carries the potential for detection of autonomic imbalance in the subclinical and asymptomatic stages. In this context, GV may affect the sympathovagal balance by increasing oxidative stress and proinflammatory cytokines. Establishing a GV risk profile could therefore be important in determining risk factors in diabetes patients. This review addresses the issues above and in particular the possible association between diabetic autonomic imbalance and GV. PMID:23063048

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

    PubMed

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

    2004-03-01

    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

  3. NPY signalling in early osteoblasts controls glucose homeostasis

    PubMed Central

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

    2015-01-01

    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

  4. Gelsolin activity controls efficient early HIV-1 infection

    PubMed Central

    2013-01-01

    Background HIV-1 entry into target lymphocytes requires the activity of actin adaptors that stabilize and reorganize cortical F-actin, like moesin and filamin-A. These alterations are necessary for the redistribution of CD4-CXCR4/CCR5 to one pole of the cell, a process that increases the probability of HIV-1 Envelope (Env)-CD4/co-receptor interactions and that generates the tension at the plasma membrane necessary to potentiate fusion pore formation, thereby favouring early HIV-1 infection. However, it remains unclear whether the dynamic processing of F-actin and the amount of cortical actin available during the initial virus-cell contact are required to such events. Results Here we show that gelsolin restructures cortical F-actin during HIV-1 Env-gp120-mediated signalling, without affecting cell-surface expression of receptors or viral co-receptor signalling. Remarkably, efficient HIV-1 Env-mediated membrane fusion and infection of permissive lymphocytes were impaired when gelsolin was either overexpressed or silenced, which led to a loss or gain of cortical actin, respectively. Indeed, HIV-1 Env-gp120-induced F-actin reorganization and viral receptor capping were impaired under these experimental conditions. Moreover, gelsolin knockdown promoted HIV-1 Env-gp120-mediated aberrant pseudopodia formation. These perturbed-actin events are responsible for the inhibition of early HIV-1 infection. Conclusions For the first time we provide evidence that through its severing of cortical actin, and by controlling the amount of actin available for reorganization during HIV-1 Env-mediated viral fusion, entry and infection, gelsolin can constitute a barrier that restricts HIV-1 infection of CD4+ lymphocytes in a pre-fusion step. These findings provide important insights into the complex molecular and actin-associated dynamics events that underlie early viral infection. Thus, we propose that gelsolin is a new factor that can limit HIV-1 infection acting at a pre-fusion step, and accordingly, cell-signals that regulate gelsolin expression and/or its actin-severing activity may be crucial to combat HIV-1 infection. PMID:23575248

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

    PubMed Central

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

    2014-01-01

    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

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

    E-print Network

    In an early branching metazoan, bacterial colonization of the embryo is controlled by maternal) Early embryos of many organisms develop outside the mother and are immediately confronted with myriads and in early embryos. If overexpressed in hydra ectodermal epithelial cells, periculin1a drastically reduces

  7. Inconsistency between glycemic and insulinemic responses to regular and fermented milk products 1-3

    Microsoft Academic Search

    Elin M Östman

    Background: Foods with a low glycemic index are increasingly being acknowledged as beneficial in relation to the insulin resis- tance syndrome. Certain organic acids can lower the glycemic index of bread products. However, the possible effect of acids in fermented milk products on the glycemic index and on insuline- mic characteristics has not been addressed. The metabolic effects of fermented

  8. 75 FR 57472 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC): Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ...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...

  9. 77 FR 60703 - Breast and Cervical Cancer Early Detection and Control Advisory Committee: Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-04

    ...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...

  10. Weighing the evidence of low glycemic index dietary intervention for the management of gestational diabetes mellitus: an Asian perspective.

    PubMed

    Mohd Yusof, Barakatun-Nisak; Firouzi, Somayyeh; Mohd Shariff, Zalilah; Mustafa, Norlaila; Mohamed Ismail, Nor Azlin; Kamaruddin, Nor Azmi

    2014-03-01

    This review aims to evaluate the effectiveness of low glycemic index (GI) dietary intervention for the treatment of gestational diabetes mellitus (GDM), specifically from the Asian perspective. A systematic review of the literature using multiple databases without time restriction was conducted. Three studies were retrieved based upon a priori inclusion criteria. While there was a trend towards improvement, no significant differences were observed in overall glycemic control and pregnancy outcomes in GDM women. However, a tendency for lower birth weight and birth centile if the intervention began earlier was noted. Low GI diets were well accepted and had identical macro-micronutrient compositions as the control diets. However, due to genetic, environment and especially food pattern discrepancies between Western countries and Asians, these results may not be contributed to Asian context. Clearly, there are limited studies focusing on the effect of low GI dietary intervention in women with GDM, particularly in Asia. PMID:24517860

  11. Carbohydrate Intake, Glycemic Index, Glycemic Load, and Stroke: A Meta-analysis of Prospective Cohort Studies.

    PubMed

    Cai, Xianlei; Wang, Chen; Wang, Shan; Cao, Gaoyang; Jin, Chao; Yu, Jiawei; Li, Xiuyang; Yan, Jing; Wang, Fudi; Yu, Wei; Ding, Fang

    2015-07-01

    The objective of this study was to investigate associations between carbohydrate intake/glycemic index (GI)/glycemic load (GL) and stroke risk. A literature search of MEDLINE, Embase, Web of Science, and CBM databases was performed to retrieve eligible studies published up to March 2014. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were used to evaluate the strength of this association. Publication bias was assessed by the Egger's regression asymmetry test and Begg's rank correlation test with Begg's funnel plot. All analyses were conducted using software STATA 12.0 (StataCorp LP, College Station, TX) and SAS version 9.1 (SAS Institute Inc, Cary, NC). We identified 7 prospective studies that met the inclusion criteria and processed data from cohort studies to update available evidence. There were 25 independent estimates and 225?000 participants free of diabetes from 6 different countries; 3046 stroke events were included; and the follow-up range was 5 to 18 years. High GI was not associated with risk of stroke events (pooled RR = 1.10; 95% CI: 0.99-1.21); GL was a risk factor for stroke (pooled RR = 1.19; 95% CI: 1.05-1.36). There was no significant association between high carbohydrate intake and stroke risk (RR = 1.12; 95% CI: 0.93-1.35). A daily high GL diet is the risk factor of stroke event, and further researches need to verify the meta-analyses results and study associated mechanisms. PMID:25593213

  12. Antecedents and Behavior-Problem Outcomes of Parental Monitoring and Psychological Control in Early Adolescence.

    ERIC Educational Resources Information Center

    Pettit, Gregory S.; Laird, Robert D.; Dodge, Kenneth A.; Bates, John E.; Criss, Michael M.

    2001-01-01

    Examined early childhood antecedents and behavior-problem correlates of monitoring and psychological control during early adolescence. Found that monitoring was anteceded by proactive parenting style and advantageous family-ecological characteristics. Psychological control was anteceded by harsh parenting and mothers' report of earlier child…

  13. Diets high and low in glycemic index versus high monounsaturated fat diets: effects on glucose and lipid metabolism in NIDDM

    Microsoft Academic Search

    ND Luscombe; M Noakes; PM Clifton

    1999-01-01

    Objective: To examine the relative effects of high and low glycemic index (GI) carbohydrates, and mono-unsaturated fats on blood glucose and lipid metabolism in NIDDM subjects.Subjects: Fourteen male and seven female variably controlled NIDDM subjects recruited by advertisement.Setting: Free living outpatients.Research design: A repeated measures, within-subject design was used such that each subject consumed three diets: (a) a high-GI diet

  14. Dietary glycemic index, glycemic load and ovarian cancer risk: a case-control study in Italy

    Microsoft Academic Search

    L. S. A. Augustin; J. Polesel; C. Bosetti; C. W. C. Kendall; C. La Vecchia; M. Parpinel; E. Conti; M. Montella; S. Franceschi; D. J. A. Jenkins; L. Dal Maso

    2003-01-01

    Results: Ovarian cancer was directly associated with dietary GI (OR for highest versus lowest quartile = 1.7, 95% CI 1.3-2.1) and GL (OR = 1.7, 95% CI 1.3-2.1). The associations were observed in pre- and post- menopausal women, and they remained consistent across strata of major covariates identified. Conclusions: This study supports the hypothesis of a direct association between GI

  15. Glycemic Variability Is Associated with Frequency of Blood Glucose Testing and Bolus: Post Hoc Analysis Results from the ProAct Study

    PubMed Central

    Weissmann, Jörg; Mougiakakou, Stavroula; Daskalaki, Elena; Weis, Norbert; Ziegler, Ralph

    2015-01-01

    Abstract Introduction: The ProAct study has shown that a pump switch to the Accu-Chek® Combo system (Roche Diagnostics Deutschland GmbH, Mannheim, Germany) in type 1 diabetes patients results in stable glycemic control with significant improvements in glycated hemoglobin (HbA1c) in patients with unsatisfactory baseline HbA1c and shorter pump usage time. Patients and Methods: In this post hoc analysis of the ProAct database, we investigated the glycemic control and glycemic variability at baseline by determination of several established parameters and scores (HbA1c, hypoglycemia frequency, J-score, Hypoglycemia and Hyperglycemia Indexes, and Index of Glycemic Control) in participants with different daily bolus and blood glucose measurement frequencies (less than four day, four or five per day, and more than five per day, in both cases). The data were derived from up to 299 patients (172 females, 127 males; age [mean±SD], 39.4±15.2 years; pump treatment duration, 7.0±5.2 years). Results: Participants with frequent glucose readings had better glycemic control than those with few readings (more than five readings per day vs. less than four readings per day: HbA1c, 7.2±1.1% vs. 8.0±0.9%; mean daily blood glucose, 151±22?mg/dL vs. 176±30?mg/dL; percentage of readings per month >300?mg/dL, 10±4% vs. 14±5%; percentage of readings in target range [80–180?mg/dL], 59% vs. 48% [P<0.05 in all cases]) and had a lower glycemic variability (J-score, 49±13 vs. 71±25 [P<0.05]; Hyperglycemia Index, 0.9±0.5 vs. 1.9±1.2 [P<0.05]; Index of Glycemic Control, 1.9±0.8 vs. 3.1±1.6 [P<0.05]; Hypoglycemia Index, 0.9±0.8 vs. 1.2±1.3 [not significant]). Frequent self-monitoring of blood glucose was associated with a higher number of bolus applications (6.1±2.2 boluses/day vs. 4.5±2.0 boluses/day [P<0.05]). Therefore, a similar but less pronounced effect on glycemic variability in favor of more daily bolus applications was observed (more than five vs. less than four bolues per day: J-score, 57±17 vs. 63±25 [not significant]; Hypoglycemia Index, 1.0±1.0 vs. 1.5±1.4 [P<0.05]; Hyperglycemia Index, 1.3±0.6 vs. 1.6±1.1 [not significant]; Index of Glycemic Control, 2.3±1.1 vs. 3.1±1.7 [P<0.05]). Conclusions: Pump users who perform frequent daily glucose readings have a better glycemic control with lower glycemic variability. PMID:25734860

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

    PubMed Central

    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

    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

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

    PubMed

    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

    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

  18. 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...

  19. 482 Research Paper CDC-42 controls early cell polarity and spindle orientation

    E-print Network

    Ahringe, Julie

    482 Research Paper CDC-42 controls early cell polarity and spindle orientation in C. elegans Monica of this early E-mail: jaa@mole.bio.cam.ac.uk asymmetry. The small G protein Cdc42 is a key regulator of polarity homolog of PAR-6. The function of Cdc42 in C. elegans had not yet been Revised: 2 February 2001 Accepted

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

    PubMed Central

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

    2009-01-01

    Background Phase 2® is a dietary supplement derived from the common white kidney bean (Phaseolus vulgaris). Phase 2 has been shown to inhibit alpha-amylase, the complex carbohydrate digesting enzyme, in vitro. The inhibition of alpha-amylase may result in the lowering of the effective Glycemic Index (GI) of certain foods. The objective of this study was to determine whether the addition of Phase 2 would lower the GI of a commercially available high glycemic food (white bread). Methods An open-label 6-arm crossover study was conducted with 13 randomized subjects. Standardized GI testing was performed on white bread with and without the addition of Phase 2 in capsule and powder form, each in dosages of 1500 mg, 2000 mg, and 3000 mg. Statistical analysis was performed by one-way ANOVA of all seven treatment groups using unadjusted multiple comparisons (t tests) to the white bread control. Results For the capsule formulation, the 1500 mg dose had no effect on the GI and the 2000 mg and 3000 mg capsule doses caused insignificant reductions in GI. For the powder, the 1500 mg and 2000 mg doses caused insignificant reductions in the GI, and the 3000 mg dose had a significant effect (-20.23 or 34.11%, p = 0.023) Conclusion Phase 2 white bean extract appears to be a novel and potentially effective method for reducing the GI of existing foods without modifying their ingredient profile. Trial Registration Trial Registration: ISRCTN50347345 PMID:19860922

  1. The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis

    Microsoft Academic Search

    Tom K J Craig; Philippa Garety; Paddy Power; Nikola Rahaman; Susannah Colbert; Miriam Fornells-Ambrojo; Graham Dunn

    2004-01-01

    Objective To evaluate the effectiveness of a service for early psychosis. Design Randomised controlled clinical trial. Setting Community mental health teams in one London borough. Participants 144 people aged 16-40 years presenting to mental health services for the first or second time with non-organic, non-affective psychosis. Interventions Assertive outreach with evidence based biopsychosocial interventions (specialised care group) and standard care

  2. Manipulation of glycemic response with isomaltulose in a milk-based drink does not affect cognitive performance in healthy adults.

    PubMed

    Dye, Louise; Gilsenan, Mary B; Quadt, Frits; Martens, Vanessa E G; Bot, Arjen; Lasikiewicz, Nicola; Camidge, Diana; Croden, Fiona; Lawton, Clare

    2010-04-01

    Previous research suggests that glucoregulation and nutrient interventions, which alter circulating glucose, impact cognitive function. To examine the effect of modulating glycemic response using isomaltulose on cognitive function 24 healthy male adult participants consumed energy and macronutrient-matched milk-based drinks containing 50 g isomaltulose, 50 g sucrose or a water control in a counterbalanced within-subject design. Interstitial glucose was measured continuously in 12 subjects and all provided 9 capillary measures on each test day. A 30-min cognitive test battery was administered before and twice (+35 and +115 min) after drink ingestion. Immediate, delayed, recognition, verbal and working memory, and psychomotor performance were assessed. Glycemic profiles induced by the drinks differed significantly during the first but not the second post-drink test battery. Neither administration of the sucrose nor isomaltulose drinks produced consistent effects on verbal or working memory, or psychomotor performance. This study used isomaltulose as an investigative tool to lower glycemic response. Importantly, it demonstrates a lack of effect of modulating glucose on cognitive performance based on reliable, continuously measured glycemia. It refutes the hypothesis that glycemia is associated with cognitive performance and questions the suggestion that isomaltulose has an effect on cognitive performance. PMID:20140897

  3. Early Archean stromatolites: Paleoenvironmental setting and controls on formation

    NASA Technical Reports Server (NTRS)

    Lowe, D. R.

    1991-01-01

    The earliest record of terrestrial life is contained in thin, silicified sedimentary layers within enormously thick, predominantly volcanic sequences in South Africa and Western Australia. This record includes bacteria-like microfossils, laminated carbonaceous structures resembling flat bacterial mats and stromatolites, and a morphologically diverse assemblage of carbonaceous particles. These structures and particles and their host sediments provide the only direct source of information on the morphology, paleoecology, and biogeochemistry of early life; the nature of interactions between organisms and surface systems on the early earth; and possible settings within which life might have evolved. The three known occurrences of 3.5 to 3.2 billion-year-old stromalites were evaluated in terms of depositional setting and biogenicity.

  4. Dietary glycemic index and the regulation of body weight

    Microsoft Academic Search

    David S. Ludwig

    2003-01-01

    Prevalence rates of overweight and obesity have risen precipitously in the United States and other developed countries since\\u000a the 1960s, despite comprehensive public health efforts to combat this problem. Although considerable attention has been focused\\u000a on decreasing dietary fat and increasing physical activity level, the potential relevance of the dietary glycemic index to\\u000a obesity treatment has received comparatively little scientific

  5. Dietary glycemic index and liver steatosis1-3

    Microsoft Academic Search

    Silvia Valtuena; Nicoletta Pellegrini; Diego Ardigo; Daniele Del Rio; Filippo Numeroso; Francesca Scazzina; Lucilla Monti; Ivana Zavaroni; Furio Brighenti

    Background: Insulin resistance (IR) and liver steatosis (LS) are interlinked metabolic derangements whose prevalence is rapidly increasing, but the effect of dietary carbohydrate quality on LS is unknown. Objective: The objective was to describe the relation of IR and LS tototalcarbohydrate,totaldietaryfiber,andtheglycemicindex(GI) and glycemic load of the diet. Design: The study was a cross-sectional evaluation of 247 appar- ently healthy subjects

  6. Glycemic index, glycemic load, dietary carbohydrate, and dietary fiber intake and risk of liver and biliary tract cancers in Western Europeans

    PubMed Central

    Fedirko, V.; Lukanova, A.; Bamia, C.; Trichopolou, A.; Trepo, E.; Nöthlings, U.; Schlesinger, S.; Aleksandrova, K.; Boffetta, P.; Tjønneland, A.; Johnsen, N. F.; Overvad, K.; Fagherazzi, G.; Racine, A.; Boutron-Ruault, M. C.; Grote, V.; Kaaks, R.; Boeing, H.; Naska, A.; Adarakis, G.; Valanou, E.; Palli, D.; Sieri, S.; Tumino, R.; Vineis, P.; Panico, S.; Bueno-de-Mesquita, H. B(as).; Siersema, P. D.; Peeters, P. H.; Weiderpass, E.; Skeie, G.; Engeset, D.; Quirós, J. R.; Zamora-Ros, R.; Sánchez, M. J.; Amiano, P.; Huerta, J. M.; Barricarte, A.; Johansen, D.; Lindkvist, B.; Sund, M.; Werner, M.; Crowe, F.; Khaw, K. T.; Ferrari, P.; Romieu, I.; Chuang, S. C.; Riboli, E.; Jenab, M.

    2013-01-01

    Background The type and quantity of dietary carbohydrate as quantified by glycemic index (GI) and glycemic load (GL), and dietary fiber may influence the risk of liver and biliary tract cancers, but convincing evidence is lacking. Patients and methods The association between dietary GI/GL and carbohydrate intake with hepatocellular carcinoma (HCC; N = 191), intrahepatic bile duct (IBD; N = 66), and biliary tract (N = 236) cancer risk was investigated in 477 206 participants of the European Prospective Investigation into Cancer and Nutrition cohort. Dietary intake was assessed by country-specific, validated dietary questionnaires. Hazard ratios and 95% confidence intervals were estimated from proportional hazard models. HBV/HCV status was measured in a nested case–control subset. Results Higher dietary GI, GL, or increased intake of total carbohydrate was not associated with liver or biliary tract cancer risk. For HCC, divergent risk estimates were observed for total sugar = 1.43 (1.17–1.74) per 50 g/day, total starch = 0.70 (0.55–0.90) per 50 g/day, and total dietary fiber = 0.70 (0.52–0.93) per 10 g/day. The findings for dietary fiber were confirmed among HBV/HCV-free participants [0.48 (0.23–1.01)]. Similar associations were observed for IBD [dietary fiber = 0.59 (0.37–0.99) per 10 g/day], but not biliary tract cancer. Conclusions Findings suggest that higher consumption of dietary fiber and lower consumption of total sugars are associated with lower HCC risk. In addition, high dietary fiber intake could be associated with lower IBD cancer risk. PMID:23123507

  7. Early risk stratification in pediatric type 1 diabetes.

    PubMed

    Broe, Rebecca

    2015-03-01

    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

  8. 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

    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

    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

  9. Early Puberty Linked to Higher Type 2 Diabetes Risk

    MedlinePLUS

    ... How Grant Money is Divided Funding the Next Generation of Brilliant Researchers Our Research Foundation Diabetes Pro: ... before the manifestation of disturbed glycemic control.” While girls that develop earlier are more likely to be ...

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

    ERIC Educational Resources Information Center

    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

    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)…

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

    ERIC Educational Resources Information Center

    Oberle, Eva; Schonert-Reichl, Kimberly A.

    2013-01-01

    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…

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

    ERIC Educational Resources Information Center

    Bedel, Emine Ferda

    2012-01-01

    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…

  13. In vitro hydrolytic digestion, glycemic response in dogs, and true metabolizable energy content of soluble corn fibers.

    PubMed

    de Godoy, M R C; Knapp, B K; Parsons, C M; Swanson, K S; Fahey, George C

    2014-06-01

    The objective of this research was to measure in vitro hydrolytic digestion, glycemic and insulinemic responses in dogs, and true ME (TMEn) content of select soluble corn fibers (SCF) in roosters. The first generation (G1) SCF included hydrochloric acid-treated corn syrup (G1-CS-HCl), an SCF with an increased total dietary fiber (TDF) content (G1-SCF-HCl), an SCF that was spray-dried (G1-SCF-SD), and a hydrogenated SCF (G1-SCF-hydrog). The second generation (G2) SCF included those prepared using phosphoric acid catalyzation in both a liquid [G2-SCF-phos (Lq)] and powder [G2-SCF-phos (Pw)] form, and SCF that were prepared using hydrochloric acid catalyzation in both a liquid [G2-SCF-HCl (Lq)] and powder [G2-SCF-HCl (Pw)] form. Also, in the G2 set of samples were SCF prepared using the same method, but in 3 separate batches, all of which contained 70% TDF and 15% sugars. Two were in liquid form [G2-SCF-phos+HCl (Lq1)] and [G2-SCF-phos+HCl (Lq2)], and one in powder form ([G2-SCF-phos+HCl (Pw)]. A lower sugar form (80% TDF and 5% sugar) of SCF was also evaluated (G2-SCF-low sugar). Glucose was the major free sugar and bound monosaccharide in all SCF except for G1-SCF-hydrog that had greater concentrations of sorbitol. All SCF had intermediate to low amounts of monosaccharides released as a result of in vitro hydrolytic digestion, with glucose being the primary sugar component released. The G1-SCF were more digestible in vitro (approximately 50%) compared to G2-SCF (approximately 32%). All SCF had attenuated glycemic responses in adult dogs compared to a maltodextrin control (P < 0.05). The G2-SCF, on average, had lower glycemic responses and TMEn values in roosters than G1-SCF. All SCF had low free sugar concentrations with varying degrees of resistance to digestion, reduced caloric content, and attenuated glycemic and insulinemic responses in adult dogs. These ingredients are potential candidates for inclusion in reduced calorie and low glycemic canine diets. PMID:24867932

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

    ERIC Educational Resources Information Center

    Stephens, Mark W.

    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…

  15. Inhibitory Control during Emotional Distraction across Adolescence and Early Adulthood

    ERIC Educational Resources Information Center

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

    2013-01-01

    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…

  16. Kinetic controls on early karst aquifer porosity development

    Microsoft Academic Search

    C. G. Groves; A. D. Howard

    1992-01-01

    A series of simulations using the newly developed model KARST has been performed to investigate limiting kinetic controls on limestone dissolution during the earliest stages of karst aquifer porosity development. This FORTRAN model couples fluid flow within and dissolution of circular cross section conduits, and considers surface reaction rates (both far from and close to thermodynamic equilibrium), mass transfer rates

  17. Optimal duration of an early intervention programme for first-episode psychosis: randomised controlled trial.

    PubMed

    Chang, Wing Chung; Chan, Gloria Hoi Kei; Jim, Olivia Tsz Ting; Lau, Emily Sin Kei; Hui, Christy Lai Ming; Chan, Sherry Kit Wa; Lee, Edwin Ho Ming; Chen, Eric Yu Hai

    2015-06-01

    Background Numerous early intervention services targeting young people with psychosis have been established, based on the premise that reducing treatment delay and providing intensive treatment in the initial phase of psychosis can improve long-term outcome. Aims To establish the effect of extending a specialised early intervention treatment for first-episode psychosis by 1 year. Method A randomised, single-blind controlled trial (NCT01202357) compared a 1-year extension of specialised early intervention with step-down care in patients who had all received a 2-year intensive early intervention programme for first-episode psychosis. Results Patients receiving an additional year of specialised intervention had better outcomes in functioning, negative and depressive symptoms and treatment default rate than those managed by step-down psychiatric care. Conclusions Extending the period of specialised early intervention is clinically desirable but may not be feasible in lower-income countries. PMID:25657355

  18. Nasal ventilation in COPD exacerbations: early and late results of a prospective, controlled study

    Microsoft Academic Search

    G. Bardi; R. Pierotello; M. Desideri; L. Valdisserri; M. Bottai; A. Palla

    2000-01-01

    ABSTRACT: Noninvasive positive pressure,mechanical,ventilation (NIPPV) in ex- acerbated,chronic obstructive pulmonary,disease (COPD) has been investigated early and,after 1 yr of follow-up. To this end, 30 patients were enrolled in a prospective, controlled trial: 15 had early administration of NIPPV (Group A), 15 had medical therapy only (Group B); assign- ment,was,made,on the basis of equipment,availability only. In-hospital mortality, need for endotracheal intubation

  19. Effect of popping on sorghum starch digestibility and predicted glycemic index.

    PubMed

    Nathakattur Saravanabavan, Sanddhya; Manchanahally Shivanna, Meera; Bhattacharya, Sila

    2013-04-01

    Effect of popping on carbohydrate, protein, phytic acid and minerals of three varieties (pop sorghum, maldandi and red sorghum) of sorghum were studied. Significant changes (p???0.05) in the starch degradability including total and soluble amylose content, and resistant starch occurred due to popping; in-vitro protein digestibility along with the content of albumin proteins increased. Starch characteristics had substantial differences among these three varieties which are based on the nature of endosperm and amylose content. Phytic acid content had a reduction of 20%-25% after popping. Glycemic index (GI) determined from kinetic study of enzymatic hydrolysis of sorghum starch was between 85 and 92; the rate constant for hydrolysis for these three varieties were in the range of 0.025 and 0.029 min(-1). Popping helped to control phytic acid content in sorghum and enhanced protein as well as starch digestibility. PMID:24425932

  20. Reduced antioxidant defense in early onset first-episode psychosis: a case-control study

    PubMed Central

    2011-01-01

    Background Our objective is to determine the activity of the antioxidant defense system at admission in patients with early onset first psychotic episodes compared with a control group. Methods Total antioxidant status (TAS) and lipid peroxidation (LOOH) were determined in plasma. Enzyme activities and total glutathione levels were determined in erythrocytes in 102 children and adolescents with a first psychotic episode and 98 healthy controls. Results A decrease in antioxidant defense was found in patients, measured as decreased TAS and glutathione levels. Lipid damage (LOOH) and glutathione peroxidase activity was higher in patients than controls. Our study shows a decrease in the antioxidant defense system in early onset first episode psychotic patients. Conclusions Glutathione deficit seems to be implicated in psychosis, and may be an important indirect biomarker of oxidative stress in early-onset schizophrenia. Oxidative damage is present in these patients, and may contribute to its pathophysiology. PMID:21320302

  1. Kinetic controls on early karst aquifer porosity development

    SciTech Connect

    Groves, C.G. (Western Kentucky Univ., Bowling Green, KY (United States)); Howard, A.D. (Univ. of Virginia, Charlottesville, VA (United States). Dept. of Environmental Sciences)

    1992-01-01

    A series of simulations using the newly developed model KARST has been performed to investigate limiting kinetic controls on limestone dissolution during the earliest stages of karst aquifer porosity development. This FORTRAN model couples fluid flow within and dissolution of circular cross section conduits, and considers surface reaction rates (both far from and close to thermodynamic equilibrium), mass transfer rates of reaction products to the bulk fluid, and rates of homogeneous reactions associated with dissolution of CO[sub 2] gas in water. Mass transfer theory for both laminar and turbulent flow cases is included. Runs were made with a wide variety of initial conditions of passage geometry, head gradient, and initial PCO[sub 2]. Results show a consistent pattern of kinetic control that varies as functions of time as well as position along the conduit. Slow, higher order surface reaction rates (close to equilibrium), diffusion rates, and rapid, lower order reaction rates (far from equilibrium) are found to be limiting steps at various times and location. Under no conditions in the simulations did the rate of CO[sub 2] hydration limit dissolution. Thresholds between the various kinetic regimes were found to be associated with a critical distance from equilibrium, as well as the transition from laminar to turbulent flow. As a result of interactions between flow and chemical conditions, passage growth (measure by fluid discharge rates) can be divided into an initial, slow period initiation and a more rapid one (enlargement). The onset of the enlargement phase was not found to coincide with any single kinetic event.

  2. Early rehabilitation of cancer patients – a randomized controlled intervention study

    PubMed Central

    2013-01-01

    Background Faced with a life-threatening illness, such as cancer, many patients develop stress symptoms, i.e. avoidance behaviour, intrusive thoughts and worry. Stress management interventions have proven to be effective; however, they are mostly performed in group settings and it is commonly breast cancer patients who are studied. We hereby present the design of a randomized controlled trial (RCT) evaluating the effectiveness and cost-effectiveness of an individual stress-management intervention with a stepped-care approach in several cancer diagnoses. Method Patients (? 18 years) with a recent diagnosis of breast cancer, colorectal cancer, lymphoma, prostate cancer or testicle cancer and scheduled for adjuvant/curative oncology treatment, will consecutively be included in the study. In this prospective longitudinal intervention study with a stepped-care approach, patients will be randomized to control, treatment as usual, or an individual stress-management intervention in two steps. The first step is a low-intensity stress-management intervention, given to all patients randomized to intervention. Patients who continue to report stress symptoms after the first step will thereafter be given more intensive treatment at the second step of the programme. In the intervention patients will also be motivated to be physically active. Avoidance and intrusion are the primary outcomes. According to the power analyses, 300 patients are planned to be included in the study and will be followed for two years. Other outcomes are physical activity level, sleep duration and quality recorded objectively, and anxiety, depression, quality of life, fatigue, stress in daily living, and patient satisfaction assessed using valid and standardized psychometric tested questionnaires. Utilization of hospital services will be derived from the computerized patient administration systems used by the hospital. The cost-effectiveness of the intervention will be evaluated through a cost-utility analysis. Discussion This RCT will provide empirical evidence of whether an individually administered stress-management programme in two steps can decrease stress as well as maintain or enhance patients’ physical activity level, quality of life and psychological well-being. Further, this RCT, with a stepped-care approach, will provide knowledge regarding the cost-effectiveness of an individually administered stress-management programme whose aim is to help and support individual patients at the right level of care. Trial registration ClinicalTrials.gov Identifier: NCT 01588262. PMID:23294513

  3. Vascular Glucose Sensor Symposium: Continuous Glucose Monitoring Systems (CGMS) for Hospitalized and Ambulatory Patients at Risk for Hyperglycemia, Hypoglycemia, and Glycemic Variability.

    PubMed

    Joseph, Jeffrey I; Torjman, Marc C; Strasma, Paul J

    2015-07-01

    Hyperglycemia, hypoglycemia, and glycemic variability have been associated with increased morbidity, mortality, length of stay, and cost in a variety of critical care and non-critical care patient populations in the hospital. The results from prospective randomized clinical trials designed to determine the risks and benefits of intensive insulin therapy and tight glycemic control have been confusing; and at times conflicting. The limitations of point-of-care blood glucose (BG) monitoring in the hospital highlight the great clinical need for an automated real-time continuous glucose monitoring system (CGMS) that can accurately measure the concentration of glucose every few minutes. Automation and standardization of the glucose measurement process have the potential to significantly improve BG control, clinical outcome, safety and cost. PMID:26078254

  4. Evaluation of a Model for Glycemic Prediction in Critically Ill Surgical Patients

    PubMed Central

    Pappada, Scott M.; Cameron, Brent D.; Tulman, David B.; Bourey, Raymond E.; Borst, Marilyn J.; Olorunto, William; Bergese, Sergio D.; Evans, David C.; Stawicki, Stanislaw P. A.; Papadimos, Thomas J.

    2013-01-01

    We evaluated a neural network model for prediction of glucose in critically ill trauma and post-operative cardiothoracic surgical patients. A prospective, feasibility trial evaluating a continuous glucose-monitoring device was performed. After institutional review board approval, clinical data from all consenting surgical intensive care unit patients were converted to an electronic format using novel software. This data was utilized to develop and train a neural network model for real-time prediction of serum glucose concentration implementing a prediction horizon of 75 minutes. Glycemic data from 19 patients were used to “train” the neural network model. Subsequent real-time simulated testing was performed in 5 patients to whom the neural network model was naive. Performance of the model was evaluated by calculating the mean absolute difference percent (MAD%), Clarke Error Grid Analysis, and calculation of the percent of hypoglycemic (?70 mg/dL), normoglycemic (>70 and <150 mg/dL), and hyperglycemic (?150 mg/dL) values accurately predicted by the model; 9,405 data points were analyzed. The models successfully predicted trends in glucose in the 5 test patients. Clark Error Grid Analysis indicated that 100.0% of predictions were clinically acceptable with 87.3% and 12.7% of predicted values falling within regions A and B of the error grid respectively. Overall model error (MAD%) was 9.0% with respect to actual continuous glucose modeling data. Our model successfully predicted 96.7% and 53.6% of the normo- and hyperglycemic values respectively. No hypoglycemic events occurred in these patients. Use of neural network models for real-time prediction of glucose in the surgical intensive care unit setting offers healthcare providers potentially useful information which could facilitate optimization of glycemic control, patient safety, and improved care. Similar models can be implemented across a wider scale of biomedical variables to offer real-time optimization, training, and adaptation that increase predictive accuracy and performance of therapies. PMID:23894489

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

    PubMed Central

    2014-01-01

    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

  6. Load Early Detection (LED): A Congestion Control Algorithm Based on Routers' Traffic Load

    Microsoft Academic Search

    Arjan Durresi; Leonard Barolli; Mukundan Sridharan; Sriram Chellappan; Raj Jain

    2006-01-01

    Efficient bandwidth allocation and low delays remain important goals, especially in high- speed networks. Existing end-to-end congestion control schemes (such as TCP+AQM\\/RED) have significant limitations to achieve these goals. In this paper, we present a new and sim- ple congestion control scheme, called Load Early Detection (LED), that achieves high link efficiency and low persistent queue length. The major novelty

  7. Family and Early Adolescent Delinquency: A Comprehensive Sequential Family Control Model.

    ERIC Educational Resources Information Center

    LeBlanc, Marc; McDuff, Pierre; Kaspy, Nathalie

    1998-01-01

    Developed a comprehensive sequential family control model to explain the effects of family functioning variables, marital relations, and parent deviant models on early adolescent delinquency. Fourteen constructs were used to build and test the model, including mother's childbearing age, socioeconomic disadvantage, family adversity, onset of…

  8. Anger and Approach Motivation in Infancy: Relations to Early Childhood Inhibitory Control and Behavior Problems

    ERIC Educational Resources Information Center

    He, Jie; Degnan, Kathryn Amey; McDermott, Jennifer Martin; Henderson, Heather A.; Hane, Amie Ashley; Xu, Qinmei; Fox, Nathan A.

    2010-01-01

    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…

  9. The Chromosomal Control of Leaf Characteristics of Early-Stage Plants in Wheat ( Triticum aestivum L.)

    Microsoft Academic Search

    Cun-dong LI; Zhi-ying BAI; G Ye; M Miyagi; S Chapman; SM Reader; Chun-ji LIU

    2011-01-01

    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

  10. Self-Control and Early Adolescent Antisocial Behavior: A Longitudinal Analysis

    ERIC Educational Resources Information Center

    de Kemp, Raymond A. T.; Vermulst, Ad A.; Finkenauer, Catrin; Scholte, Ron H. J.; Overbeek, Geertjan; Rommes, Els W. M.; Engels, Rutger C. M. E.

    2009-01-01

    The article discusses a three-wave longitudinal study that investigates the relationship between self-control and aggressive and delinquent behavior of early adolescent boys and girls. The sample consists of 1,012 Dutch adolescents (mean age = 12.3) in their first year of secondary education. Structural equation modeling analyses reveal that high…

  11. Early mobilisation versus immobilisation of surgically treated ankle fractures. Prospective randomised control trial

    Microsoft Academic Search

    A. S Dogra; A Rangan

    1999-01-01

    In a randomised prospective controlled trial of 52 patients aged 16 to 65 we compared early non-weightbearing ankle mobilisation with ankle immobilisation following surgical treatment of bimalleolar ankle fractures. At 3 months there was no significant difference between the two groups in the range of ankle movements or pain. There was however a significant difference in the gait pattern with

  12. Early maladaptive schemas in Finnish adult chronic pain patients and a control sample.

    PubMed

    Saariaho, Tom Harri; Saariaho, Anita Sylvia; Karila, Irma Anneli; Joukamaa, Matti I

    2011-04-01

    Engel (1959) suggested that negative physical or emotional experiences in childhood predispose to the development of chronic pain. Studies have shown that physical and sexual abuse in early life is connected with chronic pain. Emotional adversities are much less studied causes contributing to the development of chronic pain and disability. Early emotional abuse, neglect, maltreatment and other adversities are deleterious childhood experiences which, according to Young's schema theory (1990), produce early maladaptive schemas (EMSs). The primary goal of this study was to examine whether early adversities were more common in chronic pain patients than in a control group. A total of 271 (53% women) first-visit chronic pain patients and 331 (86% women) control participants took part in the study. Their socio-demographic data, pain variables and pain disability were measured. To estimate EMSs the Young Schema Questionnaire was used. Chronic pain patients scored higher EMSs reflecting incapacity to perform independently, catastrophic beliefs and pessimism. The most severely disabled chronic pain patients showed an increase in all the EMSs in the Disconnection and Rejection schema domain, namely Abandonment/Instability, Mistrust/Abuse, Emotional Deprivation, Defectiveness/Shame and Social Isolation/Alienation EMSs. The results of the study suggested that chronic pain patients had suffered early emotional maltreatment. PMID:21054422

  13. US honeys varying in glucose and fructose content elicit similar glycemic indexes.

    PubMed

    Ischayek, Jennifer Ilana; Kern, Mark

    2006-08-01

    The glycemic index of honey may vary, depending upon its floral variety and fructose-to-glucose ratio. We determined the glycemic index of four US honey varieties in 12 healthy adult men and women with a mean (+/-standard error) age of 24.5+/-1.5 years. The glycemic index of 250-mL solution servings of clover, buckwheat, cotton, and tupelo honeys providing 50 g carbohydrate were assessed relative to triplicate feedings of 50 g carbohydrate as a glucose solution. Fructose-to-glucose ratios were 1.09, 1.12, 1.03, 1.54, for clover, buckwheat, cotton, and tupelo, respectively. Blood was collected after an overnight fast and 15, 30, 45, 60, 90, and 120 minutes after intake. Ten minutes were allowed for food consumption. Areas under the glycemic response curves for each honey were expressed as percent means of each participant's average response to glucose feedings. The means (+/-standard error) of the glycemic index were 69.2+/-8.1, 73.4+/-6.4, 73.6+/-6.6, 74.1+/-8.2 for clover, buckwheat, cotton, and tupelo honeys, respectively. No statistically significant differences between the honeys were apparent, nor was a relationship between glycemic index and the fructose-to-glucose ratio detected, indicating that small differences in fructose-to-glucose ratios do not substantially impact honey glycemic index. PMID:16863724

  14. Inhibitory Control in Preschool Predicts Early Math Skills in First Grade: Evidence from an Ethnically Diverse Sample

    ERIC Educational Resources Information Center

    Ng, Florrie Fei-Yin; Tamis-LeMonda, Catherine; Yoshikawa, Hirokazu; Sze, Irene Nga-Lam

    2015-01-01

    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…

  15. Early depolarizing GABA controls critical period plasticity in the rat visual cortex

    PubMed Central

    Deidda, Gabriele; Allegra, Manuela; Cerri, Chiara; Naskar, Shovan; Bony, Guillaume; Zunino, Giulia; Bozzi, Yuri; Caleo, Matteo; Cancedda, Laura

    2014-01-01

    SUMMARY Hyperpolarizing and inhibitory GABA regulates “critical periods” for plasticity in sensory cortices. Here, we examine the role of early, depolarizing GABA in controlling plasticity mechanisms. We report that brief interference with depolarizing GABA during early development prolonged critical period plasticity in visual cortical circuits, without affecting overall development of the visual system. The effects on plasticity were accompanied by dampened inhibitory neurotransmission, down-regulation of BDNF expression, and reduced density of extracellular matrix-perineuronal nets. Early interference with depolarizing GABA decreased perinatal BDNF signaling, and 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

  16. Early depolarizing GABA controls critical-period plasticity in the rat visual cortex.

    PubMed

    Deidda, Gabriele; Allegra, Manuela; Cerri, Chiara; Naskar, Shovan; Bony, Guillaume; Zunino, Giulia; Bozzi, Yuri; Caleo, Matteo; Cancedda, Laura

    2015-01-01

    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

  17. 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

    Go, Min Jin; Hwang, Joo-Yeon; Park, Tae-Joon; Kim, Young Jin; Oh, Ji Hee; Kim, Yeon-Jung; Han, Bok-Ghee

    2014-01-01

    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

  18. Cognitive-Behavioral Group Therapy as an Early Intervention for Insomnia: A Randomized Controlled Trial

    Microsoft Academic Search

    Markus Jansson; Steven J. Linton

    2005-01-01

    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

  19. Estimating potato yield responses from chemical control of early blight in Minnesota

    Microsoft Academic Search

    P. S. Teng; H. L. Bissonnette

    1985-01-01

    The effect of early blight on tuber yield of two potato (Solanum tuberosum L.) cultivars (Russet Burbank and Norland) was evaluated using number and timing of applications of three chemicals to generate\\u000a different disease epidemics in 1981 and 1982. Under the non-irrigated farming conditions in Minnesota, there were no significant\\u000a differences among captafol, triphenyltin hydroxide and maneb-Zn in blight control

  20. Genes as early responders regulate quorum-sensing and control bacterial cooperation in Pseudomonas aeruginosa.

    PubMed

    Zhao, Kelei; Li, Yi; Yue, Bisong; Wu, Min

    2014-01-01

    Quorum-sensing (QS) allows bacterial communication to coordinate the production of extracellular products essential for population fitness at higher cell densities. It has been generally accepted that a significant time duration is required to reach appropriate cell density to activate the relevant quiescent genes encoding these costly but beneficial public goods. Which regulatory genes are involved and how these genes control bacterial communication at the early phases are largely un-explored. By determining time-dependent expression of QS-related genes of the opportunistic pathogen Pseudomonas aerugionsa, we show that the induction of social cooperation could be critically influenced by environmental factors to optimize the density of population. In particular, small regulatory RNAs (RsmY and RsmZ) serving as early responders, can promote the expression of dependent genes (e.g. lasR) to boost the synthesis of intracellular enzymes and coordinate instant cooperative behavior in bacterial cells. These early responders, acting as a rheostat to finely modulate bacterial cooperation, which may be quickly activated under environment threats, but peter off when critical QS dependent genes are fully functional for cooperation. Our findings suggest that RsmY and RsmZ critically control the timing and levels of public goods production, which may have implications in sociomicrobiology and infection control. PMID:25006971

  1. Single locus in BXH-2 mice responsible for inability to control early proliferation of Trypanosoma cruzi.

    PubMed

    Trischmann, T M

    1984-12-01

    The inability of the BXH-2 recombinant inbred strain to limit proliferation of Trypanosoma cruzi during the first 2 weeks after infection was found to be controlled by a single locus difference between the BXH-2 strain and each of its parental strains: C3H/HeJ and C57BL/6J. In both cases, the inability to limit parasite proliferation acted like a recessive trait. The loci in the C3H and C57BL/6 strains appear to be identical since all F2 mice derived from these strains displayed the early control trait. A mutation is thus likely to have occurred in the derivation of the BXH-2 strain. The provisional designation Crz has been given to the locus in the BXH-2 strain that is responsible for its failure to control early proliferation of T. cruzi. The Crz locus is distinct from the lpr gene which has also been associated with increased levels of parasitemia early in the course of the infection. PMID:6437987

  2. EFFECTS OF MIXING GLARGINE AND SHORT-ACTING INSULIN ANALOGS ON GLUCOSE CONTROL

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Intensive insulin management improves glycemic control and lowers the risks of long-term microvascular complications. Several new insulin analogs are in use to improve glycemic control in type 1 diabetes. Glargine in particular is a "basal insulin" and found to be relatively peakless. Glargine is th...

  3. Correlation between dietary glycemic index and cardiovascular disease risk factors among Japanese women

    Microsoft Academic Search

    Y Amano; K Kawakubo; J S Lee; A C Tang; M Sugiyama; K Mori

    2004-01-01

    Objective: To examine the correlation between dietary glycemic index (GI) and cardiovascular disease (CVD) risk factors among subjects who consume white rice as a staple food.Design: A cross-sectional study was conducted to explore the associations between dietary GI, dietary glycemic load (GL) and dietary intakes, and CVD risk factors. Dietary GI and GL were calculated from a 3-day (including two

  4. The Effects of the Dietary Glycemic Load on Type 2 Diabetes Risk Factors during Weight Loss

    Microsoft Academic Search

    Anastassios G. Pittas; Susan B. Roberts; Sai Krupa Das; Cheryl H. Gilhooly; Edward Saltzman; Julie Golden; Paul C. Stark; Andrew S. Greenberg

    2006-01-01

    Objective: To compare the effects of two calorie-restricted diets that differ in glycemic load (GL) on glucose tolerance and inflammation.Research Methods and Procedures: Thirty-four healthy overweight adults, ages 24 to 42 years, were randomized to 30% provided calorie-restricted diets with high (HG) or low (LG) glycemic load for 6 months. Outcomes were changes in glucose-insulin dynamics and C-reactive protein (CRP)

  5. Dietary glycemic index and glycemic load and risk of colorectal cancer: results from the EPIC-Italy study.

    PubMed

    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

    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

  6. Early seasonal development of brain song control nuclei in male blue tits

    PubMed Central

    Caro, Samuel P.; Lambrechts, Marcel M.; Balthazart, Jacques

    2007-01-01

    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

  7. The glycemic efficacies of insulin analogue regimens according to baseline glycemic status in Korean patients with type 2 diabetes: sub-analysis from the A1chieve® study

    PubMed Central

    Hwang, Y-C; Kang, JG; Ahn, KJ; Cha, BS; Ihm, S-H; Lee, S; Kim, M; Lee, B-W

    2014-01-01

    Aims In this study, we compared the glucose-lowering effectiveness of insulin analogues and their combination according to baseline glycemic status in patients with type 2 diabetes (T2D) from the A1chieve® study conducted in Korea. Methods This sub-analysis from the A1chieve® study was a 24-week prospective, multicenter, non-interventional, open-labelled study. Of the 4058 patients, 3074 patients who had their HbA1c level measured at baseline were included in this sub-analysis. We classified patients into three groups according to baseline HbA1c levels: group I (HbA1c < 7.5%), group II (7.5% ? HbA1c < 9.0%) and group III (HbA1c ? 9.0%). Results Patients in group I showed no significant HbA1c reduction with any insulin regimens (detemir, aspart, detemir and aspart or biphasic aspart 30 (Novo Nordisk A/S, DK-2880 Bagsværd, Denmark) after 24 weeks of treatment. In group II, although HbA1c was decreased for all insulin regimens, there was no difference in mean HbA1c reduction among the four insulin regimens. In patients with a high baseline HbA1c level (group III), mean HbA1c reduction was the greatest in patients on a basal-bolus regimen (detemir and aspart, ?3.50%) and lowest in patients on a bolus regimen (aspart, ?1.81%; p < 0.001). Conclusion For optimal glycaemic control, a basal-bolus regimen may be adequate for Korean patients with poorly controlled T2D (HbA1c ? 9.0%). PMID:25284679

  8. Early detection and late cognitive control of emotional distraction by the prefrontal cortex.

    PubMed

    García-Pacios, Javier; Garcés, Pilar; Del Río, David; Maestú, Fernando

    2015-01-01

    Unpleasant emotional distraction can impair the retention of non-emotional information in working memory (WM). Research links the prefrontal cortex with the successful control of such biologically relevant distractors, although the temporal changes in this brain mechanism remain unexplored. We use magnetoencephalography to investigate the temporal dynamics of the cognitive control of both unpleasant and pleasant distraction, in the millisecond (ms) scale. Behavioral results demonstrate that pleasant events do not affect WM maintenance more than neutral ones. Neuroimaging results show that prefrontal cortices are recruited for the rapid detection of emotional distraction, at early latencies of the processing (70-130?ms). Later in the processing (360-450?ms), the dorsolateral, the medial and the orbital sections of the prefrontal cortex mediate the effective control of emotional distraction. In accordance with the behavioral performance, pleasant distractors do not require higher prefrontal activity than neutral ones. These findings extend our knowledge about the brain mechanisms of coping with emotional distraction in WM. In particular, they show for the first time that overriding the attentional capture triggered by emotional distractors, while maintaining task-relevant elements in mind, is based on the early detection of such linked-to-survival information and on its later cognitive control by the prefrontal cortex. PMID:26067780

  9. Early detection and late cognitive control of emotional distraction by the prefrontal cortex

    PubMed Central

    García-Pacios, Javier; Garcés, Pilar; Del Río, David; Maestú, Fernando

    2015-01-01

    Unpleasant emotional distraction can impair the retention of non-emotional information in working memory (WM). Research links the prefrontal cortex with the successful control of such biologically relevant distractors, although the temporal changes in this brain mechanism remain unexplored. We use magnetoencephalography to investigate the temporal dynamics of the cognitive control of both unpleasant and pleasant distraction, in the millisecond (ms) scale. Behavioral results demonstrate that pleasant events do not affect WM maintenance more than neutral ones. Neuroimaging results show that prefrontal cortices are recruited for the rapid detection of emotional distraction, at early latencies of the processing (70-130?ms). Later in the processing (360-450?ms), the dorsolateral, the medial and the orbital sections of the prefrontal cortex mediate the effective control of emotional distraction. In accordance with the behavioral performance, pleasant distractors do not require higher prefrontal activity than neutral ones. These findings extend our knowledge about the brain mechanisms of coping with emotional distraction in WM. In particular, they show for the first time that overriding the attentional capture triggered by emotional distractors, while maintaining task-relevant elements in mind, is based on the early detection of such linked-to-survival information and on its later cognitive control by the prefrontal cortex. PMID:26067780

  10. The Contribution of Adolescent Effortful Control to Early Adult Educational Attainment.

    PubMed

    Véronneau, Marie-Hélène; Racer, Kristina Hiatt; Fosco, Gregory M; Dishion, Thomas J

    2014-01-01

    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

  11. The Contribution of Adolescent Effortful Control to Early Adult Educational Attainment

    PubMed Central

    Véronneau, Marie-Hélène; Racer, Kristina Hiatt; Fosco, Gregory M.; Dishion, Thomas J.

    2014-01-01

    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

  12. 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

    Needham, Patrick G.; Brodsky, Jeffrey L.

    2013-01-01

    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

  13. NIR fingerprint screening for early control of non-conformity at feed mills.

    PubMed

    Fernández Pierna, Juan Antonio; Abbas, Ouissam; Lecler, Bernard; Hogrel, Patrick; Dardenne, Pierre; Baeten, Vincent

    2015-12-15

    The objective of this work was to devise a complete procedure based on chemometrics and the use NIR spectroscopy at the entrance of a feed mill to provide early evidence of non-conformity and unusual ingredients and thus help to achieve cost-savings. The procedure was validated at laboratory level and was adapted for application at the Cargill Animal Nutrition feed mill. The study focused on the characterisation of pure soybean meal with the aim of creating an early control system for detecting and quantifying any unusual ingredient that might be present in the soybean meal, such as melamine, cyanuric acid or whey powder (milk serum). The study results showed that the use of NIR, combined with some simple chemometric tools based on distances and residuals from regression equations, is appropriate for authenticating important feed products (in this case, soybean meal) and detecting the presence of abnormal samples or impurities in both the laboratory and at the feed mill. PMID:26190594

  14. Ethnic Differences in Glycemic Markers in Patients With Type 2 Diabetes

    PubMed Central

    Wolffenbuttel, Bruce H.R.; Herman, William H.; Gross, Jorge L.; Dharmalingam, Mala; Jiang, Honghua H.; Hardin, Dana S.

    2013-01-01

    OBJECTIVE Recent studies have reported hemoglobin A1c (HbA1c) differences across ethnic groups that could limit its use in clinical practice. The authors of the A1C-Derived Average Glucose study have advocated to report HbA1c in estimated average glucose (AG) equivalents. The aim of this study was to assess the relationships between HbA1c and the mean of three 7-point self-monitored blood glucose (BG) profiles, and to assess whether estimated AG is an accurate measure of glycemia in different ethnic groups. RESEARCH DESIGN AND METHODS We evaluated 1,879 participants with type 2 diabetes in the DURABLE trial who were 30 to 80 years of age, from 11 countries, and, according to self-reported ethnic origin, were Caucasian, of African descent (black), Asian, or Hispanic. We performed logistic regression of the relationship between the mean self-monitored BG and HbA1c, and estimated AG, according to ethnic background. RESULTS Baseline mean (SD) HbA1c was 9.0% (1.3) (75 [SD, 14] mmol/mol), and mean self-monitored BG was 12.1 mmol/L (3.1) (217 [SD, 55] mg/dL). In the clinically relevant HbA1c range of 7.0–9.0% (53–75 mmol/mol), non-Caucasian ethnic groups had 0.2–0.5% (2–6 mmol/mol) higher HbA1c compared with Caucasians for a given BG level. At the mean self-monitored BG levels ?11.6 mmol/L, estimated AG overestimated the actual average BG; at levels >11.6 mmol/L, estimated AG underestimated the actual BG levels. CONCLUSIONS For a given degree of glycemia, HbA1c levels vary among different ethnic groups. Ethnicity needs to be taken into account when using HbA1c to assess glycemic control or to set glycemic targets. Estimated AG is not a reliable marker for mean glycemia and therefore is of limited clinical value. PMID:23757434

  15. 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

    Piehler, Timothy F.; Veronneau, Marie-Helene; Dishion, Thomas J.

    2012-01-01

    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…

  16. Early versus Deferred Treatment for Smoldering Multiple Myeloma: A Meta-Analysis of Randomized, Controlled Trials

    PubMed Central

    Tompkins, Van S.; Gao, Lu; Wu, Xiaosong; Tao, Yi; Hu, Xiaojing; Hou, Jun; Han, Ying; Xu, Hongwei; Zhan, Fenghuang; Shi, Jumei

    2014-01-01

    Purpose Whether patients with smoldering multiple myeloma (SMM) needed to receive early interventional treatment remains controversial. Herein, we conducted a meta-analysis comparing the efficacy and safety of early treatment over deferred treatment for patients with SMM. Methods MEDLINE and Cochrane Library were searched to May 2014 for randomized controlled trials (RCTs) that assessed the effect of early treatment over deferred treatment. Primary outcome measure was mortality, and secondary outcome measures were progression, response rate, and adverse events. Results Overall, 5 trials including 449 patients were identified. There was a markedly reduced risk of disease progression with early treatment (Odds Ratio [OR]?=?0.13, 95% confidence interval [CI]?=?0.07 to 0.24). There were no significant differences in mortality and response rate (OR?=?0.85, 95% CI?=?0.45 to 1.60, and OR?=?0.63, 95% CI?=?0.32 to 1.23, respectively). More patients in the early treatment arm experienced gastrointestinal toxicities (OR?=?10.02, 95%CI?=?4.32 to 23.23), constipation (OR?=?8.58, 95%CI?=?3.20 to 23.00) and fatigue or asthenia (OR?=?2.72, 95%CI?=?1.30 to 5.67). No significant differences were seen with the development of acute leukemia (OR?=?2.80, 95%CI?=?0.42 to 18.81), hematologic cancer (OR?=?2.07, 95%CI?=?0.43 to 10.01), second primary tumors (OR?=?3.45, 95%CI?=?0.81 to 14.68), nor vertebral compression (OR?=?0.18, 95%CI?=?0.02 to 1.59). Conclusions Early treatment delayed disease progression but increased the risk of gastrointestinal toxicities, constipation and fatigue or asthenia. The differences on vertebral compression, acute leukemia, hematological cancer and second primary tumors were not statistically significant. Based on the current evidence, early treatment didn’t significantly affect mortality and response rate. However, further much larger trials were needed to provide more evidence. PMID:25279718

  17. Treating anemia early in renal failure patients slows the decline of renal function: A randomized controlled trial

    Microsoft Academic Search

    CHARICLIA GOUVA; PETROS NIKOLOPOULOS; JOHN P A IOANNIDIS; KOSTAS C SIAMOPOULOS

    2004-01-01

    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

  18. Development of early mathematical skills with a tablet intervention: a randomized control trial in Malawi.

    PubMed

    Pitchford, Nicola J

    2015-01-01

    Evaluation of educational interventions is necessary prior to wide-scale rollout. Yet very few rigorous studies have been conducted on the effectiveness of tablet-based interventions, especially in the early years and in developing countries. This study reports a randomized control trial to evaluate the effectiveness of a tablet intervention for supporting the development of early mathematical skills in primary school children in Malawi. A total sample of 318 children, spanning Standards 1-3, attending a medium-sized urban primary school, were randomized to one of three groups: maths tablet intervention, non-maths tablet control, and standard face-to-face practice. Children were pre-tested using tablets at the start of the school year on two tests of mathematical knowledge and a range of basic skills related to scholastic progression. Class teachers then delivered the intervention over an 8-weeks period, for the equivalent of 30-min per day. Technical support was provided from the local Voluntary Service Overseas (VSO). Children were then post-tested on the same assessments as given at pre-test. A final sample of 283 children, from Standards 1-3, present at both pre- and post-test, was analyzed to investigate the effectiveness of the maths tablet intervention. Significant effects of the maths tablet intervention over and above standard face-to-face practice or using tablets without the maths software were found in Standards 2 and 3. In Standard 3 the greater learning gains shown by the maths tablet intervention group compared to both of the control groups on the tablet-based assessments transferred to paper and pencil format, illustrating generalization of knowledge gained. Thus, tablet technology can effectively support early years mathematical skills in developing countries if the software is carefully designed to engage the child in the learning process and the content is grounded in a solid well-constructed curriculum appropriate for the child's developmental stage. PMID:25954236

  19. Glycemic Index and Pregnancy: A Systematic Literature Review

    PubMed Central

    Louie, Jimmy Chun Yu; Brand-Miller, Jennie C.; Markovic, Tania P.; Ross, Glynis P.; Moses, Robert G.

    2010-01-01

    Background/Aim. Dietary glycemic index (GI) has received considerable research interest over the past 25 years although its application to pregnancy outcomes is more recent. This paper critically evaluates the current evidence regarding the effect of dietary GI on maternal and fetal nutrition. Methods. A systematic literature search using MEDLINE, EMBASE, CINAHL, Cochrane Library, SCOPUS, and ISI Web of Science, from 1980 through September 2010, was conducted. Results. Eight studies were included in the systematic review. Two interventional studies suggest that a low-GI diet can reduce the risk of large-for-gestational-age (LGA) infants in healthy pregnancies, but one epidemiological study reported an increase in small-for-gestational-age (SGA) infants. Evidence in pregnancies complicated by gestational diabetes mellitus (GDM), though limited (n = 3), consistently supports the advantages of a low-GI diet. Conclusion. There is insufficient evidence to recommend a low-GI diet during normal pregnancy. In pregnancy complicated by GDM, a low-GI diet may reduce the need for insulin without adverse effects on pregnancy outcomes. Until larger-scale intervention trials are completed, a low-GI diet should not replace the current recommended pregnancy diets from government and health agencies. Further research regarding the optimal time to start a low-GI diet for maximum protection against adverse pregnancy outcomes is warranted. PMID:21253478

  20. Pouteria ramiflora extract inhibits salivary amylolytic activity and decreases glycemic level in mice.

    PubMed

    De Gouveia, Neire M; De Albuquerque, Cibele L; Espindola, Laila S; Espindola, Foued S

    2013-09-01

    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

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

    PubMed

    Zenel, Alison M; Stewart, Maria L

    2015-01-01

    The present study compared the effects of three rice cultivars on postprandial glycemic control and appetite. A single-blind, randomized, crossover clinical trial was performed with 18 healthy subjects, nine males and nine females. Three treatments were administered at three separate study visits: commercially available conventional white rice (short grain), specialty high amylose white rice 1 (Dixiebelle), and specialty high amylose white rice 2 (Rondo). Postprandial capillary blood glucose, venous blood glucose and insulin measurements, and appetite visual analog scale (VAS) surveys were done over the course of two hours. The capillary blood glucose concentrations were significantly lower for Rondo compared to short grain rice at 30 min, and for Dixiebelle and Rondo compared to short grain rice at 45, 60, and 120 min. Capillary blood glucose area under the curve (AUC) was significantly lower for Dixiebelle and Rondo compared to short grain rice. Subjects were significantly more hungry at 30 min after Dixiebelle intake than Rondo intake, but there were no other significant effects in appetite ratings. The present study determined that intake of high amylose rice with resistant starch (RS) can attenuate postprandial blood glucose and insulin response in comparison to short grain rice. PMID:26147654

  2. Early Total Care versus Damage Control: Current Concepts in the Orthopedic Care of Polytrauma Patients

    PubMed Central

    Nicola, Ratto

    2013-01-01

    The management of the polytraumatized orthopedic patient remains a challenging issue. In recent years many efforts have been made to develop rescue techniques and to promote guidelines for the management of these patients. Currently controversies persist between two orthopedic approaches: the Early Total Care and the Damage Control Orthopedics. An overview of the current literature on the orthopedic management of polytrauma patient is provided. Subsequently, femoral shaft fractures, representing extremely common lesions, and pelvic ring injuries, that are associated with a high mortality rate, are analyzed in detail. PMID:24959356

  3. Structural dynamics and attitude control study of early manned capability space station configurations

    NASA Technical Reports Server (NTRS)

    Ayers, J. Kirk; Cirillo, William M.; Giesy, Daniel P.; Hitchcock, Jay C.; Kaszubowski, Martin J.; Raney, J. Philip

    1987-01-01

    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.

  4. Early psychological intervention in accidentally injured children ages 2–16: a randomized controlled trial

    PubMed Central

    Kramer, Didier N.; Landolt, Markus A.

    2014-01-01

    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

  5. Environmental controls on marine ecosystems during the early Toarcian extinction event

    NASA Astrophysics Data System (ADS)

    Danise, Silvia; Twitchett, Richard J.

    2015-04-01

    The fossil record has the potential to provide valuable insights into species response to past climate change if paleontological data are combined with appropriate proxies of environmental change. In the early Toarcian (Early Jurassic, ˜183Ma ago) rapid warming coincided with a main perturbation in the carbon cycle, seal level rise, widespread deposition of organic-rich, black shales under anoxic conditions, increased weathering rates and a biotic crisis in the marine realm, with the extinction of approximately 5% of families and 26% of genera. Because of this complex suite of inter-linked environmental and oceanographic changes, a key challenge is to determine which of these were most influential in controlling specific aspects of extinction and ecological collapse. In this study we combine high resolution palaeontological and palaeoenvironmental data from the coastal sections of the Whitby Mudstone Formation in North Yorkshire, UK, to reconstruct how climate changes controlled the structure of benthic and nektonic communities through the event, over a time period of ˜1.7 Ma. We show that benthic and nektonic ecosystems became decoupled and were driven by different environmental variables. Although rapid warming has been invoked as the main trigger of this event, the palaeotemperature proxy was a poor predictor of marine community dynamics, and abiotic factors indirectly linked to temperature, such as change in seawater dissolved oxygen concentration and nutrient inputs, were more important.

  6. Intraduodenal milk protein concentrate augments the glycemic and food intake suppressive effects of DPP-IV inhibition.

    PubMed

    Olivos, Diana R; McGrath, Lauren E; Turner, Christopher A; Montaubin, Orianne; Mietlicki-Baase, Elizabeth G; Hayes, Matthew R

    2014-02-01

    Glucagon-like peptide-1 (GLP-1) is an incretin hormone released from intestinal L-cells in response to food entering into the gastrointestinal tract. GLP-1-based pharmaceuticals improve blood glucose regulation and may hold promise for obesity treatment, as GLP-1 drugs reduce food intake and body weight in humans and animals. In an effort to improve GLP-1 pharmacotherapies, we focused our attention on macronutrients that, when present in the gastrointestinal tract, may enhance GLP-1 secretion and improve glycemic regulation and food intake suppression when combined with systemic administration of sitagliptin, a pharmacological inhibitor of DPP-IV (enzyme responsible for GLP-1 degradation). In particular, previous data suggest that specific macronutrient constituents found in dairy foods may act as potent secretagogues for GLP-1 and therefore may potentially serve as an adjunct dietary therapy in combination with sitagliptin. To directly test this hypothesis, rats received intraperitoneal injections of sitagliptin (6 mg/kg) or saline vehicle followed by intraduodenal infusions of either milk protein concentrate (MPC; 80/20% casein/whey; 4 kcal), soy protein (nondairy control infusate; 4 kcal), or 0.9% NaCl. Food intake was assessed 30 min postinfusion. In separate studies, regulation of blood glucose was examined via a 2-h oral glucose tolerance test (2 g/kg) following identical sitagliptin treatment and intraduodenal nutrient infusions. Collectively, results show that intraduodenal MPC, but not soy protein, significantly enhances both the food intake suppression and improved control of blood glucose produced by sitagliptin. These data support the hypothesis that dietary intake of dairy protein may be beneficial as an adjunct behavioral therapy to enhance the glycemic and food intake suppressive effects of GLP-1-based pharmacotherapies. PMID:24352410

  7. Early adversity, RSA, and inhibitory control: evidence of children's neurobiological sensitivity to social context.

    PubMed

    Skowron, Elizabeth A; Cipriano-Essel, Elizabeth; Gatzke-Kopp, Lisa M; Teti, Douglas M; Ammerman, Robert T

    2014-07-01

    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

  8. Early Adversity, RSA, and Inhibitory Control: Evidence of Children’s Neurobiological Sensitivity to Social Context

    PubMed Central

    Skowron, Elizabeth A.; Cipriano-Essel, Elizabeth; Gatzke-Kopp, Lisa M.; Teti, Douglas M.; Ammerman, Robert T.

    2014-01-01

    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

  9. An Examination of the Possibility of Lowering the Glycemic Index of Oat and Barley Flakes by Minimal Processing

    Microsoft Academic Search

    Yvonne Granfeldt; Ann-Charlott Eliasson; Inger Bjorck

    Differences in glycemic responses to various starchy foods are related to differences in the rate of starch digestion and absorption. In this study, the importance of the degree of gelatinization and the product thickness for postprandial glycemic and insulinemic responses to rolled oats and barley were studied in healthy subjects (5 men and 5 women). Thick (1.0 mm) rolled oats

  10. Does a reduced glucose intake prevent hyperglycemia in children early after cardiac surgery? a randomized controlled crossover study

    PubMed Central

    2012-01-01

    Introduction Hyperglycemia in children after cardiac surgery can be treated with intensive insulin therapy, but hypoglycemia is a potential serious side effect. The aim of this study was to investigate the effects of reducing glucose intake below standard intakes to prevent hyperglycemia, on blood glucose concentrations, glucose kinetics and protein catabolism in children after cardiac surgery with cardiopulmonary bypass (CPB). Methods Subjects received a 4-hour low glucose (LG; 2.5 mg/kg per minute) and a 4-hour standard glucose (SG; 5.0 mg/kg per minute) infusion in a randomized blinded crossover setting. Simultaneously, an 8-hour stable isotope tracer protocol was conducted to determine glucose and leucine kinetics. Data are presented as mean ± SD or median (IQR); comparison was made by paired samples t test. Results Eleven subjects (age 5.1 (20.2) months) were studied 9.5 ± 1.9 hours post-cardiac surgery. Blood glucose concentrations were lower during LG than SG (LG 7.3 ± 0.7 vs. SG 9.3 ± 1.8 mmol/L; P < 0.01), although the glycemic target (4.0-6.0 mmol/L) was not achieved. No hypoglycemic events occurred. Endogenous glucose production was higher during LG than SG (LG 2.9 ± 0.8 vs. SG 1.5 ± 1.1 mg/kg per minute; P = 0.02), due to increased glycogenolysis (LG 1.0 ± 0.6 vs. SG 0.0 ± 1.0 mg/kg per minute; P < 0.05). Leucine balance, indicating protein balance, was negative but not affected by glucose intake (LG -54.8 ± 14.6 vs. SG -58.8 ± 16.7 ?mol/kg per hour; P = 0.57). Conclusions Currently recommended glucose intakes aggravated hyperglycemia in children early after cardiac surgery with CPB. Reduced glucose intake decreased blood glucose concentrations without causing hypoglycemia or affecting protein catabolism, but increased glycogenolysis. Trial registration Dutch trial register NTR2079. PMID:23031354

  11. Maternal Over-Control Moderates the Association between Early Childhood Behavioral Inhibition and Adolescent Social Anxiety Symptoms

    ERIC Educational Resources Information Center

    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

    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…

  12. Transgenic stem cells in Hydra reveal an early evolutionary origin for key elements controlling self-renewal and differentiation

    E-print Network

    Transgenic stem cells in Hydra reveal an early evolutionary origin for key elements controlling June 2007 Available online 22 June 2007 Abstract Little is known about stem cells in organisms at the beginning of evolution. To characterize the regulatory events that control stem cells in the basal metazoan

  13. Reduced levels of circulating endothelial progenitor cells in acute myocardial infarction patients with diabetes or pre-diabetes: accompanying the glycemic continuum

    PubMed Central

    2014-01-01

    Background Diabetic patients have a significantly worse prognosis after an acute myocardial infarction (AMI) than their counterparts. Previous studies have shown that the number of circulating endothelial progenitor cells (EPCs) significantly increase early after an AMI in normoglycemic patients. However, it is well known that type 2 diabetes mellitus (DM) is associated with impaired function and reduced circulating EPCs levels. Nonetheless, few studies have analyzed EPCs response of diabetics to an AMI and the EPC response of pre-diabetic patients has not been reported yet. Therefore, we hypothesized that in the acute phase of an AMI, diabetic and pre-diabetics have lower circulating EPCs levels than patients with normal glucose metabolism. We also evaluated the possible capacity of chronic antidiabetic treatment in the recovery of EPCs response to an AMI in diabetics. Methods One-hundred AMI patients were prospectively enrolled in the study. Using the high-performance flow cytometer FACSCanto II, circulating EPCs (CD45dimCD34+KDR+ and CD45dimCD133+KDR+ cells) were quantified, within the first 24 hours of admission. In addition, as an indirect functional parameter, we also analyzed the fraction of EPCs coexpressing the homing marker CXCR4. Results We found that in the acute phase of an AMI, diabetic patients presented significantly lower levels of circulating CD45dimCD34+KDR+ and CD45dimCD133+KDR+ EPCs by comparison with nondiabetics, with a parallel decrease in the subpopulations CXCR4+ (p?early event in the natural history of DM, being present even in pre-diabetes. Our results, also demonstrated that numbers of all EPCs populations were inversely correlated with HbA1c (r?=?-0.432, p?glycemic control seems to be determinant for circulating EPCs levels presented in the acute phase of an AMI and chronic insulin therapy may probably attenuate the deficit in EPCs pool seen in diabetics. PMID:24934236

  14. A High Legume Low Glycemic Index Diet Improves Serum Lipid Profiles in Men

    PubMed Central

    Zhang, Zhiying; Lanza, Elaine; Kris-Etherton, Penny M.; Colburn, Nancy H.; Bagshaw, Deborah; Rovine, Michael J.; Ulbrecht, Jan S.; Bobe, Gerd; Chapkin, Robert S.; Hartman, Terryl J.

    2012-01-01

    Clinical studies have shown that fiber consumption facilitates weight loss and improves lipid profiles; however, the beneficial effects of high fermentable fiber low glycemic index (GI) diets under conditions of weight maintenance are unclear. In the Legume Inflammation Feeding Experiment, a randomized controlled cross-over feeding study, 64 middle-aged men who had undergone colonoscopies within the previous 2 years received both a healthy American (HA) diet (no legume consumption, fiber consumption = 9 g/1,000 kcal, and GI = 69) and a legume enriched (1.5 servings/1,000 kcal), high fiber (21 g/1,000 kcal), low GI (GI = 38) diet (LG) in random order. Diets were isocaloric and controlled for macronutrients including saturated fat; they were consumed each for 4 weeks with a 2–4 week break separating dietary treatments. Compared to the HA diet, the LG diet led to greater declines in both fasting serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) (P <0.001 and P <0.01, respectively). Insulin-resistant (IR) subjects had greater reductions in high density lipoprotein cholesterol (HDL-C; P <0.01), and triglycerides (TAG)/HDL-C (P = 0.02) after the LG diet, compared to the HA diet. Insulin-sensitive (IS) subjects had greater reductions in TC (P <0.001), LDL-C (P <0.01), TC/HDL-C (P <0.01), and LDL-C/HDL-C (P = 0.02) after the LG diet, compared to the HA diet. In conclusion, a high legume, high fiber, low GI diet improves serum lipid profiles in men, compared to a healthy American diet. However, IR individuals do not achieve the full benefits of the same diet on cardiovascular disease (CVD) lipid risk factors. PMID:20734238

  15. Randomised controlled trial to evaluate early discharge scheme for patients with stroke.

    PubMed Central

    Rudd, A. G.; Wolfe, C. D.; Tilling, K.; Beech, R.

    1997-01-01

    OBJECTIVE: To assess the clinical effectiveness of an early discharge policy for patients with stroke by using a community based rehabilitation team. DESIGN: Randomised controlled trial to compare conventional care with an early discharge policy. SETTING: Two teaching hospitals in inner London. SUBJECTS: 331 medically stable patients with stroke (mean age 71) who lived alone and were able to transfer independently or who lived with a resident carer and were able to transfer with help. INTERVENTIONS: 167 patients received specialist community rehabilitation for up to 3 months after randomisation. 164 patients continued with conventional hospital and community care. MAIN OUTCOME MEASURES: Barthel score at 12 months. Secondary outcomes measured impairment with motoricity index, minimental state examination, and Frenchay aphasia screening test; disability with the Rivermead activity of daily living scales, hospital anxiety and depression scale, and 5 m walk; handicap with the Nottingham health profile; carer stress with caregiver strain index and patient and carer satisfaction. The main process measure was length of stay after randomisation. RESULTS: One year after randomisation no significant differences in clinical outcomes were found apart from increased satisfaction with hospital care in the community therapy group. Length of stay after randomisation in the community therapy group was significantly reduced (12 v 18 days; P < 0.0001). Patients with impairments were more likely to receive treatment in the community therapy group. CONCLUSIONS: Early discharge with specialist community rehabilitation after stroke is feasible, as clinically effective as conventional care, and acceptable to patients. Considerable reductions in use of hospital beds are achievable. PMID:9366727

  16. Delineation of early attentional control difficulties in fragile X syndrome: Focus on neurocomputational changes

    PubMed Central

    Scerif, Gaia; Cornish, Kim; Wilding, John; Driver, Jon; Karmiloff-Smith, Annette

    2007-01-01

    Fragile X syndrome (FXS) is due to the silencing of a single X-linked gene and it is associated with striking attentional difficulties. As FXS is well characterised at the cellular level, the condition provides a unique opportunity to investigate how a genetic dysfunction can impact on the development of neurocomputational properties relevant to attention. Thirteen young boys with FXS and 13 mental-age-matched typically developing controls performed a touch-screen-based search task that manipulated the similarity between targets and distractors and their heterogeneity in size. Search speed, path and errors were recorded as multiple measures of performance. Children did not differ in overall search speed or path when searching amongst distractors, but striking error patterns distinguished children with FXS from controls. Firstly, although clear markers of previously found targets remained on screen, children with FXS perseverated on touching previous hits more than typically developing controls, consistent with the well-documented inhibitory deficits in adults with the disorder. Secondly, they could accurately discriminate single target-distractor pairs, but, when searching a complex display, they touched distractors more often than control children when distractors were similar to targets and especially so when these were infrequent, highlighting difficulties in judging relative size and allocate attentional weight independently of stimulus frequency. Thirdly, their performance was also characterised by inaccuracies in pointing, suggesting additional motor control deficits. Taken together, the findings suggest that fragile X syndrome affects the early development of multiple processes contributing to efficient attentional selection, as would be predicted from an understanding of the neurocomputational changes associated with the disorder. PMID:17254617

  17. Perceived Social Support Change in Patients with Early-stage Breast Cancer and Controls

    PubMed Central

    Thompson, Tess; Rodebaugh, Thomas L.; Pérez, Maria; Schootman, Mario; Jeffe, Donna B.

    2014-01-01

    Objective To identify variables associated with levels of and change in social support in a cohort of early-stage breast cancer patients and age-matched controls. Methods Telephone interviews measuring perceived social support and other demographic and psychosocial variables were conducted at 4–6 weeks and 6, 12, and 24 months after surgery (patients) or a normal/benign screening mammogram (controls). A latent trajectory model was used to model the intercept (starting point) and slope (changing) aspects of social support. Results Participants included 542 controls and 541 patients (77% White, 23% African American; mean age 57.7 [SD = 10.6]). Most participants reported high social support. Patients reported significantly higher levels of social support at baseline than controls. For patients, social support had a significant negative slope that significantly varied between individuals; the intercept of social support also varied significantly. Predictors of lower social support intercept in patients included not being married/partnered, being White, having lower perceived general health, and having higher negative affect (modeled as a latent variable defined by anxiety and depression symptom severity). Patients who were African American (vs. White) or had mastectomy (vs. lumpectomy) had steeper social support declines, and participants with both these characteristics had lower starting points as well as steeper declines. Social support among controls did not change significantly. Conclusions Clinicians might consider psychosocial interventions for patients reporting low social support around the time of diagnosis and surgical treatment, and for patients at risk for steeper declines in support, such as African Americans and women undergoing mastectomy. PMID:23477582

  18. Relation of perinatal risk and early parenting to executive control at the transition to school.

    PubMed

    Clark, Caron A C; Woodward, Lianne J

    2015-07-01

    Executive control (EC) develops rapidly during the preschool years and is central to academic achievement and functional outcome. Although children with perinatal adversity are at known risk for EC impairments, little is known about the underlying nature of these impairments or the mechanisms that contribute to their development over time. Drawing on a cohort of 110 high-risk children born very preterm (VPT; < 33 weeks / < 1500 g) and 113 healthy full-term children, this study examined the implications of perinatal adversity and early parenting for children's EC as they transitioned to formal schooling. Parent supportive presence, intrusiveness, and parent-child synchrony were observed during a series of problem-solving tasks at ages 2 and 4 years. At age 6, children completed a comprehensive battery of EC tasks. Academic outcomes were assessed at age 9. The VPT group showed global EC impairments at age 6, although the unitary factor that best characterized the structure of EC was the same in both groups. High-risk dyads were characterized by more intrusive and less synchronous parent-child interactions in early childhood, which in turn predicted poorer child EC at age 6. EC partially mediated the relation of risk status to poorer academic achievement at age 9. Findings demonstrate the cumulative effects of perinatal adversity on children's EC in the crucial transition to schooling. They also highlight the importance of the parent-child relationship as a target for intervention efforts to help mitigate these effects. PMID:25288501

  19. Tectonic control of Early Cretaceous carbonate platforms in the Gulf of Mexico

    SciTech Connect

    Corso, W.; Austin, J.A. Jr.

    1995-12-01

    In the Gulf of Mexico, a review of basin-wide spatial relationships between Early Cretaceous carbonate platform margins and older structures, combined with multichannel seismic reflection data from the northeastern Gulf, indicates that a tectonic hinge zone controlled the margins` initial positions. There is no evidence that this hinge zone influenced pre-Early Cretaceous sedimentation patterns throughout the basin. Thus, the authors think that it formed during latest Jurassic-earliest Cretaceous time. Such timing suggests that the hinge zone is a new type of geologic structure. During this period, the Gulf of Mexico was undergoing only thermal subsidence. The main phases of intracrustal extension and sea floor spreading, the stages of basin evolution most commonly associated with tectonic hinge zone formation at other divergent continental margins, had already taken place. The authors conclude that the hinge zone formed by processes until now not thought to be associated with hinge zone development: the cessation of sea floor spreading in the central part of the Gulf and associated rapid subsidence of cooling oceanic crust in the basin`s center.

  20. Evidence for current-controlled sedimentation along the southern Mozambique continental margin since Early Miocene times

    NASA Astrophysics Data System (ADS)

    Preu, Benedict; Spieß, Volkhard; Schwenk, Tilmann; Schneider, Ralph

    2011-12-01

    Major plastered drift sequences were imaged using high-resolution multichannel seismics during R/V Meteor cruises M63/1 and M75/3 south of the Mozambique Channel along the continental margin of Mozambique off the Limpopo River. Detailed seismic-stratigraphic analyses enabled the reconstruction of the onset and development of the modern, discontinuous, eddy-dominated Mozambique Current. Major drift sequences can first be identified during the Early Miocene. Consistent with earlier findings, a progressive northward shift of the depocenter indicates that, on a geological timescale, a steady but variable Mozambique Current existed from this time onward. It can furthermore be shown that, during the Early/Middle Miocene, a coast-parallel current was established off the Limpopo River as part of a lee eddy system driven by the Mozambique Current. Modern sedimentation is controlled by the interplay between slope morphology and the lee eddy system, resulting in upwelling of Antarctic Intermediate Water. Drift accumulations at larger depths are related to the reworking of sediment by deep-reaching eddies that migrate southward, forming the Mozambique Current and eventually merging with the Agulhas Current.

  1. Enrichment of extruded snack products with coproducts from chestnut mushroom (Agrocybe aegerita) production: interactions between dietary fiber, physicochemical characteristics, and glycemic load.

    PubMed

    Brennan, Margaret A; Derbyshire, Emma; Tiwari, Brijesh K; Brennan, Charles S

    2012-05-01

    Mushrooms are a common vegetable product that have also been linked to pharmaceutical and medicinal uses. However, the production of the fruiting bodies of mushrooms results in a large quantity of food waste in the form of spent compost. Hyphae and the base of fruit bodies from Agrocybe aegerita were retrieved from spent mushroom compost and refined as a freeze-dried powder. This fiber-rich ingredient was used in the manufacture of ready-to-eat extruded cereal snack products. Inclusions rates were 0, 5, 10, and 15% w/w replacement levels for wheat flour from a control recipe. Inclusion of mushroom coproduct material (MCM) was significantly correlated to increased product expansion (r = 0.848) and density (r = 0.949) but negatively correlated to water absorption index (WAI; r = -0.928) and water solubility index (WSI; r = -0.729). Fiber content could not be correlated to differences in pasting properties of extruded snacks even though snack products with MCM showed significantly lower final viscosity values compared to the control. The potential glycemic response of foods was significantly lowered by including MCM (p < 0.05) with a negative correlation between fiber content and overall AUC following a standardized in vitro digestion method (r = -0.910). Starch content, WAI, and WSI were positively correlated to AUC of extruded snacks (r = 0.916, 0.851, and 0.878. respectively). The results illustrate a reduction in the potential glycemic response from including 5% (w/w) of MCM in extruded snacks exceeds 20%. Thus, the incorporation of MCM in ready-to-eat snack foods may be of considerable interest to the food industry in trying to regulate the glycemic response of foods. PMID:22458938

  2. Interaction between amylose and tea polyphenols modulates the postprandial glycemic response to high-amylose maize starch.

    PubMed

    Chai, Yanwei; Wang, Mingzhu; Zhang, Genyi

    2013-09-11

    High-amylose maize starch (HAM) is a common source material to make resistant starch with its high content of amylose (>70%). In the current investigation, the self-assembly of amylose in the presence of bioactive tea polyphenols (TPLs) and resulting slow digestion property of starch were explored. The experimental results using a mouse model showed a slow digestion property can be achieved with an extended and moderate glycemic response to HAM starch cocooked with TPLs. Further studies using a dilute aqueous amylose solution (0.1%, w/v) revealed an increased hydrodynamic radius of amylose molecules, indicating that TPLs could bridge them together, leading to increased molecular sizes. On the other hand, the bound TPLs interrupted the normal process of amylose recrystallizaiton evidenced by a decreased viscosity and storage modulus (G') of HAM (5%) gel, a rough surface of the cross-section of HAM film, and decreased short-range orders examined by Fourier transform infrared spectral analysis. Single-step degradation curves in the thermal gravimetric profile demonstrated the existence of a self-assembled amylose-TPL complex, which is mainly formed through hydrogen bonding interaction according to the results of iodine binding and X-ray powder diffraction analysis. Collectively, the amylose-TPL complexation influences the normal self-assembling process of amylose, leading to a low-ordered crystalline structure, which is the basis for TPLs' function in modulating the digestion property of HAM starch to produce a slowly digestible starch material that is beneficial to postprandial glycemic control and related health effects. PMID:23964645

  3. Control of neuronal excitability by NMDA-type glutamate receptors in early developing binaural auditory neurons

    PubMed Central

    Sanchez, Jason Tait; Seidl, Armin H; Rubel, Edwin W; Barria, Andres

    2012-01-01

    Precise control of neuronal excitability in the auditory brainstem is fundamental for processing timing cues used for sound localization and signal discrimination in complex acoustic environments. In mature nucleus laminaris (NL), the first nucleus responsible for binaural processing in chickens, neuronal excitability is governed primarily by voltage-activated potassium conductances (KVA). High levels of KVA expression in NL neurons result in one or two initial action potentials (APs) in response to high-frequency synaptic activity or sustained depolarization. Here we show that during a period of synaptogenesis and circuit refinement, before hearing onset, KVA conductances are relatively small, in particular low-voltage-activated K+ conductances (KLVA). In spite of this, neuronal output is filtered and repetitive synaptic activity generates only one or two initial APs during a train of stimuli. During this early developmental time period, synaptic NMDA-type glutamate receptors (NMDA-Rs) contain primarily the GluN2B subunit. We show that the slow decay kinetics of GluN2B-containing NMDA-Rs allows synaptic responses to summate, filtering the output of NL neurons before intrinsic properties are fully developed. Weaker Mg2+ blockade of NMDA-Rs and ambient glutamate early in development generate a tonic NMDA-R-mediated current that sets the membrane potential at more depolarized values. Small KLVA conductances, localized in dendrites, prevent excessive depolarization caused by tonic activation of NMDA-Rs. Thus, before intrinsic properties are fully developed, NMDA-Rs control the output of NL neurons during evoked synaptic transmission. PMID:22826130

  4. Control of neuronal excitability by NMDA-type glutamate receptors in early developing binaural auditory neurons.

    PubMed

    Sanchez, Jason Tait; Seidl, Armin H; Rubel, Edwin W; Barria, Andres

    2012-10-01

    Precise control of neuronal excitability in the auditory brainstem is fundamental for processing timing cues used for sound localization and signal discrimination in complex acoustic environments. In mature nucleus laminaris (NL), the first nucleus responsible for binaural processing in chickens, neuronal excitability is governed primarily by voltage-activated potassium conductances (K(VA)). High levels of K(VA) expression in NL neurons result in one or two initial action potentials (APs) in response to high-frequency synaptic activity or sustained depolarization. Here we show that during a period of synaptogenesis and circuit refinement, before hearing onset, K(VA) conductances are relatively small, in particular low-voltage-activated K(+) conductances (K(LVA)). In spite of this, neuronal output is filtered and repetitive synaptic activity generates only one or two initial APs during a train of stimuli. During this early developmental time period, synaptic NMDA-type glutamate receptors (NMDA-Rs) contain primarily the GluN2B subunit. We show that the slow decay kinetics of GluN2B-containing NMDA-Rs allows synaptic responses to summate, filtering the output of NL neurons before intrinsic properties are fully developed. Weaker Mg(2+) blockade of NMDA-Rs and ambient glutamate early in development generate a tonic NMDA-R-mediated current that sets the membrane potential at more depolarized values. Small KLVA conductances, localized in dendrites, prevent excessive depolarization caused by tonic activation of NMDA-Rs. Thus, before intrinsic properties are fully developed, NMDA-Rs control the output of NL neurons during evoked synaptic transmission. PMID:22826130

  5. Effects of dietary glycemic index on brain regions related to reward and craving in men1234

    PubMed Central

    Lennerz, Belinda S; Alsop, David C; Holsen, Laura M; Stern, Emily; Rojas, Rafael; Ebbeling, Cara B; Goldstein, Jill M

    2013-01-01

    Background: Qualitative aspects of diet influence eating behavior, but the physiologic mechanisms for these calorie-independent effects remain speculative. Objective: We examined effects of the glycemic index (GI) on brain activity in the late postprandial period after a typical intermeal interval. Design: With the use of a randomized, blinded, crossover design, 12 overweight or obese men aged 18–35 y consumed high- and low-GI meals controlled for calories, macronutrients, and palatability on 2 occasions. The primary outcome was cerebral blood flow as a measure of resting brain activity, which was assessed by using arterial spin-labeling functional magnetic resonance imaging 4 h after test meals. We hypothesized that brain activity would be greater after the high-GI meal in prespecified regions involved in eating behavior, reward, and craving. Results: Incremental venous plasma glucose (2-h area under the curve) was 2.4-fold greater after the high- than the low-GI meal (P = 0.0001). Plasma glucose was lower (mean ± SE: 4.7 ± 0.14 compared with 5.3 ± 0.16 mmol/L; P = 0.005) and reported hunger was greater (P = 0.04) 4 h after the high- than the low-GI meal. At this time, the high-GI meal elicited greater brain activity centered in the right nucleus accumbens (a prespecified area; P = 0.0006 with adjustment for multiple comparisons) that spread to other areas of the right striatum and to the olfactory area. Conclusions: Compared with an isocaloric low-GI meal, a high-GI meal decreased plasma glucose, increased hunger, and selectively stimulated brain regions associated with reward and craving in the late postprandial period, which is a time with special significance to eating behavior at the next meal. This trial was registered at clinicaltrials.gov as NCT01064778. PMID:23803881

  6. Birth defects in pregestational diabetes: Defect range, glycemic threshold and pathogenesis

    PubMed Central

    Gabbay-Benziv, Rinat; Reece, E Albert; Wang, Fang; Yang, Peixin

    2015-01-01

    Currently, 60 million women of reproductive age (18-44 years old) worldwide, and approximately 3 million American women have diabetes mellitus, and it has been estimated that this number will double by 2030. Pregestational diabetes mellitus (PGD) is a significant public health problem that increases the risk for structural birth defects affecting both maternal and neonatal pregnancy outcome. The most common types of human structural birth defects associated with PGD are congenital heart defects and central nervous system defects. However, diabetes can induce birth defects in any other fetal organ. In general, the rate of birth defects increases linearly with the degree of maternal hyperglycemia, which is the major factor that mediates teratogenicity of PGD. Stringent prenatal care and glycemic control are effective means to reduce birth defects in PGD pregnancies, but cannot reduce the incidence of birth defects to the rate of that is seen in the nondiabetic population. Studies in animal models have revealed that PGD induces oxidative stress, which activates cellular stress signalling leading to dysregulation of gene expression and excess apoptosis in the target organs, including the neural tube and embryonic heart. Activation of the apoptosis signal-regulating kinase 1 (ASK1)-forkhead transcription factor 3a (FoxO3a)-caspase 8 pathway causes apoptosis in the developing neural tube leading to neural tube defects (NTDs). ASK1 activates the c-Jun-N-Terminal kinase 1/2 (JNK1/2), which leads to activation of the unfolded protein response and endoplasmic reticulum (ER) stress. Deletion of the ASK1 gene, the JNK1 gene, or the JNK2 gene, or inhibition of ER stress by 4-Phenylbutyric acid abrogates diabetes-induced apoptosis and reduces the formation of NTDs. Antioxidants, such as thioredoxin, which inhibits the ASK1-FoxO3a-caspase 8 pathway or ER stress inhibitors, may prevent PGD-induced birth defects. PMID:25897357

  7. The influence of glycemic index on cognitive functioning: a systematic review of the evidence.

    PubMed

    Philippou, Elena; Constantinou, Marios

    2014-03-01

    The impact of the rate of carbohydrate absorption, as measured by the carbohydrate's glycemic index (GI) on cognitive performance, is not clear. The aim of this review was to systematically assess the relevant research studies. A systematic review of English-language articles using Medline, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, and PsycARTICLES (up to July 2012) using the search terms "glyc(a)emic index" or "glycaemic load" combined with "cognitive function" or "cognition" or "memory" was carried out. Inclusion and exclusion criteria were prespecified. Eligibility of the identified studies was assessed independently by the 2 reviewers. Independent extraction of data was carried out by the 2 authors using predefined data fields. The primary outcome measure was the effect on cognitive function (CF) after the consumption of meals varying in GI. Eleven eligible studies were identified. The age range of the participants varied from 6 to 82 y old. Overall, the findings were inconsistent, with some studies showing benefits toward either the high-GI or the low-GI meal, others not finding any differences between the 2 meals, and other studies showing a positive or negative effect on performance on only some cognitive domain or domains after consumption of 1 of the 2 meals. A number of methodologic and confounding factors were identified that could explain these inconsistencies. These include the study design, the selected sample (size, age, blood glucose regulation), the timing of testing, the cognitive domain being examined, the number and type of cognitive tests used, the meals provided (composition, size), the timing of blood samples collected, as well as the possibility of bias because participants and investigators were not blinded to randomization. A low-GI meal may favor CF in adults, but the findings at present are inconclusive. On the basis of this review, it is suggested that future studies address the identified methodologic issues and some recommendations are proposed to this effect. PMID:24618754

  8. The Influence of Glycemic Index on Cognitive Functioning: A Systematic Review of the Evidence1

    PubMed Central

    Philippou, Elena; Constantinou, Marios

    2014-01-01

    The impact of the rate of carbohydrate absorption, as measured by the carbohydrate’s glycemic index (GI) on cognitive performance, is not clear. The aim of this review was to systematically assess the relevant research studies. A systematic review of English-language articles using Medline, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, and PsycARTICLES (up to July 2012) using the search terms “glyc(a)emic index” or “glycaemic load” combined with “cognitive function” or “cognition” or “memory” was carried out. Inclusion and exclusion criteria were prespecified. Eligibility of the identified studies was assessed independently by the 2 reviewers. Independent extraction of data was carried out by the 2 authors using predefined data fields. The primary outcome measure was the effect on cognitive function (CF) after the consumption of meals varying in GI. Eleven eligible studies were identified. The age range of the participants varied from 6 to 82 y old. Overall, the findings were inconsistent, with some studies showing benefits toward either the high-GI or the low-GI meal, others not finding any differences between the 2 meals, and other studies showing a positive or negative effect on performance on only some cognitive domain or domains after consumption of 1 of the 2 meals. A number of methodologic and confounding factors were identified that could explain these inconsistencies. These include the study design, the selected sample (size, age, blood glucose regulation), the timing of testing, the cognitive domain being examined, the number and type of cognitive tests used, the meals provided (composition, size), the timing of blood samples collected, as well as the possibility of bias because participants and investigators were not blinded to randomization. A low-GI meal may favor CF in adults, but the findings at present are inconclusive. On the basis of this review, it is suggested that future studies address the identified methodologic issues and some recommendations are proposed to this effect. PMID:24618754

  9. Interventions employing mobile technology for overweight and obesity: an early systematic review of randomized controlled trials.

    PubMed

    Bacigalupo, R; Cudd, P; Littlewood, C; Bissell, P; Hawley, M S; Buckley Woods, H

    2013-04-01

    Obesity is a global epidemic with major healthcare implications and costs. Mobile technologies are potential interventions to promote weight loss. An early systematic review of this rapidly growing area of research was conducted. Electronic databases were searched for articles published between January 1998 and October 2011. Data sources included Medline, Embase and the Cochrane Central Register of Controlled Trials. Ongoing research was searched for using clinical trials databases and registers. Out of 174 articles retrieved, 21 met the inclusion criteria of randomized controlled trials (RCTs) on mobile technology interventions facilitating weight loss in overweight and obese adults with any other comparator. A narrative synthesis was undertaken. Seven articles were included and appraised using the Cochrane risk of bias tool: four presented a low risk of bias and three presented a high risk of bias. There is consistent strong evidence across the included multiple high-quality RCTs that weight loss occurs in the short-term because of mobile technology interventions, with moderate evidence for the medium-term. Recommendations for improving the reporting and quality of future trials are made including reporting weight loss in percent to meet clinical standards, and including features such as long-term follow-up, cost-effectiveness and patient acceptability. PMID:23167478

  10. Early pitch-shift response is active in both steady and dynamic voice pitch control.

    PubMed

    Burnett, Theresa A; Larson, Charles R

    2002-09-01

    When air conducted auditory feedback pitch is experimentally shifted upward or downward during steady phonation, voice pitch changes in response. The first pitch change is an automatic deflection opposite in direction to the feedback shift. It appears to help stabilize voice pitch by counteracting unintended changes. But what happens during an intended pitch change? If the purpose of the first pitch-shift response is to stabilize voice pitch around a fixed target, it should be suppressed during voluntary pitch changes. Alternatively, if the pitch-shift response is a general process of voice control it should be modified during intended pitch changes to bring production in line with the desired output. Auditory feedback pitch was shifted during steady pitch and upward glissando vocalizations by thirty trained singers. Contrary to the "steady-specific" hypothesis, pitch-shift responses occurred during dynamic pitch vocalizations. Responses were comparable in direction, peak time, and slope, but had significantly longer latency and smaller magnitude than responses elicited during steady note phonation. Results indicate that the early pitch-shift response is a general component of voice control that serves to automatically bring phonation pitch into agreement with an intended target, whether that target is constant or changing in time. PMID:12243154

  11. Informing food choices and health outcomes by use of the dietary glycemic index

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Considerable epidemiologic evidence links consuming lower glycemic index (GI) diets with good health, particularly upon aging. The GI is a kinetic parameter that reflects the ability of carbohydrate (CHO) contained in consumed foods to raise blood glucose in vivo. Newer nutritional, clinical, and ex...

  12. Postprandial lipid responses to standard carbohydrate challenges used to determine glycemic index values

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Prior studies assessing metabolic effects of different types of carbohydrate have focused on their glycemic response. Not considered has been the response of postprandial cardiometabolic risk indicators. This study assessed the postprandial lipid responses to two forms of carbohydrates used as ref...

  13. Low Glycemic Index Breakfasts and Reduced Food Intake in Preadolescent Children

    Microsoft Academic Search

    Janet M. Warren; C. Jeya; K. Henry; Vanessa Simonite

    2009-01-01

    Objective. Recent reports have sug- gested that a low glycemic index (GI) diet may have a role in the management of obesity through its ability to increase the satiety value of food and modulate appetite. To date, no long-term clinical trials have examined the effect of dietary GI on body weight regulation. The ma- jority of evidence comes from single-day

  14. POSTPRANDIAL MONOCYTE ACTIVATION IN RESPONSE TO MEALS WITH HIGH AND LOW GLYCEMIC LOADS IN OVERWEIGHT WOMEN

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Recent data show that atherosclerosis is initiated and perpetuated by inflammatory events. Activation of immune cells such as monocytes initiates inflammation, a key step in atherosclerosis. Objective: We hypothesize that a high glycemic load meal activates inflammatory cells, and this i...

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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 ...

  16. Exploration of functionality of low glycemic impact sugars and polyols using DSC, RVA, and cookie baking

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Consumers' interest in healthy cookies is increasing, including expectations for prebiotic nutritional benefits and low glycemic impact. Plasticization of flour polymers is critical to mixing and baking for baked goods. However, concentrated sugar solutions act as anti-plasticizers compared to wat...

  17. Comparison of glycemic index of spelt and wheat bread in human volunteers

    Microsoft Academic Search

    Carole Marques; Ludovic D’auria; Patrice D. Cani; Chiara Baccelli; Raoul Rozenberg; Nike L. Ruibal-Mendieta; Géraldine Petitjean; Dominique L. Delacroix; Joëlle Quetin-Leclercq; Jean-Louis Habib-Jiwan; Marc Meurens; Nathalie M. Delzenne

    2007-01-01

    The assessment of the glycemic index (GI) seems to be an important parameter to take into account in order to better understand the physiologic effects of foods with high carbohydrate levels. Among cereals, which are major sources of carbohydrates, spelt (Triticum spelta L.) has been considered as particularly interesting from a nutritional point of view. The aim of this study

  18. Soy foods have low glycemic and insulin response indices in normal weight subjects

    Microsoft Academic Search

    Robert M Blair; EC Henley; Aaron Tabor

    2006-01-01

    BACKGROUND: Foods with a low glycemic index (GI) may provide a variety of health benefits. The objective of the present study was to measure the GI and insulin index (II) of select soy foods. METHODS: The study was conducted in two parts with low-carbohydrate products being tested separately. In Experiment 1, subjects averaged 23.2 years of age with BMI =

  19. “Greenlight Study”: A Controlled Trial of Low-Literacy, Early Childhood Obesity Prevention

    PubMed Central

    Perrin, Eliana M.; Yin, H. Shonna; Bronaugh, Andrea; Rothman, Russell L.

    2014-01-01

    Children who become overweight by age 2 years have significantly greater risks of long-term health problems, and children in low-income communities, where rates of low adult literacy are highest, are at increased risk of developing obesity. The objective of the Greenlight Intervention Study is to assess the effectiveness of a low-literacy, primary-care intervention on the reduction of early childhood obesity. At 4 primary-care pediatric residency training sites across the US, 865 infant-parent dyads were enrolled at the 2-month well-child checkup and are being followed through the 24-month well-child checkup. Two sites were randomly assigned to the intervention, and the other sites were assigned to an attention-control arm, implementing the American Academy of Pediatrics' The Injury Prevention Program. The intervention consists of an interactive educational toolkit, including low-literacy materials designed for use during well-child visits, and a clinician-centered curriculum for providing low-literacy guidance on obesity prevention. The study is powered to detect a 10% difference in the number of children overweight (BMI > 85%) at 24 months. Other outcome measures include observed physician–parent communication, as well as parent-reported information on child dietary intake, physical activity, and injury-prevention behaviors. The study is designed to inform evidence-based standards for early childhood obesity prevention, and more generally to inform optimal approaches for low-literacy messages and health literacy training in primary preventive care. This article describes the conceptual model, study design, intervention content, and baseline characteristics of the study population. PMID:24819570

  20. The role of early inhaled budesonide therapy in meconium aspiration in term newborns: a randomized control study.

    PubMed

    Garg, Neelmani; Choudhary, Mukesh; Sharma, Deepak; Dabi, Dhanraj; Choudhary, Jagveer Singh; Choudhary, Sushil Kumar

    2014-12-01

    Abstract Objective: To study the clinical spectrum of Meconium aspiration syndrome babies and to find out the efficacy of early nebulized steroids (Budesonide) in the clinical course and outcome (morbidity and mortality) of neonates with meconium aspiration: randomized controlled trial. Method and material: A total of 78 neonates were included in the study. After randomization, intervention group received nebulization with Budesonide (0.5?mg dissolved in 2.5-ml sterile normal saline within 2?h of birth and second dose was given at 12?h of birth) whereas controls were nebulized with normal saline. All neonates were accessed for serial respiratory distress score (Downe's score), requirement (dependence) of oxygen (in days), duration of neonatal intensive-care unit (NICU) stay, any complication and their final outcome. Results: The mean days of oxygen requirement for the cases and controls were 1.79 and 3.46, respectively (p?early improvement in general condition (early improvement in respiratory distress and early normalization of Downe's score) of the newborn with lesser oxygen requirement, thus early discharge from NICU but has no impact on final outcome. PMID:25373430

  1. The Modifying Effects of Galactomannan from Canadian-Grown Fenugreek (Trigonella foenum-graecum L.) on the Glycemic and Lipidemic Status in Rats

    PubMed Central

    Srichamroen, Anchalee; Field, Catherine J.; Thomson, Alan B.R.; Basu, Tapan K.

    2008-01-01

    Using high sucrose-fed male Sprague-Dawley rats, a study was conducted to determine the effects of feeding Galactomannan (GAL), a soluble dietary fiber extracted from Canadian-grown fenugreek seeds, on blood lipid and glucose responses. Rats (n = 8, 175–200 g) were randomly assigned to one of three high sucrose diets containing 10% cellulose (control), 7.5% cellulose + 2.5% GAL, and 5% cellulose + 5% GAL, respectively for 4 weeks. After 3 weeks, an oral glucose tolerance test (OGTT) was performed on each rat. A week later blood samples were collected to determine the effect on blood lipids. A significant reduction in glycemic response was observed only in 5% GAL group at 120 min following OGTT, when compared with that of control and 2.5% GAL groups. The plasma level of insulin was also significantly reduced (p<0.001) in 5% GAL-fed rats but at all times during OGTT. These animals also showed a reduction in body weight gain (p<0.05) in parallel with less food intake (p<0.05). All GAL-fed (2.5% and 5.0%) rats had significantly reduced plasma levels of triglycerides and total cholesterol in association with a reduction in epididymal adipose weight. Overall, this study demonstrated that feeding GAL from Canadian-grown fenugreek seeds has the potential to alter glycemic and lipidemic status and reduce abdominal fat in normal rats. PMID:19015751

  2. Relationship between oxidized low-density lipoprotein antibodies and obesity in different glycemic situations

    PubMed Central

    Babakr, Abdullatif Taha; Elsheikh, Osman Mohamed; Almarzouki, Abdullah A; Assiri, Adel Mohamed; Abdalla, Badr Eldin Elsonni; Zaki, Hani Yousif; Fatani, Samir H; NourEldin, EssamEldin Mohamed

    2014-01-01

    Background Autoantibodies to oxidized low-density lipoprotein (oxLDL) are a heterogeneous group of antibodies that are controversially discussed to be either pathogenic or protective. Biochemical and anthropometric measurements correlated with increased levels of these antibodies are also controversial, especially in conditions of impaired glucose tolerance and type 2 diabetes mellitus. The present study was conducted to evaluate levels of oxLDL antibodies and their correlation with obesity in different glycemic situations. Methods Two hundred and seventy-four adult males were classified into three subgroups: group 1 (n=125), comprising a control group of nondiabetic subjects; group 2 (n=77), comprising subjects with impaired glucose tolerance; and group 3 (n=72), comprising patients with type 2 diabetes mellitus. Body mass index was calculated, and measurement of oxLDL and oxLDL antibodies was performed. Results Higher mean concentrations of oxLDL were found in the type 2 diabetes mellitus and impaired glucose tolerance groups (143.5±21.9 U/L and 108.7±23.7 U/L, respectively). The mean value for the control group was 73.5±27.5 U/L (P<0.001). Higher mean concentrations of anti-oxLDL antibodies were observed in the type 2 diabetes mellitus and impaired glucose tolerance groups (55.7±17.8 U/L and 40.4±17.6 U/L, respectively). The mean value for the control group was 20.4±10 U/L (P<0.001). Levels of anti-oxLDL antibodies were found to be positively and significantly correlated with body mass index in the control group (r=0.46), impaired glucose tolerance (r=0.51), type 2 diabetes mellitus group (r=0.46), and in the whole study population (r=0.44; P<0.001). Conclusion Anti-oxLDL antibody levels were increased in subjects with type 2 diabetes mellitus and impaired glucose tolerance and were positively correlated with obesity and body mass index. PMID:25368528

  3. Environmental control on early life stages of flatfishes in the Lima Estuary (NW Portugal)

    NASA Astrophysics Data System (ADS)

    Ramos, Sandra; Ré, Pedro; Bordalo, Adriano A.

    2009-06-01

    Several flatfishes spawn in oceanic waters and pelagic larvae are transported inshore to settle in the nursery areas, usually estuaries, where they remain during their juvenile life. Nursery areas appear as extremely important habitats, not only for juveniles but also for the earlier planktonic larval fish. Yet, the majority of nursery studies tend to focus only on one development stage, missing an integrative approach of the entire early life that fishes spent within a nursery ground. Thus, the present study assessed the influence of environmental parameters on the dynamics of the larval and juvenile flatfishes, throughout their nursery life in the Lima Estuary. Between April 2002 and April 2004, fortnightly subsurface ichthyoplankton samples were collected and juveniles were collected from October 2003 until September 2005. Larval assemblages comprised nine flatfish species, while only six were observed among the juvenile assemblages. Solea senegalensis and Platichthys flesus were the most abundant species of both fractions of the Lima Estuary flatfishes. Larval flatfish assemblages varied seasonally, without relevant differences between lower and middle estuary. Platichthys flesus dominated the spring samples and summer and autumn periods were characterized by an increase of overall abundance and diversity of larval flatfishes, mainly S. senegalensis, associated with temperature increase and reduced river flow. On the contrary, during the winter abundance sharply decreased, as a consequence of higher river run-off that might compromised the immigration of incompetent marine larvae. Juvenile flatfishes were more abundant in the middle and upper areas of the estuary, but the species richness was higher near the river mouth. Sediment type, distance from the river mouth, salinity, temperature and dissolved oxygen were identified as the main environmental factors structuring the juvenile flatfish assemblages. Juveniles were spatially discrete, with the most abundant species S. senegalensis and P. flesus associated with the middle and upper estuary, while the remaining species were associated with the lower estuarine areas. The larval fraction exhibited distinct dynamics from the juvenile estuarine flatfish community. Larval flatfishes showed a strong seasonal structure mainly regulated by biological features as the spawning season and also by seasonal variations of water characteristics. On the other hand, juvenile flatfishes were markedly controlled by site specific characteristics such as sediments structure, distance from the river mouth and salinity regime. The present study emphasized the idea that the environmental control varies throughout the ontogenetic development, stressing the importance of integrating all the early life of a species in flatfish nursery studies.

  4. Glycemic index of starch affects nitrogen retention in grower pigs.

    PubMed

    Drew, M D; Schafer, T C; Zijlstra, R T

    2012-04-01

    Three studies were performed to examine the effect of starch and protein digestion rates on N retention in grower pigs. In Exp. 1, the glycemic index (GI) of corn, a malting barley, and a slow-rumen-degradable barley (SRD-barley) were measured using 6 barrows (BW = 18.0 ± 0.5 kg). The GI of malting barley was greater (P < 0.05) than that of SRD-barley (71.1 vs. 49.4), and the GI of both barley cultivars was less (P < 0.05) than that of corn (104.8). In Exp. 2, the standardized ileal digestibility of AA and DE content of the 3 ingredients were determined using 5 ileal-cannulated barrows (BW = 20.7 ± 2.3). The apparent total-tract energy digestibility values of corn (86.1%) and malting barley (85.7%) were greater (P < 0.05) than that of SRD-barley (82.3%). The standardized ileal digestibility of Lys was 94.0, 92.6, and 92.4% for corn, malting barley, and SRD-barley, respectively, and did not differ among grains. In Exp. 3, 6 diets were formulated to equal DE (3.40 Mcal/kg), standardized ileal digestibility of Lys (8.6 g/kg), starch (424.9 g/kg), and digestible CP (180.0 g/kg) using the values obtained in Exp. 2. Three GI [high (corn), medium (malting barley), and low (SRD-barley)] and 2 rates of protein digestion [rapid (soy protein hydrolysate) and slow (soy protein isolate)] were tested in a 3 × 2 factorial arrangement with 36 barrows (BW = 32.2 ± 2.5 kg). Pigs were fed 3.0 times the maintenance energy requirement daily in 2 meals for 2 wk and were housed in metabolic crates to collect feces and urine separately. At the end of the study, intestinal contents were collected from 4 equal-length segments of the small intestine. The percentage of unabsorbed CP in segment 1 relative to dietary CP was greater (P < 0.05) for the soy protein isolate diet than for the soy protein hydrolysate diet (170.3 vs. 116.5%). The percentages of unabsorbed starch in segments 1 and 2 were greater (P < 0.05) for the SRD-barley diet than for the malting barley or corn diet. Nitrogen intake and fecal N excretion were greater (P < 0.05) for pigs fed the malting barley and SRD-barley diets than for pigs fed the corn diet. Urinary N excretion was greater (P < 0.05) for pigs fed the SRD-barley diet than for pigs fed the corn or malting barley diet. Pigs fed slowly digestible starch (SRD-barley; 46.6%) had less (P < 0.05) net N retention than pigs fed corn or malting barley (54.7 and 54.1%, respectively). In conclusion, slowly digestible starch sources such as SRD-barley may not be suitable to support maximum protein deposition in restricted-fed grower pigs. PMID:21984722

  5. Truancy in Late Elementary and Early Secondary Education: The Influence of Social Bonds and Self-Control--The TRAILS Study

    ERIC Educational Resources Information Center

    Veenstra, Rene; Lindenberg, Siegwart; Tinga, Frank; Ormel, Johan

    2010-01-01

    Some pupils already show unexcused, illegal, surreptitious absences in elementary education or the first years of secondary education. Are weak social bonds (see also Hirschi, 1969) and a lack of self-control (Gottfredson & Hirschi, 1990) indicative of truancy at an early age? Of the children in our sample, 5% were persistent truants in late…

  6. Randomized Controlled Trial for Early Intervention for Autism: A Pilot Study of the Autism 1-2-3 Project

    ERIC Educational Resources Information Center

    Wong, Virginia C. N.; Kwan, Queenie K.

    2010-01-01

    We piloted a 2-week "Autism-1-2-3" early intervention for children with autism and their parents immediately after diagnosis that targeted at (1) eye contact, (2) gesture and (3) vocalization/words. Seventeen children were randomized into the Intervention (n = 9) and Control (n = 8) groups. Outcome measures included the Autism Diagnostic…

  7. How Do Therapists Ally with Adolescents in Family Therapy? An Examination of Relational Control Communication in Early Sessions

    ERIC Educational Resources Information Center

    de la Pena, Cristina Muniz; Friedlander, Myrna L.; Escudero, Valentin; Heatherington, Laurie

    2012-01-01

    Sequential analyses examined associations between the working alliance and therapist-adolescent communication patterns in 10 Spanish cases of brief conjoint family therapy. Early sessions with strong versus problematic alliances, rated by observers, were selected for coding of relational control communication patterns. No differences were found in…

  8. Early Elementary School Adjustment of Maltreated Children in Foster Care: The Roles of Inhibitory Control and Caregiver Involvement

    ERIC Educational Resources Information Center

    Pears, Katherine C.; Fisher, Philip A.; Bruce, Jacqueline; Kim, Hyoun K.; Yoerger, Karen

    2010-01-01

    In this study, 85 maltreated foster children and 56 nonmaltreated community children (M age = 3-6 years) were assessed across kindergarten and first grade to examine the hypothesis that inhibitory control and caregiver involvement mediate associations between a history of maltreatment and foster placement and early school adjustment. Specifically,…

  9. Correlative control of early stages of flower bud initiation in 'bourse' shoots of apple (Malus x domestica Borkh. cv.

    E-print Network

    Paris-Sud XI, Université de

    Correlative control of early stages of flower bud initiation in 'bourse' shoots of apple (Malus x leaves whose axillary buds differen- tiate and may grow out as shoots. The bourse shoot can flower again- tive growth. Our objectives were to determine what treatments could cause 90-100% of bourse buds

  10. A Randomised Controlled Trial to Determine the Effectiveness of an Early Psychological Intervention with Children Involved in Road Traffic Accidents

    ERIC Educational Resources Information Center

    Stallard, Paul; Velleman, Richard; Salter, Emma; Howse, Imogen; Yule, William; Taylor, Gordon

    2006-01-01

    Objective: To determine whether an early intervention using a psychological debriefing format is effective in preventing psychological distress in child road traffic accident survivors. Design: Randomised controlled trial. Setting: Accident and Emergency Department, Royal United Hospital, Bath. Subjects: 158 children aged 7-18. Follow-up…

  11. Metoclopramide Improves Gastric but not Gallbladder Emptying in Cardiac Surgery Patients with Early Intragastric Enteral Feeding: Randomized Controlled Trial

    Microsoft Academic Search

    Marko Zeliæ; Alen Protiæ

    To evaluate the effect of metoclopramide on gastric emptying in coronary artery bypass graft (CABG) surgery patients with early enteral nutrition and to evaluate the effect of metoclopramide on motility of the gallbladder in these patients. Methods A prospective, randomized, placebo-controlled, double-blind study of 40 patients treated at cardio- surgical intensive care unit after CABG surgery. The patients were divided

  12. Internet-Based Early Intervention to Prevent Posttraumatic Stress Disorder in Injury Patients: Randomized Controlled Trial

    PubMed Central

    Sijbrandij, Marit; de Vries, Giel-Jan; Reitsma, Johannes B; van de Schoot, Rens; Goslings, J Carel; Luitse, Jan SK; Bakker, Fred C; Gersons, Berthold PR; Olff, Miranda

    2013-01-01

    Background Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms. Objective To determine whether Trauma TIPS is effective in preventing the onset of PTSD symptoms in injury patients. Methods Adult, level 1 trauma center patients were randomly assigned to receive the fully automated Trauma TIPS Internet intervention (n=151) or to receive no early intervention (n=149). Trauma TIPS consisted of psychoeducation, in vivo exposure, and stress management techniques. Both groups were free to use care as usual (nonprotocolized talks with hospital staff). PTSD symptom severity was assessed at 1, 3, 6, and 12 months post injury with a clinical interview (Clinician-Administered PTSD Scale) by blinded trained interviewers and self-report instrument (Impact of Event Scale—Revised). Secondary outcomes were acute anxiety and arousal (assessed online), self-reported depressive and anxiety symptoms (Hospital Anxiety and Depression Scale), and mental health care utilization. Intervention usage was documented. Results The mean number of intervention logins was 1.7, SD 2.5, median 1, interquartile range (IQR) 1-2. Thirty-four patients in the intervention group did not log in (22.5%), 63 (41.7%) logged in once, and 54 (35.8%) logged in multiple times (mean 3.6, SD 3.5, median 3, IQR 2-4). On clinician-assessed and self-reported PTSD symptoms, both the intervention and control group showed a significant decrease over time (P<.001) without significant differences in trend. PTSD at 12 months was diagnosed in 4.7% of controls and 4.4% of intervention group patients. There were no group differences on anxiety or depressive symptoms over time. Post hoc analyses using latent growth mixture modeling showed a significant decrease in PTSD symptoms in a subgroup of patients with severe initial symptoms (n=20) (P<.001). Conclusions Our results do not support the efficacy of the Trauma TIPS Internet-based early intervention in the prevention of PTSD symptoms for an unselected population of injury patients. Moreover, uptake was relatively low since one-fifth of individuals did not log in to the intervention. Future research should therefore focus on innovative strategies to increase intervention usage, for example, adding gameplay, embedding it in a blended care context, and targeting high-risk individuals who are more likely to benefit from the intervention. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 57754429; http://www.controlled-trials.com/ISRCTN57754429 (Archived by WebCite at http://webcitation.org/6FeJtJJyD). PMID:23942480

  13. Construction and properties of pseudorabies virus recombinants with altered control of immediate-early gene expression.

    PubMed Central

    Glazenburg, K L; Peeters, B P; Pol, J M; Gielkens, A L; Moormann, R J

    1995-01-01

    To investigate how altered control of expression of the essential immediate-early (IE) gene of pseudorabies virus influences virus replication and virulence, we replaced the IE promoter with the tissue-specific promoters of the bovine cytokeratin IV gene (CKIV), the bovine cytokeratin VIb gene (CKVIb), or the inducible promoter of Drosophila heat shock gene HSP70. We compared expression of the IE gene of the wild-type virus and recombinant viruses in different cell types and at different temperatures and found that IE expression had become cell type or temperature dependent. When a recombinant virus was titrated on nonpermissive cells or was titrated at nonpermissive temperatures in vitro, the plating efficiency was reduced by more than 99%. Mice were inoculated subcutaneously (s.c.), intraperitoneally (i.p.), or intranasally (i.n.) with a dose equal to 100 times the 50% lethal dose of the wild-type virus. After inoculation with temperature-sensitive recombinant N-HSP, two (s.c.), two (i.p.), and four (i.n.) of five mice died. However, at this dose, recombinant N-CKIV, which contains a promoter specific for stratified epithelial tissue of the tongue mucosa, was not lethal when inoculated s.c. or i.p. but killed four mice when inoculated i.n. Recombinant N-CKVIb, which contains a promoter specific for the suprabasal layers of the epidermis, was not lethal after inoculation by any of the three routes. In explant cultures of nasal mucosa of pigs, replication of N-CKIV and N-CKVIb was not markedly reduced in the epithelium. However, in contrast to results obtained with wild-type virus, infection of the stroma was not observed. We conclude that the replicative ability and virulence of pseudorabies virus can be influenced by altering control of expression of the IE gene. PMID:7527083

  14. Finding the balance between capture and control: Oculomotor selection in early deaf adults.

    PubMed

    Heimler, Benedetta; van Zoest, Wieske; Baruffaldi, Francesca; Donk, Mieke; Rinaldi, Pasquale; Caselli, Maria Cristina; Pavani, Francesco

    2015-06-01

    Previous work investigating the consequence of bilateral deafness on attentional selection suggests that experience-dependent changes in this population may result in increased automatic processing of stimulus-driven visual information (e.g., saliency). However, adaptive behavior also requires observers to prioritize goal-driven information relevant to the task at hand. In order to investigate whether auditory deprivation alters the balance between these two components of attentional selection, we assessed the time-course of overt visual selection in deaf adults. Twenty early-deaf adults and twenty hearing controls performed an oculomotor additional singleton paradigm. Participants made a speeded eye-movement to a unique orientation target, embedded among homogenous non-targets and one additional unique orientation distractor that was more, equally or less salient than the target. Saliency was manipulated through color. For deaf participants proficiency in sign language was assessed. Overall, results showed that fast initiated saccades were saliency-driven, whereas later initiated saccades were goal-driven. However, deaf participants were overall slower than hearing controls at initiating saccades and also less captured by task-irrelevant salient distractors. The delayed oculomotor behavior of deaf adults was not explained by any of the linguistic measures acquired. Importantly, a multinomial model applied to the data revealed a comparable evolution over time of the underlying saliency- and goal-driven processes between the two groups, confirming the crucial role of saccadic latencies in determining the outcome of visual selection performance. The present findings indicate that prioritization of saliency-driven information is not an unavoidable phenomenon in deafness. Possible neural correlates of the documented behavioral effect are also discussed. PMID:25829265

  15. A large Legionnaires' disease outbreak in Pamplona, Spain: early detection, rapid control and no case fatality

    PubMed Central

    CASTILLA, J.; BARRICARTE, A.; ALDAZ, J.; GARCÍA CENOZ, M.; FERRER, T.; PELAZ, C.; PINEDA, S.; BALADRÓN, B.; MARTÍN, I.; GOÑI, B.; ARATAJO, P.; CHAMORRO, J.; LAMEIRO, F.; TORROBA, L.; DORRONSORO, I.; MARTÍNEZ-ARTOLA, V.; ESPARZA, M. J.; GASTAMINZA, M. A.; FRAILE, P.; ALDAZ, P.

    2008-01-01

    SUMMARY An outbreak of Legionnaire's disease was detected in Pamplona, Spain, on 1 June 2006. Patients with pneumonia were tested to detect Legionella pneumophila antigen in urine (Binax Now; Binax Inc., Scarborough, ME, USA), and all 146 confirmed cases were interviewed. The outbreak was related to district 2 (22 012 inhabitants), where 45% of the cases lived and 50% had visited; 5% lived in neighbouring districts. The highest incidence was found in the resident population of district 2 (3/1000 inhabitants), section 2 (14/1000). All 31 cooling towers of district 2 were analysed. L. pneumophila antigen (Binax Now) was detected in four towers, which were closed on 2 June. Only the strain isolated in a tower situated in section 2 of district 2 matched all five clinical isolates, as assessed by mAb and two genotyping methods, AFLP and PFGE. Eight days after closing the towers, new cases ceased appearing. Early detection and rapid coordinated medical and environmental actions permitted immediate control of the outbreak and probably contributed to the null case fatality. PMID:17662166

  16. Achieving glycemic goals with addition of incretin-based therapies to insulin in patients with type 2 diabetes mellitus.

    PubMed

    Tibaldi, Joseph

    2014-06-01

    As type 2 diabetes mellitus progresses, multiple antihyperglycemic agents are needed to maintain adequate glycemic control. Consensus guidelines recommend combining agents with complementary mechanisms of action. Given that hypoglycemic events increase the risk of cardiovascular disease and that weight gain affects mortality in obese individuals, it is important to control hyperglycemia without inducing hypoglycemia or weight gain. Peer-reviewed clinical trial data from patients requiring insulin-containing combination therapy suggest that insulin may be more effective at controlling hyperglycemia when given with appropriate combination therapy, but insulin is associated with weight gain and hypoglycemia. Some agents should not be combined with insulin because of associated weight gain and edema (ie, thiazolidinediones) or hypoglycemia (ie, sulfonylureas). Conversely, the lack of weight gain and hypoglycemia associated with metformin, glucagon-like peptide-1 agonists and dipeptidyl peptidase-4 inhibitors and suppression of glucagon secretion by both classes of incretin-based therapies suggest that these agents are well suited to combination therapy with insulin. PMID:24469234

  17. Influence of sourdough on in vitro starch digestibility and predicted glycemic indices of gluten-free breads.

    PubMed

    Wolter, Anika; Hager, Anna-Sophie; Zannini, Emanuele; Arendt, Elke K

    2014-03-01

    Gluten-free flours (buckwheat, quinoa, sorghum and teff) were fermented using obligate heterofermentative strain Weissella cibaria MG1 (Wc) and facultative heterofermentative Lactobacillus plantarum FST1.7 (Lp). Starch hydrolysis of breads with and without sourdough (controls) was analyzed in vitro using enzymatic digestion followed by dialysis (10-11 kDa). Hydrolysis indices as well as predicted glycemic indices (pGI) were calculated from reducing sugars released into the dialysate. Amounts of resistant starch (RS; % of total starch) were determined by enzymatic digestion. Upon sourdough addition, RS significantly decreased in buckwheat (Wc 1.28%, Lp 1.44%) and teff sourdough breads (Wc 0.87%, Lp 0.98%) in comparison to their controls (2.01% and 1.92%, respectively). However, no correlation was found with starch hydrolysis. Predicted GIs were reduced upon sourdough addition in wheat (ctrl 100; Wc 85; Lp 76) in comparison to control breads. This was not the case in most gluten-free breads with the exception of sorghum (ctrl 72; Lp 69) and teff sourdough breads (ctrl 74; Lp 68). In contrast, increased pGIs were found in quinoa (ctrl 95; Wc 106; Lp 103) and buckwheat sourdough breads (ctrl 80; Wc 89; Lp 86). PMID:24492829

  18. Functional limitations of plasmacytoid dendritic cells limit type I interferon, T cell responses and virus control in early life.

    PubMed

    Belnoue, Elodie; Fontannaz, Paola; Rochat, Anne-Françoise; Tougne, Chantal; Bergthaler, Andreas; Lambert, Paul-Henri; Pinschewer, Daniel D; Siegrist, Claire-Anne

    2013-01-01

    Infant mortality from viral infection remains a major global health concern: viruses causing acute infections in immunologically mature hosts often follow a more severe course in early life, with prolonged or persistent viral replication. Similarly, the WE strain of lymphocytic choriomeningitis virus (LCMV-WE) causes acute self-limiting infection in adult mice but follows a protracted course in infant animals, in which LCMV-specific CD8? T cells fail to expand and control infection. By disrupting type I IFNs signaling in adult mice or providing IFN-? supplementation to infant mice, we show here that the impaired early life T cell responses and viral control result from limited early type I IFN responses. We postulated that plasmacytoid dendritic cells (pDC), which have been identified as one major source of immediate-early IFN-I, may not exert adult-like function in vivo in the early life microenvironment. We tested this hypothesis by studying pDC functions in vivo during LCMV infection and identified a coordinated downregulation of infant pDC maturation, activation and function: despite an adult-like in vitro activation capacity of infant pDCs, the expression of the E2-2 pDC master regulator (and of critical downstream antiviral genes such as MyD88, TLR7/TLR9, NF-?B, IRF7 and IRF8) is downregulated in vivo at baseline and during LCMV infection. A similar pattern was observed in response to ssRNA polyU, a model ligand of the TLR7 viral sensor. This suggests that the limited T cell-mediated defense against early life viral infections is largely attributable to / regulated by infant pDC responses and provides incentives for novel strategies to supplement or stimulate immediate-early IFN-? responses. PMID:24376875

  19. Functional Limitations of Plasmacytoid Dendritic Cells Limit Type I Interferon, T Cell Responses and Virus Control in Early Life

    PubMed Central

    Belnoue, Elodie; Fontannaz, Paola; Rochat, Anne-Françoise; Tougne, Chantal; Bergthaler, Andreas; Lambert, Paul-Henri; Pinschewer, Daniel D.; Siegrist, Claire-Anne

    2013-01-01

    Infant mortality from viral infection remains a major global health concern: viruses causing acute infections in immunologically mature hosts often follow a more severe course in early life, with prolonged or persistent viral replication. Similarly, the WE strain of lymphocytic choriomeningitis virus (LCMV-WE) causes acute self-limiting infection in adult mice but follows a protracted course in infant animals, in which LCMV-specific CD8+ T cells fail to expand and control infection. By disrupting type I IFNs signaling in adult mice or providing IFN-? supplementation to infant mice, we show here that the impaired early life T cell responses and viral control result from limited early type I IFN responses. We postulated that plasmacytoid dendritic cells (pDC), which have been identified as one major source of immediate-early IFN-I, may not exert adult-like function in vivo in the early life microenvironment. We tested this hypothesis by studying pDC functions in vivo during LCMV infection and identified a coordinated downregulation of infant pDC maturation, activation and function: despite an adult-like in vitro activation capacity of infant pDCs, the expression of the E2-2 pDC master regulator (and of critical downstream antiviral genes such as MyD88, TLR7/TLR9, NF-?B, IRF7 and IRF8) is downregulated in vivo at baseline and during LCMV infection. A similar pattern was observed in response to ssRNA polyU, a model ligand of the TLR7 viral sensor. This suggests that the limited T cell-mediated defense against early life viral infections is largely attributable to / regulated by infant pDC responses and provides incentives for novel strategies to supplement or stimulate immediate-early IFN-? responses. PMID:24376875

  20. Extended Prandial Glycemic Profiles of Foods as Assessed Using Continuous Glucose Monitoring Enhance the Power of the 120-Minute Glycemic Index

    PubMed Central

    Chlup, Rudolf; Peterson, Karolina; Zapletalová, Jana; Kudlová, Pavla; Se?ka?, Pavel

    2010-01-01

    Background The glycemic index (GI) is routinely measured 120 minutes after food intake (GI120). The purpose of this prospective open label study was to assess (1) the dynamics of glycemia over the 210 minutes following food consumption and (2) the evolution of GIs based on 120-, 150-, 180-, and 210-minute glycemic profiles. Method Twenty healthy subjects (mean ± SE; 21.9 ± 1.39 years of age; body mass index 23.6 ± 0.63 kg/m2; 7 men and 13 women) completed the study. Each subject consumed 10 different foods with known GI120 on three separate occasions at four different times of day according to a defined meal plan over a 9-day period; 32 meals were evaluated. The GIs for intervals of 120, 150, 180 and 210 minutes after food consumption were determined using a continuous glucose monitoring system (CGMS) to measure glycemia. The Wilcoxon signed-rank test was applied to compare the GIs. Results Glycemia returned to baseline within 120 minutes for honey and tomato soup; within 210 minutes for white bread, choco-rice cookies, fish and potatoes, wafers, and meat ravioli with cheese; and later for dark chocolate, apricot dumplings, and choco-wheat cookies. The extended GIs were higher than the respective GI120s in eight of the foods. Conclusions The 120-minute glycemic index fails to fully account for changes in glycemia after ingestion of a mixed meal because glycemia remains above baseline for a longer period. The CGMS is a convenient method to determine the glucose response/GIs over intervals extended up to 210 minutes, which is adequate time for the absorption of most foods. PMID:20513328

  1. Dietary Glycemic Load and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings From CALGB 89803

    PubMed Central

    2012-01-01

    Background The influence of glycemic load and related measures on survival among colon cancer patients remains largely unknown. Methods We conducted a prospective, observational study of 1011 stage III colon cancer patients reporting dietary intake during and 6 months after participation in an adjuvant chemotherapy trial. We examined the influence of glycemic load, glycemic index, fructose, and carbohydrate intakes on cancer recurrence and mortality using Cox proportional hazards regression; all tests of statistical significance were two-sided. Results Stage III colon cancer patients in the highest quintile of dietary glycemic load experienced an adjusted hazard ratio (HR) for disease-free survival of 1.79 (95% confidence interval [CI] = 1.29 to 2.48), compared with those in the lowest quintile (P trend across quintiles <.001). Increased glycemic load was associated with similar detriments in recurrence-free (P trend across quintiles <.001) and overall survival (P trend across quintiles <.001). These associations differed statistically significant by body mass index (BMI) (P interaction =.01). Whereas glycemic load was not associated with disease-free survival in patients with BMI < 25kg/m2, higher glycemic load was statistically significant associated with worse disease-free survival among overweight or obese participants (BMI ? 25kg/m2; HR = 2.26; 95% CI = 1.53 to 3.32; P trend across quintiles <.001). Increasing total carbohydrate intake was similarly associated with inferior disease-free, recurrence-free, and overall survival (P trend across quintiles <.001). Conclusion Higher dietary glycemic load and total carbohydrate intake were statistically significant associated with an increased risk of recurrence and mortality in stage III colon cancer patients. These findings support the role of energy balance factors in colon cancer progression and may offer potential opportunities to improve patient survival. PMID:23136358

  2. Effects of green-leafy vegetable intake on postprandial glycemic and lipidemic responses and ?-tocopherol concentration in normal weight and obese men.

    PubMed

    Maruyama, Chizuko; Kikuchi, Nahoko; Masuya, Yumiko; Hirota, Saki; Araki, Risa; Maruyama, Taro

    2013-01-01

    Vegetable consumption has been encouraged as a component of nutritional education for obese and insulin-resistant patients. However, the benefits of vegetable intake in a therapeutic diet on postprandial glycemic and lipidemic responses have not been clarified. We studied the effects of the intake of spinach, a green-leafy vegetable rich in dietary fiber and ?-tocopherol, with a fat-rich meal on postprandial glycemic and lipidemic changes. Fourteen normal weight and 10 obese men consumed three test meals of bread, as a control, bread and butter, and bread and butter with boiled spinach. Blood samples were obtained prior to and 30, 60, 120, 180 and 240 min after consuming the test meals. Compared with the bread meal, consumption of the bread and butter meal showed a reduced peak glucose response at 30 min in normal (p<0.05) but not in obese subjects. The increase in triglyceride and decrease in LDL-cholesterol were greater after the butter-containing meal than after the bread meal (p<0.05). The ?-tocopherol/lipid level decreased and remained low after the bread and butter meal, but the decrease was smaller with the spinach-containing meal in obese subjects (p<0.05). These results suggest that green-leafy vegetable intake with a fat-rich meal is effective for supplying postprandial ?-tocopherol in obese subjects, but consumption of a regular-sized dish cannot be expected to improve abnormal postprandial hyperglycemic or hyperlipidemic responses. PMID:24064726

  3. The Relative Associations of ?-Cell Function and Insulin Sensitivity with Glycemic Status and Incident Glycemic Progression in Migrant Asian Indians in the United States: the MASALA study

    PubMed Central

    Gujral, UP; Narayan, KMV; Kahn, SE; Kanaya, AM

    2013-01-01

    AIMS We assessed the relative associations of ?-cell dysfunction and insulin sensitivity with baseline glycemic status and incident glycemic progression among Asian Indians in the United States. METHODS A 5-sample oral glucose tolerance test was obtained at baseline. Normoglycemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes (T2DM) were defined by ADA criteria. The Matsuda Index (ISIM) estimated insulin sensitivity, and the Disposition Index (DIo) estimated ?-cell function. Visceral fat was measured by abdominal CT. After 2.5 years, participants underwent a 2-sample oral glucose tolerance test. Standardized polytomous logistic regression was used to examine associations with prevalent and incident glycemia. RESULTS Mean age was 57±8 years and BMI 26.1±4.6 kg/m2. Log ISIM and log DIo were associated with prediabetes and T2DM after adjusting for age, sex, BMI, family history of diabetes, hypertension, and smoking. After adjusting for visceral fat, only DIo remained associated with prediabetes (OR per SD 0.17, 95% CI: 0.70, 0.41) and T2DM (OR 0.003, 95% CI: 0.0001, 0.03). Incidence rates (per 1,000 person-year) were: normoglycemia to IGT: 82.0, 95% CI (40, 150); to IFG: 8.4, 95% CI (0, 41); to T2DM: 8.6, 95% CI (0, 42); IGT to T2DM: 55.0, 95% CI (17, 132); IFG to T2DM: 64.0, 95% CI (3, 316). The interaction between sex and the change in waist circumference (OR 1.8, per SD 95% CI: 1.22, 2.70) and the change in log HOMA-?(OR 0.37, per SD 95% CI: 0.17, 0.81) were associated with glycemic progression. CONCLUSIONS The association of DIo with baseline glycemia after accounting for visceral fat as well as the association of the change in log HOMA-? with incident glycemic progression implies innate ?-cell susceptibility in Asian Indians for glucose intolerance or dysglycemia. PMID:24211090

  4. A systematic review on the effect of sweeteners on glycemic response and clinically relevant outcomes

    PubMed Central

    2011-01-01

    Background The major metabolic complications of obesity and type 2 diabetes may be prevented and managed with dietary modification. The use of sweeteners that provide little or no calories may help to achieve this objective. Methods We did a systematic review and network meta-analysis of the comparative effectiveness of sweetener additives using Bayesian techniques. MEDLINE, EMBASE, CENTRAL and CAB Global were searched to January 2011. Randomized trials comparing sweeteners in obese, diabetic, and healthy populations were selected. Outcomes of interest included weight change, energy intake, lipids, glycated hemoglobin, markers of insulin resistance and glycemic response. Evidence-based items potentially indicating risk of bias were assessed. Results Of 3,666 citations, we identified 53 eligible randomized controlled trials with 1,126 participants. In diabetic participants, fructose reduced 2-hour blood glucose concentrations by 4.81 mmol/L (95% CI 3.29, 6.34) compared to glucose. Two-hour blood glucose concentration data comparing hypocaloric sweeteners to sucrose or high fructose corn syrup were inconclusive. Based on two ?10-week trials, we found that non-caloric sweeteners reduced energy intake compared to the sucrose groups by approximately 250-500 kcal/day (95% CI 153, 806). One trial found that participants in the non-caloric sweetener group had a decrease in body mass index compared to an increase in body mass index in the sucrose group (-0.40 vs 0.50 kg/m2, and -1.00 vs 1.60 kg/m2, respectively). No randomized controlled trials showed that high fructose corn syrup or fructose increased levels of cholesterol relative to other sweeteners. Conclusions Considering the public health importance of obesity and its consequences; the clearly relevant role of diet in the pathogenesis and maintenance of obesity; and the billions of dollars spent on non-caloric sweeteners, little high-quality clinical research has been done. Studies are needed to determine the role of hypocaloric sweeteners in a wider population health strategy to prevent, reduce and manage obesity and its consequences. PMID:22093544

  5. The fiber and/or polyphenols present in lingonberries null the glycemic effect of the sugars present in the berries when consumed together with added glucose in healthy human volunteers.

    PubMed

    Linderborg, Kaisa M; Järvinen, Riikka; Lehtonen, Henna-Maria; Viitanen, Matti; Kallio, Heikki P T

    2012-07-01

    This study was undertaken on the broad hypothesis that lingonberry (Vaccinium vitis-idaea L.) has potential to reduce postprandial glycemic and lipemic response. More specifically, 2 postprandial crossover studies with healthy normal-weight male subjects were conducted to study the influence of commercial lingonberry powder on postprandial glycemia and lipemia. The test meals contained fat-free yoghurt with either glucose (50 g) or triacylglycerols (35 g) with or without (control) the lingonberry powder. The lingonberry powder provided the meals with a known amount of fiber and a known amount and composition of sugars, and it was a rich source of polyphenols. Postprandial glucose, insulin, and triacylglycerol responses were analyzed. There were no significant differences in the postprandial glucose concentration between the meals in the glycemia trial despite the fact that the lingonberry meal contained more glucose and fructose. When the meal did not contain added sugar but, instead, added triacylglycerol, no glycemia or lipemia-lowering effect was detected. On the contrary, there were indications of higher glycemic and insulinemic effect after the lingonberry meal. The results of this study indicate that the fibers and/or polyphenols present in lingonberries null the glycemic effect of the sugars present in the berries when consumed together with added glucose. By contrast, the lingonberry powder did not affect the postprandial lipemic response. PMID:22901554

  6. Early pregnancy peripheral blood gene expression and risk of preterm delivery: a nested case control study

    Microsoft Academic Search

    Daniel A Enquobahrie; Michelle A Williams; Chunfang Qiu; Seid Y Muhie; Kimberly Slentz-Kesler; Zhaoping Ge; Tanya Sorenson

    2009-01-01

    BACKGROUND: Preterm delivery (PTD) is a significant public health problem associated with greater risk of mortality and morbidity in infants and mothers. Pathophysiologic processes that may lead to PTD start early in pregnancy. We investigated early pregnancy peripheral blood global gene expression and PTD risk. METHODS: As part of a prospective study, ribonucleic acid was extracted from blood samples (collected

  7. Development of Early Handwriting: Visual-Motor Control during Letter Copying

    ERIC Educational Resources Information Center

    Maldarelli, Jennifer E.; Kahrs, Björn A.; Hunt, Sarah C.; Lockman, Jeffrey J.

    2015-01-01

    Despite the importance of handwriting for school readiness and early academic progress, prior research on the development of handwriting has focused primarily on the product rather than the process by which young children write letters. In contrast, in the present work, early handwriting is viewed as involving a suite of perceptual, motor, and…

  8. Predicting Individual Differences in Low-Income Children’s Executive Control from Early to Middle Childhood

    PubMed Central

    Raver, C. Cybele; McCoy, Dana Charles; Lowenstein, Amy L.

    2013-01-01

    The present longitudinal study tested the roles of early childhood executive control (EC) as well as exposure to poverty-related adversity at family and school levels as key predictors of low-income children’s EC in elementary school (n = 391). Findings suggest that children’s EC difficulties in preschool and lower family income from early to middle childhood are robust predictors of later EC difficulties as rated by teachers in second and third grades. Findings also suggest enrollment in unsafe elementary schools is significantly predictive of higher levels of teacher-rated EC difficulty, but only for those children who showed initially elevated levels of EC difficulty in early childhood. Implications for scientific models of cognitive development and poverty-related adversity are discussed. PMID:23587038

  9. Postural control in patients with lumbar disc herniation in the early postoperative period

    PubMed Central

    Chantsoulis, Marzena; Kuczy?ski, Micha?

    2009-01-01

    Chronic spinal disc disease leads to disorders in postural movement coordination. An incorrect asymmetrical movement pattern for the lower limbs loading impairs proprioception and deteriorates postural stability, particularly when the vision is occluded. The standard surgical treatment improves biomechanical conditions in the lumbar spine, reduces pain, yet does it reduce the stability deficit in the upright position? An answer to the latter question would help work out targeted therapy to improve postural stability. We hypothesized that the standard surgical treatment would improve postural stability reflected by decreased sway variability accounting for better use of proprioceptive inputs postoperatively. Thirty-nine patients with lumbar disc herniation participated in the study. Their postural sway was recorded in anterior/posterior and medial/lateral planes with their eyes open or closed (EC) before and after surgery. The variability, range, mean velocity of the recorded time series and the area of the ellipse enclosed by the statokinesiogram were used as measures of postural stability. Preoperatively, EC condition resulted in an increased variability and mean velocity of postural sway, while postoperatively it caused an increase in sway mean velocity and sway area only with no effect on sway variability and range. The comparison of the balance before and after the surgery in the EC condition showed significant decrease in all parameters. In the early postoperative period, the patients recover the ability to control their postural sway in EC within normal limits, however, at the expense of significantly increased frequency of corrective torques. It is probably a transient short-term strategy needed to compensate for the recovery phase when the normal weighting factors for all afferents are being reestablished. We propose that this transient postoperative period may be the best timing of therapeutic intervention targeted at facilitating and reinforcing the acquisition of correct motor patterns. PMID:19562385

  10. Timing of Peak Blood Glucose after Breakfast Meals of Different Glycemic Index in Women with Gestational Diabetes

    PubMed Central

    Louie, Jimmy Chun Yu; Markovic, Tania P.; Ross, Glynis P.; Foote, Deborah; Brand-Miller, Jennie C.

    2012-01-01

    This study aims to determine the peak timing of postprandial blood glucose level (PBGL) of two breakfasts with different glycemic index (GI) in gestational diabetes mellitus (GDM). Ten women with diet-controlled GDM who were between 30 and 32 weeks of gestation were enrolled in the study. They consumed two carbohydrate controlled, macronutrient matched bread-based breakfasts with different GI (low vs. high) on two separate occasions in a random order after an overnight fast. PBGLs were assessed using a portable blood analyser. Subjects were asked to indicate their satiety rating at each blood sample collection. Overall the consumption of a high GI breakfast resulted in a greater rise in PBGL (mean ± SEM peak PBGL: low GI 6.7 ± 0.3 mmol/L vs. high GI 8.6 ± 0.3 mmol/L; p < 0.001) and an earlier peak PBGL time (16.9 ± 4.9 min earlier; p = 0.015), with high variability in PBGL time between subjects. There was no significant difference in subjective satiety throughout the test period. In conclusion, the low GI breakfast produced lower postprandial glycemia, and the peak PBGL occurred closer to the time recommended for PBGL monitoring (i.e., 1 h postprandial) in GDM than a macronutrient matched high GI breakfast. PMID:23344248

  11. Evaluation of Glycemic and Lipid Profile of Offspring of Diabetic Wistar Rats Treated with Malpighia emarginata Juice

    PubMed Central

    Barbalho, Sandra M.; Damasceno, Débora C.; Spada, Ana Paula Machado; Palhares, Miréia; Martuchi, Karla Aparecida; Oshiiwa, Marie; Sazaki, Viviane; da Silva, Vanessa Sellis

    2011-01-01

    Knowing that maternal diabetes is related to hyperglycemia and fetal hyperinsulinemia, which affect the lipid metabolism, the aim of this study was to evaluate the effects of Malpighia emarginata (acerola) juice on the glycemic and lipid profile of offspring of diabetic and nondiabetic Wistar rats. The adult offspring of non-diabetic dams and of dams with severe streptozotocin-induced diabetes were divided into groups: G1, offspring (of control dams) treated with water, G2, offspring (of diabetic dams) treated with water, G3, male offspring (of control dams) treated with acerola juice, and G4, male offspring (of diabetic dams) treated with acerola juice. The offspring of diabetic dams treated with acerola juice showed significantly decreased levels of glucose, cholesterol, triglycerides, and increased HDL-c. The use of acerola juice is a potential strategy to aid in the prevention of DM and dyslipidemia and its complications or to act as an auxiliary in the treatment of these diseases. PMID:21318139

  12. Glycemic index of American-grown jasmine rice classified as high.

    PubMed

    Truong, Teresa H; Yuet, Wei Cheng; Hall, Micki D

    2014-06-01

    The primary objective was to determine the glycemic index (GI) of jasmine rice grown in the United States (US). Secondary objective was to compare the GI of US grown jasmine rice to those grown in Thailand. Twelve healthy subjects were served all four brands of jasmine rice and a reference food (glucose), each containing 50?g of available carbohydrate. Fingerstick blood glucose was measured at 0, 15, 30, 45, 60, 90, and 120?min after consumption following a fasting state. The GI was calculated using the standard equation. The GI values for test foods ranged from 96 to 116 and were all classified as high GI foods. No difference in GI was found between American-grown and Thailand-grown jasmine rice. Although not statistically significant, observations show glycemic response among Asian American participants may be different. GI should be considered when planning meals with jasmine rice as the main source carbohydrate. PMID:24438213

  13. Low-glycemic index diet in hyperlipidemia: Use of traditional starchy foods

    Microsoft Academic Search

    David JA Jenkins; Janet Kalmusky; Silvia Guidici; Connie Giordano; Robert Patten; Gerald S Wong; Josephine N Bird; Murray Hall; Gloria Buckley; Adele Csima; J Alick

    1988-01-01

    To define those patients most likely to benefit from the hypolipidemic effect of low-glycemic-index (GI) traditional starchy foods, 30 hyperlipidemic patients were studied for 3 mo. During the middle month, low-GI foods were substituted for those with a higher 01 with minimal change in dietary macronutnent and fiber content. Only in the group (24 patients) with raised triglyceride levels (types

  14. Low-glycemic-index starchy foods in the diabetic diet13

    Microsoft Academic Search

    DavidfA Jenkins; Gloria Buckley; Kah Yun Lam; Janet Kalmusky; Alexandra L Jenkins; Robert L Patten; Josephine Bird; Gerald S Wong; G Josse

    Eight patients with noninsulin-dependent diabetes underwent two 2-wk study periods in random order during which they were provided with carbohydrate foods with either a high or low glycemic index (GI). Over both high-GI and low-GI periods there were significant reductions in body weight, serum fructosamine, and cholesterol. Reductions in fast- ing blood glucose, HbA1?, and urinary c-peptide-to-creatinine ratio were significant

  15. Prolongation of Satiety After Low Versus Moderately High Glycemic Index Meals in Obese Adolescents

    Microsoft Academic Search

    Shauna D. Ball; Kelly R. Keller; Laurie J. Moyer-Mileur; Yi-Wen Ding; David Donaldson; W. Daniel Jackson

    2010-01-01

    Background. One in 5 American children is overweight, despite a decrease in total fat consump- tion. This has sparked an interest in the carbohydrate composition of diets, including the glycemic index (GI). Objective. To investigate whether a low-GI meal re- placement (LMR) produced similar metabolic, hormonal, and satiety responses in overweight adolescents as a low-GI whole-food meal (LWM) when compared

  16. Role of LIBS in Elemental Analysis of Psidium guajava Responsible for Glycemic Potential

    Microsoft Academic Search

    Prashant Kumar Rai; Nilesh K. Rai; A. K. Rai; Geeta Watal

    2007-01-01

    The present study deals with the detection of elements responsible for glycemic potential of ripe and unripe fruit peel aqueous extracts of Psidium guajava (P. guajava). Treatment with the aqueous extract of unripe fruit peel showed a significant fall of 17.5% (p<0.001) in blood glucose levels (BGLs) of normal rats during fasting blood glucose (FBG) test with a dose of

  17. Management of exercise-induced glycemic imbalances in type 1 diabetes.

    PubMed

    Francescato, Maria P; Carrato, Sergio

    2011-07-01

    Regular moderate-intensity exercise is strongly recommended for its beneficial effects in all people. In patients with type 1 diabetes, however, the exercise-associated glycemic imbalances remain an unresolved clinical challenge. Current guidelines require an in-depth understanding of the glycemic responses to exercise and each patient has to discover, by trial-and-error, his/her own strategy, several attempts being usually required to gain sufficient experience. Consequently, fear of hypoglycemia remains the strongest barrier to physical activity. This paper explores the potential strategies that may be employed to minimize the risk of exercise related glycemic imbalances. Moreover, a newly developed algorithm (ECRES, Exercise Carbohydrate Requirement Estimating Software) is described, which estimates on a patient- and situation-specific basis the glucose supplement required by the patient to maintain safe blood glucose levels. The algorithm was tested on 27 patients who performed three 1-hr constant intensity walks (each starting at a different time interval following insulin injection). Results showed that in 70.4% of the trials, independent of the time of day, the algorithm provided a satisfactory estimate of the carbohydrates needed by patients to complete the exercise with a glucose level within safe thresholds (i.e. 3.9 - 10 mmol·L-1). Despite the algorithm requires further experimental testing to be applied by the majority of patients, these results indicate its potential usefulness as a tool for preventing immediate exercise-induced glycemic imbalances (i.e. during exercise) in type 1 diabetic patients, in particular for spontaneous activities not planned in advance, thus allowing all insulin-dependent patients to safely enjoy the benefits of exercise. PMID:21682691

  18. Control of early seedling development by BES1/TPL/HDA19-mediated epigenetic regulation of ABI3.

    PubMed

    Ryu, Hojin; Cho, Hyunwoo; Bae, Wonsil; Hwang, Ildoo

    2014-01-01

    Seed germination and young seedling establishment should be tightly regulated to maximize plant survival and thereby enable successful propagation. Plants have evolved developmental signalling networks to integrate environmental cues for proper control of these critical processes, in which brassinosteroids are known to attenuate ABA-mediated arrest of early seedling development; however, the underlying regulatory mechanism remains elusive. Here we reveal that a BES1/TPL/HDA19 repressor complex mediates the inhibitory action of brassinosteroids on ABA responses during early seedling development. BR-activated BES1 forms a transcriptional repressor complex with TPL-HDA19, which directly facilitates the histone deacetylation of ABI3 chromatin. This event leads to the transcriptional repression of ABI3 and consequently ABI5, major ABA signalling regulators in early seedling development. Our data reveal that the BR-activated BES1-TPL-HDA19 repressor complex controls epigenetic silencing of ABI3 and thereby suppresses the ABA signalling output during early seedling development. PMID:24938150

  19. Type 2 diabetes and glycemic response to grapes or grape products.

    PubMed

    Zunino, Susanj

    2009-09-01

    Type 2 diabetes affects approximately 7% of the population in the United States and is characterized by decreased disposal of glucose in peripheral tissues due to insulin resistance and overproduction of glucose by the liver, defects in pancreatic beta-cell function, and decreased beta-cell mass. Obesity, decreased physical exercise, and consumption of foods with a high glycemic index (GI) and load are major predisposing factors in the development of type 2 diabetes. The GI is used to evaluate the rise in blood glucose levels in response to food. The GI provides an indication of the quality of carbohydrate in a food. The glycemic load (GL) is used to provide information about the quantity of carbohydrates in a food and the insulin demand. Individuals with diabetes are advised to maintain a diet of low-GL foods, because low-GL diets improve diabetes symptoms. Grapes have a mean GI and GL in the low range. Little research has been performed with grapes and/or grape products to determine the glycemic response either alone or with a meal. Grapes and other fruits contain numerous polyphenols, including the stilbene resveratrol, the flavanol quercetin, catechins, and anthocyanins that have shown potential for reducing hyperglycemia, improving beta-cell function, and protecting against beta-cell loss. Therefore, with a low mean GI and GL, grapes or grape products may provide health benefits to type 2 diabetics. PMID:19625702

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

    PubMed

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

    2010-12-01

    This work aimed to study the in vitro colonic fermentation profile of unavailable carbohydrates of two different kinds of unripe banana flour and to evaluate their postprandial glycemic responses. The unripe banana mass (UBM), obtained from the cooked pulp of unripe bananas (Musa acuminata, Nanicão variety), and the unripe banana starch (UBS), obtained from isolated starch of unripe banana, plantain type (Musa paradisiaca) in natura, were studied. The fermentability of the flours was evaluated by different parameters, using rat inoculum, as well as the glycemic response produced after the ingestion by healthy volunteers. The flours presented high concentration of unavailable carbohydrates, which varied in the content of resistant starch, dietary fiber and indigestible fraction (IF). The in vitro colonic fermentation of the flours was high, 98% for the UBS and 75% for the UBM when expressed by the total amount of SCFA such as acetate, butyrate and propionate in relation to lactulose. The increase in the area under the glycemic curve after ingestion of the flours was 90% lower for the UBS and 40% lower for the UBM than the increase produced after bread intake. These characteristics highlight the potential of UBM and UBS as functional ingredients. However, in vivo studies are necessary in order to evaluate the possible benefit effects of the fermentation on intestinal health. PMID:20839056

  1. Impact of Type 2 Diabetes Susceptibility Variants on Quantitative Glycemic Traits Reveals Mechanistic Heterogeneity

    PubMed Central

    Dimas, Antigone S.; Lagou, Vasiliki; Barker, Adam; Knowles, Joshua W.; Mägi, Reedik; Hivert, Marie-France; Benazzo, Andrea; Rybin, Denis; Jackson, Anne U.; Stringham, Heather M.; Song, Ci; Fischer-Rosinsky, Antje; Boesgaard, Trine Welløv; Grarup, Niels; Abbasi, Fahim A.; Assimes, Themistocles L.; Hao, Ke; Yang, Xia; Lecoeur, Cécile; Barroso, Inês; Bonnycastle, Lori L.; Böttcher, Yvonne; Bumpstead, Suzannah; Chines, Peter S.; Erdos, Michael R.; Graessler, Jurgen; Kovacs, Peter; Morken, Mario A.; Narisu, Narisu; Payne, Felicity; Stancakova, Alena; Swift, Amy J.; Tönjes, Anke; Bornstein, Stefan R.; Cauchi, Stéphane; Froguel, Philippe; Meyre, David; Schwarz, Peter E.H.; Häring, Hans-Ulrich; Smith, Ulf; Boehnke, Michael; Bergman, Richard N.; Collins, Francis S.; Mohlke, Karen L.; Tuomilehto, Jaakko; Quertemous, Thomas; Lind, Lars; Hansen, Torben; Pedersen, Oluf; Walker, Mark; Pfeiffer, Andreas F.H.; Spranger, Joachim; Stumvoll, Michael; Meigs, James B.; Wareham, Nicholas J.; Kuusisto, Johanna; Laakso, Markku; Langenberg, Claudia; Dupuis, Josée; Watanabe, Richard M.; Florez, Jose C.; Ingelsson, Erik; McCarthy, Mark I.; Prokopenko, Inga

    2014-01-01

    Patients with established type 2 diabetes display both ?-cell dysfunction and insulin resistance. To define fundamental processes leading to the diabetic state, we examined the relationship between type 2 diabetes risk variants at 37 established susceptibility loci, and indices of proinsulin processing, insulin secretion, and insulin sensitivity. We included data from up to 58,614 nondiabetic subjects with basal measures and 17,327 with dynamic measures. We used additive genetic models with adjustment for sex, age, and BMI, followed by fixed-effects, inverse-variance meta-analyses. Cluster analyses grouped risk loci into five major categories based on their relationship to these continuous glycemic phenotypes. The first cluster (PPARG, KLF14, IRS1, GCKR) was characterized by primary effects on insulin sensitivity. The second cluster (MTNR1B, GCK) featured risk alleles associated with reduced insulin secretion and fasting hyperglycemia. ARAP1 constituted a third cluster characterized by defects in insulin processing. A fourth cluster (TCF7L2, SLC30A8, HHEX/IDE, CDKAL1, CDKN2A/2B) was defined by loci influencing insulin processing and secretion without a detectable change in fasting glucose levels. The final group contained 20 risk loci with no clear-cut associations to continuous glycemic traits. By assembling extensive data on continuous glycemic traits, we have exposed the diverse mechanisms whereby type 2 diabetes risk variants impact disease predisposition. PMID:24296717

  2. Impact of type 2 diabetes susceptibility variants on quantitative glycemic traits reveals mechanistic heterogeneity.

    PubMed

    Dimas, Antigone S; Lagou, Vasiliki; Barker, Adam; Knowles, Joshua W; Mägi, Reedik; Hivert, Marie-France; Benazzo, Andrea; Rybin, Denis; Jackson, Anne U; Stringham, Heather M; Song, Ci; Fischer-Rosinsky, Antje; Boesgaard, Trine Welløv; Grarup, Niels; Abbasi, Fahim A; Assimes, Themistocles L; Hao, Ke; Yang, Xia; Lecoeur, Cécile; Barroso, Inês; Bonnycastle, Lori L; Böttcher, Yvonne; Bumpstead, Suzannah; Chines, Peter S; Erdos, Michael R; Graessler, Jurgen; Kovacs, Peter; Morken, Mario A; Narisu, Narisu; Payne, Felicity; Stancakova, Alena; Swift, Amy J; Tönjes, Anke; Bornstein, Stefan R; Cauchi, Stéphane; Froguel, Philippe; Meyre, David; Schwarz, Peter E H; Häring, Hans-Ulrich; Smith, Ulf; Boehnke, Michael; Bergman, Richard N; Collins, Francis S; Mohlke, Karen L; Tuomilehto, Jaakko; Quertemous, Thomas; Lind, Lars; Hansen, Torben; Pedersen, Oluf; Walker, Mark; Pfeiffer, Andreas F H; Spranger, Joachim; Stumvoll, Michael; Meigs, James B; Wareham, Nicholas J; Kuusisto, Johanna; Laakso, Markku; Langenberg, Claudia; Dupuis, Josée; Watanabe, Richard M; Florez, Jose C; Ingelsson, Erik; McCarthy, Mark I; Prokopenko, Inga

    2014-06-01

    Patients with established type 2 diabetes display both ?-cell dysfunction and insulin resistance. To define fundamental processes leading to the diabetic state, we examined the relationship between type 2 diabetes risk variants at 37 established susceptibility loci, and indices of proinsulin processing, insulin secretion, and insulin sensitivity. We included data from up to 58,614 nondiabetic subjects with basal measures and 17,327 with dynamic measures. We used additive genetic models with adjustment for sex, age, and BMI, followed by fixed-effects, inverse-variance meta-analyses. Cluster analyses grouped risk loci into five major categories based on their relationship to these continuous glycemic phenotypes. The first cluster (PPARG, KLF14, IRS1, GCKR) was characterized by primary effects on insulin sensitivity. The second cluster (MTNR1B, GCK) featured risk alleles associated with reduced insulin secretion and fasting hyperglycemia. ARAP1 constituted a third cluster characterized by defects in insulin processing. A fourth cluster (TCF7L2, SLC30A8, HHEX/IDE, CDKAL1, CDKN2A/2B) was defined by loci influencing insulin processing and secretion without a detectable change in fasting glucose levels. The final group contained 20 risk loci with no clear-cut associations to continuous glycemic traits. By assembling extensive data on continuous glycemic traits, we have exposed the diverse mechanisms whereby type 2 diabetes risk variants impact disease predisposition. PMID:24296717

  3. Dietary carbohydrate, glycemic index, glycemic load, and risk of prostate cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort

    PubMed Central

    Shikany, James M.; Flood, Andrew P.; Kitahara, Cari M.; Hsing, Ann W.; Meyer, Tamra E.; Willcox, Bradley J.; Redden, David T.; Ziegler, Regina G.

    2015-01-01

    Objective To evaluate the associations between dietary carbohydrate, glycemic index (GI), glycemic load (GL), and incident prostate cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort. Methods Between September 1993 and September 2000, 38,343 men were randomized to the screening arm of the trial at one of 10 PLCO centers. A food frequency questionnaire administered at baseline assessed usual dietary intake over the preceding 12 months. Prostate cancer was ascertained by medical follow-up of suspicious screening results and annual mailed questionnaires and confirmed with medical records. Cox proportional hazards regression was used to model the associations of carbohydrate, GI, and GL with prostate cancer risk. Results During follow-up (median = 9.2 years), 2,436 incident prostate cancers were identified among 30,482 eligible participants. Overall, there were no associations of baseline carbohydrate, GI, or GL with incident prostate cancer in minimally or fully adjusted models. There were no associations when the 228 advanced and 2,208 non-advanced cancers were analyzed separately. Conclusions Dietary carbohydrate, GI, and GL were not associated with incident prostate cancer in PLCO. The narrow range of GI in this cohort may have limited our ability to detect associations, an issue that future studies should address. PMID:21553078

  4. Behavioural and emotional problems in early-treated adolescents with phenylketonuria in comparison with diabetic patients and healthy controls

    Microsoft Academic Search

    J. Weglage; M. Grenzebach; M. Pietsch; R. Feldmann; R. Linnenbank; J. Denecke; H. G. Koch

    2000-01-01

    Even early-treated patients with phenylketonuria (PKU) have a higher risk of psychosocial maladjustment. This study was performed to determine whether emotional and behavioural problems are specific in phenylketonurics and whether they depend on the quality of biochemical control. This comparative study covered 42 PKU patients aged 10–18 years (mean 14.7 years) and 42 diabetic patients matched for sex, age and

  5. Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial

    Microsoft Academic Search

    Nanette Mutrie; Anna M Campbell; Fiona Whyte; Alex McConnachie; Carol Emslie; Laura Lee; Nora Kearney; Andrew Walker; Diana Ritchie

    2007-01-01

    Objectives To determine functional and psychological benefits of a 12 week supervised group exercise programme during treatment for early stage breast cancer, with six month follow-up.Design Pragmatic randomised controlled prospective open trial.Setting Three National Health Service oncology clinics in Scotland and community exercise facilities.Participants 203 women entered the study; 177 completed the six month follow-up. Interventions Supervised 12 week group

  6. Early dolomitization of a Lower Cretaceous shallow water carbonate platform: was microbial activity a major controlling factor?

    NASA Astrophysics Data System (ADS)

    Sena, C. N.; John, C. M.; Cosgrove, J. W.; Vandeginste, V.

    2010-12-01

    Early dolomitization of carbonate rocks has long been problematic as precipitation experiments at room temperature have shown that dolomite will not be precipitated under Earth surface conditions. To explain the widespread occurrence of early dolomite in the geological record, bacterial mediation of dolomitization has been proposed. The strongest evidence comes from modern hypersaline environments where dolomitization was shown to take place under anoxic conditions. In this study, part of the Qatar Carbonates and Carbon Storage Center (QCCSRC), we investigate whether microbial mediation of early dolomitization took place on the Barremian-Aptian carbonate platform of the Jurf Formation of Southern Oman. The sediments are characterized by a finely crystalline, poorly ordered dolomite present in various proportions. The amount of dolomite seem to be controlled by facies with tidal flats and algal/microbial facies being totally dolomitized and restricted lagoonal facies being only partially dolomitized. Results indicate that the dolomite is penecontemporaneous to sedimentation and that the dolomitizing fluids are low temperature seawater formed in an evaporative lagoon. Thus, reflux mechanisms played a role in the process of dolomitization. One of the major questions of our study is what controls the heterogeneity of the distribution of dolomite on this platform. We hypothesis that bacteria present in tidal flats and algal/microbial mats facies played an important role in controlling dolomitization. Our goal is to highlight the role of biomineralization in controlling the early diagenesis of the Jurf Formation. To test this we will use a multi-proxy approach using mineralogy, trace elements, stable and clumped isotopes, and SEM analysis, in an integrated field, petrographic and geochemical study of a Barremian-Aptian carbonate platform exposed in the Haushi-Huqf area. A bed by bed sampling was done for two 15 meters-thick outcrop sections separated by 1 km. Initial results highglight the importance of considering the presence of microbial activity to build more accurate dolomitization models and in assessing the lateral heterogeneity of dolomite bodies.

  7. Factors controlling growth and morphology of early Miocene stromatolites from Montaigu-le-Blin, France

    NASA Astrophysics Data System (ADS)

    Bontognali, Tomaso R. R.; Barilaro, Federica; McKenzie, Judith A.; Vasconcelos, Crisogono

    2015-04-01

    A large variety of stromatolite morphotypes are present in the early Miocene sedimentary sequence that outcrops in the region of Montaigu-le-Blin, France. Thanks to its good degree of preservation, this formation is an ideal place to evaluate the key factors controlling the occurrence and morphology of the stromatolites, as well as to study the diagenetic processes that transform a soft, slimy lithifying microbialite into a solid, laminated sedimentary rock. Facies analysis suggests that the Montaigu-le-Blin stromatolites formed in shallow waters, in a restricted, laterally heterogeneous basin. Various evidence suggests a biological origin for the stromatolites, whose formation cannot be explained through abiotic background precipitation driven by evaporation, temperature changes, or migration of metamorphic fluids. Microscopic observations revealed that the Montaigu-le-Blin stromatolites are mainly comprised of authigenic calcite that precipitated directly from the basin waters (no evidence for trapping and binding) in close association with algae, microbial cells, and exopolymeric substances. Well-preserved microfossils of photosynthetic organisms are widespread within the thin sections. The calcite constituting the stromatolites is characterized by positive ?13C values (1.7 to 4.4 o), suggesting that microbial mediation of calcite was mainly related to the metabolic activity of photosynthetic organisms or anoxygenic phototrophs, and not to metabolisms in which organic material is degraded (e.g. sulfate reduction). The laminated habit of the stromatolites results from alternating layers of porous, digit-like sparite and more compacted organic-rich micrite. No correlation was identified, through isotopic analysis, between these two types of laminae and external environmental factors (i.e. temperature, salinity, eutrophication state). Rather, we hypothesize that periodic fluctuations in the dominant microbial/algal species within the mat influenced the morphology and the porosity of the different laminae. The results of this study provide insights for interpreting stromatolites that are morphologically and petrographically similar to that of Montaigu-le-Blin, but are included in older and less well-preserved rocks, which makes it difficult to evaluate their biogenicity and differentiate primary features from late stage metamorphic textures.

  8. Light Water Reactor Sustainability Program Operator Performance Metrics for Control Room Modernization: A Practical Guide for Early Design Evaluation

    SciTech Connect

    Ronald Boring; Roger Lew; Thomas Ulrich; Jeffrey Joe

    2014-03-01

    As control rooms are modernized with new digital systems at nuclear power plants, it is necessary to evaluate the operator performance using these systems as part of a verification and validation process. There are no standard, predefined metrics available for assessing what is satisfactory operator interaction with new systems, especially during the early design stages of a new system. This report identifies the process and metrics for evaluating human system interfaces as part of control room modernization. The report includes background information on design and evaluation, a thorough discussion of human performance measures, and a practical example of how the process and metrics have been used as part of a turbine control system upgrade during the formative stages of design. The process and metrics are geared toward generalizability to other applications and serve as a template for utilities undertaking their own control room modernization activities.

  9. Habitually Higher Dietary Glycemic Index During Puberty Is Prospectively Related to Increased Risk Markers of Type 2 Diabetes in Younger Adulthood

    PubMed Central

    Goletzke, Janina; Herder, Christian; Joslowski, Gesa; Bolzenius, Katja; Remer, Thomas; Wudy, Stefan A.; Roden, Michael; Rathmann, Wolfgang; Buyken, Anette E.

    2013-01-01

    OBJECTIVE Carbohydrate nutrition during periods of physiological insulin resistance such as puberty may affect future risk of type 2 diabetes. This study examined whether the amount or the quality (dietary glycemic index [GI], glycemic load [GL], and added sugar, fiber, and whole-grain intake) of carbohydrates during puberty is associated with risk markers of type 2 diabetes in younger adulthood. RESEARCH DESIGN AND METHODS The analysis was based on 226 participants (121 girls and 105 boys) from the Dortmund Nutritional and Anthropometric Longitudinally Designed Study (DONALD) with an average of five 3-day weighed dietary records (range 2–6) during puberty (girls, age 9–14 years; boys, age 10–15 years) and fasting blood samples in younger adulthood (age 18–36 years) (average duration of follow-up 12.6 years). Multivariable linear regression was used to analyze the associations between carbohydrate nutrition and homeostasis model assessment–insulin resistance (HOMA-IR) as well as the liver enzymes alanine aminotransferase (ALT) and ?-glutamyltransferase (GGT) (n = 214). RESULTS A higher dietary GI was prospectively related to greater values of HOMA-IR (Ptrend = 0.03), ALT (Ptrend = 0.02), and GGT (Ptrend = 0.04). After adjustment for sex, adult age, baseline BMI, and early life and socioeconomic factors as well as protein and fiber intake, predicted mean HOMA-IR values in energy-adjusted tertiles of GI were 2.37 (95% CI 2.16–2.60), 2.47 (2.26–2.71), and 2.59 (2.35–2.85). The amount of carbohydrates, GL, and added sugar, fiber, and whole-grain intake were not related to the analyzed markers. CONCLUSIONS Our data indicate that a habitually higher dietary GI during puberty may adversely affect risk markers of type 2 diabetes in younger adulthood. PMID:23349549

  10. Corneal Bee Sting Controlled with Early Surgical Intervention and Systemic High-Dose Steroid Therapy

    PubMed Central

    Kim, Jung-Hoon; Kim, Moosang; Lee, Seung-Jun; Han, Sang Beom; Hyon, Joon Young

    2014-01-01

    A 34-year-old Asian woman presented with painful corneal bee sting. Examinations revealed severe corneal swelling with stinger stuck in deep stroma and endothelial cell loss. She was treated with early surgery including stinger removal and anterior chamber irrigation combined with systemic high-dose steroid therapy. Vision and corneal clarity was recovered in 5 days and no additional corneal endothelial damage was observed. This report suggests that early surgical intervention and high-dose steroid therapy appear to be a useful option in the treatment of corneal bee sting. PMID:25580326

  11. Yoga for Patients with Early Breast Cancer and its Impact on Quality of Life – a Randomized Controlled Trial

    PubMed Central

    Siedentopf, F.; Utz-Billing, I.; Gairing, S.; Schoenegg, W.; Kentenich, H.; Kollak, I.

    2013-01-01

    The aim of this prospective, randomized, controlled trial was to investigate the impact of yoga on newly diagnosed patients with early breast cancer in the immediate postoperative phase. 93 women newly diagnosed with early breast cancer were randomized into an intervention group (IG) and a control group (waiting group, WG). The IG started yoga immediately after the operation. The WG started yoga 5 weeks after surgery. Both groups attended yoga classes twice weekly for 5 weeks. Quality of life (QoL) was evaluated using the EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires before the intervention, immediately after the operation and after 3 months. After 3 months the patients were asked whether yoga improved their physical activity and whether they wished to continue with yoga. The overall QoL (p?=?0.002) and the functional status (p?=?0.005) increased significantly in the IG, while physical symptoms decreased over time in both groups. 86?% of patients in the IG and only 59?% of patients in the WG (p?=?0.04) confirmed a positive change in their physical activity through yoga. More women in the IG intended to continue with yoga (p?=?0.03). Early initiation of yoga as a supportive treatment in cancer had a positive impact on QoL. Teaching yoga allowed patients to practice yoga by themselves, enhanced the patients? QoL and was found to improve physical activity. PMID:24771916

  12. The ATP-sensitive K+-channel (KATP) controls early left-right patterning in Xenopus and chick embryos

    PubMed Central

    Aw, Sherry; Koster, Joseph; Pearson, Wade; Nichols, Colin; Shi, Nian-Qing; Carneiro, Katia; Levin, Michael

    2010-01-01

    Consistent left-right asymmetry requires specific ion currents. We characterize a novel laterality determinant in Xenopus laevis: the ATP-sensitive K+-channel (KATP). Expression of specific dominant-negative mutants of the Xenopus Kir6.1 pore subunit of the KATP channel induced randomization of asymmetric organ positioning. Spatio-temporally controlled loss-of-function experiments revealed that the KATP channel functions asymmetrically in LR patterning during very early cleavage stages, and also symmetrically during the early blastula stages, a period when heretofore largely unknown events transmit LR patterning cues. Blocking KATP channel activity randomizes the expression of the left-sided transcription of Nodal. Immunofluorescence analysis revealed that XKir6.1 is localized to basal membranes on the blastocoel roof and cell-cell junctions. A tight junction integrity assay showed that KATP channels are required for proper tight junction function in early Xenopus embryos. We also present evidence that this function may be conserved to the chick, as inhibition of KATP in the primitive streak of chick embryos randomizes the expression of the left-sided gene Sonic hedgehog. We propose a model by which KATP channels control LR patterning via regulation of tight junctions. PMID:20643119

  13. Perspectives on the use of Active Structural Control Systems for Seismic Early Warning

    Microsoft Academic Search

    G. Manfredi; I. Iervolino

    2007-01-01

    In thinking about feasibility of earthquake early warning systems (EEWS), the actual question to ask is if they have a potential as tools for real-time seismic risk mitigation, which implies seismology to converge alongside earthquake engineering to real-time loss reduction. In fact, although the evacuation of buildings requires warning time not available in many urbanized areas threatened by seismic hazard,

  14. The Cool Little Kids randomised controlled trial: Population-level early prevention for anxiety disorders

    Microsoft Academic Search

    Jordana K Bayer; Ronald M Rapee; Harriet Hiscock; Obioha C Ukoumunne; Cathrine Mihalopoulos; Susan Clifford; Melissa Wake

    2011-01-01

    BACKGROUND: The World Health Organization predicts that by 2030 internalising problems (e.g. depression and anxiety) will be second only to HIV\\/AIDS in international burden of disease. Internalising problems affect 1 in 7 school aged children, impacting on peer relations, school engagement, and later mental health, relationships and employment. The development of early childhood prevention for internalising problems is in its

  15. The clinical effectiveness of static resting splints in early rheumatoid arthritis: a randomized controlled trial

    Microsoft Academic Search

    J. Adams; J. Burridge; M. Mullee; A. Hammond; C. Cooper

    2008-01-01

    Objective. To evaluate the effectiveness of static resting splints in early RA. Methods. A multicentre, randomized, trial was conducted. Patients (n ¼ 120) received either static resting splints (positioned with the wrist in neutral, MCP joint (MCPJ) and IP joint (IPJ) in a maximum of 608 and 308 of flexion, respectively) plus standardized occupational therapy or standardized occupational therapy alone.

  16. Groundwater-controlled valley networks and the decline of surface runoff on early Mars

    Microsoft Academic Search

    Keith P. Harrison; Robert E. Grimm

    2005-01-01

    Fluvial erosion on early Mars was dominated by valley networks created through a combination of groundwater processes and surface runoff. A reduced greenhouse effect due to CO2 loss, together with a declining geothermal heat flux, promoted the growth of a cryosphere and a Hesperian hydrologic regime dominated by outflow channel formation. We test the hypothesis that the transition from valley

  17. The glycemic triumvirate and diabetic complications: is the whole greater than the sum of its component parts?

    PubMed

    Monnier, Louis; Colette, Claude; Owens, David

    2012-03-01

    The dysglycemia of diabetes mellitus can be depicted as the glycemic triumvirate with its 3 main components: the sustained chronic (ambient) hyperglycemia, glucose variability and hypoglycemic episodes. The respective contributions of these glycemic disorders to the overall risk for diabetic complications remain a subject of debate. At present, there is cogent evidence for the direct deleterious effect of ambient hyperglycemia while the roles exerted by glucose variability and hypoglycemia remain less documented and only based on observational and pathophysiological studies. In addition, these 3 glycemic disorders could be regarded as components of either an additive or an initiator/accelerator model according to whether each disorder exerts an independent or inter-dependent effect on the development and progression of diabetes-related complications, respectively. In the present review, pros and cons arguments for each model are debated. However it is highly likely that these 3 glycemic disorders have both direct (spoke in a wheel) and indirect (link in a chain) causal effects on clinical cardiovascular outcomes. As a consequence, the relationship between the so-called glycemic triumvirate and diabetic complications might be summarized by the famous Aristotle's aphorism: "the whole is greater than the sum of its parts". PMID:22056719

  18. Integration of thermal and environmental control systems during Space Station Freedom early assembly phase

    Microsoft Academic Search

    David A. di Pietro; John J. Tandler

    1992-01-01

    An overview of Space Station Freedom Thermal Control System (TCS) and Environmental Control and Life Support System (ECLSS) integration is presented for Stages 2-6. Particular attention is given to issues associated with integrating five distinct, functioning spacecraft with hardware not specifically designed for intermediate stages. Areas specifically addressed include integrated ECLSS temperature and humidity control performance, thermal load balancing, performance

  19. Dietary glycemic index, but not glycemic load, is positively associated with serum homocysteine concentration in free-living young Japanese women.

    PubMed

    Murakami, Kentaro; Sasaki, Satoshi; Uenishi, Kazuhiro

    2014-01-01

    It has been suggested that diets which enhance diurnal insulin secretion, such as a high glycemic index (GI) and glycemic load (GL) diet, can be expected to increase homocysteine levels. We investigated the hypothesis that dietary GI and GL are positively associated with serum homocysteine concentration in a group of free-living young Japanese women. This preliminary cross-sectional study included 1050 female Japanese dietetic students aged 18 to 22 years. Dietary intake was assessed using a validated, self-administered, comprehensive diet history questionnaire. Fasting blood samples were collected and serum homocysteine concentrations were measured. Adjustment was made for survey year, region, municipality level, current smoking, current alcohol consumption, dietary supplement use, physical activity, body mass index, energy intake, and intakes of B vitamins (folate, vitamin B6, vitamin B12, and riboflavin). After adjustment for nondietary confounding factors, both dietary GI and GL were positively associated with homocysteine concentration (both P for trend=.001). The positive association between dietary GI and homocysteine concentration remained after further adjustment for intakes of B vitamins. Mean (95% confidence interval) values of serum homocysteine concentration for each quintile of dietary GI were 6.9 (6.7-7.2), 7.1 (6.8-7.3), 7.0 (6.7-7.2), 7.4 (7.2-7.7), and 7.3 (7.0-7.6) ?mol/L, respectively (P for trend = .04). Conversely, there was no association between dietary GL and homocysteine concentration after further adjustment for intakes of B vitamins (P for trend = .40). To conclude, in a group of free-living young Japanese women, dietary GI, but not GL, was independently and positively associated with serum homocysteine concentration. PMID:24418243

  20. An early rehabilitation intervention to enhance recovery during hospital admission for an exacerbation of chronic respiratory disease: randomised controlled trial

    PubMed Central

    Williams, Johanna E A; Hussain, Syed F; Harvey-Dunstan, Theresa C; Bankart, M John; Chaplin, Emma J; Vincent, Emma E; Chimera, Rudo; Morgan, Mike D; Singh, Sally J; Steiner, Michael C

    2014-01-01

    Objective To investigate whether an early rehabilitation intervention initiated during acute admission for exacerbations of chronic respiratory disease reduces the risk of readmission over 12 months and ameliorates the negative effects of the episode on physical performance and health status. Design Prospective, randomised controlled trial. Setting An acute cardiorespiratory unit in a teaching hospital and an acute medical unit in an affiliated teaching district general hospital, United Kingdom. Participants 389 patients aged between 45 and 93 who within 48 hours of admission to hospital with an exacerbation of chronic respiratory disease were randomised to an early rehabilitation intervention (n=196) or to usual care (n=193). Main outcome measures The primary outcome was readmission rate at 12 months. Secondary outcomes included number of hospital days, mortality, physical performance, and health status. The primary analysis was by intention to treat, with prespecified per protocol analysis as a secondary outcome. Interventions Participants in the early rehabilitation group received a six week intervention, started within 48 hours of admission. The intervention comprised prescribed, progressive aerobic, resistance, and neuromuscular electrical stimulation training. Patients also received a self management and education package. Results Of the 389 participants, 320 (82%) had a primary diagnosis of chronic obstructive pulmonary disease. 233 (60%) were readmitted at least once in the following year (62% in the intervention group and 58% in the control group). No significant difference between groups was found (hazard ratio 1.1, 95% confidence interval 0.86 to 1.43, P=0.4). An increase in mortality was seen in the intervention group at one year (odds ratio 1.74, 95% confidence interval 1.05 to 2.88, P=0.03). Significant recovery in physical performance and health status was seen after discharge in both groups, with no significant difference between groups at one year. Conclusion Early rehabilitation during hospital admission for chronic respiratory disease did not reduce the risk of subsequent readmission or enhance recovery of physical function following the event over 12 months. Mortality at 12 months was higher in the intervention group. The results suggest that beyond current standard physiotherapy practice, progressive exercise rehabilitation should not be started during the early stages of the acute illness. Trial registration Current Controlled Trials ISRCTN05557928. PMID:25004917

  1. Sociodemographic Risk, Parenting, and Effortful Control: Relations to Salivary Alpha-amylase and Cortisol in Early Childhood

    PubMed Central

    Taylor, Zoe E.; Spinrad, Tracy L.; VanSchyndel, Sarah K.; Eisenberg, Nancy; Huynh, Jacqueline; Sulik, Michael J.; Granger, Douglas A.

    2012-01-01

    Early sociodemographic risk, parenting, and temperament were examined as predictors of the activity of children’s (N = 148; 81 boys, 67 girls) hypothalamic-pituitary-adrenal axis and autonomic nervous system. Demographic risk was assessed at 18 months (T1), intrusive-overcontrolling parenting and effortful control were assessed at 30 months (T2), and salivary cortisol and alpha-amylase were collected at 72 (T3) months of age. Demographic risk at T1 predicted lower levels of children’s effortful control and higher levels of mothers’ intrusive-overcontrolling parenting at T2. Intrusive-overcontrolling parenting at T2 predicted higher levels of children’s cortisol and alpha-amylase at T3, but effortful control did not uniquely predict children’s cortisol or alpha-amylase. Findings support the open nature of stress responsive physiological systems to influence by features of the early caregiving environment and underscore the utility of including measures of these systems in prevention trials designed to influence child outcomes by modifying parenting behavior. PMID:22949301

  2. Effects of a low glycemic load diet versus a low-fat diet in subjects with and without the metabolic syndrome

    Microsoft Academic Search

    T. O. Klemsdal; I. Holme; H. Nerland; T. R. Pedersen; S. Tonstad

    2010-01-01

    Background and aimAlthough many studies report benefits of low glycemic diets, the clinical effects as a whole are mixed. The study aim was to compare a low glycemic load (LGL) diet versus a low-fat diet in a trial with a moderately intense dietary intervention in subjects with varying degrees of metabolic syndrome.

  3. The effect of caloric restriction and glycemic load on measures of oxidative stress and antioxidants in humans: results from the calerie trial of human caloric restriction

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Reducing oxidative stress and increasing antioxidant defense is suggested as one mechanism by which caloric restriction (CR) increases longevity in animals. A total of 46 moderately overweight volunteers (BMI: 25-30 kg/m2), ages 20-42 yr were randomized to either high glycemic (HG) or low glycemic ...

  4. Early top-down control of visual processing predicts working memory performance

    PubMed Central

    Rutman, Aaron M.; Clapp, Wesley C.; Chadick, James Z.; Gazzaley, Adam

    2009-01-01

    Selective attention confers a behavioral benefit for both perceptual and working memory (WM) performance, often attributed to top-down modulation of sensory neural processing. However, the direct relationship between early activity modulation in sensory cortices during selective encoding and subsequent WM performance has not been established. To explore the influence of selective attention on WM recognition, we used electroencephalography (EEG) to study the temporal dynamics of top-down modulation in a selective, delayed-recognition paradigm. Participants were presented with overlapped, “double-exposed” images of faces and natural scenes, and were instructed to either remember the face or the scene while simultaneously ignoring the other stimulus. Here, we present evidence that the degree to which participants modulate the early P100 (97–129 ms) event-related potential (ERP) during selective stimulus encoding significantly correlates with their subsequent WM recognition. These results contribute to our evolving understanding of the mechanistic overlap between attention and memory. PMID:19413473

  5. Early top-down control of visual processing predicts working memory performance.

    PubMed

    Rutman, Aaron M; Clapp, Wesley C; Chadick, James Z; Gazzaley, Adam

    2010-06-01

    Selective attention confers a behavioral benefit on both perceptual and working memory (WM) performance, often attributed to top-down modulation of sensory neural processing. However, the direct relationship between early activity modulation in sensory cortices during selective encoding and subsequent WM performance has not been established. To explore the influence of selective attention on WM recognition, we used electroencephalography to study the temporal dynamics of top-down modulation in a selective, delayed-recognition paradigm. Participants were presented with overlapped, "double-exposed" images of faces and natural scenes, and were instructed to either remember the face or the scene while simultaneously ignoring the other stimulus. Here, we present evidence that the degree to which participants modulate the early P100 (97-129 msec) event-related potential during selective stimulus encoding significantly correlates with their subsequent WM recognition. These results contribute to our evolving understanding of the mechanistic overlap between attention and memory. PMID:19413473

  6. [Early antibiotic therapy following urodynamic examination. Results of a randomized, controlled study].

    PubMed

    Tosto, A; Dattolo, E; Brigadini, R; Pironti, M; Di Cello, V; Rizzo, M

    1989-01-01

    Forty-three young men from the Italian army underwent urodynamic tests following the diagnosis of enuresis. Of these, 37 were included in an assessment trial to define the rationale for early anti-bacterial therapy following the test. The subjects were subdivided into two groups: one group received 500 mg Cinoxacin b.i.d. for 5 days, and the other group was not treated. The comparison of results revealed a high incidence of irritative disorders in both groups (78.9% of treated subjects and 88.9% of untreated subjects) but the most significant complications were observed in the untreated group (feveret in 27.7% and one case of septic fever). Early anti-bacterial therapy following standard urodynamic tests therefore seems to be a ration tool in urological practice. PMID:2698515

  7. Randomized Controlled Trial of Forward-Planned Intensity Modulated Radiotherapy for Early Breast Cancer: Interim Results at 2 Years

    SciTech Connect

    Barnett, Gillian C. [Department of Oncology, University of Cambridge, Cambridge University Hospitals, National Health Service Foundation Trust, Cambridge (United Kingdom); Wilkinson, Jennifer S.; Moody, Anne M.; Wilson, Charles B.; Twyman, Nicola [Oncology Centre, Cambridge University Hospitals, National Health Services Foundation Trust, Cambridge (United Kingdom); Wishart, Gordon C. [Cambridge Breast Unit, Addenbrooke's Hospital, Cambridge (United Kingdom); Burnet, Neil G. [Department of Oncology, University of Cambridge, Cambridge University Hospitals, National Health Service Foundation Trust, Cambridge (United Kingdom); Coles, Charlotte E., E-mail: charlotte.coles@addenbrookes.nhs.uk [Oncology Centre, Cambridge University Hospitals, National Health Services Foundation Trust, Cambridge (United Kingdom)

    2012-02-01

    Purpose: This single-center randomized trial was designed to investigate whether intensity-modulated radiotherapy (IMRT) reduces late toxicity in patients with early-stage breast cancer. Methods and Materials: The standard tangential plans of 1,145 nonselected patients were analyzed. The patients with inhomogeneous plans were randomized to a simple method of forward-planned IMRT or standard radiotherapy (RT). The primary endpoint was serial photographic assessment of breast shrinkage. Results: At 2 years, no significant difference was found in the development of any photographically assessed breast shrinkage between the patients randomized to the interventional or control group (odds ratio, 1.51; 95% confidence interval, 0.83-1.58; p = .41). The patients in the control group were more likely to develop telangiectasia than those in the IMRT group (odds ratio, 1.68; 95% confidence interval 1.13-2.40; p = .009). Poor baseline surgical cosmesis resulted in poor overall cosmesis at 2 years after RT. In patients who had good surgical cosmesis, those randomized to IMRT were less likely to deteriorate to a moderate or poor overall cosmesis than those in the control group (odds ratio, 0.63; 95% confidence interval, 0.39-1.03, p = .061). Conclusions: IMRT can lead to a significant reduction in telangiectasia at comparatively early follow-up of only 2 years after RT completion. An important component of breast induration and shrinkage will actually result from the surgery and not from the RT. Surgical cosmesis is an important determinant of overall cosmesis and could partially mask the longer term benefits of IMRT at this early stage.

  8. Course of intelligence deficits in early onset, first episode schizophrenia: a controlled, 5-year longitudinal study

    Microsoft Academic Search

    Jens Richardt Moellegaard Jepsen; Birgitte Fagerlund; Anne Katrine Pagsberg; Anne Marie R. Christensen; Rikke W. Hilker; Merete Nordentoft; Erik L. Mortensen

    2010-01-01

    Only few prospective longitudinal studies have assessed the course of intelligence deficits in early onset schizophrenia (EOS),\\u000a and these have used different age appropriate versions of Wechsler Intelligence Scales and age appropriate norms. The post-psychotic\\u000a development of intelligence in EOS has predominantly been characterized as relatively stable in these studies. However, comparisons\\u000a of IQs from different test versions based on

  9. A High Dietary Glycemic Index Increases Total Mortality in a Mediterranean Population at High Cardiovascular Risk

    PubMed Central

    Castro-Quezada, Itandehui; Sánchez-Villegas, Almudena; Estruch, Ramón; Salas-Salvadó, Jordi; Corella, Dolores; Schröder, Helmut; Álvarez-Pérez, Jacqueline; Ruiz-López, María Dolores; Artacho, Reyes; Ros, Emilio; Bulló, Mónica; Covas, María-Isabel; Ruiz-Gutiérrez, Valentina; Ruiz-Canela, Miguel; Buil-Cosiales, Pilar; Gómez-Gracia, Enrique; Lapetra, José; Pintó, Xavier; Arós, Fernando; Fiol, Miquel; Lamuela-Raventós, Rosa María; Martínez-González, Miguel Ángel; Serra-Majem, Lluís

    2014-01-01

    Objective Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. Material and Methods The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. Results We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR?=?2.15 (95% CI: 1.15–4.04); P for trend ?=?0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. Conclusions High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk. PMID:25250626

  10. The Coemergence of Cognition, Language, and Speech Motor Control in Early Development: A Longitudinal Correlation Study

    PubMed Central

    Nip, Ignatius S. B.; Green, Jordan R.; Marx, David B.

    2010-01-01

    Although the development of spoken language is dependent on the emergence of cognitive, language, and speech motor skills, knowledge about how these domains interact during the early stages of communication development is currently limited. This exploratory investigation examines the strength of associations between longitudinal changes in articulatory kinematics and development of skills in multiple domains thought to support early communication development. Twenty-four infants were investigated every three months between the ages of 9 and 21 months. Movements of the upper lip, lower lip, and jaw were transduced using a three-dimensional motion capture system to obtain age-related changes in movement speed and range of movement. Standardized measures of cognition and language from the Battelle Developmental Inventory, 2nd edition and the MacArthur-Bates Child Development Inventory were also collected. Significant associations were identified between orofacial kinematic and the standardized measures of language and cognitive skills, even when age served as covariate. These findings provide preliminary evidence of interactions between cognition, language, and speech motor skills during early communication development. Further work is needed to identify and quantify causal relations among these co-emerging skills. PMID:21035125

  11. Effect of a Mediterranean Diet Intervention on Dietary Glycemic Load and Dietary Glycemic Index: The PREDIMED Study

    PubMed Central

    Rodríguez-Rejón, Ana Isabel; Ruano-Rodríguez, Cristina; Ruiz-López, María Dolores; Sánchez-Villegas, Almudena; Toledo, Estefanía; Estruch, Ramón; Covas, María Isabel; Corella, Dolores; Gómez-Gracia, Enrique; Lapetra, José; Pintó, Xavier; Arós, Fernando; Fiol, Miquel; Lamuela-Raventós, Rosa María; Ruiz-Gutierrez, Valentina; Schröder, Helmut; Ros, Emilio; Martínez-González, Miguel Ángel; Serra-Majem, Lluis

    2014-01-01

    Objective. To compare the one year effect of two dietary interventions with MeDiet on GL and GI in the PREDIMED trial. Methods. Participants were older subjects at high risk for cardiovascular disease. This analysis included 2866 nondiabetic subjects. Diet was assessed with a validated 137-item food frequency questionnaire (FFQ). The GI of each FFQ item was assigned by a 5-step methodology using the International Tables of GI and GL Values. Generalized linear models were fitted to assess the relationship between the intervention group and dietary GL and GI at one year of follow-up, using control group as reference. Results. Multivariate-adjusted models showed an inverse association between GL and MeDiet + extra virgin olive oil (EVOO) group: ? = ?8.52 (95% CI: ?10.83 to ?6.20) and MeDiet + Nuts group: ? = ?10.34 (95% CI: ?12.69 to ?8.00), when comparing with control group. Regarding GI, ? = ?0.93 (95% CI: ?1.38 to ?0.49) for MeDiet + EVOO, ? = ?1.06 (95% CI: ?1.51 to ?0.62) for MeDiet + Nuts when comparing with control group. Conclusion. Dietary intervention with MeDiet supplemented with EVOO or nuts lowers dietary GL and GI. PMID:25295183

  12. The Contribution of Adolescent Effortful Control to Early Adult Educational Attainment

    ERIC Educational Resources Information Center

    Véronneau, Marie-Hélène; Hiatt Racer, Kristina; Fosco, Gregory M.; Dishion, Thomas J.

    2014-01-01

    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…

  13. Boolean genetic network model for the control of C. elegans early embryonic cell cycles

    PubMed Central

    2013-01-01

    Background In Caenorhabditis elegans early embryo, cell cycles only have two phases: DNA synthesis and mitosis, which are different from the typical 4-phase cell cycle. Modeling this cell-cycle process into network can fill up the gap in C. elegans cell-cycle study and provide a thorough understanding on the cell-cycle regulations and progressions at the network level. Methods In this paper, C. elegans early embryonic cell-cycle network has been constructed based on the knowledge of key regulators and their interactions from literature studies. A discrete dynamical Boolean model has been applied in computer simulations to study dynamical properties of this network. The cell-cycle network is compared with random networks and tested under several perturbations to analyze its robustness. To investigate whether our proposed network could explain biological experiment results, we have also compared the network simulation results with gene knock down experiment data. Results With the Boolean model, this study showed that the cell-cycle network was stable with a set of attractors (fixed points). A biological pathway was observed in the simulation, which corresponded to a whole cell-cycle progression. The C. elegans network was significantly robust when compared with random networks of the same size because there were less attractors and larger basins than random networks. Moreover, the network was also robust under perturbations with no significant change of the basin size. In addition, the smaller number of attractors and the shorter biological pathway from gene knock down network simulation interpreted the shorter cell-cycle lengths in mutant from the RNAi gene knock down experiment data. Hence, we demonstrated that the results in network simulation could be verified by the RNAi gene knock down experiment data. Conclusions A C. elegans early embryonic cell cycles network was constructed and its properties were analyzed and compared with those of random networks. Computer simulation results provided biologically meaningful interpretations of RNAi gene knock down experiment data. PMID:24564942

  14. Longitudinal relations among parents' reactions to children's negative emotions, effortful control, and math achievement in early elementary school.

    PubMed

    Swanson, Jodi; Valiente, Carlos; Lemery-Chalfant, Kathryn; Bradley, Robert H; Eggum-Wilkens, Natalie D

    2014-01-01

    Panel mediation models and fixed-effects models were used to explore longitudinal relations among parents' reactions to children's displays of negative emotions, children's effortful control (EC), and children's math achievement (N = 291; M age in fall of kindergarten = 5.66 years, SD = .39 year) across kindergarten through second grade. Parents reported their reactions and children's EC. Math achievement was assessed with a standardized achievement test. First-grade EC mediated the relation between parents' reactions at kindergarten and second-grade math achievement, beyond stability in constructs across study years. Panel mediation model results suggested that socialization of EC may be one method of promoting math achievement in early school; however, when all omitted time-invariant covariates of EC and math achievement were controlled, first-grade EC no longer predicted second-grade math achievement. PMID:24916765

  15. Geologically Controlled Isotope-Time Patterns Reveal Early Differentiation and Crust Formation Processes

    NASA Astrophysics Data System (ADS)

    Bennett, V. C.; Nutman, A. P.

    2014-12-01

    The mechanisms of continental crust production and evolution in the early Earth remain controversial, as are questions of the relative roles of early differentiation versus subsequent tectonic procssing in creating Earth's chemical signatures. Here we present geologic observations integrated with whole rock major, trace element and Sm-Nd isotopic signatures and combined with U-Pb and Lu-Hf isotopic compositions of zircon populations from the same rocks, from the most extensive early rock record comprising the 3.9 Ga to 3.6 Ga terranes of southwest Greenland. These data reveal repeated patterns of formation of juvenile TTG crust and associated mafic and ultramafic rocks in convergent margin settings followed by formation of more evolved granites [1]. Our new zircon Lu-Hf data from rare 3.6-3.7 Ga tonalites within the Itsaq Gneiss Complex, obtained from single component, non-migmatitic gneisses with simple zircon populations, limited within sample Hf isotopic variability and accurate U-Pb ages, now document extraction of juvenile tonalites from a near chondritic mantle source between 3.9 Ga and 3.6 Ga. The more evolved, granitic rocks in each area show slightly negative initial ?Hf in accord with crustal reworking of the older (3.8-3.9 Ga) gniesses. There is no evidence for Hadean material in the sources of the granitoids. The Hf isotope-time patterns are consistent with juvenile crust production from a mantle source that experienced only modest amounts of prior crustal extraction. They are distinct from those predicted by reprocessing of an enriched Hadean mafic crust, as has been proposed for this region [2] and for the source of the Hadean Jack Hills zircons [3]. The well-documented, time decreasing, positive 142Nd anomalies [e.g., 4] from these rocks are further evidence of crustal derivation from a convecting mantle source, rather than reworking of an enriched mafic lithosphere. The 143Nd isotopic -time patterns are more complex, reflecting the interplay between early Sm/Nd fractionation processes as required by the 142Nd data, juvenile crustal growth and in some cases geologic disturbance of the whole rock Sm-Nd system. [1] Nutman, et al, (2013) Amer. Jour. Sci. 313, 877-911. [2] Naeraa et al.. (2012) Nature 485, 627-631. [3] Kemp et al., (2010) EPSL 296, 45-56. [4] Bennett et al., (20070 Science 318, 1907.

  16. Tea, coffee, and caffeine and early-onset basal cell carcinoma in a case-control study.

    PubMed

    Ferrucci, Leah M; Cartmel, Brenda; Molinaro, Annette M; Leffell, David J; Bale, Allen E; Mayne, Susan T

    2014-07-01

    Tea and coffee are hypothesized to play a protective role in skin carcinogenesis through bioactive components, such as caffeine, yet the epidemiologic evidence is mixed. Existing data support an inverse association with basal cell carcinoma (BCC), more so than for melanoma or squamous cell carcinoma. To understand whether tea, coffee, and caffeine are related to early-onset BCC, we evaluated data from 767 non-Hispanic Whites under age 40 in a case-control study in Connecticut. BCC cases (n=377) were identified through Yale's Dermatopathology database. Controls (n=390) were randomly sampled from individuals in the same database with benign skin diagnoses and frequency matched to cases on age, sex, and biopsy site. Participants completed an in-person interview including assessment of caffeinated coffee and hot tea. We calculated multivariate odds ratios (ORs) and 95% confidence intervals (CIs) with unconditional logistic regression for regular consumption and frequency and duration measures. Combined regular consumption of caffeinated coffee plus hot tea was inversely associated with early-onset BCC (OR=0.60, 95% CI=0.38-0.96). Those in the highest category of caffeine from these sources had a 43% reduced risk of BCC compared with nonconsumers (OR=0.57, 95% CI=0.34-0.95, P-trend=0.037). Our findings suggest a modest protective effect for caffeinated coffee plus tea in relation to early-onset BCC that may, in part, be due to caffeine. This study adds to the growing body of literature suggesting potential health benefits from these beverages. PMID:24841641

  17. Interplay between Wnt2 and Wnt2bb controls multiple steps of early foregut-derived organ development.

    PubMed

    Poulain, Morgane; Ober, Elke A

    2011-08-01

    The vertebrate liver, pancreas and lung arise in close proximity from the multipotent foregut endoderm. Tissue-explant experiments uncovered instructive signals emanating from the neighbouring lateral plate mesoderm, directing the endoderm towards specific organ fates. This suggested that an intricate network of signals is required to control the specification and differentiation of each organ. Here, we show that sequential functions of Wnt2bb and Wnt2 control liver specification and proliferation in zebrafish. Their combined specific activities are essential for liver specification, as their loss of function causes liver agenesis. Conversely, excess wnt2bb or wnt2 induces ectopic liver tissue at the expense of pancreatic and anterior intestinal tissues, revealing the competence of intestinal endoderm to respond to hepatogenic signals. Epistasis experiments revealed that the receptor frizzled homolog 5 (fzd5) mediates part of the broader hepatic competence of the alimentary canal. fzd5 is required for early liver formation and interacts genetically with wnt2 as well as wnt2bb. In addition, lack of both ligands causes agenesis of the swim bladder, the structural homolog of the mammalian lung. Thus, tightly regulated spatiotemporal expression of wnt2bb, wnt2 and fzd5 is central to coordinating early liver, pancreas and swim bladder development from a multipotent foregut endoderm. PMID:21771809

  18. Effect of early lactation foot trimming in lame and non-lame dairy heifers: a randomised controlled trial.

    PubMed

    Maxwell, O J R; Hudson, C D; Huxley, J N

    2015-07-25

    Foot trimming is a common management intervention in prevention of lameness in dairy cattle. Despite this, there is surprisingly limited experimental evidence on its efficacy, especially in regard to primiparous heifers. A randomised, negatively controlled trial was conducted to investigate the association between an early lactation foot trim on primiparous animals and production outcomes. 282 heifers were enrolled from eight farms in the UK, and randomly assigned to treatment or control groups. Milk yield (305-day-adjusted whole-milk yield) was not significantly different between groups (trimmed 7727?litres, untrimmed 7646?litres). However, multivariate regression analysis demonstrated that this relationship was confounded by lameness state. Animals that were lame at the time of trimming gave significantly more milk (734?litres, P=0.02) than those that were non-lame and untrimmed. The present results suggest that, based on milk production alone, it would not have been cost beneficial to trim all heifers; however, a targeted intervention aimed at lame animals would have delivered a substantial return on investment. As a very minimum, the authors recommend heifers should be regularly assessed in early lactation, and treated as soon as they are identifiably lame. The high prevalence of lesions identified suggests routine trimming for all heifers may be justifiable on welfare grounds even if the milk-yield benefits are marginal. PMID:26116268

  19. Interplay between Wnt2 and Wnt2bb controls multiple steps of early foregut-derived organ development

    PubMed Central

    Poulain, Morgane; Ober, Elke A.

    2011-01-01

    The vertebrate liver, pancreas and lung arise in close proximity from the multipotent foregut endoderm. Tissue-explant experiments uncovered instructive signals emanating from the neighbouring lateral plate mesoderm, directing the endoderm towards specific organ fates. This suggested that an intricate network of signals is required to control the specification and differentiation of each organ. Here, we show that sequential functions of Wnt2bb and Wnt2 control liver specification and proliferation in zebrafish. Their combined specific activities are essential for liver specification, as their loss of function causes liver agenesis. Conversely, excess wnt2bb or wnt2 induces ectopic liver tissue at the expense of pancreatic and anterior intestinal tissues, revealing the competence of intestinal endoderm to respond to hepatogenic signals. Epistasis experiments revealed that the receptor frizzled homolog 5 (fzd5) mediates part of the broader hepatic competence of the alimentary canal. fzd5 is required for early liver formation and interacts genetically with wnt2 as well as wnt2bb. In addition, lack of both ligands causes agenesis of the swim bladder, the structural homolog of the mammalian lung. Thus, tightly regulated spatiotemporal expression of wnt2bb, wnt2 and fzd5 is central to coordinating early liver, pancreas and swim bladder development from a multipotent foregut endoderm. PMID:21771809

  20. NK1.1+ CD8+ T cells escape TGF-? control and contribute to early microbial pathogen response.

    PubMed

    Ruiz, Anne L; Soudja, Saidi M'Homa; Deceneux, Cyril; Lauvau, Grégoire; Marie, Julien C

    2014-01-01

    Following microbial pathogen invasion, one of the main challenges for the host is to rapidly control pathogen spreading to avoid vital tissue damage. Here we report that an effector CD8(+) T-cell population that expresses the marker NK1.1 undergoes delayed contraction and sustains early anti-microbial protection. NK1.1(+) CD8(+) T cells are derived from CD8(+) T cells during priming, and their differentiation is inhibited by transforming growth factor-? signalling. After their own contraction phase, they form a distinct pool of KLRG1 CD127 double-positive memory T cells and rapidly produce both interferon-? and granzyme B, providing significant pathogen protection in an antigen-independent manner within only a few hours. Thus, by prolonging the CD8(+) T-cell response at the effector stage and by expressing exacerbated innate-like features at the memory stage, NK1.1(+) cells represent a distinct subset of CD8(+) T cell that contributes to the early control of microbial pathogen re-infections. PMID:25284210

  1. Growth of early continental crust controlled by melting of amphibolite in subduction zones.

    PubMed

    Foley, Stephen; Tiepolo, Massimo; Vannucci, Riccardo

    2002-06-20

    It is thought that the first continental crust formed by melting of either eclogite or amphibolite, either at subduction zones or on the underside of thick oceanic crust. However, the observed compositions of early crustal rocks and experimental studies have been unable to distinguish between these possibilities. Here we show a clear contrast in trace-element ratios of melts derived from amphibolites and those from eclogites. Partial melting of low-magnesium amphibolite can explain the low niobium/tantalum and high zirconium/samarium ratios in melts, as required for the early continental crust, whereas the melting of eclogite cannot. This indicates that the earliest continental crust formed by melting of amphibolites in subduction-zone environments and not by the melting of eclogite or magnesium-rich amphibolites in the lower part of thick oceanic crust. Moreover, the low niobium/tantalum ratio seen in subduction-zone igneous rocks of all ages is evidence that the melting of rutile-eclogite has never been a volumetrically important process. PMID:12075348

  2. Guanfacine enhances inhibitory control and attentional shifting in early abstinent cocaine-dependent individuals

    PubMed Central

    Fox, Helen; Sofuoglu, Mehmet; Sinha, Rajita

    2015-01-01

    Objectives Attenuation of adrenergic drive and cognitive enhancement, via stimulation of alpha2 pre- and post-synaptic receptors, may selectively enhance executive performance in early abstinent cocaine-dependent individuals. As these cognitive processes underpin important treatment-related behaviors, the alpha2 agonist, guanfacine HCl, may represent an effective pharmaco-therapeutic intervention. Methods Twenty-five early abstinent cocaine-dependent individuals were administered a battery of neurocognitive tasks on entry into treatment (baseline) and again following 3 weeks of either placebo or guanfacine treatment (up to 3 mg). Tasks included: Stop Signal, Stroop, 3-Dimentional Intra-dimensional/Extra-dimensional (IDED) task, Spatial Working Memory (SWM), Paired Associates Learning (PAL), Verbal Fluency and the Rey Auditory Verbal Learning Test (RAVLT). Results Compared with placebo, the guanfacine group demonstrated attenuated anxiety and negative affect as well as improved performance on selective executive tests. This included fewer directional errors on the stop signal task, fewer errors on the extra-dimensional shift component of the IDED task and better attentional switching during verbal fluency. Guanfacine did not improve strategic working memory or peripheral memory. Conclusion Guanfacine improves selective cognitive processes which may underlie salient treatment-related regulatory behaviors. Alpha2 agonists may therefore represent important agents for cocaine dependence. PMID:25567555

  3. A spinal opsin controls early neural activity and drives a behavioral light response.

    PubMed

    Friedmann, Drew; Hoagland, Adam; Berlin, Shai; Isacoff, Ehud Y

    2015-01-01

    Nonvisual detection of light by the vertebrate hypothalamus, pineal, and retina is known to govern seasonal and circadian behaviors. However, the expression of opsins in multiple other brain structures suggests a more expansive repertoire for light regulation of physiology, behavior, and development. Translucent zebrafish embryos express extraretinal opsins early on, at a time when spontaneous activity in the developing CNS plays a role in neuronal maturation and circuit formation. Though the presence of extraretinal opsins is well documented, the function of direct photoreception by the CNS remains largely unknown. Here, we show that early activity in the zebrafish spinal central pattern generator (CPG) and the earliest locomotory behavior are dramatically inhibited by physiological levels of environmental light. We find that the photosensitivity of this circuit is conferred by vertebrate ancient long opsin A (VALopA), which we show to be a G?(i)-coupled receptor that is expressed in the neurons of the spinal network. Sustained photoactivation of VALopA not only suppresses spontaneous activity but also alters the maturation of time-locked correlated network patterns. These results uncover a novel role for nonvisual opsins and a mechanism for environmental regulation of spontaneous motor behavior and neural activity in a circuit previously thought to be governed only by intrinsic developmental programs. PMID:25484291

  4. Development of early handwriting: Visual-motor control during letter copying.

    PubMed

    Maldarelli, Jennifer E; Kahrs, Björn A; Hunt, Sarah C; Lockman, Jeffrey J

    2015-07-01

    Despite the importance of handwriting for school readiness and early academic progress, prior research on the development of handwriting has focused primarily on the product rather than the process by which young children write letters. In contrast, in the present work, early handwriting is viewed as involving a suite of perceptual, motor, and cognitive abilities, which must work in unison if children are to write letters efficiently. To study such coordination, head-mounted eye-tracking technology was used to investigate the process of visual-motor coordination while kindergarten children (N = 23) and adults (N = 11) copied individual letters and strings of letters that differed in terms of their phonemic properties. Results indicated that kindergarten children were able to copy single letters efficiently, as did adults. When the cognitive demands of the task increased and children were presented with strings of letters, however, their ability to copy letters efficiently was compromised: Children frequently interrupted their writing midletter, whereas they did not do so on single letter trials. Yet, with increasing age, children became more efficient in copying letter strings, in part by using vision more prospectively when writing. Taken together, the results illustrate how the coordination of perceptual, motor, and cognitive processes contributes to advances in the development of letter writing skill. (PsycINFO Database Record PMID:26029821

  5. Control of SIV Rebound Through Structured Treatment Interruptions During Early Infection

    Microsoft Academic Search

    Franco Lori; Mark G. Lewis; Jianqing Xu; Georg Varga; Donald E. Zinn; Carrol Crabbs; Wendeline Wagner; Jack Greenhouse; Peter Silvera; Jake Yalley-Ogunro; Carmine Tinelli; Julianna Lisziewicz

    2000-01-01

    In a randomized controlled trial with acute simian immunodeficiency virus (SIV)-infected macaques, both highly active antiretroviral therapy (HAART) and HAART with fixed-schedule structured treatment interruption (STI-HAART; alternating 3 weeks on and 3 weeks off therapy) suppressed viral load. In the STI-HAART group, T cell virus-specific immune response (VIR) and control of viral rebound increased concurrently during subsequent interruptions. In contrast,

  6. Effect of exenatide on 24-hour blood glucose profile compared with placebo in patients with type 2 diabetes: A randomized, double-blind, two-arm, parallel-group, placebo-controlled, 2-week study

    Microsoft Academic Search

    Sherwyn L. Schwartz; Robert E. Ratner; Dennis D. Kim; Yongming Qu; Linda L. Fechner; Sheila M. Lenox; John H. Holcombe

    2008-01-01

    Objective: The aim of this study was to examine the glucose-lowering effect of exenatide over 24 hours in patients with type 2 diabetes with inadequate glycemic control using metformin, with or without a thiazolidinedione (TZD).Methods: This randomized, double-blind, 2-arm, parallel-group, placebo-controlled, 2-week study was conducted in patients with type 2 diabetes with inadequate glycemic control, despite metformin with or without

  7. Age at diagnosis predicts deterioration in glycaemic control among children and adolescents with type 1 diabetes

    PubMed Central

    Clements, Mark A; Lind, Marcus; Raman, Sripriya; Patton, Susana R; Lipska, Kasia J; Fridlington, Amanda G; Tang, Fengming; Jones, Phil G; Wu, Yue; Spertus, John A; Kosiborod, Mikhail

    2014-01-01

    Background Poor glycemic control early in the course of type 1 diabetes mellitus (T1DM) increases the risk for microvascular complications. However, predictors of deteriorating control after diagnosis have not been described, making it difficult to identify high-risk patients and proactively provide aggressive interventions. Objective We examined whether diagnostic age, gender, and race were associated with deteriorating glycemic control during the first 5?years after diagnosis. Participants 2218 pediatric patients with T1DM. Methods We conducted a longitudinal cohort study of pediatric patients with T1DM from the Midwest USA, 1993–2009, evaluating within-patient glycated hemoglobin (HbA1c) trajectories constructed from all available HbA1c values within 5?years of diagnosis. Results 52.6% of patients were male; 86.1% were non-Hispanic Caucasian. The mean diagnostic age was 9.0±4.1?years. The mean number of HbA1c values/year/participant was 2.4±0.9. HbA1c trajectories differed markedly across age groups, with older patients experiencing greater deterioration than their younger counterparts (p<0.001). HbA1c trajectories, stratified by age, varied markedly by race (p for race×diagnostic age <0.001). Non-Hispanic African-American patients experienced higher initial HbA1c (8.7% vs 7.6% (71.6 vs 59.6?mmol/mol); p<0.001), and greater deterioration in HbA1c than non-Hispanic Caucasian patients across diagnostic ages (rise of 2.04% vs 0.99% per year (22.3 vs 10.8?mmol/mol/year); p<0.0001). Conclusions Older diagnostic age and black race are major risk factors for deterioration in glycemic control early in the course of T1DM. These findings can inform efforts to explore the reasons behind these differences and develop preventive interventions for high-risk patients. PMID:25452876

  8. Fraud and Corruption Control at Education System Level: A Case Study of the Victorian Department of Education and Early Childhood Development in Australia

    ERIC Educational Resources Information Center

    Bandaranayake, Bandara

    2014-01-01

    This case describes the implementation of a fraud and corruption control policy initiative within the Victorian Department of Education and Early Childhood Development (the Department) in Australia. The policy initiative was administered and carried out by a small team of fraud control officials, including the author of this article, in the…

  9. Early Microstructural and Metabolic Changes following Controlled Cortical Impact Injury in Rat: A Magnetic Resonance Imaging and Spectroscopy Study

    PubMed Central

    Xu, Su; Zhuo, Jiachen; Racz, Jennifer; Shi, Da; Roys, Steven; Fiskum, Gary

    2011-01-01

    Abstract Understanding tissue alterations at an early stage following traumatic brain injury (TBI) is critical for injury management and limiting severe consequences from secondary injury. We investigated the early microstructural and metabolic profiles using in vivo diffusion tensor imaging (DTI) and proton magnetic resonance spectroscopy (1H MRS) at 2 and 4?h following a controlled cortical impact injury in the rat brain using a 7.0 Tesla animal MRI system and compared profiles to baseline. Significant decrease in mean diffusivity (MD) and increased fractional anisotropy (FA) was found near the impact site (hippocampus and bilateral thalamus; p<0.05) immediately following TBI, suggesting cytotoxic edema. Although the DTI parameters largely normalized on the contralateral side by 4?h, a large inter-individual variation was observed with a trend towards recovery of MD and FA in the ipsilateral hippocampus and a sustained elevation of FA in the ipsilateral thalamus (p<0.05). Significant reduction in metabolite to total creatine ratios of N-acetylaspartate (NAA, p=0.0002), glutamate (p=0.0006), myo-inositol (Ins, p=0.04), phosphocholine and glycerophosphocholine (PCh+GPC, p=0.03), and taurine (Tau, p=0.009) were observed ipsilateral to the injury as early as 2?h, while glutamine concentration increased marginally (p=0.07). These metabolic alterations remained sustained over 4?h after TBI. Significant reductions of Ins (p=0.024) and Tau (p=0.013) and marginal reduction of NAA (p=0.06) were also observed on the contralateral side at 4?h after TBI. Overall our findings suggest significant microstructural and metabolic alterations as early as 2?h following injury. The tendency towards normalization at 4?h from the DTI data and no further metabolic changes at 4?h from MRS suggest an optimal temporal window of about 3?h for interventions that might limit secondary damage to the brain. Results indicate that early assessment of TBI patients using DTI and MRS may provide valuable information on the available treatment window to limit secondary brain damage. PMID:21761962

  10. Elective Inguinal Node Irradiation in Early-Stage T2N0 Anal Cancer: Prognostic Impact on Locoregional Control

    SciTech Connect

    Zilli, Thomas, E-mail: Thomas.Zilli@hcuge.ch [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Betz, Michael [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Radiation Oncology Institute, Hirslanden Lausanne, Lausanne (Switzerland); Bieri, Sabine [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Ris, Frederic; Roche, Bruno [Department of Surgery, Geneva University Hospital, Geneva (Switzerland); Roth, Arnaud D. [Oncosurgery Unit, Geneva University Hospital, Geneva (Switzerland); Allal, Abdelkarim S. [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Department of Radiation Oncology,Hôpital Fribourgeois, Fribourg (Switzerland)

    2013-09-01

    Purpose: To evaluate the influence of elective inguinal node radiation therapy (INRT) on locoregional control (LRC) in patients with early-stage T2N0 anal cancer treated conservatively with primary RT. Methods and Materials: Between 1976 and 2008, 116 patients with T2 node-negative anal cancer were treated curatively with RT alone (n=48) or by combined chemoradiation therapy (CRT) (n=68) incorporating mitomycin C and 5-fluorouracil. Sixty-four percent of the patients (n=74) received elective INRT. Results: Over a median follow-up of 69 months (range, 4-243 months), 97 (84%) and 95 patients (82%) were locally and locoregionally controlled, respectively. Rates for 5-year actuarial local control, LRC, cancer-specific, and overall survival for the entire population were 81.7% ± 3.8%, 79.2% ± 4.1%, 91.1% ± 3.0%, and 72.1% ± 4.5%, respectively. The overall 5-year inguinal relapse-free survival was 92.3% ± 2.9%. Isolated inguinal recurrence occurred in 2 patients (4.7%) treated without INRT, whereas no groin relapse was observed in those treated with INRT. The 5-year LRC rates for patients treated with and without INRT and with RT alone versus combined CRT were 80.1% ± 5.0% versus 77.8% ± 7.0% (P=.967) and 71.0% ± 7.2% versus 85.4% ± 4.5% (P=.147), respectively. A trend toward a higher rate of grade ?3 acute toxicity was observed in patients treated with INRT (53% vs 31%, P=.076). Conclusions: In cases of node-negative T2 anal cancer, the inguinal relapse rate remains relatively low with or without INRT. The role of INRT in the treatment of early-stage anal carcinoma needs to be investigated in future prospective trials.

  11. Differentiating Processes of Control and Understanding in the Early Development of Emotion and Cognition

    ERIC Educational Resources Information Center

    Blankson, A. Nayena; O'Brien, Marion; Leerkes, Esther M.; Marcovitch, Stuart; Calkins, Susan D.

    2012-01-01

    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…

  12. Parenting and Child "DRD4" Genotype Interact to Predict Children's Early Emerging Effortful Control

    ERIC Educational Resources Information Center

    Smith, Heather J.; Sheikh, Haroon I.; Dyson, Margaret W.; Olino, Thomas M.; Laptook, Rebecca S.; Durbin, C. Emily; Hayden, Elizabeth P.; Singh, Shiva M.; Klein, Daniel N.

    2012-01-01

    Effortful control (EC), or the trait-like capacity to regulate dominant responses, has important implications for children's development. Although genetic factors and parenting likely influence EC, few studies have examined whether they interact to predict its development. This study examined whether the "DRD4" exon III variable number tandem…

  13. Glycemic index of single and mixed meal foods among common Japanese foods with white rice as a reference food

    Microsoft Academic Search

    M Sugiyama; A C Tang; Y Wakaki; W Koyama

    2003-01-01

    Objective: The objectives were to examine the feasibility of using white rice as a reference food in the study of glycemic index (GI) and to examine the GI values of both single and mixed meal foods among rice species, processed rice products, beans, and dairy products.Design: Subjects were served with 50 g carbohydrate content of white rice at least two

  14. Studies on the in vitro starch digestibility and the glycemic index of six different indigenous rice cultivars from the Philippines

    Microsoft Academic Search

    M. Frei; P. Siddhuraju; K. Becker

    2003-01-01

    Starch degradability was studied in six indigenous Philippine rice cultivars differing in amylose contents. An in vitro enzymatic starch digestion method was applied in order to estimate the expected glycemic index in vivo based on the kinetics of starch hydrolysis in vitro. Two different treatments were investigated: first, samples were cooked and analysed immediately; second, samples were cooked and stored

  15. Effect of cereal test breakfasts differing in glycemic index and content of indigestible carbohydrates on daylong glucose tolerance

    Microsoft Academic Search

    Anne C Nilsson; Elin M Ostman; Yvonne Granfeldt

    Background: Frequent hyperglycemic episodes are increasingly being associated with an increased risk of type 2 diabetes and car- diovascular disease. Objective: We studied the extent to which acute glycemia and glycemia after subsequent meals can be modulated by the charac- teristics of cereal foods, such as glycemic index (GI) and content of indigestible carbohydrates. Design: Twelve healthy subjects consumed test

  16. Cfh genotype interacts with dietary glycemic index to modulate age-related macular degeneration-like features in mice

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Age-related macular degeneration (AMD) is a leading cause of visual impairment worldwide. Genetics and diet contribute to the relative risk for developing AMD, but their interactions are poorly understood. Genetic variations in Complement Factor H (CFH), and dietary glycemic index (GI) are major ris...

  17. CONSUMPTION OF WHOLE GRAINS CONTAINING BETA-GLUCAN ALTERED SHORT-TERM SATIETY AND GLYCEMIC RESPONSE IN OVERWEIGHT WOMEN

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Beta-glucan, a predominant water soluble fiber in oats and barley, has been demonstrated to have a significant cholesterol-lowering effect and to improve acute glycemic response. However, the role of beta-glucan in the regulation of satiety and weight management is not clear. The objective of this s...

  18. Glycemic response during exercise after administration of insulin lispro compared with that after administration of regular human insulin

    Microsoft Academic Search

    Tetsuya Yamakita; Tomofusa Ishii; Keiko Yamagami; Tsunehiko Yamamoto; Masafumi Miyamoto; Masayuki Hosoi; Katsunobu Yoshioka; Toshihiko Sato; Shoko Onishi; Shiro Tanaka; Satoru Fujii

    2002-01-01

    To examine the glycemic response during exercise after administration of short-acting insulin lispro, we compared changes in plasma glucose concentrations during exercise performed by patients with diabetes after the administration of either insulin lispro or regular human insulin. Seven patients with diabetes (two with type 1 and five with type 2) participated in this study. Each of the insulin-depleted subjects

  19. The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: Cluster-randomised controlled trial

    PubMed Central

    Campbell, Karen; Hesketh, Kylie; Crawford, David; Salmon, Jo; Ball, Kylie; McCallum, Zoë

    2008-01-01

    Background Multiple factors combine to support a compelling case for interventions that target the development of obesity-promoting behaviours (poor diet, low physical activity and high sedentary behaviour) from their inception. These factors include the rapidly increasing prevalence of fatness throughout childhood, the instigation of obesity-promoting behaviours in infancy, and the tracking of these behaviours from childhood through to adolescence and adulthood. The Infant Feeding Activity and Nutrition Trial (INFANT) aims to determine the effectiveness of an early childhood obesity prevention intervention delivered to first-time parents. The intervention, conducted with parents over the infant's first 18 months of life, will use existing social networks (first-time parent's groups) and an anticipatory guidance framework focusing on parenting skills which support the development of positive diet and physical activity behaviours, and reduced sedentary behaviours in infancy. Methods/Design This cluster-randomised controlled trial, with first-time parent groups as the unit of randomisation, will be conducted with a sample of 600 first-time parents and their newborn children who attend the first-time parents' group at Maternal and Child Health Centres. Using a two-stage sampling process, local government areas in Victoria, Australia will be randomly selected at the first stage. At the second stage, a proportional sample of first-time parent groups within selected local government areas will be randomly selected and invited to participate. Informed consent will be obtained and groups will then be randomly allocated to the intervention or control group. Discussion The early years hold promise as a time in which obesity prevention may be most effective. To our knowledge this will be the first randomised trial internationally to demonstrate whether an early health promotion program delivered to first-time parents in their existing social groups promotes healthy eating, physical activity and reduced sedentary behaviours. If proven to be effective, INFANT may protect children from the development of obesity and its associated social and economic costs. Trial registration Current Controlled Trials ISRCTN81847050 PMID:18373877

  20. Early rehabilitation in critical care (eRiCC): functional electrical stimulation with cycling protocol for a randomised controlled trial

    PubMed Central

    Parry, Selina M; Berney, Sue; Koopman, René; Bryant, Adam; El-Ansary, Doa; Puthucheary, Zudin; Hart, Nicholas; Warrillow, Stephen; Denehy, Linda

    2012-01-01

    Introduction Intensive care-acquired weakness is a common problem, leads to significant impairment in physical functioning and muscle strength, and is prevalent in individuals with sepsis. Early rehabilitation has been shown to be safe and feasible; however, commencement is often delayed due to a patient's inability to co-operate. An intervention that begins early in an intensive care unit (ICU) admission without the need for patient volition may be beneficial in attenuating muscle wasting. The eRiCC (early rehabilitation in critical care) trial will investigate the effectiveness of functional electrical stimulation-assisted cycling and cycling alone, compared to standard care, in individuals with sepsis. Methods and analysis This is a single centre randomised controlled trial. Participants (n=80) aged ?18?years, with a diagnosis of sepsis or severe sepsis, who are expected to be mechanically ventilated for ?48?h and remain in the intensive care ?4?days will be randomised within 72?h of admission to (1) standard care or (2) intervention where participants will receive functional electrical muscle stimulation-assisted supine cycling on one leg while the other leg undergoes cycling alone. Primary outcome measures include: muscle mass (quadriceps ultrasonography; bioelectrical impedance spectroscopy); muscle strength (Medical Research Council Scale; hand-held dynamometry) and physical function (Physical Function in Intensive Care Test; Functional Status Score in intensive care; 6?min walk test). Blinded outcome assessors will assess measures at baseline, weekly, at ICU discharge and acute hospital discharge. Secondary measures will be evaluated in a nested subgroup (n=20) and will consist of biochemical/histological analyses of collected muscle, urine and blood samples at baseline and at ICU discharge. Ethics and dissemination Ethics approval has been obtained from the relevant institution, and results will be published to inform clinical practice in the care of patients with sepsis to optimise rehabilitation and physical function outcomes. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12612000528853. PMID:22983782

  1. Early clinical experience with an integrated continuous glucose sensor\\/insulin pump platform

    Microsoft Academic Search

    John J. Mastrototaro; Ken Cooper; Rajiv Shah

    2006-01-01

    Achieving tight glycemic control to the HbAlc targets established by the ADA and other Diabetes Organizations is predicated upon the patient's ability to perform sufficient and timely self monitoring of blood glucose and to delivery the appropriate therapy in response to these glucose values. The intermittent nature of fingerstick monitoring is not ideally suited to meet this challenge. In this

  2. Volcanism on Mars controlled by early oxidation of the upper mantle.

    PubMed

    Tuff, J; Wade, J; Wood, B J

    2013-06-20

    Detailed information about the chemical composition and evolution of Mars has been derived principally from the SNC (shergottite-nakhlite-chassignite) meteorites, which are genetically related igneous rocks of Martian origin. They are chemically and texturally similar to terrestrial basalts and cumulates, except that they have higher concentrations of iron and volatile elements such as phosphorus and chlorine and lower concentrations of nickel and other chalcophile (sulphur-loving) elements. Most Martian meteorites have relatively young crystallization ages (1.4 billion years to 180 million years ago) and are considered to be derived from young, lightly cratered volcanic regions, such as the Tharsis plateau. Surface rocks from the Gusev crater analysed by the Spirit rover are much older (about 3.7 billion years old) and exhibit marked compositional differences from the meteorites. Although also basaltic in composition, the surface rocks are richer in nickel and sulphur and have lower manganese/iron ratios than the meteorites. This has led to doubts that Mars can be described adequately using the 'SNC model'. Here we show, however, that the differences between the compositions of meteorites and surface rocks can be explained by differences in the oxygen fugacity during melting of the same sulphur-rich mantle. This ties the sources of Martian meteorites to those of the surface rocks through an early (>3.7 billion years ago) oxidation of the uppermost mantle that had less influence on the deeper regions, which produce the more recent volcanic rocks. PMID:23783628

  3. MEDSAT - A remote sensing satellite for malaria early warning and control

    NASA Technical Reports Server (NTRS)

    Vesecky, John; Slawski, James; Stottlemeyer, Bret; De La Sierra, Ruben; Daida, Jason; Wood, Byron; Lawless, James

    1992-01-01

    A remote sensing, medical satellite (MEDSAT) aids in the control of carrier (vector) borne disease. The prototype design is a light satellite to test for control of malaria. The design features a 340-kg satellite with visual/IR and SAR sensors in a low inclination orbit observing a number of worldwide test sites. The approach is to use four-band visual/IR and dual-polarized L-band SAR images obtained from MEDSAT in concert with in-situ data to estimate the temporal and spatial variations of malaria risk. This allows public health resources to focus on the most vulnerable areas at the appropriate time. It is concluded that a light-satellite design for a MEDSAT satellite with a Pegasus launch is feasible.

  4. AN ASSESSMENT OF INTEGRATED STRIGA HERMONTHICA CONTROL AND EARLY ADOPTION BY FARMERS IN NORTHERN NIGERIA

    Microsoft Academic Search

    J. ELLIS-JONES; S. SCHULZ; B. DOUTHWAITE; M. A. HUSSAINI; B. D. OYEWOLE; A. S. OLANREWAJU; R. WHITE

    2004-01-01

    SUMMARY Two sets of on-farm trials, each covering two years, were conducted in the northern Guinea savannah of Nigeria over the period 1999-2001, the objective being to compare integrated Striga hermonthica control measures (soybean or cowpea trap crops followed by maize resistant to Striga) with farmers' traditional cereal-based cropping systems. In both sets of trials, this proved to be highly

  5. Case-control study of severe pre-eclampsia of early onset

    Microsoft Academic Search

    M P Moore; C W Redman

    1983-01-01

    Twenty four women with severe pre-eclampsia diagnosed before 34 weeks' gestation were compared with 48 randomly selected controls matched for age and parity. Subjects were studied in the puerperium using a questionnaire, clinical examination, and review of case records. A history of infertility, headaches (particularly migraine), pre-eclampsia in a previous pregnancy, or a raised serum alpha-fetoprotein concentration at the time

  6. Prolonged conservative care versus early surgery in patients with sciatica caused by lumbar disc herniation: two year results of a randomised controlled trial

    Microsoft Academic Search

    Wilco C Peul; Wilbert B van den Hout; Ronald Brand; Ralph T W M Thomeer; Bart W Koes

    2008-01-01

    Objectives To evaluate the effects of early lumbar disc surgery compared with prolonged conservative care for patients with sciatica over two years of follow-up.Design Randomised controlled trial.Setting Nine Dutch hospitals.Participants 283 patients with 6-12 weeks of sciatica.Interventions Early surgery or an intended six months of continued conservative treatment, with delayed surgery if needed.Main outcome measures Scores from Roland disability questionnaire

  7. Separase, Polo Kinase, the Kinetochore Protein Slk19, and Spo12 Function in a Network that Controls Cdc14 Localization during Early Anaphase

    Microsoft Academic Search

    Frank Stegmeier; Rosella Visintin; Angelika Amon

    2002-01-01

    In budding yeast, the phosphatase Cdc14, a key regulator of exit from mitosis, is released from its inhibitor Cfi1\\/Net1 in the nucleolus during anaphase. A signaling cascade, known as the mitotic exit network (MEN), controls this release. We have identified a regulatory network, the FEAR (Cdc fourteen early anaphase release) network that promotes Cdc14 release from the nucleolus during early

  8. A Low-Glycemic-Load versus Low-Fat Diet in the Treatment of Fatty Liver in Obese Children

    PubMed Central

    Ramon-Krauel, Marta; Salsberg, Sandra L.; Ebbeling, Cara B.; Voss, Stephan D.; Mulkern, Robert V.; Apura, Margaret M.; Cooke, Emily A.; Sarao, Karen; Jonas, Maureen M.

    2013-01-01

    Abstract Background Fatty liver is highly prevalent among obese children and represents a major risk factor for chronic liver diseases and severe metabolic complications. Methods We randomly assigned 17 obese children 8–17 years of age with fatty liver to either an experimental low-glycemic-load or conventional low-fat diet for 6 months. Participants in both groups received nutrition education and behavioral counseling of equal intensity. The primary outcome was hepatic lipid content measured by proton magnetic resonance spectroscopy. Secondary outcomes included change in visceral fat, BMI, anthropometrics, alanine aminotransferase (ALT), and insulin resistance. Results A total of 16 participants completed the study. Reported glycemic load decreased in the low-glycemic-load group and reported dietary fat decreased in the low-fat group. At baseline, liver fat was 23.8% [standard deviation (SD) 12.2] in the low-glycemic-load group and 29.3% (14.1) in the low-fat group. Liver fat decreased substantially in both groups at 6 months expressed as absolute percentage change, with no between-group differences [?8.8 (standard error (SE) 4.1) vs. ?10.5 (3.7)%, respectively, p=0.76 for group×time interaction]. Secondary outcomes also improved on both diets, with no between-group differences. Baseline and change in ALT were strongly associated with hepatic fat content. Conclusions Weight-reducing diets focused either on glycemic load or dietary fat improved hepatic steatosis over 6 months. Additional research is needed to determine whether these diets differ in effectiveness over the long term. Trial Registration clinicaltrials.gov Identifier: NCT00480922 PMID:23705885

  9. Effect of traditional Arabic coffee consumption on the glycemic index of Khalas dates tested in healthy and diabetic subjects.

    PubMed

    Alkaabi, Juma; Al-Dabbagh, Bayan; Saadi, Hussein; Gariballa, Salah; Yasin, Javed

    2013-01-01

    The consumption of dates with coffee is common among Arabs and may affect postprandial hyperglycemia ex-cursion. The study aimed to determine the effect of coffee on the glycemic index of a common variety of dates (Khalas) tested in healthy and type 2 diabetes mellitus individuals. Study subjects were thirteen healthy volunteers (mean age: 40.2±6.7 years) and ten diabetic participants with a mean HbA1c of 6.6±(0.7%) and a mean age of 40.8±5.7 years. Each subject participated in five days of tests with 50 g of glucose and 50 g equivalent of available carbohydrates from the dates (with/without coffee). Capillary glucose was measured in the healthy subjects at 0, 15, 30, 45, 60, 90 and 120 min, and for the diabetics at 0, 30, 60, 90, 120, 150 and 180 min. Glycemic indices were determined as ratios of the incremental areas under the response curves for the interventions. Statistical analyses were performed using the independent samples and paired t-tests. Mean±SE glycemic indices of the Khalas dates for the healthy individuals were 55.1±7.7 and 52.7±6.2 without and with coffee consumption, respectively. Similar values were observed for those with diabetes (53.0±6.0 and 41.5±5.4). Differences between glycemic indices of Khalas with or without coffee were not significant (p=0.124). There were no significant differences in glycemic index between the diabetic and healthy subjects (p=0.834 and p=0.202 without and with coffee respectively). In conclusion, at least in the short term, coffee does not adversely affect capillary glucose levels following Khalas dates consumption in healthy and diabetic volunteers. PMID:24231017

  10. Distinguishing malaria and influenza: Early clinical features in controlled human experimental infection studies?

    PubMed Central

    Lillie, Patrick J.; Duncan, Christopher J.A.; Sheehy, Susanne H.; Meyer, Joel; O'Hara, Geraldine A.; Gilbert, Sarah C.; Hill, Adrian V.S.

    2012-01-01

    Summary During the H1N1 influenza pandemic (pH1N1/09) diagnostic algorithms were developed to guide antiviral provision. However febrile illnesses are notoriously difficult to distinguish clinically. Recent evidence highlights the importance of incorporating travel history into diagnostic algorithms to prevent the catastrophic misdiagnosis of life-threatening infections such as malaria. We applied retrospectively the UK pH1N1/09 case definition to a unique cohort of healthy adult volunteers exposed to Plasmodium falciparum malaria or influenza to assess the predictive value of this case definition, and to explore the distinguishing clinical features of early phase infection with these pathogens under experimental conditions. For influenza exposure the positive predictive value of the pH1N1/09 case definition was only 0.38 (95% CI: 0.06–0.60), with a negative predictive value of 0.27 (95% CI: 0.02–0.51). Interestingly, 8/11 symptomatic malaria-infected adults would have been inappropriately classified with influenza by the pH1N1/09 case definition, while 5/8 symptomatic influenza-exposed volunteers would have been classified without influenza (P = 0.18 Fisher's exact). Cough (P = 0.005) and nasal symptoms (P = 0.001) were the only clinical features that distinguished influenza-exposed from malaria-exposed volunteers. An open mind regarding the clinical cause of undifferentiated febrile illness, particularly in the absence of upper respiratory tract symptoms, remains important even during influenza pandemic settings. These data support incorporating travel history into pandemic algorithms. PMID:22531678

  11. Methylphenidate in early poststroke recovery: A double-blind, placebo-controlled study

    Microsoft Academic Search

    Charles Grade; Becky Redford; Jay Chrostowski; Loren Toussaint; Barry Blackwell

    1998-01-01

    Objective: To determine the efficacy and safety of methylphenidate in acute stroke rehabilitation.Design: A prospective, randomized, double-blind, placebo-controlled study.Patients and Setting: Twenty-one stroke patients consecutively admitted to a community-based rehabilitation unit.Intervention: Three-week treatment of methylphenidate (or placebo) in conjunction with physical therapy. Methylphenidate was started at 5mg and increased gradually to 30mg (15mg at 8:00AM and 15mg at 12:00 noon),

  12. Early pest development and loss of biological control are associated with urban warming.

    PubMed

    Meineke, Emily K; Dunn, Robert R; Frank, Steven D

    2014-11-01

    Climate warming is predicted to cause many changes in ectotherm communities, one of which is phenological mismatch, wherein one species' development advances relative to an associated species or community. Phenological mismatches already lead to loss of pollination services, and we predict that they also cause loss of biological control. Here, we provide evidence that a pest develops earlier due to urban warming but that phenology of its parasitoid community does not similarly advance. This mismatch is associated with greater egg production that likely leads to more pests on trees. PMID:25411378

  13. To which extent do Scleractinian coral recruits control the early stages of their biomineralization?

    NASA Astrophysics Data System (ADS)

    Gilis, M.; Meibom, A.; Domart-Coulon, I.; Stolarski, J.; Hignette, M.; Grauby, O.; Baronnet, A.

    2013-12-01

    Scleractinian corals produce a calcium carbonate skeleton constituting the basis of coral reefs. The structure of their skeletons and their mineralizing tissue has been studied in detail in several stony corals species. It is generally accepted that the formation of specifically shaped skeletal structures by both recruits and adult scleractinian corals relies on biologically controlled mineralization processes. However, the extent to which the surrounding seawater may or may not interact with these endogenous mechanisms is still debated. In the present work, we conducted a multi-scale mineralogical study on each skeletal elements deposited by Pocillopora damicornis recruits, from 12 hours to 22 days after their settlement on a flat (artificial) substrate. High resolution scanning electron microscopy (HR-SEM) allowed characterizing these elements from their sub-micron structure to their hierarchical assembly into micro and macro-structures revealing the interplay with a highly organized nano-scale organic material. Transmission electron microscopy (TEM) and electron diffraction analysis (SAED) on ion-milled lamella extracted from two different skeletal elements produced by 2 days-old recruits brought further information on their internal organization and local crystallography. Our ultrastructural and analytical observations are discussed in light of the recently reported calcium carbonate structures obtained in in vitro and in vivo experimental crystallization studies, suggesting that both biologically-induced and controlled mechanisms might be involved in the initial stages of coral biomineralization.

  14. Glycemic index of selected carbohydrate-based foods consumed in Qatar.

    PubMed

    Hassan, Abdelmonem; Elobeid, Tahra; Kerkadi, Abdelhamid; Medhat, Maha; Suheil, Ghadeer

    2010-08-01

    This study determined the glycemic index (GI) of selected carbohydrate-rich foods consumed in Qatar. Recruited volunteers (n = 19) consumed two reference foods, glucose and white bread, and 10 test foods. The foods tested for their GI were Fatayer (cheese, Zaatar, spinach), Tanour white bread, white basmati rice, Shearia, Muhalabea, Sago Awama and Qurs Aquili. Results of the study indicated that all of the foods tested had high GIs (> 70). Shearia had the highest GI (84.0 +/- 1.85) using the glucose scale, and Fatayer Spinach had the lowest GI (77.6 +/- 2.00). There was no significant correlation between the GI of all test foods, using glucose or white bread as standard foods, and the age or the body mass index of the volunteers (P > 0.05). The study provides data on the GIs of carbohydrate-based foods consumed in Qatar and other Arabian Gulf countries that have not been reported before. PMID:20141487

  15. Is the fructose index more relevant with regards to cardiovascular disease than the glycemic index?

    PubMed

    Segal, Mark S; Gollub, Elizabeth; Johnson, Richard J

    2007-10-01

    The glycemic index (G.I.) is a means for categorizing carbohydrates based on their ability to raise blood glucose, subsequently this index has been popularized as a way for selecting foods to reduce the risk for obesity, diabetes, and cardiovascular disease. We suggest that the G.I. is better aimed at identifying foods that stimulate insulin secretion rather than foods that stimulate insulin resistance. In this regard, fructose has a low G.I. but may be causally linked with the obesity and cardiovascular disease epidemic. The reported association of high G.I. with cardiovascular disease may be due to the association of sugar intake which contains fructose, but which has a high G.I. due to its glucose content. We propose the use of a fructose index to categorize foods and propose studies to determine the effect of low fructose diets as a means to prevent obesity, diabetes, and cardiovascular disease in the population. PMID:17763967

  16. Diabetic Retinopathy and Other Ocular Findings in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study

    PubMed Central

    Aiello, Lloyd Paul

    2014-01-01

    OBJECTIVE To evaluate whether intensive treatment (INT) with the goal of achieving blood glucose levels as close to the nondiabetic range as safely possible reduced the risk of onset and progression of diabetic retinopathy (DR) in subjects with type 1 diabetes (T1D) compared with conventional therapy (CON). RESEARCH DESIGN AND METHODS The Diabetes Control and Complications Trial (DCCT) (1982–1993) was a multicenter, controlled clinical trial comparing INT with CON for onset and progression of DR. The Epidemiology of Diabetes Interventions and Complications (EDIC) study (1994–present) is an observational follow-up of the DCCT cohort. RESULTS Of the 1,441 DCCT subjects, 726 had no DR (primary prevention cohort) and 715 had mild DR (secondary intervention cohort) at baseline. Subjects were followed for a mean of 6.5 years. INT median HbA1c was 7% compared with CON median of 9%. INT reduced the adjusted mean risk for the development of DR by 76% and slowed progression of DR by 54% compared with CON. Following DCCT, the HbA1c levels in the original INT and CON groups converged (year 8, INT 7.98%; CON 8.07%); nevertheless, the groups continued to have a durable effect of initial assigned therapy with significantly lower incidence of further DR progression in the INT group (hazard reduction 53–56%). Severe retinal outcomes and procedures to treat them were reduced by 50% in the original INT group. CONCLUSIONS INT delays the onset and slows the progression of DR. Furthermore, the early effects of metabolic control continue to accrue over many years despite subsequent comparable glycemic control (metabolic memory). These results emphasize the need for optimizing glycemic control as early as possible in patients with diabetes. PMID:24356593

  17. The JAK-STAT Pathway Controls Plasmodium vivax Load in Early Stages of Anopheles aquasalis Infection

    PubMed Central

    Bahia, Ana C.; Kubota, Marina S.; Tempone, Antonio J.; Araújo, Helena R. C.; Guedes, Bruno A. M.; Orfanó, Alessandra S.; Tadei, Wanderli P.; Ríos-Velásquez, Claudia M.; Han, Yeon S.; Secundino, Nágila F. C.; Barillas-Mury, Carolina

    2011-01-01

    Malaria affects 300 million people worldwide every year and 450,000 in Brazil. In coastal areas of Brazil, the main malaria vector is Anopheles aquasalis, and Plasmodium vivax is responsible for the majority of malaria cases in the Americas. Insects possess a powerful immune system to combat infections. Three pathways control the insect immune response: Toll, IMD, and JAK-STAT. Here we analyze the immune role of the A. aquasalis JAK-STAT pathway after P. vivax infection. Three genes, the transcription factor Signal Transducers and Activators of Transcription (STAT), the regulatory Protein Inhibitors of Activated STAT (PIAS) and the Nitric Oxide Synthase enzyme (NOS) were characterized. Expression of STAT and PIAS was higher in males than females and in eggs and first instar larvae when compared to larvae and pupae. RNA levels for STAT and PIAS increased 24 and 36 hours (h) after P. vivax challenge. NOS transcription increased 36 h post infection (hpi) while this protein was already detected in some midgut epithelial cells 24 hpi. Imunocytochemistry experiments using specific antibodies showed that in non-infected insects STAT and PIAS were found mostly in the fat body, while in infected mosquitoes the proteins were found in other body tissues. The knockdown of STAT by RNAi increased the number of oocysts in the midgut of A. aquasalis. This is the first clear evidence for the involvement of a specific immune pathway in the interaction of the Brazilian malaria vector A. aquasalis with P. vivax, delineating a potential target for the future development of disease controlling strategies. PMID:22069502

  18. The 2004 Aceh-Andaman Earthquake: Early clay dehydration controls shallow seismic rupture

    NASA Astrophysics Data System (ADS)

    Geersen, Jacob; McNeill, Lisa; Henstock, Timothy J.; Gaedicke, Christoph

    2013-09-01

    The physical state of the shallow plate-boundary fault governs the updip extent of seismic rupture during powerful subduction zone earthquakes and thus on a first order impacts on the tsunamigenic hazard of such events. During the 2004 Mw 9.2 Aceh-Andaman Earthquake seismic rupture extended unusually far seaward below the accretionary prism causing the disastrous Indian Ocean Tsunami. Here we show that the formation of a strong bulk sediment section and a high fluid-pressured predécollement, that likely enabled the 2004 rupture to reach the shallow plate-boundary, result from thermally controlled diagenetic processes in the upper oceanic basement and overlying sediments. Thickening of the sediment section to >2 km ˜160 km seaward of the subduction zone increases temperatures at the sediment basement interface and triggers mineral transformation and dehydration (e.g., smectite-illite) prior to subduction. The liberated fluids migrate into a layer that likely host high porosity and permeability and that is unique to the 2004 rupture area where they generate a distinct overpressured predécollement. Clay mineral transformation further supports processes of semilithification, induration of sediments, and coupled with compaction dewatering all amplified by the thick sediment section together strengthens the bulk sediments. Farther south, where the 2005 Sumatra Earthquake did not include similar shallow rupture, sediment thickness on the oceanic plate is significantly smaller. Therefore, similar diagenetic processes occur later and deeper in the subduction zone. Hence, we propose that shallow seismic rupture during the 2004 earthquake is primarily controlled by the thickness and composition of oceanic plate sediments.

  19. The JAK-STAT pathway controls Plasmodium vivax load in early stages of Anopheles aquasalis infection.

    PubMed

    Bahia, Ana C; Kubota, Marina S; Tempone, Antonio J; Araújo, Helena R C; Guedes, Bruno A M; Orfanó, Alessandra S; Tadei, Wanderli P; Ríos-Velásquez, Claudia M; Han, Yeon S; Secundino, Nágila F C; Barillas-Mury, Carolina; Pimenta, Paulo F P; Traub-Csekö, Yara M

    2011-11-01

    Malaria affects 300 million people worldwide every year and 450,000 in Brazil. In coastal areas of Brazil, the main malaria vector is Anopheles aquasalis, and Plasmodium vivax is responsible for the majority of malaria cases in the Americas. Insects possess a powerful immune system to combat infections. Three pathways control the insect immune response: Toll, IMD, and JAK-STAT. Here we analyze the immune role of the A. aquasalis JAK-STAT pathway after P. vivax infection. Three genes, the transcription factor Signal Transducers and Activators of Transcription (STAT), the regulatory Protein Inhibitors of Activated STAT (PIAS) and the Nitric Oxide Synthase enzyme (NOS) were characterized. Expression of STAT and PIAS was higher in males than females and in eggs and first instar larvae when compared to larvae and pupae. RNA levels for STAT and PIAS increased 24 and 36 hours (h) after P. vivax challenge. NOS transcription increased 36 h post infection (hpi) while this protein was already detected in some midgut epithelial cells 24 hpi. Imunocytochemistry experiments using specific antibodies showed that in non-infected insects STAT and PIAS were found mostly in the fat body, while in infected mosquitoes the proteins were found in other body tissues. The knockdown of STAT by RNAi increased the number of oocysts in the midgut of A. aquasalis. This is the first clear evidence for the involvement of a specific immune pathway in the interaction of the Brazilian malaria vector A. aquasalis with P. vivax, delineating a potential target for the future development of disease controlling strategies. PMID:22069502

  20. Limited benefits of ambulance telemetry in delivering early thrombolysis: a randomised controlled trial

    PubMed Central

    Woollard, M; Pitt, K; Hayward, A; Taylor, N

    2005-01-01

    Methods: This prospective randomised controlled trial recruited patients using the 999 ambulance service in a rural area of the UK with signs or symptoms of coronary heart disease. Subjects were assigned to receive either standard paramedic treatment or transmission of 12 lead ECG, blood pressure, pulse oximetry, and relevant medical history to a general hospital coronary care unit. Cardiology senior house officers then determined each patient's suitability for pre-hospital thrombolysis time, and transmitted this decision back to the ambulance. This was documented as the potential thrombolysis, although no thrombolytic agents were administered by paramedics. The between groups difference in time to potential thrombolysis (intervention group) and actual thrombolysis (controls) was compared. The proportion of intervention group subjects ultimately receiving thrombolysis in hospital was compared with that recommended for pre-hospital thrombolysis. Results: The potential reduction in call to treatment time for telemetry patients recommended for pre-hospital thrombolysis was 55 minutes (p = 0.022). Following hospital admission,21/213 of the telemetry patients were thrombolysed (10%, 95% confidence interval (CI) 6% to 15%). Of these patients, 3/21 received a recommendation for thrombolysis in the ambulance (14%, 95% CI 3.1% to 36.3%). The sensitivity and specificity of the telemetry system in detecting patients requiring thrombolysis was 13.6 and 99.5% respectively. Errors were made in the pre-hospital treatment recommendations for two patients. Conclusions: Continuous telemetry systems may significantly reduce call to treatment times for patients recommended for pre-hospital thrombolysis in a rural setting. However, this benefit must be balanced against the very small proportion of eligible patients identified as suitable for pre-hospital thrombolysis. This limitation may be due to communications problems, the criteria used to identify eligible patients, or the seniority of physicians tasked with making treatment decisions. PMID:15735276

  1. Relationship between Glycemic Load and Blood Lipid Level in Hospitalized Adult Chinese

    PubMed Central

    LI, Hui; LIU, Haifeng; CHEN, Jinhong; LI, Li; WANG, Huanyu; LI, Jing; WANG, Lei

    2015-01-01

    Background: Metabolic diseases in China have been on the rise in recent decades, partially due to reduced cereal consumption and excessive intake of low glycemic index (GI) foods such as meat and oil. Although the relationship between dietary glycemic load (GL) and various metabolic diseases has been extensively studied worldwide, it is unclear whether dietary GL is related to blood lipid levels and dyslipidemia risk in Chinese. The aim of the present study was to investigate the relationship between dietary GL and blood lipid levels and dyslipidemia risk in hospitalized Chinese adults. Methods: Dietary GL in 2258 hospitalized Chinese adults was calculated based upon GI, carbohydrate content and daily intake of individual foods. In addition, fasting total cholesterol (TC), triglycerides (TG), HDL cholesterol (HDL-C) and LDL cholesterol (LDL-C) data were collected. Multiple regression and logistic regression analysis were used to determine the relationship between dietary GL and plasma lipid levels or dyslipidemia risk. Results: Dietary GL remained inversely associated with blood total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) (P<0.01). With increasing dietary GL, risks of hypercholesterolemia and high blood LDL-C were significantly reduced (P<0.01). In the meantime dietary GL remained negatively associated with blood triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) (P<0.01), but showed no significant influence on risk of hypertriglyceridemia and low blood HDL-C (P>0.05). Conclusion: High GL diet, as represented by traditional Chinese dietary pattern, may contribute to reduced risk of dyslipidemia in Chinese adults. PMID:25905074

  2. Association of Dietary Quality Indices with Glycemic Status in Korean Patients with Type 2 Diabetes

    PubMed Central

    Kim, JiYoung; Park, YoungMi; Sohn, CheongMin; Rha, MiYong; Lee, Moon-Kyu; Jang, Hak C.

    2013-01-01

    The present study was performed to evaluate the relationship between dietary quality indices including the Diet Quality Index-International (DQI-I), Alternate Healthy Eating Index (AHEI), and Healthy Diet Indicator (HDI) and glycemic status in Korean patients with type 2 diabetes. A total of 110 consecutive outpatients with type 2 diabetes who visited 2 university hospitals in Seoul and Seongnam from April 2004 to November 2006 were enrolled as subjects. At the time of enrollment, anthropometric parameters, dietary habits, experience of exercise, and metabolic parameters were obtained. Experienced registered dietitians collected one-day dietary intake using the 24-hour recall method. The mean scores for DQI-I, AHEI, and HDI were 68.9 ± 8.2, 39.4 ± 8.9, and 5.0 ± 1.3, respectively. After adjustment for age, body mass index, and energy intake, DQI-I and HDI were found to have a significant correlation with hemoglobin A1c (HbA1c) (r = -0.21, p < 0.05; r = -0.28, p < 0.05), fasting plasma glucose (r = -0.21, p < 0.05; r = -0.23, p < 0.05), and postprandial 2-h glucose (r = -0.30, p < 0.05; r = -0.26, p < 0.05, respectively). However, AHEI did not have a significant correlation with HbA1c. In conclusion, the DQI-I and HDI may be useful tools in assessing diet quality and adherence to dietary recommendations in Korean patients with type 2 diabetes. Future research is required to determine whether the dietary quality indices have predictive validity for dietary and glycemic changes following diet education in a clinical setting. PMID:23908976

  3. Association of dietary quality indices with glycemic status in korean patients with type 2 diabetes.

    PubMed

    Kim, Jiyoung; Cho, Youngyun; Park, Youngmi; Sohn, Cheongmin; Rha, Miyong; Lee, Moon-Kyu; Jang, Hak C

    2013-07-01

    The present study was performed to evaluate the relationship between dietary quality indices including the Diet Quality Index-International (DQI-I), Alternate Healthy Eating Index (AHEI), and Healthy Diet Indicator (HDI) and glycemic status in Korean patients with type 2 diabetes. A total of 110 consecutive outpatients with type 2 diabetes who visited 2 university hospitals in Seoul and Seongnam from April 2004 to November 2006 were enrolled as subjects. At the time of enrollment, anthropometric parameters, dietary habits, experience of exercise, and metabolic parameters were obtained. Experienced registered dietitians collected one-day dietary intake using the 24-hour recall method. The mean scores for DQI-I, AHEI, and HDI were 68.9 ± 8.2, 39.4 ± 8.9, and 5.0 ± 1.3, respectively. After adjustment for age, body mass index, and energy intake, DQI-I and HDI were found to have a significant correlation with hemoglobin A1c (HbA1c) (r = -0.21, p < 0.05; r = -0.28, p < 0.05), fasting plasma glucose (r = -0.21, p < 0.05; r = -0.23, p < 0.05), and postprandial 2-h glucose (r = -0.30, p < 0.05; r = -0.26, p < 0.05, respectively). However, AHEI did not have a significant correlation with HbA1c. In conclusion, the DQI-I and HDI may be useful tools in assessing diet quality and adherence to dietary recommendations in Korean patients with type 2 diabetes. Future research is required to determine whether the dietary quality indices have predictive validity for dietary and glycemic changes following diet education in a clinical setting. PMID:23908976

  4. Vigor-controlling rootstocks affect early shoot growth and leaf area development of kiwifruit.

    PubMed

    Clearwater, Michael J; Seleznyova, Alla N; Thorp, T Grant; Blattmann, Peter; Barnett, Andrew M; Lowe, Russell G; Austin, Paul T

    2006-04-01

    Patterns of shoot development and the production of different types of shoots were compared with scion leaf area index (LAI) to identify how eight clonal Actinidia rootstocks influence scion development. Rootstocks selected from seven Actinidia species (A. chrysantha Merri., A. deliciosa (A. Chev.) C. F. Liang et A.R. Ferguson, A. eriantha Benth., A. hemsleyana Dunn, A. kolomikta (Maxim. et Rupr.) Maxim., A. kolomikta C.F. Liang and A. polygama (Sieb. et Zucc.) Maxim.) were grafted with the scion Actinidia chinensis Planch. var. chinensis 'Hort16A' (yellow kiwifruit). Based on an earlier architectural analysis of A. chinensis, axillary shoot types produced by the scion were classified as short, medium or long. Short and medium shoots produced a restricted number of preformed leaves before the shoot apex ceased growth and aborted, resulting in a 'terminated' shoot. The apex of long shoots continued growth and produced more nodes throughout the growing seasons. Mid-season LAI of the scion was related to the proportion of shoots that ceased growth early in the season. Scions on low-vigor rootstocks had 50% or less leaf area than scions on the most vigorous rootstocks and had a higher proportion of short and medium shoots. On low-vigor rootstocks, a higher proportion of short shoots was retained during pruning to form the parent structure of the following year. Short parent shoots produced a higher proportion of short daughter shoots than long parent shoots, thus reinforcing the effect of the low-vigor rootstocks. However, overall effects of rootstock on shoot development were consistent regardless of parent shoot type and nodal position within the parent shoot. Slower-growing shoots were more likely to terminate and scions on low-vigor rootstocks produced a higher proportion of slow-growing shoots. Shoot termination also occurred earlier on low-vigor rootstocks. The slower growth of terminating shoots was detectable from about 20 days after bud burst. Removal of a proportion of shoots at the end of bud burst increased the growth rate and decreased the frequency of termination of the remaining shoots on all rootstocks, indicating that the fate of a shoot was linked to competitive interactions among shoots during initial growth immediately after bud burst. Rootstock influenced the process of shoot termination independently of its effect on final leaf size. Scions on low-vigor rootstocks had a higher proportion of short shoots and short shoots on all rootstocks had smaller final leaf sizes at equivalent nodes than medium or long shoots. Only later in the development of long shoots was final leaf size directly related to rootstock, with smaller leaves on low-vigor rootstocks. Thus, the most important effect of these Actinidia rootstocks on scion development occurred during the initial period of shoot growth immediately after bud burst. PMID:16414929

  5. Flowering Time Genes Heading date 1 and Early heading date 1 Together Control Panicle Development in Rice

    PubMed Central

    Endo-Higashi, Naokuni; Izawa, Takeshi

    2011-01-01

    Although flowering time is often associated with plant size, little is known about how flowering time genes affect plant architecture. We grew four rice lines having different flowering time genotypes (hd1 ehd1, hd1 Ehd1, Hd1 ehd1 and Hd1 Ehd1) under distinct photoperiod conditions. By using genotype–treatment combinations that resulted in similar flowering times, we were able to compare the effects of flowering time genes on traits related to plant architecture. The results revealed that the combination of Heading-date 1 (Hd1) and Early heading date 1 (Ehd1) can reduce the number of primary branches in a panicle, resulting in smaller spikelet numbers per panicle; this occurs independently of the control of flowering time. In addition, expression of the Hd3a and Rice Flowering-locus T 1 (RFT1) florigen genes was up-regulated in leaves of the Hd1 Ehd1 line at the time of the floral transition. We further revealed that Hd1 and/or Ehd1 caused up-regulation of Terminal Flower 1-like genes and precocious expression of panicle formation-related genes at shoot apical meristems during panicle development. Therefore, two key flowering time genes, Hd1 and Ehd1, can control panicle development in rice; this may affect crop yields in the field through florigen expression in leaf. PMID:21565907

  6. OCRL controls trafficking through early endosomes via PtdIns4,5P2-dependent regulation of endosomal actin

    PubMed Central

    Vicinanza, Mariella; Di Campli, Antonella; Polishchuk, Elena; Santoro, Michele; Di Tullio, Giuseppe; Godi, Anna; Levtchenko, Elena; De Leo, Maria Giovanna; Polishchuk, Roman; Sandoval, Lisette; Marzolo, Maria-Paz; De Matteis, Maria Antonietta

    2011-01-01

    Mutations in the phosphatidylinositol 4,5-bisphosphate (PtdIns4,5P2) 5-phosphatase OCRL cause Lowe syndrome, which is characterised by congenital cataracts, central hypotonia, and renal proximal tubular dysfunction. Previous studies have shown that OCRL interacts with components of the endosomal machinery; however, its role in endocytosis, and thus the pathogenic mechanisms of Lowe syndrome, have remained elusive. Here, we show that via its 5-phosphatase activity, OCRL controls early endosome (EE) function. OCRL depletion impairs the recycling of multiple classes of receptors, including megalin (which mediates protein reabsorption in the kidney) that are retained in engorged EEs. These trafficking defects are caused by ectopic accumulation of PtdIns4,5P2 in EEs, which in turn induces an N-WASP-dependent increase in endosomal F-actin. Our data provide a molecular explanation for renal proximal tubular dysfunction in Lowe syndrome and highlight that tight control of PtdIns4,5P2 and F-actin at the EEs is essential for exporting cargoes that transit this compartment. PMID:21971085

  7. Rapid early innate control of hepatitis C virus during IFN-? treatment compromises adaptive CD4+ T-cell immunity

    PubMed Central

    Pembroke, Tom; Rees, Ian; Gallagher, Kathleen; Jones, Emma; Mizen, Paul; Navruzov, Timur; Freedman, Andrew; Fielding, Ceri; Humphreys, Ian R; Wang, Eddie C Y; Gallimore, Awen M; Godkin, Andrew

    2012-01-01

    The ability to control HCV with IFN-?-based treatments provides an opportunity in humans to study how the rate of viral clearance in vivo impinges on the development of antiviral responses. Ex vivo (IFN-?-producing) and cultured antiviral CD4+ T cells, serum cytokines, and viral loads were measured repeatedly in a cohort of chronically HCV-infected subjects (n = 33) receiving IFN-?. Rapid control of virus indicated by an increased calculated rate of virus clearance, occurred in those subjects demonstrating absent/minimal T-cell responses (p < 0.0006). Surprisingly, in subjects who demonstrated the most robust T-cell responses (and reduced serum IL-10), there was actually a reduced rate of early virus clearance. A subsequent analysis of NK-cell function in available subjects (n = 8) revealed an inverse correlation between pretreatment NK-cell expression of NKp46 and the potential to upregulate cytotoxic function on exposure to IFN-? (p < 0.004), as well as the subsequent measured rate of viral clearance (p = 0.045). Thus, the CD4+ T-cell response during IFN-? treatment appears to be shaped by the rate of innate virus suppression. These data suggest that individuals who respond most effectively to immune intervention may be most in need of subsequent vaccination to prevent reinfection. PMID:22653709

  8. Rapid early innate control of hepatitis C virus during IFN-? treatment compromises adaptive CD4+ T-cell immunity.

    PubMed

    Pembroke, Tom; Rees, Ian; Gallagher, Kathleen; Jones, Emma; Mizen, Paul; Navruzov, Timur; Freedman, Andrew; Fielding, Ceri; Humphreys, Ian R; Wang, Eddie C Y; Gallimore, Awen M; Godkin, Andrew

    2012-09-01

    The ability to control HCV with IFN-?-based treatments provides an opportunity in humans to study how the rate of viral clearance in vivo impinges on the development of antiviral responses. Ex vivo (IFN-?-producing) and cultured antiviral CD4(+) T cells, serum cytokines, and viral loads were measured repeatedly in a cohort of chronically HCV-infected subjects (n = 33) receiving IFN-?. Rapid control of virus indicated by an increased calculated rate of virus clearance, occurred in those subjects demonstrating absent/minimal T-cell responses (p < 0.0006). Surprisingly, in subjects who demonstrated the most robust T-cell responses (and reduced serum IL-10), there was actually a reduced rate of early virus clearance. A subsequent analysis of NK-cell function in available subjects (n = 8) revealed an inverse correlation between pretreatment NK-cell expression of NKp46 and the potential to upregulate cytotoxic function on exposure to IFN-? (p < 0.004), as well as the subsequent measured rate of viral clearance (p = 0.045). Thus, the CD4(+) T-cell response during IFN-? treatment appears to be shaped by the rate of innate virus suppression. These data suggest that individuals who respond most effectively to immune intervention may be most in need of subsequent vaccination to prevent reinfection. PMID:22653709

  9. The Effect of Flexible Low Glycemic Index Dietary Advice Versus Measured Carbohydrate Exchange Diets on Glycemic Control in Children With Type 1 Diabetes

    Microsoft Academic Search

    HEATHER R. GILBERTSON; JENNIE C. BRAND-MILLER; ANNE W. THORBURN; SHARON EVANS; PATTY CHONDROS; GEORGE A. WERTHER

    2001-01-01

    RESULTS — At 12 months, children in the low-GI group had significantly better HbA1c levels than those in the CHOx group (8.05 6 0.95 vs. 8.61 6 1.37%, P 5 0.05). Rates of excessive hyperglycemia (.15 episodes per month) were significantly lower in the low-GI group (35 vs. 66%, P 5 0.006). There were no differences in insulin dose, hypoglycemic

  10. Effect of the 2004 Mid Niigata Prefecture earthquake on glycemic control in type 1 diabetic patients

    Microsoft Academic Search

    Kyuzi Kamoi; Midori Tanaka; Tomoo Ikarashi; Masashi Miyakoshi

    2006-01-01

    At 5:56 p.m. on October 23, 2004, a major earthquake of magnitude 6.8 on the Richter scale struck the Chuetsu district of Niigata Prefecture, Japan, a rural area with mountain villages. Strong aftershocks of grade 5–6 on the Japanese Intensity Scale continued for 2 months. We investigated changes in the HbA1c levels of 65 type 1 diabetic patients with insulin

  11. Involvement of microRNA-related regulatory pathways in the glucose-mediated control of Arabidopsis early seedling development

    PubMed Central

    Vincentz, Michel

    2013-01-01

    In plants, sugars such as glucose act as signalling molecules that promote changes in gene expression programmes that impact on growth and development. Recent evidence has revealed the potential importance of controlling mRNA decay in some aspects of glucose-mediated regulatory responses suggesting a role of microRNAs (miRNAs) in these responses. In order to get a better understanding of glucose-mediated development modulation involving miRNA-related regulatory pathways, early seedling development of mutants impaired in miRNA biogenesis (hyl1-2 and dcl1-11) and miRNA activity (ago1-25) was evaluated. All mutants exhibited a glucose hyposensitive phenotype from germination up to seedling establishment, indicating that miRNA regulatory pathways are involved in the glucose-mediated delay of early seedling development. The expression profile of 200 miRNA primary transcripts (pri-miRs) was evaluated by large-scale quantitative real-time PCR profiling, which revealed that 38 pri-miRs were regulated by glucose. For several of them, the corresponding mature miRNAs are known to participate directly or indirectly in plant development, and their accumulation was shown to be co-regulated with the pri-miR by glucose. Furthermore, the expression of several miRNA target genes was found to be deregulated in response to glucose in the miRNA machinery mutants ago1-25, dcl1-11, and hyl1-2. Also, in these mutants, glucose promoted misexpression of genes for the three abscisic acid signalling elements ABI3, ABI4, and ABI5. Thus, miRNA regulatory pathways play a role in the adjustments of growth and development triggered by glucose signalling. PMID:23997203

  12. [Trade, wars and the venereal disease: VD epidemic and control of Korea in the late nineteenth and early twentieth century].

    PubMed

    Sihn, Kyu-hwan

    2008-12-01

    This paper examines the spread of venereal disease from the Opening of Korea to the early Japanese colonial period. It focuses on the formation and expansion of Japanese settlement in Korea, the influence of wars, and the state control of VD. The Opening of Korea made the foreign settlement, and Japanese licensed prostitution flourished in Japanese settlement. According to the First Annual Report of the Korean Government Hospital (1886) and Gyelimuisa (1887), VD patients occupied 18.3% of outpatients in Jejungwon hospital of Seoul and 8.9% of outpatients in Busan hospital. Directly after the Opening of Korea, Korean people's VD became lesser critical than Japanese people's VD. But the expansion of Japanese settlement and outbreak of two wars such as Sino-Japanese War and Russo-Japanese War made worse Korean people's VD. According to the Residency-General resources (1904-1909), syphilis patients was registered in 0.8-6.6% (average 3.6%). If it add to gonorrhea and chancroid patients which often could not be found out by the naked eyes, the number of VD patients will be increase. Ji Seok-yeong (1855-1935), the earliest smallpox vaccinarian in Korea, asserted the need of VD control. Though he warned men bought sex as well as prostitutes became the main culprit of VD diffusion, he supported licensed prostitution because of realistic possibility. The Great Han Empire (1897-1910) tried to control the lower grade whore, and gathered prostitutes in some area by police power. After Japanese annexation of Korea, while Japanese has gradually decreased in VD patients, Korean has gradually increased in VD patients. PMID:19174628

  13. Comparison of a low-fat\\/low-glycemic index diet to a low-fat only diet in the treatment of adults with hypercholesterolemia

    Microsoft Academic Search

    James M. Shikany; Anthony Goudie; Albert Oberman

    2005-01-01

    The Low Glycemic Index and Cholesterol study was a 12-week randomized clinical trial comparing the effects on serum lipids of a novel low-fat\\/low-glycemic index (GI) diet with those of a low-fat only diet in adults with hypercholesterolemia. Sixty-two subjects (men and women) with elevated serum low-density lipoprotein cholesterol were randomized to one of the two dietary interventions. The low-GI intervention

  14. The effect of caloric restriction and glycemic load on measures of oxidative stress and antioxidants in humans: Results from the calerie trial of human caloric restriction

    Microsoft Academic Search

    Mohsen Meydani; S. Das; M. Band; S. Epstein; S. Roberts

    2011-01-01

    Decreasing oxidative stress and increasing antioxidant defense has been hypothesized as one mechanism by which caloric restriction\\u000a (CR) increases longevity in animals. A total of 46 moderately overweight volunteers (BMI: 252-30 kg\\/m2), ages 20–42 yr were randomized to either high glycemic (HG) or low glycemic (LG) dietary load CR regimen at either 10% (n=12)\\u000a or 30% (n=34) of basal caloric

  15. Dietary fiber intake, dietary glycemic index and load, and body mass index: a cross-sectional study of 3931 Japanese women aged 18–20 years

    Microsoft Academic Search

    K Murakami; S Sasaki; H Okubo; Y Takahashi; Y Hosoi; M Itabashi

    2007-01-01

    Objective:Few observational studies have investigated dietary fiber intake and dietary glycemic index (GI) and glycemic load (GL) simultaneously in relation to obesity, particularly in non-Western populations. We examined the associations between dietary fiber intake and dietary GI and GL, and body mass index (BMI) in young Japanese women.Design:Cross-sectional study.Subjects:A total of 3931 female Japanese dietetic students aged 18–20 years from

  16. Dietary glycemic index and load in relation to metabolic risk factors in Japanese female farmers with traditional dietary habits1-3

    Microsoft Academic Search

    Kentaro Murakami; Satoshi Sasaki; Yoshiko Takahashi; Hitomi Okubo; Yoko Hosoi; Hyogo Horiguchi; Etsuko Oguma; Fujio Kayama

    Background:Little is known about the relation of dietary glycemic index (GI) and glycemic load (GL) to metabolic risk factors, partic- ularly in non-Western populations. Objective: We examined the cross-sectional associations between dietary GI and GL and several metabolic risk factors in healthy Japanese women with traditional dietary habits. Design: The subjects were 1354 Japanese female farmers aged 20-78 y from

  17. Sp1 Sites in the Noncoding Control Region of BK Polyomavirus Are Key Regulators of Bidirectional Viral Early and Late Gene Expression

    PubMed Central

    Bethge, Tobias; Hachemi, Helen A.; Manzetti, Julia; Gosert, Rainer; Schaffner, Walter

    2015-01-01

    ABSTRACT In kidney transplant patients with BK polyomavirus (BKPyV) nephropathy, viral variants arise bearing rearranged noncoding control regions (rr-NCCRs) that increase viral early gene expression, replicative fitness, and cytopathology. rr-NCCRs result from various deletions and duplications of archetype NCCR (ww-NCCR) sequences, which alter transcription factor binding sites (TFBS). However, the role of specific TFBS is unclear. We inactivated 28 TFBS in the archetype NCCR by selective point mutations and examined viral gene expression in bidirectional reporter constructs. Compared to the archetype, group 1 mutations increased viral early gene expression similar to rr-NCCR and resulted from inactivating one Sp1 or one Ets1 TFBS near the late transcription start site (TSS). Group 2 mutations conferred intermediate early gene activation and affected NF1, YY1, and p53 sites between early and late TSS. Group 3 mutations decreased early and late gene expression and included two other Sp1 sites near the early TSS. Recombinant viruses bearing group 1 NCCRs showed increased replication in human renal epithelial cells similar to clinical rr-NCCR variants. Group 2 and 3 viruses showed intermediate or no replication, respectively. A literature search revealed unnoticed group 1 mutations in BKPyV nephropathy, hemorrhagic cystitis, and disseminated disease. IMPORTANCE The NCCRs of polyomaviruses mediate silent persistence of the viral genome as well as the appropriately timed (re)activation of the viral life cycle. This study indicates that the basal BKPyV NCCR is critically controlled by a hierarchy of single TFBS in the archetype NCCR that direct, modulate, and execute the bidirectional early and late viral gene expression. The results provide new insights into how BKPyV NCCR functions as a viral sensor of host cell signals and shed new light on how transcription factors like Sp1 control bidirectional viral gene expression and contribute to replication and pathology. PMID:25589646

  18. Efficacy of Feedback-Controlled Robotics-Assisted Treadmill Exercise to Improve Cardiovascular Fitness Early After Stroke: A Randomized Controlled Pilot Trial

    PubMed Central

    de Bruin, Eling D.; Schindelholz, Matthias; Schuster-Amft, Corina; de Bie, Rob A.; Hunt, Kenneth J.

    2015-01-01

    Background and Purpose: Cardiovascular fitness is greatly reduced after stroke. Although individuals with mild to moderate impairments benefit from conventional cardiovascular exercise interventions, there is a lack of effective approaches for persons with severely impaired physical function. This randomized controlled pilot trial investigated efficacy and feasibility of feedback-controlled robotics-assisted treadmill exercise (FC-RATE) for cardiovascular rehabilitation in persons with severe impairments early after stroke. Methods: Twenty individuals (age 61 ± 11 years; 52 ± 31 days poststroke) with severe motor limitations (Functional Ambulation Classification 0-2) were recruited for FC-RATE or conventional robotics-assisted treadmill exercise (RATE) (4 weeks, 3 × 30-minute sessions/wk). Outcome measures focused on peak cardiopulmonary performance parameters, training intensity, and feasibility, with examiners blinded to allocation. Results: All 14 allocated participants (70% of recruited) completed the intervention (7/group, withdrawals unrelated to intervention), without serious adverse events occurring. Cardiovascular fitness increased significantly in both groups, with peak oxygen uptake increasing from 14.6 to 17.7 mL · kg?1 · min?1 (+17.8%) after 4 weeks (45.8%-55.7% of predicted maximal aerobic capacity; time effect P = 0.01; no group-time interaction). Training intensity (% heart rate reserve) was significantly higher for FC-RATE (40% ± 3%) than for conventional RATE (14% ± 2%) (P = 0.001). Discussion and Conclusions: Substantive overall increases in the main cardiopulmonary performance parameters were observed, but there were no significant between-group differences when comparing FC-RATE and conventional RATE. Feedback-controlled robotics-assisted treadmill exercise significantly increased exercise intensity, but recommended intensity levels for cardiovascular training were not consistently achieved. Future research should focus on appropriate algorithms within advanced robotic systems to promote optimal cardiovascular stress. Video abstract available for more insights from the authors (Supplemental Digital Content 1, http://links.lww.com/JNPT/A107). PMID:26050073

  19. A Randomized Controlled Trial of the First Step to Success Early InterventionDemonstration of Program Efficacy Outcomes in a Diverse, Urban School District

    Microsoft Academic Search

    Hill M. Walker; John R. Seeley; Jason Small; Herbert H. Severson; Bethany A. Graham; Edward G. Feil; Loretta Serna; Annemieke M. Golly; Steven R. Forness

    2009-01-01

    This article reports on a randomized controlled trial of the First Step to Success early intervention that was conducted over a 4-year period in Albuquerque Public Schools. First Step is a selected intervention for students in Grades 1 through 3 with externalizing behavior problems, and it addresses secondary prevention goals and objectives. It consists of three modular components (screening, school

  20. Serum Interleukin6 and interleukin-8 are early biomarkers of acute kidney injury and predict prolonged mechanical ventilation in children undergoing cardiac surgery: a case-control study

    Microsoft Academic Search

    Kathleen D Liu; Christopher Altmann; Gerard Smits; Catherine D Krawczeski; Charles L Edelstein; Prasad Devarajan; Sarah Faubel

    2009-01-01

    INTRODUCTION: Acute kidney injury (AKI) is associated with high mortality rates. New biomarkers that can identify subjects with early AKI (before the increase in serum creatinine) are needed to facilitate appropriate treatment. The purpose of this study was to test the role of serum cytokines as biomarkers for AKI and prolonged mechanical ventilation. METHODS: This was a case-control study of

  1. Maternal and neonatal risk factors for early-onset group B streptococcal disease: a case control study

    PubMed Central

    Al-Kadri, Hanan M; Bamuhair, Samira S; Johani, Sameera M Al; Al-Buriki, Namsha A; Tamim, Hani M

    2013-01-01

    Objectives To identify the prominent maternal and neonatal risk factors associated with early-onset group B streptococcus (EOGBS) disease in neonates and to determine their importance by comparing them with a control group. Setting Neonatal unit at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Patients Cases were infants <7 days of age with invasive group B streptococcus (GBS) disease diagnosed between January 1, 2000 and December 31, 2009. Controls were healthy infants born in the same hospital during the same period having the same birth weight and gestational age category. Main outcome measures Maternal risk factors for developing EOGBS disease, feto–maternal and neonatal clinical data, their morbidities, mortalities, and length of hospital stay. Results A total of 99 cases and 200 controls were included. The majority of cases presented in the first 72 hours of life (62/99 [63.9%]), of which 87/99 (89.7%) had at least one clinical risk factor for the development of EOGBS disease. Mothers of neonates with EOGBS disease were more likely to have GBS bacteriuria (odds ratio [OR] 10.76, 95% confidence interval [CI] 1.24–93.42), infection in the peripartum period (OR 8.92, CI 2.87–27.68), and temperature ?38°C (OR 7.10, CI 2.50–20.17). GBS disease was associated with premature rupture of membranes and fetal tachycardia (P<0.01 for both). Neonates with EOGBS disease were more likely to have respiratory distress disease and convulsions, require tube feeding, and have longer hospital stays compared with the controls (P<0.01 for all). Stepwise multiple logistic regression has identified three risk factors that were associated with the highest tendency for the development of EOGBS disease. These were lack of antenatal attendance (OR =0.30 and CI 0.98–0.88), rupture of membranes (OR =9.62 and CI 3.1–29.4), and antibiotic use in labor (OR =0.16 and CI 0.38–0.67). Conclusion A number of maternal risk factors were significantly associated with EOGBS disease. Taking these factors into consideration may result in preventing the occurrence of EOGBS disease, improve maternal and neonatal medical care, decrease their hospital stay, and reduce unnecessary hospital resource utilization. PMID:24194650

  2. Interstitial radiation therapy for early-stage nasal vestibule cancer: A continuing quest for optimal tumor control and cosmesis

    SciTech Connect

    Levendag, Peter C. [Department of Radiation-Oncology, Daniel den Hoed Cancer Center, Rotterdam (Netherlands)]. E-mail: p.levendag@erasmusmc.nl; Nijdam, Wideke M. [Department of Radiation-Oncology, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Moolenburgh, Sanne E. van [Department of Plastic and Reconstructive Surgery, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Tan, Lisa [Department of Radiation-Oncology, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Noever, Inge R.T.T. [Department of Radiation-Oncology, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Rooy, Peter van [Department of Radiation-Oncology, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Mureau, Marc [Department of Plastic and Reconstructive Surgery, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Jansen, Peter P. [Department of Radiation-Oncology, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Munte, Kai [Department of Dermatology, Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Hofer, Stefan O.P. [Department of Plastic and Reconstructive Surgery, Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

    2006-09-01

    Introduction: This article reports on the effectiveness, cosmetic outcome, and costs of interstitial high-dose-rate (HDR) brachytherapy for early-stage cancer of the nasal vestibule (NV) proper and/or columella high-dose-rate (HDR). Methods and Materials: Tumor control, survival, cosmetic outcome, functional results, and costs were established in 64 T1/T2N0 nasal vestibule cancers treated from 1991-2005 by fractionated interstitial radiation therapy (IRT) only. Total dose is 44 Gy: 2 fractions of 3 Gy per day, 6-hour interval, first and last fraction 4 Gy. Cosmesis is noted in the chart by the medical doctor during follow-up, by the patient (visual analog scale), and by a panel. Finally, full hospital costs are computed. Results: A local relapse-free survival rate of 92% at 5 years was obtained. Four local failures were observed; all four patients were salvaged. The neck was not treated electively; no neck recurrence in follow-up was seen. Excellent cosmetic and functional res