Science.gov

Sample records for early glycemic control

  1. Multifaceted Determinants for Achieving Glycemic Control

    PubMed Central

    Chan, Juliana C.N.; Gagliardino, Juan Jose; Baik, Sei Hyun; Chantelot, Jean-Marc; Ferreira, Sandra R.G.; Hancu, Nicolae; Ilkova, Hasan; Ramachandran, Ambady; Aschner, Pablo

    2009-01-01

    OBJECTIVE—The International Diabetes Mellitus Practice Study is a 5-year survey documenting changes in diabetes treatment practice in developing regions. RESEARCH DESIGN AND METHODS—Logistic regression analysis was used to identify factors for achieving A1C <7% in 11,799 patients (1,898 type 1 diabetic and 9,901 type 2 diabetic) recruited by 937 physicians from 17 countries in Eastern Europe (n = 3,519), Asia (n = 5,888), Latin America (n = 2,116), and Africa (n = 276). RESULTS—Twenty-two percent of type 1 diabetic and 36% of type 2 diabetic patients never had A1C measurements. In those with values for A1C, blood pressure, and LDL cholesterol, 7.5% of type 1 diabetic (n = 696) and 3.6% of type 2 diabetic (n = 3,896) patients attained all three recommended targets (blood pressure <130/80 mmHg, LDL cholesterol <100 mg/dl, and A1C <7%). Self-monitoring of blood glucose was the only predictor for achieving the A1C goal in type 1 diabetes (odds ratios: Asia 2.24, Latin America 3.55, and Eastern Europe 2.42). In type 2 diabetes, short disease duration (Asia 0.97, Latin America 0.97, and Eastern Europe 0.82) and treatment with few oral glucose–lowering drugs (Asia 0.64, Latin America 0.76, and Eastern Europe 0.62) were predictors. Other region-specific factors included lack of microvascular complications and old age in Latin America and Asia; health insurance coverage and specialist care in Latin America; lack of obesity and self-adjustment of insulin dosages in Asia; and training by a diabetes educator, self-monitoring of blood glucose in patients who self-adjusted insulin, and lack of macrovascular complications in Eastern Europe. CONCLUSIONS—In developing countries, factors pertinent to patients, doctors, and health care systems all impact on glycemic control. PMID:19033410

  2. The Mealtime Challenge: Nutrition and Glycemic Control in the Hospital

    PubMed Central

    Ryan, Donna B.; Swift, Carrie S.

    2014-01-01

    In Brief Multiple staff members and departments have a responsibility for various aspects of nutrition therapy for glycemic management in the hospital setting. Implementation is initiated by physicians, nurse practitioners, and physician's assistants and planned and operationalized by registered dietitians. Meals are delivered by food service staff, and nurses monitor and integrate glycemic control components into patients' medical treatment plan. Although nutrition therapy is recognized as an important aspect of care in the hospital setting, it can also be challenging to appropriately coordinate meals with blood glucose monitoring and insulin administration. This article addresses current mealtime practices and recommendations to improve these processes in acute care. PMID:26246774

  3. Indicators of glycemic control in patients with gestational diabetes mellitus and pregnant women with diabetes mellitus

    PubMed Central

    Hashimoto, Kunihiko; Koga, Masafumi

    2015-01-01

    Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternal-infant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus (GDM) have been changed. Therefore, in patients with GDM and pregnant women with diabetes mellitus, even stricter glycemic control than before is required to reduce the incidence of perinatal maternal-infant complications. Strict glycemic control cannot be attained without an indicator of glycemic control; this review proposes a reliable indicator. The gold standard indicator of glycemic control in patients with diabetes mellitus is hemoglobin A1c (HbA1c); however, we have demonstrated that HbA1c does not reflect glycemic control accurately during pregnancy because of iron deficiency. It has also become clear that glycated albumin, another indicator of glycemic control, is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus. However, large-population epidemiological studies are necessary in order to confirm our proposal. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol. PMID:26240701

  4. 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

  5. Glycemic control and diabetes management in hospitalized patients in Brazil

    PubMed Central

    2013-01-01

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

  6. 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

  7. Association between glycemic control and antidiabetic drugs in type 2 diabetes mellitus patients with cardiovascular complications

    PubMed Central

    Huri, Hasniza Zaman; Ling, Doris Yew Hui; Ahmad, Wan Azman Wan

    2015-01-01

    Purpose Cardiovascular disease (CVD) is a macrovascular complication in patients with type 2 diabetes mellitus (T2DM). To date, glycemic control profiles of antidiabetic drugs in cardiovascular (CV) complications have not been clearly elucidated. Therefore, this study was conducted retrospectively to assess the association of antidiabetic drugs and glycemic control with CV profiles in T2DM patients. The association of concurrent medications and comorbidities with glycemic control was also investigated. Methods A total of 220 T2DM patients from the University of Malaya Medical Centre, Malaysia, who had at least one CV complication and who had been taking at least one antidiabetic drug for at least 3 months, were included. The associations of antidiabetics, cardiovascular diseases, laboratory parameters, concurrent medications, comorbidities, demographics, and clinical characteristics with glycemic control were investigated. Results Sulfonylureas in combination (P=0.002) and sulfonylurea monotherapy (P<0.001) were found to be associated with good glycemic control, whereas insulin in combination (P=0.051), and combination biguanides and insulin therapy (P=0.012) were found to be associated with poor glycemic control. Stroke (P=0.044) was the only type of CVD that seemed to be significantly associated with good glycemic control. Other factors such as benign prostatic hyperplasia (P=0.026), elderly patients (P=0.018), low-density lipoprotein cholesterol levels (P=0.021), and fasting plasma glucose (P<0.001) were found to be significantly correlated with good glycemic control. Conclusion Individualized treatment in T2DM patients with CVDs can be supported through a better understanding of the association between glycemic control and CV profiles in T2DM patients. PMID:26316711

  8. Can smartphone-based logging support diabetologists in solving glycemic control problems?

    PubMed

    Tiefengrabner, Martin; Domhardt, Michael; Oostingh, Gertie J; Schwenoha, Karin; Stütz, Thomas; Weitgasser, Raimund; Ginzinger, Simon W

    2014-01-01

    Treatment of diabetic patients strongly relies on the continuous logging of parameters relevant to glycemic control. Keeping diabetes diaries can be tedious which can affect the data quality and completeness. Mobile technologies could provide means to overcome these limitations. However, studies analyzing the direct effect on the treatment of patients are rare. In the presented study diabetic patients were supplied with a smartphone application to record various parameters relevant for glycemic control. Questions regarding the completeness of diabetes diaries were answered by the patients before and after the study. The attending diabetologist analyzed the data obtained from the smartphone-based diaries to determine whether these provided solutions for problems in glycemic control. The analysis of the available smartphone data provided the basis for therapeutic recommendations that can improve the daily glycemic control for almost all participants. Importantly, especially the newly developed implicit-activity logging, registering the participants' movements, provided important means to generate these recommendations. PMID:24825702

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    PubMed

    Trepanowski, John F; Varady, Krista A

    2015-01-01

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

  11. Impact of hyperbaric oxygen on diabetic ulcers is unaffected by glycemic control.

    PubMed

    Bahktiani, Parkash; Mansuri, Owaise; Yadav, Abhijeet; Osuoha, Chima; Knight, Patty; Baynosa, Richard; McLafferty, Robert; Jakoby, Michael

    2015-01-01

    Hyperbaric oxygen (HBO2) therapy is an established intervention for treating chronic diabetic lower extremity ulcers, but the impact of glycemic control on its efficacy has not been determined. The purpose of this study was to evaluate the impact of blood glucose control at initiation of HBO2 treatment on wound healing. Hemoglobin A1c (HbA1c) was measured at start of HBO2 therapy for 22 patients undergoing treatment of chronic lower extremity ulcers at two regional wound care centers. Patients with HbA1c < 7.5% were stratified into a "good glycemic control" group (n = 12, mean HbA1c 6.5 ± 0.8%), and patients with HbA1c ? 7.5% were stratified into a "poor glycemic control" group (n = 10, mean HbA1c 8.8 ± 1.4%, p = 0.004 compared to "good glycemic control group"). After 20 HBO2 sessions over 30 days in addition to standard wound care interventions, there was no difference in wound healing between the two glycemic control groups as indicated by. reduction from baseline in ulcer surface area, depth, or volume. The diabetic lower extremity wound response to HBO2 therapy is unaffected by glycemic control prior to treatment, and HBO2 treatment should not be delayed for suboptimal blood glucose control. PMID:26152102

  12. Glycemic control and antidiabetic drugs in type 2 diabetes mellitus patients with renal complications

    PubMed Central

    Huri, Hasniza Zaman; Lim, Lay Peng; Lim, Soo Kun

    2015-01-01

    Background Good glycemic control can delay the progression of kidney diseases in type 2 diabetes mellitus (T2DM) patients with renal complications. To date, the association between antidiabetic agents and glycemic control in this specific patient population is not well established. Purpose This study aimed to identify antidiabetic regimens as well as other factors that associated with glycemic control in T2DM patients with different stages of chronic kidney disease (CKD). Patients and methods This retrospective, cross-sectional study involved 242 T2DM inpatients and outpatients with renal complications from January 2009 to March 2014 and was conducted in a tertiary teaching hospital in Malaysia. Glycated hemoglobin (A1C) was used as main parameter to assess patients’ glycemic status. Patients were classified to have good (A1C <7%) or poor glycemic control (A1C ?7%) based on the recommendations of the American Diabetes Association. Results Majority of the patients presented with CKD stage 4 (43.4%). Approximately 55.4% of patients were categorized to have poor glycemic control. Insulin (57.9%) was the most commonly prescribed antidiabetic medication, followed by sulfonylureas (43%). Of all antidiabetic regimens, sulfonylureas monotherapy (P<0.001), insulin therapy (P=0.005), and combination of biguanides with insulin (P=0.038) were found to be significantly associated with glycemic control. Other factors including duration of T2DM (P=0.004), comorbidities such as anemia (P=0.024) and retinopathy (P=0.033), concurrent medications such as erythropoietin therapy (P=0.047), ?-blockers (P=0.033), and antigouts (P=0.003) were also correlated with A1C. Conclusion Identification of factors that are associated with glycemic control is important to help in optimization of glucose control in T2DM patients with renal complication. PMID:26300627

  13. Glycemic Control in Youth with Diabetes: The SEARCH for Diabetes in Youth Study

    PubMed Central

    Petitti, Diana B.; Klingensmith, Georgeanna J.; Bell, Ronny A.; Andrews, Jeanette S.; Dabelea, Dana; Imperatore, Giuseppina; Marcovina, Santica; Pihoker, Catherine; Standiford, Debra; Waitzfelder, Beth; Mayer-Davis, Elizabeth

    2015-01-01

    Objective To assess correlates of glycemic control in a diverse population of children and youth with diabetes. Study design This was a cross-sectional analysis of data from a 6-center US study of diabetes in youth, including 3947 individuals with type 1 diabetes (T1D) and 552 with type 2 diabetes (T2D), using hemoglobin A1c (HbA1c) levels to assess glycemic control. Results HbA1c levels reflecting poor glycemic control (HbA1c ? 9.5%) were found in 17% of youth with T1D and in 27% of those with T2D. African-American, American Indian, Hispanic, and Asian/Pacific Islander youth with T1D were significantly more likely to have higher HbA1c levels compared with non-Hispanic white youth (with respective rates for poor glycemic control of 36%, 52%, 27%, and 26% vs 12%). Similarly poor control in these 4 racial/ethnic groups was found in youth with T2D. Longer duration of diabetes was significantly asso*ciated with poorer glycemic control in youth with T1D and T2D. Conclusions The high percentage of US youth with HbA1c levels above the target value and with poor glycemic control indicates an urgent need for effective treatment strategies to improve metabolic status in youth with diabetes. PMID:19643434

  14. Metabolic Management during Critical Illness: Glycemic Control in the ICU.

    PubMed

    Honiden, Shyoko; Inzucchi, Silvio E

    2015-12-01

    Hyperglycemia is a commonly encountered metabolic derangement in the ICU. Important cellular pathways, such as those related to oxidant stress, immunity, and cellular homeostasis, can become deranged with prolonged and uncontrolled hyperglycemia. There is additionally a complex interplay between nutritional status, ambient glucose concentrations, and protein catabolism. While the nuances of glucose management in the ICU have been debated, results from landmark studies support the notion that for most critically ill patients moderate glycemic control is appropriate, as reflected by recent guidelines. Beyond the target population and optimal glucose range, additional factors such as hypoglycemia and glucose variability are important metrics to follow. In this regard, new technologies such as continuous glucose sensors may help alleviate the risks associated with such glucose fluctuations in the ICU. In this review, we will explore the impact of hyperglycemia upon critical cellular pathways and how nutrition provided in the ICU affects blood glucose. Additionally, important clinical trials to date will be summarized. A practical and comprehensive approach to glucose management in the ICU will be outlined, touching upon important issues such as glucose variability, target population, and hypoglycemia. PMID:26595046

  15. Impacting obesity and glycemic control using a culturally-sensitive diabetes education program in Hispanic patients with type 2 diabetes

    PubMed Central

    Peterson, Ralph M.; Beeson, Larry; Shulz, Eloy; Firek, Anthony; De Leon, Marino; Balcazar, Hector; Tonstad, Serena; Cordero-MacIntyre, Zaida R.

    2011-01-01

    Objectives Diabetes mellitus and obesity are prevalent in the Hispanic community. This group has not benefited greatly from diabetes interventions due to cultural, language and financial constraints. We designed a prospective cohort study to determine the clinical impact on adiposity and glycemic control in Hispanics with type 2 diabetes. Research design and methods The program conducted in Spanish by a multidisciplinary team of health care providers focused on improving glycemic control and complications through cultural lifestyle changes. Outcomes were changes in glycemic control by fasting insulin, glucose and HbA1c, body composition and selected adipokines, adiponectin, leptin and ghrelin. Body composition was measured by dual energy x-ray absorptiometry. Changes from baseline at three months were compared using paired t-tests and with Spearman’s correlations. Results Glycemic control improved by HbA1c (7.9% ± 2.0% vs 7.1% ± 1.7%; P = <0.001), and fasting glucose (166.4 ± 66.0 mg/dl vs 143.2 ± 57.9 mg/dl; P = 0.003). Body weight (81.3 ± 17.9 kg vs 80.3 ± 18.0 kg; P = 0.002), waist circumference (101.6 ± 13.4 cm vs 99.1 ± 12.7 cm; P = 0.015), and truncal fat (16.5 ± 5.7 kg vs 15.9 ± 5.6 kg; P = 0.001) decreased. Only leptin (19.6 ± 15.0 ng/ml vs 16.3 ± 12.7 ng/ml; P = 0.002) was reduced and related to change in body weight (r = 0.392; P = 0.022). Conclusions Our program significantly improved glycemic control and decreased obesity in diabetic Hispanic subjects. The early benefits on glycemic control may be related to reductions in leptin through loss of adipose tissue. Success in impacting diabetes and related complications can occur in a culturally focused and multidisciplinary context. PMID:21318090

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

    PubMed

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

    2015-01-01

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  18. Ethnic Disparities in Glycemic Control Among Rural Older Adults with Type 2 Diabetes

    PubMed Central

    Quandt, Sara A.; Bell, Ronny A.; Snively, Beverly M.; Smith, Shannon L.; Stafford, Jeanette M.; Wetmore, Lindsay K.; Arcury, Thomas A.

    2006-01-01

    Glycemic control is a predictor of diabetes-related morbidity and mortality. However, little is known about how well older adults in rural communities, with limited access to self-care resources and specialty care practitioners, control their diabetes. Even less is known about whether minority, older, rural adults are at increased risk for poor glycemic control. We analyzed data from a cross-sectional survey of randomly selected older (?65 years) adults with type 2 diabetes in rural North Carolina. Participants (N=693) were men and women from three ethnic groups: African American, Native American, and White. Capillary blood samples were collected for HbA1C analysis. HbA1C levels (<7%, 7%–<8%, and ?8%) were compared across ethnic and gender groups. Two multiple logistic regression models (model 1: personal characteristics; model 2: personal and health characteristics) were used to evaluate potential predictors of HbA1C ?7%. Overall, 36.4% had HbA1C ?7%. Native Americans and African-American men had the highest proportion at levels of poor glycemic control (?7%), and African-American women and White men had the lowest. In bivariate analysis, ethnicity, living arrangements, use of medications for diabetes, having a diabetes-related healthcare visit in the past year, and duration of diabetes were significantly associated with glycemic control. In multivariate analysis (model 1), being Native American, having low income without Medicaid, and being married were associated with poor glycemic control. Adding health characteristics (model 2), longer diabetes duration and diabetes medication therapy were significant predictors. These data indicate that older ethnic minorities in rural communities are at increased risk for diabetes complications and need diabetes management strategies to improve glycemic control. PMID:16259490

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

    PubMed Central

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

    2015-01-01

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

  20. Achieving glycemic control in special populations in hospital: perspectives in practice.

    PubMed

    Cheng, Alice Y Y

    2014-04-01

    Achieving and maintaining glycemic control in patients with diabetes admitted to hospital is challenging because of the many competing factors of nutrition, pharmacotherapy and other patient-related and systemic factors. For patients receiving enteral or parenteral feeding, eating irregularly or receiving glucocorticoid therapy, the challenges are even greater. The basic principles to follow when managing glycemia in these populations are as follows: 1) Recognition of those at risk for hyperglycemia; 2) frequent bedside glucose monitoring; 3) a proactive approach with routine insulin administration based on the predicted glucose patterns; 4) constant reassessment of the glycemic status and titration of the routine insulin accordingly. PMID:24690508

  1. Predictors of poor glycemic control in type 2 diabetic patients attending public hospitals in Dar es Salaam

    PubMed Central

    Kamuhabwa, Appolinary R; Charles, Emmanuel

    2014-01-01

    Background Tanzania has recently experienced a significant rise in the burden of diabetes, and it is estimated that more than 400,000 people are living with diabetes. A major concern in the management of diabetes is the occurrence of diabetic complications that occur as a result of poor glycemic control. Identification of the factors associated with poor glycemic control is important in order to institute appropriate interventions for the purpose of improving glycemic control and prevention of chronic complications. Aim The aim of this study was to determine the level of glycemic control and explore the factors associated with poor glycemic control among patients with type 2 diabetes mellitus (T2DM). Methodology A cross-sectional study was carried out at the diabetic clinics for T2DM patients at the national and municipal hospitals in Dar es Salaam. A total of 469 patients were enrolled over a period of 8 weeks from March 2013 to May 2013. Patients’ information such as sociodemographic characteristics, self-care management behaviors, and medication adherence were obtained through interviews. Blood pressure, weight, and height were measured during the day of the interview. All available last readings for fasting blood glucose (FBG) measurements, lipid profile, and other clinical characteristics were obtained from patients’ records. Results The mean age of patients was 54.93 years. The majority (63.5%) of patients were females and only eight patients had records of lipid profile measurements. Out of 469 patients, 69.7% had FBG of ?7.2 mmol/L, indicating poor glycemic control. Females aged between 40 years and 59 years had significantly higher poor glycemic control (76.1%) as compared with their male counterparts. Thirty-eight percent of patients had poor medication adherence, which was associated with poor glycemic control. The proportion of poor glycemic control increased with age. A significantly high proportion of poor glycemic control was observed in patients who had had the disease for more than 20 years since diagnosis. Factors associated with poor glycemic control included lack of health insurance, using more than one oral hypoglycemic agent, normal body mass index, obesity, and nonadherence to diabetic medications. Conclusion Patients in this study had generally poor glycemic control. From these findings it is recommended that diabetic patients should be routinely screened for lipid profile to determine levels of cholesterol, triglycerides, and low-density lipoproteins, which are risk factors for cardiovascular events. An education program should be developed to educate patients on the importance of medication adherence and weight management for better glycemic control. PMID:25368533

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

    E-print Network

    , (PICU) pediatric intensive care unit, (TGC) tight glycemic control Keywords: blood glucose, children, Herestraat 49, B-3000 Leuven, Belgium; email address tom.vanherpe@esat.kuleuven.be Journal of Diabetes Science and Technology Volume 6, Issue 1, January 2012 © Diabetes Technology Society SYMPOSIUM Abstract

  3. Determinants of glycemic control in youth with type 2 diabetes at randomization in the TODAY study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The purpose of this study was to investigate insulin sensitivity and secretion indices and determinants of glycemic control in youth with recent-onset type 2 diabetes (T2DM) at randomization in the TODAY study, the largest study of youth with T2DM to date. We examined estimates of insulin sensitivit...

  4. 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

  5. Poor glycemic control in younger women attending Malaysian public primary care clinics: findings from adults diabetes control and management registry

    PubMed Central

    2013-01-01

    Background Women of reproductive age are a group of particular concern as diabetes may affect their pregnancy outcome as well as long-term morbidity and mortality. This study aimed to compare the clinical profiles and glycemic control of reproductive and non-reproductive age women with type 2 diabetes (T2D) in primary care settings, and to determine the associated factors of poor glycemic control in the reproductive age group women. Methods This was a cross-sectional study using cases reported by public primary care clinics to the Adult Diabetes Control and Management registry from 1st January to 31st December 2009. All Malaysian women aged 18 years old and above and diagnosed with T2D for at least 1 year were included in the analysis. The target for glycemic control (HbA1c < 6.5%) is in accordance to the recommended national guidelines. Both univariate and multivariate approaches of logistic regression were applied to determine whether reproductive age women have an association with poor glycemic control. Results Data from a total of 30,427 women were analyzed and 21.8% (6,622) were of reproductive age. There were 12.5% of reproductive age women and 18.0% of non-reproductive age women that achieved glycemic control. Reproductive age group women were associated with poorer glycemic control (OR = 1.5, 95% CI = 1.2-1.8). The risk factors associated with poor glycemic control in the reproductive age women were being of Malay and Indian race, longer duration of diabetes, patients on anti-diabetic agents, and those who had not achieved the target total cholesterol and triglycerides. Conclusion Women with T2D have poor glycemic control, but being of reproductive age was associated with even poorer control. Health care providers need to pay more attention to this group of patients especially for those with risk factors. More aggressive therapeutic strategies to improve their cardiometabolic control and pregnancy outcome are warranted. PMID:24325794

  6. Mobile Phone Diabetes Project Led To Improved Glycemic Control And Net Savings For Chicago Plan Participants

    PubMed Central

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

    2014-01-01

    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

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

    MedlinePLUS

    ... A Listen The Link Between Hypoglycemia and Cardiac Arrhythmias: An Answer to Why Tight Glycemic Control May ... hypoglycemia was associated with increased susceptibility to cardiac arrhythmias in patients with type 2 diabetes who had ...

  8. Evaluation of a novel artificial pancreas: closed loop glycemic control system with continuous blood glucose monitoring.

    PubMed

    Tsukamoto, Yuuki; Kinoshita, Yoshihiko; Kitagawa, Hiroyuki; Munekage, Masaya; Munekage, Eri; Takezaki, Yuka; Yatabe, Tomoaki; Yamashita, Koichi; Yamazaki, Rie; Okabayashi, Takehiro; Tarumi, Masatoshi; Kobayashi, Masaki; Mishina, Suguru; Hanazaki, Kazuhiro

    2013-04-01

    A closed-loop glycemic control system using an artificial pancreas has been applied with many clinical benefits in Japan since 1987. To update this system incorporating user-friendly features, we developed a novel artificial pancreas (STG-55). The purpose of this study was to evaluate STG-55 for device usability, performance of blood glucose measurement, glycemic control characteristics in vivo in animal experiments, and evaluate its clinical feasibility. There are several features for usability improvement based on the design concepts, such as compactness, display monitor, batteries, guidance function, and reduction of the preparation time. All animal study data were compared with a clinically available artificial pancreas system in Japan (control device: STG-22). We examined correlations of both blood glucose levels between two groups (STG-55 vs. control) using Clarke's error grid analysis, and also compared mean glucose infusion rate (GIR) during glucose clamp. The results showed strong correlation in blood glucose concentrations (Pearson's product-moment correlation coefficient: 0.97; n?=?1636). Clarke's error grid analysis showed that 98.4% of the data fell in Zones A and B, which represent clinically accurate or benign errors, respectively. The difference in mean GIRs was less than 0.2?mg/kg/min, which was considered not significant. Clinical feasibility study demonstrated sufficient glycemic control maintaining target glucose range between 80 and 110 (mg/dL), and between 140 and 160 without any hypoglycemia. In conclusion, STG-55 was a clinically acceptable artificial pancreas with improved interface and usability. A closed-loop glycemic control system with STG-55 would be a useful tool for surgical and critical patients in intensive care units, as well as diabetic patients. PMID:23506242

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  10. 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

  11. Glycemic control and motor development in a patient with intermediate DEND.

    PubMed

    Oka, Hideharu; Suzuki, Shigeru; Furuya, Akiko; Matsuo, Kumihiro; Amamiya, Satoshi; Oshima, Miho; Oka, Toshiaki; Mukai, Tokuo; Okayama, Akie; Araki, Akiko; Azuma, Hiroshi; Tanahashi, Yusuke

    2014-06-01

    The most common cause of neonatal diabetes, KCNJ11 gene mutation, can manifest as a neurological disorder. The most severe form consists of a constellation of developmental delay, epilepsy, and neonatal diabetes (DEND). Intermediate DEND (iDEND) refers to a milder presentation without epilepsy. We present a child with iDEND, for whom insulin injections were replaced with glibenclamide therapy at 17?months of age because of poor glycemic control and delayed motor development. Three?months after initiation of glibenclamide, HbA1c decreased from 10.2% to 5.6%. Continuous glucose monitoring indicated that blood glucose fluctuations were suppressed while on glibenclamide. Furthermore, after initiating glibenclamide therapy, the developmental quotient (DQ) for motor ability markedly improved from 60 to 91, whereas the DQ for language and adoptive ability remained as they had been before the sulfonylurea treatment. Sulfonylurea treatment improved glycemic control and motor development in the present patient. PMID:24894933

  12. 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

  13. 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

  14. Evaluating the effect of u-500 insulin therapy on glycemic control in veterans with type 2 diabetes.

    PubMed

    Granata, Joseph A; Nawarskas, Ann D; Resch, Nina D; Vigil, Justina M

    2015-01-01

    IN BRIEF This article describes a single-center, retrospective chart review to determine the glycemic effect of converting from U-100 to U-500 regular insulin in veterans with type 2 diabetes and the effect of this change, if any, on the frequency of provider contacts. Results showed that U-500 insulin improved glycemic control without significantly increasing the risk of hypoglycemia or total daily insulin dose, even when follow-up contacts with providers were not structured or frequent. PMID:25653468

  15. Effect of improving glycemic control on low-density lipoprotein particle size in type 2 diabetes.

    PubMed

    Wägner, Ana María; Jorba, Oscar; Rigla, Mercedes; Bonet, Rosa; de Leiva, Alberto; Ordóñez-Llanos, Jordi; Pérez, Antonio

    2003-12-01

    The current study sought to assess the effect of improving glycemic control in type 2 diabetes on the components of diabetic dyslipidemia, especially low-density lipoprotein (LDL) size. A total of 33 type 2 diabetic patients (48.5% women, age 59.6 +/- 11.1 years, body mass index [BMI] 28.9 +/- 4.9, diabetes duration 6 [0 to 40] years, 40.7% on insulin) were seen at the hospital because of poor glycemic control (hemoglobin A(1c) [HbA(1c)] 10.33% +/- 1.89%). Triglyceride, LDL-cholesterol (LDLc, Friedewald/ ultracentrifugation), high-density lipoprotein HDL-cholesterol (HDLc, direct method), apolipoproteins AI (apoAI) and B (apoB) (immunoturbidimetry), and LDL size (gradient gel electrophoresis) were measured at baseline and after improvement in glycemic control (decrease >/= 1 percentage point in HbA(1c) and final HbA(1c) glycemic control (HbA(1c) 7.01% +/- 0.63%, P <.0005 v baseline) after a follow-up of 3.5 (range, 1 to 13) months resulted in a significant reduction in LDLc (3.34 +/- 1.02 v 3.62 +/- 1.15 mmol/L, P <.05) and apoB (1.07 +/- 0.25 v 1.17 +/- 0.29 g/L, P <.01) and an increase in HDLc (1.21 +/- 0.32 v 1.13 +/- 0.34 mmol/L, P <.05) and apoAI (1.36 +/- 0.24 v 1.27 +/- 0.24 mmol/L, P < 0.01) in the whole group, and an increase in LDL particle size (25.61 +/- 0.53 v 25.10 +/- 0.31 nm, P <.005) in the 14 patients showing LDL phenotype B at baseline. No significant changes were seen in body weight or BMI. We conclude that improvement of glycemic control in type 2 diabetes improves most of the components of diabetic dyslipidemia, including a shift towards larger LDL particles in subjects with phenotype B. PMID:14669158

  16. Relationships among sleep timing, sleep duration and glycemic control in Type 2 diabetes in Thailand.

    PubMed

    Reutrakul, Sirimon; Siwasaranond, Nantaporn; Nimitphong, Hataikarn; Saetung, Sunee; Chirakalwasan, Naricha; Ongphiphadhanakul, Boonsong; Thakkinstian, Ammarin; Hood, Megan M; Crowley, Stephanie J

    2015-12-01

    There is evidence that the sleep and circadian systems play a role in glucose metabolism. In addition to physiological factors, sleep is also affected by behavioral, environmental, cultural and social factors. In this study, we examined whether morning or evening preference, sleep timing and sleep duration are associated with glycemic control in patients with type 2 diabetes residing in Thailand. Two hundred and ten type 2 diabetes patients who were not shift workers completed an interview and questionnaires to collect information on diabetes history, habitual sleep duration and sleep timing. Chronotype, an individual's tendency for being a "morning" or "evening" person, was assessed using the Composite Score of Morningness (CSM), which reflects an individual's subjective preference for activities in the morning or evening, as well as mid-sleep time on weekend nights (MSF), which reflects their actual sleep behavior. Most recent hemoglobin A1c (HbA1c) values were retrieved from medical records. Evening preference (as indicated by lower CSM), later bedtime on weekends, and shorter sleep duration correlated with higher HbA1c (r?=?-0.18, p?=?0.01; r?=?0.17, p?=?0.01 and r?=?-0.17, p?=?0.01, respectively), while there was no association between MSF or wake up time and glycemic control. In addition, later bedtime on weekends significantly correlated with shorter sleep duration (r?=?-0.34, p?glycemic control (B?=?0.018, p?=?0.02), while CSM was not. Mediation analysis revealed that this association was fully mediated by sleep duration. In summary, later bedtime on weekends was associated with shorter sleep duration and poorer glycemic control in patients with type 2 diabetes. It is likely that patients with later weekend bedtimes curtail their sleep by waking up earlier. Exploring the potential reasons for this phenomenon (e.g. cultural influences, metropolitan lifestyle, environmental factors, family and social obligations) specific to a Thai population may help identify behavioral modifications (i.e. earlier bedtime and/or sleep duration extension) that could possibly lead to improved glycemic control in this population. PMID:26595483

  17. Glibenclamide or metformin combined with honey improves glycemic control in streptozotocin-induced diabetic rats.

    PubMed

    Erejuwa, Omotayo Owomofoyon; Sulaiman, Siti Amrah; Wahab, Mohd Suhaimi Ab; Sirajudeen, Kuttulebbai Nainamohammed Salam; Salleh, Md Salzihan Md; Gurtu, Sunil

    2011-01-01

    Diabetes mellitus is associated with deterioration of glycemic control and progressive metabolic derangements. This study investigated the effect of honey as an adjunct to glibenclamide or metformin on glycemic control in streptozotocin-induced diabetic rats. Diabetes was induced in rats by streptozotocin. The diabetic rats were randomized into six groups and administered distilled water, honey, glibenclamide, glibenclamide and honey, metformin or metformin and honey. The animals were treated orally once daily for four weeks. The diabetic control rats showed hypoinsulinemia (0.27 ± 0.01 ng/ml), hyperglycemia (22.4 ± 1.0 mmol/L) and increased fructosamine (360.0 ± 15.6 µmol/L). Honey significantly increased insulin (0.41 ± 0.06 ng/ml), decreased hyperglycemia (12.3 ± 3.1 mmol/L) and fructosamine (304.5 ± 10.1 µmol/L). Although glibenclamide or metformin alone significantly (p < 0.05) reduced hyperglycemia, glibenclamide or metformin combined with honey produced significantly much lower blood glucose (8.8 ± 2.9 or 9.9 ± 3.3 mmol/L, respectively) compared to glibenclamide or metformin alone (13.9 ± 3.4 or 13.2 ± 2.9 mmol/L, respectively). Similarly, glibenclamide or metformin combined with honey produced significantly (p < 0.05) lower fructosamine levels (301.3 ± 19.5 or 285.8 ± 22.6 µmol/L, respectively) whereas glibenclamide or metformin alone did not decrease fructosamine (330.0 ± 29.9 or 314.6 ± 17.9 µmol/L, respectively). Besides, these drugs or their combination with honey increased insulin levels. Glibenclamide or metformin combined with honey also significantly reduced the elevated levels of creatinine, bilirubin, triglycerides, and VLDL cholesterol. These results indicate that combination of glibenclamide or metformin with honey improves glycemic control, and provides additional metabolic benefits, not achieved with either glibenclamide or metformin alone. PMID:21448302

  18. Effect of proton pump inhibitors on glycemic control in patients with diabetes

    PubMed Central

    Takebayashi, Kohzo; Inukai, Toshihiko

    2015-01-01

    Gastrin is a linear peptide hormone which is secreted mostly in the stomach pyloric antrum G cells. Although the main role of this hormone is the promotion of the secretion of gastric acid from the stomach parietal cells, gastrin can also behave as a growth factor and stimulate gastric cell proliferation. It is also reported that gastrin promotes ? cell neogenesis in the pancreatic ductal complex, modest pancreatic ? cell replication, and improvement of glucose tolerance in animal models, in which the remodeling of pancreatic tissues is promoted. These findings suggest the possibility that gastrin has the potential to promote an increase of ? cell mass in pancreas, and therefore that gastrin may improve glucose tolerance. Proton pump inhibitors (PPIs) are wildly used clinically for the therapy of gastro-esophageal reflex disease, gastritis due to excess stomach acid, and gastric ulcers. PPIs indirectly elevate serum gastrin levels via a negative feedback effect. Recent evidence has revealed the beneficial effect of PPIs on glycemic control especially in patients with type 2 diabetes mellitus (T2DM), probably via the elevation of the levels of serum gastrin, although the detailed mechanism remains unclear. In addition, the beneficial effects of a combination therapy of gastrin or a PPI with a glucagon-like peptide-1 receptor agonist on glycemic control in animal models have been demonstrated. Although PPIs may be possible candidates for a new approach in the therapy of diabetes, a prospective, long-term, randomized, double-blind, placebo-controlled study is needed to establish the effect of PPIs on glycemic control in a large number of patients with T2DM. PMID:26322158

  19. 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

  20. 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

  1. Factors associated with glycemic control in adult type 1 diabetes patients treated with insulin pump therapy.

    PubMed

    Matejko, Bart?omiej; Skupien, Jan; Mrozi?ska, Sandra; Grzanka, Ma?gorzata; Cyganek, Katarzyna; Kiec-Wilk, Beata; Malecki, Maciej T; Klupa, Tomasz

    2015-02-01

    Continuous subcutaneous insulin infusion (CSII) by insulin pump seems to improve glycemia and quality of life as compared to conventional insulin therapy in type 1 diabetes (T1DM). However, while many T1DM subjects achieve excellent glycemic control, some others cannot reach recommended goals. In a retrospective analysis, we searched for factors associated with glycemic control in T1DM patients treated with insulin pump therapy. Data from 192 patients (133 women and 59 men) treated with personal insulin pumps at the Department of Metabolic Diseases, University Hospital, Krakow, Poland were analyzed. Sources of information included medical records, memory read-outs from insulin pumps and data from glucose meters. Univariate, multivariate linear and logistic regression analysis for the association with hemoglobin A1c (HbA1c) level were performed. The mean age of the subjects was 28.9 (±11.2) years, the mean duration of T1DM-14.6 (±7.6) years, mean body mass index-23.5 (±3.1) kg/m2. The mean HbA1c level in the entire study group was 7.4% (57 mmol/mol). In the multivariate linear regression analysis, HbA1c correlated with the mean number of daily blood glucose measurements, number of hypoglycemic episodes per 100 blood glucose measurements, age at the examination, and continuous glucose monitoring system use. Multivariate logistic regression analysis for reaching the therapeutic target of HbA1c<7.0% (53 mmol/mol) showed that the independent predictors of achieving this goal included the same four variables. In a large clinical observation, we identified that patient-related and technological factors associated with glycemic control in adult pump-treated T1DM subjects. PMID:24798448

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    PubMed Central

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

  4. Retinal Nerve Fiber Layer Decrease during Glycemic Control in Type 2 Diabetes

    PubMed Central

    Sugimoto, Masahiko; Sasoh, Mikio; Ido, Masashi; Narushima, Chisato; Uji, Yukitaka

    2010-01-01

    Purpose. To assess an effect of glycemic control on retinal nerve fiber layer (RNFL) in type 2 diabetes mellitus. Methods. Thirty-eight eyes of 38 patients with type 2 diabetes undergoing blood glucose regulation were enrolled. All patients were examined at (1) initial visit, (2) 1 month, (3) 2 months, and (4) 4-month after the initial examination. On each occasion, glycosylated hemoglobin (HbA1c) levels and optical coherence tomography (OCT) scanning for RNFL thickness were evaluated. 360 degree circular OCT scans with a diameter of 3.4?mm centered on the optic disc were performed. Results. Significant RNFL decrease was seen in the superior area between initial and 4 months examination (P = .043). The relationship between the changes in HbA1c and the changes in RNFL thickness was observed in superior, temporal, and inferior area (P < .05) at 4 months. Conclusions. This study suggests that the glycemic control affects RNFL within 4 months. PMID:20847955

  5. Dipeptidyl peptidase-4 inhibitors and the ischemic heart: Additional benefits beyond glycemic control.

    PubMed

    Chattipakorn, Nipon; Apaijai, Nattayaporn; Chattipakorn, Siriporn C

    2016-01-01

    Obese-insulin resistance and type 2 diabetes mellitus (T2DM) have become global health problems, and they are both associated with a higher risk of ischemic heart disease. Although reperfusion therapy is the treatment to increase blood supply to the ischemic myocardium, this intervention potentially causes cardiac tissue damage and instigates arrhythmias, processes known as reperfusion injury. Dipeptidyl peptidase 4 (DPP-4) inhibitors are glycemic control drugs commonly used in T2DM patients. Growing evidence from basic and clinical studies demonstrates that a DPP-4 inhibitor could exert cardioprotection and improve left ventricular function by reducing oxidative stress, apoptosis, and increasing reperfusion injury salvage kinase (RISK) activity. However, recent reports also showed potentially adverse cardiac events due to the use of a DPP-4 inhibitor. To investigate this disparity, future large clinical trials are essential in verifying whether DPP-4 inhibitors are beneficial beyond their glycemic control particularly for the ischemic heart in obese-insulin resistant subjects and T2DM patients. PMID:26432493

  6. Impact of psychological stress caused by the Great East Japan Earthquake on glycemic control in patients with diabetes.

    PubMed

    Fujihara, K; Saito, A; Heianza, Y; Gibo, H; Suzuki, H; Shimano, H; Saito, K; Kodama, S; Yamada, N; Sone, H

    2012-10-01

    We examined the relationship between psychological stress and the worsening of glycemic control in diabetic patients at the time of the Great East Japan Earthquake. HbA1c levels in diabetic patients before and after the disaster were evaluated with the General Health Questionnaire (GHQ) and other questions including those on changes in diet, exercise, psychological stress and drug intake in 320 consecutive diabetic patients who had been followed in a diabetes clinic. Logistic regression analysis revealed that the total GHQ scores (odds ratio [OR] 1.03 [95% confidence interval 1.01-1.06]; p<0.01) and interruption of drug intake (OR 4.48 [1.57-12.7]; p=0.01) were independently associated with worsening of glycemic control defined as an increase in the HbA1c level equal to or greater than 0.5%. Among the scores on the GHQ, those for somatic symptoms (OR 1.18 [1.01-1.38]; p=0.03) and sleep disturbances or anxiety (OR 1.26 [1.08-1.46]; p<0.01) were independently associated with glycemic control. These results suggest that psychological stress during a disaster has independent effects on worsening of glycemic control. PMID:22851189

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

    PubMed Central

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

    2015-01-01

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

  8. 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

  9. GLYCEMIC CONTROL AND PROSTATE CANCER PROGRESSION: RESULTS FROM THE SEARCH DATABASE

    PubMed Central

    Kim, Howard; Presti, Joseph C.; Aronson, William J.; Terris, Martha K.; Kane, Christopher J.; Amling, Christopher L.; Freedland, Stephen J.

    2010-01-01

    Purpose Several studies have examined the association between diabetes mellitus (DM) and prostate cancer (PCa) risk and progression, however nearly all of these studies have compared diabetic vs. non-diabetic men. We sought to investigate the role of glycemic control, as measured by HbA1c, on PCa aggressiveness and prognosis in men with DM and PCa from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Methods We identified 247 men in SEARCH with DM and a recorded HbA1c value twelve months prior to radical prostatectomy between 1988 and 2009. We divided men into tertiles by HbA1c level. The association between HbA1c tertiles and risk of adverse pathology and biochemical recurrence were tested using multivariate logistic regression and Cox proportional hazards models, respectively. Results Median HbA1c level was 6.9. On multivariate analysis, HbA1c tertiles were predictive of pathological Gleason score (p-trend=0.001). Relative to the first tertile, men in the second (OR 5.90, p=0.002) and third tertile (OR 7.15, p=0.001) were more likely to have Gleason score ? 4+3. HbA1c tertiles were not associated with margin status, node status, extracapsular extension or seminal vesicle invasion (all p-trend>0.2). In the multivariate Cox proportional hazards model, increasing HbA1c tertiles were not significantly related to risk of biochemical recurrence (p-trend=0.56). Conclusion Men with higher HbA1c levels presented with more biologically aggressive prostate tumors at radical prostatectomy. Although risk of recurrence was unrelated to HbA1c levels, further studies are needed to better explore the importance of glycemic control on long-term outcomes in diabetic men with PCa. PMID:20687228

  10. 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

  11. Glycemic Control in Kenyan Children and Adolescents with Type 1 Diabetes Mellitus

    PubMed Central

    Ngwiri, Thomas; Were, Fred; Predieri, Barbara; Ngugi, Paul; Iughetti, Lorenzo

    2015-01-01

    Background. Type 1 diabetes mellitus (T1DM) is the most common endocrine disorder in children and adolescents worldwide. While data about prevalence, treatment, and complications are recorded in many countries, few data exist for Sub-Saharan Africa. The aim of this study was to determine the degree of control in patients with T1DM aged 1–19 years over a 6-month period in 3 outpatient Kenyan clinics. It also sought to determine how control was influenced by parameters of patient and treatment. Methods. Eighty-two children and adolescents with T1DM were included in the study. Clinical history regarding duration of illness, type and dose of insulin, and recent symptoms of hypoglycemia/hyperglycemia were recorded. Glycaemia, HbA1c, and ketonuria were tested. HbA1c of 8.0% and below was defined as the cut-off for acceptable control. Results. The median HbA1c for the study population was 11.1% (range: 6.3–18.8). Overall, only 28% of patients had reasonable glycemic control as defined in this study. 72% therefore had poor control. It was also found that age above 12 years was significantly associated with poor control. Conclusions. African children and with T1DM are poorly controlled particularly in adolescents. Our data strongly support the necessity of Kenya children to receive more aggressive management and follow-up. PMID:26494998

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

    PubMed

    Li, Sing-Chung; Liu, Yen-Hua; Liu, Jen-Fang; Chang, Wen-Hsin; Chen, Chiao-Ming; Chen, C-Y Oliver

    2011-04-01

    Almond consumption is associated with ameliorations in obesity, hyperlipidemia, hypertension, and hyperglycemia. The hypothesis of this 12-week randomized crossover clinical trial was that almond consumption would improve glycemic control and decrease the risk for cardiovascular disease in 20 Chinese patients with type 2 diabetes mellitus (T2DM) (9 male, 11 female; 58 years old; body mass index, 26 kg/m²) with mild hyperlipidemia. After a 2-week run-in period, patients were assigned to either a control National Cholesterol Education Program step II diet (control diet) or an almond diet for 4 weeks, with a 2-week washout period between alternative diets. Almonds were added to the control diet to replace 20% of total daily calorie intake. Addition of approximately 60 g almonds per day increased dietary intakes of fiber, magnesium, polyunsaturated fatty acid, monounsaturated fatty acid, and vitamin E. Body fat determined with bioelectrical impedance analysis was significantly lower in patients consuming almonds (almonds vs control: 29.6% vs 30.4%). The almond diet enhanced plasma ?-tocopherol level by a median 26.8% (95% confidence intervals, 15.1-36.6) compared with control diet. Furthermore, almond intake decreased total cholesterol, low-density lipoprotein cholesterol, and the ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol by 6.0% (1.6-9.4), 11.6% (2.8-19.1), and 9.7% (0.3-20.9), respectively. Plasma apolipoprotein (apo) B levels, apo B/apo A-1 ratio, and nonesterified fatty acid also decreased significantly by 15.6% (5.1-25.4), 17.4% (2.8-19.9), and 5.5% (3.0-14.4), respectively. Compared with subjects in the control diet, those in the almond diet had 4.1% (0.9-12.5), 0.8% (0.4-6.3), and 9.2% (4.4-13.2) lower levels of fasting insulin, fasting glucose, and homeostasis model assessment of insulin resistance index, respectively. Our results suggested that incorporation of almonds into a healthy diet has beneficial effects on adiposity, glycemic control, and the lipid profile, thereby potentially decreasing the risk for cardiovascular disease in patients with type 2 diabetes mellitus. PMID:20580779

  13. 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

  14. 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

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

    PubMed

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

    2015-05-01

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

  16. 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

  17. Preoperative Glycemic Control Status as a Significant Predictor of Biochemical Recurrence in Prostate Cancer Patients after Radical Prostatectomy

    PubMed Central

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

    2015-01-01

    Background The effect of diabetes mellitus (DM) on prostate cancer (PCa) outcome remains controversial. Thus, we investigated the association of DM history, glycemic control, and metformin use with oncologic outcomes after radical prostatectomy (RP). Methods We reviewed the records of 746 contemporary patients who had hemoglobin A1c (HbA1c) measured within the 6 months preceding RP. The associations between clinical variables and risk of adverse pathological features and biochemical recurrence (BCR) were tested using a multivariate logistic regression and multiple Cox-proportional hazards model, respectively. BCR was defined as prostatic specific antigen (PSA) > 0.2 ng/mL in 2 consecutive tests. Results There were no significant differences in the rates of adverse pathologic features and BCR-free survival between patients with (n = 209) and without (n = 537) a history of DM diagnosis (all p > 0.05). In multivariate analyses, high HbA1c level (? 6.5%) was significantly related with high pathologic Gleason score (? 4+3; odds ratio [OR] 1.704, p = 0.019) and BCR-free survival (OR 1.853, p = 0.007). Metformin use was not associated with BCR-free survival (OR 0.662, p = 0.125). Conclusions Poor glycemic control was significantly associated with BCR after RP. Meanwhile, metformin use was not associated with biochemical outcome after RP. Further investigation would be needed to identify exact mechanism underlying the impact of glycemic control on PCa treatment outcome. PMID:25897669

  18. 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

  19. 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

  20. Effect of low-glycemic load diet on changes in cardiovascular risk factors in poorly controlled diabetic patients

    PubMed Central

    Afaghi, Ahmad; Ziaee, Amir; Afaghi, Mahsa

    2012-01-01

    Background: One dietary strategy aimed at improving both diabetes control and control of cardiovascular risk factors is the use of low glycemic index diets. These diets have been reported to be beneficial in controlling diabetes, and also increase high density lipoprotein cholesterol (HDL-C), lower serum triglyceride, and reduce glycated protein. Aim: Therefore, we aimed to investigate the effect of a low glycemic index-low glycemic load (GL = 67–77) diet on lipids and blood glucose of poorly controlled diabetic patients. Materials and Methods: In an intervention study, 100 poorly controlled diabetic patients (age 52.8 ± 4.5 years) who were taking insulin or on oral medication underwent administration of low GL diet (GL = 67–77; energy = 1800–2200 kcal, total fat = 36%, fat derived from olive oil and nuts 15%, carbohydrate = 41%, protein = 22%) for 10 weeks. Patients were recommended to follow their regular lifestyle. Total cholesterol, low density lipoprotein (LDL), HDL, triglyceride, glycated hemoglobin (HbA1c), weight, and body mass index (BMI) were measured before and 10 weeks after the intervention. Results: Before intervention, initial blood cholesterol and triglyceride concentrations were 205.9 ± 21.6 and 181.5 ± 22.2, respectively, and were reduced to 182.6 ± 18.2 and 161.6 ± 16.7, respectively, after 10 weeks intervention (P < 0.001). LDL reduced and HDL increased significantly. The HbA1c percentage reduced by 12% (from 8.85 ± 0.22% to 7.81 ± 0.27%) (P < 0.001), and also their weight significantly reduced from 74.0 ± 5 kg to 70.7 ± 4.6 kg (P < 0.001). Conclusion: This study demonstrated that low GL diet having lower carbohydrate amount and higher fat content is an appropriate strategy in blood lipid and glucose response control of poorly controlled diabetic patients. PMID:23226649

  1. Counting Carbs? Understanding Glycemic Index and Glycemic Load

    MedlinePLUS

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

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

    PubMed Central

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

    2015-01-01

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

  3. 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

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

    PubMed Central

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

    2013-01-01

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

  5. The impact of prediabetes on glycemic control and clinical outcomes postburn injury.

    PubMed

    Somerset, Amy; Coffey, Rebecca; Jones, Larry; Murphy, Claire V

    2014-01-01

    Poor glucose control and clinical outcomes have been observed in diabetic versus nondiabetic patients postburn injury. Prediabetes is a precursor to diabetes. The purpose of this study was to assess the effects of prediabetes on postinjury glucose control and clinical outcomes. A retrospective review was conducted comparing prediabetics and euglycemic controls. Patients who were admitted for burn care were 18 to 89 years of age and had a hemoglobin A1c (HbA1c) obtained on admission. Prediabetics were defined by an HbA1c of 5.7 to 6.4% and controls by HbA1c < 5.7%. Inpatient glucose levels were recorded, in addition to clinical outcomes. Two hundred eight patients were included: 54 prediabetics and 154 controls. The prediabetic population was older (50.7 vs 39 years; P < .001) with more hypertensives (44.4 vs 16.9%; P < .001), consisted of more African-Americans (20.4 vs 12%; P = .04), and had larger areas of full-thickness burns (4.5 vs 1.75%; P = .02). Median admission HbA1c was 5.9 (5.7-6.0)% among prediabetics and 5.3 (5-5.45)% among controls (P < .001). Prediabetics had significantly higher time-weighted glucose levels (127.7 [105.5-147.6] vs 108.0 [97.1-122.2] mg/dl; P < .001) and more had an average inpatient glucose >150?mg/dl (20.4 vs 9.1%; P = .028). There was no difference in rates of hypoglycemia (glucose <70?mg/dl) or glycemic variability. Prediabetics had lower survival rates (92.6 vs 98.7%; P = .041), but similar rates of unplanned readmission (1.9 vs 3.9%; P = .68), intensive care unit admission (29.6 vs 23.4%; P = .36), mechanical ventilation (24.1 vs 16.2%; P = .20), length of hospital stay (4 [2-8] vs 3 [2-11]; P = .71), and infection (11.1 vs 11.7%; P = .99). Prediabetic status has a significant impact on glucose control and mortality after burn injury. PMID:24043230

  6. Study of the effect of vitamin D supplementation on glycemic control in type 2 diabetic prevalent hemodialysis patients.

    PubMed

    Ibrahim, Mohamed A; Sarhan, Iman I; Halawa, Mohamed R; Afify, Essam N; Hebah, Hayam A; Al-Gohary, Eman A; El-Shazly, Islam O

    2015-10-01

    Vitamin D is claimed to have an adjuvant effect on glycemic control by dual action on pancreatic ?-cells and insulin resistance. The aim of this study was to assess the possible effect of short-term alfacalcidol supply on glycemic control in type 2 diabetic hemodialysis (HD) patients. Twenty type 2 diabetic HD patients (using diet and oral drugs but not insulin) were randomly selected from our dialysis unit as well as 20 non-diabetic HD patients as control. A third group of 12 healthy subjects were studied as well. All three groups were similar in age, sex, and body mass index. Oral alfacalcidol therapy was administrated daily as recommended by Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines for 12 weeks guided by monthly serum phosphorus and Cax PO4 product. Corrected total calcium, phosphorus, intact parathyroid hormone, 25-hydroxy vitamin D (25[OH]D), and glucoparameters (fasting blood glucose, glycated hemoglobin [HbA1c%], insulin resistance by homeostatic model assessment, and ?-cell function by HOMA-?%) were measured under basal conditions and after 3 months of therapy. 25(OH)D was non-significantly lower in diabetic than non-diabetic HD patients, but significantly lower than healthy subjects at the start of the study. However, vitamin D level increased significantly after 3 months of trial, although the levels did not reach normal values. This vitamin D rise was associated with highly significant improvement in concentrations of fasting blood sugar (FBS), fasting insulin, HbA1c%, and HOMA-?-cell function in diabetic and non-diabetic controls. However, there was a significant rise in insulin resistance after treatment. The percentage of change was evident more in diabetics regarding FBS and 25(OH)D concentration. Adjustment of 25(OH)D level in type 2 diabetic prevalent HD patients may improve, at least with short-term therapy, glycemic control mainly through improving ?-cell function. PMID:26448381

  7. 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...

  8. Dyadic measures of the parent-child relationship during the transition to adolescence and glycemic control in children with type 1 diabetes.

    PubMed

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

    2009-06-01

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

  9. Enhanced Fitness: A Randomized Controlled Trial of the Effects of Home-Based Physical Activity Counseling on Glycemic Control in Older Adults with Prediabetes

    PubMed Central

    Morey, Miriam C.; Pieper, Carl F.; Edelman, David E.; Yancy, William S.; Green, Jennifer B.; Lum, Helen; Peterson, Matthew J.; Sloane, Richard; Cowper, Patricia A.; Bosworth, Hayden B.; Huffman, Kim M.; Cavanaugh, James T.; Hall, Katherine S.; Pearson, Megan P.; Taylor, Gregory A.

    2012-01-01

    Background/Objective To determine whether a home-based multi-component physical activity counseling (PAC) intervention is effective in reducing glycemic measures in older prediabetic outpatients. Design, Setting, and Participants Controlled clinical trial of 302 overweight (body mass index 25–45 kg/m2), older (ages 60–89) outpatients with impaired glucose tolerance (fasting blood glucose 100–125 mg/dL, HbA1c <7%), randomly assigned to a PAC intervention group (n=180), compared to a Usual Care (UC) control group (n=122) and recruited through primary care clinics of the Durham VA Medical Center between September 29, 2008 and March 25, 2010. Intervention A 12 month, home-based multi-component PAC program including one in-person baseline counseling session, regular telephone counseling, physician endorsement in clinic with monthly automated encouragement, and tailored mailed materials. All study participants, including UC, received a consult to a VA weight management program. Measurements The primary outcome was HOMA-IR, calculated from fasting insulin and glucose levels at baseline, 3 and 12 months. Hemoglobin A1C was the secondary indicator of glycemic control. Other secondary outcomes included anthropometric measures, and self-reported physical activity, health-related quality of life, and physical function. Results There were no significant differences between the PAC or Usual Care groups over time for any of the glycemic indicators. Both groups had small declines over time of approximately 6% in fasting blood glucose, p< 0.001, while other glycemic indicators remained stable. The declines in glucose were not sufficient to affect the change in HOMA-IR scores due to fluctuations in insulin over time. Endurance physical activity increased significantly in PAC group, P<0.001 compared to UC. Conclusion Home-based telephone counseling increased physical activity levels but was insufficient for improving glycemic indicators among older prediabetic outpatients. PMID:22985140

  10. 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

  11. 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

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

    PubMed

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

    2014-04-01

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

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

    PubMed Central

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

    2015-01-01

    Background: To study cytological alterations in the exfoliated buccal cells of diabetic patients. To analyze the cytomorphometric findings in the smears of uncontrolled and controlled diabetic patients and compare it with that of normal healthy controls. To establish a correlation between cytomorphometric changes and glycosylated hemoglobin (HbA1c) in diabetics and normal controls, for evaluation of glycemic control. Materials and Methods: The study was carried out in 40 confirmed diabetic patients from a hospital out-patient diabetic ward and 20 healthy individuals as controls (Group A: n = 20), in Chennai. Specific exclusion criteria were used to select the study group from a larger group of subjects. Based on HbA1c values, the diabetic patients were categorized into Group B = Controlled diabetics (n = 20) (HbA1c <7%) and Group C = Uncontrolled diabetics (n = 20) (HbA1c >9%). After informed consent, buccal smear was collected from clinically normal appearing mucosa and stained with papanicoloau (PAP) stain. Cytomorphometric analysis of selective PAP stained cells was done using image analysis software, Image Pro Plus 5.5 (Olympus) and parameters determined were average cytoplasmic area (CA), average nuclear area (NA) and cytoplasmic:nuclear (C: N) ratio for an average of 50 cells/patient. Results: Comparing the average NA among three groups, an increase through Group A, B, C, with a maximum significance between Group C and A was seen. The average C: N ratio showed a statistically significant difference between all three groups. Significant correlation existed between the HbA1c values and both the C: N ratio and average NA in all the three groups. Conclusions: Cytomorphometric analysis of buccal smears using the C: N ratio alteration as a reliable criteria, may serve as yet another non-invasive tool for screening programs for diabetic detection. And the technique may possibly be used also for evaluation of glycemic control in known diabetics. PMID:25859101

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

    PubMed Central

    Tura, Andrea; Farngren, Johan; Schweizer, Anja; Foley, James E.; Pacini, Giovanni; Ahrén, Bo

    2015-01-01

    The study explored the utility of four-point preprandial glucose self-monitoring to calculate several indices of glycemic control and variability in a study adding the DPP-4 inhibitor vildagliptin to ongoing insulin therapy. This analysis utilized data from a double-blind, randomized, placebo-controlled crossover study in 29 patients with type 2 diabetes treated with vildagliptin or placebo on top of stable insulin dose. During two 4-week treatment periods, self-monitoring of plasma glucose was undertaken at 4 occasions every day. Glucose values were used to assess several indices of glycemic control quality, such as glucose mean, GRADE, M-VALUE, hypoglycemia and hyperglycemia index, and indices of glycemic variability, such as standard deviation, CONGA, J-INDEX, and MAGE. We found that vildagliptin improved the glycemic condition compared to placebo: mean glycemic levels, and both GRADE and M-VALUE, were reduced by vildagliptin (P < 0.01). Indices also showed that vildagliptin reduced glycemia without increasing the risk for hypoglycemia. Almost all indices of glycemic variability showed an improvement of the glycemic condition with vildagliptin (P < 0.02), though more marked differences were shown by the more complex indices. In conclusion, the study shows that four-sample preprandial glucose self-monitoring is sufficient to yield information on the vildagliptin effects on glycemic control and variability. PMID:26587020

  15. Study of Auditory, Visual Reaction Time and Glycemic Control (HBA1C) in Chronic Type II Diabetes Mellitus

    PubMed Central

    Sembian, Umapathy; Babitha; N, Ethiya; K, Muthuselvi

    2014-01-01

    Background: Diabetes mellitus is a disease of insulin deficiencyleads to micro and macro vascular disorder. Neuropathy is one of the major complication of chronic uncontrolled Diabetes affecting the Reaction time. Objectives: To study the correlation between the glycosylated HbA1C and Auditory, visual Reaction time in chronic Type II diabetes (40-60y) of on oral hypoglycemic drugs of>10 y duration in two groups (n-100 in each group , both Males & females) and compared within the study groups and also with the age matched control group (100). Materials and Methods: HbA1C–Glycosylated HbA1C was measured by Particle enhanced immunoturbidimetric test method. Auditory and visual reaction time (ART, VRT) were measured by PC 1000 Reaction timer for control & study groups i.e. Group-I – Chronic Type II DM for >10 y with HbA1c < 7.0, and Group II - chronic Type-IIDM for >10 y with HbA1c > 7.0 ie impaired glycemic control. Exclusion Criteria- Subjects with Auditory and visual disturbances, alcoholism and smoking. Statistical Analysis – One-way ANOVA. Using SPSS 21 software. Result: Both the groups had prolonged ART and VRT than controls. Among the study group, G-II (DM with HbA1C >7) had increased Auditory & Visual Reaction time than Group I which is statistically significant p-value <0.05. Conclusion: Impairment of sensory motor function of peripheral nervous system is more in chronic diabetic with less glycemic control ie., HbA1C>7 who have shown increased Auditory and Visual Reaction time than chronic DM with HbA1C<7.Severity of Peripheral neuropathy in Type II Diabetics could be due to elevated HbA1C. PMID:25386423

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  17. Effects of exercise on glycemic control in type 2 diabetes mellitus in Koreans: the fifth Korea National Health and Nutrition Examination Survey (KNHANES V).

    PubMed

    Park, Ji-Hye; Lee, Young-Eun

    2015-11-01

    [Purpose] The aim of this study was to investigate the effect of exercise on glycemic control using data from fifth Korea National Health and Nutrition Examination Survey and to provide appropriate exercise guidelines for patients with type 2 diabetes mellitus in Korea. [Subjects and Methods] We selected 1,328 patients from the fifth Korea National Health and Nutrition Examination Survey database who had type 2 diabetes and ranged in age from 30 to 90?years. Statistical analyses included ?(2) tests, multiple linear regression, and logistic regression. [Results] Factors found to be significantly related to glycemic control included income level, physical activity based on intensity of aerobic exercise, use of diabetes medicine, presence of hypertension, duration of diabetes, and waist circumference. In addition, engaging in combined low- and moderate-intensity aerobic exercise when adjusted for resistance exercise was found to lower the risk of glycemic control failure. [Conclusion] Patients with type 2 diabetes mellitus in Korea should engage in combined low- and moderate-intensity aerobic exercise such as walking for 30 minutes or more five times a week. Physical activity is likely to improve glycemic control and thus prevent the acute and chronic complications of diabetes mellitus. PMID:26696738

  18. Effects of exercise on glycemic control in type 2 diabetes mellitus in Koreans: the fifth Korea National Health and Nutrition Examination Survey (KNHANES V)

    PubMed Central

    Park, Ji-Hye; Lee, Young-Eun

    2015-01-01

    [Purpose] The aim of this study was to investigate the effect of exercise on glycemic control using data from fifth Korea National Health and Nutrition Examination Survey and to provide appropriate exercise guidelines for patients with type 2 diabetes mellitus in Korea. [Subjects and Methods] We selected 1,328 patients from the fifth Korea National Health and Nutrition Examination Survey database who had type 2 diabetes and ranged in age from 30 to 90?years. Statistical analyses included ?2 tests, multiple linear regression, and logistic regression. [Results] Factors found to be significantly related to glycemic control included income level, physical activity based on intensity of aerobic exercise, use of diabetes medicine, presence of hypertension, duration of diabetes, and waist circumference. In addition, engaging in combined low- and moderate-intensity aerobic exercise when adjusted for resistance exercise was found to lower the risk of glycemic control failure. [Conclusion] Patients with type 2 diabetes mellitus in Korea should engage in combined low- and moderate-intensity aerobic exercise such as walking for 30 minutes or more five times a week. Physical activity is likely to improve glycemic control and thus prevent the acute and chronic complications of diabetes mellitus. PMID:26696738

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

    PubMed Central

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

    2013-01-01

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

  20. Successful implementation of a perioperative glycemic control protocol in cardiac surgery: barrier analysis and intervention using lean six sigma.

    PubMed

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

    2011-01-01

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

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

    PubMed Central

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

    2011-01-01

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

  2. Dual Endothelin Receptor Antagonism with Bosentan Reverses Established Vascular Remodeling and Dysfunctional Angiogenesis in Diabetic Rats: Relevance to Glycemic Control

    PubMed Central

    Abdelsaid, Mohammed; Kaczmarek, Jessica; Coucha, Maha; Ergul, Adviye

    2014-01-01

    Aims We have shown that diabetes causes cerebrovascular remodeling in part by the activation of the endothelin (ET-1) system in a glucose-dependent manner. We also reported increased yet dysfuctional cerebral angiogenesis in diabetes. Here, we tested the hypothesis that dual ET-1 receptor antagonism or glycemic control can reverse already established diabetes-induced vascular remodeling and neovascularization. Main Methods 18-week non-obese type-2 diabetic Goto-Kakizaki (GK) were treated with vehicle, metformin (300 mg/kg/day) or bosentan (100 mg/kg/day) for 4 weeks by oral gavage and compared to 10 and 18-weeks GK rats. Isolated middle cerebral artery (MCA) lumen diameter (LD), media thickness (MT), media:lumen (M:L) ratio, cross-sectional area (CSA) were measured using pressurized arteriograph. Assessment of remodeling and angiogenesis in the brain parenchyma was achieved by three-dimensional reconstruction of fluorescently labeled images of the vasculature acquired by confocal microscopy, and measurement of neovascularization indices including vascular volume and surface area, branch density and tortuosity. Key Findings MCA remodeling (increased M:L ratio and CSA, but decreased LD) occurred by 18 weeks and did not progress by 22 weeks in diabetic GK rats. Metformin and bosentan partially corrected large artery remodeling. Both treatments significantly reduced all indices of neovascularization compared to untreated diabetic rats. Significance Glycemic control or ET-1 antagonism can partially reverse diabetes-induced cerebrovascular remodeling and neovascularization. These results strongly suggest that either approach offers a therapeutic benefit and combination treatments need to be tested. PMID:24447630

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

    PubMed

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

    2014-01-01

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

  4. Effect of Replacing Animal Protein with Plant Protein on Glycemic Control in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Viguiliouk, Effie; Stewart, Sarah E.; Jayalath, Viranda H.; Ng, Alena Praneet; Mirrahimi, Arash; de Souza, Russell J.; Hanley, Anthony J.; Bazinet, Richard P.; Blanco Mejia, Sonia; Leiter, Lawrence A.; Josse, Robert G.; Kendall, Cyril W.C.; Jenkins, David J.A.; Sievenpiper, John L.

    2015-01-01

    Previous research on the effect of replacing sources of animal protein with plant protein on glycemic control has been inconsistent. We therefore conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effect of this replacement on glycemic control in individuals with diabetes. We searched MEDLINE, EMBASE, and Cochrane databases through 26 August 2015. We included RCTs ? 3-weeks comparing the effect of replacing animal with plant protein on HbA1c, fasting glucose (FG), and fasting insulin (FI). Two independent reviewers extracted relevant data, assessed study quality and risk of bias. Data were pooled by the generic inverse variance method and expressed as mean differences (MD) with 95% confidence intervals (CIs). Heterogeneity was assessed (Cochran Q-statistic) and quantified (I2-statistic). Thirteen RCTs (n = 280) met the eligibility criteria. Diets emphasizing a replacement of animal with plant protein at a median level of ~35% of total protein per day significantly lowered HbA1c (MD = ?0.15%; 95%-CI: ?0.26, ?0.05%), FG (MD = ?0.53 mmol/L; 95%-CI: ?0.92, ?0.13 mmol/L) and FI (MD = ?10.09 pmol/L; 95%-CI: ?17.31, ?2.86 pmol/L) compared with control arms. Overall, the results indicate that replacing sources of animal with plant protein leads to modest improvements in glycemic control in individuals with diabetes. Owing to uncertainties in our analyses there is a need for larger, longer, higher quality trials. Trial Registration: ClinicalTrials.gov registration number: NCT02037321. PMID:26633472

  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. Glycemic Index and Diabetes

    MedlinePLUS

    ... A A Listen En Español Glycemic Index and Diabetes The glycemic index, or GI, measures how a ... book-power-of-food-sticky.html More from diabetes.org Learn More: Special Book Promotion: Behind the ...

  7. Glycemic Control among Patients with Type 2 Diabetes Mellitus in Countries of Arabic Gulf

    PubMed Central

    Al-Rasheedi, Ahmad Ali

    2015-01-01

    Type 2 diabetes mellitus is a growing, worldwide public health concern. The countries of Arabic Gulf appear to have a higher prevalence of diabetes than the global average. The recent and rapid socio-economic development of these countries has been associated with this rising prevalence. Although the rate of type 2 diabetes management based on glycosylated hemoglobin level in the countries of Arabic Gulf is labeled as poor, the outcomes are almost similar to those reported from elsewhere. Unfortunately, overweight and obesity are driving the global diabetes epidemic. A minority of patients with type 2 diabetes had a normal body weight which might make the control of diabetes difficult. Anyhow, Greater efforts are urgently needed to properly manage diabetes early in order to prevent short and long-term complications. Practical strategies aimed at more effective management of type 2 diabetes patients are strongly needed. PMID:26609299

  8. 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

  9. Diabetes Care, Glycemic Control, Complications, and Concomitant Autoimmune Diseases in Children with Type 1 Diabetes in Turkey: A Multicenter Study

    PubMed Central

    ?im?ek, Damla Gök?en; Aycan, Zehra; Özen, Samim; Çetinkaya, Semra; Kara, Cengiz; Abal?, Sayg?n; Demir, Korcan; Tunç, Özgül; Uçaktürk, Ahmet; Asar, Gülgün; Ba?, Firdevs; Çetinkaya, Ergun; Ayd?n, Murat; Karagüzel, Gülay; Orbak, Zerrin; Orbak, Zerrin; ??klar, Zeynep; Alt?nc?k, Ayça; Ökten, Ay?enur; Özkan, Behzat; Öçal, Gönül; Semiz, Serap; Arslano?lu, ?lknur; Evliyao?lu, Olcay; Bundak, Rüveyde; Darcan, ?ükran

    2013-01-01

    Objective: Epidemiologic and clinical features of type 1 diabetes mellitus (T1DM) may show substantial differences among countries. The primary goal in the management of T1DM is to prevent micro- and macrovascular complications by achieving good glycemic control. The present study aimed to assess metabolic control, presence of concomitant autoimmune diseases, and of acute and long-term complications in patients diagnosed with T1DM during childhood and adolescence. The study also aimed to be a first step in the development of a national registry system for T1DM, in Turkey. Methods: Based on hospital records, this cross-sectional, multicenter study included 1 032 patients with T1DM from 12 different centers in Turkey, in whom the diagnosis was established during childhood. Epidemiological and clinical characteristics of the patients were recorded. Metabolic control, diabetes care, complications, and concomitant autoimmune diseases were evaluated. Results: Mean age, diabetes duration, and hemoglobin A1c level were 12.5±4.1 years, 4.7±3.2 years, and 8.5±1.6%, respectively. Acute complications noted in the past year included ketoacidosis in 5.2% of the patients and severe hypoglycemia in 4.9%. Chronic lymphocytic thyroiditis was noted in 12%, Graves’ disease in 0.1%, and celiac disease in 4.3% of the patients. Chronic complications including neuropathy, retinopathy, and persistent microalbuminuria were present in 2.6%, 1.4%, and 5.4% of the patients, respectively. Diabetic nephropathy was not present in any of the patients. Mean diabetes duration and age of patients with neuropathy, retinopathy and microalbuminuria were significantly different from the patients without these long-term complications (p<0.01). A significant difference was found between pubertal and prepubertal children in terms of persistent microalbuminuria and neuropathy (p=0.02 and p<0.001, respectively). Of the patients, 4.4% (n:38) were obese and 5% had short stature; 17.4% of the patients had dyslipidemia, and 14% of the dyslipidemic patients were obese. Conclusions: Although the majority of the patients in the present study were using insulin analogues, poor glycemic control was common, and chronic complications were encountered. Conflict of interest:None declared. PMID:23419424

  10. Correlation Between Glycemic Control and the Incidence of Peritoneal and Catheter Tunnel and Exit-Site Infections in Diabetic Patients Undergoing Peritoneal Dialysis

    PubMed Central

    Rodríguez-Carmona, Ana; Pérez-Fontán, Miguel; López-Muñiz, Andrés; Ferreiro-Hermida, Tamara; García-Falcón, Teresa

    2014-01-01

    ? Background: Diabetes mellitus, especially if complicated by poor glycemic control, portends an increased risk of infection. The significance of this association in the case of diabetic patients undergoing peritoneal dialysis (PD) has not been assessed. ? Methods: Using a retrospective observational design, we analyzed the association between glycemic control at the start of PD (estimated from glycosylated hemoglobin levels) and the risk of peritoneal and catheter tunnel and exit-site infections during follow-up in 183 incident patients on PD. We used the median value of glycosylated hemoglobin to classify patients into good (group A) or poor (group B) glycemic control groups. We applied multivariate strategies of analysis to control for other potential predictors of PD-related infection. ? Results: Groups A and B differed significantly in age, dialysis vintage, use of insulin, and rate of Staphylococcus aureus carriage. Neither the incidence (0.60 episodes in group A vs 0.56 episodes in group B per patient-year) nor the time to a first peritoneal infection (median: 42 months vs 38 months) differed significantly between the study groups. In contrast, group B had a significantly higher incidence of catheter tunnel and exit-site infections (0.23 episodes vs 0.12 episodes per patient-year) and shorter time to a first infection episode (64 months vs 76 months, p = 0.004). The difference persisted in multivariate analysis (adjusted hazard ratio: 2.65; 95% confidence interval: 1.13 to 6.05; p = 0.013). We observed no differences between the study groups in the spectrum of causative organisms or in the outcomes of PD-related infections. ? Conclusions: Poor glycemic control is a consistent predictor of subsequent risk of catheter tunnel and exit-site infection, but not of peritoneal infection, among diabetic patients starting PD therapy. PMID:23818005

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

    PubMed Central

    2010-01-01

    Background Reductions in postprandial glycemia have been demonstrated previously with the addition of the novel viscous polysaccharide (NVP), PolyGlycopleX® (PGX®), to an OGTT or white bread. This study explores whether these reductions are sustained when NVP is added to a range of commonly consumed foods or incorporated into a breakfast cereal. Methods Ten healthy subjects (4M, 6F; age 37.3 ± 3.6 y; BMI 23.8 ± 1.3 kg/m2), participated in an acute, randomized controlled trial. The glycemic response to cornflakes, rice, yogurt, and a frozen dinner with and without 5 g of NVP sprinkled onto the food was determined. In addition, 3 granolas with different levels of NVP and 3 control white breads and one white bread and milk were also consumed. All meals contained 50 g of available carbohydrate. Capillary blood samples were taken fasting and at 15, 30, 45, 60, 90 and 120 min after the start of the meal. The glycemic index (GI) and the glycemic reduction index potential (GRIP) were calculated. The blood glucose concentrations at each time and the iAUC values were subjected to repeated-measures analysis of variance (ANOVA) examining for the effect of test meal. After demonstration of significant heterogeneity, differences between individual means was assessed using GLM ANOVA with Tukey test to adjust for multiple comparisons. Results Addition of NVP reduced blood glucose response irrespective of food or dose (p < 0.01). The GI of cornflakes, cornflakes+NVP, rice, rice+NVP, yogurt, yogurt+NVP, turkey dinner, and turkey dinner+NVP were 83 ± 8, 58 ± 7, 82 ± 8, 45 ± 4, 44 ± 4, 38 ± 3, 55 ± 5 and 41 ± 4, respectively. The GI of the control granola, and granolas with 2.5 and 5 g of NVP were 64 ± 6, 33 ± 5, and 22 ± 3 respectively. GRIP was 6.8 ± 0.9 units per/g of NVP. Conclusion Sprinkling or incorporation of NVP into a variety of different foods is highly effective in reducing postprandial glycemia and lowering the GI of a food. Clinical Trial registration NCT00935350. PMID:21092221

  12. Impact of Intensive Glycemic Control on the Incidence of Atrial Fibrillation and Associated Cardiovascular Outcomes in Patients with Type 2 Diabetes Mellitus (from the ACCORD Study)

    PubMed Central

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

    2014-01-01

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

  13. Non-High-Density Lipoprotein Cholesterol in Children with Diabetes: Proposed Treatment Recommendations Based on Glycemic Control, Body Mass Index, Age, Sex, and Generally Accepted Cut Points.

    PubMed

    Schwab, K Otfried; Doerfer, Jürgen; Hungele, Andreas; Scheuing, Nicole; Krebs, Andreas; Dost, Axel; Rohrer, Tilman R; Hofer, Sabine; Holl, Reinhard W

    2015-12-01

    Percentile-based non-high-density lipoprotein cholesterol levels were analyzed by glycemic control, weight, age, and sex of children with type 1 diabetes (n = 26?358). Ten percent of all children and 25% of overweight adolescent girls require both immediate lipid-lowering medication and lifestyle changes to achieve non-high-density lipoprotein cholesterol levels <120 mg/dL and cardiovascular risk reduction. PMID:26427965

  14. Are differences between patient and provider explanatory models of diabetes associated with patient self-management and glycemic control?

    PubMed

    Weller, Susan C; Baer, Roberta D; de Alba Garcia, Javier Garcia; Salcedo Rocha, Ana L

    2013-11-01

    In this study we test whether differences between patient and provider explanatory models of diabetes affect self-management and glucose control in type 2 diabetes patients. Diabetic patients (n=60) and family practice physicians (n=39) in Guadalajara, Mexico, responded to a structured explanatory model interview (130 questions on causes, symptoms, and treatments). A cultural consensus analysis indicated a widely shared model among physicians and provided a single shared set of answers to the questions. Patient-provider congruence in beliefs was assessed by comparing each patient's responses with the physician answer set. Congruence in beliefs predicted self-management behaviors (r=0.27, p=.03), more than educational level (r=0.16, p=.23), but was not predictive of A1C (r=0.12, p=.40). Differences between patient and physician explanatory models can adversely affect patient-directed activities and may indirectly affect glycemic control by affecting self-management. These differences may be due to low patient educational level and resulting problems in understanding biomedical approaches to diabetes. PMID:24185147

  15. Effects of Encapsulated Propolis on Blood Glycemic Control, Lipid Metabolism, and Insulin Resistance in Type 2 Diabetes Mellitus Rats

    PubMed Central

    Li, Yajing; Chen, Minli; Xuan, Hongzhuan; Hu, Fuliang

    2012-01-01

    The present study investigates the encapsulated propolis on blood glycemic control, lipid metabolism, and insulin resistance in type 2 diabetes mellitus (T2DM) rats. The animal characteristics and biological assays of body weight, fasting blood glucose (FBG), fasting serum insulin (FINS), insulin act index (IAI), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured and euglycemic hyperinsulinemic glucose clamp technique were used to determine these effects. Our findings show that oral administration of encapsulated propolis can significantly inhibit the increasing of FBG and TG in T2DM rats and can improve IAI and M value in euglycemic hyperinsulinemic clamp experiment. There was no significant effects on body weight, TC, HDL-C, and LDL-C in T2DM rats treated with encapsulated propolis. In conclusion, the results indicate that encapsulated propolis can control blood glucose, modulate lipid metabolism, and improve the insulin sensitivity in T2DM rats. PMID:21716678

  16. A Pilot Food Bank Intervention Featuring Diabetes-Appropriate Food Improved Glycemic Control Among Clients In Three States.

    PubMed

    Seligman, Hilary K; Lyles, Courtney; Marshall, Michelle B; Prendergast, Kimberly; Smith, Morgan C; Headings, Amy; Bradshaw, Georgiana; Rosenmoss, Sophie; Waxman, Elaine

    2015-11-01

    Food insecurity-defined as not having adequate quantity and quality of food at all times for all household members to have an active, healthy life-is a risk factor for poor diabetes control, yet few diabetes interventions address this important factor. Food pantries, which receive food from food banks and distribute it to clients in need, may be ideal sites for diabetes self-management support because they can provide free diabetes-appropriate food to people in low-income communities. Between February 2012 and March 2014, we enrolled 687 food pantry clients with diabetes in three states in a six-month pilot intervention that provided them with diabetes-appropriate food, blood sugar monitoring, primary care referral, and self-management support. Improvements were seen in pre-post analyses of glycemic control (hemoglobin A1c decreased from 8.11 percent to 7.96 percent), fruit and vegetable intake (which increased from 2.8 to 3.1 servings per day), self-efficacy, and medication adherence. Among participants with elevated HbA1c (at least 7.5 percent) at baseline, HbA1c improved from 9.52 percent to 9.04 percent. Although food pantries are nontraditional settings for diabetes support, this pilot study suggests a promising health promotion model for vulnerable populations. Policies supporting such interventions may be particularly effective because of food pantries' food access and distribution capacity. PMID:26526255

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  20. 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

  1. 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

  2. Effect of low glycemic load diet with and without wheat bran on glucose control in gestational diabetes mellitus: A randomized trial

    PubMed Central

    Afaghi, Ahmad; Ghanei, Laleh; Ziaee, Amir

    2013-01-01

    Background: A low-glycemic index diet is effective in blood glucose control of diabetic subjects, reduces insulin requirement in women with gestation diabetes mellitus (GDM) and improves pregnancy outcomes when used from beginning of the second trimester. However there are limited reports to examine the effect of low glycemic load (LGL) diet and fiber on blood glucose control and insulin requirement of women with GDM. Therefore, the aim of this study was to examine the effect of low glycemic load diet with and without fiber on reducing the number of women with GDM requiring insulin. Materials and Methods: All GDM women (n = 31) were randomly allocated to consume either a LGL diet with Fiber or LGL diet. Results: We found that 7 (38.9%) of 18 women with GDM in Fiber group and 10 (76.9%) in “Without Fiber” group required insulin treatment. Conclusion: The LGL diet with added fiber for women with GDM dramatically reduced the number needing for insulin treatment. PMID:23961487

  3. 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

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

    PubMed Central

    Banerji, Mary Ann; Dunn, Jeffrey D.

    2013-01-01

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

  5. Rapid Improvement of Glycemic Control in Type 2 Diabetes Using Weekly Intensive Multifactorial Interventions: Structured Glucose Monitoring, Patient Education, and Adjustment of Therapy—A Randomized Controlled Trial

    PubMed Central

    Rodbard, David; Zanella, Maria Teresa

    2011-01-01

    Abstract Background We evaluated intensive intervention in poorly controlled patients with type 2 diabetes mellitus involving weekly clinic visits and adjustment of therapy with analysis of three seven-point glucose profiles and intervention from an interdisciplinary staff. Methods Sixty-three patients were randomized to an intensive treatment group that obtained self-monitoring of blood glucose (SMBG) profiles (six or seven values per day, 3 days/week) and were seen in the clinic at Weeks 1–6 and 12. SMBG results were downloaded, analyzed using Accu-Chek® 360° software (Roche Diagnostics, Indianapolis, IN), and used to adjust therapy. Control group subjects obtained glucose profiles and had clinic visits only at Weeks 0, 6, and 12. Results There were highly statistically significant improvements in the intensive treatment group compared with the control group between Weeks 0 and 6 with greater reductions in weekly mean glycemia (WMG) (?76.7±8.9?mg/dL vs. ?20.5±8.1?mg/dL), glycemic variability (SD) (?16.3±3.1?mg/dL vs. ?5.0±3.1?mg/dL), and glycated hemoglobin (?1.82±0.16% vs. ?0.66±0.22%) without significant changes in frequency of hypoglycemia or weight. Improvements were sustained in the intensive treatment group through Week 12. A minimal but statistically significant degree of improvement was seen in the control group at Week 12. Conclusions This short-term pilot study of an intensive monitoring, educational, and pharmacological interventions program resulted in dramatic improvement of glycemic control within 6 weeks, and these effects are sustained through Week 12. SMBG glucose profiles, calculation of WMG and SD, and graphical displays of glucose data can improve the effectiveness of adjustment of therapy at weekly clinic visits when combined with intensive support from a multidisciplinary team. PMID:21751888

  6. Physiological modeling, tight glycemic control, and the ICU clinician: what are models and how can they affect practice?

    PubMed

    Chase, J Geoffrey; Le Compte, Aaron J; Preiser, J-C; Shaw, Geoffrey M; Penning, Sophie; Desaive, Thomas

    2011-01-01

    Critically ill patients are highly variable in their response to care and treatment. This variability and the search for improved outcomes have led to a significant increase in the use of protocolized care to reduce variability in care. However, protocolized care does not address the variability of outcome due to inter- and intra-patient variability, both in physiological state, and the response to disease and treatment. This lack of patient-specificity defines the opportunity for patient-specific approaches to diagnosis, care, and patient management, which are complementary to, and fit within, protocolized approaches.Computational models of human physiology offer the potential, with clinical data, to create patient-specific models that capture a patient's physiological status. Such models can provide new insights into patient condition by turning a series of sometimes confusing clinical data into a clear physiological picture. More directly, they can track patient-specific conditions and thus provide new means of diagnosis and opportunities for optimising therapy.This article presents the concept of model-based therapeutics, the use of computational models in clinical medicine and critical care in specific, as well as its potential clinical advantages, in a format designed for the clinical perspective. The review is presented in terms of a series of questions and answers. These aspects directly address questions concerning what makes a model, how it is made patient-specific, what it can be used for, its limitations and, importantly, what constitutes sufficient validation.To provide a concrete foundation, the concepts are presented broadly, but the details are given in terms of a specific case example. Specifically, tight glycemic control (TGC) is an area where inter- and intra-patient variability can dominate the quality of care control and care received from any given protocol. The overall review clearly shows the concept and significant clinical potential of using computational models in critical care medicine. PMID:21906337

  7. Hydrogen improves glycemic control in type1 diabetic animal model by promoting glucose uptake into skeletal muscle.

    PubMed

    Amitani, Haruka; Asakawa, Akihiro; Cheng, Kaichun; Amitani, Marie; Kaimoto, Kaori; Nakano, Masako; Ushikai, Miharu; Li, Yingxiao; Tsai, Minglun; Li, Jiang-Bo; Terashi, Mutsumi; Chaolu, Huhe; Kamimura, Ryozo; Inui, Akio

    2013-01-01

    Hydrogen (H(2)) acts as a therapeutic antioxidant. However, there are few reports on H(2) function in other capacities in diabetes mellitus (DM). Therefore, in this study, we investigated the role of H(2) in glucose transport by studying cultured mouse C2C12 cells and human hepatoma Hep-G2 cells in vitro, in addition to three types of diabetic mice [Streptozotocin (STZ)-induced type 1 diabetic mice, high-fat diet-induced type 2 diabetic mice, and genetically diabetic db/db mice] in vivo. The results show that H(2) promoted 2-[(14)C]-deoxy-d-glucose (2-DG) uptake into C2C12 cells via the translocation of glucose transporter Glut4 through activation of phosphatidylinositol-3-OH kinase (PI3K), protein kinase C (PKC), and AMP-activated protein kinase (AMPK), although it did not stimulate the translocation of Glut2 in Hep G2 cells. H(2) significantly increased skeletal muscle membrane Glut4 expression and markedly improved glycemic control in STZ-induced type 1 diabetic mice after chronic intraperitoneal (i.p.) and oral (p.o.) administration. However, long-term p.o. administration of H(2) had least effect on the obese and non-insulin-dependent type 2 diabetes mouse models. Our study demonstrates that H(2) exerts metabolic effects similar to those of insulin and may be a novel therapeutic alternative to insulin in type 1 diabetes mellitus that can be administered orally. PMID:23326534

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

    PubMed

    Lee, Sung Soo; Kang, Sunghwun

    2015-06-01

    [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

  9. Eight Weeks of Cosmos caudatus (Ulam Raja) Supplementation Improves Glycemic Status in Patients with Type 2 Diabetes: A Randomized Controlled Trial

    PubMed Central

    Cheng, Shi-Hui; Ismail, Amin; Anthony, Joseph; Ng, Ooi Chuan; Hamid, Azizah Abdul; Barakatun-Nisak, Mohd Yusof

    2015-01-01

    Objectives. Optimizing glycemic control is crucial to prevent type 2 diabetes related complications. Cosmos caudatus is reported to have promising effect in improving plasma blood glucose in an animal model. However, its impact on human remains ambiguous. This study was carried out to evaluate the effectiveness of C. caudatus on glycemic status in patients with type 2 diabetes. Materials and Methods. In this randomized controlled trial with two-arm parallel-group design, a total of 101 subjects with type 2 diabetes were randomly allocated to diabetic-ulam or diabetic controls for eight weeks. Subjects in diabetic-ulam group consumed 15?g of C. caudatus daily for eight weeks while diabetic controls abstained from taking C. caudatus. Both groups received the standard lifestyle advice. Results. After 8 weeks of supplementation, C. caudatus significantly reduced serum insulin (?1.16 versus +3.91), reduced HOMA-IR (?1.09 versus +1.34), and increased QUICKI (+0.05 versus ?0.03) in diabetic-ulam group compared with the diabetic controls. HbA1C level was improved although it is not statistically significant (?0.76% versus ?0.37%). C. caudatus was safe to consume. Conclusions. C. caudatus supplementation significantly improves insulin resistance and insulin sensitivity in patients with type 2 diabetes. PMID:26713097

  10. 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

  11. Diabetes complications and glycemic control. The Pittsburgh Prospective Insulin-Dependent Diabetes Cohort Study Status Report after 5 yr of IDDM.

    PubMed

    D'Antonio, J A; Ellis, D; Doft, B H; Becker, D J; Drash, A L; Kuller, L H; Orchard, T J

    1989-01-01

    The relationship between glycemic control and complications of insulin-dependent diabetes mellitus (IDDM) remains controversial. With the use of glycosylated hemoglobin (HbA1) to assess glycemic control from diagnosis onward, the Pittsburgh Prospective Insulin-Dependent Diabetes Mellitus Cohort Study prospectively evaluated 80 new cases of IDDM diagnosed at Children's Hospital of Pittsburgh. This study presents findings in 62 patients at 5 yr postdiagnosis. Only 7 patients, all girls, had any retinopathy (microaneurysms). These subjects had an elevated 5-yr mean HbA1 compared to those with no retinopathy (13.0 vs. 11.7%; P less than .05). Six female subjects who had an elevated albumin excretion rate (AER; greater than or equal to 20 micrograms/min) had a higher 5-yr mean HbA1 (13.3%) than the 26 subjects with AER less than 20 micrograms/min (11.8%; P less than .05). Current HbA1 was correlated with AER (r = +.36, P less than .05) and systolic blood pressure (r = +.49, P less than .01) in females. However, these associations were not observed in males. Positive correlations were found between HbA1 (5-yr mean and current) and serum triglyceride and cholesterol, but only in females was HbA1 inversely related to high-density lipoprotein cholesterol. However, HbA1 was independent of sex, HLA-DR type, and urine C-peptide status. Age adjustment did not change the above results. These analyses suggest that glycemic control is related to AER, systolic blood pressure, presence of microaneurysms, and serum triglyceride and cholesterol concentrations during the first 5 yr of IDDM. However, these associations appear to be predominant in girls. PMID:2612304

  12. 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

  13. Inflammatory markers in gingival crevicular fluid of periodontitis patients with type 2 diabetes mellitus according to glycemic control: A pilot study

    PubMed Central

    Longo, Priscila Larcher; Artese, Hilana Paula Carilo; Horliana, Anna Carolina Ratto Tempestini; Gomes, Giovane Hisse; Romito, Giuseppe Alexandre; Dib, Sergio Atala; Mayer, Marcia Pinto Alves

    2015-01-01

    Background: Type 2 diabetes mellitus (T2DM) and periodontitis are inflammatory conditions with a bidirectional association. This pilot study aimed to evaluate whether T2DM and glycemic control interfere in inflammatory markers profiles in gingival crevicular fluid (GCF) in periodontitis patients. Materials and Methods: Fourteen diabetic periodontitis patients were enrolled in this study, seven with adequate glycemic control (glycated hemoglobin [HbA1c] <8.0%) (DMA + P) and seven with inadequate control (HbA1c ?8.0%) (DMI + P). Seven chronic periodontitis patients without diabetes formed the control group (P). GCF was obtained from diseased sites (probing depth >6 mm) of an entirely hemiarch, pooled and cytokines levels determined using multiplex beads immunoassay. Clinical periodontal parameters were analyzed by Mann-Whitney test and levels of cytokines by Kruskal-Wallis and Dunn's multiple comparison tests with confidence level of 95% (P < 0.05). Results: Cytokines profile of GCF obtained from deep periodontal pockets presented high levels of inflammatory cytokines, and there were no statistical differences between levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor-? according to presence of diabetes or percentage of HbA1c among the groups, despite groups with T2DM and periodontitis exhibit higher levels of PD. Conclusion: Within the limitations of this study, inflammatory mediators in GCF are dependent to the local response and do not correlate with the diabetic status. PMID:26604959

  14. The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1.

    PubMed

    Carneiro, Vera Lúcia; Fraiz, Fabian Calixto; Ferreira, Fernanda de Morais; Pintarelli, Tatiana Pegoretti; Oliveira, Ana Cristina Borges; Boguszewski, Margaret Cristina da Silva

    2015-12-01

    Objective To evaluate the influence of disease control, expressed by the mean values of glycated hemoglobin (HbA1c), in the oral health of children and adolescents with diabetes mellitus type 1 (T1DM). Subjects and methods A cross sectional study involving 87 children and adolescents (59 girls), 10 ± 2.6 years old. The participants were divided into three groups: HbA1c ? 8%, 8% < HbA1c ? 10% and HbA1c > 10%. The duration of the disease, age and average HbA1c were obtained from their medical records. Oral health was evaluated according to the following indexes: Simplified Oral Hygiene Index (OHI-S); Community Periodontal Index (CPI); Decayed, Missing or Filled Teeth Index (DMFT/dmft) for permanent and deciduous teeth; and the stimulated salivary flow rate (SSFR). Results The median SSFR was 1.1 mL/min in the group with HbA1c ? 8%, 0.7 mL/min in the intermediary group and 0.6 mL/min in the HbA1c > 10% group. A significant decrease in salivary flow was observed with an increase in HbA1c (p = 0.007). The DMFT/dmft and CPI indexes were higher in individuals with higher HbA1c values. More caries-free individuals were found in the group with HbA1c ? 8% compared to those with HbA1c > 10%. The group with HbA1c > 10% exhibited more caries and bleeding gums than the other groups. HbA1c values in girls were higher than in boys. Conclusion Children and adolescents with unsatisfactory glycemic control, represented by higher HbA1c concentrations, exhibited a higher frequency of caries and gingivitis, and a reduction in salivary flow. Arch Endocrinol Metab. 2015;59(6):535-40. PMID:26677088

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

    PubMed

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

    2015-02-15

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

  16. Cissus sicyoides: analysis of glycemic control in diabetic rats through biomarkers.

    PubMed

    Salgado, Jocelem Mastrodi; Mansi, Débora Niero; Gagliardi, Antonio

    2009-08-01

    Diabetes is a chronic degenerative disease with no cure, is found in millions of people worldwide, and can cause life-threatening complications at any age. The plant Cissus sicyoides L. is a runner plant found abundantly in Brazil, especially in the Amazon. Its therapeutic properties are widely used in popular medicine as a diuretic, anti-influenza, anti-inflammatory, anticonvulsion, and hypoglycemic agent. The objective of this study was to analyze the effects of aqueous extracts from the leaves and stem of C. sicyoides L., administered for 60 days, for the control of glycemia in alloxan (monohydrate)-induced diabetic rats, monitored by biomarkers. Data obtained in this study confirmed that C. sicyoides has a hypoglycemic effect on diabetic rats. Administration of its aqueous extracts promoted a 45% decrease in glucose levels after 60 days of administration. Furthermore, indices of hepatic glycogen, blood glucose, C-reactive peptide, and fructosamine were found to be efficient biomarkers to monitor diabetes in rats. PMID:19735170

  17. 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

  18. Polyphenols and Glycemic Control.

    PubMed

    Kim, Yoona; Keogh, Jennifer B; Clifton, Peter M

    2016-01-01

    Growing evidence from animal studies supports the anti-diabetic properties of some dietary polyphenols, suggesting that dietary polyphenols could be one dietary therapy for the prevention and management of Type 2 diabetes. This review aims to address the potential mechanisms of action of dietary polyphenols in the regulation of glucose homeostasis and insulin sensitivity based on in vitro and in vivo studies, and to provide a comprehensive overview of the anti-diabetic effects of commonly consumed dietary polyphenols including polyphenol-rich mixed diets, tea and coffee, chocolate and cocoa, cinnamon, grape, pomegranate, red wine, berries and olive oil, with a focus on human clinical trials. Dietary polyphenols may inhibit ?-amylase and ?-glucosidase, inhibit glucose absorption in the intestine by sodium-dependent glucose transporter 1 (SGLT1), stimulate insulin secretion and reduce hepatic glucose output. Polyphenols may also enhance insulin-dependent glucose uptake, activate 5' adenosine monophosphate-activated protein kinase (AMPK), modify the microbiome and have anti-inflammatory effects. However, human epidemiological and intervention studies have shown inconsistent results. Further intervention studies are essential to clarify the conflicting findings and confirm or refute the anti-diabetic effects of dietary polyphenols. PMID:26742071

  19. 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

  20. An analysis of "no effect of insulin pen with memory function on glycemic control in a patient cohort with poorly controlled type 1 diabetes: a randomized open-label study".

    PubMed

    Ampudia-Blasco, Francisco Javier

    2012-01-01

    Missing meal bolus and nonadherence is an important barrier to achieving glycemic goals in type 1 diabetes (T1DM). In this issue of Journal of Diabetes Science and Technology, Danne and coauthors reported the results of a 24-week randomized-controlled study designed to evaluate if using an insulin pen with memory function, the HumaPen® Memoir™, might improve injection compliance and, therefore, overall glycemic control in T1DM. Patients treated with the pen device with memory function improved, albeit nonsignificantly, their mean HbA1c by 0.43%. Among the reasons to justify why this study was not positive, the most important is the high proportion of adult patients included in the study (87.9%)-children and adolescents being under-represented. I am convinced that pen devices with memory function might be helpful for forgetful patients (children, adolescents), as suggested in another recent study. PMID:23294786

  1. LX4211, a Dual SGLT1/SGLT2 Inhibitor, Improved Glycemic Control in Patients With Type 2 Diabetes in a Randomized, Placebo-Controlled Trial

    PubMed Central

    Zambrowicz, B; Freiman, J; Brown, P M; Frazier, K S; Turnage, A; Bronner, J; Ruff, D; Shadoan, M; Banks, P; Mseeh, F; Rawlins, D B; Goodwin, N C; Mabon, R; Harrison, B A; Wilson, A; Sands, A; Powell, D R

    2012-01-01

    Thirty-six patients with type 2 diabetes mellitus (T2DM) were randomized 1:1:1 to receive a once-daily oral dose of placebo or 150 or 300 mg of the dual SGLT1/SGLT2 inhibitor LX4211 for 28 days. Relative to placebo, LX4211 enhanced urinary glucose excretion by inhibiting SGLT2-mediated renal glucose reabsorption; markedly and significantly improved multiple measures of glycemic control, including fasting plasma glucose, oral glucose tolerance, and HbA1c; and significantly lowered serum triglycerides. LX4211 also mediated trends for lower weight, lower blood pressure, and higher glucagon-like peptide-1 levels. In a follow-up single-dose study in 12 patients with T2DM, LX4211 (300 mg) significantly increased glucagon-like peptide-1 and peptide YY levels relative to pretreatment values, probably by delaying SGLT1-mediated intestinal glucose absorption. In both studies, LX4211 was well tolerated without evidence of increased gastrointestinal side effects. These data support further study of LX4211-mediated dual SGLT1/SGLT2 inhibition as a novel mechanism of action in the treatment of T2DM. PMID:22739142

  2. Glycemic control influences lung membrane diffusion and oxygen saturation in exercise-trained subjects with type 1 diabetes: alveolar-capillary membrane conductance in type 1 diabetes.

    PubMed

    Wheatley, Courtney M; Baldi, James C; Cassuto, Nicholas A; Foxx-Lupo, William T; Snyder, Eric M

    2011-03-01

    Lung diffusing capacity (DLCO) is influenced by alveolar-capillary membrane conductance (D (M)) and pulmonary capillary blood volume (V (C)), both of which can be impaired in sedentary type 1 diabetes mellitus (T1DM) subjects due to hyperglycemia. We sought to determine if T1DM, and glycemic control, affected DLNO, DLCO, D (M), V (C) and SaO(2) during maximal exercise in aerobically fit T1DM subjects. We recruited 12 T1DM subjects and 18 non-diabetic subjects measuring DLNO, DLCO, D (M), and V (C) along with SaO(2) and cardiac output (Q) at peak exercise. The T1DM subjects had significantly lower DLCO/Q and D (M)/Q with no difference in Q, DLNO, DLCO, D (M), or V (C) (DLCO/Q = 2.1 ± 0.4 vs. 1.7 ± 0.3, D (M)/Q = 2.8 ± 0.6 vs. 2.4 ± 0.5, non-diabetic and T1DM, p < 0.05). In addition, when considering all subjects there was a relationship between DLCO/Q and SaO(2) at peak exercise (r = 0.46, p = 0.01). Within the T1DM group, the optimal glycemic control group (HbA1c <7%, n = 6) had higher DLNO, DLCO, and D (M)/Q than the poor glycemic control subjects (HbA1c ? 7%, n = 6) at peak exercise (DLCO = 38.3 ± 8.0 vs. 28.5 ± 6.9 ml/min/mmHg, DLNO = 120.3 ± 24.3 vs. 89.1 ± 21.0 ml/min/mmHg, D (M)/Q = 3.8 ± 0.8 vs. 2.7 ± 0.2, optimal vs. poor control, p < 0.05). There was a negative correlation between HbA1c with DLCO, D (M) and D (M)/Q at peak exercise (DLCO: r = -0.70, p = 0.01; D (M): r = -0.70, p = 0.01; D (M)/Q: r = -0.68, p = 0.02). These results demonstrate that there is a reduction in lung diffusing capacity in aerobically fit athletes with T1DM at peak exercise, but suggests that maintaining near-normoglycemia potentially averts lung diffusion impairments. PMID:20936482

  3. 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

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

    PubMed Central

    Acharya, Anirudh Balakrishna; Thakur, Srinath; Muddapur, Mahadevayya Veerayya

    2015-01-01

    Aim: Chronic periodontal disease (CPD) and type 2 diabetes mellitus (T2DM) share common pathogenic pathways involving the cytokine network resulting in increased susceptibility to both diseases, leading to increased inflammatory destruction, insulin resistance, and poor glycemic control. Periodontal treatment may improve glycemic control. The aim of this study was to evaluate the effect of scaling and root planing (SRP) of T2DM patients with CPD on hyperglycemia and the levels of serum interleukin-10 (IL-10). Materials and Methods: Forty-five subjects were divided into three groups comprising 15 subjects each as Group 1 (healthy controls), Group 2 (CPD patients), and Group 3 (T2DM patients with CPD). Plaque index, gingival index (GI), probing pocket depths (PPD), clinical attachment loss (AL), bleeding on probing (BoP), random blood sugar, glycosylated hemoglobin (HbA1C), and serum IL-10 were measured at baseline; SRP was performed on Groups 2 and 3 and the selected parameters recorded again at 6 months. Results: Statistically significant (P < 0.05) differences were observed in the variables at baseline and 6 months after SRP between the three groups using one-way ANOVA. The paired samples t-test for PPD and AL in Group 3 was statistically significant. Group 3 revealed positive correlations between PPD and HbA1C, BoP and IL-10, respectively, at 6 months and a predictable association of HbA1C with PPD and GI, and IL-10 levels with BoP, respectively, at 6 months. Conclusion: Scaling and root planing is effective in reducing blood glucose levels in T2DM patient with pocket depths and effective in elevating systemic IL-10 levels in CPD patients and CPD patients with T2DM. PMID:26015670

  5. 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

  6. 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

  7. Impact of an education program on patient anxiety, depression, glycemic control, and adherence to self-care and medication in Type 2 diabetes

    PubMed Central

    Al Hayek, Ayman A.; Robert, Asirvatham A.; Al Dawish, Mohamed A.; Zamzami, Marwan M.; Sam, Asirvatham E.; Alzaid, Aus A.

    2013-01-01

    Background: Diabetes mellitus (DM) requires continuous medical care, patients’ self-management, education, and adherence to prescribed medication to reduce the risk of long-term complications. The aim of this study was to assess the benefits of an education program on diabetes, patient self-management, adherence to medication, anxiety, depression and glycemic control in type 2 diabetics in Saudi Arabia. Materials and Methods: This was a prospective study, conducted among 104 diabetic patients at a major tertiary hospital in Riyadh, Saudi Arabia, between May 2011 and October 2012. Education materials given to diabetic patients included pamphlets/handouts written in Arabic, the national language. Special videotapes about DM were made and distributed to all participants. In addition, specific educational programs through the diabetes educators and one-on-one counseling sessions with the doctor were also arranged. Patients were interviewed using a structured interview schedule both during the baseline, and after 6 months of the program. The interview schedule included, socio-demographics, clinical characteristics, diabetes self-management, adherence to medication, anxiety, and depression. Glycemic control was considered poor, if hemoglobin A1c (HbA1c) was ? 7%. Results: The mean age of the study population was 57.3 ± 14.4 years. Seventy one were males (68.3%) and 33 (31.7%) were females. After six months of the diabetes education program, there were significant improvements in patients’ dietary plan (P = 0.0001), physical exercise (P = 0.0001), self-monitoring of blood glucose (SMBG) (P = 0.0001), HbA1c (P = 0.04), adherence to medication (P = 0.007), and depression (P = 0.03). Conclusions: Implementation of education programs on diabetes among type 2 diabetic patients is associated with better outcomes such as their dietary plan, physical exercise, SMBG, adherence to medication, HbA1c and depression. PMID:23983558

  8. A proprietary alpha-amylase inhibitor from white bean (Phaseolus vulgaris): A review of clinical studies on weight loss and glycemic control

    PubMed Central

    2011-01-01

    Obesity, and resultant health hazards which include diabetes, cardiovascular disease and metabolic syndrome, are worldwide medical problems. Control of diet and exercise are cornerstones of the management of excess weight. Foods with a low glycemic index may reduce the risk of diabetes and heart disease as well as their complications. As an alternative to a low glycemic index diet, there is a growing body of research into products that slow the absorption of carbohydrates through the inhibition of enzymes responsible for their digestion. These products include alpha-amylase and glucosidase inhibitors. The common white bean (Phaseolus vulgaris) produces an alpha-amylase inhibitor, which has been characterized and tested in numerous clinical studies. A specific and proprietary product named Phase 2® Carb Controller (Pharmachem Laboratories, Kearny, NJ) has demonstrated the ability to cause weight loss with doses of 500 to 3000 mg per day, in either a single dose or in divided doses. Clinical studies also show that Phase 2 has the ability to reduce the post-prandial spike in blood glucose levels. Experiments conducted incorporating Phase 2 into food and beverage products have found that it can be integrated into various products without losing activity or altering the appearance, texture or taste of the food. There have been no serious side effects reported following consumption of Phase 2. Gastro-intestinal side effects are rare and diminish upon extended use of the product. In summary, Phase 2 has the potential to induce weight loss and reduce spikes in blood sugar caused by carbohydrates through its alpha-amylase inhibiting activity. PMID:21414227

  9. Food-Insecure Dietary Patterns Are Associated With Poor Longitudinal Glycemic Control in Diabetes: Results From the Boston Puerto Rican Health Study

    PubMed Central

    Gao, Xiang; Tucker, Katherine L.

    2014-01-01

    OBJECTIVE To determine whether dietary patterns associated with food insecurity are associated with poor longitudinal glycemic control. RESEARCH DESIGN AND METHODS In a prospective, population-based, longitudinal cohort study, we ascertained food security (Food Security Survey Module), dietary pattern (Healthy Eating Index–2005 [HEI 2005]), and hemoglobin A1c (HbA1c) in Puerto Rican adults aged 45–75 years with diabetes at baseline (2004–2009) and HbA1c at ?2 years follow-up (2006–2012). We determined associations between food insecurity and dietary pattern and assessed whether those dietary patterns were associated with poorer HbA1c concentration over time, using multivariable-adjusted repeated subjects mixed-effects models. RESULTS There were 584 participants with diabetes at baseline and 516 at follow-up. Food-insecure participants reported lower overall dietary quality and lower intake of fruit and vegetables. A food insecurity*HEI 2005 interaction (P < 0.001) suggested that better diet quality was more strongly associated with lower HbA1c in food-insecure than food-secure participants. In adjusted models, lower follow-up HbA1c was associated with greater HEI 2005 score (? = ?0.01 HbA1c % per HEI 2005 point, per year, P = 0.003) and with subscores of total vegetables (? = ?0.09, P = 0.04) and dark green and orange vegetables and legumes (? = ?0.06, P = 0.048). Compared with the minimum total vegetable score, a participant with the maximum score showed relative improvements of HbA1c of 0.5% per year. CONCLUSIONS Food insecurity was associated with lower overall dietary quality and lower consumption of plant-based foods, which was associated with poor longitudinal glycemic control. PMID:24969578

  10. A Comparison of Continuous Subcutaneous Insulin Infusion vs. Multiple Daily Insulin Injection in Children with Type I Diabetes in Kuwait: Glycemic Control, Insulin Requirement, and BMI

    PubMed Central

    Mousa, Mohammad; Al-Mahdi, Maria; Al-Sanaa, Hala; Al-Kandari, Hessa

    2015-01-01

    Objective Continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDI) are two methods currently used to manage type I diabetes mellitus (T1DM). Here we compare our experiences with CSII and MDI in a large cohort of pediatric patients in Kuwait. Methods Data on 326 patients with T1DM who were started on CSII between 2007 and 2012 were retrospectively compared with those of 326 patients on MDI. They were matched for sex, age at diagnosis, T1DM duration, glycemic control, insulin requirement, and body mass index (BMI). Data were collected at baseline and every three months and included glycated hemoglobin (HbA1c), insulin dose, and adverse events (severe hypoglycemia, diabetic ketoacidosis, and skin problems). Results The main reason for switching to CSII was to achieve better glycemic control (37%), followed by reducing hypoglycemia, and improving the quality of life (13.3% each). Although HbA1c decrease was most significant in the first year, it continued to be significantly lower in the CSII group compared to the MDI throughout the study period. Total daily insulin requirements were significantly lower in the CSII group. BMI increased in both groups, but the difference was significant only at the end of the fifth year. There was no significant change in the rate of diabetic ketoacidosis in either group. The CSII patients had more severe hypoglycemic episodes at baseline; however, it significantly decreased throughout the study period. Only five patients discontinued CSII therapy and two of these restarted within three months. Conclusion CSII is a safe intensive insulin therapy in youngsters with T1DM and achieved markedly fewer severe hypoglycemic episodes and lower daily insulin requirements PMID:26421114

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

    PubMed Central

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

    2013-01-01

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

  12. Multiple Indicators of Poor Diet Quality in Children and Adolescents with Type 1 Diabetes Are Associated with Higher Body Mass Index Percentile but not Glycemic Control

    PubMed Central

    Nansel, Tonja R.; Haynie, Denise L.; Lipsky, Leah M.; Laffel, Lori M. B.; Mehta, Sanjeev N.

    2014-01-01

    Background Diet is a cornerstone of type 1 diabetes treatment, and poor diet quality may affect glycemic control and other health outcomes. Yet diet quality in children and adolescents with type 1 diabetes remains understudied. Objective To evaluate multiple indicators of diet quality in children and adolescents with type 1 diabetes and their associations with hemoglobin A1c and body mass index percentile. Design In this cross-sectional study, participants completed 3-day diet records, and data were abstracted from participants’ medical records. Diet quality indicators included servings of fruit, vegetables, and whole grains; Healthy Eating Index-2005 (HEI-2005) score; Nutrient Rich Foods 9.3 score (NRF 9.3); and glycemic index. Participants/setting Children and adolescents with type 1 diabetes ?1 year, aged 8 to 18 years, were recruited at routine clinic visits. Of 291 families enrolled, 252 provided diet data. Statistical analyses Associations of diet quality indicators to HbA1c and body mass index percentile were examined using analysis of covariance and multiple linear regression. Results Participants demonstrated low adherence to dietary guidelines; mean HEI-2005 score was 53.4±11.0 (range = 26.7 to 81.2). Intake of fruit, vegetables, and whole grains was less than half the recommended amount. Almost half of the participants’ daily energy intake was derived from refined-grain products, desserts, chips, and sweetened beverages. Higher fruit (P=0.04) and whole-grain (P=0.03) intake were associated with lower HbA1c in unadjusted, but not adjusted analyses; vegetable intake, HEI-2005 score, NRF 9.3 score, and glycemic index were not associated with HbA1c. Higher fruit (P=0.01) and whole-grain (P=0.04) intake and NRF 9.3 score (P=0.02), but not other diet quality indicators, were associated with lower body mass index percentile in adjusted analyses. Conclusions Data demonstrate poor diet quality in youth with type 1 diabetes and provide support for the importance of diet quality for weight management. Future research on determinants of dietary intake and methods to promote improved diet quality would be useful to inform clinical care. PMID:23102173

  13. Glycemic Index Values Database

    Cancer.gov

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

  14. 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

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

    PubMed Central

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

    2015-01-01

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

  16. Effect of Tocotrienols enriched canola oil on glycemic control and oxidative status in patients with type 2 diabetes mellitus: A randomized double-blind placebo-controlled clinical trial

    PubMed Central

    Vafa, Mohammadreza; Haghighat, Neda; Moslehi, Nazanin; Eghtesadi, Shahriar; Heydari, Iraj

    2015-01-01

    Background: Tocotrienols have been shown to improve glycemic control and redox balance in an animal study, but their effects on patients with diabetes are unknown. The study aimed to investigate whether tocotrienols improves glycemic control, insulin sensitivity, and oxidative stress in individuals with type 2 diabetes mellitus (T2DM). Materials and Methods: This study was a double-blinded, placebo-controlled, randomized trial. A total of 50 patients, aged 35-60 years, with T2DM treated by noninsulin hypoglycemic drugs were randomly assigned to receive either 15 mL/day tocotrienols (200 mg) enriched canola oil (n = 25) or pure canola oil (n = 25) for 8 weeks. Fasting blood sugar (FBS), fasting insulin, total antioxidant capacity (TAC), malondialdehyde (MDA), and homeostatic model assessment for insulin resistance (HOMA-IR) were determined before and after the intervention. The data were compared between and within groups, before and after the intervention. Results: Baseline characteristics of participants including age, sex, physical activity, disease duration, and type of drug consumption were not significantly different between the two groups. In tocotrienol enriched canola oil, FBS (mean percent change: –15.4% vs. 3.9%; P = 0.006) and MDA (median percent change: –35.6% vs. 16.3%; P = 0.003) were significantly reduced while TAC was significantly increased (median percent change: 21.4% vs. 2.3%; P = 0.001) compared to pure canola oil. At the end of the study, patients who treated with tocotrienols had lower FBS (P = 0.023) and MDA (P = 0.044) compared to the pure canola oil group. However, tocotrienols had no effect on insulin concentrations and HOMA-IR. Conclusion: Tocotrienols can improve FBS concentrations and modifies redox balance in T2DM patients with poor glycemic control and can be considered in combination with hypoglycemic drugs to better control of T2DM. PMID:26600828

  17. 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

  18. Oxidative stress, mitochondrial respiration, and glycemic control: clues from chronic supplementation with Cr3+ or As3+ to male Wistar rats.

    PubMed

    Cobo, J M; Castiñeira, M

    1997-01-01

    Multiple experiments in male Wistar rats were designed to clarify the role of mitochondrial dysfunction in the mechanisms of oxidative stress-related diseases and toxicity-induced pathologies. In this particular report, 21 male Wistar rats were supplemented ad libitum with either As3+ or Cr3+ salts in drinking water to assess insulin secretion patterns in vivo and in vitro, mitochondrial dysfunction, oxidative stress, liver damage, basal insulin, and glucose tolerance curves, among other parameters. Results were compared with a control group without any metal supplementation. The CrCl3 supplements were more invasive of metabolism and had a stronger effect on mitochondrial dysfunction than As3+, despite that both seem to use similar mechanisms of toxicity; viz.: binding to thiol or -SS- group in enzymes and proteins, and releasing oxidant species during their redox-cycling and metabolic activation processes, e.g., by cytochrome P450 in liver. Results support our aim to prove the influence of oxidative stress-induced mitochondrial dysfunction on glycemic control. PMID:9433712

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

    PubMed Central

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

    2015-01-01

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

  20. Coumaglutide, a novel long-acting GLP-1 analog, inhibits ?-cell apoptosis in vitro and invokes sustained glycemic control in vivo.

    PubMed

    Sun, Lidan; Wang, Chuandong; Dai, Yuxuan; Chu, Yingying; Han, Jing; Zhou, Jie; Cai, Xingguang; Huang, Wenlong; Qian, Hai

    2015-11-15

    Glucagon-like peptide-1 (GLP-1) is a potential candidate for the treatment of type 2 diabetes. However, native GLP-1 is not suitable for therapy of diabetes due to its short half-life (t1/2=2min). Our recent discovery of the novel long-acting GLP-1 analog, coumaglutide, elicits favorable hypoglycemic effects. The present study was aimed at determining the protection effect of ?-cell from apoptosis and in vivo pharmacologic properties of coumaglutide in diabetic mice. To determine the protective effect of coumaglutide on INS-1 cell viability and apoptosis, cells were exposed to 1?M streptozotocin (STZ) and coumaglutide for 24h. Moreover, STZ-induced diabetic mice were treated daily with coumaglutide for 20 days and a range of pharmacologic parameters, including hemoglobin A1c (HbA1C), intraperitoneal glucose tolerance, food intake and body weight were assessed before and after the treatment. As with other glucagon-like peptide-1 receptor agonizts, coumaglutide was able to protect ?-cell from apoptosis in vitro and induce a durable restoration of glycemic control (normalization of both HbA1C and improvement of intraperitoneal glucose tolerance) in diabetic mice. It can be concluded that coumaglutide retains native GLP-1 activities and thus may serve as a promising hypoglycemic drug candidate. PMID:26481165

  1. Evaluation of the Effects of Cornus mas L. Fruit Extract on Glycemic Control and Insulin Level in Type 2 Diabetic Adult Patients: A Randomized Double-Blind Placebo-Controlled Clinical Trial

    PubMed Central

    Soltani, Rasool; Gorji, Abdollah; Asgary, Sedigheh; Sarrafzadegan, Nizal; Siavash, Mansour

    2015-01-01

    Background. The plant Cornus mas L. (cornelian cherry) is traditionally used as an antidiabetic supplement; however, there is no related clinical trial. In this study, we evaluated the effects of the fruit extract of this plant on biomarkers of glycemic control in adult patients with type 2 diabetes. Methods. Sixty patients with type 2 diabetes were randomly assigned to two groups to receive either the extract or placebo capsules (2 capsules twice daily) for 6 weeks. Each drug capsule contained 150 mg of anthocyanins. Fasting plasma levels of glucose, insulin, HgbA1C, and triglyceride as well as 2-hour postprandial glucose level (2Hpp) were measured before and after the intervention and finally the mean values were compared between groups. Results. After 6 weeks of intervention, significant increase in insulin level (1.13 ± 1.90 versus ?0.643 ± 1.82, P < 0.05) as well as decrease in HgbA1C (?0.24 ± 0.429 versus 0.023 ± 0.225, P < 0.05) and TG (?23.66 ± 55.40 versus 2.83 ± 15.71, P < 0.05) levels was observed in drug group compared to placebo. Conclusion. Daily consumption of the fruit extract of Cornus mas L. improves glycemic control by increasing insulin level and reduces TG serum level in type 2 diabetic adult patients. PMID:26508984

  2. The Effect of Comorbidity on Glycemic Control and Systolic Blood Pressure in Type 2 Diabetes: A Cohort Study with 5 Year Follow-Up in Primary Care

    PubMed Central

    Luijks, Hilde; Biermans, Marion; Bor, Hans; van Weel, Chris; Lagro-Janssen, Toine; de Grauw, Wim; Schermer, Tjard

    2015-01-01

    Aims To explore the longitudinal effect of chronic comorbid diseases on glycemic control (HbA1C) and systolic blood pressure (SBP) in type 2 diabetes patients. Methods In a representative primary care cohort of patients with newly diagnosed type 2 diabetes in The Netherlands (n = 610), we tested differences in the five year trend of HbA1C and SBP according to comorbidity profiles. In a mixed model analysis technique we corrected for relevant covariates. Influence of comorbidity (a chronic disease already present when diabetes was diagnosed) was tested as total number of comorbid diseases, and as presence of specific disease groups, i.e. cardiovascular, mental, and musculoskeletal disease, malignancies, and COPD. In subgroup effect analyses we tested if potential differences were modified by age, sex, socioeconomic status, and BMI. Results The number of comorbid diseases significantly influenced the SBP trend, with highest values after five years for diabetes patients without comorbidity (p = 0.005). The number of diseases did not influence the HbA1C trend (p = 0.075). Comorbid musculoskeletal disease resulted in lower HbA1C at the time of diabetes diagnosis, but in higher values after five years (p = 0.044). Patients with cardiovascular diseases had sustained elevated levels of SBP (p = 0.014). Effect modification by socioeconomic status was observed in some comorbidity subgroups. Conclusions Presence of comorbidity in type 2 diabetes patients affected the long-term course of HbA1C and SBP in this primary care cohort. Numbers and types of comorbidity showed differential effects: not the simple sum of diseases, but specific types of comorbid disease had a negative influence on long-term diabetes control parameters. The complex interactions between comorbidity, diabetes control and effect modifiers require further investigation and may help to personalize treatment goals. PMID:26426904

  3. Hepatic FoxO1 Acetylation Is Involved in Oleanolic Acid-Induced Memory of Glycemic Control: Novel Findings from Study 2

    PubMed Central

    Wang, Hao; Li, Songpei; Jo, Eunjung; Xue, Charlie C. L.; Tan, Minjia; Molero, Juan C.; Ye, Ji-Ming

    2014-01-01

    Our recent study (referred as Study 1) showed that the triterpenoid oleanolic acid (OA) was able to produce a sustained correction of hyperglycemia beyond treatment period in type 2 diabetes (T2D) mice with liver as a responsible site. To follow up the previous observations, the present study (referred as Study 2) investigated the possible role of acetylation of FoxO1 and associated events in this therapeutic memory by characterizing the pathways regulating the acetylation status during and post-OA treatments. OA treatment (100 mg/kg/day for 4 weeks, during OA treatment) reduced hyperglycemia in T2D mice by ?87% and this effect was largely (?70%) maintained even 4 weeks after the cessation of OA administration (post-OA treatment). During OA treatment, the acetylation and phosphorylation of FoxO1 were markedly increased (1.5 to 2.5-fold) while G6Pase expression was suppressed by ?80%. Consistent with this, OA treatment reversed pyruvate intolerance in high-fat fed mice. Histone acetyltransferase 1 (HAT1) content was increased (>50%) and histone deacetylases (HDACs) 4 and 5 (not HDAC1) were reduced by 30–50%. The OA-induced changes in FoxO1, G6Pase, HAT1 and HDACs persisted during the post-OA treatment period when the increased phosphorylation of AMPK, SIRT1 content and reduced liver triglyceride had subsided. These results confirmed the ability of OA to control hyperglycemia far beyond treatment period in T2D mice. Most importantly, in the present study we demonstrated acetylation of FoxO1 in the liver is involved in OA-induced memory for the control of hyperglycemia. Our novel findings suggest that acetylation of the key regulatory proteins of hepatic gluconeogenesis is a plausible mechanism by the triterpenoid to achieve a sustained glycemic control for T2D. PMID:25222566

  4. The association of lifestyle and stress with poor glycemic control in patients with diabetes mellitus type 2: a Croatian nationwide primary care cross-sectional study

    PubMed Central

    Brali? Lang, Valerija; Bergman Markovi?, Biserka; Vrdoljak, Davorka

    2015-01-01

    Aim To assess lifestyle habits and self-reported stress levels among type 2 diabetes mellitus (T2DM) patients and their association with hemoglobin A1c (HbA1c) in general practitioners' (GP) offices in Croatia. Methods 449 GPs from all Croatian regions from 2008 to 2010 consecutively recruited up to 20-25 participants diagnosed with T2DM at least 3 years prior to the study, aged ?40 years, and scheduled for diabetes control check-ups. The recruitment period lasted six months. Lifestyle habits and self-reported stress were assessed using the questionnaire from the Croatian Adult Health Survey. Results The study included 10?285 patients with T2DM with mean (±standard deviation) age of 65.7?±?10.05 years (48.1% men). Mean HbA1c level was 7.57?±?1.58%. 79% of participants reported insufficient physical activity, 24% reported inappropriate dietary patterns, 56% reported current alcohol consumption, 19% were current smokers, and 85% reported at least medium level of stress. Multivariate analysis showed that having received advice to stop drinking alcohol, inadequate physical activity, consumption of milk and dairy products, adding extra salt, and high level of stress were significantly associated with increased HbA1c (P?glycemic control was more frequent in patients who had several “unhealthy” lifestyle habits. These results suggest that diabetes patients in Croatia require more specific recommendations on diet, smoking cessation, exercise, and stress control. PMID:26321029

  5. 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

  6. 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…

  7. 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

  8. 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

    2015-12-01

    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 < 0.001) than that for those who did not switch method of delivery. A 10-point increase in CDI was associated with a 0.39% increase in A1c (95% CI: 0.16, 0.61; p = 0.001), independent of pump use. Regarding the temporal relationship between CDI score and changing method of insulin delivery, prior higher CDI score was associated with switching from pump to MDI (odds ratio = 1.21; 95% CI: 1.05, 1.39; p = 0.007). Clinicians should be aware of the associations between depressive symptoms, change in insulin delivery method, and the effect on glycemic control. PMID:25387433

  9. GLYCEMIC INDEX, CHOLECYSTOKININ, SATIETY AND DISINHIBITION: IS THERE AN UNAPPRECIATED PARADOX FOR OVERWEIGHT WOMEN?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The clinical utility of a low glycemic index (GI) diet for appetite and food intake control is controversial. Complicating the issue is psychological and behavioral influences related to eating. The aim of the present study was to investigate the satiety and glycemic response to high and low GI meal...

  10. Mobile Diabetes Intervention for Glycemic Control in 45- to 64-Year-Old Persons With Type 2 Diabetes.

    PubMed

    Quinn, Charlene C; Shardell, Michelle D; Terrin, Michael L; Barr, Erik A; Park, DoHwan; Shaikh, Faraz; Guralnik, Jack M; Gruber-Baldini, Ann L

    2016-02-01

    The purpose of this study was to assess effects of a mobile coaching system on glycated hemoglobin (HbA1c) levels in younger versus older patients over 1 year. Participants (n = 118) included adult patients with Type 2 diabetes cared for by community physicians. Intervention patients received mobile phone coaching and individualized web portal. Control patients received usual care. Patients were stratified into two age groups: younger (<55 years) and older (?55 years). The intervention resulted in greater 12-month declines in HbA1c, compared with usual care, for patients in both age groups (p < .0001). Among older patients, HbA1c changed by -1.8% (95% confidence interval [CI] = [-2.4, -1.1]) in the intervention group and -0.3% (95% CI = [-0.9, +0.3]) in the control group. Among younger patients, HbA1c changed by -2.0% (95% CI = [-2.5, -1.5]) in the intervention group and -1.0% (95% CI = [-1.6, -0.4]) in the control group. The mobile health intervention was as effective at managing Type 2 diabetes in older adults as younger persons. PMID:25098253

  11. Intraovarian control of early folliculogenesis.

    PubMed

    Hsueh, Aaron J W; Kawamura, Kazuhiro; Cheng, Yuan; Fauser, Bart C J M

    2015-02-01

    Although hormonal regulation of ovarian follicle development has been extensively investigated, most studies concentrate on the development of early antral follicles to the preovulatory stage, leading to the successful use of exogenous FSH for infertility treatment. Accumulating data indicate that preantral follicles are under stringent regulation by FSH and local intraovarian factors, thus providing the possibility to develop new therapeutic approaches. Granulosa cell-derived C-type natriuretic factor not only suppresses the final maturation of oocytes to undergo germinal vesicle breakdown before ovulation but also promotes preantral and antral follicle growth. In addition, several oocyte- and granulosa cell-derived factors stimulate preantral follicle growth by acting through wingless, receptor tyrosine kinase, receptor serine kinase, and other signaling pathways. In contrast, the ovarian Hippo signaling pathway constrains follicle growth and disruption of Hippo signaling promotes the secretion of downstream CCN growth factors capable of promoting follicle growth. Although the exact hormonal factors involved in primordial follicle activation has yet to be elucidated, the protein kinase B (AKT) and mammalian target of rapamycin signaling pathways are important for the activation of dormant primordial follicles. Hippo signaling disruption after ovarian fragmentation, combined with treating ovarian fragments with phosphatase and tensin homolog (PTEN) inhibitors and phosphoinositide-3-kinase stimulators to augment AKT signaling, promote the growth of preantral follicles in patients with primary ovarian insufficiency, leading to a new infertility intervention for such patients. Elucidation of intraovarian mechanisms underlying early folliculogenesis may allow the development of novel therapeutic strategies for patients diagnosed with primary ovarian insufficiency, polycystic ovary syndrome, and poor ovarian response to FSH stimulation, as well as for infertile women of advanced reproductive age. PMID:25202833

  12. 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

  13. Angiotensin I–Converting Enzyme Type 2 (ACE2) Gene Therapy Improves Glycemic Control in Diabetic Mice

    PubMed Central

    Bindom, Sharell M.; Hans, Chetan P.; Xia, Huijing; Boulares, A. Hamid; Lazartigues, Eric

    2010-01-01

    OBJECTIVE Several clinical studies have shown the benefits of renin-angiotensin system (RAS) blockade in the development of diabetes, and a local RAS has been identified in pancreatic islets. Angiotensin I–converting enzyme (ACE)2, a new component of the RAS, has been identified in the pancreas, but its role in ?-cell function remains unknown. Using 8- and 16-week-old obese db/db mice, we examined the ability of ACE2 to alter pancreatic ?-cell function and thereby modulate hyperglycemia. RESEARCH DESIGN AND METHODS Both db/db and nondiabetic lean control (db/m) mice were infected with an adenovirus expressing human ACE2 (Ad-hACE2-eGFP) or the control virus (Ad-eGFP) via injection into the pancreas. Glycemia and ?-cell function were assessed 1 week later at the peak of viral expression. RESULTS In 8-week-old db/db mice, Ad-hACE2-eGFP significantly improved fasting glycemia, enhanced intraperitoneal glucose tolerance, increased islet insulin content and ?-cell proliferation, and reduced ?-cell apoptosis compared with Ad-eGFP. ACE2 overexpression had no effect on insulin sensitivity in comparison with Ad-eGFP treatment in diabetic mice. Angiotensin-(1–7) receptor blockade by d-Ala7–Ang-(1-7) prevented the ACE2-mediated improvements in intraperitoneal glucose tolerance, glycemia, and islet function and also impaired insulin sensitivity in both Ad-hACE2-eGFP– and Ad-eGFP–treated db/db mice. d-Ala7–Ang-(1-7) had no effect on db/m mice. In 16-week-old diabetic mice, Ad-hACE2-eGFP treatment improved fasting blood glucose but had no effect on any of the other parameters. CONCLUSIONS These findings identify ACE2 as a novel target for the prevention of ?-cell dysfunction and apoptosis occurring in type 2 diabetes. PMID:20660625

  14. Gender-specific Effects of Treatment with Lifestyle, Metformin or Sulfonylurea on Glycemic Control and Body Weight: A German Multicenter Analysis on 9?108 Patients.

    PubMed

    Schütt, M; Zimmermann, A; Hood, R; Hummel, M; Seufert, J; Siegel, E; Tytko, A; Holl, R W

    2015-11-01

    Effects of diabetes treatment are strongly connected to individual factors, but the relevant role of gender has not been addressed so far. This observational study evaluates whether monotherapy with lifestyle, metformin or sulfonylurea has gender-specific effects on glycemic control and/or body weight. Data of 9?108 patients with type 2 diabetes from 129 German diabetes centers were assessed by a standardized, prospective, computer-based diabetes care and outcome documentation system (DPV-Wiss-database; age 63.1±12.8 years, diabetes duration 5.7±7.4 years, HbA1c 55±17.7?mmol/mol [7.2±1.6%], BMI 30.6±6.1?kg/m(2), 49.3% female patients). Antidiabetic concepts included lifestyle intervention (n=5,787), metformin (n=2,180), sulfonylurea (n=943) or other antidiabetic drugs (n=198), respectively. HbA1c and body weight were compared before and after a stable monotherapeutical period of 0.8±0.4 years. Women had a significantly higher reduction of body weight after treatment with lifestyle (women-0.8±0.1 vs. men-0.2±0.1?kg; p<0.05), metformin (women-1.8±0.2 vs. men-1.2±0.2?kg; p<0.05) or sulfonylurea drugs (women-0.9±0.2 vs. men?-?0.1±0.2?kg; p<0.05), whereas men displayed significantly higher HbA1c-reductions after treatment with lifestyle (women-6.9±0.2?mmol/mol [-?0.6±0.02%] vs. men-7.5±0.2?mmol/mol [0.7±0.02%]; p<0.05) and metformin only (women-6.3±0.3?mmol/mol [-?0.6±0.03%] vs. men?-?7.4±0.3?mmol/mol [-?0.7±0.03%]; p<0.05). No differences were seen for sulfonylurea monotherapy concerning the HbA1c-reduction (women?-?5.6±0.5?mmol/mol [-?0.5±0.05%] vs. men-6.4±0.4?mmol/mol [-?0.6±0.04%]; p=0.196). In summary, antidiabetic treatment concepts might result in gender-specific effects on body weight and HbA1c. Gender might therefore represent another important factor in the context of an individualized treatment management of type 2 diabetes. PMID:26285070

  15. Is Ramadan fasting safe in type 2 diabetic patients in view of the lack of significant effect of fasting on clinical and biochemical parameters, blood pressure, and glycemic control?

    PubMed

    M'guil, M; Ragala, M A; El Guessabi, L; Fellat, S; Chraibi, A; Chabraoui, L; Chebraoui, L; Israili, Z H; Lyoussi, B

    2008-07-01

    The study objective was to determine if Ramadan fasting was safe in patients with type 2 diabetes mellitus (T2D), based upon a determination of the effect of fasting on a broad range of physiological and clinical parameters, including markers of glycemic control and blood pressure. The study was carried out in Ramadan 1422 (December 2001-January 2002) at the Diabetology Services, Hopital Ibn Sina, Rabat, Morocco. One hundred and twenty T2D Moroccan patients (62 women, 58 men), aged 48-60 yrs with well-controlled diabetes through diet and/or oral hypoglycemic drugs (OHD), received dietary instructions and readjustment of the timing of the dose of OHD (gliclazide modified release) according to the fasting/eating periods. Anthropometric indices and physiological parameters (blood pressure, lipid, hematological, and serum electrolyte profiles, as well as markers of glycemic control, nutrition, renal and hepatic function) were measured on the day before Ramadan and then on the 15(th) and 29(th) day of fasting and thereafter 15 days later. Statistical analysis was done by standard methods. Ramadan fasting had no major effect on energy intake, body weight, body mass index, blood pressure, and liver enzymes. Fasting and post-prandial glucose levels decreased, while insulin levels increased. Diabetes was well controlled, as indicated by HbA1c, fructosamine, C-peptide, HOMA-IR, and IGF-1 values. There were fluctuations in some lipid and hematological parameters, creatinine, urea, uric acid, total protein, bilirubin, and electrolytes; however, all values stayed within the proper physiological range. In conclusion, diabetes was well-controlled in patients with dietary/medical management, without serious complications. With a regimen adjustment of OHD, diet control, and physical activity, most patients with T2D whose diabetes was well-controlled before Ramadan can safely observe Ramadan fasting. PMID:18633757

  16. Glycemic memory associated epigenetic changes.

    PubMed

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

    2010-12-15

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

  17. Effects of Korean White Ginseng (Panax Ginseng C.A. Meyer) on Vascular and Glycemic Health in Type 2 Diabetes: Results of a Randomized, Double Blind, Placebo-controlled, Multiple-crossover, Acute Dose Escalation Trial

    PubMed Central

    Shishtar, Esra'; Jovanovski, Elena; Jenkins, Alexandra

    2014-01-01

    Korean red ginseng (steam treated Panax ginseng C.A. Meyer), among most prized traditional herbal remedies, has been clinically shown to improve cardiovascular disease (CVD) risk factors. Whether this holds true for the dried non-steamed variety, known as Korean white ginseng (KWG) is unclear. This study therefore, investigated the efficacy and safety of escalating doses of KWG on vascular and glycemic parameters in type 2 diabetes (T2DM). Using an acute, randomized, placebo-controlled, double-blind, crossover design, 25 participants with well-controlled T2DM (12-males: 13-females, age: 63 ± 9 years, A1c: 6.9 ± 0.7%, BMI: 29.3 ± 4.3 kg/m2) underwent five visits during which they received 1 g, 3 g, or 6 g KWG or 3 g wheat-bran control (twice) together with 50 g-glucose load. For the duration of 240 minutes, augmentation index (AI), and central blood pressure were measured at baseline and at 60 min-intervals, and ambulatory blood pressure was assessed at baseline and at 10 min-intervals. Additionally, capillary blood was collected at time zero and at 15, 30, 45, 60, 90, 120, and 180 minutes post-treatment. A symptoms questionnaire was used to assess safety and adverse events. Two-way ANOVA demonstrated a significant time-treatment interaction effect on AI (p = 0.01) with one-way ANOVA showing significant reductions in AI with 3 g KWG relative to control (p = 0.04). Compared to control, acute administration of KWG appeared to be safe, but did not affect any other postprandial, vascular or glycemic parameters. KWG might have a beneficial effect on AI, a cumulative indicator of arterial health. However, these results are preliminary and highlight the need for long-term investigation with a focus on its accountable components. Clinical Trial Registration: NCT01699074 PMID:25136536

  18. An Elevated Glycemic Gap is Associated With Adverse Outcomes in Diabetic Patients With Community-Acquired Pneumonia

    PubMed Central

    Chen, Po-Chuan; Liao, Wen-I.; Wang, Ying-Chuan; Chang, Wei-Chou; Hsu, Chin-Wang; Chen, Ying-Hsin; Tsai, Shih-Hung

    2015-01-01

    Abstract Several studies argue against the association between admission hyperglycemia and adverse outcomes in infected diabetic patients. When investigating the association, it is necessary to consider preexisting hyperglycemia. The objective of this study was to assess whether stress-induced hyperglycemia, determined by the glycemic gap between admission glucose levels and A1c-derived average glucose levels adversely affects outcomes in diabetic patients admitted to hospital with community-acquired pneumonia (CAP). We retrospectively analyzed the glycemic gap and adverse outcomes of diabetic patients hospitalized because of CAP from June 1, 2007 to August 31, 2012 in single medical center in Taiwan. A total of 203 patients admitted with principal diagnosis of CAP and available data of glycemic gap. Patients with glycemic gaps ?40?mg/dL had greater AUROC values for the development of adverse outcomes compared with acute hyperglycemia and long-term glycemic controls. Patients with an elevated glycemic gap had an odds ratio of 3.84 for the incidence of combined adverse outcomes. Incorporation of the glycemic gap into pneumonia severity index, CURB-65 or SMART-COP scores, increased the discriminative performance of predicting the development of adverse outcomes. Glycemic gaps were associated with adverse outcomes of diabetic CAP patients. The discriminative performance of the calculated glycemic gaps was comparable with those of current clinical scoring systems and may further increase the AUROC of each system. PMID:26313809

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

    PubMed

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

    2015-09-01

    To examine whether the daily consumption of normal-protein (NP) vs higher-protein (HP) breakfasts improve free-living glycemic control in overweight/obese, 'breakfast skipping' adolescents. Twenty-eight healthy, but overweight, teens (age: 19±1 year; BMI: 29.9±0.8?kg?m(-2)) completed a 12-week randomized parallel-arm study in which the adolescents consumed either a 350?kcal NP breakfast (13?g protein) or HP breakfast (35?g protein). Pre- and post-study 24-h blood glucose measures were assessed using continuous glucose monitoring. Although no main effects of time or group were detected, time by group interactions were observed. Post hoc pairwise comparisons assessing the post-pre changes revealed that the daily consumption of the HP breakfasts tended to reduce the 24-h glucose variability (s.d.) vs NP (-0.17±0.09 vs +0.09±0.10 s.d.; P=0.06) and tended to reduce the time spent above the high glucose limit (-292±118 vs -24±80?min; P=0.09). The consumption of the HP breakfasts also reduced the 24-h maximal (peak) glucose response (-0.94±0.36 vs +0.30±0.18?mmol?l(-1); P<0.01) and reduced postprandial glucose fluctuations (-0.88±0.44 vs +0.49±0.34?mmol?l(-1); P<0.03) vs NP. These data suggest that the daily addition of a HP breakfast, containing 35?g of high-quality protein, has better efficacy at improving free-living glycemic control compared with a NP breakfast in overweight/obese, but otherwise healthy, 'breakfast skipping' adolescents. PMID:26028058

  20. 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...

  1. Genetics and early disturbances of breathing control.

    PubMed

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

    2004-05-01

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

  2. 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.

  3. Influence of HbA1c levels on platelet function profiles associated with tight glycemic control in patients presenting with hyperglycemia and an acute coronary syndrome. A subanalysis of the CHIPS Study ("Control de HIperglucemia y Actividad Plaquetaria en Pacientes con Síndrome Coronario Agudo").

    PubMed

    Vivas, David; García-Rubira, Juan C; Bernardo, Esther; Angiolillo, Dominick J; Martín, Patricia; Calle-Pascual, Alfonso; Núñez-Gil, Iván; Macaya, Carlos; Fernández-Ortiz, Antonio

    2013-02-01

    Patients with hyperglycemia, an acute coronary syndrome and poor glycemic control have increased platelet reactivity and poor prognosis. However, it is unclear the influence of a tight glycemic control on platelet reactivity in these patients. This is a subanalysis of the CHIPS study. This trial randomized patients with hyperglycemia to undergo an intensive glucose control (target blood glucose 80-120 mg/dL), or conventional glucose control (target blood glucose <180 mg/dL). We analyzed platelet function at discharge on the subgroup of patients with poor glycemic control, defined with admission levels of HbA1c higher than 6.5%. The primary endpoint was maximal platelet aggregation following stimuli with 20 ?M ADP. We also measured aggregation following collagen, epinephrine, and thrombin receptor-activated peptide, as well as P2Y12 reactivity index and surface expression of glycoprotein IIb/IIIa and P-selectin. A total of 67 patients presented HbA1c ? 6.5% (37 intensive, 30 conventional), while 42 had HbA1c < 6.5% (20 intensive, 22 conventional). There were no differences in baseline characteristics between groups. At discharge, patients with HbA1c ?6.5% had significantly reduced MPA with intensive glucose control compared with conventional control (46.1 ± 22.3 vs. 60.4 ± 20.0%; p = 0.004). Similar findings were shown with other measures of platelet function. However, glucose control strategy did not affect platelet function parameters in patients with HbA1c < 6.5%. Intensive glucose control in patients presenting with an acute coronary syndrome and hyperglycemia results in a reduction of platelet reactivity only in the presence of elevated HbA1c levels. PMID:23114538

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

    PubMed Central

    2014-01-01

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

  5. Association of dietary glycemic index and glycemic load with endometrial cancer risk among Chinese women.

    PubMed

    Xu, Wang Hong; Xiang, Yong-Bing; Zhang, Xianglan; Ruan, Zhixian; Cai, Hui; Zheng, Wei; Shu, Xiao-Ou

    2015-01-01

    We evaluated the association of dietary glycemic index (GI) and glycemic load (GL) with the risk of endometrial cancer in a population-based, case-control study of 1199 endometrial cancer patients and 1212 age-frequency-matched controls in urban Shanghai, China, where diets are typically high in carbohydrates and have a high GL. Information on dietary habits, physical activity, and other relevant information was collected using a validated questionnaire, and anthropometric measurements were taken. Logistic regression was applied in the analysis. Dietary GI and GL were independently associated with risk for endometrial cancer but carbohydrate intake was unrelated to risk. Multivariable-adjusted odds ratios (ORs) for increasing quartiles of intake were 1.0, 1.3, 1.4, and 2.2 [95% confidence interval (CI): 1.2-4.0] for dietary GL (P(trend) = 0.02) and 1.0, 1.2, 1.4, and 1.4 (95% CI: 1.0-2.0) for dietary GI (P(trend) = 0.02). High intake of staples, especially rice, was positively associated with endometrial cancer. The association with GI was more evident among lean and normal weight women, although the test for interaction was not significant. This study suggests that intake of high GL or GI foods, but not carbohydrates per se, may increase risk for endometrial cancer. PMID:25495185

  6. EFFECTS OF DIETARY GLYCEMIC LOAD ON MOOD DURING CALORIC RESTRICTION

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  7. Effects of Liraglutide Combined with Short-Term Continuous Subcutaneous Insulin Infusion on Glycemic Control and Beta Cell Function in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A Pilot Study

    PubMed Central

    Ke, Weijian; Liu, Liehua; Liu, Juan; Chen, Ailing; Deng, Wanping; Zhang, Pengyuan; Cao, Xiaopei; Liao, Zhihong; Xiao, Haipeng; Liu, Jianbin; Li, Yanbing

    2016-01-01

    The objective of this paper is to investigate the effects of liraglutide in combination with short-term continuous subcutaneous insulin infusion (CSII) therapy on glycemic control and beta cell function in patients with newly diagnosed type 2 diabetes mellitus (T2DM). Thirty-nine eligible newly diagnosed T2DM patients were recruited and randomized to receive either of two therapies: short-term CSII alone (CSII alone group) or CSII in combination with liraglutide (CSII + Lira group) for 12 weeks. Blood glucose control, homeostasis model assessment (HOMA) indices, and acute insulin response (AIR) were compared between the two groups. The patients in CSII + Lira group achieved euglycemia with equivalent insulin dosage in shorter time (1 (0) versus 2 (3) days, P = 0.039). HbA1c at the end of study was comparable between two groups (6.3 ± 0.7% versus 6.0 ± 0.5%, for CSII alone group and CSII + Lira group, resp., P = 0.325). The increment of AIR was higher in CSII + Lira group (177.58 (351.57)??U·min/mL versus 58.15 (51.30)??U·min/mL, P < 0.001). However, after stopping liraglutide, its effect on beta cell function disappeared completely. Liraglutide combined with short-term CSII was effective in further improving beta cell function, but the beneficial effects did not sustain after suspension of the therapy. PMID:26640805

  8. Effects of Liraglutide Combined with Short-Term Continuous Subcutaneous Insulin Infusion on Glycemic Control and Beta Cell Function in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A Pilot Study.

    PubMed

    Ke, Weijian; Liu, Liehua; Liu, Juan; Chen, Ailing; Deng, Wanping; Zhang, Pengyuan; Cao, Xiaopei; Liao, Zhihong; Xiao, Haipeng; Liu, Jianbin; Li, Yanbing

    2016-01-01

    The objective of this paper is to investigate the effects of liraglutide in combination with short-term continuous subcutaneous insulin infusion (CSII) therapy on glycemic control and beta cell function in patients with newly diagnosed type 2 diabetes mellitus (T2DM). Thirty-nine eligible newly diagnosed T2DM patients were recruited and randomized to receive either of two therapies: short-term CSII alone (CSII alone group) or CSII in combination with liraglutide (CSII + Lira group) for 12 weeks. Blood glucose control, homeostasis model assessment (HOMA) indices, and acute insulin response (AIR) were compared between the two groups. The patients in CSII + Lira group achieved euglycemia with equivalent insulin dosage in shorter time (1 (0) versus 2 (3) days, P = 0.039). HbA1c at the end of study was comparable between two groups (6.3 ± 0.7% versus 6.0 ± 0.5%, for CSII alone group and CSII + Lira group, resp., P = 0.325). The increment of AIR was higher in CSII + Lira group (177.58 (351.57)??U·min/mL versus 58.15 (51.30)??U·min/mL, P < 0.001). However, after stopping liraglutide, its effect on beta cell function disappeared completely. Liraglutide combined with short-term CSII was effective in further improving beta cell function, but the beneficial effects did not sustain after suspension of the therapy. PMID:26640805

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

    PubMed

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

    2015-08-15

    The relation between glycemic index, glycemic load, and subclinical coronary atherosclerosis is unknown. The aim of the study was to evaluate the associations between energy-adjusted glycemic index, glycemic load, and coronary artery calcium (CAC). This study was cross-sectional analysis of 28,429 asymptomatic Korean men and women (mean age 41.4 years) without a history of diabetes or cardiovascular disease. All participants underwent a health screening examination between March 2011 and April 2013, and dietary intake over the preceding year was estimated using a validated food frequency questionnaire. Cardiac computed tomography was used for CAC scoring. The prevalence of detectable CAC (CAC score >0) was 12.4%. In multivariable-adjusted models, the CAC score ratios (95% confidence intervals) comparing the highest to the lowest quintile of glycemic index and glycemic load were 1.74 (1.08 to 2.81; p trend = 0.03) and 3.04 (1.43 to 6.46; p trend = 0.005), respectively. These associations did not differ by clinical subgroups, including the participants at low cardiovascular risk. In conclusion, these findings suggest that high dietary glycemic index and glycemic load were associated with a greater prevalence and degree of CAC, with glycemic load having a stronger association. PMID:26073677

  10. Modeling predictors of changes in glycemic control and diabetes-specific quality of life amongst adults with type 1 diabetes 1 year after structured education in flexible, intensive insulin therapy.

    PubMed

    Cooke, Debbie; Bond, Rod; Lawton, Julia; Rankin, David; Heller, Simon; Clark, Marie; Speight, Jane

    2015-10-01

    Few studies have identified determinants of glycemic control (HbA1c) and diabetes-specific quality of life (DSQoL) in adults with type 1 diabetes. To identify factors predicting outcomes following structured diabetes education. 262 participants completed biomedical and questionnaire assessments before, and throughout 1 year of follow-up. The proportion of variance explained ranged from 28 to 62 % (DSQoLS) and 14-20 % (HbA1c). When change in psychosocial variables were examined, reduced hypoglycemia fear, lower 'perceived diabetes seriousness', greater self-efficacy and well-being predicted QoL improvements from baseline to 3-months. Increased frequency of blood glucose testing predicted improvements in HbA1c from baseline to 6-months. Greater benefits may be achieved if programs focus explicitly on psychosocial factors. Self-care behaviours did not predict HbA1c suggesting existing assessment tools need refinement. Evaluation of treatment mechanisms in self-management programs is recommended. PMID:26072044

  11. Controls on Plant Species Invasions During Early Secondary Succession

    E-print Network

    Franklin, Jerry

    Controls on Plant Species Invasions During Early Secondary Succession: The Roles of Plant Origin.S. Copyright Law. Any other reproduction for any purposes or by any means shall not be allowed without my of Washington Abstract Controls On Plant Species Invasions During Early Secondary Succession: The Roles Of Plant

  12. Relationship Between Standardized Glycemic Protocols and Healthcare Cost.

    PubMed

    Coto, Jeffrey A; Yehle, Karen S; Foli, Karen J

    2016-02-01

    Rising healthcare costs and the management of diabetes are financially straining to healthcare organizations. The study purpose was to examine whether a direct relationship existed between the cost of hospitalization, length of stay, excess admission days, and discharge blood glucose (DC-BG) levels and utilizing a standardized glycemic protocol. A retrospective cohort analysis was conducted of adult diabetes mellitus type 2 (DM-2) patients' pre-diabetic protocol (January 1, 2011-December 31, 2011) and post-diabetic protocol (August 1, 2012-October 31, 2012). The sample included DM-2 inpatients aged ?18 years admitted without complications and/or with abnormal fasting blood glucose. Pre-protocol sample comprised n = 346 subjects and post-protocol sample comprised n = 149 subjects. Patients who received the diabetic protocol in 2012 experienced a decrease in the DC-BG (p < .05) and decrease in excess admission days (p < .05). Evidence supports that utilizing a standardized glycemic protocol improves glycemic control and reduces healthcare cost. PMID:24939931

  13. 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

  14. Personalized Nutrition by Prediction of Glycemic Responses.

    PubMed

    Zeevi, David; Korem, Tal; Zmora, Niv; Israeli, David; Rothschild, Daphna; Weinberger, Adina; Ben-Yacov, Orly; Lador, Dar; Avnit-Sagi, Tali; Lotan-Pompan, Maya; Suez, Jotham; Mahdi, Jemal Ali; Matot, Elad; Malka, Gal; Kosower, Noa; Rein, Michal; Zilberman-Schapira, Gili; Dohnalová, Lenka; Pevsner-Fischer, Meirav; Bikovsky, Rony; Halpern, Zamir; Elinav, Eran; Segal, Eran

    2015-11-19

    Elevated postprandial blood glucose levels constitute a global epidemic and a major risk factor for prediabetes and type II diabetes, but existing dietary methods for controlling them have limited efficacy. Here, we continuously monitored week-long glucose levels in an 800-person cohort, measured responses to 46,898 meals, and found high variability in the response to identical meals, suggesting that universal dietary recommendations may have limited utility. We devised a machine-learning algorithm that integrates blood parameters, dietary habits, anthropometrics, physical activity, and gut microbiota measured in this cohort and showed that it accurately predicts personalized postprandial glycemic response to real-life meals. We validated these predictions in an independent 100-person cohort. Finally, a blinded randomized controlled dietary intervention based on this algorithm resulted in significantly lower postprandial responses and consistent alterations to gut microbiota configuration. Together, our results suggest that personalized diets may successfully modify elevated postprandial blood glucose and its metabolic consequences. VIDEO ABSTRACT. PMID:26590418

  15. 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…

  16. Glycemic responses and sensory characteristics of whole yellow pea flour added to novel functional foods.

    PubMed

    Marinangeli, Christopher P F; Kassis, Amira N; Jones, Peter J H

    2009-01-01

    A fundamental understanding regarding postprandial glycemic responses to foods containing whole yellow-pea flour (WYPF) remains unknown. This, alongside concerns that WYPF possesses unfavorable sensory characteristics has limited the incorporation of WYPF into new functional food products as a healthy novel ingredient. The objective of this study was to evaluate how WYPF modulates postprandial glycemic responses as well as sensory characteristics in novel foods. In a single-blind crossover trial, the present study assessed postprandial glycemic responses of banana bread, biscotti, and spaghetti containing either WYPF or whole wheat flour (WWF). Boiled yellow peas (BYP) and white bread (WB) were used as positive and negative controls, respectively. On day 1, subjects evaluated appearance, taste, texture, smell as well as overall acceptance of each WYPF and WWF food on a 5-point hedonic scale. WYPF banana bread (97.9 +/- 17.8 mmol x min/L) and biscotti (83 +/- 13 mmol x min/L), as well as BYP (112.3 +/- 19.9 mmol x min/L), reduced (P < 0.05) glycemic responses compared to WB (218.1 +/- 29.5 mmol x min/L). The glycemic response of WYPF pasta (160.7 +/- 19.4 mmol x min/L) was comparable to WB. WYPF biscotti produced a lower (P = 0.019) postprandial glycemic response compared to WWF biscotti (117.2 +/- 13.1 mmol x min/L). Hedonic responses between corresponding foods were similar except for the WYPF pasta (2.9 +/- 0.9) which possessed a lower sensory score (P = 0.02) for smell compared to WWF pasta (3.6 +/- 1). WYPF can be used to produce low-glycemic functional foods possessing sensory attributes that are comparable to identical food products containing WWF. PMID:20492127

  17. Effects of high-intensity interval exercise versus continuous moderate-intensity exercise on postprandial glycemic control assessed by continuous glucose monitoring in obese adults.

    PubMed

    Little, Jonathan P; Jung, Mary E; Wright, Amy E; Wright, Wendi; Manders, Ralph J F

    2014-07-01

    The purpose of this study was to examine the impact of acute high-intensity interval training (HIIT) compared with continuous moderate-intensity (CMI) exercise on postprandial hyperglycemia in overweight or obese adults. Ten inactive, overweight or obese adults (41 ± 11 yrs, BMI = 36 ± 7 kg/m(2)) performed an acute bout of HIIT (10 × 1 min at approximately 90% peak heart rate (HRpeak) with 1-min recovery periods) or matched work CMI (30 min at approximately 65% HRpeak) in a randomized, counterbalanced fashion. Exercise was performed 2 h after breakfast, and glucose control was assessed by continuous glucose monitoring under standardized dietary conditions over 24 h. Postprandial glucose (PPG) responses to lunch, dinner, and the following day's breakfast were analyzed and compared with a no-exercise control day. Exercise did not affect the PPG responses to lunch, but performing both HIIT and CMI in the morning significantly reduced the PPG incremental area under the curve (AUC) following dinner when compared with control (HIIT = 110 ± 35, CMI = 125 ± 34, control = 162 ± 46 mmol/L × 2 h, p < 0.05). The PPG AUC (HIIT = 125 ± 53, CMI = 186 ± 55, control = 194 ± 96 mmol/L × 2 h) and the PPG spike (HIIT = ?2.1 ± 0.9, CMI = ?3.0 ± 0.9, control = ?3.0 ± 1.5 mmol/l) following breakfast on the following day were significantly lower following HIIT compared with both CMI and control (p < 0.05). Absolute AUC and absolute glucose spikes were not different between HIIT, CMI, or control for any meal (p > 0.05 for all). We conclude that a single session of HIIT has greater and more lasting effects on reducing incremental PPG when compared with CMI. PMID:24773254

  18. Emerging trends in optical sensing of glycemic markers for diabetes monitoring

    PubMed Central

    Pandey, Rishikesh; Dingari, Narahara Chari; Spegazzini, Nicolas; Dasari, Ramachandra R.; Horowitz, Gary L.; Barman, Ishan

    2015-01-01

    In the past decade, considerable attention has been focused on the measurement of glycemic markers, such as glycated hemoglobin and glycated albumin, that provide retrospective indices of average glucose levels in the bloodstream. While these biomarkers have been regularly used to monitor long-term glucose control in established diabetics, they have also gained traction in diabetic screening. Detection of such glycemic markers is challenging, especially in a point-of-care setting, due to the stringent requirements for sensitivity and robustness. A number of non-separation based measurement strategies were recently proposed, including photonic tools that are well suited to reagent-free marker quantitation. Here, we critically review these methods while focusing on vibrational spectroscopic methods, which offer highly specific molecular fingerprinting capability. We examine the underlying principles and the utility of these approaches as reagentless assays capable of multiplexed detection of glycemic markers and also the challenges in their eventual use in the clinic. PMID:25598563

  19. Control Networks and Neuromodulators of Early Development

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  20. The effects of the dietary glycemic load on type 2 diabetes risk factors during weight loss

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objective. To compare the effects of two calorie-restricted diets that differ in glycemic load (GL) on glucose-insulin dynamics and systemic inflammation. Design. Randomized controlled feeding trial. Setting and Participants. Thirty-four healthy overweight adults aged 24-42 years with normal fasti...

  1. 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. PMID:26064075

  2. Attentional Control in Early and Later Bilingual Children.

    PubMed

    Kapa, Leah L; Colombo, John

    2013-07-01

    This study examined differences in attentional control among school-age children who were monolingual English speakers, early childhood Spanish-English bilinguals who began speaking both languages by age 3, and later childhood Spanish-English bilingual children who began speaking English after age 3. Children's attentional control was tested using the Attention Network Test (ANT). All language groups performed equally on ANT networks; however, when controlling for age and verbal ability, groups differed significantly on reaction time. Early bilingual children responded faster on the ANT compared to both monolingual and later bilingual children, suggesting an attentional monitoring advantage for early bilinguals. These results add to mounting evidence of advantaged cognitive functioning among bilinguals, and are consistent with the possibility that children who begin speaking a second language earlier in childhood have larger advantages due either to differential effects of acquiring a second language earlier during development or due to longer duration of bilingual experience. PMID:24910499

  3. 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...

  4. Sustained Attention and Age Predict Inhibitory Control during Early Childhood

    ERIC Educational Resources Information Center

    Reck, Sarah G.; Hund, Alycia M.

    2011-01-01

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

  5. 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

  6. Life stress impairs self-control in early adolescence.

    PubMed

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

    2012-01-01

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

  7. 77 FR 66469 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-05

    ... SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control... of the aforementioned committee: Name: Breast and Cervical Cancer Early Detection and Control..., regarding the early detection and control of breast and cervical cancer. The committee makes...

  8. Understanding the glycemic index and glycemic load and their practical applications.

    PubMed

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

    2009-09-01

    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 were eaten by the students were tallied, the students were divided into groups. At the next class, three members of each group, who had fasted for 8 hr, ingested 50 g of carbohydrate in food or a meal. After ingestion, the blood glucose was measured with a portable device every 30 min for a period of 2 hr. Discussion of the data obtained in experiment 1 allowed the students to understand the mechanism of action of insulin and to understand how the GI, as presented in the literature, is determined. The students also concluded that the addition of fiber to food reduces the glycemic response even with high GI foods, and these results could be a useful strategy for diet prescription. Discussion of experiment 2 allowed the students to understand that the amount of food intake is a determining factor for the glycemic response and subsequent release of insulin. These experimental observations allowed the students to transfer theoretical knowledge to their daily lives very easily. The students approved the classes and felt encouraged to study the synthesis pathways and metabolic integration in the fed state. PMID:21567757

  9. 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

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

    PubMed

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

    2014-07-15

    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

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

    ERIC Educational Resources Information Center

    Miller, Carla K.; Gutschall, Melissa

    2009-01-01

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

  13. Relation between Breast Cancer and High Glycemic Index or Glycemic Load: A Meta-analysis of Prospective Cohort Studies.

    PubMed

    Mullie, Patrick; Koechlin, Alice; Boniol, Mathieu; Autier, Philippe; Boyle, Peter

    2016-01-01

    Breast cancer is the commonest form of cancer in women worldwide. It has been suggested that chronic hyperinsulinemia associated with insulin resistance plays a role in breast cancer etiology. To test the hyperinsulinemia hypothesis, a dietary pattern associated with a high glycemic index and glycemic load, both proxies for chronic hyperinsulinemia, should be associated with an increased risk of breast cancer. A meta-analysis restricted to prospective cohort studies was undertaken using a random effects model with tests for statistical significance, publication bias and heterogeneity. The metric for analysis was the risk of breast cancer in the highest relative to the lowest glycemic index and glycemic load dietary pattern. A dietary pattern with a high glycemic index was associated with a summary relative risk (SRR) of 1.05 (95% CI: 1.00, 1.11), and a high glycemic load with a SRR of 1.06 (95% CI: 1.00, 1.13). Adjustments for body mass index [BMI], physical activity and other lifestyle factors did not influence the SRR, nor did menopausal status and estrogen receptor status of the tumor. In conclusion, the current evidence supports a modest association between a dietary pattern with high glycemic index or glycemic load and the risk of breast cancer. PMID:25747120

  14. Glycemic Variability Assessed by Continuous Glucose Monitoring and Short-Term Outcome in Diabetic Patients Undergoing Percutaneous Coronary Intervention: An Observational Pilot Study.

    PubMed

    Nusca, Annunziata; Lauria Pantano, Angelo; Melfi, Rosetta; Proscia, Claudio; Maddaloni, Ernesto; Contuzzi, Rocco; Mangiacapra, Fabio; Palermo, Andrea; Manfrini, Silvia; Pozzilli, Paolo; Di Sciascio, Germano

    2015-01-01

    Poor glycemic control is associated with unfavorable outcome in patients undergoing percutaneous coronary intervention (PCI), irrespective of diabetes mellitus. However a complete assessment of glycemic status may not be fully described by glycated hemoglobin or fasting blood glucose levels, whereas daily glycemic fluctuations may influence cardiovascular risk and have even more deleterious effects than sustained hyperglycemia. Thus, this paper investigated the effectiveness of a continuous glucose monitoring (CGM), registering the mean level of glycemic values but also the extent of glucose excursions during coronary revascularization, in detecting periprocedural outcome such as renal or myocardial damage, assessed by serum creatinine, neutrophil gelatinase-associated lipocalin (NGAL), and troponin I levels. High glycemic variability (GV) has been associated with worse postprocedural creatinine and NGAL variations. Moreover, GV, and predominantly hypoglycemic variations, has been observed to increase in patients with periprocedural myocardial infarction. Thus, our study investigated the usefulness of CGM in the setting of PCI where an optimal glycemic control should be achieved in order to prevent complications and improve outcome. PMID:26273664

  15. Glycemic Variability Assessed by Continuous Glucose Monitoring and Short-Term Outcome in Diabetic Patients Undergoing Percutaneous Coronary Intervention: An Observational Pilot Study

    PubMed Central

    Nusca, Annunziata; Lauria Pantano, Angelo; Melfi, Rosetta; Proscia, Claudio; Maddaloni, Ernesto; Contuzzi, Rocco; Mangiacapra, Fabio; Palermo, Andrea; Manfrini, Silvia; Pozzilli, Paolo; Di Sciascio, Germano

    2015-01-01

    Poor glycemic control is associated with unfavorable outcome in patients undergoing percutaneous coronary intervention (PCI), irrespective of diabetes mellitus. However a complete assessment of glycemic status may not be fully described by glycated hemoglobin or fasting blood glucose levels, whereas daily glycemic fluctuations may influence cardiovascular risk and have even more deleterious effects than sustained hyperglycemia. Thus, this paper investigated the effectiveness of a continuous glucose monitoring (CGM), registering the mean level of glycemic values but also the extent of glucose excursions during coronary revascularization, in detecting periprocedural outcome such as renal or myocardial damage, assessed by serum creatinine, neutrophil gelatinase-associated lipocalin (NGAL), and troponin I levels. High glycemic variability (GV) has been associated with worse postprocedural creatinine and NGAL variations. Moreover, GV, and predominantly hypoglycemic variations, has been observed to increase in patients with periprocedural myocardial infarction. Thus, our study investigated the usefulness of CGM in the setting of PCI where an optimal glycemic control should be achieved in order to prevent complications and improve outcome. PMID:26273664

  16. 77 FR 66469 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-05

    ... HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and... meeting of the aforementioned committee: Name: Breast and Cervical Cancer Early Detection and Control..., regarding the early detection and control of breast and cervical cancer. The committee makes...

  17. 76 FR 30723 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-26

    ... SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control..., and the Director, CDC, regarding the early detection and control of breast and cervical cancer. The... cervical cancer screening; updates on the National Breast and Cervical Cancer Early Detection...

  18. Inter- and Intra-Individual Variability in Glycemic Index Values for White Bread Determined Using Standardized Procedures

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study was conducted to evaluate the inter- and intra-individual variability of the GI value when determined under strictly controlled conditions. Twenty-three healthy adults (20-70 y) completed up to three sets of two visits per set. Each pair of visits assessed the glycemic response to 50 g a...

  19. 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

  20. DIETARY HYPERGLYCEMIA, GLYCEMIC INDEX AND METABOLIC RETINAL DISEASES

    PubMed Central

    Chiu, Chung-Jung; Taylor, Allen

    2014-01-01

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

  1. Glucose control in critical care

    PubMed Central

    Clain, Jeremy; Ramar, Kannan; Surani, Salim R

    2015-01-01

    Glycemic control among critically-ill patients has been a topic of considerable attention for the past 15 years. An initial focus on the potentially deleterious effects of hyperglycemia led to a series of investigations regarding intensive insulin therapy strategies that targeted tight glycemic control. As knowledge accumulated, the pursuit of tight glycemic control among critically-ill patients came to be seen as counterproductive, and moderate glycemic control came to dominate as the standard practice in intensive care units. In recent years, there has been increased focus on the importance of hypoglycemic episodes, glycemic variability, and premorbid diabetic status as factors that contribute to outcomes among critically-ill patients. This review provides a survey of key studies on glucose control in critical care, and aims to deliver perspective regarding glycemic management among critically-ill patients. PMID:26265994

  2. Metabolic and glycemic sequelae of sleep disturbances in children and adults.

    PubMed

    Koren, Dorit; O'Sullivan, Katie L; Mokhlesi, Babak

    2015-01-01

    The prevalence of obesity in adults and children has increased greatly in the past three decades, as have metabolic sequelae, such as insulin resistance and type 2 diabetes mellitus (T2DM). Sleep disturbances are increasingly recognized as contributors to this widespread epidemic in adults, and data are emerging in children as well. The categories of sleep disturbances that contribute to obesity and its glycemic co-morbidities include the following: (1) alterations of sleep duration, chronic sleep restriction and excessive sleep; (2) alterations in sleep architecture; (3) sleep fragmentation; (4) circadian rhythm disorders and disruption (i.e., shift work); and (5) obstructive sleep apnea. This article reviews current evidence supporting the contributions that these sleep disorders play in the development of obesity, insulin resistance, and T2DM as well as possibly influences on glycemic control in type 1 diabetes, with a special focus on data in pediatric populations. PMID:25398202

  3. The effects of hormonal contraceptives on glycemic regulation

    PubMed Central

    Cortés, Manuel E.; Alfaro, Andrea A.

    2014-01-01

    A number of side effects have been linked to the use of hormonal contraceptives, among others, alterations in glucose levels. Hence, the objective of this mini-review is to show the main effects of hormonal contraceptive intake on glycemic regulation. First, the most relevant studies on this topic are described, then the mechanisms that might be accountable for this glycemic regulation impairment as exerted by hormonal contraceptives are discussed. Finally, we briefly discuss the ethical responsibility of health professionals to inform about the potential risks on glycemic homeostasis regarding hormonal contraceptive intake. PMID:25249703

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

    PubMed

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

    2015-04-01

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

  5. Effect of Low Glycemic Index Diet Versus Metformin on Metabolic Syndrome

    PubMed Central

    Rajabi, Shirin; Mazloom, Zohreh; Zamani, Ali; Tabatabaee, Hamid Reza

    2015-01-01

    Background: Metabolic syndrome (MetS) continues to be highly prevalent and contributes to a rapidly growing problem worldwide. The most important therapeutic intervention for metabolic syndrome is diet modification, an intervention whose efficacy has been proven for metabolic syndrome. Objectives: The aim of the present study was to compare the effects of low glycemic index diet versus metformin on MetS components in adults with MetS. Patients and Methods: Fifty-one adults with MetS participated in this randomized controlled clinical trial. Patients were randomly allocated to two groups of metformin and low glycemic index diet. The intervention period was eight weeks. The studied participants were compared at baseline and the end of the trial, regarding the following factors: weight, blood pressure, waist circumference, fasting blood sugar, hemoglobin A1c and lipid profiles (Triglyceride (TG), Total Cholesterol (TC), Low-Density Lipoprotein (LDL) cholesterol, and High-Density Lipoprotein (HDL) cholesterol). Results: The anthropometric measurements, Fasting Blood Sugar (FBS), Hemoglobin A1c, serum lipid profiles (TG, TC, LDL-C, HDL-C) and lipoprotein ratio (LDL/HDL) showed a significant decrease after the intervention in both groups (P < 0.05). Comparison of the difference between the two groups was not significant, except for the mean reduction in FBS, which was more in the metformin group although this was not clinically significant. Conclusions: This study supports the assumption that low glycemic index diet as well as metformin can positively affect metabolic syndrome components. PMID:26587028

  6. Landslide Geohazard Monitoring, Early Warning and Stabilization Control Methods

    NASA Astrophysics Data System (ADS)

    Bednarczyk, Zbigniew

    2014-03-01

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

  7. 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...

  8. 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...

  9. 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

  10. The Development of Emotional and Behavioral Control in Early Childhood: Heterotypic Continuity and Relations to Early School Adjustment

    PubMed Central

    Chang, Hyein; Shaw, Daniel S; Cheong, JeeWon

    2015-01-01

    We examined heterotypic continuity of emotional and behavioral control (EBC) across early childhood and related early manifestations of EBC to children’s school adjustment in 310 low-income, ethnically diverse boys. Multiple informants and methods were used to measure different indicators of EBC at 18, 24, 42, and 60 months, which were chosen to reflect salient regulatory challenges children face across development. Teachers rated boys’ externalizing and internalizing behaviors, and social skills at 72 months. Results indicated a modest degree of heterotypic continuity of EBC, with different constructs of EBC associated between adjacent time points and, in some instances, across more distant time points. Further, children who had struggled with early EBC demonstrated higher externalizing problems and lower social skills in school. Findings suggest that early deficits in EBC may be a target for early identification and prevention, as they may forecast continued difficulty in later-developing EBC skills and socioemotional problems. PMID:26550611

  11. 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

  12. Nurse Navigators in Early Cancer Care: A Randomized, Controlled Trial

    PubMed Central

    Wagner, Edward H.; Ludman, Evette J.; Aiello Bowles, Erin J.; Penfold, Robert; Reid, Robert J.; Rutter, Carolyn M.; Chubak, Jessica; McCorkle, Ruth

    2014-01-01

    Purpose To determine whether a nurse navigator intervention improves quality of life and patient experience with care for people recently given a diagnosis of breast, colorectal, or lung cancer. Patients and Methods Adults with recently diagnosed primary breast, colorectal, or lung cancer (n = 251) received either enhanced usual care (n = 118) or nurse navigator support for 4 months (n = 133) in a two-group cluster randomized, controlled trial with primary care physicians as the units of randomization. Patient-reported measures included the Functional Assessment of Cancer Therapy–General (FACT-G) Quality of Life scale, three subscales of the Patient Assessment of Chronic Illness Care (PACIC), and selected subscales from a cancer adaptation of the Picker Institute's patient experience survey. Self-report measures were collected at baseline, 4 months, and 12 months. Automated administrative data were used to assess time to treatment and total health care costs. Results There were no significant differences between groups in FACT-G scores. Nurse navigator patients reported significantly higher scores on the PACIC and reported significantly fewer problems with care, especially psychosocial care, care coordination, and information, as measured by the Picker instrument. Cumulative costs after diagnosis did not differ significantly between groups, but lung cancer costs were $6,852 less among nurse navigator patients. Conclusion Compared with enhanced usual care, nurse navigator support for patients with cancer early in their course improves patient experience and reduces problems in care, but did not differentially affect quality of life. PMID:24276777

  13. 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

  14. 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

  15. 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...

  16. 75 FR 7282 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-18

    ... SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control... cervical cancer. The committee makes recommendations regarding national program goals and objectives... Force guidelines for breast and cervical cancer screening; Impact of the revised clinical...

  17. 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...

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  19. 75 FR 7282 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-18

    ... SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control... Force guidelines for breast and cervical cancer screening; Impact of the revised clinical screening recommendations for both breast and cervical cancer on the National Breast and Cervical Cancer Early...

  20. Evaluation of finger millet incorporated noodles for nutritive value and glycemic index.

    PubMed

    Shukla, Kamini; Srivastava, Sarita

    2014-03-01

    The present study was undertaken to develop finger millet incorporated noodles for diabetic patients. Finger millet variety VL-149 was taken. The finger millet flour and refined wheat flour (RWF) were evaluated for nutrient composition. The finger millet flour (FMF) was blended in various proportions (30 to 50%) in refined wheat flour and used for the preparation of noodles. Control consisted of RWF noodles. Sensory quality and nutrient composition of finger millet noodles was evaluated. The 30% finger millet incorporated noodles were selected best on the basis of sensory evaluation. Noodles in that proportion along with control were evaluated for glycemic response. Nutrient composition of noodles showed that 50% finger millet incorporated noodles contained highest amount of crude fat (1.15%), total ash (1.40%), crude fiber (1.28%), carbohydrate (78.54%), physiological energy (351.36 kcal), insoluble dietary fiber (5.45%), soluble dietary fiber (3.71%), iron (5.58%) and calcium (88.39%), respectively. However, control RWF noodles contained highest amount of starch (63.02%), amylose (8.72%) and amylopectin (54.29%). The glycemic index (GI) of 30% finger millet incorporated noodles (best selected by sensory evaluation) was observed significantly lower (45.13) than control noodles (62.59). It was found that finger millet flour incorporated noodles were found nutritious and showed hypoglycemic effect. PMID:24587528

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

    PubMed Central

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

    2013-01-01

    Background: Brewer's yeast may have beneficial effects on insulin receptors because of itsglucose tolerance factor in diabetic patients. This study was conducted to investigate the effects of brewer's yeast supplementation on glycemic indices in patients with type 2 diabetes mellitus. Methods: In a randomized double-blind controlled clinical trial, 84 adults (21 men and 63 women) aged 46.3 ± 6.1 years old with type 2 diabetes mellitus were recruited and divided randomly into two groups: Supplement group receiving brewer's yeast (six 300mg tablets/day, total 1800 mg) and control group receiving placebo (six 300mg tablets/day) for 12 weeks. Body weight, height, body mass index, food consumption (based on 24h food record), fasting blood sugar (FBS), glycosylated hemoglobin, insulin sensitivity, and insulin resistance were measured before and after the intervention. Data analysis was performed using the Statistical Package for Social Sciences (version 18.0). Results: The changes in FBS, glycosylated hemoglobin, and insulin sensitivity were significantly different between the two groups during the study (respectively P < 0.001, P < 0.001, P = 0.02 independent sample t-test). There was a significant difference in FBS, glycosylated hemoglobin, and insulin sensitivity at the end of the study between the two groups after removing the effects of baseline values (respectively P = 0.002, P < 0.001, P = 0.02, analysis of covariance). Changes in body mass index, 24h food record, insulin resistance were not significant. Conclusions: Dietary supplementation with brewer›s yeast besides the usual treatment of diabetes can ameliorate blood glucose variables in type 2 diabetes mellitus. PMID:24319552

  2. Can the Glycemic Index (GI) be Used as a Tool in the Prevention and Management of Type 2 Diabetes?

    PubMed Central

    Hermansen, Marie-Louise F.; Eriksen, Nina M.B.; Mortensen, Lene S.; Holm, Lotte; Hermansen, Kjeld

    2006-01-01

    The large increase in type 2 diabetes (T2DM), the considerable lifetime risk of diabetes and the loss of lifetime call for concerted action to prevent T2DM and its complications. Since diabetes is characterized by abnormal glucose metabolism, the question arises of whether a high intake of carbohydrates that are rapidly absorbed as glucose may increase the risk and worsen the course of T2DM. To quantify the impact of carbohydrates on blood glucose the glycemic index (GI) and the glycemic load (GL) have been applied. The GI of a food is a method of ranking carbohydrate rich foods according to their glycemic responses. GI is defined as the incremental area under the blood glucose curve of 50g carbohydrate of a test food expressed as a percentage of the area of the response to an equivalent amount of a reference food (glucose or white bread). In relation to GI/GL and prevention of T2DM there is insufficient information from observational studies to determine whether a positive association exists or not. Only randomized controlled clinical intervention studies will be able to provide the final answer. From meta-analyses of randomised controlled clinical trials comparing low and high GI diets in the treatment of diabetes it has been found that low GI diets improve the glycemic control. Labeling of foods with GI would be helpful for persons with diabetes, but the usefulness for healthy subjects remains to be clarified. At present it seems premature to introduce GI labeling for the entire population. PMID:17487328

  3. Effect of Fresh Royal Jelly Ingestion on Glycemic Response in Patients With Type 2 Diabetes

    PubMed Central

    Mobasseri, Majid; Ghiyasvand, Shahram; Ostadrahimi, Alireza; Ghojazadeh, Morteza; Noshad, Hamid; Pourmoradian, Samira

    2015-01-01

    Background: Type 2 diabetes is the fourth major public health problem worldwide. Royal Jelly (RJ) insulin-like activity and blood glucose modulating properties have been reported in animal and healthy volunteers. Objectives: This study aimed to investigate the effect of a single dose of fresh RJ as a complementary therapy on glycemic response in patients with type 2 diabetes. Patients and Methods: In this randomized clinical trial, 40 patients with type 2 diabetes were assigned into the RJ (n = 20) and placebo (n = 20) groups and received either 10 g fresh RJ or placebo after overnight fasting. Serum glucose, insulin and C-peptide concentrations were determined at 0, 60, 120 minutes after the intervention. Independent t-tests and repeated measures ANOVA were used to analyze data. Results: The mean serum glucose levels were significantly decreased in RJ and placebo groups; however, mean serum level was different but not statistically. (P = 0.77). One hour after RJ ingestion the mean serum insulin concentrations were increased and after 2 hours it was decreased insignificantly (P = 0.54, P = 0.20). The mean C-peptide concentrations were significantly increased after 1 and 2 hours of RJ ingestion; however, in the placebo group we observed a slight but insignificant reduction at the time of 1 and 2 hours in the mean C-peptide serum levels (P = 0.40). Moreover, there was no significant difference in none of the glycemic control parameters between both studied groups (P > 0.05). Conclusions: It seems that RJ does not appear to have significant immediate effects on glycemic factors in patients with type 2 diabetes. However, further studies with larger sample sizes and different doses of RJ are needed to achieve more precise results. PMID:26473074

  4. Automatic Detection of Excessive Glycemic Variability for Diabetes Management

    E-print Network

    Bunescu, Razvan C.

    . An automated screen for excessive glycemic variability, based on the readings from continuous glucose, blindness, and strokes [2]. Patients are routinely monitored for hyperglycemia, or high blood glucose levels work. Blood glucose profiles of diabetes patients were obtained via continuous glucose moni- toring

  5. 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

  6. Working Memory and Inhibitory Control in Early Childhood

    E-print Network

    , Temperament, and Language Christy D. Wolfe Martha Ann Bell Department of Psychology Virginia Polytechnic, temperament, and language in early childhood. WMIC skills were assessed in twenty-five 41 2-year- old children function analysis indicated that physiology, temperament, and language were able to correctly predict 90

  7. Mandibular Motor Control during the Early Development of Speech and Nonspeech Behaviors

    ERIC Educational Resources Information Center

    Steeve, Roger W.; Moore, Christopher A.

    2009-01-01

    Purpose: The mandible is often portrayed as a primary structure of early babble production, but empiricists still need to specify (a) how mandibular motor control and kinematics vary among different types of multisyllabic babble, (b) whether chewing or jaw oscillation relies on a coordinative infrastructure that can be exploited for early types of…

  8. 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.

  9. Charting Early Trajectories of Executive Control with the Shape School

    ERIC Educational Resources Information Center

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

    2013-01-01

    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

  10. Predictors of Longitudinal Growth in Inhibitory Control in Early Childhood

    ERIC Educational Resources Information Center

    Moilanen, Kristin L.; Shaw, Daniel S.; Dishion, Thomas J.; Gardner, Frances; Wilson, Melvin

    2010-01-01

    In the current study, we examined latent growth in 731 young children's inhibitory control from the ages of two to four years, and whether demographic characteristics or parenting behaviors were related to initial levels and growth in inhibitory control. As part of an ongoing longitudinal evaluation of the family check-up, children's inhibitory…

  11. 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...

  12. The Discourse of Control: Disruption and Foucault in an Early Childhood Classroom

    ERIC Educational Resources Information Center

    Millei, Zsuzsanna J.

    2005-01-01

    Disruption can be a result of a wide array of circumstances, but is commonly identified as a "control problem" in early childhood classrooms. In this article, the author argues that the recognition of disruption as a "control problem" is embedded in and governed by the social power and values entrenched in teaching discourses.…

  13. 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)…

  14. 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…

  15. 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…

  16. 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

    ... From the Federal Register Online via the Government Printing Office 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 under the Federal...

  17. 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…

  18. Controls on development and diversity of Early Archean stromatolites

    PubMed Central

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

    2009-01-01

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

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

    PubMed Central

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

    2008-01-01

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

  20. Kinetic controls on early karst aquifer porosity development

    SciTech Connect

    Groves, C.G. ); Howard, A.D. . 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.

  1. The impact of early bilingualism on controlling a language learned late: an ERP study

    PubMed Central

    Martin, Clara D.; Strijkers, Kristof; Santesteban, Mikel; Escera, Carles; Hartsuiker, Robert J.; Costa, Albert

    2013-01-01

    This study asks whether early bilingual speakers who have already developed a language control mechanism to handle two languages control a dominant and a late acquired language in the same way as late bilingual speakers. We therefore, compared event-related potentials in a language switching task in two groups of participants switching between a dominant (L1) and a weak late acquired language (L3). Early bilingual late learners of an L3 showed a different ERP pattern (larger N2 mean amplitude) as late bilingual late learners of an L3. Even though the relative strength of languages was similar in both groups (a dominant and a weak late acquired language), they controlled their language output in a different manner. Moreover, the N2 was similar in two groups of early bilinguals tested in languages of different strength. We conclude that early bilingual learners of an L3 do not control languages in the same way as late bilingual L3 learners –who have not achieved native-like proficiency in their L2– do. This difference might explain some of the advantages early bilinguals have when learning new languages. PMID:24204355

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

    PubMed Central

    2012-01-01

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

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

    PubMed Central

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

    2015-01-01

    Background We recently reported improved glycemic control with reduced insulin dose in subjects with type 1 diabetes treated with the sodium glucose co-transporter-2 inhibitor empagliflozin. To further characterize the effects, we analyzed diurnal glycemic patterns by continuous glucose monitoring (CGM). Methods In an 8-week single-arm open-label pilot study of empagliflozin, we compared ambulatory glucose profiles produced from CGM data during 2-week intervals in a placebo run-in baseline period, end-of-treatment, and post-treatment. Change in glycemic exposure was evaluated by area under the median curve according to time of day (AUCTOTAL 12:00am-11:55pm; AUCDAY 7:05am-10:55pm, AUCNIGHT 11:00pm-7:00am), as well as glycemic variability, glycemic stability and time-in-target (?70 to ?140mg/dL). Results The 40 patients (26 on insulin pump) were aged 24±5 years and BMI 24.5±3.2 kg/m2. Consistent with the observed HbA1c decrease (8.0±0.9% to 7.6±0.9%, p<0.0001), normalized AUCTOTAL CGM decreased from 153.7±25.4 to 149.0±30.2mg/dL?h at end-of-treatment (p = 0.31), and significantly increased post-treatment (164.1±29.5mg/dL?h, p = 0.02). The numerical decrease in normalized AUCNIGHT (152.0±36.6 to 141.9±34.4mg/dL?h, p = 0.13) exceeded AUCDAY (154.5±24.5 to 152.6±30.4mg/dL?h, p = 0.65). Trends toward lower glycemic variability (83.1±18.9 to 75.6±28.6mg/dL, p = 0.06) and little change in glycemic stability (10.8±3.6 to 10.3±4.5mg/dL/h, p = 0.51) were observed. When empagliflozin was discontinued, these worsened relative to baseline (89.3±19.3mg/dL, p = 0.04 and 11.8±3.7mg/dL/hr, p = 0.08). Time-in-target numerically increased (40.2±11.9 to 43.1±13.5%, p = 0.69) at end-of-treatment but reversed post-treatment. Findings were similar on stratification of pump and MDI subjects. Conclusions We observed that empagliflozin was associated with patterns of improved nighttime glycemia more prominent than daytime. Trial Registration Clinicaltrials.gov NCT01392560 PMID:26544192

  4. The route to diabetes: Loss of complexity in the glycemic profile from health through the metabolic syndrome to type 2 diabetes

    PubMed Central

    Churruca, Juan; Vigil, Luis; Luna, Esther; Ruiz-Galiana, Julian; Varela, Manuel

    2008-01-01

    Aims: In many physiologic systems, the evolution from health to disease correlates with a loss of complexity in the system’s output. We analyze the difference in complexity of the glycemic profile in healthy volunteers (H), patients with the metabolic syndrome (MS), and patients with type 2 diabetes mellitus (DM). Methods: We measured interstitial fluid glucose every 5 minutes for 3 days in 10 H, 10 MS, and 10 DM. Complexity of the glycemic profile was evaluated by means of detrended fluctuation analysis (DFA). Mean amplitude of glycemic excursions (MAGE) was also calculated. Results: Glucose profile was more complex (lower DFA) in healthy subjects than in patients with MS or DM (mean DFA [SD]: H: 1.25 (0.10), MS: 1.39 (0.07), DM: 1.42 (0.10). ANOVA: F2,27 = 9.94, p = 0.001). DM had also a less complex profile than MS, but this difference was not statistically significant. There was an inverse relation between complexity (lower DFA) and the number of MS defining criteria (rho = 0.55, p = 0.002) and between complexity and MAGE (r = 0.68, p < 0.0001). Conclusions: There is a progressive loss of complexity in the glycemic profile from health, through the metabolic syndrome to type 2 diabetes mellitus. This loss of complexity precedes hyperglycemia and correlates with other markers of disease progression. Complexity analysis may be a useful tool to track the evolution from health to type 2 diabetes. Furthermore, it may provide a way to measure glycemic control in real-life situations and has some distinct advantages over other conventional variability metrics. PMID:21437151

  5. Convergence of obesity and high glycemic diet on compounding diabetes and cardiovascular risks in modernizing China: An emerging public health dilemma

    PubMed Central

    Ding, Eric L; Malik, Vasanti S

    2008-01-01

    As China is undergoing dramatic development, it is also experiencing major societal changes, including an emerging obesity epidemic, with the prevalence of overweight and obesity doubling in the past decade. However, the implications of a high glycemic index (GI) and glycemic load (GL) traditional Chinese diet are adversely changing in modern times, as a high-glycemic diet is becoming a greater contributor to diabetes and cardiovascular risks in a population with rising obesity and decreasing physical activity. Specifically, a high GI diet adversely impacts metabolism and appetite control regulation, and notably confers substantially greater risk of weight gain, type 2 diabetes, cardiovascular disease, and certain cancers among overweight and obese individuals (P<0.05 for all); leading to an emerging vicious cycle of compounding adverse health risks. Notably, while no elevated risk of cardiovascular disease and type 2 diabetes were observed with higher GL intake among normal weight individuals, among overweight individuals, higher GL was strongly associated with higher risk of coronary heart disease (RR=2.00, 95%CI: 1.31-2.96), stroke (RR=2.13, 1.28-3.53), and type 2 diabetes (RR=1.52, 1.22-1.89 among Chinese). Additionally, the influx of Western-diets rich in saturated fats and high-glycemic sugar-sweetened beverages also threaten the health of the population. This review highlights the emerging adverse convergence of a high-glycemic Asian diet with a Chinese society experiencing an emerging obesity epidemic, and the important implications of these combined factors on compounding cardiometabolic risks. Potential policy directions in China are also discussed. PMID:18302739

  6. Impact of Alcohol on Glycemic Control and Insulin Action

    PubMed Central

    Steiner, Jennifer L.; Crowell, Kristen T.; Lang, Charles H.

    2015-01-01

    Alcohol has profound effects on tissue and whole-body fuel metabolism which contribute to the increased morbidity and mortality in individuals with alcohol use disorder. This review focuses on the glucose metabolic effects of alcohol, primarily in the muscle, liver and adipose tissue, under basal postabsorptive conditions and in response to insulin stimulation. While there is a relatively extensive literature in this area, results are often discordant and extrapolating between models and tissues is fraught with uncertainty. Comparisons between data generated in experimental cell and animals systems will be contrasted with that obtained from human subjects as often times results differ. Further, the nutritional status is also an important component of the sometimes divergent findings pertaining to the effects of alcohol on the regulation of insulin and glucose metabolism. This work is relevant as the contribution of alcohol intake to the development or exacerbation of type 2 diabetes remains ill-defined and a multi-systems approach is likely needed as both alcohol and diabetes affect multiple targets within the body. PMID:26426068

  7. Developmental Changes in the Relations between Inhibitory Control and Externalizing Problems during Early Childhood

    ERIC Educational Resources Information Center

    Utendale, William T.; Hastings, Paul D.

    2011-01-01

    Deficits in executive function, and in particular, reduced capacity to inhibit a dominant action, are a risk factor for externalizing problems (EP). Inhibitory control (IC) develops in the later preschool and early childhood periods, such that IC might not regulate EP in toddlers and younger preschoolers. Aggression was observed during peer play…

  8. Groundwater-controlled valley networks and the decline of surface runoff on early Mars

    E-print Network

    Harrison, Keith

    Groundwater-controlled valley networks and the decline of surface runoff on early Mars Keith P was dominated by valley networks created through a combination of groundwater processes and surface runoff evolution characterized by a weakening of surface runoff, leaving groundwater processes as the dominant

  9. The Control of Sexuality in the Early British Boy Scouts Movement

    ERIC Educational Resources Information Center

    Pryke, Sam

    2005-01-01

    This article looks at the way in which the early (1907-1922) British Boy Scouts movement attempted to control sexuality through archival examination of the organization's preoccupation with preventing masturbation or, as it was generally referred to, "self abuse". Having briefly outlined the origination and nature of the Scouts, it considers why…

  10. Zebrafish Pou5f1-dependent transcriptional networks in temporal control of early development

    E-print Network

    Timmer, Jens

    Zebrafish Pou5f1-dependent transcriptional networks in temporal control of early development Daria of zebrafish pou5f1 MZspg mutant embryos to identify genes regulated by Pou5f1. Comparison to mammalian systems timing. The temporospatial structure of the zebrafish Pou5f1 target networks may explain aspects

  11. Effect of Education through Support ­Group on Early Symptoms of Menopause: a Randomized Controlled Trial

    PubMed Central

    Sehhatie Shafaie, Fahimeh; Mirghafourvand, Mozhgan; Jafari, Maryam

    2014-01-01

    Introduction: Menopause is one of the most important crises in the life of women. The control of menopause symptoms is a main challenge in providing care to this population. So, the aim of present study was to investigate the effect of education through support ­group on early symptoms of menopause. Methods: In this randomized controlled clinical trial 124 postmenopausal women who had a health records in Valiasr participatory health center of Eslamshahr city were participated. These women were allocated by block randomization method into support group (62 women) and control group (62 women).Women in support group was assigned into 6 groups. Three 60-minutes educational sessions were conducted in 3 sequential weekly sessions. Early menopausal symptoms were measured before and 4 weeks after the intervention by using Greene scale (score ranged from 0 to 63). Data analysis was performed by ANCOVA statistical test. Results: There were no statistical differences between two groups in demographic characteristics and the total score of the Greene scale before intervention. The mean score of the Greene scale in support group was statistically less than control group 4 weeks after intervention. The number of hot flashes in the support group was significantly lower than control group, 4 weeks after intervention.Conclusion: Education through support group was effective in reducing the early symptoms of menopause. Thus, this educational method can be used as an appropriate strategy for enhancing women’ health and their dealing with annoying symptoms of menopause. PMID:25709980

  12. 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…

  13. 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

    ... From the Federal Register Online via the Government Printing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control... (Pub. L. 92-463) of October 6, 1972, that the Breast and Cervical Cancer Early Detection and...

  14. Moderate Intensity Training Impact on the Inflammatory Status and Glycemic Profiles in NOD Mice

    PubMed Central

    Codella, Roberto; Lanzoni, Giacomo; Zoso, Alessia; Caumo, Andrea; Montesano, Anna; Terruzzi, Ileana M.; Ricordi, Camillo; Luzi, Livio; Inverardi, Luca

    2015-01-01

    The nonobese diabetic (NOD) mouse represents a well-established experimental model analogous to human type 1 diabetes mellitus (T1D) as it is characterized by progressive autoimmune destruction of pancreatic ?-cells. Experiments were designed to investigate the impact of moderate-intensity training on T1D immunomodulation and inflammation. Under a chronic exercise regime, NOD mice were trained on a treadmill for 12 weeks (12?m/min for 30?min, 5?d/wk) while age-matched, control animals were left untrained. Prior to and upon completion of the training period, fed plasma glucose and immunological soluble factors were monitored. Both groups showed deteriorated glycemic profiles throughout the study although trained mice tended to be more compensated than controls after 10 weeks of training. An exercise-induced weight loss was detected in the trained mice with respect to the controls from week 6. After 12 weeks, IL-6 and MIP-1? were decreased in the trained animals compared to their baseline values and versus controls, although not significantly. Morphometric analysis of pancreata revealed the presence of larger infiltrates along with decreased ?-cells areas in the control mice compared to trained mice. Exercise may exert positive immunomodulation of systemic functions with respect to both T1D and inflammation, but only in a stringent therapeutic window. PMID:26347378

  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. An occupational health intervention programme for workers at risk for early retirement; a randomised controlled trial

    PubMed Central

    de Boer, A G E M; van Beek, J-C; Durinck, J; Verbeek, J; van Dijk, F J H

    2004-01-01

    Aims: To evaluate an occupational health intervention programme for workers at risk for early retirement. Methods: Between April 1997 and May 1998, 116 employees of a large company who were older than 50 years indicated that they would not be able to work up to their retirement. They were randomly assigned to an intervention (n = 61) or control group (n = 55). The intervention programme lasted six months and was executed by an occupational physician. Job position and number of sick leave days after two years were collected from the company's computer database. A questionnaire was sent to the employees at baseline, after six months, and after two years; it included the Work Ability Index, the Utrecht Burn Out Scale, and the Nottingham Health Profile measuring quality of life. Results: Fewer employees (11%) in the intervention group retired early than in the control group (28%). The total average number of sick leave days in two years was 82.3 for the intervention group and 107.8 for the control group. Six months after baseline, employees in the intervention group had better work ability, less burnout, and better quality of life than employees in the control group. Two years after randomisation no differences between the two groups were found. Conclusions: This occupational health intervention programme proved to be a promising intervention in the prevention of early retirement. PMID:15477286

  17. Early stage second-language learning improves executive control: evidence from ERP.

    PubMed

    Sullivan, Margot D; Janus, Monika; Moreno, Sylvain; Astheimer, Lori; Bialystok, Ellen

    2014-12-01

    A growing body of research has reported a bilingual advantage in performance on executive control tasks, but it is not known at what point in emerging bilingualism these advantages first appear. The present study investigated the effect of early stage second-language training on executive control. Monolingual English-speaking students were tested on a go-nogo task, sentence judgment task, and verbal fluency, before and after 6 months of Spanish instruction. The training group (n = 25) consisted of students enrolled in introductory Spanish and the control group (n = 30) consisted of students enrolled in introductory Psychology. After training, the Spanish group showed larger P3 amplitude on the go-nogo task and smaller P600 amplitude on the judgment task, indicating enhanced performance, with no changes for the control group and no differences between groups on behavioral measures. Results are discussed in terms of neural changes underlying executive control after brief second-language learning. PMID:25463819

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

    PubMed

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

    2014-10-01

    High-density lipoprotein (HDL) is a lipoprotein which has anti-atherogenic property by reverse cholesterol transport from the peripheral tissues to liver. Low HDL-cholesterol (HDL-C) levels are associated with the development of coronary artery diseases (CADs). Various epidemiological studies have suggested that the development of CAD increase in individuals with less than 40 mg/dL of HDL-C. In spite of accumulation of evidences which suggest a significant association between low HDL-C and cardiovascular diseases, effects of dietary factors on HDL metabolism remained largely unknown. There may be interracial differences in effects of dietary factors on HDL metabolism. Here we reviewed published articles about effects of carbohydrate and dietary fiber intake, glycemic index (GI) and glycemic load (GL), on HDL-C metabolism, regarding meta-analyses and clinical studies performed in Asian population as important articles. Low carbohydrate intake, GI and GL may be beneficially associated with HDL metabolism. Dietary fiber intake may be favorably associated with HDL metabolism in Asian populations. PMID:25110535

  19. Impact of consumption of vegetable, fruit, grain, and high glycemic index foods on aggressive prostate cancer risk

    PubMed Central

    Hardin, Jill; Cheng, Iona; Witte, John S.

    2011-01-01

    Prostate cancer is a common but complex disease, and distinguishing modifiable risk factors such as diet for more aggressive disease is extremely important. Previous work has detected intriguing associations between vegetable, fruit, and grains and more aggressive prostate cancer, although these remain somewhat unclear. Here we further investigate such potential relationships with a case-control study of 982 men (470 more aggressive prostate cancer cases and 512 control subjects). Comparing the highest to lowest quartiles of intake, we found that increasing intakes of leafy vegetables were inversely associated with risk of aggressive prostate cancer (adjusted odds ratio (OR) =0.66, 95% CI: 0.46, 0.96, P-trend=0.02), as was higher consumption of high carotenoid vegetables (OR=0.71, 95% CI: 0.48, 1.04; P-trend=0.04). Conversely, increased consumption of high glycemic index foods were positively associated with risk of aggressive disease (OR=1.64, 95% CI: 1.05, 2.57; P-trend=0.02). These results were driven by a number of specific foods within the food groups. Our findings support the hypothesis that diets high in vegetables and low in high glycemic index foods decrease risk of aggressive prostate cancer. PMID:21774611

  20. Early initiation of low-level parenteral dextrose induces an accelerated diabetic phenotype in septic C57BL/6J mice.

    PubMed

    Singamsetty, Srikanth; Shah, Faraaz Ali; Guo, Lanping; Watanabe, Yoshio; McDonald, Sherie; Sharma, Rohit; Zhang, Yingze; Alonso, Laura C; O'Donnell, Christopher P; McVerry, Bryan J

    2016-01-01

    Development of hyperglycemia during sepsis is associated with increased morbidity and mortality. Nutritional support is common practice in the intensive care unit, but the metabolic effects are not well understood. The purpose of this study is to determine the effect of early low-level calorie provision on the development of hyperglycemia in a clinically relevant murine model of sepsis. C57BL/6J mice underwent femoral arterial and venous catheterization followed by cecal ligation and puncture (CLP) or sham surgery and low-dose intravenous dextrose or saline infusion. Blood glucose, plasma insulin, and cytokines were measured after 24 h. Additional septic mice underwent hyperinsulinemic-euglycemic clamps or received intravenous insulin concurrent with dextrose to determine whole-body insulin sensitivity and test the efficacy of insulin to reverse hyperglycemia. Neither dextrose infusion nor CLP alone induced hyperglycemia. Early initiation of low-level dextrose in septic mice produced a variable glycemic response: 49% maintained euglycemia (blood glucose < 200) and 27% developed severe hyperglycemia (blood glucose ? 600). Hyperglycemia was associated with increased inflammation and reduced insulin secretion and sensitivity compared with control mice or CLP mice maintaining euglycemia. Insulin prevented the progression to severe hyperglycemia but was ineffective in reestablishing glycemic control once hyperglycemia had developed. In conclusion, early initiation of clinically relevant low-level dextrose (?20% daily caloric requirements) precipitated hyperglycemia akin to an acute diabetic phenotype in septic mice characterized by decreased insulin sensitivity, decreased insulin secretion, and an increased inflammatory response. PMID:26624964

  1. In vitro starch digestibility and estimated glycemic index of sorghum products 

    E-print Network

    De Castro Palomino Siller, Angelina

    2007-09-17

    Fractions from white and tannin sorghums were processed into extrudates, thick porridges, and breads. The effects of sorghum type and fraction on the in vitro starch availability of the products were evaluated, and the estimated glycemic indexes...

  2. Primer on dietary carbohydrates and utility of the glycemic index in equine nutrition.

    PubMed

    Harris, Patricia; Geor, Raymond J

    2009-04-01

    The feeding of "low carbohydrate" or "low glycemic" diets has been recommended for management of horses with metabolic and endocrine disorders in which insulin resistance is a component. A "low carbohydrate" diet is a misnomer, however, because horses require that a significant proportion of their daily ration comprises structural carbohydrates (fiber/forage) to maintain gut health and mental wellbeing. This article provides a detailed description of the different carbohydrates in equine feeds. It also reviews the terminology used to describe glucose and insulin responses to the ingestion of carbohydrates, in particular the concept of the glycemic index. Some of the factors that influence glycemic index in humans and the glycemic response to a meal in horses are also discussed. PMID:19303548

  3. 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

  4. Age-related differences in inhibitory control in the early school years.

    PubMed

    Macdonald, Jacqui A; Beauchamp, Miriam H; Crigan, Judith A; Anderson, Peter J

    2014-01-01

    The transition to school is associated with a greater requirement to inhibit irrelevant or inappropriate thought and behavior in order to concentrate on effective learning and to interact successfully with peers. Current knowledge of inhibitory control development in the early school years is limited due to a lack of normative data from age-appropriate, sensitive measures. In this study, three pictorial versions of the Stroop task were administered to investigate inhibitory control development in early school-aged children. Age-related trajectories of inhibition and effects of gender were examined in 80 children (42 boys) aged 5 to 8 years. All children were assessed with the Cognitive Assessment System Expressive Attention subtest (Big-Small Stroop), Fruit Stroop, and Boy-Girl Stroop. The Big-Small Stroop revealed substantial age-related improvement in inhibition from 5 to 7 years with a levelling of performance at 8 years of age, while the Fruit Stroop and Boy-Girl Stroop demonstrated clear but nonsignificant age trends. In particular, older children committed fewer errors and corrected their errors more frequently than younger children. Performance on all Stroop tasks correlated significantly, providing evidence that they tap similar cognitive abilities. Some gender differences were found. This study indicates that inhibitory skills develop rapidly in the early school years and suggests that error awareness may be a useful indicator of the development of cognitive inhibition for this age group. PMID:23909718

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

    PubMed Central

    Das, Sai Krupa; Gilhooly, Cheryl H.; Golden, Julie K.; Pittas, Anastassios G.; Fuss, Paul J.; Dallal, Gerard E.; McCrory, Megan A.; Saltzman, Edward; Roberts, Susan B.

    2010-01-01

    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 expenditure (TEE), resting metabolic rate (RMR), fat and fat free mass (FFM), were measured at 3, 6 and 12 months. Changes in TEE, but not changes in RMR, were greater than accounted for by the loss of FFM and fat mass (P=0.001-0.013) suggesting an adaptive response to long-term CR. There was no significant effect of diet group on change in RMR or TEE. However, in subjects who lost >5% body weight (n=26), the LG diet group had a higher percentage of weight loss as fat than the HG group (p<0.05), a finding that may have implications for dietary recommendations during weight reduction. PMID:20711415

  6. A controlled study of Tourette syndrome. VI. Early development, sleep problems, allergies, and handedness.

    PubMed

    Comings, D E; Comings, B G

    1987-11-01

    Developmental milestones, problems with bladder and bowel control, sleep disturbances, allergies, and handedness were compared in 247 consecutive Tourette syndrome (TS) patients, 17 patients with attention-deficit disorder (ADD), 15 patients with ADD secondary to TS (ADD 2(0) TS), and 47 random controls. There were no significant differences in age of first talking or walking. By contrast, there were significant differences in problems with bladder and bowel control between TS patients and controls, as measured by age of first toilet training, age of last bed-wetting, frequency of enuresis, and age that bowel control was achieved. Sleep problems were pervasive in TS patients, with a significantly increased frequency of sleepwalking, night terrors, trouble getting to sleep, early awakening, and inability to take afternoon naps as a young child. In all diagnostic categories, including mild (grade 1) TS patients, a total sleep-problem score was significantly greater than that in controls. The sleep disorders and other TS symptoms are consistent with TS as a disorder of disinhibition of the limbic system. Allergies and left-handedness have been evoked as contributing to or being associated with ADD and learning disorders. There were no significant differences in the frequency of allergies or left-handedness in TS patients compared with that in controls. We conclude that when there is a clearly defined genetic cause of ADD and learning disorders, it is not associated with an increased frequency of allergies or left-handedness. PMID:3479017

  7. 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

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

    PubMed Central

    Belle, Fabiën N.; Kampman, Ellen; McTiernan, Anne; Bernstein, Leslie; Baumgartner, Kathy; Baumgartner, Richard; Ambs, Anita; Ballard-Barbash, Rachel; Neuhouser, Marian L.

    2011-01-01

    Background Dietary intake of fiber, carbohydrate, glycemic index (GI), and glycemic load (GL) may influence breast cancer survival, but consistent and convincing evidence is lacking. Methods We investigated associations of dietary fiber, carbohydrates, GI, and GL with breast cancer prognosis among n=688 stage 0 to IIIA breast cancer survivors in the Health, Eating, Activity, and Lifestyle (HEAL) study. Pre- and postmenopausal women from Western Washington State, Los Angeles County, and New Mexico participated. Usual diet was assessed with a food frequency questionnaire. Total mortality, breast cancer mortality, non-fatal recurrence and second occurrence data were obtained from SEER registries and medical records. Cox proportional hazards regression estimated multivariate-adjusted hazard ratios and 95% CIs. Results During a median of 6.7 years follow-up after diagnosis, n= 106 total deaths, n=83 breast cancer-specific deaths and n=82 non-fatal recurrences were confirmed. We observed an inverse association between fiber intake and mortality. Multivariate-adjusted HRRs comparing high to low intake were 0.53 (95% CI 0.23-1.23) and 0.75 (95% CI 0.43-1.31). A threshold effect was observed whereby no additional benefit was observed for intakes >9 g/day. Fiber intake was suggestively inversely associated with breast-cancer specific mortality (HRR=0.68, 95% CI 0.27-1.70) and risk of non-fatal recurrence or second occurrence (HRR=0.68, 95% CI 0.27-1.70), but results were not statistically significant. Conclusion Dietary fiber was associated with a non-significant inverse association with breast cancer events and total mortality. Further studies to assess and confirm this relationship are needed in order to offer effective dietary strategies for breast cancer patients. Impact Increasing dietary fiber may an effective lifestyle modification strategy for breast cancer survivors. PMID:21430298

  9. EARLY-STAGE DESIGN AND EVALUATION FOR NUCLEAR POWER PLANT CONTROL ROOM UPGRADES

    SciTech Connect

    Ronald L. Boring; Jeffrey C. Joe; Thomas A. Ulrich; Roger T. Lew

    2015-03-01

    As control rooms are modernized with new digital systems at nuclear power plants, it is necessary to evaluate operator performance with these systems as part of a verification and validation process. While there is regulatory and industry guidance for some modernization activities, there are no well defined standard processes or predefined metrics available for assessing what is satisfactory operator interaction with new systems, especially during the early design stages. This paper proposes a framework defining the design process and metrics for evaluating human system interfaces as part of control room modernization. The process and metrics are generalizable to other applications and serve as a guiding template for utilities undertaking their own control room modernization activities.

  10. Randomised controlled trial of early discharge for inguinal hernia and varicose veins.

    PubMed Central

    Adler, M W; Waller, J J; Creese, A; Thorne, S C

    1978-01-01

    A randomised controlled trial has been conducted into the effects of discharging patients from hospital either 48 hours or six to seven days after operations for inguinal hernia and varicose veins. There was no statistically significant difference in major postoperative complications between the two lengths of stay for either of the two conditions. Similarly there was no difference between the two groups of hernia patients in relation to eventual recurrences. There was no significant difference in length of convalescence between long-stay and short-stay patients in full-time occupations. The savings to the statutory services of discharging patients early were estimated at 25.72 pounds per patient. Patients appeared to approve of the type of care they experienced, regardless of length of stay. However, the families of short-stay patients were significantly less enthusiastic in their attitudes towards the policy of early discharge than the families of long-stay patients. PMID:98548

  11. 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

  12. 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

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and... Committee Act (Pub. L. 92-463) of October 6, 1972, that the Breast and Cervical Cancer Early Detection...

  13. 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…

  14. Early intervention and child physical health: Evidence from a Dublin-based randomized controlled trial.

    PubMed

    Doyle, Orla; Fitzpatrick, Nick; Lovett, Judy; Rawdon, Caroline

    2015-12-01

    This article investigates the impact of an early intervention program, which experimentally modifies the parenting and home environment of disadvantaged families, on child physical health in the first 3 years of life. We recruited and randomized 233 (115 intervention, 118 control) pregnant women from a socioeconomically disadvantaged community in Dublin, Ireland into an intervention or control group. The treatment includes regular home visits commencing antenatally and an additional parenting course commencing at 2 years. Maternal reports of child health are assessed at 6, 12, 18, 24, and 36 months. Treatment effects are estimated using permutation testing to account for small sample size, inverse probability weighting to account for differential attrition, and both the stepdown procedure and an indices approach to account for multiple hypothesis testing. Following adjustment for multiple testing and attrition, we observe a positive and statistically significant main treatment effect for wheezing/asthma. The intervention group are 15.5 percentage points (pp) less likely to require medical attention for wheezing/asthma compared to the control group. Subgroup analysis reveals more statistically significant adjusted treatment effects for boys than girls regarding fewer health problems (d=0.63), accidents (23.9pp), and chest infections (22.8-37.9pp). Our results suggest that a community-based home visiting program may have favorable impacts on early health conditions. PMID:26439756

  15. Paleoenvironmental Controls on Early Cementation of Organic-Rich Shales in the Eagle Ford Group

    NASA Astrophysics Data System (ADS)

    Kruse, K.; Tice, M. M.

    2013-12-01

    Early carbonate cements have the potential to alter fracture toughness, and carbonate can be either promoted or inhibited by microbial processes in different redox zones. It is therefore possible that basin redox evolution could indirectly control early diagenesis and modify reservoir properties of corresponding shale units. The goals of this study are to analyze geochemical characteristics of the Late Cretaceous Eagle Ford Group in McMullen County, Texas in order to test the hypotheses that (1) the redox state of the water column controlled carbonate cement abundance and (2) carbonate cement lowered organic matter content by volumetric dilution. An X-ray analytical microscope was used to map elemental compositions of fresh core samples spanning the Eagle Ford Group. Resultant maps were used to characterize carbonate cements and to estimate the redox state of the overlying water column during deposition as proxied by the relative abundances of the trace metals Mo, V, Cr, and Zn. Preliminary results indicate that cementation occurred early relative to compaction. Ti-K?1-normalized Mo K?1 and Ca K?1 fluorescence intensities are positively correlated throughout the unit, suggesting that carbonate cementation was promoted by basin euxinia. Total organic carbon is negatively correlated with (Ca K?1)/(Ti K?1) fluorescence ratio in the upper Eagle Ford Group, consistent with volumetric dilution of sedimentary organic matter by diagenetic cementation prior to compaction. In contrast, there is no significant correlation between total organic carbon and carbonate content in the more organic-rich lower Eagle Ford Group, suggesting that variations in organic matter production, preservation, or dilution by siliciclastic input were also important in controlling final organic content.

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

    PubMed Central

    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

  17. 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

  18. 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.

  19. A randomised controlled trial of recovery focused CBT for individuals with early bipolar disorder

    PubMed Central

    2012-01-01

    Background There is increasing evidence for the effectiveness of structured psychological therapies for bipolar disorder. To date however there have been no psychological interventions specifically designed for individuals with early bipolar disorder. The primary objective of this trial is to establish the acceptability and feasibility of a new CBT based intervention (Recovery focused CBT; RfCBT) designed in collaboration with individuals with early bipolar disorder intended to improve clinical and personal recovery outcomes. Methods and design This article describes a single blind randomised controlled trial to assess the feasibility and acceptability of RfCBT compared with treatment as usual. Participants will be recruited from across the North West of England from specialist mental health services and through primary care and self referral. The primary outcome of the study is the feasibility and acceptability of RfCBT as indicated by recruitment to target and retention to follow-up as well as absence of untoward incidents associated with RfCBT. We also intend to estimate the effect size of the impact of the intervention on recovery and mood outcomes and explore potential process measures (self appraisal, stigma, hope and self esteem). Discussion This is the first trial of recovery informed CBT for early bipolar disorder and will therefore be of interest to researchers in this area as well as indicating the wider potential for evaluating approaches to the recovery informed treatment of recent onset severe mental illness in general. Trial registration number ISRCTN43062149 PMID:23171304

  20. GPS-controlled tide gauges in Indonesia - a German contribution to Indonesia's Tsunami Early Warning System

    NASA Astrophysics Data System (ADS)

    Schöne, T.; Illigner, J.; Manurung, P.; Subarya, C.; Khafid; Zech, C.; Galas, R.

    2011-03-01

    Coastal tide gauges do not only play a central role in the study of climate-related sea level changes but also in tsunami warning systems. Over the past five years, ten GPS-controlled tide gauge systems have been installed by the German Research Centre for Geosciences (GFZ) in Indonesia to assist the development of the Indonesian Tsunami Early Warning System (InaTEWS). These stations are mainly installed at the Indonesian coastline facing the Indian Ocean. The tide gauge systems deliver information about the instantaneous sea level, vertical control information through GPS, and meteorological observations. A tidal analysis at the station's computer allows the detection of rapid changes in the local sea level ("sea level events"/SLE), thus indicating, for example, the arrival time of tsunamis. The technical implementation, communication issues, the operation and the sea level event detection algorithm, and some results from recent earthquakes and tsunamis are described in this paper.

  1. Alcohol intake and early-onset basal cell carcinoma in a case-control study

    PubMed Central

    Zhang, Y; Ferrucci, L.M.; Cartmel, B.; Molinaro, A.M.; Leffell, D.J.; Bale, A.E.; Mayne, S.T.

    2014-01-01

    Background Previous epidemiologic studies of overall alcohol intake and basal cell carcinoma (BCC) are inconsistent, with some evidence for differences by type of alcoholic beverage. While alcohol may enhance the carcinogenicity of ultraviolet (UV) light, this has not been evaluated in existing epidemiologic studies. Objective To evaluate alcohol intake in relation to early-onset BCC, and explore potential interactions with UV exposure. Methods BCC cases (n=380) and controls with benign skin conditions (n=390) under age 40 were identified through Yale Dermatopathology. Participants provided information on lifetime alcohol intake, including type of beverage during an in-person interview. Self-report data on indoor tanning and outdoor sunbathing were used to categorize UV exposure. We calculated odds ratios (OR) and 95% confidence intervals (CI) using unconditional multivariate logistic regression in the full sample and in women only. Results There was no statistically significant association between lifetime alcohol intake and early-onset BCC overall (above median intake vs. no regular alcohol intake OR 1.10, 95% CI 0.69-1.73) or in women only (OR 1.21, 95% CI 0.73-2.01). Similarly, intake of red wine, white wine, beer or hard liquor and mixed drinks was not associated with early-onset BCC. In exploratory analyses, we saw limited evidence for an interaction (pinteraction=0.003), with highest risk for high alcohol and high UV exposures, especially in women, but subgroup risk estimates had wide and overlapping confidence intervals. Conclusions Overall, we did not observe any clear association between lifetime alcohol intake and early-onset BCC. PMID:25059635

  2. Modular Ankle Robotics Training in Early Sub-Acute Stroke: A Randomized Controlled Pilot Study

    PubMed Central

    Forrester, Larry W.; Roy, Anindo; Krywonis, Amanda; Kehs, Glenn; Krebs, Hermano Igo; Macko, Richard F.

    2014-01-01

    Background Modular lower extremity (LE) robotics may offer a valuable avenue for restoring neuromotor control after hemiparetic stroke. Prior studies show that visually-guided and visually-evoked practice with an ankle robot (anklebot) improves paretic ankle motor control that translates into improved overground walking. Objective Assess the feasibility and efficacy of daily anklebot training during early sub-acute hospitalization post-stroke. Methods Thirty-four inpatients from a stroke unit were randomly assigned to anklebot (N=18) or passive manual stretching (N=16) treatments. All suffered a first stroke with residual hemiparesis (ankle manual muscle test grade 1/5 to 4/5), and at least trace muscle activation in plantar- or dorsiflexion. Anklebot training employed an “assist-as-needed” approach during > 200 volitional targeted paretic ankle movements, with difficulty adjusted to active range of motion and success rate. Stretching included >200 daily mobilizations in these same ranges. All sessions lasted 1 hour and assessments were not blinded. Results Both groups walked faster at discharge, however the robot group improved more in percent change of temporal symmetry (p=0.032) and also of step length symmetry (p=0.038), with longer nonparetic step lengths in the robot (133%) vs. stretching (31%) groups. Paretic ankle control improved in the robot group, with increased peak (p? 0.001) and mean (p? 0.01) angular speeds, and increased movement smoothness (p? 0.01). There were no adverse events. Conclusion Though limited by small sample size and restricted entry criteria, our findings suggest that modular lower extremity robotics during early sub-acute hospitalization is well tolerated and improves ankle motor control and gait patterning. PMID:24515923

  3. 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.

  4. The p66Shc Adaptor Protein Controls Oxidative Stress Response in Early Bovine Embryos

    PubMed Central

    Betts, Dean H.; Bain, Nathan T.; Madan, Pavneesh

    2014-01-01

    The in vitro production of mammalian embryos suffers from high frequencies of developmental failure due to excessive levels of permanent embryo arrest and apoptosis caused by oxidative stress. The p66Shc stress adaptor protein controls oxidative stress response of somatic cells by regulating intracellular ROS levels through multiple pathways, including mitochondrial ROS generation and the repression of antioxidant gene expression. We have previously demonstrated a strong relationship with elevated p66Shc levels, reduced antioxidant levels and greater intracellular ROS generation with the high incidence of permanent cell cycle arrest of 2–4 cell embryos cultured under high oxygen tensions or after oxidant treatment. The main objective of this study was to establish a functional role for p66Shc in regulating the oxidative stress response during early embryo development. Using RNA interference in bovine zygotes we show that p66Shc knockdown embryos exhibited increased MnSOD levels, reduced intracellular ROS and DNA damage that resulted in a greater propensity for development to the blastocyst stage. P66Shc knockdown embryos were stress resistant exhibiting significantly reduced intracellular ROS levels, DNA damage, permanent 2–4 cell embryo arrest and diminished apoptosis frequencies after oxidant treatment. The results of this study demonstrate that p66Shc controls the oxidative stress response in early mammalian embryos. Small molecule inhibition of p66Shc may be a viable clinical therapy to increase the developmental potential of in vitro produced mammalian embryos. PMID:24475205

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

    PubMed Central

    Akintola, Abimbola A.; Noordam, Raymond; Jansen, Steffy W.; de Craen, Anton J.; Ballieux, Bart E.; Cobbaert, Christa M.; Mooijaart, Simon P.; Pijl, Hanno; Westendorp, Rudi G.; van Heemst, Diana

    2015-01-01

    Background The validity of continuous glucose monitoring (CGM) is well established in diabetic patients. CGM is also increasingly used for research purposes in normo-glycemic individuals, but the CGM validity in such individuals is unknown. We studied the accuracy of CGM measurements in normo-glycemic individuals by comparing CGM-derived versus venous blood-derived glucose levels and measures of glycemia and glycemic variability. Methods In 34 healthy participants (mean age 65.7 years), glucose was simultaneously measured every 10 minutes, via both an Enlite® CGM sensor, and in venous blood sampled over a 24-hour period. Validity of CGM-derived individual glucose measurements, calculated measures of glycemia over daytime (09:00h-23:00h) and nighttime (23:00h-09:00h), and calculated measures of glycemic variability (e.g. 24h standard deviation [SD]) were assessed by Pearson correlation coefficients, mean absolute relative difference (MARD) and paired t-tests. Results The median correlation coefficient between CGM and venous glucose measurements per participant was 0.68 (interquartile range: 0.40–0.78), and the MARD was 17.6% (SD = 17%). Compared with venous sampling, the calculated measure of glycemia during daytime was 0.22 mmol/L higher when derived from CGM, but no difference was observed during nighttime. Most measures of glycemic variability were lower with CGM than with venous blood sampling (e.g., 24h SD: 1.07 with CGM and 1.26 with venous blood; p-value = 0.004). Conclusion In normo-glycemic individuals, CGM-derived glucose measurements had good agreement with venous glucose levels. However, the measure of glycemia was higher during the day and most measures of glycemic variability were lower when derived from CGM. PMID:26445499

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

    PubMed Central

    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

  7. The zone diet: an anti-inflammatory, low glycemic-load diet.

    PubMed

    Sears, Barry; Bell, Stacey

    2004-01-01

    The Zone Diet was developed on the concept that the hormonal responses of macronutrients could be orchestrated to maintain key hormones within therapeutic zones to control inflammatory responses. In particular, the two hormonal systems that are directly affected by dietary macronutrients are (1) the insulin/glucagon axis and (2) eicosanoids. Each of these hormonal systems can have a significant impact on the inflammatory process. This hormonal approach to optimizing an anti-inflammatory diet has significant ramifications in treatment of those chronic diseases (obesity, type 2 diabetes, and cardiovascular disease) that are known to produce inflammatory responses. On the other hand, an inappropriate balance of macronutrients (especially high glycemic- load carbohydrates) can lead to increased inflammation. A primary example of this is the promotion of the United States Department of Agriculture's Food Guide Pyramid. Since its adoption, the prevalence of obesity and type 2 diabetes has risen substantially. Both conditions also demonstrate a significant increase in inflammatory markers. The purpose of this article is to review the historical factors that led to the development of the Zone Diet, to understand how the Zone Diet can alter inflammatory responses, and to review the published literature on its ability to affect hormonal and metabolic responses. PMID:18370674

  8. Dietary Glycemic Index and the Risk of Birth Defects

    PubMed Central

    Parker, Samantha E.; Werler, Martha M.; Shaw, Gary M.; Anderka, Marlene; Yazdy, Mahsa M.

    2012-01-01

    Prepregnancy diabetes and obesity have been identified as independent risk factors for several birth defects, providing support for a mechanism that involves hyperglycemia and hyperinsulinemia in the development of malformations. Data from the National Birth Defects Prevention Study from 1997 to 2007 were used to investigate the association between the maternal dietary glycemic index (DGI) and the risk of birth defects among nondiabetic women. DGI was categorized by using spline regression models and quartile distributions. Adjusted odds ratios and 95% confidence intervals were calculated. The joint effect of DGI and obesity was also examined. Among the 53 birth defects analyzed, high DGI, categorized by spline regression, was significantly associated with encephalocele (adjusted odds ratio (aOR) = 2.68), diaphragmatic hernia (aOR = 2.58), small intestinal atresia/stenosis (aOR = 2.97) including duodenal atresia/stenosis (aOR = 2.48), and atrial septal defect (aOR = 1.37). Using quartiles to categorize DGI, the authors identified associations with cleft lip with cleft palate (aOR = 1.23) and anorectal atresia/stenosis (aOR = 1.40). The joint effect of high DGI and obesity provided evidence of a synergistic effect on the risk of selected birth defects. High DGI is associated with an increased risk of a number of birth defects under study. Obesity coupled with high DGI appears to increase the risk further for some birth defects. PMID:23171874

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

    PubMed

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

    2010-07-01

    THE STUDY EVALUATED AND COMPARED THE DIFFERENCES OF GLUCOSE RESPONSES, INCREMENTAL AREA UNDER CURVE (IAUC), GLYCEMIC INDEX (GI) AND THE CLASSIFICATION OF GI VALUES BETWEEN MEASURED BY BIOCHEMICAL ANALYZER (FUJI AUTOMATIC BIOCHEMISTRY ANALYZER (FAA)) AND THREE GLUCOSE METERS: Accue Chek Advantage (AGM), BREEZE 2 (BGM), and Optimum Xceed (OGM). Ten healthy subjects were recruited for the study. The results showed OGM yield highest postprandial glucose responses of 119.6 +/- 1.5, followed by FAA, 118.4 +/- 1.2, BGM, 117.4 +/- 1.4 and AGM, 112.6 +/- 1.3 mg/dl respectively. FAA reached highest mean IAUC of 4156 +/- 208 mg x min/dl, followed by OGM (3835 +/- 270 mg x min/dl), BGM (3730 +/- 241 mg x min/dl) and AGM (3394 +/- 253 mg x min/dl). Among four methods, OGM produced highest mean GI value than FAA (87 +/- 5) than FAA, followed by BGM and AGM (77 +/- 1, 68 +/- 4 and 63 +/- 5, p<0.05). The results suggested that the AGM, BGM and OGM are more variable methods to determine IAUC, GI and rank GI value of food than FAA. The present result does not necessarily apply to other glucose meters. The performance of glucose meter to determine GI value of food should be evaluated and calibrated before use. PMID:20664730

  10. Organoleptic and glycemic properties of chickpea-wheat composite breads.

    PubMed

    Zafar, Tasleem A; Al-Hassawi, Fatima; Al-Khulaifi, Fatima; Al-Rayyes, Ghanima; Waslien, Carol; Huffman, Fatma G

    2015-04-01

    Prevalence of obesity and type-2-diabetes requires dietary manipulation. It was hypothesized that wheat-legume-composite breads will reduce the spike of blood glucose and increase satiety. Four pan bread samples were prepared: White bread (WB) as standard, Whole-wheat bread (WWB), WWB supplemented with chickpea flour at 25 % (25%ChB) and 35 % (35%ChB) levels. These breads were tested in healthy female subjects for acceptability and for effect on appetite, blood glucose, and physical discomfort in digestion. The breads were rated >5.6 on a 9-point hedonic scale with WB significantly higher than all other breads. No difference in area under the curve (AUC) for appetite was found, but blood glucose AUC was reduced as follows: 35%ChB < WB and WWB, WB >25%ChB = WWB or 35%ChB. We conclude that addition of chickpea flour at 35 % to whole wheat produces a bread that is acceptable to eat, causing no physical discomfort and lowers the glycemic response. PMID:25829607

  11. 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

  12. 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

  13. [THE IMPROVEMENT OF CITIES AND SANITARY CONTROL IN RUSSIA IN LATE XIX--EARLY XX CENTURIES].

    PubMed

    Sherstneva, E V

    2015-01-01

    The article considers activity of municipal self-governments of Russia concerning support of sanitary epidemiological well-being of cities in the late XIX--early XX centuries. The acuteness of problem of sanitary conditions of urban settlements particularly became visible in post-reform period due to increasing of number of urban population, alteration of setup and rhythm of life in cities, appearance of new forms of worker's daily chores. Al this, against the background of underdevelopment of communal sphere aggravated epidemiological situation in cities. The impulse to improvement and development of sanitary control was made by the city regulations of 1870 presenting to town authorities the right to deal with sanitary issues. The significant input into improvement of cities was made first of all at the expense of construction of water supplies and sewerage and support of sanitary control of these spheres of municipal economy. Under town councils of many cities the sanitary commissions were organized to support permanent sanitary control in town. The development of town sanitation followed the way of specialization. The housing and communal, trade and food, school and sanitary and sanitary and veterinary control were organized. PMID:26399074

  14. Sucrose is an early modulator of the key hormonal mechanisms controlling bud outgrowth in Rosa hybrida.

    PubMed

    Barbier, François; Péron, Thomas; Lecerf, Marion; Perez-Garcia, Maria-Dolores; Barrière, Quentin; Rol?ík, Jakub; Boutet-Mercey, Stéphanie; Citerne, Sylvie; Lemoine, Remi; Porcheron, Benoît; Roman, Hanaé; Leduc, Nathalie; Le Gourrierec, José; Bertheloot, Jessica; Sakr, Soulaiman

    2015-05-01

    Sugar has only recently been identified as a key player in triggering bud outgrowth, while hormonal control of bud outgrowth is already well established. To get a better understanding of sugar control, the present study investigated how sugar availability modulates the hormonal network during bud outgrowth in Rosa hybrida. Other plant models, for which mutants are available, were used when necessary. Buds were grown in vitro to manipulate available sugars. The temporal patterns of the hormonal regulatory network were assessed in parallel with bud outgrowth dynamics. Sucrose determined bud entrance into sustained growth in a concentration-dependent manner. Sustained growth was accompanied by sustained auxin production in buds, and sustained auxin export in a DR5::GUS-expressing pea line. Several events occurred ahead of sucrose-stimulated bud outgrowth. Sucrose upregulated early auxin synthesis genes (RhTAR1, RhYUC1) and the auxin efflux carrier gene RhPIN1, and promoted PIN1 abundance at the plasma membrane in a pPIN1::PIN1-GFP-expressing tomato line. Sucrose downregulated both RwMAX2, involved in the strigolactone-transduction pathway, and RhBRC1, a repressor of branching, at an early stage. The presence of sucrose also increased stem cytokinin content, but sucrose-promoted bud outgrowth was not related to that pathway. In these processes, several non-metabolizable sucrose analogues induced sustained bud outgrowth in R. hybrida, Pisum sativum, and Arabidopsis thaliana, suggesting that sucrose was involved in a signalling pathway. In conclusion, we identified potential hormonal candidates for bud outgrowth control by sugar. They are central to future investigations aimed at disentangling the processes that underlie regulation of bud outgrowth by sugar. PMID:25873679

  15. Motivation and Perceived Control in Early Adolescent Friendships: Relations with Self-, Friend-, and Peer-Reported Adjustment

    ERIC Educational Resources Information Center

    Ojanen, Tiina; Stratman, Aaron; Card, Noel A.; Little, Todd D.

    2013-01-01

    Motivation is assumed to influence behaviors via perceived agency over goal pursuits, but empirical research integrating motivation and action-control processes in social development is close to nonexistent. We applied this perspective to the study of early adolescent friendships by examining motivation for and perceived control (ability and…

  16. Does Parental Psychological Control Relate to Internalizing and Externalizing Problems in Early Childhood? An Examination Using the Berkeley Puppet Interview

    ERIC Educational Resources Information Center

    Stone, Lisanne L.; Otten, Roy; Janssens, Jan M. A. M.; Soenens, Bart; Kuntsche, Emmanuel; Engels, Rutger C. M. E.

    2013-01-01

    Parental psychological control has been linked to symptoms of psychopathology in adolescence, yet less is known about its correlates in childhood. The current study is among the first to address whether psychological control is related to internalizing and externalizing problems in early childhood. A community sample of 298 children aged 7.04…

  17. 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…

  18. 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

  19. Deficit irrigation strategies combined with controlled atmosphere preserve quality in early peaches.

    PubMed

    Falagán, Natalia; Artés, Francisco; Gómez, Perla A; Artés-Hernández, Francisco; Conejero, Wenceslao; Aguayo, Encarna

    2015-10-01

    Due to the water scarcity in the Mediterranean countries, irrigation must be optimized while keeping fruit quality. The effect of deficit irrigation strategies on changes in quality parameters of the early "Flordastar" peaches was studied. The deficit irrigation was programmed according to signal intensity of the maximum daily trunk shrinkage; deficit irrigation plants were irrigated to maintain maximum daily trunk shrinkage signal intensity values close to 1.4 or 1.3 in the case of DI1 or DI2 plants, respectively. Results were compared to a control watered at 150% crop evapotranspiration. Fruits were stored up to 14 days at 0 ? and 95% Relative Humidity (RH) in air or in controlled atmosphere (controlled atmosphere; 3-4 kPa O2 and 12-14 kPa CO2), followed by a retail sale period of 4 days at 15 ? and 90-95% Relative Humidity in air. Weight losses were lower in controlled atmosphere stored peaches from deficit irrigation. Air-stored fruits developed a more intense red color due to a faster ripening, which was not affected by the type of watering. At harvest, deficit irrigation peaches showed higher soluble solids content, which provided a better sensory evaluation. The soluble phenolic content was initially higher (55.26 ± 0.18 mg gallic acid equivalents/100 g fresh weight) and more stable throughout postharvest life in DI1 fruits than in those from the other irrigation treatments. Concerning vitamin C, control fruits at harvest showed higher ascorbic acid than dehydroascorbic acid content (5.43 versus 2.43 mg/100 g fresh weight, respectively), while water stressed peaches showed the opposite results. The combination of DI2 and controlled atmosphere storage allowed saving a significant amount of water and provided peaches with good overall quality, maintaining the bioactive compounds analyzed. PMID:25280939

  20. Large igneous provinces and organic carbon burial: Controls on global temperature and continental weathering during the Early Cretaceous

    NASA Astrophysics Data System (ADS)

    Bodin, Stéphane; Meissner, Philipp; Janssen, Nico M. M.; Steuber, Thomas; Mutterlose, Jörg

    2015-10-01

    There is an abundance of evidence for short intervals of cold climatic conditions during the Early Cretaceous. However, the lack of a high-resolution, long-term Early Cretaceous paleotemperature record hampers a full-scale synthesis of these putative "cold snap" episodes, as well as a more holistic approach to Early Cretaceous climate changes. We present an extended compilation of belemnite-based oxygen, carbon and strontium isotope records covering the Berriasian-middle Albian from the Vocontian Basin (SE France). This dataset clearly demonstrates three intervals of cold climatic conditions during the Early Cretaceous (late Valanginian-earliest Hauterivian, late early Aptian, latest Aptian-earliest Albian). Each of these intervals is associated with rapid and high amplitude sea-level fluctuations, supporting the hypothesis of transient growth of polar ice caps during the Early Cretaceous. As evidenced by positive carbon isotope excursions, each cold episode is associated with enhanced burial of organic matter on a global scale. Moreover, there is a relatively good match between the timing and size of large igneous province eruptions and the amplitude of Early Cretaceous warming episodes. Altogether, these observations confirm the instrumental role of atmospheric CO2 variations in driving Early Cretaceous climate change. From a long-term perspective, the coupling of global paleotemperature and seawater strontium isotopic ratio during the Early Cretaceous is best explained by temperature-controlled changes of continental crust weathering rates.

  1. Profound early control of highly pathogenic SIV by an effector-memory T cell vaccine

    PubMed Central

    Hansen, Scott G.; Ford, Julia C.; Lewis, Matthew S.; Ventura, Abigail B.; Hughes, Colette M.; Coyne-Johnson, Lia; Whizin, Nathan; Oswald, Kelli; Shoemaker, Rebecca; Swanson, Tonya; Legasse, Alfred W.; Chiuchiolo, Maria J.; Parks, Christopher L.; Axthelm, Michael K.; Nelson, Jay A.; Jarvis, Michael A.; Piatak, Michael; Lifson, Jeffrey D.; Picker, Louis J.

    2011-01-01

    The AIDS-causing lentiviruses HIV and SIV effectively evade host immunity, and once established, infections with these viruses are only rarely controlled by immunologic mechanisms1-3. However, the initial establishment of infection in the first few days after mucosal exposure, prior to viral dissemination and massive replication, may be more vulnerable to immune control4. Here, we report that SIV vaccines that include rhesus cytomegalovirus (RhCMV) vectors5 establish indefinitely persistent, high frequency, SIV-specific effector-memory T cell (TEM) responses at potential sites of SIV replication in rhesus macaques (RM) and stringently control highly pathogenic SIVmac239 infection early after mucosal challenge. Thirteen of 24 RM receiving either RhCMV vectors alone or RhCMV vectors followed by adenovirus 5 (Ad5) vectors (vs. 0 of 9 DNA/Ad5-vaccinated RM) manifested early complete control of SIV (undetectable plasma virus), and in 12/13 of these RM, we observed long-term (?1 year) protection characterized by: 1) occasional blips of plasma viremia that ultimately waned; 2) predominantly undetectable cell-associated viral load in blood and lymph node mononuclear cells; 3) no depletion of effector site CD4+ memory T cells; 4) no induction or boosting of SIVenv-specific antibodies (Abs); and 5) induction and then loss of T cell responses to an SIV protein (vif) not included in the RhCMV vectors. Protection correlated with the magnitude of the peak SIV-specific CD8+ T cell responses in the vaccine phase, and occurred without anamnestic T cell responses. Remarkably, long-term RhCMV vector-associated SIV control was insensitive to either CD8+ or CD4+ lymphocyte depletion, and at necropsy, cell-associated SIV was only occasionally measurable at the limit of detection with ultrasensitive assays, observations suggesting the possibility of eventual viral clearance. Thus, persistent vectors such as CMV and their associated TEM responses might significantly contribute to an efficacious HIV/AIDS vaccine. PMID:21562493

  2. Negative elongation factor NELF controls transcription of immediate early genes in a stimulus-specific manner

    SciTech Connect

    Fujita, Toshitsugu; Piuz, Isabelle; Schlegel, Werner

    2009-01-15

    The transcription rate of immediate early genes (IEGs) is controlled directly by transcription elongation factors at the transcription elongation step. Negative elongation factor (NELF) and 5,6-dichloro-1-{beta}-D-ribofuranosylbenzimidazole (DRB) sensitivity-inducing factor (DSIF) stall RNA polymerase II (pol II) soon after transcription initiation. Upon induction of IEG transcription, DSIF is converted into an accelerator for pol II elongation. To address whether and how NELF as well as DSIF controls overall IEG transcription, its expression was reduced using stable RNA interference in GH4C1 cells. NELF knock-down reduced thyrotropin-releasing hormone (TRH)-induced transcription of the IEGs c-fos, MKP-1, and junB. In contrast, epidermal growth factor (EGF)-induced transcription of these IEGs was unaltered or even slightly increased by NELF knock-down. Thus, stable knock-down of NELF affects IEG transcription stimulation-specifically. Conversely, DSIF knock-down reduced both TRH- and EGF-induced transcription of the three IEGs. Interestingly, TRH-induced activation of the MAP kinase pathway, a pathway essential for transcription of the three IEGs, was down-regulated by NELF knock-down. Thus, stable knock-down of NELF, by modulating intracellular signaling pathways, caused stimulation-specific loss of IEG transcription. These observations indicate that NELF controls overall IEG transcription via multiple mechanisms both directly and indirectly.

  3. Interlocking Detachable Platinum Coils, A Controlled Embolization Device: Early Clinical Experience

    SciTech Connect

    Reidy, John F.; Qureshi, Shakeel A.

    1996-03-15

    Purpose: To present the early clinical experience of a new mechanically controlled-release embolization device<+>-<+>the interlocking detachable coil (IDC)-in complex embolization outside the head. Methods: IDCs were used only when conventional embolization techniques were considered too risky or unsafe. The coils consist of unfibered coiled platinum (0.012 inch), mechanically connected to a pusher wire and deployed through a Tracker 18 catheter. IDCs come in a range of diameters (2<+>-<+>8 mm) and lengths (1<+>-<+>30 cm). Results: A total of 87 IDCs were used for 27 procedures in 25 patients (mean 14.5 years) to occlude 31 arteries or vascular lesions. Control of the coil and its release were satisfactory and all coils were fully retrievable up to the point of deployment. Two IDC coils embolized inadvertently but were retrieved; there were no other complications. The IDC coils could not be satisfactorily placed in one high-flow arteriovenous (AV) fistula, and in another case there was a small residual fistula. Occlusion was produced in 29 of 31 lesions. Ancillary techniques were needed in 5 patients: temporary balloon occlusion in 2 and 0.038-inch coils in 3. Conclusion: The IDC coil is an effective device that allows controlled embolization to be performed, especially in aneurysms and in high-flow AV fistulas in children.

  4. 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

  5. Inter- and Intra-Individual Variability in Glycemic Index Values for White Bread Determined Using Standardized Procedures

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Glycemic index (GI) values are used to classify carbohydrate-containing foods on the basis of serum glucose response relative to a glucose challenge, and both the GI and glycemic load (GL) values (GI adjusted for total carbohydrate) of diets have been used to estimate chronic disease risk. There is ...

  6. Long–Term Effects of High-and Low-Glycemic Load Energy-Restricted Diets on Metabolic Adaptation and the Composition of Weight Loss

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The effects of high glycemic load (HG) and low glycemic load (LG) diets on resting metabolic rate (RMR) and body composition changes in response to caloric restriction (CR) remains controversial. Objective To examine the effects of two CR diets differing primarily in glycemic load on RMR and the % o...

  7. Early pregnancy sex steroids and maternal breast cancer: a nested case-control study.

    PubMed

    Fortner, Renée T; Schock, Helena; Kaaks, Rudolf; Lehtinen, Matti; Pukkala, Eero; Lakso, Hans-Åke; Tanner, Minna; Kallio, Raija; Joensuu, Heikki; Grankvist, Kjell; Zeleniuch-Jacquotte, Anne; Toniolo, Paolo; Lundin, Eva; Surcel, Helja-Marja

    2014-12-01

    Pregnancy, parity, and circulating steroid hormone levels are associated with risk of breast cancer, but little is known about hormone concentrations during pregnancy and subsequent breast cancer risk. We evaluated early pregnancy (<140 days gestation) serum estradiol, estrone, progesterone, and testosterone and breast cancer risk in a nested case-control study in the Finnish Maternity Cohort. The cohort includes 98% of pregnancies registered in Finland since 1983. Individuals with samples collected in the first pregnancy leading to a live birth were eligible. Breast cancer cases (n = 1,199) were identified through linkage with the Finnish Cancer Registry; 2,281 matched controls were selected using incidence density sampling. ORs were calculated using conditional logistic regression. Hormone concentrations were not associated with breast cancer overall. Estradiol was positively associated with risk of breast cancer diagnosed age <40 [4th vs. 1st quartile OR 1.60 (1.07-2.39); Ptrend = 0.01], and inversely associated with breast cancer diagnosed at age ?40 [4th vs. 1st quartile OR 0.71 (0.51-1.00); Ptrend = 0.02]. Elevated concentrations of the steroid hormones were associated with increased risk of estrogen receptor (ER)- and progesterone receptor (PR)-negative tumors in women age <40 at diagnosis. We observed no association between steroid hormones and ER(+)/PR(+) disease. These data suggest a positive association between high concentrations of early pregnancy steroid hormones and risk of ER(-)/PR(-) breast cancer in women diagnosed age <40, and an inverse association for overall breast cancer diagnosed age ?40. Further research on pregnancy hormones and risk of steroid receptor-negative cancers is needed to further characterize this association. PMID:25281720

  8. A randomised controlled trial of occupational therapy for people with early rheumatoid arthritis

    PubMed Central

    Hammond, A; Young, A; Kidao, R

    2004-01-01

    Background: Occupational therapy (OT) aims at improving performance of daily living tasks, facilitating successful adjustments in lifestyle, and preventing losses of function. Objective: To evaluate the effects of a pragmatic, comprehensive OT programme on self management and health status of people with early rheumatoid arthritis (RA) (<2.5 years). Methods: A randomised, controlled "assessor blinded" trial was conducted with assessments made at entry, 6, 12, and 24 months. Main outcomes were AIMS2: physical function (PF), pain visual analogue scale (VAS), and Arthritis Self-Efficacy Scale (ASES). Results: Groups had similar disease duration (9 months OT (n = 162) v 10 months control (n = 164)). The OT group received 7.57 (SD 3.04) hours of therapy. Self management significantly increased in the OT group. Otherwise, there were no significant differences in any outcome measures, or between groups, by ACR functional class: AIMS2: PF (F = 0.04; p = 0.96); pain VAS (F = 0.29; p = 0.74); total ASES score (F = 0.93; p = 0.39). Conclusions: OT improved self management but not health status in early RA. Functional ability remains reasonably good for many in the first five years, so preventive benefits of self management may not yet be apparent and longer follow up is needed. Although many considered the education and therapy useful, insufficient numbers in the OT group used self management sufficiently to make a difference. Behavioural approaches can improve adherence and, potentially, the long term benefits. Future research should evaluate OT as a complex intervention and develop programmes from a theoretical and evidence base. PMID:14672887

  9. Early Life Course Risk Factors for Childhood Obesity: The IDEFICS Case-Control Study

    PubMed Central

    Bammann, Karin; Peplies, Jenny; De Henauw, Stefaan; Hunsberger, Monica; Molnar, Denes; Moreno, Luis A.; Tornaritis, Michael; Veidebaum, Toomas; Ahrens, Wolfgang; Siani, Alfonso

    2014-01-01

    Background The early life course is assumed to be a critical phase for childhood obesity; however the significance of single factors and their interplay is not well studied in childhood populations. Objectives The investigation of pre-, peri- and postpartum risk factors on the risk of obesity at age 2 to 9. Methods A case-control study with 1,024 1?1-matched case-control pairs was nested in the baseline survey (09/2007–05/2008) of the IDEFICS study, a population-based intervention study on childhood obesity carried out in 8 European countries in pre- and primary school settings. Conditional logistic regression was used for identification of risk factors. Results For many of the investigated risk factors, we found a raw effect in our study. In multivariate models, we could establish an effect for gestational weight gain (adjusted OR?=?1.02; 95%CI 1.00–1.04), smoking during pregnancy (adjusted OR?=?1.48; 95%CI 1.08–2.01), Caesarian section (adjusted OR?=?1.38; 95%CI 1.10–1.74), and breastfeeding 4 to 11 months (adjusted OR?=?0.77; 95%CI 0.62–0.96). Birth weight was related to lean mass rather than to fat mass, the effect of smoking was found only in boys, but not in girls. After additional adjustment for parental BMI and parental educational status, only gestational weight gain remained statistically significant. Both, maternal as well as paternal BMI were the strongest risk factors in our study, and they confounded several of the investigated associations. Conclusions Key risk factors of childhood obesity in our study are parental BMI and gestational weight gain; consequently prevention approaches should target not only children but also adults. The monitoring of gestational weight seems to be of particular importance for early prevention of childhood obesity. PMID:24551043

  10. The Glycemic Index of Rice and Rice Products: A Review, and Table of GI Values.

    PubMed

    Kaur, Bhupinder; Ranawana, Viren; Henry, Jeyakumar

    2016-01-25

    Rice is the principle staple and energy source for nearly half the world's population and therefore has significant nutrition and health implications. Rice is generally considered a high glycemic index (GI) food, however, this depends on varietal, compositional, processing, and accompaniment factors. Being a major contributor to the glycemic load in rice eating populations, there is increasing concern that the rising prevalence of insulin resistance is as a result of the consumption of large amounts of rice. Devising ways and means of reducing the glycemic impact of rice is therefore imperative. This review gathers studies examining the GI of rice and rice products and provides a critical overview of the current state of the art. A table collating published GI values for rice and rice products is also included. PMID:25590950

  11. 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

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

    PubMed Central

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

    2013-01-01

    Summary 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

  13. Early Diabetic Nephropathy in Type 1 Diabetes – New Insights

    PubMed Central

    Bjornstad, Petter; Cherney, David; Maahs, David M.

    2014-01-01

    Purpose of review Despite improvements in glycemic and blood pressure control in patients with T1D, diabetic nephropathy (DN) remains the most common cause of chronic kidney disease worldwide. A major challenge in preventing DN is the inability to identify high-risk patients at an early stage, emphasizing the importance of discovering new therapeutic targets and implementation of clinical trials to reduce DN risk. Recent findings Limitations of managing patients with DN with renin angiotensin aldosterone system (RAAS) blockade have been identified in recent clinical trials, including the failure of primary prevention studies in T1D and the demonstration of harm with dual RAAS blockade. Fortunately, several new targets, including serum uric acid, insulin sensitivity, vasopressin and sodium-glucose cotransporter-2 inhibition are promising in the prevention and treatment of DN. Summary DN is characterized by a long clinically silent period without signs or symptoms of disease. There is an urgent need for improved methods of detecting early mediators of renal injury, to ultimately prevent initiation and progression of DN. In this review, we will focus on early DN and summarize potential new therapeutic targets. PMID:24983394

  14. “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

  15. Cerebrospinal fluid corticotropin-releasing factor and perceived early-life stress in depressed patients and healthy control subjects.

    PubMed

    Carpenter, Linda L; Tyrka, Audrey R; McDougle, Christopher J; Malison, Robert T; Owens, Michael J; Nemeroff, Charles B; Price, Lawrence H

    2004-04-01

    Previous studies have reported elevated concentrations of cerebrospinal fluid (CSF) corticotropin-releasing factor (CRF) in patients with major depression. Elevations of CSF CRF have also been reported in adult laboratory animals exposed to the stress of brief maternal deprivation or maternal neglect in the neonatal or preweaning period. The present study was designed to determine whether major depression and a history of perceived early adversity in childhood are independently associated with elevated CSF CRF concentrations in adults. In this case-control study, 27 medication-free adults with major depression and 25 matched controls underwent standardized lumbar puncture for collection of a single CSF sample at 1200. Subjects provided data about significant adverse early-life experiences and rated their global perceived level of stress during pre-school and preteen years on a six-point Likert scale. The mean difference in CSF CRF between depressed patients and controls did not reach statistical significance. In a regression model, perceived early-life stress was a significant predictor of CSF CRF, but depression was not. Perinatal adversity and perceived adversity in the preteen adversity years (ages 6-13 years) were both independently associated with decreasing CSF CRF concentrations. The relationship observed between perceived early-life stress and adult CSF CRF concentrations in this study closely parallels recent preclinical findings. More work is needed to elucidate the critical nature and timing of early events that may be associated with enduring neuroendocrine changes in humans. PMID:14702025

  16. 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.

  17. 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…

  18. Maternal Psychological Control and Peer Victimization in Early Adolescence: An Application of the Family Relational Schema Model

    ERIC Educational Resources Information Center

    Batanova, Milena D.; Loukas, Alexandra

    2014-01-01

    Guided by the family relational schema model, the current study examined the direct and indirect contributions of maternal psychological control to subsequent relational and overt peer victimization, via early adolescents' conduct problems, fear of negative evaluation, and depressive symptoms. Participants were 499 10- to 14-year-olds (53%…

  19. "Control of protein folding and misfolding in ionic liquid media, and a conjecture on early earth biology".

    E-print Network

    Angell, C. Austen

    ) in hydrated (10-20 wt % water) protic ionic liquid solutions (PILs) in which the water activity is only protic ionic liquids, ammonium nitrate and ammonium acetate, PILs whose component acid and base members"Control of protein folding and misfolding in ionic liquid media, and a conjecture on early earth

  20. 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…

  1. Glucose polymer ingestion--effect on fluid balance and glycemic state during a 4-d march.

    PubMed

    Burstein, R; Seidman, D S; Alter, J; Moram, D; Shpilberg, O; Shemer, J; Wiener, M; Epstein, Y

    1994-03-01

    The effect of glucose-polymer solution on physical performance has been extensively studied under controlled laboratory conditions. The present study was conducted to investigate the influence of such beverages on fluid balance and on glycemic state during a moderate, prolonged field exercise. Forty-eight endurance trained, male subjects participated in the study. The maneuver consisted of a 4-d march; 29, 39, 36, 30 km.d-1, at a speed of 5-6 km.h-1. The subjects covered a total distance of 134 km at an estimated exercise intensity of approximately 40% VO2max, under hot climate conditions (ambient temperature, 32-41 degrees C; relative humidity, 60-14%). Subjects were randomly assigned to one of two groups: glucose polymer-electrolyte beverage (GP; N = 24) and tap water (TW; N = 24). Each group was then divided into two subgroups consuming fluid ad libitum (TWa, GPa) or instructed to consume 900 ml.h-1 (TWb, GPb). The mean daily fluid consumption of all subgroups was similar (5252 +/- 229 and 4640 +/- 67 ml in TWa and TWb; 5257 +/- 317 and 5253 +/- 216 ml in GPa and GPb, respectively). Weight loss, reflecting the degree of dehydration, was 1.2 +/- 0.1% and 1.9 +/- 0.3% of initial body weight in TW and GP, respectively. On day 1, plasma volume changed by +0.4% and -1.8% in the TW and GP groups, respectively. On the days 2-4 changes in both groups were similar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8183101

  2. 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

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

    PubMed

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

    2015-04-15

    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

  4. 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

  5. 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...

  6. 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 ...

  7. Impact of food processing on the glycemic index (GI) of potato products

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Potatoes are one of the most popular carbohydrate foods in industrialized and some developing countries. However, contradicting arguments and misconceptions on potatoes as a high glycemic index (GI) food is directly affecting potato consumption during the past years. Potato varieties, maturity level...

  8. Glycemic index treatment using Japanese foods in a girl with Lennox-Gastaut syndrome.

    PubMed

    Kumada, Tomohiro; Hiejima, Ikuko; Nozaki, Fumihito; Hayashi, Anri; Fujii, Tatsuya

    2013-05-01

    We introduced a low glycemic index treatment using Japanese ethnic foods to a 13-year-old girl with Lennox-Gastaut syndrome caused by tuberous sclerosis complex. She had previously refused the modified Atkins diet within 2 weeks of diet treatment because of its restrictiveness. The low glycemic index treatment was implemented by limiting the daily carbohydrate intake to 50 g of foods with a glycemic index of less than 50 relative to that of glucose, which included udon, soba, and unpolished Japonica rice with natto. One month after the initiation of the diet therapy, the clusters of tonic seizures for 30 to 60 minutes during sleep were reduced from two or three times per week to once or twice per month, and the frequent myoclonic seizures in the awake state disappeared. She has been on the diet therapy for more than 1 year, and the efficacy of the diet has been sustained. Low glycemic index treatment should be considered for patients with medication-resistant epilepsy who cannot tolerate restrictive diet therapies. Japanese ethnic foods can be used for this diet therapy. PMID:23583057

  9. Exploration of Low-Glycemic-Impact Sugars and Polyols, using SRC, DSC, and RVA

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The anti-plasticizing action of the high sucrose concentration in a cookie formula inhibits both gluten development during dough mixing and starch gelatinization/pasting during baking. If alternative sugars and polyols with lower glycemic impact are used to replace sucrose, the resulting absence of ...

  10. 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...

  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. 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. 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

  14. Evidence of early onset of antidepressant effect in randomized controlled trials.

    PubMed

    Stahl, S M; Nierenberg, A A; Gorman, J M

    2001-01-01

    Although antidepressant medications are effective in approximately 70% of patients with major depressive disorder, they have a delayed onset of therapeutic effect. This latency is problematic in that it prolongs the impairments associated with depression, leaves patients vulnerable to an increased risk of suicide, increases the likelihood that a patient will prematurely discontinue therapy, and increases medical costs associated with severe depression. No adequately designed prospective trials have been conducted to evaluate comparative time to onset of antidepressant effect. However, evidence suggests that some antidepressant agents may begin to work faster than others. Citalopram, venlafaxine, and mirtazapine each have exhibited statistically significant differences in some measures of antidepressant action within the first 2 weeks of treatment, both in placebo-controlled trials and in head-to-head comparisons with other antidepressants. This article reviews the data that hint at these drug-specific differences in time to onset of action. Given the potential benefits of early-acting antidepressant treatments, the possibility of superior speed of onset of citalopram, venlafaxine, and mirtazapine presented here merits further study in adequately designed, prospective clinical trials. PMID:11229783

  15. 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

  16. 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

  17. 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

  18. A randomized controlled trial evaluating early versus traditional oral feeding after colorectal surgery

    PubMed Central

    Dag, Ahmet; Colak, Tahsin; Turkmenoglu, Ozgur; Gundogdu, Ramazan; Aydin, Suha

    2011-01-01

    OBJECTIVE: This prospective randomized clinical study was conducted to evaluate the safety and tolerability of early oral feeding after colorectal operations. METHODS: A total of 199 patients underwent colorectal surgery and were randomly assigned to early feeding (n?=?99) or a regular diet (n?=?100). Patients' characteristics, diagnoses, surgical procedures, comorbidity, bowel movements, defecation, nasogastric tube reinsertion, time of tolerance of solid diet, complications, and length of hospitalization were assessed. RESULTS: The two groups were similar in terms of gender, age, diagnosis, surgical procedures, and comorbidity. In the early feeding group, 85.9% of patients tolerated the early feeding schedule. Bowel movements (1.7±0.89 vs. 3.27±1.3), defecation (3.4±0.77 vs. 4.38±1.18) and time of tolerance of solid diet (2.48±0.85 vs. 4.77±1.81) were significantly earlier in the early feeding group. There was no change between the groups in terms of nasogastric tube reinsertion, overall complication or anastomotic leakage. Hospitalization (5.55±2.35 vs. 9.0±6.5) was shorter in the early feeding group. CONCLUSIONS: The present study indicated that early oral feeding after elective colorectal surgery was not only well tolerated by patients but also affected the postoperative outcomes positively. Early postoperative feeding is safe and leads to the early recovery of gastrointestinal functions. PMID:22189721

  19. Design and implementation of an early warning system in vehicle for road speed control hump based on DSP and CCD

    NASA Astrophysics Data System (ADS)

    Yang, Shuyi; Zhu, Pingyu; He, Yanfang; Wang, Le

    2011-12-01

    Road speed control humps have the effect of strengthening transportation safety by preventing traffic accidents. However, vehicles will produce strong mechanical vibrations when crossing speed control humps at high speed. These vibrations affect the passenger's comfort and cause machine parts damage. Early warning systems in vehicles for road speed control humps were designed based on DSP and CCD sensors. The system uses a CCD camera to take the picture of the road speed control humps. The image information is processed and recognised by DSP. Then the related voice and image information is given quickly and accurately after the system processes. This information will remind the driver to prepare for slowing down in good time, it makes them safe and comfortable to pass over the road speed control hump.TMS320DM642DSP early warning system in vehicles was illustrated from three aspects of the image collection module, the image discernment module and the early warning export module. TMS320C6x soft develop flow was introduced in this paper. The system has strong practicality, rapid response and well directed-viewing.

  20. 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…

  1. A Novel Early Intervention for Preschool Depression: Findings from a Pilot Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Luby, Joan; Lenze, Shannon; Tillman, Rebecca

    2012-01-01

    Background: Validation for depression in preschool children has been established; however, to date no empirical investigations of interventions for the early onset disorder have been conducted. Based on this and the modest efficacy of available treatments for childhood depression, the need for novel early interventions has been emphasized. Large…

  2. GLYCEMIC REGULATION AND INSULIN SECRETION ARE ABNORMAL IN CYSTIC FIBROSIS PIGS DESPITE SPARING OF ISLET CELL MASS

    PubMed Central

    Uc, Aliye; Olivier, Alicia K.; Griffin, Michelle A.; Meyerholz, David K.; Yao, Jianrong; Abu-El-Haija, Maisam; Buchanan, Katherine M.; Vanegas Calderón, Oriana G.; Abu-El-Haija, Marwa; Pezzulo, Alejandro A.; Reznikov, Leah R.; Hoegger, Mark J.; Rector, Michael V.; Ostedgaard, Lynda S.; Taft, Peter J.; Gansemer, Nick D.; Ludwig, Paula S.; Hornick, Emma E.; Stoltz, David A.; Ode, Katie L.; Welsh, Michael J.; Engelhardt, John F.; Norris, Andrew W.

    2015-01-01

    Diabetes is a common and significant comorbidity in cystic fibrosis (CF). The pathogenesis of CF-related diabetes (CFRD) is incompletely understood. Because exocrine pancreatic disease is similar between humans and pigs with CF, the CF pig model has the potential to contribute significantly to the understanding of CFRD pathogenesis. We determined the structure of the endocrine pancreas in fetal, newborn and older CF and non-CF pigs and assessed endocrine pancreas function by intravenous glucose tolerance test (IV-GTT). In fetal pigs, pancreatic insulin and glucagon density was similar between CF and non-CF. In newborn and older pigs, the insulin and glucagon density was unchanged between CF and non-CF per total pancreatic area, but increased per remnant lobular tissue in CF reflecting exocrine pancreatic loss. Although fasting glucose levels were not different between CF and non-CF newborns, CF newborns demonstrated impaired glucose tolerance and increased glucose area under the curve during IV-GTT. Second phase insulin secretion responsiveness was impaired in CF newborn pigs and significantly lower than that observed in non-CF newborns. Older CF pigs had elevated random blood glucose levels compared to non-CF. In summary, glycemic abnormalities and insulin secretion defects were present in newborn CF pigs and spontaneous hyperglycemia developed over time. Functional changes in CF pig pancreas were not associated with a decline in islet cell mass. Our results suggest that functional islet abnormalities, independent of structural islet loss, contribute to the early pathogenesis of CFRD. PMID:25142104

  3. 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

  4. Molecular Features and Methylation Status in Early Onset (?40 Years) Colorectal Cancer: A Population Based, Case-Control Study

    PubMed Central

    Magnani, Giulia; Furlan, Daniela; Sahnane, Nora; Reggiani Bonetti, Luca; Domati, Federica; Pedroni, Monica

    2015-01-01

    Colorectal cancer is usually considered a disease of the elderly. However, a small fraction of patients develops colorectal cancer earlier. The aim of our study was to define the frequency of known hereditary colorectal syndromes and to characterise genetic and epigenetic features of early nonhereditary tumors. Thirty-three patients ?40 years with diagnosis of colorectal cancer and 41 patients with disease at >60 years of age were investigated for MSI, Mismatch Repair proteins expression, KRAS and BRAF mutations, hypermethylation, and LINE-1 hypomethylation. Detection of germline mutations was performed in Mismatch Repair, APC and MUTYH genes. Early onset colorectal cancer showed a high incidence of hereditary forms (18%). KRAS mutations were detected in 36% of early nonhereditary tumors. Early onset colorectal cancer disclosed an average number of methylated genes significantly lower when compared to the controls (p = 0.02). Finally both of the two groups were highly methylated in ESR1, GATA5, and WT1 genes and were similar for LINE-1 hypomethylation. The genetic make-up of carcinomas differs from young to elderly patients. Early onset tumors showed more frequently a constitutional defective of Mismatch Repair System and a minor number of methylated genes. Hypermethylation of ESR1, GATA5, and WT1 genes suggests possible markers in the earlier diagnosis of colorectal tumorigenesis. PMID:26557847

  5. 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

  6. 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

  7. Sequence stratigraphy and depositional controls in late Proterozoic-early Cambrian sediments of Amadeus basin, central Australia

    SciTech Connect

    Lindsay, J.F.

    1987-11-01

    The Amadeus basin is an isolated intracratonic basin at the center of the Australian continent which, because of its location and geometry, provides an ideal opportunity to investigate depositional controls. To this end, more than 6000 km of seismic data, in conjunction with a field and well-log program, have been used in a study of the late Proterozoic-Early Cambrian Arumbera Sandstone. 17 figures.

  8. RAB-5 Controls the Cortical Organization and Dynamics of PAR Proteins to Maintain C. elegans Early Embryonic Polarity

    PubMed Central

    Hyenne, Vincent; Tremblay-Boudreault, Thierry; Velmurugan, Ramraj; Grant, Barth D.; Loerke, Dinah; Labbé, Jean-Claude

    2012-01-01

    In all organisms, cell polarity is fundamental for most aspects of cell physiology. In many species and cell types, it is controlled by the evolutionarily conserved PAR-3, PAR-6 and aPKC proteins, which are asymmetrically localized at the cell cortex where they define specific domains. While PAR proteins define the antero-posterior axis of the early C. elegans embryo, the mechanism controlling their asymmetric localization is not fully understood. Here we studied the role of endocytic regulators in embryonic polarization and asymmetric division. We found that depleting the early endosome regulator RAB-5 results in polarity-related phenotypes in the early embryo. Using Total Internal Reflection Fluorescence (TIRF) microscopy, we observed that PAR-6 is localized at the cell cortex in highly dynamic puncta and depleting RAB-5 decreased PAR-6 cortical dynamics during the polarity maintenance phase. Depletion of RAB-5 also increased PAR-6 association with clathrin heavy chain (CHC-1) and this increase depended on the presence of the GTPase dynamin, an upstream regulator of endocytosis. Interestingly, further analysis indicated that loss of RAB-5 leads to a disorganization of the actin cytoskeleton and that this occurs independently of dynamin activity. Our results indicate that RAB-5 promotes C. elegans embryonic polarity in both dynamin-dependent and -independent manners, by controlling PAR-6 localization and cortical dynamics through the regulation of its association with the cell cortex and the organization of the actin cytoskeleton. PMID:22545101

  9. 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

  10. 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.

  11. Improved age control on early Homo fossils from the upper Burgi Member at Koobi Fora, Kenya.

    PubMed

    Joordens, Josephine C A; Dupont-Nivet, Guillaume; Feibel, Craig S; Spoor, Fred; Sier, Mark J; van der Lubbe, Jeroen H J L; Nielsen, Trine Kellberg; Knul, Monika V; Davies, Gareth R; Vonhof, Hubert B

    2013-12-01

    To address questions regarding the evolutionary origin, radiation and dispersal of the genus Homo, it is crucial to be able to place the occurrence of hominin fossils in a high-resolution chronological framework. The period around 2 Ma (millions of years ago) in eastern Africa is of particular interest as it is at this time that a more substantial fossil record of the genus Homo is first found. Here we combine magnetostratigraphy and strontium (Sr) isotope stratigraphy to improve age control on hominin-bearing upper Burgi (UBU) deposits in Areas 105 and 131 on the Karari Ridge in the eastern Turkana Basin (Kenya). We identify the base of the Olduvai subchron (bC2n) plus a short isolated interval of consistently normal polarity that we interpret to be the Pre-Olduvai event. Combined with precession-forced (~20 kyr [thousands of years]) wet-dry climate cycles resolved by Sr isotope ratios, the magnetostratigraphic data allow us to construct an age model for the UBU deposits. We provide detailed age constraints for 15 hominin fossils from Area 131, showing that key specimens such as cranium KNM-ER 1470, partial face KNM-ER 62000 and mandibles KNM-ER 1482, KNM-ER 1801, and KNM-ER 1802 can be constrained between 1.945 ± 0.004 and 2.058 ± 0.034 Ma, and thus older than previously estimated. The new ages are consistent with a temporal overlap of two species of early Homo that can be distinguished by their facial morphology. Further, our results show that in this time interval, hominins occurred throughout the wet-dry climate cycles, supporting the hypothesis that the lacustrine Turkana Basin was a refugium during regionally dry periods. By establishing the observed first appearance datum of a marine-derived stingray in UBU deposits at 2.058 ± 0.034 Ma, we show that at this time the Turkana Basin was hydrographically connected to the Indian Ocean, facilitating dispersal of fauna between these areas. From a biogeographical perspective, we propose that the Indian Ocean coastal strip should be considered as a possible source area for one or more of the multiple Homo species in the Turkana Basin from over 2 Ma onwards. PMID:24134960

  12. 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.

  13. Glycemic response to tortilla consumption: Influence of physical activity and insulin resistance

    E-print Network

    Fletcher, Justin Andrew

    2010-07-26

    -IR) levels will have lower postprandial glycemic responses to tortilla consumption than those who have higher insulin resistance levels. SIGNIFICANCE This research will have important implications in the field of nutrition. There is little...: The amount and type of carbohydrate in the meal can play a large role in the rate of appearance. A position statement by the American Diabetes Association titled Nutrition Recommendations and Interventions for Diabetes published in 2008 (7) 9 claims...

  14. Effect of Added Carbohydrates on Glycemic and Insulin Responses to Children’s Milk Products

    PubMed Central

    Brand-Miller, Jennie; Atkinson, Fiona; Rowan, Angela

    2013-01-01

    Powdered milk products for children (Growing Up Milk Powders or GUMPs) containing added carbohydrates such as glucose and sucrose are now well established in parts of Asia. We surveyed GUMPs in Malaysia and Indonesia to determine the content of added carbohydrates. The ingredient lists and nutrition information panels were used to calculate the percentage of declared carbohydrates contributed by added carbohydrates and a subset of seven products was tested for their glycemic index (GI) and insulin responses in healthy adults. The glycemic load for each product was calculated. In total, 58 products (n = 24 in Malaysia and n = 34 in Indonesia) were surveyed. Added carbohydrate content (excluding fibre) ranged from 0 to 21.5 g per serve. Milk powders without added sources of carbohydrate had similar GI values to standard liquid whole milk. Products containing maltodextrins, corn or glucose syrups increased the GI by more than 2-fold, and glycemic load (GL) by 7-fold compared to milk powders with no added carbohydrates. Insulin responses were significantly but not strongly correlated with glucose responses (r = 0.32, p < 0.006). Children’s milk powders containing higher levels of added carbohydrate ingredients elicit higher glucose and insulin responses than liquid or powdered whole milk. PMID:23306187

  15. 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

  16. 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

  17. 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

  18. Cognitive control moderates early childhood temperament in predicting social behavior in 7-year-old children: an ERP study.

    PubMed

    Lamm, Connie; Walker, Olga L; Degnan, Kathryn A; Henderson, Heather A; Pine, Daniel S; McDermott, Jennifer Martin; Fox, Nathan A

    2014-09-01

    Behavioral inhibition (BI) is a temperament associated with heightened vigilance and fear of novelty in early childhood, and social reticence and increased risk for anxiety problems later in development. However, not all behaviorally inhibited children develop signs of anxiety. One mechanism that might contribute to the variability in developmental trajectories is the recruitment of cognitive-control resources. The current study measured N2 activation, an ERP (event-related potential) associated with cognitive control, and modeled source-space activation (LORETA; Low Resolution Brain Electromagnetic Tomography) at 7 years of age while children performed a go/no-go task. Activation was estimated for the entire cortex and then exported for four regions of interest: ventromedial prefrontal cortex (VMPFC), ventrolateral prefrontal cortex (VLPFC), dorsal anterior cingulate cortex (dorsal ACC), and dorsal lateral prefrontal cortex (DLPFC). BI was measured in early childhood (ages 2 and 3 years). Anxiety problems and social reticence were measured at 7 years of age to ascertain stability of temperamental style. Results revealed that BI was associated with increased performance accuracy, longer reaction times, greater (more negative) N2 activation, and higher estimated dorsal ACC and DLPFC activation. Furthermore, early BI was only associated with social reticence at age 7 at higher (more negative) levels of N2 activation or higher estimated dorsal ACC or DLPFC activation. Results are discussed in the context of overcontrolled behavior contributing to social reticence and signs of anxiety in middle childhood. PMID:24754610

  19. Cognitive control moderates early childhood temperament in predicting social behavior in seven year old children: An ERP study

    PubMed Central

    Lamm, Connie; Walker, Olga L.; Degnan, Kathryn A.; Henderson, Heather A.; Pine, Daniel S.; McDermott, Jennifer Martin; Fox, Nathan A.

    2015-01-01

    Behavioral inhibition (BI) is a temperament associated with heightened vigilance and fear of novelty in early childhood, and social reticence and increased risk for anxiety problems later in development. However, not all behaviorally inhibited children develop signs of anxiety. One mechanism that might contribute to the variability in developmental trajectories is the recruitment of cognitive-control resources. The current study measured N2 activation, an ERP (event-related potential) associated with cognitive control, and modeled source-space activation (LORETA; Low Resolution Brain Electromagnetic Tomography) at seven years of age while children performed a go/no-go task. Activation was estimated for the entire cortex and then exported for four regions of interest: ventromedial prefrontal cortex (VMPFC), ventrolateral prefrontal cortex (VLPFC), dorsal anterior cingulate cortex (dorsal ACC), and dorsal lateral prefrontal cortex (DLPFC). BI was measured in early childhood (ages two and three years). Anxiety problems and social reticence were measured at seven years of age to ascertain stability of temperamental style. Results revealed that BI was associated with increased performance accuracy, longer reaction times, greater (more negative) N2 activation, and higher estimated dorsal ACC and DLPFC activation. Furthermore, early BI was only associated with social reticence at age 7 at higher (more negative) levels of N2 activation or higher estimated dorsal ACC or DLPFC activation. Results are discussed in the context of overcontrolled behavior contributing to social reticence and signs of anxiety in middle childhood. PMID:24754610

  20. Cytomegalovirus-specific T cells are primed early after cord blood transplant but fail to control virus in vivo

    PubMed Central

    McGoldrick, Suzanne M.; Bleakley, Marie E.; Guerrero, Abraham; Turtle, Cameron J.; Yamamoto, Tori N.; Pereira, Shalini E.; Delaney, Colleen S.; Riddell, Stanley R.

    2013-01-01

    A disadvantage of umbilical cord blood transplantation (UCBT) is the delay in immune reconstitution, placing patients at increased risk for infections after transplant. Cytomegalovirus (CMV) in particular has been shown to cause significant morbidity in patients undergoing UCBT. Here, we comprehensively evaluate the development of CD4+ and CD8+ T-cell responses to CMV in a cohort of patients that underwent double UCBT. Our findings demonstrate conclusively that a diverse polyclonal CMV-specific T-cell response derived from the UCB graft is primed to viral antigens as early as day 42 after UCBT, but these T cells fail to achieve sufficient numbers in vivo to control CMV reactivations. This is not due to an inherent inability of UCB-derived T cells to proliferate, as these T cells underwent rapid proliferation in vitro. The TCR diversity and antigen specificity of CMV-specific T cells remained remarkably stable in the first year after transplant, suggesting that later control of virus replication results from improved function of T cells primed early after transplant and not from de novo responses derived from later thymic emigrants. Ex vivo expansion and adoptive transfer of CMV-specific T cells isolated from UCBT recipients early after transplant could augment immunity to CMV. PMID:23412093

  1. Evolution of Developmental Control Mechanisms Independent migration of cell populations in the early gastrulation

    E-print Network

    Patel, Nipam H.

    in the early gastrulation of the amphipod crustacean Parhyale hawaiensis R. Crystal Chaw a,n,1 , Nipam H. Patel: Gastrulation Arthropod Crustacean Morphogenesis Cell-shape change Embryogenesis a b s t r a c t Cells gastrulation in the crustacean Parhyale hawaiensis. Using cytoskeletal markers and lineage tracing we observe

  2. Early maladaptive schema factors, chronic pain and depressiveness: a study with 271 chronic pain patients and 331 control participants.

    PubMed

    Saariaho, Tom; Saariaho, Anita; Karila, Irma; Joukamaa, Matti

    2012-01-01

    Chronic pain and depression are coexisting entities with high simultaneous prevalence. Both are linked with early adversities. Early maladaptive schemas (EMS) can be seen as a reflection of these adversities. EMSs extensively indicate underlying psychic patterns and provide a good opportunity to detect covert processes and psychic shapes (latent factors), which create the basis of how people rate their schemas. The purpose of this study was to explore these latent, higher order schema factors (SF) and to find out how they are associated with pain intensity or depression in chronic pain patients and a control sample. The study subjects consisted of 271 first-visit pain patients and 331 control participants. Sociodemographic and pain data were gathered by questionnaire; 18 EMSs were measured with the Young Schema Questionnaire (short form) and depressiveness was measured with the Beck Depression Inventory, Version II. Exploratory factor and regression analyses were used. The chronic pain patient group showed two SFs. The first SF showed a shameful, defective, socially isolated, failure, emotionally inhibited, deprived, submissive and resigned pattern. The second SF showed a demanding, approval seeking, self-sacrificing and punitive pattern. SF1 predicted more than half of the depressiveness in the pain patient sample. A three-factor structure was found in the control sample, and SFs 1 and 3 together predicted almost one-third of depressiveness. The pain patient and the control groups had a different, higher order factor structure. We assume that SF1 in the pain patients reflected a rather serious, undefined early psychic trauma and was also associated with their depressiveness. PMID:21210495

  3. BrpSPL9 (Brassica rapa ssp. pekinensis SPL9) controls the earliness of heading time in Chinese cabbage.

    PubMed

    Wang, Yali; Wu, Feijie; Bai, Jinjuan; He, Yuke

    2014-04-01

    The leafy heads of cabbage (Brassica oleracea), Chinese cabbage (Brassica rapa ssp. pekinensis), Brussels sprouts (B. oleracea ssp. gemmifera) and lettuce (Lactuca sativa) comprise extremely incurved leaves that are edible vegetable products. The heading time is important for high quality and yield of these crops. Here, we report that BrpSPL9-2 (B. rapa ssp. pekinensis SQUAMOSA PROMOTER BINDING-LIKE 9-2), a target gene of microRNA brp-miR156, controls the heading time of Chinese cabbage. Quantitative measurements of leaf shapes, sizes, colour and curvature indicated that heading is a late adult phase of vegetative growth. During the vegetative period, miR156 levels gradually decreased from the seedling stage to the heading one, whereas BrpSPL9-2 and BrpSPL15-1 mRNAs increased progressively and reached the highest levels at the heading stage. Overexpression of a mutated miR156-resistant form of BrpSPL9-2 caused the significant earliness of heading, concurrent with shortening of the seedling and rosette stages. By contrast, overexpression of miR156 delayed the folding time, concomitant with prolongation of the seedling and rosette stages. Morphological analysis reveals that the significant earliness of heading in the transgenic plants overexpressing BrpSPL9-2 gene was produced because the juvenile phase was absent and the early adult phase shortened, whereas the significant delay of folding in the transgenic plants overexpressing Brp-MIR156a was due to prolongation of the juvenile and early adult phases. Thus, miR156 and BrpSPL9 genes are potentially important for genetic improvement of earliness of Chinese cabbage and other crops. PMID:24237584

  4. Differential Susceptibility to Early Literacy Intervention in Children with Mild Perinatal Adversities: Short- and Long-Term Effects of a Randomized Control Trial

    ERIC Educational Resources Information Center

    Van der Kooy-Hofland, Verna A. C.; Van der Kooy, Jacoba; Bus, Adriana G.; van IJzendoorn, Marinus H.; Bonsel, Gouke J.

    2012-01-01

    In a randomized control trial, the authors tested whether short- and long-term effects of an early literacy intervention are moderated by mild perinatal adversities in accordance with differential susceptibility theory. One-hundred 5-year-old children (58% male) who scored at or below the 30th percentile on early literacy measures were randomized…

  5. Cost effectiveness of early intensive multifactorial treatment for individuals with screen-detected type 2 diabetes: analysis of the ADDITION-UK cluster randomised controlled trial

    E-print Network

    Tao, L.; Wilson, E. C. F.; Wareham, Nicholas J.; Sandbæk, A.; Rutten, G. E. H. M.; Lauritzen, T.; Khunti, K.; Davies, M. J.; Borch-Johnsen, K.; Griffin, S. J.; Simmons, R. K.

    2014-04-15

    -randomised controlled trial of early intensive treatment in people with screen-detected diabetes in 69 UK general practices. Unit treatment costs and utility decrement data were taken from published literature. Accumulated costs and quality adjusted life years (QALYs...

  6. A randomised controlled trial of early insulin therapy in very low birth weight infants, "NIRTURE" (neonatal insulin replacement therapy in Europe)

    E-print Network

    Beardsall, Kathryn; Vanhaesebrouck, Sophie; Ogilvy-Stuart, Amanda L.; Ahluwalia, Jagit; Vanhole, Christine; Palmer, Chris; Midgley, Paula; Thompson, Michael; Cornette, Luc; VanWeissenbruch, Mirjam; Thio, Marta; de Zegher, Francis; Dunger, David B.

    2007-08-10

    importance of glucose control at this time are not well established. However there is increasing evidence that the early postnatal period is critical for pancreatic development. At this time a complex set of signals appears to influence pancreatic development...

  7. Randomized controlled trial to investigate the effect of metal clips on early migration during stent implantation for malignant esophageal stricture

    PubMed Central

    Wang, Changxiong; Lou, Cui

    2015-01-01

    Background The rate of stent migration, especially in the short term after implantation, is high in the treatment process. We sought to explore an effective method for preventing early migration after stent implantation for malignant esophageal stricture and to provide the basis for clinical treatment. Methods We conducted a prospective, open-label, parallel-assignment randomized controlled trial with patients undergoing stent implantation for malignant esophageal stricture. The proximal segments of stents in the treatment group were fixed with 2 metal clips during the perioperative period of esophageal stent implantation, while no treatment was used in the control group. All patients underwent radiography at 3 and 7 days and 1 and 3 months after placement to assess the stent migration. Results There were 83 patients in our study. Demographic characteristics were similar between the groups. There was no stent migration observed in the treatment group within 2 weeks of the operation, while stent migration was observed in 6 of 41 (14.6%) cases in the control group, occurring at 3 and 7 days after placement. There were no perioperative complications. Conclusion Perioperative fixation of the proximal segments of stents with metal clips is effective in preventing early stent migration. PMID:26574828

  8. AgRISTARS: Soil moisture/early warning and crop condition assessment. Interface control document

    NASA Technical Reports Server (NTRS)

    1980-01-01

    The interactions and support functions required between the early warning/crop condition assessment (EW/CCA) project and soil moisture (SM) project are defined. The EW Project aims to develop, test and evaluate techniques and procedures for adapting remote sensing technology to provide early warning of events and the timely assessment of those factors which affect the quality and quantity of production of economically important crops. Those techniques to augment and reinforce the current assessment activities are to be developed to improve the definition of the relationship between the plant(s) and its environment. This assessment and evaluation will certainly include the need for soil moisture measurement and estimation. The SM Project aims to develop, test, and evaluate techniques and procedures to measure or predict soil moisture in the root zone using both contact and remote sensors.

  9. Controls on the formation of early diagenetic dolomite, Monterey Formation, California

    SciTech Connect

    Compton, J.S.; Siever, R.

    1985-01-01

    The clayey siliceous and phosphatic Monterey Formation in the Santa Maria basin contains 1 to 40 wt % dolomite, whose stratigraphic occurrence is relatable to sediment composition which in turn is dependent on climatic variations. Early dolomite is commonly associated with laminated, organic-rich, calcareous, phosphatic sediment in which organic carbon, pyritic sulfur, V, and Cu are positively correlated. The amounts of organic matter and calcite affect the extent of early dolomite precipitation. Bacterial degradation of sediment organic matter reduces sulfate to H/sub 2/S and increases the carbonate alkalinity, highly supersaturating pore waters with respect to dolomite. Mg transport by diffusion from overlying sea water constrains the bulk of the dolomite to have formed during early diagenesis, in agreement with field evidence of precompaction origin. Ultimately Monterey sediment composition was influenced by the effects of climatic oscillations on surface water productivity. Global temperature decrease accelerates atmospheric and oceanic circulation and O/sub 2/ renewal rates to deep waters and deepens the carbonate compensation depth (CCD), thereby limiting organic matter and calcite preservation. Organic-rich sediment forms both in upwelling regions because of high surface productivity and infringement of an expanded O/sub 2/-minimum zone, and in basins where circulation is restricted by topography. Calcite content depends on the silica/calcite ratio of the surface productivity and on the CCD and basin bathymetry.

  10. Randomized Controlled Trial of Forward-Planned Intensity Modulated Radiotherapy for Early Breast Cancer: Interim Results at 2 Years

    SciTech Connect

    Barnett, Gillian C.; Wilkinson, Jennifer S.; Moody, Anne M.; Wilson, Charles B.; Twyman, Nicola; Wishart, Gordon C.; Burnet, Neil G.; Coles, Charlotte E.

    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.

  11. Integration of thermal and environmental control systems during Space Station Freedom early assembly phase

    NASA Technical Reports Server (NTRS)

    Di Pietro, David A.; Tandler, Ohn J.

    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 and verification requirements, interface verification procedures, TCS activation sequence, resource allocation and Space Shuttle integration.

  12. Putting it into practice: Infection Control Professionals' perspectives on early career nursing graduates' microbiology and infection control knowledge and practice.

    PubMed

    Cox, Jennifer L; Simpson, Maree Donna; Letts, Will; Cavanagh, Heather Ma

    2014-11-10

    Abstract Background: The microbiology component of Australian undergraduate nursing programs varies considerably. Any actual or potential impact of this variation on infection control practice, as a nursing graduate, is relatively unknown. Aims: The aim of this study was to explore Infection Control Professionals' perceptions of the importance of microbiology and infection control training in undergraduate nursing curricula and the perceived retention of that knowledge and its transferability to practice. Method: Semi-structured interviews were conducted with eight infection control professionals from a range of hospital settings in Australia. Findings: Four main themes emerged: theory versus practice, importance of role modelling, disjunction between university curricula and 'the real world', and learning in context. Conclusion: As the underpinning element of infection control practice, the role of microbiology education and training in nursing education will benefit from review. Further discussions about the nature and timing of theoretical microbiology content and assessment of undergraduate students' microbiology knowledge to ensure retention and appropriate application of that knowledge in practice are urgently needed. PMID:25382059

  13. Comparing the risks and benefits of early applications of chlorimuron for weed control in peanut

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Chlorimuron is applied mid-season to control Florida beggarweed in peanut. Chlorimuron can be applied from 60 days after emergence (DAE) until 45 days prior to harvest. Trials were conducted in Georgia to determine if the benefits of controlling smaller Florida beggarweed with chlorimuron applied...

  14. Predictors of Parental Locus of Control in Mothers of Pre- and Early Adolescents

    ERIC Educational Resources Information Center

    Freed, Rachel D.; Tompson, Martha C.

    2011-01-01

    Parental locus of control refers to parents' perceived power and efficacy in child-rearing situations. This study explored parental locus of control and its correlates in 160 mothers of children ages 8 to 14 cross-sectionally and 1 year later. Maternal depression, maternal expressed emotion, and child internalizing and externalizing behavior were…

  15. Effects of Early Relationships on Children's Perceived Control: A Longitudinal Study

    ERIC Educational Resources Information Center

    Dan, Orrie; Sagi-Schwartz, Abraham; Bar-haim, Yair; Eshel, Yohanan

    2011-01-01

    People's response to stress depends to a large extent on their sense of perceived control over the situations they encounter. This longitudinal study of 136 children (70 girls) examined associations between attachment patterns and maternal sensitivity at 12 months of age, and perceived primary and secondary control at 11 years of age. Compared…

  16. Aerobic physical training has little effect on cardiovascular autonomic control in aging rats subjected to early menopause.

    PubMed

    Tezini, Geisa C S V; Dias, Daniel P M; Souza, Hugo C D

    2013-02-01

    We investigated and compared the effects of physiological menopause (PM) and early menopause (EM) and the adaptations promoted by physical training on the cardiovascular autonomic control of aged rats. Female Wistar rats (N=72) were assigned to 3 groups: control (22 weeks old rats, undergoing sham surgery in the 10th week of life), PM (82 weeks old rats, undergoing sham surgery in the 10th week of life) and EM (82 weeks old rats, undergoing ovariectomy in the 10th week of life). In each group, half of the rats were subjected to swimming training over a period of 10 weeks. Sedentary PM and EM groups had higher basal mean arterial pressure (MAP) and heart rate (HR) and lower intrinsic HR compared to the sedentary control group. Physical training reduced MAP in PM group. All trained groups had lower basal HR; however, only control and PM-trained groups showed decreased intrinsic HR. The assessment of cardiac autonomic balance showed that PM and EM sedentary groups exhibited sympathetic predominance compared to control group. After physical training, only EM group presented sympathetic predominance. HR variability (pulse interval) was similar among all sedentary groups. However, control and PM-trained groups showed lower power in low frequency band (LF; 0.2-0.75 Hz) and higher power in high frequency band (HF; 0.75-3.0 Hz). The analysis of systolic arterial pressure variability revealed that PM and EM sedentary groups had higher LF power. However, PM group showed lower LF power following physical training. Finally, PM and EM groups had a reduction in spontaneous baroreflex sensitivity, that was attenuated by physical training. The overall results suggest that PM or EM promotes similar negative effects on MAP, HR and cardiovascular autonomic control. However, unlike the PM group, physical training was not able to mitigate all negative effects of EM on cardiovascular autonomic control. PMID:23201548

  17. Genetic variants of OCT1 influence glycemic response to metformin in Han Chinese patients with type-2 diabetes mellitus in Shanghai

    PubMed Central

    Zhou, Yong; Ye, Weiwei; Wang, Yi; Jiang, Zhikui; Meng, Xiangying; Xiao, Qian; Zhao, Qian; Yan, Jian

    2015-01-01

    Aims/hypothesis: Genetic variation in OCT1 can influence the glycemic response to metformin. We evaluated the effects of the OCT1 single-nucleotide polymorphisms (SNPs), rs1867351, rs4709400, rs628031, and rs2297374, on metformin efficacy in type-2 diabetes mellitus (DM) patients. Methods: We performed a single-center prospective analysis of the distributions of these SNPs in a cohort of Han Chinese subjects in Shanghai, China (HCS), and evaluated the effects of each SNP on glycemic control in HCS DM patients following 3 months of incident metformin treatment. Results: The allele frequencies of rs4709400 and rs628031 in our HCS control group differed from those previously reported for Han Chinese subjects in Beijing (HCB), as well as those previously reported for Caucasians and Africans, whereas the allele frequencies of rs1867351 and rs2297374 were more similar to those in HCB subjects. The DM patients with the rs1867351 T/T or rs4709400 G/G genotype exhibited greater reductions in postprandial plasma glucose (PPG), compared to those with different genotypes of these SNPs. The DM patients with the rs2297374 C/T, rs4709400 G/G, or rs628031 G/G genotype exhibited greater reductions in fasting plasma glucose (FPG), and those with the rs1867351 T/T, rs628031 A/A, or rs2297374 C/T genotype exhibited greater reductions in HbA1c , compared to those with different genotypes of these SNPs. Conclusions /interpretation: The rs1867351, rs4709400, rs628031, and rs2297374 SNPs of OCT1 have selective effects on FPG, PPG, and HbA1c in HCS DM patients in response to metformin treatment. Future studies of these SNPs in larger samples of HCS DM patients are warranted. PMID:26464716

  18. 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.

  19. Glycemic index, glycemic load, and the risk of pancreatic cancer among postmenopausal women in the women’s health initiative observational study and clinical trial

    PubMed Central

    Shikany, J. M.; Neuhouser, M. L.; Rohan, T.; Nirmal, K.; Cui, Y.; Abrams, J.

    2013-01-01

    Background Several reports have suggested that conditions associated with hyperinsulinemia and insulin resistance, such as diets high in carbohydrates, may influence the risk of pancreatic cancer, although results from prior studies have been mixed. Methods We utilized data from the population-based women’s health initiative (WHI) cohort to determine whether dietary factors that are associated with increased postprandial blood glucose levels are also associated with an increased risk of pancreatic cancer. The WHI included 161,809 postmenopausal women of ages 50–79, in which 332 cases of pancreatic cancer were identified over a median of 8 years of follow-up; 287 of these cases met the criteria for analysis. A validated 122-item food frequency questionnaire was used to estimate dietary glycemic load (GL), glycemic index (GI), total and available carbohydrates, fructose and sucrose. Baseline questionnaires and physical exams provided information on demographic, medical, lifestyle, and anthropometric characteristics. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between the exposures of interest and pancreatic cancer risk, with adjustment for potential confounders. Results Dietary GL, GI, carbohydrates, fructose, and sucrose were not associated with increased risk of pancreatic cancer. The multivariable adjusted HR for the highest vs. the lowest quartile of GL was 0.80 (95% CI = 0.55–1.15, trend p = 0.31) and 1.13 (95% CI = 0.78–1.63, trend p = 0.94) for GI. The results remained negative when individuals with a history of diabetes were excluded. Conclusions Our results do not support the hypothesis that dietary intake of carbohydrates is associated with increased risk of pancreatic cancer. PMID:20711806

  20. The Mystery of Handprints: Assesment and Correlation of Dermatoglyphics with Early Childhood Caries A Case-Control Study

    PubMed Central

    Chadha, Dheera; Khan, Suleman Abbas; Singh, Rahul Kumar; Johri, Nikita; Navit, Pragati; Sharma, Anshul; Bahuguna, Rachana

    2015-01-01

    Background It has been acknowledged that genetics play a significant role in determination of dermatoglyphic patterns. Since caries is a multifactorial disease with the influence of genetic pattern, this study was undertaken to assess dermatoglyphic patterns and correlate them with early childhood caries. Aim The aim of the study was to determine the association and correlation of dermatoglyphic patterns with early childhood caries. Materials and Methods The study sample consisted of 100 children aged between 3 and 6 years, divided into two groups of 50 children each. The deft score was evaluated to select the experimental group and control group. Finger and palm prints were recorded using the ink method described by Cummins and Midlo. The handprints obtained were checked for their clarity with a magnifying glass (×2) and coded. The presence of core and the triradii of the dermatoglyphic pattern were checked thoroughly to include the handprint in the study. A total of 1000 digital prints and 200 palmar prints were obtained. Results The presence of whorls in the index finger of the right hand predicts significantly lower risk of caries in children (male and female; combined). Presence of whorls in the ring finger of the right hand predicts significantly lower risk of caries in female children. Statistically no correlation between atd angle and early childhood caries was obtained from the present data. Conclusion The results obtained from the present study creates a notion on the validity of the results of the previous studies and point them to be chance findings. Due to increasing acceptability of dermatoglyphics as a diagnostic tool for congenital diseases, further large scale extensive research should be undertaken to evaluate the role of the same in children with Early Childhood Caries (ECC). PMID:26557615

  1. Hnf-1? Transcription Factor Is an Early Hif-1?-Independent Marker of Epithelial Hypoxia and Controls Renal Repair

    PubMed Central

    Faguer, Stanislas; Mayeur, Nicolas; Casemayou, Audrey; Pageaud, Anne-Laure; Courtellemont, Claire; Cartery, Claire; Fournie, Gilbert J.; Schanstra, Joost P.; Tack, Ivan; Bascands, Jean-Loup; Chauveau, Dominique

    2013-01-01

    Epithelial repair following acute kidney injury (AKI) requires epithelial-mesenchyme-epithelial cycling associated with transient re-expression of genes normally expressed during kidney development as well as activation of growth factors and cytokine-induced signaling. In normal kidney, the Hnf-1? transcription factor drives nephrogenesis, tubulogenesis and epithelial homeostasis through the regulation of epithelial planar cell polarity and expression of developmental or tubular segment-specific genes. In a mouse model of ischemic AKI induced by a 2-hours hemorrhagic shock, we show that expression of this factor is tightly regulated in the early phase of renal repair with a biphasic expression profile (early down-regulation followed by transient over-expression). These changes are associated to tubular epithelial differentiation as assessed by KSP-cadherin and megalin-cubilin endocytic complex expression analysis. In addition, early decrease in Hnf1b expression is associated with the transient over-expression of one of its main target genes, the suppressor of cytokine signaling Socs3, which has been shown essential for renal repair. In vitro, hypoxia induced early up-regulation of Hnf-1? from 1 to 24 hours, independently of the hypoxia-inducible factor Hif-1?. When prolonged, hypoxia induced Hnf-1? down-regulation while normoxia led to Hnf-1? normalization. Last, Hnf-1? down-regulation using RNA interference in HK-2 cells led to phenotype switch from an epithelial to a mesenchyme state. Taken together, we showed that Hnf-1? may drive recovery from ischemic AKI by regulating both the expression of genes important for homeostasis control during organ repair and the state of epithelial cell differentiation. PMID:23704921

  2. 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 ...

  3. Early-season flood enhances native biological control agents in Wisconsin cranberry

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Biological control is predicated on the concept that crop plants are protected when predators suppress herbivore populations. However, many factors, including concurrent crop protection strategies, may modify the effectiveness of a predator in a given agroecosystem. In Wisconsin commercial cranberry...

  4. The Interaction between Negative Emotionality and Effortful Control in Early Social-emotional Development

    PubMed Central

    Moran, Lyndsey R.; Lengua, Liliana J.; Zalewski, Maureen

    2014-01-01

    Interactions between reactive and regulatory dimensions of temperament may be particularly relevant to children’s adjustment but are examined infrequently. This study investigated these interactions by examining effortful control as a moderator of the relations of fear and frustration reactivity to children’s social competence, internalizing, and externalizing problems. Participants included 306 three-year-old children and their mothers. Children’s effortful control was measured using observational measures, and reactivity was assessed with both observational and mother-reported measures. Mothers reported on children’s adjustment. Significant interactions indicated that children with higher mother-reported fear or higher observed frustration and lower executive control showed higher externalizing problems whereas children with higher observed fear and higher delay ability demonstrated lower externalizing problems. These results highlight effortful control as a moderator of the relation between reactivity and adjustment, and may inform the development of interventions geared toward the management of specific negative affects. PMID:25429192

  5. Connecting early summer cloud-controlled sunlight and late summer sea ice in the Arctic

    NASA Astrophysics Data System (ADS)

    Choi, Yong-Sang; Kim, Baek-Min; Hur, Sun-Kyong; Kim, Seong-Joong; Kim, Joo-Hong; Ho, Chang-Hoi

    2014-10-01

    This study demonstrates that absorbed solar radiation (ASR) at the top of the atmosphere in early summer (May-July) plays a precursory role in determining the Arctic sea ice concentration (SIC) in late summer (August-October). The monthly ASR anomalies are obtained over the Arctic Ocean (65°N-90°N) from the Clouds and the Earth's Radiant Energy System during 2000-2013. The ASR changes primarily with cloud variation. We found that the ASR anomaly in early summer is significantly correlated with the SIC anomaly in late summer (correlation coefficient, r ? -0.8 with a lag of 1 to 4 months). The region exhibiting high (low) ASR anomalies and low (high) SIC anomalies varies yearly. The possible reason is that the solar heat input to ice is most effectively affected by the cloud shielding effect under the maximum TOA solar radiation in June and amplified by the ice-albedo feedback. This intimate delayed ASR-SIC relationship is not represented in most of current climate models. Rather, the models tend to over-emphasize internal sea ice processes in summer.

  6. 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. PMID:26029821

  7. 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

  8. 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

  9. Tea, coffee, and caffeine and early-onset basal cell carcinoma in a case-control study

    PubMed Central

    Ferrucci, Leah M.; Cartmel, Brenda; Molinaro, Annette M.; Leffell, David J.; Bale, Allen E.; Mayne, Susan T.

    2014-01-01

    Objectives Tea and coffee are hypothesized to play a protective role in skin carcinogenesis via bioactive components, such as caffeine, yet the epidemiologic evidence is mixed. Existing data supports an inverse association with basal cell carcinoma (BCC) more so than for melanoma or squamous cell carcinoma. To understand if 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. Methods 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, gender, and biopsy site. Subjects completed an in-person interview including assessment of caffeinated coffee and hot tea. We calculated multivariate odds ratios (OR) and 95% confidence intervals (CIs) with unconditional logistic regression for regular consumption and frequency and duration measures. Results 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 to non-consumers (OR=0.57, 95% CI=0.34–0.95, p-trend=0.037). Conclusions 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

  10. Relationship between Processing Method and the Glycemic Indices of Ten Sweet Potato (Ipomoea batatas) Cultivars Commonly Consumed in Jamaica.

    PubMed

    Bahado-Singh, Perceval S; Riley, Cliff K; Wheatley, Andrew O; Lowe, Henry I C

    2011-01-01

    This study investigated the effect of different traditional cooking methods on glycemic index (GI) and glycemic response of ten Sweet potato (Ipomoea batatas) cultivars commonly eaten in Jamaica. Matured tubers were cooked by roasting, baking, frying, or boiling then immediately consumed by the ten nondiabetic test subjects (5 males and 5 females; mean age of 27 ± 2 years). The GI varied between 41 ± 5-93 ± 5 for the tubers studied. Samples prepared by boiling had the lowest GI (41 ± 5-50 ± 3), while those processed by baking (82 ± 3-94 ± 3) and roasting (79 ± 4-93 ± 2) had the highest GI values. The study indicates that the glycemic index of Jamaican sweet potatoes varies significantly with the method of preparation and to a lesser extent on intravarietal differences. Consumption of boiled sweet potatoes could minimize postprandial blood glucose spikes and therefore, may prove to be more efficacious in the management of type 2 diabetes mellitus. PMID:22132322

  11. Sequential docetaxel as adjuvant chemotherapy for early breast cancer (TACT): an open-label, phase III, randomised controlled trial

    PubMed Central

    Ellis, Paul; Barrett-Lee, Peter; Johnson, Lindsay; Cameron, David; Wardley, Andrew; O'Reilly, Susan; Verrill, Mark; Smith, Ian; Yarnold, John; Coleman, Robert; Earl, Helena; Canney, Peter; Twelves, Chris; Poole, Christopher; Bloomfield, David; Hopwood, Penelope; Johnston, Stephen; Dowsett, Mitchell; Bartlett, John MS; Ellis, Ian; Peckitt, Clare; Hall, Emma; Bliss, Judith M

    2009-01-01

    Summary Background Incorporation of a taxane as adjuvant treatment for early breast cancer offers potential for further improvement of anthracycline-based treatment. The UK TACT study (CRUK01/001) investigated whether sequential docetaxel after anthracycline chemotherapy would improve patient outcome compared with standard chemotherapy of similar duration. Methods In this multicentre, open-label, phase III, randomised controlled trial, 4162 women (aged >18 years) with node-positive or high-risk node-negative operable early breast cancer were randomly assigned by computer-generated permuted block randomisation to receive FEC (fluorouracil 600 mg/m2, epirubicin 60 mg/m2, cyclophosphamide 600 mg/m2 at 3-weekly intervals) for four cycles followed by docetaxel (100 mg/m2 at 3-weekly intervals) for four cycles (n=2073) or control (n=2089). For the control regimen, centres chose either FEC for eight cycles (n=1265) or epirubicin (100 mg/m2 at 3-weekly intervals) for four cycles followed by CMF (cyclophosphamide 600 mg/m2, methotrexate 40 mg/m2, and fluorouracil 600 mg/m2 at 4-weekly intervals) for four cycles (n=824). The primary endpoint was disease-free survival. Analysis was by intention to treat (ITT). This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN79718493. Findings All randomised patients were included in the ITT population. With a median follow-up of 62 months, disease-free survival events were seen in 517 of 2073 patients in the experimental group compared with 539 of 2089 controls (hazard ratio [HR] 0·95, 95% CI 0·85–1·08; p=0·44). 75·6% (95% CI 73·7–77·5) of patients in the experimental group and 74·3% (72·3–76·2) of controls were alive and disease-free at 5 years. The proportion of patients who reported any acute grade 3 or 4 adverse event was significantly greater in the experimental group than in the control group (p<0·0001); the most frequent events were neutropenia (937 events vs 797 events), leucopenia (507 vs 362), and lethargy (456 vs 272). Interpretation This study did not show any overall gain from the addition of docetaxel to standard anthracycline chemotherapy. Exploration of predictive biomarker-defined subgroups might have the potential to better target the use of taxane-based therapy. Funding Cancer Research UK (CRUK 01/001), Sanofi-Aventis, Pfizer, and Roche. PMID:19447249

  12. Sedimentological and diagenetic controls of gas in Lower and Early Upper Carboniferous sediments, NE Germany

    NASA Astrophysics Data System (ADS)

    Kerschke, Dorit I.; Schulz, Hans-Martin

    2015-07-01

    Fine-grained, organic-rich Paleozoic sediments are proven source rocks for conventional gas systems in NW Europe and large, unconventional gas reservoirs are assumed in Lower to Early Upper Carboniferous black shales. However, despite numerous boreholes exploring for hydrocarbons, the shale gas potential remains uncertain. This paper comprises detailed information on the sedimentary structure and lithofacies associations along with spatial distribution, thickness, thermal maturity, organic and inorganic petrology as well as geochemistry and mineralogy of Lower to Early Upper Carboniferous black shales in NE Germany to unravel the evolution of shale gas-relevant properties. Sediments of the "Kohlenkalk" Formation (Carboniferous Limestone) in the Rügen Island area were deposited on an extensive deep-water carbonate shelf. Transgressive-regressive cycles led to the formation of an up to 2000 m thick intercalation of mud- and limestones. High total organic carbon contents (2.4-7.0 wt.%) of a mainly Type II + III kerogen have been deposited under dysoxic to anoxic conditions and attained favorable present-day thermal maturities (0.8-1.8% VRr) indicating a shale oil potential in the upper part of the succession and a shale gas potential in the deeper parts. Sediments of the "Altmark-North-Brandenburg Culm" (Synorogenic Flysch Formation) were deposited as a turbidity current-derived intercalation of a sand/silt-mud interbedded and black mudrock lithofacies in a deep marine siliciclastic slope to basinal setting. The ~ 1900 m thick succession has TOC contents of 0.5-2 wt.% and present-day thermal maturities of 2.3-3.2% VRr indicating a possible hybrid gas accumulation in areas where the succession is buried < 5000 m.

  13. Dietary Soy Supplement on Fibromyalgia Symptoms: A Randomized, Double-Blind, Placebo-Controlled, Early Phase Trial

    PubMed Central

    Wahner-Roedler, Dietlind L.; Thompson, Jeffrey M.; Luedtke, Connie A.; King, Susan M.; Cha, Stephen S.; Elkin, Peter L.; Bruce, Barbara K.; Townsend, Cynthia O.; Bergeson, Jody R.; Eickhoff, Andrea L.; Loehrer, Laura L.; Sood, Amit; Bauer, Brent A.

    2011-01-01

    Most patients with fibromyalgia use complementary and alternative medicine (CAM). Properly designed controlled trials are necessary to assess the effectiveness of these practices. This study was a randomized, double-blind, placebo-controlled, early phase trial. Fifty patients seen at a fibromyalgia outpatient treatment program were randomly assigned to a daily soy or placebo (casein) shake. Outcome measures were scores of the Fibromyalgia Impact Questionnaire (FIQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline and after 6 weeks of intervention. Analysis was with standard statistics based on the null hypothesis, and separation test for early phase CAM comparative trials. Twenty-eight patients completed the study. Use of standard statistics with intent-to-treat analysis showed that total FIQ scores decreased by 14% in the soy group (P = .02) and by 18% in the placebo group (P < .001). The difference in change in scores between the groups was not significant (P = .16). With the same analysis, CES-D scores decreased in the soy group by 16% (P = .004) and in the placebo group by 15% (P = .05). The change in scores was similar in the groups (P = .83). Results of statistical analysis using the separation test and intent-to-treat analysis revealed no benefit of soy compared with placebo. Shakes that contain soy and shakes that contain casein, when combined with a multidisciplinary fibromyalgia treatment program, provide a decrease in fibromyalgia symptoms. Separation between the effects of soy and casein (control) shakes did not favor the intervention. Therefore, large-sample studies using soy for patients with fibromyalgia are probably not indicated. PMID:18990724

  14. Elective Inguinal Node Irradiation in Early-Stage T2N0 Anal Cancer: Prognostic Impact on Locoregional Control

    SciTech Connect

    Zilli, Thomas; Betz, Michael; Bieri, Sabine; Ris, Frederic; Roche, Bruno; Roth, Arnaud D.; Allal, Abdelkarim S.

    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.

  15. 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…

  16. Locus of Control in Early Childhood Education: Where Did We Come From? Where Are We Now"? Where Might We Go from Here?

    ERIC Educational Resources Information Center

    Hawkes, Brent B.

    This document is a literature review discussing research on locus of control, particularly as it relates to early childhood education. Some measures of children's sense of locus of control are discussed, including the Optimism-Pessimism Test Instrument and the Stanford Preschool Internal-External Scale. A discussion of how an educator's sense of…

  17. Evaluating a community-based early childhood education and development program in Indonesia: study protocol for a pragmatic cluster randomized controlled trial with supplementary matched control group

    PubMed Central

    2013-01-01

    Background This paper presents the study protocol for a pragmatic cluster randomized controlled trial (RCT) with a supplementary matched control group. The aim of the trial is to evaluate a community-based early education and development program launched by the Government of Indonesia. The program was developed in collaboration with the World Bank with a total budget of US$127.7 million, and targets an estimated 738,000 children aged 0 to 6 years living in approximately 6,000 poor communities. The aim of the program is to increase access to early childhood services with the secondary aim of improving school readiness. Methods/Design The study is being conducted across nine districts. The baseline survey contained 310 villages, of which 100 were originally allocated to the intervention arm, 20 originally allocated to a 9-month delay staggered start, 100 originally allocated to an 18-month delay staggered start and 90 allocated to a matched control group (no intervention). The study consists of two cohorts, one comprising children aged 12 to 23 months and the other comprising children aged 48 to 59 months at baseline. The data collection instruments include child observations and task/game-based assessments as well as a questionnaire suite, village head questionnaire, service level questionnaires, household questionnaire, and child caretaker questionnaire. The baseline survey was conducted from March to April 2009, midline was conducted from April to August 2010 and endline conducted early 2013. The resultant participation rates at both the district and village levels were 90%. At the child level, the participation rate was 99.92%. The retention rate at the child level at midline was 99.67%. Discussion This protocol paper provides a detailed record of the trial design including a discussion regarding difficulties faced with compliance to the randomization, compliance to the dispersion schedule of community block grants, and procurement delays for baseline and midline data collections. Considering the execution of the program and the resultant threats to the study, we discuss our analytical plan and intentions for endline data collection. Trials registration Current Controlled Trials ISRCTN76061874 PMID:23953975

  18. Heike K. Lotze Winfrid Schramm Dirk Schories Control of macroalgal blooms at early developmental stages

    E-print Network

    Myers, Ransom A.

    in coastal ecosys- tems aected by eutrophication, their initiation and control is little understood. Most predation in terrestrial plant communities. Key words Baltic Sea á Coastal eutrophication Crustacean grazers, which is gener- ally attributed to the eects of eutrophication (e.g. Cederwall and Elmgren 1990; Kruk

  19. Examining Temporal Associations between Perceived Maternal Psychological Control and Early Adolescent Internalizing Problems

    ERIC Educational Resources Information Center

    Loukas, Alexandra

    2009-01-01

    The present study examined a) the associations between adolescent-reported maternal psychological control and self-reported internalizing problems one year later, while simultaneously examining the opposite direction of effects and b) the equivalence of these associations across gender. Participants were 479 10-to-14-year old adolescents (55%…

  20. Group Lidcombe Program Treatment for Early Stuttering: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Arnott, Simone; Onslow, Mark; O'Brian, Sue; Packman, Ann; Jones, Mark; Block, Susan

    2014-01-01

    Purpose: This study adds to the Lidcombe Program evidence base by comparing individual and group treatment of preschoolers who stutter. Method: A randomized controlled trial of 54 preschoolers was designed to establish whether group delivery outcomes were not inferior to the individual model. The group arm used a rolling group model, in which a…

  1. Technical report on "BES Early Career. Control Graphene Electronic Structure for Energy Technology"

    SciTech Connect

    Wang, Feng

    2015-07-11

    Graphene, a one-atom thick sheet of carbon, exhibits incredible structural flexibility, electrical transport, and optical responses. And remarkably, the graphene electronic structure can be varied through interlayer coupling, nanoscale patterning, and electrical gating. In this project we made significant contribution to better understand and control physical properties of graphene and other novel two-dimensional layered materials.

  2. Relation of Perinatal Risk and Early Parenting to Executive Control at the Transition to School

    ERIC Educational Resources Information Center

    Clark, Caron A. C.; Woodward, Lianne J.

    2015-01-01

    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…

  3. Longitudinal Relations of Intrusive Parenting and Effortful Control to Ego-Resiliency during Early Childhood

    ERIC Educational Resources Information Center

    Taylor, Zoe E.; Eisenberg, Nancy; Spinrad, Tracy L.; Widaman, Keith F.

    2013-01-01

    Longitudinal relations among ego-resiliency (ER), effortful control (EC), and observed intrusive parenting were examined at 18, 30, and 42 months of age ("Ns" = 256, 230, and 210) using structural equation modeling. Intrusive parenting at 18 and 30 months negatively predicted EC a year later, over and above earlier levels. EC at…

  4. 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…

  5. The evolution of damage control orthopedics: current evidence and practical applications of early appropriate care.

    PubMed

    D'Alleyrand, Jean-Claude G; O'Toole, Robert V

    2013-10-01

    This article summarizes the evolution of literature and practice related to fracture care in polytrauma patients. Particular emphasis is given to the management of femoral shaft fractures and the concept of damage control in these complex patients. The application of these guidelines in common clinical practice is also discussed. PMID:24095066

  6. 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

  7. Stern, C.D. (1987) Control of epithelial polarity and induction in the early chick embryo. In: Mesenchymal-epithelial interactions in neural development (J.R. Wolff, J. Sievers and M.

    E-print Network

    Stern, Claudio

    1987-01-01

    Stern, C.D. (1987) Control of epithelial polarity and induction in the early chick embryo. In and induction in the early chick embryo. In: Mesenchymal-epithelial interactions in neural development (J;Stern, C.D. (1987) Control of epithelial polarity and induction in the early chick embryo. In

  8. 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.

  9. Oceanic fronts in the Sargasso Sea control the early life and drift of Atlantic eels.

    PubMed

    Munk, Peter; Hansen, Michael M; Maes, Gregory E; Nielsen, Torkel G; Castonguay, Martin; Riemann, Lasse; Sparholt, Henrik; Als, Thomas D; Aarestrup, Kim; Andersen, Nikolaj G; Bachler, Mirjam

    2010-12-01

    Anguillid freshwater eels show remarkable life histories. In the Atlantic, the European eel (Anguilla anguilla) and American eel (Anguilla rostrata) undertake extensive migrations to spawn in the oceanic Sargasso Sea, and subsequently the offspring drift to foraging areas in Europe and North America, first as leaf-like leptocephali larvae that later metamorphose into glass eels. Since recruitment of European and American glass eels has declined drastically during past decades, there is a strong demand for further understanding of the early, oceanic phase of their life cycle. Consequently, during a field expedition to the eel spawning sites in the Sargasso Sea, we carried out a wide range of dedicated bio-physical studies across areas of eel larval distribution. Our findings suggest a key role of oceanic frontal processes, retaining eel larvae within a zone of enhanced feeding conditions and steering their drift. The majority of the more westerly distributed American eel larvae are likely to follow a westerly/northerly drift route entrained in the Antilles/Florida Currents. European eel larvae are generally believed to initially follow the same route, but their more easterly distribution close to the eastward flowing Subtropical Counter Current indicates that these larvae could follow a shorter, eastward route towards the Azores and Europe. The findings emphasize the significance of oceanic physical-biological linkages in the life-cycle completion of Atlantic eels. PMID:20573625

  10. 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

  11. Early experience with electronic prescribing of controlled substances in a community setting

    PubMed Central

    Thomas, Cindy Parks; Kim, Meelee; Kelleher, Stephen J; Nikitin, Ruslan V; Kreiner, Peter W; McDonald, Ann; Carrow, Grant M

    2013-01-01

    Background In 2010, the US Drug Enforcement Administration issued regulations allowing electronic prescribing of controlled substances (EPCS), a practice previously prohibited. Objective To carry out a survey of the experience of prescribers in the nation's first study of EPCS implementation. Materials and methods Prescribers were surveyed in a community setting before and after implementation of EPCS, to assess adoption, attitudes, and challenges. Results Of the 102 prescribers enabled to use EPCS and who responded to surveys before and after implementation, 70 had sent at least one controlled substance prescription electronically. Most users reported that EPCS was significantly less burdensome than expected. Over half reported that EPCS was easy to use and improved work flow, accuracy of prescriptions (69.5%), monitoring of medications (59.3%), and coordination with pharmacists, though high prior expectations for improved efficiency were not met. EPCS users reported a significant decrease in the perceived frequency of medication errors and drug diversion, compared with controls. Barriers to use of EPCS included limited pharmacy participation and instances of unreliability of the technology. Discussion Interest in adoption of EPCS is considerable among providers, pharmacies, and vendors. The results suggest that while most EPCS security features may be more acceptable to providers than expected, barriers such as the limited participation by pharmacies may also partly explain slow adoption rates for EPCS nationally. Conclusions EPCS was a better experience for many providers than they had expected, but related improvements in practice efficiency and quality of care will depend upon implementation strategies. PMID:23564630

  12. Glycemic index differences of high-fat diets modulate primarily lipid metabolism in murine adipose tissue.

    PubMed

    van Schothorst, Evert M; Bunschoten, Annelies; Verlinde, Eline; Schrauwen, Patrick; Keijer, Jaap

    2011-08-16

    A low vs. high glycemic index of a high-fat (HF) diet (LGI and HGI, respectively) significantly retarded adverse health effects in adult male C57BL/6J mice, as shown recently (Van Schothorst EM, Bunschoten A, Schrauwen P, Mensink RP, Keijer J. FASEB J 23: 1092-1101, 2009). The LGI diet enhanced whole body insulin sensitivity and repressed HF diet-induced body and white adipose tissue (WAT) weight gain, resulting in significantly reduced serum leptin and resistin levels and increased adiponectin levels. We questioned how WAT is modulated and characterized the molecular mechanisms underlying the glycemic index-mediated effects using whole genome microarrays. This showed that the LGI diet mainly exerts its beneficial effects via substrate metabolism, especially fatty acid metabolism. In addition, cell adhesion and cytoskeleton remodeling showed reduced expression, in line with lower WAT mass. An important transcription factor showing enhanced expression is PPAR-?. Furthermore, serum levels of triglycerides, total cholesterol, and HDL- and LDL-cholesterol were all significantly reduced by LGI diet, and simultaneously muscle insulin sensitivity was significantly increased as analyzed by protein kinase B/Akt phosphorylation. Cumulatively, even though these mice were fed an HF diet, the LGI diet induced significantly favorable changes in metabolism in WAT. These effects suggest a partial overlap with pharmacological approaches by thiazolidinediones to treat insulin resistance and statins for hypercholesterolemia. It is therefore tempting to speculate that such a dietary approach might beneficially support pharmacological treatment of insulin resistance or hypercholesterolemia in humans. PMID:21673076

  13. Ebola Virus Disease: Rapid Diagnosis and Timely Case Reporting are Critical to the Early Response for Outbreak Control.

    PubMed

    Stamm, Lola V

    2015-09-01

    Ebola virus disease (EVD) is a life-threatening zoonosis caused by infection with the Ebola virus. Since the first reported EVD outbreak in the Democratic Republic of the Congo, several small outbreaks have been reported in central Africa with about 2,400 cases occurring between 1976 and 2013. The 2013-2015 EVD outbreak in west Africa is the first documented outbreak in this region and the largest ever with over 27,000 cases and more than 11,000 deaths. Although EVD transmission rates have recently decreased in west Africa, this crisis continues to threaten global health and security, particularly since infected travelers could spread EVD to other resource-limited areas of the world. Because vaccines and drugs are not yet licensed for EVD, outbreak control is dependent on the use of non-pharmaceutical interventions (e.g., infection control practices, isolation of EVD cases, contact tracing with follow-up and quarantine, sanitary burial, health education). However, delays in diagnosing and reporting EVD cases in less accessible rural areas continue to hamper control efforts. New advances in rapid diagnostics for identifying presumptive EVD cases and in mobile-based technologies for communicating critical health-related information should facilitate deployment of an early response to prevent the amplification of sporadic EVD cases into large-scale outbreaks. PMID:26175026

  14. The effect of early warm plastic bag application on postoperative pain after hemorrhoidectomy: a prospective randomized controlled trial.

    PubMed

    Balta, Ahmet Ziya; Ozdemir, Yavuz; Sucullu, Ilker; Filiz, Ali Ilker; Yucel, Ergun; Akin, Mehmet Levhi

    2015-02-01

    Hemorrhoidectomy is used for the surgical treatment of high-grade hemorrhoids. The most prominent complaint after hemorrhoidectomy is pain. Postoperative pain management is still a big problem after surgery in patients with hemorrhoidectomy. The aim of the study was to assess the effect of early application of warm bag on postoperative pain after hemorrhoidectomy. All patients were randomly divided into warm plastic bag and control groups by using sealed envelopes, which were prepared preoperatively. After standard spinal anesthesia, all patients underwent standard Milligan-Morgan hemorrhoidectomy using Ligasure™. Although the study group received the warm bag application, the control group did not receive such a treatment. Two separate visual analog scale (VAS) measurements were performed for postoperative pain assessments on postoperative days, one during the resting state and the other one during the straining phase after the onset of peristaltic bowel movement. Postoperative VAS scores were significantly lower among the warm plastic bag group as compared with the control group on Days 1 and 3 for the resting state and on Day 3 for defecation. Additionally, a significant difference existed between the two groups in terms of the need for additional anesthesia. Local thermal application appears to be a safe and effective method for pain relief after hemorrhoidectomy. PMID:25642882

  15. IL-17A-Producing ?? T Cells Suppress Early Control of Parasite Growth by Monocytes in the Liver.

    PubMed

    Sheel, Meru; Beattie, Lynette; Frame, Teija C M; de Labastida Rivera, Fabian; Faleiro, Rebecca J; Bunn, Patrick T; Montes de Oca, Marcela; Edwards, Chelsea L; Ng, Susanna S; Kumar, Rajiv; Amante, Fiona H; Best, Shannon E; McColl, Shaun R; Varelias, Antiopi; Kuns, Rachel D; MacDonald, Kelli P A; Smyth, Mark J; Haque, Ashraful; Hill, Geoff R; Engwerda, Christian R

    2015-12-15

    Intracellular infections, such as those caused by the protozoan parasite Leishmania donovani, a causative agent of visceral leishmaniasis (VL), require a potent host proinflammatory response for control. IL-17 has emerged as an important proinflammatory cytokine required for limiting growth of both extracellular and intracellular pathogens. However, there are conflicting reports on the exact roles for IL-17 during parasitic infections and limited knowledge about cellular sources and the immune pathways it modulates. We examined the role of IL-17 in an experimental model of VL caused by infection of C57BL/6 mice with L. donovani and identified an early suppressive role for IL-17 in the liver that limited control of parasite growth. IL-17-producing ?? T cells recruited to the liver in the first week of infection were the critical source of IL-17 in this model, and CCR2(+) inflammatory monocytes were an important target for the suppressive effects of IL-17. Improved parasite control was independent of NO generation, but associated with maintenance of superoxide dismutase mRNA expression in the absence of IL-17 in the liver. Thus, we have identified a novel inhibitory function for IL-17 in parasitic infection, and our results demonstrate important interactions among ?? T cells, monocytes, and infected macrophages in the liver that can determine the outcome of parasitic infection. PMID:26538396

  16. Cognitive Behavioral Therapy for Early Adolescents with Autism Spectrum Disorders and Clinical Anxiety: A Randomized, Controlled Trial

    PubMed Central

    Wood, Jeffrey J.; Ehrenreich-May, Jill; Alessandri, Michael; Fujii, Cori; Renno, Patricia; Laugeson, Elizabeth; Piacentini, John C.; De Nadai, Alessandro S.; Arnold, Elysse; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

    2014-01-01

    Background Clinically elevated anxiety is a common, impairing feature of autism spectrum disorders (ASD). A modular CBT program designed for preteens with ASD, Behavioral Interventions for Anxiety in Children with Autism (BIACA; Wood et al., 2009), was enhanced and modified to address the developmental needs of early adolescents with ASD and clinical anxiety. Method Thirty-three adolescents (11–15 years old) were randomly assigned to 16 sessions of CBT or an equivalent waitlist period. The CBT model emphasized exposure, challenging irrational beliefs, and behavioral supports provided by caregivers, as well as numerous ASD-specific treatment elements. Independent evaluators, parents, and adolescents rated symptom severity at baseline and post-treatment/post-waitlist. Results In intent-to-treat analyses, the CBT group outperformed the waitlist group on independent evaluators’ ratings of anxiety severity on the Pediatric Anxiety Rating Scale (PARS) and 79% of the CBT group met Clinical Global Impressions-Improvement scale criteria for positive treatment response at posttreatment, as compared to only 28.6% of the waitlist group. Group differences were not found for diagnostic remission or questionnaire measures of anxiety. However, parent-report data indicated that there was a positive treatment effect of CBT on autism symptom severity. Conclusions The CBT manual under investigation, enhanced for early adolescents with ASD, yielded meaningful treatment effects on the primary outcome measure (PARS), although additional developmental modifications to the manual are likely warranted. Future studies examining this protocol relative to an active control are needed. PMID:25526831

  17. Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: a randomized, controlled trial.

    PubMed

    Wood, Jeffrey J; Ehrenreich-May, Jill; Alessandri, Michael; Fujii, Cori; Renno, Patricia; Laugeson, Elizabeth; Piacentini, John C; De Nadai, Alessandro S; Arnold, Elysse; Lewin, Adam B; Murphy, Tanya K; Storch, Eric A

    2015-01-01

    Clinically elevated anxiety is a common, impairing feature of autism spectrum disorders (ASD). A modular CBT program designed for preteens with ASD, Behavioral Interventions for Anxiety in Children with Autism (BIACA; Wood et al., 2009) was enhanced and modified to address the developmental needs of early adolescents with ASD and clinical anxiety. Thirty-three adolescents (11-15 years old) were randomly assigned to 16 sessions of CBT or an equivalent waitlist period. The CBT model emphasized exposure, challenging irrational beliefs, and behavioral supports provided by caregivers, as well as numerous ASD-specific treatment elements. Independent evaluators, parents, and adolescents rated symptom severity at baseline and posttreatment/postwaitlist. In intent-to-treat analyses, the CBT group outperformed the waitlist group on independent evaluators' ratings of anxiety severity on the Pediatric Anxiety Rating Scale (PARS) and 79% of the CBT group met Clinical Global Impressions-Improvement scale criteria for positive treatment response at posttreatment, as compared to only 28.6% of the waitlist group. Group differences were not found for diagnostic remission or questionnaire measures of anxiety. However, parent-report data indicated that there was a positive treatment effect of CBT on autism symptom severity. The CBT manual under investigation, enhanced for early adolescents with ASD, yielded meaningful treatment effects on the primary outcome measure (PARS), although additional developmental modifications to the manual are likely warranted. Future studies examining this protocol relative to an active control are needed. PMID:25526831

  18. 3-Day versus 5-Day Course of Intravenous Antibiotics for Suspected Early Onset Neonatal Sepsis: A Randomized Controlled Trial

    PubMed Central

    Pasha, Yadollah Zahed; Ahmadpour-Kacho, Mussa; Behmadi, Reza; Jahangir, Tahereh

    2014-01-01

    Objective: The objective of this randomized controlled trial was to compare the treatment failure of suspected early onset neonatal sepsis with either 3-day or 5-day course of empirical antibiotic therapy. Methods: Infants with birth weight over 1500 g and/or gestational age over 34 weeks within 7 days postnatal age with clinical symptoms of neonatal sepsis received empirical antibiotics (Ampicillin + Amikacin) in two neonatal intensive care units. After 72 hours if the result of blood culture was negative and symptoms resolved they were randomly allocated to 3-day or 5-day groups. The main outcome was treatment failure which was defined as reappearance of symptoms of sepsis within two weeks after discontinuation of antibiotics. Infants with congenital anomalies, localized infections, asphyxia, those undergoing surgery or when serum C-reactive protein levels remained abnormal despite treatment, were not included. Randomization was accomplished with simple randomization procedure. Findings: Sixty patients were randomized in a 1:1 ratio to either group. Baseline characteristics were similar between two groups. The follow-up period was 2 weeks with no lost to follow-up. One infant in 3-day group had treatment failure compared with no treatment failure in 5-day group (P=0.5). No serious harm was observed due to our empirical antibiotic regimen. Conclusion: The results of this study indicated no evidence that treatment failure differs between 3-day and 5-day course antibiotic therapy for suspected early onset uncomplicated neonatal sepsis in late preterm and term newborns. PMID:26019770

  19. Overview: Core technical elements for early product development, evaluation, and control of human cell-based products.

    PubMed

    Hayakawa, Takao

    2015-09-01

    Essential scientific elements for early product development, evaluation, and control of human cell-based products for cell therapy are addressed in a comprehensive and unifying way. Among them, donor issues (autologous and allogeneic), testing of raw materials, cell banking and cell substrate characterization, testing for adventitious agents (viral safety), and product sterility are very much related to each other. A significant amount of expertise exists in these areas both for traditional biologicals as well as for biotechnology products. Thus, core principles/concepts as well as the testing methodologies are already well defined. Other critical technical elements that are essential but need further discussion in terms of relevant regulatory requirements and testing methods are touched upon very briefly and followed by a detailed discussion (elsewhere). PMID:26272542

  20. New insights into the early stages of silica-controlled barium carbonate crystallisation.

    PubMed

    Eiblmeier, Josef; Schürmann, Ulrich; Kienle, Lorenz; Gebauer, Denis; Kunz, Werner; Kellermeier, Matthias

    2014-12-21

    Recent work has demonstrated that the dynamic interplay between silica and carbonate during co-precipitation can result in the self-assembly of unusual, highly complex crystal architectures with morphologies and textures resembling those typically displayed by biogenic minerals. These so-called biomorphs were shown to be composed of uniform elongated carbonate nanoparticles that are arranged according to a specific order over mesoscopic scales. In the present study, we have investigated the circumstances leading to the continuous formation and stabilisation of such well-defined nanometric building units in these inorganic systems. For this purpose, in situ potentiometric titration measurements were carried out in order to monitor and quantify the influence of silica on both the nucleation and early growth stages of barium carbonate crystallisation in alkaline media at constant pH. Complementarily, the nature and composition of particles occurring at different times in samples under various conditions were characterised ex situ by means of high-resolution electron microscopy and elemental analysis. The collected data clearly evidence that added silica affects carbonate crystallisation from the very beginning (i.e. already prior to, during, and shortly after nucleation), eventually arresting growth on the nanoscale by cementation of BaCO3 particles within a siliceous matrix. Our findings thus shed light on the fundamental processes driving bottom-up self-organisation in silica-carbonate materials and, for the first time, provide direct experimental proof that silicate species are responsible for the miniaturisation of carbonate crystals during growth of biomorphs, hence confirming previously discussed theoretical models for their formation mechanism. PMID:25362999

  1. HSPRO controls early Nicotiana attenuata seedling growth during interaction with the fungus Piriformospora indica.

    PubMed

    Schuck, Stefan; Camehl, Iris; Gilardoni, Paola A; Oelmueller, Ralf; Baldwin, Ian T; Bonaventure, Gustavo

    2012-10-01

    In a previous study aimed at identifying regulators of Nicotiana attenuata responses against chewing insects, a 26-nucleotide tag matching the HSPRO (ORTHOLOG OF SUGAR BEET Hs1(pro)(-)(1)) gene was found to be strongly induced after simulated herbivory (Gilardoni et al., 2010). Here we characterized the function of HSPRO during biotic interactions in transgenic N. attenuata plants silenced in its expression (ir-hspro). In wild-type plants, HSPRO expression was not only induced during simulated herbivory but also when leaves were inoculated with Pseudomonas syringae pv tomato DC3000 and roots with the growth-promoting fungus Piriformospora indica. Reduced HSPRO expression did not affect the regulation of direct defenses against Manduca sexta herbivory or P. syringae pv tomato DC3000 infection rates. However, reduced HSPRO expression positively influenced early seedling growth during interaction with P. indica; fungus-colonized ir-hspro seedlings increased their fresh biomass by 30% compared with the wild type. Grafting experiments demonstrated that reduced HSPRO expression in roots was sufficient to induce differential growth promotion in both roots and shoots. This effect was accompanied by changes in the expression of 417 genes in colonized roots, most of which were metabolic genes. The lack of major differences in the metabolic profiles of ir-hspro and wild-type colonized roots (as analyzed by liquid chromatography time-of-flight mass spectrometry) suggested that accelerated metabolic rates were involved. We conclude that HSPRO participates in a whole-plant change in growth physiology when seedlings interact with P. indica. PMID:22892352

  2. Simulation of Birch and Pine Litter Influence on Early Stage of Reclaimed Soil Formation Process under Controlled Conditions.

    PubMed

    Wo?, Bart?omiej; Pietrzykowski, Marcin

    2015-07-01

    The impact of litter decomposition on chemical substrate properties and element leaching during early soil formation in afforested post-mine sites and the influence of different tree species are key issues in new ecosystem development. Scots pine ( L.) and common birch ( Roth) are important pioneering species used in afforestation of post-mine sites in central and eastern Europe. The aim of this study was to assess the impact of litter decomposition of these species on the chemical properties of mine soil substrates. The impact of litter decomposition on soil properties was tested on quaternary and neogene substrates with different textures (sands, loams, and mixtures of clays and sands) in a controlled incubation experiment using PVC columns. Simulation of precipitation and leaching was undertaken for 10 wk at a temperature of 16°C with distilled water (200 mL wk) through cylinders with litter, substrate + litter, and control substrate (no litter). Filtrated water solution was collected once a week for laboratory analysis, and the concentrations of dissolved organic C, total N, K, Ca, Mg, and P were determined. The study results indicate a stronger impact of the common birch on the chemical properties of reclaimed mine soils compared with pine. After the experiment, birch litter caused significant changes in pH in quaternary sands, concentration of P in quaternary loams (Ql) and mixtures of neogene clays and quaternary sands (QsNc), exchangeable Ca in QsNc, and Mg in Ql and QsNc compared with pine litter. Birch, in comparison to pine, may affect the intensity of early-stage soil-forming processes by increasing nutrient availability and transport into the soil profile, which may affect the development of soil microbial communities. This process results in different soil properties under the two tree species. PMID:26437090

  3. 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

  4. Early pest development and loss of biological control are associated with urban warming

    PubMed Central

    Meineke, Emily K.; Dunn, Robert R.; Frank, Steven D.

    2014-01-01

    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

  5. Six Homeoproteins Directly Activate Myod Expression in the Gene Regulatory Networks That Control Early Myogenesis

    PubMed Central

    Laclef, Christine; Pujol, Julien; Santolini, Marc; Niro, Claire; Lagha, Mounia; Rocancourt, Didier; Buckingham, Margaret; Maire, Pascal

    2013-01-01

    In mammals, several genetic pathways have been characterized that govern engagement of multipotent embryonic progenitors into the myogenic program through the control of the key myogenic regulatory gene Myod. Here we demonstrate the involvement of Six homeoproteins. We first targeted into a Pax3 allele a sequence encoding a negative form of Six4 that binds DNA but cannot interact with essential Eya co-factors. The resulting embryos present hypoplasic skeletal muscles and impaired Myod activation in the trunk in the absence of Myf5/Mrf4. At the axial level, we further show that Myod is still expressed in compound Six1/Six4:Pax3 but not in Six1/Six4:Myf5 triple mutant embryos, demonstrating that Six1/4 participates in the Pax3-Myod genetic pathway. Myod expression and head myogenesis is preserved in Six1/Six4:Myf5 triple mutant embryos, illustrating that upstream regulators of Myod in different embryonic territories are distinct. We show that Myod regulatory regions are directly controlled by Six proteins and that, in the absence of Six1 and Six4, Six2 can compensate. PMID:23637613

  6. Simplified Severe Sepsis Protocol: A Randomized Controlled Trial of Modified Early Goal-Directed Therapy in Zambia

    PubMed Central

    Andrews, Ben; Muchemwa, Levy; Kelly, Paul; Lakhi, Shabir; Heimburger, Douglas C; Bernard, Gordon R.

    2014-01-01

    Objective To assess the efficacy of a simple, goal-directed sepsis treatment protocol for reducing mortality in patients with severe sepsis in Zambia. Design Single center non-blinded randomized controlled trial Setting Emergency room, ICU, and medical wards of the national referral hospital in Lusaka, Zambia Patients 112 patients enrolled within 24 hours of admission with severe sepsis, defined as systemic inflammatory response syndrome with suspected infection and organ dysfunction Interventions Simplified Severe Sepsis Protocol (SSSP) consisting of up to 4 liters of intravenous fluids within 6 hours, guided by jugular venous pressure assessment, and dopamine and/or blood transfusion in selected patients. Control group was managed as usual care. Blood cultures were collected and early antibiotics administered for both arms. Measurements and Main Results Primary outcome was in-hospital all-cause mortality. 109 patients were included in the final analysis. 88 (80.7%) were HIV positive. Pulmonary infections were the most common source of sepsis. In-hospital mortality rate was 64.2% in the intervention group and 60.7% in the control group (RR 1.05, 95%CI:0.79-1.41). Mycobacterium tuberculosis complex was isolated from 31 of 82 (37.8%) HIV positive patients with available mycobacterial blood culture results. SSSP patients received significantly more IV fluids in the first 6 hours (2.7 liters vs. 1.7 liters, p=0.002). The study was stopped early because of high mortality rate among patients with hypoxemic respiratory failure in the intervention arm (8/8, 100%) compared with the control arm [7/10, 70%, RR 1.43 (95%CI:0.95-2.14)]. Conclusion Factors other than tissue hypoperfusion probably account for much of the end organ dysfunction in African patients with severe sepsis. Studies of fluid-based interventions should utilize inclusion criteria to accurately capture patients with hypovolemia and tissue hypoperfusion who are most likely to benefit from fluids. Exclusion of patients with severe respiratory distress should be considered when ventilator support is not readily available. PMID:25072757

  7. Glycemic Allostasis during Mental Activities on Fasting in Non-alcohol Users and Alcohol Users with Different Durations of Abstinence

    PubMed Central

    Welcome, MO; Pereverzev, VA

    2014-01-01

    Glycemic allostasis is the process by which blood glucose stabilization is achieved through the balancing of glucose consumption rate and release into the blood stream under a variety of stressors. This paper reviews findings on the dynamics of glycemic levels during mental activities on fasting in non-alcohol users and alcohol users with different periods of abstinence. Referred articles for this review were searched in the databases of PubMed, Scopus, DOAJ and AJOL. The search was conducted in 2013 between January 20 and July 31. The following keywords were used in the search: alcohol action on glycemia OR brain glucose OR cognitive functions; dynamics of glycemia, dynamics of glycemia during mental activities; dynamics of glycemia on fasting; dynamics of glycemia in non-alcohol users OR alcohol users; glycemic regulation during sobriety. Analysis of the selected articles showed that glycemic allostasis during mental activities on fasting is poorly regulated in alcohol users even after a long duration of sobriety (1-4 weeks after alcohol consumption), compared to non-alcohol users. The major contributor to the maintenance of euglycemia during mental activities after the night's rest (during continuing fast) is gluconeogenesis. PMID:25364589

  8. Glycemic Allostasis during Mental Activities on Fasting in Non-alcohol Users and Alcohol Users with Different Durations of Abstinence.

    PubMed

    Welcome, Mo; Pereverzev, Va

    2014-09-01

    Glycemic allostasis is the process by which blood glucose stabilization is achieved through the balancing of glucose consumption rate and release into the blood stream under a variety of stressors. This paper reviews findings on the dynamics of glycemic levels during mental activities on fasting in non-alcohol users and alcohol users with different periods of abstinence. Referred articles for this review were searched in the databases of PubMed, Scopus, DOAJ and AJOL. The search was conducted in 2013 between January 20 and July 31. The following keywords were used in the search: alcohol action on glycemia OR brain glucose OR cognitive functions; dynamics of glycemia, dynamics of glycemia during mental activities; dynamics of glycemia on fasting; dynamics of glycemia in non-alcohol users OR alcohol users; glycemic regulation during sobriety. Analysis of the selected articles showed that glycemic allostasis during mental activities on fasting is poorly regulated in alcohol users even after a long duration of sobriety (1-4 weeks after alcohol consumption), compared to non-alcohol users. The major contributor to the maintenance of euglycemia during mental activities after the night's rest (during continuing fast) is gluconeogenesis. PMID:25364589

  9. 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...

  10. Exploration of Functionality of Low-Glycemic-Impact Sugars and Polyols using DSC, RVA, SRC, and Cookie Baking

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Consumers’ growing interest in healthy cookies includes expectations for prebiotic nutritional benefits and low glycemic impact. The anti-plasticizing action of the high sucrose concentration in a cookie formula inhibits gluten development during dough mixing and starch gelatinization/pasting durin...

  11. Self-monitoring Using Mobile Phones in the Early Stages of Adolescent Depression: Randomized Controlled Trial

    PubMed Central

    Reid, Sophie Caroline; Crooke, Alexander Hew Dale; Khor, Angela; Hearps, Stephen John Charles; Jorm, Anthony Francis; Sanci, Lena; Patton, George

    2012-01-01

    Background The stepped-care approach, where people with early symptoms of depression are stepped up from low-intensity interventions to higher-level interventions as needed, has the potential to assist many people with mild depressive symptoms. Self-monitoring techniques assist people to understand their mental health symptoms by increasing their emotional self-awareness (ESA) and can be easily distributed on mobile phones at low cost. Increasing ESA is an important first step in psychotherapy and has the potential to intervene before mild depressive symptoms progress to major depressive disorder. In this secondary analysis we examined a mobile phone self-monitoring tool used by young people experiencing mild or more depressive symptoms to investigate the relationships between self-monitoring, ESA, and depression. Objectives We tested two main hypotheses: (1) people who monitored their mood, stress, and coping strategies would have increased ESA from pretest to 6-week follow-up compared with an attention comparison group, and (2) an increase in ESA would predict a decrease in depressive symptoms. Methods We recruited patients aged 14 to 24 years from rural and metropolitan general practices. Eligible participants were identified as having mild or more mental health concerns by their general practitioner. Participants were randomly assigned to either the intervention group (where mood, stress, and daily activities were monitored) or the attention comparison group (where only daily activities were monitored), and both groups self-monitored for 2 to 4 weeks. Randomization was carried out electronically via random seed generation, by an in-house computer programmer; therefore, general practitioners, participants, and researchers were blinded to group allocation at randomization. Participants completed pretest, posttest, and 6-week follow-up measures of the Depression Anxiety Stress Scale and the ESA Scale. We estimated a parallel process latent growth curve model (LGCM) using Mplus to test the indirect effect of the intervention on depressive symptoms via the mediator ESA, and calculated 95% bias-corrected bootstrapping confidence intervals (CIs). Results Of the 163 participants assessed for eligibility, 118 were randomly assigned and 114 were included in analyses (68 in the intervention group and 46 in the comparison group). A parallel process LGCM estimated the indirect effect of the intervention on depressive symptoms via ESA and was shown to be statistically significant based on the 95% bias-corrected bootstrapping CIs not containing zero (–6.366 to –0.029). The proportion of the maximum possible indirect effect estimated was ?2 =.54 (95% CI .426–.640). Conclusions This study supported the hypothesis that self-monitoring increases ESA, which in turn decreases depressive symptoms for young people with mild or more depressive symptoms. Mobile phone self-monitoring programs are ideally suited to first-step intervention programs for depression in the stepped-care approach, particularly when ESA is targeted as a mediating factor. Trial Registration ClinicalTrials.gov NCT00794222; http://clinicaltrials.gov/ct2/show/NCT00794222 (Archived by WebCite at http://www.webcitation.org/65lldW34k) PMID:22732135

  12. Adjunctive rifampicin to reduce early mortality from Staphylococcus aureus bacteraemia (ARREST): study protocol for a randomised controlled trial

    PubMed Central

    2012-01-01

    Background Staphylococcus aureus bacteraemia is a common and serious infection, with an associated mortality of ~25%. Once in the blood, S. aureus can disseminate to infect almost any organ, but bones, joints and heart valves are most frequently affected. Despite the infection’s severity, the evidence guiding optimal antibiotic therapy is weak: fewer than 1,500 patients have been included in 16 randomised controlled trials investigating S. aureus bacteraemia treatment. It is uncertain which antibiotics are most effective, their route of administration and duration, and whether antibiotic combinations are better than single agents. We hypothesise that adjunctive rifampicin, given in combination with a standard first-line antibiotic, will enhance killing of S. aureus early in the treatment course, sterilise infected foci and blood faster, and thereby reduce the risk of dissemination, metastatic infection and death. Our aim is to determine whether adjunctive rifampicin reduces all-cause mortality within 14 days and bacteriological failure or death within 12 weeks from randomisation. Methods We will perform a parallel group, randomised (1:1), blinded, placebo-controlled trial in NHS hospitals across the UK. Adults (?18 years) with S. aureus (meticillin-susceptible or resistant) grown from at least one blood culture who have received ?96 h of active antibiotic therapy for the current infection and do not have contraindications to the use of rifampicin will be eligible for inclusion. Participants will be randomised to adjunctive rifampicin (600-900mg/day; orally or intravenously) or placebo for the first 14 days of therapy in combination with standard single-agent antibiotic therapy. The co-primary outcome measures will be all-cause mortality up to 14 days from randomisation and bacteriological failure/death (all-cause) up to 12 weeks from randomisation. 940 patients will be recruited, providing >80% power to detect 45% and 30% reductions in the two co-primary endpoints of death by 14 days and bacteriological failure/death by 12 weeks respectively. Discussion This pragmatic trial addresses the long-standing hypothesis that adjunctive rifampicin improves outcome from S. aureus bacteraemia through enhanced early bacterial killing. If proven correct, it will provide a paradigm through which further improvements in outcome from S. aureus bacteraemia can be explored. Trial registration Current Controlled Trial ISRCTN 37666216 PMID:23249501

  13. Cell cycle control in the early embryonic development of aquatic animal species.

    PubMed

    Siefert, Joseph C; Clowdus, Emily A; Sansam, Christopher L

    2015-12-01

    The cell cycle is integrated with many aspects of embryonic development. Not only is proper control over the pace of cell proliferation important, but also the timing of cell cycle progression is coordinated with transcription, cell migration, and cell differentiation. Due to the ease with which the embryos of aquatic organisms can be observed and manipulated, they have been a popular choice for embryologists throughout history. In the cell cycle field, aquatic organisms have been extremely important because they have played a major role in the discovery and analysis of key regulators of the cell cycle. In particular, the frog Xenopus laevis has been instrumental for understanding how the basic embryonic cell cycle is regulated. More recently, the zebrafish has been used to understand how the cell cycle is remodeled during vertebrate development and how it is regulated during morphogenesis. This review describes how some of the unique strengths of aquatic species have been leveraged for cell cycle research and suggests how species such as Xenopus and zebrafish will continue to reveal the roles of the cell cycle in human biology and disease. PMID:26475527

  14. Misframed ubiquitin and impaired protein quality control: an early event in Alzheimer’s disease

    PubMed Central

    Gentier, Romina J.; van Leeuwen, Fred W.

    2015-01-01

    Amyloid ? (A?) plaque formation is a prominent cellular hallmark of Alzheimer’s disease (AD). To date, immunization trials in AD patients have not been effective in terms of curing or ameliorating dementia. In addition, ?-secretase inhibitor strategies await clinical improvements in AD. These approaches were based upon the idea that autosomal dominant mutations in amyloid precursor protein (APP) and Presenilin 1 (PS1) genes are predictive for treatment of all AD patients. However most AD patients are of the sporadic form which partly explains the failures to treat this multifactorial disease. The major risk factor for developing sporadic AD (SAD) is aging whereas the Apolipoprotein E polymorphism (?4 variant) is the most prominent genetic risk factor. Other medium-risk factors such as triggering receptor expressed on myeloid cells 2 (TREM2) and nine low risk factors from Genome Wide Association Studies (GWAS) were associated with AD. Recently, pooled GWAS studies identified protein ubiquitination as one of the key modulators of AD. In addition, a brain site specific strategy was used to compare the proteomes of AD patients by an Ingenuity Pathway Analysis. This strategy revealed numerous proteins that strongly interact with ubiquitin (UBB) signaling, and pointing to a dysfunctional ubiquitin proteasome system (UPS) as a causal factor in AD. We reported that DNA-RNA sequence differences in several genes including ubiquitin do occur in AD, the resulting misframed protein of which accumulates in the neurofibrillary tangles (NFTs). This suggests again a functional link between neurodegeneration of the AD type and loss of protein quality control by the UPS. Progress in this field is discussed and modulating the activity of the UPS opens an attractive avenue of research towards slowing down the development of AD and ameliorating its effects by discovering prime targets for AD therapeutics. PMID:26388726

  15. A randomized controlled trial to prevent childhood obesity through early childhood feeding and parenting guidance: rationale and design of study

    PubMed Central

    2013-01-01

    Background Early and rapid growth in Infants is strongly associated with early development and persistence of obesity in young children. Substantial research has linked child obesity/overweight to increased risks for serious health outcomes, which include adverse physical, psychological, behavioral, or social consequences. Methods/design The goal of this study is to compare the effectiveness of structured Community Health Worker (CHW)- provided home visits, using an intervention created through community-based participatory research, to standard care received through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) office visits in preventing the development of overweight (weight/length ?85th percentile) and obesity (weight/length ?95th percentile) in infants during their first 3 years of life. One hundred forty pregnant women in their third trimester (30–36 weeks) will be recruited and randomly assigned to the intervention or control group. Discussion This study will provide prospective data on the effects of an intervention to prevent childhood obesity in children at high risk for obesity due to ethnicity, income, and maternal body mass index (BMI). It will have wide-ranging applicability and the potential for rapid dissemination through the WIC program, and will demonstrate the effectiveness of a community approach though employing CHWs in preventing obesity during the first 3 years of life. This easy-to-implement obesity prevention intervention can be adapted for many locales and diverse communities and can provide evidence for policy change to influence health throughout life. Trial registration Clinical Trials Number: NCT01905072 PMID:24063435

  16. Fasts, feasts and festivals in diabetes-1: Glycemic management during Hindu fasts

    PubMed Central

    Kalra, Sanjay; Bajaj, Sarita; Gupta, Yashdeep; Agarwal, Pankaj; Singh, S. K.; Julka, Sandeep; Chawla, Rajeev; Agrawal, Navneet

    2015-01-01

    This communication is the first of a series on South Asian fasts, festivals, and diabetes, designed to spread awareness and stimulate research on this aspect of diabetes and metabolic care. It describes the various fasts observed as part of Hindu religion and offers a classification scheme for them, labeling them as infrequent and frequent. The infrequent fasts are further sub-classified as brief and prolonged, to facilitate a scientific approach to glycemic management during these fasts. Pre-fast counseling, non-pharmacological therapy, pharmacological modification, and post-fast debriefing are discussed in detail. All available drug classes and molecules are covered in this article, which provides guidance about necessary changes in dosage and timing of administration. While in no way exhaustive, the brief review offers a basic framework which diabetes care professionals can use to counsel and manage persons in their care who wish to observe various Hindu fasts. PMID:25729681

  17. Sorghum flour fractions: correlations among polysaccharides, phenolic compounds, antioxidant activity and glycemic index.

    PubMed

    Moraes, Érica Aguiar; Marineli, Rafaela da Silva; Lenquiste, Sabrina Alves; Steel, Caroline Joy; de Menezes, Cícero Beserra; Queiroz, Valéria Aparecida Vieira; Maróstica Júnior, Mário Roberto

    2015-08-01

    Nutrients composition, phenolic compounds, antioxidant activity and estimated glycemic index (EGI) were evaluated in sorghum bran (SB) and decorticated sorghum flour (DSF), obtained by a rice-polisher, as well as whole sorghum flour (WSF). Correlation between EGI and the studied parameters were determined. SB presented the highest protein, lipid, ash, ?-glucan, total and insoluble dietary fiber contents; and the lowest non-resistant and total starch contents. The highest carbohydrate and resistant starch contents were in DSF and WSF, respectively. Phenolic compounds and antioxidant activities were concentrated in SB. The EGI values were: DSF 84.5 ± 0.41; WSF 77.2 ± 0.33; and SB 60.3 ± 0.78. Phenolic compounds, specific flavonoids and antioxidant activities, as well as total, insoluble and soluble dietary fiber and ?-glucans of sorghum flour samples were all negatively correlated to EGI. RS content was not correlated to EGI. PMID:25766808

  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. 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

  20. A study on noodle dough rheology and product quality characteristics of fresh and dried noodles as influenced by low glycemic index ingredient.

    PubMed

    Bharath Kumar, S; Prabhasankar, P

    2015-03-01

    Low Glycemic Index (LGI) foods help to maintain blood glucose level in diabetic individuals. Pea flour (PF) is known to be one of LGI ingredients used in the food industry. To assess the influence of PF in noodle processing, thermally processed pea flour was incorporated at 20 % and 40 % in the preparation of noodles using Lab scale Noodle Making Machine. Evaluation for Physico-chemical, rheological and noodle making characteristics, in vitro starch digestibility (IVSD) and microstructure of noodles were carried out. Cooking quality did not show any significant difference among the samples, with solid leach out ranging from 6.7 to 7.2 % against control (6.5 %). Colour measurement showed the presence of greenish colour in PF incorporated samples. Texture was firmer in fresh noodles (FN) (5.52 Newton (N), 6.00 N) and dried noodles (DN) (7.60 N, 7.86 N) compared to control (4.38 N-FN, 6.88 N-DN). Sensory analysis of noodles revealed that the samples (FN, DN) were acceptable at 20 % and 40 % levels with overall quality score (>8.5). In vitro analysis revealed that with increase in PF content there was a significant decrease in the availability of glucose in DN followed by FN compared to control. Overall RDS was reduced and SDS was increased in 40 % PF incorporated FN. Scanning-electron microscopy revealed the presence of fiber matrix around the starch granules. PMID:25745208

  1. Glucose control.

    PubMed

    Preiser, Jean-Charles

    2013-01-01

    Stress-related hyperglycemia is a common finding in acutely ill patients, and is related to the severity and outcome of the critical illness. The pathophysiology of stress hyperglycemia includes hormonal and neural signals, leading to increased production of glucose by the liver and peripheral insulin resistance mediated by the translocation of transmembrane glucose transporters. In one pioneering study, tight glycemic control by intensive insulin therapy in critically ill patients was associated with improved survival. However, this major finding was not confirmed in several other prospective randomized controlled trials. The reasons underlying the discrepancy between the first and the subsequent studies could include nutritional strategy (amount of calories provided, use of parenteral nutrition), case-mix, potential differences in the optimal blood glucose level (BG) in different types of patients, hypoglycemia and its correction, and the magnitude of glucose variability. Therefore, an improved understanding of the physiology and pathophysiology of glycemic regulation during acute illness is needed. Safe and effective glucose control will need improvement in the definition of optimal BG and in the measurement techniques, perhaps including continuous monitoring of insulin algorithms and closed-loop systems. PMID:23075589

  2. Exposure to socioeconomic adversity in early life and risk of depression at 18 years: The mediating role of locus of control

    PubMed Central

    Culpin, Iryna; Stapinski, Lexine; Miles, Ömür Budanur; Araya, Ricardo; Joinson, Carol

    2015-01-01

    Background Previous studies have linked exposure to early socioeconomic adversity to depression, but the mechanisms of this association are not well understood. Locus of control (LoC), an individual's control-related beliefs, has been implicated as a possible mechanism, however, longitudinal evidence to support this is lacking. Methods The study sample comprised 8803 participants from a UK cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC). Indicators of early socioeconomic adversity were collected from the antenatal period to 5 years and modelled as a latent factor. Depression was assessed using the Clinical Interview Schedule-Revised (CIS-R) at 18 years. LoC was assessed with the Nowicki–Strickland Internal–External (CNSIE) scale at 16 years. Results Using structural equation modelling, we found that 34% of the total estimated association between early socioeconomic adversity and depression at 18 years was explained by external LoC at 16 years. There was weak evidence of a direct pathway from early socioeconomic adversity to depression after accounting for the indirect effect via external locus of control. Socioeconomic adversity was associated with more external LoC, which, in turn, was associated with depression. Limitations Attrition may have led to an underestimation of the direct and indirect effect sizes in the complete case analysis. Conclusions Results suggest that external LoC in adolescence is one of the factors mediating the link between early adversity and depression at 18 years. Cognitive interventions that seek to modify maladaptive control beliefs in adolescence may be effective in reducing risk of depression following early life adversity. PMID:26047304

  3. Delinquency and Recidivism: A Multicohort, Matched-Control Study of the Role of Early Adverse Experiences, Mental Health Problems, and Disabilities

    ERIC Educational Resources Information Center

    Barrett, David E.; Katsiyannis, Antonis; Zhang, Dalun; Zhang, Dake

    2014-01-01

    The authors examined the role of early adverse experiences, mental health problems, and disabilities in the prediction of juvenile delinquency and recidivism, using a matched-control group design. The delinquent group comprised 99,602 youth, born between 1981 and 1988, whose cases had been processed by the South Carolina Department of Juvenile…

  4. A Randomized Controlled Trial of the First Step to Success Early Intervention: Demonstration of Program Efficacy Outcomes in a Diverse, Urban School District

    ERIC Educational Resources Information Center

    Walker, Hill M.; Seeley, John R.; Small, Jason; Severson, Herbert H.; Graham, Bethany A.; Feil, Edward G.; Serna, Loretta; Golly, Annemieke M.; Forness, Steven R.

    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…

  5. Evaluation of factors associated with achieving glycemic control in a pharmacist-managed diabetes clinic.

    PubMed

    Kostoff, Matthew D; Boros, Melanie L; Moorman, John M; Frazee, Lawrence A

    2014-01-01

    The aim of this study was to identify factors that are associated with patients achieving goal A1c after 6 months in a pharmacist-managed diabetes clinic. This study is a descriptive, retrospective chart review of patients with type 2 diabetes enrolled in a pharmacist-managed diabetes clinic. The primary endpoint was the odds of each identified factor being associated with achievement of goal A1c after 6 months of enrollment. The factors were also evaluated within 2 subgroups: those with a baseline A1c >7% and those with a baseline A1c >9%. Of 112 patients enrolled, 58 were included in the analysis. There was a positive association with reaching goal for patients who had <1 failure to show (FTS) to office visits in 6 months [odds ratio (OR) 8.10, 95% confidence interval (CI) 1.47-58.65], had canceled or FTS to <50% of office visits (OR 10.0, 95% CI 1.8-72.79), and brought >75% of blood glucose logs to their office visits (OR 7.36, 95% CI 1.87-30.88). There was a negative association with reaching the goal for patients with documented social worker involvement (OR 0.22, 95% CI 0.04-0.99) and noninsulin or insulin dose increases at >50% of office visits (OR 0.10, 95% CI 0.01-0.55). Overall, this analysis found that patients who had <1 FTS, had canceled or FTS to <50% of office visits, or who brought >75% logs to office visits were more likely to achieve goal A1c, whereas patients with social work assistance or dose increases at >50% of office visits were less likely to reach goal A1c. PMID:23344108

  6. Improving glycemic control in the acute care setting through nurse education.

    PubMed

    Najarian, Joyce; Bartman, Kimberly; Kaszuba, Julie; Lynch, Christine M

    2013-12-01

    Patients with a primary or secondary diagnosis of diabetes present unique challenges during an inpatient hospital stay to treat an acute or chronic illness. Upon review of current hospital practice, an interprofessional team embarked on a performance improvement project to improve outcomes for the complex medical-surgical diabetic patient. The methods detailed herein--a comprehensive education plan, preceptorship and peer accountability, active engagement and support by the unit nursing leadership team, and interprofessional collaboration--offer strategies any organization can implement to positively impact diabetes care. PMID:24238097

  7. Effect of Taurine on Glycemic Control in Type I and Type II Diabetic Patients

    ClinicalTrials.gov

    2012-11-07

    it is a Group of Metabolic Diseases in; Which a Person Has High Blood Sugar, Either; Because the Body Does Not Produce Enough Insulin,; or Because Cells do Not Respond to the Insulin That; is Produced.

  8. Glycemic Control with Thiazolidinedione Is Associated with Fracture of T2DM Patients

    PubMed Central

    Yeh, Su-Yin; Lin, I-Ching; Yeh, Chih-Jung; Muo, Chih-Hsin; Sung, Fung-Chang; Kao, Chia-Hung

    2015-01-01

    Objective Diabetes is a common diseases and a major problem worldwide. Diabetic osteopathy might be elevated in diabetic patients and is usually caused by bone fracture. Several diabetes medications, such as thiazolidinediones (TZDs), could lead to increased risks of fracture. Methods We used the nationwide database to identified 32466 patients who had developed type 2 diabetes from 2000 to 2010 as the diabetic cohort and, from that group, we selected 3427 diabetic patients who had developed bone fracture to survey the possible risk factors, includng commonly used diabetes medication. Results We found that TZDs might present increased risks for fracture in patients who used it for an extended period (7 to 730 days before the index date), especially in female patients younger than 64 years old, for whom the risk was elevated from a 1.74- to a 2.58-fold odds ratio. Conclusions We recommend that clinics follow up with non-osteoporotic female patients younger than 64 years old who are using TZDs, to avoid the associated risks of fracture. PMID:26317995

  9. [The effect of videophone system for diabetic homecare patients on glycemic control].

    PubMed

    Kubota, Masakazu; Hosoda, Kiminori; Eguchi, Kyoko; Furuya, Ayana; Nishijima, Yuki; Nakao, Kazuwa; Kinoshita, Ayae

    2011-12-01

    It is imperative to develop a novel care approach and low-cost health care system for diabetic patients.Therefore, we conducted an intervention study to clarify how effectively a videophone system could be used in the life style guidance focusing on diet for the diabetic patients cared at home.For the period of 3 months, diabetic patients were communicated with a medical professional staff bi-directionally through a videophone-based communication system for 30 minutes once a week.During the 30-minute intervention, the medical staff checked the list with the change in weight, drug adherence and an exercise habit.We encouraged a diabetic patient to eat properly based on the diet record.The 3-month intervention program resulted in a significant decrease in BW(p<0.001 ), BMI(p<0.001 ), and the average HbA1c level(p<0.005 ).In conclusion, we showed a 3-month intensive communication result using a multimodal videophone system, which revealed a significant decrease in the body weight, BMI and the average HbA1c level.This once a week ICT communication might be useful as an auxiliary therapy to help change a bad daily habit to a good daily habit for a diabetic homecare patient. PMID:22189335

  10. Glycemic control by the brain renin-angiotensin system: Role for peripheral AT2 receptors

    E-print Network

    ) was improved (genotype x time P=0.03). Lean mass by NMR was reduced in sRA (16.54±0.79 vs 12.62±0.63, P.05), but proportional lean mass was normal (66.1±.52 vs 66.69±1.48 % total). Lean ipGTT (2g/kg lean body, P=0 nadir 72±8 vs sRA nadir 27±5 mg/dL and occasionally death, genotype x time P

  11. Template to improve glycemic control without reducing adiposity or dietary fat

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Drugs that improve chronic hyperglycemia independently of insulin signaling or reduction of adiposity or dietary fat intake may be highly desirable. Ad36, a human adenovirus, promotes glucose uptake in vitro independently of adiposity or proximal insulin signaling. We tested the ability of Ad36 to i...

  12. diabetes.ca | 1-800 BANTING*This document reflects the 2013 Canadian Diabetes Association Clinical Practice Guidelines. 2013 Copyright Glycemic Index

    E-print Network

    Shoubridge, Eric

    such as barley, bulgar, or lentils, which have a low Glycemic Index. · Consult a registered dietitian for help-grain rice OTHER: Sweet potato Yam Legumes Lentils Chickpeas Kidney beans Split peas Soy beans Baked beans

  13. Progressive Resistance Training Improves Overall Physical Activity Levels in Patients With Early Osteoarthritis of the Knee: A Randomized Controlled Trial

    PubMed Central

    Going, Scott B.; McKnight, Patrick E.; Kasle, Shelley; Cussler, Ellen C.; Cornett, Michelle

    2010-01-01

    Background Prescription of resistance training (RT) exercises is an essential aspect of management for knee osteoarthritis (OA). However, whether patients with knee OA who are randomly assigned to receive RT simply substitute RT for other modes of physical activity remains unclear. Objective The aim of this study was to determine the effect of a structured RT intervention on overall levels of moderate- and vigorous-intensity physical activity (MVPA) in patients with early-onset knee OA. The study compared patients with early-onset OA who participated in an RT program, those who participated in a self-management (SM) program, and those who participated in both RT and SM. Because participants randomly assigned to receive the RT intervention may simply switch activity modes, resulting in little net effect, we assessed total MVPA in addition to tracking changes in strength (force-generating capacity). Design and Intervention This study was a randomized controlled trial comparing the effectiveness of SM alone, RT alone, and combined RT+SM on MVPA in patients with early OA of the knee. Setting The study was conducted on a university campus, with patient recruitment from the local community. Participants The participants in this study were 171 patients (74% women, 26% men) with knee OA. They had a mean age of 55.1 (SD=7.1) years, a mean body mass index of 27.6 (SD=4.2) kg/m2, and radiographic status of grade II OA (and no higher) in at least one knee, as defined by the Kellgren and Lawrence classification. They wore an accelerometer while awake (X?=14.2 [SD=2.2] hours) for 5 to 7 contiguous days (X?=6.8 [SD=0.5] days) at baseline and at 3 and 9 months of intervention. Results The participants engaged in MVPA a mean of 26.2 (SD=19.3) minutes per day at baseline. Both groups significantly increased their MVPA from baseline to 3 months (RT group by 18% [effect size (d)=0.26]; SM group by 22% [effect size (d)=0.25]), but only the RT group sustained those changes at 9 months (RT group maintained a 10% increase [effect size (d)=0.15]; SM group maintained a 2% increase [effect size (d)=0.03]). A significant group × time interaction for MVPA indicated that the RT group maintained higher MVPA levels than the SM group. Limitations. Lack of direct measures of energy expenditure and physical function was a limitation of the study. Conclusions Patients with early-onset OA of the knee can engage in an RT program without sacrificing their overall MVPA levels. These results support the value of RT for management of knee OA. PMID:20056719

  14. Interstitial radiation therapy for early-stage nasal vestibule cancer: A continuing quest for optimal tumor control and cosmesis

    SciTech Connect

    Levendag, Peter C. . E-mail: p.levendag@erasmusmc.nl; Nijdam, Wideke M.; Moolenburgh, Sanne E. van; Tan, Lisa; Noever, Inge R.T.T.; Rooy, Peter van; Mureau, Marc; Jansen, Peter P.; Munte, Kai; Hofer, Stefan O.P.

    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 results were observed. With 10 days admission for full treatment, hospital costs amounted to Euro 5772 ($7044). Conclusion: Excellent tumor control, cosmesis, and function of nasal airway passage can be achieved when HDR-IRT for T1/T2N0 NV cancers is used. For the more advanced cancers (Wang classification: T3 tumor stage), we elect to treat by local excision followed by a reconstructive procedure. The costs, admission to hospital inclusive, for treatment by HDR-IRT amounts to Euro 5772 ($7044 US). This contrasts substantially with the full hospital costs when NV cancers are treated by plastic reconstructive surgery, being on average threefold as expensive.

  15. Early Neuromuscular Electrical Stimulation to Improve Quadriceps Muscle Strength After Total Knee Arthroplasty: A Randomized Controlled Trial

    PubMed Central

    Balter, Jaclyn E.; Wolfe, Pamela; Eckhoff, Donald G.; Kohrt, Wendy M.

    2012-01-01

    Background The recovery of quadriceps muscle force and function after total knee arthroplasty (TKA) is suboptimal, which predisposes patients to disability with increasing age. Objective The purpose of this investigation was to evaluate the efficacy of quadriceps muscle neuromuscular electrical stimulation (NMES), initiated 48 hours after TKA, as an adjunct to standard rehabilitation. Design This was a prospective, longitudinal randomized controlled trial. Methods Sixty-six patients, aged 50 to 85 years and planning a primary unilateral TKA, were randomly assigned to receive either standard rehabilitation (control) or standard rehabilitation plus NMES applied to the quadriceps muscle (initiated 48 hours after surgery). The NMES was applied twice per day at the maximum tolerable intensity for 15 contractions. Data for muscle strength, functional performance, and self-report measures were obtained before surgery and 3.5, 6.5, 13, 26, and 52 weeks after TKA. Results At 3.5 weeks after TKA, significant improvements with NMES were found for quadriceps and hamstring muscle strength, functional performance, and knee extension active range of motion. At 52 weeks, the differences between groups were attenuated, but improvements with NMES were still significant for quadriceps and hamstring muscle strength, functional performance, and some self-report measures. Limitations Treatment volume was not matched for both study arms; NMES was added to the standard of care treatment. Furthermore, testers were not blinded during testing, but used standardized scripts to avoid bias. Finally, some patients reached the maximum stimulator output during at least one treatment session and may have tolerated more stimulation. Conclusions The early addition of NMES effectively attenuated loss of quadriceps muscle strength and improved functional performance following TKA. The effects were most pronounced and clinically meaningful within the first month after surgery, but persisted through 1 year after surgery. PMID:22095207

  16. Prospective Study of Local Control and Late Radiation Toxicity After Intraoperative Radiation Therapy Boost for Early Breast Cancer

    SciTech Connect

    Chang, David W.; Marvelde, Luc te; Chua, Boon H.

    2014-01-01

    Purpose: To report the local recurrence rate and late toxicity of intraoperative radiation therapy (IORT) boost to the tumor bed using the Intrabeam System followed by external-beam whole-breast irradiation (WBI) in women with early-stage breast cancer in a prospective single-institution study. Methods and Materials: Women with breast cancer ?3 cm were recruited between February 2003 and May 2005. After breast-conserving surgery, a single dose of 5 Gy IORT boost was delivered using 50-kV x-rays to a depth of 10 mm from the applicator surface. This was followed by WBI to a total dose of 50 Gy in 25 fractions. Patients were reviewed at regular, predefined intervals. Late toxicities were recorded using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Late Radiation Morbidity Scoring systems. Results: Fifty-five patients completed both IORT boost and external-beam WBI. Median follow-up was 3.3 years (range, 1.4-4.1 years). There was no reported locoregional recurrence or death. One patient developed distant metastases. Grade 2 and 3 subcutaneous fibrosis was detected in 29 (53%) and 8 patients (15%), respectively. Conclusions: The use of IORT as a tumor bed boost using kV x-rays in breast-conserving therapy was associated with good local control but a clinically significant rate of grade 2 and 3 subcutaneous fibrosis.

  17. Differences In Early T-Cell Signaling In Cultures Grown In a Rotating Clinostat vs. Static Controls

    NASA Technical Reports Server (NTRS)

    Alexamder. M.; Nelman-Gonzales, M.; Penkala, J.; Sams, C.

    1999-01-01

    Altered gravity has previously been demonstrated to be a stress that can influence components of the immune system. Specifically, T-cell activation has been shown to be affected by changes in gravity, exhibiting a decrease in proliferative response to in vitro stimulation in microgravity. Subsequent ground based studies utilizing a rotating clinostat to model some of the effects of microgravity have been consistent with earlier flight based experiments. These ground and flight experiments have examined T-cell activation by measuring various responses including production of cytokines, DNA synthesis and the production of various cell surface activation markers. These indicators of T-cell activation were measured anywhere from 4 to 72 hours after stimulation. Prior to the work described here, the initial signaling events in T-cell activation had not been directly examined. The goal of this project was to determine how the process of early signal transduction was affected by growth in a rotating clinostat. Here we directly show a defect in signaling from TCR to MAPK in purified peripheral T-cells activated in the clinostat by OKT3/antiCD28 coated microbeads as compared to static controls.

  18. Mitigation of starch and glucose-induced postprandial glycemic excursion in rats by antioxidant-rich green-leafy vegetables’ juice

    PubMed Central

    Tiwari, Ashok Kumar; Jyothi, Atmakuri Lakshmana; Tejeswini, Vasantharao Brahma; Madhusudana, Kuncha; Kumar, Domati Anand; Zehra, Amtul; Agawane, Sachin Bharat

    2013-01-01

    Objective: Consumption of green-leafy vegetables is being advocated beneficial for type 2 diabetes mellitus individuals possibly because they are cost effective source of potent biological antioxidants. This research analyzed various phytochemicals, free radicals scavenging antioxidant potentials and starch digesting enzymes inhibitory activities in fresh juice of nine green-leafy vegetables. Furthermore, this study also investigated influence of these vegetables juice on starch and glucose induced postprandial glycemic load. Materials and Methods: Phytochemical constituents, in vitro free radicals scavenging antioxidant and enzymes inhibitory activities were evaluated applying various reported methods. Post-prandial glycemic excursion was induced in rats pretreated with vegetables juice by oral administration of starch and glucose. Results: All the leafy vegetables juice displayed potent free radicals scavenging activities. Juice of amaranthus, rumex, palak and raphanus displayed potential anti-oxidative property by reducing H2O2 induced hemolysis in rats red blood cells RBCs. Ajwain and rumex juice showed pancreatic ?-amylase inhibitory activity. Alternanthera, ajwain, methi, amaranthus and sowa leaves juice displayed intestinal ?-glucosidase inhibitory activity. Juice of raphanus, ajwain and sowa significantly mitigated starch-induced postprandial glycemic load. Amaranthus leaves juice potently mitigated glucose-induced postprandial glycemic load and also reduced hemoglobin glycation induced by glucose in vitro. Conclusions: This investigation finds that juice of leafy vegetables is potent source of biological antioxidants. In addition, juice of raphanus, ajwain and sowa leaves possess capacity to mitigate starch induced postprandial glycemic burden and amaranthus leaves’ juice can reduce glucose induced postprandial glycemic excursion. PMID:24143048

  19. Glomerular structural changes and structural-functional relationships at early stage of diabetic nephropathy in Japanese type 2 diabetic patients.

    PubMed

    Moriya, T; Tanaka, K; Moriya, R

    2000-01-01

    Details of renal structural changes and structural-functional relationships at the early stage of diabetic nephropathy (DN) in type 2 diabetes are not well known. The present review focuses on these topics from previous studies using light and electron microscopic morphometric analysis. Glomerular hypertrophy, one of the histological changes in DN, is present in type 2 as well as in type 1 diabetic patients. However, mechanisms of increased glomerular size might be different from those in type 1 diabetes. Other typical glomerular changes, glomerular basement membrane thickening and mesangial expansion, are present in normoalbuminuric type 2 diabetic patients as a group. However, these parameters are similar between normo- and microalbuminuric patients. Renal structural-functional relationships cannot be seen in type 2 diabetic patients and therefore urinary albumin might not be a reliable indicator for glomerular structural changes in type 2 diabetic patients. Although previous reports showed reversibility of advanced diabetic glomerulosclerosis in type 1 diabetes by 10 years of strict glycemic control, there is no report regarding histological reversibility by therapeutic interventions in type 2 diabetic patients. In addition, it is unclear whether DN lesions are concordant or discordant with diabetic retinopathy grade in type 2 diabetes. From this information, renal structural changes or structural-functional relationships in type 2 diabetic patients might be heterogeneous and different from those in type 1 diabetic patients. Careful longitudinal study of renal structure and function including serial renal biopsy at the early stage of DN in type 2 diabetes is necessary. PMID:11810468

  20. An Endosperm-Associated Cuticle Is Required for Arabidopsis Seed Viability, Dormancy and Early Control of Germination

    PubMed Central

    Loubery, Sylvain; Utz-Pugin, Anne; Bailly, Christophe; Mène-Saffrané, Laurent; Lopez-Molina, Luis

    2015-01-01

    Cuticular layers and seeds are prominent plant adaptations to terrestrial life that appeared early and late during plant evolution, respectively. The cuticle is a waterproof film covering plant aerial organs preventing excessive water loss and protecting against biotic and abiotic stresses. Cutin, consisting of crosslinked fatty acid monomers, is the most abundant and studied cuticular component. Seeds are dry, metabolically inert structures promoting plant dispersal by keeping the plant embryo in an arrested protected state. In Arabidopsis thaliana seeds, the embryo is surrounded by a single cell endosperm layer itself surrounded by a seed coat layer, the testa. Whole genome analyses lead us to identify cutin biosynthesis genes as regulatory targets of the phytohormones gibberellins (GA) and abscisic acid (ABA) signaling pathways that control seed germination. Cutin-containing layers are present in seed coats of numerous species, including Arabidopsis, where they regulate permeability to outer compounds. However, the role of cutin in mature seed physiology and germination remains poorly understood. Here we identify in mature seeds a thick cuticular film covering the entire outer surface of the endosperm. This seed cuticle is defective in cutin-deficient bodyguard1 seeds, which is associated with alterations in endospermic permeability. Furthermore, mutants affected in cutin biosynthesis display low seed dormancy and viability levels, which correlates with higher levels of seed lipid oxidative stress. Upon seed imbibition cutin biosynthesis genes are essential to prevent endosperm cellular expansion and testa rupture in response to low GA synthesis. Taken together, our findings suggest that in the course of land plant evolution cuticular structures were co-opted to achieve key physiological seed properties. PMID:26681322

  1. Mindfulness-Oriented Recovery Enhancement for Chronic Pain and Prescription Opioid Misuse: Results from an Early Stage Randomized Controlled Trial

    PubMed Central

    Garland, Eric L.; Manusov, Eron G.; Froeliger, Brett; Kelly, Amber; Williams, Jaclyn M.; Howard, Matthew O.

    2014-01-01

    Objective Opioid pharmacotherapy is now the leading treatment for chronic pain, a problem that affects nearly one-third of the United States population. Given the dramatic rise in prescription opioid misuse and opioid-related mortality, novel behavioral interventions are needed. The purpose of this study was to conduct an early stage randomized controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE), a multimodal intervention designed to simultaneously target mechanisms underpinning chronic pain and opioid misuse. Method Chronic pain patients (N=115; mean age = 48±14; 68% female) were randomized to 8 weeks of MORE or a Support Group (SG). Outcomes were measured at pre- and post-treatment, and at 3-month follow-up. The Brief Pain Inventory assessed changes in pain severity and interference. Changes in opioid use disorder status were measured by the Current Opioid Misuse Measure. Desire for opioids, stress, nonreactivity, reinterpretation of pain sensations, and reappraisal were also evaluated. Results MORE participants reported significantly greater reductions in pain severity (p = .038) and interference (p = .003) than SG participants, which were maintained by 3-month follow-up and mediated by increased nonreactivity and reinterpretation of pain sensations. Compared with SG participants, participants in MORE evidenced significantly less stress arousal (p = .034) and desire for opioids (p = .027), and were significantly more likely to no longer meet criteria for opioid use disorder immediately following treatment (p = .05); however, these effects were not sustained at follow-up. Conclusions Findings demonstrate preliminary feasibility and efficacy of MORE as a treatment for co-occurring prescription opioid misuse and chronic pain. PMID:24491075

  2. An Endosperm-Associated Cuticle Is Required for Arabidopsis Seed Viability, Dormancy and Early Control of Germination.

    PubMed

    De Giorgi, Julien; Piskurewicz, Urszula; Loubery, Sylvain; Utz-Pugin, Anne; Bailly, Christophe; Mène-Saffrané, Laurent; Lopez-Molina, Luis

    2015-12-01

    Cuticular layers and seeds are prominent plant adaptations to terrestrial life that appeared early and late during plant evolution, respectively. The cuticle is a waterproof film covering plant aerial organs preventing excessive water loss and protecting against biotic and abiotic stresses. Cutin, consisting of crosslinked fatty acid monomers, is the most abundant and studied cuticular component. Seeds are dry, metabolically inert structures promoting plant dispersal by keeping the plant embryo in an arrested protected state. In Arabidopsis thaliana seeds, the embryo is surrounded by a single cell endosperm layer itself surrounded by a seed coat layer, the testa. Whole genome analyses lead us to identify cutin biosynthesis genes as regulatory targets of the phytohormones gibberellins (GA) and abscisic acid (ABA) signaling pathways that control seed germination. Cutin-containing layers are present in seed coats of numerous species, including Arabidopsis, where they regulate permeability to outer compounds. However, the role of cutin in mature seed physiology and germination remains poorly understood. Here we identify in mature seeds a thick cuticular film covering the entire outer surface of the endosperm. This seed cuticle is defective in cutin-deficient bodyguard1 seeds, which is associated with alterations in endospermic permeability. Furthermore, mutants affected in cutin biosynthesis display low seed dormancy and viability levels, which correlates with higher levels of seed lipid oxidative stress. Upon seed imbibition cutin biosynthesis genes are essential to prevent endosperm cellular expansion and testa rupture in response to low GA synthesis. Taken together, our findings suggest that in the course of land plant evolution cuticular structures were co-opted to achieve key physiological seed properties. PMID:26681322

  3. Training in the practical application of damage control and early total care operative philosophy – perceptions of UK orthopaedic specialist trainees

    PubMed Central

    Eardley, WGP; Taylor, DM; Parker, PJ

    2010-01-01

    INTRODUCTION Despite improvements in the outcome of individuals sustaining significant injury, the optimum management of fractures in traumatised patients remains an area of debate and publication. There is, however, a paucity of studies regarding the specifics of acquired experience and training of junior orthopaedic surgeons in the practical application of these skills. Our null hypothesis is that, despite alteration in surgical training, the perceived confidence and adequacy of training of UK orthopaedic specialist trainees in the application of damage control orthopaedics (DCO) and early total care (ETC) philosophy is unaffected. PATIENTS AND METHODS A web-based survey was sent to a sample of orthopaedic trainees. From 888 trainees, 222 responses were required to achieve a 5% error rate with 90% confidence. RESULTS A total of 232 responses were received. Trainees reported a high level of perceived confidence with both external fixation and intramedullary devices. Exposure to cases was sporadic although perceived training adequacy was high. A similar pattern was seen in perceived operative role with the majority of trainees expecting to be performing such operations, albeit under varying levels of supervision. In a more complicated case of spanning external fixation for a ‘floating knee, trainees reported a decreased level of perceived confidence and limited exposure. One-third of trainees reported never having been involved in such a case. In contrast to nationally collated logbook data, exposure to and perceived confidence in managing cases involving ETC and DCO were similar. CONCLUSIONS Despite changes in the training of junior orthopaedic surgeons, trainee-reported confidence and adequacy of training in the practical application of DCO and ETC was high. Exposure to cases overall was, however, seen to be limited and there was a suggestion of disparity between current operative experiences of trainees and that recorded in the national trainee logbook. PMID:19995485

  4. Is Early Oral Feeding after Gastric Cancer Surgery Feasible? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Zheng, Liansheng; Mou, Tingyu; Liu, Hao; Li, Guoxin

    2014-01-01

    Aim To assess the feasibility and safety of early oral feeding (EOF) after gastrectomy for gastric cancer through a systematic review and meta-analysis based on randomized controlled trials. Methods A literature search in PubMed, Embase, Web of Science and Cochrane library databases was performed for eligible studies published between January 1995 and March 2014. Systematic review was carried out to identify randomized controlled trials comparing EOF and traditional postoperative oral feeding after gastric cancer surgery. Meta-analyses were performed by either a fixed effects model or a random effects model according to the heterogeneity using RevMan 5.2 software. Results Six studies remained for final analysis. Included studies were published between 2005 and 2013 reporting on a total of 454 patients. No significant differences were observed for postoperative complication (RR?=?0.95; 95%CI, 0.70 to 1.29; P?=?0.75), the tolerability of oral feeding (RR?=?0.98; 95%CI, 0.91 to 1.06; P?=?0.61), readmission rate (RR?=?1; 95%CI, 0.30 to 3.31; P?=?1.00) and incidence of anastomotic leakage (RR?=?0.31; 95%CI, 0.01 to 7.30; P?=?0.47) between two groups. EOF after gastrectomy for gastric cancer was associated with significant shorter duration of the hospital stay (WMD?=??2.36; 95%CI, ?3.37 to ?1.34; P<0.0001) and time to first flatus (WMD?=??19.94; 95%CI, ?32.03 to ?7.84; P?=?0.001). There were no significant differences in postoperative complication, tolerability of oral feeding, readmission rates, duration of hospital stay and time to first flatus among subgroups stratified by the time to start EOF or by partial and total gastrectomy or by laparoscopic and open surgery. Conclusions The result of this meta-analysis showed that EOF after gastric cancer surgery seems feasible and safe, even started at the day of surgery irrespective of the extent of the gastric resection and the type of surgery. However, more prospective, well-designed multicenter RCTs with more clinical outcomes are needed for further validation. PMID:25397686

  5. Low vs. high glycemic index carbohydrate gel ingestion during simulated 64-km cycling time trial performance.

    PubMed

    Earnest, Conrad P; Lancaster, Stacy L; Rasmussen, Christopher J; Kerksick, Chad M; Lucia, Alejandro; Greenwood, Michael C; Almada, Anthony L; Cowan, Patty A; Kreider, Richard B

    2004-08-01

    We examined the effect of low and high glycemic index (GI) carbohydrate (CHO) feedings during a simulated 64-km cycling time trial (TT) in nine subjects ([mean +/- SEM], age = 30 +/- 1 years; weight = 77.0 +/- 2.6 kg). Each rider completed three randomized, double blind, counter-balanced, crossover rides, where riders ingested 15 g of low GI (honey; GI = 35) and high GI (dextrose; GI = 100) CHO every 16 km. Our results showed no differences between groups for the time to complete the entire TT (honey = 128 minutes, 42 seconds +/- 3.6 minutes; dextrose = 128 minutes, 18 seconds +/- 3.8 minutes; placebo = 131 minutes, 18 seconds +/- 3.9 minutes). However, an analysis of total time alone may not portray an accurate picture of TT performance under CHO-supplemented conditions. For example, when the CHO data were collapsed, the CHO condition (128 minutes, 30 seconds) proved faster than placebo condition (131 minutes, 18 seconds; p < 0.02). Furthermore, examining the percent differences and 95% confidence intervals (CI) shows the two CHO conditions to be generally faster, as the majority of the CI lies in the positive range: placebo vs. dextrose (2.36% [95% CI; -0.69, 4.64]) and honey (1.98% [95% CI; -0.30, 5.02]). Dextrose vs. honey was 0.39% (95% CI; -3.39, 4.15). Within treatment analysis also showed that subjects generated more watts (W) over the last 16 km vs. preceding segments for dextrose (p < 0.002) and honey (p < 0.0004) treatments. When the final 16-km W was expressed as a percentage of pretest maximal W, the dextrose treatment was greater than placebo (p < 0.05). A strong trend was noted for the honey condition (p < 0.06), despite no differences in heart rate (HR) or rate of perceived exertion (RPE). Our results show a trend for improvement in time and wattage over the last 16 km of a 64-km simulated TT regardless of glycemic index. PMID:15320674

  6. Use of an Electronic Medical Record (EMR) to Identify Glycemic Intensification Strategies in Type 2 Diabetes

    PubMed Central

    Brooks, Maria; Lombardero, Manuel; DeAlmeida, Dilhari; Kanter, Justin; Magaji, Vasudev; Orchard, Trevor; Siminerio, Linda

    2015-01-01

    Background: Current treatment guidelines for type 2 diabetes (T2D) recommend individualized intensification of therapy for glycated hemoglobin (A1C) ? 7% in most patients. The purpose of this investigation was to explore the ability of an electronic medical record (EMR) to identify glycemic intensification strategies among T2D patients receiving pharmacologic therapy. Methods: Patient records between 2005 and 2011 with documentation of A1C and active prescriptions for any diabetes medications were queried to identify potential candidates for intensification based on A1C ? 7% while on 1-2 oral diabetes medications (ODM). Patients with follow-up A1C values within 1 year of index A1C were grouped according to intensification with insulin, GLP-1 receptor agonists (GLP-1RA), a new class of ODM, or no intensification. Changes in A1C and continuation of intensification therapy were determined. Results: A total of 4921 patients meeting inclusion criteria were intensified with insulin (n = 416), GLP-1RA (n = 68), ODM (n = 1408), or no additional therapy (n = 3029). Patients receiving insulin had higher baseline (9.3 ± 2.0 vs 8.3 ± 1.2 vs 8.3 ± 1.3 vs 7.6 ± 1.0%, P < .0001) and follow-up A1C (8.1 ± 1.6 vs 7.5 ± 1.2 vs 7.6 ± 1.3 vs 7.2 ± 1.1%, P < .0001) despite experiencing larger absolute A1C reductions (?1.2 ± 2.1 vs ?0.8 ± 1.4 vs ?0.7 ± 1.4 vs ?0.3 ± 1.1%, P < .0001). Patients receiving GLP-1RA were more obese at baseline (BMI: 33.6 ± 7.1 vs 37.7 ± 6.1 vs 33.7 ± 6.8 vs 32.9 ± 7.1 kg/m2, P < .0001) and follow-up (BMI: 33.9 ± 7.3 vs 36.6 ± 6.1 vs 33.8 ± 7.0 vs 32.4 ± 7.0 kg/m2, P < .0001) despite experiencing more absolute weight reduction. Insulin was the most and GLP-1RA the least likely therapy to be continued. Conclusions: An EMR allows identification of prescribing practices and compliance with T2D treatment guidelines. Patients receiving intensification of glycemic medications had baseline A1C >8% suggesting that treatment recommendations are not being followed. PMID:25526759

  7. Does Tight Glucose Control Prevent Myocardial Injury and Inflammation?

    PubMed Central

    Brown, Jeremiah R.; Furnary, Anthony P.; Mackenzie, Todd A.; Duquette, Dennis; Helm, Robert E.; Paliotta, Marco; Ross, Cathy S.; Malenka, David J.; O’Connor, Gerald T.

    2011-01-01

    Abstract: Hyperglycemia has been postulated to be cardiotoxic. We addressed the hypothesis that uncontrolled blood glucose induces myocardial damage in diabetic patients undergoing isolated coronary artery bypass graft surgery receiving continuous insulin infusion in the immediate postoperative period. Our primary aim was to assess the degree of tight glycemic control for each patient and to link the degree of glycemic control to intermediate outcome of myocardial damage. We prospectively enrolled 199 consecutive patients with diabetes undergoing isolated coronary artery bypass graft surgery from October 2003 through August 2005. Preoperative hemoglobin A1c and glucose measures were collected from the surgical admission. We measured biomarkers of myocardial damage (cardiac troponin I) and metabolic dysfunction (blood glucose and hemoglobin A1c) to identify a difference among patients under tight (90–100% of glucose measures ?150 mg/dL) or loose (<90%) glycemic control. All patients received continuous insulin infusion in the immediate postoperative period. We discovered 45.6% of the patients were in tight control. We found tight glycemic control resulted in no significant difference in troponin I release. Mean cardiac troponin I for tight and loose control was 4.9 and 8.5 (ng/mL), p value .3. We discovered patients varied with their degree of control, even with established protocols to maintain glucose levels within the normal range. We were unable to verify tight glycemic control compared to loose control was significantly associated with decreased cardiac troponin I release. Future studies are needed to evaluate the cardiotoxic mechanisms of hyperglycemia postulated in this study. PMID:22164453

  8. Eplerenone for early cardiomyopathy in Duchenne muscular dystrophy: a randomised, double-blind, placebo-controlled trial

    PubMed Central

    Raman, Subha V; Hor, Kan N; Mazur, Wojciech; Halnon, Nancy J; Kissel, John T; He, Xin; Tran, Tam; Smart, Suzanne; McCarthy, Beth; Taylor, Michael D; Jefferies, John L; Rafael-Fortney, Jill A; Lowe, Jeovanna; Roble, Sharon L; Cripe, Linda H

    2015-01-01

    Summary Background Cardiomyopathy is a leading cause of death in patients with Duchenne muscular dystrophy and myocardial damage precedes decline in left ventricular systolic function. We tested the efficacy of eplerenone on top of background therapy in patients with Duchenne muscular dystrophy with early myocardial disease. Methods In this randomised, double-blind, placebo-controlled trial, boys from three centres in the USA aged 7 years or older with Duchenne muscular dystrophy, myocardial damage by late gadolinium enhancement cardiac MRI and preserved ejection fraction received either eplerenone 25 mg or placebo orally, every other day for the first month and once daily thereafter, in addition to background clinician-directed therapy with either angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB). Computer-generated randomisation was done centrally using block sizes of four and six, and only the study statistician and the investigational pharmacy had the preset randomisation assignments. The primary outcome was change in left ventricular circumferential strain (Ecc) at 12 months, a measure of contractile dysfunction. Safety was established through serial serum potassium levels and measurement of cystatin C, a non-creatinine measure of kidney function. This trial is registered with ClinicalTrials.gov, number NCT01521546. Findings Between Jan 26, 2012, and July 3, 2013, 188 boys were screened and 42 were enrolled. 20 were randomly assigned to receive eplerenone and 22 to receive placebo, of whom 20 in the eplerenone group and 20 in the placebo group completed baseline, 6-month, and 12-month visits. After 12 months, decline in left ventricular circumferential strain was less in those who received eplerenone than in those who received placebo (median ?Ecc 1.0 [IQR 0.3–2.2]vs2.2 [1.3–3.1]; p=0.020). Cystatin C concentrations remained normal in both groups, and all non-haemolysed blood samples showed normal potassium concentrations. One 23-year-old patient in the placebo group died of fat embolism, and another patient in the placebo group withdrew from the trial to address long-standing digestive issues. All other adverse events were mild: short-lived headaches coincident with seasonal allergies occurred in one patient given eplerenone, flushing occurred in one patient given placebo, and anxiety occurred in another patient given placebo. Interpretation In boys with Duchenne muscular dystrophy and preserved ejection fraction, addition of eplerenone to background ACEI or ARB therapy attenuates the progressive decline in left ventricular systolic function. Early use of available drugs warrants consideration in this population at high risk of cardiac death, but further studies are needed to determine the effect of combination cardioprotective therapy on event-free survival in Duchenne muscular dystrophy. Funding BallouSkies, Parent Project for Muscular Dystrophy, US National Center for Advancing Translational Sciences, and US National Institutes of Health. PMID:25554404

  9. Glycemic Response and Fermentation of Crystalline Short Linear ?-Glucans from Debranched Waxy Maize Starch.

    PubMed

    Brewer, Lauren R; Weber, Casey; Haub, Mark; Cai, Liming; Shi, Yong-Cheng

    2015-11-01

    The glycemic index (GI) is used to rank foods based on postprandial blood glucose response. GI test requires that 50 g of available carbohydrate be used. Available carbohydrate is often calculated as total carbohydrate minus dietary fiber; yet, AOAC fiber methods do not always include resistant starch (RS). The objective of this study was to examine GI response and fermentation properties of crystalline short-chain ?-glucan (CSCA), which has high RS content, but no total dietary fiber (TDF) content as measured by AOAC method 991.43. Using the standard GI method, 10 adults were fed 50 g of waxy maize starch and CSCA, consumed alone and in mixed formulation. Breath hydrogen was also determined over 6 h. Fifty grams of CSCA was not entirely available in vivo, and breath hydrogen testing indicated that CSCA was as likely to ferment. Products high in RS, but with no TDF, would yield reduced GI values, and this calls for the need of a method to define available carbohydrate. PMID:26447350

  10. Glycemic Variability: How Do We Measure It and Why Is It Important?

    PubMed Central

    Suh, Sunghwan

    2015-01-01

    Chronic hyperglycemia is the primary risk factor for the development of complications in diabetes mellitus (DM); however, it is believed that frequent or large glucose fluctuations may independently contribute to diabetes-related complications. Postprandial spikes in blood glucose, as well as hypoglycemic events, are blamed for increased cardiovascular events in DM. Glycemic variability (GV) includes both of these events; hence, minimizing GV can prevent future cardiovascular events. Correcting GV emerges as a target to be pursued in clinical practice to safely reduce the mean blood glucose and to determine its direct effects on vascular complications in diabetes. Modern diabetes management modalities, including glucagon-related peptide-1-based therapy, newer insulins, modern insulin pumps and bariatric surgery, significantly reduce GV. However, defining GV remains a challenge primarily due to the difficulty of measuring it and the lack of consensus regarding the optimal approach for its management. The purpose of this manuscript was not only to review the most recent evidence on GV but also to help readers better understand the available measurement options and how the various definitions relate differently to the development of diabetic complications. PMID:26301188

  11. Low glycemic response to traditionally processed wheat and rye products: bulgur and pumpernickel bread.

    PubMed

    Jenkins, D J; Wolever, T M; Jenkins, A L; Giordano, C; Giudici, S; Thompson, L U; Kalmusky, J; Josse, R G; Wong, G S

    1986-04-01

    To look at the effect of processing wheat and rye on blood glucose responses with special reference to bulgur and pumpernickel bread, groups of 9-12 Noninsulin-dependent (NIDDM) and 5-6 Insulin-dependent diabetic volunteers (IDDM) were fed test meals containing 50 g carbohydrate portions of four wheat and three rye products. Glycemic indices for IDDM and NIDDM combined, calculated as the incremental area under the blood glucose response curve, where white bread = 100, demonstrated values of 96 +/- 5 for wholemeal wheat bread, 89 +/- 6 for wholemeal rye bread, 78 +/- 3 for pumpernickel bread, 65 +/- 4 for bulgur, 63 +/- 6 for whole wheat kernels and 48 +/- 5 for whole rye kernels. Results for IDDM and NIDDM were similar (r = 0.96, p less than 0.01). It is concluded that traditional processing of cereals, such as parboiling (bulgur) or the use of wholegrains in bread (pumpernickel) may result in the low GI value associated with the unmilled cereal. Cereal foods processed in these ways may form a useful part of the diet where a reduction in postprandial glycemia is required. PMID:3962904

  12. Cost-Effectiveness of Interventions to Prevent and Control Diabetes Mellitus: A Systematic Review

    PubMed Central

    Li, Rui; Zhang, Ping; Barker, Lawrence E.; Chowdhury, Farah M.; Zhang, Xuanping

    2010-01-01

    OBJECTIVE To synthesize the cost-effectiveness (CE) of interventions to prevent and control diabetes, its complications, and comorbidities. RESEARCH DESIGN AND METHODS We conducted a systematic review of literature on the CE of diabetes interventions recommended by the American Diabetes Association (ADA) and published between January 1985 and May 2008. We categorized the strength of evidence about the CE of an intervention as strong, supportive, or uncertain. CEs were classified as cost saving (more health benefit at a lower cost), very cost-effective (?$25,000 per life year gained [LYG] or quality-adjusted life year [QALY]), cost-effective ($25,001 to $50,000 per LYG or QALY), marginally cost-effective ($50,001 to $100,000 per LYG or QALY), or not cost-effective (>$100,000 per LYG or QALY). The CE classification of an intervention was reported separately by country setting (U.S. or other developed countries) if CE varied by where the intervention was implemented. Costs were measured in 2007 U.S. dollars. RESULTS Fifty-six studies from 20 countries met the inclusion criteria. A large majority of the ADA recommended interventions are cost-effective. We found strong evidence to classify the following interventions as cost saving or very cost-effective: (I) Cost saving— 1) ACE inhibitor (ACEI) therapy for intensive hypertension control compared with standard hypertension control; 2) ACEI or angiotensin receptor blocker (ARB) therapy to prevent end-stage renal disease (ESRD) compared with no ACEI or ARB treatment; 3) early irbesartan therapy (at the microalbuminuria stage) to prevent ESRD compared with later treatment (at the macroalbuminuria stage); 4) comprehensive foot care to prevent ulcers compared with usual care; 5) multi-component interventions for diabetic risk factor control and early detection of complications compared with conventional insulin therapy for persons with type 1 diabetes; and 6) multi-component interventions for diabetic risk factor control and early detection of complications compared with standard glycemic control for persons with type 2 diabetes. (II) Very cost-effective— 1) intensive lifestyle interventions to prevent type 2 diabetes among persons with impaired glucose tolerance compared with standard lifestyle recommendations; 2) universal opportunistic screening for undiagnosed type 2 diabetes in African Americans between 45 and 54 years old; 3) intensive glycemic control as implemented in the UK Prospective Diabetes Study in persons with newly diagnosed type 2 diabetes compared with conventional glycemic control; 4) statin therapy for secondary prevention of cardiovascular disease compared with no statin therapy; 5) counseling and treatment for smoking cessation compared with no counseling and treatment; 6) annual screening for diabetic retinopathy and ensuing treatment in persons with type 1 diabetes compared with no screening; 7) annual screening for diabetic retinopathy and ensuing treatment in persons with type 2 diabetes compared with no screening; and 8) immediate vitrectomy to treat diabetic retinopathy compared with deferred vitrectomy. CONCLUSIONS Many interventions intended to prevent/control diabetes are cost saving or very cost-effective and supported by strong evidence. Policy makers should consider giving these interventions a higher priority. PMID:20668156

  13. Rearranged JC Virus Noncoding Control Regions Found in Progressive Multifocal Leukoencephalopathy Patient Samples Increase Virus Early Gene Expression and Replication Rate ? †

    PubMed Central

    Gosert, Rainer; Kardas, Piotr; Major, Eugene O.; Hirsch, Hans H.

    2010-01-01

    Polyomavirus JC (JCV) infects ?60% of the general population, followed by asymptomatic urinary shedding in ?20%. In patients with pronounced immunodeficiency, including HIV/AIDS, JCV can cause progressive multifocal leukoencephalopathy (PML), a devastating brain disease of high mortality. While JCV in the urine of healthy people has a linear noncoding control region called the archetype NCCR (at-NCCR), JCV in brain and cerebrospinal fluid (CSF) of PML patients bear rearranged NCCRs (rr-NCCRs). Although JCV NCCR rearrangements are deemed pathognomonic for PML, their role as a viral determinant is unclear. We sequenced JCV NCCRs found in CSF of eight HIV/AIDS patients newly diagnosed with PML and analyzed their effect on early and late gene expression using a bidirectional reporter vector recapitulating the circular polyomavirus early and late gene organization. The rr-NCCR sequences were highly diverse, but all increased viral early reporter gene expression in progenitor-derived astrocytes, glia-derived cells, and human kidney compared to the expression levels with the at-NCCR. The expression of simian virus 40 (SV40) large T antigen or HIV Tat expression in trans was associated with a strong increase of at-NCCR-controlled early gene expression, while rr-NCCRs were less responsive. The insertion of rr-NCCRs into the JCV genome backbone revealed higher viral replication rates for rr-NCCR compared to those of the