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1

Diabetes management and glycemic control in youth with type 1 diabetes: test of a predictive model  

PubMed Central

The objective of this study was to test a comprehensive model of biologic (pubertal status), family (communication and conflict), and psychological influences (behavioral autonomy) on diabetes management and glycemic control in a sample of youth (N = 226) with type 1 diabetes recruited during late childhood/early adolescence (ages 9–11 years). The study design was a prospective, multisite, multi-method study involving prediction of diabetes management and glycemic control 1 year post-baseline. The primary outcome measures included diabetes management behaviors based on the Diabetes Self-Management Profile (DSMP) administered separately to mothers and youth and glycemic control measured by glycated hemoglobin (HbA1c) obtained by blood samples and analyzed by a central laboratory to ensure standardization. Our hypothesized predictive model received partial support based on structural equation modeling analyses. Family conflict predicted less adequate glycemic control 1 year later (p < 0.05). Higher conflict predicted less adequate diabetes management and less adequate glycemic control. More advanced pubertal status also predicted less adequate glycemic control, but behavioral autonomy did not. Family conflict is an important, potentially clinically significant influence on glycemic control that should be considered in primary and secondary prevention in the management of type 1 diabetes in youth. PMID:22569775

Ittenbach, Richard; Rohan, Jennifer M.; Gupta, Resmi; Pendley, Jennifer Shroff; Delamater, Alan

2014-01-01

2

Is glycemic control of the critically ill cost-effective?  

PubMed

Intensive monitoring of blood glucose levels and treatment of hyperglycemia have been associated with significant improvements in morbidity and mortality in the critically ill. In contrast to the large prospective and observational body of data relating glycemic control and clinical outcomes, the financial impact of glycemic control implementation has not been as well described. This article details data from interventional trials of intensive insulin therapy; investigations that relate dysglycemia to morbidity, particularly intensive care unit (ICU)-acquired infections and increased ICU length of stay; and evaluations of the attributable cost of nosocomial infection in order to construct a sensitivity analysis of the net economic impact of glycemic control. It concludes that glycemic control is associated with positive financial outcomes, even using very conservative assumptions, and provides the reader with an automated spreadsheet to estimate the financial implications of glycemic control using assumptions based on locally derived data. PMID:25502129

Krinsley, James S

2014-10-01

3

Glycemic control indicators in patients with neonatal diabetes mellitus  

PubMed Central

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

Suzuki, Shigeru; Koga, Masafumi

2014-01-01

4

Inpatient glycemic control: an evolving paradigm.  

PubMed

In 2001, Van den Berghe et al published a landmark study of intensive insulin therapy in the setting of a surgical intensive care unit (ICU). Increased attention was also focused on the observational evidence indicating that hyperglycemia is associated with increased morbidity and mortality among diverse patient populations. Because of the dramatic reduction in mortality with normalization of glucose levels in the single center, the Van den Berghe study led to widespread adoption of this practice in ICUs worldwide. Hospitals also began to implement rational subcutaneous insulin protocols based on the American Diabetes Association technical review, replacing the ineffective practice of sliding-scale insulin. Logistical challenges have included coordination of multiple hospital departments and achieving multidisciplinary consensus on goals and methods. Subsequent to the initial Van den Berghe study, other multicenter trials have been fraught with an increased frequency of hypoglycemia and have failed to consistently demonstrate improved outcomes with intensive insulin therapy. Hospitals and expert panels are in the process of examining the combined evidence and considering modifying treatment goals. We recommend continued focus on avoiding hyperglycemia with less aggressive glycemic targets in the critically ill and rational subcutaneous insulin in the noncritically ill, avoiding a return to the obsolescence of sliding-scale insulin. PMID:19491537

Yalla, Naga M; Reynolds, L Raymond

2009-05-01

5

Risk factors for hospital-acquired ‘poor glycemic control’: a case–control study  

PubMed Central

Objective To determine the patient and hospital characteristics associated with severe manifestations of ‘poor glycemic control’—a ‘no-pay’ hospital-acquired condition defined by the US Medicare program based on hospital claims related to severe complications of diabetes. Design A nested case–control study. Setting California acute care hospitals from 2005 to 2006. Participants All cases (n= 261) with manifestations of poor glycemic control not present on admission admitted to California acute care hospitals from 2005 to 2006 and 261 controls were matched (1:1) using administrative data for age, sex, major diagnostic category and severity of illness. Main Outcome Measure(s) The adjusted odds ratio (OR) for experiencing poor glycemic control. Results Deaths (16 vs. 9%, P= 0.01) and total costs ($26 125 vs. $18 233, P= 0.026) were significantly higher among poor glycemic control cases. Risk-adjusted conditional logistic regression revealed that each additional chronic condition increased the odds of poor glycemic control by 12% (OR: 1.12, 95% CI: 1.04–1.22). The interaction of registered nurse staffing and hospital teaching status suggested that in non-teaching hospitals, each additional nursing hour per adjusted patient day significantly reduced the odds of poor glycemic control by 16% (OR: 0.84, 95% CI: 0.73–0.96). Nurse staffing was not significant in teaching hospitals (OR: 0.98, 95% CI: 0.88–1.11). Conclusions Severe poor glycemic control complications are relatively rare but meaningful events with disproportionately high costs and mortality. Increasing nurse staffing may be an effective strategy in reducing poor glycemic control complications particularly in non-teaching hospitals. PMID:21084321

Mchugh, Matthew D.; Shang, Jingjing; Sloane, Douglas M.; Aiken, Linda H.

2011-01-01

6

Children's glycemic control: mother's knowledge and socioeconomic status.  

PubMed

The present study was designed to examine the role of socioeconomic status (SES) of the mother's knowledge about different aspects of diabetes and the glycemic control of type 1 children with diabetes. Samples were taken from successive admissions to the outpatient diabetes clinics in Prince Sultan Medical Military City (PSMMC), Riyadh, Saudi Arabia. A well designed questionnaire covering different aspects including demographic data, educational background, and socioeconomic status of the care providers was used to collect information from mothers of type 1 diabetes mellitus (T1DM) children. The questionnaire was designed on the basis of the Michigan diabetes knowledge scale and also on the basis of food habits of Saudi Arabia and it was validated. The questionnaire was completed after interviewing the mothers during visits to the PSMMC hospital. Every mother was asked with those particular questions. Glycemic control was assessed by glycosylated haemoglobin (HbA1c). The socio-demographic data of mothers was recorded by self-report. It was found that, there was significant variation in the knowledge of diabetes among mothers with different ages (P 0.05). No significant results were observed between family income and diabetes knowledge (p>0.05).However, a positive relationship was observed with higher income and higher knowledge. There was a significant association between mothers knowledge of diabetes and HbA1C level (r = -0.1739, p.<0.05) indicating that, higher knowledge ultimately leads to greater control of HbA1c level. A significant association was also observed between education and HbA1c level (r=-02538, p<0.05) with children of mothers with higher level of education showing a better control of glycated haemoglobin levels. However, no significant association was found between monthly family income and HbA1C level. In conclusion, the current study illustrated that, mothers with more knowledge of diabetes and with better education were maintaining a better glycemic control of their children, irrespective of the socio-economic status. It was found that, to improve glycemic control and to decrease acute and chronic complications of diabetes in children, mother's knowledge and education is needed. PMID:24171891

Al-Odayani, Abdulrahman Nasser; Alsharqi, Omar Zayyan; Ahmad, Alaeddin Mohammad Khalaf; Khalaf Ahmad, Ala'eddin Mohammad; Al-Borie, Hussein Mohammad; Qattan, Ameerah M N

2013-11-01

7

Improved glycemic control in moderate altitude type II diabetic residents.  

PubMed

Exposure to altitude hypoxia may elicit changes in glucose homeostasis. This work is designated to investigate the glycemic control in type II diabetic patients (DMII) permanently resident at moderately high altitude (2400 m), and to investigate whether the arterial oxygen-related parameters are different in DMII patients living at altitude compared to those living at low altitude. Blood glucose, HbA1c, hemoglobin concentration, and hematocrit (HCT) were measured in moderate altitude type II diabetics and compared with both altitude nondiabetics and diabetic patients living at normoxic and normobaric conditions. The data revealed that fasting blood glucose was lower in altitude diabetic patients compared to diabetics living at low altitude (157±33 mg/dL and 176.81±15.98 mg/dL, respectively, p<0.01). Also, glycemic control was improved in altitude diabetic patients, where their HbA1c was lower than the corresponding low altitude diabetic patients (8.68±0.79% and 9.30±1.02% respectively, p<0.01). Low oxygen tension at altitude was compensated in both diabetics and nondiabetics by a significant increase in both hemoglobin and HCT (17.33±0.72 mg/dL and 50.7±2.20%, respectively) compared to the corresponding groups living at low levels (15.53±0.55 mg/dL and 45.8±1.64%, respectively). The underlying disease neither affected the arterial oxygen tension (PaO2) nor oxygen saturation (SaO2), where insignificant correlations were observed between glucose, PaO2 (r=-0.06) and SaO2 (r=-0.2). These results suggest that moderate altitude may improve the glycemic control in type II diabetic patients compared to diabetics living at sea level. PMID:23537257

Hessien, Mohamed

2013-03-01

8

Intraoperative glycemic control procedures and the use of an artificial pancreas  

Microsoft Academic Search

Strict intraoperative glycemic control can significantly decrease the incidence of postoperative infection; however, anesthesiologists must carefully control blood glucose levels as well as properly manage the respiratory and cardiovascular systems. However, standard blood glucose measurement systems and insulin dosing algorithms, which are necessary for achieving strict glycemic control, have not yet been developed. An artificial pancreas (STG-22TM; Nikkiso Co., Tokyo,

Koichi Yamashita; Tomoaki Yatabe

2009-01-01

9

Driving Distance as a Barrier to Glycemic Control in Diabetes Kaitlin Strauss, BA,1  

E-print Network

Driving Distance as a Barrier to Glycemic Control in Diabetes Kaitlin Strauss, BA,1 Charles Mac. BACKGROUND: Despite advances in treatment of diabetes, many bar- riers to good glycemic control remain to the site of primary care. DESIGN: Cross-sectional analysis of data from the Vermont Diabetes Information

Vermont, University of

10

Determinants of glycemic control in female diabetic patients: a study from Iran  

Microsoft Academic Search

BACKGROUND: Since microvascular and macrovascular complications are reduced through strict glycemic control, this study carried out to identify the factors that affect glycemic control. METHODS: A cross-sectional design was carried out to examine the role of demographic, anthropometric, clinical and other relevant characteristics in a sample of 103 female diabetic patients in Tehran, Iran. Personal interviews were conducted to collect

Zeinab Ghazanfari; Shamsaddin Niknami; Fazlollah Ghofranipour; Bagher Larijani; Hamid Agha-Alinejad; Ali Montazeri

2010-01-01

11

Early Improvement in Glycemic Control After Bariatric Surgery and Its Relationships with Insulin, GLP-1, and Glucagon Secretion in Type 2 Diabetic Patients  

Microsoft Academic Search

Background  The surgical treatment of obesity ameliorates metabolic abnormalities in patients with type 2 diabetes. The objective of this\\u000a study was to evaluate the early effects of Roux-en-Y gastric bypass (RYGB) on metabolic and hormonal parameters in patients\\u000a with type 2 diabetes (T2DM).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Ten patients with T2DM (BMI, 39.7?±?1.9) were evaluated before and 7, 30, and 90 days after RYGB. A meal

Luciana Mela Umeda; Eliana A. Silva; Glaucia Carneiro; Carlos H. Arasaki; Bruno Geloneze; Maria Teresa Zanella

2011-01-01

12

Congestive Heart Failure and Diabetes: Balancing Glycemic Control with Heart Failure Improvement  

PubMed Central

Diabetes and congestive heart failure (HF) commonly coexist in the same patient, and the presence of diabetes in HF patients is associated with increased adverse events compared to patients without diabetes. Recent guidelines regarding glycemic control stress individualization of glycemic therapy based on patient comorbid conditions and potential adverse effects of medical therapy. This balance in glycemic control may be particularly relevant in patients with diabetes and HF. In this review, we address data regarding the influence that certain HF medications may have on glycemic control. Despite potential modest changes in glycemic control, clinical benefits of proven pharmacologic HF therapies extend to patients with diabetes and HF. In addition, we review potential benefits and challenges associated with commonly used glycemic medications in HF patients. Finally, recent data and controversies on optimal glycemic targets in HF patients are discussed. Given the large number of patients with diabetes and HF and the health burden of these conditions, much needed future work is necessary to define the optimal glycemic treatment in HF patients with diabetes. PMID:23062568

Nasir, Saifullah; Aguilar, David

2012-01-01

13

Glycemic control and diabetes management in hospitalized patients in Brazil  

PubMed Central

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

2013-01-01

14

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

Microsoft Academic Search

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

Marcus J Schultz; Robin E Harmsen; Peter E Spronk

2010-01-01

15

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 ...

16

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

Microsoft Academic Search

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

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

1999-01-01

17

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

PubMed Central

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

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

2011-01-01

18

Prognostic value of early in-hospital glycemic excursion in elderly patients with acute myocardial infarction  

PubMed Central

Background Acute phase hyperglycemia has been associated with increased mortality in patients with acute myocardial infarction (AMI). However, the predictive value of glycemic excursion for adverse outcome in elderly AMI patients is not clear. The aim of this study is to investigate the prognostic value of early in-hospital glycemic excursion and hemoglobin A1c (HbA1c) for one-year major adverse cardiac event (MACE) in elderly patients with AMI. Methods We studied 186 elderly AMI patients, whose clinical data were collected and the Global Registry of Acute Coronary Events (GRACE) risk score were calculated on admission. The fluctuations of blood glucose in patients were measured by a continuous glucose monitoring system (CGMS) for 72 hours. Participants were grouped into tertiles of mean amplitude of glycemic excursions (MAGE) and grouped into HbA1c levels (as ?6.5% or <6.5%). The MACE of patients, including new-onset myocardial infarction, acute heart failure and cardiac death, was documented during one year follow-up. The relationship of MAGE and HbA1c to the incidence of MACE in elderly AMI patients was analyzed. Results In all participants, a higher MAGE level was associated with the higher GRACE score (r?=?0.335, p?3.94 mmol/L, 2.55-3.94 mmol/L or <2.55 mmol/L) was 30.2% vs. 14.8% vs. 8.1%, respectively (p?=?0.004); by HbA1c category (?6.5% vs. <6.5%) was 22.7% vs. 14.4%, respectively (p?=?0.148). Elderly AMI patients with a higher MAGE level had a significantly higher cardiac mortality. In multivariable analysis, high MAGE level was significantly associated with incidence of MACE (HR 3.107, 95% CI 1.190-8.117, p?=?0.021) even after adjusting for GRACE risk score, but HbA1c was not. Conclusions The early in-hospital intraday glycemic excursion may be an important predictor of mortality and MACE even stronger than HbA1c in elderly patients after AMI. PMID:23399749

2013-01-01

19

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

PubMed Central

BACKGROUND Diabetes mellitus (DM) is a very well-known risk factor for development of atherosclerosis, and it has been hypothesized that poor glycemic control and hyperglycemia plays a major role in this process. In the current study, we aimed to evaluate the associates of poor glycemic control in Iranian patients who have already undergone coronary artery bypass grafting (CABG), with especial focus on the inhabitation of infectious agents within the coronary arterial wall. METHODS In January 2010, 52 consecutive patients with type 2 DM who undergone CABG at the Department of Cardiovascular Surgery of Baqiyatallah University of Medical Sciences (Tehran, Iran) were included into this cross-sectional study and biopsy specimens from their coronary plaques were taken and analyzed by polymerase chain reaction (PCR) methods for detecting Helicobacter species, cytomegalovirus (CMV) and Chlamydia pneumoniae, and their potential relation to the glycemic control status in these patients. RESULTS Compared to that in diabetic patients with mean fasting blood sugar (FBS) levels FBS < 126, atherosclerotic lesions in type 2 diabetic patients with poor glycemic control (FBS > 126) were significantly more likely to be positive for CMV PCR test (41% vs. 9%, respectively; P = 0.05). In laboratorial test results, mean triglyceride level was significantly higher among patients of poor glycemic control (168 ± 89 vs. 222 ± 125 mg/dl, respectively; P = 0.033). Hypertension was also significantly more prevalent in this population (73% vs. 36%, respectively; P = 0.034). CONCLUSION Type 2 diabetic patients with poor glycemic control can be at higher risk for developing CMV infection in their coronary arterial wall, which can promote atherosclerosis formation process in this patient population. According to the findings of this study, we recommend better control of serum glucose levels in type 2 diabetic patients to prevent formation/progression of atherosclerosis. PMID:25161684

Izadi, Morteza; Fazel, Mojgan; Karbasi-Afshar, Reza; Saadat, Seyed Hassan; Nasseri, Mohammad Hassan; Jonaidi-Jafari, Nematollah; Ranjbar, Reza; Kazemi-Saleh, Davood

2014-01-01

20

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

PubMed Central

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

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

2014-01-01

21

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

Microsoft Academic Search

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

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

2008-01-01

22

Effects of diabetes-related family stress on glycemic control in young patients with type 1 diabetes  

PubMed Central

Objective To investigate the way that family stress influences glycemic control among patients with diabetes who are younger than 18 years of age. Data sources PubMed and Scopus were searched for relevant studies published since 1990 using the following key words: diabetes type 1, glycemic control, family stress, family conflict, and family function. Study selection In total, 1478 papers were identified in the initial search. The final review included 6 cohort studies, 3 cross-sectional studies, and 1 qualitative review in which family stress was assessed using specific diabetes-related conflict measurement instruments, and glycemic control was evaluated by glycosylated hemoglobin measurement. Synthesis In most studies family stress was negatively correlated with patients' glycemic control. Family function was strongly related to patients' glycemic control, while family conflict was adversely associated with glycemic control. Families of low socioeconomic status, those of adolescents with diabetes, and those of single parents were more prone to diabetes-related stress and thus more susceptible to worse glycemic control. Conclusion Therapeutic psychological interventions and educational programs can help alleviate family diabetes-related stress and will likely improve glycemic control. PMID:23418238

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

2013-01-01

23

The Role of Self-monitoring of Blood Glucose in Glycemic Control  

PubMed Central

Despite the widespread evidence that lowering glycemic levels reduces the risks of complications in diabetic patients, there has been little improvement in glycemic control among patients in the United States and Europe in recent years. Although widely used, there has been considerable controversy surrounding the role of self-monitoring of blood glucose (SMBG) as a means for achieving glycemic control. The high cost of test strips has made considerations regarding appropriate recommendations a priority, especially given our current climate of health care cost-containment. Existing clinical recommendations lack specific guidance to patients and clinicians regarding SMBG practice intensity and frequency, particularly for those not treated with insulin. Previous studies of the association between SMBG and glycemic control found often weak and sometimes conflicting evidence. Several areas in need of development were identified. A re-examination of the role of SMBG is needed with special attention to the unique needs of patients using different diabetes treatments, within special clinical sub-populations, and during initiation of SMBG versus its ongoing use. Further understanding of the intensity and frequency of SMBG needed to capture variability in glycemic patterns would facilitate more specific guideline development. Patient education programs geared toward teaching patients appropriate SMBG practice, glycemic targets and actions to be taken in response to readings would be beneficial. Continuing medical education (CME) programs that provide guidance regarding ways to utilize patients’ SMBG records to tailor medication regimens should be developed. To facilitate communicating SMBG reports to providers, a standardized format that extracts key data elements and facilitates quick review for healthcare providers would be useful. Finally, the practice of SMBG is very expensive, and thus the health economic aspects of SMBG need to be carefully assessed. PMID:16627393

Karter, Andrew J.

2014-01-01

24

Utility of different glycemic control metrics for optimizing management of diabetes  

PubMed Central

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

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

2015-01-01

25

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

PubMed

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

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

2015-02-15

26

Changes in Treatment Adherence and Glycemic Control During the Transition to Adolescence in Type 1 Diabetes  

PubMed Central

OBJECTIVE To test models of unidirectional and bidirectional change between treatment adherence and glycemic control in youth with type 1 diabetes. RESEARCH DESIGN AND METHODS We conducted a 2-year longitudinal, multisite study of 225 youth with type 1 diabetes recruited at the cusp of adolescence (aged 9–11 years) to describe the mutual influences of glycemic control as measured by HbA1c and treatment adherence as measured by blood glucose monitoring frequency (BGMF) during the transition to adolescence. RESULTS HbA1c increased from 8.2 to 8.6% (P < 0.001) and BGMF decreased from 4.9 to 4.5 checks per day (P < 0.02) during the 2-year period. Changes in the BGMF slope predicted changes in HbA1c. A change (increase) in HbA1c was associated with a change (decrease) in BGMF of 1.26 (P < 0.001) after controlling for covariates. CONCLUSIONS The magnitude of the effect of declining treatment adherence (BGMF) on glycemic control in young adolescents may be even greater than declines observed among older adolescents. BGMF offers a powerful tool for targeted management of glycemic control for type 1 diabetes during the critical transition to adolescence. PMID:22474040

Rausch, Joseph R.; Hood, Korey K.; Delamater, Alan; Shroff Pendley, Jennifer; Rohan, Jennifer M.; Reeves, Grafton; Dolan, Lawrence; Drotar, Dennis

2012-01-01

27

Failure to Control Hyperglycemia in NonCritically Ill Diabetes Patients Despite Standard Glycemic Management in a Hospital Setting  

PubMed Central

Background Successful control of hyperglycemia has been shown to improve outcomes for diabetes patients in a clinical setting. We assessed the quality of physician-based glycemic management in two general wards, considering the most recent recommendations for glycemic control for noncritically ill patients (<140 mg/dl for premeal glucose). Methods Quality of glycemic management of 50 patients in two wards (endocrinology, cardiology) was assessed retrospectively by analyzing blood glucose (BG) levels, the glycemic management effort, and the online questionnaire. Results Glycemic control was clearly above the recommended target (mean BG levels: endocrinology: 175 ± 62 mg/dl; cardiology: 186 ± 68 mg/dl). When comparing the first half with the second half of the hospital stay, we found no difference in glycemic control (endocrinology: 168 ± 32 vs 164 ± 42 mg/dl, P = .67; cardiology: 174 ± 36 mg/dl vs 170 ± 42 mg/dl, P =.51) and in insulin dose (endocrinology: 15 ± 14 IU vs 15 ± 13 IU per day, P = .87; cardiology: 27 ± 17 IU vs 27 ± 18 IU per day, P = .92), despite frequent BG measurements (endocrinology: 2.7 per day; cardiology: 3.2 per day). A lack of clearly defined BG targets was indicated in the questionnaire. Conclusions The recommended BG target range was not achieved in both wards. Analysis of routine glycemic management demonstrated considerable glycemic management effort, but also a lack of translation into adequate insulin therapy. Implementation of corrective measures, such as structured treatment protocols, is essential. PMID:23566999

Neubauer, Katharina Maria; Schaupp, Lukas; Plank, Johannes; Augustin, Thomas; Mautner, Selma Isabella; Tschapeller, Bernd; Pieber, Thomas Rudolf

2013-01-01

28

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

PubMed Central

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

Kamuhabwa, Appolinary R; Charles, Emmanuel

2014-01-01

29

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

ERIC Educational Resources Information Center

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

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

2002-01-01

30

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

PubMed Central

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

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

2012-01-01

31

Effect of American ginseng (Panax quinquefolius L.) on glycemic control in type 2 diabetes.  

PubMed

Since diabetes tends to progressively worsen over time, glycemic control often deteriorates in spite of taking regular therapy. Therefore, numerous research studies are by and large focused on finding more efficient therapy, both new medicines for treating type 2 diabetes mellitus, as well as supplements that could serve as an addition to conventional treatment modalities. A variety of herbal preparations have been shown to have modest short-term beneficial effects on glycemia, but of these, the best studied is American ginseng (AG). AG has been shown to be effective in improving glycemic control in type 2 diabetes through increasing post-prandial insulin levels and decreasing postprandial glycemic response. However, high variability in ginsenosides may result in just as high variability in antidiabetic efficacy of over-the-counter ginseng products. Therefore, the availability of standardized extracts of AG could assist greatly in advancing our knowledge on the role of this traditionally used herb and result in a wider application of ginseng product in diabetes management. The aim of this review is to outline the efficacy and safety of American ginseng for AG preparations on glycemic control in patients with type 2 diabetes as well as to increase awareness of the evidence supporting the use of these therapies in diabetes care. PMID:23390846

Mucalo, Iva; Raheli?, Dario; Jovanovski, Elena; Bozikov, Velimir; Romi?, Zeljko; Vuksan, Vladimir

2012-12-01

32

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

PubMed Central

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

2013-01-01

33

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

PubMed Central

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

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

2014-01-01

34

Longitudinal Patterns of Glycemic Control and Diabetes Care from Diagnosis in a Population-based Cohort with Type 1 Diabetes  

Microsoft Academic Search

Glycosylated hemoglobin is an indicator of long-term glycemic control and a strong predictor of diabetic complications. This paper provides a comprehensive description of glycemic control (total glycosylated hemoglobin (GHb)) up to 4.5 years duration of diabetes by age, duration, and sex in a population-based cohort (n = 507) aged less than 20 years followed from diagnosis of Type 1 diabetes

Mari Palta; Guanghong Shen; Catherine Allen; Ronald Klein; Donn D'Alessio

35

Chronotype Is Independently Associated With Glycemic Control in Type 2 Diabetes  

PubMed Central

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

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

2013-01-01

36

The Role of Prestroke Glycemic Control on Severity and Outcome of Acute Ischemic Stroke  

PubMed Central

Background/Aim. Relatively few studies have investigated the association of prestroke glycemic control and clinical outcome in acute ischemic stroke (IS) patients, regardless of presence of diabetes mellitus (DM). The aim of this study was to investigate the importance of prestroke glycemic control on survival, stroke severity, and functional outcome of patients with acute IS. Methods. We performed a retrospective survival analysis of 501 patients with IS admitted to Sahlgrenska University Hospital from February 15, 2005, through May 31, 2009. The outcomes of interest were acute and long-term survival; the stroke severity (NIHSS) and the functional outcome, mRS, at 12 months. Results. HbA1c was a good predictor of acute (HR 1.45; CI, 1.09 to 1.93, P = 0.011) and long-term mortality (HR 1.29; CI 1.03 to 1.62; P = 0.029). Furthermore, HbA1c >6% was significantly correlated with acute stroke severity (OR 1.29; CI 1.01 to 1.67; P = 0.042) and predicted worse functional outcome at 12 months (OR 2.68; CI 1.14 to 6.03; P = 0.024). Conclusions. Our study suggests that poor glycemic control (baseline HbA1c) prior to IS is an independent risk factor for poor survival and a marker for increased stroke severity and unfavorable long-term functional outcome. PMID:25295219

Manhem, Karin; Bokemark, Lena; Andersson, Björn

2014-01-01

37

Effect of glycemic control on soluble RAGE and oxidative stress in type 2 diabetic patients  

PubMed Central

Background The interaction of advanced glycation end products (AGEs) and its receptor (RAGE) has played an important role in the pathogenesis of diabetes and its complications. A soluble form of RAGE (sRAGE) has been reported as a decoy receptor for AGEs. Oxidative stress is demonstrated in pathological condition such as atherosclerosis and diabetes mellitus. It has been suggested to be involved in the pathogenesis of both macro- and microvascular complications. This study was designed to evaluate the effect of glycemic control on sRAGE and oxidative stress markers in type 2 diabetic patients. Methods Seventy patients with type 2 diabetes and 20 healthy subjects were recruited into the study. Blood glutathione (GSH) and plasma total nitric oxide (NOx) levels were measured using commercially available colorimetric kits, blood superoxide dismutase (SOD) activity was measured by the method of Marklund and Marklund, and plasma C-peptide, oxidized LDL (ox-LDL), sRAGE, and VCAM-1 levels were measured using competitive ELISA kits. Results Plasma sRAGE levels were significantly lower (p?controlled diabetic patients compared with healthy control. Blood GSH levels were significantly lower in diabetic patients compared with healthy control (p?control. Plasma levels of sRAGE were negatively associated with circulating VCAM-1 levels in diabetic patients. Conclusion Poor glycemic control decreases plasma sRAGE and increases VCAM-1 levels while good glycemic control improves these abnormalities which provides benefit to diabetic patients. PMID:23964833

2013-01-01

38

Glibenclamide or Metformin Combined with Honey Improves Glycemic Control in Streptozotocin-Induced Diabetic Rats  

PubMed Central

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

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

2011-01-01

39

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

PubMed

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

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

2011-01-01

40

From Caregiver Psychological Distress to Adolescent Glycemic Control: The Mediating Role of Perceived Burden around Diabetes Management  

PubMed Central

Objective?To examine whether perceived caregiver burden around diabetes management mediated the relationship between caregivers’ psychological distress and adolescents’ glycemic control.?Methods?Across three visits spanning 9 months, caregivers of 147 adolescents with type 1 diabetes completed measures of anxiety and depressive symptoms and a measure of perceived burden specific to diabetes management. Adolescents’ glycemic control was also measured.?Results?Perceived burden mediated the relationship between caregiver depressive symptoms and adolescents’ glycemic control. The overall model was significant, F(10,132) = 5.0, p < .001, R2 = 0.27. Fifty percent of the relationship was explained by diabetes-specific burden. The relationship between caregiver anxiety symptoms and adolescent glycemic control was partially mediated by diabetes-specific burden, F(10,133) = 5.7, p < .001, R2 = 0.30, explaining 26% of this relationship.?Discussion?A variable linking caregiver psychological distress to adolescent glycemic control is perceived caregiver burden around diabetes management. Implications for clinical practice include targeting caregiver psychological functioning and reducing global and diabetes-specific distress. PMID:20736389

Cunningham, Natoshia Raishevich; Vesco, Anthony T.; Dolan, Lawrence M.

2011-01-01

41

Vigorous intensity exercise for glycemic control in patients with type 1 diabetes.  

PubMed

Regular physical activity has substantial health benefits in persons with type 1 diabetes, including reduced risk of complications and cardiovascular mortality as well as improved self-rated quality of life. Despite these benefits, individuals with type 1 diabetes are often less active than their peers without diabetes. When factors such as time constraints, work pressure and environmental conditions are often cited as barriers to physical activity in the general population, 2 additional major factors may also explain the low rates of physical activity in young people with type 1 diabetes: (1) fear of hypoglycemia both during and after (particularly overnight) exercise and (2) a lack of empiric evidence for the efficacy of physical activity for achieving optimal glycemic control. A number of acute exercise trials recently showed that the inclusion of vigorous intensity physical activity in conventional moderate intensity (i.e. walking and light cycling) exercise sessions may overcome these barriers. No studies have tested the efficacy of high-intensity physical activity on glycemic control (A1C) or post-exercise hypoglycemia in a randomized controlled trial. This article summarizes the literature related to the role of physical activity for the management of blood glucose levels in individuals with type 1 diabetes and provides a rationale for the need of a randomized controlled trial examining the effects of vigorous-intensity physical activity on blood glucose control. PMID:24321725

Yardley, Jane; Mollard, Rebecca; MacIntosh, Andrea; MacMillan, Freya; Wicklow, Brandy; Berard, Lori; Hurd, Carmen; Marks, Seth; McGavock, Jonathan

2013-12-01

42

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

PubMed

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/m(2). 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

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

2014-05-01

43

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....

44

Tight glycemic control and computerized decision-support systems: a systematic review  

Microsoft Academic Search

Objective  To identify and summarize characteristics of computerized decision-support systems (CDSS) for tight glycemic control (TGC)\\u000a and to review their effects on the quality of the TGC process in critically ill patients.\\u000a \\u000a \\u000a \\u000a Methods  We searched Medline (1950–2008) and included studies on critically ill adult patients that reported original data from a clinical\\u000a trial or observational study with a main objective of evaluating

Saeid Eslami; Ameen Abu-Hanna; Evert de Jonge; Nicolette F. de Keizer

2009-01-01

45

Dietary Behaviors Predict Glycemic Control in Youth With Type 1 Diabetes  

PubMed Central

OBJECTIVE—To investigate the association between dietary adherence and glycemic control among youth with type 1 diabetes. RESEARCH DESIGN AND METHODS—We conducted a cross-sectional analysis of 119 youth aged 9–14 years (mean ± SD 12.1 ± 1.6 years) with diabetes duration ?1 year (5.4 ± 3.1 years). Dietary adherence was assessed using the Diabetes Self-Management Profile diet domain. Higher score defined greater dietary adherence. Glycemic control was determined by A1C. RESULTS—Dietary adherence score was inversely correlated with A1C (r = ?0.36, P < 0.0001). In a multivariate model (R2 = 0.34, P < 0.0001), dietary adherence (P = 0.004), pump use (P = 0.03), and caregiver education (P = 0.01) were associated with A1C. A1C of youth in the lowest (9.0%) tertile of diet score was higher than A1C of youth in the middle (8.1%, P = 0.004) and upper (8.4%, P = 0.06) tertiles. Dietary adherence uniquely explained 8% of the variance in A1C in the model. CONCLUSIONS—Greater dietary adherence was associated with lower A1C among youth with type 1 diabetes. PMID:18390798

Mehta, Sanjeev N.; Volkening, Lisa K.; Anderson, Barbara J.; Nansel, Tonja; Weissberg-Benchell, Jill; Wysocki, Tim; Laffel, Lori M.B.

2008-01-01

46

Blood Viscosity, Lipid Profile, and Lipid Peroxidation in Type-1 Diabetic Patients with Good and Poor Glycemic Control  

PubMed Central

Background: In diabetic patients, persistent hyperglycemia and poor glycemic control cause disturbances of lipid profiles, especially an increased production of oxygen free radicals. Lipid peroxidation has been considered to be a pathogenic factor of diabetic complications in Type-1 Diabetes mellitus. Aims: The aim of the present study was to investigate the effect of glycemic control on blood viscosity, lipid profile, and lipid peroxidation in Type-1 Diabetic subjects. Materials and Methods: The study included three groups; Group-I (age-matched healthy control subjects, n = 50), Group-II (Type-1 Diabetics with good glycemic control, n = 10), and Group-III (Type-1 Diabetics with poor glycemic control, n = 15). The Type 1 diabetic patients with duration of diabetes for more than 5 years were taken. Blood samples of all subjects were analyzed for all biochemical, hematological, and oxidative stress parameters. Results: The Erythrocyte malondialdehyde level was non-significantly changed (P = NS) in group–II patients but significantly increased (P < 0.001) in group-III patients, and no significant changes were found (P = NS) in Blood viscosity of both the groups (group-II and group-III), as compared to healthy control subjects (group-I). Conclusions: Our findings suggest that the monitoring of Oxidative stress and Blood Viscosity in poorly controlled Type-1 diabetic patients may be very useful marker of diabetic complications. PMID:24251275

Mishra, Neetu; Singh, Neelima

2013-01-01

47

CPAP Therapy of Obstructive Sleep Apnea in Type 2 Diabetics Improves Glycemic Control During Sleep  

PubMed Central

Background: Type 2 diabetes and obstructive sleep apnea (OSA) are frequently comorbid conditions. OSA is associated with increased insulin resistance, but studies of continuous positive airway pressure (CPAP) have shown inconsistent effects on glycemic control. However, endpoints such as hemoglobin A1c and insulin sensitivity might not reflect short-term changes in glycemic control during sleep. Methods: We used a continuous glucose-monitoring system to measure interstitial glucose every 5 minutes during polysomnography in 20 patients with type 2 diabetes and newly diagnosed OSA. The measurements were repeated after an average of 41 days of CPAP (range 26–96 days). All patients were on a stable diet and medications. Each 30-second epoch of the polysomnogram was matched with a continuous glucose-monitoring system reading, and the sleeping glucose level was calculated as the average for all epochs scored as sleeping. Results: The mean sleeping glucose decreased from untreated (122.0 ± 61.7 mg/dL) to treated (102.9 ± 39.4 mg/dL; p = 0.03 by Wilcoxon paired rank test). The sleeping glucose was more stable after treatment, with the median SD decreasing from 20.0 to 13.0 mg/dL (p = 0.005) and the mean difference between maximum and minimum values decreasing from 88 to 57 mg/dL (p = 0.003). The change in the mean hemoglobin A1c from 7.1% to 7.2% was not significant. Conclusions: Our study is limited by the lack of a control group, but the results suggest that sleeping glucose levels decrease and are more stable after patients with type 2 diabetes and OSA are treated with CPAP. Citation: Dawson A; Abel SL; Loving RT; Dailey G; Shadan FF; Cronin JW; Kripke DF; Kline LE. CPAP therapy of obstructive sleep apnea in type 2 diabetics improves glycemic control during sleep. J Clin Sleep Med 2008;4(6):538–542. PMID:19110882

Dawson, Arthur; Abel, Susan L.; Loving, Richard T.; Dailey, George; Shadan, Farhad F.; Cronin, John W.; Kripke, Daniel F.; Kline, Lawrence E.

2008-01-01

48

Glycemic control and cardiovascular mortality in hemodialysis patients with diabetes: a 6-year cohort study.  

PubMed

Previous observational studies using differing methodologies have yielded inconsistent results regarding the association between glycemic control and outcomes in diabetic patients receiving maintenance hemodialysis (MHD). We examined mortality predictability of A1C and random serum glucose over time in a contemporary cohort of 54,757 diabetic MHD patients (age 63 ± 13 years, 51% men, 30% African Americans, 19% Hispanics). Adjusted all-cause death hazard ratio (HR) for baseline A1C increments of 8.0-8.9, 9.0-9.9, and ?10%, compared with 7.0-7.9% (reference), was 1.06 (95% CI 1.01-1.12), 1.05 (0.99-1.12), and 1.19 (1.12-1.28), respectively, and for time-averaged A1C was 1.11 (1.05-1.16), 1.36 (1.27-1.45), and 1.59 (1.46-1.72). A symmetric increase in mortality also occurred with time-averaged A1C levels in the low range (6.0-6.9%, HR 1.05 [95% CI 1.01-1.08]; 5.0-5.9%, 1.08 [1.04-1.11], and ?5%, 1.35 [1.29-1.42]) compared with 7.0-7.9% in fully adjusted models. Adjusted all-cause death HR for time-averaged blood glucose 175-199, 200-249, 250-299, and ?300 mg/dL, compared with 150-175 mg/dL (reference), was 1.03 (95% CI 0.99-1.07), 1.14 (1.10-1.19), 1.30 (1.23-1.37), and 1.66 (1.56-1.76), respectively. Hence, poor glycemic control (A1C ?8% or serum glucose ?200 mg/dL) appears to be associated with high all-cause and cardiovascular death in MHD patients. Very low glycemic levels are also associated with high mortality risk. PMID:22315308

Ricks, Joni; Molnar, Miklos Z; Kovesdy, Csaba P; Shah, Anuja; Nissenson, Allen R; Williams, Mark; Kalantar-Zadeh, Kamyar

2012-03-01

49

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

PubMed Central

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

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

2014-01-01

50

Effect of glycemic control on microalbuminuria development among type 2 diabetes with high-normal albuminuria.  

PubMed

This study was aimed at revealing the factors and the interrelationships between factors on microalbuminuria development among type 2 diabetes (T2D) patients. Between 2004 and 2011, 461 T2D patients with a baseline urine albumin-to-creatinine ratio (UACR) of <30?mg/g, and an estimated glomerular filtration rate (eGFR) of >60?mL/min were evaluated retrospectively. Sixty-eight (14.8%) subjects had developed microalbuminuria in a mean follow-up of 6.82 years. Statistical analysis had revealed that the higher baseline UACR (10?mg/g; sensitivity, 80.9%, specificity, 63.6%; AUC?=?0.774) and glycohemoglobin level (HbA1c) (8%; sensitivity, 72.1%, specificity, 61.6%; AUC?=?0.698) were the two independent microalbuminuria risk factors. When considering the risk of microalbuminuria, the data were normalized with respect to subjects with low-normal UACR (<10?mg/g) and HbA1c??8%, high-normal UACR/HbA1c?8% were 2.59 (p?=?0.107), 6.15 (p?=?0.001), and 16.96 (p?10%) showed a progressively increase of the hazard risk in baseline high-normal UACR group. But the same correlation was not shown in the low-normal UACR group. This study identified the relationships of high-normal albuminuria and glycemic control on microalbuminuria development among T2D patients. Glycemic control is especially beneficial for T2D patients with baseline high-normal UACR in preventing microalbuminuria development. PMID:24028605

Chen, Wei-Zhi; Hung, Cheng-Chieh; Wen, Yu-Wen; Ning, Hsiao-Chen; Gau, Bing-Ru; Huang, Yu-Yao

2014-03-01

51

Relationship Between Glycemic Control and Depression Among American Indians in the Strong Heart Study  

PubMed Central

Objectives To examine the relationship between depression and glycemic control in the Strong Heart Study (SHS), a longitudinal study of cardiovascular disease in American Indians. Methods This cross sectional analysis focused on the relationship between depression, diabetes, and glycemic control among 2,832 individuals ?age 15. Depression was measured by the CES-D scale and diabetes by American Diabetes Association criteria. An ordered logit regression model was used to assess whether diabetes was related to level of depression (none, mild, moderate, severe). Multiple logistic regression was used to explore the relationship between A1c and severe depression in participants with diabetes. Results Rates of depression were higher in men and women with diabetes when compared to those without diabetes, respectively (p<.05). For every 1-unit increase in A1c, the odds of severe depression increased by 22% (OR 1.22, 95% CI: 1.05–1.42). Female gender (OR 2.97, 95% CI: 1.32–6.69) and BMI (OR 1.04, 95% CI: 1.00–1.08) also were significantly associated with increased risk for severe depression. Although BMI appears to be significantly associated with increased risk for severe depression, the magnitude of this effect was small. Conclusions Individuals with diabetes have higher rates of depression than those without diabetes, consistent with other populations. There is a positive relationship between severity of depression and A1c levels; men and women with severe depression have higher A1c levels than those with moderate-to-no depression. PMID:19454372

Calhoun, Darren; Beals, Janette; Carter, Elizabeth A.; Mete, Mihriye; Welty, Thomas K.; Fabsitz, Richard R.; Lee, Elisa T.; Howard, Barbara V.

2014-01-01

52

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

PubMed Central

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

Zhang, Ting; Dong, H. Henry

2014-01-01

53

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

PubMed Central

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

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

2009-01-01

54

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

PubMed Central

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

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

2015-01-01

55

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

PubMed Central

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

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

2014-01-01

56

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

Microsoft Academic Search

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

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

2011-01-01

57

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

PubMed Central

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

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

2014-01-01

58

Patient-reported use of collaborative goal setting and glycemic control among patients with diabetes  

PubMed Central

Objective Little is known about how patient-clinician communication leads to better outcomes. Among patients with diabetes, we describe patient-reported use of collaborative goal setting and evaluate whether perceived competency and physician trust mediate the association between collaborative goal setting and glycemic control. Methods Data from a patient survey administered in 2008 to a cohort of insured patients aged 18+ years with diabetes who initiated oral mono-therapy between 2000–2005 were joined with pharmaceutical claims data for the prior 12 months and laboratory data for the prior and subsequent 12 months (N=1,065). A structural equation model (SEM) was used to test mediation models controlling for baseline HbA1c. Results The hypothesized mediation model was supported. Patient-reported use of more collaborative goal setting was associated with greater perceived self-management competency and increased level of trust in the physician (p<0.05). In turn, both greater perceived competence and increased trust were associated with increased control (p< 0.05). Conclusions Findings indicate that engaging patients in collaborative goal setting during clinic encounters has potential to foster a trusting patient-clinician relationship as well as enhance patient perceived competence, thereby improving clinical control. Practice Implications Fostering collaborative goal setting may yield payoffs in improved clinical outcomes among patients with diabetes. PMID:23433777

Lafata, Jennifer Elston; Morris, Heather L.; Dobie, Elizabeth; Heisler, Michele; Werner, Rachel M.; Dumenci, Levent

2014-01-01

59

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

PubMed Central

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

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

2014-01-01

60

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

PubMed Central

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

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

2015-01-01

61

The Effects of Salsalate on Glycemic Control in Patients With Type 2 Diabetes  

PubMed Central

Background Salsalate, a nonacetylated prodrug of salicylate, has been shown to decrease blood glucose concentration in small studies. Objective To compare the efficacy and safety of salsalate at different doses in patients with type 2 diabetes. Design Parallel randomized trial with computer-generated randomization and centralized allocation. Patients and investigators, including those assessing outcomes and performing analyses, were masked to group assignment. (ClinicalTrials.gov registration number: NCT00392678) Setting 3 private practices and 14 universities in the United States. Patients Persons aged 18 to 75 years with fasting plasma glucose concentrations of 12.5 mmol/L or less (?225 mg/dL) and hemoglobin A1c (HbA1c) levels of 7.0% to 9.5% treated by diet, exercise, and oral medication at stable doses for at least 8 weeks. Intervention After a 4-week, single-masked run-in period, patients were randomly assigned to receive placebo or salsalate in dosages of 3.0, 3.5, or 4.0 g/d for 14 weeks (27 patients each) in addition to their current therapy. Measurements Change in HbA1c was the primary outcome. Adverse effects and changes in measures of coronary risk and renal function were secondary outcomes. Results Higher proportions of patients in the 3 salsalate treatment groups experienced decreases in HbA1c levels of 0.5% or more from baseline (P = 0.009). Mean HbA1c changes were ?0.36% (P = 0.02) at 3.0 g/d, ?0.34% (P = 0.02) at 3.5 g/d, and ?0.49% (P = 0.001) at 4.0 g/d compared with placebo. Other markers of glycemic control also improved in the 3 salsalate groups, as did circulating triglyceride and adiponectin concentrations. Mild hypoglycemia was more common with salsalate; documented events occurred only in patients taking sulfonylureas. Urine albumin concentrations increased in all salsalate groups compared with placebo. The drug was otherwise well tolerated. Limitation The number of patients studied and the trial duration were insufficient to warrant recommending the use of salsalate for type 2 diabetes at this time. Conclusion Salsalate lowers HbA1c levels and improves other markers of glycemic control in patients with type 2 diabetes and may therefore provide a new avenue for treatment. Renal and cardiac safety of the drug require further evaluation. Primary Funding Source National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. PMID:20231565

Goldfine, Allison B.; Fonseca, Vivian; Jablonski, Kathleen A.; Pyle, Laura; Staten, Myrlene A.; Shoelson, Steven E.

2011-01-01

62

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

Microsoft Academic Search

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

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

2001-01-01

63

Effects of High Performance Inulin Supplementation on Glycemic Control and Antioxidant Status in Women with Type 2 Diabetes  

PubMed Central

Background The purpose of this study was to evaluate the effects of high performance inulin supplementation on blood glycemic control and antioxidant status in women with type 2 diabetes. Methods In a randomized, triple-blind controlled trial, 49 females (fiber intake <30 g/day, 25control, n=25) for 2 months. Fasting blood samples were obtained and both glycemic control and antioxidant status were determined at baseline and at the end of the study. Results At the end of the study period, there were significant decreases in fasting plasma glucose (8.47%), glycosylated hemoglobin (10.43%), and malondialdehyde (37.21%) levels and significant increases in total antioxidant capacity (18.82%) and superoxide dismutase activity (4.36%) in the inulin group when compared to the maltodextrin group (P<0.05). Changes in fasting insulin, homeostasis model assessment of insulin resistance, and catalase activity were not significant in the inulin group when compared with the maltodextrin group. Glutathione peroxidase activity remained unchanged in both groups. Conclusion Inulin supplementation may improve some glycemic and antioxidant indices and decrease malondialdehyde levels in women with type 2 diabetes. Further investigations are needed in order to confirm the positive effects that inulin may have on the glycemic and antioxidant indices of patients with type 2 diabetes. PMID:23641355

Pourghassem Gargari, Bahram; Aliasgharzadeh, Akbar; Asghari Jafar-abadi, Mohammad

2013-01-01

64

Are the glycemic and insulinemic index values of carbohydrate foods similar in healthy control, hyperinsulinemic and type 2 diabetic patients?  

Microsoft Academic Search

Background\\/Objectives:a criticism of glycemic index (GI) is that it does not indicate the insulin response of foods (insulinemic index, II). However, it is unknown if the GI and II values of foods are equivalent in all subjects, a necessary criterion for clinical utility. We compared GI and II values in non-diabetic subjects with fasting-serum-insulin (FSI) <40 pmol\\/l (healthy control) or

X Lan-Pidhainy; T M S Wolever; TMS Wolever

2011-01-01

65

Differences in glycemic control and cardiovascular risk in primary care patients with type 2 diabetes in West Indies  

Microsoft Academic Search

There are limited resources and facilities at primary care clinics in most developing countries. Medical professionals are\\u000a often faced with the challenges of providing standard health care delivery in the absence of adequate resources. We aimed\\u000a to evaluate the long-term glycemic control and risk of cardiovascular disease in multi-ethnic groups of diabetic patients\\u000a attending primary care clinics in Trinidad. One

C. E. EzenwakaN; N. V. Offiah

2001-01-01

66

Factors Associated with Glycemic Control in Patients with Type 2 Diabetes Mellitus in Rural Areas of the United States  

Microsoft Academic Search

Background: According to the US Department of Health and Human Services, an estimated 18.2 million Americans, or 6.3% of the population, has diabetes mellitus (DM). Approximately 90% of these individuals have type 2 DM. The most widely used clinical test for defining glycemic control is measurement of blood glycosylated hemoglobin (AIC).Objective: The goal of this study was to estimate the

Yue-Fang Chang

2007-01-01

67

Adherence and Glycemic Control among Hispanic Youth with Type 1 Diabetes: Role of Family Involvement and Acculturation  

PubMed Central

Objective?To assess whether family involvement and acculturation were related to adherence and glycemic control among Hispanic youth with type 1 diabetes (T1D).?Methods?Hispanic youth with T1D (n = 111; M age = 13.33; 53% female) and parents completed questionnaires that assessed diabetes-related family involvement (distribution of responsibility for diabetes, family support for diabetes), acculturation (linguistic acculturation, generational status), and adherence. HbA1c levels indexed glycemic control.?Results?Better adherence was associated with less adolescent independent responsibility, more family support for diabetes, and more recent immigration (fewer generations of the family living in US). Family support mediated the relationship between responsibility and adherence. Better glycemic control was associated with higher levels of parental education and adherence.?Conclusions?Family support for diabetes is important for adherence among Hispanic youth with T1D. Research should examine aspects of recent immigration that contribute to better adherence and the impact of supportive interventions on diabetes care. PMID:19491214

La Greca, Annette M.; Valenzuela, Jessica; Moine, Cortney Taylor; Delamater, Alan

2010-01-01

68

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

PubMed Central

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

2014-01-01

69

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

PubMed

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 and 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

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

2015-01-01

70

Postprandial glycemic control with biphasic insulin aspart in patients with type 1 diabetes.  

PubMed

We sought to investigate the ability of biphasic insulin aspart 30 (BIAsp 30) to control postprandial hyperglycemia and hyperlipidemia in a meal-test comparison with biphasic human insulin 30 (BHI 30). In this randomised crossover trial, 50 patients with type 1 diabetes (mean age, 35.7 +/- 9.4 years; body mass index [BMI], 24.0 +/- 2.6 kg/m(2); HbA(1c), 8.6% +/- 1.1%) were studied on 3 separate days, where the following treatments were given in random order: BIAsp 30 injected immediately before a standard breakfast, BHI 30 injected 30 minutes before breakfast (BHI 30(t=-30)), and BHI 30 injected immediately before breakfast (BHI 30(t=0)). The dose was 0.40 U/kg for all 3 treatments. BIAsp 30 reduced the area under the baseline adjusted 4-hour postprandial serum glucose curve (AUC(0-4h)) by 23% compared with BHI 30(t=0) (P <.0001) and by 9% compared with BHI 30(t=-30) (P =.013). Maximum serum glucose concentration (C(max)) was lower for BIAsp 30 compared with BHI 30(t=0) (14.0 +/- 2.4 v 16.5 +/- 2.8 mmol/L, P <.0001), and time to maximal serum glucose concentration (t(max)) was approximately 20 minutes shorter for BIAsp 30, irrespective of timing of BHI 30 injection (P <.0001). There were no significant differences among the 3 treatments with respect to postprandial levels of free fatty acids or triglycerides. The pharmacokinetic results were consistent with the above observations, ie, significantly larger insulin AUC(0-4h), higher C(max) and shorter t(max) were observed for BIAsp 30 compared with BHI 30, irrespective of timing of BHI 30 injection. We conclude that postprandial glycemic control was more effective with BIAsp 30 than with BHI 30, irrespective of timing of BHI 30 injection. PMID:12077738

Hermansen, Kjeld; Vaaler, Stein; Madsbad, Sten; Dalgaard, Marian; Zander, Mette; Begtrup, Kamilla; Soendergaard, Karsten

2002-07-01

71

DURATION-1: Exenatide Once Weekly Produces Sustained Glycemic Control and Weight Loss Over 52 Weeks  

PubMed Central

OBJECTIVE In the Diabetes Therapy Utilization: Researching Changes in A1C, Weight and Other Factors Through Intervention with Exenatide Once Weekly (DURATION-1) study, the safety and efficacy of 30 weeks of treatment with the glucagon-like peptide-1 receptor agonist exenatide once weekly (exenatide QW; 2 mg) was compared with exenatide BID in 295 patients with type 2 diabetes. We now report the safety and efficacy of exenatide QW in 1) patients who continued treatment for an additional 22 weeks (52 weeks total) and 2) patients who switched from exenatide BID to exenatide QW after 30 weeks. RESEARCH DESIGN AND METHODS In this randomized, multicenter, comparator-controlled, open-label trial, 258 patients entered the 22-week open-ended assessment phase (n = 128 QW-only; n = 130 BID?QW). A1C, fasting plasma glucose (FPG), body weight, blood pressure, fasting lipids, safety, and tolerability were assessed. RESULTS Patients continuing exenatide QW maintained A1C improvements through 52 weeks (least squares mean ?2.0% [95% CI ?2.1 to ?1.8%]). Patients switching from exenatide BID to exenatide QW achieved further A1C improvements; both groups exhibited the same A1C reduction and mean A1C (6.6%) at week 52. At week 52, 71 and 54% of all patients achieved A1C <7.0% and ?6.5%, respectively. In both treatment arms, FPG was reduced by >40 mg/dl, and body weight was reduced by >4 kg after 52 weeks. Nausea occurred less frequently in this assessment period and was predominantly mild. No major hypoglycemia was observed. CONCLUSION Exenatide QW elicited sustained improvements in glycemic control and body weight through 52 weeks of treatment. Patients switching to exenatide QW experienced further improvements in A1C and FPG, with sustained weight loss. PMID:20215461

Buse, John B.; Drucker, Daniel J.; Taylor, Kristin L.; Kim, Terri; Walsh, Brandon; Hu, Hao; Wilhelm, Ken; Trautmann, Michael; Shen, Larry Z.; Porter, Lisa E.

2010-01-01

72

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

PubMed Central

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

Gardner, Andrew John

2014-01-01

73

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

PubMed Central

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

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

2015-01-01

74

Clinical review: Consensus recommendations on measurement of blood glucose and reporting glycemic control in critically ill adults.  

PubMed

The management reporting and assessment of glycemic control lacks standardization. The use of different methods to measure the blood glucose concentration and to report the performance of insulin treatment yields major disparities and complicates the interpretation and comparison of clinical trials. We convened a meeting of 16 experts plus invited observers from industry to discuss and where possible reach consensus on the most appropriate methods to measure and monitor blood glucose in critically ill patients and on how glycemic control should be assessed and reported. Where consensus could not be reached, recommendations on further research and data needed to reach consensus in the future were suggested. Recognizing their clear conflict of interest, industry observers played no role in developing the consensus or recommendations from the meeting. Consensus recommendations were agreed for the measurement and reporting of glycemic control in clinical trials and for the measurement of blood glucose in clinical practice. Recommendations covered the following areas: How should we measure and report glucose control when intermittent blood glucose measurements are used? What are the appropriate performance standards for intermittent blood glucose monitors in the ICU? Continuous or automated intermittent glucose monitoring - methods and technology: can we use the same measures for assessment of glucose control with continuous and intermittent monitoring? What is acceptable performance for continuous glucose monitoring systems? If implemented, these recommendations have the potential to minimize the discrepancies in the conduct and reporting of clinical trials and to improve glucose control in clinical practice. Furthermore, to be fit for use, glucose meters and continuous monitoring systems must match their performance to fit the needs of patients and clinicians in the intensive care setting. PMID:23767816

Finfer, Simon; Wernerman, Jan; Preiser, Jean-Charles; Cass, Tony; Desaive, Thomas; Hovorka, Roman; Joseph, Jeffrey I; Kosiborod, Mikhail; Krinsley, James; Mackenzie, Iain; Mesotten, Dieter; Schultz, Marcus J; Scott, Mitchell G; Slingerland, Robbert; Van den Berghe, Greet; Van Herpe, Tom

2013-01-01

75

Clinical review: Consensus recommendations on measurement of blood glucose and reporting glycemic control in critically ill adults  

PubMed Central

The management reporting and assessment of glycemic control lacks standardization. The use of different methods to measure the blood glucose concentration and to report the performance of insulin treatment yields major disparities and complicates the interpretation and comparison of clinical trials. We convened a meeting of 16 experts plus invited observers from industry to discuss and where possible reach consensus on the most appropriate methods to measure and monitor blood glucose in critically ill patients and on how glycemic control should be assessed and reported. Where consensus could not be reached, recommendations on further research and data needed to reach consensus in the future were suggested. Recognizing their clear conflict of interest, industry observers played no role in developing the consensus or recommendations from the meeting. Consensus recommendations were agreed for the measurement and reporting of glycemic control in clinical trials and for the measurement of blood glucose in clinical practice. Recommendations covered the following areas: How should we measure and report glucose control when intermittent blood glucose measurements are used? What are the appropriate performance standards for intermittent blood glucose monitors in the ICU? Continuous or automated intermittent glucose monitoring - methods and technology: can we use the same measures for assessment of glucose control with continuous and intermittent monitoring? What is acceptable performance for continuous glucose monitoring systems? If implemented, these recommendations have the potential to minimize the discrepancies in the conduct and reporting of clinical trials and to improve glucose control in clinical practice. Furthermore, to be fit for use, glucose meters and continuous monitoring systems must match their performance to fit the needs of patients and clinicians in the intensive care setting. See related commentary by Soto-Rivera and Agus, http://ccforum.com/content/17/3/155 PMID:23767816

2013-01-01

76

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...

77

Dyadic Measures of the Parent-Child Relationship During the Transition to Adolescence and Glycemic Control in Children with Type 1 Diabetes  

PubMed Central

To identify aspects of family behavior associated with glycemic control in youth with type 1 diabetes mellitus (T1DM) during the transition to adolescence, we 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, we derived 2 dyadic variables, frequency of agreement (parent and child concurred exactly on who was responsible for a task) and frequency of discordance (parent and child had completely opposite reports of who was responsible). To examine the relationship between these variables and age, we divided the cohort into Younger (n = 57, M = 10.6 yrs) and Older (n = 64, M = 13.5 yrs) age groups. Family conflict was significantly related to glycemic control in the entire cohort and in both the Younger and Older age groups. However, only in the Younger (pre-teen) group was Agreement about responsibility for diabetes tasks related to glycemic control, with higher Agreement associated with better glycemic control. Findings suggest that Agreement about sharing of diabetes management responsibilities may be an important target for family-based interventions with pre-teen youth to optimize glycemic control during their transition to adolescence. PMID:19630455

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

2009-01-01

78

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

PubMed Central

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

2013-01-01

79

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

PubMed

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

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

2009-06-01

80

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

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

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

81

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

PubMed Central

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

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

2014-01-01

82

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

PubMed Central

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

Forbes, Neil Christopher; Anders, Nicola

2014-01-01

83

Glycemic control influences lung membrane diffusion and oxygen saturation in exercise-trained subjects with type 1 diabetes  

Microsoft Academic Search

Lung diffusing capacity (DLCO) is influenced by alveolar-capillary membrane conductance (D\\u000a M) and pulmonary capillary blood volume (V\\u000a C), both of which can be impaired in sedentary type 1 diabetes mellitus (T1DM) subjects due to hyperglycemia. We sought to\\u000a determine if T1DM, and glycemic control, affected DLNO, DLCO, D\\u000a M, V\\u000a C and SaO2 during maximal exercise in aerobically fit

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

2011-01-01

84

Impact of lifestyle modification on glycemic control in patients with type 2 diabetes mellitus  

PubMed Central

Background: Current treatment guidelines support the role of lifestyle modification, in terms of increasing the quantity and quality of physical activity to achieve target glycemia in patients with type 2 diabetes mellitus. Objective: To assess the effect of structured exercise training and unstructured physical activity interventions on glycemic control. Materials and Methods: This was a randomized six-month exercise intervention study conducted with previously inactive 279 patients of type 2 diabetes mellitus. Before randomization, all enrolled T2DM participants (n: 300; 30 to 60 year old, having diabetes for more than a year with HbA1c levels of 6.5% or higher) entered a one-month run-in phase to reduce dropout and maintain adherence. Results: A recommendation to increase physical activity was beneficial (0.14% HbA1c reduction; P = 0.12), but was not bringing significantly declines in HbA1c, whereas, structured exercise training is associated with a significant HbA1c decline of 0.59%. (P = 0.030). In a subgroup analysis limited to participants with a baseline HbA1c value > 7%, both the unstructured (0. 48%; P = 0.04) and structured exercise training (0.77%; P < 0.01) groups experienced significant decline in HbA1c Vs the control, whereas among participants with baseline hemoglobin A1c values less than 7%, significant reduction occurred only in the structured exercise training group. Changes in blood pressure; total cholesterol, HDL-cholesterol (high-density lipoprotein), LDL-cholesterol (low-density lipoprotein) and the atherogenic index factors did not statistically significantly differ within (baseline to follow-up) and among groups. Conclusion: Supervised structured training was more efficacious than unstructured activity in achieving declines in HbA1c. Although both structured and unstructured training provide benefits, only the former was associated with significant reductions in HbA1c levels. Therefore, T2DM patients should be stimulated to participate in specifically designed exercise intervention programs. PMID:24381880

Sanghani, Nandita B.; Parchwani, Deepak N.; Palandurkar, Kamlesh M.; Shah, Amit M.; Dhanani, Jatin V.

2013-01-01

85

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

Technology Transfer Automated Retrieval System (TEKTRAN)

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

86

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

PubMed Central

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

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

87

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

PubMed

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

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

2014-04-01

88

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

PubMed Central

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

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

2015-01-01

89

Diabetes Problem Solving by Youths with Type 1 Diabetes and their Caregivers: Measurement, Validation, and Longitudinal Associations with Glycemic Control  

PubMed Central

Objectives?This article introduces a new measure of problem-solving skills of youths with type 1 diabetes (T1DM) and adult caregivers in correcting glycemic fluctuations.?Methods?The Diabetes Problem Solving Interview (DPSI), a structured interview, was validated during a pilot study of a behavioral intervention. DPSI data and measures of diabetes management were obtained at baseline from 114 youths (ages 9–14.5) and 109 caregivers. Glycosylated hemoglobin (HbA1c) was measured quarterly over 9 months.?Results?Results confirmed the psychometric adequacy of the DPSI. For caregivers, but not youths, low DPSI scores (indicating poor problem-solving skills) were significantly associated with worse HbA1c over 9 months. Conclusions?The DPSI has clinical and research utility as a measure of diabetes problem-solving skills. Identification and targeted remediation of caregivers’ deficient diabetes problem-solving skills or promotion of youths’ utilization of these skills could possibly enhance glycemic control in youths with T1DM. PMID:18346973

Iannotti, Ronald; Weissberg-Benchell, Jill; Laffel, Lori; Hood, Korey; Anderson, Barbara; Chen, Rusan

2008-01-01

90

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

PubMed Central

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

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

2014-01-01

91

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

PubMed

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

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

2014-12-01

92

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

PubMed

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

Krinsley, James S

2014-04-01

93

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

PubMed

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

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

2014-10-01

94

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 ...

95

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

PubMed Central

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

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

2014-01-01

96

Interaction of maternal peroxisome proliferator-activated receptor gamma2 Pro12Ala polymorphism with fetal sex affects maternal glycemic control during pregnancy.  

PubMed

It was suggested that fetal sex may substantially affect maternal glycemic control during pregnancy in genetically susceptible mothers. The peroxisome proliferator-activated receptor gamma2 (PPARgamma2) Pro12Ala polymorphism is known to affect glycemic control and may act in a sex-specific manner. This polymorphism is thus an attractive candidate to test this hypothesis using a second independent functionally relevant polymorphism. We analyzed the impact of fetal sex on maternal glycemic control during pregnancy in relation to the maternal PPARgamma2 Pro12Ala polymorphism. Two-thousand fourteen Caucasian women without preexisting diabetes and preexisting hypertension with singleton pregnancies delivering consecutively at the Charité obstetrics department were genotyped. Glycemic control was analyzed by measuring total glycated hemoglobin at birth. Correction for confounding factors and multiple testing was considered in the analysis. The maternal PPARgamma2 Pro12Ala polymorphism without consideration of fetal sex had no effect on blood pressure, new onset of proteinuria and total glycated hemoglobin at delivery. Mothers carrying both G alleles (GG genotype) delivering a girl had a higher (P = 0.015) total glycated hemoglobin (6.81 or - 0.50%) versus mothers carrying the same alleles but delivering boys (5.85 + or - 0.58%). Comparing mothers with the GG genotype delivering girls with mothers with CC or CG genotypes also delivering girls (6.32 + or - 0.72%) revealed a significantly higher maternal total glycated hemoglobin at delivery in the former group (P < 0.009). Fetal sex/sex chromosomes may substantially affect maternal glycemic control in mothers who are carriers of the GG alleles of the PPARgamma2 Pro12Ala polymorphism. PMID:20032817

Hocher, Berthold; Schlemm, Ludwig; Haumann, Hannah; Poralla, Christine; Chen, You-Peng; Li, Jian; Guthmann, Florian; Bamberg, Christian; Kalache, Karim D; Pfab, Thiemo

2010-02-01

97

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

PubMed Central

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

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

2013-01-01

98

Optimizing glycemic control and minimizing the risk of hypoglycemia in patients with type 2 diabetes  

PubMed Central

Diabetic microvascular and macrovascular complications arise from hyperglycemia, presenting an increasing healthcare burden as the diabetic population continues to grow. Clinical trial evidence indicates that antihyperglycemic medications are beneficial with regard to microvascular disease (retinopathy, renal impairment, and perhaps neuropathy); however, the benefit of aggressive use of these medications with regard to cardiovascular risk has been less clear in recent studies. These studies were confounded by the propensity of the antihyperglycemic medications involved to cause hypoglycemia, which itself presents cardiovascular risk. This article presents additional context for these seemingly discordant results and maintains that the achievement of glycemic targets is warranted in most patients and provides cardiovascular benefit, provided that hypoglycemia is avoided and the treatment regimen is tailored to the needs of the individual patient. A treatment approach that is driven by these principles and emphasizes diet and exercise, a combination of noninsulin antidiabetic agents, not including sulfonylureas and glinides, and judicious use of insulin is also presented. PMID:24432042

Schwartz, Stanley S

2013-01-01

99

Colesevelam HCl Improves Glycemic Control and Reduces LDL Cholesterol in Patients With Inadequately Controlled Type 2 Diabetes on Sulfonylurea-Based Therapy  

PubMed Central

OBJECTIVE—Hyperglycemia is a risk factor for microvascular complications and may increase the risk of cardiovascular disease in patients with type 2 diabetes. This study tested the LDL cholesterol–lowering agent colesevelam HCl (colesevelam) as a potential novel treatment for improving glycemic control in patients with type 2 diabetes on sulfonylurea-based therapy. RESEARCH DESIGN AND METHODS—A 26-week, randomized, double-blind, placebo-controlled, parallel-group, multicenter study was carried out between August 2004 and August 2006 to evaluate the efficacy and safety of colesevelam for reducing A1C in adults with type 2 diabetes whose glycemic control was inadequate (A1C 7.5–9.5%) with existing sulfonylurea monotherapy or sulfonylurea in combination with additional oral antidiabetes agents. In total, 461 patients were randomized (230 given colesevelam 3.75 g/day and 231 given placebo). The primary efficacy measurement was mean placebo-corrected change in A1C from baseline to week 26 in the intent-to-treat population (last observation carried forward). RESULTS—The least squares (LS) mean change in A1C from baseline to week 26 was ?0.32% in the colesevelam group and +0.23% in the placebo group, resulting in a treatment difference of ?0.54% (P < 0.001). The LS mean percent change in LDL cholesterol from baseline to week 26 was ?16.1% in the colesevelam group and +0.6% in the placebo group, resulting in a treatment difference of ?16.7% (P < 0.001). Furthermore, significant reductions in fasting plasma glucose, fructosamine, total cholesterol, non–HDL cholesterol, and apolipoprotein B were demonstrated in the colesevelam relative to placebo group at week 26. CONCLUSIONS—Colesevelam improved glycemic control and reduced LDL cholesterol levels in patients with type 2 diabetes receiving sulfonylurea-based therapy. PMID:18458145

Fonseca, Vivian A.; Rosenstock, Julio; Wang, Antonia C.; Truitt, Kenneth E.; Jones, Michael R.

2008-01-01

100

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

PubMed Central

Introduction Hyperglycemia, hypoglycemia, and increased glycemic variability have each been independently associated with increased risk of mortality in critically ill patients. The role of diabetic status on modulating the relation of these three domains of glycemic control with mortality remains uncertain. The purpose of this investigation was to determine how diabetic status affects the relation of hyperglycemia, hypoglycemia, and increased glycemic variability with the risk of mortality in critically ill patients. Methods This is a retrospective analysis of prospectively collected data involving 44,964 patients admitted to 23 intensive care units (ICUs) from nine countries, between February 2001 and May 2012. We analyzed mean blood glucose concentration (BG), coefficient of variation (CV), and minimal BG and created multivariable models to analyze their independent association with mortality. Patients were stratified according to the diagnosis of diabetes. Results Among patients without diabetes, mean BG bands between 80 and 140 mg/dl were independently associated with decreased risk of mortality, and mean BG bands >140 mg/dl, with increased risk of mortality. Among patients with diabetes, mean BG from 80 to 110 mg/dl was associated with increased risk of mortality and mean BG from 110 to 180 mg/dl with decreased risk of mortality. An effect of center was noted on the relation between mean BG and mortality. Hypoglycemia, defined as minimum BG <70 mg/dl, was independently associated with increased risk of mortality among patients with and without diabetes and increased glycemic variability, defined as CV >20%, was independently associated with increased risk of mortality only among patients without diabetes. Derangements of more than one domain of glycemic control had a cumulative association with mortality, especially for patients without diabetes. Conclusions Although hyperglycemia, hypoglycemia, and increased glycemic variability is each independently associated with mortality in critically ill patients, diabetic status modulates these relations in clinically important ways. Our findings suggest that patients with diabetes may benefit from higher glucose target ranges than will those without diabetes. Additionally, hypoglycemia is independently associated with increased risk of mortality regardless of the patient's diabetic status, and increased glycemic variability is independently associated with increased risk of mortality among patients without diabetes. See related commentary by Krinsley, http://ccforum.com/content/17/2/131 See related commentary by Finfer and Billot, http://ccforum.com/content/17/2/134 PMID:23452622

2013-01-01

101

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

PubMed

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

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

2014-09-11

102

Pulmonary function tests in type 2 diabetes mellitus and their association with glycemic control and duration of the disease  

PubMed Central

Background: Pulmonary complications of diabetes mellitus (DM) have been poorly characterized. Some authors have reported normal pulmonary functions and even concluded that spirometry is not at all necessary in diabetic patients. Some studies have shown abnormal respiratory parameters in patients of DM. Moreover, the duration of DM and glycemic control have varied impact on the pulmonary functions. Aims and Objectives: The study was undertaken to analyze the pulmonary function parameters in diabetic patients and compare them with age and gender matched healthy subjects. We correlated forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in diabetic patients with duration of the disease and glycosylated hemoglobin (HbA1c). Materials and Methods: Pulmonary function tests (PFTs) were recorded in 60 type 2 diabetic male patients and 60 normal healthy male controls aged 40-60 years by using Helios 702 spirometer. The PFTs recorded were - FVC, FEV1, FEV1/FVC, FEF25, FEF50, FEF75, FEF25–75, FEF0.2–1.2, and peak expiratory flow rate (PEFR). HbA1c of all the patients was estimated by ion exchange resin method, which is a very standard method of estimation. PFTs of diabetic patients and controls were compared by applying Student?s unpaired t test. Associations between FVC and FEV1 and HbA1c and duration of illness in diabetic patients were analyzed by applying Pearson?s coefficient. Results: The PFTs were significantly decreased in diabetic patients compared with the healthy controls except FEV1/FVC. There was no correlation found between FVC and FEV1 and duration of illness as well as HbA1c. Conclusion: DM being a systemic disease, which also affects lungs causing restrictive type of ventilatory changes probably because of glycosylation of connective tissues, reduced pulmonary elastic recoil and inflammatory changes in lungs. We found glycemic levels and duration of disease are probably not the major determinants of lung pathology, which requires further research. PMID:23741090

Shah, Swati H.; Sonawane, Pranali; Nahar, Pradeep; Vaidya, Savita; Salvi, Sundeep

2013-01-01

103

Effects of encapsulated propolis on blood glycemic control, lipid metabolism, and insulin resistance in type 2 diabetes mellitus rats.  

PubMed

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

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

2012-01-01

104

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

PubMed Central

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

2014-01-01

105

New insight into improvement of cardiovascular outcomes with intensive glycemic control in patients with metabolic syndrome and type 2 diabetes mellitus included.  

PubMed

The epidemiology of metabolic syndrome (MetS) is very concerning since this is a widespread chronic disease in adult and elderly population. Different epidemiological studies confirmed strong relationship between type 2 diabetes mellitus (DM2) inclusive MetS and the occurrence of microvascular and macrovascular complications in these patients. Therefore, we are discussing molecular mechanisms and pathways recently introduced and intensively researched. These molecules have been held responsible for direct and indirect correlative trends important in the assessment of potential benefit of intensive glycemic control. Novel substances may improve patient's outcome in recent future regarding cardiovascular complications though their acting mechanisms have not been completely elucidated. We are reviewing whether it would intensive glycemic control be a reasonable approach in patients with MetS when DM2 is included and which recommendations are currently widely applied. The aim was therefore to emphasize current need for further investigations in the field since the utility of intensive glycemic control in all DM/MetS patients as mean for reduction of cardiovascular complications still remains controversial. PMID:25113641

Pei, Fei; Sun, Jian

2015-01-01

106

Cross-sectional and longitudinal relationships of body mass index with glycemic control in children and adolescents with type 1 diabetes mellitus  

PubMed Central

Aims Weight gain is an oft-cited outcome of improved glycemic control in adults with type 1 diabetes, though few studies have investigated this in youth. The purpose of this paper was to examine cross-sectional and longitudinal associations of body mass index (BMI, kg/m2) with glycemic control in youth with type 1 diabetes (n=340, 12.5±1.7y, 49% female, duration ?1year) participating in a 2-year multicenter intervention study targeting family diabetes management. Methods BMI was calculated from height and weight measured at clinic visits. Glycohemoglobin (HbA1c) at each visit was assayed centrally. Cross-sectional associations of baseline BMI with glycemic control, and of change in BMI and HbA1c with baseline values, were examined. Longitudinal associations of time-varying BMI and HbA1c were examined using a multilevel linear mixed effects model controlling for time-varying time (months), insulin dose (units/kg/day), regimen, Tanner stage, and time invariant baseline diabetes duration, BMI, treatment group and sociodemographic characteristics. Results Baseline HbA1c was unrelated to baseline BMI, but was related positively to subsequent BMI change (p=0.04) and inversely to HbA1c change (p=0.002). Baseline BMI was inversely related to BMI change (p=0.01) and unrelated to HbA1c change. In multilevel regression, BMI was related inversely to HbA1c (%) (?±SE=?0.11±0.02,p<0.001) and positively to insulin dose (0.23±0.07,p=0.001). In the treatment group only, BMI was positively related to pump regimen (0.18±0.08,p=0.02). Conclusions Increased insulin administered to improve glycemic control may contribute to increased BMI in youth with type 1 diabetes, indicating the importance of determining ways to minimize weight gain while optimizing glycemic control. PMID:23339757

Nansel, T.R.; Lipsky, L.M.; Iannotti, R.J.

2013-01-01

107

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

PubMed Central

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

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

2014-01-01

108

Effect of Varying Glycemic Index Meals on Blood Glucose Control Assessed With Continuous Glucose Monitoring in Youth With Type 1 Diabetes on Basal-Bolus Insulin Regimens  

PubMed Central

OBJECTIVE The purpose of this study was to test the effect of high glycemic index (HGI) and low glycemic index (LGI) meals on blood glucose levels using continuous blood glucose monitoring in youths with type 1 diabetes. RESEARCH DESIGN AND METHODS A total of 20 youths on basal-bolus regimens consumed macronutrient-matched HGI and LGI meals 1 day each in a controlled setting in varying order following consumption of a standardized evening meal. Medtronic MiniMed Continuous Glucose Monitoring Systems were used to assess blood glucose (BG) profiles. RESULTS Participants demonstrated significantly lower daytime mean BG, BG area >180 mg/dl, and high BG index when consuming LGI meals but no differences for daytime BG area <70 mg/dl, daytime low BG index, or any nighttime values. Significantly more BG values <80 mg/dl were treated on LGI days. CONCLUSIONS Findings indicate that consumption of an LGI diet may reduce glucose excursions, improving glycemic control. PMID:18202243

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

2008-01-01

109

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

PubMed

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

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

2013-06-01

110

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

PubMed Central

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

Banerji, Mary Ann; Dunn, Jeffrey D.

2013-01-01

111

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

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

Rodbard, David; Zanella, Maria Teresa

2011-01-01

112

Impact of symptomatic hypoglycemia on medication adherence, patient satisfaction with treatment, and glycemic control in patients with type 2 diabetes  

PubMed Central

Background The purpose of this study was to evaluate the impact of symptomatic hypoglycemia on medication adherence, satisfaction with treatment, and glycemic control in patients with type 2 diabetes based on the treatment goals stated in the Swedish national guidelines. Methods This cross-sectional, multicenter study was carried out between January and August 2009 in 430 consecutive primary health care patients on stable doses of metformin and sulfonylureas for at least 6 months. The patients completed questionnaires covering their experiences of low blood glucose and adherence, as well as barriers to and satisfaction with drug treatment (using the Treatment Satisfaction Questionnaire for Medication). Physicians collected the data from medical records. Results Patients who experienced moderate or worse symptoms of hypoglycemia reported poorer adherence to medication (46% versus 67%; P<0.01) and were more likely to perceive barriers such as “bothered by medication side effects” (36% versus 14%; P<0.001) compared with patients with no or mild symptoms. Patients with moderate or worse symptoms of hypoglycemia were less satisfied with their treatment than those with no or mild symptoms as determined by the Treatment Satisfaction Questionnaire for Medication-Global satisfaction (67.0 versus 71.2; P<0.05). Overall, achievement of target glycated hemoglobin (HbA1c) based on the treatment goals stated in the Swedish national guidelines was 40%. Despite poorer adherence, patients who experienced moderate or worse symptoms of hypoglycemia had lower mean HbA1c values than patients with no or mild symptoms (7.0% versus 7.3% [Diabetes Control and Complications Trial standard]; P<0.05). Conclusion Symptomatic hypoglycemia in patients with type 2 diabetes on metformin and sulfonylureas was associated with nonadherence and decreased treatment satisfaction despite lower mean HbA1c values. A broader understanding of patient preferences and self-reported outcomes could improve the management of patients with type 2 diabetes. PMID:24812495

Walz, Lotta; Pettersson, Billie; Rosenqvist, Ulf; Deleskog, Anna; Journath, Gunilla; Wändell, Per

2014-01-01

113

Changes in Insulin Requirements From the Onset of Continuous Subcutaneous Insulin Infusion (CSII) Until Optimization of Glycemic Control.  

PubMed

The aim was to evaluate changes in insulin requirements from onset of continuous subcutaneous insulin infusion (CSII) until glucose optimization in type 1 diabetes and to determine patient characteristics to be considered when CSII is implemented. We retrospectively analyzed 74 type 1 diabetic patients over a follow-up of 5 months after starting CSII. Patients without a decrease in HbA1c levels at the end of follow-up were excluded. We compared total daily doses (TDD), basal/bolus distribution, basal diurnal/nocturnal proportion, number of basal segments, and HbA1c levels in relation to sex, age, body mass index (BMI), diabetes duration, and indication for CSII. At follow-up, HbA1c decreased by 0.75%, TDD decreased by 18%, basal rate was 60% of TDD, and diurnal basal rate was 60% of total basal rate. Insulin requirements were higher in males and in obese patients. Female patients and patients with longer diabetes duration showed a higher percentage of basal insulin. The number of basal segments was 4.9 ± 2.9. Basal requirements were higher in the second half of the nocturnal period. The dawn phenomenon was more relevant in men. Improvements in glycemic control were more marked in younger patients, in patients with higher HbA1c, in patients using more basal segments, and in patients initiating CSII for glucose control before pregnancy. Sex, diabetes duration, and BMI should be considered when initiating CSII. Our findings may help clinicians in clinical decision making regarding CSII therapy. PMID:24876590

Chico, Ana; Tundidor, Diana; Jordana, Lluis; Saigi, Ignasi; Maria, Miguel A; Corcoy, Rosa; Leiva, A de

2014-02-01

114

Hydrogen Improves Glycemic Control in Type1 Diabetic Animal Model by Promoting Glucose Uptake into Skeletal Muscle  

PubMed Central

Hydrogen (H2) acts as a therapeutic antioxidant. However, there are few reports on H2 function in other capacities in diabetes mellitus (DM). Therefore, in this study, we investigated the role of H2 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 H2 promoted 2-[14C]-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. H2 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 H2 had least effect on the obese and non-insulin-dependent type 2 diabetes mouse models. Our study demonstrates that H2 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

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

115

Effect of natural honey from Ilam and metformin for improving glycemic control in streptozotocin-induced diabetic rats  

PubMed Central

Objective(s): Diabetes mellitus is a public health problem and one of the five leading causes of death globally. In the present study, the effect of Metformin with natural honey was investigated on glycemia in the Streptozotocin-induced diabetic rats. Materials and Methods: Thirty Wistar male rats were randomly divided into six groups including C: non diabetic rats received distilled water, CH: non diabetic rats received honey, CD: diabetic rats administered with distilled water, DM: Metformin treated diabetic rats, DH: honey treated diabetic rats, and DMH: diabetic rats treated with a combination of Metformin and natural honey. Diabetes was induced by a single dose of Streptozotocin (65 mg/kg; i.p.). The animals were treated by oral gavage once daily for four weeks. At the end of the treatment period, the animals were sacrificed and their blood samples collected. Amount of glucose, triglyceride (TG), total cholesterol (TC), HDL cholesterol, LDL cholesterol, VLDL cholesterol, total bilirubin, and albumin were determined in serum. Results: Group CD: showed hyperglycemia (252.2±4.1 mg/dl), while level of blood glucose was significantly (p<0.01) reduced in groups DH (124.2±2.7 mg/dl), DM (108.0±3.4 mg/dl), and DMH (115.4±2.1 mg/dl). Honey in combination with Metformin significantly (p<0.01) reduced level of bilirubin but Metformin alone did not reduce bilirubin. Honey alone and in combination with Metformin also significantly reduced triglycerides, total cholesterol, LDL, VLDL and increased HDL, but Metformin did not reduced triglycerides and increased HDL. Conclusion: The results of the present study demonstrated that consuming natural honey with Metformin improves glycemic control and is more useful than consuming Metformin alone. The higher therapeutic effect of Ilam honey on lipid abnormalities than Tualang honey was also evident. PMID:25050251

Nasrolahi, Ozra; Heidari, Reza; Rahmani, Fatima; Farokhi, Farah

2012-01-01

116

Chronic administration of alogliptin, a novel, potent, and highly selective dipeptidyl peptidase-4 inhibitor, improves glycemic control and beta-cell function in obese diabetic ob/ob mice.  

PubMed

Dipeptidyl peptidase-4 (DPP-4) inhibitors improve glycemic control in patients with type 2 diabetes by increasing plasma active glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide levels. However, the effects of chronic DPP-4 inhibition on in vivo beta-cell function are poorly characterized. We thus evaluated the chronic effects of the DPP-4 inhibitor alogliptin benzoate (formerly SYR-322) on metabolic control and beta-cell function in obese diabetic ob/ob mice. Alogliptin (0.002%, 0.01%, or 0.03%) was administered in the diet to ob/ob mice for 2 days to determine effects on plasma DPP-4 activity and active GLP-1 levels and for 4 weeks to determine chronic effects on metabolic control and beta-cell function. After 2 days, alogliptin dose-dependently inhibited DPP-4 activity by 28-82% and increased active GLP-1 by 3.2-6.4-fold. After 4 weeks, alogliptin dose-dependently decreased glycosylated hemoglobin by 0.4-0.9%, plasma glucose by 7-28% and plasma triglycerides by 24-51%, increased plasma insulin by 1.5-2.0-fold, and decreased plasma glucagon by 23-26%, with neutral effects on body weight and food consumption. In addition, after drug washout, alogliptin (0.03% dose) increased early-phase insulin secretion by 2.4-fold and improved oral meal tolerance (25% decrease in glucose area under the concentration-time curve), despite the lack of measurable plasma DPP-4 inhibition. Importantly, alogliptin also increased pancreatic insulin content up to 2.5-fold, and induced intense insulin staining of islets, suggestive of improved beta-cell function. In conclusion, chronic treatment with alogliptin improved glycemic control, decreased triglycerides, and improved beta-cell function in ob/ob mice, and may exhibit similar effects in patients with type 2 diabetes. PMID:18499100

Moritoh, Yusuke; Takeuchi, Koji; Asakawa, Tomoko; Kataoka, Osamu; Odaka, Hiroyuki

2008-07-01

117

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

PubMed Central

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

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

2013-01-01

118

Effects of a palatinose-based liquid diet (Inslow) on glycemic control and the second-meal effect in healthy men.  

PubMed

Postprandial hyperglycemia induces prolonged hyperinsulinemia, which is a risk factor for type 2 diabetes mellitus. Foods with a low glycemic index blunt the rapid rise in postprandial plasma glucose and insulin levels. We herein investigated the effects of a novel, palatinose-based liquid diet (Inslow, Meiji Dairy Products, Tokyo, Japan) on postprandial plasma glucose and insulin levels and on the rate of substrate oxidation in 7 healthy men. Furthermore, to examine the effects of Inslow on the second-meal effect, we quantified our subjects' postprandial plasma glucose, insulin, and free fatty acid levels for up to 7 hours after they ingested a breakfast containing Inslow or control formula, followed by a standard lunch 5 hours later. Our results showed that peak plasma glucose and insulin levels 30 minutes after Inslow loading were lower than after control formula loading. Postprandial fat oxidation rates in the Inslow group were higher than in the control formula group (P < .05). In the second-meal effect study, plasma glucose and insulin levels after lunch in the Inslow group were lower than in the control formula group (P < .01), although the peak levels in these groups were not different. The free fatty acid concentration in the Inslow group immediately before lunch was significantly lower than in the control formula group (P < .05). In conclusion, consumption of Inslow at breakfast appears to improve patient glycemic control by reducing their postprandial plasma glucose and insulin levels after lunch (second-meal effect). PMID:17161233

Arai, Hidekazu; Mizuno, Akira; Sakuma, Masae; Fukaya, Makiko; Matsuo, Kaoru; Muto, Kazusa; Sasaki, Hajime; Matsuura, Motoi; Okumura, Hisami; Yamamoto, Hironori; Taketani, Yutaka; Doi, Toshio; Takeda, Eiji

2007-01-01

119

The effect of case management on glycemic control in patients with type 2 diabetes  

Microsoft Academic Search

Diabetes is a chronic yet controllable disease. It is not like a broken arm; it cannot be seen and will never heal completely. Although people can live long, full lives with diabetes, the disease will affect their and their family's lifestyles. However, diabetics can take comfort in knowing that diabetes is one disease over which they, given the appropriate tools,

Judi Middleton

2003-01-01

120

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

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

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

121

Decrease of Collagen Deposition in Wound Repair in Type 1 Diabetes Independent of Glycemic Control  

Microsoft Academic Search

Results: The deposition of hydroxyproline decreased by 40% (P=.03) in type 1 compared with type 2 diabetes (median, 0.70 vs 1.16 nmol\\/mg; interquartile range, 0.48- 1.04 vs 0.56-1.63 nmol\\/mg), which in turn did not dif- fer significantly from that of controls (median, 1.35 nmol\\/ mg; interquartile range, 0.72-1.88 nmol\\/mg). The decreased collagen deposition in type 1 diabetes was not caused

Eva Black; Jette Vibe-Petersen; Lars N. Jorgensen; Søren M. Madsen; Per E. Holstein; Hans Perrild; Finn Gottrup

2003-01-01

122

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

PubMed

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

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

2015-02-15

123

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

PubMed

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

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

2014-04-01

124

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

PubMed Central

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

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

2014-01-01

125

Exenatide once weekly treatment maintained improvements in glycemic control and weight loss over 2 years  

PubMed Central

Background The once-weekly (QW) formulation of the glucagon-like peptide-1 receptor agonist exenatide has been demonstrated to improve A1C, fasting plasma glucose (FPG), body weight, serum lipid profiles, and blood pressure in patients with type 2 diabetes through 52 weeks of treatment. In this report, we describe the 2-year results of the open-label, open-ended extension to the DURATION-1 trial of exenatide QW for type 2 diabetes. Methods A 2-stage protocol was used: patients received either exenatide QW (2 mg) or exenatide twice daily for 30 weeks (5 ?g for the first 4 weeks and 10 ?g thereafter), followed by 1.5 years of treatment with exenatide QW (2 mg), for a total of 2 years (104 weeks) of exenatide treatment. Of the 295 (intent-to-treat [ITT]) patients who entered the trial, 73% (n = 216) completed 2 years of treatment (completer population). Baseline characteristics (mean ± SE) for these patients were: A1C, 8.2 ± 0.1%; FPG, 168.4 ± 43.0 mg/dL; body weight, 101.1 ± 18.7 kg; and diabetes duration, 7 ± 5 years. Results In the completer population, significant improvements (LS mean ± SE [95% CI]) were maintained after 2 years of treatment in A1C (-1.71 ± 0.08% [-1.86 to -1.55%]), FPG (-40.1 ± 2.9 mg/dL [-45.7 to -34.5 mg/dL]), and body weight (-2.61 ± 0.52 kg [-3.64 to -1.58 kg]) compared with baseline. The percentages of patients who achieved an A1C of <7.0% and ?6.5% at 2 years were 60% and 39%, respectively. A significant reduction in systolic blood pressure (SBP; -3.0 ± 1.0 mmHg [-4.9 to -1.1 mmHg]) was maintained through 2 years of treatment. Serum lipid profiles were also significantly improved, including triglycerides (geometric LS mean change from baseline, -15 ± 2.7% [-21% to -10%]), total cholesterol (-8.6 ± 2.8 mg/dL [-14.0 to -3.1 mg/dL]), and low-density lipoproteins (-4.5 ± 2.2 mg/dL [-8.9 to -0.01 mg/dL]). Changes in A1C, body weight, FPG, SBP, and lipids in the ITT population were similar to those seen in the completer population. Nausea (predominantly mild in intensity) was the most common adverse event, although the frequency and intensity of nausea decreased over time. No severe hypoglycemia was observed. Conclusions Exenatide QW was well tolerated during the 2-year treatment period. This study demonstrated sustained glucose control and weight loss throughout 2 years of treatment with exenatide QW. Trial Registration ClinicalTrials.gov NCT00308139 PMID:21529363

2011-01-01

126

Glycemic control among U.S. Hispanics/Latinos with diabetes from the HCHS/SOL Sociocultural Ancillary Study: Do structural and functional social support play a role?  

PubMed

Social support is one potential source of health-related resiliency in Hispanics with diabetes. This study examined relationships of structural (i.e., social integration) and functional (i.e., perceived) social support with glycemic control (glycosylated hemoglobin; HbA1c) in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. This study included 766 men and women representing multiple Hispanic ethnic backgrounds, aged 18-74 years, with diagnosed diabetes who completed fasting blood draw, medication review, and measures of sociodemographic factors, medical history, structural support (Cohen Social Network Index), and functional support (Interpersonal Support Evaluation List-12). After adjusting for sociodemographic covariates and medication, a one standard deviation increase in functional support was related to an 0.18 % higher HbA1c (p = 0.04). A similar trend was observed for structural support; however, this effect was non-significant in adjusted models. Greater functional support was associated with poorer glycemic control in Hispanics. PMID:25107503

Fortmann, Addie L; Roesch, Scott C; Penedo, Frank J; Isasi, Carmen R; Carnethon, Mercedes R; Corsino, Leonor; Schneiderman, Neil; Daviglus, Martha L; Teng, Yanping; Giachello, Aida; Gonzalez, Franklyn; Gallo, Linda C

2015-02-01

127

Glycemic index, glycemic load, and pancreatic cancer risk (Canada)  

Microsoft Academic Search

There is some evidence that plasma insulin and postload plasma glucose may be associated with risk of pancreatic cancer. Glycemic index and glycemic load are measures, which allow the carbohydrate content of individual foods to be classified according to their postprandial glycemic effects and hence their effects on circulating insulin levels. Therefore, we examined pancreatic cancer risk in association with

Stephanie A. N. Silvera; Thomas E. Rohan; Meera Jain; Paul D. Terry; Geoffrey R. Howe; Anthony B. Miller

2005-01-01

128

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

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

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

2011-03-01

129

Assessment of Lung Function by Spirometry and Diffusion Study and Effect of Glycemic Control on Pulmonary Function in Type 2 Diabetes Mellitus Patients of the Eastern India  

PubMed Central

Introduction: There are so many complications involving eyes, kidneys, lungs and nerves associated with diabetes. But, pulmonary complications are poorly characterized among eastern Indian diabetic populations. Aims and Objectives: To assess pulmonary function in patients with type 2 diabetes mellitus. To find out correlation of the pulmonary functions test variables with Glycemic control. Materials and Methods: Total of 60 type 2 diabetes patient of age between 35-55 y and same number of age and sex matched apparently healthy control individual were included in the present study. All subjects were evaluated for PFT by flow sensitive spirometer (RMS HELIOS-401), the spirometric parameters were measured as a percentage of predicted and DLCO (by single breath technique). HBA1c of all cases were measured and they were grouped according to HBA1c level (Group-a =>7%, Group-b =6%-7%, Group-c =<6%). Results: Significant differences in the spirometric parameters (FVC, FEV1/FVC) and diffusion capacity (DLCO% and DL/VA%) existed between cases and controls. There was a significant decrease in FVC, DLCO and DL/VA and significant increase in FEV1/FVC in that groups having HBA1c level >7% than the other groups. FEV1, FVC, DLCO, and DL/VA were negatively correlated with HbA1c where as FEV1/FVC has positive association with HbA1c. Conclusion: Significant deterioration of lung function and diffusing capacity was observed in type 2 diabetes patients with poor glycemic control. PMID:25584206

Uz-Zaman, Salim; Singhamahapatra, Anilbaran; Dey, Pranab Kumar; Roy, Anindya; Roy, Kaushik; Roy (Basu), Kakali

2014-01-01

130

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

PubMed

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

Rosak, C; Jung, R; Hofmann, U

2008-08-01

131

Serum 1,5-Anhydroglucitol Concentrations Are a Reliable Index of Glycemic Control in Type 2 Diabetes With Mild or Moderate Renal Dysfunction  

PubMed Central

OBJECTIVE To assess the relationship between 1,5-anhydroglucitol (AG) levels, which are a marker of glycemic control, and stages of chronic kidney disease (CKD). RESEARCH DESIGN AND METHODS This was a cross-sectional study with 269 subjects with type 2 diabetes who were divided into four groups based on estimated glomerular filtration rate (eGFR) using Modification of Diet in Renal Disease (eGFRMDRD) formula: 57 in control, 111 in CKD stages 1–2, 78 in stage 3, and 23 in stages 4–5. RESULTS The study groups differed significantly with respect to 1,5-AG and fasting plasma glucose (FPG), age, duration of diabetes, blood pressure, HDL, and percentage of antihypertension or antidyslipidemia medication use. Stepwise multivariate regression analyses showed that 1,5-AG levels in the control group, the CKD stages 1–2 group, and the CKD stage 3 group could be explained by HbA1c, age, duration of diabetes, FPG, and antihypertension medication. However, eGFRMDRD was the only independent determinant of 1,5-AG levels in CKD stages 4–5. Logarithmic transformed 1,5-AG values (ln[1,5-AG]) had significant inverse correlations with HbA1c and FPG levels for CKD stages 1–2 and CKD stage 3 (all P < 0.001). However, associations between ln(1,5-AG) and HbA1c or FPG were insignificant for CKD stages 4–5 (P = 0.274 and P = 0.080, respectively). CONCLUSIONS This study demonstrated that 1,5-AG levels do not appear to be influenced by mild or moderate renal dysfunction, suggesting it is a reliable glycemic marker in type 2 diabetes with CKD stages 1–3. PMID:22210564

Kim, Won Jun; Park, Cheol-Young; Lee, Kyu-Beck; Park, Se Eun; Rhee, Eun Jung; Lee, Won Young; Oh, Ki Won; Park, Sung Woo

2012-01-01

132

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

PubMed Central

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

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

2013-01-01

133

Pramlintide, the synthetic analogue of amylin: physiology, pathophysiology, and effects on glycemic control, body weight, and selected biomarkers of vascular risk  

PubMed Central

Pramlintide is a synthetic version of the naturally occurring pancreatic peptide called amylin. Amylin and pramlintide have similar effects on lowering postprandial glucose, lowering postprandial glucagon and delaying gastric emptying. Pramlintide use in type 1 and insulin requiring type 2 diabetes mellitus (DM) is associated with modest reductions in HbA1c often accompanied by weight loss. Limited data show a neutral effect on blood pressure. Small studies suggest small reductions in LDL-cholesterol in type 2 DM and modest reductions in triglycerides in type 1 DM. Markers of oxidation are also reduced in conjunction with reductions in postprandial glucose. Nausea is the most common side effect. These data indicate that pramlintide has a role in glycemic control of both type 1 and type 2 DM. Pramlintide use is associated with favorable effects on weight, lipids and other biomarkers for atherosclerotic disease. PMID:18561511

Hoogwerf, Byron J; Doshi, Krupa B; Diab, Dima

2008-01-01

134

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

PubMed Central

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

2011-01-01

135

Impact of Glycemic Control Strategies on the Progression of Diabetic Peripheral Neuropathy in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Cohort  

PubMed Central

OBJECTIVE The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial demonstrated similar long-term clinical effectiveness of insulin-sensitizing (IS) versus insulin-providing (IP) treatments for type 2 diabetes on cardiovascular outcomes in a cohort with documented coronary artery disease. We evaluated the effects of randomized glycemic control strategy (IS vs. IP) on the prevalence and incidence of diabetic peripheral neuropathy (DPN). RESEARCH DESIGN AND METHODS DPN (defined as Michigan Neuropathy Screening Instrument [MNSI] clinical examination score >2) was assessed at baseline and yearly for 4 years. DPN prevalence and incidence were compared by intention-to-treat modeling by logistic generalized estimating equation models for prevalence and Kaplan-Meier estimates and Cox regression models for incidence rates. RESULTS Results are reported for 2,159 BARI 2D participants (70% males) with valid baseline and at least one follow-up MNSI score (mean age 62 ± 9 years, mean HbA1c 7.7 ± 1.6%, diabetes duration 10 ± 9 years). There were no differences in the prevalence of DPN between the IS and the IP groups throughout the 4 years of follow-up. In 1,075 BARI 2D participants with no DPN at baseline, the 4-year cumulative incidence rate of DPN was significantly lower in the IS (66%) than in the IP (72%) strategy group (P = 0.02), which remained significant after adjusting for the in-trial HbA1c (P = 0.04). In subgroup analyses, IS strategy had a greater benefit in men (hazard ratio 0.75 [99% CI 0.58–0.99], P < 0.01). CONCLUSIONS Among patients with type 2 diabetes followed for up to 4 years during BARI 2D, a glycemic control therapy with IS significantly reduced the incidence of DPN compared with IP therapy and may add further benefit for men. PMID:23757426

Pop-Busui, Rodica; Lu, Jiang; Brooks, Maria Mori; Albert, Stewart; Althouse, Andrew D.; Escobedo, Jorge; Green, Jenifer; Palumbo, Pasquale; Perkins, Bruce A.; Whitehouse, Fred; Jones, Teresa L.Z.

2013-01-01

136

Impact of dietary fiber intake on glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry  

PubMed Central

Background Dietary fiber is beneficial for the treatment of type 2 diabetes mellitus, although it is consumed differently in ethnic foods around the world. We investigated the association between dietary fiber intake and obesity, glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese type 2 diabetic patients. Methods A total of 4,399 patients were assessed for dietary fiber intake using a brief self-administered diet history questionnaire. The associations between dietary fiber intake and various cardiovascular risk factors were investigated cross-sectionally. Results Body mass index, fasting plasma glucose, HbA1c, triglyceride and high-sensitivity C-reactive protein negatively associated with dietary fiber intake after adjusting for age, sex, duration of diabetes, current smoking, current drinking, total energy intake, fat intake, saturated fatty acid intake, leisure-time physical activity and use of oral hypoglycemic agents or insulin. The homeostasis model assessment insulin sensitivity and HDL cholesterol positively associated with dietary fiber intake. Dietary fiber intake was associated with reduced prevalence of abdominal obesity, hypertension and metabolic syndrome after multivariate adjustments including obesity. Furthermore, dietary fiber intake was associated with lower prevalence of albuminuria, low estimated glomerular filtration rate and chronic kidney disease after multivariate adjustments including protein intake. Additional adjustments for obesity, hypertension or metabolic syndrome did not change these associations. Conclusion We demonstrated that increased dietary fiber intake was associated with better glycemic control and more favorable cardiovascular disease risk factors including chronic kidney disease in Japanese type 2 diabetic patients. Diabetic patients should be encouraged to consume more dietary fiber in daily life. PMID:24330576

2013-01-01

137

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

PubMed Central

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

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

2012-01-01

138

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

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

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

2014-01-01

139

Glycemic Index and Diabetes  

MedlinePLUS

... Diabetes Forecast® magazine: wcie-carbs, In this section Food What Can I Eat Understanding Carbohydrates Types of Carbohydrates Carbohydrate Counting Make Your Carbs Count Glycemic Index and Diabetes Sugar and Desserts Sugar Alcohols Low-Calorie Sweeteners donate en -- Acknowledge ...

140

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.

141

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

PubMed Central

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

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

2014-01-01

142

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

Technology Transfer Automated Retrieval System (TEKTRAN)

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

143

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

PubMed

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

Oud, Lavi; Spellman, Craig

2014-02-01

144

Post-meal ?-cell function predicts the efficacy of glycemic control in patients with type 2 diabetes inadequately controlled by metformin monotherapy after addition of glibenclamide or acarbose  

PubMed Central

Background This study aimed to explore parameters which will predict good control of HbA1c after adding a second anti-diabetic drug in patients with type 2 diabetes mellitus (T2DM) inadequately controlled with metformin monotherapy. Methods Fifty-one patients (M/F: 25/26, mean age: 53.7?±?8.2 years, mean glycated hemoglobin [HbA1c] 8.4?±?1.2%) with T2DM inadequately controlled with metformin were randomized to add-on glibenclamide or acarbose for 16 weeks. Before and after combination therapy, the subjects underwent a 2-hour liquid mixed meal tolerance test to determine insulin secretion (HOMA-?, insulinogenic index, and disposition index [DI]) and insulin sensitivity (HOMA-IR and Matsuda insulin sensitivity index). Results At baseline, there was a significant inverse relationship between DI120 and HbA1c (p?=?0.001) in all subjects. The addition of glibenclamide and acarbose improved HbA1c significantly from 8.6?±?1.6% to 7.4?±?1.2% (p?controlled with metformin, add-on oral anti-diabetic agent with glibenclamide or acarbose resulted in the significant HbA1c reduction and improvement of ?-cell function. Subjects with greater baseline ?-cell function reserve displayed better glycemic response in the combination therapy of metformin with glibenclamide or acarbose. Trial registration This study was registered in the ClinicalTrials.gov with registration number of NCT00417729. PMID:24932223

2014-01-01

145

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

PubMed Central

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

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

2014-01-01

146

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

Microsoft Academic Search

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

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

2008-01-01

147

Glycemic control with empagliflozin, a novel selective SGLT2 inhibitor, ameliorates cardiovascular injury and cognitive dysfunction in obese and type 2 diabetic mice.  

PubMed

BackgroundThere has been uncertainty regarding the benefit of glycemic control with antidiabetic agents in prevention of diabetic macrovascular disease. Further development of novel antidiabetic agents is essential for overcoming the burden of diabetic macrovascular disease. The renal sodium glucose co-transporter 2 (SGLT2) inhibitor is a novel antihyperglycemic agent for treatment of type 2 diabetes. This work was performed to determine whether empagliflozin, a novel SGLT2 inhibitor, can ameliorate cardiovascular injury and cognitive decline in db/db mouse, a model of obesity and type 2 diabetes.Methods (1) Short-term experiment: The first experiment was performed to examine the effect of 7 days of empagliflozin treatment on urinary glucose excretion and urinary electrolyte excretion in db/db mice. (2) Long-term experiment: The second experiment was undertaken to examine the effect of 10 weeks of empagliflozin treatment on cardiovascular injury, vascular dysfunction, cognitive decline, and renal injury in db/db mice.Results (1) Short-term experiment: Empagliflozin administration significantly increased urinary glucose excretion, urine volume, and urinary sodium excretion in db/db mice on day 1, but did not increase these parameters from day 2. However, blood glucose levels in db/db mice were continuously decreased by empagliflozin throughout 7 days of the treatment. (2) Long-term experiment: Empagliflozin treatment caused sustained decrease in blood glucose in db/db mice throughout 10 weeks of the treatment and significantly slowed the progression of type 2 diabetes. Empagliflozin significantly ameliorated cardiac interstitial fibrosis, pericoronary arterial fibrosis, coronary arterial thickening, cardiac macrophage infiltration, and the impairment of vascular dilating function in db/db mice, and these beneficial effects of empagliflozin were associated with attenuation of oxidative stress in cardiovascular tissue of db/db mice. Furthermore, empagliflozin significantly prevented the impairment of cognitive function in db/db mice, which was associated with the attenuation of cerebral oxidative stress and the increase in cerebral brain-derived neurotrophic factor. Empagliflozin ameliorated albuminuria, and glomerular injury in db/db mice.ConclusionsGlycemic control with empagliflozin significantly ameliorated cardiovascular injury and remodeling, vascular dysfunction, and cognitive decline in obese and type 2 diabetic mice. Thus, empagliflozin seems to be potentially a promising therapeutic agent for diabetic macrovascular disease and cognitive decline. PMID:25344694

Lin, Bowen; Koibuchi, Nobutaka; Hasegawa, Yu; Sueta, Daisuke; Toyama, Kensuke; Uekawa, Ken; Ma, MingJie; Nakagawa, Takashi; Kusaka, Hiroaki; Kim-Mitsuyama, Shokei

2014-10-26

148

Glycemic index, glycemic load and risk of gastric cancer  

Microsoft Academic Search

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

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

2004-01-01

149

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

PubMed

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

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

2014-01-01

150

Rush University guidelines and protocols for the management of hyperglycemia in hospitalized patients: elimination of the sliding scale and improvement of glycemic control throughout the hospital.  

PubMed

The management of inpatient hyperglycemia has received much recent attention because of an expanding literature supporting the benefits of quality improvement and the creation of guidelines in this area. The authors began a process in 2002 to create modern protocols for glycemic control with intravenous insulin in their intensive care units and with subcutaneous basal-prandial insulin in all of their non-intensive care units. In this report, they describe both the process employed and the current protocols they are using. They also describe the process, perpetually ongoing, for educating nurses and residents in a large academic medical center. The annual cycle of senior residents passing on the regular insulin sliding scale to first-year interns and students can be broken. The hospital ward can be a valuable setting in which to teach basal/prandial insulin protocols, which will readily translate into the outpatient clinic. Where better to teach the importance and real-time usefulness of HbA1c than on the inpatient ward of a teaching hospital? Protocols to prevent and treat hypoglycemia can also be taught and widely accepted, hospital insulin formularies can be streamlined, and modern information technology can be used to track and improve multiple metrics of care for inpatients with hyperglycemia. The inpatient encounter with diabetic care can be a golden window of opportunity for patient as well as physician and nurse education. PMID:17102162

Donaldson, Sandra; Villanuueva, Griselda; Rondinelli, Lara; Baldwin, David

2006-01-01

151

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

PubMed Central

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

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

2014-01-01

152

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

ERIC Educational Resources Information Center

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

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

2010-01-01

153

A GIP Receptor Agonist Exhibits ?-Cell Anti-Apoptotic Actions in Rat Models of Diabetes Resulting in Improved ?-Cell Function and Glycemic Control  

PubMed Central

Aims The gastrointestinal hormone GIP promotes pancreatic islet function and exerts pro-survival actions on cultured ?-cells. However, GIP also promotes lipogenesis, thus potentially restricting its therapeutic use. The current studies evaluated the effects of a truncated GIP analog, D-Ala2-GIP1–30 (D-GIP1–30), on glucose homeostasis and ?-cell mass in rat models of diabetes. Materials and Methods The insulinotropic and pro-survival potency of D-GIP1–30 was evaluated in perfused pancreas preparations and cultured INS-1 ?-cells, respectively, and receptor selectivity evaluated using wild type and GIP receptor knockout mice. Effects of D-GIP1–30 on ?-cell function and glucose homeostasis, in vivo, were determined using Lean Zucker rats, obese Vancouver diabetic fatty rats, streptozotocin treated rats, and obese Zucker diabetic fatty rats, with effects on ?-cell mass determined in histological studies of pancreatic tissue. Lipogenic effects of D-GIP1–30 were evaluated on cultured 3T3-L1 adipocytes. Results Acutely, D-GIP1–30 improved glucose tolerance and insulin secretion. Chronic treatment with D-GIP1–30 reduced levels of islet pro-apoptotic proteins in Vancouver diabetic fatty rats and preserved ?-cell mass in streptozotocin treated rats and Zucker diabetic fatty rats, resulting in improved insulin responses and glycemic control in each animal model, with no change in body weight. In in vitro studies, D-GIP1–30 exhibited equivalent potency to GIP1–42 on ?-cell function and survival, but greatly reduced action on lipoprotein lipase activity in 3T3-L1 adipocytes. Conclusions These findings demonstrate that truncated forms of GIP exhibit potent anti-diabetic actions, without pro-obesity effects, and that the C-terminus contributes to the lipogenic actions of GIP. PMID:20231880

Widenmaier, Scott B.; Kim, Su-Jin; Yang, Gary K.; De Los Reyes, Thomas; Nian, Cuilan; Asadi, Ali; Seino, Yutaka; Kieffer, Timothy J.; Kwok, Yin Nam; McIntosh, Christopher H. S.

2010-01-01

154

Traffic Control in Early Miami  

Microsoft Academic Search

Traffic congestion has been an intractable problem in urban American history. The narrow, garbage-strewn roads which hosted as many ani- mals and pedestrians as vehicles during the early years of the republic became the site of epic traffic snarls in the bustling period following the Civil War. The advent of the automobile at the beginning of the twentieth century exacerbated

Paul S. George

155

What do herbalists suggest to diabetic patients in order to improve glycemic control? Evaluation of scientific evidence and potential risks  

Microsoft Academic Search

In the course of 12 continuing education seminars given in different regions of Italy in 2001, we distributed a questionnaire to all the attending herbalists asking information about the herbal remedy and dietary supplement they mainly recommended to subjects who required a “natural” treatment to control glycemia. We distributed 720 questionnaires and we received 685 completed ones. We have compiled

A. F. G. Cicero; G. Derosa; A. Gaddi

2004-01-01

156

The effects of subject-selected high carbohydrate, low fat diets on glycemic control in insulin dependent diabetes mellitus13  

Microsoft Academic Search

In the present study, six women with insulin dependent diabetes mellitus (IDDM) were assigned to begineither a control diet containing 45% of the calories as carbohydrate, 40% fat, and 15% protein for four weeks, or a high carbohydrate, low fat diet with 65% carbohydrate, 20% fat, and 15% protein for six weeks. All subjects completed both periods in a cross-over

Clarie B Hollenbeck; Matthew C Riddle; William E Connor

157

Correlation between the severity of apnea and hypopnea sleep, hypertension and serum lipid and glycemic: a case control study.  

PubMed

The purpose of this study was to evaluate the correlation between the severity of obstructive sleep apnea (OSA) and the levels of blood pressure (BP), lipids and glucose, as intermittent hypoxia increases BP, changes the oxidative balance, and can induce the formation of free radicals and atherogenesis. 32 patients were evaluated about BP during wakefulness and sleep, total cholesterol and lipids, LDL (low-density lipoprotein), HDL (high-density lipoprotein), triglycerides, glucose and polysomnography. They were divided into four groups according to the respiratory events per hour of sleep (RDI): control group (RDI < 5), Group I (RDI 5-15), Group II (RDI 15-30), Group III (RDI > 30). There was no increase in BP in groups' cases, the verification of systolic (p = 0.429) and diastolic (p = 0.475) BP in 24 h, systolic (p = 0.277) and diastolic (p = 0.143) BP during wakefulness, and systolic (p = 0.394) and diastolic (p = 0.703) BP during sleep in the control group. When implementing the Spearman correlation test, a correlation directly proportional to the severity of the disease was not observed. Regarding the level of serum total cholesterol (p = 0.092), LDL (p = 0.242), HDL (p = 0.517), triglycerides (p = 0.947), total lipids (p = 0.602) and glucose (0.355), there was no statistically significant difference between groups (p > 0.05 for all parameters). There is no correlation between the severity of OSA and BP levels in 24 h, during daytime, during the sleep and serum levels of LDL and HDL cholesterol. PMID:24827401

de Sousa Rodrigues, Celio Fernando; Lira, Amanda Bastos

2014-05-15

158

Dietary Carbohydrate, Glycemic Index, and Glycemic Load in Relation to Risk of Colorectal Cancer in Women  

Microsoft Academic Search

Diets with a high glycemic index and glycemic load have been hypothesized to be implicated in the etiology of colorectal cancer owing to their potential to increase postprandial glucose and insulin levels. Prospective data on glycemic index and glycemic load in relation to colorectal cancer risk are limited and inconsistent. Therefore, the authors prospectively investigated the associations of dietary carbohydrate,

Susanna C. Larsson; Edward Giovannucci; Alicja Wolk

2007-01-01

159

Effects of Nonsurgical Periodontal Therapy on Clinical Response, Microbiological Profile, and Glycemic Control in Malaysian Subjects with Type 1 Diabetes  

PubMed Central

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

Buzinin, Samira Mukhtar; Alabsi, Aied Mohammed; Tan, Alexander Tong Boon

2014-01-01

160

Resveratrol increases glucose induced GLP-1 secretion in mice: a mechanism which contributes to the glycemic control.  

PubMed

Resveratrol (RSV) is a potent anti-diabetic agent when used at high doses. However, the direct targets primarily responsible for the beneficial actions of RSV remain unclear. We used a formulation that increases oral bioavailability to assess the mechanisms involved in the glucoregulatory action of RSV in high-fat diet (HFD)-fed diabetic wild type mice. Administration of RSV for 5 weeks reduced the development of glucose intolerance, and increased portal vein concentrations of both Glucagon-like peptid-1 (GLP-1) and insulin, and intestinal content of active GLP-1. This was associated with increased levels of colonic proglucagon mRNA transcripts. RSV-mediated glucoregulation required a functional GLP-1 receptor (Glp1r) as neither glucose nor insulin levels were modulated in Glp1r-/- mice. Conversely, levels of active GLP-1 and control of glycemia were further improved when the Dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin was co-administered with RSV. In addition, RSV treatment modified gut microbiota and decreased the inflammatory status of mice. Our data suggest that RSV exerts its actions in part through modulation of the enteroendocrine axis in vivo. PMID:21673955

Dao, Thi-Mai Anh; Waget, Aurélie; Klopp, Pascale; Serino, Matteo; Vachoux, Christelle; Pechere, Laurent; Drucker, Daniel J; Champion, Serge; Barthélemy, Sylvain; Barra, Yves; Burcelin, Rémy; Sérée, Eric

2011-01-01

161

Blood glucose monitoring and glycemic control in adolescence: Contribution of diabetes-specific responsibility and family conflict  

PubMed Central

Purpose To examine age and time trends in responsibility for diabetes management tasks and diabetes-specific family conflict and their relationship to blood glucose monitoring (BGM) frequency and blood glucose control (HbA1c). Methods A sample of 147 adolescents (mean=15.5±.4 years) with type 1 diabetes and their caregivers completed measures of diabetes-specific responsibility and family conflict at baseline and six months. BGM frequency and HbA1c were measured during outpatient clinic appointments. Results Responsibility for diabetes management tasks shifted from caregivers to adolescents with increasing age by adolescent and caregiver report. Diabetes-specific conflict was stable. Similar trends in responsibility and conflict were seen over the 6 month follow-up period. Less frequent BGM and higher HbA1c were also observed with increasing adolescent age. Multivariate analyses demonstrated adolescents taking greater responsibility for management tasks and experiencing greater family conflict at baseline reported lower BGM at six months. Family, demographic, psychosocial, and disease-specific variables accounted for 26% of the variance in BGM frequency by both adolescent and caregiver report. Adolescents reporting greater diabetes-specific family conflict at baseline experienced higher HbA1c values at six months. Variables accounted for 23 and 28% of the variance in HBA1c by adolescent and caregiver report respectively. Conclusions Diabetes-specific responsibility and conflict have important implications for improving disease outcomes. Interventions targeting responsibility and conflict (i.e., reducing conflict while keeping caregivers involved in diabetes management) may help prevent the deterioration in BGM and HbA1c frequently seen during adolescence. PMID:20638012

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

2010-01-01

162

Intraovarian control of early folliculogenesis.  

PubMed

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

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

2015-02-01

163

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

PubMed Central

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

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

2012-01-01

164

Glycemic index in chronic disease: a review  

Microsoft Academic Search

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

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

2002-01-01

165

Glycemic and insulinemic responses to carbohydrate rich whole foods.  

PubMed

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

Ray, Kasturi Sen; Singhania, Pooja Ratan

2014-02-01

166

Effect of Inhaled Corticosteroids on Glycemic Status  

PubMed Central

Although the dysglycemic effects of systemic glucocorticoid therapy are well known, the effect of inhaled corticosteroids (ICS) on carbohydrate metabolism is still a subject of debate. The systemic bioavailability of ICS is claimed to be minimal and the side effects negligible. However, some large retrospective cohort studies showed a definite association between ICS use and incident diabetes or worsening glycemic control in pre-existing diabetes. There are no professional-body recommended guidelines on the diagnosis and management of steroid-induced diabetes for the general population. This review aims to evaluate the systemic dysglycemic effect of ICS treatment and to propose a management algorithm.

Egbuonu, Francis; Antonio, Farrah A; Edavalath, Mahamood

2014-01-01

167

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

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

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

2014-01-01

168

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

PubMed Central

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

2013-01-01

169

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

PubMed Central

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

2014-01-01

170

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

PubMed Central

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

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

2014-01-01

171

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

PubMed

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

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

2012-01-01

172

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

PubMed Central

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

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

2012-01-01

173

Glycemic index and glycemic load of selected Chinese traditional foods  

PubMed Central

AIM: To determine the glycemic index (GI) and glycemic load (GL) values of Chinese traditional foods in Hong Kong. METHODS: Fifteen healthy subjects (8 males and 7 females) volunteered to consume either glucose or one of 23 test foods after 10-14 h overnight fast. The blood glucose concentrations were analyzed immediately before, 15, 30, 45, 60, 90 and 120 min after food consumption using capillary blood samples. The GI value of each test food was calculated by expressing the incremental area under the blood glucose response curve (IAUC) value for the test food as a percentage of each subject’s average IAUC value for the glucose. The GL value of each test food was calculated as the GI value of the food multiplied by the amount of the available carbohydrate in a usual portion size, divided by 100. RESULTS: Among all the 23 Chinese traditional foods tested, 6 of them belonged to low GI foods (Tuna Fish Bun, Egg Tart, Green Bean Dessert, Chinese Herbal Jelly, Fried Rice Vermicelli in Singapore-style, and Spring Roll), 10 of them belonged to moderate GI foods (Baked Barbecued Pork Puff, Fried Fritter, “Mai-Lai” Cake, “Pineapple” Bun, Fried Rice Noodles with Sliced Beef, Barbecue Pork Bun, Moon Cakes, Glutinous Rice Ball, Instant Sweet Milky Bun, and Salted Meat Rice Dumpling), the others belonged to high GI foods (Fried Rice in Yangzhou-Style, Sticky Rice Wrapped in Lotus Leaf, Steamed Glutinous Rice Roll, Jam and Peanut Butter Toast, Plain Steamed Vermicelli Roll, Red Bean Dessert, and Frozen Sweet Milky Bun). CONCLUSION: The GI and GL values for these Chinese traditional foods will provide some valuable information to both researchers and public on their food preference. PMID:20333793

Chen, Ya-Jun; Sun, Feng-Hua; Wong, Stephen Heung-sang; Huang, Ya-Jun

2010-01-01

174

Postprandial Hyperglycemia and Glycemic Variability  

PubMed Central

The aim of this article is to evaluate the pros and cons of a specific impact of postprandial hyperglycemia and glycemic variability on the—mainly cardiovascular (CV)—complications of diabetes, above and beyond the average blood glucose (BG) as measured by HbA1c or fasting plasma glucose (FPG). The strongest arguments in favor of this hypothesis come from impressive pathophysiological studies, also in the human situation. Measures of oxidative stress and endothelial dysfunction seem to be especially closely related to glucose peaks and even more so to fluctuating high and low glucose concentrations and can be restored to normal by preventing those glucose peaks or wide glucose excursions. The epidemiological evidence, which is more or less confined to postprandial hyperglycemia and postglucose load glycemia, is also rather compelling in favor of the hypothesis, although certainly not fully conclusive as there are also a number of conflicting results. The strongest cons are seen in the missing evidence as derived from randomized prospective intervention studies targeting postprandial hyperglycemia longer term, i.e., over several years, and seeking to reduce hard CV end points. In fact, several such intervention studies in men have recently failed to produce the intended beneficial outcome results. As this evidence by intervention is, however, key for the ultimate approval of a treatment concept in patients with diabetes, the current net balance of attained evidence is not in favor of the hypothesis here under debate, i.e., that we should care about postprandial hyperglycemia and glycemic variability. The absence of a uniformly accepted standard of how to estimate these parameters adds a further challenge to this whole debate. PMID:21525442

Standl, Eberhard; Schnell, Oliver; Ceriello, Antonio

2011-01-01

175

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

PubMed Central

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

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

2012-01-01

176

Glycemic index, glycemic load, wellness and beauty: the state of the art  

Microsoft Academic Search

The glycemic index (GI) is a ranking system for carbohydrates' effect on blood glucose levels. It compares available carbohydrates gram for gram in individual foods, providing a numerical, evidence-based index of postprandial glycemia. The glycemic load (GL) is a ranking system for carbohydrate content in food portions based on their GI and the portion size. These two markers increasingly are

Bruno Berra; Angela Maria Rizzo

2009-01-01

177

Automatic Detection of Excessive Glycemic Variability for Diabetes Management  

E-print Network

Automatic Detection of Excessive Glycemic Variability for Diabetes Management Matthew Wiley, Razvan ARHI Diabetes and Endocrine Center Ohio University College of Osteopathic Medicine Athens, Ohio 45701 in blood glucose levels, is a significant factor in diabetes management. Excessive glycemic variability

Bunescu, Razvan C.

178

Measures of Glycemic Variability and Links with Psychological Functioning  

Microsoft Academic Search

The goal of this article is to review the recent literature on measures of glycemic variability, links between glycemic variability\\u000a and psychological functioning, and methods for examining these links. A number of commonly used measures of glycemic variability\\u000a are reviewed and compared, including recently proposed methods. Frequently used measures of glycemic variability are also\\u000a discussed in the context of research

Joseph R. Rausch

2010-01-01

179

Glycemic index of common Malaysian fruits.  

PubMed

The objective of the present study was to measure the glycemic index of durian, papaya, pineapple and water-melon grown in Malaysia. Ten (10) healthy volunteers (5 females, 5 males; body mass index 21.18+/-1.7 kg/m2) consumed 50 g of available carbohydrate portions of glucose (reference food) and four test foods (durian, papaya, pineapple and watermelon) in random order after an overnight fast. Glucose was tested on three separate occasions, and the test foods were each tested once. Postprandial plasma glucose was measured at intervals for two hours after intake of the test foods. Incremental areas under the curve were calculated, and the glycemic index was determined by expressing the area under the curve after the test foods as a percentage of the mean area under the curve after glucose. The results showed that the area under the curve after pineapple, 232+/-24 mmolxmin/L, was significantly greater than those after papaya, 147+/-14, watermelon, 139+/-8, and durian, 124+/-13 mmolxmin/L (p<0.05). Similarly, the glycemic index of pineapple, 82+/-4, was significantly greater than those of papaya, 58+/-6, watermelon, 55+/-3, and durian, 49+/-5 (p<0.05). The differences in area under the curve and glycemic index among papaya, watermelon and durian were not statistically significant. We conclude that pineapple has a high glycemic index, whereas papaya is intermediate and watermelon and durian are low glycemic index foods. The validity of these results depends on the accuracy of the data in the food tables upon which the portion sizes tested were based. PMID:18364324

Robert, S Daniel; Ismail, Aziz Al-Safi; Winn, Than; Wolever, Thomas M S

2008-01-01

180

Computerized intensive insulin dosing can mitigate hypoglycemia and achieve tight glycemic control when glucose measurement is performed frequently and on time  

Microsoft Academic Search

INTRODUCTION: Control of blood glucose (BG) in critically ill patients is considered important, but is difficult to achieve, and often associated with increased risk of hypoglycemia. We examined the use of a computerized insulin dosing algorithm to manage hyperglycemia with particular attention to frequency and conditions surrounding hypoglycemic events. METHODS: This is a retrospective analysis of adult patients with hyperglycemia

Rattan Juneja; Corbin P Roudebush; Adam A Golas; Judith Jacobi; Joni Carroll; Deborah Nelson; Victor J Abad; Samuel J Flanders

2009-01-01

181

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

Microsoft Academic Search

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

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

2004-01-01

182

Serum insulin-like growth factor-binding protein-3 level correlated with glycemic control and lipid profiles in children and adolescents with type 1 diabetes.  

PubMed

Increasing evidence suggests a role of the IGF axis in the maintenance of normal glucose and lipid metabolism. The local IGF-IGFBP environment changes significantly in response to the diabetes milieu. We aimed at determining serum IGF-1 and IGFBP-3 levels in children with type 1 diabetes mellitus (T1DM) and their relationship with clinical variables. Seventy-eight patients with T1DM and 47 healthy control subjects were included in this study. Significant reduction for concentration of serum IGF-1 was observed in patients with T1DM compared to healthy controls. However, serum IGFBP-3 levels were similar in patients with T1DM compared to controls. Both serum IGF-1 and IGFBP-3 levels were significantly correlated with age, BMI, and serum c-peptide levels. In addition, serum IGFBP-3 levels showed significant positive correlation with HbA1c, total cholesterol, and LDL-cholesterol in the uncontrolled diabetic patients. These findings suggest that IGFBP-3 may be involved in the glucose control and lipid metabolism in those with uncontrolled T1DM. Further studies are needed to document their roles on glucose and lipid metabolism in T1DM. PMID:24825082

Kim, Min Sun; Lee, Dae-Yeol

2014-09-01

183

Rationale, design and baseline characteristics of a 4-year (208-week) phase III trial of empagliflozin, an SGLT2 inhibitor, versus glimepiride as add-on to metformin in patients with type 2 diabetes mellitus with insufficient glycemic control  

PubMed Central

Background Sulfonylureas (SUs) are commonly used in the treatment of type 2 diabetes (T2DM), usually as second-line treatment after the failure of metformin. However, SUs are associated with poor durability, hypoglycemia and weight gain. Empagliflozin is a sodium glucose cotransporter 2 (SGLT2) inhibitor in development for the treatment of T2DM. In Phase II/III trials, empagliflozin reduced hyperglycemia, body weight and blood pressure, with a low incidence of hypoglycemia. The aim of this Phase III study is to compare the effects of empagliflozin and the SU glimepiride as second-line therapy in patients with T2DM inadequately controlled with metformin immediate release (IR) and diet/exercise. Method After a 2-week placebo run-in, patients were randomized to receive empagliflozin 25 mg once daily (qd) or glimepiride 1–4 mg qd double-blind for 2 years, in addition to metformin IR. Patients who participate in the initial 2-year randomization period will be eligible for a 2-year double-blind extension. The primary endpoint is change from baseline in HbA1c. Secondary endpoints are change from baseline in body weight, the incidence of confirmed hypoglycemia and changes in systolic and diastolic blood pressure. Exploratory endpoints include markers of insulin secretion, body composition and responder analyses. Safety endpoints include the incidence of adverse events (AEs) (including macro- and microvascular adverse events) and changes from baseline in clinical laboratory parameters. Results Between August 2010 and June 2011, 1549 patients were randomized and 1545 patients were treated. At baseline, mean (SD) age was 55.9 (10.4) years, HbA1c was 7.92 (0.84)%, body mass index was 30.11 (5.59) kg/m2, systolic blood pressure was 133.5 (15.9) mmHg and diastolic blood pressure was 79.5 (9.4) mmHg. Discussion This is the largest study to compare the efficacy and safety of an SGLT2 inhibitor with an SU in patients with T2DM inadequately controlled on metformin to date. In addition to determining the effects of these treatments on glycemic control over the long term, this study will investigate effects on beta-cell function, cardiovascular risk factors and markers of renal function/damage. The results will help to inform the choice of second-line treatment in patients with T2DM who have failed on metformin. Trial registration Clinicaltrials.gov NCT01167881. PMID:24007456

2013-01-01

184

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

Microsoft Academic Search

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

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

2005-01-01

185

Measures of glycemic variability and links with psychological functioning.  

PubMed

The goal of this article is to review the recent literature on measures of glycemic variability, links between glycemic variability and psychological functioning, and methods for examining these links. A number of commonly used measures of glycemic variability are reviewed and compared, including recently proposed methods. Frequently used measures of glycemic variability are also discussed in the context of research that uses continuous glucose monitoring for the collection of blood glucose data. The results of previous studies that have examined the link between psychological functioning and glycemic variability within relatively short-term time frames are reviewed. Methods for examining glycemic variability and its link with psychological functioning are discussed so that important research questions can be addressed to aid in understanding the effect of changes in psychological functioning on glycemic variability and vice versa in future research. PMID:20922582

Rausch, Joseph R

2010-12-01

186

High Glycemic Index Foods, Overeating, and Obesity  

Microsoft Academic Search

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

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

1999-01-01

187

Glycemic targets in pregnancies affected by diabetes: historical perspective and future directions.  

PubMed

The definition of optimal glycemic control in pregnancies affected by diabetes remains enigmatic. Diabetes phenotypes are heterogeneous. Moreover, fetal macrosomia insidiously occurs even with excellent glycemic control. Current blood glucose (BG) targets (FBG ?95, 1-h post-prandial <140, 2 h <120 mg/dL) have improved perinatal outcomes, but arguably they have not normalized. The conventional management approach has been to replicate a pattern of glycemia in normal pregnancy. Although these patterns are lower than previously appreciated, a randomized controlled trial (RCT) has never compared current vs. lower glucose targets powered on maternal/fetal outcomes. This paper provides historical context to the current targets by reviewing evidence supporting their evolution. Using lower targets (FBG <90, 1 h <122, 2 h <110, mean BG ?95 mg/dL) may help normalize outcomes, but phenotypic differences (type 1 vs. type 2 vs. gestational diabetes) might require different glycemic goals. There remains a critical need for well-designed RCTs to confirm optimal glycemic control that minimizes both small for and large for gestational age across pregnancies affected by diabetes. PMID:25398204

Hernandez, Teri L

2015-01-01

188

Relationship Between Patient Medication Adherence and Subsequent Clinical Inertia in Type 2 Diabetes Glycemic Management  

Microsoft Academic Search

Abstract Objective:Clinical inertia has been,identified as a criticalbarrier to glycemic control in type 2 diabetes. We assessed,the relationship between,patients’ initial medication,adherence,and subsequent,regimen,intensification among,patients with persistently elevated HbA1c levels.

Richard Grant; Alyce S. Adams; Connie Mah Trinacty; Fang Zhang; Ken Kleinman; Stephen B. Soumerai; James B. Meigs; Dennis Ross-Degnan

2007-01-01

189

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...

190

Emerging Control and Disruptive Behavior Disorders During Early Childhood  

PubMed Central

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

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

2015-01-01

191

Low glycemic index diets and body weight  

Microsoft Academic Search

In their review (low-glycaemic index diets and body weight regulation (2006)), McMillan-Price and Brand-Miller argue that the low glycemic index (GI) diet is a simple and more popular diet that will successfully improve cardiovascular risk factors and reduce body weight. We do not find that there is convincing evidence in the existing literature to suggest that a low GI diet

B Sloth; A Astrup

2006-01-01

192

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

Federal Register 2010, 2011, 2012, 2013, 2014

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

2012-11-05

193

Effect of the Glycemic Index of Carbohydrates on Acne vulgaris  

PubMed Central

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

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

2010-01-01

194

Impact of a low glycemic index diet in pregnancy on markers of maternal and fetal metabolism and inflammation.  

PubMed

This is a secondary analysis of 621 women in ROLO study, a randomized control trial of low glycemic index (GI) diet in pregnancy to prevent the recurrence of macrosomia, which aims to assess the effect of the diet on maternal and fetal insulin resistance, leptin, and markers of inflammation. In early pregnancy and at 28 weeks, serum was analyzed for insulin, leptin, tumor necrosis factor ? (TNF-?), and interleukin 6 (IL-6). At delivery, cord blood concentrations of leptin, TNF-?, IL-6, and C-peptide were recorded. We found no difference between those who did or did not receive low GI advice with respect to the concentrations of any marker in early pregnancy, at 28 weeks or in cord blood. Women in the intervention arm of the study did have a lower overall rise in insulin concentrations from early pregnancy to 28 weeks gestation, P = .04. Of the women in the intervention arm, 20% were in the highest quartile for insulin change (28-week insulin - insulin at booking) compared to 29% of controls (P = .02). In conclusion, a low GI diet in pregnancy has little effect on leptin and markers of inflammation although an attenuated response to the typical increase in insulin resistance seen in pregnancy with advancing gestation was seen in those who received the low GI advice. PMID:24642719

Walsh, Jennifer M; Mahony, Rhona M; Culliton, Marie; Foley, Michael E; McAuliffe, Fionnuala M

2014-11-01

195

Spatially and temporally controlled electroporation of early chick embryos  

E-print Network

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

Stern, Claudio

196

Sustained Attention and Age Predict Inhibitory Control during Early Childhood  

ERIC Educational Resources Information Center

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

Reck, Sarah G.; Hund, Alycia M.

2011-01-01

197

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

E-print Network

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

Heller, Barbara

198

Prescribing pattern and efficacy of anti-diabetic drugs in maintaining optimal glycemic levels in diabetic patients  

PubMed Central

Context: Despite the availability of efficacious anti-diabetic drugs, which act by different mechanisms to reduce the blood-glucose, the majority of people with diabetes on anti-diabetic drug therapy, have poor glycemic control and diabetic vascular complications. Aim and Objectives: The aim was to study the prescribing pattern and efficacy of anti-diabetic drugs in maintaining optimal glycemic levels in diabetic patients attending tertiary care teaching hospital in Navi Mumbai. Materials and Methods: A prospective, cross-sectional, observational survey was carried out in 100 patients of diabetes mellitus attending diabetes outpatient/medicine outpatient departments, to assess their prescribing pattern of anti-diabetic drugs, and their blood-glucose level was measured by Accu-Chek Active glucometer to determine their glycemic control. Results: Average number of anti-diabetic drugs per prescription was 1.4. Sulfonylureas were the most commonly prescribed class, but metformin (biguanide) was the commonest prescribed individual drug among oral hypoglycemic agents (OHA). Fixed dose combination of biguanide and sulfonylurea was prescribed commonly. Monotherapy dominated over polytherapy and there was a higher percentage of use of insulin in Type 2 diabetics. Only 41% of patients on anti-diabetic therapy had optimal glycemic control. The association between anti-diabetic therapy along with lifestyle modification and glycemic control was statistically significant (P = 0.0011). Conclusions: OHAs still dominate the prescribing pattern, but there was a shifting trend toward the use of insulin preparations in the management of Type 2 diabetes mellitus. In achieving optimal glycemic control, the efficacy of the anti-diabetic drugs was only 41%; therefore intensification of current drug treatment as well as planning multiple drug interventions with lifestyle modification is necessary. PMID:25278671

Agarwal, Akshay A.; Jadhav, Pradeep R.; Deshmukh, Yeshwant A.

2014-01-01

199

LOW GLYCEMIC LOAD EXPERIMENTAL DIET MORE SATIATING THAN HIGH GLYCEMIC LOAD DIET  

PubMed Central

Effective strategies for reducing food intake are needed to reduce risk of obesity-related cancers. We investigated the effect of low and high-glycemic load (GL) diets on satiety and whether satiety varied by BMI, gender, and serum leptin. 80 normal weight (BMI=18.5-24.9 kg/m2) and overweight/obese (BMI=28.0-40.0 kg/m2) adults participated in a randomized, cross-over controlled feeding study testing low-GL vs. high-GL diets. The 28-day diets were isocaloric with identical macronutrient distributions, differing only in GL and fiber. Participants completed visual analog satiety surveys and fasting serum leptin after each 28-day period. T-tests compared mean within- and between-person satiety scores and leptin values. Participants reported 7% greater satiation on the low-GL vs. the high-GL diet (p=0.03) and fewer food cravings on the low-GL vs. the high-GL diet (p<0.001). Compared to males, females reported less hunger (p=0.05) and more satiety on the low-GL vs. the high-GL diet (p<0.01). Participants with low body fat (<25.0% for men; <32.0% for women) and BMI < 25.0 kg/m2 reported study food was tastier on the low-GL vs. the high-GL diet (p=0.04 and p=0.05, respectively). In summary, reducing GL, and/or increasing fiber, may be an effective way to lower calories consumed, improve energy balance and ultimately reduce cancer risk. PMID:22564018

Chang, Kevin T.; Lampe, Johanna W.; Schwarz, Yvonne; Breymeyer, Kara L.; Noar, Karen A.; Song, Xiaoling; Neuhouser, Marian L.

2013-01-01

200

Low glycemic load experimental diet more satiating than high glycemic load diet.  

PubMed

Effective strategies for reducing food intake are needed to reduce risk of obesity-related cancers. We investigated the effect of low and high glycemic load (GL) diets on satiety and whether satiety varied by body mass index (BMI), gender, and serum leptin. Eighty normal weight (BMI = 18.5-24.9 kg/m²) and overweight/ obese (BMI = 28.0-40.0 kg/m²) adults participated in a randomized, crossover controlled feeding study testing low GL vs. high GL diets. The 28-day diets were isocaloric with identical macronutrient distributions, differing only in GL and fiber. Participants completed visual analog satiety surveys and fasting serum leptin after each 28-day period. T-tests compared mean within- and between-person satiety scores and leptin values. Participants reported 7% greater satiation on the low GL vs. the high GL diet (P = 0.03) and fewer food cravings on the low GL vs. the high GL diet (P < 0.001). Compared to males, females reported less hunger (P = 0.05) and more satiety on the low GL vs. the high GL diet (P < 0.01). Participants with low body fat (<25.0% for men; <32.0% for women) and BMI <25.0 kg/m² reported study food was tastier on the low GL vs. the high GL diet (P = 0.04 and P = 0.05, respectively). In summary, reducing GL, and/or increasing fiber, may be an effective way to lower calories consumed, improve energy balance, and ultimately reduce cancer risk. PMID:22564018

Chang, Kevin T; Lampe, Johanna W; Schwarz, Yvonne; Breymeyer, Kara L; Noar, Karen A; Song, Xiaoling; Neuhouser, Marian L

2012-01-01

201

Internet Blood Glucose Monitoring Systems Provide Lasting Glycemic Benefit in Type 1 and 2 Diabetes: A Systematic Review.  

PubMed

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

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

2015-01-01

202

Archean komatiite volcanism controlled by the evolution of early continents  

PubMed Central

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

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

2014-01-01

203

DIETARY HYPERGLYCEMIA, GLYCEMIC INDEX AND METABOLIC RETINAL DISEASES  

PubMed Central

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

Chiu, Chung-Jung; Taylor, Allen

2014-01-01

204

Glycemic index, glycemic load, wellness and beauty: the state of the art.  

PubMed

The glycemic index (GI) is a ranking system for carbohydrates' effect on blood glucose levels. It compares available carbohydrates gram for gram in individual foods, providing a numerical, evidence-based index of postprandial glycemia. The glycemic load (GL) is a ranking system for carbohydrate content in food portions based on their GI and the portion size. These two markers increasingly are being used to prevent typical diseases of the Western world, including type 2 diabetes mellitus, cardiovascular disease, obesity, metabolic syndrome, and acne. Data on the efficacy of GI and GL in the treatment of Western population diseases are discussed and critically evaluated, with a particular focus on acne and other skin disorders. PMID:19168005

Berra, Bruno; Rizzo, Angela Maria

2009-01-01

205

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

PubMed

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

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

2013-01-01

206

Glycemic Index and Glycemic Load of Carbohydrates in the Diabetes Diet  

Microsoft Academic Search

Medical nutrition therapy is the first line of treatment for the prevention and management of type 2 diabetes and plays an\\u000a essential part in the management of type 1 diabetes. Although traditionally advice was focused on carbohydrate quantification,\\u000a it is now clear that both the amount and type of carbohydrate are important in predicting an individual’s glycemic response\\u000a to a

Kate Marsh; Alan Barclay; Stephen Colagiuri; Jennie Brand-Miller

2011-01-01

207

Low Glycemic Load Experimental Diet More Satiating Than High Glycemic Load Diet  

Microsoft Academic Search

Effective strategies for reducing food intake are needed to reduce risk of obesity-related cancers. We investigated the effect of low and high glycemic load (GL) diets on satiety and whether satiety varied by body mass index (BMI), gender, and serum leptin. Eighty normal weight (BMI = 18.5–24.9 kg\\/m) and overweight\\/ obese (BMI = 28.0–40.0 kg\\/m) adults participated in a randomized,

Kevin T. Chang; Johanna W. Lampe; Yvonne Schwarz; Kara L. Breymeyer; Karen A. Noar; Xiaoling Song; Marian L. Neuhouser

2012-01-01

208

No difference in body weight decrease between a low-glycemic- index and a high-glycemic-index diet but reduced LDL cholesterol after 10-wk ad libitum intake of the low-glycemic-index diet1-3  

Microsoft Academic Search

Background: The role of glycemic index (GI) in appetite and body- weight regulation is still not clear. Objective: The objective of the study was to investigate the long- term effects of a low-fat, high-carbohydrate diet with either low glycemic index (LGI) or high glycemic index (HGI) on ad libitum energy intake, body weight, and composition, as well as on risk

Birgitte Sloth; Inger Krog-Mikkelsen; Anne Flint; Inge Tetens; Inger Björck; Sophie Vinoy; Helena Elmståhl; Arne Astrup; Vincent Lang; Anne Raben

209

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

PubMed

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

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

2015-01-01

210

Genetic and epigenetic control of early mouse development.  

PubMed

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

Albert, Mareike; Peters, Antoine H F M

2009-04-01

211

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

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

2010-02-18

212

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

Federal Register 2010, 2011, 2012, 2013, 2014

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

2011-05-26

213

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

PubMed

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

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

2004-03-01

214

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

PubMed Central

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

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

2014-01-01

215

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

PubMed

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

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

2014-08-15

216

Glycemic index, glycemic load and insulinemic index of Chinese starchy foods  

PubMed Central

AIM: To determine the glycemic index (GI), glycemic load (GL) and insulinemic index (II) of five starchy foods that are commonly used in Chinese diets. METHODS: Ten healthy subjects aged between 20-30 years were recruited. Each subject was asked to consume 50 g of available carbohydrate portions of test foods and reference food. Finger capillary blood samples were collected at the start of eating and 15, 30, 45, 60, 90 and 120 min after consumption. The GI and II of foods were calculated from the ratio of incremental area under the glucose/insulin response curves of test and reference foods. The GL for each test food was determined from its GI value and carbohydrate content. RESULTS: The results showed that brown rice elicited the highest postprandial glucose and insulin responses, followed by taro, adlay, yam and mung bean noodles, which produced the lowest. Among the five starchy foods, brown rice evoked the highest GI and GL at 82 ± 0.2 and 18 ± 0.2, followed by taro (69 ± 0.4, 12 ± 0.2), adlay (55 ± 0.4, 10 ± 0.2), yam (52 ± 0.3, 9 ± 0.0) and mung bean noodles (28 ± 0.5, 7 ± 0.2), respectively. The II values of the test foods corresponded with GI values. Similarly, brown rice gave the highest II at 81 ± 0.1, followed by taro (73 ± 0.3), adlay (67 ± 0.3), yam (64 ± 0.5) and mung bean noodles (38 ± 0.3). All five starchy foods had lower GI, GL and II than reference bread (P < 0.05). CONCLUSION: The GI, GL and II values of starchy foods provide important information for the public to manage their diet and could be useful for the prevention of lifestyle-related diseases such as diabetes mellitus. PMID:20954285

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

2010-01-01

217

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

Federal Register 2010, 2011, 2012, 2013, 2014

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2010-09-21

218

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

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

2012-10-04

219

Glycemic indices of five varieties of dates in healthy and diabetic subjects  

PubMed Central

Background This study was designed to determine the glycemic indices of five commonly used varieties of dates in healthy subjects and their effects on postprandial glucose excursions in individuals with type 2 diabetes mellitus. Methods Composition analysis was carried out for five types of dates (Tamer stage). The weights of the flesh of the dates equivalent to 50 g of available carbohydrates were calculated. The study subjects were thirteen healthy volunteers with a mean (± SD) age of 40.2 ± 6.7 years and ten participants with type 2 diabetes mellitus (controlled on lifestyle measures and/or metformin) with a mean HbA1c (± SD) of 6.6 ± (0.7%) and a mean age (± SD) of 40.8 ± 5.7 years. Each subject was tested on eight separate days with 50 g of glucose (on 3 occasions) and 50 g equivalent of available carbohydrates from the 5 varieties of date (each on one occasion). Capillary glucose was measured in the healthy subjects at 0, 15, 30, 45, 60, 90 and 120 min and for the diabetics at 0, 30, 60, 90, 120, 150 and 180 min. The glycemic indices were determined as ratios of the incremental areas under the response curves for the dates compared to glucose. Statistical analyses were performed using the Mann-Whitney U test and repeated measures analysis of variance. Results Mean glycemic indices ± SEM of the dates for the healthy individuals were 54.0 ± 6.1, 53.5 ± 8.6, 46.3 ± 7.1, 49.1 ± 3.6 and 55.1 ± 7.7 for Fara'd, Lulu, Bo ma'an, Dabbas and Khalas, respectively. Corresponding values for those with type 2 diabetes were very similar (46.1 ± 6.2, 43.8 ± 7.7, 51.8 ± 6.9, 50.2 ± 3.9 and 53.0 ± 6.0). There were no statistically significant differences in the GIs between the control and the diabetic groups for the five types of dates, nor were there statistically significant differences among the dates' GIs (df = 4, F = 0.365, p = 0.83). Conclusion The results show low glycemic indices for the five types of dates included in the study and that their consumption by diabetic individuals does not result in significant postprandial glucose excursions. These findings point to the potential benefits of dates for diabetic subjects when used in a healthy balanced diet. Trial Registration Number ClinicalTrials.gov NCT01307904 PMID:21619670

2011-01-01

220

Glycemic Impact and Health: New Horizons in White Bread Formulations  

Microsoft Academic Search

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

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

2011-01-01

221

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

PubMed

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

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

2012-09-01

222

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

PubMed Central

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

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

2012-01-01

223

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...

224

Early Archean stromatolites: Paleoenvironmental setting and controls on formation  

NASA Technical Reports Server (NTRS)

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.

Lowe, D. R.

1991-01-01

225

Trunk Control as an Early Predictor of Comprehensive Activities of Daily Living Function in Stroke Patients  

Microsoft Academic Search

Background and Purpose—Prediction of activities of daily living (ADL) functions at an early stage after a stroke is critical because it enables clinicians to set treatment programs and goals. The objective of this study was to assess the relationship between trunk control at an early stage and comprehensive ADL function (as assessed by combining basic ADL and instrumental ADL (IADL))

Ching-Lin Hsieh; Ching-Fan Sheu; I-Ping Hsueh; Chun-Hou Wang

2010-01-01

226

Common variants near ATM are associated with glycemic response to metformin in type 2 diabetes.  

PubMed

Metformin is the most commonly used pharmacological therapy for type 2 diabetes. We report a genome-wide association study for glycemic response to metformin in 1,024 Scottish individuals with type 2 diabetes with replication in two cohorts including 1,783 Scottish individuals and 1,113 individuals from the UK Prospective Diabetes Study. In a combined meta-analysis, we identified a SNP, rs11212617, associated with treatment success (n = 3,920, P = 2.9 × 10(-9), odds ratio = 1.35, 95% CI 1.22-1.49) at a locus containing ATM, the ataxia telangiectasia mutated gene. In a rat hepatoma cell line, inhibition of ATM with KU-55933 attenuated the phosphorylation and activation of AMP-activated protein kinase in response to metformin. We conclude that ATM, a gene known to be involved in DNA repair and cell cycle control, plays a role in the effect of metformin upstream of AMP-activated protein kinase, and variation in this gene alters glycemic response to metformin. PMID:21186350

Zhou, Kaixin; Bellenguez, Celine; Spencer, Chris C A; Bennett, Amanda J; Coleman, Ruth L; Tavendale, Roger; Hawley, Simon A; Donnelly, Louise A; Schofield, Chris; Groves, Christopher J; Burch, Lindsay; Carr, Fiona; Strange, Amy; Freeman, Colin; Blackwell, Jenefer M; Bramon, Elvira; Brown, Matthew A; Casas, Juan P; Corvin, Aiden; Craddock, Nicholas; Deloukas, Panos; Dronov, Serge; Duncanson, Audrey; Edkins, Sarah; Gray, Emma; Hunt, Sarah; Jankowski, Janusz; Langford, Cordelia; Markus, Hugh S; Mathew, Christopher G; Plomin, Robert; Rautanen, Anna; Sawcer, Stephen J; Samani, Nilesh J; Trembath, Richard; Viswanathan, Ananth C; Wood, Nicholas W; Harries, Lorna W; Hattersley, Andrew T; Doney, Alex S F; Colhoun, Helen; Morris, Andrew D; Sutherland, Calum; Hardie, D Grahame; Peltonen, Leena; McCarthy, Mark I; Holman, Rury R; Palmer, Colin N A; Donnelly, Peter; Pearson, Ewan R

2011-02-01

227

Effects of glucagon like peptide-1 to mediate glycemic effects of weight loss surgery.  

PubMed

To date, weight loss surgeries are the most effective treatment for obesity and glycemic control in patients with type 2 diabetes. Roux-en-Y gastric bypass surgery (RYGB) and sleeve gastrectomy (SG), two widely used bariatric procedures for the treatment of obesity, induce diabetes remission independent of weight loss while glucose improvement after adjustable gastric banding (AGB) is proportional to the amount of weight loss. The immediate, weight-loss independent glycemic effect of gastric bypass has been attributed to postprandial hyperinsulinemia and an enhanced incretin effect. The rapid passage of nutrients into the intestine likely accounts for significantly enhanced glucagon like-peptide 1 (GLP-1) secretion, and postprandial hyperinsulinemia after GB is typically attributed to the combined effects of elevated glucose and GLP-1. For this review we focus on the beneficial effects of the three most commonly performed bariatric procedures, RYGB, SG, and AGB, on glucose metabolism and diabetes remission. Central to this discussion will be the extent to which the effects of surgery are mediated by GLP-1. Better understanding of these mechanisms could provide insight to development of novel therapeutic strategies for treatment of diabetes as well as refinement of surgical techniques. PMID:24951252

Salehi, Marzieh; D'Alessio, David A

2014-09-01

228

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

Microsoft Academic Search

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

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

2004-01-01

229

Sex guilt and sexual control in women alcoholics in early sobriety  

Microsoft Academic Search

This study was designed to determine the degree to which alcoholic women in early sobriety report sex guilt and sexual control in comparison to a matched sample of non-alcoholic women. It was hypothesized that alcoholic women would report more sex guilt and less control over their sex lives than non-alcoholic women. Sex guilt and lack of sexual control add another

Valerie Pinhas

1980-01-01

230

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

PubMed

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

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

2010-04-01

231

SPATIALLY VARIABLE INSECTICIDE APPLICATIONS FOR EARLY SEASON CONTROL OF COTTON INSECT PESTS  

Technology Transfer Automated Retrieval System (TEKTRAN)

Our research has shown that cotton insect pests, specifically tarnished plant bugs, Lygus lineolaris (Palisot de Beauvois) (Heteroptera: Miridae), can be controlled early season in commercial cotton fields in Mississippi, USA, using spatially variable insecticide applications. Technology was develo...

232

Milestones:Early Developments in Remote-Control, 1901  

NSDL National Science Digital Library

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

233

Predictors of Longitudinal Growth in Inhibitory Control in Early Childhood  

ERIC Educational Resources Information Center

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…

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

2010-01-01

234

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

Microsoft Academic Search

Objectives: This study assessed the safety and clinical effectiveness of the training protocol for initiating insulin pump therapy with real-time continuous glucose monitoring (MiniMed Paradigm REAL-Time System) in a stepwise approach on pump naive subjects with type 1 diabetes compared to a control group who remained on multiple daily injection (MDI) therapy. Methods: This was a 15-week treat-to-target pilot study

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

2007-01-01

235

A starch hydrolysis procedure to estimate glycemic index  

Microsoft Academic Search

An in vitro procedure to measure the rate of starch digestion in starchy common foodstuffs was developed. A first-order equation that rules the hydrolytic process was found: C?C? (1?e?kt). Besides an in vivo assay, to calculate the glycemic index (GI), was carried out on thirty healthy volunteers. This is a simple in vitro method that could be used to estimate

Isabel Goñi; Alejandra Garcia-Alonso; Fulgencio Saura-Calixto

1997-01-01

236

Metamorphic density controls on early-stage subduction dynamics  

NASA Astrophysics Data System (ADS)

Subduction is primarily driven by the densification of the downgoing oceanic slab, due to dynamic P-T-fields in subduction zones. It is crucial to unravel slab densification induced by metamorphic reactions to understand the influence on plate dynamics. By analyzing the density and metamorphic structure of subduction zones, we may gain knowledge about the driving, metamorphic processes in a subduction zone like the eclogitization (i.e., the transformation of a MORB to an eclogite), the breakdown of hydrous minerals and the release of fluid or the generation of partial melts. We have therefore developed a 2D subduction zone model down to 250 km that is based on thermodynamic equilibrium assemblage computations. Our model computes the "metamorphic density" of rocks as a function of pressure, temperature and chemical composition using the Theriak-Domino software package at different time stages. We have used this model to investigate how the hydration, dehydration, partial melting and fractionation processes of rocks all influence the metamorphic density and greatly depend on the temperature field within subduction systems. These processes are commonly neglected by other approaches (e.g., gravitational or thermomechanical in nature) reproducing the density distribution within this tectonic setting. The process of eclogitization is assumed as being important to subduction dynamics, based on the very high density (3.6 g/cm3) of eclogitic rocks. The eclogitization in a MORB-type crust is possible only if the rock reaches the garnet phase stability field. This process is primarily temperature driven. Our model demonstrates that the initiation of eclogitization of the slab is not the only significant process that makes the descending slab denser and is responsible for the slab pull force. Indeed, our results show that the densification of the downgoing lithospheric mantle (due to an increase of pressure) starts in the early subduction stage and makes a significant contribution to the slab pull, where eclogitization does not occur. Thus, the lithospheric mantle acts as additional ballast below the sinking slab shortly after the initiation of subduction. Our calculation shows that the dogma of eclogitized basaltic, oceanic crust as the driving force of slab pull is overestimated during the early stage of subduction. These results improve our understanding of the force budget for slab pull during the intial and early stage of subduction. Therefore, the complex metamorphic structure of a slab and mantle wedge has an important impact on the development and dynamics of subduction zones. Further Reading: Duesterhoeft, Oberhänsli & Bousquet (2013), submitted to Earth and Planetary Science Letters

Duesterhoeft, Erik; Oberhänsli, Roland; Bousquet, Romain

2013-04-01

237

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

PubMed Central

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

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

2014-01-01

238

Gain Control Network Conditions in Early Sensory Coding  

PubMed Central

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

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

2013-01-01

239

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

PubMed Central

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

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

2008-01-01

240

Inhibitory Control during Emotional Distraction across Adolescence and Early Adulthood  

ERIC Educational Resources Information Center

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

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

2013-01-01

241

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

ERIC Educational Resources Information Center

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

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

2012-01-01

242

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

ERIC Educational Resources Information Center

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

Oberle, Eva; Schonert-Reichl, Kimberly A.

2013-01-01

243

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

PubMed

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

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

2014-06-01

244

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

PubMed Central

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

Ding, Eric L; Malik, Vasanti S

2008-01-01

245

Starch digestibility and the estimated glycemic score of different types of rice differing in amylose contents  

Microsoft Academic Search

Three types of rice cultivars (indica, japonica and hybrid rice) with four levels of amylose were selected for assessing variability in starch digestibility. A vitro enzymatic starch digestion method was applied to estimate the glycemic index in vivo based on the kinetics of starch hydrolysis in vitro. The results indicated that significant differences in term of glycemic response were observed

Peisong Hu; Haijun Zhao; Zhiying Duan; Zhang Linlin; Dianxing Wu

2004-01-01

246

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

PubMed Central

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

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

2014-01-01

247

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

PubMed Central

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

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

2014-01-01

248

Early deficits in cortical control of swallowing in Alzheimer’s disease  

PubMed Central

The goal of this study was to determine whether functional changes in cortical control of swallowing are evident in early Alzheimer’s disease (AD), before dysphagia (swallowing impairment) is evident. Cortical function was compared between an early AD group and a group of age-matched controls during swallowing. Swallowing oropharyngeal biomechanics examined from videofluoroscopic recordings were also obtained to more comprehensively characterize changes in swallowing associated with early AD. Our neuroimaging results show that the AD group had significantly lower BOLD response in many cortical areas that are traditionally involved in normal swallowing (i.e. pre and postcentral gyri, Rolandic and frontal opercula). There were no regions where the AD group recruited more brain activity than the healthy controls during swallowing and only 13% of all active voxels were unique to the AD group, even at this early stage. This suggests that the AD group is not recruiting new regions, nor are they compensating within regions that are active during swallowing. In videofluoroscopic measures, the AD group had significantly reduced hyo-laryngeal elevation than the controls. Although, swallowing impairment is usually noted in the late stages of AD, changes in cortical control of swallowing may begin long before dysphagia becomes apparent. PMID:20308785

Humbert, Ianessa A.; McLaren, Donald G.; Kosmatka, Kris; Fitzgerald, Michelle; Johnson, Sterling; Porcaro, Eva; Kays, Stephanie; Umoh, Eno-Obong; Robbins, JoAnne

2010-01-01

249

pix-1 Controls Early Elongation in Parallel with mel-11 and let-502 in Caenorhabditis elegans  

PubMed Central

Cell shape changes are crucial for metazoan development. During Caenorhabditis elegans embryogenesis, epidermal cell shape changes transform ovoid embryos into vermiform larvae. This process is divided into two phases: early and late elongation. Early elongation involves the contraction of filamentous actin bundles by phosphorylated non-muscle myosin in a subset of epidermal (hypodermal) cells. The genes controlling early elongation are associated with two parallel pathways. The first one involves the rho-1/RHOA-specific effector let-502/Rho-kinase and mel-11/myosin phosphatase regulatory subunit. The second pathway involves the CDC42/RAC-specific effector pak-1. Late elongation is driven by mechanotransduction in ventral and dorsal hypodermal cells in response to body-wall muscle contractions, and involves the CDC42/RAC-specific Guanine-nucleotide Exchange Factor (GEF) pix-1, the GTPase ced-10/RAC and pak-1. In this study, pix-1 is shown to control early elongation in parallel with let-502/mel-11, as previously shown for pak-1. We show that pix-1, pak-1 and let-502 control the rate of elongation, and the antero-posterior morphology of the embryos. In particular, pix-1 and pak-1 are shown to control head, but not tail width, while let-502 controls both head and tail width. This suggests that let-502 function is required throughout the antero-posterior axis of the embryo during early elongation, while pix-1/pak-1 function may be mostly required in the anterior part of the embryo. Supporting this hypothesis we show that low pix-1 expression level in the dorsal-posterior hypodermal cells is required to ensure high elongation rate during early elongation. PMID:24732978

Nkengfac, Bernard; Hamiche, Karim; Neault, Mathieu; Jenna, Sarah

2014-01-01

250

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

PubMed Central

The relations among infant anger reactivity, approach behavior, and frontal EEG asymmetry, and their relations to inhibitory control and behavior problems in early childhood were examined within the context of a longitudinal study of temperament. Two hundred and nine infants’ anger expressions to arm restraint were observed at 4 months of age. Infants’ approach behaviors during play with an unpredictable toy and baseline frontal electroencephalogram (EEG) asymmetry were assessed at 9 months of age. Inhibitory control during a Go/No-Go task and parent-report of behavior problems were evaluated at 4 years of age. High anger-prone infants with left, but not right, frontal EEG asymmetry showed significantly more approach behaviors and less inhibitory control relative to less anger-prone infants. Although a link between anger proneness in infancy and behavior problems in early childhood was not found, a combination of low approach behaviors and poor inhibitory control was predictive of internalizing behaviors.

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

2015-01-01

251

Differential neural control in early bilinguals and monolinguals during response inhibition.  

PubMed

We tested the hypothesis that early bilinguals and monolinguals use different brain areas when performing nonlinguistic executive control tasks. For this, we explored brain activity of early bilinguals and monolinguals during a manual stop-signal paradigm. Behaviorally, bilinguals and monolinguals did not show significant differences in the task, which led us to compare brain activation that cannot be attributed to differences in performance. Analyses demonstrated that monolinguals activated the anterior cingulate cortex more than bilinguals when performing the stop-signal task. These results offer direct support for the notion that early bilingualism exerts an effect on neural circuitry responsible for executive control. Consistent with recent reports, we found that bilinguals used the anterior cingulate more efficiently than monolinguals to monitor nonlinguistic cognitive conflicts. PMID:24735970

Rodríguez-Pujadas, Aina; Sanjuán, Ana; Fuentes, Paola; Ventura-Campos, Noelia; Barrós-Loscertales, Alfonso; Ávila, César

2014-05-01

252

Early School Competence: The Roles of Sex-Segregated Play and Effortful Control.  

ERIC Educational Resources Information Center

Examined the role of same-sex peer interactions in influencing early school competence and the degree to which effortful control (EC) moderated these relations. Results indicated that EC, measured at the end of the Fall semester, moderated the relations of children's same-sex play to their school competence, measured at the end of the following…

Fabes, Richard A.; Martin, Carol Lynn; Hanish, Laura D.; Anders, Mary C.; Madden-Derdich, Debra A.

2003-01-01

253

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

ERIC Educational Resources Information Center

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

Utendale, William T.; Hastings, Paul D.

2011-01-01

254

The Control of Sexuality in the Early British Boy Scouts Movement  

ERIC Educational Resources Information Center

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

Pryke, Sam

2005-01-01

255

History, Archaeology, and the Question of Foreign Control in Early Historic-Period Peninsular Malaysia  

Microsoft Academic Search

Foreigners' descriptions of coastal Malay states between circa A.D. 300 and A.D. 1500 often claimed that these states were ruled by foreign powers. Kedah, on the northwest coast, was generally said to be controlled by Funan, China, or Srivijaya, although other reports claimed that it was independent. More recent reports have often claimed India ruled Kedah during the early historic

S. Jane Allen

1998-01-01

256

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

PubMed

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

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

2011-04-01

257

Blending of soluble corn fiber with pullulan, sorbitol, or fructose attenuates glycemic and insulinemic responses in the dog and affects hydrolytic digestion in vitro.  

PubMed

The objective of these experiments was to measure in vitro hydrolytic digestion and glycemic and insulinemic responses of select carbohydrate blends, all containing the novel carbohydrate soluble corn fiber (SCF). Two SCF that varied in their method of production were used to formulate the carbohydrate blends. One set of blends contained a SCF that was spray dried (SCFsd) and then blended with different amounts of either pullulan, sorbitol, or fructose. The other set of blends contained a SCF produced using longer evaporation time (SCF) and then blended with different ratios of pullulan, sorbitol, and fructose. Free sugar concentrations found in the individual SCFsd and SCF substrates were low but varied. Spray-dried soluble corn fiber had a reduced free sugar concentration compared with SCF (2.8 vs. 14.2%). Glucose was the main free sugar found in both SCFsd and SCF but at different concentrations (2.7 vs. 12.7%, respectively). The majority of the SCFsd blends were completely hydrolyzed to their monosaccharide components. Glucose accounted for most of the hydrolyzed monosaccharides for SCFsd and all the SCFsd blends. Hydrolyzed monosaccharide concentrations for the SCF:pullulan:sorbitol:fructose blends followed similar trends to the SCFsd blends where greater percentages of fructose and sorbitol resulted in decreased (P < 0.05) hydrolyzed monosaccharide concentrations. The SCFsd blends had intermediate to high amounts of monosaccharides released as a result of in vitro hydrolytic digestion. The SCFsd:pullulan blends were more digestible in vitro (approximately 91%; P < 0.05) than SCFsd:fructose or SCFsd:sorbitol. Total released monosaccharides were high in SCFsd blends containing either 50% fructose or sorbitol, but the combination resulted in reduced concentrations of glucose released (P < 0.05). The SCF:pullulan:sorbitol:fructose blends also had intermediate to high released monosaccharides as a result of in vitro hydrolytic digestion. All SCF blends resulted in decreased glycemic and insulinemic responses compared with the maltodextrin control (P < 0.05) using a canine model. The addition of pullulan reduced the glycemic response compared with maltodextrin at all concentrations, but only 50:50 SCFsd:pullulan resulted in a reduction of the glycemic response compared with SCFsd alone (P < 0.05). The addition of fructose and sorbitol in the blends had the greatest impact on glycemic and insulinemic responses, even at concentrations as low as 5% of the blends. Overall, SCF and their blends may prove beneficial as components of low glycemic foodstuffs. PMID:23736045

de Godoy, M R C; Knapp, B K; Bauer, L L; Swanson, K S; Fahey, G C

2013-08-01

258

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

PubMed

Hyperpolarizing and inhibitory GABA regulates critical periods for plasticity in sensory cortices. Here we examine the role of early, depolarizing GABA in the control of plasticity mechanisms. We report that brief interference with depolarizing GABA during early development prolonged critical-period plasticity in visual cortical circuits without affecting the overall development of the visual system. The effects on plasticity were accompanied by dampened inhibitory neurotransmission, downregulation of brain-derived neurotrophic factor (BDNF) expression and reduced density of extracellular matrix perineuronal nets. Early interference with depolarizing GABA decreased perinatal BDNF signaling, and a pharmacological increase of BDNF signaling during GABA interference rescued the effects on plasticity and its regulators later in life. We conclude that depolarizing GABA exerts a long-lasting, selective modulation of plasticity of cortical circuits by a strong crosstalk with BDNF. PMID:25485756

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

2015-01-01

259

Genome-Wide Association Study Identifies Two Novel Loci with Sex-Specific Effects for Type 2 Diabetes Mellitus and Glycemic Traits in a Korean Population  

PubMed Central

Background Until recently, genome-wide association study (GWAS)-based findings have provided a substantial genetic contribution to type 2 diabetes mellitus (T2DM) or related glycemic traits. However, identification of allelic heterogeneity and population-specific genetic variants under consideration of potential confounding factors will be very valuable for clinical applicability. To identify novel susceptibility loci for T2DM and glycemic traits, we performed a two-stage genetic association study in a Korean population. Methods We performed a logistic analysis for T2DM, and the first discovery GWAS was analyzed for 1,042 cases and 2,943 controls recruited from a population-based cohort (KARE, n=8,842). The second stage, de novo replication analysis, was performed in 1,216 cases and 1,352 controls selected from an independent population-based cohort (Health 2, n=8,500). A multiple linear regression analysis for glycemic traits was further performed in a total of 14,232 nondiabetic individuals consisting of 7,696 GWAS and 6,536 replication study participants. A meta-analysis was performed on the combined results using effect size and standard errors estimated for stage 1 and 2, respectively. Results A combined meta-analysis for T2DM identified two new (rs11065756 and rs2074356) loci reaching genome-wide significance in CCDC63 and C12orf51 on the 12q24 region. In addition, these variants were significantly associated with fasting plasma glucose and homeostasis model assessment of ?-cell function. Interestingly, two independent single nucleotide polymorphisms were associated with sex-specific stratification in this study. Conclusion Our study showed a strong association between T2DM and glycemic traits. We further observed that two novel loci with multiple diverse effects were highly specific to males. Taken together, these findings may provide additional insights into the clinical assessment or subclassification of disease risk in a Korean population. PMID:25349825

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

2014-01-01

260

Impact of Fathers’ Alcohol Problems on the Development of Effortful Control in Early Adolescence  

PubMed Central

Objective: This article examines the association between fathers’ alcohol problems and children’s effortful control during the transition from middle childhood to early adolescence (fourth to sixth grade). Additionally, we examined the role of two potential moderators of this association, fathers’ antisocial behavior and child gender. Method: The sample consisted of 197 families (102 nonalcoholic [NA]; 95 father alcoholic [FA], in which only the father met diagnostic criteria for alcohol abuse or dependence). The sample was recruited from New York State birth records when the children were 12 months old. This analysis focused on 12-month alcohol problem data and child effortful control data measured in the fourth and sixth grades. Results: Structural equation modeling revealed that FA status was associated with lower effortful control on the Stroop Color and Word and Tower of London tasks in the sixth grade, but antisocial behavior did not moderate this association. Multiple group analysis revealed that FA status was associated with higher Stroop interference scores in fourth and sixth grade and lower move scores on the Tower of London task for boys but not girls. Conclusions: The association between FA status and effortful control may be attenuated in middle childhood (fourth grade) but emerge again in early adolescence (sixth grade). The results indicate that sons of alcoholics may be particularly vulnerable to poor self-regulatory strategies and that early adolescence may be an important time for intervening with these families to facilitate higher self-regulation before the transition to high school. PMID:23948526

Adkison, Sarah E.; Grohman, Kerry; Colder, Craig R.; Leonard, Kenneth; Orrange-Torchia, Toni; Peterson, Ellen; Eiden, Rina D.

2013-01-01

261

Automated glycemic pattern analysis: overcoming diabetes clinical inertia.  

PubMed

The OneTouch® Verio™ IQ Meter with PatternAlert™ Technology has been approved by the U.S. Food and Drug Administration as the first self-glucose monitor that can automatically determine glycemic patterns [high and low pre-meal blood glucose (BG)] for health care providers (HCPs) and patients. In this issue of Journal of Diabetes Science and Technology, Katz and coauthors demonstrate that this device was more accurate and quicker in detecting abnormal glucose patterns than the review by HCPs of 30-day handwritten BG logs and that its interpretations were positively accepted by the HCPs. Continued development of automated pattern analysis and decision-support software to overcome the "data-overload" associated with intensive glucose monitoring and diabetes management will reduce clinical inertia and could dramatically improve diabetes outcomes. PMID:23439174

Schwartz, Frank L; Marling, Cynthia R; Shubrook, Jay

2013-01-01

262

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

PubMed

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

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

2014-11-01

263

Inhibitory control and moral emotions: relations to reparation in early and middle childhood.  

PubMed

ABSTRACT. This study examined links between inhibitory control, moral emotions (sympathy and guilt), and reparative behavior in an ethnically diverse sample of 4- and 8-year-olds (N = 162). Caregivers reported their children's reparative behavior, inhibitory control, and moral emotions through a questionnaire, and children reported their guilt feelings in response to a series of vignettes depicting moral transgressions. A hypothesized meditation model was tested with inhibitory control relating to reparative behavior through sympathy and guilt. In support of this model, results revealed that high levels of inhibitory control were associated with high levels of reparative behavior through high levels of sympathy and guilt. However, the mediation of inhibitory control to reparation through guilt was significant for 4-year-olds only. Results are discussed in relation to the temperamental, regulatory, and affective-moral precursors of reparative behavior in early and middle childhood. PMID:25496527

Colasante, Tyler; Zuffianò, Antonio; Bae, Na Young; Malti, Tina

2014-01-01

264

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

Microsoft Academic Search

A randomized controlled design was used with a 1-yr follow-up. The purpose was to compare the effects of two early interventions, a cognitive-behavioral group intervention and a self-help information package, in patients with insomnia. In sum, 165 individuals seeking care for insomnia of 3–12 months duration were randomized to either a group receiving a CBT intervention or a group receiving

Markus Jansson; Steven J. Linton

2005-01-01

265

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

Technology Transfer Automated Retrieval System (TEKTRAN)

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

266

Study on an advanced early rehabilitation training system for postural control using a tilting bed  

NASA Astrophysics Data System (ADS)

It proposed a new early rehabilitation training system for postural control using a tilting bed, a visual display and a force plate. The conventional rehabilitation systems for postural control can't be applied to the patients lying in bed because the rehabilitation training using those systems is only possible when the patient can stand up by himself or herself. Moreover, there did not exist any device that could provide the sense of balance or the sensation of walking to the patients in bed. The software for the system consists of the training program and the analysis program. The training program was designed to improve the ability of postural control of the subjects by repeated training of moving the center of pressure (COP) applied to the forceplate. The training program consists of the COP maintaining training and the COP movement training in horizontal, vertical, 45° and -45° directions. The analysis program consists of the COP moving time analysis modules, the COP maintaining time analysis module. Through the experiments with real people, it verified the effectiveness of the new early rehabilitation training system. The results showe that this system is an effective system for early rehabilitation training and that our system might be useful as clinical equipment.

Yu, Chang-Ho; Kim, Kyong; Kwon, Tae-Kyu; Hong, Chul-Un; Kim, Nam-Gyun

2005-12-01

267

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

PubMed Central

In songbirds, the seasonal growth of the song system is generally thought to be controlled by the spring increase in plasma levels of testosterone and/or related changes in singing activity. Here we report an extremely early seasonal growth (before February) of the song control nuclei HVC and RA in Corsican blue tits (Parus caeruleus) indicating that the vernal development of these nuclei occurs well before the vernal increase in plasma testosterone, testes size and song activity. The development of HVC and RA occurred simultaneously in two populations that are known to breed consistently one month apart as an adaptation to heterogeneous landscapes (predominance of broad-leaved deciduous versus evergreen oak trees). The unidentified environmental and/or physiological cues controlling the plasticity in the song system must therefore differ, at least in part, from those affecting other morphological and physiological traits controlling reproduction. PMID:16051436

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

2007-01-01

268

Incentive effect on inhibitory control in adolescents with early-life stress: an antisaccade study  

PubMed Central

Objective Early-life stress (ES) such as adoption, change of caregiver, or experience of emotional neglect [0]may influence the way in which affected individuals respond to emotional stimuli of positive or negative valence. These modified responses may stem from a direct alteration of how emotional stimuli are coded, and/or the cognitive function implicated in emotion modulation, such as self-regulation or inhibition. These ES effects have been probed on tasks either targeting reward and inhibitory function. Findings revealed deficits in both reward processing and inhibitory control in ES youths. However, no work has yet examined whether incentives can improve automatic response or inhibitory control in ES youths. Method To determine whether incentives would only improve self-regulated voluntary actions or generalize to automated motoric responses, participants were tested on a mixed eye movement task that included reflex-like prosaccades and voluntary controlled antisaccade eye movements. Seventeen adopted children (10 females, mean age 11.3 years) with a documented history of neglect and 29 typical healthy youths (16 females, mean age 11.9 years) performed the mixed prosaccade/antisaccade task during monetary incentive conditions or during no-incentive conditions. Results Across both saccade types, ES adolescents responded more slowly than controls. As expected, control participants committed fewer errors on antisaccades during the monetary incentive condition relative to the no-incentive condition. By contrast, ES youths failed to show this incentive-related improvement on inhibitory control. No significant incentive effects were found with prepotent prosaccades trials in either group. Finally, co-morbid psychopathology did not modulate the findings. Conclusions These data suggest that youths with experience of early stress exhibit deficient modulation of inhibitory control by reward processes, in tandem with a reward-independent deficit in preparation for both automatic and controlled responses. These data may be relevant to interventions in ES youths. PMID:22425696

Mueller, Sven C.; Hardin, Michael G.; Korelitz, Katherine; Daniele, Teresa; Bemis, Jessica; Dozier, Mary; Peloso, Elizabeth; Maheu, Francoise; Pine, Daniel S.; Ernst, Monique

2012-01-01

269

Do early skin care practices alter the risk of atopic dermatitis? A case-control study  

PubMed Central

Background The rise in atopic dermatitis prevalence seen in industrialized countries in unexplained. Some authors have suggested that the increase in the use of skin care products is partly responsible. There are few studies examining skin care practices commonly used in treatment of children. We hypothesized that the use of moisturizers early in life may alter the risk for developing atopic dermatitis. Methods A case-control study utilizing two control groups was performed. Cases were defined as children under six years of age who developed atopic dermatitis. A normal control and a high-risk control group were used for comparison. Parents or caregivers of children were questioned regarding skin care practices used in early life in an attempt to identify practices that increased the risk of developing atopic dermatitis. Results The regular use of a moisturizer on the child during the first six months of life was very common in all groups, 76%, 74.7%, and 78% in the atopic, non-atopic, and high-risk groups, respectively. Because of the high rate of moisturizer use in all groups, no significant differences were found between groups. Watery lotions were the most commonly used moisturizer. Conclusions Despite published guidelines advising to the contrary, the regular use of moisturizers was common in this population. Although no one specific skin care practice was associated with atopic dermatitis, the frequent use of products potentially detrimental to the skin barrier raises concern. PMID:21895755

Rendell, Marla E.; Baig-Lewis, Shahana F.; Berry, Trista M.; Denny, Melissa E.; Simpson, Brenda M.; Brown, Peter A.; Simpson, Eric L.

2012-01-01

270

Differentiating Processes of Control and Understanding in the Early Development of Emotion and Cognition  

PubMed Central

In this study we examined the hypothesis that preschoolers’ performance on emotion and cognitive tasks is organized into discrete processes of control and understanding within the domains of emotion and cognition. Additionally, we examined the relations among component processes using mother report, behavioral observation, and physiological measures of emotion control. Participants were 263 children (42% non-White) and their mothers. Results indicated that the three approaches of measuring emotion control were unrelated. Regardless of the measurement method, a four-factor solution differentiating emotion control and understanding and cognitive control and understanding fit the data better than did either of two 2-factor models, one based on domains of emotion and cognition across processes, and one based on processes of control and understanding across domains. Results of this research replicate those of Leerkes et al. (2008) in describing a differentiated underlying structure of emotion and cognition processes in early childhood while also extending these conclusions across samples and across measurement approaches for assessing emotion control. PMID:22328805

Blankson, A. Nayena; O’Brien, Marion; Leerkes, Esther M.; Marcovitch, Stuart; Calkins, Susan D.

2011-01-01

271

Early diagnostic suggestions improve accuracy of GPs: a randomised controlled trial using computer-simulated patients  

PubMed Central

Background Designers of computerised diagnostic support systems (CDSSs) expect physicians to notice when they need advice and enter into the CDSS all information that they have gathered about the patient. The poor use of CDSSs and the tendency not to follow advice once a leading diagnosis emerges would question this expectation. Aim To determine whether providing GPs with diagnoses to consider before they start testing hypotheses improves accuracy. Design and setting Mixed factorial design, where 297 GPs diagnosed nine patient cases, differing in difficulty, in one of three experimental conditions: control, early support, or late support. Method Data were collected over the internet. After reading some initial information about the patient and the reason for encounter, GPs requested further information for diagnosis and management. Those receiving early support were shown a list of possible diagnoses before gathering further information. In late support, GPs first gave a diagnosis and were then shown which other diagnoses they could still not discount. Results Early support significantly improved diagnostic accuracy over control (odds ratio [OR] 1.31; 95% confidence interval [95%CI] = 1.03 to 1.66, P = 0.027), while late support did not (OR 1.10; 95% CI = 0.88 to 1.37). An absolute improvement of 6% with early support was obtained. There was no significant interaction with case difficulty and no effect of GP experience on accuracy. No differences in information search were detected between experimental conditions. Conclusion Reminding GPs of diagnoses to consider before they start testing hypotheses can improve diagnostic accuracy irrespective of case difficulty, without lengthening information search. PMID:25548316

Kostopoulou, Olga; Rosen, Andrea; Round, Thomas; Wright, Ellen; Douiri, Abdel; Delaney, Brendan

2015-01-01

272

Substance Use Progression from Adolescence to Early Adulthood: Effortful Control in the Context of Friendship Influence and Early-Onset Use  

ERIC Educational Resources Information Center

In a sample of 998 ethnically diverse adolescents, a multiagent, multimethod approach to the measurement of adolescent effortful control, adolescent substance use, and friendship influence was used to predict escalations to early-adult tobacco, alcohol, and marijuana use by ages 22-23. Structural equation modeling revealed that adolescent…

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

2012-01-01

273

Retinal Adaptation to Changing Glycemic Levels in a Rat Model of Type 2 Diabetes  

PubMed Central

Purpose Glucose concentrations are elevated in retinal cells in undiagnosed and in undertreated diabetes. Studies of diabetic patients suggest that retinal function adapts, to some extent, to this increased supply of glucose. The aim of the present study was to examine such adaptation in a model of type 2 diabetes and assess how the retina responds to the subsequent institution of glycemic control. Methods Electroretinography (ERG) was conducted on untreated Zucker diabetic fatty (ZDF) rats and congenic controls from 8–22 weeks of age and on ZDFs treated with daily insulin from 16–22 weeks of age. Retinal sections from various ages were prepared and compared histologically and by immunocytochemistry. Principal Findings/Conclusions Acute hyperglycemia did not have an effect on control rats while chronic hyperglycemia in the ZDF was associated with scotopic ERG amplitudes which were up to 20% higher than those of age-matched controls. This change followed the onset of hyperglycemia with a delay of over one month, supporting that habituation to hyperglycemia is a slow process. When glycemia was lowered, an immediate decrease in ZDF photoreceptoral activity was induced as seen by a reduction in a-wave amplitudes and maximum slopes of about 30%. A direct effect of insulin on the ERG was unlikely since the expression of phosphorylated Akt kinase was not affected by treatment. The electrophysiological differences between untreated ZDFs and controls preceded an activation of Müller cells in the ZDFs (up-regulation of glial fibrillary acidic protein), which was attenuated by insulin treatment. There were otherwise no signs of cell death or morphological alterations in any of the experimental groups. These data show that under chronic hyperglycemia, the ZDF retina became abnormally sensitive to variations in substrate supply. In diabetes, a similar inability to cope with intensive glucose lowering could render the retina susceptible to damage. PMID:23408985

Johnson, Leif E.; Larsen, Michael; Perez, Maria-Thereza

2013-01-01

274

Variable Classifications of Glycemic Index Determined by Glucose Meters  

PubMed Central

The study evaluated and compared the differences of glucose responses, incremental area under curve (IAUC), glycemic index (GI) and the classification of GI values between measured by biochemical analyzer (Fuji automatic biochemistry analyzer (FAA)) and three glucose meters: Accue Chek Advantage (AGM), BREEZE 2 (BGM), and Optimum Xceed (OGM). Ten healthy subjects were recruited for the study. The results showed OGM yield highest postprandial glucose responses of 119.6 ± 1.5, followed by FAA, 118.4 ± 1.2, BGM, 117.4 ± 1.4 and AGM, 112.6 ± 1.3 mg/dl respectively. FAA reached highest mean IAUC of 4156 ± 208 mg × min/dl, followed by OGM (3835 ± 270 mg × min/dl), BGM (3730 ± 241 mg × min/dl) and AGM (3394 ± 253 mg × min/dl). Among four methods, OGM produced highest mean GI value than FAA (87 ± 5) than FAA, followed by BGM and AGM (77 ± 1, 68 ± 4 and 63 ± 5, p<0.05). The results suggested that the AGM, BGM and OGM are more variable methods to determine IAUC, GI and rank GI value of food than FAA. The present result does not necessarily apply to other glucose meters. The performance of glucose meter to determine GI value of food should be evaluated and calibrated before use. PMID:20664730

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

2010-01-01

275

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

Microsoft Academic Search

Treating anemia early in renal failure patients slows the decline of renal function: A randomized controlled trial.BackgroundErythropoietin is known to improve outcomes in patients with anemia from chronic renal disease. However, there is uncertainty about the optimal timing of initiation of erythropoietin treatment in predialysis patients with non-severe anemia.MethodsWe conducted a randomized controlled trial of early versus deferred initiation of

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

2004-01-01

276

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

PubMed Central

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

2012-01-01

277

TOR controls translation initiation and early G1 progression in yeast.  

PubMed Central

Saccharomyces cerevisiae cells treated with the immunosuppressant rapamycin or depleted for the targets of rapamycin TOR1 and TOR2 arrest growth in the early G1 phase of the cell cycle. Loss of TOR function also causes an early inhibition of translation initiation and induces several other physiological changes characteristic of starved cells entering stationary phase (G0). A G1 cyclin mRNA whose translational control is altered by substitution of the UBI4 5' leader region (UBI4 is normally translated under starvation conditions) suppresses the rapamycin-induced G1 arrest and confers starvation sensitivity. These results suggest that the block in translation initiation is a direct consequence of loss of TOR function and the cause of the G1 arrest. We propose that the TORs, two related phosphatidylinositol kinase homologues, are part of a novel signaling pathway that activates eIF-4E-dependent protein synthesis and, thereby, G1 progression in response to nutrient availability. Such a pathway may constitute a checkpoint that prevents early G1 progression and growth in the absence of nutrients. Images PMID:8741837

Barbet, N C; Schneider, U; Helliwell, S B; Stansfield, I; Tuite, M F; Hall, M N

1996-01-01

278

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

PubMed Central

Background Road traffic accidents (RTA) and burns are frequent events in children. Although many children recover spontaneously, a considerable number develop long-term psychological sequelae. Evidence on early psychological interventions to prevent such long-term problems is still scarce for school-age children and completely lacking for pre-school children. Objectives To evaluate the efficacy of an early two-session cognitive-behavioral intervention in 108 children ages 2–16 after RTAs and burns. Methods Children assessed at risk for the development of posttraumatic stress disorder (PTSD) were randomly assigned to either a control group offered treatment as usual or an intervention group. Primary outcomes were PTSD, behavioral problems, and depression symptoms. Baseline and blinded 3- and 6-month follow-up assessments were conducted. Results In pre-school children, no intervention effects were found. School-age children in the intervention group exhibited significantly fewer internalizing problems at 3-month follow-up relative to controls and a borderline significant time-by-group effect for PTSD intrusion symptoms was found (p=0.06). Conclusions This is the first study examining the efficacy of an indicated, early psychological intervention among both school-age and pre-school-age children. Because the intervention was ineffective for young children, no evidence-based practice can currently be suggested. Given that parents of pre-school children perceived the intervention as helpful, brief counseling of parents in terms of psychoeducation and training in coping skills still should be provided by clinicians, despite the current lack of evidence. To prevent trauma-related disorders in school-age children, the intervention might be used in a step-wise manner, where only children at risk for long-term psychological maladjustment are provided with psychological support. PMID:24987498

Kramer, Didier N.; Landolt, Markus A.

2014-01-01

279

Argonaute-1 functions as a mitotic regulator by controlling Cyclin B during Drosophila early embryogenesis.  

PubMed

The role of Ago-1 in microRNA (miRNA) biogenesis has been thoroughly studied, but little is known about its involvement in mitotic cell cycle progression. In this study, we established evidence of the regulatory role of Ago-1 in cell cycle control in association with the G2/M cyclin, cyclin B. Immunostaining of early embryos revealed that the maternal effect gene Ago-1 is essential for proper chromosome segregation, mitotic cell division, and spindle fiber assembly during early embryonic development. Ago-1 mutation resulted in the up-regulation of cyclin B-Cdk1 activity and down-regulation of p53, grp, mei-41, and wee1. The increased expression of cyclin B in Ago-1 mutants caused less stable microtubules and probably does not produce enough force to push the nuclei to the cortex, resulting in a decreased number of pole cells. The role of cyclin B in mitotic defects was further confirmed by suppressing the defects in the presence of one mutant copy of cyclin B. We identified involvement of 2 novel embryonic miRNAs--miR-981 and miR--317-for spatiotemporal regulation of cyclin B. In summary, our results demonstrate that the haploinsufficiency of maternal Ago-1 disrupts mitotic chromosome segregation and spindle fiber assembly via miRNA-guided control during early embryogenesis in Drosophila. The increased expression of cyclin B-Cdk1 and decreased activity of the Cdk1 inhibitor and cell cycle checkpoint proteins (mei-41 and grp) in Ago-1 mutant embryos allow the nuclei to enter into mitosis prematurely, even before completion of DNA replication. Thus, our results have established a novel role of Ago-1 as a regulator of the cell cycle. PMID:24165481

Pushpavalli, Sreerangam N C V L; Sarkar, Arpita; Bag, Indira; Hunt, Clayton R; Ramaiah, M Janaki; Pandita, Tej K; Bhadra, Utpal; Pal-Bhadra, Manika

2014-02-01

280

Early loading of plalatal implants (ortho-type II) a prospective multicenter randomized controlled clinical trial  

PubMed Central

Background In orthodontic treatment, anchorage control is a fundamental aspect. Usually conventional mechanism for orthodontic anchorage control can be either extraoral or intraoral that is headgear or intermaxillary elastics. Their use are combined with various side effects such as tipping of occlusal plane or undesirable movements of teeth. Especially in cases, where key-teeth are missing, conventional anchorage defined as tooth-borne anchorage will meet limitations. Therefore, the use of endosseous implants for anchorage purposes are increasingly used to achieve positional stability and maximum anchorage. Methods/Design The intended study is designed as a prospective, multicenter randomized controlled trial (RCT), comparing and contrasting the effect of early loading of palatal implant therapy versus implant loading after 12 weeks post implantation using the new ortho-implant type II anchor system device (Orthosystem Straumann, Basel, Switzerland). 124 participants, mainly adult males or females, whose diagnoses require temporary stationary implant-based anchorage treatment will be randomized 1:1 to one of two treatment groups: group 1 will receive a loading of implant standard therapy after a healing period of 12 week (gold standard), whereas group 2 will receive an early loading of orthodontic implants within 1 week after implant insertion. Participants will be at least followed for 12 months after implant placement. The primary endpoint is to investigate the behavior of early loaded palatal implants in order to find out if shorter healing periods might be justified to accelerate active orthodontic treatment. Secondary outcomes will focus e.g. on achievement of orthodontic treatment goals and quantity of direct implant-bone interface of removed bone specimens. As tertiary objective, a histologic and microtomography evaluation of all retrieved implants will be performed to obtain data on the performance of the SLA surface in human bone evaluation of all retrieved implants. Additionally, resonance frequency analysis (RFA, Osstell™ mentor) will be used at different times for clinically monitoring the implant stability and for histological comparison in order to measure the reliability of the resonance frequency measuring device. Trial registration Current Controlled Trials ISRCTN97142521. PMID:17883841

Jung, Britta A; Wehrbein, Heinrich; Hopfenmüller, Werner; Harzer, Winfried; Gedrange, Tomasz; Diedrich, Peter; Kunkel, Martin

2007-01-01

281

High and low glycemic index mixed meals and blood glucose in youth with type 2 diabetes or impaired glucose tolerance.  

PubMed

This cross-over pilot study tested blood glucose response to low and high glycemic index meals in 12 obese youth with type 2 diabetes or impaired glucose tolerance. Participants demonstrated significantly lower mean daytime blood glucose and a trend toward lower variability, suggesting a clinically relevant impact of reducing glycemic index. PMID:19874764

Gellar, Lauren; Nansel, Tonja R

2009-03-01

282

High and Low Glycemic Index Mixed Meals and Blood Glucose in Youth with Type 2 Diabetes or Impaired Glucose Tolerance  

PubMed Central

This cross-over pilot study tested blood glucose response to low and high glycemic index meals in 12 obese youth with type 2 diabetes or impaired glucose tolerance. Participants demonstrated significantly lower mean daytime blood glucose and a trend toward lower variability, suggesting a clinically relevant impact of reducing glycemic index. PMID:19874764

Gellar, Lauren; Nansel, Tonja R.

2009-01-01

283

High and Low Glycemic Index Mixed Meals and Blood Glucose in Youth with Type 2 Diabetes or Impaired Glucose Tolerance  

Microsoft Academic Search

This cross-over pilot study tested blood glucose response to low and high glycemic index meals in 12 obese youth with type 2 diabetes or impaired glucose tolerance. Participants demonstrated significantly lower mean daytime blood glucose and a trend toward lower variability, suggesting a clinically relevant impact of reducing glycemic index.

Lauren A. Gellar; Tonja R. Nansel

2009-01-01

284

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

PubMed

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

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

2014-02-01

285

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

PubMed Central

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

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

2013-01-01

286

The Effect of Walking on Postprandial Glycemic Excursion in Patients With Type 1 Diabetes and Healthy People  

PubMed Central

OBJECTIVE Physical activity (PA), even at low intensity, promotes health and improves hyperglycemia. However, the effect of low-intensity PA captured with accelerometery on glucose variability in healthy individuals and patients with type 1 diabetes has not been examined. Quantifying the effects of PA on glycemic variability would improve artificial endocrine pancreas (AEP) algorithms. RESEARCH DESIGN AND METHODS We studied 12 healthy control subjects (five males, 37.7 ± 13.7 years of age) and 12 patients with type 1 diabetes (five males, 37.4 ± 14.2 years of age) for 88 h. Participants performed PA approximating a threefold increase over their basal metabolic rate. PA was captured using a PA-monitoring system, and interstitial fluid glucose concentrations were captured with continuous glucose monitors. In random order, one meal per day was followed by inactivity, and the other meals were followed by walking. Glucose and PA data for a total of 216 meals were analyzed from 30 min prior to meal ingestion to 270 min postmeal. RESULTS In healthy subjects, the incremental glucose area under the curve was 4.5 mmol/L/270 min for meals followed by walking, whereas it was 9.6 mmol/L/270 min (P = 0.022) for meals followed by inactivity. The corresponding glucose excursions for those with type 1 diabetes were 7.5 mmol/L/270 min and 18.4 mmol/L/270 min, respectively (P < 0.001). CONCLUSIONS Walking significantly impacts postprandial glucose excursions in healthy populations and in those with type 1 diabetes. AEP algorithms incorporating PA may enhance tight glycemic control end points. PMID:22875231

Manohar, Chinmay; Levine, James A.; Nandy, Debashis K.; Saad, Ahmed; Dalla Man, Chiara; McCrady-Spitzer, Shelly K.; Basu, Rita; Cobelli, Claudio; Carter, Rickey E.; Basu, Ananda; Kudva, Yogish C.

2012-01-01

287

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

PubMed Central

This study examined parasympathetic physiology as a moderator of the effects of early adversity (i.e., child abuse and neglect) on children’s inhibitory control. Children’s respiratory sinus arrhythmia (RSA) was assessed during a resting baseline, two joint challenge tasks with mother, and an individual frustration task. RSA assessed during each of the joint parent–child challenge tasks moderated the effects of child maltreatment (CM) status on children’s independently-assessed inhibitory control. No moderation effect was found for RSA assessed at baseline or in the child-alone challenge task. Among CM-exposed children, lower RSA levels during the joint task predicted the lowest inhibitory control, whereas higher joint task RSA was linked to higher inhibitory control scores that were indistinguishable from those of non-CM children. Results are discussed with regard to the importance of considering context specificity (i.e., individual and caregiver contexts) in how biomarkers inform our understanding of individual differences in vulnerability among at-risk children. PMID:24142832

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

2014-01-01

288

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

Microsoft Academic Search

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

Eric L Ding; Vasanti S Malik

2008-01-01

289

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

PubMed

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

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

2014-10-01

290

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

ERIC Educational Resources Information Center

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…

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

2013-01-01

291

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

ERIC Educational Resources Information Center

Behavioral inhibition (BI) and maternal over-control are early risk factors for later childhood internalizing problems, particularly social anxiety disorder (SAD). Consistently high BI across childhood appears to confer risk for the onset of SAD by adolescence. However, no prior studies have prospectively examined observed maternal over-control as…

Lewis-Morrarty, Erin; Degnan, Kathryn A.; Chronis-Tuscano, Andrea; Rubin, Kenneth H.; Cheah, Charissa S. L.; Pine, Daniel S.; Henderon, Heather A.; Fox, Nathan A.

2012-01-01

292

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

293

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

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…

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

2013-01-01

294

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

PubMed Central

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

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

295

Sucralose Affects Glycemic and Hormonal Responses to an Oral Glucose Load  

PubMed Central

OBJECTIVE Nonnutritive sweeteners (NNS), such as sucralose, have been reported to have metabolic effects in animal models. However, the relevance of these findings to human subjects is not clear. We evaluated the acute effects of sucralose ingestion on the metabolic response to an oral glucose load in obese subjects. RESEARCH DESIGN AND METHODS Seventeen obese subjects (BMI 42.3 ± 1.6 kg/m2) who did not use NNS and were insulin sensitive (based on a homeostasis model assessment of insulin resistance score ?2.6) underwent a 5-h modified oral glucose tolerance test on two separate occasions preceded by consuming either sucralose (experimental condition) or water (control condition) 10 min before the glucose load in a randomized crossover design. Indices of ?-cell function, insulin sensitivity (SI), and insulin clearance rates were estimated by using minimal models of glucose, insulin, and C-peptide kinetics. RESULTS Compared with the control condition, sucralose ingestion caused 1) a greater incremental increase in peak plasma glucose concentrations (4.2 ± 0.2 vs. 4.8 ± 0.3 mmol/L; P = 0.03), 2) a 20 ± 8% greater incremental increase in insulin area under the curve (AUC) (P < 0.03), 3) a 22 ± 7% greater peak insulin secretion rate (P < 0.02), 4) a 7 ± 4% decrease in insulin clearance (P = 0.04), and 5) a 23 ± 20% decrease in SI (P = 0.01). There were no significant differences between conditions in active glucagon-like peptide 1, glucose-dependent insulinotropic polypeptide, glucagon incremental AUC, or indices of the sensitivity of the ?-cell response to glucose. CONCLUSIONS These data demonstrate that sucralose affects the glycemic and insulin responses to an oral glucose load in obese people who do not normally consume NNS. PMID:23633524

Pepino, M. Yanina; Tiemann, Courtney D.; Patterson, Bruce W.; Wice, Burton M.; Klein, Samuel

2013-01-01

296

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

SciTech Connect

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

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

1995-12-01

297

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

PubMed

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

Clark, Caron A C; Woodward, Lianne J

2014-10-01

298

Results of a prospective randomized controlled trial of early ambulation for patients with lower extremity autografts.  

PubMed

It is common practice to keep those patients with lower extremity autografts immobile until post-operative day (POD) 5. There is however inherent risks associated with even short periods of immobility. As of now there are no randomized controlled trials looking at early ambulation of patients with lower extremity autografts in the burn community.The objective of this study was to show that patients who begin ambulation within 24 hours of lower extremity autografting will have no increased risk of graft failure than those patients who remain immobile until POD 5. Thirty-one subjects who received autografts to the lower extremity were randomized after surgery into either the early ambulation group (EAG;17 subjects) or the standard treatment group (STG;14 subjects). Those subjects randomized to the EAG began ambulating with physical therapy on POD 1. Subjects in the STG maintained bed rest until POD 5. There was no difference in the number of patients with graft loss in either the EAG or STG on POD 5, and during any of the follow-up visits. No subjects required regrafting. There was a significant difference in the mean minutes of ambulation, with the EAG ambulating longer than the STG (EAG 23.4 minutes [SD 12.03], STG 14.1 [SD 9.00], P=.0235) on POD 5. Burn patients with lower extremity autografts can safely ambulate on POD 1 without fear of graft failure compared with those patients that remain on bed rest for 5 days. PMID:25100538

Lorello, David John; Peck, Michael; Albrecht, Marlene; Richey, Karen J; Pressman, Melissa A

2014-01-01

299

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

NASA Astrophysics Data System (ADS)

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

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

2011-12-01

300

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

SciTech Connect

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.

Reidy, John F. [Department of Radiology, 2nd Floor, Guy's Tower, Guy's Hospital, St. Thomas Street, London, SE1 9RT (United Kingdom); Qureshi, Shakeel A. [Pediatric Cardiology Department, 11th Floor, Guy's Tower, Guy's Hospital, St. Thomas Street, London, SE1 9RT (United Kingdom)

1996-03-15

301

Trunk Control Ability after Minimally Invasive Lumbar Fusion Surgery during the Early Postoperative Phase  

PubMed Central

[Purpose] Lumbar fusion has been used for spinal disorders when conservative treatment fails. The minimally invasive approach causes minimal damage to the back muscles and shortens the postoperative recovery time. However, evidence regarding functional recovery in patients after minimally invasive lumbar spinal fusion is limited. The purpose of this study was to investigate how trunk control ability is affected after minimally invasive lumbar fusion surgery during the early postoperative phase. [Subjects and Methods] Sixteen patients and 16 age- and sex-matched healthy participants were recruited. Participants were asked to perform a maximum forward reaching task and were evaluated 1 day before and again 1 month after the lumbar fusion surgery. Center of pressure (COP) displacement, back muscle strength, and scores for the Visual Analog Scale, and Chinese version of the modified Oswestry Disability Index (ODI) were recorded. [Results] The healthy control group exhibited more favorable outcomes than the patient group both before and after surgery in back strength, reaching distance, reaching velocity, and COP displacement. The patient group improved significantly after surgery in all clinical outcome measurements. However, reaching distance decreased, and the reaching velocity as well as COP displacement did not differ before and after surgery. [Conclusion] The LBP patients with lumbar fusion surgery showed improvement in pain intensity 1 month after surgery but no improvement in trunk control during forward reaching. The results provide evidence that the back muscle strength was not fully recovered in patients 1 month after surgery and limited their ability to move their trunk forward. PMID:25202174

Pao, Jwo-Luen; Yang, Rong-Sen; Hsiao, Chen-Hsi; Hsu, Wei-Li

2014-01-01

302

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

SciTech Connect

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.

Fujita, Toshitsugu; Piuz, Isabelle [Fondation pour Recherches Medicales, University of Geneva, 64 av. de la Roseraie, 1211 Geneva (Switzerland); Schlegel, Werner [Fondation pour Recherches Medicales, University of Geneva, 64 av. de la Roseraie, 1211 Geneva (Switzerland)], E-mail: werner.schlegel@unige.ch

2009-01-15

303

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

PubMed Central

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

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

2014-01-01

304

Influence of threatened miscarriage on pregnancy and early postpartum period: a case-control report.  

PubMed

Abstract Objective: To evaluate the influence of threatened miscarriage on obstetric complications during pregnancy and early postpartum period. Methods: In this case-control study, hospital records of 12?050 first-trimester patients between January 2011 and December 2012 at the Research and Educational Hospital in Ankara, Turkey, were used. Of the 12?050 patients, 481 threatened miscarriage patients were evaluated. The control group was formed by age- and body mass index-matched cases without first trimester bleeding. Abortion, intrauterine foetal demise, preterm birth, preeclampsia, antenatal haematoma, uterine atony placental abruption and low birth-weights were compared between the study and the control group. Results: When compared with the control group, the risk of having a preterm birth (p?=?0.014; OR: 1.95; 95% CI: 1.15-3.24), low-birth-weight infant (p?=?0.001; OR: 2.33; 95% CI: 1.45-3.83) and abortion (p?=?0.00; OR: 2.55; 95% CI: 1.62-3.91) increased in cases of threatened miscarriage. However, the risk of uterine atony was decreased (p?=?0.006; OR: 0.09; 95% CI: 0.12-0.7) in the threatened miscarriage group when compared with the control group. Threatened miscarriage did not increase the risk of placenta praevia, placental abruption or intrauterine foetal demise. Conclusion: Increased complications after threatened miscarriage is probably due to the persistence of a triggering mechanism. As preterm birth and abortion rate increased, whilst uterine atony rate decreased, one of the mechanisms causing threatened miscarriage might be increased uterine contractility. PMID:25053196

Ozdemirci, Safak; Karahanoglu, Ertugrul; Esinler, Deniz; Gelisen, Orhan; Kay?kc?oglu, Fulya

2014-08-12

305

Extemporaneously prepared controlled release formulations for accelerating the early phase development of drug candidates.  

PubMed

Extemporaneous drug preparations, which are compounded by a pharmacist at a clinical site, are commonly used in early clinical studies to evaluate the performance of drug candidates. However, the types of formulations compounded have been limited to relatively simple preparations such as solutions, suspensions and active ingredients filled into capsules. This article describes the preparation of advanced formulations, specifically extemporaneously prepared matrix tablets and osmotic capsules, which can be used to evaluate the feasibility of controlled release for exploratory new drug candidates or new formulations of existing drugs with a differentiated medical advantage. Extemporaneously prepared dosage forms enable the rapid assessment (i.e. reduced cycle time) of new formulation ideas with minimal quantity of the active pharmaceutical ingredient needed to demonstrate proof-of-concept. PMID:24560934

Thombre, Avinash G; Berchielli, Alfred; Rogers, Janyce F

2014-05-01

306

Visual working memory gives up attentional control early in learning: ruling out interhemispheric cancellation.  

PubMed

Current research suggests that we can watch visual working memory surrender the control of attention early in the process of learning to search for a specific object. This inference is based on the observation that the contralateral delay activity (CDA) rapidly decreases in amplitude across trials when subjects search for the same target object. Here, we tested the alternative explanation that the role of visual working memory does not actually decline across learning, but instead lateralized representations accumulate in both hemispheres across trials and wash out the lateralized CDA. We show that the decline in CDA amplitude occurred even when the target objects were consistently lateralized to a single visual hemifield. Our findings demonstrate that reductions in the amplitude of the CDA during learning are not simply due to the dilution of the CDA from interhemispheric cancellation. PMID:24708027

Reinhart, Robert M G; Carlisle, Nancy B; Woodman, Geoffrey F

2014-08-01

307

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

PubMed Central

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

2014-01-01

308

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

PubMed

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

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

2012-05-01

309

Randomised controlled trial of laparoscopic versus open repair of inguinal hernia: early results.  

PubMed Central

OBJECTIVE--To establish the safety, short term outcome, and theatre costs of transabdominal laparoscopic repair of inguinal hernia performed as day surgery. DESIGN--Randomised controlled trial. The control operation was the two layer modified Maloney darn. SETTING--Teaching hospital and district general hospital. SUBJECTS--125 men randomised to laparoscopic or open repair of inguinal hernia. OUTCOME MEASURES--Morbidity, postoperative pain and use of analgesics, quality of life, and theatre costs. Outcome was assessed by questionnaires administered to patients daily for 10 days and at six weeks postoperatively and by outpatient review at six weeks. Return to normal activity was assessed by questionnaire at three months. RESULTS--One vascular complication (2%) occurred in the group that had open repair. Seven complications (12%) including vessel injury and early recurrence arose in the group that had laparoscopic repair (difference in complication rate 10% (95% confidence interval 4% to 18%; P = 0.02). Pain scores and quality of life assessed by the short form 36 showed a significant benefit to the group that had laparoscopic repair in the early postoperative period. Return to normal activity was not significantly different between the two groups. Total theatre costs were higher in the group that had laparoscopic repair (mean cost for laparoscopic repair 850 pounds (622 pounds to 1078 pounds); mean cost for open repair 268 pounds (245 pounds to 292 pounds)). CONCLUSIONS--Because of the greater complication rate and higher theatre costs for laparoscopic repair and the patient outcome preferences expressed, the results of larger trials of clinical and cost effectiveness using recurrence as the primary outcome measure should be known before laparoscopic herniorrhaphy is widely adopted. PMID:7580639

Lawrence, K.; McWhinnie, D.; Goodwin, A.; Doll, H.; Gordon, A.; Gray, A.; Britton, J.; Collin, J.

1995-01-01

310

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

PubMed Central

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

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

311

Auranofin improves outcome in early rheumatoid arthritis. Results from a 2-year, double blind placebo controlled study.  

PubMed

The effect of early initiation of auranofin (AF) therapy on outcome measures was studied in a controlled 24-month double blind trial in 138 patients with early rheumatoid arthritis (RA) using an intent to treat approach. Patients were randomized to AF or placebo but in case of insufficient effect or intolerable adverse events, they switched to open disease modifying antirheumatic drug therapy. Patients who started AF fared significantly better in improved joint swelling. Stanford Health Assessment Questionnaire index, Keitel functional test, and mental depression, and furthermore, radiologic progression was significantly retarded. Our results support a disease modifying beneficial effect of AF in early active RA.se PMID:14552308

Borg, G; Allander, E; Lund, B; Berg, E; Brodin, U; Pettersson, H; Trang, L

1988-12-01

312

Ultra-early tranexamic acid after subarachnoid hemorrhage (ULTRA): study protocol for a randomized controlled trial  

PubMed Central

Background A frequent complication in patients with subarachnoid hemorrhage (SAH) is recurrent bleeding from the aneurysm. The risk is highest within the first 6 hours after the initial hemorrhage. Securing the aneurysm within this timeframe is difficult owing to logistical delays. The rate of recurrent bleeding can also be reduced by ultra-early administration of antifibrinolytics, which probably improves functional outcome. The aim of this study is to investigate whether ultra-early and short-term administration of the antifibrinolytic agent tranexamic acid (TXA), as add-on to standard SAH management, leads to better functional outcome. Methods/Design This is a multicenter, prospective, randomized, open-label trial with blinded endpoint (PROBE) assessment. Adult patients with the diagnosis of non-traumatic SAH, as proven by computed tomography (CT) within 24 hours after the onset of headache, will be randomly assigned to the treatment group or the control group. Patients in the treatment group will receive standard treatment with the addition of a bolus of TXA (1 g intravenously) immediately after randomization, followed by continuous infusion of 1 g per 8 hours until the start of aneurysm treatment, or a maximum of 24 hours after the start of medication. Patients in the control group will receive standard treatment without TXA. The primary outcome measure is favorable functional outcome, defined as a score of 0 to 3 on the modified Rankin Scale (mRS), at 6 months after SAH. Primary outcome will be determined by a trial nurse blinded for treatment allocation. We aim to include 950 patients in 3 years. Discussion The strengths of this study are: 1. the ultra-early and short-term administration of TXA, resulting in a lower dose as compared to previous studies, which should reduce the risk for delayed cerebral ischemia (DCI), an important risk factor in the long-term treatment with antifibrinolytics; 2. the power calculation is based on functional outcome and calculated with use of recent study results of our own population, supported by data from prominent studies; and 3. the participation of several specialized SAH centers, and their referring hospitals, in the Netherlands with comparative treatment protocols. Trial registration Nederlands Trial Register (Dutch Trial Registry) number NTR3272 PMID:23680226

2013-01-01

313

Sex differences in the developmental trajectories of impulse control and sensation-seeking from early adolescence to early adulthood.  

PubMed

It has been proposed that high rates of risk-taking in adolescence are partly attributable to patterns of neurobiological development that promote an increase in sensation-seeking tendencies at a time when impulse control is still developing. It is not known, however, whether this pattern is the same for males and females. The present study investigates sex differences in the developmental trajectories of self-reported impulse control and sensation-seeking between the ages of 10 and 25 using longitudinal data from the National Longitudinal Study of Youth 1979 Child and Young Adult Survey (N = 8,270; 49 % female; 33 % Black, 22 % Hispanic, 45 % Non-Black, Non-Hispanic). Prior work has found that, consistent with the dual-systems model of adolescent neurobiological development, sensation-seeking rises and falls across this age span, whereas impulse control increases into the 20s. In the present study, we find that this same general pattern holds for both males and females, but with some key differences. As expected, males exhibit higher levels of sensation-seeking and lower levels of impulse control than females. Differences also emerged in the shapes of the developmental trajectories. Females reach peak levels of sensation-seeking earlier than males (consistent with the idea that sensation-seeking is linked to pubertal development) and decline in sensation-seeking more rapidly thereafter. Also, males increase in impulse control more gradually than females. Consequently, sex differences in both impulse control and sensation-seeking increase with age. The findings suggest that the window of heightened vulnerability to risk-taking during adolescence may be greater in magnitude and more protracted for males than for females. PMID:24682958

Shulman, Elizabeth P; Harden, K Paige; Chein, Jason M; Steinberg, Laurence

2015-01-01

314

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

PubMed

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

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

2013-04-01

315

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

PubMed Central

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

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

2013-01-01

316

Efficacy of Constraint-Induced Movement Therapy in Early Stroke Rehabilitation: A Randomized Controlled Multisite Trial.  

PubMed

Background. There is limited evidence for the effects of constraint-induced movement therapy (CIMT) in the early stages of stroke recovery. Objective. To evaluate the effect of a modified CIMT within 4 weeks poststroke. Methods. This single-blinded randomized multisite trial investigated the effects of CIMT in 47 individuals who had experienced a stroke in the preceding 26 days. Patients were allocated to a CIMT or a usual care (control) group. The CIMT program was 3 h/d over 10 consecutive working days, with mitt use on the unaffected arm for up to 90% of waking hours. The follow-up time was 6 months. The primary outcome was the Wolf Motor Function test (WMFT) score. Secondary outcomes were the Fugl-Meyer upper-extremity motor score, Nine-Hole Peg test (NHPT) score, the arm use ratio, and the Stroke Impact Scale. Analyses of covariance with adjustment for baseline values were used to assess differences between the groups. Results. After treatment, the mean timed WMFT score was significantly better in the CIMT group compared with the control group. Moreover, posttreatment dexterity, as tested with the NHPT, was significantly better in the CIMT group, whereas the other test results were similar in both the groups. At the 6-month follow-up, the 2 groups showed no significant difference in arm impairment, function, or use in daily activities. Conclusions. Despite a favorable effect of CIMT on timed movement measures immediately after treatment, significant effects were not found after 6 months. PMID:25398726

Thrane, Gyrd; Askim, Torunn; Stock, Roland; Indredavik, Bent; Gjone, Ragna; Erichsen, Anne; Anke, Audny

2014-11-14

317

Homeostatic interferon expression in neurons is sufficient for early control of viral infection.  

PubMed

The mechanisms by which neurons respond to inflammatory mediators such as interferons (IFNs) remain largely undefined. We previously showed that the activation and nuclear localization of the core IFN signaling molecule, Stat1, are muted and delayed in primary mouse hippocampal neurons treated with IFN gamma as compared to control mouse embryonic fibroblasts (MEFs). Here, we show that the kinetics of Stat1 and Stat2 activation following type I IFN exposure are also unique in neurons, affecting gene expression and neuronal response. Specifically, despite lower basal expression of many IFN stimulated genes in neurons, basal expression of the type I IFN themselves is significantly higher in primary hippocampal neurons compared to MEF. Elevated homeostatic IFN in neurons is critical and sufficient for early control of viral infection. These data provide further evidence that neurons exploit unique signaling responses to IFNs, and define an important contribution of homeostatic IFN within the CNS. Such differences are likely critical for the ability of neurons to survive a viral challenge. PMID:25669994

Cavanaugh, Sarah E; Holmgren, Alicia M; Rall, Glenn F

2015-02-15

318

Paracrine Mechanisms Involved in the Control of Early Stages of Mammalian Spermatogenesis  

PubMed Central

Within the testis, Sertoli-cell is the primary target of pituitary FSH. Several growth factors have been described to be produced specifically by Sertoli cells and modulate male germ cell development through paracrine mechanisms. Some have been shown to act directly on spermatogonia such as GDNF, which acts on self-renewal of spermatogonial stem cells (SSCs) while inhibiting their differentiation; BMP4, which has both a proliferative and differentiative effect on these cells, and KIT ligand (KL), which stimulates the KIT tyrosine-kinase receptor expressed by differentiating spermatogonia (but not by SSCs). KL not only controls the proliferative cycles of KIT-positive spermatogonia, but it also stimulates the expression of genes that are specific of the early phases of meiosis, whereas the expression of typical spermatogonial markers is down-regulated. On the contrary, FGF9 acts as a meiotic inhibiting substance both in fetal gonocytes and in post-natal spermatogonia through the induction of the RNA-binding protein NANOS2. Vitamin A, which is metabolized to Retinoic Acid in Sertoli cells, controls both SSCs differentiation through KIT induction and NANOS2 inhibition, and meiotic entry of differentiating spermatogonia through STRA8 upregulation. PMID:24324457

Rossi, Pellegrino; Dolci, Susanna

2013-01-01

319

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...

320

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...

321

Low Glycemic Index Breakfasts and Reduced Food Intake in Preadolescent Children  

Microsoft Academic Search

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

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

2009-01-01

322

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

Microsoft Academic Search

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

Robert M Blair; EC Henley; Aaron Tabor

2006-01-01

323

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...

324

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

PubMed Central

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

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

2013-01-01

325

"Greenlight study": a controlled trial of low-literacy, early childhood obesity prevention.  

PubMed

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

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

2014-06-01

326

A randomized controlled phase II trial of riluzole in early multiple sclerosis  

PubMed Central

Objectives We evaluated the effect of riluzole versus placebo added to weekly IM interferon beta-1a in early multiple sclerosis (MS). Methods This is a randomized (1:1), double-blind, placebo-controlled trial of riluzole 50 mg twice daily in subjects with MS onset less than 1 year prior. Trial participation was up to 3 years. The primary endpoint was change in percent brain volume change. Secondary endpoints included changes in normalized gray and normal-appearing white matter volumes, retinal nerve fiber layer thickness (RNFL), MS Functional Composite and Symbol Digit Modalities Test scores. Mixed model regression analysis was used to compare the changes over time between groups. Results Forty-three subjects were randomized to study drug (22 riluzole, 21 placebo). Baseline characteristics were overall similar between groups except for older age (P = 0.042), higher normalized cerebrospinal fluid volume (P = 0.050), lower normalized gray matter volume (P = 0.14), and thinner RNFL (P = 0.043) in the riluzole group. In the primary analysis, percent brain volume change in the placebo group decreased at a rate of 0.49% per year whereas the riluzole group decreased by 0.86% per year (0.37% more per year; 95% CI ?0.78, 0.024; P = 0.065). Although age did not influence the rate of brain volume decline, the difference between groups was attenuated after adjustment for baseline normalized gray matter and lesion volume (0.26% more per year in riluzole group; 95% CI ?0.057, 0.014; P = 0.22). Analyses of secondary outcomes showed no differences between groups. Interpretation This trial provides class 1 evidence that riluzole treatment does not meaningfully reduce brain atrophy progression in early MS. PMID:25356404

Waubant, Emmanuelle; Maghzi, Amir-Hadi; Revirajan, Nisha; Spain, Rebecca; Julian, Laura; Mowry, Ellen M; Marcus, Jacqueline; Liu, Shuang; Jin, Chengshi; Green, Ari; McCulloch, Charles E; Pelletier, Daniel

2014-01-01

327

Early stage carcinoma of oral tongue: prognostic factors for local control and survival.  

PubMed

The purpose of this study was to assess prognostic factors, treatment outcomes and patterns of relapse in patients with early stage (T1-2 N0) squamous cell carcinoma of oral tongue treated primarily by surgery. The medical records of all patients with early stage (T1-2 N0) oral tongue cancer, radically treated at King Faisal Specialist Hospital and Research Center between January 1980 and December 1997, were reviewed. Eighty-five patients were identified for analysis, 38 male and 47 female. With a median follow-up for surviving patients of 64 months, 5-year actuarial overall, disease-specific (DSS), and relapse-free survival (RFS) were 71, 75, and 63%, respectively. Univariate analysis for DSS showed survival advantage for patients with tumor thickness (TT) of < or =10 mm (P=0.0002) and distance from resection margin (DFRM) of > 5 mm (P=0.005). The effect of TT of < or =10 mm was maintained (P=0.001) on multivariate analysis. Higher RFS was observed with TT of < or =10 mm (P=0.0002), DFRM of > 5 mm (P=0.0002) and DFRM of >10 mm (P=0.007). On multivariate analysis higher RFS was also found for TT < or =10 mm (P=0.01) and DFRM >5 mm (P=0.01). Salvage of local tongue recurrence was higher than neck node failure, with 5-year DSS of 71 and 19%, respectively (P=0.007). Time interval for recurrence showed no significant impact on outcome. In T1-2 N0 oral tongue cancer, TT, and DFRM are significant prognostic factors for both local control and survival. Neck node recurrence is associated with poor prognosis and low salvage rate. PMID:11036243

Al-Rajhi, N; Khafaga, Y; El-Husseiny, J; Saleem, M; Mourad, W; Al-Otieschan, A; Al-Amro, A

2000-11-01

328

Early attentional processes distinguish selective from global motor inhibitory control: an electrical neuroimaging study.  

PubMed

The rapid stopping of specific parts of movements is frequently required in daily life. Yet, whether selective inhibitory control of movements is mediated by a specific neural pathway or by the combination between a global stopping of all ongoing motor activity followed by the re-initiation of task-relevant movements remains unclear. To address this question, we applied time-wise statistical analyses of the topography, global field power and electrical sources of the event-related potentials to the global vs selective inhibition stimuli presented during a Go/NoGo task. Participants (n=18) had to respond as fast as possible with their two hands to Go stimuli and to withhold the response from the two hands (global inhibition condition, GNG) or from only one hand (selective inhibition condition, SNG) when specific NoGo stimuli were presented. Behaviorally, we replicated previous evidence for slower response times in the SNG than in the Go condition. Electrophysiologically, there were two distinct phases of event-related potentials modulations between the GNG and the SNG conditions. At 110-150 ms post-stimulus onset, there was a difference in the strength of the electric field without concomitant topographic modulation, indicating the differential engagement of statistically indistinguishable configurations of neural generators for selective and global inhibitory control. At 150-200 ms, there was topographic modulation, indicating the engagement of distinct brain networks. Source estimations localized these effects within bilateral temporo-parieto-occipital and within parieto-central networks, respectively. Our results suggest that while both types of motor inhibitory control depend on global stopping mechanisms, selective and global inhibition still differ quantitatively at early attention-related processing phases. PMID:24220039

Sallard, Etienne; Barral, Jérôme; Chavan, Camille F; Spierer, Lucas

2014-02-15

329

Women's Perceptions of Breastfeeding Barriers in Early Postpartum Period: A Qualitative Analysis Nested in Two Randomized Controlled Trials  

PubMed Central

Abstract Objectives: This study examined women's perceptions of early infant feeding experiences and identified early postpartum barriers to successful breastfeeding. Subjects and Methods: We conducted semistructured exit interviews at 6 months postpartum with a subsample of participants (n=67) enrolled in two randomized controlled trials of breastfeeding promotion. Study arms included (1) routine pre- and postnatal visits with an International Board Certified Lactation Consultant (IBCLC) (LC group), (2) electronically prompted guidance from prenatal care providers (EP group), (3) EP+LC combined, and (4) standard of care (control group). Interview transcripts were coded using grounded theory and analyzed in MAXqda. Code matrices were used to identify early postpartum breastfeeding barriers and were further examined in relation to treatment group using a mixed methods analysis. Results: The majority of the participants reported experiencing at least one barrier to breastfeeding. Barriers to breastfeeding were more commonly reported in the early postpartum than late postpartum period. The most common barrier during the early postpartum period was the perception of inadequate milk supply (“lactational”) (n=18), followed by problems with latch, medical problems that were perceived as precluding breastfeeding, and medical staff and hospital practices. Participants frequently reported that the IBCLCs assisted them in anticipating, managing, and overcoming these barriers. Conclusions: Our findings underscore the importance of integrating IBCLCs into routine pre- and postpartum care because they provide critical support that effectively addresses early postpartum barriers to breastfeeding. PMID:24304033

Barnett, Josephine; Bonuck, Karen

2014-01-01

330

Glycemic variability is associated with subclinical atherosclerosis in Chinese type 2 diabetic patients  

PubMed Central

Background The contribution of glycemic variability to macrovascular complications remains unclear. We therefore investigated the association between glycemic variability and cervical and/or intracranial atherosclerosis in Chinese type 2 diabetic patients. Methods We conducted a cross-sectional study in 216 type 2 diabetic patients with a hemoglobin A1c of 8.3?±?1.7% and a median diabetes duration of 9.0 years. The standard deviation of blood glucose values (SDBG) and the mean amplitude of glycemic excursion (MAGE) were calculated from continuous glucose monitoring system data for assessing glycemic variability while 24h mean blood glucose (MBG) was calculated for measuring overall blood glucose level. Magnetic resonance angiography (MRA) was used to detect cervical and/or intracranial plaque, and ultrasonography was used to quantify carotid intima-media thickness (IMT) as an index of subclinical atherosclerosis. Results One hundred and fifty-three patients (70.8%) presented with cervical and/or intracranial lesions on MRA among 216 patients in the study. Elder age, increased systolic blood pressure, increased MBG and elevated low density lipoprotein cholesterol were independent contributors to plaque formation. In patients without stenosis (n?=?63), SDBG (r?=?0.412, P?=?0.001) and MAGE (r?=?0.365, P?=?0.005) were both correlated with carotid IMT and these relationships remained significant in multiple linear regression analysis (multiple R2?=?0.314 for the model including SDBG and multiple R2?=?0.268 for the model including MAGE). However, SDBG and MAGE were not significantly different among patients with different stenosis degrees. Conclusions Glycemic variability is associated with subclinical atherosclerosis in Chinese type 2 diabetic patients. PMID:23316958

2013-01-01

331

Dietary Glycemic Load and Breast Cancer Risk in the Women’s Health Study  

PubMed Central

A diet with a high glycemic load (GL) may contribute to a metabolic environment that enhances tumorigenesis. Little is known, however, about whether high glycemic diets increase breast cancer risk in women. We examined the associations between baseline measurements of dietary GL and overall glycemic index (GI) and subsequent breast cancer in a cohort of 39,876 women, ages 45 years or older, participating in the Women’s Health Study. During a mean of 6.8 years of follow-up there were 946 confirmed cases of breast cancer. We found no association between dietary GL [multivariable-adjusted relative risk (RR), 1.01; confidence interval (CI), 0.76–1.35, comparing extreme quintiles; P for trend = 0.96] or overall GI (corresponding RR, 1.03; CI, 0.84–1.28; P for trend = 0.66) and breast cancer risk in the cohort as a whole. Exploratory analyses stratified by baseline measurements of menopausal status, physical activity, smoking history, alcohol use, and history of diabetes mellitus, hypertension, or hypercholesterolemia showed no significant associations, except in the subgroup of women who were premenopausal and reported low levels of physical activity (GL multivariable-adjusted RR, 2.35; CI, 1.03–5.37; P for trend = 0.07; GI multivariable-adjusted RR, 1.56; CI, 0.88–2.78; P for trend = 0.02, comparing extreme quintiles). Although we did not find evidence that a high glycemic diet increases overall breast cancer risk, the increase in risk in premenopausal women with low levels of physical activity suggests the possibility that the effects of a high glycemic diet may be modified by lifestyle and hormonal factors. Prospective studies of a larger sample size and longer duration are warranted to confirm our findings. PMID:14744735

Higginbotham, Susan; Zhang, Zuo-Feng; Lee, I-Min; Cook, Nancy R.; Buring, Julie E.; Liu, Simin

2014-01-01

332

Helicobacter pylori infection and early onset myocardial infarction: case-control and sibling pairs study  

PubMed Central

Objectives To examine the association between coronary heart disease and chronic Helicobacter pylori infection. Design Case-control study of myocardial infarction at young ages and study of sibling pairs with one member affected and the other not. Setting United Kingdom. Participants 1122 survivors of suspected acute myocardial infarction at ages 30-49 (mean age 44 years) and 1122 age and sex matched controls with no history of coronary heart disease; 510 age and sex matched pairs of siblings (mean age 59 years) in which one sibling had survived myocardial infarction and one had no history of coronary heart disease. Main outcome measures Serological evidence of chronic infection with H pylori. Results 472 (42%) of the 1122 cases with early onset myocardial infarction were seropositive for H pylori antibodies compared with 272 (24%) of the 1122 age and sex matched controls, giving an odds ratio of 2.28 (99% confidence interval 1.80 to 2.90). This odds ratio fell to 1.87 (1.42 to 2.47; P<0.0001) after smoking and indicators of socioeconomic status were adjusted for and to 1.75 (1.29 to 2.36) after additional adjustment for blood lipid concentrations and obesity. Only 158 of the 510 pairs of siblings were discordant for H pylori status; among these, 91 cases and 67 controls were seropositive (odds ratio 1.33 (0.86 to 2.05)). No strong correlations were observed between H pylori seropositivity and measurements of other risk factors for coronary heart disease (plasma lipids, fibrinogen, C reactive protein, albumin, etc). Conclusion In the context of results from other relevant studies, these two studies suggest a moderate association between coronary heart disease and H pylori seropositivity that cannot be fully accounted for by other risk factors. But even if this association is causal and largely reversible by eradication of chronic infection, very large randomised trials would be needed to show this. Key messagesMost previous studies of associations between chronic H pylori infection and coronary heart disease have been too small or prone to biasThis case-control study found myocardial infarction was twice as common in people infected with H pylori as in those not infectedAmong sibling pairs, myocardial infarction was about a third more common in seropositive people than those who were seronegativeThese results support a weak association between H pylori infection and coronary heart disease PMID:10541503

Danesh, John; Youngman, Linda; Clark, Sarah; Parish, Sarah; Peto, Richard; Collins, Rory

1999-01-01

333

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

PubMed

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

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

2014-12-01

334

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

PubMed

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

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

2004-04-01

335

Efficacy of supplementary vitamin D on improvement of glycemic parameters in patients with type 2 diabetes mellitus; a randomized double blind clinical trial  

PubMed Central

Introduction: Studies have revealed the association between vitamin D deficiency and changes in blood glucose and insulin levels as well as sensitivity of the target tissues to insulin. Objective: In this study, we examined the effect of adding vitamin D (cholecalciferol ; 50,000 units) to therapeutic regimen of T2DM patients compared to placebo on regulating the blood glucose and glycemic parameters. Patients and Methods: This study was a double blind clinical trial conducted on 60 type 2 diabetes mellitus (T2DM) patients. Exclusion criteria were taking calcium, vitamin D supplements or any drugs effecting calcium and vitamin D metabolism in the past 6 months. Serum 25-Hydroxy vitamin D [25(OH)D] level was measured with ELISA method. Patients were administered weekly vitamin D supplementation (50000 units) for 12 weeks. Results: There was no significant relation between HbA1c and 25(OH)D level prior the study (p> 0.05). After intervention, 25(OH)D level in interventional group was significantly higher compared to that of control group. HbA1c in male interventional group was significantly less than that of control group (p= 0.0068). Conclusion: Weekly vitamin D supplementation had beneficial effect on glycemic parameters in male type 2 diabetic patients. PMID:25340161

Nasri, Hamid; Behradmanesh, Saeed; Maghsoudi, Ahmad Reza; Ahmadi, Ali; Nasri, Parto; Rafieian-Kopaei, Mahmoud

2014-01-01

336

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

PubMed Central

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

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

337

Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment  

Microsoft Academic Search

Objective To determine the efficacy of teaching patients with bipolar disorder (manic›depressive psychosis) to identify early symptoms of relapse and seek prompt treatment from health services. Design Single blind randomised controlled trial with matching on four baseline variables using a minimisation algorithm. Setting Mental health services in four NHS trusts (one teaching, three non›teaching). Subjects 69 patients with bipolar disorder

Alison Perry; Nicholas Tarrier; Richard Morriss; Eilis McCarthy; Kate Limb

338

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

ERIC Educational Resources Information Center

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

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

2012-01-01

339

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

ERIC Educational Resources Information Center

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…

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

2010-01-01

340

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

ERIC Educational Resources Information Center

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

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

2010-01-01

341

Formaldehyde Levels in FEMA-Supplied Trailers Early Findings from the Centers for Disease Control and Prevention  

E-print Network

Formaldehyde Levels in FEMA-Supplied Trailers Early Findings from the Centers for Disease Control trailers and mobile homes supplied by the Federal Emergency Management Agency (FEMA) in your community homes supplied by FEMA. CDC has analyzed the data from the testing and has findings that affect

342

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

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…

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

2006-01-01

343

SUPPRESSION OF TARNISHED PLANT BUGS (HETEROPTERA: MIRIDAE) IN COTTON BY CONTROL OF EARLY SEASON WILD HOST PLANTS WITH HERBICIDES  

Technology Transfer Automated Retrieval System (TEKTRAN)

Broadleaf weeds found in marginal areas by fields, roads, and ditches were controlled with the herbicides Trimec7 or Strike 3TM in 23 km2 areas of the Mississippi Delta in March or April of 1999, 2000, and 2001. These weeds can serve as early season food and reproductive hosts for tarnished plant b...

344

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

E-print Network

Correlative control of early stages of flower bud initiation in 'bourse' shoots of apple (Malus x. As a preliminary to this necessary pre- diction problem, we began experimenting on apple 'bourse' shoots leaves whose axillary buds differen- tiate and may grow out as shoots. The bourse shoot can flower again

Paris-Sud XI, Université de

345

Predicting Individual Differences in Low-Income Children's Executive Control from Early to Middle Childhood  

ERIC Educational Resources Information Center

The present longitudinal study tested the roles of early childhood executive control (EC) as well as exposure to poverty-related adversity at family and school levels as key predictors of low-income children's EC in elementary school ("n" = 391). Findings suggest that children's EC difficulties in preschool and lower family…

Raver, C. Cybele; McCoy, Dana Charles; Lowenstein, Amy E.; Pess, Rachel

2013-01-01

346

Maternal Locus of Control and Perception of Family Status at Entry and Exit of Birth to Three Early Intervention  

ERIC Educational Resources Information Center

Birth to three early intervention is unique time in the life of a family of a child with a disability in that confidence and competence of the parents can be addressed as part of the intervention goals and objectives. Locus of control is a quality measure of a parent's perception of their ability to be their child's teacher, advocate, and champion…

Coffaro, Ann

2009-01-01

347

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

PubMed Central

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

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

348

Case-control study of severe pre-eclampsia of early onset.  

PubMed Central

Twenty four women with severe pre-eclampsia diagnosed before 34 weeks' gestation were compared with 48 randomly selected controls matched for age and parity. Subjects were studied in the puerperium using a questionnaire, clinical examination, and review of case records. A history of infertility, headaches (particularly migraine), pre-eclampsia in a previous pregnancy, or a raised serum alpha-fetoprotein concentration at the time of screening for neural tube defect in the index pregnancy were all identified as significant risk factors in the pre-eclamptic women. Maternal age, a history of chronic hypertension or renal disease, or excessive maternal weight were not significantly associated with pre-eclampsia. Almost all the infants of pre-eclamptic women showed retarded growth: 18 were below the 10th centile and only one weighed more than the 25th centile. Four babies died. These observations indicate that pre-eclampsia of early onset may differ from the late onset disease not only in its very high perinatal morbidity and mortality but in its distinctive maternal risk factors. PMID:6411232

Moore, M P; Redman, C W

1983-01-01

349

Control of early stages in invariant natural killer T-cell development  

PubMed Central

Natural killer T (NKT) cells develop in the thymus from the same precursors as conventional CD4+ and CD8+?? T cells, CD4+ CD8+ double-positive cells. In contrast to conventional ??T cells, which are selected by MHC–peptide complexes presented by thymic epithelial cells, invariant NKT cells are selected by lipid antigens presented by the non-polymorphic, MHC I-like molecule CD1d, present on the surface of other double-positive thymocytes, and require additional signals from the signalling lymphocytic–activation molecule (SLAM) family of receptors. In this review, we provide a discussion of recent findings that have modified our understanding of the NKT cell developmental programme, with an emphasis on events that affect the early stages of this process. This includes factors that control double-positive thymocyte lifespan, and therefore the ability to generate the canonical V? rearrangements that characterize this lineage, as well as the signal transduction pathways engaged downstream of the T-cell receptor and SLAM molecules. PMID:21718314

Hu, Taishan; Gimferrer, Idoia; Alberola-Ila, José

2011-01-01

350

Estimating the Effectiveness of Early Control Measures through School Absenteeism Surveillance in Observed Outbreaks at Rural Schools in Hubei, China  

PubMed Central

Background School absenteeism is a common data source in syndromic surveillance, which allows for the detection of outbreaks at an early stage. Previous studies focused on its correlation with other data sources. In this study, we evaluated the effectiveness of control measures based on early warning signals from school absenteeism surveillance in rural Chinese schools. Methods A school absenteeism surveillance system was established in all 17 primary schools in 3 adjacent towns in the Chinese region of Hubei. Three outbreaks (varicella, mumps, and influenza-like illness) were detected and controlled successfully from April 1, 2012, to January 15, 2014. An impulse susceptible-exposed-infectious-recovered model was used to fit the epidemics of these three outbreaks. Moreover, it simulated the potential epidemics under interventions resulting from traditional surveillance signals. The effectiveness of the absenteeism-based control measures was evaluated by comparing the simulated datasets. Results The school absenteeism system generated 52 signals. Three outbreaks were verified through epidemiological investigation. Compared to traditional surveillance, the school absenteeism system generated simultaneous signals for the varicella outbreak, but 3 days in advance for the mumps outbreak and 2–4 days in advance for the influenza-like illness outbreak. The estimated excess protection rates of control measures based on early signals were 0.0%, 19.0–44.1%, and 29.0–37.0% for the three outbreaks, respectively. Conclusions Although not all outbreak control measures can benefit from early signals through school absenteeism surveillance, the effectiveness of early signal-based interventions is obvious. School absenteeism surveillance plays an important role in reducing outbreak spread. PMID:25250786

Fan, Yunzhou; Yang, Mei; Jiang, Hongbo; Wang, Ying; Yang, Wenwen; Zhang, Zhixia; Yan, Weirong; Diwan, Vinod K.; Xu, Biao; Dong, Hengjin; Palm, Lars; Liu, Li; Nie, Shaofa

2014-01-01

351

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

PubMed Central

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

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

2011-01-01

352

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

PubMed

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

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

2014-03-01

353

Methanolic Root Extract of Rauwolfia serpentina Benth Improves the Glycemic, Antiatherogenic, and Cardioprotective Indices in Alloxan-Induced Diabetic Mice.  

PubMed

The aim of the study was to evaluate the phytochemistry and the effect of methanolic root extract (MREt) of Rauwolfia serpentina on alloxan-induced diabetic Wister male mice. Mice were divided in control (distilled water at 1?mL/kg) and alloxan-induced diabetic mice which subdivided into diabetic (distilled water at 1?mL/kg), negative (0.05% dimethyl sulfoxide at 1?mL/kg), positive (glibenclamide at 5?mg/kg) controls, and three test groups (MREt at 10, 30, and 60?mg/kg). All treatments were given orally for 14 days. Qualitatively MREt showed the presence of alkaloids, carbohydrates, flavonoids, glycosides, cardiac glycosides, phlobatannins, resins, saponins, steroids, tannins, and triterpenoids, while quantitatively extract was rich in total phenols. The flavonoids, saponins and alkaloids were also determined in root powder. MREt found effective in improving the body weights, glucose and insulin levels, insulin/glucose ratio, glycosylated and total hemoglobin in test groups as compared to diabetic control. Similarly, significantly decreased levels of total cholesterol, triglycerides, low-density lipoprotein (LDL-c), and very low-density lipoprotein (VLDL-c) cholesterols were found in test groups. Significant lipolysis with improved glycogenesis was also found in liver tissues of all test groups. ALT levels were found normal in all groups. Thus, MREt improves the glycemic, antiatherogenic, coronary risk, and cardioprotective indices in alloxan-induced diabetic mice. PMID:23365565

Azmi, Muhammad Bilal; Qureshi, Shamim A

2012-01-01

354

Methanolic Root Extract of Rauwolfia serpentina Benth Improves the Glycemic, Antiatherogenic, and Cardioprotective Indices in Alloxan-Induced Diabetic Mice  

PubMed Central

The aim of the study was to evaluate the phytochemistry and the effect of methanolic root extract (MREt) of Rauwolfia serpentina on alloxan-induced diabetic Wister male mice. Mice were divided in control (distilled water at 1?mL/kg) and alloxan-induced diabetic mice which subdivided into diabetic (distilled water at 1?mL/kg), negative (0.05% dimethyl sulfoxide at 1?mL/kg), positive (glibenclamide at 5?mg/kg) controls, and three test groups (MREt at 10, 30, and 60?mg/kg). All treatments were given orally for 14 days. Qualitatively MREt showed the presence of alkaloids, carbohydrates, flavonoids, glycosides, cardiac glycosides, phlobatannins, resins, saponins, steroids, tannins, and triterpenoids, while quantitatively extract was rich in total phenols. The flavonoids, saponins and alkaloids were also determined in root powder. MREt found effective in improving the body weights, glucose and insulin levels, insulin/glucose ratio, glycosylated and total hemoglobin in test groups as compared to diabetic control. Similarly, significantly decreased levels of total cholesterol, triglycerides, low-density lipoprotein (LDL-c), and very low-density lipoprotein (VLDL-c) cholesterols were found in test groups. Significant lipolysis with improved glycogenesis was also found in liver tissues of all test groups. ALT levels were found normal in all groups. Thus, MREt improves the glycemic, antiatherogenic, coronary risk, and cardioprotective indices in alloxan-induced diabetic mice. PMID:23365565

Azmi, Muhammad Bilal; Qureshi, Shamim A.

2012-01-01

355

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)

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.

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

2011-12-01

356

Extended Prandial Glycemic Profiles of Foods as Assessed Using Continuous Glucose Monitoring Enhance the Power of the 120-Minute Glycemic Index  

PubMed Central

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

Chlup, Rudolf; Peterson, Karolina; Zapletalová, Jana; Kudlová, Pavla; Se?ka?, Pavel

2010-01-01

357

Dietary Glycemic Load and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings From CALGB 89803  

PubMed Central

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

2012-01-01

358

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

ERIC Educational Resources Information Center

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…

Luby, Joan; Lenze, Shannon; Tillman, Rebecca

2012-01-01

359

Early pregnancy peripheral blood gene expression and risk of preterm delivery: a nested case control study  

Microsoft Academic Search

BACKGROUND: Preterm delivery (PTD) is a significant public health problem associated with greater risk of mortality and morbidity in infants and mothers. Pathophysiologic processes that may lead to PTD start early in pregnancy. We investigated early pregnancy peripheral blood global gene expression and PTD risk. METHODS: As part of a prospective study, ribonucleic acid was extracted from blood samples (collected

Daniel A Enquobahrie; Michelle A Williams; Chunfang Qiu; Seid Y Muhie; Kimberly Slentz-Kesler; Zhaoping Ge; Tanya Sorenson

2009-01-01

360

Transcriptional Control of Cardiac Allograft Vasculopathy by Early Growth Response Gene1 (Egr1)  

Microsoft Academic Search

Expression of the zinc finger transcription factor early growth response gene-1 (Egr-1) is triggered rapidly after mechanical vascular injury or after a precipitous drop in ambient oxygen, whereupon it induces the expression of diverse gene families to elicit a pathological response. Initially characterized as an early response transcriptional activator, the role of Egr-1 in more chronic forms of vascular injury

Morihito Okada; Catherine Y. Wang; Daniel W. Hwang; Taichi Sakaguchi; Kim E. Olson; Yasushi Yoshikawa; Kanji Minamoto; Sean P. Mazer; Shi-Fang Yan; David J. Pinsky

361

The Relative Associations of ?-Cell Function and Insulin Sensitivity with Glycemic Status and Incident Glycemic Progression in Migrant Asian Indians in the United States: the MASALA study  

PubMed Central

AIMS We assessed the relative associations of ?-cell dysfunction and insulin sensitivity with baseline glycemic status and incident glycemic progression among Asian Indians in the United States. METHODS A 5-sample oral glucose tolerance test was obtained at baseline. Normoglycemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes (T2DM) were defined by ADA criteria. The Matsuda Index (ISIM) estimated insulin sensitivity, and the Disposition Index (DIo) estimated ?-cell function. Visceral fat was measured by abdominal CT. After 2.5 years, participants underwent a 2-sample oral glucose tolerance test. Standardized polytomous logistic regression was used to examine associations with prevalent and incident glycemia. RESULTS Mean age was 57±8 years and BMI 26.1±4.6 kg/m2. Log ISIM and log DIo were associated with prediabetes and T2DM after adjusting for age, sex, BMI, family history of diabetes, hypertension, and smoking. After adjusting for visceral fat, only DIo remained associated with prediabetes (OR per SD 0.17, 95% CI: 0.70, 0.41) and T2DM (OR 0.003, 95% CI: 0.0001, 0.03). Incidence rates (per 1,000 person-year) were: normoglycemia to IGT: 82.0, 95% CI (40, 150); to IFG: 8.4, 95% CI (0, 41); to T2DM: 8.6, 95% CI (0, 42); IGT to T2DM: 55.0, 95% CI (17, 132); IFG to T2DM: 64.0, 95% CI (3, 316). The interaction between sex and the change in waist circumference (OR 1.8, per SD 95% CI: 1.22, 2.70) and the change in log HOMA-?(OR 0.37, per SD 95% CI: 0.17, 0.81) were associated with glycemic progression. CONCLUSIONS The association of DIo with baseline glycemia after accounting for visceral fat as well as the association of the change in log HOMA-? with incident glycemic progression implies innate ?-cell susceptibility in Asian Indians for glucose intolerance or dysglycemia. PMID:24211090

Gujral, UP; Narayan, KMV; Kahn, SE; Kanaya, AM

2013-01-01

362

A systematic review on the effect of sweeteners on glycemic response and clinically relevant outcomes  

PubMed Central

Background The major metabolic complications of obesity and type 2 diabetes may be prevented and managed with dietary modification. The use of sweeteners that provide little or no calories may help to achieve this objective. Methods We did a systematic review and network meta-analysis of the comparative effectiveness of sweetener additives using Bayesian techniques. MEDLINE, EMBASE, CENTRAL and CAB Global were searched to January 2011. Randomized trials comparing sweeteners in obese, diabetic, and healthy populations were selected. Outcomes of interest included weight change, energy intake, lipids, glycated hemoglobin, markers of insulin resistance and glycemic response. Evidence-based items potentially indicating risk of bias were assessed. Results Of 3,666 citations, we identified 53 eligible randomized controlled trials with 1,126 participants. In diabetic participants, fructose reduced 2-hour blood glucose concentrations by 4.81 mmol/L (95% CI 3.29, 6.34) compared to glucose. Two-hour blood glucose concentration data comparing hypocaloric sweeteners to sucrose or high fructose corn syrup were inconclusive. Based on two ?10-week trials, we found that non-caloric sweeteners reduced energy intake compared to the sucrose groups by approximately 250-500 kcal/day (95% CI 153, 806). One trial found that participants in the non-caloric sweetener group had a decrease in body mass index compared to an increase in body mass index in the sucrose group (-0.40 vs 0.50 kg/m2, and -1.00 vs 1.60 kg/m2, respectively). No randomized controlled trials showed that high fructose corn syrup or fructose increased levels of cholesterol relative to other sweeteners. Conclusions Considering the public health importance of obesity and its consequences; the clearly relevant role of diet in the pathogenesis and maintenance of obesity; and the billions of dollars spent on non-caloric sweeteners, little high-quality clinical research has been done. Studies are needed to determine the role of hypocaloric sweeteners in a wider population health strategy to prevent, reduce and manage obesity and its consequences. PMID:22093544

2011-01-01

363

Impact of Early Sodium Supplementation on Hyponatremia and Growth in Premature Infants: A Randomized Controlled Trial.  

PubMed

Background: We tested the hypothesis that sodium supplementation in early preterm infants prevents late-onset hyponatremia and improves growth without increasing common morbidities during birth hospitalization. Materials and Methods: This was a randomized, masked controlled trial of 4 mEq/kg/d of sodium (intervention) versus sterile water (placebo) from days-of-life 7 to 35 in infants born at <32 weeks corrected gestational age. The primary outcome was weight gain in the first 6 weeks of life. Secondary outcomes included weekly serum sodium concentrations, growth in body length and head circumference, and complications of prematurity during birth hospitalization. Results: Fifty-three infants with an average corrected gestational age of 28.5 ± 2.4 weeks were randomized. Infants receiving the intervention had fewer (P = .012) reports of serum sodium concentrations <135 mmol/L and greater velocity of weight gain during the study period, mean (SD) 26.9 (3.1) vs 22.9 (4.7) g/kg/day, P = .012. At 6 weeks of age, infants <28 weeks' gestation who received sodium supplementation had greater percentage weight change from birth, mean (SD) 193% (22%) vs 173% (10%), P = .041, and maintained fetal reference birth percentile for body weight more often (P = .002) compared with infants receiving placebo. Growth in length and head circumference was not significantly different between study arms. No increase in common prematurity-related morbidities was detected in infants who received supplemental sodium chloride. Conclusion: Sodium supplementation of enteral feedings in very premature infants averts hyponatremia and enhances weight gain. PMID:25406227

Isemann, Barbara; Mueller, Eric W; Narendran, Vivek; Akinbi, Henry

2014-11-18

364

Sources of Glycemic Variability—What Type of Technology is Needed?  

PubMed Central

People on insulin therapy are challenged with evaluation of numerous factors affecting the blood glucose in order to select the optimal dose for reaching their glucose target. Following medical recommendations precisely still results in considerable blood glucose unpredictability, often resulting in frustration in the short term due to hypoglycemia and hyperglycemia, and, in the long term, will likely result in complications. The kinetics of insulin do indeed vary significantly and have become an important focus when developing new insulin analogues and delivery systems; however, numerous of other factors impact glycemic variability. These have different dependences and interactions and are therefore difficult to characterize. Some of the factors are highly dependent and influenced by the type of insulin and devices used in therapy. Development of future therapy products is therefore highly focused on how to minimize glycemic variability. PMID:20144350

Kildegaard, Jonas; Christensen, Toke Folke; Hejlesen, Ole Kristian

2009-01-01

365

Glycemic index of American-grown jasmine rice classified as high.  

PubMed

The primary objective was to determine the glycemic index (GI) of jasmine rice grown in the United States (US). Secondary objective was to compare the GI of US grown jasmine rice to those grown in Thailand. Twelve healthy subjects were served all four brands of jasmine rice and a reference food (glucose), each containing 50?g of available carbohydrate. Fingerstick blood glucose was measured at 0, 15, 30, 45, 60, 90, and 120?min after consumption following a fasting state. The GI was calculated using the standard equation. The GI values for test foods ranged from 96 to 116 and were all classified as high GI foods. No difference in GI was found between American-grown and Thailand-grown jasmine rice. Although not statistically significant, observations show glycemic response among Asian American participants may be different. GI should be considered when planning meals with jasmine rice as the main source carbohydrate. PMID:24438213

Truong, Teresa H; Yuet, Wei Cheng; Hall, Micki D

2014-06-01

366

Evaluation of glycemic and lipid profile of offspring of diabetic Wistar rats treated with Malpighia emarginata juice.  

PubMed

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

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

367

Evaluation of Glycemic and Lipid Profile of Offspring of Diabetic Wistar Rats Treated with Malpighia emarginata Juice  

PubMed Central

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

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

368

Role of LIBS in Elemental Analysis of Psidium guajava Responsible for Glycemic Potential  

Microsoft Academic Search

The present study deals with the detection of elements responsible for glycemic potential of ripe and unripe fruit peel aqueous extracts of Psidium guajava (P. guajava). Treatment with the aqueous extract of unripe fruit peel showed a significant fall of 17.5% (p<0.001) in blood glucose levels (BGLs) of normal rats during fasting blood glucose (FBG) test with a dose of

Prashant Kumar Rai; Nilesh K. Rai; A. K. Rai; Geeta Watal

2007-01-01

369

Glycemic index claims on food labels: review of Health Canada's evaluation.  

PubMed

Recently Health Canada (HC) published its opinion that including glycemic index (GI) values on food labels would be misleading and not add value to nutrition labeling and dietary guidelines to help consumers make healthier food choices. Important areas of concern were identified by HC, but the discussion of them is scientifically invalid. HC concluded that GI has poor precision for labeling purposes based on incorrect application of the standard deviation. In fact, GI methodology is precise enough to distinguish, with high probability, low-GI (GI ? 55) from high-GI (GI ? 70) foods and to pass the Canadian Food Inspection Agency Nutrition Compliance Test procedure. HC rightly concluded that GI does not respond to portion size, whereas glycemic response does, but no valid evidence was provided to support the assertion that a lower-GI food could have a higher glycemic response. HC's focus on glycemic response could promote a low-carbohydrate diet inconsistent with nutrition recommendations. HC correctly concluded that GI is unresponsive to the replacement of available- with unavailable-carbohydrate but this is irrelevant to GI labeling. HC is rightly concerned about promoting unhealthy low-GI foods; however, this could be avoided by prohibiting GI labeling on such foods. Therefore, HC has provided neither a helpful nor scientifically valid evaluation of GI for labeling purposes but has contributed to the wealth of misinformation about GI in the literature. Currently, Canadian consumers only have access to unregulated and misleading information about GI; well-crafted guidelines for GI labeling would provide consumers accurate information about GI and help them make healthier food choices. PMID:24105325

Wolever, T M S

2013-12-01

370

Influence of and Optimal Insulin Therapy for a Low–Glycemic Index Meal in Children With Type 1 Diabetes Receiving Intensive Insulin Therapy  

PubMed Central

OBJECTIVE—The purpose of this study was to quantify the effects of glycemic index on postprandial glucose excursion (PPGE) in children with type 1 diabetes receiving multiple daily injections and to determine optimal insulin therapy for a low–glycemic index meal. RESEARCH DESIGN AND METHODS—Twenty subjects consumed test breakfasts with equal macronutrient contents on 4 consecutive days; high–and low–glycemic index meals (glycemic index 84 vs. 48) were consumed with preprandial ultra-short-acting insulin, and the low–glycemic index meal was also consumed with preprandial regular insulin and postprandial ultra-short-acting insulin. Each child's insulin dose was standardized. Continuous glucose monitoring was used. RESULTS—The PPGE was significantly lower for the low–glycemic index meal compared with the high–glycemic index meal at 30–180 min (P < 0.02) when preprandial ultra-short-acting insulin was administered. The maximum difference occurred at 60 min (4.2 mmol/l, P < 0.0001). Regular insulin produced a 1.1 mmol/l higher PPGE at 30 min compared with ultra-short-acting insulin (P = 0.015) when the low–glycemic index meal was consumed. Postprandial ultra-short-acting insulin produced a higher PPGE at 30 and 60 min compared with preprandial administration when the low–glycemic index meal was consumed. The maximum difference was 2.5 mmol/l at 60 min (P < 0.0001). CONCLUSIONS—Low–glycemic index meals produce a lower PPGE than high–glycemic index meals. Preprandial ultra-short-acting insulin is the optimal therapy for a low–glycemic index meal. PMID:18458138

Ryan, Rochelle L.; King, Bruce R.; Anderson, Donald G.; Attia, John R.; Collins, Clare E.; Smart, Carmel E.

2008-01-01

371

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

PubMed

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

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

2010-12-01

372

Early dolomitization of a Lower Cretaceous shallow water carbonate platform: was microbial activity a major controlling factor?  

NASA Astrophysics Data System (ADS)

Early dolomitization of carbonate rocks has long been problematic as precipitation experiments at room temperature have shown that dolomite will not be precipitated under Earth surface conditions. To explain the widespread occurrence of early dolomite in the geological record, bacterial mediation of dolomitization has been proposed. The strongest evidence comes from modern hypersaline environments where dolomitization was shown to take place under anoxic conditions. In this study, part of the Qatar Carbonates and Carbon Storage Center (QCCSRC), we investigate whether microbial mediation of early dolomitization took place on the Barremian-Aptian carbonate platform of the Jurf Formation of Southern Oman. The sediments are characterized by a finely crystalline, poorly ordered dolomite present in various proportions. The amount of dolomite seem to be controlled by facies with tidal flats and algal/microbial facies being totally dolomitized and restricted lagoonal facies being only partially dolomitized. Results indicate that the dolomite is penecontemporaneous to sedimentation and that the dolomitizing fluids are low temperature seawater formed in an evaporative lagoon. Thus, reflux mechanisms played a role in the process of dolomitization. One of the major questions of our study is what controls the heterogeneity of the distribution of dolomite on this platform. We hypothesis that bacteria present in tidal flats and algal/microbial mats facies played an important role in controlling dolomitization. Our goal is to highlight the role of biomineralization in controlling the early diagenesis of the Jurf Formation. To test this we will use a multi-proxy approach using mineralogy, trace elements, stable and clumped isotopes, and SEM analysis, in an integrated field, petrographic and geochemical study of a Barremian-Aptian carbonate platform exposed in the Haushi-Huqf area. A bed by bed sampling was done for two 15 meters-thick outcrop sections separated by 1 km. Initial results highglight the importance of considering the presence of microbial activity to build more accurate dolomitization models and in assessing the lateral heterogeneity of dolomite bodies.

Sena, C. N.; John, C. M.; Cosgrove, J. W.; Vandeginste, V.

2010-12-01

373

Long-term effects of 2 energy-restricted diets differing in glycemic load on dietary adherence, body composition, and metabolism in  

E-print Network

;85: 1023­30. KEY WORDS Glycemic load, caloric restriction, body weight, metabolism INTRODUCTION, such as the need to alter centrallifestylefactorssuchasestablishedshoppingandcooking habits and food preferences

Cochran-Stafira, D. Liane

374

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

PubMed

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

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

375

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

PubMed Central

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

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

2012-01-01

376

Is exercise a therapeutic tool for improvement of cardiovascular risk factors in adolescents with type 1 diabetes mellitus? A randomised controlled trial  

PubMed Central

Background Type 1 diabetes mellitus (T1DM) is associated with a high risk for early atherosclerotic complications especially risk of coronary heart disease. Objective To evaluate the impact of six months exercise prgram on glycemic control, plasma lipids values, blood pressure, severity and frequency of hypoglycemia, anthropometric measurements and insulin dose in a sample of adolescents with T1DM. Research design and methods A total of 196 type 1 diabetic patients participated in the study. They were classified into three groups: Group (A) did not join the exercise program(n = 48), group (B) attended the exercise sessions once/week (n = 75), group (C) attended the exercise sessions three times/week (n = 73). Studied parameters were evaluated before and six months after exercise programe. Results Exercise improved glycemic control by reducing HbA1c values in exercise groups (P = 0.03, P = 0.01 respectively) and no change in those who were not physically active (P = 0.2). Higher levels of HbA1c were associated with higher levels of cholesterol, LDL-c, and triglycerides (P = 0.000 each). In both groups, B and C, frequent exercise improved dyslipidemia and reduced insulin requirements significantly (P = 0.00 both), as well as a reduction in BMI (P = 0.05, P = 0.00 respectively) and waist circumference(P = 0.02, P = 0.00 respectively). The frequency of hypoglycemic attacks were not statistically different between the control group and both intervention groups (4.7 ± 3.56 and 4.82 ± 4.23, P = 0.888 respectively). Reduction of blood pressure was statistically insignificant apart from the diastolic blood presure in group C (P = 0.04). Conclusion Exercise is an indispensable component in the medical treatment of patients with T1DM as it improves glycemic control and decreases cardiovascular risk factors among them. PMID:20618996

2010-01-01

377

Light Water Reactor Sustainability Program Operator Performance Metrics for Control Room Modernization: A Practical Guide for Early Design Evaluation  

SciTech Connect

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.

Ronald Boring; Roger Lew; Thomas Ulrich; Jeffrey Joe

2014-03-01