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1

Brief Report: Trajectories of Glycemic Control over Early to Middle Adolescence  

PubMed Central

Objectives?To identify distinct patterns of glycemic control over early to middle adolescence, and to determine whether psychosocial variables predicted those patterns.?Methods?We used trajectory analysis to examine glycemic control over 5 years among adolescents with type 1 diabetes who were of age 12 on average at study start (n = 132). Well-being, relationships, and self-care behavior were assessed with in-person interviews. Blood glucose testing was determined from blood glucose meters, and missed clinic appointments and glycosolated hemoglobin were obtained from medical records.?Results?We identified two distinct clusters of individuals, a stable good glycemic control group and a poorer deteriorating glycemic control group. Individuals in the deteriorating control group were characterized by higher peer conflict, more negative diabetes emotions, fewer blood glucose tests, and more missed clinic appointments.?Conclusion Psychosocial variables and behavioral markers of self-care may predict the course of glycemic control over early to middle adolescence. PMID:20189951

Snyder, Pamela R.; Seltman, Howard; Escobar, Oscar; Becker, Dorothy; Siminerio, Linda

2010-01-01

2

Glycemic index, glycemic control and beyond.  

PubMed

It is currently estimated that over 370 million individuals have diabetes, making diabetes a major public health issue contributing significantly to global morbidity and mortality. The steep rise in diabetes prevalence over the past decades is attributable, in a large part, to lifestyle changes, with dietary habits and behaviour as significant contributors. Despite the relatively wide availability of antidiabetic medicine, it is lifestyle approaches that still remain the cornerstone of diabetes prevention and treatment. Glycemic index (GI) is a nutritional tool which represents the glycemic response to carbohydrate ingestion. In light of the major impact of nutrition on diabetes pathophysiology, with the rising need to combat the escalating diabetes epidemic, this review will focus on the role of GI in glycemic control, the primary target of diabetic treatment and beyond. The review will present the evidence relating GI and diabetes treatment and prevention, as well as weight loss, weight maintenance and cardiovascular disease risk factors. PMID:24040877

Derdemezis, Christos S; Lovegrove, Julie A

2014-01-01

3

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

4

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

PubMed

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

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

2013-06-01

5

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

6

Glycemic control in cardiac surgery: rationale and current evidence.  

PubMed

Studies in cardiac surgical patients have shown an association of hyperglycemia with increased incidences of sepsis, mediastinitis, prolonged mechanical ventilation, cardiac arrhythmias and longer intensive care and hospital stay. There is considerable controversy regarding appropriate glycemic management in these patients and in the definition of hyperglycemia and hypoglycemia or the blood sugar levels at which therapy should be initiated. There is also dilemma regarding the usage of "tight glycemic control" with studies showing conflicting evidences. Part of the controversy can be explained by the differing designs of these studies and the variable definitions of hyperglycemia and hypoglycemia. PMID:24994733

Girish, G; Agarwal, Saket; Satsangi, Deepak Kumar; Tempe, Deepak; Dutta, Nilanjan; Pratap, Himanshu

2014-01-01

7

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

Microsoft Academic Search

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

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

2008-01-01

8

PATIENT SAFETY AND INPATIENT GLYCEMIC CONTROL: TRANSLATING CONCEPTS INTO ACTION  

Microsoft Academic Search

Objective: (1) To summarize current knowledge re- garding patient safety issues and their impact on inpatient glycemic control and (2) to provide a systematic and practi- cal approach to improving patient safety in this area. Methods: Insulin delivery in inpatient settings is ex- amined, as are the barriers to safe insulin therapy. A distinc- tion is made between safety strategies

Richard Hellman

2006-01-01

9

Interaction between functional health literacy, patient activation, and glycemic control  

PubMed Central

Background Functional health literacy (FHL) and patient activation can impact diabetes control through enhanced diabetes self-management. Less is known about the combined effect of these characteristics on diabetes outcomes. Using brief, validated measures, we examined the interaction between FHL and patient activation in predicting glycosylated hemoglobin (HbA1c) control among a cohort of multimorbid diabetic patients. Methods We administered a survey via mail to 387 diabetic patients with coexisting hypertension and ischemic heart disease who received outpatient care at one regional VA medical center between November 2010 and December 2010. We identified patients with the study conditions using the International Classification of Diseases-Ninth Revision-Clinical Modification (ICD-9-CM) diagnoses codes and Current Procedure Terminology (CPT) procedures codes. Surveys were returned by 195 (50.4%) patients. We determined patient activation levels based on participant responses to the 13-item Patient Activation Measure and FHL levels using the single-item screening question, “How confident are you filling out medical forms by yourself?” We reviewed patient medical records to assess glycemic control. We used multiple logistic regression to examine whether activation and FHL were individually or jointly related to HbA1c control. Results Neither patient activation nor FHL was independently related to glycemic control in the unadjusted main effects model; however, the interaction between the two was significantly associated with glycemic control (odds ratio 1.05 [95% confidence interval 1.01–1.09], P=0.02). Controlling for age, illness burden, and number of primary care visits, the combined effect of these measures on glycemic control remained significant (odds ratio 1.05 [95% confidence interval 1.01–1.09], P=0.02). Conclusion The interaction between FHL and patient activation is associated with HbA1c control beyond the independent effects of these parameters alone. A personalized approach to diabetes management incorporating these characteristics may increase patient-centered care and improve outcomes for patients with diabetes. PMID:25092966

Woodard, LeChauncy D; Landrum, Cassie R; Amspoker, Amber B; Ramsey, David; Naik, Aanand D

2014-01-01

10

Glycemic Control and Urinary Incontinence in Women with Diabetes Mellitus  

PubMed Central

Abstract Background Although many studies have shown that diabetes increases the risk for urinary incontinence, it is unclear whether poor glycemic control in women with diabetes is associated with incontinence. This study aims to determine the relationship between the hemoglobin A1c (HbA1c) level and urinary incontinence in a large, diverse cohort of older women. Methods We examined 6026 older women who responded to a survey (62% response rate) and were enrolled in the Diabetes and Aging Study, an ethnically stratified random sample of patients with diabetes enrolled in Kaiser Permanente Northern California. Our primary independent variable was the mean of all HbA1c measurements in the year preceding the survey. Outcomes included the presence/absence of incontinence and limitations in daily activities due to incontinence. We used modified Poisson regression and ordinal logistic regression models to account for age, race, body mass index, parity, diabetes treatment, duration of diabetes, and comorbidity. Results Sixty-five percent of women reported incontinence (mean age 59±10 years). After adjustment, HbA1c levels were not associated with the presence or absence of incontinence. However, among women reporting incontinence, HbA1c ?9% was associated with more limitations due to incontinence than HbA1c <6% (adjusted odds ratio 1.67, 95% confidence interval: 1.09–2.57). Conclusion In this cross-sectional analysis, HbA1c level is not associated with the presence or absence of incontinence. However, for women with incontinence, poor glycemic control (HbA1c ?9%) is associated with more limitations in daily activities due to incontinence. Longitudinal studies are needed to determine whether improving glycemic control to HbA1c <9% leads to fewer limitations in daily activities due to incontinence. PMID:24032999

Karter, Andrew J.; Thai, Julie N.; Van Den Eeden, Stephen K.; Huang, Elbert S.

2013-01-01

11

Effect of Fructose on Glycemic Control in Diabetes  

PubMed Central

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

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

2012-01-01

12

Periodontal disease and glycemic control in diabetics.  

PubMed

Data sourcesMedline, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL). This was supplemented by handsearching of the Journal of Clinical Periodontology, Journal of Periodontology, Journal of Dental Research, Journal of Dentistry, Journal of Periodontal Research, International Journal of Periodontics and Restorative Dentistry, Periodontology 2000, Odontology, Clinical Oral Investigations, Annals of Periodontology, Journal of American Dental Association, British Dental Journal, Community Dentistry and Oral Epidemiology, Diabetes, Diabetes Care, Diabetes & Metabolic Syndrome, Diabetes & Metabolism and Annals of Internal Medicine. There were no language restrictions.Study selectionRandomised controlled trials (RCTs) on diabetic patients with periodontal disease that reported glycated haemoglobin (HbA1c) and/or fasting plasma glucose (FPG) modification after treatment, with a minimum of three months follow-up were included. Study quality was assessed independently by two reviewers.Data extraction and synthesisData extraction was carried out independently by two reviewers. Meta-analysis was carried out to evaluate the effect of non-surgical periodontal treatment on HbA1c and FPG levels. The effect of the adjunctive use of antimicrobials was also assessedResultsFifteen studies were included, five were considered to be at low risk of bias, three at high risk and the remainder at unclear risk. Seven studies (678 patients) contributed to the meta-analysis for HbA1c. At the three-four months follow-up, the weighted mean difference was -0.38% (95% CI -0.23 to -0.53; P < 0.001) and at six months it was -0.31% (95% CI 0.11 to -0.74; P = 0.15), favouring the treatment groups [three studies contributing to meta-analysis]. There was statistically significant heterogeneity for both comparisons. For FPG, five studies presented data for three-four months and two for six months. At the three-four months follow-up, the weighted mean difference was -9.01 mg/dL (95% CI -2.24 to -15.78; P = 0.009) and at six months it was -13.62 mg/dL (95% CI 0.45 to -27.69; P = 0.06).ConclusionsDespite the limitations of the present study, it can be concluded that periodontal treatment might be effective in improving metabolic control in terms of reduction of HbA1c and FPG concentrations in patients with diabetes. However, the significance of this improvement is questionable and should be further investigated. PMID:25343401

Engebretson, Steven

2014-09-01

13

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

E-print Network

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

14

Diabetes in Primary Care: Prospective Associations between Depression, Nonadherence and Glycemic Control  

Microsoft Academic Search

Background: Findings are inconsistent regarding the degree to which depression may exert a negative impact on glycemic control in patients with type 2 diabetes. We therefore aimed to examine the longitudinal relationship between depression, behavioral factors, and glycemic control. Methods: In a prospective component of a nationally representative sample, 866 patients with type 2 diabetes aged ?18 years completed a

Jörg Dirmaier; Birgit Watzke; Uwe Koch; Holger Schulz; Hendrik Lehnert; Lars Pieper; Hans-Ulrich Wittchen

2010-01-01

15

Glycemic control in non-diabetic critically ill patients  

PubMed Central

Hyperglycemia is a common and costly health care problem in hospitalized patients. In hospital hyperglycemia is defined as any glucose value >7.8 mmol/l (140 mg/dl). Hyperglycemia is present in 40% of critically ill patients and in up to 80% of patients after cardiac surgery, with ~ 80% of ICU patients with hyperglycemia having no history of diabetes prior to admission. The risk of hospital complications relates to the severity of hyperglycemia, with a higher risk observed in patients without a history of diabetes compared to those with known diabetes. Improvement in glycemic control reduces hospital complications and mortality; however, the ideal glycemic target has not been determined. A target glucose level between 7.8 and 10.0 mmol/l (140 and 180 mg/dl) is recommended for the majority of ICU patients. This review aims to present updated recommendations for the inpatient management of hyperglycemia in critically ill patients with and without a history of diabetes. PMID:21925080

Farrokhi, Farnoosh; Smiley, Dawn; Umpierrez, Guillermo E.

2013-01-01

16

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

17

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

18

Self-Efficacy Links Health Literacy and Numeracy to Glycemic Control  

Microsoft Academic Search

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

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

2010-01-01

19

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

PubMed Central

Objective Dietary carbohydrate is the major determinant of postprandial glucose levels, and several clinical studies have shown that low-carbohydrate diets improve glycemic control. In this study, we tested the hypothesis that a diet lower in carbohydrate would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and type 2 diabetes mellitus. Research design and methods Eighty-four community volunteers with obesity and type 2 diabetes were randomized to either a low-carbohydrate, ketogenic diet (<20 g of carbohydrate daily; LCKD) or a low-glycemic, reduced-calorie diet (500 kcal/day deficit from weight maintenance diet; LGID). Both groups received group meetings, nutritional supplementation, and an exercise recommendation. The main outcome was glycemic control, measured by hemoglobin A1c. Results Forty-nine (58.3%) participants completed the study. Both interventions led to improvements in hemoglobin A1c, fasting glucose, fasting insulin, and weight loss. The LCKD group had greater improvements in hemoglobin A1c (-1.5% vs. -0.5%, p = 0.03), body weight (-11.1 kg vs. -6.9 kg, p = 0.008), and high density lipoprotein cholesterol (+5.6 mg/dL vs. 0 mg/dL, p < 0.001) compared to the LGID group. Diabetes medications were reduced or eliminated in 95.2% of LCKD vs. 62% of LGID participants (p < 0.01). Conclusion Dietary modification led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with type 2 diabetes. The diet lower in carbohydrate led to greater improvements in glycemic control, and more frequent medication reduction/elimination than the low glycemic index diet. Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes. PMID:19099589

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

2008-01-01

20

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

PubMed

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

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

2011-08-01

21

Acute Effects of Dietary Glycemic Index on Antioxidant Capacity in a Nutrient-controlled Feeding Study  

Microsoft Academic Search

Oxidative stress, caused by an imbalance between antioxidant capacity and reactive oxygen species, may be an early event in a metabolic cascade elicited by a high glycemic index (GI) diet, ultimately increasing the risk for cardiovascular disease and diabetes. We conducted a feeding study to evaluate the acute effects of low-GI compared with high-GI diets on oxidative stress and cardiovascular

Diego Botero; Cara B. Ebbeling; Jeffrey B. Blumberg; Judy D. Ribaya-Mercado; Mark A. Creager; Janis F. Swain; Henry A. Feldman; David S. Ludwig

2009-01-01

22

Pathways From Emotional Adjustment to Glycemic Control in Youths With Diabetes in Hong Kong  

Microsoft Academic Search

Objective: To examine factors that influence emotional adjustment, adherence to diabetic care, and gly- cemic control in Hong Kong youths with insulin-dependent diabetes mellitus (IDDM). Methods: Seventy youths, their mothers, and matched controls provided information on health beliefs, au- thoritarian parenting style, parent-child conflict, emotional adjustment, and adherence to medical regimen. Glycosylated hemoglobin levels were obtained to measure glycemic control.

Sunita M. Stewart; Peter W. H. Lee; Louis C. K. Low; Anna Cheng; Wilson Yeung; Kwai-Fun Huen; David O'Donnell

2000-01-01

23

Food Insecurity and Glycemic Control Among Low-Income Patients With Type 2 Diabetes  

PubMed Central

OBJECTIVE To determine whether food insecurity—the inability to reliably afford safe and nutritious food—is associated with poor glycemic control and whether this association is mediated by difficulty following a healthy diet, diabetes self-efficacy, or emotional distress related to diabetes. RESEARCH DESIGN AND METHODS We used multivariable regression models to examine the association between food insecurity and poor glycemic control using a cross-sectional survey and chart review of 711 patients with diabetes in safety net health clinics. We then examined whether difficulty following a diabetic diet, self-efficacy, or emotional distress related to diabetes mediated the relationship between food insecurity and glycemic control. RESULTS The food insecurity prevalence in our sample was 46%. Food-insecure participants were significantly more likely than food-secure participants to have poor glycemic control, as defined by hemoglobin A1c ?8.5% (42 vs. 33%; adjusted odds ratio 1.48 [95% CI 1.07–2.04]). Food-insecure participants were more likely to report difficulty affording a diabetic diet (64 vs. 49%, P < 0.001). They also reported lower diabetes-specific self-efficacy (P < 0.001) and higher emotional distress related to diabetes (P < 0.001). Difficulty following a healthy diet and emotional distress partially mediated the association between food insecurity and glycemic control. CONCLUSIONS Food insecurity is an independent risk factor for poor glycemic control in the safety net setting. This risk may be partially attributable to increased difficulty following a diabetes-appropriate diet and increased emotional distress regarding capacity for successful diabetes self-management. Screening patients with diabetes for food insecurity may be appropriate, particularly in the safety net setting. PMID:22210570

Seligman, Hilary K.; Jacobs, Elizabeth A.; Lopez, Andrea; Tschann, Jeanne; Fernandez, Alicia

2012-01-01

24

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

PubMed Central

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

2014-01-01

25

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

26

Carbohydrate intake and biomarkers of glycemic control among US adults: the third National Health and Nutrition Examination Survey  

Microsoft Academic Search

Background: Recommendations for preventing and treating type 2 diabetes include consuming carbohydrates, predominantly from whole grains, fruit, vegetables, and low-fat milk. However, the quantity and type of carbohydrates consumed may contribute to disorders of glycemic control. Objective: We evaluated the association between carbohydrate intakes and biomarkers of glycemic control in a nationally repre- sentative sample of healthy US adults who

Eun Ju Yang; Jean M Kerver; Yi Kyung Park; Jean Kayitsinga; David B Allison; Won O Song

27

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

28

Influence of glycemic control on pulmonary function and heart rate in response to exercise in subjects with type 2 diabetes mellitus  

Microsoft Academic Search

Conflicting results exist regarding the impact of glycemic control on peak oxygen uptake (V?o2peak) in subjects with type 2 diabetes mellitus. The influence of glycemic control on submaximal oxygen uptake (V?o2) in these subjects is unknown. The aim of this study was to evaluate the impact of fasting blood glucose (FBG) (short-term glycemic control) and glycated hemoglobin (HbA1c) (long-term glycemic

Patrice Brassard; Annie Ferland; Peter Bogaty; Marc Desmeules; Jean Jobin; Paul Poirier

2006-01-01

29

Antioxidant ?-tocopherol ameliorates glycemic control of GK rats, a model of type 2 diabetes  

Microsoft Academic Search

We have shown recently that oxidative stress by chronic hyperglycemia damages the pancreatic ?-cells of GK rats, a model of non-obese type 2 diabetes, which may worsen diabetic condition and suggested the administration of antioxidants as a supportive therapy. To determine if natural antioxidant ?-tocopherol (vitamin E) has beneficial effects on the glycemic control of type 2 diabetes, GK rats

Yu Ihara; Yuichiro Yamada; Shinya Toyokuni; Kazumasa Miyawaki; Nobuhiro Ban; Tetsuya Adachi; Akira Kuroe; Toshio Iwakura; Akira Kubota; Hiroshi Hiai; Yutaka Seino

2000-01-01

30

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

31

Hepatic insulin expression improves glycemic control in type 1 diabetic rats  

Microsoft Academic Search

Low levels of hepatic insulin production have been shown to prevent lethal ketoacidosis associated with type 1 diabetes. To assess the beneficial effects of sustained hepatic production of insulin on glycemic control in type 1 diabetes, we have employed the adenovirus-mediated gene delivery system to transfer an engineered rat preproinsulin gene to the livers of streptozotocin-induced diabetic nude rats. Hepatic

Hengjiang Dong; Núria Morral; Robert McEvoy; Marcia Meseck; Swan N. Thung; Savio L. C. Woo

2001-01-01

32

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

33

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; Rodriguez-Cano, Ameyalli; Legorreta-Legorreta, Jennifer; Parra-Covarrubias, Adalberto; Vadillo-Ortega, Felipe

2012-01-01

34

Cushing's syndrome in type 2 diabetes patients with poor glycemic control.  

PubMed

Cushing's syndrome may be more frequent in some specific patient groups such as type 2 diabetes and obesity. The aim of this study was to investigate the prevalence of Cushing's syndrome in outpatients with type 2 diabetes with poor glycemic control despite at least 3-months insulin therapy. Outpatients with type 2 diabetes whose glycemic control is poor (Hb Alc value >7 %) despite receiving at least 3-months long insulin treatment (insulin alone or insulin with oral antidiabetics) were included. Patients with classic features of Cushing's syndrome were excluded. Overnight 1 mg dexamethasone suppression test (DST) was performed as a screening test. A total of 277 patients with type 2 diabetes whose glycemic control is poor (Hb Alc value >7 %) despite insulin therapy were included. Two of the 277 patients with type 2 diabetes were diagnosed with Cushing's syndrome (0.72 %). Hypertension was statistically more frequent in the patients with cortisol levels ?1.8 ?g/dL than the patients with cortisol levels <1.8 ?g/dL after overnight 1 mg DST (p = 0.041). Statistically significant correlation was determined between cortisol levels after 1 mg DST and age, daily insulin dose (r = 0.266 and p < 0.001, r = 0.163 and p = 0.008, respectively). According to our findings, the prevalence of Cushing's syndrome among patients with type 2 diabetes with poor glycemic control despite insulin therapy is much higher than in the general population. The patients with type 2 diabetes with poor glycemic control despite at least three months of insulin therapy should be additionally tested for Cushing's syndrome if they have high dose insülin requirements. PMID:24740545

Gungunes, Askin; Sahin, Mustafa; Demirci, Taner; Ucan, Bekir; Cakir, Evrim; Arslan, Muyesser Sayki; Unsal, Ilknur Ozturk; Karbek, Basak; Cal?skan, Mustafa; Ozbek, Mustafa; Cakal, Erman; Delibasi, Tuncay

2014-12-01

35

Patterns and Predictors of Long-Term Glycemic Control in Patients with Type 2 Diabetes  

PubMed Central

Aims/Introduction. To describe patterns of long-term glycemic control among patients with type 2 diabetes in Isfahan, Iran and identify factors associated with glycemic control. Methods. During the mean (standard deviation (SD)) follow-up period of 8.4 (4.2) (range 1–18) years, 4,582 patients with type 2 diabetes have been examined to determine glycemic changes. Their glycated hemoglobin (GHb) at the last clinic visit was compared with the initial visit data. The mean (SD) age of participants was 49.3 (9.6) years with a mean (SD) duration of diabetes of 5.0 (5.1) years at initial registration. Results. Mean (SD) GHb was 8.7% (2.3) at baseline and 7.9% (1.9) at the study end and decreased by mean of 0.8% (95% confidence interval (CI) 0.74, 0.87; P < 0.001) and varied by the severity of baseline GHb. 74.6% at the initial visit versus 64.4% at the last clinic visit had GHb values above the target level of 7.0%. Using a stepwise multiple regression models, age, higher GHb, FPG, follow-up period, and number of follow-up visits increased and higher systolic BP and female gender significantly decreased the percent glycemic change. Conclusions. This study highlights that more than 64.4% of the patients have GHb values higher than 7.0% at last clinic visit andindicatesthe difficult challenges physicians face when treating their patients with type 2 diabetes. Clinical efforts should focus on more effective methods for glycemic control in diabetic patients. PMID:23119180

Janghorbani, Mohsen; Amini, Masoud

2012-01-01

36

Impact of Glycemic Control on Heart Rate Variability in Youth with Type 1 Diabetes: The SEARCH CVD Study  

PubMed Central

Abstract Aim: This study explored the role of glycemic control on cardiac autonomic function, measured by heart rate variability (HRV), in youth with type 1 diabetes. Patients and Methods: A retrospective cohort of 345 youth with type 1 diabetes (mean age, 18.5 years; duration, 10 years) participating in the SEARCH for Diabetes in Youth study were enrolled in the ancillary SEARCH Cardiovascular Disease (CVD) study. Anthropometric, metabolic, and HRV parameters were collected at the current research visit. Glycemic control over time was assessed by the mean glycated hemoglobin (A1c) levels collected over the past 6 years. Multiple linear regression analysis assessed the association between A1c over time and HRV parameters, independent of demographic and CVD risk factors. Participants were categorized into four glycemic control categories based on their mean A1c over time: Group 1, optimal (mean A1c, ?7.4%); Group 2 (mean A1c, 7.5–8.4%); Group 3 (mean A1c, 8.5–9.4%), and Group 4, poor (mean A1c, ?9.5%), and a linear trend was explored across these categories. Results: For every 1% increase in the average A1c over 6 years there was a 5% decrease in the SD of the normal RR interval (SDNN) (P=0.02) and 7% decrease in the root mean square successive difference of the RR interval (RMSSD) (P=0.02), independent of demographic and traditional CVD risk factors. A dose–response relationship between worsening glucose control categories and measures of overall reduced HRV was found. Conclusions: Chronic hyperglycemia is the main determinant of early cardiac autonomic dysfunction, manifested as reduced overall HRV and parasympathetic loss, among youth with type 1 diabetes. PMID:24010960

Jaiswal, Mamta; Fingerlin, Tasha E.; Urbina, Elaine M.; Wadwa, R. Paul; Talton, Jennifer W.; D'Agostino, Ralph B.; Hamman, Richard F.; Daniels, Stephen R.; Marcovina, Santica M.; Dolan, Larry M.

2013-01-01

37

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

38

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

39

The influence of a low glycemic index dietary intervention on maternal dietary intake, glycemic index and gestational weight gain during pregnancy: a randomized controlled trial  

PubMed Central

Background Maternal diet is known to impact pregnancy outcome. Following a low glycemic index (GI) diet during pregnancy has been shown to improve maternal glycemia and reduce infant birthweight and may be associated with a higher fibre intake. We assessed the impact of a low GI dietary intervention on maternal GI, nutritional intake and gestational weight gain (GWG) during pregnancy. Compliance and acceptability of the low GI diet was also examined. Method Eight hundred women were randomised in early pregnancy to receive low GI and healthy eating dietary advice or to receive standard maternity care. The intervention group received dietary advice at a group education session before 22 weeks gestation. All women completed a 3 day food diary during each trimester of pregnancy. Two hundred and thirty five women from the intervention arm and 285 women from the control arm returned complete 3x3d FDs and were included in the present analysis. Results Maternal GI was significantly reduced in the intervention group at trimester 2 and 3. The numbers of women within the lowest quartile of GI increased from 37% in trimester 1 to 52% in trimester 3 (P?early pregnancy had a positive influence on maternal GI, food and nutrient intakes and GWG. Following a low GI diet may be particularly beneficial for women at risk of exceeding the GWG goals for pregnancy. Trial registration Current Controlled Trials Registration Number: ISRCTN54392969. PMID:24175958

2013-01-01

40

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

PubMed Central

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

Marshall, Merville C.

2007-01-01

41

Effects of self-care, self-efficacy, social support on glycemic control in adults with type 2 diabetes  

PubMed Central

Background A number of studies have examined the influence of self-efficacy, social support and patient-provider communication (PPC) on self-care and glycemic control. Relatively few studies have tested the pathways through which these constructs operate to improve glycemic control, however. We used structural equation modeling to examine a conceptual model that hypothesizes how self-efficacy, social support and patient-provider communication influence glycemic control through self-care behaviors in Chinese adults with type 2 diabetes. Methods We conducted a cross-sectional study of 222 Chinese adults with type 2 diabetes in one primary care center. We collected information on demographics, self-efficacy, social support, patient-provider communication (PPC) and diabetes self-care. Hemoglobin A1c (HbA1c) values were also obtained. Measured variable path analyses were used to determine the predicted pathways linking self-efficacy, social support and PPC to diabetes self-care and glycemic control. Results Diabetes self-care had a direct effect on glycemic control (??=??0.21, p?=?.007), No direct effect was observed for self-efficacy, social support or PPC on glycemic control. There were significant positive direct paths from self-efficacy (??=?0.32, p?glycemic control. So longitudinal studies are needed to explore the effect of self-efficacy, social support and PPC on changes in diabetes self-care behaviors and glycemic control. PMID:23705978

2013-01-01

42

Determinants of Glycemic Control among Insulin Treated Diabetic Patients in Southwest Ethiopia: Hospital Based Cross Sectional Study  

PubMed Central

Background Good glycemic control reduces the risk of diabetic complications. Despite this, achieving good glycemic control remains a challenge in diabetic patients. The objective of this study is to identify determinants of glycemic control among insulin treated diabetic patients at Jimma University Hospital, Southwest Ethiopia. Methods Hospital-based cross-sectional study was conducted on systematically sampled 284 insulin-treated diabetic patients with a regular follow up. Data was collected by interviewing patients during hospital visits and reviewing respective databases of September 2010 to December 2011. Data collection took place from February 20 to May 20, 2012. Poor glycemic control was defined as fasting blood sugar (FBS) ?126 mg/dL. Binary logistic regression analysis was conducted to identify predictors of poor glycemic control. Results Patients had a mean age of 41.37 (±15.08) years, 58.5% were males, the mean duration of insulin treatment was 4.9 (±5.1) years, 18.3% achieved good glycemic control (FBS?126 mg/dL), 95% self-reported repeated use of disposable insulin syringe-needle and 48% correctly rotating insulin injection sites. Most (83.1%) of study participants had one or more complications. On multivariable logistic regression analyses, body weight of >70 Kg (AOR?=?0.21; P<0.001), total daily dose of insulin ?35 IU/day (AOR?=?0.26; P<0.001), total daily dose variation without checking glycemic level (AOR?=?3.39; P?=?0.020), knowledge deficit about signs and symptoms of hyperglycemia (AOR?=?3.60; P?=?0.004), and non-adherence to dietary management (AOR?=?0.35; P?=?0.005) were independent predictors of poor glycemic control. Conclusions The proportion of patients with poor glycemic control was high, which resulted in the development of one or more complications regardless of duration on insulin treatment. Hence, appropriate management of patients focusing on the relevant associated factors and independent predictors of poor glycemic control would be of great benefit in glycemic control. PMID:23620789

Angamo, Mulugeta Tarekegn; Melese, Belete Habte; Ayen, Wubeante Yenet

2013-01-01

43

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

PubMed

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

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

2013-01-01

44

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

Microsoft Academic Search

The current study sought to assess the effect of improving glycemic control in type 2 diabetes on the components of diabetic dyslipidemia, especially low-denisty lipoprotein (LDL) size. A total of 33 type 2 diabetic patients (48.5% women, age 59.6 ± 11.1 years, body mass index [BMI] 28.9 ± 4.9, diabetes duration 6 [0 to 40] years, 40.7% on insulin) were

Ana Mar??a Wägner; Oscar Jorba; Mercedes Rigla; Rosa Bonet; Alberto de Leiva; Jordi Ordóñez-Llanos; Antonio Pérez

2003-01-01

45

Combined aerobic and resistance exercise improves glycemic control and fitness in type 2 diabetes  

Microsoft Academic Search

We investigated the effect of an 8 week circuit training (CT) program, combining aerobic and resistance exercise, on indices of glycemic control, cardiorespiratory fitness, muscular strength and body composition in 16 subjects (age 52±2 years) with type 2 diabetes using a prospective randomised crossover protocol. Submaximal exercise heart rate and rate pressure product were significantly lower after training (P<0.05), whilst

Andrew Maiorana; Gerard O'Driscoll; Carmel Goodman; Roger Taylor; Daniel Green

2002-01-01

46

Effect of Ethnicity on the Progression of Diabetic Kidney Disease Independent of Glycemic Control  

Microsoft Academic Search

Background\\/Aims: The prevalence of diabetic kidney disease (DKD) and risk of progression to end-stage renal disease is higher in African-Americans as compared to Caucasians. Whether the higher rate of estimated glomerular filtration rate (eGFR) decline in African-Americans is mediated by poor glycemic control is unclear. Methods: We conducted a prospective study of 183 (African-American, n = 95; Caucasian, n =

Moro O. Salifu; Syed Shah; Muhammad H. Iqbal; Mushtaq Nabi; Amir Hayat; Adam T. Whaley-Connell; James R. Sowers; Samy I. McFarlane

2009-01-01

47

A Focus on Blood Glucose Monitoring: Relation to Glycemic Control and Determinants of Frequency  

PubMed Central

Objective To re-examine the relation of blood glucose monitoring to glycemic control among adolescents with type 1 diabetes and to evaluate the relation of demographic, behavioral, and psychosocial characteristics of adolescents who monitor more and less frequently. Research Design and Methods Participants were 132 adolescents with type 1 diabetes (average age = 12 years) and their parents, recruited from Children's Hospital of Pittsburgh. Adolescents were interviewed annually for five consecutive years after routine clinic appointments. At each assessment, data from blood glucose meters were downloaded and glycosylated hemoglobin (HbA1c) was recorded from medical records. Results More frequent blood glucose monitoring was related to better glycemic control. Adolescents who monitored more frequently were younger, from higher social status families, on insulin pumps, and had higher self-efficacy. Age-related declines in blood glucose monitoring occurred among adolescents with low self-esteem, high stressful life events, and lower parental support. Conclusions Given the importance of blood glucose monitoring for good glycemic control, future research should enhance adolescents' self-efficacy for monitoring and intervene with those who are at risk for age-related declines in blood glucose monitoring. PMID:20522169

Helgeson, Vicki S.; Honcharuk, Erin; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

2010-01-01

48

Evaluation of Glycemic Variability in Well-Controlled Type 2 Diabetes Mellitus  

PubMed Central

Abstract Aims It is necessary to evaluate glucose variability and postprandial hyperglycemia in patients with well-controlled type 2 diabetes mellitus because of the limitations associated with hemoglobin A1c (HbA1c) measurements. We evaluated parameters reflecting postprandial hyperglycemia and glycemic variability in patients with optimal HbA1c. Patients and Methods Thirty-nine patients with HbA1c levels below 7% were recruited to the study. A continuous glucose monitoring system (CGMS) was applied for two 72-h periods. 1,5-Anhydroglucitol (1,5-AG) and fructosamine (FA) were measured as parameters for postprandial hyperglycemia and glucose variability. Using CGMS data, the following postprandial hyperglycemia parameters were calculated: mean postprandial maximum glucose (MPMG) and area under the curve for glucose above 180?mg/dL (AUC-180). To measure glycemic variability, we calculated mean amplitude of glucose excursion (MAGE) using a classical (MAGEc) and new method (MAGE group of sign [MAGEgos]). Results The baseline HbA1c level was 6.3±0.3%. The mean MPMG was 10.34±1.84?mmol/L, and the mean AUC-180 was 0.17±0.23?mmol/L/day. The mean MAGEgos was 3.27±1.29?mmol/L, and MAGEc was 4.30±1.43?mmol/L, indicating glycemic variability in our patients. The mean levels of 1,5-AG and FA were 16.7±7.4??g/mL and 273.0±22.5??mol/L, respectively. In a correlation analysis, FA was significantly correlated with MPMG, AUC-180, MAGEgos, and MAGEc. In contrast, 1,5-AG was only correlated with AUC-180. Conclusions This study demonstrated postprandial hyperglycemia and glycemic variability in subjects with well-controlled diabetes. FA may reflect postprandial hyperglycemia and glycemic variability, but 1,5-AG may be of limited value for assessing glucose variability in patients with well-controlled type 2 diabetes mellitus. PMID:23617251

Chon, Suk; Lee, Yun Jung; Fraterrigo, Gemma; Pozzilli, Paolo; Choi, Moon Chan; Kwon, Mi-Kwang; Chin, Sang Ouk; Rhee, Sang Youl; Oh, Seungjoon; Kim, Young-Seol

2013-01-01

49

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

50

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

51

Improved glycemic control and risk of ESRD in patients with type 1 diabetes and proteinuria.  

PubMed

Most patients with type 1 diabetes (T1D) and proteinuria have poor glycemic control and a high risk of ESRD. We investigated whether long-term improvement of glycemic control reduces risk of ESRD in a prospective 7- to 15-year follow-up observation of 349 patients with CKD stages 1-3 enrolled in the Joslin Proteinuria Cohort of adults with T1D. All patients developed proteinuria between 1990 and 2004 and were followed until 2011 to ascertain onset of ESRD and deaths unrelated to ESRD. Furthermore, we analyzed data from 279 patients with ?3 years of clinic follow-up available to assess the level of glycemic control after enrollment. Average HbA1c during the 5 years before study enrollment (prebaseline) was compared with HbA1c (postbaseline) averaged during the first half of follow-up (median, 5.1 years). Median prebaseline HbA1c was 9.3%, decreasing to 8.7% postbaseline. Cumulative risk of ESRD after 15 years was significantly lower for patients whose HbA1c decreased than for those whose HbA1c increased or remained poor (29% versus 42%; P<0.001). The difference between these groups was not visible at 5 years of follow-up but became visible at 10 and 15 years of follow-up. In multivariate Cox regression analysis of ESRD risk, the hazard ratio corresponding to a 1-percentage point improvement in postbaseline HbA1c was 0.76 (95% confidence interval, 0.63 to 0.91; P=0.003). In conclusion, results of this study suggest that long-term sustained improvement in HbA1c decelerates eGFR loss and delays the onset of ESRD in patients with T1D and proteinuria. PMID:24904086

Skupien, Jan; Warram, James H; Smiles, Adam; Galecki, Andrzej; Stanton, Robert C; Krolewski, Andrzej S

2014-12-01

52

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

53

Importance of Perioperative Glycemic Control in General Surgery  

PubMed Central

Objective To determine the relationship of perioperative hyperglycemia and insulin administration on outcomes in elective colon/rectal and bariatric operations. Background There is limited evidence to characterize the impact of perioperative hyperglycemia and insulin on adverse outcomes in patients, with and without diabetes, undergoing general surgical procedures. Methods The Surgical Care and Outcomes Assessment Program is a Washington State quality improvement benchmarking-based initiative. We evaluated the relationship of perioperative hyperglycemia (>180 mg/dL) and insulin administration on mortality, reoperative interventions, and infections for patients undergoing elective colorectal and bariatric surgery at 47 participating hospitals between fourth quarter of 2005 and fourth quarter of 2010. Results Of the 11,633 patients (55.4 ± 15.3 years; 65.7% women) with a serum glucose determination on the day of surgery, postoperative day 1, or postoperative day 2, 29.1% of patients were hyperglycemic. After controlling for clinical factors, those with hyperglycemia had a significantly increased risk of infection [odds ratio (OR) 2.0; 95% confidence interval (CI), 1.63–2.44], reoperative interventions (OR, 1.8; 95% CI, 1.41–2.3), and death (OR, 2.71; 95% CI, 1.72–4.28). Increased risk of poor outcomes was observed both for patients with and without diabetes. Those with hyperglycemia on the day of surgery who received insulin had no significant increase in infections (OR, 1.01; 95% CI, 0.72–1.42), reoperative interventions (OR, 1.29; 95% CI, 0.89–1.89), or deaths (OR, 1.21; 95% CI, 0.61–2.42). A dose-effect relationship was found between the effectiveness of insulin-related glucose control (worst 180–250 mg/dL, best <130 mg/dL) and adverse outcomes. Conclusions Perioperative hyperglycemia was associated with adverse outcomes in general surgery patients with and without diabetes. However, patients with hyperglycemia who received insulin were at no greater risk than those with normal blood glucoses. Perioperative glucose evaluation and insulin administration in patients with hyperglycemia are important quality targets. PMID:23235393

Kwon, Steve; Thompson, Rachel; Dellinger, Patchen; Yanez, David; Farrohki, Ellen; Flum, David

2014-01-01

54

Barriers to achieving optimal glycemic control in a multi-ethnic society: a US focus.  

PubMed

The increasing prevalence of diabetes is particularly apparent in certain ethnic groups, such as African and Hispanic Americans. These groups generally also have poorer glycemic control and outcomes. To better understand the issues surrounding these problems and possible methods to overcome them we performed a literature review from the past 15 years on barriers to glycemic control with a focus on US data. The literature reveals that barriers may be inherent (eg, genetic, cultural, and language/communication) or acquired (eg, those associated with changes in lifestyle and socioeconomic factors). Healthcare interventions that take into consideration cultural and population-specific characteristics can reduce the prevalence and severity of diabetes and its resulting complications. Implementing such strategies will require suitable education for patients and providers, the availability of culturally-sensitive, patient-centered healthcare teams, the creation of collaborative relationships between providers and patients, better use of community resources, and assistance for patients to make informed decisions about available treatment options. There is also evidence suggesting that at the same level of glucose control Hispanics and African Americans have the same degree of complications as whites; therefore, good control is essential for the future well-being of all patients. Addressing these issues may help to decrease the ethnic disparities that currently exist in diabetes care. PMID:18220633

Dagogo-Jack, Samuel; Funnell, Martha M; Davidson, Jaime

2006-08-01

55

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

PubMed Central

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

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

2012-01-01

56

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

PubMed Central

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

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

2014-01-01

57

Diabetes and cardiovascular disease: Changing the focus from glycemic control to improving the long-term survival  

PubMed Central

Diabetes is the fifth leading cause of death worldwide and contributes to leading causes of death, cancer and cardiovascular disease including coronary heart disease, stroke, peripheral vascular disease and other vascular disease. While glycemic management remains a cornerstone of diabetes care, the co-management of hypertension, atherosclerosis, cardiovascular risk reduction and prevention of long-term consequences associated with diabetes are now well recognized as essential to improve long-term survival. Clinical trial evidence substantiates the importance of glycemic control, LDL-cholesterol lowering therapy, blood-pressure lowering, control of albuminuria, and comprehensive approaches targeting multiple risk factors to reduce cardiovascular risk. This article presents a review of the role of diabetes in pathogenesis of atherosclerosis and cardiac dysfunction, recent evidence regarding degree of glycemic control and mortality, and available evidence for a multi-faceted approach to improve long-term outcomes for patients. PMID:23062569

Wang, Cecilia C. Low; Reusch, Jane EB

2012-01-01

58

Self-Efficacy Links Health Literacy and Numeracy to Glycemic Control  

PubMed Central

The mechanisms underlying the relationship between health literacy, numeracy, and glycemic control are unclear. We explored the role of self-efficacy in the predicted pathway linking health literacy and numeracy to glycemic control (A1C). Adults with type 1 or type 2 diabetes mellitus (N=383) were enrolled in a cross-sectional study at primary care and diabetes clinics at three medical centers. Data collected included demographic information, health literacy, general numeracy, and A1C. Path analytic models estimated relations among health literacy, numeracy, and self-efficacy as predictors of A1C. Health literacy (r=0.14, p<0.01) and numeracy skills (r=0.17, p<0.001) were each associated with greater self-efficacy; and greater diabetes self-efficacy was associated with lower A1C levels (r=?0.25, p<001). When considered in combination, numeracy was related to self-efficacy (r=0.13, p<0.05) and the effect of health literacy on self-efficacy was reduced to non-significance (r=0.06, p=0.30). Health literacy and numeracy are each associated with greater diabetes self-efficacy; and greater diabetes self-efficacy is associated with lower A1C levels. Diabetes self-efficacy may be an important target of interventions to improve diabetes control and promote health equity related to health literacy and general numeracy skills needed for diabetes management. PMID:20845200

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

2011-01-01

59

Diet, inflammation, and glycemic control in type 2 diabetes: an integrative review of the literature.  

PubMed

Type 2 diabetes (T2D) is a growing national health problem affecting 35% of adults ?20 years of age in the United States. Recently, diabetes has been categorized as an inflammatory disease, sharing many of the adverse outcomes as those reported from cardiovascular disease. Medical nutrition therapy is recommended for the treatment of diabetes; however, these recommendations have not been updated to target the inflammatory component, which can be affected by diet and lifestyle. To assess the current state of evidence for which dietary programs contain the most anti-inflammatory and glycemic control properties for patients with T2D, we conducted an integrative review of the literature. A comprehensive search of the PubMed, CINAHL, Scopus, and Web of Science databases from January 2000 to May 2012 yielded 786 articles. The final 16 studies met the selection criteria including randomized control trials, quasiexperimental, or cross-sectional studies that compared varying diets and measured inflammatory markers. The Mediterranean and DASH diets along with several low-fat diets were associated with lower inflammatory markers. The Mediterranean diet demonstrated the most clinically significant reduction in glycosylated hemoglobin (HbA(1c)). Information on best dietary guidelines for inflammation and glycemic control in individuals with T2D is lacking. Continued research is warranted. PMID:23316349

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

2012-01-01

60

Low prevalence of glucokinase gene mutations in gestational diabetic patients with good glycemic control.  

PubMed

Glucokinase (GCK) plays a key role in glucose homeostasis. Gestational diabetes mellitus increases the risk of gestational complications in pregnant women and fetuses. We screened for mutations in coding and flanking regions of the GCK gene in pregnant women with or without gestational diabetes in a Brazilian population. A sample of 200 pregnant women classified as healthy (control, N = 100) or with gestational diabetes (N = 100) was analyzed for mutations in the GCK gene. All gestational diabetes mellitus patients had good glycemic control maintained by diet alone and no complications during pregnancy. Mutations were detected by single-strand conformation polymorphism and DNA sequencing. Thirteen of the 200 subjects had GCK gene mutations. The mutations detected were in intron 3 (c.43331A>G, new), intron 6 (c.47702T>C, rs2268574), intron 9 (c.48935C>T, rs2908274), and exon 10 (c.49620G>A, rs13306388). None of these GCK mutations were found to be significantly associated with gestational diabetes mellitus. In summary, we report a low frequency of GCK mutations in a pregnant Brazilian population and describe a new intronic variation (c.43331A>G, intron 3). We conclude that mutations in GCK introns and in non-translatable regions of the GCK gene do not affect glycemic control and are not correlated with gestational diabetes mellitus. PMID:22653590

Frigeri, H R; Santos, I C R; Réa, R R; Almeida, A C R; Fadel-Picheth, C M T; Pedrosa, F O; Souza, E M; Rego, F G M; Picheth, G

2012-01-01

61

Initiating basal insulin therapy in type 2 diabetes: practical steps to optimize glycemic control.  

PubMed

Primary care practitioners are increasingly responsible for the management of the escalating numbers of patients with type 2 diabetes. The majority of these patients will require insulin replacement therapy as their disease progresses, because glycemic control is often unsustainable using oral antidiabetic drugs. This review explains the practicalities of initiating and optimizing basal insulin in clinical practice, emphasizing the need for regular glycated hemoglobin (A1c) monitoring to allow timely initiation of insulin when the A1c target is not met. The importance of patient education in overcoming barriers to insulin is discussed, as well as the choice of available basal insulins and the necessity to optimize basal insulin dosage by self-titration. The traditional view of insulin therapy as a last resort is challenged with the modern basal insulin analogues (insulin detemir and insulin glargine), which offer simple and effective glycemic control with a reduced risk of hypoglycemia compared with older insulin formulations such as neutral protamine Hagedorn. PMID:23953076

Philis-Tsimikas, Athena

2013-09-01

62

Vegetarian diets and glycemic control in diabetes: a systematic review and meta-analysis  

PubMed Central

Introduction Previous studies have suggested an association between vegetarian diets and improvements in glycemic control in diabetes, although this relationship is not well established. No meta-analysis of these studies has been performed. Methods To conduct a systematic review and meta-analysis of controlled clinical trials examining the association between vegetarian diets and glycemic control in type 2 diabetes. Data source: The electronic databases Medline, Web of Science, Excerpta Medica Database (EMBASE), and Cochrane Central Register of Controlled Trials were searched for articles published in any language through December 9, 2013. Study selection: The following criteria were used for study inclusion: (I) age of participants >20 years; (II) vegetarian diet as intervention; (III) mean difference in hemoglobin A1c (HbA1c) and/or fasting blood glucose levels used as outcomes; and (IV) controlled trials, duration ?4 weeks. Exclusion criteria were: (I) not an original investigation; (II) duplicate samples; (III) diabetes other than type 2; (IV) multiple interventions; and (V) uncontrolled studies. Data extraction and synthesis: The data collected included study design, baseline population characteristics, dietary data, and outcomes. Data were pooled using a random-effects model. Main outcomes and measures: Differences in HbA1c and fasting blood glucose levels associated with vegetarian diets were assessed. Results Of 477 studies identified, six met the inclusion criteria (n=255, mean age 42.5 years). Consumption of vegetarian diets was associated with a significant reduction in HbA1c [?0.39 percentage point; 95% confidence interval (CI), ?0.62 to ?0.15; P=0.001; I2=3.0; P for heterogeneity =0.389], and a non-significant reduction in fasting blood glucose concentration (?0.36 mmol/L; 95% CI, ?1.04 to 0.32; P=0.301; I2=0; P for heterogeneity =0.710), compared with consumption of comparator diets. Conclusions Consumption of vegetarian diets is associated with improved glycemic control in type 2 diabetes. PROSPERO registration number is CRD42013004370.

Barnard, Neal D.; Levin, Susan M.; Watanabe, Mitsuhiro

2014-01-01

63

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

PubMed Central

Stress hyperglycemia and hypoglycemia are associated with increased mortality and morbidity in critically ill patients. Three randomized controlled trials, in the surgical, medical, and pediatric intensive care unit (PICU) of the Leuven University in Belgium, demonstrated the beneficial response of tightly controlling blood glucose levels within age-adjusted narrow limits by applying intensive insulin therapy. Follow-up studies could not confirm the results obtained in the Leuven studies but revealed the complexity associated with tight glycemic control (TGC). This article gives an overview of the methodological aspects typical of the Leuven TGC concept, with the focus on the PICU. Differences between the adult and the PICU are described. This overview article might help other ICUs by addressing potential differences in clinical practice when implementing TGC. PMID:22401318

Van Herpe, Tom; Vanhonsebrouck, Koen; Mesotten, Dieter; De Moor, Bart; Van den Berghe, Greet

2012-01-01

64

Is glycemic control modulating endoplasmic reticulum stress in leukocytes of type 2 diabetic patients?  

PubMed

Abstract Oxidative and endoplasmic reticulum (ER) stress is related to type 2 diabetes (T2D), but the influence of glycemic control on these parameters and its relationship with leukocyte-endothelial interactions is not known. In our study population consisting of 164 diabetic patients, (102 with glycated hemoglobin [HbA1c] <7% and 62 with HbA1c >7%) and 84 nondiabetic controls, we have verified a common anthropometric and metabolic pattern of T2D with dyslipidemia. Inflammatory parameters (high-sensitive C-reactive protein [hs-CRP] and tumor necrosis factor alpha [TNF?]) and E-selectin levels were enhanced in the HbA1c >7% group with regard to controls. O2 consumption and mitochondrial membrane potential were lower in diabetic patients than in controls. Reactive oxygen species (ROS) production was enhanced in diabetic patients than in controls and positively correlated with HbA1c levels. GRP78 levels were higher in both diabetic groups. However, HbA1c <7% patients displayed higher levels of spliced X-box binding protein 1 (sXBP1), whereas HbA1c >7% patients exhibited preferentially enhanced levels of CHOP (CCAAT/enhancer binding protein [C/EBP] homologous protein) and activating transcription factor 6 (ATF6). Reduced leukocyte rolling velocity and increased rolling flux and adhesion were observed in diabetic patients. Our findings lead to the hypothesis of an association between poor glycemic control in T2D and increased leukocyte ROS production and chronic ER stress that could finally promote leukocyte-endothelial interactions, which, in turn, poses a risk of vascular complications for these patients. Antioxid. Redox Signal. 21, 1759-1765. PMID:25000244

Rovira-Llopis, Susana; Bañuls, Celia; Apostolova, Nadezda; Morillas, Carlos; Hernandez-Mijares, Antonio; Rocha, Milagros; Victor, Victor M

2014-10-20

65

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

PubMed Central

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

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

2014-01-01

66

Postpregnancy Glycemic Control and Weight Changes in Type 1 Diabetic Women  

PubMed Central

OBJECTIVE Pregnancy in type 1 diabetes requires excellent glycemic control. Most pregnant type 1 diabetic women achieve normoglycemia; however, there is scarce data on their postdelivery characteristics. We aimed to examine postpregnancy glycemic control and weight changes in type 1 diabetes. RESEARCH DESIGN AND METHODS We identified and followed (median 20 months) 254 women with singleton pregnancies receiving postdelivery medical care at a single institution. RESULTS Study subjects were 28.3 ± 4.7 years of age (mean ± SD), with a diabetes duration of 12.0 ± 7.7 years. Mean A1C before conception was 6.9 ± 1.4%, and preconception weight and BMI were 64.4 ± 10.0 kg and 23.9 ± 3.3 kg/m2, respectively. Mean A1C decreased during pregnancy, reaching 5.7 ± 0.8% in the third trimester. We observed a mean weight gain of 14.4 ± 6.5 kg during pregnancy. Within 6 months after delivery, A1C increased by 0.8% (P < 0.0001) compared with the last trimester, and body weight and BMI were 4.4 kg and 2.5 kg/m2 higher (P < 0.0001) compared with the preconception baseline. A1C further deteriorated by 0.8% until the end of follow-up. For women in the “pregnancy planning” program (n = 117), A1C >12 months after delivery was worse compared with before conception (7.1 vs. 6.5%, P = 0.0018), whereas in women with unplanned pregnancies, it was similar to the pregestational levels (7.3 vs.7.4%, P = 0.59). Weight and BMI in the entire study group did not return to prepregnancy levels and were 2.5 kg (P = 0.0079) and 0.9 kg/m2 higher (P = 0.0058). CONCLUSIONS In this clinical observation, type 1 diabetic women showed postpregnancy deterioration in glycemic control and were unable to return to prepregnancy weight. Type 1 diabetic women seem to require special attention after delivery to meet therapeutic targets. PMID:23250804

Cyganek, Katarzyna; Hebda-Szydlo, Alicja; Skupien, Jan; Janas, Izabela; Walczyk, Joanna; Lipowska, Anna; Borys, Sebastian; Malecki, Maciej T.

2013-01-01

67

Walking behaviour and glycemic control in type 2 diabetes: seasonal and gender differences-Study design and methods  

Microsoft Academic Search

BACKGROUND: The high glucose levels typically occurring among adults with type 2 diabetes contribute to blood vessel injury and complications such as blindness, kidney failure, heart disease, and stroke. Higher physical activity levels are associated with improved glycemic control, as measured by hemoglobin A1C. A 1% absolute increase in A1C is associated with an 18% increased risk for heart disease

Kaberi Dasgupta; Cathy Chan; Deborah Da Costa; Louise Pilote; Mirella De Civita; Nancy Ross; Ian Strachan; Ronald Sigal; Lawrence Joseph

2007-01-01

68

Prevention of cardiovascular disease through glycemic control in type 2 diabetes: A meta-analysis of randomized clinical trials  

Microsoft Academic Search

Background and aimsRandomized clinical trials (RCTs) aimed at the assessment of the efficacy of lowering blood glucose in the prevention of diabetic complications have always failed to detect a significant effect on cardiovascular events. Aim of this meta-analysis is the assessment of the effects of improvement of glycemic control on the incidence of cardiovascular diseases in patients with type 2

E. Mannucci; M. Monami; C. Lamanna; F. Gori; N. Marchionni

2009-01-01

69

Importance of controlling diabetes early--the concept of metabolic memory, legacy effect and the case for early insulinisation.  

PubMed

Most of the microvascular complications of diabetes are related to the degree and the length of exposure to hyperglycaemia. New data from the follow-up studies of the Diabetes Control and Complications Trial-the Epidemiology of Diabetes Intervention and Complications Study (DCCT-EDIC), and the United Kingdom Prospective Diabetes Study (UKPDS) emphasize the role of glycemic control early in the course of the disorder and its value in prevention of later complications. The phenomenon of ongoing beneficial effects on diabetic complications after a period of improved glycemic control even if followed by a return to usual (often poorer) metabolic control has been described as representing "metabolic memory" by the DCCT/EDIC investigators and as a "legacy effect" by the UKPDS investigators. This article reviews these concepts and explores the role of early use of insulin as a tool to achieve good glycemic control in type 2 diabetes. PMID:21818992

Ranjit Unnikrishnan, I; Anjana, R M; Mohan, V

2011-04-01

70

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

PubMed Central

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

2014-01-01

71

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

PubMed Central

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

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

2013-01-01

72

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

73

Glycemic management in ESRD and earlier stages of CKD.  

PubMed

The management of hyperglycemia in patients with kidney failure is complex, and the goals and methods regarding glycemic control in chronic kidney disease (CKD) are not clearly defined. Although aggressive glycemic control seems to be advantageous in early diabetic nephropathy, outcome data supporting tight glycemic control in patients with advanced CKD (including end-stage renal disease [ESRD]) are lacking. Challenges in the management of such patients include therapeutic inertia, monitoring difficulties, and the complexity of available treatments. In this article, we review the alterations in glucose homeostasis that occur in kidney failure, current views on the value of glycemic control and issues with its determination, and more recent approaches to monitor or measure glycemic control. Hypoglycemia and treatment options for patients with diabetes and ESRD or earlier stages of CKD also are addressed, discussing the insulin and noninsulin agents that currently are available, along with their indications and contraindications. The article provides information to help clinicians in decision making in order to provide individualized glycemic goals and appropriate therapy for patients with ESRD or earlier stages of CKD. PMID:24461727

Williams, Mark E; Garg, Rajesh

2014-02-01

74

Chronic leucine supplementation improves glycemic control in etiologically distinct mouse models of obesity and diabetes mellitus  

PubMed Central

Background Leucine may function as a signaling molecule to regulate metabolism. We have previously shown that dietary leucine supplementation significantly improves glucose and energy metabolism in diet-induced obese mice, suggesting that leucine supplementation could potentially be a useful adjuvant therapy for obesity and type 2 diabetes. Since the underlying cause for obesity and type 2 diabetes is multifold, we further investigated metabolic effects of leucine supplementation in obese/diabetes mouse models with different etiologies, and explored the underlying molecular mechanisms. Methods Leucine supplementation was carried out in NONcNZO10/LtJ (RCS10) - a polygenic model predisposed to beta cell failure and type 2 diabetes, and in B6.Cg-Ay/J (Ay) - a monogenic model for impaired central melanocortin receptor signaling, obesity, and severe insulin resistance. Mice in the treatment group received the drinking water containing 1.5% leucine for up to 8 months; control mice received the tap water. Body weight, body composition, blood HbA1c levels, and plasma glucose and insulin levels were monitored throughout and/or at the end of the study period. Indirect calorimetry, skeletal muscle gene expression, and adipose tissue inflammation were also assessed in Ay mice. Results Leucine supplementation significantly reduced HbA1c levels throughout the study period in both RCS10 and Ay mice. However, the treatment had no long term effect on body weight or adiposity. The improvement in glycemic control was associated with an increased insulin response to food challenge in RCS10 mice and decreased plasma insulin levels in Ay mice. In leucine-treated Ay mice, energy expenditure was increased by ~10% (p < 0.05) in both dark and light cycles while the physical activity level was unchanged. The expression levels of UCP3, CrAT, PPAR-alpha, and NRF-1, which are known to regulate mitochondrial oxidative function, were significantly increased in the soleus muscle of leucine-treated Ay mice whereas the expression levels of MCP-1 and TNF-alpha and macrophage infiltration in adipose tissue were significantly reduced. Conclusions Chronic leucine supplementation significantly improves glycemic control in multiple mouse models of obesity and diabetes with distinct etiologies. The metabolic benefits of leucine supplementation are likely mediated via multiple mechanisms in different tissues, but are not necessarily dependent of weight reduction. PMID:20624298

2010-01-01

75

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

76

Periprocedural glycemic control in patients with diabetes mellitus undergoing coronary angiography with possible percutaneous coronary intervention.  

PubMed

Periprocedural hyperglycemia is an independent predictor of mortality in patients who underwent percutaneous coronary intervention (PCI). However, periprocedural management of blood glucose is not standardized. The effects of routinely continuing long-acting glucose-lowering medications before coronary angiography with possible PCI on periprocedural glycemic control have not been investigated. Patients with diabetes mellitus (DM; n = 172) were randomized to continue (Continue group; n = 86) or hold (Hold group; n = 86) their clinically prescribed long-acting glucose-lowering medications before the procedure. The primary end point was glucose level on procedural access. In a subset of patients (no DM group: n = 25; Continue group: n = 25; and Hold group: n = 25), selected measures of platelet activity that change acutely were assessed. Patients with DM randomized to the Continue group had lower blood glucose levels on procedural access compared with those randomized to the Hold group (117 [97 to 151] vs 134 [117 to 172] mg/dl, p = 0.002). There were two hypoglycemic events in the Continue group and none in the Hold group, and no adverse events in either group. Selected markers of platelet activity differed across the no DM, Continue, and Hold groups (leukocyte platelet aggregates: 8.1% [7.2 to 10.4], 8.7% [6.9 to 11.4], 10.9% [8.6 to 14.7], p = 0.007; monocyte platelet aggregates: 14.0% [10.3 to 16.3], 20.8% [16.2 to 27.0], 22.5% [15.2 to 35.4], p <0.001; soluble p-selectin: 51.9 ng/ml [39.7 to 74.0], 59.1 ng/ml [46.8 to 73.2], 72.2 ng/ml [58.4 to 77.4], p = 0.014). In conclusion, routinely continuing clinically prescribed long-acting glucose-lowering medications before coronary angiography with possible PCI help achieve periprocedural euglycemia, appear safe, and should be considered as a strategy for achieving periprocedural glycemic control. PMID:24630791

Shah, Binita; Berger, Jeffrey S; Amoroso, Nicholas S; Mai, Xingchen; Lorin, Jeffrey D; Danoff, Ann; Schwartzbard, Arthur Z; Lobach, Iryna; Guo, Yu; Feit, Frederick; Slater, James; Attubato, Michael J; Sedlis, Steven P

2014-05-01

77

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

Microsoft Academic Search

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

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

2010-01-01

78

Pharmacology of exenatide (synthetic exendin-4): a potential therapeutic for improved glycemic control of type 2 diabetes  

Microsoft Academic Search

Exenatide (synthetic exendin-4), glucagon-like peptide-1 (GLP-1), and GLP-1 analogues have actions with the potential to significantly improve glycemic control in patients with diabetes. Evidence suggests that these agents use a combination of mechanisms which may include glucose-dependent stimulation of insulin secretion, suppression of glucagon secretion, enhancement of ?-cell mass, slowing of gastric emptying, inhibition of food intake, and modulation of

Loretta L. Nielsen; Andrew A. Young; David G. Parkes

2004-01-01

79

Achieving glycemic control in young children with type 1 diabetes: approaches, pitfalls and new technologies.  

PubMed

Advances in technologies for insulin administrations, glucose monitoring, development of an artificial pancreas and cell-based therapy will ultimately have a profound effect on the lives of people wit diabetes. There is both current success and substantial promise, indicating that these approches may offer, for the first time, real potential for achieving euglycemia without hypoglycemia. Given the physiological and psychosocial impact of type 1 diabetes in young children, this group of patients and their parents stand to gain especially great benefit from these developments. However, the potential for improvements in the mangement of diabetes in young children based on available technologies should not be overlooked and should be effectively utilized as the standard for patient care. Only twenty years ago blood glucose reagent strips were first coming into routine use. Current meters have greatly reduced the amount of blood required ( now less than 1 microliter for many meters) and greatly imporved precision. The advent modified, recombinant insulins, which became available only in the last several years, allows for an insulin regimen to better match the absorption of dietary carbohydrate. All technologies have improved our ability to attain glycemic control, thereby reducing the risk of long-term complication in even our youngest patients. PMID:12751364

Gruppuso, Philip A

2003-04-01

80

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

PubMed

We evaluated the associations between glycemic therapies and prevalence of diabetic peripheral neuropathy (DPN) at baseline among participants in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial on medical and revascularization therapies for coronary artery disease (CAD) and on insulin-sensitizing vs. insulin-providing treatments for diabetes. A total of 2,368 patients with type 2 diabetes and CAD was evaluated. DPN was defined as clinical examination score >2 using the Michigan Neuropathy Screening Instrument (MNSI). DPN odds ratios across different groups of glycemic therapy were evaluated by multiple logistic regression adjusted for multiple covariates including age, sex, hemoglobin A1c (HbA1c), and diabetes duration. Fifty-one percent of BARI 2D subjects with valid baseline characteristics and MNSI scores had DPN. After adjusting for all variables, use of insulin was significantly associated with DPN (OR = 1.57, 95% CI: 1.15-2.13). Patients on sulfonylurea (SU) or combination of SU/metformin (Met)/thiazolidinediones (TZD) had marginally higher rates of DPN than the Met/TZD group. This cross-sectional study in a cohort of patients with type 2 diabetes and CAD showed association of insulin use with higher DPN prevalence, independent of disease duration, glycemic control, and other characteristics. The causality between a glycemic control strategy and DPN cannot be evaluated in this cross-sectional study, but continued assessment of DPN and randomized therapies in BARI 2D trial may provide further explanations on the development of DPN. PMID:19335534

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

2009-03-01

81

Plasma Lipopolysaccharide Is Closely Associated With Glycemic Control and Abdominal Obesity  

PubMed Central

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

Tr?seid, Marius; Nestvold, Torunn K.; Rudi, Knut; Thoresen, Hanne; Nielsen, Erik W.; Lappegard, Knut T.

2013-01-01

82

Assessment of an educational intervention in the management of non-critical inpatient glycemic control.  

PubMed

In hospitalized diabetic patients, the recommended insulin therapy is basal bolus plus correction-dose regimen instead of sliding-scale insulin. The purpose of this study was to evaluate the effect of the implementation of a new protocol based on basal bolus therapy on managing diabetes in a university hospital setting. We performed a cross-sectional study before and 12 months after a 4-month intervention period to implement a basal bolus regimen in hospitalized patients. Non-critical patients admitted into the hospital for at least 72 h were included. Changes in prescribing habits, glucose control and incidence of hypoglycemia were evaluated. An increase in the use of the new protocol and a decrease in sliding scale were observed after the intervention. In the pre-intervention group, a total of 59.2 % glucose readings were between 70 and 180 mg/dL versus 57.1 % after the intervention, without observing statistical differences. Significant reductions in hypoglycemia between pre- and post-intervention (13.04 vs. 4.08 %, p = 0.0215) were observed. The percentage of hospitalized diabetic patients who had HbA1c was 10.43 and 4.08 % in pre- and post-intervention phases, respectively. The protocol showed beneficial outcomes in terms of fewer hypoglycemia episodes and reflected a change in prescription habits, but it did not improve glycemic control. Furthermore, the percentage of patients who had an HbA1c test during their hospitalization remained very low after the intervention. This fact may seriously limit the correct management of hyperglycemia after the hospital discharge. PMID:24121872

Gomez-Huelgas, R; Lopez-Carmona, M D; Jansen-Chaparro, S; Sobrino, B; Chaves, M; Martin-Gallardo, P; Garcia-Fernandez, C; Bernal-Lopez, M R

2014-06-01

83

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

84

Counting Carbs? Understanding Glycemic Index and Glycemic Load  

MedlinePLUS

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

85

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

PubMed Central

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

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

2013-01-01

86

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

87

Testosterone Deficiency Associated with Poor Glycemic Control in Korean Male Diabetics  

PubMed Central

Background Recent studies have shown that men with diabetes have lower testosterone levels than healthy men. However, studies on the correlation between testosterone and diabetes are rare in Korea. We examined the relationship between testosterone deficiency and markers related to diabetes in adult Korean men. Methods A total 464 men with diabetes who visited an outpatient clinic at Ajou University Hospital and had serum total testosterone and serum insulin levels measured between January 2000 and September 2013 were selected. Blood samples were collected after the subjects had fasted overnight. We divided the participants into testosterone deficient and normal groups. Testosterone deficiency was defined as having a serum total testosterone level <3.5 ng/mL. Results Of 464 subjects, 34.9% had a testosterone deficiency. The mean levels of fasting plasma glucose (P=0.007) and glycated hemoglobin (HbA1c; P=0.038) were significantly higher in the testosterone deficiency group than in the normal group. To clarify the relationship between serum total testosterone level and fasting plasma glucose or HbA1c values, Pearson's correlation test was performed. Fasting plasma glucose levels (r=-0.142, P=0.002) and HbA1c values (r=-0.097, P=0.040) showed a significant negative correlation with serum testosterone levels in men with diabetes. Conclusion Major markers of diabetes that are associated with testosterone deficiency are fasting plasma glucose and HbA1c values. Poor glycemic control appears to be associated with testosterone deficiency in Korean men with diabetes. PMID:25309788

Kim, Joo-Sung; Kim, Bong Sun; Jeon, Ja Young; Choi, Yong Jun

2014-01-01

88

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

PubMed Central

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

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

2014-01-01

89

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

90

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, Jurgen Michael

2014-01-01

91

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

92

Effect of a short-term exercise program on glycemic control measured by fructosamine test in type 2 diabetes patients  

PubMed Central

Background Glycated hemoglobin (A1C) and Fasting Plasma Glucose (FPG) are the two monitoring blood glucose tests most frequently used. However, both methods are shown to be insensitive to detect glycemic variations in short duration periods. Therefore, we aimed to assess the effect of a short-term exercise program on glycemic levels measured by fructosamine concentrations in type 2 diabetes patients. Methods Eight volunteers (51.1?±?8.2 years) underwent a supervised exercise program during eight weeks (3 d.wk-1, 50-60% of VO2 peak for 30–60 minutes). The body composition, VO2 peak, A1C, FPG, fructosamine and capillary blood glucose (CBG) were evaluated. We used ANOVA - One Way for repeated measures followed by Tukey post-hoc test and paired t test. P values <0.05 were considered significant. Results We found statistical differences on the concentrations of fructosamine, VO2 peak and CBG. However, A1C and FPG showed no statistical difference. Fructosamine declined by 15% (57 ?mol/L) between the beginning and the end of the study. Individually, 50% of the sample reached the reference values for the normality in fructosamine test. VO2 peak increased by 14.8% (3.8 ml.kg-1.min-1) and CBG decreased on an average of 34.4% (69.3 mg/dL). Conclusions Fructosamine test is effective in the evaluation of glucose with type 2 diabetes patients when undergoing a short exercise program, alternatively to the traditional A1C and FPG assessment. Our results are relevant in clinical practice, because the significant improvement in glycemic status can help to evaluate the inclusion of exercise as adjunct therapy to replace the prescription of additional drugs in poorly controlled patients. PMID:24512719

2014-01-01

93

Which factors predict glycemic control in children diagnosed with type 1 diabetes before 6.5 years of age?  

PubMed

Predictors of long-term glycemic control and growth patterns in children diagnosed with type 1 diabetes (T1D) before 6.5 years of age were evaluated. One hundred seventy-three children (84 boys) with a mean diabetes duration of 4.9 ± 2.8 years participated in this observational study. Medical charts were reviewed for background, disease- and treatment-related parameters, and growth parameters. Study endpoints were HbA1c value, rates of severe hypoglycemia and diabetic ketoacidosis events, and growth patterns. Mean HbA1c for the total duration of diabetes (HbA1c-TDD) was 7.9 ± 0.8%. Comparison of the study variables between patients with HbA1c-TDD <7.5% (n = 53) or ?7.5% yielded a significantly shorter duration of diabetes (P = 0.01) and lower rate of diabetic ketoacidosis (P = 0.02) in those with HbA1C-TDD <7.5%, without differences between these groups in age at diabetes onset, insulin regimens, daily glucose measurements, and rate of severe hypoglycemia. Factors significantly predicting achievement of the mean target HbA1c-TDD <7.5% were lower HbA1c at 0.5 years and 1 year after diabetes diagnosis (P = 0.002 and P < 0.001, respectively). Patients followed for at least 5 years (n = 48) showed a significant decrease in height-SDS (P < 0.001) and a significant increase in weight-SDS (P = 0.004) from diabetes diagnosis to the last follow-up visit, without a significant change in weight-SDS from 0.5 years after diagnosis to the last follow-up visit. Our results suggest that in patients with T1D diagnosed during the preschool-age, mean HbA1c level in the first year is a strong predictor of achieving target HbA1c level in the subsequent years, regardless the type of insulin regimen. This "metabolic tracking" emphasizes the importance of achieving early optimal control even in younger children. PMID:21866397

Shalitin, S; Phillip, M

2012-10-01

94

Improvement in glycemic control after left ventricular assist device implantation in advanced heart failure patients with diabetes mellitus.  

PubMed

Left ventricular assist devices (LVADs) have been shown to improve outcomes in advanced heart failure (HF). We hypothesized that LVADs improve glycemic control in HF patients with diabetes mellitus (DM). During a 6 year time period, 202 patients underwent mechanical circulatory support. Of these, 50 patients with DM were included. Data were collected within 2 months before LVAD implantation and at 5.6 ± 1.1 months post-LVAD implant. There was no significant difference in body mass index, hemoglobin, hematocrit, and renal function pre-LVAD and post-LVAD. Fasting blood glucose improved from 136 ± 35 to 108 ± 29 mg/dl post-LVAD (p < 0.001). In 18 patients taking insulin only, daily insulin dose decreased from 43 ± 37 to 29 ± 24 units (p = 0.02). Of the 17 patients taking oral hypoglycemic agents, four did not require antidiabetic medications, six continued the same dose, two required higher doses, and five patients were switched to insulin post-LVAD. In a subset of 22 patients with available data, hemoglobin A1c improved significantly post-LVAD (p < 0.001). C-reactive protein in a subset of 18 patients decreased post-LVAD (p = 0.059). In conclusion, diabetic patients with advanced HF appear to have significant improvement in glycemic control and require less antidiabetic medications post-LVAD. PMID:25232763

Choudhary, Naila; Chen, Leway; Kotyra, Lisa; Wittlin, Steven D; Alexis, Jeffrey D

2014-01-01

95

A Telemedicine System That Includes a Personal Assistant Improves Glycemic Control in Pump-Treated Patients with Type 1 Diabetes  

PubMed Central

Background The DIABTel system, a Web-based telemedicine application, integrates a whole communication system (glucometer, insulin pump, wireless hand-held assistant) for medical remote advice. We sought to evaluate, in terms of glycemic control, the DIABTel system in a randomized crossover clinical study. Methods Ten patients with type 1 diabetes [5 women, age 40.6 (21–62) years, diabetes duration 14.7 (3–52) years] were included. During the 4-week active phase, data sent by patients were analyzed by the physician and modifications of the basal rate and bolus were advised in the following 24 hours. During the control phase, patients sent glucose data without any feedback from the medical center. Results The mean numbers of daily glucose values and bolus sent by patients during the active period were 4.46 ± 0.91 and 4.58 ± 0.89, respectively. The personal digital assistant functionalities used more frequently by patients were (times per week) data visualization (8.1 ± 6.8), data download from the insulin pump (6.8 ± 3.3), and synchronization with the telemedicine server (8.5 ± 4.9). After the experimental phase, serum fructosamine decreased significantly (393 ± 32 vs 366 ± 25 µmol/liter; p < 0.05) and hemoglobin A1c (HbA1c) tended to decrease (8.0 ± 0.6 vs 7.78 ± 0.6; p = 0.073), whereas no changes were observed during the control phase. The number of treatment modifications proposed and performed by the patients correlated with the change observed in HbA1c during the active phase (r = ?0.729, p = 0.017). Conclusions The DIABTel system, a telemedicine system that includes a wireless personal assistant for remote treatment advising, allows better glycemic control in pump-treated patients with type 1 diabetes. To our knowledge, this is the first study that demonstrates improved glycemic control with the use of a telemedicine system that incorporates insulin delivery data. PMID:19885113

Rigla, Mercedes; Hernando, M. Elena; Gomez, Enrique J.; Brugues, Eulalia; Garcia-Saez, Gema; Torralba, Veronica; Prados, Agustina; Erdozain, Luisa; Vilaverde, Joana; de Leiva, Alberto

2007-01-01

96

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

PubMed Central

Background Complications from diabetes mellitus can compromise a driver's ability to safely operate a motor vehicle, yet little is known about whether euglycemia predicts normal driving risks among adults with diabetes. We studied the association between glycosylated hemoglobin (HbA1c) and the risk of a motor vehicle crash using a population-based case control analysis. Methods and Findings We identified consecutive drivers reported to vehicle licensing authorities between January 1, 2005 to January 1, 2007 who had a diagnosis of diabetes mellitus and a HbA1c documented. The risk of a crash was calculated taking into account potential confounders including blood glucose monitoring, complications, and treatments. A total of 57 patients were involved in a crash and 738 were not involved in a crash. The mean HbA1c was lower for those in a crash than controls (7.4% versus 7.9%, unpaired t-test, p?=?0.019), equal to a 26% increase in the relative risk of a crash for each 1% reduction in HbA1c (odds ratio?=?1.26, 95% confidence interval 1.03–1.54). The trend was evident across the range of HbA1c values and persisted after adjustment for measured confounders (odds ratio?=?1.25, 95% confidence interval 1.02–1.55). The two other significant risk factors for a crash were a history of severe hypoglycemia requiring outside assistance (odds ratio?=?4.07, 95% confidence interval 2.35–7.04) and later age at diabetes diagnosis (odds ratio per decade?=?1.29, 95% confidence interval 1.07–1.57). Conclusions In this selected population, tighter glycemic control, as measured by the HbA1c, is associated with an increased risk of a motor vehicle crash. Please see later in the article for the Editors' Summary PMID:19997624

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

2009-01-01

97

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

98

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

PubMed Central

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

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

2014-01-01

99

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 AUC0-120min was observed, as compared to baseline control in healthy dogs (n=5), thus indicating a similar mode of action of Sitagliptin between healthy dogs and humans. Future studies to validate the use of Sitagliptin with dogs suffering from insulin independent diabetes are warranted. PMID:24931645

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

2014-11-01

100

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

Microsoft Academic Search

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

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

2009-01-01

101

Fenofibrate treatment is associated with better glycemic control and lower serum leptin and insulin levels in type 2 diabetic patients with hypertriglyceridemia  

Microsoft Academic Search

Background: Hertriglyceridemia is commonly encountered in type 2 diabetic patients. Fibrates are a group of drugs that efficiently decrease triglycerides, increase HDL, and improve the prognosis in both diabetic and nondiabetic patients. However, the effects of fibrates on glycemic control, blood pressure, fasting serum insulin, and leptin concentrations are not clear. The present study addresses the question of whether fenofibrate

Taner Damci; Serkan Tatliagac; Zeynep Osar; Hasan Ilkova

2003-01-01

102

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

PubMed Central

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

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

2014-01-01

103

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

PubMed

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

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

2014-11-01

104

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

PubMed Central

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

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

2014-01-01

105

Parental Mastery of Continuous Subcutaneous Insulin Infusion Skills and Glycemic Control in Youth with Type 1 Diabetes  

PubMed Central

Abstract Objective The purpose of this study is to determine whether parental knowledge of the continuous subcutaneous insulin infusion (CSII) device affects glycemic control as measured by hemoglobin A1c (A1C) level. Subjects and Methods Parents of children with type 1 diabetes mellitus (T1DM) using CSII completed a 14-item questionnaire. Questions 1–10 were knowledge-based questions that required the parent to extract specific information from their child's CSII device. Questions 11–14 asked parents to provide a self-assessment of their CSII knowledge. Results Twenty-two parents of youth with T1DM participated in the study. Ten of the youth were in the Low-A1C group (A1C<8%), and the other 12 were in the High-A1C group (A1C?8%). Parents of youth in the Low-A1C group scored statistically better on the 10-item performance survey than parents of youth in the High-A1C group. Most of the parents of children in the Low-A1C group responded that they knew their child's insulin pump “very well” and that their pump knowledge had “increased” since their child started on the insulin pump. Conclusions Our findings reveal that youth with T1DM whose parents are more knowledgeable about pump functions have optimal glycemic control as evidenced by A1C. These findings underscore the importance of ongoing pump training for both pediatric patients and their parents. PMID:23799273

Mitchell, Kathleen; Johnson, Kimberley; Cullen, Karen; Lee, Mary M.

2013-01-01

106

Risk Factors for Childhood Overweight in Offspring of Type 1 Diabetic Women With Adequate Glycemic Control During Pregnancy  

PubMed Central

OBJECTIVE Pregnancy in type 1 diabetic women remains a high-risk situation for both mother and child. In this study, we investigated long-term effects on body composition, prevalence of overweight, and insulin resistance in children of type 1 diabetic women who had had adequate glycemic control during pregnancy (mean A1C 6.2%), and we related their outcome to perinatal factors, including macrosomia (birth weight >90th percentile). RESEARCH DESIGN AND METHODS Anthropometric measurements were performed at 6–8 years of age in 213 offspring of type 1 diabetic mothers who participated in a previous nationwide study. Homeostasis model assessment of insulin resistance (HOMA-IR) was determined from a fasting blood sample in 155 of these children. In addition, we studied BMI standard deviation score (SDS) growth trajectories. Results were compared with national reference data. RESULTS The prevalence of overweight in the study population was not different from that in the reference population. However, children who were born macrosomic showed twice as much overweight as nonmacrosomic children. Macrosomia and maternal overweight were independent predictors of childhood overweight. Overweight children showed an increase in BMI SDS starting already after 6 months of age and had a significantly increased HOMA-IR. CONCLUSIONS In type 1 diabetic women with adequate glycemic control during pregnancy, long-term effects on body composition and overweight in their offspring at school age are limited and related mainly to macrosomia at birth. Possible targets for prevention of childhood overweight are fetal macrosomia, maternal overweight, and an increase in BMI SDS during the first years of life. PMID:19651922

Rijpert, Maarten; Evers, Inge M.; de Vroede, Monique A.M.J.; de Valk, Harold W.; Heijnen, Cobi J.; Visser, Gerard H.A.

2009-01-01

107

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

PubMed

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

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

2014-01-01

108

Effects of MK-0941, a Novel Glucokinase Activator, on Glycemic Control in Insulin-Treated Patients With Type 2 Diabetes  

PubMed Central

OBJECTIVE To assess the efficacy and safety of MK-0941, a glucokinase activator (GKA), when added to stable-dose insulin glargine in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS In this double-blind study, 587 patients taking stable-dose insulin glargine (±metformin ?1,500 mg/day) were randomized (1:1:1:1:1) to MK-0941 10, 20, 30, or 40 mg or matching placebo t.i.d. before meals (a.c.). This study included an initial 14-week, dose-ranging phase followed by a 40-week treatment phase during which patients were to be uptitrated as tolerated to 40 mg (or placebo) t.i.d. a.c. The primary efficacy end point was change from baseline in A1C at Week 14. RESULTS At Week 14, A1C and 2-h postmeal glucose (PMG) improved significantly versus placebo with all MK-0941 doses. Maximal placebo-adjusted least squares mean changes from baseline in A1C (baseline A1C 9.0%) and 2-h PMG were ?0.8% and ?37 mg/dL (?2 mmol/L), respectively. No significant effects on fasting plasma glucose were observed at any dose versus placebo. By 30 weeks, the initial glycemic responses noted at 14 weeks were not sustained. MK-0941 at one or more doses was associated with significant increases in the incidence of hypoglycemia, triglycerides, systolic blood pressure, and proportion of patients meeting criteria for predefined limits of change for increased diastolic blood pressure. CONCLUSIONS In patients receiving stable-dose insulin glargine, the GKA MK-0941 led to improvements in glycemic control that were not sustained. MK-0941 was associated with an increased incidence of hypoglycemia and elevations in triglycerides and blood pressure. PMID:21994424

Meininger, Gary E.; Scott, Russell; Alba, Maria; Shentu, Yue; Luo, Edmund; Amin, Himal; Davies, Michael J.; Kaufman, Keith D.; Goldstein, Barry J.

2011-01-01

109

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

PubMed

Tight glycemic control (TGC) has shown benefits in ICU patients, but been difficult to achieve consistently due to inter- and intra- patient variability that requires more adaptive, patient-specific solutions. STAR (Stochastic TARgeted) is a flexible model-based TGC framework accounting for patient variability with a stochastically derived maximum 5% risk of blood glucose (BG) below 72 mg/dL. This research describes the first clinical pilot trial of the STAR approach and the post-trial analysis of the models and methods that underpin the protocol. The STAR framework works with clinically specified targets and intervention guidelines. The clinically specified glycemic target was 125 mg/dL. Each trial was 24 h with BG measured 1-2 hourly. Two-hourly measurement was used when BG was between 110-135 mg/dL for 3 h. In the STAR approach, each intervention leads to a predicted BG level and outcome range (5-95th percentile) based on a stochastic model of metabolic patient variability. Carbohydrate intake (all sources) was monitored, but not changed from clinical settings except to prevent BG<100 mg/dL when no insulin was given. Insulin infusion rates were limited (6 U/h maximum), with limited increases based on current infusion rate (0.5-2.0 U/h), making this use of the STAR framework an insulin-only TGC approach. Approval was granted by the Ethics Committee of the Medical Faculty of the University of Liege (Liege, Belgium). Nine patient trials were undertaken after obtaining informed consent. There were 205 measurements over all 9 trials. Median [IQR] per-patient results were: BG: 138.5 [130.6-146.0]mg/dL; carbohydrate administered: 2-11 g/h; median insulin:1.3 [0.9-2.4]U/h with a maximum of 6.0 [4.7-6.0]U/h. Median [IQR] time in the desired 110-140 mg/dL band was: 50.0 [31.2-54.2]%. Median model prediction errors ranged: 10-18%, with larger errors due to small meals and other clinical events. The minimum BG was 63 mg/dL and no other measurement was below 72 mg/dL, so only 1 measurement (0.5%) was below the 5% guaranteed minimum risk level. Post-trial analysis showed that patients were more variable than predicted by the stochastic model used for control, resulting in some of the prediction errors seen. Analysis and (validated) virtual trial re-simulating the clinical trial using stochastic models relevant to the patient's particular day of ICU stay were seen to be more accurate in capturing the observed variability. This analysis indicated that equivalent control and safety could be obtained with similar or lower glycemic variability in control using more specific stochastic models. STAR effectively controlled all patients to target. Observed patient variability in response to insulin and thus prediction errors were higher than expected, likely due to the recent insult of cardiac surgery or a major cardiac event, and their immediate recovery. STAR effectively managed this variability with no hypoglycemia. Improved stochastic models will be used to prospectively test these outcomes in further ongoing clinical pilot trials in this and other units. PMID:21885150

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

2012-11-01

110

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

PubMed Central

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

Simsek, Damla Goksen; Aycan, Zehra; Ozen, Samim; Cetinkaya, Semra; Kara, Cengiz; Abal?, Sayg?n; Demir, Korcan; Tunc, Ozgul; Ucakturk, Ahmet; Asar, Gulgun; Bas, Firdevs; Cetinkaya, Ergun; Ayd?n, Murat; Karaguzel, Gulay; Orbak, Zerrin; Orbak, Zerrin; S?klar, Zeynep; Alt?nc?k, Ayca; Okten, Aysenur; Ozkan, Behzat; Ocal, Gonul; Semiz, Serap; Arslanoglu, Ilknur; Evliyaoglu, Olcay; Bundak, Ruveyde; Darcan, Sukran

2013-01-01

111

The Challenges of Measuring Glycemic Variability  

PubMed Central

This commentary reviews several of the challenges encountered when attempting to quantify glycemic variability and correlate it with risk of diabetes complications. These challenges include (1) immaturity of the field, including problems of data accuracy, precision, reliability, cost, and availability; (2) larger relative error in the estimates of glycemic variability than in the estimates of the mean glucose; (3) high correlation between glycemic variability and mean glucose level; (4) multiplicity of measures; (5) correlation of the multiple measures; (6) duplication or reinvention of methods; (7) confusion of measures of glycemic variability with measures of quality of glycemic control; (8) the problem of multiple comparisons when assessing relationships among multiple measures of variability and multiple clinical end points; and (9) differing needs for routine clinical practice and clinical research applications. PMID:22768904

Rodbard, David

2012-01-01

112

[Glycemic targets and cardiovascular morbi-mortality].  

PubMed

The 2008-year was full of learning experience and suspense in diabetologia. The past studies, UKPDS in type 2 diabetic patients and DCCT in type 1 diabetic patients have shown that intensive treatment during a short period did reduce the incidence of microvascular events and in the long term, the incidence of macrovascular events linked to diabetes. The conclusions of recent studies quote, from ACCORD, an increased mortality in the type 2 diabetic patients using intensive therapy, from ADVANCE, a reduction of microvascular complications and from VADT, no effect. The analysis of studies published since 2008 brings lessons for the clinical practice: presence of glycemic memory, absence of tensional memory, usefulness of control of every cardiovascular risk factors, need of early treatment of diabetes. Moreover, to define HbA1c objective, age, duration of diabetes, presence of cardiovascular risk factors, former HbA1c level and potential undesirable effects, such hypoglycaemia, must be considered. The management of type 2 diabetic patients requires an early, not to quick intensive treatment, which avoids hypoglycaemia and is combined with a strict control of cardiovascular risk factors. So, the recent position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) consideres needs and preferences of each patient and individualizes glycemic targets and treatments. PMID:23286961

Bordier, Lyse; Bauduceau, Bernard

2013-05-01

113

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

PubMed Central

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

114

Does Physician Communication Influence Older Patients' Diabetes Self-Management and Glycemic Control? Results From the Health and Retirement Study (HRS)  

Microsoft Academic Search

Background. Effective chronic disease self-management among older adults is crucial for improved clinical outcomes. We assessed the relative importance of two dimensions of physician communication—provision of information (PCOM) and participatory decision-making (PDM)—for older patients' diabetes self-management and glycemic control. Methods. We conducted a national cross-sectional survey among 1588 older community-dwelling adults with diabetes (response rate: 81%). Independent associations were examined

Michele Heisler; Ian Cole; David Weir; Eve A. Kerr; Rodney A. Hayward

2007-01-01

115

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

116

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

117

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

PubMed Central

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

Karthick, S.; Nagarjuna, B.

2014-01-01

118

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

119

Conflicts of Interest among Authors of Clinical Practice Guidelines for Glycemic Control in Type 2 Diabetes Mellitus  

PubMed Central

Background Conflict of interest (COI) is an important potential source of bias in the development of clinical practice guidelines (CPGs). Objectives To examine rates of disclosure of COI, including financial interests in companies that manufacture drugs that are recommended in CPGs on glycemic control in type 2 diabetes mellitus, and to explore the relationship between recommendations for specific drugs in a guideline and author COI. Methods We identified a cohort of relevant guidelines from the National Guideline Clearinghouse (NGC) and abstracted COI disclosures from all guideline authors for this observational, cross-sectional study. We determined which hypoglycemic drugs were recommended in each guideline, and explored the relationship between specific disclosures and whether a drug was recommended. Results Among 13 included guidelines, the percentage of authors with one or more financial disclosures varied from 0 to 94% (mean 44.2%), and was particularly high for two US-based guidelines (91% and 94%). Three guidelines disclosed no author financial COI. The percentage of authors with disclosures of financial interests in manufacturers of recommended drugs was also high (mean 30%). On average, 56% of manufacturers of patented drugs recommended in each guideline had one or more authors with a financial interest in their company. We did not find a significant relationship between financial interests and whether a drug was recommended in our sample; US-based guidelines were more likely to make recommendations for a specific drug compared to non-US based guidelines. Discussion Authors of this cohort of guidelines have financial interests directly related to the drugs that they are recommending. Although we did not find an association between author COI and drugs recommended in these guidelines and we cannot draw conclusions about the validity of the recommendations, the credibility of many of these guidelines is in doubt. PMID:24155870

Norris, Susan L.; Holmer, Haley K.; Ogden, Lauren A.; Burda, Brittany U.; Fu, Rongwei

2013-01-01

120

The Relationship Between Adult Neuropsychological Profiles and Diabetic Patients' Glycemic Control  

Microsoft Academic Search

The purpose of this study was to assess, in relation to metabolic control, the cognitive, depressive, and anxiety symptoms among 40 adult patients (age: 18–60 years) with either type 1 (n = 28) or type 2 (n = 12) diabetes mellitus (DM1, DM2). Nineteen healthy subjects matched for age, gender, and education served as the control group. For most cognitive domains, no significant performance

Josef Zihl; Ludwig Schaaf; Eric A. Zillmer

2010-01-01

121

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

122

Promoting glycemic control through diabetes self-management: evaluating a patient activation intervention  

Microsoft Academic Search

This study compared an activation intervention to passive education in a randomized attention-control trial of 232 patients with type 2 diabetes. The activation intervention was based on Expanding Patient Involvement in Care (EPIC) trials, and was compared to time-matched passive education viewing of ADA video-tapes. Patient demographics and clinical characteristics of their diabetes were assessed with questionnaires, active involvement was

Geoffrey C. Williams; Holly McGregor; Allan Zeldman; Zachary R. Freedman; Edward L. Deci; Daniel Elder

2005-01-01

123

Characterization of the use of liraglutide for glycemic control in healthy and Type 1 diabetes mellitus suffering dogs.  

PubMed

Glucagon-like peptide 1 (GLP-1) is a glucose-lowering, intestinal-derived factor with multiple physiological effects, making it attractive for diabetes therapy. However, the therapeutic potential of endogenous GLP-1 is limited, because of rapid inactivation by dipeptidyl peptidase-4. Recently, enhanced incretin preparations, such as liraglutide, have emerged, which are more resistant to degradation and longer lasting. Liraglutide is a long-acting acylated human GLP-1 receptor agonist, with a 97% amino acid sequence identity to endogenous human GLP-1, and 100% amino acid sequence homology with canine GLP-1. Since liraglutide has yet to be examined for use in dogs, and the incretin effect has been reported to exist in dogs, we sought to initially characterize liraglutide's ability for glycemic control in healthy dogs, under an oral glucose tolerance test (OGTT) environment initially. This was followed up a more realistic scenario involving food with insulin injection +/- liraglutide injection resulting in a glucose curve based study involving dogs suffering from Type 1 diabetes mellitus (T1DM). Overall, liraglutide had a stabilizing effect on glucose levels, maintaining circulating levels between 77.0 and 137.0mg/ml throughout the OGTT test period, resulting in a significant reduction of 13.8% in glucose AUC0-120 min (total area under the curve for 0-120 min) as compared to baseline control in healthy dogs (n=5). Interestingly, the liraglutide associated reduction in circulating glucose was not accompanied by any significant increase in insulin. Moreover, T1DM dogs (n=4) responded favorably to liraglutide treatment, which lead to a significant reduction of 46.0% in glucose AUC0-12h (total area under the curve for 0-12h), and a significant reduction of 66.5% in serum glucose as compared to baseline controls (insulin treatment only). Therefore, liraglutide's prandial glucagon suppressive ability appears to play a key role in its glucose-lowering capability, and offers great potential for use with dogs suffering from T1DM. PMID:23632200

Oda, H; Mori, A; Lee, P; Saeki, K; Ishioka, K; Arai, T; Sako, T

2013-10-01

124

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

PubMed Central

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

2014-01-01

125

Tight glycemic control does not affect asymmetric-dimethylarginine in septic patients  

Microsoft Academic Search

Objective  We investigated whether preventing hyperglycemia in septic patients affected the plasma concentration of asymmetric-dimethylarginine\\u000a and if this was associated with clinical benefit.\\u000a \\u000a \\u000a \\u000a Design  A prospective, multicenter, randomized, controlled, clinical study.\\u000a \\u000a \\u000a \\u000a Setting  Intensive care units (ICU) in three university hospitals.\\u000a \\u000a \\u000a \\u000a Patients  A total of 72 patients admitted for severe sepsis or septic shock, who stayed at least 3 days in the ICU. At admission the

Gaetano Iapichino; Maura Albicini; Michele Umbrello; Francesca Sacconi; Isabella Fermo; Radmila Pavlovich; Rita Paroni; Giacomo Bellani; Giovanni Mistraletti; Massimo Cugno; Antonio Pesenti; Luciano Gattinoni

2008-01-01

126

Factors Influencing Disease Self-Management Among Veterans with Diabetes and Poor Glycemic Control  

Microsoft Academic Search

\\u000a Specific Aim  Although the Department of Veterans Affairs (VA) has made significant organizational changes to improve diabetes care, diabetes\\u000a self-management has received limited attention. The purpose of this study is to assess factors influencing diabetes self-management\\u000a among veterans with poorly controlled diabetes.\\u000a \\u000a \\u000a \\u000a Methods  Surveys were mailed to patients with type 2 diabetes and a HbA1c of 8% or greater who attended 1

Karin M. Nelson; Lynne McFarland; Gayle Reiber

2007-01-01

127

Glycemic control in familial vs. sporadic type 1 diabetes patients over 5 years.  

PubMed

Abstract Background: Studies have shown that familial type 1 diabetes patients (FTID) have less severe metabolic derangement at presentation compared to sporadic patients (ST1D), but data on long-term metabolic control are lacking. Objective/Hypothesis: (1) FT1D will have less severe presentation and better HbA1c over 5 years compared to ST1D; (2) HbA1c in the offspring will correlate with parent HbA1c in parent-offspring group; and (3) HbA1c of the second affected sibling (SP2) will correlate with the first affected sibling (SP1) in sib-pairs. Methods: Cohort of 33 parent-offspring and 19 sib-pairs; controls included 33 sporadic subjects matched by age, sex, ethnicity, puberty, and insulin regimen. Paired t-test and Pearson's correlation were used for statistical analysis. Results: At diagnosis, mean age in FT1D vs. matched ST1D (7.7±4.9 vs. 7.6±4.5 years), mean HbA1c (9.6% vs. 10.7%), HCO3 (21 vs. 18 meq/L), glucose (428 vs. 463 mg/dL) and pH (7.35 vs. 7.36; p=ns) were not different. At 5 years, HbA1c (8.9% vs. 8.8%; p=0.81), clinic visits (12 vs. 12.5, p=0.68) and emergency room visits (0.48 vs. 0.24, p=0.10) were not different. In affected siblings, only HCO3 was different (SP1:18 vs. SP2: 24 meq/L; p<0.01). HbA1c for SP2 correlated positively with SP1 (r=0.67, p<0.01). Offspring HbA1c correlated positively with affected parents (9.3% vs. 8.6%, r=0.57, p=0.18) but was not significant. Conclusion: Metabolic control at diagnosis and at 5 years was similar in FT1D and ST1D. In sib-pairs, the second affected sibling had milder clinical presentation compared to the first affected sibling. PMID:23934637

Reddy, Sujana; Reinert, Steven E; Gopalakrishnan, Geetha; Plante, Wendy; Boney, Charlotte M; Quintos, Jose Bernardo

2014-01-01

128

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

PubMed Central

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

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

2013-01-01

129

Changes in Glycemic Control are Associated with Changes in Cognition in Non-Diabetic Elderly  

PubMed Central

The aim of the present study was to examine the relationship of changes in long term glucose levels as measured by Hemoglobin A1c (HbA1c) with simultaneous changes in cognition. The sample included in the present analysis consisted of 101 community dwelling non-diabetic elderly subjects participating in ongoing longitudinal studies of cognition. Subjects were included in this study if they were cognitively normal at baseline, had at least one co-temporaneous follow-up assessment of HbA1c and the Mini Mental State Exam (MMSE), and complete data on age, gender, race, and years of education. MMSE decline over time was the main outcome measure. In TOBIT mixed regression models, MMSE was the dependent variable and HbA1c the time-varying covariate. Sociodemographic (age, gender, and education), cardiovascular (hypertension and APOE4 status), and lifestyle (smoking and physical activity) covariates were included in the statistical model. After adjusting for age at follow-up, there was a decrease of 1.37 points in the MMSE (p = 0.0002) per unit increase in HbA1c. This result remained essentially unchanged after adjusting also for gender and education (p = 0.0005), cardiovascular factors (p = 0.0003), and lifestyle (p = 0.0006). Additionally, results remained very similar after excluding subjects with potentially incipient diabetes with HbA1c between 6 and 7. These findings suggest that in non-diabetic non-demented elderly subjects, an increase in HbA1c over time is associated with cognitive decline. Such results may have broad clinical applicability since manipulation of glucose control, even in non-diabetics, may affect cognitive performance, perhaps enabling preventive measures against dementia. PMID:22426020

Ravona-Springer, Ramit; Moshier, Erin; Schmeidler, James; Godbold, James; Akrivos, Jimmy; Rapp, Michael; Grossman, Hillel T.; Wysocki, Michael; Silverman, Jeremy M.; Haroutunian, Vahram; Beeri, Michal Schnaider

2013-01-01

130

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

131

Three 15-min Bouts of Moderate Postmeal Walking Significantly Improves 24-h Glycemic Control in Older People at Risk for Impaired Glucose Tolerance  

PubMed Central

OBJECTIVE The purpose of this study was to compare the effectiveness of three 15-min bouts of postmeal walking with 45 min of sustained walking on 24-h glycemic control in older persons at risk for glucose intolerance. RESEARCH DESIGN AND METHODS Inactive older (?60 years of age) participants (N = 10) were recruited from the community and were nonsmoking, with a BMI <35 kg/m2 and a fasting blood glucose concentration between 105 and 125 mg dL?1. Participants completed three randomly ordered exercise protocols spaced 4 weeks apart. Each protocol comprised a 48-h stay in a whole-room calorimeter, with the first day serving as the control day. On the second day, participants engaged in either 1) postmeal walking for 15 min or 45 min of sustained walking performed at 2) 10:30 a.m. or 3) 4:30 p.m. All walking was on a treadmill at an absolute intensity of 3 METs. Interstitial glucose concentrations were determined over 48 h with a continuous glucose monitor. Substrate utilization was measured continuously by respiratory exchange (VCO2/VO2). RESULTS Both sustained morning walking (127 ± 23 vs. 118 ± 14 mg dL?1) and postmeal walking (129 ± 24 vs. 116 ± 13 mg dL?1) significantly improved 24-h glycemic control relative to the control day (P < 0.05). Moreover, postmeal walking was significantly (P < 0.01) more effective than 45 min of sustained morning or afternoon walking in lowering 3-h postdinner glucose between the control and experimental day. CONCLUSIONS Short, intermittent bouts of postmeal walking appear to be an effective way to control postprandial hyperglycemia in older people. PMID:23761134

DiPietro, Loretta; Gribok, Andrei; Stevens, Michelle S.; Hamm, Larry F.; Rumpler, William

2013-01-01

132

High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study  

PubMed Central

Background The role of dietary factors in the pathophysiology of acne vulgaris is highly controversial. Hence, the aim of this study was to determine the association between dietary factors and acne vulgaris among Malaysian young adults. Methods A case–control study was conducted among 44 acne vulgaris patients and 44 controls aged 18 to 30?years from October 2010 to January 2011. Comprehensive acne severity scale (CASS) was used to determine acne severity. A questionnaire comprising items enquiring into the respondent’s family history and dietary patterns was distributed. Subjects were asked to record their food intake on two weekdays and one day on a weekend in a three day food diary. Anthropometric measurements including body weight, height and body fat percentage were taken. Acne severity was assessed by a dermatologist. Results Cases had a significantly higher dietary glycemic load (175?±?35) compared to controls (122?±?28) (p?controls. Females in the case group had a higher daily energy intake compared to their counterparts in the control group, 1812?±?331 and 1590?±?148?kcal respectively (p?control groups (p?>?0.05). Conclusions Glycemic load diet and frequencies of milk and ice cream intake were positively associated with acne vulgaris. PMID:22898209

2012-01-01

133

Impact of Intensive Glycemic Control on the Incidence of Atrial Fibrillation and Associated Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus (from the Action to Control Cardiovascular Risk in Diabetes Study).  

PubMed

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

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

2014-10-15

134

Monocyte chemoattractant protein 1 is correlated with glycemic control and peripheral arterial disease in type 2 diabetic patients with metabolic syndrome.  

PubMed

We evaluated the serum levels of monocyte chemoattractant protein 1 (MCP-1) and their association with peripheral arterial disease (PAD) in 199 patients with type 2 diabetes mellitus (T2DM) and metabolic syndrome ([MetS], group A) in comparison with 109 healthy controls (group B). In group A, MCP-1 levels were significantly (P < .001) higher than group B and exhibited a positive correlation with HbA1c (P < .001) and a negative correlation with ankle-brachial index (P < .001). In the same group, patients with PAD had significantly higher MCP-1 levels compared with those without PAD (P < .001). In conclusion, T2DM patients with MetS exhibit higher serum MCP-1 levels. The latter is associated with worse glycemic control and PAD. These results suggest a potential contributory role for MCP-1 in the pathogenesis of PAD in the presence of hyperglycemia and MetS in T2DM. PMID:22492254

Papatheodorou, K; Papanas, N; Papazoglou, D; Gioka, T; Antonoglou, C; Glaros, D; Maltezos, E

2013-04-01

135

The effect of insurance status and parental education on glycemic control and cardiovascular disease risk profile in youth with Type 1 Diabetes  

PubMed Central

Background Adult studies have shown a correlation between low socioeconomic status and Type 1 Diabetes complications, but studies have not been done in children to examine the effect of socioeconomic status on risk for future complications. This study investigates the relationship between insurance status and parental education and both glycemic control and cardiovascular disease (CVD) risk factors in youth with type 1 diabetes. Methods A cross-sectional study of 295 youth with established type 1 diabetes who underwent examination with fasting blood draw and reported insurance status and parental education. Results Youth with type 1 diabetes and public insurance had higher hemoglobin A1c (HbA1c), body mass index, hs-CRP, and blood pressure (p?controlling for insulin regimen. Parental education was not associated with HbA1c or CVD risk factors. Conclusions Youth with type 1 diabetes and public insurance have worse glycemic control and elevated CVD risk factors compared to those with private insurance, but this was no longer seen when insulin regimen was controlled for. Further research is needed to look at differences between those with public insurance and private insurance that contribute to differences in type 1 diabetes outcomes, and to identify modifiable risk factors in pediatric patients in order to focus earlier interventions to decrease and prevent future diabetes complications. PMID:24955334

2014-01-01

136

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

PubMed

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

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

2014-01-01

137

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

PubMed

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

Barrett, Marilyn L; Udani, Jay K

2011-01-01

138

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

139

The reduced form of coenzyme Q10 improves glycemic control in patients with type 2 diabetes: an open label pilot study.  

PubMed

Coenzyme Q10 (CoQ10) provides the energy for vital cellular functions and is known to act as an antioxidant. We conducted an open label study to examine the clinical effects of supplementation of the reduced form of CoQ10, ubiquinol, in addition to conventional glucose-lowering agents in patients with type 2 diabetes. Nine subjects (3 males and 6 females) with type 2 diabetes and receiving conventional medication were recruited. The subjects were assigned to receive an oral dose of 200 mg ubiquinol daily for 12 weeks. The effect of ubiquinol on blood pressure, lipid profile, glycemic control, oxidative stress, and inflammation were examined before and after ubiquinol supplementation. In addition, five healthy volunteers were also assigned to receive an oral dose of 200 mg ubiquinol daily for 4 weeks to examine the effects of ubiquinol on insulin secretion. In patients with diabetes, there were no differences with respect to blood pressure, lipid profile, oxidative stress marker, and inflammatory markers. However, there were significant improvements in glycosylated hemoglobin (53.0 ± 4.3 to 50.5 ± 3.7 mmol/mol, P = 0.01) (7.1 ± 0.4 to 6.8 ± 0.4%, P = 0.03). In healthy volunteers, the insulinogenic index (0.65 ± 0.29 to 1.23 ± 0.56, P = 0.02) and the ratio of proinsulin to insulin were significantly improved (3.4 ± 1.8 to 2.1 ± 0.6, P = 0.03). The results of our study are consistent with the suggestion that the supplementation of ubiquinol in subjects with type 2 diabetes, in addition to conventional antihyperglycemic medications, improves glycemic control by improving insulin secretion without any adverse effects PMID:22887051

Mezawa, Morito; Takemoto, Minoru; Onishi, Shunichiro; Ishibashi, Ryoichi; Ishikawa, Takahiro; Yamaga, Masaya; Fujimoto, Masaki; Okabe, Emiko; He, Peng; Kobayashi, Kazuki; Yokote, Koutaro

2012-01-01

140

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

141

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

PubMed Central

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

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

2013-01-01

142

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

143

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

PubMed Central

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

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

2010-01-01

144

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

145

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

146

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

E-print Network

Background: Complications from diabetes mellitus can compromise a driver’s ability to safely operate a motor vehicle, yet little is known about whether euglycemia predicts normal driving risks among adults with diabetes. We studied the association between glycosylated hemoglobin (HbA1c) and the risk of a motor vehicle crash using a population-based case control analysis. Methods and Findings: We identified consecutive drivers reported to vehicle licensing authorities between January 1, 2005 to January 1, 2007 who had a diagnosis of diabetes mellitus and a HbA1c documented. The risk of a crash was calculated taking into account potential confounders including blood glucose monitoring, complications, and treatments. A total of 57 patients were involved in a crash and 738 were not involved in a crash. The mean HbA1c was lower for those in a crash than controls (7.4 % versus 7.9%, unpaired t-test, p = 0.019), equal to a 26 % increase in the relative risk of a crash for each 1% reduction in HbA1c (odds ratio = 1.26, 95 % confidence interval 1.03–1.54). The trend was evident across the range of HbA1c values and persisted after adjustment for measured confounders (odds ratio = 1.25, 95 % confidence interval 1.02–1.55). The two other significant risk factors for a crash were a history of severe hypoglycemia requiring outside assistance (odds ratio = 4.07, 95 % confidence interval 2.35–7.04) and later age at diabetes diagnosis (odds ratio per decade = 1.29, 95% confidence interval 1.07–1.57).

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

147

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

148

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.

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

2014-01-01

149

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

PubMed

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

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

2014-01-01

150

Glycemic index in sport nutrition.  

PubMed

Carbohydrates (CHO) can be classified on the basis of their glycemic index (GI), and the use of this classification has been increasingly supported by science. Because of its impact on blood glucose and insulin responses following the ingestion of CHO foods, the GI has been studied in many fields of medicine, including sport nutrition. As a new tool in sport nutrition, glycemic index manipulation has been evaluated to improve the first and second phases of glycogen recovery, glycogen load, and exercise metabolism, including control of rebound hypoglycemia and, it is interesting to note, stimulation of lipid oxidation for longer availability of glucose sources during endurance exercise. Although attractive, the use of GI in sport nutrition has received only partial support from available experimental evidence. At the biochemical level, consistent evidence has been attained to suggest that GI manipulation can determine variations in adipocyte lipolysis, plasma free fatty acids levels, and lipid and CHO oxidation rates during exercise. However, when the effects of GI manipulation have been assessed at the functional level, the results have been inconsistent, with evidence of improved exercise performance in some studies, but not in many others. The purpose of the current article is to review the effects and limits of GI manipulation in sport nutrition, and to propose an overall strategy for its application. PMID:20234033

Mondazzi, Luca; Arcelli, Enrico

2009-08-01

151

Impact of Baseline BMI on Glycemic Control and Weight Change with Metformin Monotherapy in Chinese Type 2 Diabetes Patients: Phase IV Open-Label Trial  

PubMed Central

Background Differences exist between treatment recommendations regarding the choice of metformin as first-line therapy for type 2 diabetes patients according to body mass index (BMI). This study compared the efficacy of metformin monotherapy among normal-weight, overweight, and obese patients with newly diagnosed type 2 diabetes. Methods In this prospective, multicenter, open-label study in China, patients aged 23–77 years were enrolled 1?1:1 according to baseline BMI: normal-weight (BMI 18.5?23.9 kg/m2; n?=?125); overweight (BMI 24.0?27.9 kg/m2; n?=?122) or obese (BMI ?28 kg/m2; n?=?124). Extended-release metformin was administered for 16 weeks (500 mg/day, up-titrated weekly to a maximum 2,000 mg/day). The primary efficacy endpoint was the effect of baseline BMI on glycemic control with metformin monotherapy, measured as the change from baseline in glycosylated hemoglobin (HbA1c) at week 16 compared among BMI groups using ANCOVA. Other endpoints included comparisons of metformin’s effects on fasting plasma glucose (FPG), lipid levels and body weight. Results Mean HbA1c decreases at week 16, adjusted for baseline values, were –1.84%, –1.78% and –1.78% in normal-weight, overweight and obese patients, (P?=?0.664); body weight decreased by 2.4%, 3.9% and 3.5%, respectively. FPG levels decreased similarly over time in all BMI groups (P?=?0.461) and changes from baseline in high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) did not differ significantly among BMI groups at week 16 (P?=?0.143 and 0.451, respectively). Conclusions Baseline BMI had no impact on glycemic control, weight change or other efficacy measures with metformin monotherapy. These data suggest that normal-weight type 2 diabetes patients would derive the same benefits from first-line treatment with metformin as overweight and obese patients, and are not at increased risk of excess weight loss. Trial Registration ClinicalTrials.gov NCT00778622 PMID:23468941

Ji, Linong; Li, Hongmei; Guo, Xiaohui; Li, Yan; Hu, Renming; Zhu, Zhengying

2013-01-01

152

Four Weeks of Treatment With Liraglutide Reduces Insulin Dose Without Loss of Glycemic Control in Type 1 Diabetic Patients With and Without Residual ?-Cell Function  

PubMed Central

OBJECTIVE To investigate the effect of 4 weeks of treatment with liraglutide on insulin dose and glycemic control in type 1 diabetic patients with and without residual ?-cell function. RESEARCH DESIGN AND METHODS Ten type 1 diabetic patients with residual ?-cell function (C-peptide positive) and 19 without (C-peptide negative) were studied. All C-peptide–positive patients were treated with liraglutide plus insulin, whereas C-peptide–negative patients were randomly assigned to liraglutide plus insulin or insulin monotherapy. Continuous glucose monitoring with identical food intake and physical activity was performed before (week 0) and during (week 4) treatment. Differences in insulin dose; HbA1c; time spent with blood glucose <3.9, >10, and 3.9–9.9 mmol/L; and body weight were evaluated. RESULTS Insulin dose decreased from 0.50 ± 0.06 to 0.31 ± 0.08 units/kg per day (P < 0.001) in C-peptide–positive patients and from 0.72 ± 0.08 to 0.59 ± 0.06 units/kg per day (P < 0.01) in C-peptide–negative patients treated with liraglutide but did not change with insulin monotherapy. HbA1c decreased in both liraglutide-treated groups. The percent reduction in daily insulin dose was positively correlated with ?-cell function at baseline, and two patients discontinued insulin treatment. In C-peptide–positive patients, time spent with blood glucose <3.9 mmol/L decreased from 3.0 to 1.0 h (P = 0.03). A total of 18 of 19 patients treated with liraglutide lost weight during treatment (mean [range] ?2.3 ± 0.3 kg [?0.5 to ?5.1]; P < 0.001). Transient gastrointestinal adverse effects occurred in almost all patients treated with liraglutide. CONCLUSIONS Treatment with liraglutide in type 1 diabetic patients reduces insulin dose with improved or unaltered glycemic control. PMID:21593296

Kielgast, Urd; Krarup, Thure; Holst, Jens Juul; Madsbad, Sten

2011-01-01

153

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

154

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

PubMed Central

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

2013-01-01

155

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

156

Effects of glycemic control on saliva flow rates and protein composition in non-insulin-dependent diabetes mellitus  

Microsoft Academic Search

Objective. The objective of this study was to determine whether improvements in the level of diabetic control in a group of subjects with poorly controlled non-insulin-dependent diabetes mellitus influence salivary output and composition.Study design. Repeated whole unstimulated and stimulated parotid saliva samples were collected from diabetic patients attending an outpatient diabetes education program and a matched nondiabetic control group. Saliva

Michael W. J Dodds; Anne P Dodds

1997-01-01

157

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

158

COH-SR4 Reduces Body Weight, Improves Glycemic Control and Prevents Hepatic Steatosis in High Fat Diet-Induced Obese Mice  

PubMed Central

Obesity is a chronic metabolic disorder caused by imbalance between energy intake and expenditure, and is one of the principal causative factors in the development of metabolic syndrome, diabetes and cancer. COH-SR4 (“SR4”) is a novel investigational compound that has anti-cancer and anti-adipogenic properties. In this study, the effects of SR4 on metabolic alterations in high fat diet (HFD)-induced obese C57BL/J6 mice were investigated. Oral feeding of SR4 (5 mg/kg body weight.) in HFD mice for 6 weeks significantly reduced body weight, prevented hyperlipidemia and improved glycemic control without affecting food intake. These changes were associated with marked decreases in epididymal fat mass, adipocyte hypertrophy, increased plasma adiponectin and reduced leptin levels. SR4 treatment also decreased liver triglycerides, prevented hepatic steatosis, and normalized liver enzymes. Western blots demonstrated increased AMPK activation in liver and adipose tissues of SR4-treated HFD obese mice, while gene analyses by real time PCR showed COH-SR4 significantly suppressed the mRNA expression of lipogenic genes such as sterol regulatory element binding protein-1c (Srebf1), acetyl-Coenzyme A carboxylase (Acaca), peroxisome proliferator-activated receptor gamma (Pparg), fatty acid synthase (Fasn), stearoyl-Coenzyme A desaturase 1 (Scd1), carnitine palmitoyltransferase 1a (Cpt1a) and 3-hydroxy-3-methyl-glutaryl-CoA reductase (Hmgcr), as well as gluconeogenic genes phosphoenolpyruvate carboxykinase 1 (Pck1) and glucose-6-phosphatase (G6pc) in the liver of obese mice. In vitro, SR4 activates AMPK independent of upstream kinases liver kinase B1 (LKB1) and Ca2+/calmodulin-dependent protein kinase kinase ? (CaMKK?). Together, these data suggest that SR4, a novel AMPK activator, may be a promising therapeutic compound for treatment of obesity, fatty liver disease, and related metabolic disorders. PMID:24376752

Figarola, James Lester; Singhal, Preeti; Rahbar, Samuel; Gugiu, Bogdan Gabriel; Awasthi, Sanjay; Singhal, Sharad S.

2013-01-01

159

Cardiovascular disease and glycemic control in type 2 diabetes: now that the dust is settling from large clinical trials.  

PubMed

The relationship between glucose control and cardiovascular outcomes in type 2 diabetes has been a matter of controversy over the years. Although epidemiological evidence exists in favor of an adverse role of poor glucose control on cardiovascular events, intervention trials have been less conclusive. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, the Action in Diabetes and Vascular Disease (ADVANCE) study, and the Veterans Affairs Diabetes Trial (VADT) have shown no beneficial effect of intensive glucose control on primary cardiovascular endpoints in type 2 diabetes. However, subgroup analysis has provided evidence suggesting that the potential beneficial effect largely depends on patients' characteristics, including age, diabetes duration, previous glucose control, presence of cardiovascular disease, and risk of hypoglycemia. The benefit of strict glucose control on cardiovascular outcomes and mortality may be indeed hampered by the extent and frequency of hypoglycemic events and could be enhanced if glucose-lowering medications, capable of exerting favorable effects on the cardiovascular system, were used. This review examines the relationship between intensive glucose control and cardiovascular outcomes in type 2 diabetes, addressing the need for individualization of glucose targets and careful consideration of the benefit/risk profile of antidiabetes medications. PMID:23387439

Giorgino, Francesco; Leonardini, Anna; Laviola, Luigi

2013-04-01

160

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

Microsoft Academic Search

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

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

2006-01-01

161

A simple meal plan of 'eating vegetables before carbohydrate' was more effective for achieving glycemic control than an exchange-based meal plan in Japanese patients with type 2 diabetes.  

PubMed

This study aimed to determine whether educating diabetic patients to 'eat vegetables before carbohydrate' was as effective on long-term glycemic control as a traditional exchange-based meal plan. To test this hypothesis, we carried out a randomized, controlled trial in patients with type 2 diabetes that compared changes in HbA1c as the primary outcome. A total of 101 patients were stratified according to sex, age, BMI, duration of diabetes, and HbA1c, and then randomized to receive instructions to eat either vegetables before carbohydrate (VBC, n=69) or an exchange-based meal plan (EXB, n=32). The impact of the two plans on glycemic control was compared over 24 months of follow-up. Significant improvements in HbA1c over 24 months were observed in both groups (VBC, 8.3 to 6.8% vs EXB, 8.2 to 7.3%). HbA1c levels were significantly lower in the VBC group than in the EXB group after 6, 9, 12 and 24 months of the study. Both groups exhibited similar improvements in dietary practices with respect to intake of carbohydrate, fats and sweets, while the VBC group had a significant increase in consumption of green vegetables and a significant decrease in fruit consumption. A simple meal plan of 'eating vegetables before carbohydrate' achieved better glycemic control than an exchange-based meal plan in Japanese patients with type 2 diabetes over a 24-month period. PMID:21669583

Imai, Saeko; Matsuda, Mikuko; Hasegawa, Goji; Fukui, Michiaki; Obayashi, Hiroshi; Ozasa, Neiko; Kajiyama, Shizuo

2011-01-01

162

Association of antidiabetic therapies to glycemic control and to body weight in type 2 diabetes: a German multicenter analysis on 9294 patients.  

PubMed

Glycemic and body weight control are two outstanding goals in the treatment of patients with type 2 diabetes that often are not appropriately achieved. This observational study evaluates whether treatment by quality controlled diabetes centers generates an improvement in this regard and focuses on associations with different therapies. Data of 9.294 type 2 diabetic patients (mean age 66.9±11.6 years, mean diabetes duration 12.4±9.2 years) from 103 German diabetes centers were assessed by a standardized, prospective, computer-based diabetes care and outcome documentation system (DPV-Wiss-database). Therapeutic concepts included lifestyle intervention (n=1.813), oral antidiabetics (OAD, n=1.536), insulin (n=4.504) and insulin plus OAD (n=1.441). HbA1c and body weight were compared before and after a stable therapeutical period of 1.07±0.3 years. Change in HbA1c (%): all patients 7.4±1.6-7.0±1.3, lifestyle intervention 7.5±1.9-6.9±1.5, OAD 6.7±1.1-6.5±1.0, insulin 7.6±1.6-7.2±1.4, insulin plus OAD 7.5±1.5-7.2±1.3; each p?0.05. Change in body weight (kg): all patients +0.08±0.07, n.?s.; lifestyle intervention -0.28±0.20, OAD -0.56±0.13, each p<0.05 [metfomin -0.77±0.21, sulfonylurea drugs -0.75±0.34, each p<0.05; glitazones +0.62±0.70, ?-glucosidase inhibitors -0.22±0.76, each n.?s.], insulin +0.27±0.10, insulin plus OAD +0.63±0.14, each n.?s. In summary, lifestyle, metformin or sulfonylurea drug treatment resulted in HbA1c-values below 7.0% plus a significant weight reduction. Insulin treatment-associated concepts resulted in HbA1c-values slightly above 7.0% without body weight alterations. These "real life" data underline that a specialised and quality controlled diabetes care is able to achieve significant treatment results even in patients with disease progression and a high proportion of insulin therapies. PMID:20200811

Schütt, M; Kern, W; Zimmermann, A; Busch, P; Kerner, W; Voll, A; Wagner, C; Kann, P H; Dapp, A; Holl, R W

2010-08-01

163

Normal mortality in the elderly with diabetes under strict glycemic and blood pressure control: Outcome of 6-year prospective study  

Microsoft Academic Search

Mortality, macroangiopathic events and end-stage renal disease (ESRD) in the elderly under long-term, intensive multifactorial diabetes control were prospectively investigated. Three hundred and eighty-eight elderly patients (?65 years) with type 2 diabetes (the mean age 72.9 years, men\\/women ratio 176\\/212) were followed-up for 6 years with HbA1c 7.0%, BP 145\\/80mmHg and total cholesterol<240mg\\/dl as targets. The mean baseline HbA1c was

Masafumi Katakura; Motoji Naka; Teruki Kondo; Mitsuhisa Komatsu; Keishi Yamauchi; Kiyoshi Hashizume; Toru Aizawa

2007-01-01

164

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

PubMed Central

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

Richard, John W.; Raskin, Philip

2011-01-01

165

Determinants of the Changes in Glycemic Control with Exercise Training in Type 2 Diabetes: A Randomized Trial  

PubMed Central

Aims To assess the determinants of exercise training-induced improvements in glucose control (HbA1C) including changes in serum total adiponectin and FFA concentrations, and skeletal muscle peroxisome proliferator-activated receptor-? coactivator-1? (PGC-1?) protein content. Methods A sub-cohort (n?=?35; 48% men; 74% Caucasian) from the HART-D study undertaking muscle biopsies before and after 9 months of aerobic (AT), resistance (RT), or combination training (ATRT). Results Changes in HbA1C were associated with changes in adiponectin (r?=??0.45, P?=?0.007). Participants diagnosed with type 2 diabetes for a longer duration had the largest increase in PGC-1? (r?=?0.44, P?=?0.008). Statistical modeling examining changes in HbA1C suggested that male sex (P?=?0.05), non-Caucasian ethnicity (P?=?0.02), duration of type 2 diabetes (r?=?0.40; P<0.002) and changes in FFA (r?=?0.36; P<0.004), adiponectin (r?=??0.26; P<0.03), and PGC-1? (r?=??0.28; P?=?0.02) explain ?65% of the variability in the changes in HbA1C. Conclusions Decreases in HbA1C after 9 months of exercise were associated with shorter duration of diabetes, lowering of serum FFA concentrations, increasing serum adiponectin concentrations and increasing skeletal muscle PGC-1? protein expression. Trial Registration ClinicalTrials.gov NCT00458133 PMID:23805175

Zhang, Zhengyu; Earnest, Conrad P.; Smith, Steven R.; Church, Timothy S.; Ravussin, Eric

2013-01-01

166

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

167

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

Microsoft Academic Search

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

J. A. Monro

1999-01-01

168

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

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

169

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

170

LOGIC-Insulin AlgorithmGuided Versus Nurse-Directed Blood Glucose Control  

E-print Network

-directed glycemic control (Nurse-C) or algorithm-guided glycemic control (LOGIC-C). Glycemic penalty index (GPI patients is difficult and labor intensive, resulting in poor efficacy of glycemic control and increased be rec- ommended (9­11). Regardless of the tar- get level of glycemic control, insulin infusion can

171

Dietary fiber and the glycemic response.  

PubMed

Addition of purified fiber to carbohydrate test meals has been shown to flatten the glycemic response in both normal and diabetic volunteers, reduce the insulin requirement in patients on the artificial pancreas and in the longer term reduce urinary glucose loss and improve diabetes control. In the context of high fiber-high carbohydrate diets these findings have had a major impact in influencing recommendations for the dietary management of diabetes internationally. The mechanism of action appears in part to be due to the effect of fiber in slowing absorption rather than by increasing colonic losses of carbohydrate. Consequently postprandial GIP and insulin levels are reduced and the more viscous purified fibers (e.g., guar and pectin) appear most effective. In addition it has been suggested that colonic fermentation products of fiber may enhance glucose utilization. More recently it has become clear that many aspects of carbohydrate foods (food form, antinutrients, etc.) in addition to fiber may influence the rate of digestion and has led to a classification especially of starchy foods in terms of glycemic index to define the degree to which equicarbohydrate portions of different foods raise the blood glucose. Use of such data may maximize the effectiveness of high carbohydrate and high fiber diets in the management of diabetes and related disorders. PMID:3001740

Jenkins, D J; Jenkins, A L

1985-12-01

172

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

PubMed Central

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

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

2013-01-01

173

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

174

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

PubMed

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

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

2013-02-01

175

The glycemic index: methodology and clinical implications\\  

Microsoft Academic Search

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

David JA; Alexandra L Jenkins Jenkins; Robert G Josse

176

Glycemic control and weight reduction without causing hypoglycemia: the case for continued safe aggressive care of patients with type 2 diabetes mellitus and avoidance of therapeutic inertia.  

PubMed

Diabetes mellitus (DM) is a major and growing concern in the United States, in large part because of an epidemic of obesity in America and its relation to type 2 DM. In affected patients, postprandial glucose may be an early indicator of glucose intolerance or a prediabetes condition, which may be a better predictor of cardiovascular risk than impaired fasting glucose level. Treating patients who have early signs of hyperglycemia, including elevated postprandial glucose level, with intensive glucose control that does not lead to weight gain, and ideally may be associated with weight reduction, may be vital to preventing or reducing later cardiovascular morbidity and mortality. Because hypoglycemia is an important complication of current DM treatments and may cause acute secondary adverse cardiovascular outcomes, not causing hypoglycemia is mandatory. Given that weight loss can significantly lower cardiovascular risk and improve other cardiovascular risk factors in patients with type 2 DM and that medications are available that can result in weight reduction without leading to hypoglycemia, the successful treatment of patients with type 2 DM should be individualized and should address the complete pathophysiologic process. This review is a hypothesis article that presents arguments against general approaches to the treatment of type 2 DM. An algorithm is presented in which the goal for managing patients with type 2 DM is to lower the blood glucose level as much as possible for as long as possible without causing hypoglycemia. In addition, body weight should ideally be improved, reducing cardiovascular risk factors and avoiding therapeutic inertia. PMID:21106867

Schwartz, Stanley S; Kohl, Benjamin A

2010-12-01

177

Glycemic Variability and Oxidative Stress: A Link between Diabetes and Cardiovascular Disease?  

PubMed Central

Diabetes is associated with a two to three-fold increase in risk of cardiovascular disease. However, intensive glucose-lowering therapy aiming at reducing HbA1c to a near-normal level failed to suppress cardiovascular events in recent randomized controlled trials. HbA1c reflects average glucose level rather than glycemic variability. In in vivo and in vitro studies, glycemic variability has been shown to be associated with greater reactive oxygen species production and vascular damage, compared to chronic hyperglycemia. These findings suggest that management of glycemic variability may reduce cardiovascular disease in patients with diabetes; however, clinical studies have shown conflicting results. This review summarizes the current knowledge on glycemic variability and oxidative stress, and discusses the clinical implications. PMID:25314300

Saisho, Yoshifumi

2014-01-01

178

Glycemic variability and acute ischemic stroke: the missing link?  

PubMed

Hyperglycemia is commonly encountered in both diabetic and non-diabetic patients in acute ischemic stroke. Hyperglycemia in stroke has been associated with poor clinical outcome, a phenomenon that has been studied in experimental models, where hyperglycemia was shown to enhance cortical toxicity, increase infarct volumes, promote inflammation, and affect the cerebral vasculature. This has led to many trials attempting to modulate the hyperglycemic response as a therapeutic and neuroprotective strategy. Intensive glycemic control has been evaluated in stroke patients, with conflicting results. The evidence linking hyperglycemia with neurotoxicity coupled with the failure of intensive glucose control regimens to improve functional outcomes in stroke suggests that novel approaches should be devised. Recent attention has been paid to another related phenomenon, that of glycemic variability, which has been proven to be a predictor of outcome in critically ill patients; however, its the impact in stroke has not been evaluated. PMID:25085437

González-Moreno, Emmanuel I; Cámara-Lemarroy, Carlos R; González-González, José G; Góngora-Rivera, Fernando

2014-12-01

179

Application of glycemic index to mixed meals1'2  

Microsoft Academic Search

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

Irene Chew; Janette C Brand; Anne W Thorburn

180

Metabolic effects of a low-glycemic-index diet13  

Microsoft Academic Search

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

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

181

The Effects of Vitamin D Supplementation on Hepatic Dysfunction, Vitamin D Status, and Glycemic Control in Children and Adolescents with Vitamin D Deficiency and Either Type 1 or Type 2 Diabetes Mellitus  

PubMed Central

Background The effects of vitamin D supplementation on mild hepatic dysfunction and glycemic control are unclear in children and adolescents with either type 1 (T1D) or type 2 diabetes (T2D). Hypothesis Vitamin D supplementation will improve hepatic dysfunction and glycemic control. Aim To determine the effect of vitamin D supplementation on alanine transaminase (ALT), hemoglobin A1c (HbA1c), and serum 25-hydroxyvitamin D [25(OH)D] concentration. Subjects and Methods A retrospective study of 131 subjects with either T1D (n?=?88?46 females, 42 males), or T2D (n?=?43?26 females, 17 males) of ages 3–18 years between 2007–2013. All subjects had (1) a diagnosis of diabetes for >12 mo, (2) received vitamin D supplementation for the management of vitamin D deficiency (3) had baseline and subsequent simultaneous measurements of HbA1c, ALT, and 25(OH)D. Vitamin D deficiency was defined as 25(OH)D concentration of <50 nmol/L (20 ng/mL). Results At baseline, vitamin D deficiency occurred in 72.1% of patients with T2D and in 37.5% of T1D patients (p<0.001). Patients with T2D had significantly higher values for BMI SDS (p<0.001), alanine transaminase (ALT) (p?=?0.001), but lower 25(OH)D (p<0.001), and no difference in HbA1c (p?=?0.94), and total daily dose (TDD) of insulin per kg body weight (p?=?0.48) as compared to T1D patients. After 3 months of vitamin D supplementation, there was a significant increase in 25(OH)D in both T2D (p?=?0.015), and T1D patients (p<0.001); significant reduction in BMI SDS (p?=?0.015) and ALT (p?=?0.012) in T2D, but not in T1D. There was a clinically-significant decrease in HbA1c in T2D from 8.5±2.9% at baseline to 7.7±2.5 at 3 mo, but not in T1D, 8.5±1.2 to 8.53±1.1%. Conclusions Vitamin D supplementation in subjects with T2D was associated with statistically significant decreases in BMI SDS, ALT, and a clinically-significant decrease in HbA1c. PMID:24918447

Nwosu, Benjamin Udoka; Maranda, Louise

2014-01-01

182

The relationship between glycemic intake and insulin resistance in older women.  

E-print Network

??Glycemic intake influences the rise in blood glucose concentration following consumption of a carbohydrate containing meal, known as the postprandial glycemic response. The glycemic response… (more)

O'Sullivan, Therese Anne

2008-01-01

183

Benefits of tight blood pressure control in diabetic patients with hypertension: importance of early and sustained implementation of effective treatment strategies.  

PubMed

In 2008, when the UK Prospective Diabetes Study (UKPDS) group presented their 30-year findings concerning the possible sustained effects of improved glycemic control after 10 years of extended follow-up in type 2 diabetic patients, a so-called "legacy effect" was reported to address the long-term emergent and/or sustained benefits of early improved glycemic control. Opposite results were obtained by the Hypertension in Diabetes Study (HDS) carried out in the frame of UKPDS, with no evidence of any legacy effect on cardiovascular (CV) outcomes for an initial 4-year period of tight blood pressure (BP) control. Thus, it was concluded that BP control has to be continued over time, since, although it had a short time-to-effect relationship in preventing stroke, BP control was associated with a short persistence of its clinical benefits once the intervention was discontinued. These findings are unique because, whereas most interventional trials in hypertension that included diabetic patients have shown a reduction in CV outcomes shortly after starting treatment, only the UKPDS-HDS specifically explored the possible persistence of clinical benefits after discontinuing intensive BP-lowering intervention. This article aims to provide a critical interpretation of the UKPDS findings of lack of BP legacy, in the context of the currently available evidence on the benefits of antihypertensive treatment. The importance of effective BP control in type 2 diabetic patients to prevent CV outcomes and other diabetes-related complications is underlined, with emphasis on early, tight, and continuous BP control to optimize patients' protection. PMID:21525472

Parati, Gianfranco; Bilo, Grzegorz; Ochoa, Juan E

2011-05-01

184

Understanding the Glycemic Index and Glycemic Load and Their Practical Applications  

ERIC Educational Resources Information Center

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

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

2009-01-01

185

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

PubMed Central

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

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

2014-01-01

186

Automatic Detection of Excessive Glycemic Variability for Diabetes Management  

E-print Network

Automatic Detection of Excessive Glycemic Variability for Diabetes Management Matthew Wiley, Razvan, USA Email: shubrook@ohio.edu, schwartf@ohio.edu Abstract--Glycemic variability, or fluctuation in blood glucose levels, is a significant factor in diabetes management. Excessive glycemic variability

Bunescu, Razvan C.

187

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

Microsoft Academic Search

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

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

2008-01-01

188

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

189

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

Microsoft Academic Search

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

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

2002-01-01

190

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

191

Maternal control of early mouse development  

PubMed Central

The hiatus between oocyte and embryonic gene transcription dictates a role for stored maternal factors in early mammalian development. Encoded by maternal-effect genes, these factors accumulate during oogenesis and enable the activation of the embryonic genome, the subsequent cleavage stages of embryogenesis and the initial establishment of embryonic cell lineages. Recent studies in mice have yielded new findings on the role of maternally provided proteins and multi-component complexes in preimplantation development. Nevertheless, significant gaps remain in our mechanistic understanding of the networks that regulate early mammalian embryogenesis, which provide an impetus and opportunities for future investigations. PMID:20179092

Li, Lei; Zheng, Ping; Dean, Jurrien

2010-01-01

192

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

193

The Effect of Diabetes Self-Management Education on Body Weight, Glycemic Control, and Other Metabolic Markers in Patients with Type 2 Diabetes Mellitus  

PubMed Central

Aims. To comprehensively evaluate the effect of a short-term diabetes self-management education (DSME) on metabolic markers and atherosclerotic parameters in patients with type 2 diabetes. Methods. 76 patients with type 2 diabetes were recruited in this study. They were divided into the intervention group (n = 36) and control group (n = 40). The patients in the intervention group received a 3-month intervention, including an 8-week education on self-management of diabetes mellitus and subsequent 4 weeks of practice of the self-management guidelines. The patients in the control group received standard advice on medical nutrition therapy. Metabolic markers, carotid intima-media thickness (CIMT), and carotid arterial stiffness (CAS) of the patients in both groups were assessed before and after the 3-month intervention. Results. There was a significant reduction in hemoglobin A1c (HbA1c, ?0.2 ± 0.56% versus 0.08 ± 0.741%; P < 0.05) and body weight (?1.19 ± 1.39?kg versus ?0.61 ± 2.04?kg; P < 0.05) in the intervention group as compared to the control group. However, no significant improvements were found in other metabolic markers, CIMT and CAS (P > 0.05). Conclusions. DSME can improve HbA1c and body weight in patients with type 2 diabetes. PMID:25136645

Lai, Christopher W. K.; Chan, Lawrence W. C.; Law, Helen K. W.; Ying, Michael

2014-01-01

194

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

PubMed Central

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

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

2009-01-01

195

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

PubMed Central

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

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

2013-01-01

196

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

PubMed Central

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

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

2013-01-01

197

The ABCG5 ABCG8 sterol transporter opposes the development of fatty liver disease and loss of glycemic control independently of phytosterol accumulation.  

PubMed

ABCG5 and ABCG8 form a complex (G5G8) that opposes the absorption of plant sterols but is also expressed in liver where it promotes the excretion of cholesterol into bile. Hepatic G5G8 is transcriptionally regulated by a number of factors implicated in the development of insulin resistance and nonalcoholic fatty liver disease. Therefore, we hypothesized that G5G8 may influence the development of diet-induced obesity phenotypes independently of its role in opposing phytosterol absorption. G5G8 knock-out (KO) mice and their wild type (WT) littermates were challenged with a plant sterol-free low fat or high fat (HF) diet. Weight gain and the rise in fasting glucose were accelerated in G5G8 KO mice following HF feeding. HF-fed G5G8 KO mice had increased liver weight, hepatic lipids, and plasma alanine aminotransferase compared with WT controls. Consistent with the development of nonalcoholic fatty liver disease, macrophage infiltration, the number of TUNEL-positive cells, and the expression of proinflammatory cytokines were also increased in G5G8 KO mice. Hepatic lipid accumulation was associated with increased peroxisome proliferator activated receptor ?, CD36, and fatty acid uptake. Phosphorylation of eukaryotic translation initiation factor 2? (eiF2?) and expression of activating transcription factor 4 and tribbles 3 were elevated in HF-fed G5G8 KO mice, a pathway that links the unfolded protein response to the development of insulin resistance through inhibition of protein kinase B (Akt) phosphorylation. Phosphorylation of Akt and insulin receptor was reduced, whereas serine phosphorylation of insulin receptor substrate 1 was elevated. PMID:22715101

Su, Kai; Sabeva, Nadezhda S; Liu, Jingjing; Wang, Yuhuan; Bhatnagar, Saloni; van der Westhuyzen, Deneys R; Graf, Gregory A

2012-08-17

198

The ABCG5 ABCG8 Sterol Transporter Opposes the Development of Fatty Liver Disease and Loss of Glycemic Control Independently of Phytosterol Accumulation*  

PubMed Central

ABCG5 and ABCG8 form a complex (G5G8) that opposes the absorption of plant sterols but is also expressed in liver where it promotes the excretion of cholesterol into bile. Hepatic G5G8 is transcriptionally regulated by a number of factors implicated in the development of insulin resistance and nonalcoholic fatty liver disease. Therefore, we hypothesized that G5G8 may influence the development of diet-induced obesity phenotypes independently of its role in opposing phytosterol absorption. G5G8 knock-out (KO) mice and their wild type (WT) littermates were challenged with a plant sterol-free low fat or high fat (HF) diet. Weight gain and the rise in fasting glucose were accelerated in G5G8 KO mice following HF feeding. HF-fed G5G8 KO mice had increased liver weight, hepatic lipids, and plasma alanine aminotransferase compared with WT controls. Consistent with the development of nonalcoholic fatty liver disease, macrophage infiltration, the number of TUNEL-positive cells, and the expression of proinflammatory cytokines were also increased in G5G8 KO mice. Hepatic lipid accumulation was associated with increased peroxisome proliferator activated receptor ?, CD36, and fatty acid uptake. Phosphorylation of eukaryotic translation initiation factor 2? (eiF2?) and expression of activating transcription factor 4 and tribbles 3 were elevated in HF-fed G5G8 KO mice, a pathway that links the unfolded protein response to the development of insulin resistance through inhibition of protein kinase B (Akt) phosphorylation. Phosphorylation of Akt and insulin receptor was reduced, whereas serine phosphorylation of insulin receptor substrate 1 was elevated. PMID:22715101

Su, Kai; Sabeva, Nadezhda S.; Liu, Jingjing; Wang, Yuhuan; Bhatnagar, Saloni; van der Westhuyzen, Deneys R.; Graf, Gregory A.

2012-01-01

199

Mindfulness and Inhibitory Control in Early Adolescence  

ERIC Educational Resources Information Center

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

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

2012-01-01

200

Early Experience with a Computerized Robotically Controlled Catheter System  

Microsoft Academic Search

Background: Recently, the use of robotic assisted surgery has been utilized in cardiac surgical procedures. The use of robotics may offer benefits in precision, stability and control of instruments remotely. We report early experience with a novel remote robotic catheter control system (CCS).Methods: We used a computerized robotically controlled catheter system that enables the user to remotely manipulate the tip

Amin Al-Ahmad; Jessica D. Grossman; Paul J. Wang

2005-01-01

201

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

Microsoft Academic Search

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

Earl S. Ford; Simin Liu

2001-01-01

202

Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance  

PubMed Central

Background Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions, probably owing to the fact that the studies had insufficient power. Methods We enrolled overweight adults from eight European countries who had lost at least 8% of their initial body weight with a 3.3-MJ (800-kcal) low-calorie diet. Participants were randomly assigned, in a two-by-two factorial design, to one of five ad libitum diets to prevent weight regain over a 26-week period: a low-protein and low-glycemic-index diet, a low-protein and high-glycemic-index diet, a high-protein and low-glycemic-index diet, a high-protein and high-glycemic-index diet, or a control diet. Results A total of 1209 adults were screened (mean age, 41 years; body-mass index [the weight in kilograms divided by the square of the height in meters], 34), of whom 938 entered the low-calorie-diet phase of the study. A total of 773 participants who completed that phase were randomly assigned to one of the five maintenance diets; 548 completed the intervention (71%). Fewer participants in the high-protein and the low-glycemic-index groups than in the low-protein–high-glycemic-index group dropped out of the study (26.4% and 25.6%, respectively, vs. 37.4%; P = 0.02 and P = 0.01 for the respective comparisons). The mean initial weight loss with the low-calorie diet was 11.0 kg. In the analysis of participants who completed the study, only the low-protein–high-glycemic-index diet was associated with subsequent significant weight regain (1.67 kg; 95% confidence interval [CI], 0.48 to 2.87). In an intention-to-treat analysis, the weight regain was 0.93 kg less (95% CI, 0.31 to 1.55) in the groups assigned to a high-protein diet than in those assigned to a low-protein diet (P = 0.003) and 0.95 kg less (95% CI, 0.33 to 1.57) in the groups assigned to a low-glycemic-index diet than in those assigned to a high-glycemic-index diet (P = 0.003). The analysis involving participants who completed the intervention produced similar results. The groups did not differ significantly with respect to diet-related adverse events. Conclusions In this large European study, a modest increase in protein content and a modest reduction in the glycemic index led to an improvement in study completion and maintenance of weight loss. (Funded by the European Commission; ClinicalTrials.gov number, NCT00390637.) PMID:21105792

Larsen, Thomas Meinert; Dalskov, Stine-Mathilde; van Baak, Marleen; Jebb, Susan A.; Papadaki, Angeliki; Pfeiffer, Andreas F.H.; Martinez, J. Alfredo; Handjieva-Darlenska, Teodora; Kunesova, Marie; Pihlsgard, Mats; Stender, Steen; Holst, Claus; Saris, Wim H.M.; Astrup, Arne

2012-01-01

203

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

Microsoft Academic Search

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

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

204

Dietary carbohydrate, glycemic index, and glycemic load in relation to colorectal cancer risk in the Women’s Health Initiative  

Microsoft Academic Search

Evidence implicating hyperinsulinemia and insulin resistance in the etiology of colorectal cancer suggests that a diet characterized\\u000a by a high glycemic index and load may increase the risk of this disease, but previous studies have yielded inconsistent results.\\u000a We assessed the association between intake of total carbohydrates, sugars, fiber, and the glycemic index (GI) and glycemic\\u000a load (GL) of individual

Geoffrey C. Kabat; James M. Shikany; Shirley A. A. Beresford; Bette Caan; Marian L. Neuhouser; Lesley F. Tinker; Thomas E. Rohan

2008-01-01

205

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

206

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.

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

2014-01-01

207

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

208

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

Federal Register 2010, 2011, 2012, 2013

...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

209

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

ERIC Educational Resources Information Center

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

Miller, Carla K.; Gutschall, Melissa

2009-01-01

210

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

Microsoft Academic Search

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

Anthony M Ocana; Venketeshwer A Rao; Gregory R Collier

211

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

Microsoft Academic Search

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

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

212

Life Stress Impairs Self-Control in Early Adolescence  

PubMed Central

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

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

2013-01-01

213

Kiwifruit, carbohydrate availability, and the glycemic response.  

PubMed

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

Monro, John A

2013-01-01

214

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

Microsoft Academic Search

Clinical studies have shown that fiber consumption facilitates weight loss and improves lipid profiles; however, the beneficial\\u000a effects of high fermentable fiber low glycemic index (GI) diets under conditions of weight maintenance are unclear. In the\\u000a Legume Inflammation Feeding Experiment, a randomized controlled cross-over feeding study, 64 middle-aged men who had undergone\\u000a colonoscopies within the previous 2 years received both a

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

2010-01-01

215

Is exercise a therapeutic tool for improvement of cardiovascular risk factors in adolescents with type 1 diabetes mellitus? A randomised controlled trial  

Microsoft Academic Search

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

Mona A Salem; Mohammed A AboElAsrar; Nancy S Elbarbary; Rana A ElHilaly; Yara M Refaat

2010-01-01

216

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

217

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

218

Glycemic load, glycemic index, and body mass index in Spanish adults12345  

PubMed Central

Background: Studies on obesity and glycemic index (GI) or glycemic load (GL) have had inconsistent results, perhaps in part because of underreporting or to heterogeneous dietary patterns across food cultures. Objectives: We examined associations between body mass index (BMI) and GI or GL in a Mediterranean population, accounting for underreporting. We also constructed dietary factors related to GI and GL to better understand food patterns related to these measures. Design: Cross-sectional data on 8195 Spanish adults aged 35–74 y were analyzed. A validated food-frequency questionnaire was used to estimate GI and GL, with glucose as the reference value. Reduced-rank regression was used to construct dietary patterns that explained variation in GI and GL. Multivariate linear regression was used to estimate associations between BMI and GI, GL, and their respective diet factors with and without adjusting for energy, which may lie on the causal pathway between glycemic quality and obesity. Effects of excluding underreporters (ratio of energy intake:basal metabolic rate < 1.20) were examined. Results: Food patterns underlying high GI differed substantially from those of high GL, with fruits, vegetables, and legumes related positively to GL but negatively to GI. After excluding underreporters, GL was negatively associated with BMI, adjusting for energy. GI was not associated with BMI in any model. Conclusions: After adjusting for energy, GL was associated with reduced BMI in this Mediterranean population. Underreporting did not explain this inverse relation, which was observed among subjects with plausible intakes. PMID:19056597

Mendez, Michelle A; Covas, Maria Isabel; Marrugat, Jaume; Vila, Joan; Schroder, Helmut

2009-01-01

219

Tight Glycemic Control in Intensive Care: Model-based Methods of Glycemic Control  

E-print Network

-dependent glucose removal through receptor-bound insulin Endogenous glucose production EGP Central Nervous System a TGC protocol using a virtual patient profile identified from clinical data and different insulin to 1-16U/hour #12;A bit more detail Blood Glucose G(t) Interstitial Insulin Q(t) Insulin

Sainudiin, Raazesh

220

Education on the glycemic index of foods fails to improve treatment outcomes in a behavioral weight loss program  

Microsoft Academic Search

The glycemic index (GI) may play an important role in weight management by helping to control appetite and insulin levels. The impact of adding education on the GI of foods to a behavioral weight loss program (BWLP) was examined. Fifty-three obese, sedentary participants were randomly assigned to receive either a BWLP or a BWLP+GI education. Pre- and posttreatment weight loss,

Robert A. Carels; Lynn A. Darby; Olivia M. Douglass; Holly M. Cacciapaglia; Sofia Rydin

2005-01-01

221

Archean komatiite volcanism controlled by the evolution of early continents.  

PubMed

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

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

2014-07-15

222

Translational Control of Protein Synthesis: The Early Years  

PubMed Central

For the past fifty-five years, much of my research has focused on the function and biogenesis of red blood cells, including the cloning and study of many membrane proteins such as glucose and anion transporters and the erythropoietin receptor. We have also elucidated the mechanisms of membrane insertion, folding, and maturation of many plasma membrane and secreted proteins. Despite all of this work and more, I remain extremely proud of our very early work on the regulation of mRNA translation: work on bacteriophage f2 RNA in the 1960s and on translation of ?- and ?-globin mRNAs in the early 1970s. Using techniques hopelessly antiquated by today's standards, we correctly elucidated many important aspects of translational control, and I thought readers would be interested in learning how we did these experiments. PMID:22988251

Lodish, Harvey F.

2012-01-01

223

Inhibitory Control During Emotional Distraction Across Adolescence and Early Adulthood  

PubMed Central

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 the International Affective Picture System. Longer reaction times for negative trials were found across all age groups, suggesting that negative but not positive emotional images captured attention across this age range. However, age differences in accuracy on inhibitory trials suggest that response inhibition is more readily disrupted by negative emotional distraction in early adolescence relative to late childhood, late adolescence or early adulthood. PMID:23506340

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

2013-01-01

224

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

Microsoft Academic Search

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

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

2005-01-01

225

Landslide Geohazard Monitoring, Early Warning and Stabilization Control Methods  

NASA Astrophysics Data System (ADS)

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

Bednarczyk, Zbigniew

2014-03-01

226

Increasing Evidence Links High Glycemic Index Foods and Dairy Products to Acne  

MedlinePLUS

... Evidence Links High Glycemic Index Foods and Dairy Products to Acne 2013-02-20 Medical Nutrition Therapy ... particularly from high glycemic load diets and dairy products, and that medical nutrition therapy (MNT) can play ...

227

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

Microsoft Academic Search

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

Elin M Östman

228

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

E-print Network

Abstract # 6851 Assessing the Role of Potatoes and Glycemic Index in Body Weight Management for weight loss than glycemic index, we expect no difference in body weight (BW) changes between low glycemic)]. Preliminary data indicates no significant treatment effect on body weight or composition, glucose tolerance

Heller, Barbara

229

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

Federal Register 2010, 2011, 2012, 2013

...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

230

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

Federal Register 2010, 2011, 2012, 2013

...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

231

Dietary Glycemic Load and Glycemic Index and Risk of Cerebrovascular Disease in the EPICOR Cohort  

PubMed Central

Background Studies on the association of stroke risk to dietary glycemic index (GI) and glycemic load (GL) have produced contrasting results. Objective To investigate the relation of dietary GI and GL to stroke risk in the large EPIC-Italy cohort (EPICOR) recruited from widely dispersed geographic areas of Italy. Design We studied 44099 participants (13,646 men and 30,453 women) who completed a dietary questionnaire. Multivariable Cox modeling estimated adjusted hazard ratios (HRs) of stroke with 95% confidence intervals (95%CI). Over 11 years of follow-up, 355 stroke cases (195 ischemic and 83 hemorrhagic) were identified. Results Increasing carbohydrate intake was associated with increasing stroke risk (HR?=?2.01, 95%CI?=?1.04–3.86 highest vs. lowest quintile; p for trend 0.025). Increasing carbohydrate intake from high-GI foods was also significantly associated with increasing stroke risk (HR 1.87, 95%CI?=?1.16–3.02 highest vs. lowest, p trend 0.008), while increasing carbohydrate intake from low-GI foods was not. Increasing GL was associated with significantly increasing stroke risk (HR 2.21, 95%CI?=?1.16–4.20, highest vs. lowest; p trend 0.015). Dietary carbohydrate from high GI foods was associated with increased both ischemic stroke risk (highest vs. lowest HR 1.92, 95%CI?=?1.01–3.66) and hemorrhagic stroke risk (highest vs. lowest HR 3.14, 95%CI?=?1.09–9.04). GL was associated with increased both ischemic and hemorrhagic stroke risk (HR 1.44, 95%CI?=?1.09–1.92 and HR 1.56, 95%CI?=?1.01–2.41 respectively, continuous variable). Conclusions In this Italian cohort, high dietary GL and carbohydrate from high GI foods consumption increase overall risk of stroke. PMID:23717392

Sieri, Sabina; Brighenti, Furio; Agnoli, Claudia; Grioni, Sara; Masala, Giovanna; Bendinelli, Benedetta; Sacerdote, Carlotta; Ricceri, Fulvio; Tumino, Rosario; Giurdanella, Maria Concetta; Pala, Valeria; Berrino, Franco; Mattiello, Amalia; Chiodini, Paolo; Panico, Salvatore; Krogh, Vittorio

2013-01-01

232

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

Microsoft Academic Search

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

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

2003-01-01

233

Public Health Implications of Recommendations to Individualize Glycemic Targets in Adults With Diabetes  

PubMed Central

OBJECTIVE To estimate how many U.S. adults with diabetes would be eligible for individualized A1C targets based on 1) the 2012 American Diabetes Association (ADA) guideline and 2) a published approach for individualized target ranges. RESEARCH DESIGN AND METHODS We studied adults with diabetes ?20 years of age from the National Health and Nutrition Examination Survey 2007–2008 (n = 757). We assigned A1C targets based on duration, age, diabetes-related complications, and comorbid conditions according to 1) the ADA guideline and 2) a strategy by Ismail-Beigi focused on setting target ranges. We estimated the number and proportion of adults with each A1C target and compared individualized targets to measured levels. RESULTS Using ADA guideline recommendations, 31% (95% CI 27–34%) of the U.S. adult diabetes population would have recommended A1C targets of <7.0%, and 69% (95% CI 66–73%) would have A1C targets less stringent than <7.0%. Using the Ismail-Beigi strategy, 56% (51–61%) would have an A1C target of ?7.0%, and 44% (39–49%) would have A1C targets less stringent than <7.0%. If a universal A1C <7.0% target were applied, 47% (41–54%) of adults with diabetes would have inadequate glycemic control; this proportion declined to 30% (26–36%) with the ADA guideline and 31% (27–36%) with the Ismail-Beigi strategy. CONCLUSIONS Using individualized glycemic targets, about half of U.S. adults with diabetes would have recommended A1C targets of ?7.0% but one-third would still be considered inadequately controlled. Diabetes research and performance measurement goals will need to be revised in order to encourage the individualization of glycemic targets. PMID:22961575

Laiteerapong, Neda; John, Priya M.; Nathan, Aviva G.; Huang, Elbert S.

2013-01-01

234

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

PubMed

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

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

2014-03-01

235

Case-control study of early childhood caries in Australia.  

PubMed

The aim of this case-control study of 617 children was to investigate early childhood caries (ECC) risk indicators in a non-fluoridated region in Australia. ECC cases were recruited from childcare facilities, public hospitals and private specialist clinics to source children from different socioeconomic backgrounds. Non-ECC controls were recruited from the same childcare facilities. A multinomial logistic modelling approach was used for statistical analysis. The results showed that a large percentage of children tested positive for Streptococcus mutans if their mothers also tested positive. A common risk indicator found in ECC children from childcare facilities and public hospitals was visible plaque (OR 4.1, 95% CI 1.0-15.9, and OR 8.7, 95% CI 2.3-32.9, respectively). Compared to ECC-free controls, the risk indicators specific to childcare cases were enamel hypoplasia (OR 4.2, 95% CI 1.0-18.3), difficulty in cleaning child's teeth (OR 6.6, 95% CI 2.2-19.8), presence of S. mutans (OR 4.8, 95% CI 0.7-32.6), sweetened drinks (OR 4.0, 95% CI 1.2-13.6) and maternal anxiety (OR 5.1, 95% CI 1.1-25.0). Risk indicators specific to public hospital cases were S. mutans presence in child (OR 7.7, 95% CI 1.3-44.6) or mother (OR 8.1, 95% CI 0.9-72.4), ethnicity (OR 5.6, 95% CI 1.4-22.1), and access of mother to pension or health care card (OR 20.5, 95% CI 3.5-119.9). By contrast, a history of chronic ear infections was found to be protective for ECC in childcare children (OR 0.28, 95% CI 0.09-0.82). The biological, socioeconomic and maternal risk indicators demonstrated in the present study can be employed in models of ECC that can be usefully applied for future longitudinal studies. PMID:19136829

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

2009-01-01

236

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

Microsoft Academic Search

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

ND Luscombe; M Noakes; PM Clifton

1999-01-01

237

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

Microsoft Academic Search

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

Genyi Zhang; Bruce R. Hamaker

2009-01-01

238

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

239

Does a patient-managed insulin intensification strategy with insulin glargine and insulin glulisine provide similar glycemic control as a physician-managed strategy? Results of the START (Self-Titration With Apidra to Reach Target) Study: a randomized noninferiority trial.  

PubMed

OBJECTIVE Diabetes self-management is universally regarded as a foundation of diabetes care. We determined whether comparable glycemic control could be achieved by self-titration versus physician titration of a once-daily bolus insulin dose in patients with type 2 diabetes who are unable to achieve optimal glycemia control with a basal insulin. RESEARCH DESIGN AND METHODS Patients with type 2 diabetes, an HbA1c level >7% (53 mmol/mol), and either nocturnal hypoglycemia episodes or an insufficient basal insulin glargine level (with or without oral agents) to achieve a fasting plasma glucose level ?6 mmol/L (108 mg/dL) were studied. Participants all had bolus insulin glulisine added at breakfast and were allocated to either algorithm-guided patient self-titration or physician titration. The primary outcome was an HbA1c level ?7% (53 mmol/mol) without severe hypoglycemia. RESULTS After a mean (SD) follow-up of 159.4 days (36.2 days), 28.4% of participants in the self-titration arm vs. 21.2% in the physician titration arm achieved an HbA1c level of ?7% (53 mmol/mol) without severe hypoglycemia (between-group absolute difference 7.2%; 95% CI -3.2 to 17.7). The lower end of this 95% confidence interval was within the predetermined noninferiority boundary of -5% (P noninferiority = 0.011). CONCLUSIONS In stable patients with type 2 diabetes who are receiving doses of basal insulin glargine who require bolus insulin, a simple bolus insulin patient-managed titration algorithm is as effective as a physician-managed algorithm. PMID:24170757

Harris, Stewart B; Yale, Jean-François; Berard, Lori; Stewart, John; Abbaszadeh, Babak; Webster-Bogaert, Susan; Gerstein, Hertzel C

2014-03-01

240

The goal of blood pressure control for prevention of early diabetic microvascular complications.  

PubMed

Lowering blood pressure may confer a benefit to diabetic microvascular complications comparable with glycemic control. Hypertension is causally related to kidney outcomes and is a risk factor for the development of diabetic retinopathy. The prevalence of hypertension increases as kidney disease progresses, so that it coexists with diabetes in up to 80% of those with overt nephropathy. A significant number of patients have hypertension or rising blood pressures in earlier stages, or even before microvascular complications appear. Because microalbuminuria markedly increases the risk of overt nephropathy as well as of cardiovascular complications, primary prevention (i.e., preventing or delaying the onset of microalbuminuria) continues to be explored, predominantly through use of renin-angiotensin blockade. Available data reviewed suggest that primary prevention through blood pressure reduction is more likely to benefit select groups (those with hypertension, cardiovascular risks, or old age). This review discusses the relationship between hypertension, diabetes, and kidney disease, the rationale for primary prevention, and the data that led to that conclusion. PMID:21526351

Williams, Mark E

2011-08-01

241

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

242

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

Microsoft Academic Search

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

José Galgani; Carolina Aguirre; Erik Díaz

2006-01-01

243

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

244

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; Magi, Reedik; Strawbridge, Rona J; Rehnberg, Emil; Gustafsson, Stefan; Kanoni, Stavroula; Rasmussen-Torvik, Laura J; Yengo, Loic; 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, Tonu; 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; Muller-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, Goran; 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; Lindstrom, 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; Korner, 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, Josee; 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, Ines

2012-01-01

245

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

Federal Register 2010, 2011, 2012, 2013

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

2010-09-21

246

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

ERIC Educational Resources Information Center

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

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

2001-01-01

247

Early nutritional stress impairs development of a song-control brain region in both male and  

E-print Network

Early nutritional stress impairs development of a song-control brain region in both male and female stress hypothesis predicts that early food restriction should impair development of song-control brain phase of song learning) and rapidly developing the brain regions associated with this process. Thus

Zanette, Liana

248

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

Federal Register 2010, 2011, 2012, 2013

...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

249

Glycemic index and glycemic load in relation to changes in body weight, body fat distribution, and body composition in adult Danes13  

Microsoft Academic Search

Background: A diet with a high glycemic index (GI) and glycemic load (GL) may promote overconsumption of energy and increase the risk of weight gain. Objective: The objective of the study was to investigate the relation between GI and GL of habitual diets and subsequent 6-y changes in body weight, body fat distribution, and body composition in a ran- dom

Helle Hare-Bruun; Anne Flint; Berit L Heitmann

250

Increased concentration of C-reactive protein in obese patients with type 2 diabetes is associated with obesity and presence of diabetes but not with macrovascular and microvascular complications or glycemic control.  

PubMed

The purpose of this study was to assess the concentration of C-reactive protein (CRP) in obese type 2 diabetes mellitus (DM2) patients and its association with macrovascular and microvascular complications. The study group consisted of 80 obese DM2 patients, including 20 macrovascular, 20 microvascular, 20 both macrovascular and microvascular, and 20 with no complications patients. The control group comprised 40 normoglycemic subjects--20 obese and 20 of normal body weight. Highly sensitive CRP and metabolic control parameters were assessed. CRP levels in obese diabetes subgroups and normoglycemic obese were similar and significantly higher than those in nonobese controls. No correlation was found between CRP and diabetes control parameters. There was a strong positive correlation between CRP level and body mass index in all groups. A multivariate analysis showed that DM2 and obesity are independent factors increasing CRP levels. Increased concentration of CRP in obese DM2 patients is related to obesity and diabetes itself. The lack of association between CRP and vascular complications remains unclear. PMID:24197824

Fronczyk, Aneta; Mol?da, Piotr; Safranow, Krzysztof; Piechota, Wies?aw; Majkowska, Lilianna

2014-04-01

251

Low glycemic index lunch on satiety in overweight and obese people with type 2 diabetes.  

PubMed

Several studies have shown that isocaloric diets have different effects on satiety. The aim of the present study was to compare the effect of lunches with different glycemic indexes (GI) in type 2 diabetics. Ten men and women with type 2 diabetes participated in the study. Subjects were given two experimental lunches with glycemic indexes of 43 and 88. Visual analogue rating scales were completed before and after each experimental meal periodically to record subjective feelings of satiety. Satiety Area Under the Curve was 1024 +/- 160 mm after the low GI diet and 711 +/- 190 mm after the high GI diet. Eating a lunch with a low GI index resulted in higher satiety perception. These results suggest the need to promote culturally based combined foods with high fiber and low GI. This approach might contribute to the prevention of obesity by increasing the perception of satiety while also improving metabolic control of diabetics. In addition, this is a low cost approach for people with limited financial resources. PMID:16229403

Jiménez-Cruz, A; Gutiérrez-González, Aaron Noriki; Bacardi-Gascon, M

2005-01-01

252

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

253

Properties of starch from potatoes differing in glycemic index.  

PubMed

Potatoes are a popular source of dietary carbohydrate worldwide and are generally considered to be a high glycemic index (GI) food. Potato starch characteristics play a key role in determining their rate of digestion and resulting glycemic response. Starches isolated from seven potato cultivars with different GI values, including a low GI cultivar (Carisma), were examined for relative crystallinity, granule size distribution, amylopectin chain length, and thermal and pasting properties. Starch from the Carisma cultivar was more thermally stable and more resistant to gelatinization, with significantly higher (p < 0.05) pasting temperature and differential scanning calorimetry (DSC) gelatinization onset, peak and conclusion temperatures, compared to the other cultivars. Differences between the potatoes in the other properties measured did not align with the GI ranking. Thermal analysis and starch pasting properties may be useful indicators for preliminary identification of potato cultivars that are digested slowly and have a lower GI. PMID:25124366

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

2014-10-24

254

Long-term effects of provided low & high glycemic load low energy diets on mood and cognition  

PubMed Central

Energy-restricted low glycemic load diets are being used increasingly for weight loss. However, the long-term effects of such regimens on mood and cognitive performance are not known. We assessed the effects of low glycemic load (LG) and high glycemic load (HG) energy-restricted diets on mood and cognitive performance during 6 months of a randomized controlled trial when all food was provided. Subjects were 42 healthy overweight adults (age 35 ± 5 y; BMI 27.8 ± 1.6 kg/m2) with a mean weight loss of 8.7 ± 5.0% that did not differ significantly by diet randomization. Mood was assessed by using the Profile of Mood States (POMS) questionnaire. Cognitive performance was assessed by using computerized tests of simple reaction time, vigilance, learning, short-term memory and attention, and language-based logical reasoning. Worsening mood outcome over time was observed in the HG diet group compared to the LG for the depression subscale of POMS (P=0.009 after including hunger as a covariate). There was no significant change over time in any cognitive performance values. These findings suggest a negative effect of an HG weight loss diet on sub-clinical depression but, in contrast to a previous suggestion, provide no support for differential effects of LG versus HD diets on cognitive performance. PMID:19576915

Cheatham, Rachel A.; Roberts, Susan B.; Das, Sai Krupa; Gilhooly, Cheryl H.; Golden, Julie K.; Hyatt, Raymond; Lerner, Debra; Saltzman, Edward; Lieberman, Harris R.

2009-01-01

255

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

256

Dietary glycemic index and liver steatosis1-3  

Microsoft Academic Search

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

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

257

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

258

Dietary glycemic index and the regulation of body weight  

Microsoft Academic Search

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

David S. Ludwig

2003-01-01

259

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

260

CNX-012-570, a direct AMPK activator provides strong glycemic and lipid control along with significant reduction in body weight; studies from both diet-induced obese mice and db/db mice models  

PubMed Central

Objectives AMP activated protein kinase (AMPK) regulates the coordination of anabolic and catabolic processes and is an attractive therapeutic target for T2DM, obesity and metabolic syndrome. We report the anti-hyperglycemic and anti-hyperlipidemic effects of CNX-012-570 is an orally bioavailable small molecule (molecular weight of 530 Daltons) that directly activates AMPK in DIO and db/db animal models of diabetes. Methods Activity and efficacy of the compound was tested in cell based as well as cell free systems in vitro. Male C57BL/6 mice fed with high fat diet (HFD) were assigned to either vehicle or CNX-012-570 (3 mg/kg, orally once a day) for 8 weeks (n?=?8). Genetically diabetic db/db mice on chow diet were dosed with vehicle control or CNX-012-570 (2.5 mg/kg, orally once a day) for 6 weeks (n?=?8). Results CNX-012-570 is a highly potent and orally bioavailable compound activating AMPK in both cell and cell free systems. It inhibits lipolysis (33%) and gluconeogenesis (28%) in 3T3L1 cells and rat primary hepatocytes respectively. The efficacy of the molecule was translated to both DIO and db/db animal models of diabetes. CNX-012-570 has reduced fasting blood glucose levels by 14%, body weight by 24% and fasting serum triglycerides (TG) by 24%. CNX-012-570 showed a 22% reduction in fed serum cholesterol levels and 19% increase in HDL levels. In db/db mice model, CNX-012-570 has shown 18% decrease in fed glucose and 32% decrease in fasting glucose with a 2.57% reduction in absolute HbA1c. Decrease in serum insulin and glucose AUC indicates the increased insulin sensitivity. Body weight was reduced by 13% with increased browning of adipose tissue and decreased inguinal and mesenteric fat mass. There was significant reduction in liver TG and liver total cholesterol. Conclusions CNX-012-570 has the potential to control hyperglycemia and hyperlipidemia. It also reduces body weight gain with an additional benefit of minimizing cardiovascular risks in diabetics. PMID:24460834

2014-01-01

261

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.

262

Time-Driven Early Discard (TED) to Improve the Fairness of TCP Congestion Control  

E-print Network

Time-Driven Early Discard (TED) to Improve the Fairness of TCP Congestion Control Mario Baldi adaptive AQM (advanced queue management) approach called Time-Driven Early Discard (TED). The basic. TED is shown to improve fairness among TCP connections sharing congested links when the deadline

Baldi, Mario

263

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

E-print Network

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

Ahringe, Julie

264

Effect of controlled co-delivery of synergistic neurotrophic factors on early nerve regeneration in rats  

Microsoft Academic Search

Present interventions to repair severed peripheral nerves provide slow and poor early axonal regeneration, which may cause unsatisfactory functional reinnervation. To improve early axonal regeneration in a 10 mm rat sciatic nerve gap model, we developed collagen nerve conduits loaded with the synergistically acting glial cell line-derived neurotrophic factor (GDNF) and nerve growth factor (NGF). For controlling the concomitant GDNF and

Srinivas Madduri; Pietro di Summa; Michaël Papaloïzos; Daniel Kalbermatten; Bruno Gander

2010-01-01

265

Parental Attachment, Parental Control, and Early Development of Alcohol Use: A Longitudinal Study  

Microsoft Academic Search

The authors explored the predictive influence of both parental attachment and parental control on early onset of alcohol consumption in adolescence by use of a longitudinal sample of 1,012 young adolescents. Whether the relationship between parental control and adolescents' drinking is moderated by parental attachment was also examined. Consistent with other studies, attachment and strict control were cross-sectionally related to

Haske van der Vorst; Rutger C. M. E. Engels; Wim Meeus; Maja Dekovi?; Ad Vermulst

2006-01-01

266

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, Ramon

2013-01-01

267

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

ERIC Educational Resources Information Center

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

Stephens, Mark W.

268

Early Indications of Future Cognitive Decline: Stable versus Declining Controls  

PubMed Central

This study aimed to identify baseline features of normal subjects that are associated with subsequent cognitive decline. Publicly available data from the Alzheimer’s Disease Neuroimaging Initiative was used to find differences in baseline clinical assessments (ADAScog, AVLT, FAQ) between cognitively healthy individuals who will suffer cognitive decline within 48 months and those who will remain stable for that period. Linear regression models indicated an individual’s conversion status was significantly associated with certain baseline neuroimaging measures, including posterior cingulate glucose metabolism. Linear Discriminant Analysis models built with baseline features derived from MRI and FDG-PET measures were capable of successfully predicting whether an individual will convert to MCI within 48 months or remain cognitively stable. The findings from this study support the idea that there exist informative differences between normal people who will later develop cognitive impairments and those who will remain cognitively stable for up to four years. Further, the feasibility of developing predictive models that can detect early states of cognitive decline in seemingly normal individuals was demonstrated. PMID:24040166

Rizk-Jackson, Angela; Insel, Philip; Petersen, Ronald; Aisen, Paul; Jack, Clifford; Weiner, Michael

2013-01-01

269

Controls on development and diversity of Early Archean stromatolites.  

PubMed

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

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

2009-06-16

270

Controls on development and diversity of Early Archean stromatolites  

PubMed Central

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

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

2009-01-01

271

Role of proteins in insulin secretion and glycemic control.  

PubMed

Dietary proteins are essential for the life of all animals and humans at all stages of the life cycle. They serve many structural and biochemical functions and have significant effects on health and wellbeing. Dietary protein consumption has shown an upward trend in developed countries in the past two decades primarily due to greater supply and affordability. Consumption is also on the rise in developing countries as affluence is increasing. Research shows that proteins have a notable impact on glucose homeostasis mechanisms, predominantly through their effects on insulin, incretins, gluconeogenesis, and gastric emptying. Since higher protein consumption and impaired glucose tolerance can be commonly seen in the same population demographics, a thorough understanding of the former's role in glucose homeostasis is crucial both toward the prevention and management of the latter. This chapter reviews the current state of the art on proteins, amino acids, and their effects on blood glucose and insulin secretion. PMID:23722093

Ranawana, Viren; Kaur, Bhupinder

2013-01-01

272

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

273

Gait control and executive dysfunction in early schizophrenia.  

PubMed

Dysexecutive functioning, which is described as an enduring core feature of schizophrenia, has been associated with gait disorders. However, few studies have reported gait disorders in schizophrenia patients. The objective of this study was to examine the association between executive dysfunction and gait performance in recent-onset schizophrenia patients using the dual task paradigm. Thirty-two subjects participated to the study: 17 with recent-onset schizophrenia and 15 healthy age-matched controls. Executive functions were evaluated using the Frontal Assessment Battery, Stroop and Trail-Making tests. Mean values and coefficients of variation (CV) of the temporal gait parameters while single tasking (just walking) and while dual tasking (walking and forward counting, walking and backward counting, walking and verbal fluency) were measured using the SMTEC(®)-footswitch system. We focused on the CV of stride time as this measure has been shown to be the most representative parameter of higher gait control. A strong effect of the stride time was found in the group factor for the verbal fluency dual-task when compared to controls (Cohen's d mean = 1.28 and CV = 1.05). The effect was lower in the other dual tasks, and insignificant in the single task of walking. This study shows that patients exhibit higher stride-to-stride variability while dual tasking than controls. It also shows a stronger impact of verbal fluency on gait regularity compared to the other dual tasks revealing a relationship between the executive dysfunction and gait modification. Those results are in line with the idea that schizophrenia implies not only cognitive but also motor functioning and coordination impairment. PMID:24201834

Lallart, Elise; Jouvent, Roland; Herrmann, François R; Perez-Diaz, Fernando; Lallart, Xavier; Beauchet, Olivier; Allali, Gilles

2014-04-01

274

Motivational Interviewing Early After Acute Stroke A Randomized, Controlled Trial  

Microsoft Academic Search

Background and Purpose—The purpose of this study was to determine whether motivational interviewing, a patient- centered counseling technique, can benefit patients' mood 3 months after stroke. Methods—A single-center, open, randomized, controlled trial was conducted at a single hospital with a stroke unit. Subjects consisted of 411 consecutive patients on the stroke register who were over 18 years of age and

Caroline L. Watkins; Malcolm F. Auton; Carol F. Deans; Hazel A. Dickinson; Cathy I. A. Jack; C. Elizabeth Lightbody; Christopher J. Sutton; Martin D. van den Broek; Michael J. Leathley

275

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

276

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

ERIC Educational Resources Information Center

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

Bedel, Emine Ferda

2012-01-01

277

TEMPORAL AND SPATIAL CONTROL OF RNA STABILITY IN THE EARLY EMBRYO OF DROSOPHILA MELANOGASTER  

E-print Network

TEMPORAL AND SPATIAL CONTROL OF RNA STABILITY IN THE EARLY EMBRYO OF DROSOPHILA MELANOGASTER Thesis controls the timing of maternal transcript elimination at the midblastula transition in Drosophila melanogaster Appendix 1: Mammalian NUMB is an evolutionarily conserved signaling adapter protein that specifies

Winfree, Erik

278

Entropy Controlled Gauss-Markov Random Measure Field Models for Early Vision  

E-print Network

Field model. Our proposal introduces an explicit entropy control for the estimated posterior marginals function; therefore, one can compute very efficiently the optimal (Maximizer of the Posterior MarginalsEntropy Controlled Gauss-Markov Random Measure Field Models for Early Vision Mariano Rivera, Omar

Rivera, Mariano

279

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

280

Impact of Sleep Duration on Obesity and the Glycemic Level in Patients With Type 2 Diabetes  

PubMed Central

OBJECTIVE Few studies are currently available regarding the influence of sleep duration on glycemic control in diabetic patients. The objective of the current study was to examine the relationship between sleep duration, obesity, and the glycemic level in type 2 diabetic patients. RESEARCH DESIGN AND METHODS A total of 4,870 Japanese type 2 diabetic patients aged ?20 years were divided into six groups according to their self-reported sleep duration: less than 4.5 h, 4.5–5.4 h, 5.5–6.4 h, 6.5–7.4 h, 7.5–8.4 h, and more than 8.5 h. The associations of sleep duration with obesity and the HbA1c levels were examined in a cross-sectional manner. RESULTS The HbA1c levels showed a quadratic association with sleep duration; namely, a shorter or longer sleep duration was associated with a higher level compared with a sleep duration of 6.5–7.4 h (P for quadratic trend <0.001). This association remained significant after adjusting for potential confounders, including the total energy intake and depressive symptoms. Furthermore, additional adjustments for obesity, which also showed a U-shaped relationship with sleep duration, did not attenuate the U-shaped sleep-HbA1c association. A significant interaction between sleep duration and age or the use of insulin was observed for the HbA1c levels. CONCLUSIONS Sleep duration was shown to have U-shaped associations with obesity and the HbA1c levels in type 2 diabetic patients, independent of potential confounders, and therefore may be an important modifiable factor for the clinical management of patients with type 2 diabetes. PMID:23150286

Ohkuma, Toshiaki; Fujii, Hiroki; Iwase, Masanori; Kikuchi, Yohei; Ogata, Shinako; Idewaki, Yasuhiro; Ide, Hitoshi; Doi, Yasufumi; Hirakawa, Yoichiro; Nakamura, Udai; Kitazono, Takanari

2013-01-01

281

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

PubMed Central

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

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

2013-01-01

282

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

PubMed Central

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

2014-01-01

283

A review of "Control of Religious Printing in Early Stuart England." by S. Mutchow Towers  

E-print Network

tradition of love imagery that the book precisely does not address. S. Mutchow Towers. Control of Religious Printing in Early Stuart England. Woodbridge, U.K.: The Boydell Press, 2003. viii + 296 pp. $75.00. Review by STEVEN MATTHEWS, THE UNIVERSITY... tradition of love imagery that the book precisely does not address. S. Mutchow Towers. Control of Religious Printing in Early Stuart England. Woodbridge, U.K.: The Boydell Press, 2003. viii + 296 pp. $75.00. Review by STEVEN MATTHEWS, THE UNIVERSITY...

Steven Matthews

2004-01-01

284

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

Microsoft Academic Search

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

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

2007-01-01

285

Glycemic variability in nondiabetic morbidly obese persons: results of an observational study and review of the literature.  

PubMed

Glycemic variability (GV) is correlated with oxidative stress which may lead to increased cardiovascular risk and poor clinical outcomes in people with prediabetes and diabetes. We sought to understand whether morbidly obese persons without diabetes by standard criteria have dysglycemia as measured by GV. We performed an observational study of GV metrics and carotid intima media thickness (CIMT) in 21 morbidly obese normoglycemic and 15 morbidly obese prediabetic applicants to The Biggest Loser television show. The results were compared to previously published studies in normoglycemic nonobese and obese individuals. Glucose was measured with a masked continuous glucose monitor (CGM) over 3 to 8 days and carotid intima media thickness (CIMT) was determined by ultrasound. CGM-derived GV metrics for GV were coefficient of variation (CV), standard deviation (SD), mean amplitude of glycemic excursions (MAGE), continuous overall net glycemic action-1 hour (CONGA1), and mean of daily differences (MODD). We found that morbidly obese subjects (n = 21) who were normoglycemic by standard criteria had higher GV (CV = 22%, SD = 24.2 mg/dl and MAGE = 48.6 mg/dl) than previous reports of normoglycemic, nonobese individuals (CV = 12-18%, SD = 11.5-15.0 mg/dl, and MAGE = 26.3-28.3 mg/dl). Morbidly obese prediabetic subjects (n = 15) had GV metrics indistinguishable from those morbidly obese subjects who were normoglycemic. CIMT was higher in both morbidly obese groups compared with historical age- and sex-matched controls. Normoglycemic and prediabetic morbidly obese individuals have higher GV compared with normal weight, nondiabetic individuals. We speculate that this may increase the risk for macrovascular disease through excessive oxidative stress. PMID:24876453

Salkind, Sara J; Huizenga, Robert; Fonda, Stephanie J; Walker, M Susan; Vigersky, Robert A

2014-09-01

286

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

287

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

ERIC Educational Resources Information Center

The relations among infant anger reactivity, approach behavior, and frontal electroencephalogram (EEG) asymmetry, and their relations to inhibitory control and behavior problems in early childhood were examined within the context of a longitudinal study of temperament. Two hundred nine infants' anger expressions to arm restraint were observed at 4…

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

2010-01-01

288

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

Microsoft Academic Search

Rapid expansion of leaves of early-stage plants in wheat produced by chromosomal control of characteristics related to rapid expansion of the first six leaves of wheat were investigated using a set of single chromosome substitution lines under two different temperature regimes (TRs). Results from this study indicated that several chromosomes could be responsible for each of the four characteristics studied

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

2011-01-01

289

A controlled trial of anti-tuberculosis chemotherapy in the early complicated pneumoconiosis of coalworkers  

Microsoft Academic Search

A controlled trial in coalminers under the age of 50 in South Wales with sputum-negative, early complicated pneumoconiosis was used to compare three regimes: (1) chemotherapy (rest in hospital and 1 g. streptomycin, 200 mg. INH, 10 g. PAS, for 3 months; then 200 mg. INH, 10 g. PAS for 9 months); (2) rest (in hospital for 3 months); and

J. D. Ball; G. Berry; W. G. Clarke; J. C. Gilson; J. Thomas; Catherine Exall; Marjorie Roberts

1969-01-01

290

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

291

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

292

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

293

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

E-print Network

Insulin resistance (IR) reduces glucose uptake and leads to elevated glucose levels (EGL). Foods that limit postprandial glycemic response (PPGR) and exercising can help limit these EGL. 25 subjects consumed 6 different ...

Fletcher, Justin Andrew

2010-07-26

294

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

Microsoft Academic Search

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

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

2004-01-01

295

Dietary carbohydrate, glycemic index, glycemic load, and risk of prostate cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort  

Microsoft Academic Search

Objective  To evaluate the associations between dietary carbohydrate, glycemic index (GI), glycemic load (GL), and incident prostate\\u000a cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Between September 1993 and September 2000, 38,343 men were randomized to the screening arm of the trial at one of 10 PLCO\\u000a centers. A food frequency questionnaire administered at baseline assessed

James M. Shikany; Andrew P. Flood; Cari M. Kitahara; Ann W. Hsing; Tamra E. Meyer; Bradley J. Willcox; David T. Redden; Regina G. Ziegler

2011-01-01

296

Predicting individual differences in low-income children's executive control from early to middle childhood.  

PubMed

The present longitudinal study tested the roles of early childhood executive control (EC) as well as exposure to poverty-related adversity at family and school levels as key predictors of low-income children's EC in elementary school (n = 391). Findings suggest that children's EC difficulties in preschool and lower family income from early to middle childhood are robust predictors of later EC difficulties as rated by teachers in 2nd and 3rd grades. Findings also suggest enrollment in unsafe elementary schools is significantly predictive of higher levels of teacher-rated EC difficulty, but only for those children who showed initially elevated levels of EC difficulty in early childhood. Implications for scientific models of cognitive development and poverty-related adversity are discussed. PMID:23587038

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

2013-05-01

297

Early pregnancy peripheral blood gene expression and risk of preterm delivery: a nested case control study  

PubMed Central

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 at 16 weeks gestational age) from 14 women who had PTD (cases) and 16 women who delivered at term (controls). Gene expressions were measured using the GeneChip® Human Genome U133 Plus 2.0 Array. Student's T-test and fold change analysis were used to identify differentially expressed genes. We used hierarchical clustering and principle components analysis to characterize signature gene expression patterns among cases and controls. Pathway and promoter sequence analyses were used to investigate functions and functional relationships as well as regulatory regions of differentially expressed genes. Results A total of 209 genes, including potential candidate genes (e.g. PTGDS, prostaglandin D2 synthase 21 kDa), were differentially expressed. A set of these genes achieved accurate pre-diagnostic separation of cases and controls. These genes participate in functions related to immune system and inflammation, organ development, metabolism (lipid, carbohydrate and amino acid) and cell signaling. Binding sites of putative transcription factors such as EGR1 (early growth response 1), TFAP2A (transcription factor AP2A), Sp1 (specificity protein 1) and Sp3 (specificity protein 3) were over represented in promoter regions of differentially expressed genes. Real-time PCR confirmed microarray expression measurements of selected genes. Conclusions PTD is associated with maternal early pregnancy peripheral blood gene expression changes. Maternal early pregnancy peripheral blood gene expression patterns may be useful for better understanding of PTD pathophysiology and PTD risk prediction. PMID:20003277

2009-01-01

298

Job demands and job control as correlates of early retirement thoughts in Finnish social and health care employees  

Microsoft Academic Search

Given the ageing workforce, there is an increasing interest in understanding the retirement process. This study examined whether early retirement thoughts can be explained by job demands, job control and their interaction, a hypothesis derived from the job demand-control model of Karasek (1979). The moderated hierarchical regression analyses of early retirement thoughts were based on a sample of 274 male

Marko Elovainio; Pauli Forma; Mika Kivimäki; Timo Sinervo; Risto Sutinen; Marjukka Laine

2005-01-01

299

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

Microsoft Academic Search

The purpose of this research was to examine the role that young children's same-sex peer interactions play in influencing early school competence. The authors also examined the degree to which effortful control (EC) moderated these relations. The same-sex play preferences of 98 young children (50 boys and 48 girls; mean age = 54.77 months) were observed during the fall semester.

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

2003-01-01

300

Genes as Early Responders Regulate Quorum-Sensing and Control Bacterial Cooperation in Pseudomonas aeruginosa  

PubMed Central

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

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

2014-01-01

301

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

302

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

303

Randomised controlled trial of the Lidcombe programme of early stuttering intervention  

PubMed Central

Objectives To evaluate the efficacy of the Lidcombe programme of early stuttering intervention by comparison to a control group. Design A pragmatic, open plan, parallel group, randomised controlled trial with blinded outcome assessment. Setting Two public speech clinics in New Zealand. Participants Stuttering preschool children who presented to the speech clinics for treatment. Inclusion criteria were age 3-6 years and frequency of stuttering of at least 2% syllables stuttered. Exclusion criteria were onset of stuttering during the six months before recruitment and treatment for stuttering during the previous 12 months. 54 participants were randomised: 29 to the Lidcombe programme arm and 25 to the control arm. 12 of the participants were girls. Intervention Lidcombe programme of early stuttering intervention. Main outcome measures Frequency of stuttering was measured as the proportion of syllables stuttered, from audiotaped recordings of participants' conversational speech outside the clinic. Parents in both arms of the trial collected speech samples in three different speaking situations before randomisation and at three, six, and nine months after randomisation. Results Analysis showed a highly significant difference (P = 0.003) at nine months after randomisation. The mean proportion of syllables stuttered at nine months after randomisation was 1.5% (SD 1.4) for the treatment arm and 3.9% (SD 3.5) for the control arm, giving an effect size of 2.3% of syllables stuttered (95% confidence interval 0.8 to 3.9). This effect size was more than double the minimum clinically worthwhile difference specified in the trial protocol. Conclusions The results provide evidence from a randomised controlled trial to support early intervention for stuttering. The Lidcombe programme is an efficacious treatment for stuttering in children of preschool age. PMID:16096286

Jones, Mark; Onslow, Mark; Packman, Ann; Williams, Shelley; Ormond, Tika; Schwarz, Ilsa; Gebski, Val

2005-01-01

304

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

PubMed

In this study, extracts of plant species from the Cerrado biome were assessed in order to find potential inhibitors of human salivary alpha-amylase. The plants were collected and extracts were obtained from leaves, bark, and roots. We performed a preliminary phytochemical analysis and a screening for salivar alpha-amylase inhibitory activity. Only three botanical families (Sapotaceae, Sapindaceae and Flacourtiaceae) and 16 extracts showed a substantial inhibition (>75%) of alpha-amylase. The ethanolic extracts of Pouteria ramiflora obtained from stem barks and root barks decreased amylolytic activity above 95% at a final concentration of 20 µg/mL. Thus, adult male Swiss mice were treated orally with P. ramiflora in acute toxicity and glycemic control studies. Daily administration with 25, 50 and 100 mg/kg of aqueous extract of P. ramiflora for eight days can reduce significantly body weight and blood glucose level in mice. These data suggest that the crude polar extract of P. ramiflora decreases salivary amylolytic activity while lowering the blood levels of glucose. PMID:24068095

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

2013-09-01

305

Linking tobacco control policies and practices to early cancer endpoints: surveillance as an agent for change.  

PubMed

State tobacco control programs provide an important laboratory for the development, implementation, and evaluation of comprehensive tobacco control interventions. Studies have shown that states and municipalities with aggressive tobacco control programs have experienced more rapid decreases in per capita cigarette sales, smoking prevalence, lung cancer, and heart disease than entities without such programs. Despite strong evidence that population-level interventions are critical in achieving large and sustained reductions in tobacco use, states do not fund tobacco control efforts at levels recommended by the Centers for Disease Control and Prevention. Research on the effectiveness and cost effectiveness of these activities is essential to inform and strengthen tobacco control at the state level. A workshop, co-organized by the American Cancer Society, the National Cancer Institute, the American Association for Cancer Research, and the Centers for Disease Control and Prevention, was held in Philadelphia in December, 2007, to discuss the topic "Linking tobacco control policies and practices to early cancer endpoints: surveillance as an agent for change." Participants represented three different disciplines. Tobacco surveillance researchers described the data currently collected on state-level tobacco control policies, protobacco countermeasures by the industry, public attitudes toward tobacco use, and measures of smoking prevalence and consumption. Cancer registry experts described the geographic coverage of high quality, population-based cancer registries. Mathematical modeling experts discussed various modeling approaches that can be used to relate upstream tobacco promotion and control activities to downstream measures such as public attitudes, changes in tobacco use, and trends in tobacco-related diseases. The most important recommendation of the Workshop was a call for national leadership to enhance the collection and integration of data from multiple sources as a resource to further study and strengthen the scientific basis for tobacco control. PMID:18768485

Hartman, Anne M; Thun, Michael J; Ballard-Barbash, Rachel

2008-09-01

306

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

PubMed Central

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

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

1978-01-01

307

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

PubMed Central

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

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

2014-01-01

308

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

PubMed

The transcription factor POU5f1/OCT4 controls pluripotency in mammalian ES cells, but little is known about its functions in the early embryo. We used time-resolved transcriptome analysis of zebrafish pou5f1 MZspg mutant embryos to identify genes regulated by Pou5f1. Comparison to mammalian systems defines evolutionary conserved Pou5f1 targets. Time-series data reveal many Pou5f1 targets with delayed or advanced onset of expression. We identify two Pou5f1-dependent mechanisms controlling developmental timing. First, several Pou5f1 targets are transcriptional repressors, mediating repression of differentiation genes in distinct embryonic compartments. We analyze her3 gene regulation as example for a repressor in the neural anlagen. Second, the dynamics of SoxB1 group gene expression and Pou5f1-dependent regulation of her3 and foxD3 uncovers differential requirements for SoxB1 activity to control temporal dynamics of activation, and spatial distribution of targets in the embryo. We establish a mathematical model of the early Pou5f1 and SoxB1 gene network to demonstrate regulatory characteristics important for developmental timing. The temporospatial structure of the zebrafish Pou5f1 target networks may explain aspects of the evolution of the mammalian stem cell networks. PMID:20212526

Onichtchouk, Daria; Geier, Florian; Polok, Bozena; Messerschmidt, Daniel M; Mössner, Rebecca; Wendik, Björn; Song, Sungmin; Taylor, Verdon; Timmer, Jens; Driever, Wolfgang

2010-01-01

309

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

NASA Astrophysics Data System (ADS)

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

Kruse, K.; Tice, M. M.

2013-12-01

310

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

311

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

NASA Technical Reports Server (NTRS)

A study was performed to determine the vibration and attitude control characteristics of critical space station configurations featuring early manned capability during buildup from initial user support through the operations capability reference station. Five configurations were selected and were examined thus determining the changes that are likely to occur in the characteristics of the system as the station progresses from a single boom structure to a mature, dual keel, operations capability reference station. Both 9 foot and 5 meter truss bay sizes were investigated. All configurations analyzed were stable; however, the 5 meter truss bay size structure exhibited superior stability characteristics.

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

1987-01-01

312

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

Microsoft Academic Search

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

Yvonne Granfeldt; Ann-Charlott Eliasson; Inger Bjorck

313

Influence of two breakfast meals differing in glycemic load on satiety, hunger, and energy intake in preschool children  

Microsoft Academic Search

BACKGROUND: Glycemic load (GL) is the product of glycemic index of a food and amount of available carbohydrate in that food divided by 100. GL represents quality and quantity of dietary carbohydrate. Little is known about the role of GL in hunger, satiety, and food intake in preschool children. The aim of this study was to investigate the effect of

Alison LaCombe; Vijay Ganji

2010-01-01

314

Linking tobacco control policies and practices to early cancer endpoints: Surveillance as an agent for change  

PubMed Central

State tobacco control programs provide an important laboratory for the development, implementation, and evaluation of comprehensive tobacco control interventions. Studies have demonstrated that states and municipalities with aggressive tobacco control programs have experienced more rapid decreases in per capita cigarette sales, smoking prevalence, lung cancer, and heart disease than entities without such programs. Despite strong evidence that population-level interventions are critical in achieving large and sustained reductions in tobacco use, states do not fund tobacco control efforts at levels recommended by the CDC. Research on the effectiveness and cost-effectiveness of these activities is essential to inform and strengthen tobacco control at the state-level. A workshop, co-organized by ACS, NCI, AACR, and CDC, was held in Philadelphia in December, 2007 to discuss the topic “Linking tobacco control policies and practices to early cancer endpoints: Surveillance as an agent for change”. Participants represented three different disciplines. Tobacco surveillance researchers described the data currently collected on state-level tobacco control policies, pro-tobacco countermeasures by the industry, public attitudes towards tobacco use and measures of smoking prevalence and consumption. Cancer registry experts described the geographic coverage of high quality, population-based cancer registries. Mathematical modeling experts discussed various modeling approaches that can be used to relate upstream tobacco promotion and control activities to downstream measures such as public attitudes, changes in tobacco use, and trends in tobacco-related diseases. The most important recommendation of the Workshop was a call for national leadership to enhance the collection and integration of data from multiple sources as a resource to further study and strengthen the scientific basis for tobacco control. PMID:18768485

Hartman, Anne M.; Thun, Michael J.; Ballard-Barbash, Rachel

2009-01-01

315

Temporally Dissociable Mechanisms of Self-Control: Early Attentional Filtering Versus Late Value Modulation  

PubMed Central

Optimal decision-making often requires exercising self-control. A growing fMRI literature has implicated the dorsolateral prefrontal cortex (dlPFC) in successful self-control, but due to the limitations inherent in BOLD measures of brain activity, the neurocomputational role of this region has not been resolved. Here we exploit the high temporal resolution and whole-brain coverage of event-related potentials (ERPs) to test the hypothesis that dlPFC affects dietary self-control through two different mechanisms: attentional filtering and value modulation. Whereas attentional filtering of sensory input should occur early in the decision process, value modulation should occur later on, after the computation of stimulus values begins. Hungry human subjects were asked to make food choices while we measured neural activity using ERP in a natural condition, in which they responded freely and did not exhibit a tendency to regulate their diet, and in a self-control condition, in which they were given a financial incentive to lose weight. We then measured various neural markers associated with the attentional filtering and value modulation mechanisms across the decision period to test for changes in neural activity during the exercise of self-control. Consistent with the hypothesis, we found evidence for top-down attentional filtering early on in the decision period (150–200 ms poststimulus onset) as well as evidence for value modulation later in the process (450–650 ms poststimulus onset). We also found evidence that dlPFC plays a role in the deployment of both mechanisms. PMID:24285897

Hare, Todd; Rangel, Antonio

2013-01-01

316

Abnormal susceptibility to distracters hinders perception in early stage Parkinson's disease: a controlled study  

PubMed Central

Background One of the perceptual abnormalities observed in Parkinson's disease (PD) is a deficit in the suppression of reflexive saccades that are automatically triggered by the onset of a peripheral target. Impairment of substantia nigra function is thought to lead to this reduced ability to suppress reflexive saccades. Methods The present study examined whether this perceptual deficit is also present in early stage PD when using hardly noticeable task-irrelevant stimuli. Eleven non-demented de novo, untreated PD patients (mean age 57 yr, range 44 – 70) participated in the study as well as 12 age-matched controls. Performance on an 'oculomotor capture' task, in which in half of the trials an irrelevant stimulus with sudden onset was added to the display, was compared between patients and controls. Analysis of variance (ANOVA) was performed with group (patients/controls) and age (< 61 yrs/? 61 yrs) as independent factors and type of trial (control/distracter) as repeated measurements factor. The factor sex was used as covariate. Results With respect to Reaction Time (RT), a significant interaction between group and condition was found. RTs increased under the 'irrelevant stimulus' condition in both groups, the patients exhibiting a significantly larger increase in RTs than the control group. Also, a significant interaction effect between group and condition for number of correct responses was found. The number of correct responses was reduced in the onset distracter condition, the reduction being larger in the patients. In the patient group, contrary to the control group, a higher age was associated with fewer correct responses at baseline and in the onset distracter condition, suggesting that perceptual functions in PD are highly susceptible to the effects of ageing. The increased reaction times and larger number of incorrect responses of the PD patients in the onset distracter condition may be related to impairments of substantia nigra function and lower brain stem. Conclusion The capture task seems to be a sensitive instrument to detect early perceptual deficits in PD. The magnitude of the observed deficits suggests that perceptual functions in early stage PD are so substantially impaired that this may interfere with daily activities. PMID:17156486

Deijen, Jan Berend; Stoffers, Diederick; Berendse, Henk W; Wolters, Erik Ch; Theeuwes, Jan

2006-01-01

317

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

318

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

319

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

320

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

321

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

NASA Astrophysics Data System (ADS)

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

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

2011-03-01

322

Early intervention in panic: randomized controlled trial and cost-effectiveness analysis  

PubMed Central

Background Panic disorder (PD) is a common, severe and persistent mental disorder, associated with a high degree of distress and occupational and social disability. A substantial proportion of the population experiences subthreshold and mild PD and is at risk of developing a chronic PD. A promising intervention, aimed at preventing panic disorder onset and reducing panic symptoms, is the 'Don't Panic' course. It consists of eight sessions of two hours each. The purpose of this study is to evaluate the effectiveness of this early intervention – based on cognitive behavioural principles – on the reduction of panic disorder symptomatology. We predict that the experimental condition show superior clinical and economic outcomes relative to a waitlisted control group. Methods/design A pragmatic, pre-post, two-group, multi-site, randomized controlled trial of the intervention will be conducted with a naturalistic follow-up at six months in the intervention group. The participants are recruited from the general population and are randomized to the intervention or a waitlist control group. The intervention is offered by community mental health centres. Included are people over 18 years of age with subthreshold or mild panic disorder, defined as having symptoms of PD falling below the cut-off of 13 on the Panic Disorder Severity Scale-Self Report (PDSS-SR). Primary outcomes are panic disorder and panic symptoms. Secondary outcomes are symptoms of agoraphobia, anxiety, cognitive aspects of panic disorder, depressive symptoms, mastery, health-related quality of life, and cost-effectiveness. We will examine the following variables as potential mediators: cognitive aspects of panic disorder, symptoms of agoraphobia, anxiety and mastery. Potential moderating variables are: socio-demographic characteristics, panic disorder, agoraphobia, treatment credibility and mastery. Discussion This study was designed to evaluate the (cost) effectiveness of an early intervention based on cognitive behavioural principles. The strong external validity is one of the strengths of the study design. Trial registration Current Controlled Trials ISRCTN33407455. PMID:19038038

Meulenbeek, Peter; Willemse, Godelief; Smit, Filip; van Balkom, Anton; Spinhoven, Philip; Cuijpers, Pim

2008-01-01

323

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

324

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

PubMed Central

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

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

2014-01-01

325

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

PubMed Central

In a sample of 998 ethnically diverse adolescents, a multiagent, multimethod approach to the measurement of adolescent effortful control, adolescent substance use, and friendship influence was used to predict escalations to early-adult tobacco, alcohol, and marijuana use by ages 22–23. Structural equation modeling revealed that adolescent substance use and friends’ substance use tended to be highly correlated and together were robust predictors of a problematic pattern of usage for all substances in early adulthood. In addition, the adolescent effortful control construct directly predicted progressions to problematic use of tobacco and marijuana, but not for alcohol. In the alcohol model, effortful control interacted with the construct of substance use lifestyle (based on adolescent alcohol use and friends’ substance use) when predicting problematic alcohol use in early adulthood. Results held when comparing across genders and across ethnic groups. These findings emphasize the importance of addressing adolescent self-regulation in interventions designed to treat and prevent early-adult substance abuse. PMID:22527607

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

2012-01-01

326

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

PubMed Central

The early childhood antecedents and behavior-problem correlates of monitoring and psychological control were examined in this prospective, longitudinal, multi-informant study. Parenting data were collected during home visit interviews with 440 mothers and their 13-year-old children. Behavior problems (anxiety/depression and delinquent behavior) were assessed via mother, teacher, and/or adolescent reports at ages 8 through 10 years and again at ages 13 through 14. Home-interview data collected at age 5 years were used to measure antecedent parenting (harsh/reactive, positive/proactive), family background (e.g., socioeconomic status), and mother-rated child behavior problems. Consistent with expectation, monitoring was anteceded by a proactive parenting style and by advantageous family–ecological characteristics, and psychological control was anteceded by harsh parenting and by mothers’ earlier reports of child externalizing problems. Consistent with prior research, monitoring was associated with fewer delinquent behavior problems. Links between psychological control and adjustment were more complex: High levels of psychological control were associated with more delinquent problems for girls and for teens who were low in preadolescent delinquent problems, and with more anxiety/depression for girls and for teens who were high in preadolescent anxiety/depression. PMID:11333086

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

2009-01-01

327

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

328

Sink or swim? Bone density as a mechanism for buoyancy control in early cetaceans.  

PubMed

Previous analyses have shown that secondarily aquatic tetrapods, including whales, exhibit osteological adaptations to life in water as part of their complex buoyancy control systems. These structural specializations of bone span hyperostosis through osteoporosis. The past 15 years of paleontological effort has provided an unprecedented opportunity to examine the osteological transformation of whales as they make their transition to an obligate aquatic lifestyle over a 10-million-year period. It is hypothesized that whales manifest their osteological specialization in the same manner as extant semiaquatic and fully aquatic mammals. This study presents and analysis of the microstructural features of bone in early and late archaic cetaceans, and in a comparative sample of modern terrestrial, semiaquatic, and aquatic mammals. Bone histology was examined from the ribs of 10 fossilized individuals representing five early cetacean families, including Pakicetidae, Ambulocetidae, Protocetidae, Remintonocetidae, and Basilosauridae. Comparisons were then made with rib histology from nine genera of extant mammals including: Odocoileus (deer), Bos (cow), Equus (horse), Canis (dog), Lutra (river otter), Enhydra (sea otter), Choeropsis (pygmy hippo), Trichechus (sea cow), and Delphinus (dolphin). Results show that the transition from terrestrial, to semiaquatic, to obligate aquatic locomotion in archaeocetes involved a radical shift in bone function achieved by means of profound changes at the microstructural level. A surprising finding was that microstructural change predates gross anatomical shift in archaeocetes associated with swimming. Histological analysis shows that high bone density is an aquatic specialization that provides static buoyancy control (ballast) for animals living in shallow water, while low bone density is associated with dynamic buoyancy control for animals living in deep water. Thus, there was a shift from the typical terrestrial form, to osteopetrosis and pachyosteosclerosis, and then to osteoporosis in the first quarter of cetacean evolutionary history. PMID:17516430

Gray, Noel-Marie; Kainec, Kimberly; Madar, Sandra; Tomko, Lucas; Wolfe, Scott

2007-06-01

329

Extraordinary exposed in early motherhood - a qualitative study exploring experiences of mothers with type 1 diabetes  

PubMed Central

Background Women with type 1 diabetes face several challenges during pregnancy, childbirth and in relation to breastfeeding. It is therefore of utmost importance to consider their need for specific support, early postpartum as well as in daily life after discharge from maternity care. Few studies have investigated these aspects of healthcare. The aim of this study was to explore experiences after childbirth regarding breastfeeding, glycemic control, support and well-being in women with type 1 diabetes. Methods A hermeneutic reflective life world research approach was used in this qualitative study. Data was gathered through audio-recorded focus group discussions and individual interviews with 23 women with type 1 diabetes, 6-24 months after childbirth. After verbatim transcription, the text was analyzed in order to identify themes of meaning and a conclusive interpretation of the explored phenomenon. Results Experiences of extraordinary exposure challenged the women with type 1 diabetes in their transition to early motherhood. The exposure included a struggle with breastfeeding, although with a driving force to succeed. Everyday life was filled with uncertainty and unpredictability related to one's own unstable glycemic control and the women down-prioritized their own needs in favor of the child. A feeling of being disconnected from professional care further contributed to the experiences of extraordinary exposure. Conclusion In early motherhood women with type 1 diabetes have a great need for support in managing daily life postpartum, which requires contemporary approaches to overlap insufficient linkage between health care professionals in maternity and child health care, and diabetes care. PMID:21473755

2011-01-01

330

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

331

Acute Fructose Administration Decreases the Glycemic Response to an Oral Glucose Tolerance Test in Normal Adults  

Microsoft Academic Search

In animal models, a small (catalytic) dose of fructose administered with glucose decreases the glycemic response to the glucose load. Therefore, we examined the effect of fructose on glucose tolerance in 11 healthy human volunteers (5 men and 6 women). Each subject underwent an oral glucose tolerance test (OGTT) on 2 separate oc- casions, at least 1 week apart. Each

MARY COURTNEY MOORE; ALAN D. CHERRINGTON; STEPHNIE L. MANN; STEPHEN N. DAVIS

332

Evidence-Based Critical Evaluation of Glycemic Potential of Cynodon dactylon  

Microsoft Academic Search

The present study is an extension of our previous work carried out on Cynodon dactylon. This study deals with the critical evaluation of glycemic potential of ethanolic extract of defatted C. dactylon. The doses of 250, 500 and 750 mg kg? 1 bw of the extract were administered orally to normal as well as Streptozotocin-induced diabetic rats to study its

Santosh Kumar Singh; Prashant Kumar Rai; Dolly Jaiswal; Geeta Watal

2008-01-01

333

A High Glycemic Meal Suppresses the Postprandial Leptin Response in Normal Healthy Adults  

Microsoft Academic Search

Background\\/Aims: To evaluate the metabolic effects of meals with varying glycemic index (GI). Methods: We measured the glucose, insulin and leptin responses to two contrasting breakfast cereals in a group of 10 young healthy volunteers. Meals were provided on two separate occasions in random order after a 12-hour overnight fast, and consisted of 50 g of available carbohydrate from either

Hope Barkoukis; Christine M. Marchetti; Brian Nolan; Sakita N. Sistrun; Raj K. Krishnan; John P. Kirwan

2007-01-01

334

Dietary Fiber Intake, Dietary Glycemic Load, and the Risk for Gestational Diabetes Mellitus  

Microsoft Academic Search

OBJECTIVE — We aimed to examine whether pregravid dietary fiber consumptions from cereal, fruit, and vegetable sources and dietary glycemic load were related to gestational diabetes mellitus (GDM) risk. RESEARCH DESIGN AND METHODS — This study was a prospective cohort study among 13,110 eligible women in the Nurses' Health Study II. GDM was self-reported and validated by medical record review

CUILIN ZHANG; SIMIN LIU; CAREN G. SOLOMON; FRANK B. HU

335

Lower glycemic response to sucrose in the diets of children with type 1 diabetes  

Microsoft Academic Search

Objective: To compare glycemic responses of isocaloric mixed meals containing 2% and 17% sucrose in children with type 1 diabetes who had fasting euglycemia.Study design: Nine children (11 to 16 years) with type 1 diabetes were randomized in a crossover design to receive 2 isocaloric diets (2% or 17% sucrose) in the Clinical Research Center. In the 2% sucrose diet,

Karyl A. Rickard; Emily S. Loghmani; Jennifer L. Cleveland; Naomi S. Fineberg; Gary R. Freidenberg

1998-01-01

336

Arginine topology controls escape of minimally cationic proteins from early endosomes to the cytoplasm.  

PubMed

Proteins represent an expanding class of therapeutics, but their actions are limited primarily to extracellular targets because most peptidic molecules fail to enter cells. Here we identified two small proteins, miniature protein 5.3 and zinc finger module ZF5.3, that enter cells to reach the cytosol through rapid internalization and escape from Rab5+ endosomes. The trafficking pathway mapped for these molecules differs from that of Tat and Arg(8), which require transport beyond Rab5+ endosomes to gain cytosolic access. Our results suggest that the ability of 5.3 and ZF5.3 to escape from early endosomes is a unique feature and imply the existence of distinct signals, encodable within short sequences, that favor early versus late endosomal release. Identifying these signals and understanding their mechanistic basis will illustrate how cells control the movement of endocytic cargo and may allow researchers to engineer molecules to follow a desired delivery pathway for rapid cytosolic access. PMID:22840770

Appelbaum, Jacob S; LaRochelle, Jonathan R; Smith, Betsy A; Balkin, Daniel M; Holub, Justin M; Schepartz, Alanna

2012-07-27

337

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

338

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

339

Early-Life Stress Is Associated with Impairment in Cognitive Control in Adolescence: An fMRI Study  

ERIC Educational Resources Information Center

Early-life stress (ES) has been associated with diverse forms of psychopathology. Some investigators suggest that these associations reflect the effects of stress on the neural circuits that support cognitive control. However, very few prior studies have examined the associations between ES, cognitive control, and underlying neural architecture.…

Mueller, Sven C.; Maheu, Francoise S.; Dozier, Mary; Peloso, Elizabeth; Mandell, Darcy; Leibenluft, Ellen; Pine, Daniel S.; Ernst, Monique

2010-01-01

340

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

341

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

342

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

343

Early vs. Non-Early Intervention in Acute Migraine — ‘Act When Mild (AwM)’. A Double-Blind, Placebo-Controlled Trial of Almotriptan  

Microsoft Academic Search

The study was designed to compare the response to almotriptan in migraine patients who take medication early in the course of the attack with that when medication is taken after pain has become moderate or severe. A randomized, four-arm, multicentre, multinational, double-blind, placebo-controlled trial of almotriptan (12.5 mg) comparing treatment administration when pain intensity was mild and within 1 h

PJ Goadsby; G Zanchin; G Geraud; N de Klippel; S Diaz-Insa; H Gobel; L Cunha; N Ivanoff; M Falques; J Fortea

2008-01-01

344

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

PubMed

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

Philippou, Elena; Constantinou, Marios

2014-03-01

345

Translation repressors, an RNA helicase, and developmental cues control RNP phase transitions during early development.  

PubMed

Like membranous organelles, large-scale coassembly of macromolecules can organize functions in cells. Ribonucleoproteins (RNPs) can form liquid or solid aggregates, but control and consequences of these RNP states in living, developing tissue are poorly understood. Here, we show that regulated RNP factor interactions drive transitions among diffuse, semiliquid, or solid states to modulate RNP sorting and exchange in the Caenorhabditis elegans oocyte cytoplasm. Translation repressors induce an intrinsic capacity of RNP components to coassemble into either large semiliquids or solid lattices, whereas a conserved RNA helicase prevents polymerization into nondynamic solids. Developmental cues dramatically alter both fluidity and sorting within large RNP assemblies, inducing a transition from RNP segregation in quiescent oocytes to dynamic exchange in the early embryo. Therefore, large-scale organization of gene expression extends to the cytoplasm, where regulation of supramolecular states imparts specific patterns of RNP dynamics. PMID:24176641

Hubstenberger, Arnaud; Noble, Scott L; Cameron, Cristiana; Evans, Thomas C

2013-10-28

346

Parenting and Child DRD4 Genotype Interact to Predict Children’s Early Emerging Effortful Control  

PubMed Central

Effortful control (EC), or the trait-like capacity to regulate dominant responses, has important implications for children’s development. Although genetic factors and parenting likely influence EC, few studies have examined whether they interact to predict its development. The current study examined whether the DRD4 exon III variable number tandem repeat polymorphism moderated the relationship between parenting and children’s EC. A total of 382 three-year-olds and primary caregivers completed behavioural tasks assessing children’s EC and parenting. Children’s DRD4 genotypes moderated the relationship between parenting and EC: children with at least one 7-repeat allele displayed lower EC in the context of negative parenting than children without this allele. These findings suggest opportunities for modifying early risk for low EC. PMID:22862680

Smith, Heather J.; Sheikh, Haroon I.; Dyson, Margaret W.; Olino, Thomas M.; Laptook, Rebecca S.; Durbin, C. Emily; Hayden, Elizabeth P.; Singh, Shiva M.; Klein, Daniel N.

2012-01-01

347

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

348

Parenting and Child DRD4 Genotype Interact to Predict Children's Early Emerging Effortful Control.  

PubMed

Effortful control (EC), or the trait-like capacity to regulate dominant responses, has important implications for children's development. Although genetic factors and parenting likely influence EC, few studies have examined whether they interact to predict its development. This study examined whether the DRD4 exon III variable number tandem repeat polymorphism moderated the relation between parenting and children's EC. Three hundred and eighty-two 3-year-olds and primary caregivers completed behavioral tasks assessing children's EC and parenting. Children's DRD4 genotypes moderated the relation between parenting and EC: Children with at least one 7-repeat allele displayed lower EC in the context of negative parenting than children without this allele. These findings suggest opportunities for modifying early risk for low EC. PMID:22862680

Smith, Heather J; Sheikh, Haroon I; Dyson, Margaret W; Olino, Thomas M; Laptook, Rebecca S; Durbin, C Emily; Hayden, Elizabeth P; Singh, Shiva M; Klein, Daniel N

2012-11-01

349

Translation Repressors, an RNA Helicase, and Developmental Cues Control RNP Phase Transitions during Early Development  

PubMed Central

SUMMARY Like membranous organelles, large-scale coassembly of macromolecules can organize functions in cells. Ribonucleoproteins (RNPs) can form liquid or solid aggregates, but control and consequences of these RNP states in living, developing tissue are poorly understood. Here, we show that regulated RNP factor interactions drive transitions among diffuse, semiliquid, or solid states to modulate RNP sorting and exchange in the Caenorhabditis elegans oocyte cytoplasm. Translation repressors induce an intrinsic capacity of RNP components to coassemble into either large semiliquids or solid lattices, whereas a conserved RNA helicase prevents polymerization into nondynamic solids. Developmental cues dramatically alter both fluidity and sorting within large RNP assemblies, inducing a transition from RNP segregation in quiescent oocytes to dynamic exchange in the early embryo. Therefore, large-scale organization of gene expression extends to the cytoplasm, where regulation of supramolecular states imparts specific patterns of RNP dynamics. PMID:24176641

Hubstenberger, Arnaud; Noble, Scott L.; Cameron, Cristiana; Evans, Thomas C.

2013-01-01

350

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

351

Cfh Genotype Interacts With Dietary Glycemic Index to Modulate Age-Related Macular Degeneration-Like Features in Mice  

PubMed Central

Purpose. Age-related macular degeneration (AMD) is a leading cause of visual impairment worldwide. Genetics and diet contribute to the relative risk for developing AMD, but their interactions are poorly understood. Genetic variations in Complement Factor H (CFH), and dietary glycemic index (GI) are major risk factors for AMD. We explored the effects of GI on development of early AMD-like features and changes to central nervous system (CNS) inflammation in Cfh-null mice. Methods. Aged 11-week-old wild type (WT) C57Bl/6J or Cfh-null mice were group pair-fed high or low GI diets for 33 weeks. At 10 months of age, mice were evaluated for early AMD-like features in the neural retina and RPE by light and electron microscopy. Brains were analyzed for Iba1 macrophage/microglia immunostaining, an indicator of inflammation. Results. The 10-month-old WT mice showed no retinal abnormalities on either diet. The Cfh-null mice, however, showed distinct early AMD-like features in the RPE when fed a low GI diet, including vacuolation, disruption of basal infoldings, and increased basal laminar deposits. The Cfh-null mice also showed thinning of the RPE, hypopigmentation, and increased numbers of Iba1-expressing macrophages in the brain, irrespective of diet. Conclusions. The presence of early AMD-like features by 10 months of age in Cfh-null mice fed a low GI diet is surprising, given the apparent protection from the development of such features in aged WT mice or humans consuming lower GI diets. Our findings highlight the need to consider gene–diet interactions when developing animal models and therapeutic approaches to treat AMD. PMID:24370827

Rowan, Sheldon; Weikel, Karen; Chang, Min-Lee; Nagel, Barbara A.; Thinschmidt, Jeffrey S.; Carey, Amanda; Grant, Maria B.; Fliesler, Steven J.; Smith, Donald; Taylor, Allen

2014-01-01

352

Mobile phone base stations and early childhood cancers: case-control study  

PubMed Central

Objective To investigate the risk of early childhood cancers associated with the mother’s exposure to radiofrequency from and proximity to macrocell mobile phone base stations (masts) during pregnancy. Design Case-control study. Setting Cancer registry and national birth register data in Great Britain. Participants 1397 cases of cancer in children aged 0-4 from national cancer registry 1999-2001 and 5588 birth controls from national birth register, individually matched by sex and date of birth (four controls per case). Main outcome measures Incidence of cancers of the brain and central nervous system, leukaemia, and non-Hodgkin’s lymphomas, and all cancers combined, adjusted for small area measures of education level, socioeconomic deprivation, population density, and population mixing. Results Mean distance of registered address at birth from a macrocell base station, based on a national database of 76?890 base station antennas in 1996-2001, was similar for cases and controls (1107 (SD 1131) m v 1073 (SD 1130) m, P=0.31), as was total power output of base stations within 700 m of the address (2.89 (SD 5.9) kW v 3.00 (SD 6.0) kW, P=0.54) and modelled power density (?30.3 (SD 21.7) dBm v ?29.7 (SD 21.5) dBm, P=0.41). For modelled power density at the address at birth, compared with the lowest exposure category the adjusted odds ratios were 1.01 (95% confidence interval 0.87 to 1.18) in the intermediate and 1.02 (0.88 to 1.20) in the highest exposure category for all cancers (P=0.79 for trend), 0.97 (0.69 to 1.37) and 0.76 (0.51 to 1.12), respectively, for brain and central nervous system cancers (P=0.33 for trend), and 1.16 (0.90 to 1.48) and 1.03 (0.79 to 1.34) for leukaemia and non-Hodgkin’s lymphoma (P=0.51 for trend). Conclusions There is no association between risk of early childhood cancers and estimates of the mother’s exposure to mobile phone base stations during pregnancy. PMID:20570865

2010-01-01

353

[The motility test, an early warning system for biological water control].  

PubMed

A satisfying continuous control of waters on toxicants by chemical and physical analysis is not possible, and therefore biological methods must be used in addition. Hereby the fish test obtained special importance. To perform this test qualified experimental fish are put into the water, which should be controlled, and the effect of the water upon the fish is observed. As is known fish react to every small change of the quality of water by changing their motility behaviour. Consequently, the most sensitive fish test method is a Motility Test, then with it toxicants appearing in waters can be registered already in such low concentrations, by which the test fish feel disturbed first only in their well-being. Thus, the Motility Test can be used as "early warning system" in the biological control of waters. The prior condition to perform the Motility Test is a reliable technique for registrating the body movements if fish. Well qualified is the principle of magnet induction. Hereto the test fish is marked by a small permanent magnet and kept in the sensitive area of a wire coil. If the fish moves, voltage impulses are induced in the coil, which are registered as measure of the animal moving activity. In this work the practicability of the Motility Test by means of magnet marked trouts (Salmo gairdneri, 260-320 g) was checked: In the first series of tests the "normal" motility of trouts in freshwater was registered. Thereby, the influence of feeding, of a hiding shelter, of holding in groups, and of the water temperature upon the spontaneous activity of the fish was studied. In the second series of tests the chemo-physical quality of the water was modified (O2-decrease, CO2-increase, pH-change), and the changes of the motility of the test trouts effected thereby were registered. In the third series of tests there was measured the motor reaction of trouts upon some toxicants (ammonia, nitrite, phenol, detergents, zinc) given into the water. The results are shown by some representative actograms. In addition "reaction values" (toxicant concentration in the water) determined in the tests at the beginning of the motor unrest of the fish were listed in a table. According to the positive results obtained in all these tests the Motility Test by means of magnet marked trouts can be recommended as an useful early warning system for the biological control of waters. PMID:7148211

Petry, H

1982-08-01

354

Basement control in the development of the early cretaceous West and Central African rift system  

NASA Astrophysics Data System (ADS)

The structural framework of the Precambrian basement of the West and Central African Rift System (WCARS) is described in order to examine the role of ancient structures in the development of this Early Cretaceous rift system. Basement structures are represented in the region by large Pan-African mobile belts (built at ca. 600 Ma) surrounding the > 2 Ga West African, Congo and Sao Francisco cratons. Except for the small Gao trough (eastern Mali) located near the contact nappe of the Pan-African Iforas suture zone along the edge of the West African craton, the entire WCARS is located within the internal domains of the Pan-African mobile belts. Within these domains, two main structural features occur as the main basement control of the WCARS: (1) an extensive network of near vertical shear zones which trend north-south through the Congo, Brazil, Nigeria, Niger and Algeria, and roughly east-west through northeastern Brazil and Central Africa. The shear zones correspond to intra-continental strike-slip faults which accompanied the oblique collision between the West African, Congo, and Sao Francisco cratons during the Late Proterozoic; (2) a steep metamorphic NW-SE-trending belt which corresponds to a pre-Pan-African (ca. 730 Ma) ophiolitic suture zone along the eastern edge of the Trans-Saharian mobile belt. The post-Pan-African magmatic and tectonic evolution of the basement is also described in order to examine the state of the lithosphere prior to the break-up which occurred in the earliest Cretaceous. After the Pan-African thermo-tectonic event, the basement of the WCARS experienced a long period of intra-plate magmatic activity. This widespread magmatism in part relates to the activity of intra-plate hotspots which have controlled relative uplift, subsidence and occasionally block faulting. During the Paleozoic and the early Mesozoic, this tectonic activity was restricted to west of the Hoggar, west of Aïr and northern Cameroon. During the Late Jurassic-Early Cretaceous the St. Helena mantle plume may have had an important effect in weakening the lithosphere across a broad zone from Brazil to Sudan. However, causes of extension and stretching are likely to be found in a plate tectonic framework. At that time, the opening of both the Indian and Atlantic oceans were the dominant forces which favoured the development of the WCARS and its propagation by strike-slip movements and extensional displacements along pre-existing Pan-African lithospheric zones of weakness.

Maurin, Jean-Christophe; Guiraud, René

1993-12-01

355

A cotwin-control analysis of drug use and abuse\\/dependence risk associated with early-onset cannabis use  

Microsoft Academic Search

We assessed whether, after controlling for genetic and shared environmental influences, early cannabis use remains a significant predictor of other drug use, abuse, and dependence, and whether the risk for early-users is greater than that for later cannabis users. Data from a 1992 telephone diagnostic interview of 8169 male twins (M=42.0 years at interview) who served in the U.S. military during

Julia D. Grant; Michael T. Lynskey; Jeffrey F. Scherrer; Arpana Agrawal; Andrew C. Heath; Kathleen K. Bucholz

2010-01-01

356

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

357

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

358

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

359

Early control of seizures improves long-term outcome in children with tuberous sclerosis complex  

Microsoft Academic Search

Epilepsy associated with tuberous sclerosis complex (TSC) is characterized by early onset and intractable seizures in the majority of children. There is a solid evidence of clinical efficacy of vigabatrin in interrupting infantile spasms associated with TSC. Due to an early diagnosis we were able to start vigabatrin at the very early onset of seizures in 10 children, who subsequently

Roberta Bombardieri; Mariangela Pinci; Romina Moavero; Caterina Cerminara; Paolo Curatolo

2010-01-01

360

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

361

"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

362

A cotwin-control analysis of drug use and abuse/dependence risk associated with early-onset cannabis use.  

PubMed

We assessed whether, after controlling for genetic and shared environmental influences, early cannabis use remains a significant predictor of other drug use, abuse, and dependence, and whether the risk for early-users is greater than that for later cannabis users. Data from a 1992 telephone diagnostic interview of 8169 male twins (M=42.0 years at interview) who served in the U.S. military during the Vietnam-era were used to identify a subsample of 293 monozygotic (MZ) and dizygotic (DZ) twin pairs discordant for early cannabis use (before age 18). Using cotwin-control analyses, outcomes assessed were: lifetime illegal drug use (stimulant/cocaine, sedative, opiate, and hallucinogen/PCP), lifetime DSM-III-R illegal drug abuse/dependence, and lifetime DSM-III-R alcohol dependence. After controlling for covariates, early cannabis users were at greater risk than their later/never-using cotwins for 8 of 9 substance-related comparisons, including: using other illegal drugs (ORs: 2.71-4.09), having illegal drug abuse/dependence (ORs: 2.02-2.13), and developing alcohol dependence (OR=2.36). When analyses were limited to pairs in which the cotwin used cannabis later, early and later-users only differed significantly on sedative, opiate, and hallucinogen use. After familial influences on early cannabis use were controlled for, cannabis use-regardless of the age of initiation-still conferred increased risk of other illegal drug use, drug abuse/dependence, and alcohol dependence. In contrast to previous research, there is limited evidence for increased risk associated with early-onset use in this sample of Vietnam-era veterans. PMID:19717242

Grant, Julia D; Lynskey, Michael T; Scherrer, Jeffrey F; Agrawal, Arpana; Heath, Andrew C; Bucholz, Kathleen K

2010-01-01

363

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

NASA Astrophysics Data System (ADS)

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

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

2009-06-01

364

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

365

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

366

Mitochondrial quality control systems sustain brain mitochondrial bioenergetics in early stages of type 2 diabetes.  

PubMed

Mitochondria have a crucial role in the supply of energy to the brain. Mitochondrial alterations can lead to detrimental consequences on the function of brain cells and are thought to have a pivotal role in the pathogenesis of several neurologic disorders. This study was aimed to evaluate mitochondrial function, fusion-fission and biogenesis and autophagy in brain cortex of 6-month-old Goto-Kakizaki (GK) rats, an animal model of nonobese type 2 diabetes (T2D). No statistically significant alterations were observed in mitochondrial respiratory chain and oxidative phosphorylation system. A significant decrease in the protein levels of OPA1, a protein that facilitates mitochondrial fusion, was observed in brain cortex of GK rats. Furthermore, a significant decrease in the protein levels of LC3-II and a significant increase in protein levels of mTOR phosphorylated at serine residue 2448 were observed in GK rats suggesting a suppression of autophagy in diabetic brain cortex. No significant alterations were observed in the parameters related to mitochondrial biogenesis. Altogether, these results demonstrate that during the early stages of T2D, brain mitochondrial function is maintained in part due to a delicate balance between mitochondrial fusion-fission and biogenesis and autophagy. However, future studies are warranted to evaluate the role of mitochondrial quality control pathways in late stages of T2D. PMID:24833464

Santos, R X; Correia, S C; Alves, M G; Oliveira, P F; Cardoso, S; Carvalho, C; Seiça, R; Santos, M S; Moreira, P I

2014-09-01

367

Effortful Control and Parenting: Associations with HPA Axis Reactivity in Early Childhood  

PubMed Central

While activation of the hypothalamic-pituitary-adrenal (HPA) axis is an adaptive response to stress, excessive HPA axis reactivity may be an important marker of childhood vulnerability to psychopathology. Parenting, including parent affect during parent-child interactions, may play an important role in shaping the developing HPA system; however, the association of parent affect may be moderated by child factors, especially children’s emerging self-regulatory skills. We therefore tested the relationship between parent affectivity and 160 preschoolers’ cortisol reactivity during a laboratory visit, examining children’s effortful control (EC) as a moderator. Greater parent negative affectivity was related to greater initial and increasing cortisol over time, but only when children were low in EC. Higher parent positive affectivity was related to a higher baseline cortisol for children with low EC and lower baseline cortisol for children with high EC. Results indicate that children’s EC moderates the extent to which parent affect shapes stress reactive systems in early childhood. PMID:23786471

Kryski, Katie R.; Dougherty, Lea R.; Dyson, Margaret W.; Olino, Thomas M.; Laptook, Rebecca S.; Klein, Daniel N.; Hayden, Elizabeth P.

2013-01-01

368

Hybrid Random Early Detection Algorithm for Improving End-to-End Congestion Control in TCP\\/IP Networks  

Microsoft Academic Search

Abstract The successful operation of the present Internet depends,mainly upon TCP\\/IP which employs end-to-end congestion control mechanisms,built in the end hosts. In order to further enhance this paradigm of end-to-end control the Random,Early Detection algorithm has been proposed, which starts to mark or drop packets at the onset of congestion. The paper addresses issues related to the choice of queue

Aun Haider; Harsha Sirisena; Krzysztof Pawlikowski

2005-01-01

369

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

370

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

371

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. The bourse is the swollen basal part of an inflorescence axis at the onset of fruit development; it bears

Paris-Sud XI, Université de

372

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

373

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

374

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

ERIC Educational Resources Information Center

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

Batanova, Milena D.; Loukas, Alexandra

2014-01-01

375

Extended Follow-Up of a Randomized Controlled Trial of the Lidcombe Program of Early Stuttering Intervention  

ERIC Educational Resources Information Center

Background: In the Lidcombe Program of Early Stuttering Intervention, parents present verbal contingencies for stutter-free and stuttered speech in everyday situations. A previous randomized controlled trial of the programme with preschool-age children from 2005, conducted in two public speech clinics in New Zealand, showed that the odds of…

Jones, Mark; Onslow, Mark; Packman, Ann; O'Brian, Sue; Hearne, Anna; Williams, Shelley; Ormond, Tika; Schwarz, Ilsa

2008-01-01

376

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

377

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

378

Prolongation of Satiety After Low Versus Moderately High Glycemic Index Meals in Obese Adolescents  

Microsoft Academic Search

Background. One in 5 American children is overweight, despite a decrease in total fat consump- tion. This has sparked an interest in the carbohydrate composition of diets, including the glycemic index (GI). Objective. To investigate whether a low-GI meal re- placement (LMR) produced similar metabolic, hormonal, and satiety responses in overweight adolescents as a low-GI whole-food meal (LWM) when compared

Shauna D. Ball; Kelly R. Keller; Laurie J. Moyer-Mileur; Yi-Wen Ding; David Donaldson; W. Daniel Jackson

2010-01-01

379

Low-glycemic-index starchy foods in the diabetic diet13  

Microsoft Academic Search

Eight patients with noninsulin-dependent diabetes underwent two 2-wk study periods in random order during which they were provided with carbohydrate foods with either a high or low glycemic index (GI). Over both high-GI and low-GI periods there were significant reductions in body weight, serum fructosamine, and cholesterol. Reductions in fast- ing blood glucose, HbA1?, and urinary c-peptide-to-creatinine ratio were significant

DavidfA Jenkins; Gloria Buckley; Kah Yun Lam; Janet Kalmusky; Alexandra L Jenkins; Robert L Patten; Josephine Bird; Gerald S Wong; G Josse

380

Low-glycemic index diet in hyperlipidemia: Use of traditional starchy foods  

Microsoft Academic Search

To define those patients most likely to benefit from the hypolipidemic effect of low-glycemic-index (GI) traditional starchy foods, 30 hyperlipidemic patients were studied for 3 mo. During the middle month, low-GI foods were substituted for those with a higher 01 with minimal change in dietary macronutnent and fiber content. Only in the group (24 patients) with raised triglyceride levels (types

David JA Jenkins; Janet Kalmusky; Silvia Guidici; Connie Giordano; Robert Patten; Gerald S Wong; Josephine N Bird; Murray Hall; Gloria Buckley; Adele Csima; J Alick

1988-01-01