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Fakheran O, Bencze B, Mischak I, Vegh D, Payer M. The reliability of using gingival crevicular blood to measure blood glucose and hba1c levels in the dental setting: a systematic review and meta-analysis. Clin Oral Investig 2024; 28:299. [PMID: 38702475 PMCID: PMC11068679 DOI: 10.1007/s00784-024-05685-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/24/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE There are 500 million patients living with diabetes mellitus worldwide and 50% of them remain undiagnosed. Routine periodontal probing provides gingival crevicular blood in patients with gingivitis. Gingival blood may be useful for diabetes screening without the need for any expensive, painful or time-consuming method by using convenient glucometers. Therefore, the objective of this systematic review and meta-analysis is to answer the question to "is there a difference in glucose or HbA1c levels (O) in patients with positive gingival bleeding (P) measured on gingival crevicular blood (GCB) (I) compared to finger prick capillary blood (CB) (C). MATERIALS AND METHODS The authors performed an electronic search of six databases using identical MeSH phrases. Only human clinical studies without limitations on the year of publication were considered. Data extraction was done by using standardized data collection sheets. Risk of bias assessment were conducted using QUADAS-2 and QUADAS-C. Meta-analyses were carried out with the random effects model to aggregate the correlation coefficients and the difference between the means between gingival and capillary blood reading, using 95% confidence intervals. RESULTS The database and manual search yielded 268 articles, from which the selection procedure provided 36 articles for full-text screening, and the final pool of eligible articles composed of 23 studies with 1680 patients. Meta-analysis results on glycemic levels showed differences between the GCB and CB procedures in patients with and without diabetes with values of -6.80 [-17.35; 3.76] and - 4.36 [-9.89; 1.18], respectively. Statistically significant correlations were found (p = 0.001) between GCB and CB measurements in patients with (0.97 [0.927; 0.987]) and without diabetes (0.927 [0.873; 0.958]). CONCLUSION Gingival blood could prove to be useful to identify patients with undiagnosed diabetes when the necessary amount of uncontaminated blood is present. However, this technique is limited by the possibility of contamination, prandial status and inaccuracies, so it is unsuited to address the patient's glycemic control accurately.
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Affiliation(s)
- Omid Fakheran
- Division of Oral Surgery and Orthodontics, Department of Dentistry and Oral Health, Medical University of Graz, Billrothgasse 4, Graz, 8010, Austria
| | - Bulcsu Bencze
- Department of Prosthodontics, Semmelweis University, Szentkiralyi utca 47, Budapest, 1088, Hungary
| | - Irene Mischak
- Department of Prosthodontics, Semmelweis University, Szentkiralyi utca 47, Budapest, 1088, Hungary
| | - Daniel Vegh
- Department of Prosthodontics, Semmelweis University, Szentkiralyi utca 47, Budapest, 1088, Hungary.
| | - Michael Payer
- Division of Oral Surgery and Orthodontics, Department of Dentistry and Oral Health, Medical University of Graz, Billrothgasse 4, Graz, 8010, Austria
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Kobayashi R, Sakazaki M, Nagai Y, Okamoto T, Hashimoto Y, Sato K, Seki S, Hata U, Esaki K, Tanigawa R, Mitsuoka A, Funaki A, Niki Y, Hashiguchi T, Negoro H. Habitual isomaltulose intake reduces arterial stiffness associated with postprandial hyperglycemia in middle-aged and elderly people: a randomized controlled trial. Heart Vessels 2024; 39:123-134. [PMID: 37777673 DOI: 10.1007/s00380-023-02316-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/06/2023] [Indexed: 10/02/2023]
Abstract
Endothelin-1 (ET-1), produced by vascular endothelial cells, plays a pivotal role in the regulation of vascular tone. Isomaltulose, a naturally occurring sweetener and structural isomer of sucrose, reduces postprandial hyperglycemia, but its effect on arteriosclerosis due to hyperglycemia is unknown. The effects of 12 weeks of isomaltulose administration on ET-1 levels, a peptide that regulates arterial stiffness, blood pressure, and vascular tone, were tested before and after an oral glucose tolerance test. Fifty-four healthy middle-aged and older adults (30 men and 24 women) were divided into two groups: (1) a 25 g isomaltulose jelly drink intake group (Group I, 27 participants, mean age 55 ± 1 years) and (2) a sucrose jelly drink intake group (Group S, 27 participants, mean age 55 ± 1 years), each consuming isomaltulose or sucrose daily for 12 weeks, and a randomized, controlled study was conducted. Participants visited the laboratory before the intervention and 4, 8, and 12 weeks after the intervention to measure carotid-femoral (cf) and brachial-ankle (ba) pulse wave velocity (PWV), systolic blood pressure (BP), plasma glucose (PG), insulin, and ET-1 levels before and 60 and 120 min after a 75-g OGTT. baPWV, and ET-1 levels before intervention were significantly increased after 75-g OGTT compared to before 75-g OGTT in both groups (p < 0.05). The post-intervention baPWV, and ET-1 levels were significantly increased after 75-g OGTT in Group S compared to before 75-g OGTT (p < 0.05), whereas no significant changes were observed in Group I. These results suggest that consumption of isomaltulose, which has a lower GI than sucrose, is more effective in preventing the increases in systemic arterial stiffness associated with postprandial hyperglycemia in healthy middle-aged and older adults.
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Affiliation(s)
- Ryota Kobayashi
- Department of Natural & Environmental Science, Teikyo University of Science, 2-2-1 Senju, Sakuragi, Adachi-ku, Tokyo, 120-0045, Japan.
| | - Miki Sakazaki
- Life Energy Business Development Unit, Mitsui DM Group R&D Center, Mitsui DM Sugar Co., Ltd., 2-28-7 Kamiochiai, Shinjuku-ku, Tokyo, 161-0034, Japan
| | - Yukie Nagai
- Life Energy Business Development Unit, Mitsui DM Group R&D Center, Mitsui DM Sugar Co., Ltd., 2-28-7 Kamiochiai, Shinjuku-ku, Tokyo, 161-0034, Japan
| | - Takanobu Okamoto
- Department of Exercise Physiology, Nippon Sport Science University, 7-1-1, Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan
| | - Yuto Hashimoto
- Department of Exercise Physiology, Nippon Sport Science University, 7-1-1, Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan
| | - Kaori Sato
- Health and Physical Education Program, International Christian University, 3-10-2, Osawa, Mitaka-shi, Tokyo, 181-0015, Japan
| | - Shotaro Seki
- Graduate School of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan
| | - Urara Hata
- Graduate School of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan
| | - Kazuki Esaki
- Graduate School of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan
| | - Ryuya Tanigawa
- Graduate School of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan
| | - Amane Mitsuoka
- Graduate School of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan
| | - Akiko Funaki
- Department of Judo Therapy, Teikyo University of Science, 2525 Yatsusawa, Uenohara-shi, Yamanashi, 409-0193, Japan
| | - Yasuhiro Niki
- Department of Sport Management, Shobi University, 1-1-1 Toyodacho, Kawagoe-shi, Saitama, 350-1110, Japan
| | - Takeo Hashiguchi
- Department of School Education, Teikyo University of Science, 2-2-1 Senju, Sakuragi, Adachi-ku, Tokyo, 120-0045, Japan
| | - Hideyuki Negoro
- Department of Medicine, Nara Medical University, 840 Shijo, Kashihara-shi, Nara, 634-8521, Japan
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H Ibrahim SM, Shahat EA, Amer LA, Aljohani AK. The Impact of Using Carbohydrate Counting on Managing Diabetic Patients: A Review. Cureus 2023; 15:e48998. [PMID: 38111457 PMCID: PMC10726644 DOI: 10.7759/cureus.48998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2023] [Indexed: 12/20/2023] Open
Abstract
Carbohydrate counting (CC) is a meal planning practice for diabetic patients, focusing on tracking the amount of carbohydrates in grams consumed at meals to manage blood glucose (BG) levels. The purpose of this narrative review is to evaluate the impact of CC in helping people with diabetes manage their condition. It reveals that CC offers superior glycemic control and flexibility compared to other food planning techniques. Specifically, when applied to children and teenage patients diagnosed with type 1 diabetes mellitus (T1DM), CC demonstrates the potential for substantial improvements in metabolic control without any adverse effects on weight or increased insulin requirements. In the context of T1DM, the combination of CC and the use of automated bolus calculators (ABCs) contributes to lowering glycated hemoglobin (HbA1c) levels. Furthermore, the study highlights that CC also holds promise in the management of type 2 diabetes mellitus (T2DM). In T2DM patients, adhering to a low glycemic index (GI) diet has proven to be more effective in controlling HbA1c and fasting BG levels compared to a higher GI diet or standard dietary control. This research underscores the evolving significance of CC as a pivotal component in diabetes management, attributed to increased awareness and education among patients. CC emerges as a versatile tool that can benefit individuals with various forms of diabetes by enhancing their glycemic control and overall quality of life. The findings affirm the impact of CC in improving patient outcomes, solidifying its status as a vital strategy in the multifaceted landscape of diabetes care.
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Affiliation(s)
| | | | - Lamar A Amer
- Medicine and Surgery, Taibah University, Medina, SAU
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Chkroun C, Trouwborst I, Cherta-Murillo A, Owen L, Darimont C, Rytz A. Defining a Continuous Glucose Baseline to assess the impact of nutritional interventions. Front Nutr 2023; 10:1203899. [PMID: 37588050 PMCID: PMC10425768 DOI: 10.3389/fnut.2023.1203899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/17/2023] [Indexed: 08/18/2023] Open
Abstract
Accurate and robust estimation of individuals' basal glucose level is a crucial measure in nutrition research but is typically estimated from one or more morning fasting samples. The use of Continuous Glucose Monitoring (CGM) devices presents an opportunity to define more robust basal glucose levels, which estimates can be generalized to any time of the day. However, to date, no standardized method has been delineated. The current paper seeks to define a reliable algorithm to characterize the individual's basal glucose level over 24 h from CGM measurements. Data drawn from four nutritional intervention studies performed on adults free from chronic diseases were used to define that basal glucose levels were optimally estimated using the 40th percentile of the previous 24 h CGM data. This simple algorithm provides a Continuous Glucose Baseline over 24 h (24 h-CGB) that is an unbiased and highly correlated estimator (r = 0.86, p-value < 0.01) of standard fasting glucose. We conclude that 24-CGB can provide reliable basal glucose estimates across the day while being more robust to interference than standard fasting glucose, adaptable to evolving daily routines and providing useful reference values for free-living nutritional intervention research in non-diabetic individuals.
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Affiliation(s)
- Célina Chkroun
- Clinical Research Unit, Nestlé Research, Lausanne, Switzerland
| | - Inez Trouwborst
- Metabolic Health Department, Nestlé Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland
| | - Anna Cherta-Murillo
- Metabolic Health Department, Nestlé Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland
| | - Lauren Owen
- Brain Health Department, Nestlé Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland
| | - Christian Darimont
- Metabolic Health Department, Nestlé Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland
| | - Andreas Rytz
- Clinical Research Unit, Nestlé Research, Lausanne, Switzerland
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Cornejo F, Salazar R, Martínez-Espinosa R, Villacrés E, Paredes-Escobar M, Ruales J, Penafiel D. Evaluation of starch digestibility of Andean crops oriented to healthy diet recommendation. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2022. [DOI: 10.1080/10942912.2022.2074036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Fabiola Cornejo
- Escuela Superior Politécnica del Litoral, ESPOL, Facultad de Ingeniería en Mecánica y Ciencias de la Producción, Guayaquil, Ecuador
| | - Rómulo Salazar
- Escuela Superior Politécnica del Litoral, ESPOL, Facultad de Ingeniería en Mecánica y Ciencias de la Producción, Guayaquil, Ecuador
| | | | - Elena Villacrés
- Department of Nutrition and Quality, National Institute of Agricultural Research, Mejía, Ecuador
| | - Mayra Paredes-Escobar
- Faculty of Food Science and Engineering, Universidad Técnica de Ambato, Ambato, Ecuador
| | - Jenny Ruales
- Department of Food Science and Biotechnology, Escuela Politécnica Nacional, Quito, Ecuador
| | - Daniela Penafiel
- Escuela Superior Politécnica del Litoral, ESPOL, Centro de Investigaciones Rurales, Facultad de Ciencias Sociales y Humanísticas, Guayaquil, Ecuador
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Effects of high-amylose maize starch on the glycemic index of Chinese steamed buns (CSB). Heliyon 2022; 8:e09375. [PMID: 35574202 PMCID: PMC9096677 DOI: 10.1016/j.heliyon.2022.e09375] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/14/2021] [Accepted: 04/29/2022] [Indexed: 11/22/2022] Open
Abstract
The incorporation of resistant starch (RS) in food has gained importance to be a good replacement for digestible carbohydrate. This study examined the effect of compositing RS (high-amylose maize starch (HM)) as wheat flour substitute (30%) in Chinese steamed bun (CSB) formulation on postprandial glycemic response in healthy human subject. In this single-blind and cross-over experimental trial, a total of 15 female participants (mean age = 31.5 ± 3.9) were randomly assigned to receive CSB containing 30% HM (HM30) or control CSB (without HM) with their blood glucose were recorded throughout the test. The blood glucose concentrations recorded for HM30 were significantly lower than control CSB at 15 min (6.03 vs. 7.04 mmol/L, p = 0.041), 30 min (6.93 vs. 7.76 mmol/L, p = 0.021), 45 min (6.21 vs. 7.55 mmol/L, p = 0.032), 60 min (5.68 vs. 6.26 mmol/L, p = 0.038), and 90 min (5.08 vs. 5.73 mmol/L, p = 0.022). The 2-h postprandial glucose was significantly lower in HM30 (iAUC = 105.2 mmol x min/L) than the control (186.1 mmol x min/L). The low GI property of HM30 (GI = 39.11 ± 5.6) did not cause sudden rapid increase in blood glucose concentration as observed in medium-GI control CSB (GI = 69.18 ± 9.8). This study suggests that adding 30g of HM decreased the glycemic index of CSB in healthy female adult.
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Chekima K, Wong BTZ, Noor MI, Ooi YBH, Yan SW, Chekima B. Use of a Continuous Glucose Monitor to Determine the Glycaemic Index of Rice-Based Mixed Meals, Their Effect on a 24 h Glucose Profile and Its Influence on Overweight and Obese Young Adults' Meal Preferences. Foods 2022; 11:foods11070983. [PMID: 35407070 PMCID: PMC8997962 DOI: 10.3390/foods11070983] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/28/2022] [Accepted: 02/10/2022] [Indexed: 12/16/2022] Open
Abstract
Postprandial hyperglycaemia is associated with an increased risk of type-2 diabetes. This study aims to determine the glycaemic index (GI) of three varieties of rice-based mixed meals and their effects on glycaemic variability (GV), 24 h mean glucose levels and target ranges, and rice variety preferences among overweight and obese young adults using real-time continuous glucose monitoring (rtCGM). In a randomised controlled crossover design, 14 participants (22.8 ± 4.6 years, 32.9 ± 5.8 kg/m2) were randomly assigned to receive 3 rice-based mixed meals containing 50 g of available carbohydrates (white rice meal = WRM; brown rice meal = BRM; and parboiled basmati rice meal = PBRM) and 50 g of a glucose reference drink on alternate days. GI, GV, 24 h mean glucose levels and target ranges were measured. Rice variety preferences were compared with those of baseline data and determined at the end of the study period. Results: The analysis found that PBRM was low in GI (45.35 ± 2.06), BRM medium in GI (56.44 ± 2.34), and WRM high in GI (83.03 ± 2.19). PBRM had a significantly (p < 0.05) lower 24 h mean glucose level, higher in-target 24 h glucose level percentage and non-significantly (p > 0.05) lower GV compared to WRM. Prior to observing their postprandial glucose levels generated by rtCGM, the participants preferred WRM (64.3%) over other meals, whereas this preference changed significantly (p < 0.05) at the endpoint (PBRM, 71.4%). PBRM reduced 24 h glucose level and GV of overweight and obese young adults. The rtCGM is proven to be reliable in measuring GI, while providing robust continuous glycaemic information. This may serve as an educational tool that motivates eating behaviour changes among overweight and obese young adults.
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Affiliation(s)
- Khadidja Chekima
- Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Selangor, Malaysia; (K.C.); (S.W.Y.)
| | - Benjamin Tziak Ze Wong
- Faculty of Social Sciences & Leisure Management, Taylor’s University, Subang Jaya 47500, Selangor, Malaysia;
| | - Mohd Ismail Noor
- Faculty of Medicine and Health Sciences, The National University of Malaysia, Bangi 43600, Selangor, Malaysia;
| | - Yasmin Beng Houi Ooi
- Faculty of Food Science and Nutrition, University Malaysia Sabah, Kota Kinabalu 88450, Sabah, Malaysia;
| | - See Wan Yan
- Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Selangor, Malaysia; (K.C.); (S.W.Y.)
| | - Brahim Chekima
- Faculty of Business, Economics and Accountancy, University Malaysia Sabah, Kota Kinabalu 88450, Sabah, Malaysia
- Correspondence:
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Vici G, Perinelli DR, Camilletti D, Carotenuto F, Belli L, Polzonetti V. Nutritional Properties of Rice Varieties Commonly Consumed in Italy and Applicability in Gluten Free Diet. Foods 2021; 10:foods10061375. [PMID: 34198605 PMCID: PMC8232128 DOI: 10.3390/foods10061375] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022] Open
Abstract
Gluten-free diets are often characterized by an inadequate intake of nutrients and are generally monotonous for the limited number of products celiac patients can use. As rice is the most used cereal by celiac consumers, studying rice varieties nutritional characteristics is of interest to manage diet quality and variety. Proteins, total carbohydrates and amylose content of six rice varieties (Ribe, Vialone Nano, Carnaroli, Arborio, Basmati, and Fragrance) were analyzed. Analyses were performed in raw products and after boiling, stewing, and microwaving. A decrease of proteins and total carbohydrates amount was observed in cooked rice. The same was reported for amylose content with boiling showing the highest loss (average retained amylose 53%). Considering amylose percentage with respect to total carbohydrates, each variety showed either an increase or a decrease depending on cooking method. The highest values were obtained with stewing above all for Basmati rice and Arborio rice. However, exceptions can be underlined as Carnaroli rice, showing the highest percentage when boiled. In this context, nutritional characteristics of cooked rice varieties appear to be of great importance to increase specific nutritional knowledge to better manage gluten-free diets.
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Affiliation(s)
- Giorgia Vici
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Gentile III da Varano, 62032 Camerino, MC, Italy; (D.C.); (F.C.); (L.B.); (V.P.)
- Correspondence:
| | - Diego Romano Perinelli
- School of Pharmacy, University of Camerino, Via Gentile III da Varano, 62032 Camerino, MC, Italy;
| | - Dalia Camilletti
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Gentile III da Varano, 62032 Camerino, MC, Italy; (D.C.); (F.C.); (L.B.); (V.P.)
| | - Flora Carotenuto
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Gentile III da Varano, 62032 Camerino, MC, Italy; (D.C.); (F.C.); (L.B.); (V.P.)
| | - Luca Belli
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Gentile III da Varano, 62032 Camerino, MC, Italy; (D.C.); (F.C.); (L.B.); (V.P.)
| | - Valeria Polzonetti
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Gentile III da Varano, 62032 Camerino, MC, Italy; (D.C.); (F.C.); (L.B.); (V.P.)
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