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Gao J, Shi J, Ma X, Lu F, Fu C, Chen Z, Miao L, Qu H, Zhao Y, Zhang Y, Yang Z, Pan D, Zhu C, Li Q, Shi D. Effects of ginseng berry saponins from panax ginseng on glucose metabolism of patients with prediabetes: A randomized, double-blinded, placebo-controlled, crossover trial. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 132:155842. [PMID: 39004031 DOI: 10.1016/j.phymed.2024.155842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/31/2024] [Accepted: 06/24/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Prediabetes strongly increases the risk of type 2 diabetes and cardiovascular events. However, lifestyle intervention, the first-line treatment for prediabetes currently, was inconsistently beneficial for glucose metabolism, and the conventional medicines, such as metformin, is controversial for prediabetes due to the possible side effects. PURPOSE This study was designed to evaluate the effects of Zhenyuan Capsule, a Chinese patented medicine consisting of ginseng berry saponins extracted from the mature berry of Panax Ginseng, on the glucose metabolism of prediabetic patients as a complementary therapy. STUDY DESIGN AND METHODS In this randomized, double-Blinded, placebo-controlled, crossover trial, 195 participants with prediabetes were randomized 1:1 to receive either placebo followed by Zhenyuan Capsule, or vice versa, alongside lifestyle interventions. Each treatment period lasted 4 weeks with a 4-week washout period in between. The primary outcomes were the changes in fasting plasma glucose (FPG) and 2-h postprandial plasma glucose (2-h PG) from baseline. Secondary outcomes includes the changes in fasting and 2-h postprandial insulin and C-peptide, the homeostatic model assessment-insulin resistance (HOMA-IR) index and quantitative insulin sensitivity check index (QUICKI) from baseline. Blood lipids and adverse events were also assessed. RESULTS Compared with placebo, Zhenyuan Capsule caused remarkable reduction in 2-h PG (-0.98 mmol/l) after adjusting treatment order. Zhenyuan Capsule also reduced the fasting and 2-h postprandial levels of insulin and C-peptide, lowered HOMA-IR index (-1.26), and raised QUICKI index (+0.012) when compared to placebo. Additionally, a significant increase in high density lipoprotein cholesterol (HDL-C; +0.25 mmol/l) was found in patients with Zhenyuan Capsule. No serious adverse event occurred during the study. CONCLUSIONS Among prediabetic patients, Zhenyuan Capsule further reduced 2-h PG level, alleviated insulin resistance and raised HDL-C level on the background of lifestyle interventions. The study protocol is registered with the Chinese Clinical Trial Registry (ChiCTR2000034000).
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Affiliation(s)
- Jie Gao
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China academy of Chinese Medical Sciences, Beijing,100091, China
| | - Junhe Shi
- Institute of Clinical Pharmacology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Xiaojuan Ma
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China academy of Chinese Medical Sciences, Beijing,100091, China
| | - Fang Lu
- Institute of Clinical Pharmacology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Changgeng Fu
- Institute of Clinical Pharmacology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Zhuhong Chen
- Department of endocrinology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Lina Miao
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China academy of Chinese Medical Sciences, Beijing,100091, China
| | - Hua Qu
- Institute of Clinical Pharmacology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Yang Zhao
- Institute of Clinical Pharmacology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Ying Zhang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China academy of Chinese Medical Sciences, Beijing,100091, China
| | - Zhen Yang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China academy of Chinese Medical Sciences, Beijing,100091, China
| | - Deng Pan
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China academy of Chinese Medical Sciences, Beijing,100091, China
| | - Chunlin Zhu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China academy of Chinese Medical Sciences, Beijing,100091, China
| | - Qiuyan Li
- Department of endocrinology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
| | - Dazhuo Shi
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China academy of Chinese Medical Sciences, Beijing,100091, China.
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Hong JY, Li YJ, Metcalfe RS, Chen YC. Effects of acute and chronic stair-climbing exercise on metabolic health: A systematic review. J Sports Sci 2024; 42:498-510. [PMID: 38695325 DOI: 10.1080/02640414.2024.2345414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/12/2024] [Indexed: 05/15/2024]
Abstract
Stair climbing exercise (SE) provides a feasible approach to elevate physical activity, but the effects on metabolic health are unclear. We systematically reviewed the currently available evidence on the effects of SE on fasting and postprandial glycaemia and lipidaemia. Studies were included if they investigated the effects of acute or chronic (at least 2 weeks) SE on fasting and/or postprandial glycaemic (insulin and glucose) and lipidaemic (triacylglycerols and non-esterified fatty acids) responses in healthy, prediabetic or type 2 diabetic adult populations. PubMed, Web of Science and Scopus were searched for eligible studies until July 2022. A total of 25 studies (14 acute and 11 chronic) were eligible for review. Acute bout(s) of SE can reduce postprandial glycaemia in individuals with prediabetes and type 2 diabetes (8 of 9 studies), but not in normoglycemic individuals. The effects of acute SE on postprandial lipidaemic responses and SE training on both fasting and postprandial glycaemia/lipidaemia were unclear. Acute SE may reduce postprandial glucose concentrations in people with impaired glycaemic control, but high-quality studies are needed. More studies are needed to determine the effect of chronic SE training on postprandial glucose and lipid responses, and the acute effects of SE on lipid responses.
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Affiliation(s)
- Jing-Yuan Hong
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Yun-Jui Li
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Richard S Metcalfe
- Applied Sports Technology, Exercise and Medicine Research Centre (A-STEM), Swansea University, Swansea, UK
| | - Yung-Chih Chen
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
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Khalafi M, Symonds ME, Ghasemi F, Rosenkranz SK, Rohani H, Hossein Sakhaei M. The effects of exercise training on postprandial glycemia and insulinemia in adults with overweight or obesity and with cardiometabolic disorders: a systematic review and meta-analysis. Diabetes Res Clin Pract 2023:110741. [PMID: 37276984 DOI: 10.1016/j.diabres.2023.110741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/11/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND We performed a systematic review and meta-analysis to investigate the effects of exercise training on postprandial glycemia (PPG) and insulinemia (PPI) in adults with overweight or obesity and with cardiometabolic disorders. METHODS PubMed, Web of Science, and Scopus databases were searched until May 2022 using the key words "exercise," "postprandial," and "randomized control trial" to identify original studies investigating the effects of exercise training on PPG and/or PPI in adults with a body mass indexes (BMI) ≥ 25 kg.m2. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated using random effects models to calculate effect sizes for outcomes and to generate forest plots. Sub-group analyses and meta-regressions were performed for potential categorical and continuous moderators. RESULTS Twenty-nine studies involving 41 intervention arms and 1,401 participants were included in the systematic review and meta-analysis. Overall, exercise training significantly decreased PPG [-0.36 (95% CI -0.50 to -0.22), p=0.001] and PPI [-0.37 (95% CI -0.52 to -0.21), p=0.001]. Subgroup analyses showed that PPG decreased following both aerobic and resistance training; whereas PPI was reduced following aerobic training, independent of age, BMI, and baseline glucose levels. Meta-regression analyses showed that frequency of exercise sessions, intervention durations, and duration of exercise time, did not moderate the effects of exercise training on PPI or PPG (p>0.05). CONCLUSION In adults with overweight or obesity and with cardiometabolic disorders, exercise training is effective for reducing PPG and PPI, across ages and BMIs, irrespective of baseline glucose levels and exercise training characteristics.
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Affiliation(s)
- Mousa Khalafi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
| | - Michael E Symonds
- Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Faeghe Ghasemi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran
| | - Sara K Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Hadi Rohani
- Department of Exercise Physiology, Sport Sciences Research Institute, Tehran, Iran
| | - Mohammad Hossein Sakhaei
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran
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Bourne JE, Leary S, Page A, Searle A, England C, Thompson D, Andrews RC, Foster C, Cooper AR. Electrically assisted cycling for individuals with type 2 diabetes mellitus: a pilot randomized controlled trial. Pilot Feasibility Stud 2023; 9:60. [PMID: 37072802 PMCID: PMC10111297 DOI: 10.1186/s40814-023-01283-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/28/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) and its associated complications puts considerable strain on healthcare systems. With the global incidence of T2DM increasing, effective disease management is essential. Physical activity (PA) is a key component of T2DM management; however, rates of PA engagement are low in this population. Developing effective and sustainable interventions that encourage PA is a high priority. Electrically assisted bicycles are becoming increasingly popular and may increase PA in healthy adults. This study aimed to provide evidence of the feasibility of conducting a randomized controlled trial to evaluate the efficacy of an e-cycling intervention to increase PA and improve health in individuals with T2DM. METHODS A parallel-group two-arm randomized, waitlist-controlled pilot study was conducted. Individuals were randomized to either an e-bike intervention or standard care. The intervention incorporated two one-to-one e-bike skills training and behavioural counselling sessions delivered by a community-based cycling charity, followed by a 12-week e-bike loan with two further sessions with the instructors. Feasibility was assessed via measures related to recruitment, retention and intervention implementation. Post-intervention interviews with instructors and participants explored the acceptability of the study procedures and intervention. Clinical, physiological and behavioural outcomes were collected at baseline and post-intervention to evaluate the intervention's potential. RESULTS Forty participants (Mage = 57) were randomized, of which 34 were recruited from primary care practices. Thirty-five participants were retained in the trial. The intervention was conducted with high fidelity (> 80% content delivered). E-bike training provided participants with the skills, knowledge and confidence needed to e-bike independently. Instructors reported being more confident delivering the skills training than behavioural counselling, despite acknowledging its importance. The study procedures were found to be acceptable to participants. Between-group differences in change during the intervention were indicative of the interventions potential for improving glucose control, health-related quality of life and cardiorespiratory fitness. Increases in overall device measured moderate-to-vigorous PA behaviour following the intervention were found, and there was evidence that this population self-selected to e-cycle at a moderate intensity. CONCLUSIONS The study's recruitment, retention, acceptability and potential efficacy support the development of a definitive trial subject to identified refinements. TRIAL REGISTRATION ISRCTN, ISRCTN67421464 . Registered 17/12/2018.
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Affiliation(s)
- Jessica E Bourne
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.
| | - Sam Leary
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Angie Page
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Aidan Searle
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Clare England
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, BA2 7PB, UK
| | - Robert C Andrews
- Institute of Biomedical and Clinical Sciences, Medical Research, University of Exeter Medical School, RILD Level 3, Barrack Road, Exeter, EX2 5DW, Devon, UK
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Ashley R Cooper
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
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Lin HJ, Wang J, Tseng PY, Fu LC, Lee YC, Wu MS, Yang WS, Chiu HM. Lower-than-normal glycemic levels to achieve optimal reduction of diabetes risk among individuals with prediabetes: A prospective cohort study. Diabetes Res Clin Pract 2023; 197:110567. [PMID: 36740021 DOI: 10.1016/j.diabres.2023.110567] [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: 08/29/2022] [Revised: 01/16/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
AIMS/HYPOTHESIS To determine whether lower than currently accepted glycemic levels could lead to optimal risk reduction of incident diabetes among individuals with prediabetes. METHODS We enrolled 9903 individuals with prediabetes and 16,902 individuals with normoglycemia from a prospective cohort participating health check-ups between 2006 and 2017. While classifying fasting glucose into <5.0, 5.0-5.5, and 5.6-6.9 mmol/L and postprandial glucose into <6.7, 6.7-7.7, and 7.8-11.0 mmol/L, we grouped fasting/postprandial glucose into five categories (<5.0/<6.7, <5.0/6.7-7.7, 5.0-5.5/<6.7, 5.0-5.5/6.7-7.7 mmol/L, 5.6-6.9/7.8-11.0 mmol/L). The primary outcome was incident diabetes. RESULTS In individuals with prediabetes, the presence of a baseline fasting glucose <5.0 mmol/L or a postprandial glucose <6.7 mmol/L led to a greater risk reduction of incident diabetes with hazard ratios of 0.34 (95% confidence interval, 0.27-0.42) and 0.47 (0.41-0.54), respectively, relative to a fasting glucose 5.6-6.9 mmol/L and a postprandial glucose 7.8-11.0 mmol/L. For individuals with prediabetes having fasting/postprandial glucose <5.0/<6.7 mmol/L, the incidence of 6.4 (4.7-8.8) per 1000 person-years corresponded to that of 5.8 (4.2-8.0) per 1000 person-years for individuals with normoglycemia having 5.0-5.5/6.7-7.7 mmol/L. CONCLUSIONS/INTERPRETATION Given that lower-than-normal glycemic levels were plausible for optimal risk reduction of diabetes, stringent glycemic management could be beneficial for diabetes prevention among individuals with prediabetes.
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Affiliation(s)
- Hung-Ju Lin
- Health Management Center, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Jui Wang
- Health Management Center, National Taiwan University Hospital, Taipei, Taiwan.
| | - Po-Yuan Tseng
- All Vista Healthcare Center, Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taiwan.
| | - Li-Chen Fu
- Department of Electrical Engineering, Department of Computer Science and Information Engineering, and Center for Artificial Intelligence & Advanced Robotics, National Taiwan University, Taipei, Taiwan.
| | - Yi-Chia Lee
- Health Management Center, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Integrative Medical Database Center, Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan..
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Wei-Shiung Yang
- Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Integrative Medical Database Center, Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Han-Mo Chiu
- Health Management Center, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Cremonini E, Daveri E, Iglesias DE, Kang J, Wang Z, Gray R, Mastaloudis A, Kay CD, Hester SN, Wood SM, Fraga CG, Oteiza PI. A randomized placebo-controlled cross-over study on the effects of anthocyanins on inflammatory and metabolic responses to a high-fat meal in healthy subjects. Redox Biol 2022; 51:102273. [PMID: 35255426 PMCID: PMC8902616 DOI: 10.1016/j.redox.2022.102273] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 12/13/2022] Open
Abstract
This study investigated the effects of supplementation with a cyanidin- and delphinidin-rich extract (CDRE) on the postprandial dysmetabolism, inflammation, and redox and insulin signaling, triggered by the consumption of a high fat meal (HFM) in healthy individuals. Participants (n = 25) consumed a 1026-kcal HFM simultaneously with either the CDRE providing 320.4 mg of anthocyanins (90% cyanidin and delphinidin) or placebo. Diets were randomly assigned in a double blind, placebo-controlled crossover design. Blood was collected prior to (fasted, time 0), and for 5 h after meal consumption; plasma, serum, and peripheral blood mononuclear cells (PBMC) were isolated. AC metabolites were detected in serum as early as 30 min after CDRE consumption. The CDRE mitigated HFM-induced endotoxemia, reducing increases in plasma LPS and LPS-binding protein. The CDRE also reduced other events associated with HFM-triggered postprandial dysmetabolism including: i) plasma glucose and triglyceride increases; ii) TNFα and NOX4 upregulation in PBMC; and iii) JNK1/2 activation in PBMC. The CDRE did not significantly affect HFM-mediated increases in plasma insulin, GLP-1, GLP-2, GIP, and LDL- and HDL-cholesterol, and IKK phosphorylation in PBMC. In summary, dietary AC, i.e. cyanidin and delphinidin, exerted beneficial actions against unhealthy diets by modulating the associated postprandial dysmetabolism, endotoxemia, alterations of glycemia and lipidemia, and redox and insulin signaling.
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Khalafi M, Ravasi AA, Malandish A, Rosenkranz SK. The impact of high-intensity interval training on postprandial glucose and insulin: A systematic review and meta-analysis. Diabetes Res Clin Pract 2022; 186:109815. [PMID: 35271876 DOI: 10.1016/j.diabres.2022.109815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/10/2022] [Accepted: 02/28/2022] [Indexed: 12/14/2022]
Abstract
AIMS We performed a systematic review and meta-analysis to investigate the effects of high-intensity interval training (HIIT) on postprandial glucose (PPG) and insulin (PPI) versus non-exercise control and moderate-intensity continuous training (MICT) in participants with both normal and impaired glucose. METHODS The PubMed, Scopus, and Web of Science electronic databases were searched up to October 2021 for randomized trials evaluating HIIT versus control and/or versus MICT on glucose and insulin AUC using oral glucose tolerance testing. Subgroup analyses based on intervention duration (short-duration < 8 weeks, moderate-duration ≥ 8 weeks), baseline glucose levels (normal glucose and impaired glucose) and type of HIIT (L-HIIT and SIT) were also conducted across included studies. RESULTS A total of 25 studies involving 870 participants were included in the current meta-analysis. HIIT effectively reduced glucose [-0.37 (95% CI -0.60 to -0.13), p = 0.002] and insulin [-0.36 (95% CI -0.68 to -0.04), p = 0.02] AUC when compared with a CON group. Reductions in glucose AUC were significant for those with impaired glucose at baseline (p = 0.03), but not for those with normal glucose levels (p = 0.11) and following moderate-duration (p = 0.01), but not short-duration interventions (p = 0.18). However, there were no differences in glucose (p = 0.76) or insulin (p = 0.43) AUC between HIIT and MICT intervention arms. CONCLUSIONS Our results demonstrated that both HIIT and MICT are effective for reducing postprandial glycemia and insulinemia, particularly by moderate-duration interventions, and in those with impaired glucose.
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Affiliation(s)
- Mousa Khalafi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
| | - Ali A Ravasi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Abbas Malandish
- Department of Exercise Physiology, Faculty of Sport Sciences, Urmia University, Urmia, Iran
| | - Sara K Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS, USA
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Nakayama Y, Ono K, Okagawa J, Urabe J, Yamau R, Ishikawa A. Home-Based High-Intensity Interval Exercise Improves the Postprandial Glucose Response in Young Adults with Postprandial Hyperglycemia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074227. [PMID: 35409907 PMCID: PMC8998503 DOI: 10.3390/ijerph19074227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 12/20/2022]
Abstract
Postprandial hyperglycemia can be corrected by exercise; however, the effect of home-based high-intensity interval exercise (HIIE), a new time-efficient exercise, on glycemic control is unclear. This study aimed to investigate the effect of home-based HIIE on postprandial hyperglycemia. Twelve young adult males (mean age: 24.3 ± 2.3 y) with postprandial hyperglycemia that had not yet led to diabetes completed home-based HIIE, moderate-intensity continuous exercise (MICE), and control conditions on separate days, randomly. The intervention began 30 min after the start of a standardized meal intake, with 11 min of HIIE completed at maximal effort in the home-based HIIE condition, 30 min of running performed at 50% maximum oxygen uptake in the MICE condition, or 30 min of sitting at rest completed in the control condition. The participants sat at rest after each intervention for up to 120 min. Interstitial fluid glucose concentrations were measured using a continuous glucose monitoring system that scanned every 15 min for up to 2 h after the meal. The glucose concentrations after the meal were significantly lower in the home-based HIIE and MICE conditions than in the control condition (p < 0.001). There were no significant differences in the glucose concentrations between the home-based HIIE and MICE conditions. In conclusion, home-based HIIE was able to correct postprandial hyperglycemia.
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Affiliation(s)
- Yuto Nakayama
- Graduate School of Health Sciences, Kobe University, 7-10-2, Tomogaoka, Suma, Kobe 654-0142, Hyogo, Japan; (J.O.); (J.U.); (A.I.)
- Correspondence: (Y.N.); (K.O.)
| | - Kumiko Ono
- Graduate School of Health Sciences, Kobe University, 7-10-2, Tomogaoka, Suma, Kobe 654-0142, Hyogo, Japan; (J.O.); (J.U.); (A.I.)
- Correspondence: (Y.N.); (K.O.)
| | - Junya Okagawa
- Graduate School of Health Sciences, Kobe University, 7-10-2, Tomogaoka, Suma, Kobe 654-0142, Hyogo, Japan; (J.O.); (J.U.); (A.I.)
| | - Junji Urabe
- Graduate School of Health Sciences, Kobe University, 7-10-2, Tomogaoka, Suma, Kobe 654-0142, Hyogo, Japan; (J.O.); (J.U.); (A.I.)
| | - Ryoga Yamau
- School of Medicine Faculty of Health Sciences, Kobe University, 7-10-2, Tomogaoka, Suma, Kobe 654-0142, Hyogo, Japan;
| | - Akira Ishikawa
- Graduate School of Health Sciences, Kobe University, 7-10-2, Tomogaoka, Suma, Kobe 654-0142, Hyogo, Japan; (J.O.); (J.U.); (A.I.)
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Cordon NM, Smart CEM, Smith GJ, Davis EA, Jones TW, Seckold R, Burckhardt MA, King BR. The relationship between meal carbohydrate quantity and the insulin to carbohydrate ratio required to maintain glycaemia is non-linear in young people with type 1 diabetes: A randomized crossover trial. Diabet Med 2022; 39:e14675. [PMID: 34415640 DOI: 10.1111/dme.14675] [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: 05/12/2021] [Revised: 08/13/2021] [Accepted: 08/18/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine if the relationship between meal carbohydrate quantity and the insulin to carbohydrate ratio (ICR) required to maintain glycaemia is linear in people with type 1 diabetes. METHODS We used an open labelled randomized four-arm cross-over study design. Participants (N = 31) aged 12-27 years, HbA1c ≤ 64 mmol/mol (8.0%) received insulin doses based on the individual's ICR and the study breakfast carbohydrate quantity and then consumed four breakfasts containing 20, 50, 100 and 150 g of carbohydrate over four consecutive days in randomized order. The breakfast fat and protein percentages were standardized. Postprandial glycaemia was assessed by 5 h continuous glucose monitoring. The primary outcome was percent time in range (TIR) and secondary outcomes included hypoglycaemia, glucose excursion and incremental area under the curve. Statistical analysis included linear mixed modelling and Wilcoxon signed rank tests. RESULTS The 20 g carbohydrate breakfast had the largest proportion of TIR (0.74 ± 0.29 p < 0.04). Hypoglycaemia was more frequent in the 50 g (n = 13, 42%) and 100 g (n = 15, 50%) breakfasts compared to the 20 g (n = 6, 20%) and 150 g (n = 7, 26%) breakfasts (p < 0.029). The 150 g breakfast glucose excursion pattern was different from the smaller breakfasts with the lowest glucose excursion 0-2 h and the highest excursion from 3.5 to 5 h. CONCLUSIONS A non-linear relationship between insulin requirement and breakfast carbohydrate content was observed, suggesting that strengthened ICRs are needed for meals with ≤20 and ≥150 g of carbohydrate. Meals with ≥150 g of carbohydrate may benefit from dual wave bolusing.
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Affiliation(s)
- Natalie M Cordon
- Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Carmel E M Smart
- Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
| | - Grant J Smith
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Elizabeth A Davis
- Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- Faculty of Health, School of Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Timothy W Jones
- Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- Faculty of Health, School of Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Rowen Seckold
- Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
- The School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Marie-Anne Burckhardt
- Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- Faculty of Health, School of Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Bruce R King
- Department of Paediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
- The School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
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10
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Chen W, Wang J, Wang X, Chang P, Liang M. Knockdown of hypoxia-inducible factor 1-alpha (HIF1α) interferes with angiopoietin-like protein 2 (ANGPTL2) to attenuate high glucose-triggered hypoxia/reoxygenation injury in cardiomyocytes. Bioengineered 2022; 13:1476-1490. [PMID: 34974813 PMCID: PMC8805963 DOI: 10.1080/21655979.2021.2019874] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
To investigate the role of hypoxia-inducible factor 1-alpha (HIF1A) in hypoxia/reoxygenation (H/R) injury of cardiomyocytes induced by high glucose (HG). The in vitro model of coronary heart disease with diabetes was that H9c2 cells were stimulated by H/R and HG. Quantitative reverse transcription PCR (RT-qPCR) and Western blot analysis were used to detect the expression of HIF1A and angiopoietin-like protein 2 (ANGPTL2) in H9c2 cells. Cell viability and apoptosis were, respectively, estimated by Cell Counting Kit 8 (CCK-8) and TUNEL assays. Lactate dehydrogenase (LDH) activity, inflammation and oxidative stress were in turn detected by their commercial assay kits. Luciferase reporter assay and chromatin immunoprecipitation (ChIP) assay were used to confirm the association between HIF1A and ANGPTL2 promoter. The expression of nuclear factor E2-related factor 2 (Nrf2)/heme oxygenase 1 (HO-1) pathway-related proteins and apoptosis-related proteins were also detected by Western blot analysis. As a result, ANGPTL2 expression was upregulated in H9c2 cells induced by HG or/and H/R. ANGPTL2 positively modulated HIF1A expression in H9c2 cells. HG or/and H/R suppressed the cell viability and promoted apoptosis, inflammatory response and oxidative stress levels in H9c2 cells. However, the knockdown of ANGPTL2 could reverse the above phenomena in H/R-stimulated-H9c2 cells through activation of Nrf2/HO-1 pathway. HIF1A transcriptionally activated ANGPTL2 expression. The effect of knockdown of ANGPTL2 on H/R triggered-H9c2 cells was weakened by HIF1A overexpression. In conclusion, knockdown of HIF1A downregulated ANGPTL2 to alleviate H/R injury in HG-induced H9c2 cells by activating the Nrf2/HO-1 pathway.
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Affiliation(s)
- Weiguo Chen
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, P.R. China
| | - Jianbang Wang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, P.R. China
| | - Xihui Wang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, P.R. China
| | - Pan Chang
- Experimental Center, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, P.R. China
| | - Meng Liang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Medical University, Xi'an, P.R. China
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11
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Curtis PJ, Berends L, van der Velpen V, Jennings A, Haag L, Chandra P, Kay CD, Rimm EB, Cassidy A. Blueberry anthocyanin intake attenuates the postprandial cardiometabolic effect of an energy-dense food challenge: Results from a double blind, randomized controlled trial in metabolic syndrome participants. Clin Nutr 2021; 41:165-176. [PMID: 34883305 PMCID: PMC8757535 DOI: 10.1016/j.clnu.2021.11.030] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 11/04/2021] [Accepted: 11/24/2021] [Indexed: 12/13/2022]
Abstract
Background & aims Whilst the cardioprotective effects of blueberry intake have been shown in prospective studies and short-term randomized controlled trials (RCTs), it is unknown whether anthocyanin-rich blueberries can attenuate the postprandial, cardiometabolic dysfunction which follows energy-dense food intakes; especially in at-risk populations. We therefore examined whether adding blueberries to a high-fat/high-sugar meal affected the postprandial cardiometabolic response over 24 h. Methods A parallel, double-blind RCT (n = 45; age 63.4 ± 7.4 years; 64% male; BMI 31.4 ± 3.1 kg/m2) was conducted in participants with metabolic syndrome. After baseline assessments, an energy-dense drink (969 Kcals, 64.5 g fat, 84.5 g carbohydrate, 17.9 g protein) was consumed with either 26 g (freeze-dried) blueberries (equivalent to 1 cup/150 g fresh blueberries) or 26 g isocaloric matched placebo. Repeat blood samples (30, 60, 90, 120, 180, 360 min and 24 h), a 24 h urine collection and vascular measures (at 3, 6, and 24 h) were performed. Insulin and glucose, lipoprotein levels, endothelial function (flow mediated dilatation (FMD)), aortic and systemic arterial stiffness (pulse wave velocity (PWV), Augmentation Index (AIx) respectively), blood pressure (BP), and anthocyanin metabolism (serum and 24 h urine) were assessed. Results Blueberries favorably affected postprandial (0–24 h) concentrations of glucose (p < 0.001), insulin (p < 0.01), total cholesterol (p = 0.04), HDL-C, large HDL particles (L-HDL-P) (both p < 0.01), extra-large HDL particles (XL-HDL-P; p = 0.04) and Apo-A1 (p = 0.01), but not LDL-C, TG, or Apo-B. After a transient higher peak glucose concentration at 1 h after blueberry intake ([8.2 mmol/L, 95%CI: 7.7, 8.8] vs placebo [6.9 mmol/L, 95%CI: 6.4, 7.4]; p = 0.001), blueberries significantly attenuated 3 h glucose ([4.3 mmol/L, 95%CI: 3.8, 4.8] vs placebo [5.1 mmol/L, 95%CI: 4.6, 5.6]; p = 0.03) and insulin concentrations (blueberry: [23.4 pmol/L, 95%CI: 15.4, 31.3] vs placebo [52.9 pmol/L, 95%CI: 41.0, 64.8]; p = 0.0001). Blueberries also improved HDL-C ([1.12 mmol/L, 95%CI: 1.06, 1.19] vs placebo [1.08 mmol/L, 95%CI: 1.02, 1.14]; p = 0.04) at 90 min and XL-HDLP levels ([0.38 × 10-6, 95%CI: 0.35, 0.42] vs placebo [0.35 × 10-6, 95%CI: 0.32, 0.39]; p = 0.02) at 3 h. Likewise, significant improvements were observed 6 h after blueberries for HDL-C ([1.17 mmol/L, 95%CI: 1.11, 1.24] vs placebo [1.10 mmol/L, 95%CI: 1.03, 1.16]; p < 0.001), Apo-A1 ([1.37 mmol/L, 95%CI: 1.32, 1.41] vs placebo [1.31 mmol/L, 95%CI: 1.27, 1.35]; p = 0.003), L-HDLP ([0.70 × 10-6, 95%CI: 0.60, 0.81] vs placebo [0.59 × 10-6, 95%CI: 0.50, 0.68]; p = 0.003) and XL-HDLP ([0.44 × 10-6, 95%CI: 0.40, 0.48] vs placebo [0.40 × 10-6, 95%CI: 0.36, 0.44]; p < 0.001). Similarly, total cholesterol levels were significantly lower 24 h after blueberries ([4.9 mmol/L, 95%CI: 4.6, 5.1] vs placebo [5.0 mmol/L, 95%CI: 4.8, 5.3]; p = 0.04). Conversely, no effects were observed for FMD, PWV, AIx and BP. As anticipated, total anthocyanin-derived phenolic acid metabolite concentrations significantly increased in the 24 h after blueberry intake; especially hippuric acid (6-7-fold serum increase, 10-fold urinary increase). In exploratory analysis, a range of serum/urine metabolites were associated with favorable changes in total cholesterol, HDL-C, XL-HDLP and Apo-A1 (R = 0.43 to 0.50). Conclusions For the first time, in an at-risk population, we show that single-exposure to the equivalent of 1 cup blueberries (provided as freeze-dried powder) attenuates the deleterious postprandial effects of consuming an energy-dense high-fat/high-sugar meal over 24 h; reducing insulinaemia and glucose levels, lowering cholesterol, and improving HDL-C, fractions of HDL-P and Apo-A1. Consequently, intake of anthocyanin-rich blueberries may reduce the acute cardiometabolic burden of energy-dense meals. Clinical trial registry NCT02035592 at www.clinicaltrials.gov.
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Affiliation(s)
- Peter J Curtis
- Nutrition & Preventive Medicine Group, Norwich Medical School, University of East Anglia, Norwich, NR47UQ, UK
| | - Lindsey Berends
- Nutrition & Preventive Medicine Group, Norwich Medical School, University of East Anglia, Norwich, NR47UQ, UK
| | - Vera van der Velpen
- Nutrition & Preventive Medicine Group, Norwich Medical School, University of East Anglia, Norwich, NR47UQ, UK
| | - Amy Jennings
- Institute for Global Food Security, Queen's University Belfast, BT9 5DL, Ireland
| | - Laura Haag
- Nutrition & Preventive Medicine Group, Norwich Medical School, University of East Anglia, Norwich, NR47UQ, UK
| | - Preeti Chandra
- Food Bioprocessing & Nutrition Sciences, Plants for Human Health Institute, North Carolina State University, North Carolina Research Campus, Kannapolis, NC, USA
| | - Colin D Kay
- Food Bioprocessing & Nutrition Sciences, Plants for Human Health Institute, North Carolina State University, North Carolina Research Campus, Kannapolis, NC, USA
| | - Eric B Rimm
- Departments of Epidemiology & Nutrition, Harvard T.H. Chan School of Public Health, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Aedín Cassidy
- Institute for Global Food Security, Queen's University Belfast, BT9 5DL, Ireland.
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12
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Askari M, Dehghani A, Abshirini M, Raeisi T, Alizadeh S. Glycemic index, but not glycemic load, is associated with an increased risk of metabolic syndrome: Meta-analysis of observational studies. Int J Clin Pract 2021; 75:e14295. [PMID: 33928722 DOI: 10.1111/ijcp.14295] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 03/02/2021] [Accepted: 04/27/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Diets with high glycemic index (GI) or high glycemic load (GL) have been linked to important risk factors associated with the development of metabolic syndrome (MetS), such as dyslipidemia, higher blood glucose, and insulin concentrations. However, the role of GI and GL in relation to Mets is still understudied and controversial. This review, therefore, assessed whether high GI or GL contribute to development of Mets. METHODS A systematic search of four bibliographic databases was conducted (MEDLINE/PubMed, EMBASE, Web of Sciences, and Scopus) from inception to January 2020 for observational studies assessing GI/GL in relation to MetS. Risk estimates were pooled using random-effect models for the highest versus lowest intake categories, and assessed for heterogeneity using subgroup analysis. The dose-response nature of the relationship was also investigated. Sensitivity analysis and Egger test were used to check the robustness of findings and the possibility of publication bias, respectively. RESULTS Data from 12 publications (one cohort study and eleven cross-sectional studies) with a total sample size of 36,295 subjects are included. The pooled effect sizes from the nine studies indicated high versus low dietary GI was associated with increased risk of MetS (OR = 1.05, 95% CI: 1.01 to 1.09) (I2 = 58.1, P = .004). This finding was supported by all subgroup analyses except where studies used 24-h recalls for dietary assessment. Additionally, a linear dose-response investigation revealed that each 5-point increment in GI was associated with 2% increase in the risk of MetS (OR = 1.02, 95% CI: 1.01 to 1.02); non-linear pattern was insignificant, however (p-nonlinearity = 0.63). Moreover, pooled effect sizes from ten studies suggested that no association was found between the GL and MetS with results remaining consistent in all subgroup analyses. CONCLUSION A diet with lower GI may protect against MetS. Nutrition policy and clinical practices should encourage a diet with low GI. Future studies should include both GI and GL and different criteria of MetS to provide a better comparison.
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Affiliation(s)
- Mohammadreza Askari
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Dehghani
- Nutrition Research Center, Department of Community Nutrition, faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Abshirini
- School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand
| | - Tahereh Raeisi
- Department of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shahab Alizadeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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13
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Lammi C, Bartolomei M, Bollati C, Cecchi L, Bellumori M, Sabato E, Giulio V, Mulinacci N, Arnoldi A. Phenolic Extracts from Extra Virgin Olive Oils Inhibit Dipeptidyl Peptidase IV Activity: In Vitro, Cellular, and In Silico Molecular Modeling Investigations. Antioxidants (Basel) 2021; 10:antiox10071133. [PMID: 34356366 PMCID: PMC8301156 DOI: 10.3390/antiox10071133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/10/2021] [Accepted: 07/14/2021] [Indexed: 11/16/2022] Open
Abstract
Two extra virgin olive oil (EVOO) phenolic extracts (BUO and OMN) modulate DPP-IV activity. The in vitro DPP-IV activity assay was performed at the concentrations of 1, 10, 100, 500, and 1000 μg/mL, showing a dose-dependent inhibition by 6.8 ± 1.9, 17.4 ± 6.1, 37.9 ± 2.4, 57.8 ± 2.9, and 81 ± 1.4% for BUO and by 5.4 ± 1.7, 8.9 ± 0.4, 28.4 ± 7.2, 52 ± 1.3, and 77.5 ± 3.5% for OMN. Moreover, both BUO and OMN reduced the DPP-IV activity expressed by Caco-2 cells by 2.9 ± 0.7, 44.4 ± 0.7, 61.2 ± 1.8, and 85 ± 4.2% and by 3 ± 1.9, 35 ± 9.4, 60 ± 7.2, and 82 ± 2.8%, respectively, at the same doses. The concentration of the most abundant and representative secoiridoids within both extracts was analyzed by nuclear magnetic resonance (1H-NMR). Oleuropein, oleacein, oleocanthal, hydroxytyrosol, and tyrosol, tested alone, reduced the DPP-IV activity, with IC50 of 472.3 ± 21.7, 187 ± 11.4, 354.5 ± 12.7, 741.6 ± 35.7, and 1112 ± 55.6 µM, respectively. Finally, in silico molecular docking simulations permitted the study of the binding mode of these compounds.
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Affiliation(s)
- Carmen Lammi
- Department of Pharmaceutical Sciences, University of Milan, 20133 Milan, Italy; (M.B.); (C.B.); (E.S.); (V.G.); (A.A.)
- Correspondence: ; Tel.: +39-025-031-9372
| | - Martina Bartolomei
- Department of Pharmaceutical Sciences, University of Milan, 20133 Milan, Italy; (M.B.); (C.B.); (E.S.); (V.G.); (A.A.)
| | - Carlotta Bollati
- Department of Pharmaceutical Sciences, University of Milan, 20133 Milan, Italy; (M.B.); (C.B.); (E.S.); (V.G.); (A.A.)
| | - Lorenzo Cecchi
- Department of Neuroscience, Psychology, Drug and Child Health, Pharmaceutical and Nutraceutical Section, University of Florence, 50019 Florence, Italy; (L.C.); (M.B.); (N.M.)
| | - Maria Bellumori
- Department of Neuroscience, Psychology, Drug and Child Health, Pharmaceutical and Nutraceutical Section, University of Florence, 50019 Florence, Italy; (L.C.); (M.B.); (N.M.)
| | - Emanuela Sabato
- Department of Pharmaceutical Sciences, University of Milan, 20133 Milan, Italy; (M.B.); (C.B.); (E.S.); (V.G.); (A.A.)
| | - Vistoli Giulio
- Department of Pharmaceutical Sciences, University of Milan, 20133 Milan, Italy; (M.B.); (C.B.); (E.S.); (V.G.); (A.A.)
| | - Nadia Mulinacci
- Department of Neuroscience, Psychology, Drug and Child Health, Pharmaceutical and Nutraceutical Section, University of Florence, 50019 Florence, Italy; (L.C.); (M.B.); (N.M.)
| | - Anna Arnoldi
- Department of Pharmaceutical Sciences, University of Milan, 20133 Milan, Italy; (M.B.); (C.B.); (E.S.); (V.G.); (A.A.)
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14
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Hatamoto Y, Yoshimura E, Takae R, Komiyama T, Matsumoto M, Higaki Y, Tanaka H. The effects of breaking sedentary time with different intensity exercise bouts on energy metabolism: A randomized cross-over controlled trial. Nutr Metab Cardiovasc Dis 2021; 31:1879-1889. [PMID: 33992509 DOI: 10.1016/j.numecd.2021.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/13/2021] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Breaking up sedentary periods, particularly with light activity, increases total energy expenditure (EE), and helps provide better glycemic control. However, the effects of activities of various intensities to interrupt prolonged sedentary time are unclear. The purpose of the present study was to examine potential differences in glycemic control and EE from breaking up sedentary time with short exercise bouts of different intensities. METHODS AND RESULTS Nine overweight/obesity young men underwent whole body indirect calorimetry at 19:00 on day 1 and stayed overnight. After awakening on day 2, they performed short duration jogging every 30 min over 8 h (16-time bouts in total) under 3 different conditions with the same running distance: (1) lactate threshold (LT) for 2 min, (2) 60% LT for 200 s, and (3) onset of blood lactate accumulation (OBLA) for 75 s. The 24-h EE and interstitial glucose concentration (from 8:00 to 19:00 on day 2) was continuously measured throughout the trials. The standard deviation during intervention and indexes of postprandial of the interstitial glucose concentration was significantly lower at LT and OBLA than at 60% LT (p < 0.05). The 24-h EE was not significantly different among conditions, but EE at OBLA during intervention was slightly but significantly higher than at 60% LT and LT. CONCLUSION Breaking up sedentary time with short-duration jogging at LT and with OBLA intensities may have better glycemic control and increased use of carbohydrate as a fuel, while short-duration a jogging at OBLA intensity may increase EE. TRIAL REGISTRATION UMIN000041361.
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Affiliation(s)
- Yoichi Hatamoto
- The Fukuoka University Institute for Physical Activity, 8-19-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan; Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan.
| | - Eiichi Yoshimura
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan.
| | - Rie Takae
- The Fukuoka University Institute for Physical Activity, 8-19-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan; Faculty of Nursing and Nutrition, University of Nagasaki, Siebold, 1-1-1 Manabino, Nagayo-cho, Nishi-Sonogi-gun, Nagasaki, 851-2195, Japan.
| | - Takaaki Komiyama
- Center for Education in Liberal Arts and Sciences, Osaka University, 1-17 Machikaneyama, Toyonaka, 560-0043, Osaka, Japan.
| | - Mai Matsumoto
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan.
| | - Yasuki Higaki
- The Fukuoka University Institute for Physical Activity, 8-19-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
| | - Hiroaki Tanaka
- The Fukuoka University Institute for Physical Activity, 8-19-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
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15
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Gillen JB, Estafanos S, Govette A. Exercise-nutrient interactions for improved postprandial glycemic control and insulin sensitivity. Appl Physiol Nutr Metab 2021; 46:856-865. [PMID: 34081875 DOI: 10.1139/apnm-2021-0168] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Type 2 diabetes (T2D) is a rapidly growing yet largely preventable chronic disease. Exaggerated increases in blood glucose concentration following meals is a primary contributor to many long-term complications of the disease that decrease quality of life and reduce lifespan. Adverse health consequences also manifest years prior to the development of T2D due to underlying insulin resistance and exaggerated postprandial concentrations of the glucose-lowering hormone insulin. Postprandial hyperglycemic and hyperinsulinemic excursions can be improved by exercise, which contributes to the well-established benefits of physical activity for the prevention and treatment of T2D. The aim of this review is to describe the postprandial dysmetabolism that occurs in individuals at risk for and with T2D, and highlight how acute and chronic exercise can lower postprandial glucose and insulin excursions. In addition to describing the effects of traditional moderate-intensity continuous exercise on glycemic control, we highlight other forms of activity including low-intensity walking, high-intensity interval exercise, and resistance training. In an effort to improve knowledge translation and implementation of exercise for maximal glycemic benefits, we also describe how timing of exercise around meals and post-exercise nutrition can modify acute and chronic effects of exercise on glycemic control and insulin sensitivity. Novelty: Exaggerated postprandial blood glucose and insulin excursions are associated with disease risk. Both a single session and repeated sessions of exercise improve postprandial glycemic control in individuals with and without T2D. The glycemic benefits of exercise can be enhanced by considering the timing and macronutrient composition of meals around exercise.
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Affiliation(s)
- Jenna B Gillen
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada
| | - Stephanie Estafanos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada
| | - Alexa Govette
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada
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16
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Musa-Veloso K, Noori D, Venditti C, Poon T, Johnson J, Harkness LS, O'Shea M, Chu Y. A Systematic Review and Meta-Analysis of Randomized Controlled Trials on the Effects of Oats and Oat Processing on Postprandial Blood Glucose and Insulin Responses. J Nutr 2021; 151:341-351. [PMID: 33296453 DOI: 10.1093/jn/nxaa349] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/31/2020] [Accepted: 10/12/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Oats are a whole grain cereal with potentially favorable effects on the postprandial glycemic response; however, the effects of oat processing on these glycemic benefits are not well understood. OBJECTIVES The study objective was to determine the effects of differently processed oats on the postprandial blood glucose and insulin responses relative to refined grains. METHODS Eleven electronic databases were systematically searched to identify studies published up to and including May 2019. Randomized controlled trials comparing the postprandial blood glucose and insulin responses to oats compared with any refined grain were included, so long as the available carbohydrate content of the test meals was similar. Pooled effect sizes were computed using the difference in incremental area under the curves for blood glucose and insulin following the consumption of oats compared with the refined grain control. RESULTS Ten publications were included, with intact oat kernels studied in 3 comparisons, thick oat flakes (>0.6 mm) in 7 comparisons, and thin/quick/instant oat flakes (≤0.6 mm) in 6 comparisons. Compared with the consumption of the refined grain control, the consumption of intact oat kernels was associated with significant reductions in postprandial blood glucose (-45.5 mmol x min/L; 95% CI: -80.1, -10.9 mmol x min/L; P = 0.010) and insulin (-4.5 nmol x min/L; 95% CI: -7.1, -1.8 nmol x min/L; P = 0.001) responses; the consumption of thick oat flakes was associated with significant reductions in postprandial blood glucose (-30.6 mmol x min/L; 95% CI: -40.4, -20.9 mmol x min/L; P < 0.001) and insulin (-3.9 nmol x min/L; 95% CI: -5.3, -2.5 nmol x min/L; P < 0.001) responses; but, the consumption of thin/quick/instant oat flakes was not associated with any effects on the postprandial blood glucose and insulin responses. CONCLUSIONS A disruption in the structural integrity of the oat kernel is likely associated with a loss in the glycemic benefits of oats.
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Affiliation(s)
| | - Daniel Noori
- Intertek Health Sciences Inc., Mississauga, Ontario, Canada
| | | | - Theresa Poon
- Intertek Health Sciences Inc., Mississauga, Ontario, Canada
| | - Jodee Johnson
- Quaker Oats Center of Excellence, PepsiCo R&D Nutrition Sciences, Barrington, IL, USA
| | - Laura S Harkness
- Quaker Oats Center of Excellence, PepsiCo R&D Nutrition Sciences, Barrington, IL, USA
| | - Marianne O'Shea
- Quaker Oats Center of Excellence, PepsiCo R&D Nutrition Sciences, Barrington, IL, USA
| | - YiFang Chu
- Quaker Oats Center of Excellence, PepsiCo R&D Nutrition Sciences, Barrington, IL, USA
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17
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Gotlib J, Kluin-Nelemans HC, Akin C, Hartmann K, Valent P, Reiter A. Practical management of adverse events in patients with advanced systemic mastocytosis receiving midostaurin. Expert Opin Biol Ther 2021; 21:487-498. [PMID: 33063554 DOI: 10.1080/14712598.2021.1837109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Systemic mastocytosis (SM) is characterized by the overproduction and accumulation of neoplastic mast cells (MCs) in the bone marrow, skin, and visceral organs. The KIT D816V mutation is found in approximately 90% of cases. In advanced SM (advSM), inferior survival often relates to MC-induced organ damage that may impact multiple organ systems. In addition, mediator symptoms related to MC activation can severely impact the quality of life. The oral multikinase/KIT inhibitor midostaurin was approved by the US Food and Drug Administration and the European Medicines Agency as monotherapy for advSM based on data from phase 2 clinical studies. AREAS COVERED This review discusses the management of common adverse events (AEs) in patients with advSM who participated in phase 2 clinical studies that led to the approval of midostaurin. EXPERT OPINION In the advSM population undergoing treatment with midostaurin, treatment-related AEs are often difficult to distinguish from disease-related symptoms, which can lead to premature discontinuation and improper dose reduction of midostaurin therapy in patients who might have benefitted from continued therapy. Here we present strategies to help optimize AE management and maximize the potential benefits of midostaurin in advSM.
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Affiliation(s)
- Jason Gotlib
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Hanneke C Kluin-Nelemans
- Department of Hematology, University Medical Center, University of Groningen, Groningen, The Netherlands
| | - Cem Akin
- Division of Allergy and Clinical Immunology, University of Michigan, Ann Arbor, MI, USA
| | - Karin Hartmann
- Division of Allergy, Department of Dermatology, University of Basel, Basel, Switzerland.,Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Andreas Reiter
- University Hospital Mannheim, Heidelberg University, Mannheim, Germany
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18
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Moore J, Salmons H, Vinoskey C, Kressler J. A single one-minute, comfortable paced, stair-climbing bout reduces postprandial glucose following a mixed meal. Nutr Metab Cardiovasc Dis 2020; 30:1967-1972. [PMID: 32811738 DOI: 10.1016/j.numecd.2020.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/26/2020] [Accepted: 06/22/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Postprandial blood glucose (PBG) is an independent predictor of disease and mortality risk. To date, the shortest, single, moderate-intensity exercise intervention to reduce PBG is a 1 min bout of stair stepping during an oral glucose tolerance test. Whether this effect translates to real meal consumption is unknown. METHODS AND RESULTS Subjects (N = 30) participated in a randomized controlled crossover trial performing 0 min (seated control), 1 min, 3 min or 10 min of stair climbing and descending bouts (SCD) at a self-selected pace after consumption of a mixed meal on four separate visits. Compared to control, all SCD reduced PBG at least one timepoint: at 30-min the 3 min (-10.8 (-18.7 to -2.8) mg/dL, p = 0.010) and 10 min (-36.3 (-46.4 to -26.3) mg/dL), p < .001), and at 45-min the 1 min (-7.3 (-13.9 to -0.7) mg/dL, p = 0.030, 3 min (-8.7 (-13.9 to -3.6) mg/dL, p = 0.002 and 10 min SCD (-12.2 (-18.2 to -6.1)mg/dL, p < 0.000) reduced PBG. The area under the curve (AUC) for PBG was lower following the 3 min (-4.4% (-7.5 to -1.4%), p = 0.006) and 10 min (-8.9% (-12.4 to -5.3%), p < 0.001), while the incremental AUC (iAUC) was reduced only following the 10 min (-38.0% (-63.7 to -12.3%), p = 0.005) SCD. All SCD were rated by subjects as very light to light intensity. CONCLUSIONS Single, subjectively "light" intensity stair climbing and descending bouts as short as 1 min in duration attenuate the postprandial glucose response in normal weight individuals following consumption of a mixed meal. More pronounced effects require longer bouts in a dose-dependent manner.
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Affiliation(s)
- Jeff Moore
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182-7251, USA.
| | - Hannah Salmons
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182-7251, USA
| | - Cameron Vinoskey
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182-7251, USA
| | - Jochen Kressler
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182-7251, USA
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19
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Kong Z, Shi Q, Sun S, Tong TK, Zhang H, Nie J. High-intensity interval exercise lowers postprandial glucose concentrations more in obese adults than lean adults. Prim Care Diabetes 2019; 13:568-573. [PMID: 31109784 DOI: 10.1016/j.pcd.2019.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 12/14/2018] [Accepted: 04/05/2019] [Indexed: 11/24/2022]
Abstract
AIMS To compare postprandial glucose responses to high-intensity interval exercise (HIE) between obese and lean individuals. METHODS Thirty healthy young adult males (15 obese, 15 lean) ate a standardised meal, then performed HIE (4 × 30-s Wingate cycling/4-min rest) or a no-exercise control trial (CON). Blood glucose was measured preprandially and up to 150 min postprandially. RESULTS Compared to CON, HIE reduced postprandial glucose concentrations at 120-150 min in obese (p < 0.001) and lean men (p < 0.05), with greater reductions in obese than lean subjects at 120 (-27.0% vs. -8.3%), 135 (-31.9% vs. -15.7%), and 150 min (-21.8% vs. -10.6%). The total glucose area under the curve (AUC) for the testing period was lower with HIE than CON among obese men (p < 0.05), but not lean men (p > 0.05). We found moderate correlations between body mass and postprandial glucose changes (r = 0.39-0.44, p < 0.05), and between glucose AUC and body mass and fat free mass (r = 0.39-0.48, p < 0.05). CONCLUSIONS Our findings suggest that HIE may act as a time-efficient lifestyle intervention strategy for improving obesity-related diabetes risk factors, and might play a role in primary diabetes prevention for the healthy but sedentary population.
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Affiliation(s)
- Zhaowei Kong
- Faculty of Education, University of Macau, Macao, China.
| | - Qingde Shi
- School of Physical Education and Sports, Macao Polytechnic Institute, Macao, China.
| | - Shengyan Sun
- Faculty of Education, University of Macau, Macao, China; Institute of Physical Education, Huzhou University, Huzhou, Zhejiang Province, China.
| | - Tomas K Tong
- Dr. Stephen Hui Research Centre for Physical Recreation and Wellness, Department of Physical Education, Hong Kong Baptist University, Hong Kong, China.
| | - Haifeng Zhang
- College of Physical Education, Hebei Normal University, Shijiazhuang, Hebei Province, China.
| | - Jinlei Nie
- School of Physical Education and Sports, Macao Polytechnic Institute, Macao, China.
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20
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Gilbertson NM, Miller SL, Eichner NZ, Malin SK. Endothelial function following interval exercise plus low-calorie diet treatment in obese females. Physiol Rep 2019; 7:e14239. [PMID: 31552710 PMCID: PMC6759506 DOI: 10.14814/phy2.14239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 08/30/2019] [Indexed: 12/30/2022] Open
Abstract
We determined if interval exercise plus a low-calorie diet (LCD + INT) increases endothelial function more than an energy-matched LCD. Obese women (47.2 ± 2.6y, 37.5 ± 1.3kg/m2 ) were randomized to 13 days of a LCD (n = 12; mixed meals of ~ 1200kcal/d) or LCD + INT (n = 13; 12 supervised 60-min INT bouts of 3 min at 90% and 50% HRpeak ). LCD + INT subjects received 350kcal postexercise to equate energy availability with LCD. Fitness (VO2 peak) and body composition (BodPod) were determined and a 120 min, 75 g oral glucose tolerance test was performed to examine fasting and postprandial flow-mediated dilation (FMD, endothelial function), respiratory exchange ratio (RER) via indirect calorimetry as well as glucose and insulin incremental area under the curve (iAUC120min ). LCD + INT increased VO2 peak (P = 0.02) compared with LCD, and both treatments decreased fat mass (P < 0.001) and insulin iAUC120min (P = 0.03). There was no overall treatment effect on fasting or iAUC120min FMD. However, in participants who increased fasting endothelial function after each treatment (Δ > 50%; LCD n = 5, LCD + INT n = 7), LCD + INT increased fasted (P = 0.005) and decreased iAUC120min (P = 0.003) FMD compared with LCD. Enhanced fitness correlated with increased fasting FMD (r = 0.43, P = 0.03) and diminished FMD iAUC120min (r = -0.44, P = 0.03). Decreased FMD iAUC120min correlated with reduced glucose iAUC120min (r = 0.64, P = 0.001) as well as increased 60-min RER (r = -0.42, P = 0.04). Low baseline fasting and iAUC120min FMD was also linked to enhanced fasting and iAUC120min FMD post-treatment (r = -0.71, P < 0.001; r = -0.89, P < 0.001, respectively). In conclusion, increasing fitness via INT may increase the effect of LCD on lowering cardiovascular disease risk in obese women.
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Affiliation(s)
| | | | | | - Steven K. Malin
- Department of KinesiologyUniversity of VirginiaCharlottesvilleVirginia
- Division of Endocrinology & MetabolismDepartment of MedicineUniversity of VirginiaCharlottesvilleVirginia
- Robert M. Berne Cardiovascular Research CenterUniversity of VirginiaCharlottesvilleVirginia
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21
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Chen SC, Lin CP, Hsu HC, Shu JH, Liang Y, Hsu PF, Wang YJ, Ding YZ, Liou TL, Wang YW, Chang YC, Chan WL, Chen JW, Lin SJ, Leu HB. Serum bilirubin improves the risk predictions of cardiovascular and total death in diabetic patients. Clin Chim Acta 2019; 488:1-6. [DOI: 10.1016/j.cca.2018.10.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/25/2018] [Accepted: 10/21/2018] [Indexed: 12/30/2022]
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22
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Rodriguez-Segade S, Rodriguez J, Camiña F, Fernández-Arean M, García-Ciudad V, Pazos-Couselo M, García-López JM, Alonso-Sampedro M, González-Quintela A, Gude F. Continuous glucose monitoring is more sensitive than HbA1c and fasting glucose in detecting dysglycaemia in a Spanish population without diabetes. Diabetes Res Clin Pract 2018; 142:100-109. [PMID: 29807103 DOI: 10.1016/j.diabres.2018.05.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/06/2018] [Accepted: 05/16/2018] [Indexed: 11/28/2022]
Abstract
AIMS To investigate whether continuous glucose monitoring (CGM) reveals patterns of glycaemic behaviour, the detection of which might improve early diagnosis of dysglycaemia. METHODS A total 1521 complete days of valid CGM data were recorded under real-life conditions from a healthy sample of a Spanish community, as were matching FPG and HbA1C data. No participant was pregnant, had a history of kidney or liver disease, or was taking drugs known to affect glycaemia. RESULTS CGM and fingerstick measurements showed a mean relative absolute difference of 6.9 ± 2.2%. All subjects were normoglycaemic according to FPG and HbA1C except 21% who were prediabetic. The normoglycaemic subjects had a 24-hour mean blood glucose concentration (MBG) of 5.7 ± 0.4 mmol/L, spending a median of 97% of their time within the target range (3.9-7.8 mmol/L). 73% of them experienced episodes with blood glucose levels above the threshold for impaired glucose tolerance, and 5% levels above the threshold for diabetes. These normoglycaemic participants with episodes of high glycaemia had glycaemic variabilities similar to those of prediabetic subjects with episodes of similar intensity or combined duration. CONCLUSIONS CGM is a better indicator of possible early dysglycaemia than either FPG or HbA1c.
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Affiliation(s)
- Santiago Rodriguez-Segade
- The Department of Biochemistry and Molecular Biology, University of Santiago de Compostela, 15782 Santiago de Compostela, A Coruña, Spain; Hospital Clinical Biochemistry Laboratory of the University of Santiago de Compostela, 15706 Santiago de Compostela, A Coruña, Spain.
| | - Javier Rodriguez
- The Department of Biochemistry and Molecular Biology, University of Santiago de Compostela, 15782 Santiago de Compostela, A Coruña, Spain; Hospital Clinical Biochemistry Laboratory of the University of Santiago de Compostela, 15706 Santiago de Compostela, A Coruña, Spain
| | - Félix Camiña
- The Department of Biochemistry and Molecular Biology, University of Santiago de Compostela, 15782 Santiago de Compostela, A Coruña, Spain
| | | | | | - Marcos Pazos-Couselo
- The Division of Endocrinology of Hospital de Conxo, 15705 Santiago de Compostela, A Coruña, Spain
| | - Jose M García-López
- The Division of Endocrinology of Hospital de Conxo, 15705 Santiago de Compostela, A Coruña, Spain
| | - Manuela Alonso-Sampedro
- The Clinical Epidemiology Unit and of the University of Santiago de Compostela, 15706 Santiago de Compostela, A Coruña, Spain; Department of Internal Medicine of the Hospital Clinico Universitario de Santiago de Compostela, 15706 Santiago de Compostela, A Coruña, Spain
| | - Arturo González-Quintela
- Department of Internal Medicine of the Hospital Clinico Universitario de Santiago de Compostela, 15706 Santiago de Compostela, A Coruña, Spain
| | - Francisco Gude
- The Clinical Epidemiology Unit and of the University of Santiago de Compostela, 15706 Santiago de Compostela, A Coruña, Spain
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23
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Kumar SS, Rao KB. Efficacy of Alpha Glucosidase Inhibitor from Marine Actinobacterium in the Control of Postprandial Hyperglycaemia in Streptozotocin (STZ) Induced Diabetic Male Albino Wister Rats. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2018; 17:202-214. [PMID: 29755552 PMCID: PMC5937091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The current study was carried out to evaluate the in-vitro and in-vivo efficiency of alpha glucosidase inhibitor of marine actinobacteria in the control of postprandial hyperglycaemia. Soil samples were collected from salterns, coastal area in Kothapatnam, Ongole, Andhra Pradesh, India. Among the actinobacterial isolates tested for yeastα-glucosidase inhibitory activity, only three isolates showed prominent inhibition. The patient isolate was selected and identified as Streptomyces coelicoflavus SRBVIT13 using 16S r-RNA gene sequencing. In in-vitro studies, the chloroform extract of Streptomyces coelicoflavus SRBVIT13 showed significant enzyme inhibitory activity against yeast and mammalian α-glucosidaseenzymes. In animal studies, the oral ingestion of chloroform extract (600 mg/kg) of S. coelicoflavus SRBVIT13 in maltose and sucrose loaded diabetic rats, showed significant regulation of postprandial blood glucose by 82.25% and a 77.25% reduction, respectively. The lead compound from S. coelicoflavusSRBVIT13 was isolated, purified, characterized, and identified by stranded analytical techniques as 2-t-butyl-5-chloromethyl-3-methyl-4-oxoimidazolidine-1-carboxylic acid, t-butyl ester. The results obtained in the present study are promising and the bioactive compound from S. coelicoflavusSRBVIT13 may be considered as a potential agent in regulating the postprandial hyperglycaemia.
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24
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Hatamoto Y, Goya R, Yamada Y, Yoshimura E, Nishimura S, Higaki Y, Tanaka H. Effect of exercise timing on elevated postprandial glucose levels. J Appl Physiol (1985) 2017; 123:278-284. [DOI: 10.1152/japplphysiol.00608.2016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 12/20/2022] Open
Abstract
There is no consensus regarding optimal exercise timing for reducing postprandial glucose (PPG). The purpose of the present study was to determine the most effective exercise timing. Eleven participants completed four different exercise patterns 1) no exercise; 2) preprandial exercise (jogging); 3) postprandial exercise; and 4) brief periodic exercise intervention (three sets of 1-min jogging + 30 s of rest, every 30 min, 20 times total) in a random order separated by a minimum of 5 days. Preprandial and postprandial exercise consisted of 20 sets of intermittent exercise (1 min of jogging + 30 s rest per set) repeated 3 times per day. Total daily exercise volume was identical for all three exercise patterns. Exercise intensities were 62.4 ± 12.9% V̇o2peak. Blood glucose concentrations were measured continuously throughout each trial for 24 h. After breakfast, peak blood glucose concentrations were lower with brief periodic exercise (99 ± 6 mg/dl) than those with preprandial and postprandial exercise (109 ± 10 and 115 ± 14 mg/dl, respectively, P < 0.05, effect size = 0.517). After lunch, peak glucose concentrations were lower with brief periodic exercise than those with postprandial exercise (97 ± 5 and 108 ± 8 mg/dl, P < 0.05, effect size = 0.484). After dinner, peak glucose concentrations did not significantly differ among exercise patterns. Areas under the curve over 24 h and 2 h postprandially did not differ among exercise patterns. These findings suggest that brief periodic exercise may be more effective than preprandial and postprandial exercise at attenuating PPG in young active individuals. NEW & NOTEWORTHY This was the first study to investigate the effect of different exercise timing (brief periodic vs. preprandial vs. postprandial exercise) on postprandial glucose (PPG) attenuation in active healthy men. We demonstrated that brief periodic exercise attenuated peak PPG levels more than preprandial and postprandial exercise, particularly in the morning. Additionally, PPG rebounded soon after discontinuing postprandial exercise. Thus, brief periodic exercise may be better than preprandial and postprandial exercise at attenuating PPG levels.
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Affiliation(s)
- Yoichi Hatamoto
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
| | - Ryoma Goya
- Graduate School of Sports and Health Science, Fukuoka University, Fukuoka, Japan
| | - Yosuke Yamada
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
- Department of Nutritional Science, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan; and
| | - Eichi Yoshimura
- Department of Food and Health Sciences, Prefectural University of Kumamoto Faculty of Environmental and Symbiotic Sciences, Kumamoto, Japan
| | - Sena Nishimura
- Graduate School of Sports and Health Science, Fukuoka University, Fukuoka, Japan
| | - Yasuki Higaki
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
- Graduate School of Sports and Health Science, Fukuoka University, Fukuoka, Japan
| | - Hiroaki Tanaka
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
- Graduate School of Sports and Health Science, Fukuoka University, Fukuoka, Japan
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25
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Miles MP, Horrigan LC, Jay SE, Brown KM, Porter JW, Steward AN. Concentric and eccentric exercise, glycemic responses to a postexercise meal, and inflammation in women with high versus low waist circumference. Appl Physiol Nutr Metab 2016; 41:1262-1270. [PMID: 27841026 DOI: 10.1139/apnm-2016-0281] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Carbohydrate ingestion and level of concentric versus eccentric muscle activity may alter exercise-induced health benefits for individuals who have high waist circumference as a metabolic risk factor. The purpose of this study was to determine whether metabolic and inflammation responses to an exercise recovery meal differ between women with lower (Lo-WC, <80 cm) compared with higher (Hi-WC) waist circumference when the exercise is primarily concentric (uphill walking; UPHILL) versus primarily eccentric (downhill walking; DOWNHILL). Recreationally active women (age, 18-39 years; body mass index, 19-35.4 m·kg-2; Lo-WC, n = 13; Hi-WC, n = 10) completed UPHILL, DOWNHILL, and resting (CONTROL) conditions followed 30 min later by a mixed meal tolerance test (MMTT) with carbohydrates to protein ratio of 4:1, and blood glucose, insulin, and inflammation markers were compared across conditions. Compared with Lo-WC, the Hi-WC group had higher (p < 0.05) (i) insulin during the MMTT in CONTROL (mean ± SE; 48.5 ± 8.2 vs 22.9 ± 2.8 pmol·L-1), (ii) baseline (0.7 ± 0.4 vs 2.0 ± 1.7 pg·mL-1) interleukin-6 (IL-6), and (iii) IL-6 responses 8 h after UPHILL and CONTROL. Both groups had (i) increases in IL-6 at 0 h after UPHILL and at 8 h after DOWNHILL, and (ii) lower glycemic responses in UPHILL. Women with Hi-WC had higher IL-6 at rest and delayed increases in IL-6 after a high-carbohydrate meal in all conditions. This is consistent with an inflammation response to the meal and or uphill walking exercise. However, both concentrically and eccentrically biased exercises offered benefits to insulin responses to a high carbohydrate meal for Hi-WC.
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Affiliation(s)
- Mary P Miles
- Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA.,Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA
| | - Laura C Horrigan
- Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA.,Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA
| | - Sara E Jay
- Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA.,Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA
| | - Karen M Brown
- Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA.,Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA
| | - Jay W Porter
- Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA.,Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA
| | - Andrea N Steward
- Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA.,Montana State University, Dept. of Health and Human Development, Bozeman, MT 59171, USA
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Selvin E, Rawlings A, Lutsey P, Maruthur N, Pankow JS, Steffes M, Coresh J. Association of 1,5-Anhydroglucitol With Cardiovascular Disease and Mortality. Diabetes 2016; 65:201-8. [PMID: 26395741 PMCID: PMC4686946 DOI: 10.2337/db15-0607] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 09/16/2015] [Indexed: 12/16/2022]
Abstract
In diabetes, low concentrations of the biomarker 1,5-anhydroglucitol (1,5-AG) reflect hyperglycemic excursions over the prior 1-2 weeks. To the extent that hyperglycemic excursions are important in atherogenesis, 1,5-AG may provide independent information regarding cardiovascular risk. Nonetheless, few studies have evaluated associations of 1,5-AG with long-term cardiovascular outcomes in a population-based setting. We measured 1,5-AG in 11,106 participants in the Atherosclerosis Risk in Communities (ARIC) study without cardiovascular disease at baseline (1990-1992) and examined prospective associations with coronary heart disease (n = 1,159 events), ischemic stroke (n = 637), heart failure (n = 1,553), and death (n = 3,120) over 20 years of follow-up. Cox proportional hazards models were adjusted for demographic and cardiovascular risk factors. Compared with persons with 1,5-AG ≥6 μg/mL and no history of diabetes, persons with diabetes and 1,5-AG <6.0 μg/mL had an increased risk of coronary heart disease (HR 3.85, 95% CI 3.11-4.78), stroke (HR 3.48, 95% CI 2.66-4.55), heart failure (HR 3.50, 95% CI 2.93-4.17), and death (HR 2.44, 95% CI 2.11-2.83). There was a threshold effect, with little evidence for associations at "nondiabetic" concentrations of 1,5-AG (e.g., >10 μg/mL). Associations remained but were attenuated with additional adjustment for fasting glucose or HbA1c. These data add to the growing evidence for the prognostic value of 1,5-AG for long-term complications in the setting of diabetes.
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Affiliation(s)
- Elizabeth Selvin
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Division of General Internal Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - Andreea Rawlings
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Pamela Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Nisa Maruthur
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Division of General Internal Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Michael Steffes
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Josef Coresh
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Division of General Internal Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD
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27
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Extra virgin olive oil use is associated with improved post-prandial blood glucose and LDL cholesterol in healthy subjects. Nutr Diabetes 2015; 5:e172. [PMID: 26192450 PMCID: PMC4521177 DOI: 10.1038/nutd.2015.23] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 06/03/2015] [Accepted: 06/15/2015] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES Extra virgin olive oil (EVOO) is a key component of the Mediterranean diet and seems to account for the protective effect against cardiovascular disease. However, the underlying mechanism is still elusive. DESIGN We tested the effect of EVOO, added to Mediterranean-type meal, on post-prandial glycemic and lipid profile. SUBJECTS Post-prandial glycemic and lipid profile were investigated in 25 healthy subjects who were randomly allocated in a cross-over design to a Mediterranean-type meal added with or without 10 g EVOO (first study), or Mediterranean-type meal with EVOO (10 g) or corn oil (10 g; second study). Glycemic profile, which included glucose, insulin, dipeptidyl-peptidase-4 (DPP-4) protein and activity, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), and lipid profile, which included, low-density lipoprotein (LDL) cholesterol (LDL-C), oxidized LDL (ox-LDL), triglycerides and high-density lipoprotein (HDL) cholesterol (HDL-C), were analyzed before and 2 h after the meal. RESULTS In the first study, 2 h after meal, subjects who assumed a meal with EVOO had significantly lower blood glucose (P<0.001), DPP-4 protein (P<0.001) and activity (P<0.001), LDL-C (P<0.001) and ox-LDL (P<0.001) and higher insulin (P<0.05), GLP-1 (P<0.001) and GIP (P<0.05) compared with those without EVOO. The second study showed that compared with corn oil, EVOO improved both glycemic and lipid profile. Thus, a significantly smaller increase of glucose (P<0.05), DPP4 protein (P<0.001) and activity (P<0.05) and higher increase of insulin (P<0.001) and GLP-1 (P<0.001) were observed. Furthermore, compared with corn oil, EVOO showed a significantly less increase of LDL-C (P<0.05) and ox-LDL (P<0.001). CONCLUSIONS We report for the first time that EVOO improves post-prandial glucose and LDL-C, an effect that may account for the antiatherosclerotic effect of the Mediterranean diet.
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28
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Digenio A, Karve S, Candrilli SD, Dalal M. Prandial insulin versus glucagon-like peptide-1 added to basal insulin: comparative effectiveness in the community practice setting. Postgrad Med 2015; 126:49-59. [PMID: 25414934 DOI: 10.3810/pgm.2014.10.2820] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Real-world data on emerging combination approaches for type 2 diabetes mellitus (T2DM) management are limited. The objective of the current study was to document the characteristics and clinical outcomes of patients with T2DM initiating prandial insulin or a glucagon-like peptide-1 (GLP-1) receptor agonist while on basal insulin. METHODS This was a retrospective analysis of an electronic medical records database of patients with T2DM managed in a community practice setting in the United States. The main outcome measures were glycated hemoglobin (HbA1c), body weight, hypoglycemia, and health care resource utilization at baseline and at 6-month and 1-year follow-up. RESULTS A total of 33 810 patients were included in the study: 31 848 on prandial insulin and 1962 on a GLP-1 receptor agonist. At baseline there were significant differences in mean age (60 vs 56 years), mean Charlson Comorbidity Index score (1.1 vs 0.7), mean HbA1c (8.8% vs 8.4%), and mean body weight (99 vs 112 kg) between the prandial insulin and GLP-1 receptor agonist groups, respectively (P < 0.001 for each). After matching for baseline differences, significant and similar changes from baseline were observed between the prandial insulin and the GLP-1 receptor agonist groups during follow-up at the 6 months/1 year post-index date for HbA1c (-0.45/-0.60% vs -0.44/-0.58%, respectively; P = 0.907/0.723 between groups). Body weight changes between the groups were significantly different at 6 months/1 year (+1.7/-1.7 vs -0.9/-3.7 kg; P < 0.001). Hypoglycemia incidence and health care resource utilization were significantly greater in the prandial insulin versus GLP-1 receptor agonist group. CONCLUSIONS The results of this real-world analysis of patients with T2DM adding a GLP-1 receptor agonist or prandial insulin to basal insulin suggest an association between adding a GLP-1 receptor agonist with similar glycemic control, greater reduction in body weight, lower hypoglycemia incidence, and lower health care utilization compared with adding prandial insulin.
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Bernardo MA, Silva ML, Santos E, Moncada MM, Brito J, Proença L, Singh J, de Mesquita MF. Effect of Cinnamon Tea on Postprandial Glucose Concentration. J Diabetes Res 2015; 2015:913651. [PMID: 26258147 PMCID: PMC4516848 DOI: 10.1155/2015/913651] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 07/01/2015] [Indexed: 12/16/2022] Open
Abstract
Glycaemic control, in particular at postprandial period, has a key role in prevention of different diseases, including diabetes and cardiovascular events. Previous studies suggest that postprandial high blood glucose levels (BGL) can lead to an oxidative stress status, which is associated with metabolic alterations. Cinnamon powder has demonstrated a beneficial effect on postprandial glucose homeostasis in animals and human models. The purpose of this study is to investigate the effect of cinnamon tea (C. burmannii) on postprandial capillary blood glucose level on nondiabetic adults. Participants were given oral glucose tolerance test either with or without cinnamon tea in a randomized clinical trial. The data revealed that cinnamon tea administration slightly decreased postprandial BGL. Cinnamon tea ingestion also results in a significantly lower postprandial maximum glucose concentration and variation of maximum glucose concentration (p < 0.05). Chemical analysis showed that cinnamon tea has a high antioxidant capacity, which may be due to its polyphenol content. The present study provides evidence that cinnamon tea, obtained from C. burmannii, could be beneficial for controlling glucose metabolism in nondiabetic adults during postprandial period.
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Affiliation(s)
- Maria Alexandra Bernardo
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Cooperativa de Ensino Superior Egas Moniz, Monte de Caparica, 2829-511 Caparica, Portugal
| | - Maria Leonor Silva
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Cooperativa de Ensino Superior Egas Moniz, Monte de Caparica, 2829-511 Caparica, Portugal
| | - Elisabeth Santos
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Cooperativa de Ensino Superior Egas Moniz, Monte de Caparica, 2829-511 Caparica, Portugal
| | - Margarida Maria Moncada
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Cooperativa de Ensino Superior Egas Moniz, Monte de Caparica, 2829-511 Caparica, Portugal
| | - José Brito
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Cooperativa de Ensino Superior Egas Moniz, Monte de Caparica, 2829-511 Caparica, Portugal
| | - Luis Proença
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Cooperativa de Ensino Superior Egas Moniz, Monte de Caparica, 2829-511 Caparica, Portugal
| | - Jaipaul Singh
- School of Forensic and Investigative Sciences and School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston PR1 2HE, UK
| | - Maria Fernanda de Mesquita
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Cooperativa de Ensino Superior Egas Moniz, Monte de Caparica, 2829-511 Caparica, Portugal
- *Maria Fernanda de Mesquita:
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Little JP, Francois ME. High-intensity interval training for improving postprandial hyperglycemia. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2014; 85:451-456. [PMID: 25412127 DOI: 10.1080/02701367.2014.963474] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
High-intensity interval training (HIIT) has garnered attention in recent years as a time-efficient exercise option for improving cardiovascular and metabolic health. New research demonstrates that HIIT may be particularly effective for improving postprandial hyperglycemia in individuals with, or at risk for, type 2 diabetes (T2D). These findings have clinical relevance because elevated postprandial hyperglycemia is a significant risk factor for cardiovascular morbidity and mortality. This article summarizes the latest evidence demonstrating that HIIT can improve postprandial glucose control to highlight the potential application of HIIT in the prevention and management of T2D and associated cardiovascular complications.
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Higher breakfast glycaemic load is associated with increased metabolic syndrome risk, including lower HDL-cholesterol concentrations and increased TAG concentrations, in adolescent girls. Br J Nutr 2014; 112:1974-83. [DOI: 10.1017/s0007114514003092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Almost all previous studies examining the associations between glycaemic load (GL) and metabolic syndrome risk have used a daily GL value. The daily value does not distinguish between peaks of GL intake over the day, which may be more closely associated with the risk of the metabolic syndrome. The aim of the present study was to investigate the cross-sectional associations between daily and mealtime measures of GL and metabolic syndrome risk, including metabolic syndrome components, in adolescents. Adolescents participating in the 14-year follow-up of the Western Australian Pregnancy Cohort (Raine) Study completed 3 d food records and metabolic assessments. Breakfast GL, lunch GL, dinner GL and a score representing meal GL peaks over the day were determined in 516 adolescents. Logistic regression models were used to investigate whether GL variables were independent predictors of the metabolic syndrome in this population-based cohort (3·5 % prevalence of the metabolic syndrome). Breakfast GL was found to be predictive of the metabolic syndrome in girls (OR 1·15, 95 % CI 1·04, 1·27; P <0·01), but not in boys. Other meal GL values and daily GL were found to be not significant predictors of the metabolic syndrome. When breakfast GL was examined in relation to each of the components of the metabolic syndrome in girls, it was found to be negatively associated with fasting HDL-cholesterol concentrations (P= 0·037; β = − 0·004; 95 % CI − 0·008, − 0·002) and positively associated with fasting TAG concentrations (P= 0·008; exp(β) = 1·002; 95 % CI 1·001, 1·004). The results of the present study suggest that there may be an association between breakfast composition and metabolic syndrome components in adolescent girls. These findings support further investigation into including lower-GL foods as part of a healthy breakfast in adolescence, particularly for girls.
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Long-term prognostic value of admission haemoglobin A1c (HbA1c) levels in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2014; 10:166-74. [PMID: 25489302 PMCID: PMC4252307 DOI: 10.5114/pwki.2014.45143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 03/17/2014] [Accepted: 04/28/2014] [Indexed: 12/30/2022] Open
Abstract
Introduction Many studies have reported the diagnostic and prognostic value of haemoglobin A1c (HbA1c) levels in patients with acute coronary syndrome. However, the short- and long-term prognostic value of HbA1c level in patients with ST elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) is controversial. Aim To investigate whether admission HbA1c level has a prognostic value for in-hospital, short-, and long-term cardiovascular (CV) mortality and major adverse cardiovascular events in patients with STEMI undergoing primary PCI. Material and methods This prospective study included 443 consecutive patients with STEMI who underwent primary PCI between September 2010 and July 2012. The patients were divided into three groups based on admission HbA1c levels: group I (HbA1c ≤ 5.6%), group II (HbA1c 5.7–6.4%), and group III (HbA1c ≥ 6.5%). The in-hospital, 1-month, and 1-year CV events of all 3 patient groups were followed up. Results A significant association was found between HbA1c level and 1-year primary clinical outcomes, including CV mortality, non-fatal reinfarction, and stroke (p = 0.037). In addition, age, Killip class > 1, and left ventricular ejection fraction were found to be independent predictors of long-term CV mortality in multivariate analysis (hazard ratios (95% confidence interval) 1.081 (1.020–1.146), 4.182 (1.171–14.935), and 0.832 (0.752–0.920); p = 0.009, p = 0.028, and p < 0.001, respectively). Conclusions In this study, we demonstrated that increased admission HbA1c levels were associated with higher rates of major adverse CV events, including mortality, non-fatal reinfarction, and stroke, in patients with STEMI who underwent primary PCI.
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Seaman DR, Palombo AD. An Overview of the Identification and Management of the Metabolic Syndrome in Chiropractic Practice. J Chiropr Med 2014; 13:210-9. [DOI: 10.1016/j.jcm.2014.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 06/06/2014] [Accepted: 06/09/2014] [Indexed: 10/24/2022] Open
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Little JP, Jung ME, Wright AE, Wright W, Manders RJF. Effects of high-intensity interval exercise versus continuous moderate-intensity exercise on postprandial glycemic control assessed by continuous glucose monitoring in obese adults. Appl Physiol Nutr Metab 2014; 39:835-841. [PMID: 24773254 DOI: 10.1139/apnm-2013-0512] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2023]
Abstract
The purpose of this study was to examine the impact of acute high-intensity interval training (HIIT) compared with continuous moderate-intensity (CMI) exercise on postprandial hyperglycemia in overweight or obese adults. Ten inactive, overweight or obese adults (41 ± 11 yrs, BMI = 36 ± 7 kg/m(2)) performed an acute bout of HIIT (10 × 1 min at approximately 90% peak heart rate (HRpeak) with 1-min recovery periods) or matched work CMI (30 min at approximately 65% HRpeak) in a randomized, counterbalanced fashion. Exercise was performed 2 h after breakfast, and glucose control was assessed by continuous glucose monitoring under standardized dietary conditions over 24 h. Postprandial glucose (PPG) responses to lunch, dinner, and the following day's breakfast were analyzed and compared with a no-exercise control day. Exercise did not affect the PPG responses to lunch, but performing both HIIT and CMI in the morning significantly reduced the PPG incremental area under the curve (AUC) following dinner when compared with control (HIIT = 110 ± 35, CMI = 125 ± 34, control = 162 ± 46 mmol/L × 2 h, p < 0.05). The PPG AUC (HIIT = 125 ± 53, CMI = 186 ± 55, control = 194 ± 96 mmol/L × 2 h) and the PPG spike (HIIT = Δ2.1 ± 0.9, CMI = Δ3.0 ± 0.9, control = Δ3.0 ± 1.5 mmol/l) following breakfast on the following day were significantly lower following HIIT compared with both CMI and control (p < 0.05). Absolute AUC and absolute glucose spikes were not different between HIIT, CMI, or control for any meal (p > 0.05 for all). We conclude that a single session of HIIT has greater and more lasting effects on reducing incremental PPG when compared with CMI.
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Affiliation(s)
- Jonathan P Little
- a School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
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Hu L, Li DH. Relationship between modified homeostasis model assessment/correlative serum factors and diabetic retinopathy among type 2 diabetics with insulin therapy in Guangzhou, China. Int J Ophthalmol 2014; 7:463-8. [PMID: 24967192 DOI: 10.3980/j.issn.2222-3959.2014.03.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 12/12/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To explore the related risk factors for diabetic retinopathy (DR) in type 2 diabetes with insulin therapy. METHODS We studied the relationships among blood glucose, serum C-peptide, plasma insulin, beta-cell function and the development of DR. Beta-cell function was assessed by a modified homeostasis model assessment (modified HOMA) which was gained by using C-peptide to replace insulin in the homeostasis model assessment (HOMA) of beta-cell function. We also studied the relationships between modified HOMA index and serum C-peptide response to 100g tasteless steamed bread to determine the accuracy of modified HOMA. RESULTS Our study group consisted of 170 type 2 diabetic inpatients with DR (age: 58.35±13.87y, mean±SD) and 205 type 2 diabetic inpatients with no DR (NDR) (age: 65.52±11.59y). DR patients had higher age, longer diabetic duration, higher hypertension grade, higher postprandial plasma glucose, higher fluctuation level of plasma glucose, lower body mass index (BMI), lower postprandial serum insulin and C-peptide, lower fluctuation level of serum insulin and C-peptide (P<0.05). In our logistic regression model, duration of diabetes, hypertension grade, fasting plasma insulin and glycosylated hemoglobin (HbA1C) were significantly associated with the presence of DR after adjustment for confounding factors (P<0.05). CONCLUSION Our results suggested although modified HOMA showed significant correlation to the occurrence of DR on Spearman's rank-correlation analysis, logistic regression showed no significant association between these two variables after adjustment for relevant confounding factors (such as age, sex, duration of diabetes, BMI, hypertension grade, HbA1C, plasma insulin). Duration of diabetes, hypertension grade, fasting plasma insulin and HbA1C were independently associated with the development of DR in Chinese type 2 diabetics.
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Affiliation(s)
- Li Hu
- Department of Ophthalmology, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, Guangdong Province, China
| | - Dong-Hao Li
- Department of Ophthalmology, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, Guangdong Province, China
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Kakuda H, Matoba M, Nakatoh H, Nagao S, Takekoshi N. Comparison of atorvastatin, pitavastatin and rosuvastatin for residual cardiovascular risk using non-fasting blood sampling. Scand J Clin Lab Invest 2014; 74:285-95. [DOI: 10.3109/00365513.2014.882015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gerich J. Pathogenesis and management of postprandial hyperglycemia: role of incretin-based therapies. Int J Gen Med 2013; 6:877-95. [PMID: 24403842 PMCID: PMC3884108 DOI: 10.2147/ijgm.s51665] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Postprandial plasma glucose concentrations are an important contributor to glycemic control. There is evidence suggesting that postprandial hyperglycemia may be an independent risk factor for cardiovascular disease. Glucagon-like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors are antidiabetic agents that predominantly reduce postprandial plasma glucose levels. DPP-4 inhibitors are associated with fewer gastrointestinal side effects than GLP-1 receptor agonists and are administered orally, unlike GLP-1 analogs, which are administered as subcutaneous injections. GLP-1 receptor agonists are somewhat more effective than DPP-4 inhibitors in reducing postprandial plasma glucose and are usually associated with significant weight loss. For these reasons, GLP-1 receptor agonists are generally preferred over DPP-4 inhibitors as part of combination treatment regimens in patients with glycated hemoglobin levels above 8.0%. This article reviews the pathogenesis of postprandial hyperglycemia, the mechanisms by which GLP-1 receptor agonists and DPP-4 inhibitors reduce postprandial plasma glucose concentrations, and the results of recent clinical trials (ie, published 2008 to October 2012) that evaluated the effects of these agents on postprandial plasma glucose levels when evaluated as monotherapy compared with placebo or as add-on therapy to metformin, a sulfonylurea, or insulin. Findings from recent clinical studies suggest that both GLP-1 receptor agonists and DPP-4 inhibitors could become valuable treatment options for optimizing glycemic control in patients unable to achieve glycated hemoglobin goals on basal insulin, with the added benefits of weight loss and a low risk of hypoglycemia.
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Affiliation(s)
- John Gerich
- Department of Medicine, Endocrine/Metabolism Division, University of Rochester School of Medicine, Rochester, NY, USA
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Tu YK, D'Aiuto F, Lin HJ, Chen YW, Chien KL. Relationship between metabolic syndrome and diagnoses of periodontal diseases among participants in a large Taiwanese cohort. J Clin Periodontol 2013; 40:994-1000. [DOI: 10.1111/jcpe.12157] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Francesco D'Aiuto
- Periodontology Unit; Department of Clinical Research; UCL Eastman Dental Institute; London UK
| | - Hung-Ju Lin
- Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
- Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
| | - Yi-Wen Chen
- Department of Dentistry; National Taiwan University Hospital; Taipei Taiwan
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
- Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
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Constructing a point-based prediction model for the risk of coronary artery disease in a Chinese community: a report from a cohort study in Taiwan. Int J Cardiol 2012; 157:263-8. [PMID: 22503568 DOI: 10.1016/j.ijcard.2012.03.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 03/03/2012] [Indexed: 11/23/2022]
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Dash S, Crisp S, Hartnell S, Donald S, Davenport K, Simmons D, Evans M. Successful use of acarbose to manage post-prandial glycaemia in two patients with type 1 diabetes on continuous subcutaneous insulin infusion. Diabetes Res Clin Pract 2012; 95:e49-51. [PMID: 22136721 DOI: 10.1016/j.diabres.2011.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 11/07/2011] [Indexed: 11/27/2022]
Abstract
Post-prandial hyperglycaemia is a particular problem for some patients with diabetes despite administering continuous subcutaneous insulin infusion (CSII) to deliver insulin flexibly. We describe two cases of patients on CSII with persistent post-prandial hyperglycaemia despite varying insulin doses and timing. Treatment with acarbose improved their glycaemic control.
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Affiliation(s)
- Satya Dash
- University of Cambridge Metabolic Research Laboratories, Department of Medicine, NIHR Cambridge Biomedical Research Centre, IMS-MRL, Box 289 Addenbrookes Hospital, Cambridge CB2 0QQ, UK
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Bao J, Gilbertson HR, Gray R, Munns D, Howard G, Petocz P, Colagiuri S, Brand-Miller JC. Improving the estimation of mealtime insulin dose in adults with type 1 diabetes: the Normal Insulin Demand for Dose Adjustment (NIDDA) study. Diabetes Care 2011; 34:2146-51. [PMID: 21949219 PMCID: PMC3177729 DOI: 10.2337/dc11-0567] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Although carbohydrate counting is routine practice in type 1 diabetes, hyperglycemic episodes are common. A food insulin index (FII) has been developed and validated for predicting the normal insulin demand generated by mixed meals in healthy adults. We sought to compare a novel algorithm on the basis of the FII for estimating mealtime insulin dose with carbohydrate counting in adults with type 1 diabetes. RESEARCH DESIGN AND METHODS A total of 28 patients using insulin pump therapy consumed two different breakfast meals of equal energy, glycemic index, fiber, and calculated insulin demand (both FII = 60) but approximately twofold difference in carbohydrate content, in random order on three consecutive mornings. On one occasion, a carbohydrate-counting algorithm was applied to meal A (75 g carbohydrate) for determining bolus insulin dose. On the other two occasions, carbohydrate counting (about half the insulin dose as meal A) and the FII algorithm (same dose as meal A) were applied to meal B (41 g carbohydrate). A real-time continuous glucose monitor was used to assess 3-h postprandial glycemia. RESULTS Compared with carbohydrate counting, the FII algorithm significantly decreased glucose incremental area under the curve over 3 h (-52%, P = 0.013) and peak glucose excursion (-41%, P = 0.01) and improved the percentage of time within the normal blood glucose range (4-10 mmol/L) (31%, P = 0.001). There was no significant difference in the occurrence of hypoglycemia. CONCLUSIONS An insulin algorithm based on physiological insulin demand evoked by foods in healthy subjects may be a useful tool for estimating mealtime insulin dose in patients with type 1 diabetes.
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Affiliation(s)
- Jiansong Bao
- Boden Institute of Obesity, Nutrition & Exercise and the School of Molecular Biosciences, University of Sydney, Sydney, Australia
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Ovalle F. Cardiovascular implications of antihyperglycemic therapies for type 2 diabetes. Clin Ther 2011; 33:393-407. [PMID: 21635987 DOI: 10.1016/j.clinthera.2011.04.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2011] [Indexed: 01/06/2023]
Abstract
BACKGROUND Several risk factors for cardiovascular disease (CVD), including insulin resistance/hyperinsulinemia, hyperglycemia, overweight/obesity, dyslipidemia, and hypertension, are often present in varying combinations in patients with type 2 diabetes mellitus (DM). Patients with a clustering of these risk factors, termed the metabolic syndrome, are at greater risk for CVD than are patients with only a single risk factor. Although glycemic control is the central feature of type 2 DM management, patients require an individualized approach to therapy that takes their other CVD risk factors into account. OBJECTIVE This review examined the effects of antidiabetes therapy on glycemic control, as well as its potential to affect body weight, serum lipids, and blood pressure (BP), and thus CVD risk. METHODS Information was obtained by searching the MEDLINE and EMBASE databases from 1995 through March 2010. The search terms included type 2 DM, metabolic syndrome, CV complications of type 2 DM, and therapy for type 2 DM. Articles that described relevant details of the metabolic syndrome, CV complications of type 2 DM, and effects of antidiabetes therapy on glycosylated hemoglobin, body weight, serum lipids, and BP were selected for in-depth review. Only English language publications were reviewed. Clinical trials, meta-analyses, and review articles on the key words were preferentially selected for review and analysis. Non-English language publications, case reports, letters to the editor, and similar types of publications were excluded. RESULTS Although all approved antidiabetes agents lowered glucose, their effect on other CV risk factors, such as BP, lipids, and weight, differed significantly. Therapy with insulin, the sulfonylureas, and the thiazolidinediones was associated with weight gain. Metformin and the dipeptidyl-peptidase-4 inhibitors were generally considered weight neutral, whereas the glucagon-like peptide-1 receptor agonists and amylin agonists were associated with weight loss. Metformin, sulfonylureas, thiazolidinedioness, and dipeptidyl-peptidase-4 inhibitors had modest effects on serum lipid levels and BP. The glucagon-like peptide-1 receptor agonists generally had beneficial effects on serum lipid levels and systolic and diastolic BP. CONCLUSION A wide variety of agents were available to aid glycemic control in patients with type 2 DM. These agents had variable effects on known CV risk factors that might be present in this patient population, including excess body weight, elevated BP, and increased serum lipids. Some of the newer agents improved glycemic control while also having potentially favorable effects on these CV risk factors. The impact of various agents on known CV risk factors should be considered when selecting a therapeutic regimen.
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Affiliation(s)
- Fernando Ovalle
- Division of Endocrinology, Diabetes and Metabolism, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
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Kerr KF, McClelland RL, Brown ER, Lumley T. Evaluating the incremental value of new biomarkers with integrated discrimination improvement. Am J Epidemiol 2011; 174:364-74. [PMID: 21673124 PMCID: PMC3202159 DOI: 10.1093/aje/kwr086] [Citation(s) in RCA: 150] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 02/28/2011] [Indexed: 12/31/2022] Open
Abstract
The integrated discrimination improvement (IDI) index is a popular tool for evaluating the capacity of a marker to predict a binary outcome of interest. Recent reports have proposed that the IDI is more sensitive than other metrics for identifying useful predictive markers. In this article, the authors use simulated data sets and theoretical analysis to investigate the statistical properties of the IDI. The authors consider the common situation in which a risk model is fitted to a data set with and without the new, candidate predictor(s). Results demonstrate that the published method of estimating the standard error of an IDI estimate tends to underestimate the error. The z test proposed in the literature for IDI-based testing of a new biomarker is not valid, because the null distribution of the test statistic is not standard normal, even in large samples. If a test for the incremental value of a marker is desired, the authors recommend the test based on the model. For investigators who find the IDI to be a useful measure, bootstrap methods may offer a reasonable option for inference when evaluating new predictors, as long as the added predictive capacity is large.
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Affiliation(s)
- Kathleen F Kerr
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, USA.
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Two hour glucose post loading: a biomarker of cardiovascular risk in isolated clinic hypertension. J Hypertens 2011; 29:749-57. [PMID: 21192271 DOI: 10.1097/hjh.0b013e328342eeeb] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Isolated clinic hypertension (ICHT) may be an indicator of both future hypertension and diabetes. This study examines the 2-h plasma glucose level post load (2hPG), and measures of arterial stiffness, autonomic function and circulating biomarkers in ICHT, normotension and hypertension. METHODS Participants aged 39-75 years, who were untreated for hypertension, nonsmokers and not known diabetic (n=105) were categorized as normotension, ICHT and hypertension, based on clinic and mean daytime ambulatory blood pressures. Participants had measurements of autonomic function, aorto-femoral pulse wave velocity (PWVc), as well as blood sampling for lipids and potential circulating biomarkers [high sensitivity C-reactive protein (hsCRP), plasminogen activator inhibitor 1 (PAI-1), asymmetric dimethylarginine (ADMA), and von Willebrand factor (vWF)], followed by a glucose tolerance test. RESULTS A total of 8.3% normotension, 37.9% ICHT and 15% hypertension patients had impaired glucose tolerance. Mean 2hPG adjusted for age and waist circumference was 5.7 mmol/l [interquartile range (IQR) 5.2-6.4] for normotension, 7.4 mmol/l (IQR 6.5-8.3) for ICHT (P=0.002 vs. normotension) and 6.2 mmol/l (IQR 5.6-6.9) for hypertension group. Other measures of insulin resistance were similar in the three groups. Mental stress testing induced a greater blood pressure response in the ICHT group (P=0.01 vs. normotension); other autonomic function measures were similar in the three groups. Mean PWVc, adjusted for age and blood pressure, was similar in ICHT and normotension but increased in the hypertension group. Circulating biomarker levels were not different in the three groups. CONCLUSION Assessment of total cardiovascular risk in patients with ICHT should include measurement of postprandial glucose.
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Sheu WHH, Rosman A, Mithal A, Chung N, Lim YT, Deerochanawong C, Soewondo P, Lee MK, Yoon KH, Schnell O. Addressing the burden of type 2 diabetes and cardiovascular disease through the management of postprandial hyperglycaemia: an Asian-Pacific perspective and expert recommendations. Diabetes Res Clin Pract 2011; 92:312-21. [PMID: 21605924 DOI: 10.1016/j.diabres.2011.04.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 03/29/2011] [Accepted: 04/25/2011] [Indexed: 11/16/2022]
Abstract
The world is facing an epidemic of cardiovascular disease (CVD) and type 2 diabetes, with populations in low- to middle-income countries, including many in the Asia Pacific (AP) region, being disproportionately affected. Emerging data identify postprandial hyperglycaemia (PPHG) as an important predictor of CVD, and several professional bodies, including the International Diabetes Federation, have issued guidelines on the management of PPHG in type 2 diabetes. Guidance on how international recommendations could be implemented in Asian populations is currently lacking. Therefore, a panel of experts from the AP region convened to consider the current status of PPHG and CVD in the region, and to develop recommendations for clinical practice. The group concluded that improved awareness of the impact of PPHG on CVD risk, among clinicians and the general public, and more widespread use of routine screening for PPHG, using oral glucose tolerance testing in those without recognised diabetes, are required. Additionally, frequent meal-based testing and effective PPHG management are essential to the management of IGT and type 2 diabetes.
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Affiliation(s)
- Wayne H-H Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
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Tzoulaki I, Liberopoulos G, Ioannidis JPA. Use of reclassification for assessment of improved prediction: an empirical evaluation. Int J Epidemiol 2011; 40:1094-105. [PMID: 21325392 DOI: 10.1093/ije/dyr013] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND An increasing number of studies evaluate the ability of predictors to change risk stratification and alter medical decisions, i.e. reclassification performance. We examined the reported design and analysis of recent studies of reclassification and the robustness of their claims for improved reclassification. METHODS Two independent investigators searched PubMed and citations to the article that introduced the currently most popular reclassification metric (net reclassification index, NRI) to identify studies performing reclassification analysis (January 2006-January 2010). We focused on articles that included any analyses comparing the performance of a baseline predictive model vs the baseline model plus some additional predictor for a prospectively assessed outcome. We recorded information on the baseline model used, outcomes assessed, choice of risk thresholds and features of reclassification analyses. RESULTS Of 58 baseline models used in 51 eligible papers, only 14 (24%) were previously described, used as described and had same outcomes as originally intended. Calibration was examined in 53% of the studies. Sixteen studies (31%) provided a reference for the choice of risk thresholds and only six used the previously proposed categories or justified the use of alternative thresholds. Only 14 studies (27%) stated that the chosen risk thresholds had different therapeutic intervention implications. NRI was calculated in 38 studies and was smaller in studies with adequately referenced or justified risk thresholds vs others (P < 0.0001). CONCLUSIONS Reclassification studies would benefit from more rigorous methodological standards; otherwise claims for improved reclassification may remain spurious.
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Affiliation(s)
- Ioanna Tzoulaki
- Department of Epidemiology and Biostatistics, Imperial College of Medicine, London, UK
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Ahmed MH, Byrne CD. Potential therapeutic uses for ezetimibe beyond lowering LDL-c to decrease cardiovascular events. Diabetes Obes Metab 2010; 12:958-66. [PMID: 20880342 DOI: 10.1111/j.1463-1326.2010.01261.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Ezetimibe is a relatively new drug that inhibits the absorption of dietary cholesterol in the small intestine. It is a low density lipoprotein-cholesterol (LDL-C) lowering medication that acts directly on the intestine by inhibiting Niemann-Pick C1 Like1 (NPC1L1). Recently, results of the ARBITER 6-HALTS trial (Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol 6-HDL and LDL Treatment Strategies) and the ENHANCE trial (Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression) showed that ezetimibe had no effect on atherosclerosis despite producing a marked decrease in LDL-C. Recent studies show a potential benefit of ezetimibe in treating insulin resistance, non-alcoholic fatty liver disease (NAFLD), gallstones and dyslipidaemia associated with chronic renal failure and organ transplantation. All of these conditions are known to be associated with an increase in risk of cardiovascular disease (CVD) and further studies are needed to assess the potential benefits of ezetimibe in these therapeutics areas.
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Affiliation(s)
- M H Ahmed
- Chemical Pathology Department, Southampton University Hospitals NHS Trust, Southampton, UK
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Lapauw B, Ouwens M, 't Hart LM, Wuyts B, Holst JJ, T'Sjoen G, Kaufman JM, Ruige JB. Sex steroids affect triglyceride handling, glucose-dependent insulinotropic polypeptide, and insulin sensitivity: a 1-week randomized clinical trial in healthy young men. Diabetes Care 2010; 33:1831-3. [PMID: 20484128 PMCID: PMC2909071 DOI: 10.2337/dc10-0515] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate metabolic effects of sex steroids in nonfasting and fasting conditions, independent from changes in body composition. RESEARCH DESIGN AND METHODS A randomized clinical trial was performed to create contrasting sex steroid levels in healthy young men: by letrozole (aromatase inhibitor) to lower estradiol (E(2)) and increase testosterone (group T, n = 10) versus letrozole plus E(2) patches to lower T and raise E(2) (group E, n = 10). Mixed meals and hyperinsulinemic-euglycemic clamps were performed before and after a 1-week treatment period. RESULTS Following intervention, the postprandial triglyceride response displayed a diverging response with a decline in group T and an increase in group E; the postprandial glucose-dependent insulinotropic polypeptide (GIP) response increased in group T. Insulin sensitivity increased in group T but remained unaltered in group E. CONCLUSIONS In healthy young men, short-term changes in sex steroids affect postprandial triglyceride and GIP response and insulin sensitivity.
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Affiliation(s)
- Bruno Lapauw
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
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Ahmed MH, Byrne CD. Ezetimibe as a potential treatment for non-alcoholic fatty liver disease: is the intestine a modulator of hepatic insulin sensitivity and hepatic fat accumulation? Drug Discov Today 2010; 15:590-5. [DOI: 10.1016/j.drudis.2010.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 05/30/2010] [Accepted: 06/14/2010] [Indexed: 01/12/2023]
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