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Manallack S, Holloway EE, Pouwer F, Speight J, Holmes-Truscott E. Associations between weight self-stigma and healthy diet and physical activity among adults with type 2 diabetes: Cross-sectional results from the second Diabetes MILES - Australia (MILES-2) study. Diabet Med 2024:e15440. [PMID: 39344796 DOI: 10.1111/dme.15440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 09/05/2024] [Accepted: 09/09/2024] [Indexed: 10/01/2024]
Abstract
AIMS To examine associations between weight self-stigma and healthy diet or physical activity, and potential moderating effects of self-esteem, diabetes self-efficacy, and diabetes social support, among adults with type 2 diabetes. METHODS Diabetes MILES-2 data were used, an Australian cross-sectional online survey. Participants with type 2 diabetes who considered themselves overweight, and reported concern about weight management (N = 726; 48% insulin-treated), completed the Weight Self-Stigma Questionnaire (WSSQ; total score and subscales: self-devaluation, fear of enacted stigma), measures of diabetes self-care (diet, exercise), and hypothesised psychosocial moderators (self-esteem, diabetes self-efficacy, and diabetes social support). Adjusted linear regression tested associations and interaction effects, separately by insulin treatment status. RESULTS Greater weight self-stigma (WSSQ total) was associated with less optimal dietary self-care (both groups: β = -0.3), and with a lower level of exercise (non-insulin only: β = -0.2; all p < 0.001). All hypothesised moderators were negatively associated with weight self-stigma (range r = -0.2 to r = -0.5). Positive associations were identified between the hypothesised moderators and self-care behaviours (strongest between diet and diabetes self-efficacy, r = > 0.5). No significant interaction effects were observed. CONCLUSIONS This study provides novel evidence of negative associations between weight self-stigma and self-care behaviours among adults with type 2 diabetes. Weight self-stigma is a demonstrated barrier to self-care behaviours in type 2 diabetes cohorts. Acknowledgement and strategies to address weight self-stigma are needed in clinical care and health programmes.
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Affiliation(s)
- Sarah Manallack
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes (ACBRD), Diabetes Victoria, Melbourne, Australia
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Edith E Holloway
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes (ACBRD), Diabetes Victoria, Melbourne, Australia
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Frans Pouwer
- School of Psychology, Deakin University, Geelong, Australia
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense, Denmark
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes (ACBRD), Diabetes Victoria, Melbourne, Australia
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes (ACBRD), Diabetes Victoria, Melbourne, Australia
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Ramírez-Morros A, Berenguera A, Millaruelo L, Buil-Cosiales P, Gomez Garcia C, Cos X, Ávila Lachica L, Artola S, Millaruelo JM, Mauricio D, Franch-Nadal J. Impact of Gender on Patient Experiences of Self-Management in Type 2 Diabetes: A Qualitative Study. Patient Prefer Adherence 2024; 18:1885-1896. [PMID: 39290823 PMCID: PMC11407317 DOI: 10.2147/ppa.s466931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 08/16/2024] [Indexed: 09/19/2024] Open
Abstract
Purpose This study aims to identify gender disparities in knowledge, attitudes and behaviors related to self-management and control of Type 2 diabetes Mellitus (T2DM) among primary care patients. The research was conducted across multiple Spanish cities. Patients and Methods The study involved 8 Primary Care Centres located in four distinct regions of Spain: East (Barcelona), Centre (Madrid), North (Pamplona and Zumaia) and South (Vélez-Málaga and Málaga). A total of 111 individuals diagnosed with T2DM, comprising 52 women and 59 men, participated in 12 group discussions at these primary healthcare centers from February to June 2015. Participation was voluntary, and all participants provided informed consent by signing the consent form. A qualitative hermeneutic phenomenological study with a maximum variation sample was done. Participant profiles were defined based on gender, age, place of residence, type of treatment, years living with T2DM and the presence or absence of a cardiovascular event. Thematic analysis was used to analyze the data. Results Participants were aware that diabetes is a chronic condition, with varied levels of concern regarding the diagnosis. Participants' locus of control influenced their perception of the disease's cause, with women attributing it to stress and emotional situations, while men linked it to risky behaviors. Self-management strategies were shaped by beliefs about diabetes, with both genders facing challenges in implementing recommended practices. Gender differences were also evident in caregiving roles, with men receiving more family support for diet adherence, while women prioritized family needs over their self-care. Participants expressed satisfaction with professional-patient interactions but highlighted the need for more accessible information and specialist care, suggesting support groups for women and clear health guidelines for men. Conclusion Gender differences significantly influence how patients perceive and manage type 2 diabetes, with women experiencing greater concern and care burden compared to men. Effective diabetes management requires tailored support that addresses these gender-specific challenges. Enhancing healthcare services with clear guidelines and support groups can improve self-management outcomes in both men and women.
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Affiliation(s)
- Anna Ramírez-Morros
- DAP-Cat Group, Unitat de Suport a la Recerca de la Catalunya Central, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sant Fruitós de Bages, Spain
- Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
- red GDPS Foundation, Sabadell, Spain
| | - Anna Berenguera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | | | - Pilar Buil-Cosiales
- red GDPS Foundation, Sabadell, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Atención Primaria, Servicio Navarro de Salud, Navarra, Spain
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Navarra, Spain
| | - Carmen Gomez Garcia
- red GDPS Foundation, Sabadell, Spain
- Unidad de Gestión Clínica Vélez Norte, Vélez-Málaga, Servicio Andaluz de Salud, Vélez-Málaga, Spain
| | - Xavier Cos
- red GDPS Foundation, Sabadell, Spain
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Barcelona, Spain
- EAP Sant Martí, Institut Catalá de la Salut, Barcelona, Spain
| | - Luis Ávila Lachica
- red GDPS Foundation, Sabadell, Spain
- Unidad de Gestión Clínica Vélez Norte, Vélez-Málaga, Servicio Andaluz de Salud, Vélez-Málaga, Spain
| | - Sara Artola
- red GDPS Foundation, Sabadell, Spain
- Centro de Salud José Marvá, Madrid, Spain
| | | | - Didac Mauricio
- DAP-Cat Group, Unitat de Suport a la Recerca de la Catalunya Central, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sant Fruitós de Bages, Spain
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Barcelona, Spain
- Institut de Recerca Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Endocrinology and Nutrition, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Medicine, University of Vic - Central University of Catalonia, Vic, Spain
| | - Josep Franch-Nadal
- DAP-Cat Group, Unitat de Suport a la Recerca de la Catalunya Central, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sant Fruitós de Bages, Spain
- red GDPS Foundation, Sabadell, Spain
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Barcelona, Spain
- Equip d'Atenció Primària (EAP) Raval Sud-Gerencia Territorial Barcelona, Institut Català de la Salut, Barcelona, Spain
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3
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Khalafi M, Habibi Maleki A, Symonds ME, Rosenkranz SK, Rohani H, Ehsanifar M. The effects of intermittent fasting on body composition and cardiometabolic health in adults with prediabetes or type 2 diabetes: A systematic review and meta-analysis. Diabetes Obes Metab 2024; 26:3830-3841. [PMID: 38956175 DOI: 10.1111/dom.15730] [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: 04/17/2024] [Revised: 05/23/2024] [Accepted: 05/31/2024] [Indexed: 07/04/2024]
Abstract
AIM To perform a meta-analysis to investigate the effects of intermittent fasting (IF), as compared with either a control diet (CON) and/or calorie restriction (CR), on body composition and cardiometabolic health in individuals with prediabetes and type 2 diabetes (T2D). METHODS PubMed, Web of Science, and Scopus were searched from their inception to March 2024 to identify original randomized trials with parallel or crossover designs that studied the effects of IF on body composition and cardiometabolic health. Weighted mean differences (WMDs) or standardized mean differences with 95% confidence intervals (CIs) were calculated using random-effects models. RESULTS Overall, 14 studies involving 1101 adults with prediabetes or T2D were included in the meta-analysis. IF decreased body weight (WMD -4.56 kg [95% CI -6.23 to -2.83]; p = 0.001), body mass index (BMI; WMD -1.99 kg.m2 [95% CI -2.74 to -1.23]; p = 0.001), glycated haemoglobin (HbA1c; WMD -0.81% [95% CI -1.24 to -0.38]; p = 0.001), fasting glucose (WMD -0.36 mmol/L [95% CI -0.63 to -0.09]; p = 0.008), total cholesterol (WMD -0.31 mmol/L [95% CI -0.60 to -0.02]; p = 0.03) and triglycerides (WMD -0.14 mmol/L [95% CI -0.27 to -0.01]; p = 0.02), but did not significantly decrease fat mass, insulin, low-densitiy lipoprotein, high-density lipoprotein, or blood pressure as compared with CON. Furthermore, IF decreased body weight (WMD -1.14 kg [95% CI -1.69 to -0.60]; p = 0.001) and BMI (WMD -0.43 kg.m2 [95% CI -0.58 to -0.27]; p = 0.001), but did not significantly affect fat mass, lean body mass, visceral fat, insulin, HbA1c, lipid profiles or blood pressure. CONCLUSION Intermittent fasting is effective for weight loss and specific cardiometabolic health markers in individuals with prediabetes or T2D. Additionally, IF is associated with a reduction in body weight and BMI compared to CR, without effects on glycaemic markers, lipid profiles or blood pressure.
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Affiliation(s)
- Mousa Khalafi
- Department of Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
| | - Aref Habibi Maleki
- Department of Exercise Physiology and Corrective Exercises, Faculty of Sport Sciences, Urmia University, Urmia, Iran
| | - Michael E Symonds
- Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sara K Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Hadi Rohani
- Department of Exercise Physiology, Sport Sciences Research Institute, Tehran, Iran
| | - Mahsa Ehsanifar
- Department of Exercise Physiology and Corrective Exercises, Faculty of Sport Sciences, Urmia University, Urmia, Iran
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Wu YJ, Hsu CC, Hwang SJ, Lin KD, Lin PC, Huang YF, Lee CH, Chang CI, Huang MC. Inter-Relations between Dietary Patterns and Glycemic Control-Related Biomarkers on Risk of Retinopathy in Type 2 Diabetes. Nutrients 2024; 16:2274. [PMID: 39064717 PMCID: PMC11279548 DOI: 10.3390/nu16142274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/27/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Diabetic retinopathy (DR), which can cause vision loss, may progress faster with poor glycemic control and oxidative stress. This study aims to examine how dietary patterns and glycemic control biomarkers relate to retinopathy risk in type 2 diabetes patients. In this study, we enrolled diabetic patients with retinopathy (DR) (n = 136) and without retinopathy (no DR) (n = 466) from a cohort of participants in the "Blood Pressure Control to Reduce the Risk of Type 2 Diabetic Nephropathy Study". Hemoglobin A1c (HbA1c) and malondialdehyde were defined as elevated when their levels reached ≥8.5% and ≥2/3 (16.2 μm), respectively. Dietary data were collected by a food frequency questionnaire. Dietary patterns were identified by factor analysis. Elevated HbA1c was significantly correlated with increased risk of DR (OR: 2.12, 95% CI: 1.14-3.93, p = 0.017). In subjects with a high animal protein and processed food dietary pattern (≥highest tertile score) or a low vegetable intake pattern (
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Affiliation(s)
- Yu-Ju Wu
- Department of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
- Graduate Institute of Medicine and Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County 350401, Taiwan; (C.-C.H.); (Y.-F.H.)
- Department of Health Services Administration, China Medical University, Taichung 4064040, Taiwan
- Department of Family Medicine, Min-Sheng General Hospital, Taoyuan 330056, Taiwan
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin 632007, Taiwan
| | - Shang-Jyh Hwang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
| | - Kun-Der Lin
- The Lin’s Clinics, Kaohsiung 807057, Taiwan;
| | - Pi-Chen Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
| | - Ya-Fang Huang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County 350401, Taiwan; (C.-C.H.); (Y.-F.H.)
| | - Chien-Hung Lee
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
| | - Chiao-I Chang
- Graduate Institute of Medicine and Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
| | - Meng-Chuan Huang
- Department of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
- Graduate Institute of Medicine and Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
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Mamri S, Daoudi NE, Baraich A, Ouahhoud S, Khoulati A, Choukri M, Asehraou A, Bnouham M, Jaouadi B, Abousalham A, Dabiellil F, Salamatullah AM, Saalaoui E. Comprehensive analysis of bioactive compounds in Crocus sativus stamens extracts by HPLC-DAD: investigating antidiabetic activity via in vitro, in vivo, and molecular docking simulation. Front Chem 2024; 12:1419120. [PMID: 39072261 PMCID: PMC11272647 DOI: 10.3389/fchem.2024.1419120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/10/2024] [Indexed: 07/30/2024] Open
Abstract
Introduction: Medicinal herbs used in traditional diabetes treatment are a rich source of anti-diabetic compounds. Pancreatic α-amylase inhibitors offer an effective strategy to reduce postprandial hyperglycemic levels via control of starch degradation. In this context, our study for the first time investigates the effect of Crocus sativus stamens extracts on α-amylase inhibition. Material and methods: The hydromethanolic and hydroethanolic extracts were obtained by macerating the dried stamen powder with methanol/water or ethanol/water, respectively. The total phenolic content of the stamen extracts was assessed using the Folin-Ciocalteu reagent method, while the total flavonoid content was determined using the Aluminum Chloride method. Phytochemicals were further quantified and identified using HPLC-DAD. For evaluation of hypoglycemic activity, in vitro α-amylase enzyme inhibition was calculated. The results were confirmed in vivo using an oral starch tolerance test in both normal and diabetic rats. Results: Our findings demonstrated a higher level of polyphenols and flavonoids in the hydroethanolic extract. Important flavonoids found were kaempferol, rutin, and vanillic acid, while prominent carotenoids contained trans- and cis-crocins. The in vitro study showed that both hydromethanolic and hydroethanolic extracts had considerable inhibitory effects, with maximum inhibitions of approximately 83% and 89%, respectively. In vivo tests indicated that both extracts effectively lowered peak blood glucose and area under the curve in both normal and diabetic rats following oral starch treatment. The obtained results are also supported by a docking study. Conclusion: These findings imply that C. sativus stamens possess a distinctive capability to reduce postprandial blood glucose levels. This effect is likely mediated through the inhibition of α-amylase, presenting a novel dietary avenue for managing diabetes.
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Affiliation(s)
- Samira Mamri
- Laboratory of Bioresources, Biotechnology, Ethnopharmacology and Health, Department of Biology, Faculty of Sciences, Mohammed the First University, Oujda, Morocco
| | - Nour Elhouda Daoudi
- Laboratory of Bioresources, Biotechnology, Ethnopharmacology and Health, Department of Biology, Faculty of Sciences, Mohammed the First University, Oujda, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Oujda, Morocco
| | - Abedellah Baraich
- Laboratory of Bioresources, Biotechnology, Ethnopharmacology and Health, Department of Biology, Faculty of Sciences, Mohammed the First University, Oujda, Morocco
| | - Sabir Ouahhoud
- Laboratory of Biological Engineering, Faculty of Sciences and Technology, University Sultan Moulay Slimane, Beni Mellal, Morocco
- Faculty of Medicine and Pharmacy, University Sultan Moulay Slimane Beni Mellal, Beni Mellal, Morocco
| | - Amine Khoulati
- Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, Morocco
| | - Mohammed Choukri
- Biochemistry Laboratory, Central Laboratory Service—University Hospital Center, Oujda, Morocco
| | - Abdeslam Asehraou
- Laboratory of Bioresources, Biotechnology, Ethnopharmacology and Health, Department of Biology, Faculty of Sciences, Mohammed the First University, Oujda, Morocco
| | - Mohamed Bnouham
- Laboratory of Bioresources, Biotechnology, Ethnopharmacology and Health, Department of Biology, Faculty of Sciences, Mohammed the First University, Oujda, Morocco
| | - Bassem Jaouadi
- Microbial Biotechnology and Enzyme Engineering Laboratory (LBMIE), Center for Biotechnology of Sfax (CBS), University of Sfax, Sfax, Tunisia
| | - Abdelkrim Abousalham
- Institute of Chemistry and Molecular and Supramolecular Biochemistry (ICBMS), Enzymatic Engineering, Biomimetic Membranes, and Supramolecular Assemblies (GEMBAS), Courrier d'Entreprise à Distribution Exceptionnelle, University Lyon, Villeurbanne, France
| | | | - Ahmad Mohammad Salamatullah
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ennouamane Saalaoui
- Laboratory of Bioresources, Biotechnology, Ethnopharmacology and Health, Department of Biology, Faculty of Sciences, Mohammed the First University, Oujda, Morocco
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Urrutia-Espinosa M, Concha-Fuentealba F, Fuentes-Barría H, Angarita Dávila LC, Carrasco Hernández ME, Aguilera-Eguía RA. [Effects of D-tagatose, Stevia and Sucrose on pH and oral bacterial activity in dentistry students. A randomized controlled trial]. NUTR HOSP 2024. [PMID: 39037177 DOI: 10.20960/nh.05253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND stevia and D-tagatose have shown a reduction in total calorie and carbohydrate intake as a substitute for sucrose, demonstrating a stabilizing effect on pH and bacterial proliferation. OBJECTIVE to evaluate the effect of D-tagatose, stevia and sucrose on salivary pH and bacterial activity in odontology students. METHODOLOGY a controlled study of parallel and randomized groups with a single blind, whose sample considered three groups subjected to a mouthwash of D-tagatose (n = 10), stevia (n = 10) and sucrose (n = 10). These solutions were administered over 1 minute in a single 6.4 % concentrated dose. Data collection and analysis considered the recording of salivary pH 5 min before exposure to the sweetener, immediately after expulsion of the mouthwash and 15 min later, 30 min, 45 min and 48 hours. The counting of the final number of colony-forming units per mL (CFU/mL) was counted using the salivary samples obtained immediately after exposure of the sweetener together with the sample obtained 30 minutes later, with the cultures performed on agar plates. RESULTS D-tagatose, stevia and sucrose presented significant differences in total CFU/mL at 30 minutes (p < 0.001), while salivary pH showed significant differences at 48 hours after administration (p < 0.001). CONCLUSION D-tagatose, stevia and sucrose present significant differences in total CFU/mL and salivary pH, these findings being a possible indication of a partial inhibitory effect on bacterial metabolism.
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Affiliation(s)
| | | | - Héctor Fuentes-Barría
- Escuela de Odontología. Facultad de Odontología. Universidad Andrés Bello. Universidad Arturo Prat
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El-Deyarbi M, Ahmed LA, King J, Al Nuaimi H, Al Juboori A, Mansour NA, Jarab AS, Abdel-Qader DH, Aburuz S. Effect of structured diet with exercise education on anthropometry and lifestyle modification in patients with type 2 diabetes: A 12-month randomized clinical trial. Diabetes Res Clin Pract 2024; 213:111754. [PMID: 38906331 DOI: 10.1016/j.diabres.2024.111754] [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: 02/19/2024] [Revised: 06/12/2024] [Accepted: 06/17/2024] [Indexed: 06/23/2024]
Abstract
AIMS Lifestyle modification involving active engagement of specialised dietitian with diet and exercise education, can be effective as first-line treatment for diabetes. METHODS 192 patients were enrolled with diabetes in a randomised controlled trial and followed up for one year. Ninety-four patients in the intervention group participated in a comprehensive structured diet and exercise education conducted by a specialised dietitian at ambulatory centre in the United Arab Emirates. RESULTS The mean difference in the change in body mass index between study groups at study exit and baseline was statistically significant (BMI difference = -1.86, 95 % CI -2.68 - -1.04, P < 0.01). The intervention group reported significant decrease in total carbohydrate and daily energy intake compared to baseline (173.7 g vs 221.1 g and 1828.5 kcal vs 2177.9 kcal, respectively). Moreover, the mean metabolic equivalents (METs) in the intervention group increased significantly at study exit from baseline compared to control group METs, with mean difference between all between-group differences after baseline of 0.63 (95 % 0.29 - 0.97, P < 0.01). CONCLUSIONS Structured diet and exercise counselling by specialised dietitian in ambulatory settings significantly reduced carbohydrate and daily energy intake, with improved anthropometric measurements and physical activity.
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Affiliation(s)
- Marwan El-Deyarbi
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Department of Pharmacy, Oud Al-Touba Diagnostic and Screening Clinic, Ambulatory Health Services, Abu Dhabi Health Services Co. (SEHA), Al Ain, United Arab Emirates
| | - Luai A Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Jeffrey King
- David Geffen School of Medicine at the University of California, Los Angeles, CA USA; Department of Veterans Affairs, Greater Los Angeles, Department of Geriatrics and Extended Care, Los Angeles, CA USA
| | - Huda Al Nuaimi
- Clinical Nutrition and Dietary Department, Oud Al-Touba Diagnostic and Screening Clinic, Ambulatory Health Services, Abu Dhabi Health Services Co. (SEHA), Al Ain, United Arab Emirates
| | - Ahmed Al Juboori
- Division of Endocrinology, Oud Al-Touba Diagnostic and Screening Clinic, Ambulatory Health Services, Abu Dhabi Health Services Co. (SEHA), Al Ain, United Arab Emirates
| | - Nirmin A Mansour
- Division of Endocrinology, Oud Al-Touba Diagnostic and Screening Clinic, Ambulatory Health Services, Abu Dhabi Health Services Co. (SEHA), Al Ain, United Arab Emirates
| | - Anan S Jarab
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates; Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Salahdein Aburuz
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
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Oliveira JSE, Gomes JMG, Costa JDA, Oliveira LLD, Alfenas RDCG. Increased calcium intake from skimmed milk in energy-restricted diets reduces glycation markers in adults with type 2 diabetes and overweight: A secondary analysis of a randomized clinical trial. Nutr Res 2024; 127:40-52. [PMID: 38861793 DOI: 10.1016/j.nutres.2024.04.008] [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: 02/28/2024] [Revised: 04/30/2024] [Accepted: 04/30/2024] [Indexed: 06/13/2024]
Abstract
The effect of calcium (Ca) on glycation markers is unknown. We hypothesized that increased Ca intake from skimmed milk associated with an energy-restricted diet intake will reduce glycation markers. This reduction will be associated with a greater improvement in markers of metabolic control in adults with type 2 diabetes, overweight, and low habitual Ca intake (<600 mg/d). In this secondary data analysis based on a crossover clinical trial, 14 adults were allocated into 2 groups: high calcium (shake containing 700 mg Ca/day) or low calcium (shake with 6.4 mg Ca/day), for 12 consecutive weeks per session. Energy-restricted diets were also prescribed (-500 kcal/d, 800 mg of dietary Ca/d) to all participants. Advanced glycation end products (AGEs), soluble receptor for AGEs (sRAGE), glycemic control, and lipid profile were assessed at baseline and after 12 weeks. High-calcium serum AGE concentrations and AGE/sRAGE ratio were lower at the end of the study. ΔAGE and ΔAGE/sRAGE ratio were both positively associated with Δtriglycerides, Δtotal cholesterol, Δtriglyceride-glucose index and variations, and Δvisceral adiposity index. ΔAGE/sRAGE was positively associated with Δfructosamine and Δhigh-density lipoprotein-cholesterol, and negatively associated with male sex. Consumption of approximately 1200 mg/day of calcium (3 servings of skim milk) reduced serum AGEs concentrations and the AGE/sRAGE ratio in individuals with diabetes. In general, positive changes in glycation markers are associated with lipid profile, insulin resistance, and adiposity markers worsening. ΔAGEs/ΔsRAGE ratio seems to be a better marker of metabolic status than ΔAGEs and ΔsRAGE alone. Registered in ClinicalTrials.gov (NCT02377076).
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Affiliation(s)
- Julia Silva E Oliveira
- Departamento de Nutricao e Saude, Universidade Federal de Viçosa, 36570-900, Vicosa, Minas Gerais, Brazil.
| | - Júnia Maria Geraldo Gomes
- Instituto Federal de Educacao, Ciencia e Tecnologia do Sudeste de Minas Gerais, 36205-018, Barbacena, Minas Gerais, Brazil
| | - Jorge de Assis Costa
- Departamento de Ciencia Humana e Línguas, Universidade Estadual de Minas Gerais, 36500-000, Uba, Minas Gerais, Brazil
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9
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Chen H, Wang Y, Ge S, Li W, Li J, Chen W. The effects of major dietary patterns on patients with type 2 diabetes: Protocol for a systematic review and network meta-analysis. PLoS One 2024; 19:e0306336. [PMID: 38941329 PMCID: PMC11213329 DOI: 10.1371/journal.pone.0306336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 06/12/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) represents a significant worldwide health issue, experiencing an increasing incidence rate. Effective dietary strategies are vital for T2DM management, but the optimal dietary patterns remain debated due to inconsistent research outcomes and single-outcome reporting. Network Meta-Analysis (NMA) provides a powerful approach for integrating data from randomized controlled trials (RCTs), enabling a detailed evaluation of the impact of different dietary patterns. This document presents our strategy for a systematic review and network meta-analysis, aimed at assessing the influence of key dietary patterns on glycemic control, lipid profiles, and weight management in individuals with Type 2 Diabetes Mellitus (T2DM). MATERIALS AND METHODS Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and network meta-analyses guidelines, we conducted a comprehensive search of PubMed, EMBASE, and the Cochrane Library, without language or date restrictions. Our objective is to assess the efficacy of various dietary interventions in managing Type 2 Diabetes Mellitus (T2DM). We used standardized mean differences for pairwise comparisons and a Bayesian framework for ranking interventions via Surface Under the Cumulative Ranking Curve (SUCRA). Key analyses include heterogeneity, transitivity, and sensitivity assessments, along with quality and risk evaluations using the Cochrane Collaboration's tool and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. ETHICS AND DISSEMINATION This systematic review and network meta-analysis involve aggregate data from previous trials, obviating the need for additional ethical approval. The search strategy will be executed starting October 2023, with all searches completed by December 2023, to encompass the most current studies available. Findings will be shared through academic conferences and peer-reviewed journals focused on diabetes care and nutrition. TRIAL REGISTRATION PROSPERO registration number CRD42023465791.
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Affiliation(s)
- Hongyu Chen
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Yuanyuan Wang
- Department of Intensive Care Unit, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Song Ge
- Department of Natural Sciences, University of Houston-Downtown, Houston, Texas, United States of America
| | - Wanyang Li
- Department of Clinical Nutrition, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Jing Li
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Chen
- Department of Clinical Nutrition, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
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10
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Rico JL, Aya-Ramos L, Dueñas Z. Effects of early-life stress followed by access to stevia or sucralose during adolescence on weight gain, glycemia, and anxiety-related behaviors in male and female rats. Physiol Behav 2024; 280:114529. [PMID: 38555006 DOI: 10.1016/j.physbeh.2024.114529] [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: 09/22/2023] [Revised: 02/07/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
Early-life stress and subsequent high-calorie diets during adolescence are known to be risk factors for developing metabolic and psychological disorders. Although non-nutritive sweeteners such as stevia and sucralose have been a useful alternative to reduce sugar consumption, the effects of prolonged consumption of these sweeteners on metabolism and behavior in adolescents remain unclear. Here, we evaluated the effects of early-stress followed by access to stevia or sucralose during adolescence on weight gain, glycemia, and anxiety-related behaviors in male and female rats. During postnatal days (PNDs) 1-21, pups were separated twice a day, for 180 min each time, from their dam nest while non-separated pups served as controls. The pups were weaned, separated by sex and randomly distributed into the stevia, sucralose and water conditions. During PNDs 26-50, two bottles containing water and stevia or sucralose were placed in the animal home-cages, and body weight and blood glucose measures were scored. On PNDs 50 and 51, behavioral measures were obtained in the open-field test. Results showed that male rats consuming stevia reduced body weight gain, blood glucose and increased locomotion. Early-stress led to low blood glucose and alterations in anxiety and locomotion-related behaviors in a sex-dependent manner. Moreover, sucralose access during adolescence reversed the effects of early-stress on anxiety-related behaviors in female rats. The results suggest that the consumption of stevia and sucralose could be an alternative for the replacement of sugar-sweetened beverages, especially in adolescents who have had adverse early-life experiences.
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Affiliation(s)
- Javier Leonardo Rico
- Facultad de Psicología, Fundación Universitaria Konrad Lorenz, Bogotá, 111321, Colombia
| | - Laura Aya-Ramos
- Facultad de Medicina, Departamento de Ciencias Fisiológicas, Universidad Nacional de Colombia, Bogotá, 111321, Colombia
| | - Zulma Dueñas
- Facultad de Medicina, Departamento de Ciencias Fisiológicas, Universidad Nacional de Colombia, Bogotá, 111321, Colombia.
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11
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Wilson-Barnes SL, Pagkalos I, Patra E, Kokkinopoulou A, Hassapidou M, Lalama E, Csanalosi M, Kabisch S, Pfeiffer AFH, DeCorte E, Cornelissen V, Bacelar P, Balula Dias S, Stefanidis K, Tsatsou D, Gymnopoulos L, Dimitropoulos K, Rouskas K, Argiriou N, Leoni R, Botana JM, Russell D, Lanham-New SA, Hart K. The development of an EU-wide nutrition and physical activity expert knowledge base to support a personalised mobile application across various EU population groups. NUTR BULL 2024; 49:220-234. [PMID: 38773712 DOI: 10.1111/nbu.12673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 05/24/2024]
Abstract
A healthy lifestyle comprising regular physical activity and an adequate diet is imperative for the prevention of non-communicable diseases such as hypertension and some cancers. Advances in information computer technology offer the opportunity to provide personalised lifestyle advice directly to the individual through devices such as smartphones or tablets. The overall aim of the PROTEIN project (Wilson-Barnes et al., 2021) was to develop a smartphone application that could provide tailored and dynamic nutrition and physical activity advice directly to the individual in real time. However, to create this mobile health (m-health) smartphone application, a knowledge base of reference ranges for macro-/micronutrient intake, anthropometry, biochemical, physiological and sleep parameters was required to underpin the parameters of the recommender systems. Therefore, the principal aim of this emerging research paper is to describe the process by which experts in nutrition and physiology from the PROTEIN consortium collaborated to develop the nutritional and physical activity requirements, based upon existing recommendations, for 10 separate population groups living within the EU including, but not limited to healthy adults, adults with type 2 diabetes mellitus, cardiovascular disease, excess weight, obesity and iron deficiency anaemia. A secondary aim is to describe the development of a library of 24-h meal plans appropriate for the same groups and also encompassing various dietary preferences and allergies. Overall, the consortium devised an extensive nutrition and physical activity knowledge base that is pertinent to 10 separate EU user groups, is available in 7 different languages and is practically implemented via a library of culturally appropriate, 24-h meal plans.
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Affiliation(s)
- S L Wilson-Barnes
- School of Biosciences & Medicine, University of Surrey, Guildford, UK
| | - I Pagkalos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - E Patra
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - A Kokkinopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - M Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - E Lalama
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - M Csanalosi
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - S Kabisch
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - A F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - E DeCorte
- Department of Rehabilitation Sciences and Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - V Cornelissen
- Department of Rehabilitation Sciences and Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - P Bacelar
- Healthium/Nutrium Software, Porto e Região, Portugal
| | - S Balula Dias
- Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculdade de Motricidade Human, Universidade de Lisboa, Lisbon, Portugal
| | - K Stefanidis
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - D Tsatsou
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - L Gymnopoulos
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - K Dimitropoulos
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - K Rouskas
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | - N Argiriou
- Centre for Research & Technology Hellas, Thessaloniki, Greece
| | | | | | | | - S A Lanham-New
- School of Biosciences & Medicine, University of Surrey, Guildford, UK
| | - K Hart
- School of Biosciences & Medicine, University of Surrey, Guildford, UK
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12
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Gebreyesus HA, Abreha GF, Beshirie SD, Abera MA, Weldegerima AH, Bezabih AM, Lemma TB, Nigatu TG. Patient-centered nutrition education improved the eating behavior of persons with uncontrolled type 2 diabetes mellitus in North Ethiopia: a quasi-experimental study. Front Nutr 2024; 11:1352963. [PMID: 38660065 PMCID: PMC11040084 DOI: 10.3389/fnut.2024.1352963] [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: 12/09/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Background Improving the clinical outcome of people with type 2 diabetes mellitus by modifying their eating behavior through nutrition education is an important element of diabetes self-management. Significant data from the literature supports this idea, however in the Ethiopian setting, there is a practice gap. Therefore, the purpose of this study was to assess how patient-centered nutrition education affected the eating behavior and clinical outcomes of people with uncontrolled type 2 diabetes mellitus. Method In this quasi-experimental trial, 178 people with uncontrolled type 2 diabetes were purposely assigned to the intervention (n = 89) or control (n = 89) arm. The intervention arm was given patient-centered nutrition education, whereas the control arm received the routine care. Eating behavior and clinical outcome indicators such as HbAc, lipid profile, anthropometric indices, and blood pressure were assessed in both groups at the start and completion of the intervention. All scale variables were tested for normality and log transformed when appropriate. The baseline characteristics of the intervention and control groups were compared using the t-test for continuous variables and the chi-square test for categorical variables. The effect of nutrition education was determined using a difference in differences (DID) approach. P < 0.05 was established as the criterion of significance. Result Food selection (DID = 15.84, P < 0.001), meal planning (DID = 31.11, P < 0.001), and calorie needs (DID = 37.65, P < 0.001) scores were statistically higher in the nutrition education arm. Furthermore, their overall eating behavior score (DID = 27.06, P < 0.001) was statistically greater than the controls. In terms of clinical outcomes, the overall picture reveals that the intervention did not outperform over the routine care. However, in comparison to the controls, the intervention arm showed clinically significant improvement in HbA1c (DID = -0.258, P = 0.485). Conclusion Patient-centered nutrition education has resulted in positive adjustments in the eating behavior of people with uncontrolled type 2 diabetes mellitus. Furthermore, it has shown a great potential for improving their glycemic control.
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Affiliation(s)
- Hagos Amare Gebreyesus
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
- College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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13
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Farford BA, Eglinger BJ, Kane L, Gilbert JN, Ball CT. Impact of a diabetes-designed meal delivery service on changes in hemoglobin A 1c and quality of life in patients with diabetes. Diabetes Metab Syndr 2024; 18:103004. [PMID: 38626649 DOI: 10.1016/j.dsx.2024.103004] [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: 09/07/2022] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Over 34 million Americans have diabetes, and nutrition therapy is essential in self-management. AIMS The primary aim of the study was to evaluate the impact of meals designed for patients with type 2 diabetes (T2D) through a meal delivery program. The primary outcome was a 3-month change in hemoglobin A1c (HbA1c). Secondary outcomes included a 3-month change in weight, blood pressure, high-density lipoprotein, low-density lipoprotein, and triglycerides. Furthermore, the study aimed to evaluate the impact of the meal delivery program on the participants' quality of life. METHODS In this randomized crossover clinical trial, patients were allocated in a 1:1 fashion to treatment sequence AB or treatment sequence BA. In Phase 1, participants allocated to sequence AB received 10 meals per week for 3 months, followed by a 3-month washout period and a 3-month standard intervention period with no meals. Participants allocated to sequence BA received 3 months of standard intervention with no meals followed by a 3-month washout period and a 3-month period with 10 meals per week. A quality-of-life survey was obtained during weeks 0, 12, 24, and 36. RESULTS The mean 3-month change in HbA1c (primary outcome) was nearly a half point lower with meal delivery (-0.44% [95% CI: -0.85%, -0.03%]; P = 0.037). The estimated mean 3-month change in quality of life was approximately 2 points lower (better) with meal delivery (-2.2 points [95% CI: -4.2, -0.3]; P = .027). There were no statistically significant differences in secondary outcomes with meal delivery (all P ≥ 0.15). CONCLUSIONS A meal delivery system for patients with T2D improves glycemic control and quality of life.
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Affiliation(s)
- Bryan A Farford
- Department of Family Medicine (Farford), Department of Research (Eglinger), and Department of Quantitative Health Sciences (Ball), Mayo Clinic, Jacksonville, FL, USA; Director of Nutrition (Kane), Sunbasket, Philadelphia, PA, USA; Chief Medical Officer (Gilbert), Aspire Health Plan, Monterey, CA, USA.
| | - Brian J Eglinger
- Department of Family Medicine (Farford), Department of Research (Eglinger), and Department of Quantitative Health Sciences (Ball), Mayo Clinic, Jacksonville, FL, USA; Director of Nutrition (Kane), Sunbasket, Philadelphia, PA, USA; Chief Medical Officer (Gilbert), Aspire Health Plan, Monterey, CA, USA
| | - Lindsey Kane
- Department of Family Medicine (Farford), Department of Research (Eglinger), and Department of Quantitative Health Sciences (Ball), Mayo Clinic, Jacksonville, FL, USA; Director of Nutrition (Kane), Sunbasket, Philadelphia, PA, USA; Chief Medical Officer (Gilbert), Aspire Health Plan, Monterey, CA, USA
| | - James N Gilbert
- Department of Family Medicine (Farford), Department of Research (Eglinger), and Department of Quantitative Health Sciences (Ball), Mayo Clinic, Jacksonville, FL, USA; Director of Nutrition (Kane), Sunbasket, Philadelphia, PA, USA; Chief Medical Officer (Gilbert), Aspire Health Plan, Monterey, CA, USA
| | - Colleen T Ball
- Department of Family Medicine (Farford), Department of Research (Eglinger), and Department of Quantitative Health Sciences (Ball), Mayo Clinic, Jacksonville, FL, USA; Director of Nutrition (Kane), Sunbasket, Philadelphia, PA, USA; Chief Medical Officer (Gilbert), Aspire Health Plan, Monterey, CA, USA
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14
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Skurk T, Bosy-Westphal A, Grünerbel A, Kabisch S, Keuthage W, Kronsbein P, Müssig K, Nussbaumer H, Pfeiffer AFH, Simon MC, Tombek A, Weber KS, Rubin D. Dietary Recommendations for Persons with Type 2 Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2024; 132:182-215. [PMID: 38286422 DOI: 10.1055/a-2166-6772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Affiliation(s)
- Thomas Skurk
- ZIEL Institute for Food & Health, Technical University of Munich, Freising, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition, Faculty of Agriculture and Nutritional Sciences, Christian-Albrechts University of Kiel, Kiel, Germany
| | | | - Stefan Kabisch
- German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
- German Center for Diabetes Research (DZD), Munich, Germany
| | - Winfried Keuthage
- Specialist Practice for Diabetes and Nutritional Medicine, Münster, Germany
| | - Peter Kronsbein
- Faculty of Nutrition and Food Sciences, Niederrhein University of Applied Sciences, Mönchengladbach Campus, Mönchengladbach, Germany
| | - Karsten Müssig
- Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | | | - Andreas F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Marie-Christine Simon
- Institute of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Astrid Tombek
- Diabetes Centre Bad Mergentheim, Bad Mergentheim, Germany
| | - Katharina S Weber
- Institute for Epidemiology, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Diana Rubin
- Vivantes Hospital Spandau, Berlin, Germany
- Vivantes Humboldt Hospital, Berlin, Germany
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15
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Loizou P, Taylor CM, Buckland G. The dietary approaches to stop hypertension (DASH) dietary pattern in childhood in relation to cardiometabolic risk in adolescence and early adulthood in the ALSPAC birth cohort. Public Health Nutr 2024; 27:e86. [PMID: 38511334 DOI: 10.1017/s136898002400048x] [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] [Indexed: 03/22/2024]
Abstract
OBJECTIVE To investigate the relationship between the dietary approaches to stop hypertension (DASH)-style dietary patterns in childhood and cardiometabolic risk (CMR) in adolescence/early adulthood. DESIGN Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC) prospective cohort. Diet diary data collected at 7, 10 and 13 years were used to calculate DASH-style diet scores (DDS). Multivariable linear regression models were used to investigate the associations between the DDS at 7, 10 and 13 years and CMR scores, calculated at 17 and 24 years. SETTING The ALSPAC cohort included children born in south-west England in 1991-1992. PARTICIPANTS Children with complete dietary, covariate and cardiometabolic data at 17 (n 1,526) and 24 years (n 1,524). RESULTS A higher DDS at 7 and 10 years was negatively associated with CMR scores at 17 years (β = -0·64 (95 % CI -1·27, -0·006), Ptrend=0·027 for fifth v. first DDS quintile at 7 years; β = -0·73 (95 % CI -1·35, -0·12) and Ptrend=0·037 for fifth v. first DDS quintile at 10 years) and at 24 years (β = -0·92 (95 % CI -1·49, -0·34) Ptrend = 0·001 for fifth v. first DDS quintile at 7 years; β = -0·60 (95 % CI -1·20, -0·05) Ptrend = 0·092 for fifth v. first DDS quintile at 10 years). No associations were found between the DDS at 13 years and CMR score at 17 and 24 years. CONCLUSION Greater adherence with a DASH-style diet during childhood was associated with better cardiometabolic health in adolescence/adulthood in the ALSPAC cohort. The components of the DASH diet could be recommended to improve children's cardiometabolic health.
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Affiliation(s)
| | - Caroline M Taylor
- Centre for Academic Child Health, Canynge Hall, 39 Whatley Road, Bristol Medical School, University of Bristol, BristolBS8 2PS, UK
| | - Genevieve Buckland
- Centre for Academic Child Health, Canynge Hall, 39 Whatley Road, Bristol Medical School, University of Bristol, BristolBS8 2PS, UK
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Lopez-Pedrosa JM, Camprubi-Robles M, Guzman-Rolo G, Lopez-Gonzalez A, Garcia-Almeida JM, Sanz-Paris A, Rueda R. The Vicious Cycle of Type 2 Diabetes Mellitus and Skeletal Muscle Atrophy: Clinical, Biochemical, and Nutritional Bases. Nutrients 2024; 16:172. [PMID: 38202001 PMCID: PMC10780454 DOI: 10.3390/nu16010172] [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: 12/05/2023] [Revised: 12/30/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
Today, type 2 diabetes mellitus (T2DM) and skeletal muscle atrophy (SMA) have become increasingly common occurrences. Whether the onset of T2DM increases the risk of SMA or vice versa has long been under investigation. Both conditions are associated with negative changes in skeletal muscle health, which can, in turn, lead to impaired physical function, a lowered quality of life, and an increased risk of mortality. Poor nutrition can exacerbate both T2DM and SMA. T2DM and SMA are linked by a vicious cycle of events that reinforce and worsen each other. Muscle insulin resistance appears to be the pathophysiological link between T2DM and SMA. To explore this association, our review (i) compiles evidence on the clinical association between T2DM and SMA, (ii) reviews mechanisms underlying biochemical changes in the muscles of people with or at risk of T2DM and SMA, and (iii) examines how nutritional therapy and increased physical activity as muscle-targeted treatments benefit this population. Based on the evidence, we conclude that effective treatment of patients with T2DM-SMA depends on the restoration and maintenance of muscle mass. We thus propose that regular intake of key functional nutrients, along with guidance for physical activity, can help maintain euglycemia and improve muscle status in all patients with T2DM and SMA.
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Affiliation(s)
| | | | | | | | - Jose Manuel Garcia-Almeida
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain;
| | - Alejandro Sanz-Paris
- Nutrition Unit, Universitary Hospital Miguel Servet, Isabel the Catholic 1-3, 50009 Zaragoza, Spain;
| | - Ricardo Rueda
- Abbott Nutrition R&D, 18004 Granada, Spain; (M.C.-R.); (A.L.-G.); (R.R.)
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Zhang Y, Han H, Chu L. The effects of a plate model on the remission and need for hypoglycemic drugs of newly diagnosed type 2 diabetes in China: A randomized trial. Prev Med Rep 2024; 37:102537. [PMID: 38162116 PMCID: PMC10755480 DOI: 10.1016/j.pmedr.2023.102537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
To assess the effect of the plate model on the remission of diabetes and the demand for hypoglycemic drugs in China. We selected 456 participants with newly diagnosed type 2 diabetes and not required to take hypoglycemic drugs at baseline. The plate education model consists of three parts: a colored leaflet suitable for low literacy reading, regular medical visits and health education sessions. The primary outcomes were remission of diabetes and the time to first use of hypoglycemic drugs. The study was ended after 8.1 years of follow-up. The incidence of the using hypoglycemic drugs was 36.15 % in the plate model, and 75.54 % in the low-fat model (P < 0.001). The prevalence of any remission in plate model was 27.1 % (95 % CI 16.8-37.4 %) during the first 2 years, decreasing to 14.5 % (95 % CI 6.3-22.7 %) during year 4, to 10.1 % (95 % CI 4.4-15.8 %) during year 6, and to 9.6 % (95 % CI 5.3-13.9 %) during year 8, compared with 12.2 % (95 % CI 5.2-19.2 %) at year 2, 6.1 % (95 % CI 2.1-10.1 %) at year 4, 4.7 %(95 % CI 2.2-7.2 %) at year 6, and 2.6 % (95 % CI 1.1-4.2 %) at year 8 in the low-fat group. The HbA1c of plate group was significantly decreased at the endpoint (7.74 ± 0.45 % vs. 6.70 ± 0.46 %, P < 0.001). The plate model may significantly improve the remission rate of diabetes, delay the demand for diabetes drugs, more suitable for patients with low educational level, and reduce the long-term level of HbA1c. Clinical trials registry The study was registered at ChiCTR (www.chictr.org.cn) (ChiCTR1900027097).
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Affiliation(s)
- Yongwen Zhang
- Department of Endocrinology, Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated with Nanjing University of Chinese Medicine, Nanjing 210014, China
| | - Huanhuan Han
- Department of Endocrinology, Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated with Nanjing University of Chinese Medicine, Nanjing 210014, China
| | - Lanfang Chu
- Department of Integrated Traditional Chinese and Western Medicine, General Hospital of Eastern Military Area, Nanjing 210012, China
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18
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Dinesh S, Sharma S, Chourasiya R. Therapeutic Applications of Plant and Nutraceutical-Based Compounds for the Management of Type 2 Diabetes Mellitus: A Narrative Review. Curr Diabetes Rev 2024; 20:e050523216593. [PMID: 37151065 DOI: 10.2174/1573399819666230505140206] [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: 11/07/2022] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 05/09/2023]
Abstract
Diabetes mellitus is a condition caused by a deficiency in insulin production or sensitivity that is defined by persistent hyperglycemia as well as disturbances in glucose, lipid, and protein metabolism. Uncurbed diabetes or incessant hyperglycemic condition can lead to severe complications, including renal damage, visual impairment, cardiovascular disease, neuropathy, etc., which promotes diabetes-associated morbidity and mortality rates. The therapeutic management of diabetes includes conventional medications and nutraceuticals as complementary therapies. Nutraceuticals are bioactive compounds derived from food sources that have health-promoting properties and are instrumental in the management and treatment of various maladies. Nutraceuticals are clinically exploited to tackle DM pathogenesis, and the clinical evidence suggests that nutraceuticals can modulate biochemical parameters related to diabetes pathogenesis and comorbidities. Hypoglycemic medicines are designed to mitigate DM in traditional medicinal practice. This review intends to emphasize and comment on the various therapeutic strategies available to manage this chronic condition, conventional drugs, and the potential role of nutraceuticals in managing the complexity of the disease and reducing the risk of complications. In contrast to conventional antihyperglycemic drugs, nutraceutical supplements offer a higher efficacy and lesser adverse effects. To substantiate the efficacy and safety of various functional foods in conjunction with conventional hypoglycemic medicines, additional data from clinical studies are required.
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Affiliation(s)
- Susha Dinesh
- Department of Bioinformatics, BioNome, Bengaluru, 560043, India
| | - Sameer Sharma
- Department of Bioinformatics, BioNome, Bengaluru, 560043, India
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Minari TP, Tácito LHB, Yugar LBT, Ferreira-Melo SE, Manzano CF, Pires AC, Moreno H, Vilela-Martin JF, Cosenso-Martin LN, Yugar-Toledo JC. Nutritional Strategies for the Management of Type 2 Diabetes Mellitus: A Narrative Review. Nutrients 2023; 15:5096. [PMID: 38140355 PMCID: PMC10746081 DOI: 10.3390/nu15245096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Thinking about greater adherence to dietary planning, it is extremely important to be aware of all nutritional strategies and dietary prescriptions available in the literature, and of which of them is the most efficient for the management of T2DM. METHODS A search was carried out in 2023 for randomized clinical trials, systematic reviews, meta-analyses, and guidelines in the following databases: Pubmed, Scielo, Web of Science, CrossRef and Google Scholar. In total, 202 articles were collected and analyzed. The period of publications was 1983-2023. RESULTS There is still no consensus on what the best nutritional strategy or ideal dietary prescription is, and individuality is necessary. In any case, these references suggest that Mediterranean Diet may of greater interest for the management of T2DM, with the following recommended dietary prescription: 40-50% carbohydrates; 15-25% proteins; 25-35% fats (<7% saturated, 10% polyunsaturated, and 10% monounsaturated); at least 14 g of fiber for every 1000 kcal consumed; and <2300 mg sodium. CONCLUSIONS Individuality is the gold standard for dietary prescriptions, however, the Mediterranean diet with low levels of carbohydrates and fats seems to be the most promising strategy for the management of T2DM.
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Affiliation(s)
- Tatiana Palotta Minari
- Department of Hypertension, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
| | - Lúcia Helena Bonalume Tácito
- Department of Endocrinology, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
| | | | - Sílvia Elaine Ferreira-Melo
- Cardiovascular Pharmacology & Hypertension Laboratory, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - Carolina Freitas Manzano
- Department of Hypertension, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
| | - Antônio Carlos Pires
- Department of Endocrinology, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
| | - Heitor Moreno
- Cardiovascular Pharmacology & Hypertension Laboratory, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - José Fernando Vilela-Martin
- Department of Hypertension, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
| | - Luciana Neves Cosenso-Martin
- Department of Endocrinology, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
| | - Juan Carlos Yugar-Toledo
- Department of Hypertension, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
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20
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Tajadod S, Shekari S, Khalatbari Mohseni G, Abbasi K, Torki SA, Salimi Z, Keshavarz Mohammadian M, Shapouri M, Jarrahi SAM, Sobhani Far F, Shafaei H, Doaei S, YazdiMoghaddam H, Gholamalizadeh M. Association between type 2 diabetes and different types of dietary fats: A case-control study. Clin Nutr ESPEN 2023; 58:67-72. [PMID: 38057038 DOI: 10.1016/j.clnesp.2023.08.034] [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: 12/28/2022] [Revised: 08/14/2023] [Accepted: 08/30/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND The effect of dietary fats on type 2 diabetes (T2D) is not clear. This study aimed to determine the association between T2D and dietary fatty acids among Iranian adults. METHODS This case-control study was performed on 4241 participants aged 35-70, including 1804 people with T2D and pre-diabetes as the case group and 2437 people without diabetes as the control group. Dietary intake was assessed using a food frequency questionnaire (FFQ). RESULTS The cases had higher age (48.36 ± 8.62 vs. 54.53 ± 7.75 y, P < 0.001), weight (73.7713.41 vs. 76.18 ± 13.49 kg, P = 0.001), body mass index (BMI) (28.02 ± 4.70 vs. 24 ± 4.74 kg/m2, P = 0.001), right systolic blood pressure (RSBP) (113.33 ± 16.7 vs. 121.61 ± 17.24 mmHg, P = 0.001), right diastolic blood pressure (RDBP) (71.41 ± 10.53 vs. 75.33 ± 9.92 mmHg, P = 0.001), fasting blood sugar (FBS) (96.87 ± 19.39 vs. 169.95 ± 69.28 mg/dl, P = 0.001), blood urine nitrogen (BUN) (13.65 ± 3.74 vs. 14.26 ± 4.03 mg/dl, P = 0.001), triglyceride (TG) (141.61 ± 99.37 vs. 175.96 ± 114.74 mg/dl, P = 0.001), alkaline phosphatase (ALP) (218.24 ± 66.35 vs. 246.97 ± 72.65 IU/L, P = 0.001), low-density lipoprotein cholesterol (LDL) (111.68 ± 33.02 vs. 101.97 ± 36.54 mg/dl, P = 0.001), serum glutamic-pyruvic transaminase (SGPT) (21.88 ± 15.15 vs. 23.55 ± 15.96 IU/L, P = 0.001), gamma-glutamyl transferase (GGT) (24.66 ± 20.42 vs. 30.72 ± 30.43 IU/L P = 0.001), and cholesterol (192.45 ± 39.1190 vs. 187.12 ± 46.19 mg/dl P = 0.001) compared to the control group. T2D was negatively associated with dietary intake of PUFAs (OR = 0.93, CI95%:0.84-1.03, P = 0.01) and positively associated with dietary cholesterol (OR: 1.01, CI95%:1.001-1.01, P = 0.02). CONCLUSION In summary, cholesterol was positively and PUFAs were negatively associated with diabetes. If the results of the present study on the effect of fat intake on diabetes are proven, future dietary recommendations for people at risk of diabetes may be corrected by providing diets rich in polyunsaturated fatty acids and low in cholesterol.
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Affiliation(s)
- Shirin Tajadod
- Department of Nutrition, School Of Public Health, International Campus, Iran University of Medical Sciences, Tehran, Iran
| | - Soheila Shekari
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Golsa Khalatbari Mohseni
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Khadijeh Abbasi
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saheb Abbas Torki
- Department of Nutrition, Faculty of Nutrition Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Salimi
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Mahsa Shapouri
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Hanieh Shafaei
- Nursing and Midwifery School, Guilan University of Medical Sciences, Rasht, Iran
| | - Saeid Doaei
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hamideh YazdiMoghaddam
- Iranian Research Center on Healthy Aging, Operating Room Department, Faculty of Paramedics, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Maryam Gholamalizadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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21
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Ansari MA, Chauhan W, Shoaib S, Alyahya SA, Ali M, Ashraf H, Alomary MN, Al-Suhaimi EA. Emerging therapeutic options in the management of diabetes: recent trends, challenges and future directions. Int J Obes (Lond) 2023; 47:1179-1199. [PMID: 37696926 DOI: 10.1038/s41366-023-01369-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 07/04/2023] [Accepted: 08/17/2023] [Indexed: 09/13/2023]
Abstract
Diabetes is a serious health issue that causes a progressive dysregulation of carbohydrate metabolism due to insufficient insulin hormone, leading to consistently high blood glucose levels. According to the epidemiological data, the prevalence of diabetes has been increasing globally, affecting millions of individuals. It is a long-term condition that increases the risk of various diseases caused by damage to small and large blood vessels. There are two main subtypes of diabetes: type 1 and type 2, with type 2 being the most prevalent. Genetic and molecular studies have identified several genetic variants and metabolic pathways that contribute to the development and progression of diabetes. Current treatments include gene therapy, stem cell therapy, statin therapy, and other drugs. Moreover, recent advancements in therapeutics have also focused on developing novel drugs targeting these pathways, including incretin mimetics, SGLT2 inhibitors, and GLP-1 receptor agonists, which have shown promising results in improving glycemic control and reducing the risk of complications. However, these treatments are often expensive, inaccessible to patients in underdeveloped countries, and can have severe side effects. Peptides, such as glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), are being explored as a potential therapy for diabetes. These peptides are postprandial glucose-dependent pancreatic beta-cell insulin secretagogues and have received much attention as a possible treatment option. Despite these advances, diabetes remains a major health challenge, and further research is needed to develop effective treatments and prevent its complications. This review covers various aspects of diabetes, including epidemiology, genetic and molecular basis, and recent advancements in therapeutics including herbal and synthetic peptides.
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Affiliation(s)
- Mohammad Azam Ansari
- Department of Epidemic Disease Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, 31441, Saudi Arabia.
| | - Waseem Chauhan
- Department of Hematology, Duke University, Durham, NC, 27710, USA
| | - Shoaib Shoaib
- Department of Biochemistry, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Sami A Alyahya
- Wellness and Preventive Medicine Institute, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia
| | - Mubashshir Ali
- USF Health Byrd Alzheimer's Center and Neuroscience Institute, Department of Molecular Medicine, Tampa, FL, USA
| | - Hamid Ashraf
- Rajiv Gandhi Center for Diabetes and Endocrinology, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Mohammad N Alomary
- Advanced Diagnostic and Therapeutic Institute, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia.
| | - Ebtesam A Al-Suhaimi
- King Abdulaziz & his Companions Foundation for Giftedness & Creativity, Riyadh, Saudi Arabia.
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22
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Ruissen MM, Torres-Peña JD, Uitbeijerse BS, Arenas de Larriva AP, Huisman SD, Namli T, Salzsieder E, Vogt L, Ploessnig M, van der Putte B, Merle A, Serra G, Rodríguez G, de Graaf AA, de Koning EJP, Delgado-Lista J, Sont JK. Clinical impact of an integrated e-health system for diabetes self-management support and shared decision making (POWER2DM): a randomised controlled trial. Diabetologia 2023; 66:2213-2225. [PMID: 37775611 PMCID: PMC10627940 DOI: 10.1007/s00125-023-06006-2] [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: 02/23/2023] [Accepted: 07/21/2023] [Indexed: 10/01/2023]
Abstract
AIMS/HYPOTHESIS There is a lack of e-health systems that integrate the complex variety of aspects relevant for diabetes self-management. We developed and field-tested an e-health system (POWER2DM) that integrates medical, psychological and behavioural aspects and connected wearables to support patients and healthcare professionals in shared decision making and diabetes self-management. METHODS Participants with type 1 or type 2 diabetes (aged >18 years) from hospital outpatient diabetes clinics in the Netherlands and Spain were randomised using randomisation software to POWER2DM or usual care for 37 weeks. This RCT assessed the change in HbA1c between the POWER2DM and usual care groups at the end of the study (37 weeks) as a primary outcome measure. Participants and clinicians were not blinded to the intervention. Changes in quality of life (QoL) (WHO-5 Well-Being Index [WHO-5]), diabetes self-management (Diabetes Self-Management Questionnaire - Revised [DSMQ-R]), glycaemic profiles from continuous glucose monitoring devices, awareness of hypoglycaemia (Clarke hypoglycaemia unawareness instrument), incidence of hypoglycaemic episodes and technology acceptance were secondary outcome measures. Additionally, sub-analyses were performed for participants with type 1 and type 2 diabetes separately. RESULTS A total of 226 participants participated in the trial (108 with type 1 diabetes; 118 with type 2 diabetes). In the POWER2DM group (n=111), HbA1c decreased from 60.6±14.7 mmol/mol (7.7±1.3%) to 56.7±12.1 mmol/mol (7.3±1.1%) (means ± SD, p<0.001), compared with no change in the usual care group (n=115) (baseline: 61.7±13.7 mmol/mol, 7.8±1.3%; end of study: 61.0±12.4 mmol/mol, 7.7±1.1%; p=0.19) (between-group difference 0.24%, p=0.008). In the sub-analyses in the POWER2DM group, HbA1c in participants with type 2 diabetes decreased from 62.3±17.3 mmol/mol (7.9±1.6%) to 54.3±11.1 mmol/mol (7.1±1.0%) (p<0.001) compared with no change in HbA1c in participants with type 1 diabetes (baseline: 58.8±11.2 mmol/mol [7.5±1.0%]; end of study: 59.2±12.7 mmol/mol [7.6±1.2%]; p=0.84). There was an increase in the time during which interstitial glucose levels were between 3.0 and 3.9 mmol/l in the POWER2DM group, but no increase in clinically relevant hypoglycaemia (interstitial glucose level below 3.0 mmol/l). QoL improved in participants with type 1 diabetes in the POWER2DM group compared with the usual care group (baseline: 15.7±3.8; end of study: 16.3±3.5; p=0.047 for between-group difference). Diabetes self-management improved in both participants with type 1 diabetes (from 7.3±1.2 to 7.7±1.2; p=0.002) and those with type 2 diabetes (from 6.5±1.3 to 6.7±1.3; p=0.003) within the POWER2DM group. The POWER2DM integrated e-health support was well accepted in daily life and no important adverse (or unexpected) effects or side effects were observed. CONCLUSIONS/INTERPRETATION POWER2DM improves HbA1c levels compared with usual care in those with type 2 diabetes, improves QoL in those with type 1 diabetes, improves diabetes self-management in those with type 1 and type 2 diabetes, and is well accepted in daily life. TRIAL REGISTRATION ClinicalTrials.gov NCT03588104. FUNDING This study was funded by the European Union's Horizon 2020 Research and Innovation Programme (grant agreement number 689444).
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Affiliation(s)
- Merel M Ruissen
- Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Department of Biomedical Data Sciences, Medical Decision Making Section, Leiden University Medical Center, Leiden, the Netherlands
| | - José D Torres-Peña
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofía University Hospital, Córdoba, Spain
- Department of Medical and Surgical Sciences, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Bas S Uitbeijerse
- Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Antonio P Arenas de Larriva
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofía University Hospital, Córdoba, Spain
- Department of Medical and Surgical Sciences, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Sasja D Huisman
- Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Tuncay Namli
- SRDC Software Research & Development and Consultancy Corp., Ankara, Turkey
| | | | - Lutz Vogt
- Diabetes Service Center GmbH, Karlsburg, Germany
| | | | | | | | | | | | - Albert A de Graaf
- Netherlands Organization for Applied Scientific Research (TNO), Utrecht, the Netherlands
| | - Eelco J P de Koning
- Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands.
| | - Javier Delgado-Lista
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofía University Hospital, Córdoba, Spain
- Department of Medical and Surgical Sciences, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Jacob K Sont
- Department of Biomedical Data Sciences, Medical Decision Making Section, Leiden University Medical Center, Leiden, the Netherlands
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Gitsi E, Livadas S, Angelopoulos N, Paparodis RD, Raftopoulou M, Argyrakopoulou G. A Nutritional Approach to Optimizing Pump Therapy in Type 1 Diabetes Mellitus. Nutrients 2023; 15:4897. [PMID: 38068755 PMCID: PMC10707799 DOI: 10.3390/nu15234897] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
Achieving optimal glucose control in individuals with type 1 diabetes (T1DM) continues to pose a significant challenge. While continuous insulin infusion systems have shown promise as an alternative to conventional insulin therapy, there remains a crucial need for greater awareness regarding the necessary adaptations for various special circumstances. Nutritional choices play an essential role in the efficacy of diabetes management and overall health status for patients with T1DM. Factors such as effective carbohydrate counting, assessment of the macronutrient composition of meals, and comprehending the concept of the glycemic index of foods are paramount in making informed pre-meal adjustments when utilizing insulin pumps. Furthermore, the ability to handle such situations as physical exercise, illness, pregnancy, and lactation by making appropriate adjustments in nutrition and pump settings should be cultivated within the patient-practitioner relationship. This review aims to provide healthcare practitioners with practical guidance on optimizing care for individuals living with T1DM. It includes recommendations on carbohydrate counting, managing mixed meals and the glycemic index, addressing exercise-related challenges, coping with illness, and managing nutritional needs during pregnancy and lactation. Additionally, considerations relating to closed-loop systems with regard to nutrition are addressed. By implementing these strategies, healthcare providers can better equip themselves to support individuals with T1DM in achieving improved diabetes management and enhanced quality of life.
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Affiliation(s)
- Evdoxia Gitsi
- Diabetes and Obesity Unit, Athens Medical Center, 15125 Athens, Greece; (E.G.); (M.R.)
| | | | | | - Rodis D. Paparodis
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43614, USA;
| | - Marina Raftopoulou
- Diabetes and Obesity Unit, Athens Medical Center, 15125 Athens, Greece; (E.G.); (M.R.)
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24
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Tirfessa D, Abebe M, Darega J, Aboma M. Dietary practice and associated factors among type 2 diabetic patients attending chronic follow-up in public hospitals, central Ethiopia, 2022. BMC Health Serv Res 2023; 23:1273. [PMID: 37978526 PMCID: PMC10657141 DOI: 10.1186/s12913-023-10293-1] [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: 03/11/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Diabetes Mellitus (DM) is affecting numerous Ethiopian populations regardless of environmental and social status. Diabetic people all over the world are commonly urged to acquire a healthy eating habit, which necessitates lifelong changes in food habits, beliefs, and meal patterns. Dietary management is considered one of the cornerstones of diabetes care, as it is an important component of the overall treatment plan. Choosing and following a healthy diet is important for everyone, especially people with diabetes. OBJECTIVE This study aims to assess dietary practices and associated factors among type 2 diabetes patients in the west Shewa Zone, Oromia Regional State, Ethiopia, in 2022. METHODS A hospital-based cross-sectional study design was conducted in West Shewa Zone public hospitals among 421 randomly selected type 2 diabetic patients from February 1 to March 30, 2022. Data were collected using a structured and pre-tested interviewer-administered questionnaire. Descriptive, bivariate, and multivariate binary logistic regression analyses were done using SPSS. RESULTS In this study, about 35.6% (95% CI: 30.9-39.9) of type 2 diabetes patients had good dietary practices. Diabetes knowledge (AOR 9 2; 95% CI 4.4-19.4), food-secured households (AOR 3.3; 95% CI 1.6-6.9), high self-efficacy (AOR 6.6; 95% CI 3.2-13.9), diabetes diet information from healthcare professionals (AOR 2.9; 95% CI 1.3-6.4), complete dietary change (AOR = 2.3; 95% CI 1.1-4.8), and female gender (AOR 3.6; 95% CI 1.6-8.1) were independent predictors of good dietary practice. CONCLUSION The proportion of patients with type 2 diabetes, who attended follow-up at West Shawa Public Hospitals and practiced good dietary habits, was low. Patients' household food insecurity, diabetes knowledge, self-efficacy, source of information on the diabetic diet, complete dietary change after diabetes diagnosis, and gender were all significantly associated with type 2 diabetic patients' dietary practices. Thus, promoting the provision of continuous, modified, and comprehensive education and advice on the importance of diabetes self-management, particularly adherence to dietary recommendations, is fundamental to decreasing the burden of diabetes complications and massive health expenses among diabetic patients.
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Affiliation(s)
- Dureti Tirfessa
- Department of Public Health, Ambo University College of Medicine and Health Sciences, P.O Box 19, Ambo, Ethiopia
| | - Mitsiwat Abebe
- Department of Public Health, Ambo University College of Medicine and Health Sciences, P.O Box 19, Ambo, Ethiopia
| | - Jiregna Darega
- Department of Public Health, Ambo University College of Medicine and Health Sciences, P.O Box 19, Ambo, Ethiopia
| | - Mecha Aboma
- Department of Public Health, Ambo University College of Medicine and Health Sciences, P.O Box 19, Ambo, Ethiopia.
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25
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Brown JE, Pham T, Burden H, Braakhuis AJ. Specific Genotypes Associated with Differences in Fasting Insulin Levels and Body Mass Index in Healthy Young Males: Implications for Gene-Nutrient Interactions-an Exploratory Study. Curr Dev Nutr 2023; 7:102018. [PMID: 38026570 PMCID: PMC10663744 DOI: 10.1016/j.cdnut.2023.102018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023] Open
Abstract
Background Genetic variation may significantly impact an individual's susceptibility to diseases, particularly when combined with specific nutrients. Additionally, genetic variations can lead to interindividual differences in metabolic responses. Objective The present study explores the association between gene variants and observed interindividual differences in metabolic responses. Methods The study included 30 healthy males (aged 20-34) who underwent a fasting period and subsequently consumed a standardized meal. Blood samples were collected both before and after the meal to assess metabolic changes. BMI served as an indirect measure for assessing physiological responses associated with body composition. Appetite changes were assessed using an online Visual Analog 100-point Scale. Buccal swabs were collected to analyze genetic variants in single nucleotide polymorphisms (SNPs). Results The data underwent multiple regression analysis, revealing significant associations with 3 SNPs and their metabolic status: the insulin-receptor substrate 1 (IRS1) gene variant rs2943641, genotypes CT and CC, with elevated fasting insulin levels (R2 = 0.639, P = < 0.0001); the mitochondrial uncoupling protein 1 (UCP1) gene variant rs1800592, genotypes GG and GA, with increased BMI (R2 = 0.261, P = 0.007); and the peroxisome proliferator-activated receptor γ2 (PPARγ2) gene variant rs1801282, genotypes GG and GC, with increased BMI (R2 = 0.200, P = 0.024). Conclusions Therefore, our study established significant associations between these 3 SNPs and differences in fasting insulin levels and BMI within our cohort.
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Affiliation(s)
- Julie E. Brown
- The Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Toan Pham
- The Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Hannah Burden
- The Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Andrea J. Braakhuis
- The Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Marx N, Federici M, Schütt K, Müller-Wieland D, Ajjan RA, Antunes MJ, Christodorescu RM, Crawford C, Di Angelantonio E, Eliasson B, Espinola-Klein C, Fauchier L, Halle M, Herrington WG, Kautzky-Willer A, Lambrinou E, Lesiak M, Lettino M, McGuire DK, Mullens W, Rocca B, Sattar N. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J 2023; 44:4043-4140. [PMID: 37622663 DOI: 10.1093/eurheartj/ehad192] [Citation(s) in RCA: 250] [Impact Index Per Article: 250.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
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27
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Mohammadi S, Asbaghi O, Dolatshahi S, Omran HS, Amirani N, Koozehkanani FJ, Garmjani HB, Goudarzi K, Ashtary-Larky D. Effects of supplementation with milk protein on glycemic parameters: a GRADE-assessed systematic review and dose-response meta-analysis. Nutr J 2023; 22:49. [PMID: 37798798 PMCID: PMC10557355 DOI: 10.1186/s12937-023-00878-1] [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: 04/24/2023] [Accepted: 09/25/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND It is suggested that supplementation with milk protein (MP) has the potential to ameliorate the glycemic profile; however, the exact impact and certainty of the findings have yet to be evaluated. This systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) assessed the impact of MP supplementation on the glycemic parameters in adults. METHODS A systematic search was carried out among online databases to determine eligible RCTs published up to November 2022. A random-effects model was performed for the meta-analysis. RESULTS A total of 36 RCTs with 1851 participants were included in the pooled analysis. It was displayed that supplementation with MP effectively reduced levels of fasting blood glucose (FBG) (weighted mean difference (WMD): -1.83 mg/dL, 95% CI: -3.28, -0.38; P = 0.013), fasting insulin (WMD: -1.06 uU/mL, 95% CI: -1.76, -0.36; P = 0.003), and homeostasis model assessment of insulin resistance (HOMA-IR) (WMD: -0.27, 95% CI: -0.40, -0.14; P < 0.001) while making no remarkable changes in serum hemoglobin A1c (HbA1c) values (WMD: 0.01%, 95% CI: -0.14, 0.16; P = 0.891). However, there was a significant decline in serum levels of HbA1c among participants with normal baseline body mass index (BMI) based on sub-group analyses. In addition, HOMA-IR values were significantly lower in the MP supplement-treated group than their untreated counterparts in short- and long-term supplementation (≤ 8 and > 8 weeks) with high or moderate doses (≥ 60 or 30-60 g/d) of MP or whey protein (WP). Serum FBG levels were considerably reduced upon short-term administration of a low daily dose of WP (< 30 g). Furthermore, the levels of serum fasting insulin were remarkably decreased during long-term supplementation with high or moderate daily doses of WP. CONCLUSION The findings of this study suggest that supplementation with MP may improve glycemic control in adults by reducing the values of fasting insulin, FBG, and HOMA-IR. Additional trials with longer durations are required to confirm these findings.
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Affiliation(s)
- Shooka Mohammadi
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sina Dolatshahi
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Salehi Omran
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niusha Amirani
- Faculty of Medicine, Alborz University of Medical Sciences, Tehran, Iran
| | - Fatemeh Jahangir Koozehkanani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kian Goudarzi
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Damoon Ashtary-Larky
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Sharma R, Upadhyay B, Lal N, Sagar R, Jain V. Carbohydrate Counting vs. Fixed Meal Plan in Indian Children with Type 1 Diabetes Mellitus: A Randomized Controlled Trial. Indian J Pediatr 2023:10.1007/s12098-023-04850-z. [PMID: 37787966 DOI: 10.1007/s12098-023-04850-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/17/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVES To study the impact of carbohydrate counting vs. fixed-meal plan on glycemic control, quality of life (QoL) and diabetes-related emotional distress in children with Type 1 diabetes mellitus (T1DM). METHODS Children aged 6-18 y with T1DM of duration >1 y were eligible for the study if they were on multiple daily injections of insulin and regularly monitoring blood glucose. Those with celiac disease, hypothyroidism, any underlying chronic renal/liver/systemic disease or HbA1c >13% were excluded. Both groups received education on diabetes management and healthy diet. In the intervention arm, parents were taught to quantify carbohydrate content and modify insulin doses according to insulin-carbohydrate ratio. The control arm had dietary prescription according to recommended dietary allowance and food exchange list. Standard validated questionnaires were used to assess the QoL and emotional distress related to diabetes. RESULTS One hundred twenty five patients (61 intervention, 64 controls) were enrolled and 91.8% and 84.3%, respectively, completed 6-mo follow-up. There was a reduction in HbA1c in both the groups, but was not statistically significant within or between groups {Intervention: 8.9 (1.4) to 8.6 (1.5) vs. control: 9.1 (1.6) to 8.8 (1.9), [95% CI 8.3-9.3 vs. 8.3-9.0, intention to treat (ITT), p = 0.63]}. There was a significant reduction in diabetes distress in the intervention group; DAWN Problem Areas in Diabetes Questionnaire (PAID) score with a median (interquartile range) of 21 (11-33) vs. control: 27 (20-40), (p = 0.04). CONCLUSIONS Patients in the carbohydrate-counting group demonstrated lower diabetes distress scores and less emotional burnout compared to fixed-meal plan over a 6 mo period though overall glycemic control was comparable between groups.
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Affiliation(s)
- Rajni Sharma
- Division of Pediatric Endocrinology, Department of Pediatrics, Mother and Child Block, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Babita Upadhyay
- Division of Pediatric Endocrinology, Department of Pediatrics, Mother and Child Block, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Nitika Lal
- Division of Pediatric Endocrinology, Department of Pediatrics, Mother and Child Block, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Vandana Jain
- Division of Pediatric Endocrinology, Department of Pediatrics, Mother and Child Block, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
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Neyman A, Hannon TS. Low-Carbohydrate Diets in Children and Adolescents With or at Risk for Diabetes. Pediatrics 2023; 152:e2023063755. [PMID: 37718964 DOI: 10.1542/peds.2023-063755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 09/19/2023] Open
Abstract
Carbohydrate restriction is increasingly popular as a weight loss strategy and for achieving better glycemic control in people with diabetes, including type 1 and type 2 diabetes. However, evidence to support low-carbohydrate diets in youth (children and adolescents 2-18 years of age) with obesity or diabetes is limited. There are no guidelines for restricting dietary carbohydrate consumption to reduce risk for diabetes or improve diabetes outcomes in youth. Thus, there is a need to provide practical recommendations for pediatricians regarding the use of low-carbohydrate diets in patients who elect to follow these diets, including those with type 1 diabetes and for patients with obesity, prediabetes, and type 2 diabetes. This clinical report will: Provide background on current dietary patterns in youth, describe how moderate-, low-, and very low-carbohydrate diets differ, and review safety concerns associated with the use of these dietary patternsReview the physiologic rationale for carbohydrate reduction in youth with type 1 diabetes and for youth with obesity, prediabetes, and type 2 diabetesReview the evidence for low-carbohydrate diets in the management of youth with type 1 diabetesReview the evidence for low-carbohydrate diets in the management of youth with obesity, prediabetes, and type 2 diabetesProvide practical information for pediatricians counseling families and youth on carbohydrate recommendations for type 1 diabetes and for obesity, prediabetes, and type 2 diabetes.
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Affiliation(s)
- Anna Neyman
- Indiana University School of Medicine, Riley Children's Hospital, Indianapolis, Indiana
| | - Tamara S Hannon
- Indiana University School of Medicine, Riley Children's Hospital, Indianapolis, Indiana
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30
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Grygiel-Górniak B, Skoczek W. Molecular Background and Clinical Implications of Glucose Disorders in Patients with Psoriatic Arthritis. J Clin Med 2023; 12:5814. [PMID: 37762754 PMCID: PMC10532042 DOI: 10.3390/jcm12185814] [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: 08/05/2023] [Revised: 08/22/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Psoriatic arthritis (PsA) is an inflammatory musculoskeletal disease characterized by joint and entheses involvement. This condition is often associated with an increased prevalence of obesity, encompassing more than one-third of all patients. Given the presence of metabolic disorders, it becomes crucial to enhance clinical oversight of metabolic parameters. An early diagnosis of glucose irregularities in PsA allows for the assessment of an effective treatment strategy. The approach proves valuable in preventing the development of insulin resistance (IR) or diabetes mellitus type 2 (DMt2). Similar pathways characterize the pathomechanism of PsA and DMt2, offering an innovative perspective on treatment management. The cytokines and adipokines synthesized in the course of PsA significantly impact the development process of IR and DMt2 in different mechanisms of action. Conversely, glucose disorders influence the activity of PsA and therapy outcomes. Given the chronic inflammatory background shared by PsA, obesity, and DMt2, it is evident that inadequate management of any of the mentioned conditions can exacerbate the others. Thus, when PsA coincides with DMt2, a comprehensive multidimensional approach is necessary. This includes an effective immunosuppressive regimen complemented by appropriate anti-diabetic and insulin therapies. Moreover, often overlooked recommendations concerning overall well-being and lifestyle adjustments hold significance. This manuscript explores the connections and the relationship between the molecular background of PsA and glucose disorders. It provides a detailed exposition of specific therapeutic approaches for both conditions.
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Affiliation(s)
- Bogna Grygiel-Górniak
- Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland
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31
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Law KK, Coyle DH, Neal B, Huang L, Barrett EM, Arnott C, Chow CK, Di Tanna GL, Lung T, Mozaffarian D, Berkowitz SA, Wong J, Wu T, Twigg S, Gauld A, Simmons D, Piya MK, MacMillan F, Khoo CL, Tian M, Trieu K, Wu JHY. Protocol for a randomized controlled trial of medically tailored meals compared to usual care among individuals with type 2 diabetes in Australia. Contemp Clin Trials 2023; 132:107307. [PMID: 37516164 DOI: 10.1016/j.cct.2023.107307] [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: 05/07/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND 'Food is medicine' strategies aim to integrate food-based nutrition interventions into healthcare systems and are of growing interest to healthcare providers and policy makers. 'Medically Tailored Meals' (MTM) is one such intervention, which involves the 'prescription' by healthcare providers of subsidized, pre-prepared meals for individuals to prevent or manage chronic conditions, combined with nutrition education. OBJECTIVE This study will test the efficacy of an MTM program in Australia among participants with type 2 diabetes (T2D) and hyperglycemia, who experience difficulties accessing and eating nutritious food. METHODS This study will be a two-arm parallel trial (goal n = 212) with individuals randomized in a 1:1 ratio to a MTM intervention group or a control group (106 per arm). Over 26 weeks, the intervention group will be prescribed 20 MTM per fortnight and up to 3 sessions with an accredited dietitian. Controls will continue with their usual care. The primary outcome is glycated hemoglobin (HbA1c, %) and secondary outcomes include differences in blood pressure, blood lipids and weight, all measured at 26 weeks. Process and economic data will be analyzed to assess the feasibility, acceptability, scalability, and cost-effectiveness of the intervention. Recruitment commenced in the first quarter of 2023, with analyses and results anticipated to be available by March 2025. DISCUSSION Few randomized controlled trials have assessed the impact of MTM on clinical outcomes. This Australian-first trial will generate robust data to inform the case for sustained, large-scale implementation of MTM to improve the management of T2D among vulnerable populations. ANZCTR ACTRN12622000852752. PROTOCOL VERSION Version 1.1, July 2023.
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Affiliation(s)
- Kristy K Law
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
| | - Daisy H Coyle
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Bruce Neal
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Liping Huang
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Eden M Barrett
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Clare Arnott
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Clara K Chow
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Westmead Hospital, Westmead, NSW, Australia
| | - Gian Luca Di Tanna
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Lugano, Switzerland
| | - Thomas Lung
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States of America
| | - Seth A Berkowitz
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Jencia Wong
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Faculty of Medicine and Health, Sydney Medical School, Central Clinical School, Central Sydney (Patyegarang) Precinct, University of Sydney, NSW, Australia
| | - Ted Wu
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Stephen Twigg
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Faculty of Medicine and Health, Sydney Medical School, Central Clinical School, Central Sydney (Patyegarang) Precinct, University of Sydney, NSW, Australia
| | - Amanda Gauld
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - David Simmons
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia; Macarthur Diabetes Endocrinology and Metabolism Service, Camden and Campbelltown Hospitals, Campbelltown, NSW, Australia
| | - Milan K Piya
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia; Macarthur Diabetes Endocrinology and Metabolism Service, Camden and Campbelltown Hospitals, Campbelltown, NSW, Australia
| | - Freya MacMillan
- Macarthur Diabetes Endocrinology and Metabolism Service, Camden and Campbelltown Hospitals, Campbelltown, NSW, Australia.; School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | - Chee L Khoo
- Healthfocus Family Practice, Sydney, NSW, Australia
| | - Maoyi Tian
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Public Health, Harbin Medical University, Harbin, China
| | - Kathy Trieu
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Jason H Y Wu
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Population Health, University of New South Wales, Sydney, NSW, Australia
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Jing T, Zhang S, Bai M, Chen Z, Gao S, Li S, Zhang J. Effect of Dietary Approaches on Glycemic Control in Patients with Type 2 Diabetes: A Systematic Review with Network Meta-Analysis of Randomized Trials. Nutrients 2023; 15:3156. [PMID: 37513574 PMCID: PMC10384204 DOI: 10.3390/nu15143156] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Dietary patterns play a critical role in diabetes management, while the best dietary pattern for Type 2 diabetes (T2DM) patients is still unclear. The aim of this network meta-analysis was to compare the impacts of various dietary approaches on the glycemic control of T2DM patients. METHODS Relevant studies were retrieved from PubMed, Embase, Web of Knowledge, Cochrane Central Register of Controlled Trials (CENTRAL), and other additional records (1949 to 31 July 2022). Eligible RCTs were those comparing different dietary approaches against each other or a control diet in individuals with T2DM for at least 6 months. We assessed the risk of bias of included studies with the Cochrane risk of bias tool and confidence of estimates with the Grading of Recommendations Assessment, Development, and Evaluation approach for network meta-analyses. In order to determine the pooled effect of each dietary approach relative to each other, we performed a network meta-analysis (NMA) for interventions for both HbA1c and fasting glucose, which enabled us to estimate the relative intervention effects by combing both direct and indirect trial evidence. RESULTS Forty-two RCTs comprising 4809 patients with T2DM were included in the NMA, comparing 10 dietary approaches (low-carbohydrate, moderate-carbohydrate, ketogenic, low-fat, high-protein, Mediterranean, Vegetarian/Vegan, low glycemic index, recommended, and control diets). In total, 83.3% of the studies were at a lower risk of bias or had some concerns. Findings of the NMA revealed that the ketogenic, low-carbohydrate, and low-fat diets were significantly effective in reducing HbA1c (viz., -0.73 (-1.19, -0.28), -0.69 (-1.32, -0.06), and -1.82 (-2.93, -0.71)), while moderate-carbohydrate, low glycemic index, Mediterranean, high-protein, and low-fat diets were significantly effective in reducing fasting glucose (viz., -1.30 (-1.92, -0.67), -1.26 (-2.26, -0.27), -0.95 (-1.51, -0.38), -0.89 (-1.60, -0.18) and -0.75 (-1.24, -0.27)) compared to a control diet. The clustered ranking plot for combined outcomes indicated the ketogenic, Mediterranean, moderate-carbohydrate, and low glycemic index diets had promising effects for controlling HbA1c and fasting glucose. The univariate meta-regressions showed that the mean reductions of HbA1c and fasting glucose were only significantly related to the mean weight change of the subjects. CONCLUSIONS For glycemic control in T2DM patients, the ketogenic diet, Mediterranean diet, moderate-carbohydrate diet, and low glycemic index diet were effective options. Although this study found the ketogenic diet superior, further high-quality and long-term studies are needed to strengthen its credibility.
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Affiliation(s)
- Tiantian Jing
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.J.)
| | - Shunxing Zhang
- Department of Global Public Health/Media, Culture, and Communication, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY 10016, USA
| | - Mayangzong Bai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.J.)
| | - Zhongwan Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.J.)
| | - Sihan Gao
- School of Public Health, University of Washington Seattle Campus, Seattle, WA 98105, USA
| | - Sisi Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.J.)
| | - Jing Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.J.)
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Rapinski M, Cuerrier A, Davy D. Adaptations in the transformation of cassava ( Manihot esculenta Crantz; Euphorbiaceae) for consumption in the dietary management of diabetes: the case of Palikur, or Parikwene People, from French Guiana. Front Nutr 2023; 10:1061611. [PMID: 37252236 PMCID: PMC10213250 DOI: 10.3389/fnut.2023.1061611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/06/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction In the French overseas department of French Guiana, in South America, nutrition therapy for the management of diabetes is based on French guidelines. However, this region is demographically diverse and includes several populations of Indigenous Peoples, Parikwene among others, also called Palikur. Due to socio-economical, cultural, and geographical differences, along with distinctions in the local food system, dietary recommendations, which many consider in the context of post-colonial power dynamics, are not well suited to local populations. In the absence of suitable recommendations, it is hypothesized that local populations will adapt their dietary practices considering diabetes as an emerging health problem. Methods Seventy-five interviews were conducted with community members and Elders, as well as healthcare professionals and administrators providing services to the Parikwene population of Macouria and Saint-Georges de l'Oyapock communes. Data regarding the representation of cassava (Manihot esculenta Crantz) consumption and diabetes were collected via semi-structured interviews and participant observation (i.e., observation and participation in community activities), namely via participating in activities related to the transformation of cassava tubers at swidden and fallow fields. Results and Discussion Parikwene have adapted the transformation of cassava tubers for their consumption in the management of diabetes.The importance of cassava tubers as a staple and core food to the Parikwene food system was established by identifying it as a cultural keystone species. Narratives illustrated conflicting perceptions regarding the implication of cassava consumption in the development of diabetes. Adaptations to the operational sequence involved in the transformation of cassava tubers led to the production of distinct cassava roasted semolina (i.e., couac), based on organoleptic properties (i.e., sweet, and acidic couac). Preferences for the consumption of acidic couac were grounded in the Parikwene knowledge system, as well as attention to diabetes related symptoms and glucometer readings. Conclusion These results provide important insights related to knowledge, attitudes, and practices in developing locally and culturally adapted approaches to providing dietary recommendations in the treatment of diabetes.
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Affiliation(s)
- Michael Rapinski
- Institut de Recherche en Biologie Végétale (IRBV), Université de Montréal, Jardin botanique de Montréal, Montréal, QC, Canada
- UAR 3456 Laboratoire Ecologie, Evolution, Interactions des Systèmes Amazoniens (LEEISA), CNRS, Université de Guyane, IFREMER, Cayenne, French Guiana
| | - Alain Cuerrier
- Institut de Recherche en Biologie Végétale (IRBV), Université de Montréal, Jardin botanique de Montréal, Montréal, QC, Canada
| | - Damien Davy
- UAR 3456 Laboratoire Ecologie, Evolution, Interactions des Systèmes Amazoniens (LEEISA), CNRS, Université de Guyane, IFREMER, Cayenne, French Guiana
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Saidi S, Remok F, Handaq N, Drioiche A, Gourich AA, Menyiy NE, Amalich S, Elouardi M, Touijer H, Bouhrim M, Bouissane L, Nafidi HA, Bin Jardan YA, Bourhia M, Zair T. Phytochemical Profile, Antioxidant, Antimicrobial, and Antidiabetic Activities of Ajuga iva (L.). Life (Basel) 2023; 13:life13051165. [PMID: 37240812 DOI: 10.3390/life13051165] [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: 03/01/2023] [Revised: 04/03/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
In Morocco, many applications in ethnomedicine on Ajuga iva (L.) have been recognized as able to treat various pathologies such as diabetes, stress, and microbial infections. The objective of this work is to carry out phytochemical, biological, and pharmacological investigations on the extracts of Ajuga iva leaves in order to confirm its therapeutic effects. The phytochemical screening carried out on the different extracts of Ajuga iva showed its richness in primary (lipids and proteins) and secondary metabolites (flavonoids, tannins, reducing compounds, oses, and holoside. The best contents of polyphenols, flavonoids, and tannins evaluated by spectrophotometric methods were found in the hydroethanolic extract (69.850 ± 2.783 mg EAG/g DE, 17.127 ± 0.474 mg EQ/g DE, 5.566 ± 0.000 mg EQC/g DE), respectively. Analysis of the chemical composition of the aqueous extract by LC/UV/MS revealed 32 polyphenolic compounds including ferulic acid (19.06%), quercetin (10.19%), coumaric acid (9.63%), and apigenin-7-(2-O-apiosylglucoside) (6.8%). The antioxidant activity of Ajuga iva extracts was evaluated by three methods (DPPH*, FRAP, CAT). The hydroethanolic extract recorded the strongest reducing power: DPPH* (IC50 = 59.92 ± 0.7 µg/mL), FRAP (EC50 = 196.85 ± 1.54 (µg/mL), and CAT (199.21 ± 0.37 mg EAG/gE). A strong correlation between phenolic compounds and antioxidant activities was confirmed by the determination of Pearson's coefficient. The antimicrobial activity of Ajuga iva studied by the microtiter method revealed potent antifungal and antibacterial qualities against Candida parapsilosis and Staphylococcus aureus BLACT. An in vivo oral glucose tolerance test (OGTT) using normal rats revealed that the antihyperglycemic action of the aqueous extract significantly reduced postprandial hyperglycaemia at (30 min, p < 0.01) and area under the curve (AUC glucose), p < 0.01. Similarly, the aqueous extract, tested on pancreatic α-amylase enzyme activity in vitro and in vivo significantly inhibited pancreatic α-amylase activity with IC50 = 1.52 ± 0.03 mg/mL. In conclusion, the extract from Ajuga iva could be a good source of bioactive molecules, which exhibit potent antioxidant and antimicrobial activity, as well as strong antidiabetic activity, for applications in the pharmaceutical industry.
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Affiliation(s)
- Soukaina Saidi
- Research Team of Bioactive Molecules and Environment Chemistry, Laboratory of Innovative Materials and Biotechnology of Natural Resources, Faculty of Sciences, Moulay Ismail University, Meknes 50070, Morocco
- Laboratory of Molecular Chemistry, Materials and Catalysis, Faculty of Science and Technologies, Sultan Moulay Slimane University, Beni Mellal 23000, Morocco
| | - Firdaous Remok
- Research Team of Bioactive Molecules and Environment Chemistry, Laboratory of Innovative Materials and Biotechnology of Natural Resources, Faculty of Sciences, Moulay Ismail University, Meknes 50070, Morocco
| | - Nadia Handaq
- Research Team of Bioactive Molecules and Environment Chemistry, Laboratory of Innovative Materials and Biotechnology of Natural Resources, Faculty of Sciences, Moulay Ismail University, Meknes 50070, Morocco
- Plant Valorization and Protection Research Team, Laboratory of Environmental Biology and Sustainable Development, Higher Normal School of Tetouan, Abdelmaek Essaadi University, Tetouan 93000, Morocco
| | - Aziz Drioiche
- Research Team of Bioactive Molecules and Environment Chemistry, Laboratory of Innovative Materials and Biotechnology of Natural Resources, Faculty of Sciences, Moulay Ismail University, Meknes 50070, Morocco
| | - Aman Allah Gourich
- Research Team of Bioactive Molecules and Environment Chemistry, Laboratory of Innovative Materials and Biotechnology of Natural Resources, Faculty of Sciences, Moulay Ismail University, Meknes 50070, Morocco
| | - Naoual El Menyiy
- Laboratory of Pharmacology and Phytochemistry, National Agency of Medicinal and Aromatic Plants, Taounate 34025, Morocco
| | - Smail Amalich
- Laboratory of Pharmacology and Phytochemistry, National Agency of Medicinal and Aromatic Plants, Taounate 34025, Morocco
| | - Mohamed Elouardi
- Research Team of Bioactive Molecules and Environment Chemistry, Laboratory of Innovative Materials and Biotechnology of Natural Resources, Faculty of Sciences, Moulay Ismail University, Meknes 50070, Morocco
| | - Hanane Touijer
- Research Team of Bioactive Molecules and Environment Chemistry, Laboratory of Innovative Materials and Biotechnology of Natural Resources, Faculty of Sciences, Moulay Ismail University, Meknes 50070, Morocco
| | - Mohamed Bouhrim
- Laboratory of Biological Engineering, Team of Functional and Pathological Biology, Faculty of Sciences and Technology Beni Mellal, University Sultan Moulay Slimane, Beni Mellal 23000, Morocco
| | - Latifa Bouissane
- Laboratory of Molecular Chemistry, Materials and Catalysis, Faculty of Science and Technologies, Sultan Moulay Slimane University, Beni Mellal 23000, Morocco
| | - Hiba-Allah Nafidi
- Department of Food Science, Faculty of Agricultural and Food Sciences, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Yousef A Bin Jardan
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11495, Saudi Arabia
| | - Mohammed Bourhia
- Department of Chemistry and Biochemistry, Faculty of Medicine and Pharmacy, Laayoune 70000, Morocco
| | - Touriya Zair
- Research Team of Bioactive Molecules and Environment Chemistry, Laboratory of Innovative Materials and Biotechnology of Natural Resources, Faculty of Sciences, Moulay Ismail University, Meknes 50070, Morocco
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Arefhosseini S, Roshanravan N, Asghari S, Tutunchi H, Ebrahimi-Mameghani M. Expression of inflammatory genes, WBC-derived inflammatory biomarkers and liver function indices: Effects of myo-inositol supplementation in obese patients with NAFLD. J Funct Foods 2023. [DOI: 10.1016/j.jff.2023.105524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
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Shon J, Seong Y, Choi Y, Kim Y, Cho MS, Ha E, Kwon O, Kim Y, Park YJ, Kim Y. Meal-Based Intervention on Health Promotion in Middle-Aged Women: A Pilot Study. Nutrients 2023; 15:2108. [PMID: 37432253 DOI: 10.3390/nu15092108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 07/12/2023] Open
Abstract
Middle-aged women belong to a risk group for metabolic dysregulation and menopausal symptoms, mainly due to a dramatic hormonal shift. Supplementation with functional compounds or a single nutrient has been dominantly explored as a nutritional approach for improving aging-related health parameters. However, a meal-based approach might be another strategy for promoting the overall health of the target population. This pilot study aimed to develop a meal-based intervention for middle-aged women and to evaluate its potential health benefits. Considering the nutrient intake status of Korean middle-aged women, diets enriched with four major nutrients (isoflavone, omega-3, fiber, and calcium) were designed and provided to forty-nine women aged 50 to 65 with mild levels of menopausal symptoms for 8 weeks. In the post-intervention phase, they showed reduced body weight and body fat, and improved biochemical metabolic parameters with decreased levels of cholesterol, low-density lipoprotein-cholesterol, ApoB, and fasting insulin. Moreover, bone resorption markers and menopause symptoms were lower in the post-intervention phase. In conclusion, the meal-based intervention might be a prominent strategy for overall health promotion in relatively healthy middle-aged women and further investigation is needed to test its efficacy with a randomized controlled study.
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Affiliation(s)
- Jinyoung Shon
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Republic of Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Yehee Seong
- Graduate School of Clinical Biohealth, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Yeji Choi
- Graduate School of Clinical Biohealth, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Yeri Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Mi Sook Cho
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Eunhee Ha
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea
- Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea
| | - Oran Kwon
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Republic of Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Yuri Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Republic of Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Yoon Jung Park
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Republic of Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Yangha Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Republic of Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea
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Jiang Y, Zhang Z, Zhu Y, Chai Y, Xie H. Dose-response association between dietary folate and niacin intakes with diabetes among Chinese adults: a cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:31. [PMID: 37038237 PMCID: PMC10084685 DOI: 10.1186/s41043-023-00362-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/01/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND The aim of this study was to examine the relationship between dietary intake of folate and niacin and diabetes risk in Chinese adults. METHODS This is a cross-sectional study. Demographic and anthropometric data along with information on dietary intake of vitamins were collected, and eligible participants were recruited to complete the questionnaire. A binary logistic regression analysis was conducted to examine the association between dietary intake of vitamins and diabetes risk, with adjustment for potential confounders. Non-linear dose-response relationships between dietary intake of folate and niacin and diabetes risk were also evaluated using adjusted restricted cubic splines. RESULTS Of the 3106 eligible participants, 15.9% had diabetes. Median folate was significantly higher in diabetic patients than in controls (32.030 vs. 27.600 gμ), while median niacin was significantly lower (7.000 vs. 7.900 mg). After controlling for potential confounders, binary logistic regression analysis showed that each unit increase in folate intake was associated with a 1.002-fold increase in the risk of developing diabetes (odds ratio (OR) = 1.002; 95% confidence interval (CI) 1.000-1.004; P = 0.022), while each unit increase in niacin intake was associated with a 3.5% reduction in diabetes risk (OR = 0.965; 95% CI 0.944-0.986; P = 0.001). The plots of restricted cubic splines presented an atypical inverted U-shaped association between dietary intake of folate and diabetes risk. CONCLUSIONS Diabetic patients had a low intake of vitamins, especially the B vitamins. Dietary intake of folate and niacin tended to be independently associated with the risk of diabetes. Nevertheless, this study is observational and a large-scale randomized controlled trial is yet to be conducted, which will add to the evidence of the study results.
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Affiliation(s)
- Yuhong Jiang
- Department of Epidemiology and Health Statistics, School of Public Health, Bengbu Medical College, Bengbu, China
| | - Zhiwen Zhang
- School of Public Health, Bengbu Medical College, Bengbu, China
| | - Yi Zhu
- School of Public Health, Bengbu Medical College, Bengbu, China
| | - Yongfei Chai
- School of Public Health, Bengbu Medical College, Bengbu, China
| | - Hong Xie
- Department of Nutrition and Food Hygiene School of Public Health, Bengbu Medical College, Bengbu, China.
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Ayabakan S, Bardhan IR, Zheng Z(E. Impact of Telehealth and Process Virtualization on Healthcare Utilization. INFORMATION SYSTEMS RESEARCH 2023. [DOI: 10.1287/isre.2023.1220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Telehealth has emerged as a tool to improve patient access by virtualizing healthcare services, particularly during the COVID-19 pandemic. However, concerns have been raised that telehealth may actually increase healthcare spending by leading to new types of utilization. Our research provides empirical evidence that this concern is unfounded based on a state-wide study of patient visit-level data of telehealth use in 58 hospitals in Maryland from 2012 to 2021. On average, telehealth use can reduce future outpatient visits by 13.6% within 30 days after a telehealth visit, leading to a cost reduction of $239. The benefits of telehealth are most apparent for diseases with high potential for process virtualization, such as mental health, skin disorders, metabolic, and musculoskeletal diseases. Although telehealth has a substitution effect on future healthcare utilization, this effect is not observed among rural patients who use telehealth as a gateway to utilize more primary care and specialist services. Our findings suggest that policymakers should promote the use of telehealth in a value-based healthcare environment by providing monetary incentives to expand telehealth use among patients and providers, and expand the scope of telehealth services to include consultation with specialists especially among rural patients.
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Mohammadi Zadeh M, Dehghan P, Eslami Z. Effect of date seed ( Phoenix dactylifera) supplementation as functional food on cardiometabolic risk factors, metabolic endotoxaemia and mental health in patients with type 2 diabetes mellitus: a blinded randomised controlled trial protocol. BMJ Open 2023; 13:e066013. [PMID: 36931666 PMCID: PMC10030472 DOI: 10.1136/bmjopen-2022-066013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 02/26/2023] [Indexed: 03/19/2023] Open
Abstract
INTRODUCTION Recently, the improvement of chronic hyperglycaemia-related damage of type 2 diabetes mellitus (T2DM) through functional food consumption has attracted the attention of many clinicians. This study aims to determine the effectiveness of date seed powder (DSP) as a functional food (prebiotic) on the cardiometabolic risk factors, oxidative stress, anti-/inflammatory biomarkers, metabolic endotoxaemia (gut microbiota), adipokines, hypothalamic-pituitary-adrenal axis biomarkers, immune system, anthropometric indices and mental health in patients with T2DM. METHODS This study protocol will be conducted as randomised, triple-blind, placebo-controlled trial with the inclusion of 48 patients with T2DM. The participants will be randomly assigned into two equal groups of intervention (n=24) and placebo (n=24) and receive 5 g/day of DSP or placebo for 8 weeks, respectively. At baseline and post-intervention, fasting blood samples will be collected to assess the serum levels of lipid profile, glycaemic indices, antioxidant and oxidative stress, anti-/inflammatory biomarkers, lipopolysaccharide, 8-hydroxy-guanine, adipokines, hypothalamic-pituitary-adrenal axis biomarkers, immune system and mental health. Data will be analysed using the SPSS software (V.16.0). To compare the quantitative variables, paired and unpaired Student's t-tests and covariance analyses will be used. DISCUSSION In this study, the potential effects of DSP on patients with T2DM will be evaluated for the first time. It is hoped that the results would increase the body of scientific knowledge about DSP supplementation on the cardiometabolic risk factors, oxidative stress, anti-/inflammatory biomarkers, metabolic endotoxaemia, adipokines, hypothalamic-pituitary-adrenal axis biomarkers, immune system, anthropometric indices and mental health in patients with T2DM. ETHICS AND DISSEMINATION The study protocol was approved by the Ethical Committee of the Tabriz University of Medical Sciences, Tabriz, Iran (code: IR.TBZMED.REC.1400.752). TRIAL REGISTRATION NUMBER Iranian Registry of Clinical Trials (www.irct.ir/IRCT20150205020965N10).
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Affiliation(s)
- Mehdi Mohammadi Zadeh
- Student Research Committee, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Dehghan
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Eslami
- Department of Nutrition, Kerman University of Medical Sciences, Kerman, Iran
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Aihara M, Irie T, Yasukawa K, Minoura I, Miyauchi N, Nishi M, Katayama N, Yachiku K, Jinnouchi H, Kadowaki T, Yamauchi T, Yatomi Y, Kubota N, Sekimizu K. Development of a high-performance liquid chromatographic glycated albumin assay using finger-prick blood samples. Clin Chim Acta 2023; 542:117272. [PMID: 36858193 DOI: 10.1016/j.cca.2023.117272] [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: 11/27/2022] [Revised: 02/15/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND Home blood glucose monitoring can be effective for the self-management of diabetic patients. Hemoglobin A1c (HbA1c) is a widely used marker that reflects the average blood glucose within 1-2 months but does not sensitively respond to behavioral changes. Self-monitoring of blood glucose, continuous glucose monitoring, and flush glucose monitoring are sensitive; however, the cost and invasiveness of these tests prevent their widespread use. We focused on glycated albumin (GA), which reflects the average blood glucose levels over 1-2 weeks, and established a GA measurement method for self-sampling, finger-prick blood, which may be submitted for testing through postal service to receive weekly results. METHODS A high-performance liquid chromatography assay was established to measure GA levels in finger-prick blood samples from 103 diabetic patients and the results were compared with venous blood measurements using an enzymatic method. Furthermore, conditions for sending blood samples by mail were evaluated. Under these conditions, samples from 27 healthy and 32 patient volunteers sent through postal service were compared with samples stored in the laboratory. RESULTS GA levels were measured in samples containing > 20 μg albumin, which resulted in a CV less than 0.3%. The correlation between the GA levels of finger-prick blood measured using HPLC and the GA levels of venous blood measured using the enzymatic method was R2 = 0.988 with the slope ∼ 1.0, suggesting that the two were nearly equivalent. GA levels were stable for four days at 30 °C and two days at 37 °C. Mail-delivered samples exhibited a high correlation with samples that were not sent (R2 > 0.99). CONCLUSIONS We established a method to measure GA levels in self-sampled, finger-prick blood sent through postal service in Japan. The method is applicable for weekly feedback of GA levels, which is potentially useful for motivating behavioral changes. In addition to markers such as HbA1c and blood glucose, GA can be used as a marker for assessing dietary and physical activities. This study highlighted the importance of GA monitoring by developing a suitable measurement method for weekly monitoring of GA levels.
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Affiliation(s)
- Masakazu Aihara
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Tomoko Irie
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Keiko Yasukawa
- Department of Clinical Laboratory, The University of Tokyo Hospital, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Itsushi Minoura
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Noriko Miyauchi
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Mitsumi Nishi
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Norikazu Katayama
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kenji Yachiku
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Hideaki Jinnouchi
- Jinnouchi Hospital, Kuhonji 6-2-3, Chuo-ku, Kumamoto 862-0976, Japan
| | - Takashi Kadowaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; Toranomon Hospital, Toranomon 2-2-2, Minato-ku, Tokyo 105-8470, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University of Tokyo Hospital, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Naoto Kubota
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
| | - Koshin Sekimizu
- Provigate Inc., University of Tokyo Entrepreneur Plaza, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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Arefhosseini S, Roshanravan N, Tutunchi H, Rostami S, Khoshbaten M, Ebrahimi-Mameghani M. Myo-inositol supplementation improves cardiometabolic factors, anthropometric measures, and liver function in obese patients with non-alcoholic fatty liver disease. Front Nutr 2023; 10:1092544. [PMID: 36824177 PMCID: PMC9941177 DOI: 10.3389/fnut.2023.1092544] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/17/2023] [Indexed: 02/10/2023] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) as the hepatic manifestation of metabolic syndrome is closely associated with type 2 diabetes mellitus. Myo-inositol (MI)-a 6-C sugar alcohol-with insulin-mimetic, anti-diabetic, lipid-lowering, and anti-inflammatory properties has exerted favorable effects on insulin resistance-related disorders and metabolic disease, while recent animal studies revealed its positive effects on liver function. This study aimed to investigate the effects of MI supplementation on cardiometabolic factors, anthropometric measures, and liver function in obese patients with NAFLD. Methods This double-blinded placebo-controlled randomized clinical trial was carried out on 48 obese patients with NAFLD who were randomly assigned to either MI (4g/day) or placebo (maltodextrin 4g/day) along with dietary recommendations for 8 weeks. Glycemic indices, lipid profile, liver enzymes anthropometric measures, and blood pressure were evaluated pre- and post-intervention. Dietary intakes were assessed using a 3-day 24 h recall and analyzed by Nutritionist IV software. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR), and beta-cell function (HOMA-B) was also estimated. Results Anthropometric measures decreased significantly in both groups, while the reduction in weight (p = 0.049) and systolic blood pressure (p = 0.006) in the MI group was significantly greater than in the placebo group after adjusting for baseline values and energy intake. Although energy and macronutrient intakes decreased significantly in both groups, between-group differences were not significant after adjusting for the potential confounders. MI supplementation led to a significant reduction in serum fasting insulin (p = 0.008) and HOMA-IR (p = 0.046). There were significant improvements in lipid profile, liver enzymes, and aspartate aminotransferase/alanine aminotransferase ratio as well as serum ferritin level in the MI group, compared to the placebo group at the endpoint. By MI supplementation for eight weeks, 1 in 3 patients reduced one- grade in the severity of NAFLD. Conclusion MI supplementation could significantly improve IR, lipid profile, and liver function in patients with NAFLD. Further clinical trials with larger sample sizes, longer duration, different MI doses, and other inositol derivatives are recommended.
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Affiliation(s)
- Sara Arefhosseini
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Roshanravan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Helda Tutunchi
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somayyeh Rostami
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Manuchehr Khoshbaten
- Department of Internal Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrangiz Ebrahimi-Mameghani
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran,*Correspondence: Mehrangiz Ebrahimi-Mameghani ✉
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Saati S, Dehghan P, Azizi-Soleiman F, Mobasseri M. The effect of bitter almond (Amygdalus communis L. var. Amara) gum as a functional food on metabolic profile, inflammatory markers, and mental health in type 2 diabetes women: a blinded randomized controlled trial protocol. Trials 2023; 24:35. [PMID: 36650599 PMCID: PMC9847170 DOI: 10.1186/s13063-023-07085-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Using functional foods in the prevention and treatment of type 2 diabetes mellitus (T2DM) has increased across the world owing to their availability, cultural acceptability, and lower side effects. The present study will aim to examine the impact of bitter almond (Amygdalus communis L. var. Amara) gum as a functional food on metabolic profile, inflammatory markers, and mental health in women with T2DM. METHODS We will conduct a randomized, triple-blind, placebo-controlled trial. A total of 44 women with T2DM will be randomly allocated into two groups: an intervention group (n = 20) and a placebo group (n = 20). Patients will receive either 5 g/d of bitter melon gum or a placebo for 8 weeks. Clinical and biochemical outcome parameters which include glycemic indices, lipid profile, inflammatory markers, oxidative stress indices, tryptophan (Trp), kynurenine (KYN), cortisol, glucagon-like peptide 1 (GLP-1), leptin, adiponectin, ghrelin, peroxisome proliferator-activated receptor (PPAR) gene expression, brain-derived neurotrophic factor (BDNF), endothelial cell adhesion molecules, plasminogen, cluster deference 4 (CD4), cluster deference 8 (CD8), anthropometric indices, blood pressure, dietary intake, and mental health will be measured at the baseline and end of the study. Statistical analysis will be conducted using the SPSS software (version 24), and P value less than 0.05 will be considered statistically significant. DISCUSSION The present randomized controlled trial will aim to investigate any beneficial effects of bitter almond gum supplementation on the cardio-metabolic, immune-inflammatory, and oxidative stress biomarkers, as well as mental health in women with T2DM. ETHICS AND DISSEMINATION The study protocol was approved by the Ethical Committee of the Tabriz University of Medical Sciences (IR.TBZMED.REC.1399.726). TRIAL REGISTRATION Iranian Registry of Clinical Trials ( www.irct.ir/IRCT20150205020965N7 ).
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Affiliation(s)
- Saba Saati
- grid.412888.f0000 0001 2174 8913Student Research Committee, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Dehghan
- grid.412888.f0000 0001 2174 8913Nutrition Research Center, Department of Biochemistry and Diet Therapy Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, 5166614711 Iran
| | - Fatemeh Azizi-Soleiman
- grid.468130.80000 0001 1218 604XDepartment of Nutrition, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Majid Mobasseri
- grid.412888.f0000 0001 2174 8913Department of Internal Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Smith IP, Whichello CL, Veldwijk J, Rutten-van Mölken MPMH, Groothuis-Oudshoorn CGM, Vos RC, de Bekker-Grob EW, de Wit GA. Diabetes patient preferences for glucose-monitoring technologies: results from a discrete choice experiment in Poland and the Netherlands. BMJ Open Diabetes Res Care 2023; 11:11/1/e003025. [PMID: 36649973 PMCID: PMC9853131 DOI: 10.1136/bmjdrc-2022-003025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 12/10/2022] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION New glucose-monitoring technologies have different cost-benefit profiles compared with traditional finger-prick tests, resulting in a preference-sensitive situation for patients. This study aimed to assess the relative value adults with diabetes assign to device attributes in two countries. RESEARCH DESIGN AND METHODS Adults with type 1 or 2 diabetes from the Netherlands (n=226) and Poland (n=261) completed an online discrete choice experiment. Respondents choose between hypothetical glucose monitors described using seven attributes: precision, effort to check, number of finger pricks required, risk of skin irritation, information provided, alarm function and out-of-pocket costs. Panel mixed logit models were used to determine attribute relative importance and to calculate expected uptake rates and willingness to pay (WTP). RESULTS The most important attribute for both countries was monthly out-of-pocket costs. Polish respondents were more likely than Dutch respondents to choose a glucose-monitoring device over a standard finger prick and had higher WTP for a device. Dutch respondents had higher WTP for device improvements in an effort to check and reduce the number of finger pricks a device requires. CONCLUSION Costs are the primary concern of patients in both countries when choosing a glucose monitor and would likely hamper real-world uptake. The costs-benefit profiles of such devices should be critically reviewed.
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Affiliation(s)
- Ian P Smith
- Healthcare Innovation and Evaluation, University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
| | - Chiara L Whichello
- Evidera, London, UK
- Erasmus School of Health Policy and Management, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
- Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jorien Veldwijk
- Healthcare Innovation and Evaluation, University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
- Erasmus School of Health Policy and Management, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
- Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - C G M Groothuis-Oudshoorn
- Health Technology and Services Research (HTSR), Faculty of Behavioural Management and Social Sciences, University of Twente, Enschede, The Netherlands
| | - Rimke C Vos
- Public Health and Primary Care/LUMC Campus The Hague, Leiden University Medical Center, Leiden, The Netherlands
| | - Esther W de Bekker-Grob
- Erasmus School of Health Policy and Management, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
- Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - G Ardine de Wit
- Healthcare Innovation and Evaluation, University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
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Zhang C, Jia J, Zhang P, Zheng W, Guo X, Ai C, Song S. Fucoidan from Laminaria japonica Ameliorates Type 2 Diabetes Mellitus in Association with Modulation of Gut Microbiota and Metabolites in Streptozocin-Treated Mice. Foods 2022; 12:33. [PMID: 36613249 PMCID: PMC9818518 DOI: 10.3390/foods12010033] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/10/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Chronic diseases have been a leading cause of death worldwide, and polysaccharide supplementation is an effective therapeutic strategy for chronic diseases without adverse effects. In this study, the beneficial effect of Laminaria japonica fucoidan (LJF) on type 2 diabetes mellitus (T2DM) was evaluated in streptozocin-treated mice. LJF ameliorated the symptoms of T2DM in a dose-dependent manner, involving reduction in weight loss, water intake, triglyceride, blood glucose, cholesterol and free fatty acids, and increases in high-density lipoprotein cholesterol, catalase, glucagon-like peptide-1, and superoxide dismutase. In addition, LJF regulated the balance between insulin resistance and insulin sensitivity, reduced islet necrosis and β-cell damage, and inhibited fat accumulation in T2DM mice. The protective effect of LJF on T2DM can be associated with modulation of the gut microbiota and metabolites, e.g., increases in Lactobacillus and Allobaculum. Untargeted and targeted metabolomics analysis showed that the microbiota metabolite profile was changed with LJF-induced microbiota alterations, mainly involving amino acids, glutathione, and glyoxylate and dicarboxylate metabolism pathways. This study indicates that LJF can be used as a prebiotic agent for the prevention and treatment of diabetes and microbiota-related diseases.
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Affiliation(s)
- Chenxi Zhang
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, China
| | - Jinhui Jia
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, China
| | - Panpan Zhang
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, China
| | - Weiyun Zheng
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, China
| | - Xiaoming Guo
- Shenzhen Key Laboratory of Food Nutrition and Health, Institute for Advanced Study, Shenzhen University, Shenzhen 518060, China
| | - Chunqing Ai
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, China
- National & Local Joint Engineering Laboratory for Marine Bioactive Polysaccharide Development and Application, Dalian Polytechnic University, Dalian 116034, China
| | - Shuang Song
- School of Food Science and Technology, National Engineering Research Center of Seafood, Dalian Polytechnic University, Dalian 116034, China
- National & Local Joint Engineering Laboratory for Marine Bioactive Polysaccharide Development and Application, Dalian Polytechnic University, Dalian 116034, China
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Annan SF, Higgins LA, Jelleryd E, Hannon T, Rose S, Salis S, Baptista J, Chinchilla P, Marcovecchio ML. ISPAD Clinical Practice Consensus Guidelines 2022: Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2022; 23:1297-1321. [PMID: 36468223 DOI: 10.1111/pedi.13429] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 12/07/2022] Open
Affiliation(s)
- S Francesca Annan
- Paediatric Division, University College London Hospitals, London, UK
| | - Laurie A Higgins
- Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, Massachusetts, USA
| | - Elisabeth Jelleryd
- Medical Unit Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden
| | - Tamara Hannon
- School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Shelley Rose
- Diabetes & Endocrinology Service, MidCentral District Health Board, Palmerston North, New Zealand
| | - Sheryl Salis
- Department of Nutrition, Nurture Health Solutions, Mumbai, India
| | | | - Paula Chinchilla
- Women's and Children's Department, London North West Healthcare NHS Trust, London, UK
| | - Maria Loredana Marcovecchio
- Department of Paediatrics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Hill AJ, Patterson CC, Young IS, Holmes VA, McCance DR. Carbohydrate quantity is more closely associated with glycaemic control than weight in pregnant women with type 1 diabetes: Insights from the Diabetes and Pre-eclampsia Intervention Trial (DAPIT). J Hum Nutr Diet 2022; 35:1115-1123. [PMID: 35614848 PMCID: PMC9796361 DOI: 10.1111/jhn.13042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 05/16/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND The present study aimed to explore the relationships between carbohydrate intake, body mass index (BMI) and glycaemic control (HbA1c) in pregnant women with type 1 diabetes mellitus (T1DM) METHODS: Secondary analysis of data was undertaken to assess dietary intake in a cohort of women who participated in a randomised controlled trial (RCT) of antioxidant supplementation to prevent preeclampsia (DAPIT10 ). Study-specific peripheral venous blood samples were obtained for HbA1c at 26 and 34 weeks. Diet was collected using a validated semiquantitative food frequency questionnaire at 26-28 weeks of gestation which assessed dietary intake over 2 weeks. Mean daily average nutrient intakes were analysed using Q Builder nutritional software and SPSS, version 25. RESULTS Dietary data were available for 547 pregnant women (72% of cohort) aged 29 years (95% confidence interval [CI] = 28.9-29.9) with average diabetes duration 11.8 years (95% confidence interval = 11.1-12.6). Average body mass index (BMI) (<16 weeks of gestation) was 26.7 kg/m2 (95% CI = 26.3 -27, range 18.8-45.6 kg/m2 ); 43% (n = 234) were overweight (BMI = 25.0-29.9 kg/m2 ) and 20% (n = 112) were obese (BMI ≥ 30 kg/m2 ). Differences in HbA1c and carbohydrate quantity and quality were found when adjusted for age and insulin dose. No differences between BMI group were observed for total carbohydrate and glycaemic control; however, differences were noted in fibre and glycaemic index. CONCLUSIONS Average quantity of dietary carbohydrate influenced HbA1c when adjusted for insulin dose however, BMI had less impact. More research is required on the relationship between carbohydrate consumption and glycaemic control in pregnancy.
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Affiliation(s)
- Alyson J. Hill
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUniversity of UlsterColeraineUK
| | | | - I. S. Young
- Centre for Public HealthQueen's University BelfastBelfastUK
| | - V. A. Holmes
- Centre for Public HealthQueen's University BelfastBelfastUK
| | - D. R. McCance
- Regional Centre for Endocrinology and Diabetes, Royal Victoria HospitalBelfastUK
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47
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Anderson CAM, Ilori T. Nutrition and Kidney Health: Processing Emerging Evidence About Foods. Am J Kidney Dis 2022; 80:566-568. [PMID: 36153152 DOI: 10.1053/j.ajkd.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 06/23/2022] [Indexed: 02/02/2023]
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48
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Roversi C, Vettoretti M, Del Favero S, Facchinetti A, Choudhary P, Sparacino G. Impact of Carbohydrate Counting Error on Glycemic Control in Open-Loop Management of Type 1 Diabetes: Quantitative Assessment Through an In Silico Trial. J Diabetes Sci Technol 2022; 16:1541-1549. [PMID: 33978501 PMCID: PMC9631512 DOI: 10.1177/19322968211012392] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND In the management of type 1 diabetes (T1D), systematic and random errors in carb-counting can have an adverse effect on glycemic control. In this study, we performed an in silico trial aiming at quantifying the impact of different levels of carb-counting error on glycemic control. METHODS The T1D patient decision simulator was used to simulate 7-day glycemic profiles of 100 adults using open-loop therapy. The simulation was repeated for different values of systematic and random carb-counting errors, generated with Gaussian distribution varying the error mean from -10% to +10% and standard deviation (SD) from 0% to 50%. The effect of the error was evaluated by computing the difference of time inside (∆TIR), above (∆TAR) and below (∆TBR) the target glycemic range (70-180mg/dl) compared to the reference case, that is, absence of error. Finally, 3 linear regression models were developed to mathematically describe how error mean and SD variations result in ∆TIR, ∆TAR, and ∆TBR changes. RESULTS Random errors globally deteriorate the glycemic control; systematic underestimations lead to, on average, up to 5.2% more TAR than the reference case, while systematic overestimation results in up to 0.8% more TBR. The different time in range metrics were linearly related with error mean and SD (R2>0.95), with slopes of <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:msub><mml:mi>β</mml:mi><mml:mrow><mml:mi>M</mml:mi><mml:mi>E</mml:mi><mml:mi>A</mml:mi><mml:mi>N</mml:mi></mml:mrow></mml:msub><mml:mo>=</mml:mo><mml:mn>0</mml:mn><mml:mo>.</mml:mo><mml:mn>21</mml:mn></mml:mrow></mml:math>, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:msub><mml:mi>β</mml:mi><mml:mrow><mml:mi>S</mml:mi><mml:mi>D</mml:mi></mml:mrow></mml:msub><mml:mo>=</mml:mo><mml:mo>-</mml:mo><mml:mn>0</mml:mn><mml:mo>.</mml:mo><mml:mn>07</mml:mn></mml:mrow></mml:math> for ∆TIR, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:msub><mml:mi>β</mml:mi><mml:mrow><mml:mi>M</mml:mi><mml:mi>E</mml:mi><mml:mi>A</mml:mi><mml:mi>N</mml:mi></mml:mrow></mml:msub><mml:mo>=</mml:mo><mml:mo>-</mml:mo><mml:mn>0</mml:mn><mml:mo>.</mml:mo><mml:mn>25</mml:mn></mml:mrow></mml:math>, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:msub><mml:mi>β</mml:mi><mml:mrow><mml:mi>S</mml:mi><mml:mi>D</mml:mi></mml:mrow></mml:msub><mml:mo>=</mml:mo><mml:mo>+</mml:mo><mml:mn>0</mml:mn><mml:mo>.</mml:mo><mml:mn>06</mml:mn></mml:mrow></mml:math> for ∆TAR, and <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:msub><mml:mi>β</mml:mi><mml:mrow><mml:mi>M</mml:mi><mml:mi>E</mml:mi><mml:mi>A</mml:mi><mml:mi>N</mml:mi></mml:mrow></mml:msub><mml:mo>=</mml:mo><mml:mn>0</mml:mn><mml:mo>.</mml:mo><mml:mn>05</mml:mn></mml:mrow></mml:math>, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:msub><mml:mi>β</mml:mi><mml:mrow><mml:mi>S</mml:mi><mml:mi>D</mml:mi></mml:mrow></mml:msub><mml:mo>=</mml:mo><mml:mo>+</mml:mo><mml:mn>0</mml:mn><mml:mo>.</mml:mo><mml:mn>01</mml:mn></mml:mrow></mml:math> for ∆TBR. CONCLUSIONS The quantification of carb-counting error impact performed in this work may be useful understanding causes of glycemic variability and the impact of possible therapy adjustments or behavior changes in different glucose metrics.
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Affiliation(s)
- Chiara Roversi
- Department of Information Engineering,
University of Padova, Padova, Italy
| | - Martina Vettoretti
- Department of Information Engineering,
University of Padova, Padova, Italy
| | - Simone Del Favero
- Department of Information Engineering,
University of Padova, Padova, Italy
| | - Andrea Facchinetti
- Department of Information Engineering,
University of Padova, Padova, Italy
| | | | - Giovanni Sparacino
- Department of Information Engineering,
University of Padova, Padova, Italy
- Giovanni Sparacino, PhD, Department of
Information Engineering, University of Padova, via G. Gradenigo 6B, Padova
35131, Italy
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49
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Sánchez-Rosales AI, Guadarrama-López AL, Gaona-Valle LS, Martínez-Carrillo BE, Valdés-Ramos R. The Effect of Dietary Patterns on Inflammatory Biomarkers in Adults with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2022; 14:4577. [PMID: 36364839 PMCID: PMC9654560 DOI: 10.3390/nu14214577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/06/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Some evidence supports the fact that chronic low-grade inflammation contributes to the physiopathology of type 2 diabetes mellitus (T2DM), and circulating markers of inflammation (e.g., C-reactive protein (CRP), pro- and anti-inflammatory biomarkers (e.g., adiponectin), and endothelial function markers could indicate an ongoing pathology. Following certain dietary patterns (DPs) may result in favorable changes in inflammatory biomarkers. The overarching aim of this systematic review and meta-analysis is to explore the inflammatory effect of healthy DPs on inflammatory biomarkers in adults with T2DM. A systematic search of the literature was conducted using the electronic databases MEDLINE, SCOPUS, and Cochrane Central Register of Controlled Trials. A total of 10 randomized controlled clinical trials (RCTs) were analyzed. In our linear meta-analysis, the random-effects model was applied to estimate standardized mean differences (SMD) to associate the effect of the interventions. Dietary Approaches to Stop Hypertension (DASH), Diabetes UK healthy eating, Mediterranean Diet (MD), Diabetes Prevention Program (DPP), and the American Heart Association’s Therapeutic Lifestyle Changes diet were associated with a significant reduction in CRP (SMD: −0.83, 99% CI −1.49, −0.17, p < 0.001; I2 94%), while plasma levels of adiponectin were significantly higher with the intake of MD, DPP, and Diabetes UK healthy eating (SMD: 0.81, 99% CI 0.06,1.56, p < 0.005; I2 96%), both of which indicate less inflammation. Sensitivity analyses were carried out, and potential publication bias was examined. In conclusion, low- moderate-quality evidence from RCTs suggests that, for the DPs evaluated, there are favorable changes in CRP and adiponectin.
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Affiliation(s)
| | - Ana L. Guadarrama-López
- Multidisciplinary Clinic of Health, Universidad Autónoma del Estado de México, Toluca 50180, Mexico
| | - Laura S. Gaona-Valle
- Centro Médico Lic. Adolfo López Mateos, Instituto de Salud del Estado de México (ISEM), Toluca 50010, Mexico
| | | | - Roxana Valdés-Ramos
- Faculty of Medicine, Universidad Autónoma del Estado de México, Toluca 50180, Mexico
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50
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Peter PI, Steinberg WJ, van Rooyen C, Botes J. Type 2 diabetes mellitus patients’ knowledge, attitude and practice of lifestyle modifications. Health SA 2022; 27:1921. [PMID: 36337447 PMCID: PMC9634683 DOI: 10.4102/hsag.v27i0.1921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) is a significant health burden globally, with uncontrolled DM often resulting in short- and long-term complications. Unfortunately, healthcare providers have little control over patients’ necessary lifestyle modification practices outside the consultation room. Aim To determine the level of knowledge, attitude and practice (KAP) of lifestyle modifications among patients with T2DM attending the National District Hospital Outpatient Department, Bloemfontein, and identify possible barriers to lifestyle modifications experienced by patients. Setting Outpatient Department at a Free State hospital. Methods Using a cross-sectional study, patients with previously diagnosed T2DM were invited to participate. Respondents completed a structured questionnaire to assess their KAP regarding lifestyle modifications. Results Of the 149 respondents, 64.4% (n = 94) were obese and 24.0% (n = 35) overweight despite good knowledge of lifestyle modifications. Respondents displayed a positive attitude toward physical exercise but less so to adjusting their diets. In practice, 63.4% (n = 83) claimed to exercise regularly, but two-thirds irregularly monitored their weight. The practice of a controlled and planned diet was poor. Perceived barriers to lifestyle modifications included being too busy to engage in physical exercise, bad weather and financial constraints. Conclusion Despite displaying good knowledge regarding lifestyle modifications, the attitude and practice thereof remain poor. It is essential to re-emphasise to patients why it is crucial to engage in lifestyle modification practices and assess whether they are doing so correctly. Contribution It highlights the importance of lifestyle considerations of T2DM patients in the clinical context.
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Affiliation(s)
- Paul I. Peter
- Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Wilhelm J. Steinberg
- Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Cornel van Rooyen
- Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Johan Botes
- Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
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