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Water-soluble polyphenol-rich clove extract lowers pre- and post-prandial blood glucose levels in healthy and prediabetic volunteers: an open label pilot study.
Mohan, R, Jose, S, Mulakkal, J, Karpinsky-Semper, D, Swick, AG, Krishnakumar, IM
BMC complementary and alternative medicine. 2019;(1):99
Abstract
BACKGROUND/OBJECTIVES Type 2 diabetes (T2D) is a global pandemic, and contributes significantly to the increasing incidence of conditions such as cardiovascular disease (CVD). Postprandial plasma glucose measured 2-h after the start of a meal is a good indicator of the overall status of glucose homeostasis. Clove (Syzygium aromaticum L.) and its essential oils (eugenol and acetyl eugenol) have been shown in preclinical studies to modulate pathways involved in glucose homeostasis. In addition, a water-soluble polyphenolic extract of unopened clove buds was recently shown to benefit liver function and redox status. Therefore, we conducted an open-label pilot study to test whether this polyphenolic clove extract (PCE) could influence glucose metabolism. METHODS We evaluated the effect of PCE supplementation (250 mg once daily for 30 days) on preprandial glucose levels and 2-h postprandial glucose levels in 13 otherwise healthy volunteers who were stratified into two groups according to their initial preprandial glucose levels: Group I (n = 7) ≤100 mg/dL, Group II (n = 6) - between 101 and 125 mg/dL. In an effort to elucidate the molecular mechanisms of PCE action, we tested in vitro the effects of PCE on glucose uptake, hepatocyte glucose production, and carbohydrate hydrolyzing enzymes. RESULTS At day 12 of supplementation, we observed statistically significant reductions in mean postprandial glucose levels in both groups [(Group I: Initial - Day 12 PPG = 13.29 mg/dL, 95% CI: 3.329-23.24) (Group II: Initial - Day 12 PPG = 16.67 mg/dL, 95% CI: 4.687-28.65, P = 0.0159)], which continued through study completion at day 30. PCE supplementation significantly decreased mean preprandial glucose levels only in Group II at Days 24 (Initial - Day 24 = 13.00 mg/dL, 95% CI: 1.407-24.59, P = 0.0345) and 30 (Initial - Day 30 = 13.67 mg/dL, 95% CI: 5.766-21.57, P = 0.0067). In cell-based assays, PCE enhanced glucose uptake in L6 myocytes and inhibited hepatocyte glucose production HepG2 cells. In cell-free assays, PCE inhibited α-amylase activity and α-glucosidase activity. CONCLUSIONS These findings underscore the therapeutic utility of PCE for maintaining healthy glucose metabolism and warrant further larger-scale clinical trials. TRIAL REGISTRATION This trial was retrospectively registered in the ISRCTN registry on September 29, 2018 ( ISRCTN15680985 ).
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Vitamin D and Incidence of Prediabetes or Type 2 Diabetes: A Four-Year Follow-Up Community-Based Study.
Gao, Y, Zheng, T, Ran, X, Ren, Y, Chen, T, Zhong, L, Yan, D, Yan, F, Wu, Q, Tian, H
Disease markers. 2018;:1926308
Abstract
AIM: To examine whether the baseline 25-hydroxyvitamin D [25(OH)D] level was predictive of the onset of prediabetes or type 2 diabetes (T2DM) in the Chinese population. METHODS This was a 4-year follow-up study that was conducted in the Chengdu region of China as part of the China National Diabetes and Metabolic Disorders Study. The study included 490 participants that were free of prediabetes and type 2 diabetes mellitus (T2DM) at baseline and had complete data by follow-up examinations. Glucose, insulin, and 25(OH)D levels were measured at baseline and at 4 years later. Prediabetes and T2DM were defined by results obtained from an oral glucose tolerance test. RESULTS Over a 4-year follow-up, 95 (48.5‰) developed prediabetes and 31 (15.8‰) individuals developed diabetes. Low 25(OH)D status was significantly associated with the risk of developing prediabetes [OR 3.01 (95% CI: 1.50-6.06), P = 0.002] and T2DM [OR 5.61 (95% CI: 1.73-18.27), P = 0.004] after adjustment for multiple potential confounders. In a multiple linear regression analysis, low baseline levels of 25(OH)D were an independent predictor of increased insulin resistance over a 4-year period (P < 0.05). CONCLUSIONS The current prospective study suggests that low 25(OH)D levels might have contributed to the incidence of prediabetes or T2DM in Chinese individuals. This trial is registered with TR-CCH-ChiCTR-OCS-09000361.
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Association Between Metabolic Syndrome Components and Polyneuropathy in an Obese Population.
Callaghan, BC, Xia, R, Reynolds, E, Banerjee, M, Rothberg, AE, Burant, CF, Villegas-Umana, E, Pop-Busui, R, Feldman, EL
JAMA neurology. 2016;(12):1468-1476
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Abstract
IMPORTANCE Past studies have shown an association between metabolic syndrome and polyneuropathy, but the precise components that drive this association remain unclear. OBJECTIVES To determine the prevalence of polyneuropathy stratified by glycemic status in well-characterized obese and lean participants and investigate the association of specific components of metabolic syndrome with polyneuropathy. DESIGN, SETTING, AND PARTICIPANTS We performed a cross-sectional, observational study from November 1, 2010, to December 31, 2014, in obese participants (body mass index [calculated as weight in kilograms divided by height in meters squared] of 35 or more with no comorbid conditions or 32 or more with at least 1 comorbid condition) from a weight management program and lean controls from a research website. The prevalence of neuropathy, stratified by glycemic status, was determined, and a Mantel-Haenszel χ2 test was used to investigate for a trend. Logistic regression was used to model the primary outcome of polyneuropathy as a function of the components of metabolic syndrome after adjusting for demographic factors. Participants also completed quantitative sudomotor axon reflex testing, quantitative sensory testing, the neuropathy-specific Quality of Life in Neurological Disorders instrument, and the short-form McGill Pain Questionnaire. EXPOSURES Components of metabolic syndrome (as defined by the National Cholesterol Education Program Adult Treatment Panel III), including glycemic status (as defined by the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus). MAIN OUTCOMES AND MEASURES Toronto consensus definition of probable polyneuropathy. Secondary outcomes included intraepidermal nerve fiber density and nerve conduction study parameters. RESULTS We enrolled 102 obese participants (mean [SD] age, 52.9 [10.2] years; 48 men and 54 women; 45 with normoglycemia [44.1%], 31 with prediabetes [30.4%], and 26 with type 2 diabetes [25.5%]) and 53 lean controls (mean [SD] age, 48.5 [9.9] years; 16 men and 37 women). The prevalence of polyneuropathy was 3.8% in lean controls (n = 2), 11.1% in the obese participants with normoglycemia (n = 5), 29% in the obese participants with prediabetes (n = 9), and 34.6% in the obese participants with diabetes (n = 9) (P < .01 for trend). Age (odds ratio, 1.09; 95% CI, 1.02-1.16), diabetes (odds ratio, 4.90; 95% CI, 1.06-22.63), and waist circumference (odds ratio, 1.24; 95% CI, 1.00-1.55) were significantly associated with neuropathy in multivariable models. Prediabetes (odds ratio, 3.82; 95% CI, 0.95-15.41) was not significantly associated with neuropathy. CONCLUSIONS AND RELEVANCE The prevalence of polyneuropathy is high in obese individuals, even those with normoglycemia. Diabetes, prediabetes, and obesity are the likely metabolic drivers of this neuropathy. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02689661.
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Dietary intake modification in response to a participation in a resistance training program for sedentary older adults with prediabetes: findings from the Resist Diabetes study.
Halliday, TM, Davy, BM, Clark, AG, Baugh, ME, Hedrick, VE, Marinik, EL, Flack, KD, Savla, J, Winett, S, Winett, RA
Eating behaviors. 2014;(3):379-82
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Engagement in one type of health behavior change may exert a "spillover" effect resulting in other behavior changes. Few studies have examined dietary intake following prolonged training, and none have evaluated spontaneous dietary changes beyond alterations in energy or macronutrient intake following initiation of strength/resistance training (RT). The purpose of this observational investigation was to determine if spontaneous dietary intake modifications occur in response to initiation of an RT program, among older adults. Previously sedentary adults with prediabetes (n=134, age=59±1 years) were enrolled in a supervised 12-week RT program. Participants were not given dietary advice or encouraged to change eating behaviors. Three non-consecutive 24-hour dietary recalls were collected at baseline and after 12 weeks of RT. Reductions in intake of energy (1914±40 kcal vs. 1834±427 kcal, p=0.010), carbohydrate (211.6±4.9 g vs. 201.7±5.2 g, p=0.015), total sugar (87.4±2.7 g vs. 81.5±3.1 g, p=0.030), glycemic load (113.4±3.0 vs. 108.1±3.2, p=0.031), fruits and vegetables (4.6±0.2 servings vs. 4.1±0.2 servings, p=0.018), and sweets and desserts (1.1±0.07 servings vs. 0.89±0.07 servings, p=0.023) were detected over time. No changes in other dietary intake variables were observed. Mode of exercise and disease state may be important factors in determining whether dietary modifications occur with exercise initiation, among previously sedentary adults. Successful initiation of RT may represent an opportunity for health care professionals to promote beneficial changes in dietary habits, among older adults with prediabetes.
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A novel fasting blood test for insulin resistance and prediabetes.
Cobb, J, Gall, W, Adam, KP, Nakhle, P, Button, E, Hathorn, J, Lawton, K, Milburn, M, Perichon, R, Mitchell, M, et al
Journal of diabetes science and technology. 2013;(1):100-10
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BACKGROUND Insulin resistance (IR) can precede the dysglycemic states of prediabetes and type 2 diabetes mellitus (T2DM) by a number of years and is an early marker of risk for metabolic and cardiovascular disease. There is an unmet need for a simple method to measure IR that can be used for routine screening, prospective study, risk assessment, and therapeutic monitoring. We have reported several metabolites whose fasting plasma levels correlated with insulin sensitivity. These metabolites were used in the development of a novel test for IR and prediabetes. METHODS Data from the Relationship between Insulin Sensitivity and Cardiovascular Disease Study were used in an iterative process of algorithm development to define the best combination of metabolites for predicting the M value derived from the hyperinsulinemic euglycemic clamp, the gold standard measure of IR. Subjects were divided into a training set and a test set for algorithm development and validation. The resulting calculated M score, M(Q), was utilized to predict IR and the risk of progressing from normal glucose tolerance to impaired glucose tolerance (IGT) over a 3 year period. RESULTS M(Q) correlated with actual M values, with an r value of 0.66. In addition, the test detects IR and predicts 3 year IGT progression with areas under the curve of 0.79 and 0.70, respectively, outperforming other simple measures such as fasting insulin, fasting glucose, homeostatic model assessment of IR, or body mass index. CONCLUSIONS The result, Quantose(TM), is a simple test for IR based on a single fasting blood sample and may have value as an early indicator of risk for the development of prediabetes and T2DM.