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Visual food cues decrease postprandial glucose concentrations in lean and obese men without affecting food intake and related endocrine parameters.
Brede, S, Sputh, A, Hartmann, AC, Hallschmid, M, Lehnert, H, Klement, J
Appetite. 2017;:255-262
Abstract
The abundance of highly palatable food items in our environment represents a possible cause of overconsumption. Neuroimaging studies in humans have demonstrated that watching pictures of food increases activation in brain areas involved in homeostatic and hedonic food cue processing. Nevertheless, the impact of food cues on actual food intake and metabolic parameters has not been systematically investigated. We tested the hypothesis that watching high-calorie food cues increases food intake and modifies anticipatory blood parameters in lean and especially in obese men. In 20 normal-weight and 20 obese healthy fasted men, we assessed the effects of watching pictures of high-calorie food items versus neutral contents on food intake measured during a standardized test buffet and subsequent snacking as well as on glucose homeostasis and endocrine parameters. Compared to neutral pictures, viewing food pictures reduced postprandial blood glucose concentrations in lean (p = 0.016) and obese (p = 0.044) subjects, without any differences in insulin or C-peptide concentrations (all p > 0.4). Viewing food pictures did not affect total calorie intake during the buffet (all p > 0.5) and snack consumption (all p > 0.4). Concentrations of ghrelin, adrenocorticotropic hormone (ACTH), cortisol, and glucagon also remained unaffected (all p > 0.08). These data indicate that preprandial processing of food cues curbs postprandial blood glucose excursions, without immediately affecting eating behavior in normal-weight and obese men. Findings indicate that exposure to food cues does not acutely trigger calorie overconsumption but rather improves the glucoregulatory response to food intake.
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Subgroup analysis of phase 3 studies of dulaglutide in Japanese patients with type 2 diabetes.
Onishi, Y, Oura, T, Nishiyama, H, Ohyama, S, Takeuchi, M, Iwamoto, N
Endocrine journal. 2016;(3):263-73
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Abstract
The efficacy and tolerability of once weekly dulaglutide 0.75 mg in Japanese patients with type 2 diabetes (T2D) were evaluated by subgroups defined by key demographic characteristics. This post hoc analysis included data from patients who received dulaglutide 0.75 mg for up to 26 weeks in three phase 3 trials (one open-label, randomized; one double-blind and open-label, randomized; one open-label, nonrandomized). Patients were classified into subgroups on the basis of sex (male, female), age (<65, ≥65 years), body weight (<70, ≥70 kg), body mass index (BMI; <25, ≥25 kg/m(2)), duration of diabetes (<7, ≥7 years), HbA1c (≤8.5, >8.5%), use of concomitant sulfonylurea (yes, no), and use of concomitant biguanide (yes, no). Efficacy measures analyzed were changes from baseline in HbA1c and body weight and percentages of patients achieving HbA1c <7.0%. Safety measures analyzed were incidence of hypoglycemia and nausea and change from baseline in seated pulse rate. A total of 855 patients were analyzed. Once weekly dulaglutide 0.75 mg improved blood glucose control as measured by HbA1c regardless of patient characteristics; patients with higher baseline HbA1c values had greater improvements compared to patients with lower baseline values. Weight loss was greater in patients with lower baseline HbA1c and in patients taking concomitant biguanides. Concomitant use of sulfonylureas had the greatest effect on the incidence of hypoglycemia. Treatment of T2D with once weekly dulaglutide 0.75 mg for 26 weeks was associated with significant improvement in glycemic control irrespective of age, sex, duration of diabetes, body weight, BMI, or concomitant medication.
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Impact of Diabetes-Specific Nutritional Formulas versus Oatmeal on Postprandial Glucose, Insulin, GLP-1 and Postprandial Lipidemia.
Mottalib, A, Mohd-Yusof, BN, Shehabeldin, M, Pober, DM, Mitri, J, Hamdy, O
Nutrients. 2016;(7)
Abstract
Diabetes-specific nutritional formulas (DSNFs) are frequently used as part of medical nutrition therapy for patients with diabetes. This study aims to evaluate postprandial (PP) effects of 2 DSNFs; Glucerna (GL) and Ultra Glucose Control (UGC) versus oatmeal (OM) on glucose, insulin, glucagon-like peptide-1 (GLP-1), free fatty acids (FFA) and triglycerides (TG). After an overnight fast, 22 overweight/obese patients with type 2 diabetes were given 200 kcal of each of the three meals on three separate days in random order. Blood samples were collected at baseline and at 30, 60, 90, 120, 180 and 240 min. Glucose area under the curve (AUC0-240) after GL and UGC was lower than OM (p < 0.001 for both). Insulin positive AUC0-120 after UGC was higher than after OM (p = 0.02). GLP-1 AUC0-120 and AUC0-240 after GL and UGC was higher than after OM (p < 0.001 for both). FFA and TG levels were not different between meals. Intake of DSNFs improves PP glucose for 4 h in comparison to oatmeal of similar caloric level. This is achieved by either direct stimulation of insulin secretion or indirectly by stimulating GLP-1 secretion. The difference between their effects is probably related to their unique blends of amino acids, carbohydrates and fat.
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Community-based peer support significantly improves metabolic control in people with Type 2 diabetes in Yaoundé, Cameroon.
Assah, FK, Atanga, EN, Enoru, S, Sobngwi, E, Mbanya, JC
Diabetic medicine : a journal of the British Diabetic Association. 2015;(7):886-9
Abstract
AIMS: To examine the effectiveness of a community-based multilevel peer support intervention in addition to usual diabetes care on improving glycaemic levels, blood pressure and lipids in patients with Type 2 diabetes in Yaoundé, Cameroon. METHODS A total of 96 subjects with poorly controlled Type 2 diabetes (intervention group) and 96 age- and sex-matched controls were recruited and followed up over 6 months. The intervention subjects underwent a peer support intervention through peer-led group meetings, personal encounters and telephone calls. Both intervention subjects and controls continued their usual clinical care. HbA1c , blood pressure, blood lipids and self-care behaviours were measured at 0 and 6 months. RESULTS There was significant reduction in HbA1c in the intervention group [-33 mmol/mol (-3.0%)] compared with controls [-14 mmol/mol (-1.3%)]; P < 0.001. Peer support also led to significant reductions in fasting blood sugar (-0.83 g/l P < 0.001), cholesterol (-0.54 g/l P < 0.001), HDL (-0.09 g/l, P < 0.001), BMI (-2.71 kg/m² P < 0.001) and diastolic pressure (-6.77 mmHg, P < 0.001) over the 6-month period. Also, diabetes self-care behaviours in the intervention group improved significantly over the 6 months of peer support. CONCLUSION Community-based peer support, in addition to usual care, significantly improved metabolic control in patients with uncontrolled Type 2 diabetes in Yaoundé, Cameroon. This could provide a model for optimizing diabetes care and control in other settings with limited healthcare and financial resources.
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The effect of nopal (Opuntia ficus indica) on postprandial blood glucose, incretins, and antioxidant activity in Mexican patients with type 2 diabetes after consumption of two different composition breakfasts.
López-Romero, P, Pichardo-Ontiveros, E, Avila-Nava, A, Vázquez-Manjarrez, N, Tovar, AR, Pedraza-Chaverri, J, Torres, N
Journal of the Academy of Nutrition and Dietetics. 2014;(11):1811-8
Abstract
Nopal is a plant used in traditional Mexican medicine to treat diabetes. However, there is insufficient scientific evidence to demonstrate whether nopal can regulate postprandial glucose. The purpose for conducting this study was to evaluate the glycemic index, insulinemic index, glucose-dependent insulinotropic peptide (GIP) index, and the glucagon-like peptide 1 (GLP-1) index, and the effect of nopal on patients with type 2 diabetes after consumption of a high-carbohydrate breakfast (HCB) or high-soy-protein breakfast (HSPB) on the postprandial response of glucose, insulin, GIP, GLP-1, and antioxidant activity. In study 1, the glycemic index, insulinemic index, GIP index, and GLP-1 index were calculated for seven healthy participants who consumed 50 g of available carbohydrates from glucose or dehydrated nopal. In study 2, 14 patients with type 2 diabetes consumed nopal in HCB or HSPB with or without 300 g steamed nopal. The glycemic index of nopal was 32.5±4, insulinemic index was 36.1±6, GIP index was 6.5±3.0, and GLP-1 index was 25.9±18. For those patients with type 2 diabetes who consumed the HCB+nopal, there was significantly lower area under the curve for glucose (287±30) than for those who consumed the HCB only (443±49), and lower incremental area under the curve for insulin (5,952±833 vs 7,313±1,090), and those patients with type 2 diabetes who consumed the HSPB avoided postprandial blood glucose peaks. Consumption of the HSPB+nopal significantly reduced the postprandial peaks of GIP concentration at 30 and 45 minutes and increased the antioxidant activity after 2 hours measured by the 2,2-diphenyl-1-picrilhidracyl method. These findings suggest that nopal could reduce postprandial blood glucose, serum insulin, and plasma GIP peaks, as well as increase antioxidant activity in healthy people and patients with type 2 diabetes.
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Model of care for the management of complex Type 2 diabetes managed in the community by primary care physicians with specialist support: an open controlled trial.
Russell, AW, Baxter, KA, Askew, DA, Tsai, J, Ware, RS, Jackson, CL
Diabetic medicine : a journal of the British Diabetic Association. 2013;(9):1112-21
Abstract
AIMS: To evaluate patient outcomes for a novel integrated primary/specialist model of community care for complex Type 2 diabetes mellitus management compared with outcomes for usual care at a tertiary hospital for diabetes outpatients. METHODS This was a prospective open controlled trial performed in a primary and tertiary care setting in Australia. A total of 330 patients with Type 2 diabetes aged >18 years were allocated to an intervention (n=185) or usual care group (n=145). The intervention arm was a community-based model of care led by a general practitioner with advanced skills and an endocrinologist partnership. Usual care was provided via the hospital diabetes outpatient department. The primary end point was HbA(1c) concentration at 12 months. Secondary end points included serum lipids and blood pressure. RESULTS The mean change in HbA1c concentration in the intervention group was -9 mmol/mol (-0.8%) at 12 months and in the usual care group it was -2 mmol/mol (-0.2%) (95% CI -5,1). The percentage of patients in the intervention group achieving the HbA(1c) target of ≤53 mmol/mol (7%) increased from 21 to 42% (P<0.001); for the usual care group there was a 1% increase to 39% of patients attaining this target (P=0.99). Patients in the intervention group experienced significant improvements in blood pressure and total cholesterol compared with those in the usual care group. The percentage of patients achieving clinical targets was greater in the intervention group for the combined target of HbA(1c) concentration, blood pressure and LDL cholesterol. CONCLUSIONS A community-based, integrated model of complex diabetes care, delivered by general practitioners with advanced skills, produced clinical and process benefits compared with a tertiary diabetes outpatient clinic.
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Composition of two Spanish common dry beans (Phaseolus vulgaris), 'Almonga' and 'Curruquilla', and their postprandial effect in type 2 diabetics.
Olmedilla-Alonso, B, Pedrosa, MM, Cuadrado, C, Brito, M, Asensio-S-Manzanera, C, Asensio-Vegas, C
Journal of the science of food and agriculture. 2013;(5):1076-82
Abstract
BACKGROUND Legume consumption has been associated with a lower risk of developing type 2 diabetes. However, the type of legume is a modifier of its effect. Two Spanish dry bean varieties-white ('Almonga') and cream ('Curruquilla')-were analyzed and used in a postprandial study in type 2 diabetics to assess glucose, insulin and triacylglycerol in blood. RESULTS 'Curruquilla' variety had higher total galactoside (stachyose, mainly), trypsin inhibitors and lectin content than 'Almonga'. The canning liquid was discarded prior to the analysis and the bean consumption by the subjects. The canning process reduced the total α-galactoside content (>50%), practically eliminated trypsin inhibitors, and no lectin content was found. After bean consumption, maximum glucose was obtained at 60 min and was three times lower than that in bread. After bean intake, maximum insulin was produced 60 min with 'Almonga' and occurred later (90 min) with 'Curruquilla' and bread. After 'Almonga' intake, the area under the curve response of triglycerides was 14% lower compared to bread (P = 0.013). CONCLUSIONS 'Almonga' and 'Curruquilla' are similar in the content of the nutritional but not in that of the antinutritional components. Both beans showed similar effects on blood glucose and insulin in type 2 diabetics and marked differences compared to those of bread in terms of magnitude and time course, but only 'Almonga' rendered a significant reduction in the triglyceridemic response.
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Effect of the yellow passion fruit peel flour (Passiflora edulis f. flavicarpa deg.) in insulin sensitivity in type 2 diabetes mellitus patients.
de Queiroz, Mdo S, Janebro, DI, da Cunha, MA, Medeiros, Jdos S, Sabaa-Srur, AU, Diniz, Mde F, Dos Santos, SC
Nutrition journal. 2012;:89
Abstract
BACKGROUND A study with the yellow passion fruit peel flour showed positive action in blood glucose control as therapies' adjuvant in patients with type 2 diabetes mellitus. Therefore, we evaluated its effect on insulin sensitivity since there is a quest for studies that focus at better understanding of insulin resistance aspects in diabetic patients. Furthermore its relationship with chronic complications can also give good prospects for alternative treatments. METHODS A total of 43 type 2 diabetes volunteers (28 females and 15 males) ingested 30 g/day of the yellow passion fruit peel flour for two months. The levels of blood glucose and fasting insulin, HOMA index and glycated hemoglobin were measured for each patient before and after dietary supplementation. RESULTS There was a significant difference in the fasting blood glucose values (P = 0.000) and glycated hemoglobin (P = 0.032) after supplementation. It was also seen a reduction in HOMA IR (P = 0.005) in the supplemented group, however it was not observed changes in insulin values for females. HOMA beta (P = 0.000) showed significant increase in its values for the studied group. CONCLUSIONS The supplementation used decreased insulin resistance in type 2 diabetic patients, suggesting a positive action in blood glucose control as adjuvant therapy in conventional treatments.
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Determination of the transient period of the EIS complex and investigation of the suppression of blood glucose levels by L-arabinose in healthy adults.
Shibanuma, K, Degawa, Y, Houda, K
European journal of nutrition. 2011;(6):447-53
Abstract
PURPOSE L-Arabinose uncompetitively inhibits intestinal sucrase by forming an enzyme-inhibitor-substrate (EIS) complex. The transient period of the EIS complex affects the time span of inhibition. We determined the apparent transient period of the EIS complex of sucrase, L-arabinose, and sucrose both in vitro and in humans. METHODS Intestinal acetone powder (a source of sucrase), L-arabinose, and sucrose were mixed and injected into a dialysis membrane that was placed in a sucrose solution. The production rate of D-glucose and the release rate of L-arabinose from sucrase were determined. We also investigated the suppression of blood glucose levels by L-arabinose in 21 healthy volunteers. Sucrose (40 g) was ingested with or without L-arabinose (2 g), then blood glucose values were measured, which returned to steady-state conditions within 2 h. Volunteers were then given 90 g of commercial adzuki bean jelly containing 40 g sucrose as the sucrose load, and blood glucose values were measured again. RESULTS Addition of L-arabinose reduced the production rate of D -glucose compared to the rates measured in the absence of L-arabinose for several hours in vitro. L-Arabinose was released at a lower rate in the presence of sucrose than in its absence. Blood glucose values measured 2 h after sucrose was given with L -arabinose were significantly lower than those measured when L-arabinose was not given (Δ change in maximum value: with L-arabinose, 53.8 ± 19.7 mg/dL; without L-arabinose, 65.0 ± 17.7 mg/dL). CONCLUSION The EIS complex of sucrase-L -arabinose-sucrose was maintained for several hours both in vitro and in humans.
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Prevention of diabetes self-management program (PREDIAS): effects on weight, metabolic risk factors, and behavioral outcomes.
Kulzer, B, Hermanns, N, Gorges, D, Schwarz, P, Haak, T
Diabetes care. 2009;(7):1143-6
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OBJECTIVE To evaluate the efficacy of the group program PREDIAS for diabetes prevention. RESEARCH DESIGN AND METHODS PREDIAS consists of 12 lessons and aims at lifestyle modification. The control group received written information about diabetes prevention. In this study, a total of 182 persons with an elevated diabetes risk participated (aged 56.3 +/- 10.1 years, 43% female, and BMI 31.5 +/- 5.3 kg/m(2)). RESULTS After 12 months, weight loss was significantly higher (P = 0.001) in PREDIAS than in the control group (-3.8 +/- 5.2 vs. -1.4 +/- 4.09 kg). There were also significant effects (P = 0.001) on fasting glucose (control group 1.8 +/- 13.1 mg/dl vs. PREDIAS -4.3 +/- 11.3 mg/dl), duration of physical activity per week (control group 17.9 +/- 63.8 min vs. PREDIAS 46.6 +/- 95.5 min; P = 0.03), and eating behavior. CONCLUSIONS PREDIAS significantly modified lifestyle factors associated with an elevated diabetes risk.