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Glycaemic variability

Bruce A Griffin, Celia G Walker, Susan A Jebb, Carmel Moore, Gary S Frost, Louise Goff, Tom A B Sanders, Fiona Lewis, Margaret Griffin, Rachel Gitau, Julie A Lovegrove
We examined the impact of APOE genotype on plasma lipids and glucose in a secondary analysis of data from a five-arm, randomised controlled, parallel dietary intervention trial ('RISCK' study), to investigate the impact of replacing saturated fatty acids (SFA) with either monounsaturated fat (MUFA) or carbohydrate of high or low glycaemic index (GI) on CVD risk factors and insulin sensitivity. We tested the impact of APOE genotype (carriage of E2 and E4 alleles versus E3/E3), determined retrospectively, on plasma lipids, lipoproteins and glucose homeostasis at baseline ( n = 469), and on the change in these variables after 24 weeks of dietary intervention ( n = 389)...
October 17, 2018: Nutrients
Gareth A Wallis, Javier T Gonzalez
The objective of this review paper is to evaluate the impact of undertaking aerobic exercise in the overnight-fasted v. fed-state, in the context of optimising the health benefits of regular physical activity. Conducting a single bout of aerobic exercise in the overnight-fasted v. fed-state can differentially modulate the aspects of metabolism and energy balance behaviours. This includes, but is not limited to, increased utilisation of fat as a fuel source, improved plasma lipid profiles, enhanced activation of molecular signalling pathways related to fuel metabolism in skeletal muscle and adipose tissue, and reductions in energy intake over the course of a day...
October 18, 2018: Proceedings of the Nutrition Society
Luca Boeri, Paolo Capogrosso, Eugenio Ventimiglia, Filippo Pederzoli, Nicola Frego, Walter Cazzaniga, Francesco Chierigo, Massimo Alfano, Lorenzo Piemonti, Paola Viganò, Marina Pontillo, Emanuele Montanari, Francesco Montorsi, Andrea Salonia
OBJECTIVE: To study the prevalence and the risk associated with prediabetes (PreDM) in primary infertile men. PATIENTS AND METHODS: Data from 744 infertile men were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Serum hormones were measured in every man. Semen analysis was based on 2010 World Health Organization (WHO) reference criteria. PreDM was defined according to the clinical criteria detailed by the American Diabetes Association (Diabetes Care 2014; 37 (Suppl...
October 16, 2018: BJU International
Sanjay Kalra
This opinion piece describes a cricket-based analogy, the Glycaemic Sixer, for diabetes care. The hexad lists six glycaemic parameters which must be targeted to achieve optimal cardiovascular outcomes. All six parameters, i.e., fasting glucose, post prandial glucose, glycosylated haemoglobin, avoidance of hypoglycaemia, avoidance of nocturnal hypoglycaemia, and minimization of glycaemic variability, are associated with cardiovascular outcomes. Hence, equal attention must be paid to all these while planning strategies and choosing drugs for diabetes management...
October 2018: JPMA. the Journal of the Pakistan Medical Association
Rocío Fernández-Méndez, Sancho Rodríguez-Villar, Pablo F Méndez, Richard Windle, Gary George Adams
RATIONALE, AIMS, AND OBJECTIVES: The practice of glycaemic control of critically ill patients admitted to intensive care units (ICUs) is guided by clinical management protocols, designed locally by the ICUs. These protocols differ significantly in their aims and methods. The aim of this study was to develop a standardized methodology for the systematic and objective analysis and comparison of protocols for glycaemic control implemented in any ICU. METHOD: The protocols for glycaemic control implemented in seven ICUs of a UK-based ICU network were analysed using techniques of inductive content analysis, through an open coding process and the framework method...
October 11, 2018: Journal of Evaluation in Clinical Practice
Jingyi Lu, Xiaojing Ma, Lei Zhang, Yifei Mo, Lingwen Ying, Wei Lu, Wei Zhu, Yuqian Bao, Jian Zhou
OBJECTIVE: The relationship between glycaemic variability (GV) and diabetic complications has gained much interest and remains under debate. Moreover, the association of GV with diabetic complications has not been examined in latent autoimmune diabetes of the adult (LADA). Therefore, we evaluated the relationships among several metrics of GV with diabetic retinopathy (DR) in patients with LADA and type 2 diabetes (T2DM). METHODS: A total of 192 patients with LADA and 2927 patients with T2DM were enrolled...
October 10, 2018: Journal of Diabetes Investigation
Anjana Radhakutty, Morton G Burt
Glucocorticoids are frequently prescribed to patients with a wide range of inflammatory and autoimmune diseases. The semi-synthetic glucocorticoid prednisolone is most commonly prescribed and in two main patterns. Prednisolone is prescribed short term at medium-high doses to treat an acute inflammatory illness or long term at lower doses to attenuate chronic inflammatory disease progression. In hospitalized patients with acute prednisolone-induced hyperglycaemia, there is a distinct circadian pattern of glucose elevation, which occurs predominantly in the afternoon and evening...
October 1, 2018: European Journal of Endocrinology
F Carbone, G Adami, L Liberale, A Bonaventura, M Bertolotto, G Andraghetti, N Scopinaro, G B Camerini, F S Papadia, R Cordera, F Dallegri, F Montecucco
AIM: Bariatric surgery has been shown to effectively improve glycaemic control in morbidly obese subjects. However, the molecular bases of this association are still elusive and may act independently of weight loss. Here, our retrospective study has investigated the inflammatory molecule osteopontin (OPN) as a potential predictor of type 2 diabetes mellitus (T2DM) remission. METHODS: Baseline serum levels of OPN were analyzed in 41 T2DM patients who underwent bariatric surgery...
September 27, 2018: Diabetes & Metabolism
A C Paing, K A McMillan, A F Kirk, A Collier, A Hewitt, S F M Chastin
AIM: To explore the dose-response between frequency of interruption of sedentary time and basal glucose (fasting glucose, the dawn phenomenon and night-time glucose) in Type 2 diabetes. METHODS: In a randomized three-treatment, two-period balanced incomplete block trial, 12 people with Type 2 diabetes (age, 60.0 ± 3.2 years; BMI, 30.2 ± 1.4 kg/m2 ) completed two of three conditions: sitting for 7 h interrupted every 60 min (Condition 1), 30 min (Condition 2), and 15 min (Condition 3) by 3-min light-intensity walking breaks...
September 28, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Lise L Kurtzhals, Sidse K Nørgaard, Anna L Secher, Vibeke L Nichum, Helle Ronneby, Ann Tabor, H David McIntyre, Peter Damm, Elisabeth Reinhardt Mathiesen
AIMS/HYPOTHESIS: We aimed to investigate the impact of maternal gestational weight gain (GWG) during dietary treatment on fetal growth in pregnancies complicated by gestational diabetes (GDM). METHODS: This was a retrospective cohort study of 382 women consecutively diagnosed with GDM before 34 weeks' gestation with live singleton births in our centre (Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark) between 2011 and 2017. The women were stratified into three groups according to restricted (53%), appropriate (16%) and excessive (31%) weekly GWG during dietary treatment (using the Institute of Medicine guidelines) to estimate compliance with an energy-restricted 'diabetes diet' (6000 kJ/day [1434 kcal/day], with approximately 50% of energy intake coming from carbohydrates with a low glycaemic index, and a carbohydrate intake of 175 g/day)...
September 25, 2018: Diabetologia
Sonya Chelvanayagam, Janet James
Diabulimia has become a common term used to describe a condition when a person with type 1 diabetes has an eating disorder. The individual may omit or restrict their insulin dose to lose/control weight. Evidence suggests that as many as 20% of women with type 1 diabetes may have this condition. The serious acute and long-term complications of hyperglycaemia are well documented. Detection of this condition is challenging and health professionals need to be vigilant in assessing reasons for variable glycaemic control and weight changes...
September 20, 2018: British Journal of Nursing: BJN
Jocelyn J Drinkwater, Wendy A Davis, Timothy M E Davis
Type 2 diabetes (T2D) is a risk factor for cataract development. With T2D prevalence increasing, the burden of cataract-associated vision loss will also increase. We aimed to characterise cataract diabetes-specific risk factors to assist prevention and management strategies. As part of a systematic review, two investigators independently searched online electronic databases according to a predetermined protocol for relevant published data to end-March 2018. Studies were included if they were longitudinal with ≥100 participants, diabetes was defined, a description of cataract assessment was provided, data were from humans, and the reports were in English...
September 12, 2018: Diabetes/metabolism Research and Reviews
C K Boughton, R Hovorka
The artificial pancreas is now a viable treatment option for people with Type 1 diabetes and has demonstrated improved glycaemic outcomes while also reducing the onus of self-management of Type 1 diabetes. Closed-loop glucose-responsive insulin delivery guided by real-time sensor glucose readings can accommodate highly variable day-to-day insulin requirements and reduce the hypoglycaemia risk observed with tight glycaemic control in Type 1 diabetes. In 2011, the James Lind Alliance research priorities for Type 1 diabetes were produced and priority 3 was to establish whether an artificial pancreas (closed-loop system) for Type 1 diabetes is effective...
September 5, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Richard S Metcalfe, Ben Fitzpatrick, Sinead Fitzpatrick, Gary McDermott, Noel Brick, Conor McClean, Gareth W Davison
PURPOSE: Reduced-exertion high-intensity interval training (REHIT) is a genuinely time-efficient exercise intervention that improves aerobic capacity and blood pressure in men with type 2 diabetes. However, the acute effects of REHIT on 24-h glycaemia have not been examined. METHODS: 11 men with type 2 diabetes (mean ± SD: age, 52 ± 6 years; BMI, 29.7 ± 3.1 kg/m2 ; HbA1c , 7.0 ± 0.8%) participated in a randomised, four-trial crossover study, with continual interstitial glucose measurements captured during a 24-h dietary-standardised period following either (1) no exercise (CON); (2) 30 min of continuous exercise (MICT); (3) 10 × 1 min at ~ 90 HRmax (HIIT; time commitment, ~ 25 min); and (4) 2 × 20 s 'all-out' sprints (REHIT; time commitment, 10 min)...
August 31, 2018: European Journal of Applied Physiology
Ra'eesa Doola, Ristan M Greer, Rod Hurford, Christopher Flatley, Josephine M Forbes, Alwyn S Todd, Chris J Joyce, David J Sturgess
BACKGROUND & AIMS: Extremes of dysglycaemia as well as glycaemic variability are associated with excess mortality in critically ill patients. Glycaemic variability is an increasingly important measure of glucose control in the intensive care unit (ICU) due to this association; however, there is limited data pertaining to the relationship between exogenous glucose from nutrition and glycaemic variability and clinical outcomes. The primary aim of this study was to determine if glycaemic variability is associated with an increase in mortality...
August 16, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Andrea O Y Luk, Benny C Y Zee, Marc Chong, Risa Ozaki, Carl W Rausch, Michael H M Chan, Ronald C W Ma, Alice P S Kong, Francis C C Chow, Juliana C N Chan
BACKGROUND: Galactomannan(s) are plant-derived fiber shown to reduce post-prandial blood glucose by delaying intestinal absorption of carbohydrates and slowing down gastric emptying. We examined glucose-lowering effects of BTI320, a propriety fractionated mannan(s) administered as a chewable tablet before meal in a proof-of-concept study in Chinese subjects with prediabetes. METHODS: Sixty Chinese adults aged 18-70 years with either impaired fasting glucose, impaired glucose tolerance, or glycated haemoglobin 5...
August 31, 2018: BMC Endocrine Disorders
A W Roberts, S Penfold
This paper is an abridged and modified version of guidelines produced by the Joint British Diabetes Societies for inpatient care on glycaemic management during the enteral feeding of people with stroke and diabetes. These were revised in 2017 and have been adapted specifically for Diabetic Medicine. The full version can be found at: or Many people have both diabetes and an acute stroke, and a stanv dard approach to the management of people with stroke is the provision of adequate nutrition...
August 2018: Diabetic Medicine: a Journal of the British Diabetic Association
U Dashora, H R Murphy, R C Temple, K P Stanley, E Castro, S George, K Dhatariya, M Haq, M Sampson
Optimal glycaemic control before and during pregnancy improves both maternal and fetal outcomes. This article summarizes the recently published guidelines on the management of glycaemic control in pregnant women with diabetes on obstetric wards and delivery units produced by the Joint British Diabetes Societies for Inpatient Care and available in full at and Hyperglycaemia following steroid administration can be managed by variable rate intravenous insulin infusion (VRIII) or continuous subcutaneous insulin infusion (CSII) in women who are willing and able to safely self-manage insulin dose adjustment...
August 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Fabio A Teixeira, Daniela P Machado, Juliana T Jeremias, Mariana R Queiroz, Cristiana F F Pontieri, Marcio A Brunetto
The source of starch may interfere with glycaemic control in dogs, but few studies have evaluated these aspects in diabetic dogs. This study compared the effects of two isonutrient diets with different starch sources, peas and barley (PB) v. maize (Mi), on diabetic dogs. The Mi diet was processed in order to generate a lower starch gelatinisation index. In all, fifteen adult diabetic dogs without other conditions were included. The animals were fed two dry extruded rations with moderate levels of fat and starch and high levels of protein and fibre using a random, double-blind cross-over design...
October 2018: British Journal of Nutrition
Estelle Lowry, Nina Rautio, Ville Karhunen, Jouko Miettunen, Leena Ala-Mursula, Juha Auvinen, Sirkka Keinänen-Kiukaanniemi, Katri Puukka, Inga Prokopenko, Karl-Heinz Herzig, Alexandra Lewin, Sylvain Sebert, Marjo-Riitta Järvelin
BACKGROUND: The prevention of the risk of type 2 diabetes (T2D) is complicated by multidimensional interplays between biological and psychosocial factors acting at the individual level. To address the challenge we took a systematic approach, to explore the bio-psychosocial predictors of blood glucose in mid-age. METHODS: Based on the 31-year and 46-year follow-ups (5,078 participants, 43% male) of Northern Finland Birth Cohort 1966, we used a systematic strategy to select bio-psychosocial variables at 31 years to enable a data-driven approach...
August 17, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
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