Effects of Sambiloto (Andrographis paniculata) on GLP-1 and DPP-4 Concentrations between Normal and Prediabetic Subjects: A Crossover Study

Background. The extract of Andrographis paniculata (Burm. F.) Wall. Ex. Nees. (sambiloto) (穿心蓮 chuān xīn lián) has been reported to have an antidiabetic effect on mice models and has been used traditionally in the community. The exact mechanism of sambiloto extract in decreasing plasma glucose is unclear, so we investigated the role of sambiloto extract in the incretin pathway in healthy and prediabetic subjects. Methods. This study was a randomized, placebo-controlled, crossover, double-blind trial. It included 38 people who were healthy and 35 people who had prediabetes. All subjects were randomly assigned to receive either the intervention sambiloto extract or a placebo. All subjects were randomly assigned to receive the first intervention for 14 days. There was a washout period between subsequent interventions. The primary outcome was glucagon-like peptide 1 (GLP-1) concentration, and secondary outcomes were fasting insulin, 2-hour postprandial insulin, homeostasis model assessment of insulin resistance (HOMA-IR), fasting blood glucose, 2-hour postprandial blood glucose, dipeptidyl peptidase-4 (DPP-4), and glycated albumin before and after the intervention. Result. After the intervention, GLP-1 concentration significantly increased in prediabetes by 19.6% compared to the placebo ( p = 0.043 ). There were no significant differences in the changes of fasting insulin, 2-hour postprandial insulin, HOMA-IR, fasting blood glucose, 2-hour postprandial blood glucose, DPP-4, and glycated albumin levels after the intervention. Sambiloto extract did not inhibit the DPP-4 enzyme in healthy and prediabetic subjects. Conclusion. Sambiloto extract increased GLP-1 concentration without inhibiting the DPP-4 enzyme in prediabetic subjects. This trial is registered with ClinicalTrials.gov (ID: NCT03455049), registered on 6 March 2018—retrospectively registered (https://clinicaltrials.gov/ct2/show/NCT03455049).

Energy Intake of Men With Excess Weight During Normobaric Hypoxic Confinement

Due to the observations of weight loss at high altitude, normobaric hypoxia has been considered as a method of weight loss in obese individuals. With this regard, the aim of the present study was to determine the effect of hypoxia per se on metabolism in men with excess weight. Eight men living with excess weight (125.0 ± 17.7 kg; 30.5 ± 11.1 years, BMI: 37.6 ± 6.2 kg⋅m–2) participated in a randomized cross-over study comprising two 10-day confinements: normobaric (altitude of facility ≃ 940 m) normoxia (NORMOXIA; PIO2 = 133 mmHg), and normobaric hypoxia (HYPOXIA). The PIO2 in the latter was reduced from 105 (simulated altitude of 2,800 m) to 98 mmHg (simulated altitude of 3,400 m over 10 days. Before, and at the end of each confinement, participants completed a meal tolerance test (MTT). Resting energy expenditure (REE), circulating glucose, GLP-1, insulin, catecholamines, ghrelin, peptide-YY (PYY), leptin, gastro-intestinal blood flow, and appetite sensations were measured in fasted and postprandial states. Fasting REE increased after HYPOXIA (+358.0 ± 49.3 kcal⋅day–1, p = 0.03), but not after NORMOXIA (−33.1 ± 17.6 kcal⋅day–1). Postprandial REE was also significantly increased after HYPOXIA (p ≤ 0.05), as was the level of PYY. Furthermore, a tendency for decreased energy intake was concomitant with a significant body weight reduction after HYPOXIA (−0.7 ± 0.2 kg) compared to NORMOXIA (+1.0 ± 0.2 kg). The HYPOXIA trial increased the metabolic requirements, with a tendency toward decreased energy intake concomitant with increased PYY levels supporting the notion of a hypoxia-induced appetite inhibition, that could potentially lead to body weight reduction. The greater postprandial blood-glucose response following hypoxic confinement, suggests the potential development of insulin resistance.

Inhibition of α-glucosidase by trilobatin and its mechanism: kinetics, interaction mechanism and molecular docking

α-Glucosidase is related to the increase of postprandial blood glucose in vivo. Inhibition of α-glucosidase is supposed to be an effective approach to treat type 2 diabetes mellitus (T2DM). Trilobatin,...

In-vitro antidiabetic activity of methanolic extract of leaves and fruits of Pouteria campechiana (Kunth) Baehni

Introduction and Aim: Herbal medicine have been used to treat several ailments since decades. Pouteria campechiana (Kunth) Baehni belongs to the family Sapotaceae which is widely found around the world. In folk medicine, various parts of P. campechiana is used to treat various illness. Inhibition of alpha-amylase and alpha-glucosidase enzymes can be an important strategy in management of postprandial blood glucose level in non-insulin dependent diabetic patient. Hence, present study focused to evaluate the in vitro antidiabetic activity of leaf and fruit methanolic extract of Pouteria campechiana (Kunth) Baehni. Materials and Methods: Methanolic extract of P. campechiana leaf (PCL) and fruit (PCF) was screened by biochemical assay such as ?-amylase inhibition activity by CNPG3 method (2-chloro-p-nitrophenyl-?-D-maltotrioside) and ?- glucosidase inhibition activity and in vitro cellular assay such as glucose uptake assay in 3T3-L1 cell line. Results: Methanolic extract of P. campechiana leaf and fruit showed inhibition of ??Amylase and ??Glucosidase enzymes. The methanolic extract of P. campechiana leaf and fruit at varying concentrations (?g/ml), did not exhibit cytotoxicity against 3T3-L1 cell line after 24 hours of incubation. The test compounds PCL and PCF induced the uptake of 2?(N?(7?Nitrobenz?2?oxa?1,3?diazol?4?yl) Amino) ? 2?Deoxyglucose (2-NBDG) in 3T3L1 cells. PCF and PCL both showed almost similar activity of standard drug, Metformin at higher concentrations. Conclusion: Based on the results, it can be concluded that methanolic leaf and fruit extract of P. campechiana possess antidiabetic activity.

Dietary fiber and risk of coronary heart diseases

Dietary fiber is the portion of plant-derived food that cannot be completely broken down by human digestive enzymes. Dietary fibers can be grouped generally by their solubility, viscosity, and fermentation, which affect how fibers are processed in the body. Dietary fiber has two main components: soluble fiber and insoluble fiber, which are components of plant foods, such as legumes, whole grains and cereals, vegetables, fruits, and nuts or seeds. Consumption of cereals, vegetable and fruit may lower the risk of coronary heart disease. Coronary heart disease involves the reduction of blood flow to the heart muscle due to build-up of plaque on the arteries of the heart. Dietary fiber makes three primary contributions: bulking, viscosity and fermentation. The bulking effect of some fibers reduces constipation and the risk of colon disease because they absorb water, which increases bulking and promotes regularity. Viscosity effects on fibers reduce the absorption of cholesterol and other nutrients because of the formation of gels that attenuate postprandial blood glucose and lipid rises. The formation of gels also slows gastric emptying, maintaining levels of satiety and contributing towards less weight gain. In the fermentation process, the bacteria GIT helps to digest fiber through a process of microbial fermentation to generate short chain fatty acids like acetate, propionate and butyrate. Butyrate binds to G-protein coupled receptors on the brush borders of intestinal lining and trigger a signal cascade that release GLP-1 and PYY. These peptides behave like hormones to trigger satiety. One of the reasons for eating fiber rich foods is because they promote satiety and prevent uncontrollable quest for food. People that eat food low in fiber experience over feeding issues. When people over eat they consume more calories leading to weight gain and that contributes to obesity. Obesity is the accumulation of fats in fat tissues. Excess fats are converted to cholesterol (LDL) which accumulates on the walls of the arteries and prevent the flow of blood to the heart. This is prevented when an individual consumes foods rich in fiber.

Case Report: A Novel ABCC8 Variant in a Chinese Pedigree of Maturity-Onset Diabetes of the Young

BackgroundWe aimed to analyze a novel ABCC8 variant of a Chinese patient with suspected maturity-onset diabetes of the young (MODY) and to provide evidence for precise diagnosis and appropriate treatment.MethodA Chinese family with suspected MODY was recruited in this study, which included a 15-year-old female patient with diabetes. Clinical data and blood samples were collected from the proband and other family members. All of the living relatives were given an oral glucose tolerance test. Next-generation sequencing was performed to identify the mutated genes in the proband. Sanger sequencing was utilized to confirm the location of the pathogenic variant in all subjects. Further treatment was referred to targeted family members according to genetic testing.ResultsThe proband was found to have a random blood glucose level of 244.8 mg/dl and an HbA1c level of 9.2%. Before this investigation, her grandparents had been diagnosed with diabetes. The second uncle, two aunts, mother, and cousin of the proband were diagnosed with diabetes by abnormal HbA1C (6.5–12.1%) and fasting blood glucose (FBG, 91.4–189.7 mg/dl). The second aunt of the proband had impaired glucose homeostasis (HbA1C = 6.4% and FBG = 88.0 mg/dl). One novel missense variant c.1432G>A (p.A478T) in exon 9 of the ABCC8 gene was detected in the proband with suspected MODY. The variant was also found in six family members with diabetes or impaired glucose homeostasis, including her second uncle, two aunts, mother, and cousin. After the treatment was switched to glimepiride, the fasting blood glucose was adjusted to 99.54 mg/dl, the 2-h postprandial blood glucose was 153.54 mg/dl, serum fructosamine was 259 μmol/l, and HbA1c was 5.8%. The glycemic control remained optimal, and no hypoglycemic episodes were observed in the living relatives.ConclusionThis study revealed one novel missense variant of the ABCC8 gene in Chinese families. The present findings indicated that the members of this family responded to treatment with sulfonylureas as previously seen in ABCC8 MODY.

Blood Glucose Level, Gestational Diabetes Mellitus and Maternal Birth Season: A Retrospective Cohort Study

BackgroundPrevious evidence indicates that birth season is associated with type 2 diabetes in adults. However, information on the association of birth with gestational diabetes mellitus (GDM) is lacking. The present study explores the association between birth seasonality and GDM in East China.MethodsThis retrospective cohort study was conducted at the International Peace Maternal and child health hospital between 2014 and 2019. A total of 79, 292 pregnant women were included in the study after excluding participants with previous GDM, stillbirth, polycystic ovary syndrome, and lack of GDM laboratory records. The multivariate logistic regression model was employed to estimate the odds ratio and 95% confidence interval. After log transformation of blood glucose level, the percentage change and 95% confidence interval were estimated by a multivariate linear model.ResultsThe risk of GDM among pregnant women born in spring, autumn, and winter was not significantly different compared to that among participants born in summer. Pregnant women born in autumn had significantly higher 1-hour postprandial blood glucose (PBG-1h) and 2-hour postprandial blood glucose (PBG-2h) levels than pregnant women born in summer. Compared to pregnant women born in August, the PBG-1h level of pregnant women born in October, November, and December increased significantly, whereas the PBG-2h levels of pregnant women born in November and December increased significantly.ConclusionPregnant women born in autumn exhibit higher postprandial blood glucose levels during pregnancy than in those born in summer. The findings provide evidence that exposure to seasonal changes in early life may influence blood glucose metabolism during pregnancy.

Effectivness of specific mobile health applications (mHealth-apps) in gestational diabtetes mellitus: a systematic review

Background Gestational diabetes mellitus (GDM) emerges worldwide and is closely associated with short- and long-term health issues in women and their offspring, such as pregnancy and birth complications respectively comorbidities, Type 2 Diabetes (T2D), metabolic syndrome as well as cardiovascular diseases. Against this background, mobile health applications (mHealth-Apps) do open up new possibilities to improve the management of GDM. Therefore, we analyzed the clinical effectiveness of specific mHealth-Apps on clinical health-related short and long-term outcomes in mother and child. Methods A systematic literature search in Medline (PubMed), Cochrane Library, Embase, CINAHL and Web of Science Core Collection databases as well as Google Scholar was performed. We selected studies published 2008 to 2020 analyzing women diagnosed with GDM using specific mHealth-Apps. Controlled clinical trials (CCT) and randomized controlled trials (RCT) were included. Study quality was assessed using the Effective Public Health Practice Project (EPHPP) tool. Results In total, n = 6 publications (n = 5 RCTs, n = 1 CCT; and n = 4 moderate, n = 2 weak quality), analyzing n = 408 GDM patients in the intervention and n = 405 in the control groups, were included. Compared to control groups, fasting blood glucose, 2-h postprandial blood glucose, off target blood glucose measurements, delivery mode (more vaginal deliveries and fewer (emergency) caesarean sections) and patient compliance showed improving trends. Conclusion mHealth-Apps might improve health-related outcomes, particularly glycemic control, in the management of GDM. Further studies need to be done in more detail.

Impact of insufficient sleep on dysregulated blood glucose control under standardised meal conditions

Aims/hypothesis Sleep, diet and exercise are fundamental to metabolic homeostasis. In this secondary analysis of a repeated measures, nutritional intervention study, we tested whether an individual’s sleep quality, duration and timing impact glycaemic response to a breakfast meal the following morning. Methods Healthy adults’ data (N = 953 [41% twins]) were analysed from the PREDICT dietary intervention trial. Participants consumed isoenergetic standardised meals over 2 weeks in the clinic and at home. Actigraphy was used to assess sleep variables (duration, efficiency, timing) and continuous glucose monitors were used to measure glycaemic variation (>8000 meals). Results Sleep variables were significantly associated with postprandial glycaemic control (2 h incremental AUC), at both between- and within-person levels. Sleep period time interacted with meal type, with a smaller effect of poor sleep on postprandial blood glucose levels when high-carbohydrate (low fat/protein) (pinteraction = 0.02) and high-fat (pinteraction = 0.03) breakfasts were consumed compared with a reference 75 g OGTT. Within-person sleep period time had a similar interaction (high carbohydrate: pinteraction = 0.001, high fat: pinteraction = 0.02). Within- and between-person sleep efficiency were significantly associated with lower postprandial blood glucose levels irrespective of meal type (both p < 0.03). Later sleep midpoint (time deviation from midnight) was found to be significantly associated with higher postprandial glucose, in both between-person and within-person comparisons (p = 0.035 and p = 0.051, respectively). Conclusions/interpretation Poor sleep efficiency and later bedtime routines are associated with more pronounced postprandial glycaemic responses to breakfast the following morning. A person’s deviation from their usual sleep pattern was also associated with poorer postprandial glycaemic control. These findings underscore sleep as a modifiable, non-pharmacological therapeutic target for the optimal regulation of human metabolic health. Trial registrationClinicalTrials.gov NCT03479866. Graphical abstract