Treatment of Newly Diagnosed Diabetic Cats with Glargine Insulin Improves Glycaemic Control and Results in Higher Probability of Remission than Protamine Zinc and Lente Insulins

2009 ◽  
Vol 11 (8) ◽  
pp. 683-691 ◽  
Author(s):  
R.D. Marshall ◽  
J.S. Rand ◽  
J.M. Morton

Glycaemic control and remission probabilities were compared in 24 newly diagnosed diabetic cats treated twice daily with either glargine, protamine zinc (PZI) or lente insulin and fed a low carbohydrate diet. After day 17, the probability of remission was substantially higher for cats with lower mean 12 h blood glucose concentrations on day 17, irrespective of insulin type. Glargine-treated cats had lower mean 12 h blood glucose concentrations on day 17 than PZI- or lente-treated cats, and all eight glargine-treated cats achieved remission compared to three PZI- and two lente-treated cats. The probability of remission was greater for cats treated with glargine than cats treated with PZI or lente insulin. In newly diagnosed diabetic cats, twice daily treatment with glargine provides better glycaemic control and higher probability of remission compared to twice daily treatment with PZI or lente insulin. Good glycaemic control soon after diagnosis is associated with increased probability of remission and should be the goal of insulin therapy.

2018 ◽  
pp. 13-18 ◽  
Author(s):  
Hiroshi Bando ◽  
Koji Ebe ◽  
Tetsuo Muneta ◽  
Masahiro Bando ◽  
Yoshikazu Yonei

Background: Arguments have continued about Low Carbohydrate Diet (LCD) and Calorie Restriction (CR). Authors have reported clinical research of LCD and Morbus (M) value. Subjects and Methods: Subjects enrolled are 84 patients with Type 2 diabetes mellitus (T2DM), 60.9 ± 10.9 years. The protocol were as follows: 1) CR diet on day 1, 2 with 60% carbohydrates, and LCD on day 3-14 with 12% carbohydrates, 2) Daily profile of blood glucose 7 times a day on day 2 (CR) and day 4 (LCD), 3) urinary C-Peptide radioimmunoassay (u-CPR) excretion, 4) M value calculation, 5) investigation of these data with correlation. Results: Subjects were classified into 4 groups according to M value, which were .4–21, 23–66, 29–192, 200–728, respectively. HbA1c value was 6.2, 8.0, 7.8, 9.2 %, respectively. Blood glucose in median from day 2 to day 4 were 123 to 107 mg/dL, 164 to 130 mg/dL, 193 to 156 mg/dL, 277 to 201 mg/dL, respectively. M value in median from day 2 to 4 was 6.3 to 9, 41 to 7, 108 to 16, 367 to 88, respectively. u-CPR was 88 to 58, 53 to 35, 65 to 52, 74 to 64, respectively. There were significant correlations among among glucose, M value and u-CPR. Discussion and Conclusion: Average glucose, M value and u-CPR decreased remarkably on day 4. As average glucose and M value were higher, decrease degree were larger. These results suggested that carbohydrate in meal would influence glucose variability in T2DM. Our data would become basic data for pathophysiological analysis of glucose variability research in the future.


2019 ◽  
Vol 28 (15) ◽  
pp. 1015-1019
Author(s):  
Caroline de Souza Bosco Paiva ◽  
Maria Helena Melo Lima

Type 1 diabetes mellitus is a serious autoimmune disease for which no cure is available. The treatment includes insulin therapy, carbohydrate counting, eating healthy foods, exercising regularly, and maintaining a healthy weight. The goal is to keep blood glucose levels close to normal most of the time to delay or prevent complications. Despite the increase in the use of insulin pumps and continuous glucose monitors in recent years, the management of type 1 diabetes remains suboptimal in terms of glycaemic control and normal glycated haemoglobin (HbA1c) level. This article discusses the case of a child with type 1 diabetes who was successfully treated with a very low-carbohydrate diet, resulting in normal levels of HbA1c and normal blood glucose 95% of the time in a range of 70–180 mg/dL (4.0 mmol/L−10 mmol/L). Therefore, further studies are needed to verify how a very low carbohydrate diet impacts child development.


2019 ◽  
Vol 2 (S1) ◽  
pp. 4-15 ◽  
Author(s):  
Hiroshi Bando ◽  
Koji Ebe ◽  
Tetsuo Muneta ◽  
Masahiro Bando ◽  
Yoshikazu Yonei

Background: There have been lots of discussion and controversy concerning the difference between Low Carbohydrate Diet (LCD) and Calorie Restriction (CR). The important points include glucose variability, glucose-lowering effect, weight reduction degree and influence on lipid metabolism. Subjects and Methods: Enrolled subjects were 47 patients with T2DM. Methods included the study for providing subjects CR meal with 60% carbohydrate on day 1-2 and LCD meal with 12% on day 3-14. Daily profile of blood glucose was studied seven times a day on day 2 and day 4. Further, biomarkers including HbA1c, average blood glucose, and M value were investigated and analyzed for mutual correlations. Results: Subjects were categorized into 4 groups according to the average glucose value, which were 124mg/dL, 160mg/dL, 206mg/dL, and 281mg/dL, respectively. Data in 4 groups were as follows: Number; 12,12,12,11, Male/Female; 6/6, 3/9, 6/6, 5/6, mean age; 51.3, 60.9, 65.3, 60.6 years old, HbA1c; 6.1%, 7.1%, 8.0%, 8.9%, fasting glucose on day 2; 109 mg/dL, 136 mg/dL, 178 mg/dL, 224mg/dL, respectively. Daily profiles of blood glucose in 4 groups on day 4 were remarkably decreased than those of day 2. The levels of M value indicating average blood glucose and mean amplitude of glycemic excursions (MAGE) on day 2 vs 4 were compared in 4 groups, which are 7.1 vs 10.5, 39.7 vs 5.0, 139 vs 15.7, 367 vs88, respectively. Correlations among HbA1c, M value and average blood glucose showed significant correlations (p<0.01). Discussion and Conclusion: Obtained results showed that the distribution of daily profile of blood glucose in 4 groups is separated. Further similar tendency was observed in HbA1c and M value.


2021 ◽  
Vol 12 ◽  
Author(s):  
Yuxin Han ◽  
Bingfei Cheng ◽  
Yanjun Guo ◽  
Qing Wang ◽  
Nailong Yang ◽  
...  

ObjectiveMultiple studies have confirmed that diet restrictions can effectively realize glycemic control and reduce metabolic risks in patients with type 2 diabetes mellitus (T2DM). In 2018, the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) stated that individuals can select a low-carbohydrate diet (LCD) according to their needs and preferences. Owing to the influence of Chinese traditional eating habits, only a small portion of patients in China have achieved their blood glucose goals. As a result, the Chinese government will incur huge expenditures.MethodThis study recruited 134 T2DM participants and randomly assigned them to the LCD group (n = 67) or the low-fat diet (LFD) group (n = 67). All of the patients had a fixed amount of exercise and were guided by clinicians. After a period of dietary washout, all of the patients received corresponding dietary education according to group. The follow-up time was 6 months. The indicators for anthropometry, glycemic control, and medication application parameters were collected and compared between the two groups.ResultsThere were 121 participants who finally entered the study. The proportions of calories from three major nutrients the participants consumed met the requirements of LCD and LFD. Compared with baseline, the pre-postdifferences of body weight, BMI, and several other indicators were significant except for dosages of insulin used in the LCD group and MES in the LFD group. After the intervention, body weight, body weight index (BMI), fasting blood glucose (FBG), postprandial 2-h blood glucose (PPG), and glycosylated hemoglobin (HbA1c) levels in the LCD group decreased significantly (p &lt; 0.05) compared with the LFD group. The number of patients using lipid-lowering agents was significant higher in the LCD group and lower in the LFD group. However, there was no significant difference between the two groups for antihypertensive, hormone-replacement, and other agents.ConclusionsThe LCD diet can decrease body weight, glycemic levels, MES, and lipid-lowering agents more than the LFD diet, thus decreasing cost burden in Chinese patients with T2DM. Strict diet control and monitoring are the keys to managing diabetes.


2005 ◽  
Vol 15 (2) ◽  
pp. 97-116 ◽  
Author(s):  
Amanda Claassen ◽  
Estelle V. Lambert ◽  
Andrew N. Bosch ◽  
Ian M. Rodger ◽  
Alan St. Clair Gibson ◽  
...  

The impact of altered blood glucose concentrations on exercise metabolism and performance after a low carbohydrate (CHO) diet was investigated. In random order, 1 wk apart, 9 trained men underwent euglycemic (CI) or placebo (PI) clamps, while performing up to 150 min of cycling at 70% VO2max, after 48 h on a low CHO diet. The range in improvement in endurance capacity with glucose infusion was large (28 ± 26%, P < 0.05). Fifty-six percent of subjects in CI failed to complete 150 min of exercise despite maintenance of euglycemia, while only 2 subjects in PI completed 150 min of exercise, despite being hypoglycemic. Total CHO oxidation remained similar between trials. Despite longer exercise times in CI, similar amounts of muscle glycogen were used to PI. Maintenance of euglycemia in the CHO-depleted state might have an ergogenic effect, however, the effect is highly variable between individuals and independent of changes in CHO oxidation.


2021 ◽  
Vol 4 (1) ◽  
pp. 419-423
Author(s):  
Aarem Karkee ◽  
Samir Singh ◽  
Pradeep Krishna Shrestha ◽  
Nani Shova Shakya ◽  
Sadiksha Shrestha ◽  
...  

Introduction: Low-carbohydrate diet is effective in improving blood glucose parameters, glycated hemoglobin A1c, weight, and waist circumference. The effectiveness of this diet is well accepted in America and the United Kingdom but in Nepal due to many preexisted misbeliefs regarding carbohydrates, we still have a carbohydrate-based diet for type 2 diabetes mellitus.Material and Methods: Fifty-four newly diagnosed type 2 diabetes mellitus without any treatment were selected for solely low-carbohydrate diet intervention (<130g carbohydrate) in the endocrinology unit of Tribhuvan University Teaching Hospital, Kathmandu from March to August 2019. Antidiabetic medications were not used. Individualized diet plans and repeated counseling were given and followed for 3 months. Blood glucose (fasting and postprandial),glycated hemoglobin A1c, weight, and waist circumference were compared at entry and 3 months. Statistical analysis was done using SPSS version 21.Results: The mean ± SD age was 44.77 ± 10.32. The mean body weight decreased by 4.52 ± 1.79 kg (p<0.001), mean waist circumference decreased by 7.85±0.72 cm (p<0.001), mean fasting blood glucose decreased from 10.44±3.52 mmol/L to 6.18±1.02 mmol/L (p<0.001), mean postprandial blood glucose decreased from 16.76±8.26 mmol/L to 8.26±1.66 mmol/L (p<0.001) and mean glycated hemoglobin A1c decreased by 2.38 ± 1.49 % (p<0.001) after 3months of low-carbohydrate diet intervention.Conclusions: The use of a low-carbohydrate diet may effectively produce glycemic control and decrease glycated hemoglobin A1c without medication in newly diagnosed type 2 diabetes mellitus. Additionally, this diet may also help to lower weight and waist circumference in newly diagnosed type 2 diabetes mellitus.


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