Elevated Circulating Levels of Motilin are Associated with Diabetes in Individuals after Acute Pancreatitis

2019 ◽  
Vol 128 (01) ◽  
pp. 43-51 ◽  
Author(s):  
Fuchsia D. Gold-Smith ◽  
Ruma G. Singh ◽  
Maxim S. Petrov
Keyword(s):  
Acute Pancreatitis ◽  
Blood Glucose ◽  
Glycaemic Control ◽  
Confidence Interval ◽  
Gastrointestinal Motility ◽  
Fasting Blood Glucose ◽  
Glycated Haemoglobin ◽  
Symptom Index ◽  
Plasma Motilin ◽  
Cardinal Symptom

Abstract Aim The study aimed to investigate the associations between glycaemic control after acute pancreatitis and gastrointestinal motility, using plasma motilin concentration and gastroparesis cardinal symptom index score as proxies. Methods This cross-sectional study recruited a total of 93 individuals after acute pancreatitis. Gastroparesis cardinal index scores, demographic and anthropometric factors, as well as pancreatitis-related factors were analysed. Fasting venous blood was collected to measure motilin, glycated haemoglobin, and fasting blood glucose. Linear regression analyses were conducted to investigate the associations between glycaemic control and gastrointestinal motility in unadjusted and adjusted models. Results Motilin was significantly higher in individuals with diabetes across all adjusted models, with the highest ß-coefficient (95% confidence interval) of 588.89 (138.50, 1039.28); P=0.010. Fasting blood glucose was significantly associated with motilin across all models, with the highest ß-coefficient (95% confidence interval) of 156.30 (55.49, 257.10); P=0.002. Glycated haemoglobin was significantly associated with motilin in one adjusted model with ß-coefficient (95% confidence interval) of 18.78 (1.53, 36.02); P=0.033. Gastroparesis cardinal symptom index was not significantly associated with any measure of glycaemic control. Conclusions Diabetes in individuals after acute pancreatitis appears to be characterised by elevated plasma motilin but not gastroparesis cardinal symptom index. The role of motilin in this setting warrants further investigations.

Glucose responses to acute and chronic exercise during pregnancy: a systematic review and meta-analysis

2018 ◽  
Vol 52 (21) ◽  
pp. 1357-1366 ◽  
Author(s):  
Margie H Davenport ◽  
Frances Sobierajski ◽  
Michelle F Mottola ◽  
Rachel J Skow ◽  
Victoria L Meah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Glucose ◽  
Glycaemic Control ◽  
Acute Exercise ◽  
Exercise Intervention ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
Chronic Exercise ◽  
Prenatal Exercise ◽  
Frequency Intensity

ObjectiveTo perform a systematic review and meta-analysis to explore the relationship between prenatal exercise and glycaemic control.DesignSystematic review with random-effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were included (except case studies and reviews) if they were published in English, Spanish or French, and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of acute or chronic exercise, alone (‘exercise-only’) or in combination with other intervention components (eg, dietary; ‘exercise+cointervention’) at any stage of pregnancy), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and outcome (glycaemic control).ResultsA total of 58 studies (n=8699) were included. There was ‘very low’ quality evidence showing that an acute bout of exercise was associated with a decrease in maternal blood glucose from before to during exercise (6 studies, n=123; mean difference (MD) −0.94 mmol/L, 95% CI −1.18 to −0.70, I2=41%) and following exercise (n=333; MD −0.57 mmol/L, 95% CI −0.72 to −0.41, I2=72%). Subgroup analysis showed that there were larger decreases in blood glucose following acute exercise in women with diabetes (n=26; MD −1.42, 95% CI −1.69 to −1.16, I2=8%) compared with those without diabetes (n=285; MD −0.46, 95% CI −0.60 to −0.32, I2=62%). Finally, chronic exercise-only interventions reduced fasting blood glucose compared with no exercise postintervention in women with diabetes (2 studies, n=70; MD −2.76, 95% CI −3.18 to −2.34, I2=52%; ‘low’ quality of evidence), but not in those without diabetes (9 studies, n=2174; MD −0.05, 95% CI −0.16 to 0.05, I2=79%).ConclusionAcute and chronic prenatal exercise reduced maternal circulating blood glucose concentrations, with a larger effect in women with diabetes.

scholarly journals The Effects of Almonds on Gut Microbiota, Glycometabolism, and Inflammatory Markers in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3377
Author(s):  
Omorogieva Ojo ◽  
Xiao-Hua Wang ◽  
Osarhumwese Osaretin Ojo ◽  
Amanda Rodrigues Amorim Adegboye
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Gut Microbiota ◽  
Inflammatory Markers ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
Glycated Haemoglobin ◽  
Postprandial Blood Glucose

The use of nutritional interventions for managing diabetes is one of the effective strategies aimed at reducing the global prevalence of the condition, which is on the rise. Almonds are the most consumed tree nut and they are known to be rich sources of protein, monounsaturated fatty acids, essential minerals, and dietary fibre. Therefore, the aim of this review was to evaluate the effects of almonds on gut microbiota, glycometabolism, and inflammatory parameters in patients with type 2 diabetes. Methods: This systematic review and meta-analysis was carried out according to the preferred reporting items for systematic review and meta-analysis (PRISMA). EBSCOhost, which encompasses the Health Sciences Research Databases; Google Scholar; EMBASE; and the reference lists of articles were searched based on population, intervention, control, outcome, and study (PICOS) framework. Searches were carried out from database inception until 1 August 2021 based on medical subject headings (MesH) and synonyms. The meta-analysis was carried out with the Review Manager (RevMan) 5.3 software. Results: Nine randomised studies were included in the systematic review and eight were used for the meta-analysis. The results would suggest that almond-based diets have significant effects in promoting the growth of short-chain fatty acid (SCFA)-producing gut microbiota. Furthermore, the meta-analysis showed that almond-based diets were effective in significantly lowering (p < 0.05) glycated haemoglobin (HbA1c) levels and body mass index (BMI) in patients with type 2 diabetes. However, it was also found that the effects of almonds were not significant (p > 0.05) in relation to fasting blood glucose, 2 h postprandial blood glucose, inflammatory markers (C-reactive protein and Tumour necrosis factor α, TNF-α), glucagon-like peptide-1 (GLP-1), homeostatic model assessment of insulin resistance (HOMA–IR), and fasting insulin. The biological mechanisms responsible for the outcomes observed in this review in relation to reduction in HbA1c and BMI may be based on the nutrient composition of almonds and the biological effects, including the high fibre content and the low glycaemic index profile. Conclusion: The findings of this systematic review and meta-analysis have shown that almond-based diets may be effective in promoting short-chain fatty acid-producing bacteria and lowering glycated haemoglobin and body mass index in patients with type 2 diabetes compared with control. However, the effects of almonds were not significant (p > 0.05) with respect to fasting blood glucose, 2 h postprandial blood glucose, inflammatory markers (C-reactive protein and TNF-α), GLP-1, HOMA–IR, and fasting insulin.

Rapid-onset clozapine-induced hyperglycaemia: pathways of glycaemic dysregulation

2021 ◽  
Vol 14 (9) ◽  
pp. e243938
Author(s):  
Mariana Barbosa ◽  
Vera Fernandes
Keyword(s):  
Parkinson’S Disease ◽  
Metabolic Syndrome ◽  
Parkinson's Disease ◽  
Blood Glucose ◽  
Glycaemic Control ◽  
Glycated Haemoglobin ◽  
Rapid Onset ◽  
Proper Treatment ◽  
Increased Risk ◽  
History Of

Clozapine is an atypical antipsychotic used in refractory schizophrenia, also efficient in alleviating dyskinesia in Parkinson’s disease. Despite its potency, this drug is associated with severe metabolic side effects, including increased risk for diabetes. We report the case of a 45-year-old overweight woman with Parkinson’s disease who presented with rapid-onset hyperglycaemia within 2 months after starting clozapine for refractory dyskinaesia. She had a history of gestational diabetes. At presentation, her blood glucose level was 505 mg/dL and glycated haemoglobin 12.4%, with no catabolic symptoms. Clozapine was suspended and metformin was started, but adequate glycaemic control was achieved only with insulin therapy, along with exenatide and empagliflozin afterwards. We assume that clozapine acted as a trigger for rapid deterioration of glycaemic control through direct pathophysiological mechanisms, rather than an indirect slowly evolving weight gain-related metabolic syndrome pathway. Clinicians should be aware of this complication, enabling timely diagnosis and proper treatment.

Knowledge of Diabetes mellitus and Glycaemic Control

1997 ◽  
Vol 6 (4) ◽  
pp. 186-197
Author(s):  
David L. Robinson ◽  
Mahmoud Al-Bustan ◽  
Milad S. Bitar ◽  
Adnan Al-Asousi ◽  
Sobia Majeed
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glycaemic Control ◽  
Hospital Admissions ◽  
Factor Model ◽  
Fasting Blood Glucose ◽  
General Factor ◽  
Diabetes Knowledge ◽  
Glucose Levels ◽  
Blood Glucose Levels

It has been claimed that lack of knowledge of diabetes mellitus has been a cause of excess admissions and morbidity. There is also some evidence that diabetic education programs can improve self-regulatory behaviour and reduce hospital admissions. In this report we test the hypothesis that greater knowledge of diabetes should be associated with better glycaemic control and lower fasting blood glucose levels. Responses to diabetes knowledge questions were provided by 420 patients attending diabetic clinics in Kuwait. In an earlier and complementary report a principal components analysis revealed that knowledge of diabetes cannot be understood in terms of a single general factor. With a subsequent Varimax rotation we obtained 12 uncorrelated knowledge factors with eigenvalues greater than unity and these would all be confounded in the simple aggregation of correct answers to diabetes knowledge questions employed in earlier studies. Results are now described which show that the 12-factor model of diabetes knowledge is better able to predict blood glucose levels than the scores obtained on a single scale by just summing the correct answers to all diabetes knowledge questions. A standard multiple linear regression with the diabetes knowledge factors age, sex and ‘years since diagnosis’ as independent variables, and fasting blood glucose levels as the dependent variable, shows that 4 of the 12 factors yield statistically significant semi-partial correlation coefficients that account for unique fractions of the total variance of blood glucose levels. The meaning of these 4 factors is discussed with special reference to glycaemic control and blood glucose levels.

Biphasic Insulin Aspart 30 in Insulin Initiation

2010 ◽  
Vol 7 (2) ◽  
pp. 121
Author(s):  
Wenying Yang ◽  
Keyword(s):  
Blood Glucose ◽  
Glycaemic Control ◽  
Insulin Aspart ◽  
Fasting Blood Glucose ◽  
Postprandial Glucose ◽  
Insulin Initiation ◽  
Biphasic Insulin Aspart ◽  
Biphasic Insulin ◽  
Biphasic Insulin Aspart 30 ◽  
Clinical Literature

This case report concerns a patient with poor glycaemic control on oral antidiabetic drugs who initiated biphasic insulin aspart 30 (BIAsp 30), and reviews supporting clinical literature, alternative treatment choices and the options for intensification. During the six-month follow-up after initiation of BIAsp 30, glycosylated haemoglobin (HbA1c) was reduced from 10.2 % to 6.4 %, mean fasting blood glucose (FBG) was reduced from 9.0 mmol/l to 6.8 mmol/l and mean postprandial glucose (PPG) was reduced from 15.3 mmol/l to 8.8 mmol/l. Body weight increased by 4 kg. The patient experienced eight episodes of hypoglycaemia over the six-month period (four pre-lunch, one at bedtime and three nocturnal). The patient had six episodes with blood glucose (BG) <4.0 mmol/l but no episodes with BG <2.8 mmol/l. Insulin initiation with a premix insulin analogue offers a simple and convenient regimen of once- or twice-daily dosing and provides effective glycaemic control by providing coverage of both FBG and PPG.

scholarly journals 100 % Fruit juice and measures of glucose control and insulin sensitivity: a systematic review and meta-analysis of randomised controlled trials

2017 ◽  
Vol 6 ◽  
Author(s):  
Mary M. Murphy ◽  
Erin C. Barrett ◽  
Kara A. Bresnahan ◽  
Leila M. Barraj
Keyword(s):  
Systematic Review ◽  
Blood Glucose ◽  
Glycaemic Control ◽  
Glucose Control ◽  
Randomised Controlled Trials ◽  
Fruit Juice ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
Controlled Trials ◽  
Randomised Controlled

AbstractStudies on the effects of consuming 100 % fruit juice on measures of glycaemic control are conflicting. The purpose of the present study was to systematically review and quantitatively summarise results from randomised controlled trials (RCT) examining effects of 100 % fruit juice on glucose–insulin homeostasis. Eligible studies were identified from a systematic review of PubMed and EMBASE and hand searches of reference lists from reviews and relevant papers. Using data from eighteen RCT, meta-analyses evaluated the mean difference in fasting blood glucose (sixteen studies), fasting blood insulin (eleven studies), the homeostatic model assessment of insulin resistance (HOMA-IR; seven studies) and glycosylated Hb (HbA1c; three studies) between the 100 % fruit juice intervention and control groups using a random-effects model. Compared with the control group, 100 % fruit juice had no significant effect on fasting blood glucose (−0·13 (95 % CI −0·28, 0·01) mmol/l; P = 0·07), fasting blood insulin (−0·24 (95 % CI −3·54, 3·05) pmol/l; P = 0·89), HOMA-IR (−0·22 (95 % CI −0·50, 0·06); P = 0·13) or HbA1c (−0·001 (95 % CI −0·38, 0·38) %; P = 0·28). Results from stratified analyses and univariate meta-regressions also largely showed no significant associations between 100 % fruit juice and the measures of glucose control. Overall, findings from this meta-analysis of RCT suggest a neutral effect of 100 % fruit juice on glycaemic control. These findings are consistent with findings from some observational studies suggesting that consumption of 100 % fruit juice is not associated with increased risk of diabetes.

scholarly journals Effect of once‐weekly dulaglutide on glycated haemoglobin ( HbA1c ) and fasting blood glucose in patient subpopulations by gender, duration of diabetes and baseline HbA1c

2017 ◽  
Vol 20 (2) ◽  
pp. 409-418 ◽  
Author(s):  
Baptist Gallwitz ◽  
Samuel Dagogo‐Jack ◽  
Vivian Thieu ◽  
Luis‐Emilio Garcia‐Perez ◽  
Imre Pavo ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Glycated Haemoglobin ◽  
Baseline Hba1c ◽  
Duration Of Diabetes

scholarly journals Humán inzulinról glargininzulin-alapú bázis-bolus kezelésre váltott betegek glykaemiás állapotának javulása a váltás után

2018 ◽  
Vol 159 (29) ◽  
pp. 1201-1207
Author(s):  
Erzsébet Nagy ◽  
Gábor Kovács
Keyword(s):  
Blood Glucose ◽  
Glycaemic Control ◽  
Insulin Glargine ◽  
Control Method ◽  
Fasting Blood Glucose ◽  
Postprandial Blood Glucose ◽  
Efficacy Analysis ◽  
Before And After ◽  
Bolus Insulin ◽  
Basal Bolus

Abstract: Introduction: The effectiveness of human and analogue insulins is similar but the latter have more advantageous pharmacokinetic features, leading to an improvement in hypoglycaemia and come closer to achieving the physiologic insulin profile. Aim: To demonstrate that switching from a human basal-bolus insulin treatment to an insulin glargine-based basal-bolus regimen can achieve a better glycaemic control. Method: This 3-month prospective, non-interventional study, including a 12-month retrospective data collection phase, enrolled patients who were switched to the insulin glargine- – 100 U/mL – based basal-bolus treatment at the time of enrolment if they were inadequately controlled and had at least one additional HbA1c result in the 12 months before the switch. Of 1513 patients 1181 had the data that were needed for the efficacy analysis. Results: The mean age of the efficacy population was 58.3 years and 48.1% were male. Their mean HbA1c levels remained unchanged in the year before the switch: it was 8.8 ± 1.4% at 12 months prior to the switch and 8.8 ± 1.2% at the switch, but decreased significantly to 7.7 ± 1.0% (p<0.001) after 3 months. Between the baseline and 3 months, the fasting blood glucose and the postprandial blood glucose improved significantly (from 10.0 ± 3.2 mmol/L to 7.4 ± 1.9 mmol/L, p<0.001 and from 11.1 ± 2.8 mmol/L to 8.8 ± 1.7 mmol/L, p<0.001, respectively). Insulin doses were increased both before and after the switch. Conclusions: Switch to an insulin glargine-based basal-bolus regimen could achieve a significant improvement in the glycaemic control in patients who were inadequately controlled prior to the switch. Orv Hetil. 2018; 159(29): 1201–1207.

scholarly journals Comparing Glycemic Indices among Different Ethnic Groups Residing in Yenegoa, Bayelsa State, Nigeria

2021 ◽  
pp. 38-41
Author(s):  
Jonathan Nyebuchi ◽  
Victor Tuanwii ◽  
Felix Eedee Konne ◽  
Fyneface Chikadibia Amadi ◽  
Friday Ogidigba
Keyword(s):  
Blood Glucose ◽  
Ethnic Groups ◽  
Fasting Blood Glucose ◽  
Glycated Haemoglobin ◽  
Incidence Rates ◽  
P Value ◽  
Significant Difference ◽  
Glycemic Indices ◽  
Study Population

Increased prevalence and incidence rates within ethnic minorities have been reported by numerous studies on tribal differences in type 2 diabetes patients, sharing a western setting. This study was aimed at comparing glycemic indices among different ethnic groups residing in Yenegoa, Bayelsa State. The study population consisted of apparently150 healthy male and female subjects; 116 Ijaws, 21 Igbos and 13 Yorubas residing in Yenagoa Local Government Area, Bayelsa State of Nigeria. All subjects were aged between 16 and 48 years. 4 mls of Blood samples was collected from each subject. 2mls of the blood was withdrawn into EDTA for HbA1c estimation while the other 2mls was withdrawn into fluoride oxalate for fasting blood glucose. Glycated haemoglobin (HbA1c) was determined using the automated CLOVER A1c Analyser while FBG was assayed using Glucose Oxidase Method. Results revealed that there was a significant difference in the mean levels of FBG among the studied groups (P-value < 0.05) but there was no significant difference in the HbA1c mean levels (P-value > 0.05). This study has revealed that ethnic differences may cause significant changes on fasting blood glucose but may not in HbA1c.

scholarly journals The effect comparisons of different exercise interventions on blood glucose and insulin resistance relative indicators for prediabetes: a network meta-analysis

2019 ◽  
Author(s):  
Lijun Tang ◽  
Yingjie Fang ◽  
Jianchun Yin
Keyword(s):  
Insulin Resistance ◽  
Blood Glucose ◽  
Glycaemic Control ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
The Body ◽  
Model Assessment ◽  
Curative Effect ◽  
Exercise Interventions

Abstract Background: In order to recommend the optimum type of exercise for type 2 diabetes prevention, the effect of different exercise interventions on glycaemic control and insulin resistance relative indicators were compared. Methods: The studies involving the curative effect of aerobic exercise trailing (AET) or resistance trailing (RT) for prediabetes were searched with pre-established strategy . The Body Mass Index (BMI), fasting blood glucose (FBG), glycated haemoglobin (HbA1c), Insulin and homeostasis model assessment-insulin resistance index (HOMAIR) were used as outcomes indictors. Q statistic was calculated to evaluate the heterogeneity within studies. A fixed effects model was chosen for pooling data with p > 0.05, otherwise, a random effects model was chosen. The consistency test in this network meta-analysis was conducted by Node-splitting analysis. Results: A total of 12 eligible studies were included into this network meta-analysis. According to p score values, prediabetes individuals in AET group had better curative effect in BMI (p score = 0.7525), Insulin (p score = 0.6411) and HOMAIR (p score = 0.6411) value controls than in other groups, while the curative effect of RT on FBG (p score = 0.8465) and HbA1c (p score = 0.8550) values were optimum. The rank of P-scores for each indicator under above two effect models was basically consistent, indicating that our results of network meta-analysis were stable. Conclusions: AET might be a better intervene method for improving insulin resistance to prediabetes, while RT was more effective than AET, AET+RT or CT for glycaemic control in prediabetes.

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