scholarly journals Glycemic Response to Two Doses of Resistant Starch Type 4: A Randomized Controlled Crossover Trial (P08-091-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Trevor Steele ◽  
Clodualdo Maningat ◽  
Paul Seib ◽  
Mark Haub ◽  
Sara Rosenkranz
Keyword(s):  
Blood Glucose ◽  
Beneficial Effect ◽  
Resistant Starch ◽  
Crossover Trial ◽  
Glycemic Response ◽  
Postprandial Glycemia ◽  
Standard Testing ◽  
Dose Response Effect ◽  
Peak Blood ◽  
Peak Blood Glucose

Abstract Objectives Resistant starches (RS) have a beneficial effect on glucose and insulin responses in the postprandial period following carbohydrate (CHO) consumption. In comparison to resistant starch types 1–3, there is little evidence investigating the effects of resistant starch type 4 (RS4) on these metabolic responses. The primary aim of the current study was to determine whether the glycemic response to a nutritional RS4 bar (RS4) was different compared to a puffed wheat bar (PWB), provided at the standard testing amount of 50 g available CHO and a lower dose of 30 g available CHO, thereby investigating a dose-response effect. Methods Apparently healthy adults (n = 15; 26.1 ± 4.8yrs) participated in this controlled randomized crossover trial. All participants completed six trials: 50 g dextrose control drink (50DEX), 30 g dextrose control drink (30DEX); and nutrition bars containing: 50 g available CHO of PWB or RS4 (50PWB; 50RS4), and 30 g available CHO PWB or RS4 (30PWB; 30RS4). Participants fasted for 10–12 hrs prior to each visit with a minimum 72hr washout period between trials. Blood glucose was measured via LDX Cholestech at baseline and 10, 20, 30, 60, 90, and 120 min post consumption. Primary outcomes were determined using mixed-effects models in GraphPad Prism 8.0.1. Results Glucose incremental area under the curve (iAUC) was not significantly different between the 50 g conditions (P = 0.054). However, peak blood glucose was significantly lower in the 50RS4 condition compared to 50PWB and 50CON (P = 0.027; P = 0.004 respectively); and there was no difference between 50PWB and 50CON (P = 0.496). While 30RS4 and 30PWB glucose iAUCs were lower compared to 30CON (P = 0.002), there was no difference between 30RS4 and 30PWB (P = 0.48). Peak blood glucose was reduced for both 30PWB and 30RS4 when compared to 30CON (P = 0.005; P = 0.002 respectively), with no difference between 30 g CHO bars (P = 0.22). Conclusions These results indicate a potential dose-response effect for RS4 on postprandial glycemia. Specifically, at the 50 g available CHO standard testing amount, RS4 reduced peak blood glucose as compared to the 50PWB control. At the lower dose of available CHO, there was not a statistically significant beneficial effect for 30RS4 on postprandial glycemia. There may be a potential floor effect where RS4 has no further benefit when available CHO is low. Funding Sources MGP Ingredients Inc.

scholarly journals Swertiamarin Contributes to Glucose Homeostasis via Inhibition of Carbohydrate Metabolizing Enzymes

2017 ◽  
Vol 16 (4) ◽  
pp. 125 ◽  
Author(s):  
Javed Ahamad ◽  
Naila Hassan ◽  
Saima Amin ◽  
Showkat R. Mir
Keyword(s):  
Blood Glucose ◽  
Glucose Homeostasis ◽  
In Vivo Studies ◽  
Metabolizing Enzymes ◽  
Treatment Groups ◽  
Whole Plant ◽  
Peak Blood ◽  
Peak Blood Glucose

<strong>Objective:</strong> Swertiamarin is a common secoiridoid found among the members of Gentianaceae. The present study aimed to establish the effectiveness of swertiamarin in achieving glucose homeostasis via inhibition of carbohydrate metabolizing enzymes by in-vitro and in-vivo studies. <strong>Materials and methods:</strong> Swertiamarin was obtained from dried whole plant samples of <em>Enicostemma littorale</em> Blume chromatographic fractionation over the silica gel column. Its effect on carbohydrate metabolizing enzymes viz., α-amylase and α-glucosidase were evaluated at 0.15 to 10 mg/mL in-vitro. The results were supplemented by anti-hyperglycemic studies in carbohydrate challenged mice pretreated with swertiamarin at a dose of 20 mg/kg body weight orally. <strong>Results:</strong> Swertiamarin was effective in inhibiting α-amylase and α-glucosidase with IC<em>50</em> values of 1.29±0.25 mg/mL and 0.84±0.11 mg/mL, respectively. The studies in starch and sucrose challenged mice showed that swertiamarin effectively restricted the increase in the peak blood glucose level (BGL). The increase in peak BGL was 49 mg/dL and 57 mg/dL only in the treatment groups compared to 70 mg/dL and 80 mg/dL in untreated groups after 30 min in starch and sucrose-fed mice, respectively. Acarbose (10 mg/kg b.w.) also produced significant (p&lt;0.01) blood glucose lowering response in both the models. <strong>Conclusion:</strong> Swertiamarin was effective in the achieving stricter glycemic control in carbohydrate challenged mice through the inhibition of carbohydrate metabolizing enzymes.

Some Effects of Metabolic Acidosis on Carbohydrate Metabolism in the Rat

1970 ◽  
Vol 39 (3) ◽  
pp. 375-382 ◽  
Author(s):  
G. A. O. Alleyne ◽  
H. S. Fraser ◽  
H. S. Besterman
Keyword(s):  
Metabolic Acidosis ◽  
Blood Glucose ◽  
Muscle Glycogen ◽  
Fasting Blood Glucose ◽  
Liver Glycogen ◽  
Carbohydrate Diet ◽  
And Control ◽  
Peak Blood ◽  
Peak Blood Glucose

1. Metabolic acidosis was induced by feeding ammonium chloride to rats which were maintained on a carbohydrate diet for 48 h. 2. Fasting blood glucose was the same in acidotic and control animals, but there was an increase in liver glycogen in the former. Muscle glycogen was unchanged. 3. In vitro glycogenolysis was the same in liver slices from normal rats when incubated at a range of pH from 6·90 to 7·40. 4. The peak blood glucose in response to intraperitoneal injections of glucagon was the same in control and acidotic rats. The rate of disappearance of glucose was slower in acidotic rats both after the glucagon induced hyperglycaemia and after intravenously injected glucose. 5. Liver phosphorylase, total glycogen synthetase and the I form of this enzyme were unchanged in acidosis. 6. The data are compatible with the hypothesis that in the acidotic rat there is a block in glycolysis—possibly at the phosphofructokinase step.

scholarly journals Association of Hyperglycaemia with Outcome in Critically Ill Children in Central India - A Prospective Study

2021 ◽  
Vol 8 (13) ◽  
pp. 811-815
Author(s):  
Suman Sudha Tirkey ◽  
Rakesh Kumar Verma
Keyword(s):  
Intensive Care Unit ◽  
Blood Glucose ◽  
Critically Ill ◽  
Central India ◽  
Critically Ill Children ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Mean Blood Glucose ◽  
Peak Blood ◽  
Peak Blood Glucose

BACKGROUND Hyperglycaemia is a common occurrence in children with critical illness. Several studies relate hyperglycaemia occurring during intensive care unit (ICU) admission to be associated with increased mortality. We wanted to evaluate the incidence of hyperglycaemia and its association with mortality among critically ill children. METHODS A prospective observational study was conducted among critically ill children admitted to the Paediatric Intensive Care Unit (PICU) of a tertiary care centre, Raipur, Chhattisgarh in central India, from 1st May 2016 to 31st October 2016. All patients aged 1 month to 14 years who were admitted in PICU during this study period (N = 113) were included. Children who were known cases of diabetes mellitus, hepatic failure or renal failure requiring dialysis and children who left against medical advice (LAMA) or died within 24 hours of admission were excluded (N = 13). Thus 100 children were included in the study. RESULTS In the study population, incidence of hyperglycaemia was 60 %; overall 37 (37 %) died and the mortality rate was significantly higher (46.6 % vs. 19.4 %) in children with hyperglycaemia than in children without hyperglycaemia. Nonsurvivors had higher mean blood glucose levels at 48 hours (218.35 ± 87.42 mg / dL) than survivors (141.12 ± 55.26 mg / dL) (P < .001). Peak blood glucose (218.35 ± 87.42 mg / dL vs. 141.12 ± 55.26 mg / dL), need for mechanical ventilation (54.5 % vs. 27.3 %), need for inotropes (76.4 % vs. 23.5 %) and Paediatric Risk of Mortality Score (PRISM) III (16.25 ± 5.46 vs. 9.06 ± 4.35) were significantly higher in non-survivors than in survivors. On regression analysis, blood sugar at 24 hours and duration of stay were found to be significant. CONCLUSIONS In this study, in the PICU, the mortality rate was significantly higher in children with hyperglycaemia than in children without hyperglycaemia. Non-survivors had significantly higher mean blood glucose levels at 48 hours than survivors. Peak blood glucose, need for mechanical ventilation, need for inotropes and PRISM III scores were significantly higher in non-survivors than in survivors. KEYWORDS Hyperglycaemia, Critically Ill, PICU, Outcome, Mortality

scholarly journals Timing of Peak Blood Glucose after Breakfast Meals of Different Glycemic Index in Women with Gestational Diabetes

Nutrients ◽  
2012 ◽  
Vol 5 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Jimmy Louie ◽  
Tania Markovic ◽  
Glynis Ross ◽  
Deborah Foote ◽  
Jennie Brand-Miller
Keyword(s):  
Blood Glucose ◽  
Gestational Diabetes ◽  
Glycemic Index ◽  
Peak Blood ◽  
Peak Blood Glucose

scholarly journals Glycemic control is associated with lower odds of mortality and successful extubation in severe COVID-19

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jay M. Pescatore ◽  
Juan Sarmiento ◽  
Ruben A. Hernandez-Acosta ◽  
Britt Skaathun ◽  
Nancy Quesada-Rodriguez ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Patient Characteristics ◽  
Lower Blood Glucose ◽  
Lower Odds ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Lower Blood ◽  
Peak Blood ◽  
Peak Blood Glucose ◽  
Successful Extubation

Abstract Context Corticosteroids, specifically dexamethasone, have become the mainstay of treatment for moderate to severe COVID-19. Although the RECOVERY trial did not report adverse effects of corticosteroids, the METCOVID (Methylprednisolone as Adjunctive Therapy for Patients Hospitalized with COVID-19) study reported a higher blood glucose level in patients receiving methylprednisolone. Objectives This study aims to analyze the association between corticosteroids and COVID-19–related outcomes in patients admitted to the medical ICU (MICU) for COVID-19 pneumonia. Methods This is an observational study of 141 patients admitted to the MICU between March 18 and June 7, 2020. Data on demographics, laboratory and imaging studies, and clinical course were obtained, including data on corticosteroid use. Bivariate analyses and logistic regression were performed between patient characteristics and mortality and successful extubation. Results Of the 141 patients, 86 required mechanical ventilation, 50 received steroids, and 71 died. Regarding demographics, patients had a median age of 58 (interquartile range [IQR] 48, 65), Hispanic (57.4%, n=81), and non-Hispanic Black (37.5%, n=53). The most prevalent comorbidities were hypertension (49.6%, n=70) and diabetes (48.2%, n=68). Lower blood glucose levels on admission (125.5 vs. 148 mg/dL, p=0.025) and lower peak blood glucose levels on corticosteroids (215.5 vs. 361 mg/dL, p=0.0021) were associated with lower prevalence of mortality. Patients who were successfully extubated had a lower admission blood glucose (126.5 vs. 149 mg/dL, p=0.0074) and lower peak blood glucose on corticosteroids (217 vs. 361 mg/dL, p=0.0023). Conclusions Lower blood glucose on admission and lower maximum blood glucose on corticosteroids were associated with lower odds of mortality and successful extubation, regardless of preexisting diabetes. Hyperglycemia may be negating any potential benefit of corticosteroid therapy. These findings suggest that glucose control could be a parameter that impacts the outcome of patients receiving corticosteroids for COVID-19 pneumonia.

scholarly journals Whole Grains, Legumes, and the Subsequent Meal Effect: Implications for Blood Glucose Control and the Role of Fermentation

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Janine A. Higgins
Keyword(s):  
Blood Glucose ◽  
Resistant Starch ◽  
Glucose Control ◽  
Blood Glucose Control ◽  
Whole Grains ◽  
Diabetes Incidence ◽  
Whole Grain ◽  
Postprandial Glycemia ◽  
Meal Effect

Whole grains and legumes are known to reduce postprandial glycemia and, in some instances, insulinemia. However, the subsequent meal effect of ingesting whole grains and legumes is less well known. That is, inclusion of whole grains or legumes at breakfast decreases postprandial glycemia at lunch and/or dinner on the same day whereas consumption of a whole grain or lentil dinner reduces glycemia at breakfast the following morning. This effect is lost upon milling, processing, and cooking at high temperatures. The subsequent meal effect has important implications for the control of day-long blood glucose, and may be partly responsible for the reduction in diabetes incidence associated with increased whole grain and legume intake. This paper describes the subsequent meal effect and explores the role of acute glycemia, presence of resistant starch, and fermentation of indigestible carbohydrate as the mechanisms responsible for this effect.

scholarly journals Glycemic and Insulinemic Response to Two Doses of Resistant Starch Type 4: A Randomized Controlled Crossover Trial

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 664-664
Author(s):  
Trevor Steele ◽  
Clodualdo Maningat ◽  
Paul Seib ◽  
Mark Haub ◽  
Sara Rosenkranz
Keyword(s):  
Resistant Starch ◽  
Crossover Trial ◽  
Area Under The Curve ◽  
Healthy Adults ◽  
Standard Testing ◽  
Beneficial Effects ◽  
Randomized Controlled ◽  
Funding Sources ◽  
Insulinemic Response ◽  
Apparently Healthy

Abstract Objectives Resistant starches (RS) have beneficial effects on glucose and insulin responses in the postprandial period following carbohydrate (CHO) consumption. In comparison to resistant starch types 1–3, evidence regarding the effects of resistant starch type 4 (RS4) on metabolic responses is sparse. The primary aim of the current study was to determine whether the glycemic and insulinemic responses to a nutritional RS4 bar (RS4) were lower as compared to a puffed wheat bar (PWB), when provided at the standard testing amounts of 50 g available CHO, as well as at a lower dose of 30 g available CHO. Methods Apparently healthy adults (n = 15; 9 M/6F; 26.1 ± 4.8 yrs) participated in this randomized controlled crossover trial. All participants completed six sessions, consuming a dextrose beverage or nutrition bar at each session. Two doses of 50 g and 30 g of available CHO were tested using dextrose control beverages (50DEX; 30DEX), puffed wheat bars (50PWB; 30PWB) and RS4 bars (50RS4; 30RS4). Participants fasted for 10–12 hrs prior to each visit with a minimum 72hr washout between sessions. Whole blood glucose and plasma insulin were measured at baseline and 10, 20, 30, 60, 90, and 120 min post consumption. Primary outcomes were determined using mixed-effects models in GraphPad Prism 8.0.1. Results Glucose incremental area under the curve (iAUC) was not significantly different between the 50 g conditions (P = 0.054). Insulin iAUC was lower for the 50RS4 bar compared to the 50PWB (Mean ± SD; DEX: 3339 ± 2020, PWB: 3968 ± 2454, RS4: 2046 ± 928.7μIU/mL; P = 0.034), with no differences between 50PWB and 50DEX or 50RS4 and 50DEX (ps &gt; 0.05). Both 30 g bars had lower glucose iAUCs compared to 30DEX (ps &lt; 0.05), with no difference between bars (P &gt; 0.05). The 30RS4 bar elicited a lower insulin iAUC compared to 30PWB and 30DEX (DEX: 2400 ± 1689, PWB: 1855 ± 665.7, RS4: 1115 ± 832.2 μIU/mL; ps &lt; 0.05) with no difference between 30PWB and 30DEX (P &gt; 0.05). Conclusions Resistant starch type 4 elicited a reduced insulinemic response despite a similar glycemic response, at standard testing amounts of 50 g CHO, as compared to puffed wheat. This effect was also observed at the 30 g dose, thereby showing consistent results following consumption. Therefore, RS4 seems to improve insulin function in apparently healthy adults regardless of the amount of RS4 consumed. Funding Sources MGP Ingredient Inc.

scholarly journals Delayed timing of post-challenge peak blood glucose predicts declining beta cell function and worsening glucose tolerance over time: insight from the first year postpartum

Diabetologia ◽  
2015 ◽  
Vol 58 (6) ◽  
pp. 1354-1362 ◽  
Author(s):  
Caroline K. Kramer ◽  
Chang Ye ◽  
Anthony J. G. Hanley ◽  
Philip W. Connelly ◽  
Mathew Sermer ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glucose Tolerance ◽  
Beta Cell ◽  
Beta Cell Function ◽  
Cell Function ◽  
First Year ◽  
Post Challenge ◽  
Peak Blood ◽  
Peak Blood Glucose ◽  
Over Time

scholarly journals Association of increased morbidity with the occurrence of hyperglycemia in the immediate postoperative period after elective pediatric neurosurgery

2016 ◽  
Vol 17 (5) ◽  
pp. 625-629 ◽  
Author(s):  
Nazel Oliveira Filho ◽  
Rodrigo L. Alves ◽  
Adriano T. Fernandes ◽  
Fernanda S. P. Castro ◽  
José Roberto Tude Melo ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Pediatric Neurosurgery ◽  
Perioperative Period ◽  
Cns Tumors ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Peak Blood ◽  
Peak Blood Glucose

OBJECTIVE The acute elevation of blood glucose in perioperative pediatric patients subjected to cardiac surgery and in victims of head trauma is associated with higher rates of postoperative complications. Data on the occurrence of hyperglycemia and its association with unfavorable outcomes among patients who have undergone elective neurosurgery are scarce in the literature. This study aimed to determine whether the occurrence of hyperglycemia during the perioperative period of elective neurosurgery for the resection of tumors of the CNS in children is associated with increased morbidity. METHODS This retrospective cohort analysis included 105 children up to 12 years of age who underwent elective neurosurgery for resection of supratentorial and infratentorial CNS tumors between January 2005 and December 2010 at the São Rafael Hospital, a tertiary care medical center in Salvador, Brazil. Demographic data and intraoperative and postoperative information were collected from the medical records. Differences in blood glucose levels during the perioperative period were evaluated with nonparametric tests. RESULTS The patients who developed postoperative complications exhibited higher blood glucose levels on admission to the intensive care unit (ICU) (162.0 ± 35.8 mg/dl vs 146.3 ± 43.3 mg/dl; p = 0.016) and peak blood glucose levels on postoperative Day 1 (171.9 ± 30.2 mg/dl vs 156.1 ± 43.2 mg/dl; p = 0.008). Multivariate analysis showed that peak blood glucose levels on postoperative Day 1 were independently associated with a higher odds ratio for postoperative complication (OR 1.05). The occurrence of hyperglycemia (>150 mg/dl) upon admission to the ICU was associated with longer ICU (p = 0.003) and hospital (p = 0.001) stays. CONCLUSIONS The occurrence of hyperglycemia during the postoperative period after elective pediatric neurosurgery for the resection of CNS tumors was associated with longer hospital and ICU stays. Postoperative complications were associated with higher blood glucose levels upon admission to the ICU and higher peak blood glucose on the first postoperative day.

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