Personalized Postprandial Glucose Response–Targeting Diet Versus Mediterranean Diet for Glycemic Control in Prediabetes

OBJECTIVE To compare the clinical effects of a Personalized Postprandial-Targeting (PPT) diet vs a Mediterranean (MED) diet, on glycemic control and metabolic health in prediabetes. RESEARCH DESIGN AND METHODS We randomly assigned adults with prediabetes (n=225) to follow a MED diet or a PPT diet for a 6-month dietary intervention and additional 6-month follow-up. The PPT diet relies on a machine-learning algorithm that integrates clinical and microbiome features to predict personal postprandial-glucose-responses (PPGR). During the intervention, all participants were connected to continuous glucose monitoring (CGM) and self-reported dietary intake using a smartphone application. RESULTS Among 225 participants randomized (58.7% women; mean±SD age, 50±7 years; BMI, 31.3±5.8 kg/m2; HbA1c, 5.9±0.2% (41±2.4 mmol/mol); fasting plasma glucose 114±12mg/dl [6.33±0.67 mmol/L]), 200 (89%) completed the 6-month intervention. A total of 177 participants additionally contributed 12-month follow-up data. Both interventions reduced the daily time with glucose levels above 140 mg/dl (7.8 mmol/L) and HbA1c levels, but reductions were significantly greater in PPT compared to MED. The mean 6-month change in ‘time above 140 mg/dl (7.8 mmol/L)’ was -0.3±0.8 hour/day and -1.3±1.5 hour/day for MED and PPT, respectively (95% CI between-group difference, -1.29 to -0.66; p<0.001). The mean 6-month change in HbA1c was -0.08±0.19% (-0.9±2.1 mmol/mol) and -0.16±0.24% (-1.7±2.6 mmol/mol) for MED and PPT, respectively (95% CI between-group difference, -0.14 to -0.02; p=0.007). The significant between-group differences maintained at 12-month follow-up. No significant differences were noted between the groups in an oral glucose tolerance test (OGTT, CGM-measured). CONCLUSIONS In this clinical trial in prediabetes, a PPT diet improved glycemic control significantly more than a MED diet as measured by daily time of glucose levels above 140 mg/dl (7.8 mmol/L) and HbA1c. These findings may have implications to dietary advice in clinical practice.

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TOLTERODINE IMPROVES QUALITY OF LIFE IN PATIENTS WITH AN OVERACTIVE BLADDER, WITH OR WITHOUT URINARY INCONTINENCE: A PROSPECTIVE MULTICENTER STUDY

Urogynaecologia ◽

10.4081/uij.2008.1.5 ◽

2010 ◽

Vol 22 (1) ◽

pp. 5

Author(s):

F. Mantovani ◽

G. Bozzini ◽

P. Acquati ◽

S.S. Di Pierro ◽

M.G. Spinelli ◽

...

Keyword(s):

Quality Of Life ◽

Overactive Bladder ◽

Clinical Effects ◽

Health Questionnaire ◽

Prospective Multicenter Study ◽

Study Materials ◽

Trial Entry ◽

The Mean

AIMS: In order to analyse the effect of tolterodine on the Quality of life (QoL) of patients with overactive bladder (OB) we conducted a prospective multicentre clinical study. MATERIALS AND METHODS: Subjects were questioned at entry and 4, 12 and 24 weeks later about the number of micturitions and incontinent and urgency episodes/day, using a micturition diary. The mean volume voided per micturition and the number of pads used per day was also recorded. The QoL was measured using the Kings Health Questionnaire (KHQ) and the Incontinence Impact Questionnaire (IIQ). A total of 179 patients entered the study: 59 dropped out (4 due to lack of efficacy, 10 due to adverse events, 25 because of lack of interest in the study/other reason and 20 were lost at follow up), leaving 120 patients for analysis. One hundred and eight patients (90%) were female, their mean age was 56.5 years (SD 11.2); 87 had never received treatment for OB/UI (80.6%) and their mean weight was 70.0 Kg (SD 12.7). RESULTS: The mean number of micturitions/day was 9.3 at trial entry and it decreased to 6.8 by the end of the study. The corresponding values for the number of urge episodes, incontinence episodes and number of pads used per day were 3.5, 2.7 and 1.2 and 0.8, 0.9 and 0.4 respectively. The mean volume voided per micturition increased from 146 ml. to 178 ml. All the differences between trial entry and end of study values were statistically significant (p<0.05). Considering the results of the KHQ, the values of all the different areas/domini (?) decreased markedly and in a statistically significant way between the start of treatment and the end of study evaluations. Similar findings emerged when we considered values of the IIQ. The decrease was constant and marked during the first three months and remained constant thereafter. CONCLUSIONS: This study, conducted in a population of subjects with dry and wet OB, shows that tolterodine given for six months lowers the frequency of urgency episodes and incontinence episodes without troublesome adverse effects. These clinical effects are mirrored in the QoL, KHQ and IIQ questionnaire scores, which improved by about 50% over the same period.

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Glucose levels during gestational diabetes pregnancy and the risk of developing postpartum diabetes or prediabetes

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04352-w ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Chadakarn Phaloprakarn ◽

Siriwan Tangjitgamol

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Glycemic Control ◽

Gestational Diabetes ◽

Confidence Interval ◽

Control Group ◽

Oral Glucose ◽

Glucose Levels ◽

Blood Glucose Levels ◽

The Impact

Abstract Background Blood glucose levels during pregnancy may reflect the severity of insulin secretory defects and/or insulin resistance during gestational diabetes mellitus (GDM) pregnancy. We hypothesized that suboptimal glycemic control in women with GDM could increase the risk of postpartum type 2 diabetes mellitus (T2DM) or prediabetes. Our objective was to evaluate the impact of plasma glucose levels throughout GDM pregnancy on the risk of postpartum T2DM or prediabetes. Methods The medical records of 706 women with GDM who underwent a postpartum 75-g, 2-hour oral glucose tolerance test at our institution between January 2011 and December 2018 were reviewed. These women were classified into 2 groups according to glycemic control during pregnancy: ≤ 1 occasion of either fasting glucose ≥ 95 mg/dL or 2-hour postprandial glucose ≥ 120 mg/dL was defined as optimal glycemic control or else was classified as suboptimal glycemic control. Rates of postpartum T2DM and prediabetes were compared between women with optimal (n = 505) and suboptimal (n = 201) glycemic control. Results The rates of postpartum T2DM and prediabetes were significantly higher in the suboptimal glycemic control group than in the optimal glycemic control group: 22.4% vs. 3.0%, P < 0.001 for T2DM and 45.3% vs. 23.5%, P < 0.001 for prediabetes. In a multivariate analysis, suboptimal glucose control during pregnancy was an independent risk factor for developing either postpartum T2DM or prediabetes. The adjusted odds ratios were 8.4 (95% confidence interval, 3.5–20.3) for T2DM and 3.9 (95% confidence interval, 2.5–6.1) for prediabetes. Conclusion Our findings suggest that blood glucose levels during GDM pregnancy have an impact on the risk of postpartum T2DM and prediabetes.

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A Novel Earwax Method to Measure Acute and Chronic Glucose Levels

Diagnostics ◽

10.3390/diagnostics10121069 ◽

2020 ◽

Vol 10 (12) ◽

pp. 1069

Author(s):

Andrés Herane-Vives ◽

Susana Espinoza ◽

Rodrigo Sandoval ◽

Lorena Ortega ◽

Luis Alameda ◽

...

Keyword(s):

Postprandial Glucose ◽

The Novel ◽

Sampling Device ◽

Clinical Method ◽

Postprandial Glycemia ◽

Novel Device ◽

Glucose Levels ◽

Standard Serum

Diabetes is the fourth cause of death globally. To date, there is not a practical, as well as an accurate sample for reflecting chronic glucose levels. We measured earwax glucose in 37 controls. Participants provided standard serum, glycated hemoglobin (HbA1c) and earwax samples at two time-points, one month apart. The specimens measured baseline fasting glucose, a follow-up postprandial glucose level and a between sample chronic glucose, calculated using the average level on the two occasions. The baseline earwax sample was obtained using a clinical method and the follow-up using a novel self-sampling earwax device. The earwax analytic time was significantly faster using the novel device, in comparison to the clinical use of the syringe. Earwax accurately reflected glucose at both assessments with stronger correlations than HbA1c. Follow-up postprandial concentrations were more significant than their respective fasting baseline concentrations, reflecting differences in fasting and postprandial glycemia and more efficient standardization at follow up. Earwax demonstrated to be more predictable than HbA1c in reflecting systemic fasting, postprandial and long-term glucose levels, and to be less influenced by confounders. Earwax glucose measurements were approximately 60% more predictable than HbA1c in reflecting glycemia over a month. The self-sampling device provided a sample that might accurately reflect chronic glycemia.

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Effects of dietary fiber on postprandial glucose in healthy adults

Mediscope ◽

10.3329/mediscope.v6i1.38940 ◽

2018 ◽

Vol 6 (1) ◽

pp. 25-29

Author(s):

F Yesmin ◽

MOI Ali ◽

MMR Sardar ◽

MK Munna ◽

S Baksh

Keyword(s):

Dietary Fiber ◽

Blood Sugar ◽

Postprandial Glucose ◽

Water Soluble ◽

Controlled Clinical Trial ◽

Oral Glucose ◽

Soluble Dietary Fiber ◽

Medical College ◽

Randomized Controlled ◽

The Mean

Frequently and persistently raised glucose level causes numerous complications. So it is important to find out a component of diet that can improve glucose homeostasis after ingestion of food without causing any side effect or complication. The aim of this randomized controlled clinical trial study was to verify the effect of dietary fiber on postprandial blood sugar (PPBS). The study was carried out in a sample of fifty healthy adult subjects at the Department Physiology of Rajshahi Medical College during the period from January 2014 to December 2014. Fasting blood sugar of the subjects was estimated before ingestion of identical glucose drink with or without dietary fiber (ispaghula husk) and PPBS was measured at 30, 60 and 120 min after the drink. The mean plasma glucose concentrations after a 50 gm oral glucose load significantly (p < 0.05, p < 0.001) decreased at 30, 60 and 120 min in both condition with dietary fiber and without dietary fiber. The mean plasma postprandial glucose concentration in condition with dietary fiber was significantly (p < 0.001) lower than the corresponding value without dietary fiber. The study suggests that ingestion of water soluble dietary fiber along with glucose drink reduces sharp rise as well as sustained rise of postprandial glucose. Mediscope Vol. 6, No. 1: Jan 2019, Page 25-29

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Effect of Cinnamon Tea on Postprandial Glucose Concentration

Journal of Diabetes Research ◽

10.1155/2015/913651 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 13

Author(s):

Maria Alexandra Bernardo ◽

Maria Leonor Silva ◽

Elisabeth Santos ◽

Margarida Maria Moncada ◽

José Brito ◽

...

Keyword(s):

Blood Glucose ◽

Glucose Concentration ◽

Postprandial Glucose ◽

Tolerance Test ◽

Oral Glucose ◽

High Blood Glucose ◽

Postprandial Period ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Oxidative Stress Status

Glycaemic control, in particular at postprandial period, has a key role in prevention of different diseases, including diabetes and cardiovascular events. Previous studies suggest that postprandial high blood glucose levels (BGL) can lead to an oxidative stress status, which is associated with metabolic alterations. Cinnamon powder has demonstrated a beneficial effect on postprandial glucose homeostasis in animals and human models. The purpose of this study is to investigate the effect of cinnamon tea (C. burmannii) on postprandial capillary blood glucose level on nondiabetic adults. Participants were given oral glucose tolerance test either with or without cinnamon tea in a randomized clinical trial. The data revealed that cinnamon tea administration slightly decreased postprandial BGL. Cinnamon tea ingestion also results in a significantly lower postprandial maximum glucose concentration and variation of maximum glucose concentration (p< 0.05). Chemical analysis showed that cinnamon tea has a high antioxidant capacity, which may be due to its polyphenol content. The present study provides evidence that cinnamon tea, obtained fromC. burmannii, could be beneficial for controlling glucose metabolism in nondiabetic adults during postprandial period.

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A Novel Earwax Method to Measure Acute and Chronic Glucose Levels

10.20944/preprints202010.0302.v1 ◽

2020 ◽

Author(s):

Andres Herane-Vives ◽

Susana Espinoza ◽

Rodrigo Sandoval ◽

Lorena Ortega ◽

Luis Alameda ◽

...

Keyword(s):

Glycated Haemoglobin ◽

Postprandial Glucose ◽

The Novel ◽

Serum Samples ◽

Sampling Device ◽

Clinical Method ◽

Novel Device ◽

Glucose Levels ◽

Standard Serum

Increased chronic glucose is associated with pandemic diseases. To date, there is not a practical, as well as accurate sample for reflecting that level. We measured earwax glucose in 37 controls. They provided standard serum samples, Glycated Haemoglobin (HbA1c) and earwax samples on two time-points, one month a part. The specimens measured baseline fasting glucose, a follow-up postprandial glucose level and a between sample chronic glucose, calculated using the average level on the two occasions. The baseline earwax sample was obtained using a clinical method and the follow-up using a novel self-sampling earwax device. The earwax analytic time was significantly faster using the novel device in comparison to the clinical use of the syringe. Earwax accurately reflected glucose at both assessments with stronger correlations than HbA1c. Follow-up postprandial concentrations were more significant than their respective fasting baseline concentrations, reflecting differences in fasting and postprandial glycaemia and more efficient standardisation at follow up. Earwax demonstrated to be more predictable than HbA1c in reflecting systemic fasting, postprandial and long-term glucose levels and immune by confounders. Earwax glucose was approximately 60% more predictable than HbA1c in reflecting glycaemia over a month. The self-sampling device provided a sample that might accurately reflect chronic glycaemia.

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Can the outcome of an impaired oral glucose absorption test in horses be improved with fat supplementation and dietary modifications?

Veterinary Record Case Reports ◽

10.1136/vetreccr-2019-000844 ◽

2019 ◽

Vol 7 (3) ◽

pp. e000844

Author(s):

NIcolas Cayetano Galinelli ◽

Wendy Wambacq ◽

Laurence Lefère ◽

Ellen Paulussen ◽

Myriam Hesta

Keyword(s):

Corticosteroid Treatment ◽

Tolerance Test ◽

Glucose Absorption ◽

Malabsorption Syndrome ◽

Dietary Advice ◽

Oral Glucose ◽

Valuable Adjunct ◽

Dietary Modifications ◽

Horse Owners

Malabsorption syndrome results in impaired nutrient digestion/absorption. Diagnostic tests in horses are focused on reduced carbohydrate absorption demonstrated by abnormal oral glucose tolerance test. However, to determine the definitive diagnosis a biopsy should be performed. The objective was to evaluate the progress of horses believed to be suffering from malabsorption syndrome without other infectious conditions, following institution of appropriate dietary advice. Medical records of 15 horses admitted to the equine hospital of Ghent University (2014–2017) were reviewed. All horses had received corticosteroid treatment and individual dietary advice. All horse owners were contacted in 2017 for a follow-up. Most horses (86 per cent) had tolerated the recommended diets well and gained weight. Owners noticed the greatest improvements at three and six months after starting the diet. Adequate dietary formulation may therefore be a valuable adjunct to medical treatment. However, it may take several months before increases in bodyweight and condition are seen.

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Association Between Plasma Irisin in Mid-Pregnancy and Postpartum Glucose Levels Among Chinese Women

Current Developments in Nutrition ◽

10.1093/cdn/nzaa054_158 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1086-1086

Author(s):

Nu Tang ◽

Yajun Chen ◽

Weijia Wu ◽

Jingshu Zhang ◽

Kaiyun Tan ◽

...

Keyword(s):

Glucose Tolerance ◽

Quantile Regression ◽

Chinese Women ◽

Fasting Blood Glucose ◽

Postprandial Glucose ◽

Tolerance Test ◽

Oral Glucose ◽

Glucose Levels ◽

Modifiable Factors ◽

Pregnancy And Postpartum

Abstract Objectives The association between plasma irisin and glucose levels in general population was controversial and few researches longitudinally explored this correlation. We aimed to examine whether mid-pregnancy irisin was associated with postpartum glucose among Chinese women and explore the potential modifiable factors. Methods We conducted a prospective cohort study in Guangzhou, China during 2017–2018 and 453 pregnant women (20–28 weeks) were enrolled. At 6–8 weeks after birth, 94 women with gestational diabetes mellitus (GDM) underwent a 75 g oral glucose tolerance test, and the other 359 women had a fasting blood glucose (FBG) test. Multivariable linear regression, quantile regression, and logistic regression analysis were conducted. Results Mean baseline plasma irisin was 13.73 ng/ml. The prevalence of postpartum impaired fasting glucose (IFG) was 14.35% in all participants. Among women with previous GDM, 23 (24.47%) had impaired glucose tolerance (IGT). We found a significantly negative association between mid-pregnancy irisin and postpartum FBG (β: −0.056 ± 0.024). While quantile regression showed the associations were only significant in high percentiles of FBG (P50 to P95), and the magnitude displayed an increasing trend. In addition, higher baseline irisin was associated with lower risk of postpartum IFG (RR, 0.563; CI, 0.384–0.825). Furthermore, we detected significant interactions between irisin and breastfeeding on FBG and IFG (both Pinteraction < 0.05). But baseline irisin was not significantly associated with postpartum postprandial glucose levels or the risk of IGT in women with GDM. Conclusions Plasma irisin levels during mid-pregnancy were negatively associated with FBG and IFG at 6–8 weeks postpartum among Chinese women, and stronger associations in women with higher FBG values were observed. Moreover, breastfeeding may modify this relationship. Funding Sources This work was supported by the National Natural Science Foundation of China (81,602,862) and the Sanming Project of Medicine in Shenzhen (SZSM201803061).

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Exercise and Glycemic Control in Diabetes: Benefits, Challenges, and Adjustments to Pharmacotherapy

Physical Therapy ◽

10.2522/ptj.20080114 ◽

2008 ◽

Vol 88 (11) ◽

pp. 1297-1321 ◽

Cited By ~ 50

Author(s):

Eric Arthur Gulve

Keyword(s):

Glycemic Control ◽

Aerobic Exercise ◽

Dietary Intervention ◽

Moderate Intensity ◽

Independent Manner ◽

Glucose Lowering ◽

Beneficial Effects ◽

Glucose Levels ◽

First Line Therapy ◽

Patients With Diabetes

Exercise, along with dietary intervention, represents first-line therapy for diabetes mellitus. Aerobic exercise is recommended for its beneficial effects on glucose control as well as its abilities to retard the progression of other comorbidities common in patients with diabetes, such as cardiovascular disease. The capability of aerobic exercise to improve glycemic control in diabetes is well documented, although adherence to exercise regimens is problematic. More recently, the glucose-lowering effects of resistance training have also been documented; this form of exercise has additional benefits, such as the capability to counteract sarcopenia, which is common in older people with type 2 diabetes. Exercise in people with diabetes, however, also can present significant challenges to glycemic control. Excessive glucose lowering can occur under certain conditions, enhancing the threat of hypoglycemia; in other situations, hyperglycemia can be accentuated. An understanding of the interactions between specific antidiabetic medications and various forms and intensities of exercise is essential to optimizing glycemic control while minimizing the potential for acute derangements in plasma glucose levels. Exogenous forms of insulin and agents that stimulate insulin secretion in a glucose-independent manner (such as sulfonylureas and glinides) increase the propensity for hypoglycemia during low- to moderate-intensity aerobic exercise. In contrast, exercise protocols characterized by high intensity are more likely to result in episodes of hyperglycemia. Strategies to minimize inappropriate swings in glycemic control are reviewed.

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The Use of 1.5-Anhydroglucitol for Monitoring Glycemic Control in Islet Transplant Recipients

Cell Transplantation ◽

10.3727/096368913x669734 ◽

2014 ◽

Vol 23 (10) ◽

pp. 1213-1219 ◽

Cited By ~ 3

Author(s):

Eduardo Moraes Leao Peixoto ◽

Nujen Colak Bozkurt ◽

Shari Messinger ◽

Maria Isabel Del Olmo García ◽

Vincenzo Lauriola ◽

...

Keyword(s):

Glycemic Control ◽

Glucose Variability ◽

Postprandial Glucose ◽

Cell Transplant ◽

Self Monitoring ◽

Glucose Levels ◽

Unit Increase ◽

Capillary Glucose ◽

Type 1 Dm

We evaluated whether 1,5-anhydroglucitol (1,5-AG) (GlycoMark®), a test for measuring postprandial glucose and glucose variability, could be a tool for assessing short-term glycemic control in islet cell transplant (ICT) subjects. Data of 21 subjects, with type 1 DM and allogenic islet transplantation, who had concomitant fructosamine, HbA1c, 1,5-AG ( n = 85 samples), and capillary glucose self-monitoring measurements ( n = 2,979) were analyzed retrospectively at different time points after ICT. A significant negative association was observed between 1,5-AG and HbA1c ( p = 0.02), but not with fructosamine. When HbA1c was divided in quartiles as <5.6, 5.6–5.9, 5.9–6.2, and >6.2, a decrease of an estimated 0.70 ± 0.30 μg/ml in 1,5-AG was associated with each quartile of increase in HbA1c ( p < 0.0001). There was a significant decline of 1.64 ± 0.3mg/dl in postprandial glucose values for each 1 unit increase in 1,5-AG ( p < 0.0001). For those with HbA1c ≥ 6.0% when 1,5-AG was ≥8.15 μg/ml, the mean estimated glucose level was 103.71 ± 3.66 mg/dl, whereas it was 132.12 ± 3.71 mg/ dl when 1,5-AG was <8.15 μg/ml. The glucose variability (Glumax - Glumin) in subjects with 1,5-AG <8.15 μg/ml was 46.23 mg/dl greater than the subjects with 1,5-AG ≥8.15 μg/ml (HbA1c ≥ 6.0%). There was no significant association between GlycoMark and glucose variability where HbA1c < 6%. 1,5-AG significantly associated with postprandial glucose levels and glucose variability in ICT recipients with near-normal HbA1c (6.0–6.5%) levels. These findings suggest that 1,5-AG can be used to differentiate those ICT subjects with higher glucose variability despite having near-normal HbA1c. However, prospective studies are needed to evaluate the association between GlycoMark levels and the parameters of graft dysfunction/failure.

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