scholarly journals Safety and Effectiveness of Sodium–Glucose Cotransporter 2 Inhibitor Combined with Medical Nutrition Therapy for Hyperglycemia in Acute Stroke: A Retrospective Study

Metabolites ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 25
Author(s):  
Takahisa Mori ◽  
Kazuhiro Yoshioka ◽  
Yuhei Tanno ◽  
Shigen Kasakura
Keyword(s):  
Retrospective Study ◽  
Blood Glucose ◽  
Acute Stroke ◽  
Fasting Blood Glucose ◽  
Nutrition Therapy ◽  
Energy Restriction ◽  
Medical Nutrition Therapy ◽  
Stroke Patients ◽  
Sodium Glucose Cotransporter ◽  
Medical Nutrition

Background: Hyperglycemia, a predictor of poor clinical outcomes in acute stroke, must be lowered safely and promptly. We investigated the safety and effectiveness of sodium-glucose cotransporter 2 inhibitors (SGLT2is) combined with medical nutrition therapy in lowering blood glucose levels. Method: This retrospective study included stroke patients admitted between 2014 and 2019, who (1) had glycated hemoglobin ≥6.5%, blood glucose level ≥ 11.1 mmol/L at admission, (2) took their diet and drugs orally during hospitalization, (3) underwent SGLT2is pharmacotherapy after admission, and (4) underwent a fasting blood glucose (FBG) test on day 7. Patients were provided with a moderate-carbohydrate diet combined with total energy restriction. We assessed the achievement of FBG < 7 mmol/L on day 7 and the need for sulfonylurea or a long-acting insulin analog (LIA) treatment during hospitalization, which carries a risk of hypoglycemia. Results: Fifty-one patients met our inclusion criteria. Of them, 33 (64.7%) achieved the target FBG on day 7. Only eight patients were treated with a small dose of LIA; however, no patients required sulfonylurea. No dehydration occurred. Conclusion: SGLT2is combined with a moderate carbohydrate- and energy-restricted diet achieved the target FBG level safely, effectively, and promptly in mild stroke patients with oral ingestion.

Searching for Utopia, the Challenge of Standardized Medical Nutrition Therapy Prescription in Gestational Diabetes Mellitus Management: A Critical Review

2021 ◽  
Author(s):  
Nina Meloncelli ◽  
Shelley A. Wilkinson ◽  
Susan de Jersey
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Lifestyle Modification ◽  
Nutrition Therapy ◽  
Medical Nutrition Therapy ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Medical Nutrition

AbstractGestational diabetes mellitus (GDM) is a common pregnancy disorder and the incidence is increasing worldwide. GDM is associated with adverse maternal outcomes which may be reduced with proper management. Lifestyle modification in the form of medical nutrition therapy and physical activity, as well as self-monitoring of blood glucose levels, is the cornerstone of GDM management. Inevitably, the search for the “ultimate” diet prescription has been ongoing. Identifying the amount and type of carbohydrate to maintain blood glucose levels below targets while balancing the nutritional requirements of pregnancy and achieving gestational weight gain within recommendations is challenging. Recent developments in the area of the gut microbiota and its impact on glycemic response add another layer of complexity to the success of medical nutrition therapy. This review critically explores the challenges to dietary prescription for GDM and why utopia may never be found.

scholarly journals Influencing Factors of Knowledge, Attitude, and Practice regarding Medical Nutrition Therapy in Patients with Diabetes: A National Cross-Sectional Study in Urban China

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Zijian Li ◽  
Haimin Jin ◽  
Wei Chen ◽  
Zilin Sun ◽  
Lulu Jing ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Influencing Factors ◽  
Nutrition Therapy ◽  
Urban China ◽  
Postprandial Blood Glucose ◽  
Medical Nutrition Therapy ◽  
Attitude And Practice ◽  
Medical Nutrition ◽  
Knowledge Attitude And Practice ◽  
Diabetes Patients

To investigate the knowledge-attitude-practice (KAP) score in diabetes patients living in urban China regarding Medical Nutrition Therapy (MNT) and explore the influencing factors, this national survey recruited diabetes and prediabetes patients in 40 hospitals across 26 provinces in China. A self-designed questionnaire was used to collect the data and assess the knowledge, attitude, and practice regarding MNT. Logistic regression was used to explore the factor influencing KAP scores. A total of 6441 diabetes patients (mean age: 60.02±13.14 years) completed this survey. The mean glycosylated hemoglobin (HbA1c) level was 8.12±2.12%, and the control rate of HbA1c (HbA1c < 7.0%) was 38.92%. Of the total, 53.56% had received MNT education. Over half of the patients had a poor total KAP score as well as poor K, A, and P scores. Patients with higher KAP scores had higher control rate of HbA1c (P<0.05) but lower levels of fasting plasma glucose (FPG) and 2-hour postprandial blood glucose (2h-PG). Gender, occupation, residence, education level, and MNT education could influence the KAP scores (P<0.05). This study showed that diabetes patients in urban China generally had poor understandings and practices related to MNT. Patients with higher KAP scores exhibited better control of blood glucose.

scholarly journals Management of a Patient With Chylomicronemia Syndrome During Pregnancy With Medical Nutrition Therapy: a Case Report

2020 ◽  
Author(s):  
Maryam Zahedi ◽  
Golaleh Asghari ◽  
Parvin Mirmiran ◽  
Farhad Hosseinpanah
Keyword(s):  
Case Report ◽  
Blood Glucose ◽  
Necrotizing Pancreatitis ◽  
Nutrition Therapy ◽  
Elective Cesarean Section ◽  
Medical Nutrition Therapy ◽  
Omega 3 ◽  
Serum Triglycerides ◽  
History Of ◽  
Medical Nutrition

Abstract Background: Hypertriglyceridemia (HTG) during pregnancy may be accompanied by acute pancreatitis, hyperviscosity syndrome, and preeclampsia. HTG during pregnancy should be managed by a multidisciplinary team, however, no clinical guidelines exist for severe gestational HTG.Case presentation: We herein present a case of 36-year-old G1P0Ab0, with a history of severe HTG-induced necrotizing pancreatitis 9 years ago. There was no family history of HTG. During these years, she did not follow any appropriate diet or medical therapy for HTG. She became pregnant in May 2019, without preconception counseling. Eruptive and tuberoeruptive xanthomas appeared in 27th week of pregnancy. Serum triglycerides (TGs) and fasting blood sugar (FBS) were 6620 and 124 mg/dL, respectively. Showing HTG and gestational diabetes (GDM). After admission for management of severe HTG; she was put on parenteral nutrition with dextrose water 5% and infusion insulin therapy without receiving any enteral carbohydrate for two days. Following that, very low fat diet and omega-3 fatty acids (1200 mg/day) were stated. After 4 weeks, TG levels reached 1000 mg/dL and her self-monitoring blood glucose levels showed appropriate blood glucose for pregnancy. She underwent a successful elective cesarean section in 39th of pregnancy.Conclusion: This case report demonstrates that HTG during pregnancy could be well managed by medical nutrition therapy (MNT).

scholarly journals Case Report: Management of a Patient With Chylomicronemia Syndrome During Pregnancy With Medical Nutrition Therapy

2021 ◽  
Vol 8 ◽  
Author(s):  
Maryam Zahedi ◽  
Golaleh Asghari ◽  
Parvin Mirmiran ◽  
Farhad Hosseinpanah
Keyword(s):  
Case Report ◽  
Blood Glucose ◽  
Necrotizing Pancreatitis ◽  
Nutrition Therapy ◽  
Elective Cesarean Section ◽  
Medical Nutrition Therapy ◽  
Omega 3 ◽  
Serum Triglycerides ◽  
History Of ◽  
Medical Nutrition

Background: Hypertriglyceridemia (HTG) during pregnancy may be accompanied by acute pancreatitis, hyperviscosity syndrome, and preeclampsia. HTG during pregnancy should be managed by a multidisciplinary team; however, no clinical guidelines exist for severe gestational HTG.Case Presentation: We herein present a case of a 36-year-old in the first pregnancy (G1P0Ab0), with a history of severe HTG-induced necrotizing pancreatitis 9 years earlier. There was no family history of HTG. During these years, she did not follow any appropriate diet or medical therapy for HTG. She became pregnant in May 2019, without preconception counseling. Eruptive and tuberoeruptive xanthomas appeared in the 27th week of pregnancy. Serum triglycerides (TGs) and fasting blood sugar (FBS) were 6,620 and 124 mg/dL, respectively, indicating HTG and gestational diabetes (GDM). After admission for the management of severe HTG, she was put on parenteral nutrition with dextrose water 5% and infusion insulin therapy without receiving any enteral carbohydrate for 2 days. Following that, a very low-fat diet and omega-3 fatty acids (1,200 mg/day) were started. After 4 weeks, TG levels reached 1,000 mg/dL, and her self-monitoring blood glucose levels showed appropriate blood glucose for pregnancy. She underwent a successful elective cesarean section in the 39th of pregnancy.Conclusion: This case report demonstrates that HTG during pregnancy could be managed by medical nutrition therapy (MNT).

280-OR: Medical Nutrition Therapy and Glycemic Control in Youth-Onset Diabetes: SEARCH for Diabetes in Youth Study

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 280-OR
Author(s):  
KATHERINE A. SAUDER ◽  
JEANETTE M. STAFFORD ◽  
NATALIE S. THE ◽  
ELIZABETH J. MAYER-DAVIS ◽  
JOAN THOMAS ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Nutrition Therapy ◽  
Medical Nutrition Therapy ◽  
Onset Diabetes ◽  
Youth Study ◽  
Medical Nutrition ◽  
Diabetes In Youth

scholarly journals Effects of intermittent (5:2) or continuous energy restriction on basal and postprandial metabolism: a randomised study in normal-weight, young participants

2021 ◽  
Author(s):  
Yangfan Gao ◽  
Kostas Tsintzas ◽  
Ian A. Macdonald ◽  
Sally M. Cordon ◽  
Moira A. Taylor
Keyword(s):  
Blood Glucose ◽  
Serum Insulin ◽  
Fasting Blood Glucose ◽  
Normal Weight ◽  
Energy Restriction ◽  
Healthy Weight ◽  
Post Intervention ◽  
Postprandial Metabolism ◽  
Continuous Energy ◽  
Time Interaction

Abstract Background/objectives Intermittent energy restriction (IER) may overcome poor long-term adherence with continuous energy restriction (CER), for weight reduction. We compared the effects of IER with CER for fasting and postprandial metabolism and appetite in metabolically healthy participants, in whom excess weight would not confound intrinsic metabolic differences. Subjects/methods In a 2-week randomised, parallel trial, 16 young, healthy-weight participants were assigned to either CER (20% below estimated energy requirements (EER)) or 5:2 IER (70% below EER on 2 non-consecutive days; 5 days at EER, per week). Metabolic and appetite regulation markers were assessed before and for 3 h after a liquid breakfast; followed by an ad libitum lunch; pre- and post-intervention. Results Weight loss was similar in both groups: −2.5 (95% CI, −3.4, −1.6) kg for 5:2 IER vs. −2.3 (−2.9, −1.7) kg for CER. There were no differences between groups for postprandial incremental area under the curve for serum insulin, blood glucose or subjective appetite ratings. Compared with CER, 5:2 IER led to a reduction in fasting blood glucose concentrations (treatment-by-time interaction, P = 0.018, η2p = 0.14). Similarly, compared with CER, there were beneficial changes in fasting composite appetite scores after 5:2 IER (treatment-by-time interaction, P = 0.0003, η2p = 0.35). Conclusions There were no significant differences in postprandial insulinaemic, glycaemic or appetite responses between treatments. However, 5:2 IER resulted in greater improvements in fasting blood glucose, and beneficial changes in fasting subjective appetite ratings.

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