Resistant Starch Consumption Effects on Glycemic Control and Glycemic Variability in Patients with Type 2 Diabetes: A Randomized Crossover Study

We previously observed beneficial effects of native banana starch (NBS) with a high resistant starch (RS) content on glycemic response in lean and obese participants. Here, we aimed to determine the effects of NBS and high-amylose maize starch (HMS) on glycemic control (GC) and glycemic variability (GV) in patients with type 2 diabetes (T2D) when treatments were matched for digestible starch content. In a randomized, crossover study, continuous glucose monitoring (CGM) was performed in 17 participants (aged 28–65 years, BMI ≥ 25 kg/m2, both genders) consuming HMS, NBS, or digestible maize starch (DMS) for 4 days. HMS and NBS induced an increase in 24 h mean blood glucose during days 2 to 4 (p < 0.05). CONGA, GRADE, and J-index values were higher in HMS compared with DMS only at day 4 (p < 0.05). Yet, NBS intake provoked a reduction in fasting glycemia changes from baseline compared with DMS (p = 0.0074). In conclusion, under the experimental conditions, RS from two sources did not improve GC or GV. Future longer studies are needed to determine whether these findings were affected by a different baseline microbiota or other environmental factors.

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755-P: A Plant-Based Meal Stimulates Incretin and Insulin Secretion More than an Energy- and Macronutrient-Matched Standard Meal in Type 2 Diabetes: A Randomized Crossover Study

Diabetes ◽

10.2337/db19-755-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 755-P

Author(s):

HANA KAHLEOVA ◽

ANDREA TURA ◽

MARTA KLEMENTOVA ◽

LENKA BELINOVA ◽

MARTIN HALUZIK ◽

...

Keyword(s):

Type 2 Diabetes ◽

Insulin Secretion ◽

Crossover Study ◽

Standard Meal ◽

Randomized Crossover Study

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The Impact of Glycemic Control on Retinal Photoreceptor Layers and Retinal Pigment Epithelium in Patients With Type 2 Diabetes Without Diabetic Retinopathy: A Follow-Up Study

Frontiers in Endocrinology ◽

10.3389/fendo.2021.614161 ◽

2021 ◽

Vol 12 ◽

Author(s):

Fukashi Ishibashi ◽

Aiko Kosaka ◽

Mitra Tavakoli

Keyword(s):

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

Retinal Pigment Epithelium ◽

Glycemic Control ◽

Pigment Epithelium ◽

Outer Nuclear Layer ◽

Retinal Pigment ◽

Glycemic Variability ◽

Hba1c Levels

AimsTo establish the sequential changes by glycemic control in the mean thickness, volume and reflectance of the macular photoreceptor layers (MPRLs) and retinal pigment epithelium in patients with type 2 diabetes without diabetic retinopathy.MethodsThirty-one poorly controlled (HbA1c > 8.0%) patients with type 2 diabetes without diabetic retinopathy undergoing glycemic control and 39 control subjects with normal HbA1c levels (< 5.9%) underwent periodical full medical, neurological and ophthalmological examinations over 2 years. Glycemic variability was evaluated by standard deviation and coefficient of variation of monthly measured HbA1c levels and casual plasma glucose. 3D swept source-optical coherence tomography (OCT) and OCT-Explorer-generated enface thickness, volume and reflectance images for 9 subfields defined by Early Treatment Diabetic Retinopathy Study of 4 MPRLs {outer nuclear layer, ellipsoid zone, photoreceptor outer segment (PROS) and interdigitation zone} and retinal pigment epithelium were acquired every 3 months.ResultsGlycemic control sequentially restored the thickness and volume at 6, 4 and 5 subfields of outer nuclear layer, ellipsoid zone and PROS, respectively. The thickness and volume of outer nuclear layer were restored related to the decrease in HbA1c and casual plasma glucose levels, but not related to glycemic variability and neurological tests. The reflectance of MPRLs and retinal pigment epithelium in patients was marginally weaker than controls, and further decreased at 6 or 15 months during glycemic control. The reduction at 6 months coincided with high HbA1c levels.ConclusionGlycemic control sequentially restored the some MPRL thickness, especially of outer nuclear layer. In contrast, high glucose during glycemic control decreased reflectance and may lead to the development of diabetic retinopathy induced by glycemic control. The repeated OCT examinations can clarify the benefit and hazard of glycemic control to the diabetic retinopathy.

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Which is better, high‐dose metformin monotherapy or low‐dose metformin/linagliptin combination therapy, in improving glycemic variability in type 2 diabetes patients with insufficient glycemic control despite low‐dose metformin monotherapy? A randomized, cross‐over, continuous glucose monitoring‐based pilot study

Journal of Diabetes Investigation ◽

10.1111/jdi.12922 ◽

2018 ◽

Vol 10 (3) ◽

pp. 714-722 ◽

Cited By ~ 3

Author(s):

Hiroshi Takahashi ◽

Rimei Nishimura ◽

Daisuke Tsujino ◽

Kazunori Utsunomiya

Keyword(s):

Type 2 Diabetes ◽

Pilot Study ◽

Glycemic Control ◽

Combination Therapy ◽

Low Dose ◽

Glucose Monitoring ◽

Glycemic Variability ◽

High Dose ◽

Metformin Monotherapy

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Review for "Nasal Glucagon as a Viable Alternative to Treat Insulin‐induced Hypoglycemia in Japanese Patients with Type 1 and Type 2 Diabetes: A Phase 3 Randomized Crossover Study"

10.1111/dom.14019/v2/review1 ◽

2020 ◽

Keyword(s):

Type 2 Diabetes ◽

Crossover Study ◽

Japanese Patients ◽

Viable Alternative ◽

Phase 3 ◽

Randomized Crossover Study

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Decision letter for "Nasal Glucagon as a Viable Alternative to Treat Insulin‐induced Hypoglycemia in Japanese Patients with Type 1 and Type 2 Diabetes: A Phase 3 Randomized Crossover Study"

10.1111/dom.14019/v1/decision1 ◽

2019 ◽

Keyword(s):

Type 2 Diabetes ◽

Crossover Study ◽

Japanese Patients ◽

Viable Alternative ◽

Phase 3 ◽

Randomized Crossover Study

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Effectiveness of Dose Adjustment of Insulin in Type 2 Diabetes among Hemodialysis Patients with End-Stage Renal Disease: A Randomized Crossover Study

Journal of Diabetes Research ◽

10.1155/2019/6923543 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Amol Singhsakul ◽

Ouppatham Supasyndh ◽

Bancha Satirapoj

Keyword(s):

Type 2 Diabetes ◽

Renal Disease ◽

Crossover Study ◽

End Stage Renal Disease ◽

Hemodialysis Patients ◽

Insulin Group ◽

Stage Renal Disease ◽

End Stage ◽

Randomized Crossover Study

Determining insulin requirements for hemodialysis patients with end-stage renal disease (ESRD) is difficult. We performed a randomized crossover study among type 2 diabetes (T2DM) patients with ESRD on continuous hemodialysis and receiving standard insulin for glycemic control. The patients were randomized in 2 groups: daily insulin needed on the day after hemodialysis and a 25% decrease in daily insulin needed on the day after hemodialysis. A total of 51 T2DM patients with ESRD were enrolled. The adjusted-insulin group had higher plasma glucose levels at the 2nd hour of dialysis than those of the nonadjusted-insulin group. Incidence of hypoglycemia per dialysis session (3.3% vs. 0.7%, P=0.02) and symptoms related to hypoglycemia (6.9% vs. 0.7%, P=0.001) were more frequent in the nonadjusted-insulin group. A reduced insulin administration of 25% among T2DM patients undergoing hemodialysis on the day of dialysis was associated with sustained glycemic efficacy and the production of fewer hypoglycemic symptoms. This trial is registered with TCTR20180724002.

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