Effects of functional foods in diabetic patients: a systematic review

The control of Type II Diabetes Mellitus is directly related to the dietary profile, so an adequate diet for this group of patients must be implemented as soon as possible. But what foods can we use to facilitate glycemic and insulin control? Therefore, this study aims to systematically review the literature on the effects of functional foods in diabetic patients. Method: Systematic review of randomized clinical trials published between 2014 and 2021. Using as descriptors: Diabetes Mellitus Type 2 (Diabetes Mellitus Type 2), Functional Food. Results: Of the 566 articles found, 65 articles were selected, which passed the PEDro scale of methodological quality, and 11 articles were included. Of which they addressed different functional foods and their effects on different variables in diabetic patients. It can be concluded that several foods have beneficial effects on glycemic and insulin control in diabetic patients. Still, as a benefit, they had side effects in controlling dyslipidemia, blood pressure, and BMI.

The Intelligent Auto-Tuning Controller Design Based on Dolphin Echo Location for Blood Glucose Monitoring System

This paper presents an enhancement technique for tracking and regulating the blood glucose level for diabetic patients using an intelligent auto-tuning Proportional-Integral-Derivative PID controller. The proposed controller aims to generate the best insulin control action responsible for regulating the blood glucose level precisely, accurately, and quickly. The tuning control algorithm used the Dolphin Echolocation Optimization (DEO) algorithm for obtaining the near-optimal PID controller parameters with a proposed time domain specification performance index. The MATLAB simulation results for three different patients showed that the effectiveness and the robustness of the proposed control algorithm in terms of fast generating insulin control action and tracking the dynamics behavior of the blood glucose level of the diabetic patients through minimizing overshoot, rise time and settling time in the transient state as well as the steady-state blood glucose level error is reduced approximately to zero and keep it in the desired glucose level, especially when we added a meal as disturbance effect.

Effect of Afrezza on glucose dynamics during HCL treatment

<b>Objective: </b>A major obstacle in optimizing the performance of closed-loop (CL) automated insulin delivery systems has been the delay in insulin absorption and action that results from the subcutaneous (SC) route of insulin delivery leading to exaggerated post-meal hyperglycemic excursions. We aimed to investigate the effect of Afrezza inhaled insulin with ultrafast-in and out action profile on improving post-prandial blood glucose control during hybrid closed loop (HCL) treatment in young adults with type 1 diabetes. <p><b>Methods: </b>We conducted an inpatient, three-way, randomized crossover standardized meal study to assess the efficacy and safety of Afrezza at a low (A_L) and a high (<a>A_H</a>) dose as compared to a standard SC rapid-acting insulin (aspart) pre-meal bolus during Diabetes Assistant (DiAs) HCL treatment. Participants received two sequential meals on three study days, and pre-meal insulin bolus was determined based on home insulin to carbohydrate ratio for each meal (rounded up to the closest available Afrezza cartridge dose for A_Hand down for A_L). The primary efficacy outcome was the peak postprandial plasma glucose (PPG) level calculated by pooling data for up to four hours after the start of each meal. Secondary outcomes included hyperglycemic, hypoglycemic, and euglycemic venous glucose metrics. </p> <p><b>Results: </b>The mean PPG for the rapid acting insulin control arm and A_H were similar (185±50mg/dL vs. 195±46mg/dL, respectively; p=0.45), while it was higher for meals using A_L (208±54mg/dL, p=0.04). The A_H achieved significantly lower early PPG level than the control arm (30 min; p<0.001), and improvement in PPG waned at later time points (120 and 180 min; p=0.02) coinciding with the end of Afrezza glucodynamic action. </p> <p><b>Conclusions: </b>Afrezza (A_H) pre-meal bolus reduced the early glycemic excursion and improved PPG during HCL compared to aspart pre-meal bolus. The improvement in PPG was not sustained after the end of Afrezza glucodynamic action at 120min. </p>

Effect of Afrezza on glucose dynamics during HCL treatment

<b>Objective: </b>A major obstacle in optimizing the performance of closed-loop (CL) automated insulin delivery systems has been the delay in insulin absorption and action that results from the subcutaneous (SC) route of insulin delivery leading to exaggerated post-meal hyperglycemic excursions. We aimed to investigate the effect of Afrezza inhaled insulin with ultrafast-in and out action profile on improving post-prandial blood glucose control during hybrid closed loop (HCL) treatment in young adults with type 1 diabetes. <p><b>Methods: </b>We conducted an inpatient, three-way, randomized crossover standardized meal study to assess the efficacy and safety of Afrezza at a low (A_L) and a high (<a>A_H</a>) dose as compared to a standard SC rapid-acting insulin (aspart) pre-meal bolus during Diabetes Assistant (DiAs) HCL treatment. Participants received two sequential meals on three study days, and pre-meal insulin bolus was determined based on home insulin to carbohydrate ratio for each meal (rounded up to the closest available Afrezza cartridge dose for A_Hand down for A_L). The primary efficacy outcome was the peak postprandial plasma glucose (PPG) level calculated by pooling data for up to four hours after the start of each meal. Secondary outcomes included hyperglycemic, hypoglycemic, and euglycemic venous glucose metrics. </p> <p><b>Results: </b>The mean PPG for the rapid acting insulin control arm and A_H were similar (185±50mg/dL vs. 195±46mg/dL, respectively; p=0.45), while it was higher for meals using A_L (208±54mg/dL, p=0.04). The A_H achieved significantly lower early PPG level than the control arm (30 min; p<0.001), and improvement in PPG waned at later time points (120 and 180 min; p=0.02) coinciding with the end of Afrezza glucodynamic action. </p> <p><b>Conclusions: </b>Afrezza (A_H) pre-meal bolus reduced the early glycemic excursion and improved PPG during HCL compared to aspart pre-meal bolus. The improvement in PPG was not sustained after the end of Afrezza glucodynamic action at 120min. </p>

An introductory review of resistant starch type 2 from high-amylose cereal grains and its effect on glucose and insulin homeostasis

Refined carbohydrates result from milling techniques that remove the outer layers of a cereal grain and grind the endosperm into a flour ingredient that is devoid of dietary fiber. Technologies have been developed to produce high-amylose cereal grains that have a significantly higher resistant starch type 2 and thus dietary fiber content in the endosperm of the cereal grain, which has positive implications for human health. A review of the literature was conducted to study the effects of resistant starch type 2 derived from high-amylose grains on glucose and insulin response. While thousands of articles have been published on resistant starch, only 30 articles have focused on how resistant starch type 2 from high-amylose grains affects acute and long-term responses of glucose and insulin control. The findings showed that resistant starch has the ability to attenuate acute postprandial responses when replacing rapidly digestible carbohydrate sources, but there is insufficient evidence to conclude that resistant starch can improve insulin resistance and/or sensitivity.

How Charge and Triple Size-Selective Membrane Separation of Peptides from Salmon Protein Hydrolysate Orientate their Biological Response on Glucose Uptake

The valorization of by-products from natural organic sources is an international priority to respond to environmental and economic challenges. In this context, electrodialysis with filtration membrane (EDFM), a green and ultra-selective process, was used to separate peptides from salmon frame protein hydrolysate. For the first time, the simultaneous separation of peptides by three ultrafiltration membranes of different molecular-weight exclusion limits (50, 20, and 5 kDa) stacked in an electrodialysis system, allowed for the generation of specific cationic and anionic fractions with different molecular weight profiles and bioactivity responses. Significant decreases in peptide recovery, yield, and molecular weight (MW) range were observed in the recovery compartments depending on whether peptides had to cross one, two, or three ultrafiltration membranes. Moreover, the Cationic Recovery Compartment 1 fraction demonstrated the highest increase (42%) in glucose uptake on L6 muscle cells. While, in the anionic configuration, both Anionic Recovery Compartment 2 and Anionic Recovery Compartment 3 fractions presented a glucose uptake response in basal condition similar to the insulin control. Furthermore, Cationic Recovery Compartment 3 was found to contain inhibitory peptides. Finally, LC-MS analyses of the bioassay-guided bioactive fractions allowed us to identify 11 peptides from salmon by-products that are potentially responsible for the glucose uptake improvement.