Low-Glycemic Index Diets as an Intervention in Metabolic Diseases: A Systematic Review and Meta-Analysis

We aimed to investigate the effects of a low-glycemic index (GI) diet on the body mass and blood glucose of patients with four common metabolic diseases by conducting a systematic review and meta-analysis of studies comparing a low-GI diet (LGID) and other types of diet. Search terms relating to population, intervention, comparator, outcomes, and study design were used to search three databases: PubMed, Embase, and the Cochrane Library. We identified 24 studies involving 2002 participants. Random-effects models were used for 16 studies in the meta-analysis and stratified analyses were performed according to the duration of the intervention. The systematic review showed that LGIDs slightly reduced body mass and body mass index (BMI) (p < 0.05). BMI improved more substantially after interventions of >24 weeks and there was no inter-study heterogeneity (I2 = 0%, p = 0.48; mean difference (MD) = −2.02, 95% confidence interval (CI): −3.05, −0.98). Overall, an LGID had superior effects to a control diet on fasting blood glucose (FBG) and glycosylated hemoglobin. When the intervention exceeded 30 days, an LGID reduced FBG more substantially (MD = −0.34, 95% CI: −0.55, −0.12). Thus, for patients with metabolic diseases, an LGID is more effective at controlling body mass and blood glucose than a high-GI or other diet.

Lipocalin, Resistin and Gut Microbiota-Derived Propionate Could Be Used to Predict Metabolic Bariatric Surgery Selected Outcomes

Many patients with clinically severe obesity (CSO) need to undergo bariatric surgery, with possible side effects, so individualized predictive methods are required. Adipocytokines and gut/intestinal microbiota-derived metabolites could be predictive biomarkers of metabolic success post- surgery, but the knowledge in this field is undefined. The objective of this work was to determine whether adipocytokines and microbiota-derived metabolites can be used to predict the metabolic improvement post- surgery in women with CSO. We analyzed circulating levels of some cytokines and some microbiota-derived metabolites at baseline and 12 months post-surgery from 44 women with CSO and 21 women with normal weight. Results showed that glucose, insulin, glycosylated hemoglobin A1c (HbA1c), low-density lipoprotein (LDL-C), and triglycerides levels were decreased post-surgery, while high density lipoprotein increased. Twelve months later, leptin, resistin, lipocalin, PAI-1, TNF-α, and IL-1β levels were lower than baseline, meanwhile adiponectin, IL-8, and IL-10 levels were increased. Moreover, baseline lipocalin levels were associated with HbA1c reduction post-surgery; meanwhile baseline resistin was related to postoperative HOMA2 (insulin resistance) and baseline propionate was associated with LDL-C decrease. To conclude, the detection of lipocalin, resistin, and propionate levels may be used to predict the metabolic success following bariatric surgery, although new knowledge is needed.

Technological, Sensory, and Hypoglycemic Effects of Quinoa Flour Incorporation into Biscuits

Background. Biscuits are consumed by all of society in the world. Incorporation of different ratios of quinoa flour into wheat flour for the production of biscuits is needed for the production of functional foods. Objective. This study aimed to evaluate the incorporation of 12.5% or 25% quinoa flour into biscuit production, evaluate rheological and sensory characteristics, and investigate the effect of the consumption of 20% cooked biscuits on diabetic rats. Design. The gross chemical composition, total carotenoids, phenolic and flavonoids of wheat flour and quinoa flour, and the rheological properties of the control, 12.5% quinoa, and 25% quinoa biscuit dough were determined. The effects of consumption of 12.5% quinoa and 25% quinoa biscuits on diabetic rats were investigated. Results. Quinoa flour had significantly higher levels of the gross chemical composition except for carbohydrate and increased phenolic compound and flavonoids content than those in wheat flour. Increasing the amount of quinoa flour in the biscuits could increase the farinograph and extensograph values of the dough. Biological results showed that the highest improvement in nutritional values appeared in the diabetic rat group, which consumed 25% quinoa biscuit for 60 days. The consumption of 12.5% quinoa biscuit and 25% quinoa biscuit showed a decline in blood glycosylated hemoglobin and glucose and an elevation in insulin levels compared with the positive control diabetic rat group. Discussion and Conclusion. It is encouraging to replace wheat flour with quinoa flour in biscuit manufacturing owing to positive effects on both the technological properties and sensory evaluation of biscuits. The increase of quinoa flour up to 25% had favorable nutritional values and hypoglycemic effects.

Correlation between echocardiographic parameters of left ventricle and glycosylated hemoglobin in children with type 1 Diabetes Mellitus

Introduction. Deterioration of left ventricular (LV) parameters in Diabetes Mellitus (DM) can occur in the absence of other heart problems. An association between glycosylated hemoglobin (HbA1c) and changes of the LV parameters in DM has been reported. However, data regarding this association model in children with Type 1 Diabetes Mellitus (T1DM) are limited. The purpose of the work was to investigate the association between HbA1c and the LV parameters in pediatric patients. Material and methods. The study was conducted on 28 children with T1DM ((aged 10 - 18 years, gender M (15)/F (13), duration ≥5 years). The clinical (standard medical examination) and paraclinical (biochemical dosage – HbA1c, echocardiography – LV functional and structural parameters) data was carried out. Statistical analysis used the SPSS version 20. Results. The correlational study between the HbA1c and the LV parameters revealed a statistically significant positive correlation coefficient with aortic root diameter (mm) (r=0.7**, p<0.001), left atrium (mm) (r=0.8**, p<0.001 LV diastolic diameter (mm) (r=0.7**, p<0.001), LV systolic diameter (mm) (r=0.7**, p<0.001), septal wall thickness (mm) (r=0.5*, p=0.036), posterior wall thickness (mm) (r=0.5*, p=0.032), LV diastolic volume (ml) (r=0.5*, p=0.025), LV systolic volume (ml) (r=0.6**, p=0.01), ejection fraction (%) (r=0.7**, p=0.001), fractional shortening (%) (r=0.6**, p=0.002). Conclusions. The results of the study show that in children with T1DM, the increase value of the HbA1c is associated with a consensual and proportional increase in the values of the parameters of the left ventricle.

Gene expression of inflammatory immune factors and clinical parameters in diabetes and nondiabetes patients with periodontal disease

Objective: This study evaluated clinical, glucose, and immunological parameters in patients with type 2 diabetes mellitus (DM) compared to those without systemic alterations (NDM), both with generalized chronic periodontitis. Methodology: Twenty-one patients were selected with indications of tooth loss. Surgeries were performed using the Widman flap modified to obtain a gingival collar at 1 mm from the gingival margin. Before the surgical procedure, the following clinical parameters were evaluated: pocket probing depth (PPD), gingival recession (GR), clinical attachment level (CAL), and bleeding on probing (BOP). Fasting glucose levels (FGL) and glycosylated hemoglobin Hba1c (HbA1c) were also assessed. During the surgery, gingival tissue samples were collected and frozen for later laboratorial analysis. The samples were processed to obtain mRNA, cDNA and determine the gene expression of the immune parameters IL-1-β, IL-6, TNF-α, IL-10 and NF-kB by real-time polymerase chain reaction (RT-PCR). Data were analyzed statistically considering p<0.05. Results: The clinical and glucose parameters BOP, FGL, and HbA1c were statistically higher in the DM group. RNAm levels of IL-1β, TNF-α, and NF-kB were higher in the DM group (p<0.05). Conclusion: The presence of diabetes and hyperglycemic status increase the levels of pro-inflammatory immune factors and severity of the periodontal disease.

The Effects of Snack Control Education and Telephone Coaching on Self-Management, Social Support, Self-Efficacy, and Blood Glucose in Diabetes Patients

Dietary therapy for diabetes is the most basic way to manage blood glucose. Currently, the nutritional intake rate of diabetic patients in Korea is beyond the recommended rate of the Korean Diabetes Association, showing large amounts of carbohydrates in foods consumed as snacks with an additional focus on sugar. Thus, it is necessary to support healthy dietary habits through snack control. This study is a random assignment experimental study with a total of 56 participants; 28 participants were in the control group, while the remaining 28 patients had type 2 diabetes and had visited Kyung Hee University Hospital. The experimental group with snack control education and telephone coaching exhibited a higher self-management score (t = –9.494, P < 0.001), perceived social support score (t = 7.201, P < 0.001), and self-efficacy score (t = 7.185, P < 0.001) than the control group. Additionally, the experimental group showed lower levels of glycosylated hemoglobin and average blood glucose compared to the control group (t = –4.820, P < 0.001). Thus, snack control education and telephone coaching are effective in improving diabetes self-management behavior, perceived social support, self-efficacy, and reducing glycosylated hemoglobin and average blood glucose. These results confirm the usefulness of snack education materials, and I suggest snack control education as a means of arbitration to improve the self-care of diabetics.

Eucalyptus globulus Methanol Leaf Extract Improves Glycosylated Hemoglobin, Lipid Profile Levels and Haematological Sub-inflammatory Biomarkers in Streptozotocin-induced Diabetic Rats

Background: Eucalyptus leaf is used traditionally to treat a lot of diseases, but little is known about its use in the management of diabetes mellitus (DM) and its complications. Objectives: Antidiabetic property of Eucalyptus globulus leaf extract (EGLEX) was assessed on recent Makers of therapeutic response and diabetic disease progression in streptozotocin-induced diabetic rats. Methods: Eucalyptus globullus leaf powder (200 g) was extracted with methanol using standard procedure. Hyperglycemia was induced in Wistar rats with single intravenous dose of 50 mg/kg/bwt streptozotocin. The rats were divided into five groups (n = 5): Anormal control, B- diabetic control, C, D and E were diabetic rats treated with Eucalyptus globullus leaf extract (EGLEX), metformin and insulin respectively for four weeks. Samples were collected for biochemical and hematological studies. Data obtained were analysed using One Way Analysis of Variance at <0.05 significance level. Results and Conclusion: The results showed significant (p<0.05) blood glucose reduction of 68%, 51% and 68%, and weight gain of 17%, 18% and 11% in rats treated with EGLEX, metformin and insulin respectively. HBA1c level was significantly (p<0.05) raised (9.30%) in diabeticuntreated rats when compared with normal control (3.77%), EGLEX (4.24%), metformin (4.94%) and insulin (5.33%) groups. The deranged lipid profile indices, malondialdehyde and reduced glutathione levels, superoxide dismutase activity, platelet count, % neutrophil and % lymphocyte were normalized in diabetic rats treated with EGLEX when compared with the values in diabetic untreated rats. The findings concluded that EGLEX possesses antidiabetic property and improves biomarkers of diabetic disease progression.