Blood Glucose In Type Research Articles

Management of elevated blood glucose in type 2 diabetes

The first of a series of three articles, Patrick Holmes discusses the findings of several trials exploring the pharmaceutical manangement of type 2 diabetes which will aid nurses advising patients on hyperglycaemia The aim of this series of three articles is to give an overview and an update on the pharmaceutical management of elevated glucose in patients with type 2 diabetes. The articles will incorporate the findings of the published (or soon to be published) Cardiovascular Outcome Trials, offer opinion on their potential impact on clinical practice, and evaluate guidelines. Most importantly, they aim to help practice nurses make informed choices alongside patients with diabetes when choosing when and how to manage hyperglycaemia.

Administration of Iranian Propolis attenuates oxidative stress and blood glucose in type II diabetic patients: a randomized, double-blind, placebo-controlled, clinical trial.

Background:Hyperglycemia in diabetic people resulted in oxidative conditions. Propolis is the third most important component of bee products which has various functional properties such as anti-oxidant due to its components. The aim of this study was to evaluate the propolis effect on fructosamine level, the catalase activity, and the level of oxidized LDL changes in type 2 diabetic patients.Methods:In this double-blind, randomized controlled trial study, 62 type 2 diabetic patients, attending Endocrine clinic in Velayat Hospital (Qazvin, Iran) in 2017, were randomly assigned to one of intervention and placebo (n=31) groups. Participants in intervention group took propolis capsule (500 mg) 3 times a day and those in placebo group took placebo capsules for 8-week. Fructosamine level, catalase activity and the level of oxidized-LDL were measured at the baseline and at the end of the study. Statistical analysis was performed using SPSS software.Results:At the end of the study, significant differences were seen within groups and in-between groups. In Propolis group compared to the placebo, fructosamine (p<0.05), and the level of oxidized LDL (p<0.05) decreased, and catalase activity (p<0.05) improved. However, there were no significant changes in the placebo group at the end of trial.Conclusion:Eight weeks intake of propolis as a supplement in type II diabetic patients could improve anti-oxidant defense and decline production of hyperglycemia induced products such as fructosamine.

Improvement of high-glucose and insulin resistance of chromium malate in 3T3-L1 adipocytes by glucose uptake and insulin sensitivity signaling pathways and its mechanism.

Previous study has revealed that chromium malate could improve insulin resistance and the regulation of fasting blood glucose in type 2 diabetic rats. This study was designed to investigate the effect of chromium malate on hypoglycemic and improve insulin resistance activities in 3T3-L1 adipocytes with insulin resistance and investigate the acting mechanism. The result indicated that chromium malate exhibited direct hypoglycemic activity in vitro. Compared with the model group, chromium malate could significantly promote the expression levels of GLUT-4, Akt, Irs-1, PPARγ, PI3K and p38-MAPK and their mRNA, increase p-AKT/AKT level, AKT and AMPKβ1 phosphorylation and reduce Irs-1 phosphorylation and p-Irs-1/Irs-1 level in 3T3-L1 adipocytes (p < 0.05). Chromium malate is more effective in regulating the proteins and mRNA expressions than those of chromium trichloride and chromium picolinate. Compared to the model group, pretreatment with the specific p38-MAPK inhibitor completely inhibited the GLUT-4 and Irs-1 proteins and mRNA expressions induced by the chromium malate. In conclusion, chromium malate had a beneficial influence on improvement of controlling glucose levels and insulin resistance in 3T3-L1 adipocytes with insulin resistance by regulating proteins productions and genes expressions in glucose uptake and insulin sensitivity signaling pathways.

Study on the effect of acupoint massage on blood glucose in type 2 diabetic patients

Objective To investigate the effect of acupoint massage on blood glucose in type 2 diabetic patients. Methods A total of 67 patients with type 2 diabetes mellitus patients, using the random number table method were divided into experimental group of 34 cases and 33 cases in the control group by random number table method. The experimental group was given groups of acupoint massage and five carriages management to diabetes patients (control diet, exercise, blood sugar and lipid lowering drugs, diabetes knowledge propaganda and education, blood glucose monitoring). The control group was administered only the five carriages of diabetes. The two groups were observed for 2 months, and were compared the changes of biochemical indexes of glucose metabolism. Results After 2 months, the experimental group's fasting plasma glucose (FBG), 2 hours postprandial blood glucose (2 hBG), and glycated hemoglobin (HbA1c) decreased from the original (10.12±4.15) mmol/L, (15.32±5.65) mmol/L, and (9.36±2.78)% to (6.04±1.75) mmol/L, (8.42±3.01) mmol/L, (6.35±0.78) %, respectively, there were statistically significant differences within the group (t = 5.28, 6.28, 6.08 respectively, all P 0.05). Conclusions To acupoint massage with basic intervention for type 2 diabetes patients can effectively consolidate the hypoglycemic effect, which is worthy of clinical reference and promotion. Key words: Diabetes, type 2; Acupoint massage; Basic intervention; Clinical efficacy

Assessment of self-monitoring of blood glucose in type 1 diabetic children and adolescents: practice and perspective

Assessment of self-monitoring of blood glucose in type 1 diabetic children and adolescents: practice and perspective

Effectiveness of LPK Composite Flour as an Additive in the Formula of Enteral Diabetes Mellitus on Blood Glucose Levels of Type 2 Diabetes Mellitus Patients

Diabetes Mellitus (DM) is a group of metabolic diseases, more than 90-95% are Type 2 DM. Commercial enteral DM formulas such as diabetasol are quite expensive and there is a need for enteral DM formulas made from local foods that have the potential to be antihyglycemic and antidiabetic. Development of local food based enteral DM formulas with the addition of composite flour Labu Kuning, Kepok Banana and Green Beans (LPK). The food has a low glycemic index so that it can be used to control blood glucose levels in DM patients. The study was conducted to determine the effectiveness of LPK composite flour in the enteral DM formula for blood glucose levels in type 2 DM patients. Quasi experimental research, with a pre-post test with control group design. The treatment group was given FDM-LPK and the control group was given diabetasol, each 60 g per serving then measured blood glucose level 2 hours postprandial. Interventions are given for 5 consecutive days. The number of research subjects was 60 people consisting of 30 treatment people and 30 control people. Blood glucose in type 2 DM patients after 2 jpp in the treatment group and the control group showed a high average value (above 200 mg / dL). The treatment group ranged from 283.83 ± 103.62 mg / dL, while the control group ranged from 359.87 ± 134.43 mg / dL. On the second day there was a significant decrease in blood glucose levels (p 0.05). The provision of FDM-LPK by adding 85 g of LPK composite flour was effective to reduce blood glucose levels 2 jpp in type 2 DM patients. Reduction of blood glucose level of 2 jpp was 18.56%. Keywords: LPK composite flour, FDM-LPK, Diabetes mellitus, Blood glucose

Vigorous Intervals and Hypoglycemia in Type 1 Diabetes: A Randomized Cross Over Trial

Adding vigorous-intensity intervals (VII) to moderate-intensity exercise prevents immediate declines in blood glucose in type 1 diabetes (T1D) however the intensity required to minimize post-exercise hypoglycemia is unknown. To examine this question, ten sedentary T1D individuals completed four treadmill exercise sessions: a control session of 45 minutes of walking at 45–55% of heart rate reserve (HRR) and three sessions consisting of 60 seconds (VII) at 70%, 80%, or 90% of HRR every 4 minutes during exercise at 45–55% of HRR. We used continuous glucose monitoring (CGM) to measure time ≤3.9 mmol/L, glucose variability, hypoglycemia frequency and area under the curve (AUC) for hypoglycemia and hyperglycemia for 12 hours post-exercise. We also examined growth hormone and cortisol responses during and following exercise. In the 12 hours post-exercise, the percentage of time ≤3.9 mmol/L, glucose variability, and AUC for hypoglycemia and hyperglycemia were similar across conditions. The frequency of hypoglycemic events was highest after the 90% intervals compared to the control arm (12 vs 3 events, p = 0.03). There was a trend towards elevated growth hormone with increasing exercise intensity but cortisol levels were similar across conditions. Adding VII to moderate intensity exercise may increase hypoglycemia risk at higher intensities.

Valuing injection frequency and other attributes of type 2 diabetes treatments in Australia: a discrete choice experiment

BackgroundMultiple pharmacotherapy options are available to control blood glucose in Type 2 Diabetes Mellitus (T2DM). Patients and prescribers may have different preferences for T2DM treatment attributes, such as mode and frequency of administration, based on their experiences and beliefs which may impact adherence. As adherence is a pivotal issue in diabetes therapy, it is important to understand what patients value and how they trade-off the risks and benefits of new treatments. This study aims to investigate the key drivers of choice for T2DM treatments, with a focus on injection frequency, and explore patients’ associated willingness-to-pay.MethodsA discrete choice experiment (DCE) was used to present patients with a series of trade-offs between different treatment options, injectable and oral medicines that were made up of 10 differing levels of attributes (frequency and mode of administration, weight change, needle type, storage, nausea, injection site reactions, hypoglycaemic events, instructions with food and cost). A sample of 171 Australian consenting adult T2DM patients, of which 58 were receiving twice-daily injections of exenatide and 113 were on oral glucose-lowering treatments, completed the national online survey. An error components model was used to estimate the relative priority and key drivers of choice patients place on different attributes and to estimate their willingness to pay for new treatments.ResultsInjection frequency, weight change, and nausea were shown to be important attributes for patients receiving injections. Within this cohort, a once-weekly injection generated an additional benefit over a twice-daily injection, equivalent to a weighted total willingness to pay of AUD$22.35 per month.ConclusionsBased on the patient preferences, the importance of frequency of administration and other non-health benefits can be valued. Understanding patient preferences has an important role in health technology assessment, as the identification of the value as well as the importance weighting for each treatment attribute may assist with funding decisions beyond clinical trial outcomes.

Assessment of compliance to self monitoring of blood glucose in type 2 diabetic patients and level of implementation of Polish Diabetes Association Recommendation for general practitioners

Introduction. Self monitoring of blood glucose is one of basic elements of effective diabetes treatment. Due to proper self monitoring of blood glucose adequate modification of diabetes treatment — fulfilling criteria of good glycemic control — is possible. Effective treatment enables prevention of late diabetic complications — a cause of disability or death in diabetic population. Material and methods. 765 type 2 diabetic patients (above 18 yrs) treated with both oral hypoglycaemic drugs or insulin in different schemes were observed (mean age: 64.5 ± 10.9 yrs). Therapy was in line with general standards of treatment, medication choice was based on indications and previous independent physician decision. Patients were given glucometer ContourPlus and were taught how to use it and how often measurement had to be taken (on the basis of Polish Diabetes Association Recommendation for 2016). After 3 months (± 2 weeks) assessment of compliance to self monitoring of blood glucose was performed. Additionally, level of implementation of Polish Diabetes Association Recommendation for general practitioners, functionality of glucometer and usefulness of “second chance” measurement were evaluated. Results. 440 participants completely fulfilled recommendations (65.1%) of general practitioner (investigator) regarding self monitoring documentation (type of documentation provided: glucometer, glucose monitoring diary). In investigators opinion, 315 patients (below 50%) were conscientiously compliant to self monitoring of blood glucose based on Polish Diabetes Association Recommendations. In general practice for about 68.0% of patients (n = 506) Polish Diabetes Association Recommendations for self blood glucose monitoring were implemented. Based on investigators opinion the most important features of glucometers which determine effectiveness of self monitoring of glucose are: simplicity, high capacity memory, accuracy and precision of measurement, evaluation of mean glucose in general and mean pre-/after meal. 67.7% patients (n = 451) regarded possibility of “second chance” measurement in glucometer ContourPlus as useful in daily self monitoring of blood glucose. Conclusions. Discrepancy between Polish Diabetes Association Recommendations of self blood glucose monitoring and its realization by type 2 diabetic patients, carried out by general practitioners, was observed. Effective glucose monitoring is dependent on tight cooperation between doctor and patient.

Enhanced self-monitoring blood glucose in non-insulin-requiring Type 2 diabetes: A qualitative study in primary care.

To contribute to both theoretical and practical understanding of the role of self-monitoring blood glucose for self-management by describing the experience of people with non-insulin-requiring Type 2 diabetes in an enhanced structured self-monitoring blood glucose intervention. The complex context of self-monitoring blood glucose in Type 2 diabetes requires a deeper understanding of the clients' illness experience with structured self-monitoring of blood glucose. Clients' numeracy skills contribute to their response to blood glucose readings. Nurses' use of motivational interviewing to increase clients' regulatory self-efficacy is important to the theoretical perspective of the study. A qualitative descriptive study. A purposive sample of eleven adults recently (<2years) diagnosed with non-insulin-requiring Type 2 diabetes who had experienced a structured self-monitoring blood glucose intervention participated in this study. Audio recordings of semi-structured interviews and photographs of logbooks were analysed for themes using constant comparison and member checking. The illness experience states of Type 2 diabetes include 'Diagnosis,' 'Behavior change,' and 'Routine checking.' People check blood glucose to confirm their Type 2 diabetes diagnosis, to console their diabetes-related fears, to create personal explanations of health behaviour's impact on blood glucose, to activate behaviour change and to congratulate their diabetes self-management efforts. These findings support the Transtheoretical model's stages of change and change processes. Blood glucose checking strengthens the relationships between theoretical concepts found in Diabetes Self-management Education-Support including the following: engagement, information sharing and behavioural support. Tailoring diabetes care specifically to clients' stage of their illness experience with use of self-monitoring blood glucose contributes to engagement in self-management. Motivational interviewing and collaborative decision-making using blood glucose checking increase regulatory self-efficacy for people living with non-insulin-requiring Type 2 diabetes.

Combined treatment with interleukin-1 and tumor necrosis factor-alpha antagonists improve type 2 diabetes in rats.

In the present study, combined treatment with etanercept and anakinra were tested in the streptozotocin-induced diabetic rats. Forty male Wistar albino rats were divided into 5 groups: healthy control (HC), diabetic control (DC), diabetic + anakinra (DAT), diabetic + etanercept (DET), and diabetic + etanercept + anakinra (DEAT). HC and DC groups received subcutaneous (s.c.) injection with a saline solution, while DAT and DET groups received anakinra (10 mg/kg per day, s.c.) or etanercept (10 mg/kg, twice a week, s.c.), and DEAT rats received both anakinra and etanercept treatments for 21 days after diabetes has developed. Anakinra and etanercept treatments significantly increased insulin and homeostatic model assessment β-cell function levels and decreased glucose levels compared to the DC group as single (DAT and DET) and combined treatments (DEAT). The thiobarbituric acid reactive substances level was significantly decreased in DAT group. The combine use of etanercept and anakinra can improve insulin and blood glucose in type 2 diabetic rats. The combined treatment of anakinra and etanercept together was more effective than single treatment and might have a potential new treatment strategy and to reduce the mortality and morbidity resulting from diabetes.

Puerarin promotes MIN6 cell survival by reducing cellular reactive oxygen species.

Type 1 diabetes is caused by destruction of the pancreatic β‑cells and, to date, no cure has been developed. Promoting the survival of pancreatic β‑cells may be beneficial for patients with type 1 diabetes. Puerarin is an estrogen analogue that been demonstrated in previous studies to be able to decreased blood glucose in patients with type 1 diabetes. Similar results were demonstrated in previous studies which additionally demonstrated that puerarin was able to decreased blood glucose in type 1 diabetic mice by protecting pancreatic β‑cells. However, the mechanism underlying the function of puerarin in pancreatic β‑cells remains unclear. Therefore, the present study sought to investigate the detailed function of puerarin in pancreatic β‑cells. In the present study, H2O2 was used to induce apoptosis. It was observed that puerarin significantly decreased H2O2‑induced apoptosis in mouse insulinoma MIN6 cells. It was additionally observed that puerarin decreased the levels of intracellular reactive oxygen species and mitochondrial superoxide in MIN6 cells. The protective effect of puerarin was markedly decreased by 6‑aminonicotinamide, an inhibitor of glucose‑6‑phosphate dehydrogenase (G6PD). In conclusion, the results of the present study suggested that puerarin may increase the activity of G6PD, decreased the level of oxidative stress in MIN6 cells, protect mitochondria and promote MIN6 cell survival. Investigating the mechanism underlying the effect of puerarin in MIN6 cells may provide a novel approach for development of a cure for type 1 diabetes.

Circulating PANDER concentration is associated with increased HbA1c and fasting blood glucose in Type 2 diabetic subjects

AimPANcreatic-DERived factor (PANDER, FAM3B) is a novel hormone that regulates glucose levels via interaction with both the endocrine pancreas and liver. Prior studies examining PANDER were primarily conducted in murine models or in vitro but little is known regarding the circulating concentration of PANDER in humans, especially with regard to the association of type 2 diabetes (T2D) or overall glycemic regulation. To address this limitation, we performed a cross-sectional analysis of circulating serum PANDER concentration in association with other hormones that serve as either markers of insulin resistance (insulin and adiponectin) or to metabolic parameters of glycemic control such as fasting HbA1c and blood glucose (FBG). MethodsFasting serum was obtained from a commercial biorepository from 300 de-identified adult subjects with 150 T2D and non-T2D adult subjects collected from a population within the United States, respectively, matched on gender, age group and race/ethnicity. Concentration of PANDER, insulin and adiponectin were measured for all samples as determined by commercial ELISA. Metadata was provided for each subject including demography, anthropometry, and cigarette and alcohol use. In addition, fasting blood glucose (FBG) and HbA1c were available on T2D subjects. ResultsMultiple linear regression analyses were performed to examine the relationships between circulating log PANDER concentration on HbA1c, fasting glucose, log insulin, log HOMA-β and log HOMA-IR among T2D subjects and for insulin and adiponectin in non-T2D subjects. A significant linear association was identified between PANDER with fasting HbA1c (β 0.832 ± SE 0.22, p = 0.0003) and FBG (β 20.66 ± SE 7.43, p = 0.006) within T2D subjects. However, insulin, HOMA-β, HOMA-IR and adiponectin (p > 0.05) were not found to be linearly associated with PANDER concentration. ConclusionWithin T2D subjects, PANDER is modestly linearly associated with increased HbA1c and FBG in a US population. In addition, highest circulating PANDER levels were measured in T2D subjects with HbA1c above 9.9. No association was identified with PANDER and insulin resistance or pancreatic β-cell function in T2D subjects.

Study of correlation between serum uric acid and fasting blood glucose in type 2 diabetics, their healthy offspring’s matching with healthy controls

Study of correlation between serum uric acid and fasting blood glucose in type 2 diabetics, their healthy offspring’s matching with healthy controls

Exenatide upregulates gene expression of glucagon-like peptide-1 receptor and nerve growth factor in streptozotocin/nicotinamide-induced diabetic mice.

Glucagon-like peptide-1 (GLP-1) is an incretin hormone that has modulating effects on insulin release. GLP-1 and receptors for GLP-1 are widely expressed throughout the body including the brain. The expression of GLP-1 receptors is very specific to large neurons in hippocampus, neocortex, and cerebellum. GLP-1 receptor stimulation enhances glucose-dependent insulin secretion and lowers blood glucose in type 2 diabetes mellitus. Studies on adipobiology of neurotrophins have focused on nerve growth factor (NGF) as an example of adipose-derived neurotrophins. Compromised trophic factor signaling may underlie neurodegenerative diseases ranging from Alzheimer's disease to diabetic neuropathies. Exenatide, a potent and selective agonist for the GLP-1 receptor, is currently approved for the treatment of type 2 diabetes mellitus. The aim of this study was to assess the effect of chronic exenatide treatment on the hippocampal gene expression levels of GLP-1 receptor and NGF in diabetic mice. The effects of chronic exenatide treatment (0.1 μg/kg, s.c., twice daily for 2 weeks) on GLP-1 receptor and NGF gene expression levels in the hippocampus of streptozotocin/nicotinamide (STZ-NA)-induced diabetic mice were assessed by quantitative real-time polymerase chain reaction (RT-PCR). The results of this study revealed that hippocampal gene expression of GLP-1 receptor and NGF were downregulated in diabetic mice. Importantly, a significant increase in the gene expression level of GLP-1 receptor and NGF was determined after 2 weeks of exenatide administration. Increased gene expression level of GLP-1 receptor and NGF may underlie the beneficial action of exenatide in STZ/NA-induced diabetes.

Recent advances in understanding/managing type 2 diabetes mellitus.

The treatment of type 2 diabetes mellitus has evolved in the present century toward safer and maybe more effective drugs, which in some cases can also reduce the risk of cardiovascular and renal outcomes. Nevertheless, we still need better strategies to reduce excess body weight in order to achieve diabetes remission, which is now a feasible target, as has been demonstrated with bariatric surgery. This review focuses on the significant advances in the management of blood glucose in type 2 diabetes mellitus, including the current understanding of the mechanisms of drug action but keeping in mind that the treatment of the disease is multifactorial.

Anti-hyperglycemic effect of aqueous extract of Juglans regia L. leaf (walnut leaf) on type 2 diabetic patients: A randomized controlled trial

ObjectiveThe Juglans regia leaf (walnut leaf) has been traditionally used to treat diabetes in Iran. The aim of this study was to evaluate the effect of aqueous extract of Juglans regia leaf on blood glucose in type 2 diabetic patients. MethodsThirty-seven type 2 diabetic patients aged 35–70 years with fasting blood glucose levels between 130mg/dl (7.2mmol/L) and 250mg/dl (13.9mmol/L) and HbA1c more than 7% despite using conventional oral hypoglycemic drugs received the Juglans regia capsule (250mg/TDS) or toast powder capsule (placebo) randomly for 3 months. Fasting blood glucose (FPG), postprandial blood glucose (PPG), and glycosylated hemoglobin (HbA1c) were assessed as primary outcome measures. Lipid profile and hepatic and renal function were assessed as secondary outcome measures. Nonparametric statistical tests were employed to compare the results with baseline in both groups using SPSS version 17. ResultsNineteen patients in the Juglans regia group and 18 in the control group with a mean (±SD) age 55.8 (±7) completed the study. The FPG (p=0.02), PPG (p=0.008) and HbA1c (p=0.003) levels decreased significantly in the Juglans regia group after 3 months compared to baseline without any side effects. The changes of the variables were not significant in the control group. ConclusionsThis study suggests that the aqueous extract of J. regia leaf had a lowering effect of FPG, PPG and HbA1c in type 2 diabetic patients. Conducting further clinical studies is suggested with larger sample sizes to make precise conclusions about the efficacy and safety of this herb.

C-C Chemokine Receptor Type 2-Dependent Migration of Myeloid-Derived Suppressor Cells in Protection of Islet Transplants.

Islet transplantation is a promising therapeutic approach to restore the physical response to blood glucose in type 1 diabetes. Current chronic use of immunosuppressive reagents for preventing islet allograft rejection is associated with severe complications. In addition, many of the immunosuppressive drugs are diabetogenic. The induction of transplant tolerance to eliminate the dependency on immunosuppression is ideal, but remains challenging. Addition of hepatic stellate cells allowed generation of myeloid-derived suppressor cells (MDSC) from precursors in mouse bone marrow. Migration of MDSC was examined in an islet allograft transplant model by tracking the systemic administered MDSC from CD45.1 congenic mice. The generated MDSC were expressed C-C chemokine receptor type 2 (CCR2), which was enhanced by exposure to interferon-γ. A single systemic administration of MDSC markedly prolonged survival of islet allografts without requirement of immunosuppression. Tracking the administered MDSC showed that they promptly migrated to the islet graft sites, at which point they exerted potent immune suppressive activity by inhibiting CD8 T cells, enhancing regulatory T cell activity. MDSC generated from CCR2 mice failed to be mobilized and lost tolerogenic activity in vivo, but sustained suppressive activity in vitro. MDSC migration was dependent on expression of CCR2, whereas CCR2 does not directly participate in immune suppression. Expression of CCR2 needs to be closely monitored for quality control purpose when MDSC are generated in vitro for immune therapy.

The Impact of a One Week Be-Fit-FoodTM Delivered Meal Program on Body Composition and Blood Glucose in Type 2 Diabetes Mellitus Patients: Preliminary Data

The Impact of a One Week Be-Fit-FoodTM Delivered Meal Program on Body Composition and Blood Glucose in Type 2 Diabetes Mellitus Patients: Preliminary Data

Use of Sitagliptin With Closed-Loop Technology to Decrease Postprandial Blood Glucose in Type 1 Diabetes.

Postprandial hyperglycemia poses a challenge to closed-loop systems. Dipeptidyl peptidase-4 (DPP-4) inhibitors, like sitagliptin, reduce postprandial glucose concentrations in patients with type 2 diabetes. The objective of this study was to assess sitagliptin's role in type 1 diabetes (T1DM) as an adjunct therapy in reducing postprandial blood glucose with an insulin-only closed-loop system. This was a randomized, double-blinded, placebo controlled, crossover design trial. The participants were18-35 years old, had T1DM, and an HbA1c of ≤ 8.5%. A dose determination study included eight subjects with T1DM. There were three study visits. Four hours after receiving study drug (placebo, sitagliptin 50 mg, sitagliptin 100 mg), subjects underwent a mixed meal tolerance test with assessment of hormone concentrations. In a second study, 15 subjects underwent two visits receiving either placebo or 100 mg of sitagliptin plus an insulin only closed-loop system for 25 hours with timed meals. Blood glucose and other hormone concentrations were analyzed using repeated measures ANOVA. For the dose determination study, sitagliptin 100 mg resulted in reduced postprandial blood glucose ( P = .006). For the closed-loop study, glucose concentrations were lower in the treatment group, most prominently during the first two study meals ( P = .03). There was no difference in glucagon concentrations, but insulin concentrations and insulin delivery were lower in the treatment group. Sitagliptin may be considered as an adjunct therapy in a closed-loop setting. Larger studies are needed to determine the role of oral agents like sitagliptin to lower postprandial hyperglycemia with closed loop.