Non-insulin Dependent Diabetic Subjects Research Articles

Studies on dietary pattern of seleceted dibetic subjects of Parbhani city in Maharashtra

Diabetes is one of the most challenging non-communicable health problems in the twenty first century. Non-communicable diseases (NCD), also known as chronic diseases include cardiovascular diseases, diabetes, stroke, most forms of cancers and injuries. Such diseases mainly result from lifestyle related factors such as unhealthy diet, lack of physical activity and tobacco use. Hence, study was conducted with an objective to determine the socio-economic status, information about diabetes and food and nutrient intake of diabetics. Thirty non-insulin dependent diabetic subjects (men and women) were selected from Parbhani city of Maharashtra state. Information regarding their socio-economic status, duration and history about diabetes and food consumption pattern etc. was collected. The information regarding their dietary habits, frequency of consumption of different food groups in a day etc. were collected. The actual food intake of the selected diabetic subjects was collected for the immediate past 24 hours. The intake of different nutrients per day by each selected subject was then calculated from the food intake values using food composition tables. Food and nutrient adequacy was calculated based on balanced diets and recommended dietary allowances, respectively. It was observed that subjects were more diabetic subjects from 50-60 years age group 63.33 per cent, respectively. Sex wise data indicated that more number of male were sufferers of diabetes (53.33 %). Maximum subjects were from nuclear families (60%). Diabetes was observed more among the subjects who were engaged in the service (36.66 %). The income wise distribution indicated that there was increase in the number of subjects as the income was increased. Among them forty per cent were suffering from more than five years and 33.33 per cent subjects were suffering from 3 -5 years and few of them having family history of diabetes. These results clearly show that protein, energy, iron and fibre intake was lower than the RDA of ICMR among both these subjects. While fat consumption exceeded than RDA given by ICMR. It can be concluded that diabetes cannot be cured but it can be well controlled by modification in the diet and lifestyle.

Effect of supplementation of wheat grass (Triticum aestivum L.) powder on blood glucose level of selected diabetic subjects

Diabetes mellitus is reaching potentially epidemic proportions in India. The experiment was conducted with an objective to study the effect of supplementation of wheat grass powder on blood glucose level of the diabetic subjects. Thirty noninsulin dependent diabetic subjects as control group (15) and experimental group (15) were selected from Parbhani city of Maharashtra state. Data regarding anthropometric measurements and fasting as well as post prandial blood glucose level of the selected subjects of control and experimental group was recorded initially, at 30 th day and 60 th day of experiment. Supplementation of 3 g of wheat grass powder was given daily to the subjects of experimental group for 60 days. The anthropometric measurements such as weight (kg), body mass index, mid upper arm circumference (cm) and triceps skinfold thickness (mm) were found to be decreased after the supplementation of wheat grass powder for two months, but the significant difference was noticed only for weight and BMI values. On the other hand specific trend was not noticed in the anthropometric measurements of the subjects of control group. Mean fasting and post prandial blood glucose level of the selected diabetic subjects of experimental group were significantly decreased from 192.13 ± 59.41 mg/dl to 179.46 ± 54.79 mg/dl and from 266.93 ± 81.47 mg/dl to 244.86 ± 77.59 mg/dl, respectively after 60 days of supplementation of wheat grass powder, whereas slight increase was noticed in the selected diabetic subjects of control group. Hence, supplementation of wheat grass powder for two months resulted in reducing the blood glucose level of diabetic subjects therefore being a natural product; wheat grass could be considered as effective measure for management of diabetes mellitus.

Food and nutrient intake and health status of diabetics

India is known as the capital of diabetes as the rate is increasing day by day. Particularly, type II diabetes is more common. As food and dietary pattern of an individual have an important role to play in the development, treatment or prevention of NIDDM, the present study was conducted with an objective to determine the health status and food and nutrient intake of diabetics.Thirty non-insulin dependent diabetic subjects (men and women) were selected randomly from Parbhani city of Maharashtra state. Information regarding their diabetic symptoms and complications, exercise pattern, family history of diabetes, awareness regarding diabetes mellitus, consumption of different food groups in a day etc. was collected. Food intake was assessed by conducting 24 hours dietary recall method and nutrient intake was calculated using Nutritive Value of Indian foods. It was observed that almost all selected diabetic subjects had family history of diabetes and various symptoms and complications of diabetes mellitus. It was also observed that more than 50 per cent of the selected diabetic subjects were performing some or other exercise daily, preferred exercise was walking and yoga. Most of them acquired the information about various aspects of diabetes mellitus from physician, television and newspaper. Results indicated that consumption of foods such as cereals, pulses, green leafy vegetables, other vegetables, milk and milk products were found to be more by men and consumption of roots and tubers and fruits were found to be more by women. It was also noticed that intake of fats and oils and sugar and jaggary by men and women were almost same. Intake of almost all nutrients was more by men than women except calcium. The results of nutrient adequacy showed that the adequacy of nutrients such as fat, calcium, thiamin, niacin and vitamin C was more than 100 per cent, while the lowest nutrient adequacy was recorded for the β-carotene followed by riboflavin and energy in both men and women. On the whole the diet of the selected diabetic subjects was found to be nutritionally imbalanced. Hence, a dietary modification along with changes in behaviour and lifestyle needs to be followed by diabetic subjects to overcome the problems of diabetes.

General status and effect of bael and nutrition intervention on sign, symptoms and physical activity of type 2 diabeties patient

The one hundred twenty non-insulin dependent diabetic selected subjects from Punjab Agricultural University and Civil Hospital of Ludhiana were divided into four groups viz., group I, II, III and IV having thirty subjects each. The subjects of group I was not given any treatment. The nutrition education was given for three months after fifteen days interval to the subjects of group II, III and IV through individual and group contact and gain in nutrition knowledge was assessed after the study. General information, diabetic information and dietary pattern of the subjects were recorded. Significant improvements were seen in physical activity, sleeping pattern and dietary pattern of the subjects of group II, III and IV after study. Therefore, it can be reported from the results that supplementation of bael (Aegle marmelos L.) leaf, pulp and seed powder along with nutrition counseling significantly improved the general status of the diabetic patients.

Salud oral en pacientes con diabetes tipo 2: caries dental, enfermedad periodontal y pérdida dentaria

El propósito de este estudio fue determinar la relación entre la salud bucodental y el grado de control metabólico entre sujetos con diabetes mellitus tipo 2 no insulino dependiente. Trescientos sujetos fueron divididos en dos grupos de 150: Grupo I, con control metabólico (hemoglobina glucosilada [HbA1c] < 8.0%) y Grupo II, sin control metabólico (HbA1c ≥ 8.0%). La examinación clínica incluyó frecuencia de prácticas de higiene oral, estado periodontal usando el Índice Comunitario Periodontal de Necesidades de Tratamiento (ICPNT), Índice de Caries de Necesidades de Tratamiento (ICNT) y el número de dientes perdidos. Una correlación positiva y estadísticamente significativa fue observada entre los dos indicadores de salud bucodental (CITN and CPITN) y la duración de la enfermedad y el grado de control metabólico. El estudio demostró que los sujetos con diabetes tendrían que mejorar sus prácticas de higiene oral, abandonar el hábito de fumar, y controlar los niveles de glucosa sanguínea.

Impact of Nutrition Education on Anthropometric and Knowledge, Attitudes and Practices (KAP) Score on Nutritional Status of Non-Insulin Dependent Diabetics

One hundred twenty non-insulin dependent diabetic subjects were selected from Punjab Agricultural University and Civil Hospital of Ludhiana. The selected subjects were divided into four groups, viz. Group I, II, III and IV having thirty subjects each. The nutrition education was given for three months after fifteen days interval to the subjects of Group II, III and IV through individual and group contact and gain in nutrition knowledge was assessed after the study. The anthropometric measurements of the subjects were measured. Significant improvements were seen in weight, BMI, MUAC and TSFT of the subjects in Group II, III and IV after study. There were also a significant increase (P<0.01) in the knowledge, attitude and practice score obtained by the subjects in Group II, III and IV and a non-significant increase (P<0.01) was seen in knowledge, attitude and practice score of the subjects in Group I. Therefore, it can be reported from the results that nutrition education significantly improved the nutritional status of the diabetic patients. So the objective of the study was planned to assess nut ritional status of the non-insulin dependent diabetics.

Efficacy of Flaxseed Supplementation on Nutrient Intake and Other Lifestyle Pattern in Menopausal Diabetic Females

Ninety non-insulin dependent menopausal diabetic female subjects free from serious complications were selected and equally divided into three groups, viz. E1, E2 and C. Subjects of group E1 and E2 ...

Hypoglycemic and hypolipidemic effect of Aloe vera L. in non-insulin dependent diabetics.

Ninety non-insulin dependent diabetic subjects were selected from Punjab Agricultural University and Civil hospitals of Ludhiana. The selected subjects were divided into three groups viz. Group I, II and III having thirty subjects each. The subjects of group I were not given any treatment. The subjects of group II and III were supplemented with 100mg and 200mg of Aloe vera L. gel powder respectively for a period of 3months and supplementation was continued along with nutrition counselling for the next 3months. The nutrition education was given for 3months after 15days interval to the subjects of group II and III through individual and group contact. The blood glucose and lipid profile were analyzed. The blood pressure of the subjects was also measured. It was seen that there was a significant (p ≤ 0.01) reduction in fasting blood glucose level by 11.4% and 15.4% and post prandial glucose level 18.5% and 27.8% in the subjects of group II and III respectively after the study. Significant (p ≤ 0.01) reduction in total cholesterol 8.6% and 10.1%, triglycerides 9.6% and 12.2%, low density lipoprotein cholesterol (LDL-C) 12.8% and 14.6%, very low density lipoprotein cholesterol (VLDL-C) 9.6% and 12.2% and an increase in high density lipoprotein cholesterol (HDL-C) 7.3% and 9.4% was observed in the subjects of group II and III respectively. The ratio of total cholesterol to HDL-C reduced from 5.6 to 4.8 and 6.1 to 5.0 and LDL-C to HDL-C from 3.7 to 3.0 and 4.1 to 3.1 in the subjects of group II and III respectively after the study. There was also a significant decrease (p ≤ 0.01) in the blood pressure of the subjects of group II and III and a non significant decrease (p ≤ 0.01) was seen in the subjects of group I. With the intervention of Aloe vera L., significant reduction was observed in blood glucose, lipid profile and blood pressure of the diabetic patients.

Assessment of Food Consumption Pattern, Anthropometric Parameters and Physical Activity Pattern of Non-Insulin Dependent Diabetics

Fifty non-insulin dependent diabetic subjects, 25 males and 25 females, free from serious complications were selected from posh areas of Ludhiana city. Diabetic and dietary information was collected using a questionnaire. Diabetic information of the subjects related to etiology of disease, family history and prevalence of symptoms was collected. Dietary information of the subjects was collected to know about their food habits and frequency of consumption of different food groups. Activity pattern of the subjects was recorded from their daily routine, and their involvement in other activities like time spent in recreational activities. Type of job, working hours, duration of sleep and any kind of physical exercise was recorded. Various anthropometric parameters viz. height, weight, Body Mass Index (BMI) and Waist Hip Ratio (WHR), were recorded. The most common reason for diabetes among the selected subjects was obesity which lead 22% subjects to be diabetic. Family history of diabetes was found in 38% subjects. The most common symptoms were polyuria (56%), polydypsia (48%), nocturia (44%), delayed healing (44%), polyphagia (40%) and loss of weight (38%). Twenty-eight percent of the males had normal weight and 56% and 16% males were in 1st and 2nd grades of obesity respectively. Sixty-eight percent and 24% of the female subjects were in 1st and 2nd grades of obesity respectively. As reported by the subjects, majority of them (78%) were not doing any kind of physical exercise. In all 76% of the subjects had disturbed sleep of 5-6 hours. It was found that the majority of the subjects 54% were ova/non-vegetarians. Ninety-four percent subjects liked sweet and salty foods. All the subjects took wheat flour thrice a day. Pulses were consumed by 90% subjects once a day. Forty-eight percent subjects used GLV's twice a week, 84% of the subjects consumed roots and tubers at least once a day. Fifty-two percent of the subjects consumed fruits once daily. All the subjects consumed milk. About 50% of the subjects consumed fried foods daily.

Effect of magnesium supplementation on plasma glucose in patients with diabetes mellitus

Magnesium depletion and/or deficiency are known feature of diabetes mellitus, and could lead to increased insulin resistance and diabetic complications. This study therefore looked at the potential benefit of magnesium administration on the management of diabetic mellitus. Twelve apparently healthy and 6 non-insulin dependent diabetic (NIDDM) subjects received 15mmol (360 mg) elemental magnesium as NUG2 (Meram Laboratories, France) in 500 ml of 0.9% saline intravenously over four hours. Blood samples were collected at baseline and at hourly intervals. The diabetic subjects had lower ionized (0.41±0.03 vs 0.48±0.01 mmoIAL; P< 0.05) and total (0.73±0.04 vs 0.88±0.02 mmol/L; P< 0.05) plasma magnesium concentrations than the non-diabetic subjects, reflecting a depletion of body magnesium. The administration of magnesium led to a significant increase in ionized and total plasma magnesium in both non-diabetic and diabetic subjects. Similarly, plasma glucose and insulin were significantly decreased, and homeostasis model assessment showed an increase in insulin sensitivity in diabetic subjects. In established cases of magnesium depletion and/or deficiency in diabetes mellitus, magnesium supplementation could be of great benefit in diabetic management

Blood Glucose Lowering Effect of the Leaves of Tinospora cordifolia and Sauropus androgynus in Diabetic Subjects

To study the blood glucose lowering effect of the aqueous leaf digest prepared from T. cordifolia and S. androgynus . Materials and methods : The effect of the aqueous leaf digest (10g/200ml water) of the two experimental plants on post-prandial blood glucose levels was determined separately, in non-insulin dependent diabetic (NIDDM) subjects using the method of glucose tolerance test (GTT). The effect was compared with the glycemic response elicited by the control (glucose=50g) and the hypoglycaemic activity was evaluated in terms of glycemic index (GI) score. Results : The rise in the blood glucose levels of the subjects administered with the experimental samples were lower than the levels observed after feeding glucose control, with the glucose levels reverting back to fasting levels after 2 h. of administration in experimental groups. The GI scores of T. cordifolia (GI=39) and S. androgynus (GI=55) were significantly lower than that of glucose control (GI=100). Conclusion: T. cordifolia is found to exhibit a significant ability to reduce blood sugar levels in human subjects. This corroborates with the results of earlier animal studies and its use as an anti-diabetic agent in ayurvedic medical system. The hypoglycaemic activity of S. androgynus indicated in the present study warrants investigation into the compounds/extracts with anti-diabetic activity.

4.P.415 Lipoprotein (a) and apolipoprotein (a) phenotypes in non-insulin dependent diabetic subjects

4.P.415 Lipoprotein (a) and apolipoprotein (a) phenotypes in non-insulin dependent diabetic subjects

2.P.260 Independent effect of hyperglycaemia on coronary heart disease mortality among non-insulin dependent diabetic subjects: The Reykjavik study

2.P.260 Independent effect of hyperglycaemia on coronary heart disease mortality among non-insulin dependent diabetic subjects: The Reykjavik study

A long-term comparison between enalapril and captopril on insulin sensitivity in normotensive non-insulin dependent diabetic volunteers

There are conflicting reports about the effects of angiotensin converting enzyme inhibitors on insulin sensitivity and glycaemic control. In addition, the chronic effects of ACEI on insulin sensitivity in normotensive but insulin resistant individuals have been controversial. To determine the long-term effects of low-dose captopril or enalapril on insulin sensitivity and lipid parameters in normotensive non-insulin dependent diabetic volunteers. Twenty-eight normotensive non-insulin dependent diabetes mellitus subjects on diet alone or diet plus oral hypoglycaemic agents were randomized in a single-blind cross-over study to receive either captopril (12.5 mg daily) or enalapril (5 mg daily). Initially, captopril was compared with enalapril for 28 days with a 28-day washout period between drug regimens. For the long-term study, the subjects then remained on the second ACEI for a further 11 months. Insulin sensitivity was measured using the isoglycaemic hyperinsulinaemic clamp (insulin infusion rate 20 mIU/kg/min) at the start and completion of each part of the cross-over study and then at 3, 6 and 12 months of drug therapy. Fasting glucose, insulin, HbA1, lipids and lipoproteins were measured at the start of each clamp. No first or second order carry-over effects were demonstrated between the ACEIs. No differences were detected between enalapril and captopril on insulin sensitivity at any of the time points. Statistically significant hypotension was avoided, and at doses used the ACEIs did not modify any parameters of glycaemic control over the 12-month study period. There were no significant alterations in plasma cholesterol, triglycerides, HDL cholesterol or Apo A1 levels during the study. Long-term low-dose ACEIs (captopril/enalapril) do not modify insulin sensitivity, glycaemic control or lipids in normotensive non-insulin dependent diabetic subjects.

Proinsulin-like molecules and plasminogen activator inhibitor type 1 (PAI-1) activity in diabetic and non-diabetic subjects with and without myocardial infarction

Elevated plasminogen activator inhibitor type 1 (PAI-1) activity has been shown to correlate with plasma insulin, proinsulin-like molecules, serum triglycerides and insulin sensitivity in both non-insulin dependent diabetic (NIDDM) subjects and subjects with coronary heart disease. We examined the relative roles of these variables in determining PAI-1 activity in four groups of male caucasian subjects: non-diabetic subjects with ( n=38) and without ( n=38) previous myocardial infarction (MI) and NIDDM subjects with ( n=26) and without ( n=30) previous MI. Insulin and proinsulin-like molecules were measured using specific two-site immunometric assays and insulin sensitivity estimated using the Homeostasis Model Assessment (HOMA) model. Subjects were comparable in age and body mass index. In univariate analysis, there were significant correlations of PAI-1 activity with intact and des-31,32-proinsulin and serum triglycerides in non-diabetic subjects with ( r=0.52, P=0.001; r=0.58, P<0.001; r=0.41, P=0.010) and without ( r=0.31, P=0.056; r=0.46, P=0.006; r=0.41, P=0.011) MI, but not with plasma insulin or insulin sensitivity. In NIDDM subjects, PAI-1 activity correlated significantly with intact and des-31,32-proinsulin and serum triglyceride ( r=0.47, P=0.015; r=0.58, P=0.002; r=0.44, P=0.026) only in subjects with MI. In multiple regression analysis, MI was the most important determinant of PAI-1 activity levels ( r 2=0.31, F=55.6, P<0.001). In conclusion, concentrations of proinsulin-like molecules and serum triglycerides appear to be stronger determinants of PAI-1 activity than plasma insulin or insulin sensitivity in both NIDDM subjects and non-diabetic subjects with and without MI. However, the relationship of MI with PAI-1 activity is independent of these variables.

Outcome of unstable angina in patients with diabetes mellitus.

This prospective hospital-based, case-control study compares the outcome of unstable angina in non-insulin dependent diabetic patients and non-diabetic control subjects. One hundred and sixty-two diabetic patients and 162 non-diabetic control patients with unstable angina were entered into the study. The 3-month mortality was 8.6% (95% confidence interval, CI = 4.4-12.9%) in diabetic patients and 2.5% (CI = 0.1-4.9%) in control patients (p = 0.014). The 1-year mortality was 16.7% (CI = 10.9%-22.4%) in diabetic patients and 8.6% (CI = 4.4%-12.9%) in non-diabetic patients (p = 0.029). Diabetic patients received beta-blockade and underwent coronary angiography and angioplasty less frequently than controls; the frequency of unstable angina, of acute myocardial infarction, and coronary artery bypass grafting was similar in both groups at 1 year of follow-up. It is concluded that diabetic patients with unstable angina have a higher mortality than non-diabetic patients and that this difference is largely accounted for by early (first 3 months) mortality.

Diabetic damage of selective renal reabsorption assessed by albumin negative charge

To clarify the pathogenesis of diabetic albuminuria at its onset, the percentage of glycated albumin (%G-albumin) in excreted urinary albumin and its negative charge were assayed. In non-diabetic albuminuria (control-A) group, the high ratio of urinary %G-albumin to serum %G-albumin (urine/serum ratio of %G-albumin) suggested a selective renal excretion of glycated albumin (G-albumin) over albumin as a result of normally-functioning selective reabsorption of albumin over G-albumin in renal tubules. Urinary %G-albumin and albumin negative charge indexing the degree of glycation, which was assayed by the binding capacity of positively-charged Alcian Blue (ABBC), thus negatively correlated with serum %G-albumin. In non-insulin dependent diabetic subjects with albuminuria (DM-A), however, urinary %G-albumin and ABBC positively correlated with serum %G-albumin, and the urine/serum ratio of %G-albumin was low and gradually increased toward 1 as serum %G-albumin increased. Although the strict glycemic control for 3 weeks reduced the increased urinary %G-albumin and ABBC, the decreased urine/serum ratio of %G-albumin remained unaltered. It is concluded that hyperglycemia-induced renal damage starts with the loss of selective tubular reabsorption of albumin over G-albumin, and that this damage cannot be recovered by strict glycemic control for 3 weeks.

Hypolipidaemic Effect of Fenugreek Seeds: a Chronic Study in Non-insulin Dependent Diabetic Patients

The lipid lowering activity of fenugreek seeds (Trigonella foenum graecum L.) was studied in 60 non-insulin dependent diabetic subjects. Isocaloric diets without and with fenugreek were given for 7 days and 24 weeks respectively. Ingestion of an experimental diet containing 25 g fenugreek seed powder resulted in a significant reduction of total cholesterol, LDL and VLDL cholesterol and triglyceride levels. These results indicate the beneficial effect of fenugreek seeds in diabetic subjects.

Association of Chlamydia pneumoniae and acute coronary heart disease events in non-insulin dependent diabetic and non-diabetic subjects in Finland.

It has been suggested that Chlamydia pneumoniae, a Gram-negative intracellular bacterium, is a risk factor for both myocardial infarction and chronic coronary heart disease. Previous studies have been done predominantly in non-diabetic subjects and thus the effect of diabetes on the association between C. pneumoniae antibodies and coronary heart disease has not been analysed. The aim of our study was to investigate the association between prior chlamydial infection and the risk of serious coronary heart disease events (myocardial infarction or coronary death) in a 7-year prospective study of cohorts of diabetic and non-diabetic subjects in two areas of Finland. It was found that the prevalence of elevated chlamydial antibodies at baseline was higher in nondiabetic subjects who had serious coronary heart disease events during the follow-up than in subjects without coronary heart disease events (32 vs 15%, relative risk 2.56, P = 0.013) in East Finland. In non-diabetic subjects living in West Finland we did not find this association. The association between the C. pneumoniae antibodies and coronary heart disease events did not markedly change after controlling for other risk factors for coronary heart disease (OR 2.44, P = 0.055) in non-diabetic subjects living in eastern Finland. In diabetic patients we did not find any association between chlamydial antibodies and coronary heart disease events. We found an association between C. pneumoniae antibodies and coronary heart disease events in non-diabetics living in eastern Finland. This association remained strong even after controlling for the other risk factors for coronary heart disease. In diabetic patients with high risk for coronary heart disease, C. pneumoniae was not a risk factor for coronary heart disease.

The effects of increasing doses of enalapril on insulin sensitivity in normotensive non-insulin dependent diabetic subjects.

There are conflicting reports about the effects of ACE inhibitors (ACEI) on insulin sensitivity and glycaemic control. Most studies have used a standard high dose of an ACEI but there have been no studies reported to establish whether any changes in glycaemic control or insulin sensitivity associated with ACEI are dose-related. To examine the effect of increasing doses of enalapril on insulin sensitivity in normotensive non-insulin dependent diabetic subjects. The effects of increasing doses of enalapril on insulin sensitivity in ten normotensive non-insulin dependent diabetic subjects were measured, using the hyperinsulinaemic isoglycaemic clamp technique. Following a baseline study, enalapril was commenced at 5 mg daily and increased to 10 mg daily then 20 mg daily at 14 day intervals. Repeat studies were undertaken after 14 days at each dosage. There was a significant dose-related reduction of systolic blood pressure with enalapril. In contrast enalapril at 5-20 mg daily produced no significant changes in insulin mediated glucose uptake (M-value) or insulin sensitivity index (ISI). These findings indicate that in this insulin resistant population of normotensive non-insulin dependent diabetics, angiotensin converting enzyme inhibition with enalapril has no significant effect on insulin mediated glucose uptake.