Postprandial Blood Glucose Concentrations Research Articles

α-Glucosidase inhibitory effect of resveratrol and piceatannol

Dietary polyphenols have been shown to inhibit α-glucosidase, an enzyme target of some antidiabetic drugs. Resveratrol, a polyphenol found in grapes and wine, has been reported to inhibit the activity of yeast α-glucosidase. This triggered our interest to synthesize analogs and determine their effect on mammalian α-glucosidase activity. Using either sucrose or maltose as substrate resveratrol, piceatannol and 3′-hydroxypterostilbene showed strong inhibition of mammalian α-glucosidase activity; pinostilbene, cis-desoxyrhapontigenin and trans-desoxyrhapontigenin had moderate inhibition. Compared to acarbose (IC50 3–13 μg/ml), piceatannol and resveratrol inhibited mammalian α-glucosidase to a lesser extent (IC50 14–84 and 111–120 μg/ml, respectively). 3′-Hydroxypterostilbene (IC50 105–302 μg/ml) was 23–35-fold less potent than acarbose. We investigated the effect of piceatannol and resveratrol on postprandial blood glucose response in high-fat-fed C57Bl/6 mice. Animals administered resveratrol (30 mg/kg body weight [BW]) or piceatannol (14 mg/kg BW) 60 min prior to sucrose or starch loading had a delayed absorption of carbohydrates, resulting in significant lowering of postprandial blood glucose concentrations, similar to the antidiabetic drug acarbose, while no significant effect was observed with the glucose-loaded animals. Our studies demonstrate that the dietary polyphenols resveratrol and piceatannol lower postprandial hyperglycemia and indicate that inhibition of intestinal α-glucosidase activity may be a potential mechanism contributing to their antidiabetic property.

Fate of d-Fagomine after Oral Administration to Rats.

d-Fagomine is an iminosugar found in buckwheat that is capable of inhibiting the adhesion of potentially pathogenic bacteria to epithelial mucosa and reducing the postprandial blood glucose concentration. This paper evaluates the excretion and metabolism of orally administered d-fagomine in rats and compares outcomes with the fate of 1-deoxynojirimycin. d-Fagomine and 1-deoxynojirimycin show similar absorption and excretion kinetics. d-Fagomine is partly absorbed (41-84%, dose of 2 mg/kg of body weight) and excreted in urine within 8 h, while the non-absorbed fraction is cleared in feces within 24 h. d-Fagomine is partially methylated (about 10% in urine and 3% in feces). The concentration of d-fagomine in urine from 1 to 6 h after administration is higher than 10 mg/L, the concentration that inhibits adhesion of Escherichia coli. Orally administered d-fagomine is partially absorbed and then rapidly excreted in urine, where it reaches a concentration that may be protective against urinary tract infections.

Effect of High Intensity Intermittent Games-Based Activity on Adolescent Cardio-Metabolic Health

In adults emerging evidence suggests that games-based activity acutely stimulates anti-inflammatory and inhibits pro-inflammatory cytokine production, proposed to induce cardio-metabolic health benefits. The acute effects of high-intensity intermittent games on adolescent cardio-metabolic health remain unexplored. PURPOSE: To examine the effects of an acute bout of games-based activity on adolescent cardio-metabolic health. METHODS: Following ethical approval 18 adolescents (12.5±0.6 y) completed an exercise (E) and resting (R) trial in a counter-balanced, randomised crossover design. Following a standardised breakfast (1.5 g.kg-1 bm carbohydrate), participants completed 1 h games-based activity (basketball). Capillary blood samples were taken at baseline, immediately and 1 h post-exercise. A standardised lunch was consumed (1.5 g.kg-1 bm carbohydrate) and capillary blood samples were taken 30, 60 and 120 min post-lunch. A final blood sample was taken the following morning. Capillary blood samples were analysed for blood glucose, plasma insulin and cytokine (IL-6, IL-10, IL-1ra, IL-1β, IL-8 and TNF-α) concentrations. Data were analysed using repeated measures ANOVA and paired sample t-tests in SPSS. RESULTS: The blood glucose response to lunch was attenuated following exercise (trial*time interaction, p=0.008), with a tendency for a lower peak blood glucose concentration on the exercise trial (E: 5.6±0.7 mmol.L-1, R: 6.3±1.4 mmol.L-1, p=0.070). Similarly, the plasma insulin response was attenuated (trial*time interaction, p=0.002), with a lower peak plasma insulin concentration on the exercise trial (E: 217.2±29.2 pmol.L-1, R: 366.1±45.3 pmol.L-1, p <0.001). IL-6 concentration was higher (E: 4.22±0.80 pg.mL-1, R: 3.46±0.69 pg.mL-1, p=0.005) and there was a tendency for TNF-α to be attenuated (E: 1.24±0.22 pg.mL-1, R: 1.34±0.23 pg.mL-1, p=0.081) on the exercise trial. Exercise had no effect on the remaining cytokines. CONCLUSION: High-intensity intermittent games-based activity attenuated postprandial blood glucose and plasma insulin concentrations, whilst demonstrating an increase in IL-6 concentration, potentially mediating the reduced TNF-α concentrations. Thus high-intensity games-based physical activity elicits cardio-metabolic health benefits in adolescents.

Concordant and divergent strategies to improve postprandial glucose and lipid metabolism

AbstractFollowing ingestion of a mixed‐macronutrient meal, blood glucose and triacylglycerol (TAG) concentrations are elevated for approximately 2 and 8 hours, respectively, depending on factors such as the amount and type of food ingested. For many individuals who consume at least three meals per day, the majority of waking hours are thus spent in a postprandial state. Exaggerated postprandial glycaemia and triglyceridemia are associated with cardiovascular and metabolic diseases, and so strategies to alleviate such perturbations are desirable (e.g. exercise and/or diet). An acute bout of endurance, resistance or high‐intensity and interval exercise typically mitigates postprandial glucose and TAG responses to subsequent meals. Regular exercise training also facilitates adaptations that beneficially alter postprandial metabolism. The health benefits of various dietary protocols have been debated in research and in the media over recent decades. To complicate matters, these strategies may be beneficial for glucose metabolism but simultaneously impair TAG metabolism or vice versa. Finally, despite the finding that diet and exercise can independently alter postprandial metabolism, there are fewer investigations of their ability to act synergistically to achieve a prophylactic response on postprandial blood glucose and TAG concentrations. This may provide the basis for future public health guidelines and is an important consideration in the context of the current worldwide prevalence of cardiovascular and metabolic diseases.

Short-Term Effects of Lupin vs. Whey Supplementation on Glucose and Insulin Responses to a Standardized Meal in a Randomized Cross-Over Trial.

Background: Whey protein is known to reduce postprandial glycaemia in people with type 2 diabetes mellitus. Lupin as a vegetable source of protein could be considered as an alternative, as the percentage of vegetarian and vegan consumers is raising. The present study compares the acute glycemic effects of whey and lupin in healthy volunteers following a carbohydrate-rich reference meal.Methods In cross-over design, three standardized meals (reference meal; reference meal + whey; reference meal + lupin) were provided to 12 healthy male and female volunteers, aged between 23 and 33, in a balanced, randomized order. Volunteers' blood glucose and insulin concentrations were analyzed at baseline and at seven time points following the ingestion of the meals.Results: The supplementation of whey or lupin significantly blunted the postprandial increase in blood glucose concentrations compared to the reference meal (p < 0.001). In the overall statistical analysis, this effect was comparable for whey and lupin [Δ AUC whey-lupin = 8%, 0–60 min area under the curve (0–60 min AUC), p = 0.937], with a blunting effect of −46% by whey (p = 0.005, 0–60 min AUC) and of −54% by lupin (p < 0.001, 0–60 min AUC). When comparing whey and lupin data only, the insulin increase was found to be more pronounced for whey protein than for lupin supplementation (Δ AUC whey-lupin = 39%, 0–60 min AUC, p = 0.022). However, when comparing the insulin response of each supplementation to the one of the reference meal, no differences could be detected (whey p = 0.259, 0–60 min AUC; lupin p = 0.275, 0–60 min AUC).Conclusions: Results suggest that lupin and whey can both lower the increase of postprandial blood glucose concentrations to a comparable extent, implying the usability of lupin to reduce postprandial glycaemia. However, the insulin response following the supplementations to a carbohydrate-rich meal seems to differ for these two protein sources.

Erratum: Effects of roux-en-Y gastric bypass surgery on postprandial fructose metabolism.

Objective Fructose is partly metabolized in small bowel enterocytes, where it can be converted into glucose or fatty acids. It was therefore hypothesized that Roux-en-Y gastric bypass (RYGB) may significantly alter fructose metabolism. Methods We performed a randomized clinical study in eight patients 12-17 months after RYGB and eight control (Ctrl) subjects. Each participant was studied after ingestion of a protein and lipid meal (PL) and after ingestion of a protein+lipid+fructose+glucose meal labeled with 13C-fructose (PLFG). Postprandial blood glucose, fructose, lactate, apolipoprotein B48 (apoB48), and triglyceride (TG) concentrations, 13C-palmitate concentrations in chylomicron-TG and VLDL-TG, fructose oxidation (13CO2 production), and gluconeogenesis from fructose (GNGf) were measured over 6 hours. Results After ingestion of PLFG, postprandial plasma fructose, glucose, insulin, and lactate concentrations increased earlier and reached higher peak values in RYGB than in Ctrl. GNGf was 33% lower in RYGB than Ctrl (P = 0.041), while fructose oxidation was unchanged. Postprandial incremental areas under the curves for total TG and chylomicrons-TG were 72% and 91% lower in RYGB than Ctrl (P = 0.064 and P = 0.024, respectively). ApoB48 and 13C-palmitate concentrations were not significantly different. Conclusions Postprandial fructose metabolism was not grossly altered, but postprandial lipid concentrations were markedly decreased in subjects having had RYGB surgery.

Chickpeas suppress postprandial blood glucose concentration, and appetite and reduce energy intake at the next meal.

The current study was designed to explore the beneficial properties of chickpeas consumption on suppressing appetite, excessive blood glucose excursions, and energy intake (EI) from a subsequent meal. Two caloric preloaded foods, chickpeas, and white bread were compared to water control, fed to healthy female subjects at equal energy density, volume, and available carbohydrate content in two experiments spanning over 60 and 120min. Blood glucose was measured by a portable glucometer and satiety by using a visual analogue scale questionnaire at baseline and every 15 up to 60min in both experiments and then every 30 until 120min in Experiment 2 after the preloads ingestion. A test meal was served at the end of both experiments to calculate EI and percent energy compensation (%EC). The results suggest a reduction of 29-36% in blood glucose concentration, and 83-98% EC after the chickpeas in Experiments 1 and 2 respectively compared to white bread. The average appetite showed a positive association with EI. We conclude that the consumption of chickpeas is beneficial on glycemic control and may help in body weight management through suppressing appetite and energy intake.

Breaking up Prolonged Sitting does not Alter Postprandial Glycemia in Young, Normal-Weight Men and Women.

A randomized, controlled, cross-over study was used to investigate the effects of breaking up prolonged sitting with low intensity physical activity on postprandial blood glucose concentrations in healthy, young, normal-weight adults. 14 men (n=6) and women (n=8) were assigned to 2.5 h of prolonged sitting (CON) and 2.5 h of prolonged sitting with 2-min bouts of walking every 20 min (LIPA). After ingesting a standardized test drink, capillary blood was sampled every 10 min to establish a postprandial blood glucose profile. Based on individual glucose responses, peak blood glucose, time-to-peak glucose, and incremental area under the glucose curve (iAUC) were determined. Paired sample t-tests were used to detect differences between trials. Peak blood glucose (p=0.55) and iAUC (CON: 252 mmol·L-1·2.5 h-1 [163-340]; LIPA: 214 mmol·L-1·2.5 h-1 [146-282]; p=0.45) were not different between trials. Also, time-to-peak glucose was not different between LIPA and CON (p=0.37). Taking advantage of high temporal resolution blood glucose profiles, we showed that breaking up prolonged sitting with low-intensity physical activity does not alter the postprandial blood glucose response in young, healthy, normal-weight adults. Our results indicate that postprandial glycemic control is maintained during prolonged sitting in young, healthy adults.

Dietary supplementation with myo-inositol in women during pregnancy for treating gestational diabetes.

Dietary supplementation with myo-inositol in women during pregnancy for treating gestational diabetes.

Insulin Injection Into Lipohypertrophic Tissue: Blunted and More Variable Insulin Absorption and Action and Impaired Postprandial Glucose Control.

Lipohypertrophy (LHT) is common in insulin-treated patients but its exact impact on insulin absorption and action is unclear. In this crossover study, 13 patients with type 1 diabetes received subcutaneous abdominal injections of 0.15 units/kg insulin lispro into LHT (confirmed by examination and ultrasound) and normal adipose tissue (NAT). On one day, a euglycemic clamp was performed with two injections each into LHT and NAT, and on another day one injection per region was given before a standardized mixed meal (75 g carbohydrates), all in randomized order. Compared with NAT, LHT reduced insulin absorption (mean area under the insulin concentration curve [AUCINS0-4h] 131 vs. 165 h * mU/L [LHT vs. NAT]; Cmax 61 vs. 79 mU/L, P < 0.02, respectively) and effect (areas under glucose infusion rate [GIR] curves [AUCGIR0-4h 625 vs. 775 mg/kg, P < 0.05]) but increased intrasubject variability ([coefficient of variation] AUCINS0-4h 52 vs. 11%, Cmax 55 vs. 15%, AUCGIR0-4h 57 vs. 23%, all P < 0.01). Postprandial blood glucose (BG) concentrations were ≥26% higher with LHT (AUCBG0-5h 731 vs. 513 mg * h/dL, BGmax 199 vs. 157 mg/dL, 2-h BG 150 vs. 104 mg/dL, 5-h BG 145 vs. 81 mg/dL, all P < 0.05) and maximum concentrations occurred later. Hypoglycemia (BG ≤50 mg/dL) occurred numerically less frequently with LHT injection (two vs. six patients), whereas profound hyperglycemia (BG ≥300 mg/dL) only occurred with LHT injection (two patients). Tmax-INS did not differ between LHT and NAT in either study. Insulin absorption and action are blunted and considerably more variable with LHT injection, leading to profound deterioration in postprandial glucose control.

Evaluation of the Effect of Carbohydrate Intake on Postprandial Glucose in Patients With Type 1 Diabetes Treated With Insulin Pumps.

It has been suggested that dietary freedom in functional insulin therapy may be detrimental to glycemic control in type 1 diabetes. This study evaluates the effect of carbohydrate intake on glycemic control and postprandial blood glucose concentrations. Insulin pump data from 148 adults with type 1 diabetes, trained in functional insulin therapy, using pumps for ≥6 months, with ≥2 weeks of consecutive downloaded data, ≥80% use of a bolus calculator, ≥3 capillary blood glucose tests/day, and a concurrent HbA1C, were analyzed. More detailed periprandial data (pre- and postmeal glucose, carbohydrate intake, insulin bolus) were collected from a subset of 105 downloads (3495 meals). Mean (± SD) age of contributors was 43 ± 13 years, HbA1C 7.84% ± 0.93 (62.19 mmol/mol); daily carbohydrate intake 166 ± 71 g. HbA1C reduced with increased meals/day (r = -.370, P < .0005) and increased with mean carbohydrate content/meal (r = .198, P = .043). However, total daily carbohydrate intake had a weak but significant negative association with HbA1C (r = -.181, P = .027). There was no association between standard deviation of carbohydrate intake and HbA1C (r = .021, P = .802) or between meal carbohydrate content and postprandial change in blood glucose (r = -.004, P = .939) for meals with early postprandial (1-3 hours; n = 390) readings. There was a weak positive correlation (r = .184, P = .008) between meal carbohydrate content and late (4-7 hours; n = 390) postprandial readings. With appropriate training, patients using insulin pumps can accommodate a flexible diet with variable carbohydrate intake, without detriment to glycemic control. However, large carbohydrate meals may contribute to poorer outcomes, through impact on late postprandial glycemia.

Macronutrient Composition and Glycemic Index of Varied Prepared Meals of Irish Potatoes in Non Diabetic Subjects

The glycemic response of white potatoes consumed in Nigeria was determined using various methods of cooking. Twenty healthy volunteers aged 20 to 30 years participated in the study. Subjects consumed 50 g baked potato (Bp), boiled potato consumed hot (Boph), boiled potato consumed cold (Bopc), French fries potato (Ffp) and white bread (control). Blood glucose concentration was determined before and after the test meals. The post-prandial blood glucose concentration over a period of 2 hours were determined half hourly, after the consumption of the test meals and blood glucose curves were constructed to calculate the glycemic index of the test meals. The results revealed that the glycemic values of potatoes varied significantly (p<0.05) depending on cooking method, ranging from intermediate (boiled potatoes consumed cold) 55, to moderately high baked potatoes 74, boiled potatoes consumed hot 87. The French fries had glycemic value of 63 which are widely consumed all over the world including Nigeria. The glycemic index of potatoes is influenced by method of cooking and the white potatoes consumed in Nigeria have a moderately high glycemic index. Individuals who wish to minimize dietary glycemic index should be cautious of the prepared pattern of Irish potatoes.

Vascular disease risk in type 2 diabetes: high sugars, fluctuating sugars, both?

Optimal glucose control is important for the prevention of the microvascular complications in type 1 and type 2 diabetes (T2D). Although hyperglycemia is associated with oxidative stress, studies in adults have demonstrated that increased blood glucose variability can magnify this effect and may be as important or potentially, even more important, than the degree of blood glucose control in increasing the risk of microvascular and macrovascular disease. As the TODAY study demonstrated, youth with T2D have earlier appearance and more rapid progression of complications than do adults with T2D; it is important to determine if adolescents have the same effect of glycemic variability on oxidative stress as do adults. In this issue of The Journal, Dasari et al evaluated the mean amplitude of glycemic excursion (MAGE) using continuous glucose monitoring in normal weight (n = 12), normoglycemic obese (n = 10), and adolescents with T2D (n = 12). The authors quantified MAGE and counted the number of glucose excursions, calculating the mean and standard deviation for each set of glucose values. All subjects wore a continuous glucose monitor and step activity monitor for 5 days. Markers of oxidative stress were correlated with MAGE, with oxidized low density lipoprotein, an inflammatory marker of atherosclerotic risk, having the highest correlation. Traditional cardiovascular risk factors moderately to strongly associated with MAGE were body mass index, body fat, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, C-reactive protein, and nonesterified fatty acids. The vascular inflammatory biomarkers, E-selectin and intercellular adhesion molecule 1, also correlated with MAGE. This study demonstrates the significance of glycemic variability in inducing oxidative stress in youth with T2D. Although diabetologists typically have patients measure blood glucose values before meals, at bedtime, and occasionally at 2:00 a.m., glycemic variability is not assessed routinely. Pre- and postprandial blood glucose concentrations are usually measured only when adjusting insulin doses in an effort to improve glycemic control. Because this study indicates that glycemic variability is at least as important as blood glucose concentrations as a risk for endothelial dysfunction, clinicians should consider asking patients to monitor both pre- and postprandial blood glucose levels routinely and to adjust bolus insulin doses to attempt to minimize pre- and postprandial glucose excursions. Article page 47▶ Glycemic Variability Is Associated with Markers of Vascular Stress in AdolescentsThe Journal of PediatricsVol. 172PreviewWe used continuous glucose monitoring to test the hypothesis that mean amplitude of glycemic excursions (MAGE) is associated with circulating markers of oxidative and vascular stress in adolescents with habitually low physical activity classified as healthy weight, healthy obese, or obese with type 2 diabetes mellitus (T2DM). Full-Text PDF

Blood glucose and lipid concentrations after overload are not associated with the risk of alcohol relapse

AimsThere is evidence for the functioning of feedback between alcohol consumption and fat (positive) and carbohydrate (negative) intake. We tried to verify the hypothesis that blood glucose and lipid concentration in a fasting state and after loading may affect the risk of relapse in alcohol-dependent male patients during withdrawal therapy. MethodsBlood glucose, total cholesterol (TC) and triglycerides (TG) were determined at the beginning of the study, and again after 4 weeks and 6 months of observation in 54 alcohol-dependent male patients treated against drinking relapse. Glucose concentration was checked after fasting and 2h after loading with a 75g water solution of glucose, and blood lipids were determined on an empty stomach and 5h after butter loading (0.5g of butter per kilogram of body mass). ResultsPatients who relapsed compared to subjects who remained abstinent during the 6-month observation did not differ significantly in relation to blood glucose, TC or TG blood concentrations, either in a fasting state or after loading. Patients with an initial above-median increase in TG blood concentration after butter loading (>38%) before the beginning of the study, and who smoked cigarettes with a greater content of nicotine and tar, preferred vodka and had lower values of aminotransferases. ConclusionFasting and postprandial blood glucose, TC and TG concentrations had no relationship with the outcome of anti-relapse treatment. However, they presented some associations with the pathomechanism of addiction to nicotine.

Effects of roux-en-Y gastric bypass surgery on postprandial fructose metabolism.

Fructose is partly metabolized in small bowel enterocytes, where it can be converted into glucose or fatty acids. It was therefore hypothesized that Roux-en-Y gastric bypass (RYGB) may significantly alter fructose metabolism. We performed a randomized clinical study in eight patients 12-17 months after RYGB and eight control (Ctrl) subjects. Each participant was studied after ingestion of a protein and lipid meal (PL) and after ingestion of a protein+lipid+fructose+glucose meal labeled with (13) C-fructose (PLFG). Postprandial blood glucose, fructose, lactate, apolipoprotein B48 (apoB48), and triglyceride (TG) concentrations, (13) C-palmitate concentrations in chylomicron-TG and VLDL-TG, fructose oxidation ((13) CO2 production), and gluconeogenesis from fructose (GNGf) were measured over 6 hours. After ingestion of PLFG, postprandial plasma fructose, glucose, insulin, and lactate concentrations increased earlier and reached higher peak values in RYGB than in Ctrl. GNGf was 33% lower in RYGB than Ctrl (P = 0.041), while fructose oxidation was unchanged. Postprandial incremental areas under the curves for total TG and chylomicrons-TG were 72% and 91% lower in RYGB than Ctrl (P = 0.064 and P = 0.024, respectively). ApoB48 and (13) C-palmitate concentrations were not significantly different. Postprandial fructose metabolism was not grossly altered, but postprandial lipid concentrations were markedly decreased in subjects having had RYGB surgery.

A Comprehensive Review of Novel Drug-Disease Models in Diabetes Drug Development.

Type2 diabetes mellitus (T2DM) is a chronic metabolic disease, which affects millions of people worldwide. The disease is characterized by chronically elevated blood glucose concentrations (hyperglycaemia), which result in comorbidities and multi-organ dysfunction. This is due to a gradual loss of glycaemic control as a result of increasing insulin resistance, as well as decreasing β-cell function. The objective of T2DM drug interventions is, therefore, to reduce fasting and postprandial blood glucose concentrations to normal, healthy levels without hypoglycaemia. Several classes of novel antihyperglycaemic drugs with various mechanisms of action have been developed over the past decades or are currently under clinical development. The development of these drugs is routinely supported by the application of pharmacokinetic/pharmacodynamic modelling and simulation approaches. They integrate information on the drug's pharmacokinetics, clinically relevant biomarker information and disease progression into a single, unifying approach, which can be used to inform clinical study design, dose selection and drug labelling. The objective of this review is to provide a comprehensive overview of the quantitative approaches that have been reported since the 2008 review by Landersdorfer and Jusko in an increasing order of complexity, starting with glucose homeostasis models. Each of the presented approaches is discussed with respect to its strengths and limitations, and respective knowledge gaps are highlighted as potential opportunities for future drug-disease model development in the area of T2DM.

The Effect of Intramuscular versus Intra-Amniotic Dexamethasone Administration on Blood Glucose Level in Diabetic Pregnant Women

Background: To investigate the blood glucose level response of diabetic pregnant women when administrating antenatal dexamethasone to accelerate fetal lung maturity in different routes. Methods: This prospective cohort study included 60 pregnant women with diabetes who required promotion of fetal lung maturity in Peking University First Hospital from January 2013 to April 2015. Dexamethasone was administered by IM (n = 29) or IAC (n = 31). Blood glucose level was monitored before injection, and 1 day, 2 days and 3 days after injection. Results: In the intramuscular injection group, the preprandial and postprandial blood glucose concentration was significantly elevated in the first two days (P < 0.001), and the postprandial blood glucose level was still higher than basal level (P = 0.034) on the third day. In the intra-amniotic injection group, the preprandial and postprandial blood glucose concentration was also significantly elevated on the first day (P < 0.001), but soon returned to the basal level on the second day. No significant difference was found in the magnitude of glucose increase between the two groups. Conclusion: Blood glucose level is significantly influenced by intramuscular injection of antenatal dexamethasone rather than amniotic cavity injection.

Mastication Frequency and Postprandial Blood Sugar Levels in Normoglycaemic and Dysglycaemic Individuals: A Cross- Sectional Comparative Study.

Mastication has potential to affect postprandial blood glucose levels by affecting cephalic phase of insulin release. However, limited number of studies done in this regard has yielded conflicting results. To evaluate effects of mastication on postprandial blood glucose levels. We compared routine and thorough mastication in 2 separate groups: dysglycaemic (prediabetics and diabetics) and normoglycaemic in prospective interventional study. Blood glucose levels were measured pre-prandial and postprandial (after 2 hours) on separate days after routine and thorough mastication in both groups. In normoglycaemic group, thorough mastication significantly reduced postprandial blood glucose levels at 2 hours (128.25± 7.82 mg/dl on routine mastication vs 119.74±9.08 mg/dl on thorough mastication, p<0.05). Comparatively, in dysglycaemic group, thorough mastication had little effect on postprandial blood glucose levels at 2 hours (244.07±22.37 mg/dl vs. 243.55±22.87 mg/dl). In normoglycaemic group, postprandial blood glucose concentration upon thorough mastication was significantly lower, due to early-phase insulin secretion. This simple lifestyle modification of thorough mastication can be a useful preventive measure against diabetes in people with a strong family history and other risk factors for diabetes who have not yet developed diabetes or prediabetes.

Effect of co-ingestion of amino acids with rice on glycaemic and insulinaemic response.

Consumption of high glycaemic index (GI) and glycaemic response (GR) food such as white rice has been implicated in the development of type 2 diabetes. Previous studies have reported the ability of individual amino acids to reduce GR of carbohydrate-rich foods. Because of the bitter flavour of amino acids, they have rarely been used to reduce GR. We now report the use of a palatable, preformed amino acid mixture in the form of essence of chicken. In all, sixteen healthy male Chinese were served 68 or 136 ml amino acid mixture together with rice, or 15 or 30 min before consumption of white rice. Postprandial blood glucose and plasma insulin concentrations were measured at fasting and every 15 min after consumption of the meal until 60 min after the consumption of the white rice. Subsequent blood samples were taken at 30-min intervals until 210 min. The co-ingestion of 68 ml of amino acid mixture with white rice produced the best results in reducing the peak blood glucose and GR of white rice without increasing the insulinaemic response. It is postulated that amino acid mixtures prime β-cell insulin secretion and peripheral tissue uptake of glucose. The use of ready-to-drink amino acid mixtures may be a useful strategy for lowering the high-GI rice diets consumed in Asia.

Sleep Duration and Blood Glucose Control in Women With Gestational Diabetes Mellitus.

To describe the relationship between objectively assessed sleep and blood glucose in a prospective cohort of women recently diagnosed with gestational diabetes mellitus (GDM). Women with GDM were enrolled immediately after attending a GDM education class. All patients were recruited during their first week of attempted dietary management of GDM. They were instructed on the use of a glucometer and on the principles of a GDM diet. Women wore an actigraph and completed a sleep log for 7 consecutive days. Glucose records were compared against the objective sleep data. Linear mixed model analysis was used to estimate the association of sleep duration on morning fasting and 1-hour postprandial blood glucose concentrations. Thirty-seven participants provided data for 213 sleep intervals that corresponded to at least one glucose reading. Sleep duration was negatively associated with fasting and 1-hour postprandial blood glucose concentrations In analyses adjusted for age, gestational age, and body mass index, a 1-hour increase in sleep time was associated with statistically significant reductions in fasting glucose (-2.09 mg/dL, 95% confidence interval [CI] -3.98 to -0.20) as well as postprandial glucose concentrations (lunch -4.62 mg/dL, 95% CI -8.75 to -0.50; dinner -6.07 mg/dL, 95% CI -9.40 to -2.73). Short sleep durations are associated with worsened glucose control in women with gestational diabetes. Educating women on healthy sleep and screening for and treating sleep disorders during pregnancy may have a role in optimizing blood glucose control in gestational diabetes. II.