Postprandial Plasma Glucose Research Articles

Fasting Plasma Glucose and Its Relationship to Anthropometric Phenotype in Women Diagnosed with Gestational Diabetes According to IADPSG Criteria.

Gestational diabetes mellitus (GDM) is characterized by new-onset hyperglycemia in pregnancy. According to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommendations, GDM may be diagnosed based on repeatedly increased fasting glucose levels in the first trimester, or later, the detection of increased fasting glucose and/or increased glucose levels during a 75 g oral glucose tolerance test (OGTT). The study aimed to assess whether differences may be found between women diagnosed with GDM by fasting glucose or glucose challenge tests in early or late pregnancy. The retrospective observational study enrolled 418 women diagnosed with GDM in accordance with the IADPSG criteria: early pregnancy fasting plasma glucose (FPG) ≥ 5.1 mmol/L; late pregnancy FPG ≥ 5.1 mmol/L (0 min) and/or postprandial plasma glucose (PPG) ≥ 10.0 mmol/L (60 min), PPG ≥ 8.5 mmol/L (120 min) 75 g OGTT. The analyses included anthropometric parameters at the beginning and during pregnancy, laboratory values of glycated hemoglobin, fructosamine, birth weight measures and the presence of neonatal complications. There were significant differences in body weight (78.3 ± 19.1; 74.0 ± 16.7; 67.2 ± 15.7 kg) and body mass index (BMI) (27.9 ± 6.6; 26.4 ± 5.8; 24.4 ± 5.2 kg/m2) in early pregnancy. Differences were also found in gestational weight gain (9.3 ± 6.8 vs. 12.4 ± 6.9 vs. 11.1 ± 4.7 kg) and the need for insulin therapy (14.7%; 7.1%; 4.0%). The study revealed no difference in the presence of neonatal complications but differences in birth weight (3372.2 ± 552.2 vs. 3415.6 ± 529.0 vs. 3199.0 ± 560.5 g). Gestational diabetes, characterized by FPG ≥ 5.1 mmol/L in early pregnancy, is associated with higher body weight and BMI at the beginning of pregnancy as well as with a higher risk for insulin therapy and increased birth weight.

Study of Association of Serum Prolactin Levels with Insulin Resistance in Type 2 Diabetes Mellitus Patients.

Prolactin (PRL) regulates glucose metabolism and insulin sensitivity. The study aimed to evaluate the role of PRL in glucose homeostasis and its association with insulin resistance in patients with diabetes mellitus (DM). This cross-sectional, observational study included 100 patients (25-60 years) with T2DM. Primary information including demographics, anthropometric measurements, and biochemical measures (complete blood count, glucose parameters, liver and kidney function test, lipid profile, thyroid function test, serum fasting insulin levels, serum PRL levels) was collected. A total of 100 patients, 50 men and 50 women (25 premenopausal and 25 postmenopausal), were enrolled in this study. The correlation between serum cholesterol and PRL was found to be statistically non-significant (P = 0.129) in men and significant (P = 0.041) in women. There was an inverse relationship between fasting plasma glucose and serum PRL levels in both men (r = -0.88; P < 0.0001) and women patients (r = -0.768; P < 0.0001). Negative correlation between postprandial plasma glucose and PRL was found to be statistically significant (r = -0.398; P = 0.048) in postmenopausal women. The comparison in both men and women indicated an inverse correlation between serum PRL and glycated haemoglobin levels. There was a significant negative correlation between homeostasis model assessment-estimated insulin resistance (HOMA-IR) and PRL levels in both men (r = -0.362; P = 0.039) and women patients (r = -0.362; P = 0.003). Homeostasis model assessment of β cell function (HOMA-β), which directly correlates with residual pancreatic beta cell function, was positively correlated with prolactin levels, irrespective of gender and menopausal status of female subjects. Serum PRL levels correlate with improved glycaemic control.

Evaluation of interleukin-33 & sST2 levels in type-2 diabetic mellitus patients with or without metabolic syndrome.

Diabetes mellitus (DM) is characterized by increase in blood glucose levels due to defective insulin secretion or insulin sensitivity. Interleukins (ILs) are known to play an important role in the pathogenesis of DM. The aim of this study was to investigate the serum concentration of IL-33 and its receptor soluble ST2 (sST2) in patients with diabetes and draw a correlation between their serum levels and different standard glycaemic indices of patients affected with type-2 diabetes with or without metabolic syndrome. Thirty type-2 diabetic individuals and 30 healthy controls were recruited for this study. Serum and plasma were separated by centrifugation of blood for quantitative measurement of IL-33, sST2 and other biochemical parameters. It was observed that serum IL-33 levels were significantly less and sST2 levels were significantly high in type-2 diabetic individuals as compared to healthy controls. A significant correlation between the serum IL-33 concentration and fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) levels were also found. Additionally, data also elucidated that serum levels of high-density lipoprotein, low-density lipoprotein or triglyceride in type-2 diabetics did not influence the serum levels of IL-33 and sST2, thereby excluding these factors as the major drivers of changes in serum IL-33 and sST2 concentration. This study demonstrated alteration in serum levels of IL-33 and sST2 in type-2 diabetic individuals. Further mechanistic studies, focusing on the progression of type-2 diabetes could elucidate the involvement of IL-33 in the cellular acquisition of insulin resistance as observed in type-2 diabetics.

Diabetic Neuropathy, a Cause of Pulmonary Dysfunction in Patients of Type 2 Diabetes Mellitus

Introduction: Diabetic neuropathy (DN) is most commonly associated with diabetic peripheral neuropathy (DPN). About 66% of diabetic patients have either clinical or subclinical neuropathy. Materials and Methods: One hundred and twenty patients were enrolled in our study, 60 patients are of Type 2 diabetes mellitus (T2DM) with neuropathy (DPN), and 60 were of T2DM without neuropathy. They were assessed for neuropathy. Serum fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin A1C (HbA1C), and duration of disease were obtained from the patients. Forced expiratory volume at the 1st s (FEV1) and forced vital capacity were recorded and % FEV1 was calculated. Results: The mean age of T2DM with neuropathy was 49.17 ± 7.1 and in patients of T2DM without neuropathy was 46.63 ± 8.028. The mean value of % FEV1 in T2DM with neuropathy is 95.45 ± 7.16, while in T2DM without neuropathy, it is 83.53 ± 6.22, and the difference was statistically significant. Linear correlation of % FEV1 with fasting plasma glucose (FPG) (r = 0.474, P = 0.008) and HbA1C (r = 0.588, P = 0.001) shows a statistically significant association in diabetic peripheral neuropathy. The standardized β weights of FPG, postprandial plasma glucose, and HbA1C show significant values in patients of DPN. Conclusion: Diabetic peripheral neuropathy (DPN) is associated with decreased pulmonary function as compared to patients of diabetes without neuropathy, the glycemic status of patients may also adversely affect % FEV1. Thus, proper control of hyperglycemia will decrease the further progression of the disease. We also suggest performing pulmonary function test in patients of diabetes mellitus with DN in the preoperative period so as to optimize the perioperative care.

O efeıto do tempo de consumo de fruta na regulação da glıcose na gravıdez com dıabetes gestacıonal

ABSTRACT Objective This study aims to determine the effect of fruit consumption time on blood glucose regulation in pregnant women with gestational diabetes. Methods The study was carried out with 64 volunteer participants diagnosed with gestational diabetes. Participants who were directed to the Department of Nutrition and Dietetics were divided into two groups according to the order of application; Group 1 was included in the nutrition treatment program for a week, consuming fruit for the main meal and Group 2 for the snack. During this process, the participants were applied a personalized nutrition plan that was adjusted equally for macronutrients of all meals containing isocaloric 3 main and 4 snacks. In this process, blood glucose values were measured six times a day by the participants and the blood glucose results of both groups before starting the nutrition therapy and on the seventh day after starting the medical nutrition therapy were compared. Results The mean age of the women participating in the study was 33.50±4.95 years and 32.28±5.18 years for the 1st and 2nd groups, respectively, and the groups were similar in terms of anthropometric measurements. The post-diet average of postprandial blood glucose levels in the morning within each group dropped from 180mg/d to 115mg/dL (p&lt;0,001) for Group 1 and from 185mg/dL to 110mg/dL (p&lt;0,001) for Group 2. There was a decrease in the fasting plasma glucose and postprandial blood glucose levels measured in the morning, noon and evening before and after the medical nutrition therapy of the groups, but no statistically significant difference was found between the groups (p&gt;0.05). All participants on the gestational diabetes diet had normal blood sugar levels without the need for insulin. A statistically significant decrease was observed in the postprandial blood glucose-fasting plasma glucose difference levels of the pregnant women in the group that consumed fruit for snacks (Group 2) on the seventh day of the study (p&lt;0,001). There was no significant difference in the pre-diet and post-diet morning fasting plasma glucose values of both groups (p&gt;0,05). Conclusion This study found that medical nutrition therapy in pregnant women with gestational diabetes led to a decrease in blood glucose levels, but consuming fruits as a snack or at the main meal did not make a significant difference on fasting plasma glucose and postprandial blood glucose. It was concluded that the type and amount of carbohydrates consumed daily in gestational diabetes are determinative on blood glucose level.

Correlations of Omentin-1 and Leptin with Bone Metabolism and Plasma Glucose Upon Type 2 Diabetes Mellitus and Osteoporosis.

The goal was to investigate the correlations of peripheral blood Omentin-1 and leptin (LEP) levels with bone metabolism and plasma glucose in patients with type 2 diabetes mellitus (T2DM) complicated with oste-oporosis (OP). One hundred patients with T2DM admitted from September 2019 to September 2021 were divided into group A (n = 36, OP with T-score ≤ -2.5), group B (n = 50, osteopenia with T-score between -1 and -2.5), and group C (n = 14, non-OP with T-score > -1) according to the values of bone mineral density (BMD). Thirty healthy adults physically examined in the same period were selected as group D. The levels of peripheral blood Omentin-1 and LEP, bone metabolism, and plasma glucose were compared among the four groups. The correlations of peripheral blood Omentin-1 and LEP levels with bone metabolism and plasma glucose were explored by Pearson's analysis. In group A, the levels of Omentin-1 and LEP in peripheral blood were lowest, the serum levels of beta C-terminal cross-linked telopeptides of type I collagen (β-CTX) and osteocalcin (OCN) were highest, the serum level of total N-terminal propeptide of type I procollagen (tPINP) was lowest, and the levels of fasting plasma glucose (FPG), 2-hours postprandial plasma glucose (2hPG) and glycosylated hemoglobin A1c (HbA1c) were highest, se-quentially followed by those of group B, group C, and group D (p < 0.05). Omentin-1 and LEP in peripheral blood were negatively correlated with β-CTX, OCN, 2hPG, and HbA1c and positively correlated with tPINP and FPG (p < 0.05). The expressions of Omentin-1 and LEP in peripheral blood have correlations with bone metabolism and plasma glucose in patients with T2DM complicated with OP.

Viscoelastic or Viscoplastic Glucose Theory (VGT #47): Using Viscoplasticity/Viscoplasticity to Explore the Inter-Relationships on Cancer Risk % Versus Sensor Measured Fasting Plasma Glucose and Body Weight Based on Eleven Collected Annual Data Over A 10+ Year Period From 1/1/2012 to 3/20/2022 using the GHMethod: Math-Physical Medicine (No. 632)

The purpose of this research article is to explore a possible link between cancer risk probability percentage (Cancer %) and body weight (BW) in the early morning. Body weight is very easy to measure by standing on a weight scale. Weight in the early morning is highly correlated with fasting plasma glucose (FPG) measured in the early morning or averaged glucose during sleeping hours. FPG also serves as the baseline of postprandial plasma glucose (PPG) and contributes around 25% to 29% of daily average glucose (eAG). Daily average glucose levels or quarterly HbA1C values (average eAG during the past 90-115 days) determine the severity of diabetes disease. Finally, diabetes is one of the major influential chronic diseases for developing many kinds of diseases and complications, including cancers. From the author’s mathematical view, in this biomedical field, an output biomarker sometimes turns into an input biomarker of a third biomarker. Therefore, many biomedical problems can be described as a scenario of the matrix with “m by n by p” dimensions.

The prevalence and risk factors of diabetic peripheral artery disease in Chinese communities

Objective: To investigate the prevalence and risk factors of diabetic peripheral artery disease (PAD) in patients with type 2 diabetes mellitus (T2DM) managed in primary health care in China. Methods: A total of 2 528 T2DM patients were selected using a two-stage cluster random sampling method based on the baseline survey of the "China Diabetic Foot Prevention Model Project." The study was conducted in 2015 among T2DM patients in 8 primary healthcare centers in Changshu county and Jiang'an district of Wuhan, China. Data collection methods included a questionnaire, body measurement, and blood glucose detection. The Ankle-Brachial Index (ABI) is the most widely used noninvasive vascular test. A binary logistic regression model was used to analyze the influence factors. Results: The prevalence of PAD was 11.2% among the diabetic patients managed in primary health care in the two cities. The prevalence of PAD under 55 years old, 55- years old, 65- years old, and ≥75 years old were 7.8%, 6.0%, 12.9% and 22.5%, respectively. Multivariate stepwise logistic regression identified influence factors included older age, higher education level, smoking, drinking, postprandial glucose uncontrol, and prior myocardial infarction or angina. Compared to age <55 years, the odds ratio for PAD were 0.74 for 55- years (95%CI: 0.43-1.28), 1.72 for 65- years (95%CI: 1.05-2.81), 3.56 for 75 years and above (95%CI: 2.07-6.11), respectively. Compared to patients with education in primary school and below, the odds ratio was 1.37 (95%CI: 0.97-1.94), 2.48 (95%CI: 1.73-3.55), 1.99 (95%CI: 1.26-3.13) for those with education levels of junior high school, senior high school, and college, respectively. Current smoking (OR=1.49, 95%CI: 1.02-2.17), current drinking (OR=0.45, 95%CI: 0.28-0.71), postprandial glucose uncontrol (2 h postprandial plasma glucose >10.0 mmol/L: OR=1.72, 95%CI: 1.22-2.43), and prior myocardial infarction or angina (OR=2.32, 95%CI: 1.50-3.61) were influencing factors of PAD. Conclusions: Despite the high prevalence of PAD in diabetes managed in primary health care; multiple risk factors are not effectively aware of and under control. It is urgent to promote ABI screening and standardized management for diabetes, especially in primary health care.

Estimation of Novel Anthropometric Measurements among Normoglycemic Persons, Prediabetes, and Diabetes in the Indian Population: An Analytical Cross-Sectional Study

Background: Central obesity is a risk factor for the development of diabetes mellitus (DM) and can be measured using various anthropometric measurements. Aim: This study is done to estimate novel anthropometric markers of obesity such as mid-upper arm circumference (MUAC), wrist circumference (WrC), waist–height ratio (WHtR), and neck circumference (NC) in healthy individuals, prediabetes, and DM. Methods: This was a cross-sectional study among 58 normoglycemic healthy volunteers, 59 prediabetics, and 59 diabetics in a tertiary care center from India. Participants were tested for fasting plasma glucose, postprandial plasma glucose, and glycated hemoglobin. Anthropometric measurements were done. We used partial ordinal regression to look for the association between anthropometric markers and diabetic status. Results: NC, MUAC, WrC, and WHtR were significantly higher in and highest in diabetics compared to controls. They significantly correlated with body mass index. They had significantly higher odds (odd ratio [OR1] NC – 1.60, OR1 WrC – 1.92, OR1 MUAC – 1.45, and OR1 WHtR – 1.33) for control to prediabetes. OR of only WHtR was significant for prediabetes to diabetes (OR2 WHtR– 1.10). Conclusion: Association of novel anthropometric markers was significant for prediabetes compared to controls, but not significant for diabetes compared to prediabetes.

Effect of Psychological Behavior Intervention on the Control of Chronic Diseases Resulting from the Adherence to Lifestyle and Medication Including Geriatric Longevity Study Via Effective Health Age, Using GH-Method: Math-Physical Medicine or Mentality-Personality Modeling (No. 392)

In this article, the author uses his 11 years of collected data from body weight and glucose with several prominent lifestyle details, mainly food portion/carbs &amp; sugar intake amount, and daily/post-meal walking steps to address the reduction trend patterns of weight and glucose. This research project is based on progressive behavioral modifications of his lifestyle which is also a part of his developed Mentality-Personality Modeling (MPM) of psychology. He identified the quantitative linkage between the physiological phenomena of obesity and diabetes and their associated psychological lifestyle behavioral interventions of a patient with both obesity and type 2 diabetes (T2D). The physiological part uses his developed GH-Method: math-physical medicine (MPM) research methodology. In addition, he utilizes the signal processing technique of wave theory to decompose the postprandial plasma glucose (PPG) wave into three primary sub-waves of food, exercise, and medications. Furthermore, he used his developed linear elastic glucose theory (LEGT) in 2020 to study the impact and adherence of medications on T2D for elderly patients. To address the common concern of longevity among elderly people, he further applied his metabolism index (MI) model developed in 2014 to calculate the effective health ages of elderly people in comparison with their real biological ages in terms of reducing or prolonging their perspective lifespan. For this research process, he creates a special geometric presentation model with the meal portion percentage and carbs/sugar intake amount as the x-axis, daily walking steps and post-meal walking steps as the y-axis, and daily weight and glucose data as the z-axis. He then “folds over” the z-axis and superimposes it with the x-y planar space in a “radio wave” format. These radio waves represent the different annual statuses of both weight and glucose. Under this created three-dimensional (3D) presentation on a two-dimensional (2D) planar space, the biomarker improvement patterns and moving trend of biomarkers, such as weight, glucose, and effective health age become ultra-clear. For effective health age, the same “pseudo-3D” geometric presentation model also applies. Instead, we can use medical conditions as the x-axis and lifestyle details as the y-axis. Over the past 11 years (2010 - 2020), the path of his annual weight and glucose moving patterns started from the upper right corner (subregion E5 in 2010), moving with a downward angle of 30 to 45 degrees, and finally reaching the lower left corner (subregion A1 in 2020). Through analyzing the distinctive daily weight and glucose trend patterns, the personality traits and related psychological behavior characteristics of this patient with both obesity and T2D can be revealed instantly and clearly. As a result, more practical guidance on progressive behavior modification can be provided to other patients to improve their medical conditions for chronic diseases, where some are caused by obesity. He was dependent on diabetes medications from 2010 through 2015 with a reduction trend pattern in the types and dosages of medications. Finally, on 12/8/2015, he ceased taking any medications for his chronic disease control. The author’s collected detailed data on diet, exercise, and medications began in 2014. From the decomposed PPG sub-component waves, during 2014-2015, the medication contributed a -21 mg/dL of PPG reduction. Thereafter, the combined contribution of diet and exercise replaced the role of medication.

Detection of Hemostasis Abnormalities in Type 2 Diabetes Mellitus Using Thromboelastography.

Type 2 DM (T2DM) is associated with inflammation and vascular dysfunction which impact hemostasis. Thromboelastography (TEG) as a hemostasis assessment method, is not routinely applied in T2DM. We aimed to detect hemostasis abnormalities by using the TEG method in association with glycemic levels and type of therapy among T2DM patients. A cross-sectional study was conducted among T2DM patients attending the Endocrinology Clinic of Saiful Anwar Hospital, Indonesia. Glycemic profiles were determined using fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2hPPG), and glycosylated hemoglobin (HbA1c). Therapy for T2DM was classified into insulin and non-insulin regimens. The primary and secondary hemostasis profile were examined using TEG and was classified as hypo- hyper- and normo-coagulable states. A total of 57 T2DM patients were included. Kruskal-Wallis test did not reveal a significant association between glycemic profiles and groups of hemostasis. However, the median HbA1c was higher in the hypercoagulable group of primary hemostasis and fibrinolysis. The median FPG and 2hPPG were higher in the normo-coagulable group of secondary hemostasis. Logistic regression did not indicate a significant association between type of therapy for diabetes and hemostasis profile. This study did not find significant associations between glycemic levels and type of DM therapy with hemostasis profiles using the TEG method in patients with T2DM.

#1315712: A Case of Post Bariatric Surgery Hypoglycemia Requiring Percutaneous Gastrostomy (PEG) Tube Placement in the Remnant Stomach

As the prevalence of bariatric procedures increases, an important phenomenon to consider is post-gastric bypass hypoglycemia (PBH). PBH is defined as a post-prandial plasma glucose < 55 mg/dL accompanied by adrenergic and/or neuroglycopenic symptoms that are resolved by carbohydrate intake. PBH is explained by multiple mechanisms: increased GLP-1 secretion, inappropriate insulin release, reduced insulin clearance, and impaired glucagon counter-regulation. Although rare, PBH can be very serious and distressing to patients due to the symptom burden and difficulty to manage.

Feeding pigs amino acids as protein-bound or in free form influences postprandial concentrations of amino acids, metabolites, and insulin

Dietary proteins need to be digested first while free amino acids (AAs) and small peptides are readily available for absorption and rapidly appear in the blood. The rapid postprandial appearance of dietary AA in the systemic circulation may result in inefficient AA utilisation for protein synthesis of peripheral tissues if other nutrients implicated in AA and protein metabolism are not available at the same time. The objective of this experiment was to compare the postprandial concentrations of plasma AA and other metabolites after the ingestion of a diet that provided AA either as proteins or as free AA and small peptides. Twenty-four male growing pigs (38.8 ± 2.67 kg) fitted with a jugular catheter were assigned to one of three diets that provided AA either in protein form (INT), free AA and small peptides (HYD), or as free AA (FAA). After an overnight fast and initial blood sampling, a small meal was given to each pig followed by serial blood collection for 360 min. Postprandial concentrations of plasma AA, glucose, insulin, and urea were then measured from the collected blood. Non-linear regression was used to summarise the postprandial plasma AA kinetics. Fasting concentrations of urea and some AA were higher (P < 0.05) while postprandial plasma insulin and glucose were lower (P < 0.01) for INT than for HYD and FAA. The area under the curve of plasma concentration after meal distribution was lower for INT for most AAs (P < 0.05), resulting in a flatter curve compared to HYD and FAA. This was the result of the slower appearance of dietary AA in the plasma when proteins are fed instead of free AA and small peptides. The flatter curve may also result from more AAs being metabolised by the intestine and liver when INT was fed. The metabolism of AA of the intestine and liver was higher for HYD than FAA. Providing AA as proteins or as free AA and small peptides affected the postprandial plasma kinetics of AA, urea, insulin, and glucose. Whether the flat kinetics when feeding proteins has a positive or negative effect on AA metabolism still needs to be explored.

Enhancing cardiometabolic health through physical activity and breakfast manipulations in children and adolescents: good for humans, good for the planet.

The human health benefits of cardiometabolic disease prevention can be accompanied by planetary co-benefits. Focusing efforts towards young people, including children and adolescents, is conducive to disease prevention. In the context of cardiometabolic disease prevention, this review paper critically summarises the available literature on the acute cardiometabolic responses to physical activity and breakfast manipulations among young people. Given the seriousness of global climate change, which will disproportionally affect our younger generations, this review paper offers new insights into the inherent interactions between child-adolescent behaviour and cardiometabolic health from an environmental sustainability perspective to aid climate change mitigation efforts, including exploring future research avenues. A growing evidence base suggests acute moderate- to high-intensity exercise bouts can attenuate postprandial plasma glucose, insulin and triacylglycerol concentrations for up to 24-48 h in young people. Whether accumulating physical activity throughout the day with short, frequent bouts promotes cardiometabolic risk marker attenuations is unclear. Breakfast consumption may enhance free-living physical activity and reduce glycaemic responses to subsequent meals for a possible additive impact. If repeated habitually, attenuations in these cardiometabolic risk factors would be conducive to disease prevention, reducing the greenhouse gas emissions associated with disease diagnosis and treatment. To progress current understanding with high public health and planetary relevance, research among samples of 'at risk' young people that span cellular-level responses to ecologically valid settings and address human and planetary health co-benefits is needed. Indeed, certain physical activity opportunities, such as active travel to school, offer important direct co-benefits to humans and planetary health.

Olea Europaea Effects on Glyco-Metabolic Parameters and on Glycemic Status in Patients with Impaired Fasting Glucose

Aim: the aim of this study was to evaluate the effects of a food supplement based on an infusion of olive leaves and marigold (Olife®) on glyco-metabolic parameters and glycemic status in patients with impaired fasting glucose (IFG). Material and methods: 148 patients were randomized to follow a standardized diet or a standardized diet plus Olife® for 3 months, in an open label, randomized, controlled study design. Olife® was self-administered, once a day, 70 ml/die (about half water glass), during breakfast in addition to diet. Results: in the group treated with Olife® plus diet there was a significant decrease of fasting and post-prandial plasma glucose after 3 months, both compared to baseline, and to diet group. There was a significant decrease of HOMA index in the group treated with Olife® plus diet, both compared to baseline and to diet. At baseline, all patients were affected by IFG. At the end of the study, 21 of 74 patients (28.3 %) returned to a condition of euglycemia according to OGTT in the Olife® plus diet vs 3 of 74 patients (4.1 %) in the diet group. The group treated with Olife® plus diet had an improvement of LDLox and Hs-CRP levels after 3 months, both compared to baseline, and to diet. Conclusions: the study showed the effects of a food supplement based on an infusion of olive leaves and marigold (Olife®) on glyco-metabolic parameters and glycemic status in patients with IFG.

Growth differentiation factor 15 is not associated with glycemic control in patients with type 2 diabetes mellitus treated with metformin: a post-hoc analysis of AIM study

BackgroundGrowth differentiation factor 15 (GDF15) was newly discovered to be a promising target of metformin. The study was aimed to investigate the relationship between GDF15 and glycemic control after metformin treatment in patients with type 2 diabetes mellitus.MethodsThe study was a post-hoc analysis of AIM (the effect of Acarbose on glycemic variability in patients with type 2 diabetes mellitus using premixed Insulin compared to Metformin) study. The participants were randomly assigned to 12 weeks of metformin (MET) or acarbose (ACA) treatment combined with insulin. Serum GDF15 levels of 51 subjects from MET group and 53 subjects from ACA group were measured at baseline and after a 12-week treatment. Fasting plasma glucose (FPG), 2-h postprandial plasma glucose (2-h PG) and glycated hemoglobin A1c (HbA1c) were measured at baseline and endpoint.ResultsAfter a 12-week treatment, serum GDF15 levels significantly increased in MET group [baseline vs. endpoint, 936.70 (741.00, 1205.40) pg/mL vs. 1265.20 (1027.90, 1634.00) pg/mL, P < 0.001], but not in ACA group [baseline vs. endpoint, 920.60 (701.45, 1332.55) pg/mL vs. 893.80 (663.25, 1284.05) pg/mL, P = 0.944]. However, there were no significant differences of glycemic control parameters (ΔFPG, Δ2-h PG and ΔHbA1c) between subgroups of MET group divided by median of ΔGDF15 (all P > 0.05). Spearman correlation coefficient and analysis of covariance after adjustment for baseline HbA1c levels showed that ΔGDF15 was not correlated with ΔFPG, Δ2-h PG and ΔHbA1c (all P > 0.05).ConclusionSerum GDF15 levels were significantly elevated after metformin treatment in patients with type 2 diabetes mellitus. However, the increase was not an indicator of the glucose-lowering effect of metformin.Trial registrationClinicaltrials.gov, NCT02438397. Registered 8 May 2015.

Recent Updates on Phytoconstituent Alpha-Glucosidase Inhibitors: An Approach towards the Treatment of Type Two Diabetes.

Diabetes is a common metabolic disorder marked by unusually high plasma glucose levels, which can lead to serious consequences such as retinopathy, diabetic neuropathy and cardiovascular disease. One of the most efficient ways to reduce postprandial hyperglycemia (PPHG) in diabetes mellitus, especially insulin-independent diabetes mellitus, is to lower the amount of glucose that is absorbed by inhibiting carbohydrate hydrolyzing enzymes in the digestive system, such as α-glucosidase and α-amylase. α-Glucosidase is a crucial enzyme that catalyzes the final stage of carbohydrate digestion. As a result, α-glucosidase inhibitors can slow D-glucose release from complex carbohydrates and delay glucose absorption, resulting in lower postprandial plasma glucose levels and control of PPHG. Many attempts have been made in recent years to uncover efficient α-glucosidase inhibitors from natural sources to build a physiologic functional diet or lead compound for diabetes treatment. Many phytoconstituent α-glucosidase inhibitors have been identified from plants, including alkaloids, flavonoids, anthocyanins, terpenoids, phenolic compounds, glycosides and others. The current review focuses on the most recent updates on different traditional/medicinal plant extracts and isolated compounds’ biological activity that can help in the development of potent therapeutic medications with greater efficacy and safety for the treatment of type 2 diabetes or to avoid PPHG. For this purpose, we provide a summary of the latest scientific literature findings on plant extracts as well as plant-derived bioactive compounds as potential α-glucosidase inhibitors with hypoglycemic effects. Moreover, the review elucidates structural insights of the key drug target, α-glucosidase enzymes, and its interaction with different inhibitors.

Low-fat dairy consumption improves intestinal immune function more than high-fat dairy in a diet-induced swine model of insulin resistance.

To understand the effects of consuming high-fat and low-fat dairy products on postprandial cardiometabolic risk factors and intestinal immune function, we used an established low birthweight (LBW) swine model of diet-induced insulin resistance. LBW piglets were randomized to consume one of the 3 experimental high fat diets and were fed for a total of 7weeks: (1) Control high fat (LBW-CHF), (2) CHF diet supplemented with 3 servings of high-fat dairy (LBW-HFDairy) and (3) CHF diet supplemented with 3 servings of low-fat dairy (LBW-LFDairy). As comparison groups, normal birthweight (NBW) piglets were fed a CHF (NBW-CHF) or standard pig grower diet (NBW-Chow). At 11weeks of age, all piglets underwent an established modified oral glucose and fat tolerance test. At 12weeks of age, piglets were euthanized and ex vivo cytokine production by cells isolated from mesenteric lymph node (MLN) stimulated with mitogens was assessed. Dairy consumption did not modulate postprandial plasma lipid, inflammatory markers and glucose concentrations. A lower production of IL-2 and TNF-α after pokeweed mitogen (PWM) stimulation was observed in LBW-CHF vs NBW-Chow (P < 0.05), suggesting impaired MLN T cell function. While feeding high-fat dairy had minimal effects, feeding low-fat dairy significantly improved the production of IL-2 and TNF-α after PWM stimulation (P < 0.05). Irrespective of fat content, dairy had a neutral effect on postprandial cardiometabolic risk factors. Low-fat dairy products improved intestinal T cell function to a greater extent than high-fat dairy in this swine model of obesity and insulin resistance.

TCF7L2 gene associated postprandial triglyceride dysmetabolism- a novel mechanism for diabetes risk among Asian Indians.

Aim TCF7L2 gene is believed to increase the risk of T2DM by its effects on insulin secretion. However, the exact mechanism of this enhanced risk is not clearly known. While TCF7L2 gene has been shown to affect lipid metabolism, these effects have remained largely unexplored in the context of diabetes risk.MethodsPostprandial lipid responses to a standardized fat challenge test were performed in 620 Asian Indian subjects (310 with NGT and 310 with T2DM/prediabetes) and compared between the risk and wild genotypes of the rs7903146 TCF7L2 gene. In 30 subjects scheduled to undergo abdominal surgery (10 each with NGT, Prediabetes and T2DM), adipocyte TCF7L2 gene expression was also performed by real time qPCR and confirmed by protein expression in western blot.ResultsT allele of rs7903146 TCF7L2 gene was confirmed as the risk allele for T2DM (OR=1.8(1.2-2.74), p=0.005). TT+CT genotypes of rs7903146 TCF7L2 gene showed significantly higher 4hrTg (p<0.01), TgAUC (p<0.01), peakTg (p<0.01) as well as higher postprandial plasma glucose (p=.006) levels and HOMA-IR (p=0.03) and significantly lower adiponectin levels (p=0.02) as compared to CC genotype. The expression of TCF7L2 gene in VAT was 11-fold higher in prediabetes group as compared to NGT (P<0.01) and 5.7-fold higher in T2DM group as compared to NGT group(P=0.003) and was significantly associated with PPTg and glucose levels.ConclusionThere is significant PPTg dysmetabolism associated with the risk allele of rs7903146 polymorphism as well as adipocyte expression of TCF7L2 gene. Significant upregulation of TCF7L2 gene expression in VAT that correlates with PPTg and glycaemia is also seen in Asian Indians with glucose intolerance. Modulation of PPTg metabolism by TCF7L2 gene and the resultant PPHTg may be a novel mechanism that contributes to its diabetes risk in them.

Discordance between postprandial plasma glucose measurement and continuous glucose monitoring

There has been growing interest in studying postprandial glucose responses using continuous glucose monitoring (CGM) in nondiabetic individuals. Accurate measurement of glucose responses to meals can facilitate applications such as precision nutrition and early detection of diabetes. We aimed to quantify the discordance between simultaneous postprandial glucose measurements made using plasma and CGM. We studied 10 nondiabetic older adults who randomly consumed 9 predefined meals of varying macronutrient compositions. Glucose was measured for 8 h after the meal by the CGM, blood samples for plasma collection were taken regularly, and plasma glucose was quantified using gold-standard laboratory measurement and a fingerstick blood glucose meter. The primary outcome measured was the mean absolute relative difference (MARD) of CGM and fingerstick measurements relative to the gold standard. Secondary outcomes were Bland-Altman statistics, Clarke Error Grid, and time in range metrics. Additional subgroup analyses were performed by stratifying the postprandial glucose measurements based on the macronutrient composition of the meals. When compared against the gold-standard postprandial glucose measurements, the fingerstick meter was more accurate (MARD: 8.0%; 95% CI: 7.6%, 8.6%) than the CGM (MARD: 13.7%; 95% CI: 13.1%, 14.3%; P<0.0001). After the meals, Bland-Altman analysis demonstrated that the CGM underestimated the 8-h gold-standard glucose rise by 12.8mg/dL on average (P<0.0001), whereas the fingerstick meter did so by 5.5mg/dL on average (P<0.0001). The CGM underestimated the time spent in the 70-180mg/dL range (P=0.002) and overestimated the time spent <70mg/dL (P<0.0001) compared with the other 2 methods. We discovered discordance between gold standard, fingerstick, and CGM in measuring plasma glucose concentrations after a meal. Consequently, emerging applications of CGM in healthy individuals, such as precision nutrition and diabetes onset prediction, may need to account for these discordances.This trial was registered at clinicaltrials.gov as NCT04928872.