Postprandial Blood Glucose Levels Research Articles

Blood glucose-lowering activity of protocatechuic acid is mediated by inhibiting α-glucosidase

α-Glucosidase inhibitors are effective in controlling postprandial hyperglycemia, which play crucial roles in the management of type 2 diabetes. Protocatechuic acid (PCA) is one of phenolic acids existing not only in various plant foods but also as a major microbial metabolite of dietary anthocyanins in the large colon. The present study investigated the inhibitory mechanism of PCA on α-glucosidase in vitro and examined its effect on postprandial blood glucose levels in vivo. Results from in vitro experiments demonstrated that PCA was a mix-type inhibitor of α-glucosidase. Driven by hydrogen bonds and van der Waals interactions, PCA reversibly bound with α-glucosidase to form a stable α-glucosidase-PCA complex in a spontaneous manner. The computational simulation found that PCA could insert into the active cavity of α-glucosidase and establish hydrogen bonds with catalytic amino acid residues. PCA binding aroused the steric hindrance for substrates to enter active sites and caused the structural changes of interacted catalytic amino acid residues. PCA also exhibited postprandial hypoglycemic capacity in diabetic mice. This study may provide the theoretical basis for the application of PCA as an active ingredient of functional foods in dietary management of diabetes.

Functional assessments of Psidium guajava L. and Morus alba L. leaf extracts on postprandial glucose control

AbstractDiabetes is a leading cause of death, according to statistics published by the Department of Health, Executive Yuan of Taiwan. In modern medicine, diabetes can be controlled using various medications; however, some drugs often have undesirable side effects. It therefore became a goal to find plant‐based material that can reduce glucose concentration in the blood while reducing the incidence of complications and not causing side effects. Alpha‐glucosidase inhibitors (AGIs) are effective glucose‐lowering medicines and are enzymes essential to carbohydrate digestion. Inhibition of α‐glucosidase leads to a delayed and reduced rise in postprandial blood glucose levels. This study evaluates the inhibitory effect of mixed extracts of Psidium guajava L. and Morus alba L. leaves on α‐glucosidase activity and postprandial hyperglycemia in normal and diabetic rats. The inhibition of α‐glucosidase activity was assayed in vitro. Half maximal inhibitory concentration (IC50) values of Psidium guajava L. and Morus alba L. were 2.25 and 0.1 mg/mL, respectively. The IC50 value of a commercial anti‐hyperglycemic agent (Glucobay) is 6.41 mg/mL. The IC50 value of a mixture of extracts of Psidium guajava L. and Morus alba L. was 0.07 mg/mL. In cytotoxicity tests, survival percentages and shape did not significantly affect the murine embryonic liver cell line (BNL CL.2) when treated with varying concentrations of mixture extracts for varying periods of time. In summary, Psidium guajava L. and Morus alba L. showed positive anti‐diabetes activity and suggested promising potential for alternative functional foods for diabetes mellitus (DM) patients.

Influence of blood glucose fluctuations on chemotherapy efficacy and safety in type 2 diabetes mellitus patients complicated with lung carcinoma.

Patients with type 2 diabetes mellitus (T2DM) have large fluctuations in blood glucose (BG), abnormal metabolic function and low immunity to varying degrees, which increases the risk of malignant tumor diseases and affects the efficacy of tumor chemotherapy. Controlling hyperglycemia may have important therapeutic implications for cancer patients. To clarify the influence of BG fluctuations on chemotherapy efficacy and safety in T2DM patients complicated with lung carcinoma (LC). The clinical data of 60 T2DM + LC patients who presented to the First Affiliated Hospital of Ningbo University between January 2019 and January 2021 were retrospectively analyzed. All patients underwent chemotherapy and were grouped as a control group (CG; normal BG fluctuation with a mean fluctuation < 3.9 mmol/L) and an observation group (OG; high BG fluctuation with a mean fluctuation ≥ 3.9 mmol/L) based on their BG fluctuations, with 30 cases each. BG-related indices, tumor markers, serum inflammatory cytokines and adverse reactions were comparatively analyzed. Pearson correlation analysis was performed to analyze the correlation between BG fluctuations and tumor markers. The fasting blood glucose and 2-hour postprandial blood glucose levels in the OG were notably elevated compared with those in the CG, together with markedly higher mean amplitude of glycemic excursions (MAGE), mean of daily differences, largest amplitude of glycemic excursions and standard deviation of blood glucose (P < 0.05). In addition, the OG exhibited evidently higher levels of carbohydrate antigen 19-9, carbohydrate antigen 125, carcinoembryonic antigen, neuron-specific enolase, cytokeratin 19, tumor necrosis factor-α, interleukin-6, and high-sensitivity C-reactive protein than the CG (P < 0.05). Pearson analysis revealed a positive association of MAGE with serum tumor markers. The incidence of adverse reactions was significantly higher in the OG than in the CG (P < 0.05). The greater the BG fluctuation in LC patients after chemotherapy, the more unfavorable the therapeutic effect of chemotherapy; the higher the level of tumor markers and inflammatory cytokines, the more adverse reactions the patient experiences.

Synthesis of Sucrose-Mimicking Disaccharide by Intramolecular Aglycone Delivery.

Rare sugars are known for their ability to suppress postprandial blood glucose levels. Therefore, oligosaccharides and disaccharides derived from rare sugars could potentially serve as functional sweeteners. A disaccharide [α-d-allopyranosyl-(1→2)-β-d-psicofuranoside] mimicking sucrose was synthesized from rare monosaccharides D-allose and D-psicose. Glycosylation using the intermolecular aglycon delivery (IAD) method was employed to selectively form 1,2-cis α-glycosidic linkages of the allopyranose residues. Moreover, β-selective psicofuranosylation was performed using a psicofuranosyl acceptor with 1,3,4,6-tetra-O-benzoyl groups. This is the first report on the synthesis of non-reducing disaccharides comprising only rare d-sugars by IAD using protected ketose as a unique acceptor; additionally, this approach is expected to be applicable to the synthesis of functional sweeteners.

Effects of Dexamethasone on Postoperative Glycemic Control in Patients After Primary Total Joint Arthroplasty: A Randomized Double-Blind Controlled Trial

BackgroundIn patients undergoing total joint arthroplasty (TJA), the use of dexamethasone (DEX) may cause perioperative blood glucose (BG) disorders, leading to complications even in patients who do not have diabetes. We aimed to evaluate the effects of different DEX doses on perioperative BG levels. MethodsA total of 135 patients who do not have diabetes were randomized into three groups: preoperative intravenous injection of normal saline (Group A, the placebo group), preoperative intravenous injection of 10 mg DEX (Group B), and preoperative intravenous injection of 20 mg DEX (Group C). Postoperative fasting blood glucose (FBG) levels were designated as the primary outcome, while postoperative postprandial blood glucose (PBG) levels were assigned as the secondary outcome. The incidence of complications was recorded. We also investigated the risk factors for FBG ≥ 140 mg/dl and PBG ≥ 180 mg/dl. ResultsThe FBG levels were higher in Groups B and C than in Group A on postoperative days (POD) 0 and 1. The PBG levels were lower for Groups A and B compared to Group C on POD 1. No differences in FBG or PBG were detected beyond POD 1. Elevated preoperative glycosylated hemoglobin A1c (HbA1c) levels increased the risk of FBG ≥ 140 mg/dl and PBG ≥ 180 mg/dl, respectively. However, preoperative intravenous injection of DEX was not associated with FBG ≥ 140 mg/dl or PBG ≥ 180 mg/dl. No differences were found in postoperative complications among the three groups. ConclusionThe preoperative intravenous administration of 10 or 20 mg DEX in patients who do not have diabetes showed transient effects on postoperative BG after TJA. The preoperative HbA1c level threshold (regardless of the administration or dosage of DEX) that increased the risk for the occurrence of FBG ≥ 140 mg/dl and PBG ≥ 180 mg/dl was 5.75% and 5.85%, respectively.

Real-World Assessment of Personalized Approach With Voglibose Fixed-Dose Combination in Type 2 Diabetes Mellitus.

Post-prandial hyperglycemia (PPHG) remains a complex aspect in the management of type 2 diabetes mellitus (T2DM) in the Indian population due to uncertainty in the optimal utilization of alpha-glucosidase inhibitors (AGIs) either as standalone therapy or in combination, whether initiated initially or as a sequential therapy. This was a post-approval, observational, multicentric clinical study conducted at 50 centers according to principles of the International Council for Harmonisation of Technical Requirements of Pharmaceuticals for Human Use Guideline for Good Clinical Practice (ICH-GCP) and Declaration of Helsinki and local ethics approval. Descriptive and analytical statistics were applied for conclusion and categorical variables using SPSS version 29.0.1.0 (171) (Armonk, NY: IBM Corp.). Protocol analyses of 515 cases revealed baseline demographics as follows: age 57.35±10.04 years, weight 72.86±10.92 kg, and BMI 28.33±6.07 kg/m2. Comorbidities included hypertension (N=169, 32.82%), thyroid disorders (N=99, 19.22%), and heart failure (N=92, 17.86%). Concomitant oral antidiabetics (OADs) prescribed as DPP4i (9.50%), SGLT2i (19.20%), and DPP4i+SGLT2i (7.20%). Study drug reduced glycosylated hemoglobin (HbA1c) by 13.77% (1.25% mean change, p<0.01), fasting blood glucose (FBG) by 23.69% (44.61 mg/dL mean change, p<0.01), post-prandial blood glucose (PPBG) by 24.57% (70.46 mg/dL mean change, p<0.01), and body weight by 4.43% (3.21 kg mean change, p<0.01) over 12 weeks. A total of 161 patients accomplished targeted PPBG of <180 mg/dL (119.13 mg/dL mean change, p<0.01). Regression analysis considering PPBG and HbA1c ≤7.5% showed a weak correlation between them (R-value=0.13, R-squared value=0.02), whereas between PPBG and HbA1c ≤9% yielded moderate positive correlation (R-value=0.53, R-squared value=0.28). There were no adverse events reported or analyzed during the observation period. Voglibose fixed-dose combination (FDC) demonstrates significant effectiveness at the initial dosage when started early in the management of T2DM and high PPBG levels. Moreover, it exhibits good tolerability, thereby contributing to higher compliance among Indian patients who consume a high-carbohydrate diet.

Effect of Combination of Porang and Moringa Flour on Blood Glucose Levels and Body Weight in Rats

Porang tuber is rich in fiber and low in calories of carbohydrates. Moringa oleifera leaf has a high protein and a low content of lipids. Obesity and diabetes mellitus are the risk factors of cardiovascular disease, also known as cardiovascular disease risk factors. Combining of porang and moringa as feed can increase nutrition without causing weight gain. This study aims to determine these two materials as antidiabetic and antiobesity agents. The samples are porang tuber, a combination of porang tuber and M. oleifera leaves, a combination of M. oleifera leaves and wheat flour, wheat flour, and standard feed of mice. The parameters tested in this study are analysis of macronutrients of feed, loss of weight of mice, average consuming feed in 28 days, and reduction of blood glucose with a glucometer. The results obtained are a combination of porang tuber and moringa had a low contain carbohydrates and a high contain lipids and protein, can reduction in body weight of 21%, the lowest consumption of feed, and the lowest fasting and postprandial blood glucose levels compared to the other feeds. A combination of porang and moringa can be an antidiabetic and antiobesity agent.

Australian native grain reduces blood glucose response and Glycemic Index

Australian Aboriginal and Torres Strait Islander peoples are disproportionately affected by diet-related disease such as type 2 diabetes, the rate of which is 20 fold higher than that of non-Indigenous young Australians(1). Before colonisation, Gomeroi and other First Nations people harvested, threshed and ground native grass seeds with water into a paste before cooking(2). The introduction of white refined flour has meant that time-consuming grass seed processing has mainly ceased, and native grains are no longer eaten habitually. The aim of this study was to determine the effect of 10% incorporation of two native grain flours on postprandial blood glucose response and Glycemic Index (GI). Five male and five female subjects, with a mean age of 30 ± 0.9 and BMI of 21.6 ± 0.4 and normoglycemic, participated in GI testing of three flour + water pancake compositions matched for available carbohydrate: 100% wheat (Wheat) and 90% wheat:10% native grains (Native_a and Native_b). Effect on satiety was determined using subjective ratings of hunger/fullness over the time course of the GI testing. In comparison to the plain flour pancake, replacing 10% plain wheat flour with Native_b flour significantly reduced the GI by 28.8% from 73 ± 5 to 48 ± 5, having a profound effect on postprandial blood glucose levels in 9 of 10 subjects (p&lt;0.05, paired t-test). The GI of 10% Native_a flour pancake was not different from 100% wheat flour pancake (75 ± 5). Satiety tended to be greater when native grains were incorporated but this study was not powered to detect effect on satiety. In conclusion, replacing only 10% of plain wheat flour with Native_b flour was sufficient to significantly reduce the blood glycemic response to the pancake. This replacement could be easily implemented for prevention and treatment of type 2 diabetes. For Aboriginal people with access to grain Country, the nutritional health benefits associated with eating native grains, as well as the cultural benefits of caring for Country, will have a direct transformational impact on local communities. Our vision is to revitalise Gomeroi grains and to guide a sustainable Indigenous-led industry to heal Country and people through co-designed research.

The effect of yoga practices on health parameters: A review

Yoga, a practice originating in India thousands of years ago, has gained immense popularity today and its effects are under scrutiny. Numerous studies demonstrate the positive impact of various types of yoga on human physiology. Specifically, research highlights the ability of yoga to mitigate stress and anxiety, as well as increase serotonin and dopamine hormones, facilitating healthy coping mechanisms in modern living. For a healthy lifestyle, yoga can be an important addition to a nutritious diet. While numerous studies have reported on the positive effects of yoga, its complete impact has yet to be fully understood. It may be recommended that the studies planned to be addressed in the future on the subject should be carried out for a specific health problem, should have a methodologically good and high quality structure and the sample size should be kept large. This review found that yoga has significant positive effects on anxiety and depression. It also increases hormones such as serotonin and dopamine in the body, which can lead to a more positive outlook. However, the review found statistically insignificant decreases in fasting blood glucose levels, postprandial blood glucose levels, and HbA1c. Additionally, yoga was found to significantly improve quality of life.

Formulation and assessment of chickpea pulao using fenugreek seeds and Indian rennet to improve blood glycemic levels

AbstractDiabetes is becoming a significant health concern in Asia, where the prevalence has reached alarming levels. An important contributing factor is the consumption of high‐carbohydrate foods, including rice, bread, etc. These high‐carbohydrate foods pose a major risk to public health due to their impact on postprandial hyperglycemia. This research aimed to formulate a chickpea pulao (cooked Indian–Pakistani rice dish) and to evaluate its effects on postprandial blood glucose levels in type 2 diabetic individuals. Antioxidant potential and total phenolic contents of herbs at different concentrations (1, 3, 5, 7, and 9%) were measured through DPPH and Folin Ciocalteu assays. The antidiabetic potential was tested by α‐amylase and α‐glucosidase inhibition assays. After sensory evaluation, the best‐chosen concentration was used to formulate the chickpea pulao. The study trial was advertised under “DP trial,” and 12 participants were recruited. A single‐blind randomized cross‐over trial was conducted for 3 weeks with a one‐week wash‐over time in between. Participants' preprandial and postprandial blood glucose levels were recorded for control and intervention recipes. Results indicated that both fenugreek seeds (FS) and Indian rennet (IR) showed good antioxidant and hypoglycemic activity (p = .000) in raw and boiled extracts. For DPPH, the IC50 values of unboiled and boiled combined (FS + IR) extracts were calculated as 7.4% and 8.02%, respectively. Similarly, for α‐amylase, the IC50 values of combined IR and FS unboiled and boiled extracts were 6.58% and 6.83%, and for α‐glucosidase inhibition assay, the values were measured as 14.98% and 16.24%. The single‐blind randomized cross‐over trial showed that consuming the intervention recipe significantly reduced postprandial hyperglycemia (p = .000) in type 2 diabetic participants. The intervention recipe decreased hyperglycemia by approximately 15% daily compared to the control recipe. Incorporation of hypoglycemic herbs into dietary patterns can work as an adjunct therapy for diabetes management, especially in populations with a high prevalence of this disease.

Immediate Impact of Switching from Dipeptidyl Peptidase4 (DPP4) Inhibitors to Low-Dose (0.3mg) Liraglutide on Glucose Profiles: A Retrospective Observational Study.

As treatment agents for diabetes, liraglutide is a long-acting glucagon-like peptide1 receptor agonist, and dipeptidyl peptidase4 (DPP4) inhibitors are widely used because of their safety and tolerability. Regular treatment with liraglutide has been reported to significantly reduce blood glucose levels, but the impact of low-dose (0.3mg) liraglutide on blood glucose levels immediately after treatment switching from a DPP4 inhibitor remains unknown. We conducted a single-arm, retrospective, observational study in 55 inpatients with type2 diabetes (T2D) to investigate the changes (Δ) in their blood glucose levels at six time points (6-point) from the day before (day-1) to the day after (day1) by switching the antidiabetic treatment from a DPP4 inhibitor to liraglutide 0.3mg (low-dose liraglutide) once daily. We also attempted to identify factors associated with the blood glucose-lowering effects of liraglutide. The median values of the changes in fasting, preprandial, and postprandial blood glucose levels and the fluctuations in the blood glucose levels expressed as the standard deviation of the 6-point blood glucose levels were significantly lower on day1 than on day-1 (P < 0.05, P < 0.0001, P < 0.0001, P < 0.01, respectively); there were no cases of severe hypoglycemia. The Δblood glucose levels were not associated with the baseline serum hemoglobin A1c values or with any markers of the insulin secreting capacity. There were no associations between the previously used blood glucose-lowering drug and the Δblood glucose levels. Switching from a DPP4 inhibitor to low-dose (0.3mg) liraglutide once daily significantly reduced the blood glucose levels and excursions of the blood glucose levels even from the very day after the treatment switch, with no serious adverse events.

Chinese bayberry (Myrica rubra Sieb. et Zucc.) leaves proanthocyanidins inhibit intestinal glucose transport in human Caco-2 cells.

Background: The hypoglycemic effects of Chinese bayberry leaves proanthocyanidins (BLPs) have been demonstrated. It is unclear, nevertheless, whether BLPs reduced postprandial blood glucose levels by regulating glucose uptake and glucose transport. Method: This study investigated the effect of BLPs (25, 50, and 100μg/mL) on glucose uptake and glucose transport in human intestinal epithelial cells (Caco-2 cells). The uptake of 2-Deoxy-2-[(7-nitro-2,1,3-benzoxadiazol-4-yl) amino]-D-glucose (2-NBDG) and disaccharidases activity in Caco-2 cells were measured. The glucose transport ability across the cell membrane was determined using the established Caco-2 monolayer model. The transcript and protein levels of key glucose transporters were analyzed using real-time quantitative polymerase chain reaction (RT-qPCR) and western blotting, respectively. Results: The results showed that BLPs significantly decreased glucose uptake and disaccharidases activity (p < 0.05). Otherwise, BLPs treatment obviously inhibited glucose transport across the Caco-2 monolayer in both simulated-fast (5mM glucose) and simulated-fed (25mM glucose) conditions. It was attributed to the suppression of glucose transporter2 (GLUT2) and sodium-dependent glucose cotransporter 1 (SGLT1) by BLPs. BLPs were found to significantly downregulated the transcript level and protein expression of glucose transporters (p < 0.05). Meanwhile, the mRNA expression of phospholipase C (PLC) and protein kinase C (PKC) involved in the signaling pathway associated with glucose transport were decreased by BLPs. Conclusion: These results suggested that BLPs inhibited intestinal glucose transport via inhibiting the expression of glucose transporters. It indicated that BLPs could be potentially used as a functional food in the diet to modulate postprandial hyperglycemia.

Hypoglycemic Activity and Safety Assessment of Pediococcus acidilactici Strain DNH16 in Experimental Type 2 Diabetes Mellitus Rats Induced with Streptozotocin

BACKGROUND: Type 2 diabetes mellitus (T2DM) cases tend to rise throughout the year in all parts of the world. The α-glucosidase inhibitors are frequently used to both prevent and treat T2DM. This α-glucosidase inhibitor activity is seen in some probiotic species, and a certain strain of Pediococcus acidilactici exhibits promising characteristics as an α-glucosidase inhibitor. This study was conducted to assess the hypoglycemic activity and safety of P. acidilactici strain DNH16 (PADNH16) in experimental rats with T2DM induced by streptozotocin.METHODS: The experiment was conducted in vivo using Wistar rats. Acarbose was employed as a positive control, and Lactobacillus casei was used as a comparative. For 24 days, post-prandial blood glucose levels were assessed every 3 days, followed by serum biochemical levels measurement of liver, kidney, and lipid profiles. The pancreas was histopathologically examined utilizing the Hematoxyline-Eosin staining procedure.RESULTS: Administration of PADNH16 to T2DM rats lowered post-prandial blood glucose levels and gave hypoglycemic benefits comparable to acarbose and commercial probiotics. PADNH16 dosing did not affect serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), urea, or creatinine levels, showing that PADNH16 was not hazardous to liver or kidney function. The lipid profile assessment revealed that the values, including high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides, were comparable to the control group. The pancreatic histopathology revealed that injection of PADNH16 caused no alterations to pancreatic β cells.CONCLUSION: P. acidilactici isolate DNH16 has a hypoglycemic effect on T2DM rats, but does not affect liver function enzymes, kidneys, lipid profiles and does not provide significant changes in pancreatic β cells.KEYWORDS: diabetes mellitus, inhibitor α-glucosidase, Pediococcus acidilactici strain DNH16

Efficacy of information and communication technology interventions for the management of diabetes mellitus: An umbrella review and evidence map.

We validated the quality of evidence and potential benefits of information and communication technology interventions on diabetes-related health outcomes. We systematically searched PubMed/MEDLINE, Embase, Google Scholar, and CINAHL and manually searched the reference lists of the retrieved review articles from each database's inception to October 2022. Randomized controlled trials were included to determine the benefits of information and communication technology interventions on diabetes outcomes. Ten meta-analyses of randomized controlled trials were included, with 37 unique outcomes encompassing 379 studies and >70,000 participants across 47 countries and six continents. Information and communication technology intervention was associated with reduced HbA1c levels in patients with type 1 (moderate certainty), type 2 (moderate certainty), and gestational diabetes (low certainty) and showed potential benefits for type 2 diabetes, demonstrating a reduction in systolic blood pressure (high certainty), low-density lipoprotein cholesterol (low certainty), and body weight (low certainty), whereas those for gestational diabetes demonstrated a reduction in fasting (low certainty) and 2-h postprandial blood glucose levels (low certainty). This umbrella review and evidence map revealed varying evidence on the potential benefits of information and communication technology interventions for diabetes-related outcomes. Our results demonstrate these interventions to be novel treatment options for policymakers and physicians to establish personalized health strategies.

Regular Intermittent Aerobic Exercise Reduces Arterial Stiffness Associated with Postprandial Hyperglycemia in Middle-Aged and Older Individuals

Hardening of arterial walls associated with elevated postprandial blood glucose levels increases the risk of cardiovascular disease; however, the impact of intermittent aerobic training on reducing arterial stiffness is unknown. The aim of this study was to examine the chronic effects of intermittent aerobic exercise on arterial stiffness during hyperglycemia in middle-aged adults: 30 healthy middle-aged adults were randomly assigned to an 8-week intermittent aerobic training group (n = 15, jogging or running, 30 min/run, 3 times/week, 65% reserve heart rate) and a control group (n = 15, no training). Pulse wave velocity (PWV) of carotid-femoral (cf) and brachial-ankle (ba), heart rate, blood pressure, and blood glucose was measured before a 75 g oral glucose tolerance test (OGTT) and 30, 60, and 90 min after the test, before the exercise intervention, and 4 and 8 weeks after intervention. The baPWV and blood glucose levels before the intervention were elevated at 30, 60, and 90 min in both groups compared to levels before the 75 g OGTT (p &lt; 0.01). The baPWV and blood glucose levels after 4 and 8 weeks of intervention were unchanged in the training group compared to that before the 75 g OGTT, but increased at 30, 60, and 90 min in the control group compared to that before the 75 g OGTT (p &lt; 0.01). The baPWV and blood glucose levels at 30 and 60 min after the 75 g OGTT after 4 and 8 weeks of intervention were lower in the training group than in the control group (p &lt; 0.01). These results indicate that intermittent aerobic exercise training may reduce the acute increase in arterial stiffness after hyperglycemia.

The Synergistic Effect of Compound Sugar with Different Glycemic Indices Combined with Creatine on Exercise-Related Fatigue in Mice

In this study, a compound sugar (CS) with different glycemic index sugars was formulated via hydrolysis characteristics and postprandial glycemic response, and the impact of CS and creatine emulsion on exercise-related fatigue in mice was investigated. Thirty-five C57BL/6 mice were randomly divided into five groups to supply different emulsions for 4 weeks: initial emulsion (Con), glucose emulsion (62 mg/10 g MW glucose; Glu), CS emulsion (62 mg/10 g MW compound sugar; CS), creatine emulsion (6 mg/10 g MW creatine; Cr), and CS and creatine emulsion (62 mg/10 g MW compound sugar, 6 mg/10 g MW creatine, CS-Cr). Then, the exhaustion time of weight-bearing swimming and forelimb grip strength were measured to evaluate the exercise capacity of mice, and some fatigue-related biochemical indexes of blood were determined. The results demonstrated that the ingestion of CS significantly reduced the peak of postprandial blood glucose levels and prolonged the energy supply of mice compared to ingesting an equal amount of glucose. Mouse exhaustion time was 1.22-fold longer in the CS group than in the glucose group. Additionally, the supplementation of CS increased the liver glycogen content and total antioxidant capacity of mice. Moreover, the combined supplementation of CS and creatine increased relative forelimb grip strength and decreased blood creatine kinase activity. The findings suggested that the intake of CS could enhance exercise capacity, and the combined supplementation of CS and creatine has a synergistic effect in improving performance.

Comparison of efficacy and safety of insulin degludec/liraglutide and insulin glargine U-100/lixisenatide in individuals with type 2 diabetes mellitus using professional continuous glucose monitoring.

Insulin glargine U100/lixisenatide and insulin degludec/liraglutide are fixed-ratio combinations containing basal insulin and a glucagon-like peptide-1 receptor agonist capable of reducing both fasting and postprandial blood glucose levels with a single formulation. This study aimed to compare the time in range (TIR) and the time below range (TBR) level 1 using professional continuous glucose monitoring and to establish criteria for the differential use of the fixed-ratio combinations. Thirty-six outpatients with type 2 diabetes mellitus (24 men and 12 women; average age, 62.1 years) were randomly assigned to the groups. At 0 and 18 weeks, a device was worn to compare the TIR and TBR level 1. Thecorrelation between the C-peptide index at baseline and TIR at 18 weeks was assessed. The TIR and TBR level 1 showed no significant differences between the two groups. Both groups showed significant positive correlations between the C-peptide index and the TIR (P = 0.002, r = 0.679; P = 0.002, r = 0.681, respectively). The changes in glycemic variability, therapeutic indices, and body mass index were not significantly different among the groups (P > 0.05). The receiver operating curve analysis revealed that the cut-off values of the C-peptide index to achieve TIR of >70% at 18 weeks were 1.258 (sensitivity, 77.8%; specificity, 100%) and 1.099 (sensitivity, 57.1%; specificity, 90.9%) in the insulin glargine U100/lixisenatide and insulin degludec/liraglutide groups, respectively. A TIR of >70% was achieved for both fixed-ratio combinations without significant differences.

Recrystallized resistant starch by encapsulation with konjac glucomannan: Structural changes, digestibility, and its effect on glucose response and short-term satiety in mice

The effects of the structure and digestibility of konjac glucomannan (KGM)-recrystallized resistant starch complex (KRS3) on the glycemic response and short-term satiety in mice were investigated. KRS3 samples were prepared by recrystallized debranched starch (RS3) at 50 °C, and then combined with KGM. The RS3 and KRS3 samples displayed an A-type pattern and maintained peak temperature values above 110 °C. With an increase in KGM, the swelling power and apparent viscosity of KRS3 increased. The results of in vitro and in vivo digestion revealed that KRS3 with a resistant starch content ranging from 69.4 % to 78.8 % could effectively maintain postprandial blood glucose levels. KRS3, particularly with 0.5 % KGM, slowed gastric emptying of mice from 82.7 % to 36.6 % and intestinal propulsion rate from 60.9 % to 35.3 %, resulting in strong satiety. RS3 combined with KGM could serve as a new approach to develop RS3 based foods with low glycemic responses and high-satiety.

Loneliness in older adults with diabetes mellitus: a scoping review

ABSTRACT This scoping review aimed to explore and synthesize existing research on predictors of loneliness, and the impact of loneliness on physiological and psychological health outcomes and health behaviors in older adults with diabetes. Results from 12 studies showed that low education, being unmarried/divorced/separated, having diabetes-related complications, being physically inactive, having diabetes distress, being of a certain race/ethnicity, being female, having depressive symptoms, and being younger age were consistently identified as predictors of loneliness. In addition, loneliness was found to affect both psychological (depressive symptoms and negative perceptions of diabetes) and physiological health outcomes (increased postprandial blood glucose and A1C levels, decreased cortisol levels, increased MCP-1 levels, slower gait speed, and weaker hand grip) and health behaviors (decreased engagement in physical activity, increased disability in activities of daily living and instrumental activities of daily living, and increased likelihood of antidepressant use). The results of this scoping review suggest that loneliness is a complex issue for older adults with diabetes and its effects are far-reaching. Therefore, further research should be conducted to explore the potential causal relationships between loneliness and physiological and psychological health outcomes and to identify the best interventions to reduce loneliness in older adults with diabetes. For healthcare providers, it is important to recognize that loneliness is an appropriate risk factor for older adults with diabetes that may affect psychological and physiological health outcomes and health behaviors and to address it through interventions such as social support programs, group therapy, or psychosocial counseling.

Impact of regular consumption of millets on fasting and post-prandial blood glucose level: a systematic review and meta-analysis

Millets have a low Glycemic Index and are thus expected to help reduce concentration of Fasting and Post-Prandial Blood Sugar (FBS and PPBS) and glycated hemoglobin (HbA1c), which can potentially help the management of type 2 diabetes. This study conducts a systematic review and meta-analysis of the effects of millets consumption on FBS, PPBS, and HbA1c levels in comparison to major staple diets using the difference-in-differences (DID) method, where the effect size was computed on the Standardized Mean Difference scale. Among twelve eligible articles, ten were used in the meta-analysis to assess the effects on FBS levels, while five were used to assess the effects on PPBS levels. The results show significant effects on FBS (p &amp;lt; 0.01) and PPBS (p &amp;lt; 0.05) levels with the effect size of −0.71 and −0.42, respectively. There were 11.8% (p = 0.001) and 15.1% (p = 0.012) reductions in FBS and PPBS level respectively observed in the millet consuming group whereas the comparator group did not have significant reductions in either indicator. On the other hand, the effects on HbA1c levels were insignificant, presumably due to the small sample size where only two studies were undertaken over 90 days, which warrants further research. The findings corroborate the evidence that millets can contribute to managing FBS and PPBS levels better than major staple diets, implying that millets consumption helps reduce the risk of type 2 diabetes.