Postprandial Glucose Responses Research Articles

Effects of a personalized nutrition program on cardiometabolic health: a randomized controlled trial.

Large variability exists in people's responses to foods. However, the efficacy of personalized dietary advice for health remains understudied. We compared a personalized dietary program (PDP) versus general advice (control) on cardiometabolic health using a randomized clinical trial. The PDP used food characteristics, individual postprandial glucose and triglyceride (TG) responses to foods, microbiomes and health history, to produce personalized food scores in an 18-week app-based program. The control group received standard care dietary advice (US Department of Agriculture Guidelines for Americans, 2020-2025) using online resources, check-ins, video lessons and a leaflet. Primary outcomes were serum low-density lipoprotein cholesterol and TG concentrations at baseline and at 18 weeks. Participants (n = 347), aged 41-70 years and generally representative of the average US population, were randomized to the PDP (n = 177) or control (n = 170). Intention-to-treat analysis (n = 347) between groups showed significant reduction in TGs (mean difference = -0.13 mmol l-1; log-transformed 95% confidence interval = -0.07 to -0.01, P = 0.016). Changes in low-density lipoprotein cholesterol were not significant. There were improvements in secondary outcomes, including body weight, waist circumference, HbA1c, diet quality and microbiome (beta-diversity) (P < 0.05), particularly in highly adherent PDP participants. However, blood pressure, insulin, glucose, C-peptide, apolipoprotein A1 and B, and postprandial TGs did not differ between groups. No serious intervention-related adverse events were reported. Following a personalized diet led to some improvements in cardiometabolic health compared to standard dietary advice. ClinicalTrials.gov registration: NCT05273268 .

Abstract PO2-02-02: BREAst Cancer Personalized NuTrition (BREACPNT): dietary intervention in HR+ breast cancer patients treated with endocrine therapy

Abstract BACKGROUND Breast cancer patients treated with adjuvant endocrine therapy commonly experience weight gain, which has been associated with low adherence to therapy and worse breast cancer prognosis. Dietary interventions are the first-line treatment for weight management in breast cancer patients and have beneficial results. Yet, the ability to maintain these outcomes requires further research. Here, we aimed to assess whether a personalized postprandial glucose targeting (PPT) diet is beneficial for weight management and metabolic health as compared with the recommended Mediterranean (MED) diet in this population. DESIGN AND METHODS BREACPNT is a phase-2 randomized trial in HR+ patients with breast cancer, treated with adjuvant endocrine therapy. We randomly assigned participants to follow a MED diet or a PPT diet for a 6-month dietary intervention and additional 6-month follow-up. The PPT diet is based on a machine-learning algorithm that integrates clinical and microbiome features to predict personal postprandial glucose responses (PPGRs). During the intervention, participants were monthly followed by a registered dietitian, they were additionally connected to a 2-week continuous glucose monitoring (CGM) on 3-timepoints, provided stool and blood samples and self-reported dietary intake using a smartphone application. RESULTS Among 127 randomized patients (mean ± SD age 53 ± 10 years, BMI 28.6 ± 5 kg/m2), 103 (81%) completed the 6-month intervention period. A total of 94 participants provided 12-month follow-up data. Both interventions led to a significant weight loss. The PPT-diet showed numerically greater weight loss with median change of -1.45kg (IQR -3.75 – 0) compared to the MED-diet with median change of -1kg (IQR -3.2 - 0.1) , however this was not significant (p=0.9). Notably, at the 12-month time point , participants in the PPT arm were more likely to maintain the weight loss (median -1.2kg, IQR -4 - 0.1) compared to participants in the MED-arm (median -0.15kg , IQR -4.25 - 1.5), p=0.14) and had significantly improved waist circumference (median, IQR; -5 cm, -8-(-2) in the PPT arm, compared to -1cm, -6.5-3 in the MED arm, p=0.01). In terms of glucose metabolism the PPT-diet led to improved glycemic control as measured by CGM, with significant lower average postprandial glucose responses (PPGRs) and glucose coefficient of variation (CV) compared to the MED-diet arm (mean 6-month change in PPGR was 2.1 ± 7.5 mg/dL × h for MED and −3.4 ± 5.6 mg/dL × h for PPT, p&amp;lt; 0.001, and the 6-month mean change for CV was 0.15 ± 2.76 for MED and −1.37 ± 3.2 for PPT, p&amp;lt; 0.01). Within the entire cohort, participants who experienced the greatest weight loss (upper quartile) were more likely to be postmenopausal compared to participants in the lower quartile. Additionally, participants who did not achieve weight loss (lower quartile) were significantly more likely to be treated with tamoxifen than AI (p=0.015). CONCLUSIONS In this dietary intervention in HR+ breast cancer patients, both PPT diet and MED diet led to weight loss and improved food quality, with a slight advantage to PPT diet. PPT diet additionally improved glycemic features as compared to MED diet, which are linked to lower risk of obesity and disease recurrence, suggesting an advantage in a glucose targeting approach. Premenopausal and Tamoxifen treated patients were less likely to lose weight through the intervention. These findings may have implications for dietary advice in clinical practice. Citation Format: Michal Rein, Maya Dadiani, Anastasia Godneva, Michal Bakalenik-Gavry, Dana Morzaev-Sulzbach, Maya Lotan-Pompan, Adina Weinberger, Eran Segal, Einav Gal-Yam. BREAst Cancer Personalized NuTrition (BREACPNT): dietary intervention in HR+ breast cancer patients treated with endocrine therapy [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-02-02.

Impact of chickpea hummus on postprandial blood glucose, insulin and gut hormones in healthy humans combined with mechanistic studies of food structure, rheology and digestion kinetics

Slowing the rate of carbohydrate digestion leads to low postprandial glucose and insulin responses, which are associated with reduced risk of type 2 diabetes. There is increasing evidence that food structure plays a crucial role in influencing the bioaccessibility and digestion kinetics of macronutrients. The aims of this study were to compare the effects of two hummus meals, with different degrees of cell wall integrity, on postprandial metabolic responses in relation to the microstructural and rheological characteristics of the meals. A randomised crossover trial in 15 healthy participants was designed to compare the acute effect of 27 g of starch, provided as hummus made from either intact chickpea cells (ICC) or ruptured chickpea cells (RCC), on postprandial metabolic responses. In vitro starch digestibility, microstructural and rheological experiments were also conducted to evaluate differences between the two chickpea hummus meals. Blood insulin and GIP concentrations were significantly lower (P < 0.02, P < 0.03) after the consumption of the ICC meal than the meal containing RCC. In vitro starch digestion for 90 min was slower in ICC than in RCC. Microscopic examination of hummus samples digested in vitro for 90 min revealed more intact chickpea cells in ICC compared to the RCC sample. Rheological experiments showed that fracture for ICC hummus samples occurred at smaller strains compared to RCC samples. However, the storage modulus for ICC was higher than RCC, which may be explained by the presence of intact cells in ICC. Food structure can affect the rate and extent of starch bioaccessibility and digestion and may explain the difference in the time course of metabolic responses between meals. The rheological properties were measured on the two types of meals before ingestion, showing significant differences that may point to different breakdown mechanisms during subsequent digestion.This trial was registered at clinicaltrial.gov as NCT03424187.

Effects of rosemary extract addition on starch bioavailability and antioxidant properties of extruded pet foods

This study aimed to investigate the effects of rosemary extract (RE) addition on the starch digestion and antioxidant properties of extruded pet foods. Pet foods were extruded using rice, round pea (RP), and wrinkled pea (WP) flours as the sole starch sources with RE incorporated at levels of 0 (control), 1.0, 10.0, and 30.0g/kg (RE0, RE1, RE10, and RE30, respectively). High-amylose WP pet food exhibited lower damaged/gelatinized starch content compared with rice and RP pet foods. The total phenolic contents and the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging ability of the pet foods notably increased after the addition of RE, showing a clear upward trend as the incorporation level was elevated. RE10 (except for rice) and RE30 significantly decreased the starch digestibility of pet foods according to in vitro testing, with the greatest reduction observed for the high-amylose WP sample. Although RE1 did not significantly impact the overall in vitro and in vivo starch digestibility, the treatment consistently postponed the peak times of postprandial blood glucose responses to all the three extruded diets in beagles. The results indicated that RE effectively enhanced the antioxidant properties of extruded pet foods and slowed starch digestion rates.

Effects of nut and legume powder substitution in crackers prepared with wheat flour on postprandial plasma glucose response among healthy Thai adults

Introduction: Crackers, one of the most consumed baked products, primarily contain refined wheat flour and have a moderate glycaemic index (GI). Nut and legume powders are used in baked goods to help regulate postprandial glycaemia; however, their glycaemic responses remain controversial. Our study aimed to compare the postprandial glycaemic responses between crackers with 30% wheat flour substitution by white kidney beans, cashew nuts, and almonds versus standard wheat crackers. Methods: Twelve adults were recruited for a five-session randomised controlled crossover study. In each session, they were randomly assigned to receive 50g carbohydrates from either a glucose solution or one of the four crackers. Plasma glucose levels were measured at baseline and 15, 30, 45, 60, 90, and 120 minutes after consumption. Satiety and hunger were evaluated using 100mm visual analogue scales at baseline and every 30 minutes until 120 minutes. Results: Mean incremental area under the curve (IAUC) for plasma glucose did not differ between the alternatives and wheat crackers, but was lowest for almond crackers. Compared with GI value of glucose solution, that of wheat, cashew nut, white kidney bean, and almond crackers were 39.97±23.13, 37.66±24.66, 35.85±10.86, and 28.09±17.92, respectively. Almond cracker consumption resulted in the highest mean IAUC for satiety and lowest for hunger, though non-significant. Conclusion: Crackers with 30% wheat flour substitution by nut and legume powders tended to improve postprandial glycaemia more than the standard crackers; however, acute responses on insulin and glucagon-like peptide-1 require further examination.

Effects of Wheat Biscuits Enriched with Plant Proteins Incorporated into an Energy-Restricted Dietary Plan on Postprandial Metabolic Responses of Women with Overweight/Obesity.

This study investigates the effect of daily consumption of wheat biscuits enriched with plant proteins in postprandial metabolic responses of women with overweight/obesity who follow an energy-restricted diet. Thirty apparently healthy women participated in a 12-week randomized controlled trial and were assigned either to a control (CB) or an intervention (PB) group. Participants consumed daily either a conventional (CB) or an isocaloric wheat biscuit enriched with plant proteins (PB) containing high amounts of amino acids with appetite-regulating properties, i.e., BCAAs and L-arg. At baseline and the end of the intervention, a mixed meal tolerance test was performed. The responses of glucose, insulin, ghrelin, GLP-1, and glicentin were evaluated over 180 min. After 12 weeks, both groups experienced significant decreases in body weight, fat mass, and waist circumference. In the PB group, a trend towards higher weight loss was observed, accompanied by lower carbohydrate, fat, and energy intakes (p < 0.05 compared to baseline and CB group), while decreases in fasting insulin and the HOMA-IR index were also observed (p < 0.05 compared to baseline). In both groups, similar postprandial glucose, ghrelin, and GLP-1 responses were detected, while iAUC for insulin was lower (p < 0.05). Interestingly, the iAUC of glicentin was greater in the PB group (p < 0.05 compared to baseline). Subjective appetite ratings were beneficially affected in both groups (p < 0.05). Consumption of wheat biscuits enriched in plant proteins contributed to greater weight loss, lower energy intake, and insulin resistance and had a positive impact on postprandial glicentin response, a peptide that can potentially predict long-term weight loss and decreased food intake.

Glycemic response to meals with a high glycemic index differs between morning and evening: a randomized cross-over controlled trial among students with early or late chronotype.

Glycemic response to the same meal depends on daytime and alignment of consumption with the inner clock, which has not been examined by individual chronotype yet. This study examined whether the 2-h postprandial and 24-h glycemic response to a meal with high glycemic index (GI) differ when consumed early or late in the day among students with early or late chronotype. From a screening of 327 students aged 18-25years, those with early (n = 22) or late (n = 23) chronotype participated in a 7-day randomized controlled cross-over intervention study. After a 3-day observational phase, standardized meals were provided on run-in/washout (days 4 and 6) and intervention (days 5 and 7), on which participants received a high GI meal (GI = 72) in the morning (7 a.m.) or in the evening (8 p.m.). All other meals had a medium GI. Continuous glucose monitoring was used to measure 2-h postprandial and 24-h glycemic responses and their variability. Among students with early chronotype 2-h postprandial glucose responses to the high GI meal were higher in the evening than in the morning (iAUC: 234 (± 92) vs. 195 (± 91) (mmol/L) × min, p = 0.042). Likewise, mean and lowest 2-h postprandial glucose values were higher when the high GI meal was consumed in the evening (p < 0.001; p = 0.017). 24-h glycemic responses were similar irrespective of meal time. Participants with late chronotype consuming a high GI meal in the morning or evening showed similar 2-h postprandial (iAUC: 211 (± 110) vs. 207 (± 95) (mmol/L) × min, p = 0.9) and 24-h glycemic responses at both daytimes. Diurnal differences in response to a high GI meal are confined to those young adults with early chronotype, whilst those with a late chronotype seem vulnerable to both very early and late high GI meals. Registered at clinicaltrials.gov (NCT04298645; 22/01/2020).

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.

Acute and two-week effects of neotame, stevia rebaudioside M and sucrose-sweetened biscuits on postprandial appetite and endocrine response in adults with overweight/obesity—a randomised crossover trial from the SWEET consortium

BackgroundSweeteners and sweetness enhancers (S&SE) are used to replace energy yielding sugars and maintain sweet taste in a wide range of products, but controversy exists about their effects on appetite and endocrine responses in reduced or no added sugar solid foods. The aim of the current study was to evaluate the acute (1 day) and repeated (two-week daily) ingestive effects of 2 S&SE vs sucrose formulations of biscuit with fruit filling on appetite and endocrine responses in adults with overweight and obesity. MethodsIn a randomised crossover trial, 53 healthy adults (33 female, 20 male) with overweight/obesity in England and France consumed biscuits with fruit filling containing 1) sucrose, or reformulated with either 2) Stevia Rebaudioside M (StRebM) or 3) Neotame daily during three, two-week intervention periods with a two-week washout. The primary outcome was composite appetite score defined as [desire to eat + hunger + (100 − fullness) + prospective consumption]/4. Findings Each formulation elicited a similar reduction in appetite sensations (3-hour postprandial net iAUC). Postprandial insulin (2-hour iAUC) was lower after Neotame (95% CI (0.093, 0.166); p < 0.001; d = -0.71) and StRebM (95% CI (0.133, 0.205); p < 0.001; d = -1.01) compared to sucrose, and glucose was lower after StRebM (95% CI (0.023, 0.171); p < 0.05; d = -0.39) but not after Neotame (95% CI (-0.007, 0.145); p = 0.074; d = -0.25) compared to sucrose. There were no differences between S&SE or sucrose formulations on ghrelin, glucagon-like peptide 1 or pancreatic polypeptide iAUCs. No clinically meaningful differences between acute versus two-weeks of daily consumption were found. InterpretationIn conclusion, biscuits reformulated to replace sugar using StRebM or Neotame showed no differences in appetite or endocrine responses, acutely or after a two-week exposure, but can reduce postprandial insulin and glucose response in adults with overweight or obesity. FundingThe present study was funded by the Horizon 2020 program: Sweeteners and sweetness enhancers: Impact on health, obesity, safety and sustainability (acronym: SWEET, grant no: 774293).

Time of day and glycaemic response in pregnant women: A gap in current guidelines?

Advice to monitor and distribute carbohydrate intake is a key recommendation for treatment of gestational diabetes, but fails to consider circadian regulation of glucose homeostasis. In the non-pregnant state, glucose responses to a meal at night-time are significantly higher than during the day and are associated with an increased risk of developing type 2 diabetes. However, the impact of night time eating on postprandial glucose in pregnancy is uncertain. Using a systematic approach we explored postprandial glucose responses to dietary intake at night compared to during the day in pregnant women. Searches were conducted in four databases (Ovid MEDLINE, Ovid Embase, CINAHL plus and Scopus), in September 2022 (updated, June 2023). Eligible studies reported on postprandial glucose at a minimum of two times a day, after identical meals or an oral glucose tolerance test, in pregnant women with or without gestational diabetes. Publication bias was assessed using the ROBINS-I tool. Four eligible studies were retrieved. Two studies reported within group comparison of two timepoints, and observed reduced glucose tolerance in the afternoon compared to the morning in pregnant women, irrespective of diabetes status. The other two studies meeting inclusion criteria did not report time of day comparisons. It is unclear as to whether the higher (and extended) postprandial glucose levels observed at night in non-pregnant populations are observed in pregnancy. Clinical studies are needed to explore the impact of circadian rhythmicity on glucose metabolism during pregnancy, and the implications of current dietary advice on when and what to eat for management of gestational diabetes.

Enhanced hypoglycemic effects of konjac glucomannan combined with Polygonatum cyrtonema Hua polysaccharide in complete nutritional liquid diet fed type 2 diabetes mice

In our aging society, dysphagia and malnutrition are growing concerns, necessitating intervention. Liquid nutrition support offers a practical solution for traditional dietary issues, but it raises a key issue: the potential for post-meal glucose spikes impacting efficacy. This study examined the effects of supplementation of Polygonatum cyrtonema Hua polysaccharide (PCP), konjac glucomannan (KGM) and their combination on acute phase postprandial glycemic response and long-term glucose metabolism in T2DM mice on a complete nutritional liquid diet. KGM was more effective in reducing postprandial glucose response, while PCP was more prominent in ameliorating long-term glucose metabolism. The KGM-PCP combination demonstrated superior outcomes in fasting blood glucose, insulin, and glucose homeostasis. PCP and KGM also influenced the composition and abundance of the gut microbiome, with the H-PCP group showing optimal performance. Moreover, the KGM-PCP combination improved body weight, lipid homeostasis, and liver health the most. PCP potentially regulates glycemia through metabolic pathways, while KGM improves glycemic metabolism by reducing postprandial glucose levels in response to viscous intestinal contents. This research identifies the structure, viscosity properties, and hypoglycemic effects of KGM and PCP in complete nutritional liquid diet fed T2DM mice, enabling their strategic utilization as hypoglycemic components in nutritional administration and glycemic regulation.

Genetic Evidence of Causal Relation Between Intestinal Glucose Absorption and Early Postprandial Glucose Response: A Mendelian Randomization Study.

The post-prandial glucose response is an independent risk factor for type 2 diabetes. Observationally, early glucose response after an oral glucose challenge has been linked to intestinal glucose absorption, largely influenced by the expression of sodium-glucose-co-transporter-1 (SGLT1). This study utilizes Mendelian randomization (MR) to estimate the causal effect of intestinal SGLT1 expression on early glucose response. Involving 1547 subjects with class II/III obesity from the ABOS cohort, the study employs SGLT1 genotyping, oral glucose tolerance tests, and jejunal biopsies to measure SGLT1 expression. A loss-of-function SGLT1 haplotype served as the instrumental variable, with intestinal SGLT1 expression as the exposure and the change in 30-minute post-load glycemia from fasting glycemia (Δ30 glucose) as the outcome. Results showed that 12.8% of the 1,342 genotyped patients carried the SGLT1 loss-of-function haplotype, associated with a mean Δ30 glucose reduction of -0.41 mmol/L and a significant decrease in intestinal SGLT1 expression. The observational study linked a one standard deviation decrease in SGLT1 expression to a Δ30 glucose reduction of -0.097 mM/L. MR analysis paralleled these findings, associating a statistically significant reduction in genetically instrumented intestinal SGLT1 expression with a Δ30 glucose decreases of -0.353. In conclusion, the MR analysis provides genetic evidence that reducing intestinal SGLT1 expression causally lowers early post-load glucose response. This finding has a potential translational impact on managing early glucose response in type 2 diabetes.

Unveiling the Benefits of Resistant Starch in Legumes: Overview of Current and Future Prospective

AbstractResistant starch has gained substantial attention in recent years due to its potential health benefits. Among the various sources of RS, legumes have appeared as a prominent and promising contributor. Legumes like beans, lentils, and chickpeas, comprise a unique composition that promotes the resistant starch formation during cooking and processing. The review begins by presenting an overview of resistant starch and its classification based on its structure and digestibility. The mechanisms by which legume‐based resistant starch impacts human health are discussed, including its potential role in controlling postprandial glucose and insulin responses, improve satiety, boost colonic health, and influence lipid metabolism. The promising role of resistant starch from legumes in controlling chronic diseases like obesity, cardiovascular disorders, and type 2 diabetes is also explored. This review briefly covers the recent advancements in regulating the starch biosynthesis pathway through the utilization of RNA interference (RNAi) and CRISPR/Cas9 techniques. In summary, the association between resistant starch and legumes offers a compelling pathway to enhance human health and mitigate the risk of chronic diseases. Legumes as a regular part of the diet can be a viable and effective approach to augment resistant starch intake and harness its potential health‐promoting effects.

High-protein, low glycemic index snack from optimized blend of three wholegrains exhibits nutraceutical quality and elicits low glycemic response in diabetic human subjects

Snack products are evolving as new carriers of functional ingredients with nutritional and health-promoting benefits. A blend of whole grains is increasingly being utilized to harness the functional potential of the grain mix. Amaranth, acha, and pearl millet grains flours were optimized using response surface methodology (RSM), to obtain optimum blends (90:5:5 and 47.98:26.68:25.34) with high protein content and low glycemic index. Snack bar products from the blends were labelled MBY and MBZ. A total of 40 diabetic and 10 non-diabetic subjects were recruited. Of the diabetic, about 42% were overweight while 40% were obese, the non-diabetic had normal weights. Each was allowed to consume snacks containing the equivalent of 50 g of carbohydrates. Finger prick was employed to evaluate the postprandial glucose response of snack products while venous blood was evaluated for antioxidant enzymes, carbohydrate-hydrolyzing activities, and insulin using standard methods. Consumption of the multigrain snacks elicited a stable postprandial response (133–141 mg/dL) with 16 and 24% postprandial decline. In addition, snacks had low to intermediate glycemic index (52 and 56) in diabetic and low glycemic index (43 and 45) in non-diabetics; likewise reduced α-amylase/α-glucosidase activities compared to control snacks. Similarly, glutathione level, glutathione peroxidase, superoxide dismutase, and catalase activities in serum from subjects that consumed multigrain snacks were upregulated compared to control and market sample groups. Moreso, snack products promoted a reduction in serum insulin levels in diabetic subjects (45 and 17% for MBY and MBZ respectively). Following the nutraceutical properties displayed by the formulated snack especially MBY, it can be promoted as a functional snack for the management of diabetes while solving the limited snack product choice of diabetes sufferers.Graphical

Postprandial glucose variability and clusters of sex hormones, liver enzymes, and cardiometabolic factors in a South African cohort of African ancestry

IntroductionThis study aimed to, first, determine the clusters of sex hormones, liver enzymes, and cardiometabolic factors associated with postprandial glucose (PPG) and, second to evaluate the variation these clusters account...

Differential diagnosis of post pancreatitis diabetes mellitus based on pancreatic and gut hormone characteristics.

Distinguishing different types of diabetes is important in directing optimized treatment strategies and correlated epidemiological studies. Through detailed analysis of hormone responses to mixed meal tolerance test (MMTT), we aimed to find representing characteristics of post-acute pancreatitis diabetes mellitus (PPDM-A) and post-chronic pancreatitis diabetes mellitus (PPDM-C). Participants with PPDM-A, PPDM-C, type 1 diabetes, type 2 diabetes and normal controls underwent MMTT. Fasting and postprandial responses of serum glucose, C-peptide, insulin, glucagon, pancreatic polypeptide (PP), ghrelin, gastric inhibitory peptide (GIP), glucagon like peptide-1 (GLP-1) and peptide YY (PYY) were detected and compared among different groups. Focused analysis on calculated insulin sensitivity and secretion indices were performed to reason major causes of hyperglycemia in different conditions. Participants with PPDM-A were characterized by increased C-peptide, insulin, glucagon and PP, while decreased ghrelin, GIP and PYY compared with controls. Patients with PPDM-C showed secretion insufficiency of C-peptide, insulin, ghrelin and PYY, higher postprandial responses of glucagon and PP than controls. In particular, both fasting and postprandial levels of ghrelin in PPDM-C were significantly lower than other diabetes groups. PYY responses in patients with PPDM-A and PPDM-C were markedly reduced. Besides, the insulin sensitivity of PPDM-A was decreased, and the insulin secretion for PPDM-C was decreased. Along with the continuum from acute to chronic pancreatitis, the pathological mechanism of PPDM changes from insulin resistance to insulin deficiency. Insufficient PYY secretion is a promising diagnostic marker for distinguishing PPDM from type 1 and type 2 diabetes. Absent ghrelin secretion to MMTT may help identify PPDM-C.

Study on the effectiveness of postprandial blood glucose control and glycemic index of acetylated wheat flour in healthy volunteers

Background: The study was conducted to determine the ability to control postprandial blood glucose response and glycemic index of acetylated wheat starch cakes containing 31,2% of resistant starch on 12 healthy volunteers. Material and methods: Research designed using experimental and double-blind methods. During the two days of the clinical trial, after more than 12 hours of overnight fasting, each volunteer consumed a diet consisting of 1 cake containing 50 g of acetylated wheat starch or 50 g of natural wheat starch and 330 ml of filtered water in 15 minutes. Volunteers had determined their capillary blood glucose concentrations at times before meals, 60 and 120 minutes after meals. Results: Blood glucose concentration at 60 minutes after eating acetylated wheat starch cake (G1= 8.6 ± 0.8 mmol/L) was lower than natural wheat starch cake (G1= 11.7 + 1.1 mmol/L) (p &lt; 0.05). Similarly, blood glucose concentration at 120 minutes after eating acetylated wheat starch cake (G2= 7.1 ± 0.7 mmol/L) was lower than natural wheat starch cake (G2= 9.2 ± 1.7 mmol/L) (p &lt; 0.05). The area under the curve of blood glucose concentration after 120 minutes of eating natural wheat starch cake (AUC0-120min= 337.0 min*mmol/L) is doulble times larger than the acetylated wheat starch cake (AUC0-120min= 175.5 min*mmol/L) (p &lt; 0.05). Glycemic index of acetylated wheat starch cake is 52.0. Conclusion: Acetylated wheat starch cake has a low glycemic index, possessing the ability to control postprandial blood glucose effectively, limiting the increase of postprandial blood glucose concentration within the safe range, and it did not cause any digestive disorders in volunteers. This is very meaningful in the application of acetylated wheat starch to process foods not only for diabetic patients but also for pre-diabetic or overweight and obese people to support treatment and improve quality of life. Key words: resistant starch, blood glucose, glycemic index, volunteers.

A high sucrose detection threshold is associated with increased energy intake and improved post-prandial glucose response independent of the sweetness intensity of isocaloric sucrose solutions

Several studies proposed a role for the sweet taste receptor in energy intake and blood glucose regulation, but little is yet known about the impact of the individual sweet taste perception. Here, we found in a cross-over human intervention study with 29 male participants that modulating the sweetness of an isocaloric sucrose solution did not influence postprandial plasma concentrations of blood glucose and associated hormones over 120 min and 2 h post-load energy intake. Independent of the sweetness of the test solution, tests persons with a higher sucrose detection threshold had an average of 402 ± 78.8 kcal (39 ± 21%) higher energy intake and a higher glucose/insulin ratio, combined with a higher liking for sweet tasting food, than the test persons of the low threshold group. The body composition suggested a higher fat-free mass in the high threshold group that may have influenced energy intake and post-prandial glucose responses.

EFEKTIVITAS BUNGA TELANG (CLITORIA TERNATEA) TERHADAP RESPON GLIKEMIK: SISTEMATIK REVIEW

Background: Diabetes mellitus is a chronic disease that is globally prevalent and has reached a very high prevalence rate. In 2021, more than 422 million people worldwide will suffer from diabetes. Various databases have reported that one of the ornamental plants, namely the butterfly pea flower (Clitoria Ternatea), has quite a hypoglycemic effect. &#x0D; Purpose: The aim of this systematic research is to help in understanding the potential of butterfly pea flowers as an antidiabetic agent.&#x0D; Methods: The research method we used in this systematic review search was the PRISMA method. This article searches literature sources in Pubmed and Google Scholar databases from 2013 to 2023 using appropriate inclusion criteria. Clitoria Ternatea has excellent anti-diabetic properties.&#x0D; Result: In vitro analysis showed that water extract of butterfly pea flower (Clitoria Ternatea), ethanol extract, and protein extract effectively inhibited the α-amylase enzyme, hemoglobin glycosylation, and AGE formation. They also show increased glucose absorption.&#x0D; Conclusion: This explains that CTE can suppress postprandial glucose and insulin responses induced by sucrose through inhibiting intestinal sucrose. It can be concluded that butterfly pea flowers (Clitoria Ternatea) are effective against glycemic responses in the body.

Protein Hydrolysates and Bioactive Peptides as Mediators of Blood Glucose-A Systematic Review and Meta-Analysis of Acute and Long-Term Studies.

Type 2 diabetes mellitus (T2DM) is a major public health concern associated with high mortality and reduced life expectancy. Since diabetes is closely linked with lifestyle, not surprisingly, nutritional intervention and increased physical activity could play a vital role in attenuating the problems related to diabetes. Protein hydrolysates (PHs) and their bioactive peptides (BP) have been shown to exert a wide range of biological effects, including antioxidative, antihypertensive, and in particular, hypoglycaemic activities. To better understand the efficacy of such interventions, a systematic review and meta-analysis of randomised controlled trials (RCTs) were performed concerning the influence of protein hydrolysates on glycaemic biomarkers in subjects with and without hyperglycaemia. Five different databases were used to search for RCTs. In total, 37 RCTs were included in the systematic review and 29 RCTs in the meta-analysis. The meta-analysis revealed a significant reduction in postprandial blood glucose response (PPGR) in normoglycaemic (-0.22 mmol/L; 95% CI -0.43, -0.01; p ≤ 0.05) and in hyperglycaemic adults (-0.88 mmol/L; 95% CI -1.37, -0.39; p ≤ 0.001) compared with the respective control groups. A meta-regression analysis revealed a dose-dependent response for PPGR following PH consumption in normoglycaemic adults, specifically for doses ≤ 30 g. The postprandial blood insulin responses (PPIR) were significantly higher after the ingestion of PHs in both the group with and the group without hyperglycaemia, respectively (23.05 mIU/L; 95% CI 7.53, 38.57; p ≤ 0.01 and 12.57 mIU/L; 95% CI 2.72, 22.41; p ≤ 0.01), compared with controls. In terms of long-term responses, there was a small but significant reduction in both fasting blood glucose (FBG) and fasting glycated haemoglobin (HbA1c) in response to PH compared with the control group (p < 0.05). The PHs significantly improved the parameters of glycaemia in adults and, hence, it may contribute to the management and regulation of the future risk of developing T2DM.