Prandial Glucose Research Articles

Evaluation of an Automated Priming Bolus for Improving Prandial Glucose Control in Full Closed Loop Delivery.

Background: Automated insulin delivery (AID) is widely available to people with type 1 diabetes (T1D), providing superior glycemic control versus traditional methods. The next generation of AID devices focus on minimizing user/device interactions, especially around meals ("full closed loop," [FCL]). Our goal was to assess the postprandial glycemic impact of the bolus priming system (BPS), an algorithm delivering fixed insulin doses based on the likelihood of a meal having occurred, in conjunction with UVA's latest AID. Method: Eleven adults with T1D participated in a supervised randomized-crossover trial assessing glycemic control during two 24-h sessions with identical meals and activity-with and without BPS. On the day in-between study sessions, participants underwent food and activity challenges to test BPS safety and robustness. Continuous glucose monitor (CGM) outcomes and total insulin doses were assessed overall and following meals with potential for BPS to dose additional insulin (CGM >90 mg/dL for 1 h prior). Results: Daytime CGM outcomes were similar with and without BPS: time-in-range (TIR) 70-180 mg/dL 70.6% [62.2-76.5] versus 65.7% [58.6%-80.6%]; time-below-range <70 mg/dL 0% [0-2.1] versus 0% [0-1.3]; respectively. Insulin delivery during 3 h postprandial was indistinguishable 33.5 U [26.4-47.0] versus 35.7 U [28.7-44.9]. Among 43 out of 66 meals with potential to trigger BPS (24/19 BPS/no-BPS), postprandial incremental area-under-the-curve (iAUC) was lower for BPS versus no-BPS (2530 ± 1934 versus 3228 ± 2029, P = 0.047), but CGM outcomes were inconclusive: 4-h-TIR 51.2% [19.8-83.3] versus 40.2% [20.8-56.3] (P = 0.24). There were no severe adverse events. Conclusion: While there was no difference in TIR, when BPS was active an improved postprandial AUC in FCL was obtained via earlier insulin injection.

A study of SGLT2 inhibitors on levels of plasma atherogenesis biomarkers in diabetes

ABSTRACT Background: Diabetes, a chronic metabolic disorder with microvascular and macrovascular complications. Metabolites of hyperglycemia mediates endothelial injury resulting in cascade of atherosclerosis. Atherosclerosis sets up plaque in vessel wall and obliterates the vascular lumen which results in stroke, myocardial infarction, and peripheral vascular disease. Biomarkers like IL-6, hsCRP, fibrinogen are correlated with cardiovascular disease. In our study, we use non-invasive tool to predict the CVD risk like atherogenic index of plasma, Triglyceride to high-density lipoprotein, and triglyceride glucose index. Methods: This is a prospective observational study on type 2 diabetes patients on SGLT2 inhibitors attending medicine departments. Data was collected on disease duration, anthropometry, fasting and post prandial glucose, HbA1C, lipid profile at initial visit and after 6 months. Atherosclerosis indices were compared accordingly. Results: Among 300 patients enrolled, mean age was 44±6.41 yrs. Triglycerides was 143±4.6mg/dl, after 6 months was123±6.1 with significance(p&lt;0.01). Low-density Lipoprotein(LDL) was 116 ±12.5mg/dL and after 6 months was 123±17which was significant(p&lt;0.01). High-density Lipoprotein (HDL) at baseline was 37.9±2.6 mg/dL,at 6 months 49±3.6 with significance (p&lt;0.01). Atherogenic index of plasma, baseline was 0.227±0.03, at 6 months was 0.040±0.040 with significance(p&lt;0.01). Triglyceride glucose index(TyG), baseline was 5±0.05 and 6 months was 4.8±0.04 with significance(p&lt;0.01). Triglyceride to HDL(TG:HDL), baseline was 3.7±0.2 and at 6 months was 2.56±0.2 with significance (p&lt;0.01). Conclusion: From our study, we observed that SGLT2 inhibitor shows significant improvement in glycemic profile in addition to lipid profile. SGLT2 inhibitor lowered atherogenic indices.

Screening of Pre-Diabetes and Type-II Diabetes Mellitus Among the Personnel of Bangladesh Air Force

Background: Medical Squadron (Med Sqn) of Bangladesh Air Force (BAF) Base Bashar (BSR) has been providing medical support for BAF Base BSR, Air Headquarters, most of the retired officers and their families. It has been observed that the number of Diabetes Mellitus (DM) patient is increasing day by day, and now it becomes a major health problem among the members of BAF, even among the young age group. In view of above, a study was conducted among the BAF uniform members who reported for laboratory investigation to Med Sqn BAF Base BSR. Assessing prevalence of DM among BAF personnel will also help for overall assessment of health problem of BAF personnel to make a preventive guideline. Methods: A descriptive type of cross-sectional study was conducted with available data in the pathological laboratory of Med Sqn BAF Base BSR during the period from 01 July 2021 to 30 Jun 2022. Within this period a total 9269 Air Force uniform members reported for routine as well as diagnostic purpose of checking blood sugar. Associated risk factor like overweight or obesity was also assessed by latest data from personal documents. Age and job pattern wise data were also analyzed. Statistical Package for Social Sciences (SPSS) version 29.0 was used to analyze data. Results: Out of 9269 BAF members a total 683 persons (7.36%) had high (above normal) plasma glucose. Of these 413(60.46%) were diabetic and 270(39.53%) were pre-diabetic (IFG/IGT). Among the 413 diabetic patients 292(42.75%) had fasting plasma glucose (FPG) ≥7 mmol/L as well as post prandial plasma glucose (PPPG) level ≥11.1 mmol/L. Among the 270 pre-diabetic patients 205(30.01%) had FPG level between 6.1-6.9 mmol/L with PPPG level &lt;7.8 mmol/L (Impaired Fasting Glucose/IFG) and 65(9.51%) had FPG level &lt;7 mmol/L with PPPG level between 7.8-11 mmol/L (Impaired Glucose Tolerance/IGT). Conclusion: DM has become a major health concern all over the world. This study attempted to identify the prevalence of age-related factors for DM among BAF uniform members between the ages 30 to 60 years. It has been observed that the prevalence of pre-diabetes is more among the 41 to 45 years age group and Type-II DM among the 46-50 years age group. Bangladesh Armed Forces Med J Vol 57 No (1) June 2024, pp 22-27

A proposal for breakfast to improve the postprandial glucose response in children with type 1 diabetes - Preliminary results from a camp-based study

This study aimed to evaluate post – prandial glucose response (PPGR) after a traditional Italian breakfast and an alternative meal in children with type 1 diabetes (T1D). Preliminary findings showed that by replacing a small portion ofcarbohydrates with fats helpsimprovingPPGR after breakfast in children with T1D.

Assessment of glycemic control and correlation of HbA1c level with lipid profile and duration of diabetes in type 2 diabetes mellitus patients

Background &amp; Objectives: The prevalence of Type 2 diabetes mellitus, or Type 2 DM, is rising globally. A periodic estimation of HbA1c has been recommended to track the state of glycemic control of Type 2 DM patients, in order to control the diabetes associated disorders. The main consequence and cause of death in Type 2 diabetes has been identified as cardiovascular disease (CVD).Optimization of glycemic status along with decreasing CVD risk factors are critical to preventing morbidity and mortality in patients with Type 2 DM. Since there is a lack of data on these CVD risk factors, in Madhesh Province, Nepal, we aimed to evaluate the glycemic status, estimate the lipid profile, and ascertain their correlation, including duration of Type 2 DM among patients in tertiary care hospitals in Madhesh Province, Nepal. Materials and Methods: The tertiary care hospital based cross-sectional study was conducted on 139 Type 2 DM patients, in Madhesh Province, Nepal. In order to gather information of the participants, a systematic questionnaire was introduced. A physical and clinical examination was performed, and an appropriate volume of blood was drawn with prior written consent. The lipid profile parameters, HbA1C, Fasting and post prandial serum glucose were estimated. Results: In 84 (60.3%) and 106 (76.3%) cases, there was an increased fasting and postprandial blood sugar. The mean±SD HbA1c level was 8.40±0.8%. More than half (52.5%) of the patients had poor glycemic control, while 22.3% had inadequate glycemic control, in reference to HbA1c &gt;8% and 7 to 8%, respectively. A substantial increased level of LDL-C, triglycerides and total cholesterol was observed in 122 patients and 85.6% had reduced HDL-C. A significant strong positive association was found between HbA1c level and total cholesterol and triglycerides, in contrast, no discernible association with duration of disease observed. Conclusion: Glycemic control was inadequate. Triglycerides and total cholesterol were significantly positively correlated with HbA1c, but not with HDL-C, LDL-C, or the course of diabetes.

The Physiological Association Between Mean Platelet Volume and Diabetes Mellitus Type 2: Correlation Between HbA1c Score and MPV Index

Objective: To evaluate difference in mean platelet volume between non-diabetics and diabetics individual and to find the relationship between Hba1c level and MPV among type 2 diabetic individuals. Methodology: This was a retrospective study conducted from December 2022 to November 2023 in Muhammad Medical College and Hospital with prior approval from ethical committee via letter No: Physiol dated 10-03-20. By random sampling 370 participants were selected in which 214 were diabetics and 156 were non-diabetics. Their blood pressure, BMI, Hba1c level, fasting and post prandial glucose level was measured. For evaluation of complete blood picture and MPV an automatic (Beckman coulter) machine was used. Statistical analysis was done by Graph Pad Prism 9. Results: it was noted that both male and female show significant association between raised MPV and increased serum glycemic level (P value less than 0.05). In male MPV increased in 21.89% patients (x2 =33.96, df=3 and P value= 0.0001). In female MPV increased in 17.29% patients (Odd ratio3.07 and P value= 0.0006). Conclusion: Mean platelet volume in diabetics was found to be higher as compared to non-diabetic subjects. In diabetic patients with Hba1c less than 6.5% had less raised MPV as compare to diabetics with Hba1c level greater than 6.5%.

Relationship between Serum Zinc Level and Retinopathy in Type 2 Diabetic Patients

Abstract Background Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia caused by insulin resistance (IR) or impaired insulin production. Diabetic retinopathy (DR) is a common microvascular disorder which occurs in type 2 diabetes mellitus (T2DM) patients due to chronic hyperglycemia. Previous studies reported that serum zinc (Zn) was associated with certain diabetic microvascular complications. Objective To evaluate relation between serum zinc level and diabetic retinopathy in patients with type 2 diabetes mellitus. Subjects and Methods The current study included 60 subjects with their ages ranging from 18- 60, selected from diabetes and ophthalmology outpatient clinics of Ain Shams University Hospitals for 7 months in a period from July 2022 to January 2023 with matched age and sex . fasting and post prandial blood glucose, hemoglobin A1c (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP),serum creatnine, LDL, HDL, TG,TC and serum zinc levels were measured among groups. Results The study shows statistically significant difference between DM type II subgroups regarding duration of disease (yrs) being higher in DM II with retinopathy 12.5 (10.5 – 16.5) than DM II without retinopathy 9 (6 – 12) with p &amp;lt; 0.001. serum Zn levels were significantly lower in the DR group than the controls and diabetic without retinopathy.in whole DM type II group, there was statistically significant negative correlation found between zinc level and duration of diabetes, HbA1c, LDL, TC, FBS, 2PP and serum creatinine level, while in DM II without retinopathy there was statistically significant negative correlation found between zinc level and duration of diabetes, LDL, TC and FBS and also in DM type II retinopathy there was statistically significant negative correlation found between zinc level and duration of diabetes, HbA1c, FBS, 2PP and serum cretainine level .There is no statistically significant difference found between control group and DM type II group regarding weight, height and BMI of the studied patients with p-value = 0.108, 0.198 and 0.343; respectively. There is no statistically significant difference found between control group and DM type II group regarding systolic and diastolic blood pressure of the studied patients with p- value = 0.554 and 0.405; respectively. Conclusion Our study suggested that lower serum zinc level in T2D patients was related to higher prevalence of diabetic microvascular complications. Patients with lower serum zinc level were more likely to have a longer duration of diabetes, poorer glucose control, and worse β-cell function. Older age, higher HbA1c level, and the prevalence of DN were risk factors related to the lower serum zinc level.

Prevalence and impact of diabetes and prediabetes on presentation and complications of primary hyperaldosteronism at diagnosis

BACKGROUND Primary hyperaldosteronism (PH) is considered to contribute to increased risk of developing type 2 diabetes mellitus (T2DM) and prediabetes. Both PH and DM are associated with increased risk for hypertension, cardiovascular diseases, and chronic kidney diseases. However, data on prevalence of T2DM and prediabetes in PH, and impact of T2DM and prediabetes on presentation and cardio renal complications in PH at presentation is sparse. AIM To determine the prevalence of T2DM and prediabetes in PH at diagnosis and impact on presentation and complications of PH. METHODS A retrospective cohort study was conducted in tertiary care settings in individuals with confirmed diagnosis of PH at presentation. Demographic variables, clinical presentations, duration and degree of hypertension, complications, laboratory parameters including sodium, potassium levels, plasma aldosterone concentration (PAC), plasma renin activity (PRA), and aldosterone to renin ratio (ARR) and cardio-renal parameters were collected. Comparison was done between three groups: PH with no DM (Group A) or with pre-diabetes (Group B) or with T2DM (Group C). P &lt; 0.05 was statistically significant. RESULTS Among 78 individuals with confirmed PH, 62% had pre-diabetes or diabetes; with 37% having DM. Mean duration of T2DM was 5.97 ± 4.7 years. The mean levels of glycaemic parameters among the group A vs B vs C individuals were fasting plasma glucose (mg/dL): 87.9 ± 6.5, 105.4 ± 9.02, 130.6 ± 21.1; post prandial plasma glucose (mg/dL): 122.7 ± 9.8, 154.9 ± 14, 196.7 ± 38.0; glycated haemoglobin (%) (5.3 ± 0.2, 5.9 ± 0.2, 7.5 ± 0.6, P &lt; 0.05 ), respectively. There was no significant difference in the biochemical parameters (PAC, PRA, ARR, sodium, potassium levels), presentation and complications between the groups. Cardio renal parameters or degree and duration of hypertension were comparable between the groups. CONCLUSION Significant prevalence of T2DM and prediabetes in PH at diagnosis does not impact its presentation or complications. Early screening for undetected PH in T2DM and prediabetes subjects with hypertension may prevent complications.

929-P: A Study to Evaluate Clinical and Metabolic Profile of Type 2 Diabetes Patients Receiving SGLT2 Inhibitors

Aim: The aim of the study was to determine the efficacy of SGLT2i and its impact on metabolic profile of type 2 diabetes (T2DM) patients with reference to serum glucagon and blood ketones. Methodology: The study was conducted in T2DM patients with inadequate glycemic control on a background therapy of either metformin and sulphonylurea (Group A) or metformin and DPP4 inhibitor(Group B) Blood samples were taken for estimation of fasting plasma glucose (FPG), post prandial plasma glucose (PPPG), HbA1c, beta-hydroxybutyrate (β-HB) and glucagon levels. Empagliflozin 10mg, was added to the existing anti-diabetic medication. The metabolic parameters were reassessed after 12 weeks. Results: At the end of 12 weeks glucagon levels increased significantly (28.8 ± 28.74 at baseline vs 108 ± 74 pg/ml; p&amp;lt;0.001). A significant increase in β-HB levels was also observed (0.1 ± 0.07 mmol/L at baseline versus 0.12 ± 0.07 mmol/L (p=0.03). FPG, PPPG and HbA1c decreased significantly by 30.33mg%, 53.16mg% and 1.05% respectively(p&amp;lt;0.01) In group A, FPG and PPPG decreased by 34.43 mg/dl and 51.71mg/dl respectively (p&amp;lt;0.001) with a mean HbA1c reduction of 1.09% (p&amp;lt;0.001) Serum glucagon and β-HB levels increased significantly [82.63 pg/ml (p&amp;lt;0.001) and 0.04 mmol/L (p&amp;lt;0.01) respectively]. In group B, there was decrease in FPG (mean difference 23.6mg %; p=0.003) and PPPG (mean difference 55.5mg%; p&amp;lt;0.001) at 12 weeks. HbA1c reduction of 0.99% was observed. (p=0.003) There was a significant increase in glucagon levels (mean difference +73.52 pg/ml; p&amp;lt;0.001). Conclusion: Addition of Empagliflozin to T2DM patients with inadequate glycemic control on either metformin and sulphonylurea or metformin and DPP4 inhibitors significantly improved efficacy. Plasma glucagon and β-HB levels increased with chronic empagliflozin treatment suggesting a change in substrate utilization towards fat. Disclosure S. Kandula: None. M.A. Meshram: None. A.C. Sonwane: None.

A Review on Hypoglycemic Role of Wheatgrass

The factory- grounded drug and diet is gaining significance in recent days. The consumption of Triticum aestivum lawn in the form of juice and tablets is adding among common people. The present study elaborates on the nutritive, antioxidant, and antimicrobial eventuality of a nongenetically modified type of T. aestivum lawn, along with the substantiation of molecular docking studies. TheT. aestivum lawn excerpts like decoction, waterless, ethanol, and chloroform were subordinated to primary Phyto- chemical tests, quantitative estimation, antioxidant analysis, and antimicrobial exertion determination. Diabetes mellitus is a major complaint over worldwide numerous deaths every time. α- amylase is an enzyme that plays an important part in the carbohydrate digestion. One antidiabetic remedial approach reduces the post prandial glucose position in blood by the inhibition of nascence- amylase enzymes. These can be an important strategy in operation of blood glucose. The end of the present study is to probe the phytochemical bioactive composites of the ethanoic excerpt of factory excerpt, it’s in vitro anti-diabetic exertion.

Remission of Type-2 Diabetes on Plant Based Diet

The incidence of diabetes has amplified worldwide, but health outcomes have not improved significantly. Anti-hyperglycemic medications are often accompanied by weight gain, hypoglycemia, and risk of cardiovascular events. Most diabetics are suggested a “low carb diet” as a nutritional strategy but the results short-termed and often unsustainable in most cases. Aim: This case report depicts the effectiveness of a personalized nutritional intervention program focused on Whole Food Plant Based Diet (WFPBD) and Intermittent Fasting (IF) in reducing blood glucose, body weight, waist circumference, without any pharmacological treatment. Methods: We present a case of a personalized nutritional intervention program of a 47-year-old diabetic female, weighing 86kg, measuring 168cm (BMI 30.5), with waist circumference of 43 inches. Her pre-intervention glycated hemoglobin (HbA1c) was 12.5%, post prandial glucose (PPG) was 342mg/dl, and fasting blood glucose (FBG) was 250mg/dl. Besides following a WFPBD, the patient was advised to do intermittent fasts of 14 hours, starting from about 6 pm in the evening and extending till about 8 am the next morning. The primary measures were changes in HbA1c, fasting and postprandial glucose levels, body weight, waist circumference, and BMI. Results: Nutritional intervention brought substantial improvements in several health parameters of the patient. Post-intervention, the patient was able to achieve an HbA1c of 6.40%, average FBG of 113mg/dl, average PPG of 127mg/dl, body weight of 74kg, BMI of 26.2, and waist circumference of 37 inches. Conclusions: The results suggest that a personalized dietary modification program combining WFPBD and IF can significantly improve metabolic health and potentially reverse T2D without the need for pharmacological treatment.

Differential effect of endogenous glucagon-like peptide-1 on prandial glucose counterregulatory response to hypoglycaemia in humans with and without bariatric surgery.

To determine the effect of endogenous glucagon-like peptide 1 (GLP-1) on prandial counterregulatory response to hypoglycaemia after gastric bypass (GB). Glucose fluxes, and islet-cell and gut hormone responses before and after mixed-meal ingestion, were compared during a hyperinsulinaemic-hypoglycaemic (~3.2 mmol/L) clamp with and without a GLP-1 receptor (GLP-1R) antagonist exendin-(9-39) infusion in non-diabetic patients who had previously undergone GB compared to matched participants who had previously undergone sleeve gastrectomy (SG) and non-surgical controls. Exendin-(9-39) infusion raised prandial endogenous glucose production (EGP) response to insulin-induced hypoglycaemia in the GB group but had no consistent effect on EGP response among the SG group or non-surgical controls (p < 0.05 for interaction). The rates of systemic appearance of ingested glucose or prandial glucose utilization did not differ among the three groups or between studies with and without exendin-(9-39) infusion. Blockade of GLP-1R had no effect on insulin secretion or insulin action but enhanced prandial glucagon in all three groups. These results indicate that impaired post-meal glucose counterregulatory response to hypoglycaemia after GB is partly mediated by endogenous GLP-1, highlighting a novel pathogenic mechanism of GLP-1 in developing hypoglycaemia in this population.

Exploring the glycaemic impact and culinary qualities of rice through Genome-Wide Association studies on starch composition and viscosity profiles

Starch is the major component in rice grain that determines not just the cooking and eating quality of rice but also the nutritive value of a particular rice variety. It also plays a key role in determining the consumer acceptance of a variety, its trade and market value. Thus, it is essential to assess the available genetic variation for starch composition in the rice germplasm and its effective utilization in varietal improvement programmes. In assessing the nutritional value of rice, resistant starch has received a lot of attention lately. It plays vital roles in reducing glycaemic index and post prandial glucose. The study evaluated a set of 192 rice genotypes of diverse origins for starch composition and viscosity parameters and observed significant variation for these traits. Genome-wide association studies (GWAS) using the multi-locus models BLINK and FarmCPU in GAPIT software resulted in the identification of 45 significant Marker Trait Associations (MTAs) distributed in 11 of the 12 chromosomes except chromosome 8. A total of 15 annotated genes in the 250 kb LD region flanking the significant SNP were identified as putative candidates through insilico analysis. Some of the important genes underlying the MTAs found were GBSSI, OsACS, SSG6, RSR1 and OsPUL which are known to be associated with starch synthesis in rice. The significant MTAs could be deployed in manipulating the starch composition and developing tailored rice varieties for various consumer needs.

Effects of Ellagic Acid on Glucose and Lipid Metabolism: A Systematic Review and Meta‐Analysis

Background. Abnormal glucose and lipid metabolism (GALM) serve as both a cause and an inducer for the development of the disease. Improvement and treatment of GALM are an important stage to prevent the occurrence and development of the disease. However, current clinical treatment for GALM is limited. Ellagic acid (EA), a common polyphenol present in foods, has been shown to improve abnormalities in GALM observed in patients suffering from metabolic diseases. Objective. This study used a meta‐analysis method to systematically assess the effects of EA on GALM. Method. As of November 8, 2023, a comprehensive search was conducted across 5 databases, namely, PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar to identify randomized controlled trials (RCTs) in which EA served as the primary intervention for diseases related to GALM. The risk of bias within the included studies was assessed according to the Cochrane Handbook. All statistical analyzes were performed using RevMan 5.4 software. Results. In this study, a total of 482 articles were retrieved, resulting in the inclusion of 10 RCTs in the meta‐analysis. The results showed that EA could reduce fasting blood glucose (FBG) (p = 0.008), increase insulin secretion (p = 0.01), improve insulin resistance index (HOMA‐IR) (p = 0.003), decrease triglyceride (TG) (p = 0.004), and reduce cholesterol (Chol) (p = 0.04) and low‐density lipoprotein (LDL‐c) (p = 0.0004). EA had no significant effect on waist circumference (WC), body weight (BW), body mass index (BMI), 2 hours after prandial blood glucose (2 h‐PG), total cholesterol (TC), and high‐density lipoprotein (HDL‐c). Conclusions. The effect of improvement in glucose and lipids of EA was closely related to the dose and the intervention time. EA can improve GALM caused by diseases. To corroborate the findings of this study and improve the reliability of the results, EA is imperative to refine the research methodology and increase the sample size in future investigations.

Diabetes Management through α-Glucosidase Inhibitors Challenges and Current Perspectives

Type 2 diabetes mellitus (T2DM) known as non-insulin dependent diabetes mellitus, is a chronic metabolic disorder caused by insulin deficiency or insulin resistance. The incidence of T2DM is increasing day by day. According to data from World Health Organization (WHO), the number of diabetic patients is expected to rise up to 642 million by 2040.This alarming situation needs proper treatment to control diabetes. Physicians mostly prescribe insulin based medications, but in this new medical era, α-glucosidase inhibitors (AGIs) based drug therapy possess tremendous preventive and potential inhibitory effect upon the over expression of the enzyme which digests the carbohydrate macromolecules and breaks down into single chain monomeric α-glucose units. As a result, carbohydrate breaks down gradually decreases, which slowing down the absorption of post prandial glucose PPG, regulating the blood glucose level. This review article addresses about the management of T2DM through AGIs along with new potential leads from natural products in the pipeline of new AGI drugs development from synthetic and natural origin.

Decoding the alpha-amylase inhibitory activity of Garcinia indica Choisy by computational and experimental studies

Garcinia indica Choisy is traditionally used to manage diabetes mellitus, also used in various herbal formulations, and is indicated as an insulin sensitizer. The present study investigates the hydroalcoholic extract of G. indica Choisy rind as an α-amylase inhibitor, followed by the identification of the probable lead hits via a computational approach. LC-MS analyse were carried out. In vitro assays for alpha amylase were performed at concentrations of G. indica ranging from (1000–125 µg/mL) and acarbose (25–1.56 µg/mL) with inhibition times ranging from 5th to 30th min. In silico study was performed based upon the bioactives traced from LC-MS data retrieved from the PubChem database and predicted for probable targets of diabetes mellitus, followed by a drug-likeness score, probable side effects, and an ADMET profile. In addition, molecular docking and the dynamics of the representative complex were explored using AutoDock Vina and Gromac. In vitro study revealed IC50 values of 400.5, 526.07, 728.05, 792.7, 848.3, and 897.5 µg/mL and acarbose displayed IC50 values of <1.56, 6.6, 10.46, 12.6, 14.14, and 15.24 µg/mL respectively. LC-MS analysis identified 17 bioactives, of which 13 showed positive druglikness; among them, 5 bioactives were predicted to modulate AMY2A. The gene set enrichment analysis revealed that AMY2A and gambogic acid possessed high edge counts, with the lowest binding energy of gambogic acid- AMY2A (-11.7 kcal/mol), followed by amentoflavone (-10.6 kcal/mol), volkensiflavone (-9.3 kcal/mol), fukugcide (-8.8 kcal/mol), and garcinol (-7.7 kcal/mol) when compared with acarbose- AMY2A (-7.7 kcal/mol), which also indicates high stability up to 100 ns in molecular simulation. Hydroalcoholic extract of G. indica rind α-amylase inhibitory activity, may be due to the presence of gambogic acid and other bioactives. Thus, it can be speculated that G. indica may possess anti-diabetic activity by reducing the post prandial glucose level. This needs to be further confirmed via enriched fractions or pure substances with inhibitory activity to develop Traditional medicine based new drugs

Calisthenics versus Pilates training on glycemic control and body fat in overweight individuals with type 2 diabetes mellitus

BACKGROUND: Physical activity plays an important role in management and preventing complications of type 2 diabetes mellitus (DM). Effectiveness of Pilates on DM showed that there was improvement in glucose control. Presently, resistance training forms are becoming very popular for weight loss and DM. Calisthenics is a relatively new form of resistance exercise training that has been less studied in obese and diabetic individuals. STUDY PURPOSE: To evaluate and compare the effect of Calisthenics and Pilates training approaches on percentage body fat and glycemic control (HbA1C, Post Prandial Blood Glucose (PPBG)) in overweight individuals with type 2 Diabetes mellitus (DM). METHODS: Thirty (n = 30) over weight individuals with type 2 DM with HbA1C levels &gt;6.5% were recruited for the study. The participants were randomly allocated to calisthenics (CG) and Pilates (PG) study groups who received respective exercise interventions for 12 weeks. The outcome measures were HbA1C, PPBG and percentage body fat assessed at pre and post intervention. RESULTS: Both CG and PG study groups showed statistically significant difference for glycemic control (HbA1C, PPBG) post 12 week intervention. However, significant improvement was noted in CG than PG in terms of HbA1c (p = 0.03), PPBG (P = 0.01) and body fat percentage (p &lt; 0.0001). CONCLUSION: Calisthenics exercise training was more effective than the Pilates training in achieving long term (HbA1c) and post meal (PPBS) glycemic control with significant reduction in body fat percentage in overweight individuals with type 2 DM.

Correlation of Fasting and Postprandial Blood Glucose with Hba1c in monitoring Glycemic Control of Diabetic Patients in FCT Abuja, Nigeria

Achieving glycemic control or reduction of hyperglycemia would significantly decrease most of the complications associated with hyperglycemia in diabetes mellitus. It has been stated that measurement of glycosylated hemoglobin (HbA1C) remains the gold standard for the assessment of glycemic control; there is no consensus whether the Fasting or Postprandial is a better predictor of glycemic control in poor resource setting where HbA1C is not easily accessed or available. The aim of this research is to determine fasting and postprandial plasma glucose and their correlation with HbA1C in glycemic control. A cross sectional case control study was carried out from January, 2023 to July, 2023; a total of 203 participants were recruited into the study. Fasting blood glucose (FBG), 2 hours post prandial blood glucose (2HPBG) were determined in all the subjects using the enzymatic glucose oxidase method for glucose estimation according to the instruction of the manufacturer, while HbA1C was determined using Boroaffinity Chromatographic method according to the instruction of the manufacturer. Statistical data analysis was carried out using SPSS software (Version 25.0, IBM Corp., Armonk, New York USA), and p&lt;0.001 were defined as statistically significant; the correlation between the parameters was carried out using Pearson’s correlation. Both the FBG and the 2HPBG showed positive correlation with HbA1C in the diabetic and control subjects; however, the level of correlation varies. The correlation of FBG and 2HPBG with HbA1C is directly proportional to the concentration of blood glucose level. The FBG for the control and the subjects are 7.40±1.59 and 143.67±5.01, with HbA1C of 4.45±0.05; 6.26±1.47 respectively. The 2HPBG for the control and the subjects are 120.70±1.75 and 192.92±7.05, with HbA1C of 5.56±0.07; 7.82±0.22 respectively. The FBG correlation to HbA1C is r= 0.875, p&lt;0.001; while 2HPBG is r= 0.908, NEWPORT INTERNATIONAL JOURNAL OF PUBLIC HEALTH AND PHARMACY (NIJPP) Volume 4 Issue 2 2023 OPEN ACCESS ©NIJPP ONLINE ISSN: 2992-5479 Publications 2023 PRINT ISSN: 2992-605X Page | 10 p&lt;0.001. The study showed positive correlation of FBG and 2HPBG with HbA1C, since HbA1C is the value of the percentage concentration of glucose at a given period of time; FBG, 2HPBG and HbA1C can be used to evaluate the degree of glycemic control in diabetic patients’ management, in order to minimize or avoid diabetic complications. Keywords: FBG, PBG, Diabetes, HbA1C, Correlation, Complications

Effect of cooking and storage temperature on resistant starch in commonly consumed Indian wheat products and its effect upon blood glucose level

Background/objectivesThe health benefits provided by resistant starch have been well documented; however, few studies are available on the resistant starch content of wheat products in India. Moreover, few studies have examined the in vivo efficacy of resistant starch in wheat products in improving glucose levels. This study was conducted to evaluate the effect of cooking and storage temperature on the formation of resistant starch in Indian wheat products and its effect on blood glucose levels in humans and rats.MethodsWheat products were prepared by common cooking methods including roasting (Chapati), boiling (Dalia), Shallow frying (Paratha), and Deep frying (Poori). They were then stored at different temperatures including freshly prepared within 1 h (T1), stored for 24 h at room temperature (20-22°C) (T2), kept at 4°C for 24 h (T3) and reheated after storing at 4°C for 24 h (T4). The products were then analyzed for proximate composition (moisture, crude protein, crude fat, ash crude fibre, and carbohydrates). The effect of different cooking methods and storage temperatures on Resistant, non-resistant and total starch, total dietary fibre (soluble and insoluble), in vitro starch digestion rate (rapidly and slowly digestible starch), amylose and amylopectin content were analysed using standard operating procedures. The effect of products found to have higher resistant starch was studied on the post prandial blood glucose response of 10 healthy individuals using change in by analysing their glycemic index and glycemic load of wheat products. Further, the effect of resistant starch rich chapati on the blood glucose level of rats was also studied. Tukey’s test in factorial CRD was used to assess the effect of cooking and temperature on various parameters.ResultsThe amount of resistant starch was found to be high in dalia (boiling, 7.74%), followed by parantha (shallow frying, 4.94%), chapati (roasting, 2.77%) and poori (deep frying 2.47%). Under different storage temperatures, it was found high in products stored at 4°C (T3), followed by products stored at room temperature (T2), reheated products (T4) and lesser in freshly prepared products (T1). The glycemic index and glycemic load were found low in chapati (43, 32.3) and dalia (41.1, 28.6) stored at 4°C (T3) compared to others. The resistant starch content found in chapati stored at T3 was found to be more effective at reducing blood glucose levels in rats from 291.0 mg/100 mL to 225.2 mg/100 mL in 28 days of study compared to freshly prepared chapati (T1) and stored at room temperature (T2).ConclusionCooking methods including boiling, roasting and shallow frying increased the amount of resistant starch in foods, but cooking methods such as deep frying decreased the amount of resistant starch in food. Products stored at 4°C and at room temperature for 24 h increased the amount of resistant starch whereas the products that were freshly cooked and reheated decreased the amount of resistant starch in foods. At 4°C the stored products have a high amount of insoluble dietary fibre, slowly digestible starch, high amylose and low glycemic index. They take time to digest, meaning that they slowly increase blood glucose levels. The effect of insoluble dietary fibre and resistant starch in the inhibition of glucose diffusion in the small intestine is suggested to be due to the absorption or inclusion of the smaller sugar molecules. In vivo research showed that fibre and resistant starch in the digestive system of rats acts as the main factors in slowing glucose absorption and reducing a rise in blood glucose levels by promoting glycogen synthesis and inhibition of gluconeogenesis.

Effect of Amla Powder and Turmeric Powder Consumption on Geriatric Subjects Suffering from Non-Insulin Dependent Diabetes Mellitus

Diabetes mellitus is the most challenging public health problem of 21st century. International Diabetes Federation, (2015) reported 69.1 million cases of diabetes in India. Worldwide 2011 estimation of prevalence of diabetes in the elderly population (60 years &amp; above) is between 15% to 20% (IDF Diabetes Atlas, 2012). The present study titled “Effect of amla powder and turmeric powder consumption on geriatric subjects (60 years &amp; above) suffering from non-insulin dependent diabetes mellitus” involved multistage random sampling technique. The study was conducted on 18 geriatric subjects residing in Kala Mahal &amp; Pipal Mandi area of Agra city, randomly divided into 2 groups- experimental group (N1=8) and control group (N2=9). 2.5g each of amla powder and turmeric powder was consumed by experimental geriatric non-insulin dependent subjects for 45 continuous days and its effect on fasting and post prandial blood glucose level was recorded and compared with the control group. Demographic, anthropometric and dietary patterns of both groups was also recorded. Statistical tests were applied and it was found that consumption of amla powder and turmeric powder was significantly effective on geriatric subjects (60 years &amp; above) and there was a significant drop in the fasting &amp; post prandial blood glucose level of experimental group on 45th day of feeding trial. In the 24-hour diet recall average consumption of thiamine (mg) was significant at 95% confidence interval (p&lt;0.05)nwhen t-test was applied while energy (kcal), protein (g), carbohydrates(g), fat(g), phosphorus (mg), iron (mg), vitamin A (mcg), riboflavin (mg), niacin (mg) and vitamin C (mg) intake were not significant (p&gt;0.05).