Reduction Of Postprandial Glycemia Research Articles

N-Caffeoyltryptophan enhances adipogenic differentiation in preadipocytes and improves glucose tolerance in mice

Coffee consumption has been shown to reduce the risk of developing type 2 diabetes mellitus (T2DM) in humans; however, the exact mechanism is not completely understood. Here, we demonstrate that N-caffeoyltryptophan (CTP), an ingredient of coffee, enhances adipogenic differentiation and promotes glucose uptake into adipocytes. CTP increased lipid accumulation and adipogenic markers (PPARγ, C/EBPα, and FABP4) expression in mouse 3T3-L1 preadipocyte cell lines and primary preadipocytes. In addition, CTP promoted glucose uptake in 3T3-L1 cells. In the oral glucose tolerance test, daily administration of CTP (30 mg/kg/day, i.p.) for a week reduced blood glucose levels in mice. In 3T3-L1 cells, adipogenic differentiation and increased adipogenic markers expression induced by CTP were inhibited by U0126, a selective MEK1/2 inhibitor. Furthermore, mRNA induction of Pparg by CTP was abrogated in SIRT1 siRNA-transfected 3T3-L1 cells. These results suggest the involvement of the MEK/ERK signaling and SIRT1 in the mechanism of adipogenic function of CTP. Taken together, CTP might contribute to the reduction in postprandial glycemia and a subsequent reduction in onset risk for T2DM.

Postprandial Glycemic and Insulinemic Response by a Brewer's Spent Grain Extract-Based Food Supplement in Subjects with Slightly Impaired Glucose Tolerance: A Monocentric, Randomized, Cross-Over, Double-Blind, Placebo-Controlled Clinical Trial.

Dietary fiber exerts beneficial effects on human health reducing the risk factors of metabolic related diseases such as hyperglycemia, insulin resistance, and hypercholesterolemia. The aim of this study is to demonstrate the efficacy of a food supplement based on brewer’s spent grain (BSG) extract in the reduction of postprandial glycemia and insulinemia in normoglycemic subjects. BSG was chemically characterized, revealing the presence of resistant starch (14.64 g/100 g), arabinoxylans (7.50 g/100 g), β-glucans (1.92 g/100 g) and other soluble fibers (6.43 g/100 g), and bioaccessible ferulic acid (91.3 mg/100 g). For the clinical study, 40 normoglycemic subjects were randomized into two groups, 1 and 2 (n = 20), for a cross-over clinical design and received either BSG extract-based food supplement or placebo. Postprandial blood glucose values were significantly lower than corresponding values in the placebo group after 90 and 120 min, while at the baseline and in the first 60 min, the two glycemic curves overlapped substantially. This improved clinical outcome was corroborated by significant reductions in postprandial insulinemia. None of the subjects reported adverse effects. This study showed that the tested BSG extract-based food supplement improves glucose metabolism and insulinemic response in normoglycemic subjects with at most a mild insulin resistance.

1209-P: Profound Metabolic Benefits Observed in an Eight-Week GK Rat Study of a Novel Orally Administered Polymeric Duodenal Exclusion Therapy: Implications for Type 2 Diabetes (T2D) Therapy

Background: Roux-en-Y gastric bypass surgery produces significant weight loss and improvement in T2D and insulin resistance, attributed predominantly to duodenal exclusion. To mimic this effect non-invasively, we developed an oral, gut-restricted, inert polymer (GLY-POL) that interacts with mucus in the proximal small intestine to form a dynamic barrier excluding the duodenal lining from luminal contents. We therefore hypothesized that such treatment would result in significant improvement in glycemia and weight loss in a rodent model of type 2 diabetes. Methods: Goto-kakizaki (GK) rats were gavaged daily for 8 weeks. The treatment group (n = 7) received 1.5 ml of GLY-POL (8 wt %) solution and control group (n=7) received saline. Five metabolic responses were evaluated weekly: body weight, food intake, oral glucose (oGTT) and mixed meal tolerance (mMTT) tests, and HOMA-IR. Results: oGTT performed after chronic GLY-POL therapy produced a profound reduction of post-prandial glycemia (PPG) (incremental area under curve (iAUC)  = 60 – 70%, p<0.0005) compared to control; the PPG reduction amplified with duration of therapy through the study period. Similar robust reduction in PPG iAUC was evident during mMTT (iAUC  > 55%, p < 0.005). Fasting plasma glucose was lower in GLY-POL group (p<0.05) with improvement in HOMA-IR (p<0.005). GLY-POL therapy resulted in 6% weight loss compared to control (p<0.005), without a difference in food intake between the groups. Conclusion: Our results confirm a key role for chronic duodenal exclusion in improving the systemic metabolic milieu. Chronic once daily oral GLY-POL therapy results in a profound reduction in FPG, PPG, insulin resistance and weight loss. GLY-POL therapy offers the potential for a novel non-invasive approach for glycemic and weight control in T2D patients that mimics the effects of gastric bypass without the adverse effects associated with this surgery. Disclosure A. Nimgaonkar: Employee; Self; Glyscend Inc. S. Kulkarni: None. J. S. Petersen: Employee; Self; Glyscend Inc. S. Polomoscanik: Employee; Self; Glyscend Inc. P. J. Pasricha: Stock/Shareholder; Self; Glyscend. K. Colbert: Employee; Self; Glyscend Inc., LifeSprout, Inc. T. H. Jozefiak: Employee; Self; Glyscend Inc., Stock/Shareholder; Self; GLYCOLOGIX LLC. J. Vora: Advisory Panel; Self; Bayer Inc., Other Relationship; Self; AstraZeneca. M. Vieira: Employee; Self; AstraZeneca. T. Carlson: None. L. Liu: None. Funding National Science Foundation (1521347)

Resistant Starch Type 2 from Wheat Reduces Postprandial Glycemic Response with Concurrent Alterations in Gut Microbiota Composition

The majority of research on the physiological effects of dietary resistant starch type 2 (RS2) has focused on sources derived from high-amylose maize. In this study, we conduct a double-blind, randomized, placebo-controlled, crossover trial investigating the effects of RS2 from wheat on glycemic response, an important indicator of metabolic health, and the gut microbiota. Overall, consumption of RS2-enriched wheat rolls for one week resulted in reduced postprandial glucose and insulin responses relative to conventional wheat when participants were provided with a standard breakfast meal containing the respective treatment rolls (RS2-enriched or conventional wheat). This was accompanied by an increase in the proportions of bacterial taxa Ruminococcus and Gemmiger in the fecal contents, reflecting the composition in the distal intestine. Additionally, fasting breath hydrogen and methane were increased during RS2-enriched wheat consumption. However, although changes in fecal short-chain fatty acid (SCFA) concentrations were not significant between control and RS-enriched wheat roll consumption, butyrate and total SCFAs were positively correlated with relative abundance of Faecalibacterium, Ruminoccocus, Roseburia, and Barnesiellaceae. These effects show that RS2-enriched wheat consumption results in a reduction in postprandial glycemia, altered gut microbial composition, and increased fermentation activity relative to wild-type wheat.

Effects of Sustained Treatment With Lixisenatide on Gastric Emptying and Postprandial Glucose Metabolism in Type 2 Diabetes: A Randomized Controlled Trial.

Tachyphylaxis for slowing of gastric emptying is seen with continuous exposure to glucagon-like peptide 1 (GLP-1). We therefore aimed to establish whether prolonged use of a "short-acting" GLP-1 receptor agonist, lixisenatide, achieves sustained slowing of gastric emptying and reduction in postprandial glycemia. A total of 30 patients with metformin-treated type 2 diabetes underwent assessment of gastric emptying (scintigraphy) and glucose metabolism (dual tracer technique) after a 75-g glucose drink, before and after 8 weeks' treatment with lixisenatide (20 μg subcutaneously daily) or placebo, in a double-blind randomized parallel design. Gastric retention of the glucose drink was markedly increased after lixisenatide versus placebo (ratio of adjusted geometric means for area under the curve [AUC] over 240 min of 2.19 [95% CI 1.82, 2.64], P < 0.001), associated with substantial reductions in the rate of systemic appearance of oral glucose (P < 0.001) and incremental AUC for blood glucose (P < 0.001). Lixisenatide suppressed both glucagon (P = 0.003) and insulin (P = 0.032), but not endogenous glucose production, over 120 min after oral glucose intake. Postprandial glucose lowering over 240 min was strongly related to the magnitude of slowing of gastric emptying by lixisenatide (r = -0.74, P = 0.002) and to the baseline rate of emptying (r = 0.52, P = 0.048) but unrelated to β-cell function (assessed by β-cell glucose sensitivity). Eight weeks' treatment with lixisenatide is associated with sustained slowing of gastric emptying and marked reductions in postprandial glycemia and appearance of ingested glucose. Short-acting GLP-1 receptor agonists therefore potentially represent an effective long-term therapy for specifically targeting postprandial glucose excursions.

Milk Bioactive Peptides: Antioxidant, Antimicrobial and Anti-Diabetic Activities

The main milk proteins are caseins and whey proteins, some other minor proteins and peptides, are also found in milk. Proteins are vital ingredients for human because they provide all the essential amino acids needed for body and human health. Milk proteins are very important sources of bioactive peptides. The bioactive peptides are inactive within the sequence of the parent protein and can be released by proteolytic enzymes, during gastrointestinal digestion or during milk processing, for example the adding coagulation enzymes and starter culture. Once bioactive peptides are present in the body, these peptides may act as regulatory compounds with hormone-like activity. Furthermore, Bioactive peptides from milk proteins have many biological activities such as antimicrobial, antihypertensive, antithrombotic, antioxidant, mineral binding, and anti-diabetic. Bioactive peptides have potential health and have pharmaceutical applications. Antimicrobial peptides are recognized as an important component of innate immunity, particularly at mucosal surfaces such as the lungs and small intestine that are constantly exposed to a range of potential pathogens. The ability of protein hydrolysates to inhibit deleterious changes caused by lipid oxidation appears to be related to the nature and composition of the different peptide fractions. Milk protein hydrolysate possesses free-radical-scavenging and anti-inflammatory activities have many beneficial effects on the increase of the glucose-induced insulin secretion and reduction in postprandial glycemia. This article is tried through exposure in some detail to review characteristics of some milk protein peptides and its positive effects on human health.

Acute Effects of Dietary Carbohydrate Restriction on Glycemia, Lipemia and Appetite Regulating Hormones in Normal-Weight to Obese Subjects

Postprandial responses to food are highly dependent on the macronutrient composition of the diet. We investigated the acute effects of transition from the recommended moderately high carbohydrate (HC) diet towards a carbohydrate-reduced high-protein (CRHP) diet on postprandial glycemia, insulinemia, lipemia, and appetite-regulating hormones in non-diabetic adults. Fourteen subjects, including five males (Mean ± SD: age 62 ± 6.5; BMI 32 ± 7.6 kg/m2; hemoglobin A1c (HbA1c) 40 ± 3.0 mmol/mol; HOMA2-IR 2.1 ± 0.9) were included in this randomized, cross-over study. Iso-caloric diets were consumed for two consecutive days with a median wash-out period of 21 days (range 2–8 weeks) between diets (macronutrient energy composition: CRHP/HC; 31%/54% carbohydrate, 29%/16% protein, 40%/30% fat). Postprandial glucose, insulin secretion rate (ISR), triglycerides (TGs), non-esterified fatty acids (NEFAs), and satiety ratings were assessed after ingestion of breakfast (Br) and lunch (Lu), and gut hormones and glucagon were assessed after ingestion of Br. Compared with the HC diet, the CRHP diet reduced peak glucose concentrations (Br 11%, p = 0.024; Lu 11%, p < 0.001), glucose excursions (Br 80%, p = 0.20; Lu 85%, p < 0.001), and ISR (Br 31%; Lu 64%, both p < 0.001) whereas CRHP, as compared with HC, increased glucagon-like peptide-1 (Br 27%, p = 0.015) and glucagon values (Br 249%, p < 0.001). NEFA and TG levels increased in the CRHP diet as compared with the HC diet after Br, but no difference was found after Lu (NEFA Br 22%, p < 0.01; TG Br 42%, p = 0.012). Beta-cell glucose sensitivity, insulin clearance, cholecystokinin values, and subjective satiety ratings were unaffected. It is possible to achieve a reduction in postprandial glycemia and insulin without a deleterious effect on beta-cell glucose sensitivity by substituting part of dietary carbohydrate with iso-caloric protein and fat in subjects without type 2 diabetes mellitus (T2DM). The metabolic effects are more pronounced after the second meal.

Effects of guar gum as a fat substitute in low fat meat emulsions

The physicochemical, oxidative, and sensory properties were determined for low fat meat emulsions containing varying levels of guar gum (0.5, 1.0, and 1.5%) as a fat substitute. Reduction of fat and incorporation of guar gum resulted in higher emulsion stability and cooking yield but lower penetration force. Color evaluation revealed that low fat formulations had significantly lower lightness and higher redness values than high fat control formulation (p .05). pH value was higher in low-fat formulation containing 1.5% guar gum (p .05). The MetMb % of the high fat emulsion formulation was higher than low fat formulations (p < .05). The significant increase of TBARS value, protein carbonyl groups and loss of protein sulfhydryl groups in high fat formulation reflect the more oxidative degradation of the lipids and muscle proteins during the preparation of meat emulsion than low fat formulations (p < .05). Microstructure observations using SEM shows that increase in guar gum levels lead to formation of gel network, which holds more water. Sensory evaluation indicates that low fat formulation supplemented with 0.5% gum had quality characteristics that were similar to those of the high fat control. Practical applications Nowadays consumers demand healthier meat products that are low in salt, fat, cholesterol, and calories and contain in addition health-promoting bioactive components such as fibers and natural antioxidants. Thus, use of fat replacers with health promoting properties needs research studies. The study of emulsions with added fat replacers is important because the parameters studied in this work facilitate prediction of changes in the final product. Furthermore, the fat replacer guar gum used in this study is a source of soluble dietary fiber in food products and a number of clinical studies have shown a reduction in postprandial glycemia and insulinemia on consumption of it. Since traditional meat products of India especially in the state of Jammu and Kashmir, contain higher amounts of animal fat and no work has done on such products to reduce fat content with alternate ingredients having health benefits with minimal effects on the product quality. Thus, this research work was conducted to study the properties of low fat meat emulsions, because quality of the final product depends on emulsion characteristics.

Whey protein: The "whey" forward for treatment of type 2 diabetes?

A cost-effective nutritional approach to improve postprandial glycaemia is attractive considering the rising burden of diabetes throughout the world. Whey protein, a by-product of the cheese-making process, can be used to manipulate gut function in order to slow gastric emptying and stimulate incretin hormone secretion, thereby attenuating postprandial glycaemic excursions. The function of the gastrointestinal tract plays a pivotal role in glucose homeostasis, particularly during the postprandial period, and this review will discuss the mechanisms by which whey protein slows gastric emptying and stimulates release of gut peptides, including the incretins. Whey protein is also a rich source of amino acids, and these can directly stimulate beta cells to secrete insulin, which contributes to the reduction in postprandial glycaemia. Appetite is suppressed with consumption of whey, due to its effects on the gut-brain axis and the hypothalamus. These properties of whey protein suggest its potential in the management of type 2 diabetes. However, the optimal dose and timing of whey protein ingestion are yet to be defined, and studies are required to examine the long-term benefits of whey consumption for overall glycaemic control.

Postprandial glucose and insulin responses to grain products in diabetics and healthy subjects

A study on the commonly consumed cereals products was conducted to elicit their postprandial blood glucose and insulin responses in diabetics and non – diabetics subjects. Bread, acha (hungry rice, fonio), rice, maize and spaghetti were the meals used. The result showed that the low glycaemic index meals (acha and rice) had lowering effect on the blood glucose and insulin responses. Also the meal that is of whole grain had lower responses of blood glucose and insulin. Ingestion of whole grains may cause reduction of postprandial glycemia at the meal in which they were consumed. This effect may prove useful in public health efforts for diabetes prevention and could be a factor in the documented relationship between whole grain intake and lower risk of diabetes. Ingestion of whole grains may cause reduction of postprandial glycemia. However it is important to note that extensive milling or cooking negates the subsequent meal effect. Therefore, whole grains should be consumed in their native state or with minimal processing for full benefit. Keyword: whole grains, blood glucose, insulin, glycaemic index

Resistant starch

Resistant starch represents a diverse range of indigestible starch-based dietary carbohydrates. Resistant starch has been investigated in the past for its effects on bowel health (pH, epithelial thickness, and apoptosis of colorectal cancer cells); reduction in postprandial glycemia; increased insulin sensitivity; and effects on the gut microbiome. This review highlights advances as resistant starch gains clinical relevance as a potential treatment/preventive tool for diseases such as colorectal cancer (CRC) and diabetes. Recent articles have evaluated the comparative physiological effects of different types of resistant starch and investigated the effects of resistant starch on blood lipids, body weight, and defining resistant starch-induced changes to the micriobiome that may be important in health and disease. The most novel and relevant recent data describe a role for resistant starch in ameliorating inflammation; the use of resistant starch for optimal bowel health and prevention of CRC; and, further, that the systemic effects of resistant starch may be important for the treatment of other forms of cancer, such as breast cancer. This review describes advances in resistant starch research highlighting the gastrointestinal effects that are now being linked to systemic, whole body effects with clinical relevance. These effects have important implications for overall health and the prevention or amelioration of various chronic diseases.

Investigation of the mechanisms contributing to the compensatory increase in insulin secretion during dexamethasone-induced insulin resistance in rhesus macaques

Dexamethasone has well-described effects to induce insulin resistance and increase insulin secretion. Herein, we examined potential contributors to the effect of dexamethasone to increase insulin secretion in rhesus macaques. Six male rhesus macaques received daily injections of either saline or dexamethasone (0.25 mg/kg i.m. for 7 days) in random order with 3 weeks between treatments. At the end of the treatment period, animals were fasted overnight and underwent a feeding study the next day, during which blood samples were taken before and for 60 min after a meal in order to assess islet hormone and incretin secretion. Dexamethasone induced marked increases in fasting plasma insulin, glucagon, leptin, and adiponectin concentrations (P<0.05). Surprisingly, the glycemic response after meal ingestion was decreased twofold during dexamethasone treatment (P<0.05). Dexamethasone-treated animals exhibited a significant increase in both insulin and glucose-dependent insulinotropic polypeptide (GIP) secretion during the feeding study (P<0.05). However, glucagon-like peptide-1 secretion was significantly lower in dexamethasone-treated animals compared with controls (P<0.01). Fasting and meal-stimulated pancreatic polypeptide concentrations (an index of the parasympathetic input to the islet) did not differ between saline and dexamethasone treatments. However, the proinsulin:insulin ratio was decreased throughout the feeding study with dexamethasone treatment suggesting an improvement of β-cell function (P<0.05). In conclusion, the maintenance of euglycemia and reduction of postprandial glycemia with short-term dexamethasone treatment appears to be due to the marked elevations of fasting and meal-stimulated insulin secretion. Furthermore, increases in postprandial GIP secretion with dexamethasone treatment appear to contribute to the effect of dexamethasone treatment to increase insulin secretion.

Almond ingestion at mealtime reduces postprandial glycemia and chronic ingestion reduces hemoglobin A1c in individuals with well-controlled type 2 diabetes mellitus

Cohort studies are equivocal regarding a relationship between regular nut consumption and reduced risk of type 2 diabetes mellitus. Although acute trials show reductions in postprandial glycemia in healthy individuals ingesting 60 to 90 g almonds, trials have not been conducted using a single serving of almonds (28 g) in individuals with type 2 diabetes mellitus. This randomized crossover trial examined the impact of one serving of almonds at mealtime on postprandial glycemia, insulinemia, and plasma glucagon-like peptide-1 in healthy individuals and individuals with type 2 diabetes mellitus. On 2 occasions separated by at least 1 week, 19 adults (including 7 adults with type 2 diabetes mellitus) consumed a standardized evening meal and fasted overnight before ingesting the test meal (bagel, juice, and butter) with or without almonds. A small pilot study (6-7 subjects per group) was also conducted to observe whether chronic almond ingestion (1 serving 5 d/wk for 12 weeks) lowered hemoglobin A(1c) in individuals with type 2 diabetes mellitus. A standard serving of almonds reduced postprandial glycemia significantly in participants with diabetes (-30%, P = .043) but did not influence glycemia in participants without diabetes (-7%, P = .638). Insulinemia and glucagon-like peptide-1 at 30 minutes postmeal were not impacted by almond ingestion for either group. In the pilot study, regular almond ingestion for 12 weeks reduced hemoglobin A(1c) by 4% (P = .045 for interaction) but did not influence fasting glucose concentrations. These data show that modest almond consumption favorably improves both short-term and long-term markers of glucose control in individuals with uncomplicated type 2 diabetes mellitus.

Effect of adding the novel fiber, PGX®, to commonly consumed foods on glycemic response, glycemic index and GRIP: a simple and effective strategy for reducing post prandial blood glucose levels - a randomized, controlled trial

BackgroundReductions in postprandial glycemia have been demonstrated previously with the addition of the novel viscous polysaccharide (NVP), PolyGlycopleX® (PGX®), to an OGTT or white bread. This study explores whether these reductions are sustained when NVP is added to a range of commonly consumed foods or incorporated into a breakfast cereal.MethodsTen healthy subjects (4M, 6F; age 37.3 ± 3.6 y; BMI 23.8 ± 1.3 kg/m2), participated in an acute, randomized controlled trial. The glycemic response to cornflakes, rice, yogurt, and a frozen dinner with and without 5 g of NVP sprinkled onto the food was determined. In addition, 3 granolas with different levels of NVP and 3 control white breads and one white bread and milk were also consumed. All meals contained 50 g of available carbohydrate. Capillary blood samples were taken fasting and at 15, 30, 45, 60, 90 and 120 min after the start of the meal. The glycemic index (GI) and the glycemic reduction index potential (GRIP) were calculated. The blood glucose concentrations at each time and the iAUC values were subjected to repeated-measures analysis of variance (ANOVA) examining for the effect of test meal. After demonstration of significant heterogeneity, differences between individual means was assessed using GLM ANOVA with Tukey test to adjust for multiple comparisons.ResultsAddition of NVP reduced blood glucose response irrespective of food or dose (p < 0.01). The GI of cornflakes, cornflakes+NVP, rice, rice+NVP, yogurt, yogurt+NVP, turkey dinner, and turkey dinner+NVP were 83 ± 8, 58 ± 7, 82 ± 8, 45 ± 4, 44 ± 4, 38 ± 3, 55 ± 5 and 41 ± 4, respectively. The GI of the control granola, and granolas with 2.5 and 5 g of NVP were 64 ± 6, 33 ± 5, and 22 ± 3 respectively. GRIP was 6.8 ± 0.9 units per/g of NVP.ConclusionSprinkling or incorporation of NVP into a variety of different foods is highly effective in reducing postprandial glycemia and lowering the GI of a food.Clinical Trial registrationNCT00935350.

Reduction of Postprandial Glycemia by the Novel Viscous Polysaccharide PGX, in a Dose-Dependent Manner, Independent of Food Form

Objective: Health benefits of viscous fiber intake are well established; nevertheless few effective and palatable preparations are available. The objective of the study therefore was to determine palatability and effectiveness of escalating doses of PGX, a novel viscous polysaccharide (NVP), in reducing postprandial glycemia when added to a liquid and a solid meal.Design: Two open-label, randomized, controlled trials were undertaken.Setting: Glycemic Index Laboratories, Inc, Toronto, Ontario, Canada.Subjects: Two groups of 10 healthy subjects each (group 1: 5 M, 5 F; 35.6 ± 13.2 y; 24.6 ± 2.1 kg/m2; and group 2: 3 M, 7 F; 33.5 ± 11.1 y; 26.3 ± 5.2 kg/m2) were studied.Interventions: Zero, 2.5, 5, and 7.5 g of NVP were added to a glucose drink (group 1) or to white bread and margarine (WB + Marg) (group 2). Subjects repeated glucose control (group 1) or WB control (group 2) 3 times to allow calculation of the glycemic index (GI).Measures of Outcomes: Palatability of foods and capillary blood glucose concentrations were measured fasting and at 15, 30, 45, 60, 90, and 120 minutes after the start of the meal.Results: Addition of NVP to the meal reduced blood glucose incremental areas under the curve irrespective of dose, reaching significance at the 7.5 g dose when added to glucose (p < 0.01), and at the 5 and 7.5 g doses when added to WB + Marg (p < 0.001). The GI values of glucose with 0, 2.5, 5, or 7.5 g of NVP were (mean ± standard error of the mean [SEM]) 100.0 ± 0.0, 83.7 ± 9.0, 77.7 ± 8.2, and 72.5 ± 5.9, respectively; the GI of the WB alone, or of WB + Marg, with 0, 2.5, 5, or 7.5 g of NVP was 71.0 ± 0.0, 66.8 ± 3.0, 47.5 ± 5.9, 37.3 ± 5.9, and 33.9 ± 3.6, respectively.Conclusion: Addition of NVP to different food matrices is highly effective in lowering the glycemic index of a food in a dose-responsive manner.

Reduction in postprandial glucose excursion and prolongation of satiety: possible explanation of the long-term effects of whole grain Salba (Salvia Hispanica L.)

Despite strong correlations linking whole-grain consumption to reductions in heart disease, the physiological mechanisms involved remain ambiguous. We assessed whether Salba (Salvia Hispanica L.) whole grain reduces postprandial glycemia in healthy subjects, as a possible explanation for its cardioprotective effects observed in individuals with diabetes. The study used acute, randomized, double-blind, controlled design in which 11 healthy individuals (6 males and 5 females; body mass index 22.3+/-2.8 kg/m(2)) received 0, 7, 15 or 24 g of Salba baked into white bread. Capillary samples and appetite ratings were collected over 2 h after consumption. A dose-response reduction in postprandial glycemia (P=0.002, r(2)=0.203) was observed with all three doses of Salba, significantly decreasing incremental areas under the curve (iAUCs) and time point-specific blood glucose (P<0.05). Appetite ratings were decreased at 60 min after high, 90 min after high and intermediate and at 120 min after all treatments (P<0.05). Decrease in postprandial glycemia provides a potential explanation for improvements in blood pressure, coagulation and inflammatory markers previously observed after 12-week Salba supplementation in type II diabetes.

Metformin improves postprandial glucose homeostasis in rainbow trout fed dietary carbohydrates: a link with the induction of hepatic lipogenic capacities?

Carnivorous fish are poor users of dietary carbohydrates and are considered to be glucose intolerant. In this context, we have tested, for the first time in rainbow trout, metformin, a common anti-diabetic drug, known to modify muscle and liver metabolism and to control hyperglycemia in mammals. In the present study, juvenile trout were fed with very high levels of carbohydrates (30% of the diet) for this species during 10 days followed by feeding with pellets supplemented with metformin (0.25% of the diet) for three additional days. Dietary metformin led to a significant reduction in postprandial glycemia in trout, demonstrating unambiguously the hypoglycemic effect of this drug. No effect of metformin was detected on mRNA levels for glucose transporter type 4 (GLUT4), or enzymes involved in glycolysis, mitochondrial energy metabolism, or on glycogen level in the white muscle. Expected inhibition of hepatic gluconeogenic (glucose-6-phosphatase, fructose-1,6-bisphosphatase, and phosphoenolpyruvate carboxykinase) mRNA levels was not found, showing instead paradoxically higher mRNA levels for these genes after drug treatment. Finally, metformin treatment was associated with higher mRNA levels and activities for lipogenic enzymes (fatty acid synthase and glucose-6-phosphate dehydrogenase). Overall, this study strongly supports that the induction of hepatic lipogenesis by dietary glucose may permit a more efficient control of postprandial glycemia in carnivorous fish fed with high carbohydrate diets.

Effects of a Protein Preload on Gastric Emptying, Glycemia, and Gut Hormones After a Carbohydrate Meal in Diet-Controlled Type 2 Diabetes

OBJECTIVEWe evaluated whether a whey preload could slow gastric emptying, stimulate incretin hormones, and attenuate postprandial glycemia in type 2 diabetes.RESEARCH DESIGN AND METHODSEight type 2 diabetic patients ingested 350 ml beef soup 30 min before a potato meal; 55 g whey was added to either the soup (whey preload) or potato (whey in meal) or no whey was given.RESULTSGastric emptying was slowest after the whey preload (P < 0.0005). The incremental area under the blood glucose curve was less after the whey preload and whey in meal than after no whey (P < 0.005). Plasma glucose-dependent insulinotropic polypeptide, insulin, and cholecystokinin concentrations were higher on both whey days than after no whey, whereas glucagon-like peptide 1 was greatest after the whey preload (P < 0.05).CONCLUSIONSWhey protein consumed before a carbohydrate meal can stimulate insulin and incretin hormone secretion and slow gastric emptying, leading to marked reduction in postprandial glycemia in type 2 diabetes.

Open-label, randomized, multiple-center, parallel study comparing glycemic responses and safety profiles of Glucerna versus Fresubin in subjects of type 2 diabetes mellitus

Since the increase of prevalence of type 2 diabetes mellitus (T-2DM), the replacing quickly absorbed carbohydrates with a fat source rich in monounsaturated fatty acid to provide improved glycemic control in these patients has become an important assistant therapy. In the present study, we compared glycemic response and safety of two nutritional products, Glucerna and Fresubin, in Chinese subjects with T-2DM. Overall, 203 T-2DM subjects were randomly assigned (1:1) to either Glucerna or Fresubin. The primary endpoint was the adjusted area under the curve (adj-AUC) for plasma glucose at 0-240 min. Blood samples were collected at 0, 30, 60, 90, 120, 180, and 240 min to compare the adjusted area under the curve (AUC) for the change in plasma glucose or insulin from 0 to 240 min. Adjusted peak values and times of glucose and insulin responses and adjusted glucose and insulin values were collected at the same time points. Safety parameters were also evaluated. The adjusted AUC for the change in plasma glucose in the Glucerna group was significantly lower than in Fresubin group (5.60 +/- 5.88 mmol/l*h vs. 7.97 +/- 6.32 mmol/l*h, P = 0.0061), as was the adjusted peak value of glucose (3.51 +/- 2.04 mmol/l vs. 4.69 +/- 1.99 mmol/l, P < 0.0001). Glucerna subjects had a longer adjusted peak time to insulin response compared to Fresubin subjects (105.00 +/- 43.4 min vs. 88.81 +/- 37.69 min, P = 0.0050). Glucerna subjects also experienced more gradual changes in glucose and insulin values. In conclusion, Glucerna provided better control of postprandial plasma glucose and insulin levels in Chinese subjects with T-2DM. Variation of postprandial glucose tended to be relatively stable after patients took Glucerna. Study results suggest that Glucerna may be beneficial in the reduction of postprandial glycemia.

The Effects of Escalating Quantities of Salvia hispanica L. (Salba) on Postprandial Glycemia and Appetite in Healthy Individuals

Objective: To assess the effects of escalating quantities of the whole grain Salvia hispanica L. (Salba) on postprandial glycemia and appetite.Methods: Using an acute randomized controlled design, 12 healthy individuals (7M;5F;BMI 22.3±2.8 kg/m2) received either 0, 7, 15 or 24 g of Salba baked into white bread. The control (0g) was repeated twice. All meals contained 50 g of available carbohydrates. Thus, subjects consumed 5 different meals with at least 3 days in between visits. Fingerprick blood samples and ratings of satiety scores on a 100 mm visual analog scale were taken at 0, 15, 30, 45, 60, 90 and 120 minutes post‐consumption.Results: There was a dose‐response reduction of postprandial glycemia with the highest and intermediate quantities of Salba resulting in an IAUC blood glucose reduction of 43% (p=0.0013) and 33% (p=0.0115), respectively. Only the intermediate dose resulted in a significant reduction in combined satiety score, with an average reduction of 47% compared to the two other experimental meals and controls at every time point after 15 minutes.Conclusions: Addition of the whole grain Salba to white bread lowers postprandial glycemia and appetite, and may be potentially cardioprotective. Thus, further research is warranted to assess the effects of Salba on long‐term reduction of cardiovascular risk factors, carbohydrate metabolism and control of body weight.Sponsor: Salba Inc, Toronto