Significant Differences In Fasting Glucose Research Articles

Denosumab Improves Glycaemic Parameters in Postmenopausal Osteoporosis Patients with Combined Type 2 Diabetes Mellitus.

This study aimed to determine whether RANKL inhibitors in postmenopausal osteoporosis patients with combined type 2 diabetes mellitus (T2DM) could improve their glucose metabolism index. First of all, 84 patients affected with postmenopausal osteoporosis with combined T2DM attending the Department of Endocrinology at the Third Hospital of Hebei Medical University were selected and randomized into two groups of 42 patients each. One group was given Denosumab 60 mg once every six months (denosumab group, D.G.), and the other group was given 2 mg ibandronate once every three months (ibandronate group, I.G.). Blood glucose parameters were compared before and after treatment in both groups and serum active GLP-1 levels and DPP-4 levels were also assessed. After treatment, there was no significant difference in fasting glucose between the two groups, but there was a significant decrease in fasting glucose in the Denosumab Group (D.G.) compared to before treatment. There was a significant difference in 2-hour postprandial glucose (2hPG) between the two groups after treatment, with the D.G. being lower than the ibandronate group (I.G.). Glycosylated haemoglobin (HbA1c) was lower in the D.G. than in the I.G. after treatment, but the difference between them was insignificant. In the D.G., serum active GLP-1 levels increased after treatment, and serum DPP-4 levels decreased. Serum GLP-1 and DPP-4 levels in the I.G. did not change compared with those before treatment. In conclusion, In the clinical management of postmenopausal osteoporosis patients with combined T2DM, the choice of RANKL inhibitors as anti-osteoporosis therapy may benefit their glycaemic parameters by elevating serum active GLP-1 levels and decreasing serum DPP-4 levels.

Association of blood pressure variability with target organ damage in older patients with essential hypertension.

Although multiple measures of blood pressure variability (BPV) have been proposed, whether they are better than mean blood pressure in predicting target organs is unclear. We aimed to determine the relationship between short term BPV and target organ injury. This study was a retrospective study, and 635 inpatients in the Department of Cardiology from 2015 to 2020 were selected. We divided participants into four groups on the basis of the quartiles of BPV. One-way analysis of variance was used to compare the differences between the groups, and linear regression was used to analyze the relationship between BPV and target organ damage. The average age of 635 patients was 74.36 ± 6.50 years old. Among them, 354 of 627 patientshad diminished renal function (56.5%), 221of 604 patients had associated left ventricular hypertrophy (36.6%), and 227 of 231 patients had carotid plaque formation (98.3%). The baseline data indicated significant differences in fasting glucose, total cholesterol, low-density lipoprotein, creatinine, glomerular filtration rate, sex, calcium channel blocker use, and the rate of diminished renal function. Multiple linear regression analysis showed that BPV was negatively correlated with renal injury (creatinine: r = 0.306, p < 0.01; estimated glomerular filtration rate: r = 0.058, p < 0.01), and BPV is positively correlated with cardiac injury (r = 0.083, p < 0.01). Elevated BPV was not found to be associated with vascular injury. Renal function decreases with increasing BPVand left ventricular mass increases with increasing BPV.

Comparative analysis of obesity prevalence, antioxidant and oxidant status in children with Down syndrome - asibling-controlled study.

Down syndrome (DS), acommon genetic disorder, leads to various physical, cognitive, and developmental challenges. The supplementary copy of chromosome 21 introduces an abundance of genes, which potentially can influence metabolic irregularities. The aim of the study is to conduct acomprehensive comparative assessment of oxidative stress indicators (TAS, TOS, OSI), BMI, fasting glucose, and insulin levels, HOMA-IR among children and adolescents with DS in contrast to their non-DS siblings. and the control group (CG) comprised 20 individuals, siblings of SG (mean age 15.92 years). Anthropometric measurements were conducted. TAS, TOS, fasting glucose, and insulin were assessed. BMI, BMI SDS, OSI and HOMA-IR were calculated. SG vs. CG: BMI - overweight (29,19% vs. 15%), obese (19,05% vs. 5%); TAS (1.92 mmol/l vs. 1.79 mmol/l (p=0.0015)); TOS (51.52mmol/l vs. 33.05 mmol/l (p=0.014)); OSI (2475.02 vs. 1949,75 (p=0.038)); no significant differences in fasting glucose, insulin and HOMA-IR. Statistically significant correlations in SG: TOS and BMI, BMI SDS, HOMA-IR; OSI and BMI, BMI SDS, HOMA-IR; HOMA-IR and BMI SDS; fasting insulin and BMI PC; in CG: TAS and BMI; fasting glucose and fasting insulin. The research results indicate differences in metabolic processes between the group of individuals with DS compared to the CG, despite shared environmental conditions. The presence of an additional copy of chromosome 21 may contribute to the occurrence of metabolic disorders. These findings emphasize the need for further research that will lead to abetter understanding of these relationships and contribute to the development of effective therapeutic strategies.

The effect of 8 weeks resistance and concurrent training on irisin, some glycemic indexes and the visceral fat to muscle mass ratio on sedentary obese women

Background: The prevalence of obesity and type2 diabetes are escalating at an alarming rate in many developed as well as developing countries. Irisin is a novel muscle and adipose derived chemokine that is, proteolytically processed from the product of the FNDC5 (fibronectin type ш domain containing 5) gene. The purpose of this study is to examine the effect of tow kind of training on irisin in sedentary obese women. Methods: In this study 22 obese women (medium age: 37± 6 year, height: 1.55 ± 0.04 meter, BMI: 35 ± 0.29 kg/m2) were randomly assigned to two training groups Isocracy (resisting (n: 12) and concurrent (n: 11)). They attributed for three sessions a week for eight weeks. Before and after the period, the levels of irisin, fasting glucose, insulin and insulin resistance with HOMA-IR index and viscera ratio to body muscle were investigated. Finally, the data were analyzed using tow way ANOVA evaluated. Results: After 8 weeks exercise glucose in resistance groups and irisin in all groups had significant changes (P<0.05) but we did not find significant differences in fasting glucose, insulin, HOMA-IR and irisin between the groups (P>0.05). Conclusion: In summery in this study there were no difference between groups of training. It can be hypothesis that the increase of irisin in obese people is one of the preventing ways against of obesity's side effects. Exercise could improve the signaling pathways and consume the fat accumulations, therefore at the end of exercise duration, irisin decreased.

Sex-specific associations between insulin resistance and bone parameters in overweight and obese older adults.

To determine sex-specific associations between insulin resistance and bone parameters measured by peripheral quantitative computed tomography in overweight and obese community-dwelling older adults. Cross-sectional study of 79 community-dwelling overweight and obese adults (mean±SD age 62.8±7.9years; body mass index 32.3±6.1kg/m2 ; 58% women). Peripheral quantitative computed tomography assessed distal radius and tibia trabecular volumetric bone mineral density (vBMD) and proximal radius and tibia cortical vBMD, periosteal circumference, endosteal circumference and stress-strain index. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score was calculated from fasting glucose and insulin values. Lean mass was assessed using dual-energy X-ray absorptiometry. Total minutes of moderate and vigorous physical activity (MVPA) were calculated using the Active Australia Survey. Men and women in this cohort had no significant differences in fasting glucose and insulin concentrations, HOMA-IR valuesand diabetes prevalence (all P>0.05). In women, HOMA-IR was positively correlated with proximal radius periosteal and endosteal circumference (r=0.331; P=0.034 and r=0.325; P=0.038, respectively). These associations became nonsignificant in multivariable regression analyses; however, HOMA-IR was negatively associated with proximal radius cortical vBMD (B=-4.79; 95% CI -8.66, -0.92) after adjusting for age, lean mass and MVPA. All associations between HOMA-IR and bone parameters became nonsignificant in a sensitivity analysis excluding individuals with diabetes, or self-reported use of glucose-lowering medications. There were no associations between HOMA-IR and bone parameters in men. Homeostatic Model Assessment of Insulin Resistance was negatively associated with radial cortical vBMD in overweight and obese older women, but not in men. Further studies are needed to clarify sex-specific associations between insulin resistance and bone health in overweight and obese older adults.

The Use of Omega-3 Fatty Acids to Improve Insulin Sensitivity in Pregnancy: A Pilot Study of Safety and Tolerability [6Q

INTRODUCTION: Omega-3 fatty acid (n3 FA) consumption is associated with improved insulin sensitivity in some diabetic populations, but can cause adverse effects at high doses. The objective was to evaluate the tolerability of high-dose n3 FA supplementation in obstetric patients with diet-controlled gestational diabetes (GDM). METHODS: Women with diet-controlled GDM between 24 and 30 weeks of gestation were randomized in a prospective, double-blind fashion to receive either 2200 mg daily of commercial fish oil (1300 mg eicosapentaenoic acid (EPA) + 900 mg docosahexaenoic acid (DHA)) or an identical placebo for a minimum of 6 weeks. Pre-and post-treatment evaluations were calculated using the homeostatic model assessment of insulin resistance (HOMA-IR) and measures of safety and tolerability. RESULTS: In this pilot study, 14 GDM patients were randomized to treatment with fish oil (N=7) or placebo (N=7). Of these, 35.7% (3 in the treatment group, 2 in the placebo group) did not complete the treatment course due to intolerance. No clinically significant adverse effects, obstetric or neonatal complications were noted. Two patients in each group required initiation of medical therapy for glucose control subsequent to enrollment. While the pilot study was not adequately powered to detect a difference in objective measures of glucose control between the groups, no significant differences in fasting glucose, fasting insulin, or HOMA-IR levels were noted. CONCLUSION: High dose omega-3 fatty acid supplementation appears to be safe in pregnancy, but some patients have bothersome side effects that may limit compliance. The use of omega-3 fatty acids to mitigate insulin resistance in gestational diabetes warrants further investigation.

The role of a pulse-based diet on infertility measures and metabolic syndrome risk: protocol of a randomized clinical trial in women with polycystic ovary syndrome

BackgroundPolycystic Ovary Syndrome (PCOS) is an endocrine disorder in women of reproductive age with an estimated prevalence of 5–20% of premenopausal women. The clinical symptoms common to PCOS include menstrual dysfunction, hyperandrogenemia, hirsutism, polycystic ovaries, insulin resistance, and hyperinsulinemia. Women with PCOS are at an increased risk of infertility, obesity and type 2 diabetes mellitus. Insulin resistance and hyperinsulinemia are believed to be key contributing factors to the pathogenesis of PCOS; excessive amounts of insulin are directly associated with the increased ovarian production of androgens and metabolic features of PCOS. Pulse-based diets (e.g., beans, chickpeas) are associated with improved glycemic control and have insulin lowering effects. The purpose of this study is to determine whether a pulse-based diet is more effective than the diet recommended by the National Cholesterol Education Program. The primary outcomes of this study are disease measures related to PCOS, with secondary outcomes including measures related to metabolic syndrome.MethodsWomen with symptoms of PCOS will be recruited for the study and a diagnosis of PCOS will be determined by an obstetrician-gynecologist. Women with PCOS will be randomly assigned to receive either a pulse-based diet or the National Cholesterol Education Program therapeutic lifestyle changes (TLC) diet for 16 weeks while participating in an aerobic exercise program. One hundred participants will be required (drop-out rate of 32%) for recruitment to provide 80% power for detecting a significant difference in fasting glucose (p < 0.05). Measures related to infertility, metabolic syndrome, quality of life, dietary intake and physical activity will be assessed pre- and post-intervention with follow up assessment at 6- and 12-months post-intervention.DiscussionPolycystic ovary syndrome is the most common endocrine disorder in women of reproductive age and there is currently no recommended diet for this population of women. The multidisciplinary nature of this study, including determination of measures related to metabolic syndrome, infertility and physical activity provide a comprehensive assessment of any benefits associated with a pulse-based diet in women with PCOS. The results of this study will help in providing evidence-based recommendations for the optimum diet to reduce symptoms associated with PCOS.Trial registrationNCT01288638. Trial registered January 13, 2011.

Incretin effects, gastric emptying and insulin responses to low oral glucose loads in patients after gastric bypass and lean and obese controls

BackgroundAfter laparoscopic Roux-en-Y gastric bypass (LRYGB), many patients suffer from dumping syndrome. Oral glucose tolerance tests are usually carried out with 50–75 g of glucose. The aim of this study was to examine whether minimal glucose loads of 10 g and 25 g induce a reliable secretion of satiation peptides without dumping symptoms after LRYGB. In addition, lean and obese controls were examined. ObjectiveThe objective of this study was to determine the effects of low oral glucose loads on incretin release and gastric emptying. SettingAll surgical procedures were performed by the same surgeon (RP) at the St. Claraspital Basel in Switzerland. Oral glucose challenges were carried out at the University Hospital of Basel (Phase 1 Research Unit). MethodsEight patients 10±.4 weeks after LRYGB (PostOP; body mass index [BMI]: 38.6 kg/m2±1.7) as well as 12 lean controls (LC; BMI: 21.8 kg/m2±.6) and 12 obese controls (OC; BMI 38.7 kg/m2±1.3) received 10 g and 25 g of oral glucose. We examined clinical signs of dumping syndrome; plasma glucose, insulin, glucagon-like peptide 1, glucose-dependent insulinotropic peptide, and peptide tyrosine tyrosine concentrations; and gastric emptying with a 13 C-sodium acetate breath test. ResultsNo signs of dumping were seen in PostOP. Compared with OC, LC showed lower fasting glucose, insulin, and C-peptide, and lower homeostasis model assessment (HOMA) and AUC-180 for insulin and C-peptide. In PostOP, fasting insulin, HOMA and AUC-180 for insulin was lower and no difference was found in fasting C-peptide or AUC-180 for C-peptide compared to OC. There was no significant difference in fasting glucose, insulin, C-peptide, HOMA and AUC-180 for insulin in PostOP compared to LC, but AUC-180 for C-peptide was higher in PostOP. AUC-60 for gut hormones was similar in OC and LC and higher in PostOP compared to OC or LC. gastric emptying was slower in LC and OC compared with PostOP. ConclusionAfter LRYGB, 25 g oral glucose is well tolerated and leads to reliable secretion of gut hormones. Fasting glucose, insulin and C-peptide are normalized, while glucagon-like peptide 1, glucose-dependent insulinotropic peptide and peptide tyrosine tyrosine are overcorrected. Pouch emptying is accelerated after LRYGB.

Impaired Glucose Handling Is Revealed in Prostate Cancer Patients

Prostate cancer survivors have increased risk for diabetes and cardiovascular disease. Here, we evaluate glucose handling and lipid profiles in men with prostate cancer and compared them with 2 cancer-free reference groups to elucidate potential cancer-related changes in metabolism. Eight high-risk, newly diagnosed prostate cancer patients (>T3 or Gleason >8 or PSA >20ng/mL), 7 age-matched, cancer-free (HM) males and 10 young healthy (HY) males were included. Fasting blood samples were obtained for glucose- and lipid-related parameters followed by an oral glucose tolerance test (OGTT) to assess glucose handling, insulin and c-peptide response. There were no significant differences in fasting glucose between groups (patients: 4.87±1.18mM; HM: 3.65±0.21mM; HY: 3.70±0.46mM). However, patients demonstrated impaired 2-hr glucose concentrations (8.68±2.87mM where normal is defined as <7.8mM), which were significantly higher compared with HM and HY groups (HM: 5.21±1.92mM, p=0.002; HY: 3.24±1.05mM, p<0.001). Similarly, insulin and c-peptide responses demonstrated significantly greater 2-hr insulin and c-peptide concentration vs HM and HY groups. There were no significant differences in total cholesterol, HDL, LDL, triglycerides between the 3 groups. Thus, glucose handling, not the lipid profile, may be affected by prostate cancer, which may influence the risk of diabetes in survivorship. Funded by the Motorcycle Ride for Dad Foundation and the Canadian Institute of Health Research.

The relationship of fasting glucose in basic state with the results of head-up tilt table test in children

Objective To explore the relationship of fasting glucose in basic state with the results of head-up tilt table test (HUTT) in children.Methods We choosed 157 cases of children (male 86 and female 71) with unexplained syncope,headache,dizziness and sigh,they were 3 ～ 18 (11.34 ± 3.29) years old and were outpatients or had been hospitalized in the Second Xiangya Hospital of Central South University from Sep 2012 to Feb 2013.The HUTT were carried on after eliminate organic disease of heart,head,bloodvessel and other reasons caused by the above symptoms and obtain written informed consent from participants or guardian.Before HUTI,trace fasting glucose of children would be monitored in based condition.Results (1) Between HUTT negative group (n =63) and HUTT positive group (n =94),there was no significant difference in fasting glucose [(5.40 ± 0.52) mmol/L vs (5.35 ± 0.61) mmoL/L,t =-0.590,P ＞ 0.05].(2) Only 1 case of heart inhibited type vasovagal syncope did not be included in 94 children with HUTT positive.There were no significant differences in fasting glucose between vascular inhibited type vasovagal syncope (n =67) and mixed vasovagal syncope (n =10) and orthostatic tachycardia syndrome (n =16)[(5.34 ±0.54) mmol/L vs (5.07 ±0.64) mmol/L vs (5.49 ±0.81) mmol/L,P ＞0.05].(3) Among 67 cases of vascular inhibitory type vasovagal syncope in children,two kinds induced way of based tilt table test (n =16) and sublingual nitroglycerin tilt table test (n =51) showed no significant differences in fasting glucose [(5.32 ±0.54) mmol/L vs (5.35 ±0.55) mmol/L,t =0.166,P ＞0.05].(4) In two groups of fasting glucose ＜5.5 mmol/L and ≥5.5 mmol/L,HUTT negative rate [37.63％ (35/93) vs 43.75％ (28/64)] and HUTT positive rate [62.37％ (58/93) vs 56.25％ (36/64)] showed no statistical significance (x2 =0.585,P ＞ 0.05).Conclusion Fasting glucose in basic state has no predictive value to HUTT results in children. Key words: Fasting glucose; Head-up tilt table test; Children

Impact of a new total Western diet for rodents on metabolic health and colorectal carcinogenesis

Our group developed a new total Western diet (TWD) for rodents that mimics typical human nutrition patterns with respect to macronutrient composition (amounts and types of sugar, fat, protein) and micronutrient content (vitamins and minerals) on a nutrient density basis. The goal of the present study was to determine the relative roles of macro‐ and micronutrients in dysregulating metabolism. Mice fed the TWD appeared to compensate for its high energy content by reducing food consumption, whereas animals fed a commercial DIO diet did not. However, food and energy intakes in mice fed a diet modified only for vitamin and mineral content was similar to the AIN93‐fed controls, whereas food and energy intakes by mice fed a diet modified for macronutrient composition were highly similar to DIO‐fed mice. These patterns were reflected in the average final body weight for each group, and body weight gain was entirely attributed to an increase in fat mass. Overall, based on our observations, the altered micronutrient composition of the TWD blocked the macronutrient driven increase in body weight. Significant differences in fasting glucose or oral glucose tolerance were observed only for mice fed the DIO diet. Our observations point to a complex interaction between macro‐ and micronutrients with respect to satiety and energy intake. We are currently examining the impact of these westernized rodent diets on colon carcinogenesis.

A variant in the fibrillin-3 gene is associated with TGF-β and inhibin B levels in women with polycystic ovary syndrome

In an attempt to evaluate the association between allele 8 (A8) of D19S884 in the fibrillin-3 gene and circulating transforming growth factor (TGF) β and inhibin levels in women with polycystic ovary syndrome (PCOS), we studied 120 similarly aged women from families with PCOS and compared 40 women with PCOS who did not have A8 (A8- PCOS) with 40 women with PCOS who had A8 (A8+ PCOS) and 40 normally menstruating women who did not have either PCOS or A8 (A8- Non-PCOS). A8- PCOS is associated with higher levels of TGF-β1 compared with A8+ PCOS or A8- Non-PCOS, similar levels of TGF-β2 compared with A8+ PCOS but lower levels of TGF-β2 compared with A8- Non-PCOS, and lower levels of inhibin B and aldosterone compared with A8+ PCOS.

Ziprasidone Vs Olanzapine in Recent-Onset Schizophrenia and Schizoaffective Disorder: Results of an 8-Week Double-Blind Randomized Controlled Trial

Head-to-head comparisons of antipsychotics have predominantly included patients with chronic conditions. The aim of the present study was to compare the efficacy and tolerability of ziprasidone and olanzapine in patients with recent-onset schizophrenia. The study was an 8-week, double-blind, parallel-group, randomized, controlled multicenter trial (NCT00145444). Seventy-six patients with schizophreniform disorder, schizophrenia or schizoaffective disorder (diagnosis < 5 y), and a maximum lifetime antipsychotic treatment < 16 weeks participated in the study. Efficacy of ziprasidone (80-160 mg/d) and olanzapine 10-20 mg was measured using the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impression (CGI) Scale, the Calgary Depression Scale for Schizophrenia (CDSS), and the Heinrich Quality of Life Scale (HQLS); tolerability assessments included laboratory assessments, body weight, and electroencephalogram. Olanzapine (n = 34) and ziprasidone (n = 39) showed equal efficacy as measured by the PANSS, CDSS, CGI, and HQLS. However, mean weight gain was significantly higher in the olanzapine group (6.8 vs 0.1 kg, P < .001). Ziprasidone was associated with decreasing levels of triglycerides, cholesterol, and transaminases, while these parameters increased in the olanzapine group (all P values < .05). There were no significant differences in fasting glucose and prolactin levels or in cardiac or sexual side effects. Patients on ziprasidone used biperiden for extrapyramidal side effects more frequently (P < .05). The results of this study indicate that ziprasidone and olanzapine have comparable therapeutic efficacy but differ in their side effect profile. However, there is a risk of a type II error with this sample size. Clinically significant weight gain and laboratory abnormalities appear early after initiating treatment and are more prominent with olanzapine, while more patients on ziprasidone received anticholinergic drugs to treat extrapyramidal symptoms.

Diet and acne: a review of the evidence

Pharmaceutical acne treatments are costly and have potentially severe side-effects. Adolescent acne is typically the result of clogged, infected, pilosebaceous follicles. Adults may experience fewer comedones and more inflammatory lesions. 1 Normally, sebum travels up the follicle to the skin surface. Hormones may increase sebum production and cause follicular cells to hyperproliferate and block the follicular opening, forming a comedo. 4 Complete follicle blockage results in closed comedones (i.e. “whiteheads”), whereas incomplete blockage results in open comedones (“blackheads”). Comedo formation typically occurs over the course of 2–3 weeks. Acne may manifest in the form of noninflammatory comedones, superficial inflammatory lesions (papules, pustules), and/or deeper inflammatory lesions (nodules, cysts). Inflammatory lesion formation occurs most commonly when Propionibacterium acnes colonizes the pilosebaceous unit, triggering follicular rupture and a neutrophil cascade. 5

Long-term use of a diabetes-specific oral nutritional supplement results in a low-postprandial glucose response in diabetes patients

Background To determine the effect of 12 weeks supplementation with a high-MUFA, high-fibre diabetes-specific oral nutritional supplement (ONS) on postprandial glucose response in type 2 diabetic patients at risk for malnutrition. Methods Forty patients participated in this randomised, controlled, double-blind, parallel-group study. Subjects consumed 2 × 200 ml of diabetes-specific ONS (Diasip ®) or standard ONS per day in addition to their normal diet. At baseline, after 6 and 12 weeks postprandial glucose responses and secondary parameters were assessed. Results Postprandial glucose responses (incremental area under curve) ( p < 0.01) and delta postprandial peak glucose concentration ( p < 0.01) were significantly lower in the diabetes-specific ONS group compared with the standard ONS group at all visits. In time, iAUC glucose ( p = 0.074, t = 0 week vs. t = 12 weeks) and delta postprandial peak plasma glucose concentration ( p < 0.05, t = 0 week vs. t = 12 weeks) were decreased within the diabetes-specific ONS group, but not in the standard ONS group. No significant differences in fasting glucose, insulin, HbA1c, lipid profile, hs-CRP, oxidized LDL and malondialdehyde, laboratory safety parameters and nutritional status parameters were found between both groups at either of the visits. Conclusions These data demonstrate that diabetic patients at risk for malnutrition benefit from use of this diabetes-specific ONS to improve postprandial blood glucose control.

Smaller, More Frequent Meals are Associated with Greater Reduction in Total Cholesterol and Triglycerides in Obese Adults After Three Months on Isocaloric Weight Loss Regimens

Learning Outcome: To examine whether the type of meal pattern (3 meals, 3 meals and 3 snacks, or 6 meals) influences heart disease risk factors in obese adults on calorie controlled diets.Text:The frequency and size of meals may influence chronic disease risk. This study aimed to investigate the effects of 3 different iso-caloric meal patterns on serum lipid, fasting glucose and insulin levels. Obese adults (131F, 50M) were randomly assigned to one of three daily meal patternsmthree meals (3D) (n=61); three meals and three snacks (3,3D) (n=59); and six meals. (6D) (n=61). Participants were instructed to follow the assigned weight loss diet for 6 months, with subsequent follow up at 9 and 12 months. Caloric intake was restricted to 1200 to 1800 calories daily, depending on gender and activity. All diets met national dietary goals (30% fat, 14% sat fat, 45-50% CHO, 15-20% Pro). Fasting bloods were collected and analysed at 3 month intervals. Preliminary findings at 3 months (one way ANOVA) suggest that subjects assigned to 6D (n=38) had significantly greater reduction in total cholesterol, compared to 3,3D (n=41) or 3D (n=33): (m0.39 (p0.9) (psd) vs. m0.13 (p0.6), +0.09 (p0.7) respectively, p=0.036) and significantly greater reduction in triglycerides (m0.31 (p0.7) vs. m0.02 (p0.5), 0.02 (p0.4), p=0.020). No significant differences in fasting glucose, LDL cholesterol, HDL cholesterol, insulin, and HOMA score of insulin resistance were noted at 3 months. Preliminary findings suggest that 6 smaller meals daily may provide greater reduction in selected heart disease risk factors over a three month period. Longer term outcomes will be needed to assess overall disease risk reduction.Funding Disclosure: Australian Postgraduate Award and William Arnott Scholarship

Olanzapine Versus Ziprasidone: Results of a 28-Week Double-Blind Study in Patients With Schizophrenia

The efficacy and safety of olanzapine were compared with those of ziprasidone. This was a multicenter randomized, double-blind, parallel-group, 28-week study of patients with schizophrenia. Patients were randomly assigned to treatment with 10-20 mg/day of olanzapine or 80-160 mg/day of ziprasidone. The primary efficacy measure was the Positive and Negative Syndrome Scale total score. Secondary efficacy and safety measures included Positive and Negative Syndrome Scale subscales as well as mood, quality of life, and extrapyramidal symptom scales. Safety was evaluated by recording treatment-emergent adverse events and measuring vital signs and weight. The study was completed by significantly more olanzapine-treated patients (165 of 277, 59.6%) than ziprasidone-treated patients (115 of 271, 42.4%). At 28 weeks, the olanzapine-treated patients showed significantly more improvement than the ziprasidone-treated patients on the Positive and Negative Syndrome Scale overall scale and all subscales and on the Clinical Global Impression ratings of severity of illness and improvement. The responder rate was higher for olanzapine than for ziprasidone. Extrapyramidal symptoms were not significantly different between groups in change-to-endpoint analyses, but results favored olanzapine on baseline-to-maximum changes. Weight change was significantly greater with olanzapine (mean=3.06 kg, SD=6.87) than with ziprasidone (mean=-1.12 kg, SD=4.70). Fasting lipid profiles were significantly superior in the ziprasidone group; there was no significant difference in fasting glucose level. Olanzapine treatment resulted in significantly greater psychopathology improvement and higher response and completion rates than ziprasidone treatment, while ziprasidone was superior for weight change and lipid profile.

Influence of family history of type 2 diabetes on insulin sensitivity in prepubertal children.

The objective of this study was to examine the influence of positive family history (FH) of type 2 diabetes (T2D) on aspects of insulin resistance in prepubertal children. Twenty-one children (Tanner stage I or II) with a positive FH were compared with children with no FH. FH was defined by presence of T2D in a parent or grandparent as assessed by interview. The two groups of children were matched for age, gender, Tanner stage, ethnicity, geographical location, and body fat mass using a pair-matched design. These 21 pairs of children included Caucasian, African American, and Hispanic children who were studied either in Birmingham, Alabama, or Los Angeles, California, using similar techniques. Insulin sensitivity (S(I)) and the acute insulin response to glucose (AIR) were determined by an iv glucose tolerance test and minimal modeling, and body composition was determined by dual-energy x-ray absorptiometry. There were no significant differences in fasting glucose or insulin, S(I), AIR, the disposition index (product of S(I) and AIR), or body composition between children with a FH vs. those without a FH of T2D, and there were no significant differences in these parameters when the data were analyzed separately in each ethnic group. In conclusion, a positive FH for T2D does not seem to have any significant effect on insulin sensitivity, as assessed by the minimal model and associated risk factors for T2D in young children.

POM + EBM = CPD?

<h3>Background</h3> The increasing incidence of type 2 diabetes mellitus is attributed to increasing weight, reduced physical activity, and poor diet quality. Lifestyle change in patients with pre-diabetes can reduce progression...

Increased level of hemoglobin A 1C, but not impaired insulin sensitivity, found in hypertensive and normotensive smokers

Smoking is associated with an abnormal plasma lipoprotein pattern. Recently, both insulin resistance and normal insulin action have been reported in smokers. In a total of 191 hypertensive and normotensive subjects recruited from a health survey, serum lipoprotein lipids, glucose tolerance (by intravenous glucose tolerance test (IVGTT), insulin secretion, and insulin sensitivity (euglycemic insulin clamp) were compared in the 41 smokers and 150 nonsmokers. Subjects were examined in the morning during a fasting state and after abstinence from smoking for 10 to 12 hours. Smokers showed a higher level of hemoglobin A 1c (HbA 1c) as compared with nonsmokers, 4.9% versus 4.7% ( P < .05). There were no significant differences in fasting glucose, insulin, or insulin-mediated glucose disposal. However, a number of indices of insulin sensitivity tended to show enhanced insulin action among smokers. Only lower glucose and insulin values during the late phase (40 to 90 minutes) of the IVGTT reached statistical significance. Compared with nonsmokers, smokers had an expected higher level of serum triglycerides (2.1 v 1.8 mmol/L, P < .05) and an increased low-density lipoprotein (LDL) to high-density lipoprotein (HDL) cholesterol ratio (4.5 v 3.9, P < .05). These differences between smokers and nonsmokers were similar in both hypertensives and normotensives. In conclusion, smokers examined in the abstinence phase showed no signs of impaired insulin action. Lipoprotein abnormalities and elevated HbA 1c may be caused in part by the insulin resistance induced during acute smoking and therefore may be quantitatively related to the time exposed to smoking. The effect on insulin sensitivity appears to be reversible over 10 to 12 hours.