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Glycaemic variability

Anne Rieder, Svein H Knutsen, Aida Sainz Fernandez, Simon Ballance
Cereal beta-glucan can reduce post-prandial glycaemic responses, which makes it an interesting ingredient to improve the health impact of bread, a staple food with a high glycaemic index (GI). Here we compare the ability of different wheat-based breads prepared with oat bran concentrate and barley flour and a Norwegian type of soft wrap (lompe) for their ability to reduce glycaemic responses in healthy adults. Both breads with the highest beta-glucan content (3.8 g per serving) significantly reduced peak blood glucose rise (PBGR), incremental area under the blood glucose curve (iAUC) and GI compared to wheat control regardless of beta-glucan Mw and solubility...
February 20, 2019: Food & Function
Hossein Rafiei, Emily Robinson, Julianne Barry, Mary Elizabeth Jung, Jonathan Peter Little
Exercise is recognized as a frontline therapy for the prevention and treatment of type 2 diabetes (T2D) but the optimal type of exercise is not yet determined. We compared the effects of high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) for improvement of continuous glucose monitoring (CGM)-derived markers of glycaemic variability, and biomarkers of endothelial cell damage (CD31+ and CD62+ endothelial microparticles (EMPs)) within a population at elevated risk of developing T2D...
February 18, 2019: European Journal of Sport Science
P Choudhary, F Campbell, N Joule, P Kar
In both adults and children with diabetes, technologies such as continuous subcutaneous insulin infusion using insulin pumps and continuous glucose monitoring can help improve diabetes control, reduce hypoglycaemia and improve quality of life. Access to these technologies in the UK is very variable. Some technologies are recommended by the National Institute for Health and Care Excellence, while others have not been appraised, and new technologies are emerging all the time. Additionally, different guidelines for adults and children further complicate access to diabetes technology in the transition from paediatric to adult care...
February 17, 2019: Diabetic Medicine: a Journal of the British Diabetic Association
Mourad Benalia, Marianne Zeller, Basile Mouhat, Charles Guenancia, Valentin Yameogo, Camille Greco, Hermann Yao, Maud Maza, Bruno Vergès, Yves Cottin
BACKGROUND: - In patients with type 2 diabetes (T2D), glycaemic variability (GV), another component of glycaemic abnormalities, is a novel potentially aggravating factor for coronary artery disease (CAD). OBJECTIVES: - The aim of our study was to identify interactions between GV and severity of CAD in diabetes patients admitted for acute myocardial infarction (AMI). METHODS: - All patients with T2D admitted to our university hospital for AMI from March 2015 to February 2017 who received intravenous (IV) insulin therapy and underwent coronary angiography were included...
February 11, 2019: Diabetes & Metabolism
A Stahl-Pehe, L Glaubitz, C Bächle, K Lange, K Castillo, T Tönnies, R Yossa, R W Holl, J Rosenbauer
AIM: This study aimed to determine cross-sectional relationships between diabetes distress and health-related variables, and prospective associations between diabetes distress and future glycaemic control (HbA1c ) and health status among young adults with early-onset Type 1 diabetes. METHODS: Data were collected from a nationwide cohort study of adults whose Type 1 diabetes onset occurred from 0 to 4 years of age during 1993-2002. Questionnaire surveys were conducted in 2012-2013 and 2015-2016 (N = 584)...
February 14, 2019: Diabetic Medicine: a Journal of the British Diabetic Association
Khaw Kher Kee, Harikrishna K R Nair, Ng Pei Yuen
OBJECTIVE: Objectives. To determine the prevalence and risk factors for diabetic foot infection (DFI), and to identify factors associated with delayed wound healing of diabetic foot ulcer (DFU). METHOD: The retrospective study was performed in a referral wound care clinic in Hospital Kuala Lumpur. Data was collected from January 2014 to October 2016 on DFU patients who attended this clinic. RESULTS: Of the 340 patients (216 male and 124 female) DFU patients who attended the clinic (mean age: 58...
January 1, 2019: Journal of Wound Care
P Choudhary, S de Portu, A Delbaere, J Lyon, J C Pickup
AIMS: To develop a novel interactive budget impact model that assesses affordability of diabetes treatments in specific populations, and to test the model in a hypothetical scenario by estimating cost savings resulting from reduction in HbA1c from ≥69 mmol/mol (8.5%) to a target of 53 mmol/mol (7.0%) in adults with Type 1 diabetes in the UK. METHODS: A dynamic, interactive model was created using the projected incidence and progression over a 5-year horizon of diabetes-related complications (micro- and macrovascular disease, severe hypoglycaemia and diabetic ketoacidosis) for different HbA1c levels, with flexible input of population size, complications and therapy costs, HbA1c distribution and other variables...
February 2, 2019: Diabetic Medicine: a Journal of the British Diabetic Association
K Ismail, K Stewart, K Ridge, E Britneff, R Freudenthal, D Stahl, P McCrone, C Gayle, A M Doherty
AIMS: We examined the effectiveness of a service innovation, Three Dimensions for Diabetes (3DFD), that consisted of a referral to an integrated mental health, social care and diabetes treatment model, compared with usual care in improving biomedical and health economic outcomes. METHODS: Using a non-randomized control design, the 3DFD model was offered in two inner-city boroughs in London, UK, where diabetes health professionals could refer adult residents with diabetes, suboptimal glycaemic control [HbA1c ≥ 75 mmol/mol (≥ 9...
February 1, 2019: Diabetic Medicine: a Journal of the British Diabetic Association
Penelope J Taylor, Campbell H Thompson, Natalie D Luscombe-Marsh, Thomas P Wycherley, Gary Wittert, Grant D Brinkworth
INTRODUCTION: Optimising patient adherence to prescribed lifestyle interventions to achieve improved blood glucose control remains a challenge. Combined use of real-time continuous glucose monitoring systems (RT-CGM) may promote improved glycaemic control. This pilot study examines the effects of a prescriptive lifestyle modification programme when combined with RT-CGM on blood glucose control and cardiovascular disease risk markers. METHODS: Twenty adults (10 men, 10 women) with obesity and type-2 diabetes (T2D) (age 60...
January 31, 2019: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Nathanaëlle Montanier, Lise Bernard, Céline Lambert, Bruno Pereira, Françoise Desbiez, Daniel Terral, Armand Abergel, Jérôme Bohatier, Eugenio Rosset, Jeannot Schmidt, Valérie Sautou, Samy Hadjadj, Marie Batisse-Lignier, Igor Tauveron, Salwan Maqdasy, Béatrice Roche
INTRODUCTION: Insulin infusion is recommended during management of diabetic patients in critical care units to rapidly achieve glycaemic stability and reduce the mortality. The application of an easy-to-use standardized protocol, compatible with the workload is preferred. Glycaemic target must quickly be reached, therefore static algorithms should be replaced by dynamic ones. The dynamic algorithm seems closer to the physiological situation and appreciates insulin sensitivity. However, the protocol must meet both safety and efficiency requirements...
2019: PloS One
L Monnier, C Colette, J-L Schlienger, B Bauduceau, D R Owens
Recognizing the role of dysglycaemia, 'ambient' hyperglycaemia, 'metabolic memory' and glycaemic variability as risk factors for macrovascular diseases is mandatory for effective diabetes management. Chronic hyperglycaemia, also referred to as 'ambient hyperglycaemia', was only fully acknowledged as a risk factor for adverse cardiovascular events when the beneficial effects of intensive glucose-lowering strategies were consolidated in the extended follow-up (> 10 years) of patients included in the United Kingdom Prospective Diabetes Study (UKPDS) and Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Study...
January 24, 2019: Diabetes & Metabolism
V K Alamanda, B D Springer
AIMS: Prosthetic joint infection (PJI) remains a serious complication that is associated with high morbidity and costs. The aim of this study was to prepare a systematic review to examine patient-related and perioperative risk factors that can be modified in an attempt to reduce the rate of PJI. MATERIALS AND METHODS: A search of PubMed and MEDLINE was conducted for articles published between January 1990 and February 2018 with a combination of search terms to identify studies that dealt with modifiable risk factors for reducing the rate of PJI...
January 2019: Bone & Joint Journal
Nicola J Rooney, Claire M Guest, Lydia C M Swanson, Steve V Morant
AIMS: Domestic dogs are trained to a wide variety of roles including an increasing number of medical assistance tasks. Glycaemia alert dogs are reported to greatly improve the quality of life of owners living with Type 1 diabetes. Research into their value is currently sparse, on small numbers of dogs and provides conflicting results. In this study we assess the reliability of a large number of trained glycaemic alert dogs at responding to hypo- and hyper-glycaemic (referred to as out-of-range, OOR) episodes, and explore factors associated with variations in their performance...
2019: PloS One
Stuart J McGurnaghan, Liam Brierley, Thomas M Caparrotta, Paul M McKeigue, Luke A K Blackbourn, Sarah H Wild, Graham P Leese, Rory J McCrimmon, John A McKnight, Ewan R Pearson, John R Petrie, Naveed Sattar, Helen M Colhoun
AIMS/HYPOTHESIS: Dapagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, is indicated for improving glycaemic control in type 2 diabetes mellitus. Whether its effects on HbA1c and other variables, including safety outcomes, in clinical trials are obtained in real-world practice needs to be established. METHODS: We used data from the comprehensive national diabetes register, the Scottish Care Information-Diabetes (SCI-Diabetes) collaboration database, available from 2004 to mid-2016...
January 10, 2019: Diabetologia
K Ajlouni, A Batieha, H Jaddou, Y Khader, N Abdo, M El-Khateeb, D Hyassat, D Al-Louzi
AIM: The prevalence of diabetes has been increasing over the past few decades. The objective of this study is to assess the time trends in diabetes between 1994 and 2017 in Jordan. METHODS: Surveys were conducted in 1994, 2004, 2009 and 2017 by the same investigators using generally similar methods. Fasting blood glucose was measured in all surveys. Variables were obtained using structured questionnaires designed specifically for the surveys. Crude and age-specific diabetes prevalence rates were derived for each sex, together with overall, crude and age-standardized prevalence rates...
January 6, 2019: Diabetic Medicine: a Journal of the British Diabetic Association
Jason I Chiang, Bhautesh Dinesh Jani, Frances S Mair, Barbara I Nicholl, John Furler, David O'Neal, Alicia Jenkins, Patrick Condron, Jo-Anne Manski-Nankervis
INTRODUCTION: Type 2 diabetes (T2D) is a major health priority worldwide and the majority of people with diabetes live with multimorbidity (MM) (the co-occurrence of ≥2 chronic conditions). The aim of this systematic review was to explore the association between MM and all-cause mortality and glycaemic outcomes in people with T2D. METHODS: The search strategy centred on: T2D, MM, comorbidity, mortality and glycaemia. Databases searched: MEDLINE, EMBASE, CINAHL Complete, The Cochrane Library, and SCOPUS...
2018: PloS One
Taeko Osawa, Kazuya Fujihara, Mayuko Harada, Masahiko Yamamoto, Masahiro Ishizawa, Hiroshi Suzuki, Hajime Ishiguro, Yasuhiro Matsubayashi, Hiroyasu Seida, Nauta Yamanaka, Shiro Tanaka, Hitoshi Shimano, Satoru Kodama, Hirohito Sone
AIMS: To determine incidence and predictors of starting dialysis in patients with diabetes emphasizing blood pressure variables. METHODS: A nationwide database with claim data on 18,935 people (15,789 men and 3,146 women) with diabetes mellitus aged 19-72 y in Japan was used to elucidate predictors for starting dialysis. Initiation of dialysis was determined from claims using ICD-10 codes and medical procedures. Using multivariate Cox modeling, interactions between glycaemic and blood pressure values were determined...
December 22, 2018: Diabetes/metabolism Research and Reviews
Sophie Cassidy, Vivek Vaidya, David Houghton, Pawel Zalewski, Jelena P Seferovic, Kate Hallsworth, Guy A MacGowan, Michael I Trenell, Djordje G Jakovljevic
BACKGROUND: This is the first randomised controlled trial to assess the impact of unsupervised high-intensity interval training on cardiovascular autonomic function in adults with type 2 diabetes. METHODS: A total of 22 individuals with type 2 diabetes (age 60 ± 2 years, 17 males) lay in a supine position for 20 min for evaluation of cardiovascular autonomic function, which included (1) time domain measures of heart rate variability, (2) frequency domain measures of heart rate variability and blood pressure variability and (3) baroreflex receptor sensitivity...
December 12, 2018: Diabetes & Vascular Disease Research
Dana Prídavková, Matej Samoš, Ivana Kazimierová, Ľudovít Šutarík, Soňa Fraňová, Peter Galajda, Marián Mokáň
BACKGROUND: To report changes in body composition and biochemical parameters in patients with type 1 diabetes mellitus (T1D) after switching from multiple daily injection (MDI) to continuous subcutaneous insulin infusion (CSII). METHODS: 31 patients switched over from MDI to CSII. Body composition, biochemical parameters, glycaemic variability (GV) and level of physical activity were evaluated before and 6 months on CSII. RESULTS: In both sexes, we found an increase in skeletal muscle mass (SMM), (p = 0...
2018: Obesity Facts
Silvia Díaz, Tatiana Dilla, Jesus Reviriego
The aim of this systematic literature review (SLR) was to provide an overview of the Spanish research landscape of observational studies conducted with antidiabetic drugs in T2DM patients, published in the last five years, with special focus on the objectives, methodology and main research areas. Twenty-two articles, corresponding to 20 studies, were included in the analysis. Around 82% of the studies employed a longitudinal study design, collected data retrospectively (72.7%), and were based on secondary data use (63...
December 5, 2018: Endocrinología, Diabetes y Nutrición
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