Diabetic Diet Research Papers - Academia.edu (original) (raw)

2025

To describe clinical characteristics and genetic finding in the first Vietnamese patient with mutation of FOXP3 gene Case study: Clinical features, biochemical finding, mutation analysis in a 12 day-old-boy were studied. Based on analysis of clinical symptoms associated with biochemical examination, the diagnosis of IPEX was therefore confirmed by mutation analysis. Genomic DNAs were extracted from peripheral blood leukocytes of proband and his parents with their informed consent for genetic studies. Mutation analysis of the coding regions and conserved splice sites of the KCNJ11, ABCC8, INS, INSR, EIF2AK3, FOXP3, GATA4, GATA6, GCK, GLIS3, HNF1B, IER3IP1, PDX1, PTF1A, NEUROD1, NEUROG3, RFX6, SLC2A2, SLC19A2, WFS1 and ZFP57 genes was performed using targeted next generation sequencing. Mutation in exon 11 of FOXP3 was confirmed using Sanger sequencing.

2025, Journal of Perinatology

Hypertrichosis in a newborn girl infant of a diabetic mother with congenital hypothyroidism is reported. Both neonatal hyperinsulism and increased testosterone levels were documented. The hypertrichosis resolved after 3 months' of thyroxine replacement treatment. The possible causal association between hypothyroidism, and hypertrichosis has not been previously reported in neonatal period. Thyroid function should be evaluated in all newborn babies with hypertrichosis or abnormal distribution of body hair.

2025, Perspectives in Biology and Medicine

A terrible beauty is born. -W. B. Yeats, 1921 [1] Diseases are not what they used to be . Thumb through William Osier's 1892 textbook, The Principles and Practice of Medicine, and the pages testify that diseases in developed countries have changed dramatically during the intervening 100 years . This remarkable sweep of change, on closer inspection, resolves into several patterns of disease alteration (see table ). The two most prominent patterns reflect the decline of infectious illnesses and the concomitant rise of degenerative chronic ailments; many scholars have targeted these patterns of reciprocal diminishment and substitution as the most important processes of dis-

2025

DIABETES MELLITUS DUE TO KCNJ11/ABCC8 GENE MUTATIONS IN VIETNAM Can Thi Bich Ngoc1, Vu Chi Dung1, Bui Phuong Thao1 Nguyen Ngoc Khanh1, Nguyen Phu Dat1 , Nguyen Thi Hoan1, Sian Ellard2, Maria Craig3 ,Le Thanh Hai1 1Department of Endocrinology, Metabolism and Genetics. Vietnam National Hospital of Paediatrics, Hanoi, Vietnam; 2Molecular Genetics, Old Path Lab, Royal Devon & Exeter Hospital, Barrack Road, Exeter, UK 3 The Children Hospital at Westmead, Sydney, Australia

2025, Pediatric Diabetes

Recent studies in adult patients with type 1 diabetes mellitus (T1DM) and T2DM have examined the potential utility, benefits, and side effects of agents that augment insulin secretion after oral ingestion of nutrients in comparison with intravenous nutrient delivery, the so-called incretins. Two families of incretinlike substances are now approved for use in adults. Glucagon-like peptide-1 (GLP-1) or agents that bind to its receptor (exenatide, Byetta Ò ) or agents that inhibit its destruction [dipeptidyl peptidase-IV (DPP-IV) inhibitors, Vildagliptin] improve insulin secretion, delay gastric emptying, and suppress glucagon secretion while decreasing food intake without increasing hypoglycemia. Pramlintide, a synthetic amylin analog, also decreases glucagon secretion and delays gastric emptying, improves hemoglobin A1c (HbA1C), and facilitates weight reduction without causing hypoglycemia. We review the historical discovery of these agents, their physiology applications, and their current applications. Remarkably, only one or two studies have been reported in children. Pediatricians caring for children with T1DM and T2DM should become familiar with these agents and investigate their applicability, as they seem likely to enhance our therapeutic armamentarium to treat children with diabetes mellitus.

2025, Diabetes Care

The goal of this research was to quantify therelationships between patient survival and a set of explanatory variables in a randomly selected sample of community-based patients with non-insulin-dependent diabetes mellitus (NIDDM). The sample included 343 patients with NIDDM initially entered into the study in 1981–1982 and reexamined in 1985–1986. Mortality data were collected on reexamination in 1985 and updated from death-certificate data through 1 January 1986. The data collected from the patients included demographic and clinical variables, psychosocial variables related to diabetes, measures of physiologic control, hospitalization, and mortality. The Cox proportionalhazards model was used to compute a hazard rate for each individual and to determine risk covariates. The results indicated that the variables most associated with the risk of mortality were patient age, social impact of diabetes, renal function, complexity of diet regimen, and history of smoking. Two of these varia...

2025, Diabetologia

Aims/hypothesis. Our aim was to test the hypothesis that TNF-α protein levels in skeletal muscle are important in mediating the improvements in glucose homeostasis that are associated with diet and exercise regimens intended to reduce cardiovascular risk. Methods. We recruited 20 people with a body mass index of 32.1±1.2 kg/m 2 (mean ± SEM) and one other component of the metabolic syndrome. The average age was 51.2±8.1 years (mean ± SD). Of the 20 subjects, 6 were men and 14 were women. All subjects completed an 8-week control period, followed by randomisation to 8 weeks of moderate cycling exercise (30 min, three times per week) or to a diet with the following characteristics: low in saturated fat, high in fibre, low glycaemic index, rich in complex carbohydrates. Results. Diet induced a small reduction in body mass index (3.0±0.7%, p<0.05), although weight loss was not intended. Exercise training increased maximum oxygen consumption by 12±6% (p<0.05). Both interventions reduced fasting plasma insulin levels by about 20%. Diet reduced skeletal muscle TNF-α protein by 54±10% (p<0.05), an effect that was independent (p=0.94 in covariate analysis) of the small concurrent weight loss (-2.8±0.7 kg). Levels of GLUT4 protein were unchanged in the diet group. In contrast, exercise training did not significantly change TNF-α protein expression, but GLUT4 protein expression increased by 105±37% (p<0.05). Conclusions/interpretation. These data indicate that the metabolic benefits of a diet aimed at cardiovascular risk reduction are associated with a decrease in skeletal muscle TNF-α protein.

2025, Journal of Perinatology

2025, Patient Education and Counseling

The South Asians in The Netherlands have a high diabetes prevalence in combination with a low socio-economic position. A new, culture-specific type of care was developed. This intervention study investigates which patient characteristics are associated with success and whether those in the lowest socio-economic position have been reached. Before and after the end of the intensive guidance, the HbAlc of the patients (n = 101) was measured. The following variables were significantly related to success (defined as a decrease in HbAlc ≥ 0.8%): a high initial HbAlc, a low BMI and presence of complications. The average improvement in HbAlc was significant only in the group with a higher socio-economic position. Although the patients with the lowest socio-economic position did not sufficiently benefit from this intervention, an overall improvement was achieved in this poorly educated study population. The further improvements in the care after the completion of this study should be evaluated.

2025, Diabetic Medicine

Aims To describe the baseline clinical and laboratory findings and treatment modalities of 367 children and adolescents diagnosed with Type 2 diabetes in various paediatric endocrinology centres in Turkey. Methods A standard questionnaire regarding clinical and laboratory characteristics at onset was uploaded to an online national database system. Data for 367 children (aged 6-18 years) newly diagnosed with Type 2 diabetes at 37 different paediatric endocrinology centres were analysed. Results After exclusion of the children with a BMI Z-score < 1 SD, those with genetic syndromes associated with Type 2 diabetes, and those whose C-peptide and/or insulin levels were not available, 227 cases were included in the study. Mean age was 13.8 AE 2.2 (range 6.5-17.8) years, with female preponderance (68%). Family history of Type 2 diabetes was positive in 86% of the children. The mean BMI was 31.3 AE 6.5 kg/m 2 (range 18.7-61) and BMI Z-score was 2.4 AE 0.8 (range 1-5). More than half (57%) of the children were identified by an opportunistic diabetes screening due to existing risk markers without typical symptoms of diabetes. Only 13% (n = 29) were treated solely by lifestyle modification, while 40.5% (n = 92) were treated with metformin, 13% (n = 30) were treated with insulin, and 33.5% (n = 76) were treated with a combination of insulin and metformin initially. Mean HbA 1C levels of the insulin and combination of insulin and metformin groups were 98 (11.1%) and 102 mmol/mol (11.5%), respectively, and also were significantly higher than the lifestyle modification only and metformin groups mean HbA 1C levels (70(8.6%) and 67 mmol/mol (8.3%), respectively). Conclusions An opportunistic screening of children who are at high risk of Type 2 diabetes is essential, as our data showed that > 50% of the children were asymptomatic at diagnosis. The other important result of our study was the high rate of exclusion from the initial registration (38%), suggesting that accurate diagnosis of Type 2 diabetes in youth is still problematic, even for paediatric endocrinologists.

2025, Gastroenterology

Background & Aims-Gastroparesis can lead to food aversion, poor oral intake, and subsequent malnutrition. We characterized dietary intake and nutritional deficiencies in patients with diabetic and idiopathic gastroparesis. Methods-Patients with gastroparesis on oral intake (n=305) were enrolled in the NIDDK Gastroparesis Registry and completed diet questionnaires at 7 centers. Medical history, gastroparesis symptoms, answers to a block food frequency questionnaire, and gastric emptying scintigraphy results were analyzed

2025, Journal of Pediatric Nursing

Self-management of type I diabetes is key to good physical and psychosocial outcomes of the disease, yet little is known about how youth and their parents share responsibility for illness management. This study describes the division of labor between youth and their parents, self-management conflict, and three patterns of self-management in youth across four developmental stages: preadolescence, early adolescence, mid-adolescence, and late adolescence. Twenty-two youth (8-19 years) with type I diabetes and one of their parents were interviewed using semistructured interviews. Data were analyzed using qualitative content analysis. Results indicated that parents of preadolescents (8 -11 years) performed much of their children's diabetes care. Dyads reported some conflicts, particularly over food, amount of bolus, and blood glucose testing. The dyads demonstrated a self-management pattern that we identified as parent-dominant. Most early adolescents (11 -15 years) performed much of their own daily care, but parents actively participated in their self-management and oversaw it. The majority of dyads reported conflict over food and blood glucose testing. Most early adolescents demonstrated a transitional selfmanagement pattern whereby they managed their own daily care, with varying amounts of parental oversight. In midadolescence (15 -17 years), youth managed nearly all of their diabetes care; however, some dyads reported that parental oversight of illness care was still considerable. Exercise was conflictual for the majority of these dyads. Over half of the youth and, by late adolescence (17 -19 years), all youth demonstrated a pattern of adolescent-dominant self-management. In adolescent-dominant self-management, youth independently managed their diabetes. Half of the dyads reported that there were sometimes conflicts over food and blood glucose testing. Understanding the nature of sharing self-management responsibilities, the nature of conflict in carrying out such responsibilities, and the pattern of self-management may help nurses provide more targeted assistance to youth with diabetes and to their parents.

2025, Journal of Diabetes Science and Technology

Abbreviations: (BG) blood glucose, (ICT) information and communication technologies, (RCT) randomized controlled trial, (SUS) System Usability Scale

2025, Revista Panamericana de Salud Pública

To evaluate the quality of diabetic care in three clinics (one of them private and the other two public) in Jamaica, which is a middle-income country with a high prevalence (13%) of diabetes. Methods. During a six-week census in 1995 at the three clinics we collected data retrospectively on a total of 437 diabetic patients. One of the clinics was a specialist public-hospital clinic ("SPMC"), one was a private group general practice ("PRMC"), and one was a public polyclinic ("PUBMC"). The patients' median age ranged from 56 years at SPMC and PRMC to 63 years at PUBMC. Median follow-up had been 6.0 years at SPMC, 9.2 years at PRMC, and 6.3 years at PUBMC. Results. Fewer than 10% of the patients were controlled with diet alone. Insulin was the most commonly prescribed agent at SPMC (46%), compared to 7% each at the two other clinics. Sulfonylurea drugs alone or in combination with metformin were the most common agents at PUBMC and PRMC. Overall, 40% of the patients had satisfactory blood glucose control (< 8 mmol/L fasting or < 10 mmol/L postprandial). There was no significant difference among the clinics in the proportion of patients with satisfactory blood glucose control (P = 0.26). A blood glucose measurement had been recorded in the preceding year in 84% of the patients at SPMC, 79% at PRMC, and 67% at PUBMC. Glycosylated hemoglobin was infrequently measured: 16% at SPMC, 10% at PRMC, and 0% at PUBMC. Overall, 96% of patients had had surveillance for hypertension, and 81% had had surveillance for proteinuria. Surveillance for foot and retinal complications was generally infrequent and had been noted in patients' clinic records most commonly at SPMC (14% for foot complications, and 13% for retinal complications). The staff at the three clinics seldom advised the diabetic patients on diet, exercise, and other nonpharmacological measures, according to the clinics' records. Conclusions. The management of diabetes in Jamaica fell short of international guidelines. Our results also indicate the need to better sensitize health care professionals to these standards in order to reduce the burden of diabetes. Diabetes mellitus, Jamaica, delivery of health care.

2025, BMC Family Practice

Background: The purpose of this study is to better understand differences in diabetes self-management, specifically needs, barriers and challenges among men and women living with type 2 diabetes mellitus (T2DM). Methods: 35 participants were recruited from a diabetes education center (DEC) in Toronto, Canada. Five focus groups and nine individual interviews were conducted to explore men and women's diabetes self-management experiences. Results: The average age of participants was 57 years and just over half (51.4%) were female. Analyses revealed five themes: disclosure and identity as a person living with diabetes; self-monitoring of blood glucose (SMBG); diet struggles across varying contexts; utilization of diabetes resources; and social support. Women disclosed their diabetes more readily and integrated management into their daily lives, whereas men were more reluctant to tell friends and family about their diabetes and were less observant of self-management practices in social settings. Men focused on practical aspects of SMBG and experimented with various aspects of management to reduce reliance on medications whereas women focused on affective components of SMBG. Women restricted foods from their diets perceived as prohibited whereas many men moderated their intake of perceived unhealthy foods, except in social situations. Women used socially interactive resources, like education classes and support groups whereas men relied more on self-directed learning but also described wanting more guidance to help navigate the healthcare system. Finally, men and women reported wanting physician support for both affective and practical aspects of self-management. Conclusions: Our findings highlight the differences in needs and challenges of diabetes self-management among men and women, which may inform gender-sensitive diabetes, care, counseling and support.

2024, British Journal of Nutrition

The present study was aimed at evaluating in patients with type 2 diabetes: (1) the glycaemic response to four starchy foods based on wheat, typical of the Italian diet; (2) the importance of some food characteristics in relation to their effects on postprandial glucose response. Seventeen patients with type 2 diabetes (eleven men and six women) participated in the study. All patients consumed, in random order and on alternate days, 50 g available carbohydrate provided by 90 g white bread and, according to a randomised procedure, an equivalent amount of carbohydrate provided by one (n 8) or two (n 9) of three other different test foods (g): pizza 85, potato dumplings 165, hard toasted bread 60. Foods had a similar nutrient composition. Plasma glucose response, measured for 180 min, was significantly lower after the potato dumplings than after white bread at 90 P , 0´05Y 120 P , 0´01 and 150 P , 0´05 min. No difference was observed in postprandial plasma insulin response after the various test foods. The percentage of starch hydrolysed after 5 h in vitro hydrolysis with a-amylase was about 30 % lower for potato dumplings than for the other foods. However, no differences in the resistant starch content, the rate of diffusion of simple sugars added to a dialysis tube containing the food, and the viscosity of digesta were observed among the test foods. Scanning electron microscopy of potato dumplings showed a compact structure compatible with impaired accessibility of starch to digestive enzymes. In conclusion, carbohydrate-rich foods typical of the Italian diet which are often consumed as an alternative to pasta dishes are not equivalent in terms of metabolic impact in diabetic patients. Due to their low blood glucose response, potato dumplings represent a valid alternative to other starchy foods in the diabetic diet. Food structure plays an important role in determining starch accessibility to digestion, thus influencing the postprandial blood glucose response.

2024, British Journal of Nutrition

2024, Diabetes Care

OBJECTIVE: To examine whether Konjac-mannan (KJM) fiber improves metabolic control as measured by glycemia, lipidemia, and blood pressure in high-risk type 2 diabetic patients. RESEARCH DESIGN AND METHODS: A total of 11 hyperlipidemic and hypertensive type 2 diabetic patients treated conventionally by a low-fat diet and drug therapy participated. After an 8-week baseline, all were randomly assigned to take either KJM fiber-enriched test biscuits (0.7 g/412 kJ [100 kcal] of glucomannan) or matched placebo wheat bran fiber biscuits during two 3-week treatment phases separated by a 2-week washout period. The diet in either case was metabolically controlled and conformed to National Cholesterol Education Program Step 2 guidelines, while medications were maintained constant. Efficacy measures included serum fructosamine, lipid profiles, apolipoproteins, blood pressure, body weight, and nutritional analysis. RESULTS: Compared with placebo, KJM significantly reduced the metabolic control p...

2024, Diabetes Care

The per capita consumption of sugars in the United States accounts for -2 1 % of total calorie intake. Most Americans eat and enjoy sugar-containing foods every day, but the use of sugars in the diabetic diet has traditionally been proscribed for fear of aggravating hyperglycemia. However, short-term and most longerterm studies demonstrate that dietary sucrose does not cause a greater postprandial rise in plasma glucose than isocaloric amounts of other common carbohydrates. The available evidence suggests that sucrose has a glycemic effect similar to that of bread, potatoes, and rice. Dietary fructose, in contrast, may produce a lesser postprandial rise in plasma glucose than other common carbohydrates. There is considerable controversy about the effects of dietary sucrose and fructose on serum lipids, and their effects on other metabolic events, such as the nonenzymatic glycosylation of proteins, are uncertain. Nevertheless, it is reasonable to allow diabetic patients to consume sugar-containing foods as long as they do so in a controlled fashion. Diabetes Care 12:56-61, 1989 A ccording to the 1977-1978 United States Department of Agriculture food consumption survey, the per capita consumption of sugars in the United States averages 95 g/day and accounts for 21% of total calorie intake and 48% of total carbohydrate intake (1; Table ). Average daily per capita consumption of sucrose is 41 g, which represents 9% of total calorie intake. Of these 41 g of sucrose, 13 g occur naturally and 28 g are added to foodstuffs. The

2024, Diabetes Care

The next sections of this technical review paper focus on MNT for the management of diabetes. The first section includes nutrition recommendations for type 1 and type 2 diabetes-intake of carbohydrate, sweeteners, protein, fat, micronutrients, and alcohol; energy balance and obesity; and special considerations. The second section reviews MNT for special populations-children and adolescents, pregnant and lactating women, and older adults. The third section reviews MNT for acute complications-hypoglycemia and acute illness-and comorbid conditions-hypertension, dyslipidemia, nephropathy, and catabolic illness. The last section reviews lifestyle recommendations for the prevention or delay of diabetes. When referring to common food carbohydrates, the following terms are preferred: sugars, starch, and fiber (Table ). This classification is based on the recommendations of the Food and Agriculture

2024, Diabetes Care

Objective— To assess in diabetic subjects the effects of dietary sucrose on glycemia and lipemia. Research Design and Methods— Twelve type II diabetic subjects consumed, in random order, two isocaloric, 55% carbohydrate study diets for 28 days. In one diet, 19% of energy was derived from sucrose. In the other diet, <3% of energy was derived from sucrose, and carbohydrate energy came primarily from starch. Both study diets were composed of common foods. All meals were prepared in a metabolic kitchen where foods were weighed during meal preparation. Results— No significant differences were noted between the study diets at any time point in mean plasma glucose. At day 28, mean plasma glucose values for the sucrose diet were 9.6 ± 0.5 mM and for the starch diet were 9.4 ± 0.6 mM (P = 0.63). Also, no significant differences were observed between the study diets in urine glucose, fasting serum total, HDL, or LDL cholesterol; fasting serum TG; or peak postprandial serum TG. Conclusions—...

2024, Diabetes Care

OBJECTIVE To assess the metabolic effects of chronic dietary fructose consumption in diabetic subjects. RESEARCH DESIGN AND METHODS Six type I and 12 type II diabetic subjects consumed, in random order, two isocaloric study diets for 28 days. In one diet, 20% of energy was derived from fructose. In the other diet, <3% of energy came from fructose, and carbohydrate energy was derived primarily from starch. Both study diets were composed of common foods. All meals were prepared in a metabolic kitchen where all foods were weighed during meal preparation. RESULTS Mean plasma glucose, urine glucose, and serum glycosylated albumin values were lower during the fructose diet than during the starch diet, but the differences achieved only marginal statistical significance. The day-28 value for mean plasma glucose was 12.5% lower (P = 0.03) during the fructose diet than during the starch diet. At days 14, 21, and 28, fasting serum cholesterol and LDL cholesterol were both significantly high...

2024, Diabetes Care

The per capita consumption of sugars in the United States accounts for ∼21% of total calorie intake. Most Americans eat and enjoy sugar-containing foods every day, but the use of sugars in the diabetic diet has traditionally been proscribed for fear of aggravating hyperglycemia. However, short-term and most longerterm studies demonstrate that dietary sucrose does not cause a greater postprandial rise in plasma glucose than isocaloric amounts of other common carbohydrates. The available evidence suggests that sucrose has a glycemic effect similar to that of bread, potatoes, and rice. Dietary fructose, in contrast, may produce a lesser postprandial rise in plasma glucose than other common carbohydrates. There is considerable controversy aboutthe effects of dietary sucrose and fructose on serum lipids, and their effects on other metabolic events, such as the nonenzymatic glycosylation of proteins, are uncertain. Nevertheless, it is reasonable to allow diabetic patients to consume sugar...

2024, Clinical Diabetes

2024

Aims/hypothesis Monogenic diabetes is estimated to account for 1-6% of paediatric diabetes cases in primarily non-consanguineous populations, while the incidence and genetic spectrum in consanguineous regions are insufficiently defined. In this single-centre study we aimed to evaluate diabetes subtypes, obtain the consanguinity rate and study the genetic background of individuals with syndromic and neonatal diabetes in a population with a high rate of consanguinity. Methods Data collection was carried out cross-sectionally in November 2021 at the paediatric diabetic clinic, Dr Jamal Ahmad Rashed Hospital, in Sulaimani, Kurdistan, Iraq. At the time of data collection, 754 individuals with diabetes (381 boys) aged up to 16 years were registered. Relevant participant data was obtained from patient files. Consanguinity status was known in 735 (97.5%) participants. Furthermore, 12 families of children with neonatal diabetes and seven families of children with syndromic diabetes consented to genetic testing by next-generation sequencing. Prioritised variants were evaluated using the American College of Medical Genetics and Genomics guidelines and confirmed by Sanger sequencing. Results A total of 269 of 735 participants (36.5%) with known consanguinity status were offspring of consanguineous families. An overwhelming majority of participants (714/754, 94.7%) had clinically defined type 1 diabetes (35% of them were born to consanguineous parents), whereas only eight (1.1%) had type 2 diabetes (38% consanguineous). Fourteen (1.9%) had neonatal diabetes (50% consanguineous), seven (0.9%) had syndromic diabetes (100% consanguineous) and 11 (1.5%) had clinically defined MODY (18% consanguineous). We found that consanguinity was significantly associated with syndromic diabetes (p=0.0023) but not with any other diabetes subtype. The genetic cause was elucidated in ten of 12 participants with neonatal diabetes who consented to genetic testing (homozygous variants in GLIS3 [sibling pair], PTF1A and ZNF808 and heterozygous variants in ABCC8 and INS) and four of seven participants with syndromic diabetes (homozygous variants in INSR, SLC29A3 and WFS1 [sibling pair]). In addition, a participant referred as syndromic diabetes was diagnosed with mucolipidosis gamma and probably has type 2 diabetes. Conclusions/interpretation This unique single-centre study confirms that, even in a highly consanguineous population, clinically defined type 1 diabetes is the prevailing paediatric diabetes subtype. Furthermore, a pathogenic cause of monogenic diabetes was identified in 83% of tested participants with neonatal diabetes and 57% of participants with syndromic diabetes, with most variants being homozygous. Causative genes in our consanguineous participants were markedly different from genes reported from non-consanguineous populations and also from those reported in other consanguineous populations. To correctly diagnose syndromic diabetes in consanguineous populations, it may be necessary to re-evaluate diagnostic criteria and include additional phenotypic features such as short stature and hepatosplenomegaly.

2024, Diabetes & Metabolism

To explore the beliefs and perceptions of type 2 diabetic patients in La Réunion where the disease is highly prevalent (17.5% among 30-69 yr old subjects) with a strong link to the metabolic syndrome and nutritional habits. Methods: Two sets of data were analysed. An 80-item questionnaire explored the perceptions of causal factors, knowledge of complications and therapeutic issues in 331 known diabetic patients included in the REDIA study. The data were completed by semi-structured interviews of 40 diabetic patients in a hospital setting. Results: Perceived causal factors of diabetes are mainly sugar excess, heredity and stress or life events. Weight excess and lack of physical activity are virtually never mentioned as causes. Diabetes is predominantly perceived as potentially acute, with risk of coma and death. Its chronic and progressive nature is not appreciated, and chronic complications are not well understood, especially in poorly educated people. Only 33% of males and 42% of females are willing to change their nutritional habits and the role of fats is largely underestimated (30.2%) although 90% consider physical activity as an effective course of action. Most patients are tardy in the way that they adopt medical recommendations and treatment in the course of the disease. Conclusion: These results highlight the discrepancy between medical knowledge and patients' perceptions, especially concerning etiological issues and complications. Lifestyle and therapeutic recommendations are not well understood. Educational activities need to consider the knowledge issues and understanding by patients early in the course of chronic diseases like diabetes.

2024, European journal of endocrinology

Plasma immunoreactive secretin levels were measured in 22 newly diagnosed non-ketotic, maturity-onset diabetics and 10 healthy control subjects during 50 gram oral glucose tolerance test (OGTT). The test was repeated in the diabetic group after 6 months' dietary treatment. At diagnosis the fasting secretin levels in the diabetics were higher than in control subjects but fell within the normal range following dietary treatment. In the diabetics there was a significant positive correlation between the fasting glucose and fasting secretin levels at the time of diagnosis. Suppression of secretin levels occurred during the OGTT, both in diabetic and control subjects. For a long time the chief activity ascribed to secretin had been its function in stimulation of exocrine pancreatic secretion. In recent years two other roles have received attention. These are its lipolytic and insulinogenic properties. The former action has been demonstrated in rat adipose tissue (Lazarus et al. 1968; Butcher 8c Carlson 1970). The possible insulinogenic role remains contro¬ versial. Secretin has been shown to increase insulin release from rat pancreas slices (Guiddoux-Grassi 8c Felber 1968), to raise insulin levels after endoportal

2024, Diabetes Care

Individuals with an upper-body form of obesity show greater associations with higher glucose excursions, exacerbated insulin resistance, increased abnormality of lipoprotein profile, and higher cardiovascular risk. Individuals with obesity and diabetes are at great risk for cardiovascular disease. Weight reduction and improvement in blood glucose control through dietary interventions for the obese person with non-insulin-dependent diabetes mellitus (NIDDM) hold the greatest potential for reducing morbidity and mortality. The relative merits of different weightreduction programs are unclear, but regimens should be nutritionally complete, easy to follow, and include a program for maintaining the reduced weight level. Improvement in insulin action and the possibility of slowing development of clinical nephropathy or endstage renal disease in NIDDM through weight loss have been found. Very low calorie diets, when used with medical supervision, may lead to significant weight loss, improved metabolic status, and even reduction or elimination of the need for oral hypoglycemic agents or insulin; however, further studies are needed to examine possible negative outcomes in people with NIDDM before very low calorie diets can be recommended. The causes of obesity and its connection with diabetes are unclear, but even modest calorie restriction may be beneficial to obese diabetic patients because of the positive effects on blood glucose levels and requirements for insulin and oral antidiabetic agents.

2024, Journal of Chronic Diseases

An education program to improve dietary compliance in insulin-dependent diabetics was evaluated from 1978 to 1980 at the Royal North Shore Hospital of Sydney. Dietary intake, biochemical status, health beliefs, knowledge, anthropometric and other measurements were made on 140 diabetics and their family members before and, where possible, 6 months after the program. Four aspects of compliance were assessed: dietary composition, body weight, carbohydrate spacing among meal periods and carbohydrate variation between days. There was a significant increase in the proportion of subjects who achieved the recommended goal of a high carbohydrate/low fat diet. Diabetics who complied with this recommendation were sinificantly more likely to have adequate glycemic control. Most of the participants were initially near ideal weight and there were few substantial weight changes. The proportions of diabetics with acceptable scores for carbohydrate spacing and variation did not change significantly. Subjects who complied with one aspect of the dietary regimen did not necessarily comply with other aspects. Dietary compliance was related to initial patterns of dietary intake but could not be predicted from any other factors such as demographic characteristics, duration of disease, knowledge or health beliefs, although this could have been due to small sample sizes.

2024, Health Policy

A sample of 142 diabetic patients was interviewed twice, in 1984 and 1986, following an educational program administered to primary care staff. Positive changes were recorded regarding several aspects. (a) Process of care -the percentage of untreated patients decreased from 15% to 4%; the proportion of patients on diet only increased from 36% to 41%, while the insulin-treated proportion decreased from 12% to 8%; the percentage of patients treated with oral drugs went up from 36% to 46%. (b) Patient knowledge -an improvement in various aspects, such as diet and exercise. (c) Patient behavior -an improvement in adherence to diet and in compliance with medications.

2024, Diabetes Care

A: Utility of B-type natriuretic peptide (BNP) as a screen for left ventricular dysfunction in patients with diabetes.

2024, Diabetes Care

2024, Archives of Internal Medicine

Background: Legumes, including beans, chickpeas, and lentils, are among the lowest glycemic index (GI) foods and have been recommended in national diabetes mellitus (DM) guidelines. Yet, to our knowledge, they have never been used specifically to lower the GI of the diet. We have therefore undertaken a study of low-GI foods in type 2 DM with a focus on legumes in the intervention. Methods: A total of 121 participants with type 2 DM were randomized to either a low-GI legume diet that encouraged participants to increase legume intake by at least 1 cup per day, or to increase insoluble fiber by consumption of whole wheat products, for 3 months. The primary outcome was change in hemoglobin A 1c (HbA 1c) values with calculated coronary heart disease (CHD) risk score as a secondary outcome. Results: The low-GI legume diet reduced HbA 1c values by −0.5% (95% CI, −0.6% to −0.4%) and the high wheat fiber diet reduced HbA 1c values by −0.3% (95% CI, −0.4% to −0.2%). The relative reduction in HbA 1c values after the low-GI legume diet was greater than after the high wheat fiber diet by −0.2% (95% CI, −0.3% to −0.1%; P Ͻ .001). The respective CHD risk reduction on the low-GI legume diet was −0.8% (95% CI, −1.4% to −0.3%; P=.003), largely owing to a greater relative reduction in systolic blood pressure on the low-GI legume diet compared with the high wheat fiber diet (−4.5 mm Hg; 95% CI, −7.0 to −2.1 mm Hg; P Ͻ.001). Conclusion: Incorporation of legumes as part of a low-GI diet improved both glycemic control and reduced calculated CHD risk score in type 2 DM.

2024, The Diabetes Educator

Objective The purpose of this study was to investigate screening practices for celiac disease in patients with type 1 diabetes across North America. The research question investigated was whether diabetes centers screen for celiac disease in type 1 diabetes more frequently than other facilities. Research Design and Methods A survey with 27 questions on screening practices for celiac disease in patients with type 1 diabetes was designed by experts in celiac disease and diabetes. Surveys were sent by email to diabetes educators and dietitians throughout the United States and Canada between December 2010 and May 2011. Results There were 514 respondents from 484 endocrine clinics, diabetes clinics, private practices, community nutrition centers, and inpatient centers. Thirty-five percent of work locations screened for celiac disease, with endocrine clinics reporting screening at the highest frequency (80%). Tissue transglutaminase was the most common screening test used. The most freque...

2024, @article{article, author = {Fayad, Joseph and Agaf, and Md, Aditi and Singh, A.K. and Md, Thomas and Fayad, Christine and Chang, Kenneth and Facg, Md}, year = {2013}, month = {11}, pages = {}, title = {The Gut CFO the ileal hormones} }

The Gut CFO: the ileal hormones. Decreasing insulin resistance, triglycerides, liver enzymes, signaling caloric intake, using caloric reserve, and tuning body to health with every meal. Long term stimulation of the ileal hormones by an oral GRAS compliant agent Aphoeline. Effects on metabolic syndrome, fatty liver, type II diabetes and hepatitis c. Abstract: The physiological response to oral chronic stimulation of the ileal hormones has not been well studied. We report the results of a pilot retrospective study on 18 patients with the following conditions, obese, prediabetes, hyperlipidemia, fatty liver with elevated liver enzymes, Hep c with cirrhosis, metabolic syndrome, with normal anatomy (i.e. without intestinal or gastric surgeries) followed during chronic oral daily stimulation of the ileal hormones with Aphoeline from 4 to 16 months. Oral chronic stimulation of the ileal hormones in all patients studied appear to help decrease the average baseline levels of: insulin(9.92mIU/ml; P-value = .012), proinsulin (10.3 pmol/l; P-value = .014), AST (SGOT, 26.7IU/L; P-value = .003), ALT (SGPT, 40.94IU/L; P-value = .003), triglycerides (39.67mg/dL; P-value = .033), HgA1c (0.32; P-value = .005) towards normal levels in a statistically significant manner; moreover, percent reduction in weight was also substantial (%weight 6.62; P-value = 0.000). When only patients with abnormally elevated baseline levels are averaged the decrease is even more dramatic: insulin(15.77 mIU/ml; P-value = .034), proinsulin (10.3 pmol/l; P-value = .04), AST (SGOT, 39.46 IU/L; P-value = .001), ALT (SGPT, 78 IU/L; P-value = .000), and triglycerides (100.2 mg/dL; P-value = .004). Our study suggests that oral stimulation of the ileal hormones with Aphoeline seems promising to approach problems of insulin resistance, fatty liver, prediabetes, early diabetes type II, hypertriglyceridemia, obesity and metabolic syndrome in general.

2024, Diabetologia

To clarify the separate influences of digestible carbohydrate and of dietary fibre on blood glucose control and serum lipoproteins, 14 diabetic patients (six Type 1 and eight Type 2) were submitted to three weight-maintaining diets for 10 days each: (1) low carbohydrate/low fibre diet with 42% carbohydrate and 20 g fibre; (2) high carbohydrate/low fibre diet (carbohydrate 53%, fibre 16 g); (3) high carbohydrate/ high fibre diet (carbohydrate 53%, fibre 54 g). In comparison with the low carbohydrate/low fibre diet, the 2-h post-prandial blood glucose and the daily blood glucose profile decreased significantly on the high carbohydrate/high fibre diet, without significant changes during the high carbohydrate/low fibre diet. The diet-induced modifications of blood glucose control were similar in both types of diabetic patients (twoway analysis of variance: F= 5.86, p < 0.02 for dietary treatment and F = 2.09, NS for type of diabetes). Total and lowdensity lipoprotein cholesterol were also decreased after the high carbohydrate/high fibre diet in comparison with the low carbohydrate/low fibre diet (p < 0.001 for both), while they were not significantly modified after the high carbohydrate/ low fibre diet. Again the modifications of low density lipoprotein cholesterol induced by diet were similar in both types of diabetic patients (F= 10.02, p < 0.005 for dietary treatment and F = 0.14 for type of diabetes, NS). High-density lipoprotein cholesterol was lower after the two test diets than after the low carbohydrate/low fibre diet. However statistical significance was found only for the high carbohydrate/high fibre diet (p < 0.005). In conclusion: (1) a simple increase of digestible carbohydrate without a parallel increase of dietary fibre does not help in improving the metabolic control of diabetic patients; (2) the hypoglycaemic and hypolipidaemic effects of high carbohydrate/high-fibre diets are due principally to dietary fibre.

2024, Eastern Mediterranean Health Journal

A 3-year study assessed the prevalence and causes of severe treatment-related hypoglycaemia in type 2 diabetes mellitus patients admitted to hospital in Piraeus. Out of the 2858 patients admitted, 207 (7.2%) had severe hypoglycaemia: 72 were being managed with insulin, 132 oral hypoglycaemic drugs and 3 combined insulin/oral drugs. Only 28.5% of patients were attending a diabetes clinic. The cause of the hypoglycaemic attack could be determined for 86.1% of cases; 30.8% were due to a missed meal. Interviews showed that education and level of knowledge about diabetes mellitus, and particularly hypoglycaemia symptoms, was inadequate. Logistic regression analysis showed that knowledge about diabetes mellitus correlated with educational status and with follow-up in a diabetes clinic. Facteurs de risque d'hypoglycémie sévère chez des patients diabétiques de type 2 hospitalisés au Pirée (Grèce) RÉSUMÉ Une étude sur trois ans a permis d'évaluer la prévalence et les causes de l'hypoglycémie sévère associée au traitement chez des patients atteints de diabète sucré de type 2 hospitalisés au Pirée. Parmi les 2858 patients hospitalisés, 207 (7,2 %) avaient une hypoglycémie sévère ; 72 étaient traités par insuline, 132 par hypoglycémiants oraux et 3 par l'association insuline antidiabétiques oraux. Seuls 28,5 % des patients consultaient dans une clinique du diabète. La cause de la crise d'hypoglycémie a pu être déterminée pour 86,1 % des cas, 30,8 % étant dus à un repas sauté. Les entretiens ont montré que l'éducation et le niveau de connaissances sur le diabète sucré, et en particulier les symptômes d'hypoglycémie, étaient insuffisants. L'analyse de régression logistique a indiqué qu'il y avait une corrélation entre les connaissances sur le diabète sucré, le niveau d'instruction et le suivi dans une clinique du diabète.

2024, The Review of Diabetic Studies

BACKGROUND: Dessert compositions may conform to diabetic diet when it contains low sugar or artificial sweetener to replace sugar. However, it is still questionable whether glycemic control in type 2 diabetes patients is improved by the use of diet-conforming dessert compositions. OBJECTIVE: To compare, in type 2 diabetes patients, the glycemic, insulin, and C-peptide responses to seven modified dessert compositions for diabetics (D-dessert) with the response to seven similar desserts of non-modified composition, used as control desserts (C-dessert). METHODS: Seventy type 2 diabetes patients were allocated to seven groups of ten. On three occasions, each patient received either the meal which consisted of bread and cheese, or the meal and D-dessert, or the meal and the respective C-dessert. Differences in postprandial glucose, insulin, and C-peptide were evaluated using analysis of repeated measures at 0, 30, 60, 90, and 120 min after consumption. RESULTS: D-cake and D-pastry cream resulted in lower glucose levels (8.81 ± 0.32 mmol/l and 8.67 ± 0.36 mmol/l, respectively) and Dstrawberry jelly in lower insulin levels (16.46 ± 2.66 µU/ml) than the respective C-desserts (9.99 ± 0.32 mmol/l for Ccake, 9.28 ± 0.36 mmol/l for C-pastry cream, and 27.42 ± 2.66 µU/ml for C-strawberry jelly) (p < 0.05). Compared with the meal, D-cake did not increase glucose or insulin levels (p > 0.05), while C-cake did (p < 0.05). D-pastry cream increased glucose to a lesser extent than C-pastry cream (p < 0.05). Similar effects were reported for D-milk dessert, Dmillefeuille, and D-chocolate on glucose, insulin, and Cpeptide at specific timepoints. D-crème caramel showed no effect. CONCLUSIONS: Some desserts formulated with sugar substitutes and soluble fiber may have a favorable effect on postprandial levels of glucose, insulin, and C-peptide in type 2 diabetic patients.

2024

The search for more effective and compatible medical treatments with the changing lifestyle of the people in the context of diabetes mellitus type 1 propelled the use of the intensified therapy with insulin that allows the patients to balance the carbohydrate intake with the insulin Administered exogenously and favors the choice of more autonomous and flexible diets. However, the difficulty in quantifying carbohydrates in foods with irregular shapes and sizes and the consequent inaccuracy of the calculated insulin doses or boluses constitute the main drawbacks of the treatment. This article presents the development of a mobile application associated to an electronic weighing device that, together, accurately quantify the carbohydrate content of the food analyzed. Given its conception is a prototype avant-garde and pioneer in the national industry by integrating in an interactive user interface the quantification of carbohydrates of the main national food consumption with the calcula...

2024, Acta Diabetologica

The objective was to determine the level of knowledge on diabetes in an adult population in Turkey. In this cross-sectional study, 524 people aged over 30 were selected from the population of Narlıdere Health District, Izmir, Turkey. A questionnaire was performed to determine sociodemographic characteristics and knowledge of diabetes. Each item on the questionnaire was given a score with a possible final total of 100 points. Knowledge level was evaluated in the whole group, DMpositive and-negative groups. "DM-positive" group refers to respondents who either have diabetes themselves or whose relatives have it. "DM-negative" group refers to respondents who do not have diabetes themselves and whose relatives do not. In total, 479 people were included in the study (response rate=87.6%). The mean age of the study group was 50.2±12.8 and 61% of them were women. Mean diabetes knowledge scores were 62.9±17.9 for the study group, 68.3±16.1 for the "DM-positive" group and 60.6±18.2 for the "DM-negative" group. The "DM-negative" group had a significantly lower mean score than the other two groups. Overall, diabetes knowledge was higher in participants with diabetes or who had a relative with diabetes, who were educated for more than 5 years and who had health insurance. The diabetes knowledge of the study group was not satisfactory. Diabetics and people who have relatives with diabetes had a higher knowledge level than the population without diabetes. Detailed information regarding diabetes should be provided to not only diabetics, but also the population as a whole.

2024, Asian Journal of Pharmaceutical and Clinical Research

Diabetes can be defined as a metabolic disorder characterized by resistance to the action of insulin, insufficient insulin secretion, or both. In this article, we reviewed about the non-pharmacological approaches in the management of diabetes mellitus that includes diet and stress management programs such as Pranayama, meditation, and exercises along with the lifestyle modification which has to be followed by the diabetics for the better management of diabetes in natural ways. By following, these approaches besides regular usage of medications one can lead a healthy life with very less complications. The quality of life can be increased in the patients who follow these methods when compared to those patients who do not consider any of these methods in their daily life. Not only the patient, a healthy individual but can also prefer these methods to prevent chronic diseases and make their day to day life happy and healthy.

2024, Asian Journal of Pharmaceutical and Clinical Research

2024, Nutrition Journal

Background: This study was designed to determine the glycemic indices of five commonly used varieties of dates in healthy subjects and their effects on postprandial glucose excursions in individuals with type 2 diabetes mellitus. Methods: Composition analysis was carried out for five types of dates (Tamer stage). The weights of the flesh of the dates equivalent to 50 g of available carbohydrates were calculated. The study subjects were thirteen healthy volunteers with a mean (± SD) age of 40.2 ± 6.7 years and ten participants with type 2 diabetes mellitus (controlled on lifestyle measures and/or metformin) with a mean HbA1c (± SD) of 6.6 ± (0.7%) and a mean age (± SD) of 40.8 ± 5.7 years. Each subject was tested on eight separate days with 50 g of glucose (on 3 occasions) and 50 g equivalent of available carbohydrates from the 5 varieties of date (each on one occasion). Capillary glucose was measured in the healthy subjects at 0, 15, 30, 45, 60, 90 and 120 min and for the diabetics at 0, 30, 60, 90, 120, 150 and 180 min. The glycemic indices were determined as ratios of the incremental areas under the response curves for the dates compared to glucose. Statistical analyses were performed using the Mann-Whitney U test and repeated measures analysis of variance. Results: Mean glycemic indices ± SEM of the dates for the healthy individuals were 54.0 ± 6. 1, 53.5 ± 8.6, 46.3 ± 7.1, 49.1 ± 3.6 and 55.1 ± 7.7 for Fara'd, Lulu, Bo ma'an, Dabbas and Khalas, respectively. Corresponding values for those with type 2 diabetes were very similar (46.1 ± 6.2, 43.8 ± 7.7, 51.8 ± 6.9, 50.2 ± 3.9 and 53.0 ± 6.0). There were no statistically significant differences in the GIs between the control and the diabetic groups for the five types of dates, nor were there statistically significant differences among the dates' GIs (df = 4, F = 0.365, p = 0.83). The results show low glycemic indices for the five types of dates included in the study and that their consumption by diabetic individuals does not result in significant postprandial glucose excursions. These findings point to the potential benefits of dates for diabetic subjects when used in a healthy balanced diet.

2024

Endothelial dysfunction plays a central role in the development of atherosclerotic disease, and is considered an early marker of cardiovascular risk. Emerging evidence suggests an important role of dietary factors, especially fatty acids intake, in modulating endothelial function. The aim of this manuscript was to review the role of dietary fatty acids in modulating endothelial function and their potential association with endothelial dysfunction. Epidemiologic and clinical trials suggest an adverse effect of dietary saturated and trans fat acids in the modulation of endothelial function, whereas dietary polyunsaturated fatty acid had a beneficial effect. The role of monounsaturated fat remains obscure. Overall, the evidence suggest that total fat per se does not have a strong effect on vascular function and that the composition of dietary fatty acid may play a more important role. However, the modification of the composition of fatty acids in the diet necessarily implies manipulating more than one component to maintain the energy value, thus making it difficult to interpret the role of each fatty acid by itself in endothelial function. Randomized clinical essays, especially long-term ones, are still needed to show clearer evidence of the different effects of FA composition in the diet and its mechanisms on vascular function.