Glycaemic instability is an underestimated problem in Type II diabetes

2006 ◽  
Vol 111 (2) ◽  
pp. 119-126 ◽  
Author(s):  
Stephan F. E. Praet ◽  
Ralph J. F. Manders ◽  
Ruth C. R. Meex ◽  
A. G. Lieverse ◽  
Coen D. A. Stehouwer ◽  
...  

The aim of the present study was to assess the level of glycaemic control by the measurement of 24 h blood glucose profiles and standard blood analyses under identical nutritional and physical activity conditions in patients with Type II diabetes and healthy normoglycaemic controls. A total of 11 male patients with Type II diabetes and 11 healthy matched controls participated in a 24 h CGMS (continuous subcutaneous glucose-monitoring system) assessment trial under strictly standardized dietary and physical activity conditions. In addition, fasting plasma glucose, insulin and HbA1c (glycated haemoglobin) concentrations were measured, and an OGTT (oral glucose tolerance test) was performed to calculate indices of whole-body insulin sensitivity, oral glucose tolerance and/or glycaemic control. In the healthy control group, hyperglycaemia (blood glucose concentration >10 mmol/l) was hardly present (2±1% or 0.4±0.2/24 h). However, in the patients with Type II diabetes, hyperglycaemia was experienced for as much as 55±7% of the time (13±2 h over 24 h) while using the same standardized diet. Breakfast-related hyperglycaemia contributed most (46±7%; P<0.01 as determined by ANOVA) to the total amount of hyperglycaemia and postprandial glycaemic instability. In the diabetes patients, blood HbA1c content correlated well with the duration of hyperglycaemia and the postprandial glucose responses (P<0.05). In conclusion, CGMS determinations show that standard measurements of glycaemic control underestimate the amount of hyperglycaemia prevalent during real-life conditions in Type II diabetes. Given the macro- and micro-vascular damage caused by postprandial hyperglycaemia, CGMS provides an excellent tool to evaluate alternative therapeutic strategies to reduce hyperglycaemic blood glucose excursions.

2020 ◽  
Vol 125 (2) ◽  
pp. 147-160
Author(s):  
Mariana O. C. Coelho ◽  
Alistair J. Monteyne ◽  
Marlou L. Dirks ◽  
Tim J. A. Finnigan ◽  
Francis B. Stephens ◽  
...  

AbstractMycoprotein consumption has been shown to improve acute postprandial glycaemic control and decrease circulating cholesterol concentrations. We investigated the impact of incorporating mycoprotein into the diet on insulin sensitivity (IS), glycaemic control and plasma lipoprotein composition. Twenty healthy adults participated in a randomised, parallel-group trial in which they consumed a 7 d fully controlled diet where lunch and dinner contained either meat/fish (control group, CON) or mycoprotein (MYC) as the primary source of dietary protein. Oral glucose tolerance tests were performed pre- and post-intervention, and 24 h continuous blood glucose monitoring was applied throughout. Fasting plasma samples were obtained pre- and post-intervention and were analysed using quantitative, targeted NMR-based metabonomics. There were no changes within or between groups in blood glucose or serum insulin responses, nor in IS or 24 h glycaemic profiles. No differences between groups were found for 171 of the 224 metabonomic targets. Forty-five lipid concentrations of different lipoprotein fractions (VLDL, LDL, intermediate-density lipoprotein and HDL) remained unchanged in CON but showed a coordinated decrease (7–27 %; all P < 0·05) in MYC. Total plasma cholesterol, free cholesterol, LDL-cholesterol, HDL2-cholesterol, DHA and n-3 fatty acids decreased to a larger degree in MYC (14–19 %) compared with CON (3–11 %; P < 0·05). Substituting meat/fish for mycoprotein twice daily for 1 week did not modulate whole-body IS or glycaemic control but resulted in changes to plasma lipid composition, the latter primarily consisting of a coordinated reduction in circulating cholesterol-containing lipoproteins.


2019 ◽  
Vol 19 (7) ◽  
pp. 991-1004
Author(s):  
Inya Joseph ◽  
Ojiako Okey ◽  
Emejulu Angela

Objective: The effect of dietary incorporation of ethanolic extracts of single and combinatorial formulations of Acanthus montanus (ACMO), Asystaciagangetica (ASGA), Gongronemalatifolium (GOLA) and Solanummelongena (SOME) on glucose tolerance was studied in normoglycaemicWistar rats. Methods: A total of 128 Wistar rats were used for the research work. The rats were divided into 32 groups of 4 rats each. One group was the normal control group and 15 groups were orally administered 200mg/kg body weight extract(s) for the single and combinatorial formulations. Another group (negative control) was given oral glucose load (4g/100ml) of 200mg/kg body weight alone and the remaining 15 groups were given oral glucose load (4g/100ml) of 200mg/kg body weight before giving the test extract(s) of 200mg/kg body weight. Results: Post-prandial serum glucose response at 30 minutes interval was plotted and the area under the curve (AUC) used to determine glycaemic index (GI) of each herbs. The herbs (ACMO, ASGA, GOLA and SOME) resulted in a marked improvement in oral glucose tolerance in rats after 10 days of treatment at an interval of 2 days. Blood glucose concentration (mmol/l) of rats administered with the combinations; ACMO+GOLA, ACMO+SOME, SOME+GOLA, ACMO+SOME+GOLA+GLU, ACMO+ASGA+GOLA, ACMO+SOME+GOLA and ACMO+ASGA+GOLA+SOME was found to belowered, with ACMO+ASGA+GOLA combination having the best result. This might be a result of hypoglycaemic synergy promoted by the various bioactive principles present in the combined extracts thereby lowering the GI. These findings revealed that the listed combinations have hypoglycaemic potentials and habitual consumption could positively modulate oral glucose tolerance. Conclusion: The herbs could be useful in the dietary management of diabetes as they could help regulate blood glucose level when consumed with normal meals and could also be incorporated into meals to prevent or delay the onset of diabetes or reverse the same in its early stages.


2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Christian Kuété Fofié ◽  
Elvine Pami Nguelefack-Mbuyo ◽  
Nole Tsabang ◽  
Albert Kamanyi ◽  
Télesphore Benoît Nguelefack

Parts of Ceiba pentandra are wildly used in Africa to treat diabetes and previous works have demonstrated their in vivo antidiabetic effects on type 1 diabetes models. In addition, it has been recently shown that the decoction and the methanol extract from the stem bark of C. pentandra potentiate in vitro, the peripheral glucose consumption by the liver and skeletal muscle slices. But nothing is known about its effect on type II diabetes, especially on insulin resistance condition. We investigated herein the antihyperglycemic, insulin-sensitizing potential, and cardioprotective effects of the dried decoction from the stem bark of Ceiba pentandra (DCP) in dexamethasone-induced insulin resistant rats. DCP phytochemical analysis using LC-MS showed the presence of many compounds, including 8-formyl-7-hydroxy-5-isopropyl-2-methoxy-3-methyl-1,4-naphthaquinone, 2,4,6-trimethoxyphenol, and vavain. Wistar rats were given intramuscularly (i.m.) dexamethasone (1 mg/kg/day) alone or concomitantly with oral doses of DCP (75 or 150 mg/kg/day) or metformin (40 mg/kg/day) for 9 days. Parameters such as body weight, glycemia, oral glucose tolerance, plasma triglycerides and cholesterol, blood pressure, and heart rate were evaluated. Moreover, cardiac, hepatic and aortic antioxidants (reduced glutathione, catalase, and superoxide dismutase), malondialdehyde level, and nitric oxide content were determined. DCP decreased glycemia by up to 34% and corrected the impairment of glucose tolerance induced by dexamethasone but has no significant effect on blood pressure and heart rate. DCP reduced the total plasma cholesterol and triglycerides as compared to animals treated only with dexamethasone. DCP also increased catalase, glutathione, and NO levels impaired by dexamethasone, without any effect on SOD and malondialdehyde. In conclusion, the decoction of the stem bark of Ceiba pentandra has insulin sensitive effects as demonstrated by the improvement of glucose tolerance, oxidative status, and plasma lipid profile. This extract may therefore be a good candidate for the treatment of type II diabetes.


2018 ◽  
Vol 5 (7) ◽  
pp. 2440-2454
Author(s):  
D. A. Omoboyowa ◽  
F. O. Afolabi ◽  
T. C. Aribigbola

Background: The anti-hyperglycemic potential of methanol stem bark extract of Anacardium occidentale (MSBEAO) was investigated using an alloxan-induced diabetic rat model. Alloxan administration induces the generation of free radicals which can affect antioxidant status resulting in the disruption of the β-cells of the pancreas. Therefore, this study examines the antioxidant potential of the plant extract and the ameliorating effect on the pancreas of alloxan-induced diabetic rats. Methods: Diabetes was induced by intraperitoneal injection of 150 mg/kg body weight of alloxan monohydrate. MSBEAO, at a concentration of 100 or 200 mg/kg b.w. was orally administered to alloxan-induced diabetic rats and normal rats. The hypoglycemic effect, oral glucose tolerance test, and biochemical assay of alloxan-induced diabetic rats were assayed using standard procedures. Results: Preliminary phytochemical screening of the extract revealed the presence of alkaloids, tannins, saponins, terpenoids, carbohydrates, and phenols at moderate concentrations. The lethality dose (LD50) of the plant extract was found to be equal to or less than 5000 mg/kg b.w. The hypoglycemic effect of the extract on the non-diabetic rats revealed a significant (p<0.05) decrease in the blood glucose concentration of animals administered with 1 g/kg b.w. of the extract, compared to normal control rats administered with normal saline. In the oral glucose tolerance test, the methanol extract exerted the highest response, similar to glibenclamide after 15 and 30 minutes of administration, compared to the control rats. The methanol extract yielded the highest blood glucose lowering effects after 9 days of treatment (p<0.05), compared to diabetic rats administered with normal saline and 0.3 mg/kg b.w. of glibenclamide. Administration of the extract at 200 mg/kg b.w. showed improved pancreas architecture and regeneration of the β-cells, compared with the pancreas of animals in the other groups. Conclusion: The results of this study suggest that MSBEAO is a potentially effective agent for the management of diabetes which might result from the antioxidant-generating capacity of the stem bark.


2012 ◽  
Vol 19 (04) ◽  
pp. 462-468
Author(s):  
M. IKRAM ◽  
SYED HAIDER HASAN ALAM ◽  
SHAFQAT MUKHTAR ◽  
M. Saeed

Introduction: Gestational diabetes mellitus is common disorder in pregnancy. It is associated with adverse pregnancy outcome. There is no consensus regarding the optimal approach to screening of gestational diabetes mellitus. The present study has tried toobserve the value of fasting blood glucose in screening of gestational diabetes. Objective: To determine the frequency of patients in whomfasting blood glucose and 100gm glucose tolerance show agreement for screening of gestational diabetes mellitus at 24 -28 wks. Studydesign: Comparative cross sectional study. Settings: The study was conducted at Gynecology and Obstetrics department Shaikh ZayedFederal Post Graduate Institute Lahore. Duration of study with dates: 6 months from 12Nov 2010 to 11 May 2011. Material and method: Thestudy included 135 booked patients with positive family history of diabetes mellitus. All patients underwent fasting blood glucose at 24-28 weeksof gestation, regardless of results of fasting blood glucose on next visit they underwent 100g oral glucose tolerance test (OGTT). The agreementbetween fasting blood glucose and 100g oral glucose tolerance test was calculated in frequency and percentages. Results: The mean age ofwomen in studied population was 27.15±3.70.Out of 135 patients 86.7 %( 117) showed agreement between results of fasting blood glucose and100g OGTT while 13.31 %( 18) showed no agreement between both of the tests. Conclusions: Fasting blood glucose is a good screeningoption for gestational diabetes mellitus along with positive history. It provides a simple, cheap and more practical test for screening of gestationaldiabetes mellitus. However diagnostic confirmation with 100g OGTT should be done.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mrs. Vanitha. S s ◽  
Dr. Pramjit kaur

Challenges in lifestyle, such as increasesin energy intake and decreasesin physical activity are causing overweight and obesity leading to epidemic increases in type II Diabetes Mellitus. The research approach used for this study was evaluative approach and the research design was true experimental design. 60 patients with type II diabetes, 30 in experimental group and 30 in control group were selected for this study by using purposive sampling technique. Data was collected with the help of self-structured interview schedule. Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (chi-square, paired ‘t’ test) were used to analyse the data and to test the hypotheses. In the experimental group,the pre-test mean score was 2.966, mean percentage was 59% and standard deviation was 1.129 and in post-testmean score was 2.533, mean percentage was 50.66% and standard deviation was 1.074 with effectiveness of 8.34% and paired‘t’ test value of t=3.971,which was statistically significant (p<0.05) which is an evidence ofthe effectiveness of Amla juice in reducing blood glucose level. Comparison of blood glucose levels in experimental and control groups, shows that the value is statistically highly significant, as was observed from the unpaired ‘t’ test value of 13.39 with P value of <0.05, which is an evidence indicatingthe effect of Amla juice in reducing postprandial blood glucose levels. The resultsfound that the administration of Amla juice did have aneffect in reducing blood glucose level in the experimental group. By comparing the findings of pre-test and post test between the experimental group and the control group,the effect was identified (assessed). The study concluded that the Amlajuice is effective in reducing blood glucose level.


2015 ◽  
Vol 10 (2) ◽  
pp. 326 ◽  
Author(s):  
Emordi Jonathan Emeka ◽  
Agbaje Esther Oluwatoyin ◽  
Oreagba Ibrahim Adekunle ◽  
Iribhogbe Osede Ignis

<p>The purpose of this study is to evaluate the hypoglycaemic properties and preliminary phytochemical screening of <em>Uveria chamae</em>. The hypoglycaemic properties of <em>Uveria chamae</em> was assessed on normoglycaemic rat that received single dose of the extract at 250 and 500 mg/kg body weight and blood glucose levels estimated at 2, 4, and 6 hours (single dose study). The hypoglycaemic property of the extract was also evaluated in normoglycemic rats by oral glucose tolerance test. Phytochemical screening of the extract for the presence of secondary metabolites was performed with standard methods. The extract showed a significant (p&lt;0.05) reduction in blood glucose levels at 2h and 6h compared to control.  The oral glucose tolerance test  result also showed a significant decrease (p&lt;0.05) in blood glucose levels . The study showed that the extract, <em>Uveria chamae</em> has hypoglycaemic properties which may be accounted for by the presence of the phytochemicals.</p><p> </p>


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