scholarly journals Postprandial Glucose Levels Are Better Associated with the Risk Factors for Diabetes Compared to Fasting Glucose and Glycosylated Hemoglobin (HbA1c) Levels in Elderly Prediabetics: Beneficial Effects of Polyherbal Supplements—A Randomized, Double-Blind, Placebo Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-13
Author(s):  
Jingfen Zhu ◽  
Guoqiang Xing ◽  
Tian Shen ◽  
Gang Xu ◽  
Yun Peng ◽  
...  

Backgrounds. Prediabetes is a condition in which a person’s blood glucose levels are higher than normal physiological levels but lower compared to patients with diabetes. Up to 70% of individuals with prediabetes will eventually develop diabetes. To date, there have been no pharmaceutical drugs to treat diabetes. It is believed that early diagnosis and nonpharmacological intervention for prediabetes are critical for effective prevention of diabetes. Most individuals with prediabetes remain undiagnosed even after being evaluated using the standard tests for fasting glucose (FG) and HbA1c. We investigated if postprandial glucose levels (2h-PG) were associated with pre/diabetes and if polyherbal supplements could be beneficial for individuals with prediabetes. Materials and Methods. 100 elderly individuals with impaired 2h-PG or fasting glucose levels were recruited to receive either a 12-week supplement of GlucoVita (an antioxidative polyherbal formulation) (n=50) or placebo (n=50). Results. No baseline differences were observed for FG, HbA1c, or 2h-PG. Individuals who received a twelve-week administration of GlucoVita supplements had significantly reduced 2h-PG (8.15±1.67 versus 7.35±2.06 mmol/l, P<0.05) levels compared to individuals in the placebo group. In addition, HbA1c levels were lower in individuals who received GlucoVita (5.81±0.49 %) compared to the individuals in the placebo group (6.00±0.51%) (P=0.08) after 12-weeks. Stratified analysis, based on impaired fasting glucose (IFG), 2h-PG, metabolic symptom, and age, demonstrated that, after the 12-week intervention, HbA1c levels were significantly lower in the GlucoVita administered group compared to the placebo group (IFG subgroup; 5.85±0.46%, n= 27 versus 6.14±0.50, n=33, P<0.05) and the metabolic symptom-free subgroup (5.73±0.45%, n=23 versus 6.04±0.52%, n=24, P<0.05). GlucoVita also reduced FG in individuals with normal 2h-PG (6.37±0.27 versus 6.08±0.38 mmol/l, P<0.05). Baseline 2h-PG levels, but not HbA1c or FG levels, were significantly correlated with body weight, waist circumference, and BMI (r=0.25, P<0.05; r=0.31, P<0.01; r=0.22, P<0.05, respectively). Conclusion. 2h-PG levels were better associated with body weight, waist circumference, and BMI risk factors compared to FG and HbA1c levels in elderly individuals with prediabetes. Polyherbal formulation GlucoVita supplements improved 2h-PG and HbA1c levels only in elderly individuals who were overweight but were symptom-free and under 65 years of age. Due to the small cohort size of this pilot study, future studies are required to validate our findings.

2014 ◽  
Vol 4 (7) ◽  
pp. 276 ◽  
Author(s):  
Masashi Akaike ◽  
Ken-ichi Aihara ◽  
Hiroaki Yanagawa ◽  
Takashi Iwase ◽  
Sumiko Yoshida ◽  
...  

Objective: This study was undertaken to explore the efficacy and safety of Citrus sudachi peel for metabolic risk factors in obese male and female adults.Background: Citrus sudachi Hort. ex Shirai (Rutaceae), called “sudachi”, is a small, round, green citrus fruit that is mainly cultivated in Tokushima Prefecture in Japan. Our group reported that Citrus sudachi peel powder improved glucose tolerance and dyslipidemia in Zucher-fatty rats and reduced hyperglycemia and hypertriglyceridemia in GK diabetic rats.Materials and Methods: We conducted a randomized, double-blind, placebo-controlled trial in 40 participants with abdominal obesity and metabolic risk factors including hypertension, impaired glucose tolerance and elevated triglyceride levels. Participants were randomized to receive either tablets that contained 1.3 g dried Citrus sudachi peel powder or placebo tablets for 12 weeks. The sudachi peel group included 14 males and 5 females with a mean age of 54.5 years, and the placebo group included 18 males and 2 females with a mean age of 51.9 years. Results: Physical status including body weight, waist circumference and blood pressure and laboratory markers including metabolic parameters were not different at any observation point between the two groups. However, among participants with serum triglyceride levels of more than 120 mg/dl, body weight, waist circumference and serum triglyceride levels were significantly decreased at several observation points after the start of treatment in the sudachi peel group but not in the placebo group. No serious adverse events were observed in the sudachi peel group. Conclusions: Citrus sudachi peel has the potential effect to safely improve abdominal obesity and lower serum levels of TG in obese individuals with hypertriglyceridemia. A large-scale randomized, double-blind clinical study targeting subjects with both abdominal obesity and high TG levels is needed to confirm the metabolic effects of Citrus sudachi peel.Trial registration: UMIN Clinical Trials Registry (UMIN-CTR) UMIN000002682.  Accession number of the Ethics Committee for Clinical Trials of Food in Tokushima University Hospital is F5.Key words: health functional food, anti-obesity, triglyceride


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Jason R Jaggers ◽  
Gregory A Hand ◽  
Vivek Prasad ◽  
Xuemei Sui ◽  
Stephanie Burgess ◽  
...  

Background: Metabolic Syndrome (MetSyn) is a strong predictor of type 2 diabetes and cardiovascular disease (CVD). Recent data show that people living with HIV/AIDS (PLWHA) are at a greater risk of CVD, which could possibly be explained by an increased prevalence of MetSyn as a result of the metabolic disturbances known to be associated with antiretroviral therapy (ART). The purpose of this study is to examine the relationships among physical activity (PA) and risk factors for MetSyn in a sample of HIV+ adults currently taking ART. Methods: A total of 32 males and 38 females living with HIV and currently taking ART were enrolled in an ongoing PA intervention aimed to reduce risk factors for CVD. Clinical assessments included measures of resting blood pressure (BP), waist circumference, height, weight, PA levels via accelerometer, and a fasted blood draw. Inactivity was defined as measured activity < 3 metabolic equivalents (METS) or if the person was sedentary, whereas moderate to vigorous PA was defined as any activity ≥ 3 METS. Accelerometer data was considered valid if the participant had a total on-body time of at least 10 hours a day for 4 days. Levels of PA were divided into 4 quartiles (Q1=0-40 mins of PA; Q2=40-80 mins; Q3=80-160 mins; Q4≥160mins). A one-way ANOVA was used to determine differences between quartiles. Results: Waist circumference was significantly lower across PA quartiles (p < 0.001). A similar pattern was observed in fasting glucose levels; however the results were not significant. Pearson correlation showed a significant association between PA and waist circumference (r = - 0.526; p < 0.001), but not BP or fasting glucose. Although fasting glucose was not significantly associated with PA, the Pearson correlation did show a significant association between inactivity and fasting glucose (r = 0.433; p = 0.019). Conclusions: These data show that greater amounts of PA are significantly associated with a smaller waist circumference for PLWHA who currently took ART. A significant relationship was also observed among inactivity and fasting glucose. In conclusion, routine PA can be beneficial in helping PLWHA reduce waist circumference and decrease sedentary time ultimately leading to a reduction in fasted glucose levels. This in turn would help PLWHA self-manage known risk factors for MetSyn, thus reducing their risk of CVD.


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Xiang Li ◽  
Hui Ren ◽  
Zhang-rong Xu ◽  
Yan-jun Liu ◽  
Xiao-pin Yang ◽  
...  

Objectives. The aim of this study was to evaluate the prevalence and the risk factors of prolonged QTc interval among Chinese patients with type 2 diabetes.Methods. The retrospective study included 3156 outpatients from the Diabetes Centre, the 306th Hospital of PLA, during the period from September 2003 to June 2010. QT interval was measured manually in the 12-lead conventional electrocardiogram. The QT interval corrected for heart rate (QTc) was calculated using Bazett’s formula. Additional demographic and laboratory data were also collected. Potential risk factors of prolonged QTc interval were assessed using multivariable regression.Results.The prevalence of prolonged QTc interval among Chinese patients with type 2 diabetes was 30.1%. Height (OR 0.156, 95% CI 0.032~0.748), waist circumference (OR 1.025, 95% CI 1.010~1.040), diastolic blood pressure (OR 1.016, 95% CI 1.007~1.026), postprandial glucose (OR 1.040, 95% CI 1.022~1.059), fasting insulin (OR 1.014, 95% CI 1.003~1.025), and presence of microalbuminuria (OR 1.266, 95% CI 1.033~1.551) were significant risk factors.Conclusions. The prevalence of prolonged QTc interval among Chinese patients with type 2 diabetes is high. Risk factors for prolongation of QTc interval were low height, high waist circumference, increasing diastolic blood pressure levels, high postprandial glucose levels, high fasting insulin levels, and presence of microalbuminuria.


2016 ◽  
Vol 115 (9) ◽  
pp. 1586-1597 ◽  
Author(s):  
Michelle Alessandra Castro ◽  
Valéria Troncoso Baltar ◽  
Dirce Maria Marchioni ◽  
Regina Mara Fisberg

AbstractThe association between dietary patterns and metabolic cardiovascular risk factors has long been addressed but there is a lack of evidence towards the effects of the overall diet on the complex net of biological inter-relationships between risk factors. This study aimed to derive dietary patterns and examine their associations with metabolic cardiovascular risk factors following a theoretic model for the relationship between them. Participants included 417 adults of both sexes, enrolled to the cross-sectional population-based study performed in Brazil. Body weight, waist circumference, high-sensitivity C-reactive protein, blood pressure, total cholesterol:HDL-cholesterol ratio, TAG:HDL-cholesterol ratio, fasting plasma glucose and serum leptin were evaluated. Food consumption was assessed by two non-consecutive 24-h dietary recalls adjusted for the within-person variation of intake. A total of three dietary patterns were derived by exploratory structural equation modelling: ‘Traditional’, ‘Prudent’ and ‘Modern’. The ‘Traditional’ pattern had a negative and direct effect on obesity indicators (serum LEP, body weight and waist circumference) and negative indirect effects on total cholesterol:HDL-cholesterol ratio, TAG:HDL-cholesterol ratio and fasting plasma glucose. The ‘Prudent’ pattern had a negative and direct effect on systolic blood pressure. No association was observed for the ‘Modern’ pattern and metabolic risk factors. In conclusion, the ‘Traditional’ and ‘Prudent’ dietary patterns were negatively associated with metabolic cardiovascular risk factors among Brazilian adults. Their apparent protective effects against obesity and high blood pressure may be important non-pharmacological strategies for the prevention and control of obesity-related metabolic disorders and CVD.


Author(s):  
PULAK MAJUMDER ◽  
PARIDHAVI M

Objective: The concept of the synergistic effect of poly-herbalism was as old as medicine history. Present novel polyherbal formulation (PHF) composed of five different herbs. The present investigation aimed to evaluate the synergistic therapeutic hypoglycemic potential of PHF against streptozotocin (STZ) (60 mg/kg b.w, ip)-induced diabetic rats. Methods: For this therapeutic study, the dose was framed orally once a day to the test objects after STZ dosing at 500 mg/kg/5 ml dosage levels for 21 days. The transformation of body weight and blood glucose level was examined, and the histopathological changes of beta cells of the pancreas, cellular architectures of liver and kidney were also perceived after scarification of the objects. Results: The outcomes were compared to that of glibenclamide (5 mg/kg) treated group. Declines of body weight and blood glucose levels were perceived in STZ-induced diabetic animals very significantly (p<0.01 or p<0.05). However, these diabetic changes were significantly (p<0.01 or p<0.05) decreased in PHF-dosing groups revealed more encouraging effects compared to that of glibenclamide. In the other hand, various liver function and enzymes test (creatinine, urea, total bilirubin, total albumin, alkaline phosphatase, gamma-glutamyl transferase, aspartate transaminases, and alanine transaminases) and lipid profile (total cholesterol, triglycerides, high-density lipoprotein cholesterol, total protein, low-density lipoprotein [LDL], and very LDL) studies strongly indicate the potential action of this novel formulation. Conclusions: It is deliberated that PHF has the favorable effect to normalize the blood glucose levels, and also rejuvenation and reproduction of beta cells lead a better futuristic ant diabetic therapy for diabetic management.


Diabetologia ◽  
2020 ◽  
Vol 63 (8) ◽  
pp. 1648-1658 ◽  
Author(s):  
Jeroen H. P. M. van der Velde ◽  
Annemarie Koster ◽  
Elsa S. Strotmeyer ◽  
Werner H. Mess ◽  
Danny Hilkman ◽  
...  

Abstract Aims/hypothesis We aimed to examine associations of cardiometabolic risk factors, and (pre)diabetes, with (sensorimotor) peripheral nerve function. Methods In 2401 adults (aged 40–75 years) we previously determined fasting glucose, HbA1c, triacylglycerol, HDL- and LDL-cholesterol, inflammation, waist circumference, blood pressure, smoking, glucose metabolism status (by OGTT) and medication use. Using nerve conduction tests, we measured compound muscle action potential, sensory nerve action potential amplitudes and nerve conduction velocities (NCVs) of the peroneal, tibial and sural nerves. In addition, we measured vibration perception threshold (VPT) of the hallux and assessed neuropathic pain using the DN4 interview. We assessed cross-sectional associations of risk factors with nerve function (using linear regression) and neuropathic pain (using logistic regression). Associations were adjusted for potential confounders and for each other risk factor. Associations from linear regression were presented as standardised regression coefficients (β) and 95% CIs in order to compare the magnitudes of observed associations between all risk factors and outcomes. Results Hyperglycaemia (fasting glucose or HbA1c) was associated with worse sensorimotor nerve function for all six outcome measures, with associations of strongest magnitude for motor peroneal and tibial NCV, βfasting glucose = −0.17 SD (−0.21, −0.13) and βfasting glucose = −0.18 SD (−0.23, −0.14), respectively. Hyperglycaemia was also associated with higher VPT and neuropathic pain. Larger waist circumference was associated with worse sural nerve function and higher VPT. Triacylglycerol, HDL- and LDL-cholesterol, and blood pressure were not associated with worse nerve function; however, antihypertensive medication usage (suggestive of history of exposure to hypertension) was associated with worse peroneal compound muscle action potential amplitude and NCV. Smoking was associated with worse nerve function, higher VPT and higher risk for neuropathic pain. Inflammation was associated with worse nerve function and higher VPT, but only in those with type 2 diabetes. Type 2 diabetes and, to a lesser extent, prediabetes (impaired fasting glucose and/or impaired glucose tolerance) were associated with worse nerve function, higher VPT and neuropathic pain (p for trend <0.01 for all outcomes). Conclusions/interpretation Hyperglycaemia (including the non-diabetic range) was most consistently associated with early-stage nerve damage. Nonetheless, larger waist circumference, inflammation, history of hypertension and smoking may also independently contribute to worse nerve function.


2020 ◽  
pp. 1-9
Author(s):  
Marielly Rodrigues de Souza ◽  
Morgana Egle Alves Neves ◽  
Amanda de Moura Souza ◽  
Ana Paula Muraro ◽  
Rosangela Alves Pereira ◽  
...  

Abstract Breakfast is considered as the most important meal of the day. The habit of skipping this meal in adolescence tends to remain until adulthood and has been associated with cardiometabolic risk factors. The present study estimated the prevalence of skipping breakfast and its association with cardiometabolic risk factors. This is a cross-sectional study with data from the Study of Cardiovascular Risks in Adolescents (ERICA), with a nationally representative sample of 36 956 Brazilian adolescents, aged 12–17 years, enrolled in public and private schools. The outcomes were excess body weight (BMI), central obesity (waist circumference and waist:height ratio), lipid profile (total cholesterol (TC), LDL-cholesterol, HDL-cholesterol and TAG) and glycidic profile (fasting glycaemia, fasting insulin and glycated Hb). The association between skipping breakfast and each outcome was estimated using multiple Poisson regression models (prevalence ratio (PR) and 95 % CI). Prevalence of skipping breakfast was 68·7 % and, after adjustments, it was associated with excess body weight (PR = 1·30; 95 % CI 1·18, 1·43), central obesity both by waist circumference (PR = 1·27; 95 % CI 1·00, 1·61) and by waist:height ratio (PR = 1·32; 95 % CI 1·13, 1·54) and high fasting glucose levels (PR = 1·54; 95 % CI 1·09, 2·18), fasting insulin (PR = 1·64; 95 % CI 1·21, 2·22), glycated Hb (PR = 1·16; 95 % CI 1·03, 1·31) and total cholesterol (PR = 1·14; 95 % CI 1·02, 1·27). Skipping breakfast was associated with cardiometabolic risk factors in adolescence. In this context, the school environment is an ideal space to promote healthy eating habits, favouring the implementation of food and nutrition education activities to make adolescents aware of the importance of consuming breakfast daily.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Mary Farrell ◽  
Emily Sonestedt ◽  
Anne Raben ◽  
Juscelino Tovar ◽  
Stina Ramne ◽  
...  

AbstractIntroductionWhen compared to other primates, humans elicit a large variation in the copy number for the salivary amylase gene, AMY1. This variation can range from 2 to 17 copies. The AMY1 gene is responsible for coding for salivary amylase, an enzyme needed to catalyze the hydrolysis of starch molecules into smaller sugars. AMY1 copy number correlates with the amount and activity of salivary amylase. Few studies have investigated the effect of amylase copy number on fasting and postprandial glucose levels. The aim was first to investigate the association between AMY1 copy numbers and fasting glucose in an observational study, and secondly to investigate the difference in postprandial effect of high-starch meals in individuals with either high or low AMY1 copy numbers.Materials and methodsFor the observational study, we used data from 436 participants from the Malmö Offspring Study (MOS) cohort whom have been genotyped for AMY1. For the meal study (conducted during May 2019), we used genotype-based-recall to recruit 24 participants from the observational study of the MOS cohort: 12 with low AMY1 copy number (from the lowest 20%) and 12 with high AMY1 copy numbers (from the highest 20%). Each subject will be served a breakfast meal of white wheat bread on two separate test days: one containing 40 g and the other containing 80 g of carbohydrates (mainly starch). Blood samples will then be taken at various time points to investigate postprandial glucose and insulin responses.ResultsWhen using linear regression analyses adjusting for age and sex, no significant association between AMY1 copy number and fasting glucose was observed (p = 0.23). However, there was a difference (p = 0.05) in fasting glucose levels between the lowest (2–4 copy numbers: 5.31 mmol/L; 95% CI: 5.13–5.50) and highest (10–16 copy numbers: 5.57 mmol/L; 95% CI: 5.39–5.75) copy number groups. The results for the meal study will be obtained in June 2019 and be presented at the conference.DiscussionOur findings of higher fasting glucose among the group with more than 10 AMY1 copy numbers is the first study to find this and needs to be replicated in other populations.


2020 ◽  
Vol 9 (4) ◽  
pp. 1161 ◽  
Author(s):  
Eun-Soo Jung ◽  
Eun-Kyung Choi ◽  
Byung-Hyun Park ◽  
Soo-Wan Chae

Menopause compounds many cardiometabolic risk factors through endogenous estrogen withdrawal. This study aimed to find the association between serum follicle-stimulating hormone (FSH) levels and cardiometabolic risk factors in post-menopausal Korean women. A total of 608 post-menopausal women from eight randomized double-blind, placebo-controlled clinical trials on menopause during the year 2012–2019 were analyzed. Cardiometabolic risk factors such as body mass index, waist circumference, systolic blood pressure, fasting glucose, triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), and TG/HDL-C ratio were significantly improved as the FSH quartiles increased. Metabolic syndrome (MetS) and the number of components of MetS decreased as FSH quartiles increased. In regression analysis, FSH level was negatively associated with cardiometabolic risk factors including body mass index, body weight, waist circumference, fasting glucose and TG, while it was positively associated with HDL-C. The odds ratio of MetS in the first quartile of FSH was 2.682 compared with that in the fourth quartile of FSH in a logistic regression model. Serum FSH levels had a negative correlation with cardiometabolic risk factors in post-menopausal Korean women, suggesting that a low FSH can be a predictor for cardiovascular disease in post-menopausal women.


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