scholarly journals Acute Metabolic Responses to Glucose and Fructose Supplementation in Healthy Individuals: A Double-Blind Randomized Crossover Placebo-Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4095
Author(s):  
Max L. Eckstein ◽  
Antonia Brockfeld ◽  
Sandra Haupt ◽  
Janis R. Schierbauer ◽  
Rebecca T. Zimmer ◽  
...  

The aim of this study was to investigate the impact of glucose (Glu), fructose (Fru), glucose and fructose (GluFru) and sucralose on blood glucose response in healthy individuals. Fifteen healthy individuals (five females, age of 25.4 ± 2.5 years, BMI of 23.7 ± 1.7 kg/m2 with a body mass (BM) of 76.3 ± 12.3 kg) participated in this double-blind randomized crossover placebo-controlled trial. Participants received a mixture of 300 mL of water with 1 g/kg BM of Glu, 1 g/kg BM of Fru, 0.5 g/kg BM of GluFru (each), and 0.2 g sucralose as a placebo. Peak BG values Glu were reached after 40 ± 13 min (peak BG: 141 ± 20 mg/dL), for Fru after 36 ± 22 min (peak BG: 98 ± 7 mg/dL), for GluFru after 29 ± 8 min (BG 128 ± 18 mg/dL), and sucralose after 34 ± 27 min (peak BG: 83 ± 5 mg/dL). Significant differences regarding the time until peak BG were found only between Glu and GluFru supplementation (p = 0.02). Peak blood glucose levels were significantly lower following the ingestion of Fru compared to the supplementation of Glu and GluFru (p < 0.0001) while Glu and GluFru supplementation showed no difference in peak values (p = 0.23). All conditions led to a significantly higher peak BG value compared to sucralose (p < 0.0001). Blood lactate increased in Glu (p = 0.002), Fru and GluFru (both p < 0.0001), whereas sucralose did not increase compared to the baseline (p = 0.051). Insulin levels were significantly higher in all conditions at peak compared to sucralose (p < 0.0001). The findings of this study prove the feasibility of combined carbohydrate supplementations for many applications in diabetic or healthy exercise cohorts.

2019 ◽  
pp. 1-5
Author(s):  
Bhavana Parmar ◽  
Rupali Sengupta

Background: Bread is one of the most commonly used breakfast food in India. The consumption also increased tremendously among children and adolescents as well as to some extent among adults. It was found that white bread raises the blood glucose levels and is not considered to be a healthy breakfast option especially for those with diabetes mellitus and those at risk of increased or borderline glucose intolerance. Aim: To assess different commercially available bread and its effect on Blood Glucose Levels of Healthy Individuals. Study Design: 5 bread varieties were chosen (namely White, Brown, Multigrain, Oats and Tutty fruity bread). The samples were fed to 30 subjects and their effect on blood glucose was analysed. Place of Study: The study was conducted in BMN College of Home Science, Matunga, Mumbai, India. Methodology: A pilot study was conducted on 30 samples to assess the Blood Glucose Levels of each type of bread. The subjects were then given bread-butter and the blood glucose response was re-tested at gap of 1 hour and 2 hour respectively. Each subject was given 5 different varieties of bread for 5 consecutive days i.e. White bread, Brown bread, Multigrain bread, Tutty Fruity bread and Oats bread. White bread is a universal standard, was used as a standard in the study.  The average plasma glucose levels were analysed in the study. Results: The average plasma glucose spike of the standard (White bread) was found to be the highest i.e (131.63 mg/dl).  It was observed that oats bread was found to have the lowest spike post 1 hour (103.43mg/dl) while tutty fruity bread exhibited a very high blood glucose response (123.90mg/dl) following the standard white bread. Conclusion: Investigations proved that oats bread should be consumed by people to mitigate metabolic syndrome due to a stressful lifestyle. Also, a healthy diet and exercise regime to be followed by subjects in the study.


2021 ◽  
Vol 8 (13) ◽  
pp. 811-815
Author(s):  
Suman Sudha Tirkey ◽  
Rakesh Kumar Verma

BACKGROUND Hyperglycaemia is a common occurrence in children with critical illness. Several studies relate hyperglycaemia occurring during intensive care unit (ICU) admission to be associated with increased mortality. We wanted to evaluate the incidence of hyperglycaemia and its association with mortality among critically ill children. METHODS A prospective observational study was conducted among critically ill children admitted to the Paediatric Intensive Care Unit (PICU) of a tertiary care centre, Raipur, Chhattisgarh in central India, from 1st May 2016 to 31st October 2016. All patients aged 1 month to 14 years who were admitted in PICU during this study period (N = 113) were included. Children who were known cases of diabetes mellitus, hepatic failure or renal failure requiring dialysis and children who left against medical advice (LAMA) or died within 24 hours of admission were excluded (N = 13). Thus 100 children were included in the study. RESULTS In the study population, incidence of hyperglycaemia was 60 %; overall 37 (37 %) died and the mortality rate was significantly higher (46.6 % vs. 19.4 %) in children with hyperglycaemia than in children without hyperglycaemia. Nonsurvivors had higher mean blood glucose levels at 48 hours (218.35 ± 87.42 mg / dL) than survivors (141.12 ± 55.26 mg / dL) (P < .001). Peak blood glucose (218.35 ± 87.42 mg / dL vs. 141.12 ± 55.26 mg / dL), need for mechanical ventilation (54.5 % vs. 27.3 %), need for inotropes (76.4 % vs. 23.5 %) and Paediatric Risk of Mortality Score (PRISM) III (16.25 ± 5.46 vs. 9.06 ± 4.35) were significantly higher in non-survivors than in survivors. On regression analysis, blood sugar at 24 hours and duration of stay were found to be significant. CONCLUSIONS In this study, in the PICU, the mortality rate was significantly higher in children with hyperglycaemia than in children without hyperglycaemia. Non-survivors had significantly higher mean blood glucose levels at 48 hours than survivors. Peak blood glucose, need for mechanical ventilation, need for inotropes and PRISM III scores were significantly higher in non-survivors than in survivors. KEYWORDS Hyperglycaemia, Critically Ill, PICU, Outcome, Mortality


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jay M. Pescatore ◽  
Juan Sarmiento ◽  
Ruben A. Hernandez-Acosta ◽  
Britt Skaathun ◽  
Nancy Quesada-Rodriguez ◽  
...  

Abstract Context Corticosteroids, specifically dexamethasone, have become the mainstay of treatment for moderate to severe COVID-19. Although the RECOVERY trial did not report adverse effects of corticosteroids, the METCOVID (Methylprednisolone as Adjunctive Therapy for Patients Hospitalized with COVID-19) study reported a higher blood glucose level in patients receiving methylprednisolone. Objectives This study aims to analyze the association between corticosteroids and COVID-19–related outcomes in patients admitted to the medical ICU (MICU) for COVID-19 pneumonia. Methods This is an observational study of 141 patients admitted to the MICU between March 18 and June 7, 2020. Data on demographics, laboratory and imaging studies, and clinical course were obtained, including data on corticosteroid use. Bivariate analyses and logistic regression were performed between patient characteristics and mortality and successful extubation. Results Of the 141 patients, 86 required mechanical ventilation, 50 received steroids, and 71 died. Regarding demographics, patients had a median age of 58 (interquartile range [IQR] 48, 65), Hispanic (57.4%, n=81), and non-Hispanic Black (37.5%, n=53). The most prevalent comorbidities were hypertension (49.6%, n=70) and diabetes (48.2%, n=68). Lower blood glucose levels on admission (125.5 vs. 148 mg/dL, p=0.025) and lower peak blood glucose levels on corticosteroids (215.5 vs. 361 mg/dL, p=0.0021) were associated with lower prevalence of mortality. Patients who were successfully extubated had a lower admission blood glucose (126.5 vs. 149 mg/dL, p=0.0074) and lower peak blood glucose on corticosteroids (217 vs. 361 mg/dL, p=0.0023). Conclusions Lower blood glucose on admission and lower maximum blood glucose on corticosteroids were associated with lower odds of mortality and successful extubation, regardless of preexisting diabetes. Hyperglycemia may be negating any potential benefit of corticosteroid therapy. These findings suggest that glucose control could be a parameter that impacts the outcome of patients receiving corticosteroids for COVID-19 pneumonia.


2016 ◽  
Vol 17 (5) ◽  
pp. 625-629 ◽  
Author(s):  
Nazel Oliveira Filho ◽  
Rodrigo L. Alves ◽  
Adriano T. Fernandes ◽  
Fernanda S. P. Castro ◽  
José Roberto Tude Melo ◽  
...  

OBJECTIVE The acute elevation of blood glucose in perioperative pediatric patients subjected to cardiac surgery and in victims of head trauma is associated with higher rates of postoperative complications. Data on the occurrence of hyperglycemia and its association with unfavorable outcomes among patients who have undergone elective neurosurgery are scarce in the literature. This study aimed to determine whether the occurrence of hyperglycemia during the perioperative period of elective neurosurgery for the resection of tumors of the CNS in children is associated with increased morbidity. METHODS This retrospective cohort analysis included 105 children up to 12 years of age who underwent elective neurosurgery for resection of supratentorial and infratentorial CNS tumors between January 2005 and December 2010 at the São Rafael Hospital, a tertiary care medical center in Salvador, Brazil. Demographic data and intraoperative and postoperative information were collected from the medical records. Differences in blood glucose levels during the perioperative period were evaluated with nonparametric tests. RESULTS The patients who developed postoperative complications exhibited higher blood glucose levels on admission to the intensive care unit (ICU) (162.0 ± 35.8 mg/dl vs 146.3 ± 43.3 mg/dl; p = 0.016) and peak blood glucose levels on postoperative Day 1 (171.9 ± 30.2 mg/dl vs 156.1 ± 43.2 mg/dl; p = 0.008). Multivariate analysis showed that peak blood glucose levels on postoperative Day 1 were independently associated with a higher odds ratio for postoperative complication (OR 1.05). The occurrence of hyperglycemia (>150 mg/dl) upon admission to the ICU was associated with longer ICU (p = 0.003) and hospital (p = 0.001) stays. CONCLUSIONS The occurrence of hyperglycemia during the postoperative period after elective pediatric neurosurgery for the resection of CNS tumors was associated with longer hospital and ICU stays. Postoperative complications were associated with higher blood glucose levels upon admission to the ICU and higher peak blood glucose on the first postoperative day.


2016 ◽  
Vol 52 (4) ◽  
pp. 761-769 ◽  
Author(s):  
Any de Castro Ruiz Marques ◽  
Fabiana Percinoto Monteiro Schiavon ◽  
Patricia Batista Travassos ◽  
Vanessa Fontana Eik ◽  
Guilherme Godoy ◽  
...  

2014 ◽  
Vol 29 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Derrick Brown ◽  
Matthew Wyon

Ingesting quality carbohydrates has been shown to be essential for dancers. Given that most dance classes take place in the morning, it has been recommended that dancers eat a well-balanced breakfast containing carbohydrates, fats, and protein as a means of fueling this activity. The aim of this study was to determine the effect of a moderate glycemic index energy (MGI) bar or a fasting condition on dancers’ blood glucose levels and perceived pleasure-displeasure response during the first dance class of the day. In a randomized counterbalanced design, 10 female preprofessional dance students took their regular scheduled contemporary dance class, on four separate occasions. On each occasion, they consumed either a commercially prepared carbohydrate (CHO)-dense energy bar (47.3 g CHO) or water (FAST). Plasma glucose responses and pleasure-displeasure affect were measured before and at two time points during the class. Dancers who consumed the MGI bar had significantly greater peak blood glucose levels at all time points than those who fasted (p<0.05). Regarding affective state measures, participants who had breakfast had significantly greater pleasure scores than those who only ingested water (p<0.05). In conclusion, results suggest that CHO with an MGI value positively impacts blood glucose concentrations during a dance class. Further, we conclude that skipping breakfast can have an unfavorable effect on the pleasure-displeasure state of dancers. These findings highlight the impact of breakfast on how one feels, as well as the physiological and metabolic benefits of CHO as an exogenous energy source in dancers.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Chadakarn Phaloprakarn ◽  
Siriwan Tangjitgamol

Abstract Background Blood glucose levels during pregnancy may reflect the severity of insulin secretory defects and/or insulin resistance during gestational diabetes mellitus (GDM) pregnancy. We hypothesized that suboptimal glycemic control in women with GDM could increase the risk of postpartum type 2 diabetes mellitus (T2DM) or prediabetes. Our objective was to evaluate the impact of plasma glucose levels throughout GDM pregnancy on the risk of postpartum T2DM or prediabetes. Methods The medical records of 706 women with GDM who underwent a postpartum 75-g, 2-hour oral glucose tolerance test at our institution between January 2011 and December 2018 were reviewed. These women were classified into 2 groups according to glycemic control during pregnancy: ≤ 1 occasion of either fasting glucose ≥ 95 mg/dL or 2-hour postprandial glucose ≥ 120 mg/dL was defined as optimal glycemic control or else was classified as suboptimal glycemic control. Rates of postpartum T2DM and prediabetes were compared between women with optimal (n = 505) and suboptimal (n = 201) glycemic control. Results The rates of postpartum T2DM and prediabetes were significantly higher in the suboptimal glycemic control group than in the optimal glycemic control group: 22.4% vs. 3.0%, P < 0.001 for T2DM and 45.3% vs. 23.5%, P < 0.001 for prediabetes. In a multivariate analysis, suboptimal glucose control during pregnancy was an independent risk factor for developing either postpartum T2DM or prediabetes. The adjusted odds ratios were 8.4 (95% confidence interval, 3.5–20.3) for T2DM and 3.9 (95% confidence interval, 2.5–6.1) for prediabetes. Conclusion Our findings suggest that blood glucose levels during GDM pregnancy have an impact on the risk of postpartum T2DM and prediabetes.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Febrika Wediasari ◽  
Gumilar A. Nugroho ◽  
Zahra Fadhilah ◽  
Berna Elya ◽  
Heri Setiawan ◽  
...  

Introduction. Researchers usually use herbal combinations to explore and develop traditional medicine to obtain additional benefits in the treatment of diseases, including diabetes. This study aims to evaluate the hypoglycemic effect of the combination of Andrographis paniculata (Burm. f.) Wall ex Nees and Caesalpinia sappan Linn extract (APCSE) on diabetes-induced rats. There has not been sufficient research on this combination; however, single extract studies of these plants have been widely conducted. Materials and Methods. Male Sprague Dawley rats (160–200 g) were induced by injecting a low dose of streptozotocin (35 mg/kg BW) twice and fed with a high-fat diet containing 25% fat, whereas control animals received only standard feed. Rats were treated with APCSE at doses of 100 mg and 200 mg/kg BW for seven days and compared to the APE and CSE groups treated with the extract at 100 mg, respectively. For the control group, rats were treated with metformin with a dose of 250 mg/kg. The antihyperglycemic and antihyperlipidemic effects were determined by measuring blood glucose levels and lipid profiles (cholesterol, triglycerides, HDL, and LDL). To assess the impact of the extract on pancreatic and adipose tissue, the number of pancreatic beta cells and adipocytes was evaluated through histopathological and immunohistochemical study. Results and Discussion. In a nonfasting state, the blood glucose change in APCSE 200 mg was 18.65% and was significantly lower from the DM group. However, a single extract of APE and CSE showed lower fasting blood glucose levels compared to the combined extract. Lipid profiles show no significant differences in cholesterol levels between groups; however, all treatment groups, including metformin, showed higher triglyceride levels. The APE-treated group showed significantly lower HDL and LDL, whereas CSE only showed lower LDL. The β-cell number was significantly higher after treatment with single extract CSE. The CSE and the combined extract groups showed hyperplasia adipocytes. Conclusion. The combined extract of APCSE has a moderate antihyperglycemic effect; however, a single extract may have better potential than the combined extract.


2017 ◽  
Vol 65 (4) ◽  
pp. 772-783 ◽  
Author(s):  
Jie Zhang ◽  
Lixin Guo

Postprandial hypotension (PPH) is a common condition that occurs primarily in elderly patients with type 2 diabetes mellitus (T2DM). This study aimed to assess the effectiveness of acarbose for PPH; it also investigated possible mechanisms behind PPH development. This single-blind, randomized controlled trial included 91 elderly patients with T2DM, aged between 60 and 80 years, who were inpatients at Beijing Hospital between March 2012 and November 2014. The patients were included into one of three groups: Group A, patients with T2DM without PPH; Group B, patients with T2DM with PPH receiving placebo; and Group C, patients with T2DM with PPH receiving acarbose. After an overnight fast, patients received a single dose of acarbose (100 mg) or placebo and then consumed a standardized 450 kcal meal. Blood pressure, glucose levels, heart rate (HR), and catecholamine levels were evaluated. Acarbose ameliorated PPH as determined by significant improvements in the duration and maximal fall in blood pressure (both p<0.001); however, no differences in HR and blood glucose levels were observed. In patients with PPH, blood pressure was correlated with blood glucose and HR variability values (p<0.05). Correlations between epinephrine and glucagon-like peptide-1 with blood pressure in groups A and C were largely lost in group B. Acarbose reduced postprandial blood pressure fluctuations in elderly patients with diabetes. PPH may be related to impaired autonomic nervous system function, reduced catecholamine secretion, and postprandial fluctuations in blood glucose levels.Trial registration numberChinese Clinical Trial Registry ChiCTR-IPR-15006177.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Pariyarath Sangeetha Thondre ◽  
Helen Lightowler ◽  
Lis Ahlstrom ◽  
Andrew Gallagher

Abstract Background There are many benefits of maintaining healthy blood glucose levels, and studies have shown that lifestyle changes such as changes to diet can successfully restore normoglycaemia in participants with dysglycaemia. Significant health-related lifestyle changes are often difficult to implement and functional ingredients that can reduce glycaemic and insulaemic responses may help at risk populations. The aim of this study was to investigate whether a mulberry leaf extract could lower the glycaemic and insulinaemic responses to 75 g sucrose in healthy individuals. Methods A double-blind, randomised, placebo-controlled, crossover design trial was conducted by the Oxford Brookes Centre for Nutrition and Health. Thirty-eight participants were recruited into the trial and, after an overnight fast, were given 75 g sucrose + white mulberry leaf extract, or 75 g sucrose alone. Capillary blood samples were collected at 15-min intervals in the first hour and at 30-min intervals over the second hour to determine glucose and plasma insulin levels. Data analysis was conducted using a paired samples T test or a Wilcoxon signed rank test. Results The addition of mulberry leaf extract to sucrose resulted in a significantly lower glycaemic response and insulinaemic response compared to a matched placebo (sucrose alone). The change in blood glucose measurements were significantly lower at 15 min (p < 0.001), 30 min (p < 0.001), 45 min (p = 0.008), and 120 min (p < 0.001) and plasma insulin measurements were significantly lower at 15 min (p < 0.001), 30 min (p < 0.001), 45 min (p < 0.001), 60 min (p = 0.001) and 120 min (p < 0.001). The glucose iAUC (− 42%, p = 0.001), insulin iAUC (− 40%, p < 0.001), peak glucose (− 40.0%, p < 0.001) and peak insulin (− 41%, p < 0.001) from baseline were significantly lower for white mulberry leaf extract compared with the placebo. White mulberry leaf extract was well tolerated and there were no reported adverse events. Conclusions Mulberry leaf extract can be used as part of lifestyle changes that may lead to healthy blood glucose levels. Trial registration: ISRCTN99601810 (23 October 2020, retrospectively registered)


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