Influence of chromium-enriched yeast on blood glucose and insulin variables, blood lipids, and markers of oxidative stress in subjects with type 2 diabetes mellitus.

The aim of this study was to determine the effect of chromium (Cr)- enriched yeast on blood glucose and insulin variables, blood lipids, and blood markers of oxidative stress in persons with type 2 diabetes mellitus (median duration: 3.0 yr). Thirty-six subjects (9 men, 27 women; mean age: 61.3 yr; mean body mass index: 34.33 kg/m2) were supplemented with 400 microg Cr/d as Cr-enriched yeast (n = 19) or placebo (n = 17) for 12 wk in a randomized, double-blind study. The most interesting results were obtained by comparison of the change in the placebo group to the change in the Cr group. The Cr group showed a significantly greater increase in serum Cr compared to the placebo group (p < 0.05). Supplementation with Cr-enriched yeast was associated with a significant decrease in fasting serum glucose compared to placebo (p < 0.01). Blood markers of oxidative stress glutathione peroxidase activity and levels of reduced glutathione were essentially unchanged in the Cr group after 12 wk, but decreased significantly in the placebo group (p < 0.05, p < 0.01, respectively). Serum HbA1c and glycated protein (fructosamine) were essentially unchanged in the Cr group, whereas HbA1c tended to increase in the placebo group (from 6.94% to 7.11%). Fasting serum insulin decreased in both groups, with a greater tendency in the Cr group (-16.5% vs -9.5%). These data suggest that supplementation of well-controlled type 2 diabetics with Cr-enriched yeast is safe and can result in improvements in blood glucose variables and oxidative stress.

Post-pyloric enteral nutrition in septic patients: effects on hepato-splanchnic hemodynamics and energy status.

OBJECTIVE: To evaluate the effects of post-pyloric enteral nutrition (EN) on hepato-splanchnic and systemic hemodynamics, metabolism and gastric mucosal energy balance in septic patients. DESIGN: Prospective clinical study. SETTING: Medical intensive care unit (ICU) in a university hospital. PATIENTS: Ten hemodynamically stable, mechanically ventilated patients with severe sepsis. Eight patients required norepinephrine. INTERVENTION: Low dose post-pyloric EN (Survimed, 40 ml bolus, 40 ml h(-1) continuously). MEASUREMENTS AND RESULTS: Three data sets: F1 = baseline fasting, EN(120) = after 120 min of EN, F2=120 min after EN cessation. In addition to global hemodynamics and gastric mucosal PCO(2), we measured hepato-splanchnic blood flow (HSBF) using continuous primed indocyanine green dye infusion with hepatic venous sampling. The mean arterial pressure remained unchanged. During EN systemic vascular resistance decreased ( p<0.05), while cardiac index increased (p<0.001). Simultaneously, HSBF increased during EN and decreased again at F2 (1.54 [0.88; 1.66] l min(-1) m(-2 )at F1; 1.72 [1.18; 1.83] l min(-1) m(-2 )at EN and 1.38 [0.91; 1.63] l min(-1) m-(2 )at F2, p<0.001). Hepatic venous acid base status, lactate/pyruvate ratio and splanchnic lactate balance remained unchanged. There was also no change in splanchnic oxygen extraction ratio or in gastric mucosal to arterial PCO(2) difference. CONCLUSION: The initiation of low dose post-pyloric EN in medical ICU patients with severe sepsis led to the parallel increase of systemic and hepato-splanchnic blood flow. Hepato-splanchnic energy metabolism, oxygen kinetics and gastric mucosal energy balance did not deteriorate during EN, suggesting that EN during sepsis may not be harmful even in patients requiring norepinephrine.

An evaluation of the influence of therapeutic interventions on serum trace element levels in groups of patients.

The aim of the study was to propose a method of large amount data evaluation. A new graphical method for data evaluation was suggested: the data were ranked according to the initial values and both the initial values and final values were intersected by polynomial curves. This method was used in the following situations: 1. Serum levels of Mg and Zn were measured just before and after hemodialysis (HD) in 87 patients in chronic renal failure. 2. Mg levels in serum, red blood cells and urine were estimated in 20 patients before and after administration of a Mg containing drug. Three basic graphic forms of curves were established: 1. Significant decrease of serum Mg levels during HD resulted in two uncrossed lines, the initial-values line being higher than terminal-values one (the higher the initial level the more pronounced was its decrease during HD). 2. Balanced effect of HD on the serum levels of Zn (low values increased, high levels decreased) represented two crossing-lines. 3. Significant increase of urine Mg in patients supplemented by Mg demonstrated two uncrossed lines. The position of initial-values curve was lower than the terminal-values one. The proposed graphical method of the evaluation of large amounts of data is simple and enables a quick orientation in the assessment of the effects of therapeutic interventions (trace elements, drugs and other relevant substances).