A Preliminary Study for the Suppressive Effect of Mulberry Leaf Powder-containing Foods on the Postprandial Blood Glucose Level / 日本補完代替医療学会誌

A crossover study was conducted to evaluate suppressive effect of a commercially available green juice (Katuna-Aojiru;Egao Co., Ltd.) containing mulberry leaf powder as the main ingredient on postprandial hyperglycemia. The blood glucose and iAUC (0-120min) values after loading cooked white rice were significantly lower with the consumption of Katuna-Aojiru than with the consumption of water. Katuna-Aojiru is effective in controlling postprandial blood glucose.

Ambulatory glucose profile in managing post-prandial hyperglycaemia in patients with type 2 diabetes mellitus: a case report

The case report describes the potential role of real-time Ambulatory Glucose Profile (AGP) in identifying and managing a patient with hyperglycemia. This 55-years-old male patient with type 2 Diabetes Mellitus (T2DM) was presented to the clinic with weakness, increased urinary frequency, with constipation for the past 3 months. The patient was a known case of T2DM for 10 years, along with dyslipidemia, hypertension, and obesity. The profile obtained from AGP revealed glucose fluctuations with post-prandial excursions. Consequently, the patient抯 treatment regimen was changed. The use of glimepiride was discontinued, and the patient was recommended with voglibose 0.2 mg bid with two meals, metformin 100 mg + dapagliflozin 10 mg combination with morning meals, and metformin 1000 mg with evening meals. The treatment for hypertension and dyslipidemia was continued. This case study indicates that CGM can help improve our understanding of glycemic patterns and can have a beneficial effect on glycemic control.

Effect of High β-glucan Barley on Postprandial Blood Glucose and Insulin Levels in Type 2 Diabetic Patients

Chemo-biological evaluation of antidiabetic activity of Mentha arvensis L. and its role in inhibition of advanced glycation end products

Background: There has been enormous curiosity in the development of alternative plant based medicinesto control diabetes, oxidative stress and related disorders. One of the therapeutic approaches is to reducepostprandial release of glucose in the blood. Two key enzymes that are involved in reducing postprandialglucose are a-amylase and a-glucosidase. Mentha arvensis L. has been traditionally used by several tribesas a medicinal plant to treat various disorders.Objective: The present study was undertaken to test M. arvenisis L. for inhibition of postprandialhyperglycemia.Material and method: We performed various in vitro and in vivo tests to evaluate efficacy of M. arvenisis L.for antidiabetic activity (postprandial hyperglycemia).Results: Methanolic extract of M. arvensis L. leaves showed DPPH free radical scavenging activity (morethan 78% mg/ml) and high antiglycation potential (more than 90% inhibition of AGE formation). Methanolic extract also showed remarkable inhibitory effects on a-amylase (more than 50% mg/ml) and aglucosidase (68% mg/ml) and significant inhibition of postprandial hyperglycemia in starch induced diabetic Wistar rats.Conclusion: The non-insulin dependent antidiabetic or inhibition of postprandial hyperglycemic activityof methanolic extract of M. arvensis L. leaves was shown by using in vitro and in vivo approaches in thepresent study.© 2018 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Effect of High β-glucan Barley on Postprandial Blood Glucose Levels in Subjects with Normal Glucose Tolerance: Assessment by Meal Tolerance Test and Continuous Glucose Monitoring System

The effect of white rice (WR) mixed with high β-glucan-containing barley at 50% on improvement of postprandial blood glucose levels was assessed by meal tolerance test and continuous glucose monitoring (CGM) in 15 healthy subjects with normal glucose tolerance (age 31.6 ± 12.9 years old, 4 males and 11 females). A meal tolerance test (500 kcal) was conducted using 2 types of test meals: a test meal only with WR and a test meal WR mixed 50% barley, and the side dish was the same in both meals. Blood glucose levels of the subjects 180 minutes after ingestion of the test meals were compared. In addition, a CGM device was attached to the subjects for 2 days when the WR or barley as a staple food was provided 3 times a day for consecutive days, and the daily variation of glucose was investigated. The glucose levels 30 minutes after dietary loads and the area under the blood concentration-time curve over 180 minutes were significantly decreased in the barley consumption group. In CGM, 24-hour mean blood glucose and 24-hour standard deviation of blood glucose were also significantly decreased after ingestion of the barley. Postprandial glucose level elevation was suppressed by mixing high-β-glucan barley with WR in subjects with normal glucose tolerance.

Effect of Nutrient Preload and Food Order on Glucose, Insulin, and Gut Hormones / 임상당뇨병

Postprandial hyperglycemia is associated with the risk of diabetes mellitus, cardiovascular disease, and mortality. Nutrition therapy is an important component of the management of postprandial hyperglycemia. Postprandial glucose levels are determined by several factors, such as the quantity and composition of nutrients, gastric emptying rates, secretion of incretin hormones, insulin secretion, glucose uptake by peripheral tissues, and endogenous glucose production. Nutrient preload and food order (or meal sequence) are dietary approaches targeting these factors. Nutrient preload reduces postprandial glucose excursion by enhancing insulin secretion, augmenting the secretion of glucagonlike peptide-1, and delaying gastric emptying. Carbohydrates-last food order improves glycemic control, increases the secretion of glucagon-like peptide-1, and decreases insulin requirements. Therefore, both nutrient preload and manipulation of food order can be an effective, safe, and feasible strategy for treating hyperglycemia in individuals with diabetes mellitus.

Postprandial Hyperglycemia / 임상당뇨병

Postprandial hyperglycemia is an important factor in the progression of diabetes and related complications. To reduce the burden of the diabetes epidemic in Korea, a better understanding of the pathophysiology of postprandial hyperglycemia is needed as well as optimal treatment modalities based on individual characteristics of the patient. The standard oral glucose tolerance test can be used to identify those at high risk for diabetes and cardiovascular disease. In the treatment of postprandial hyperglycemia, physicians should provide lifestyle modification support as well as appropriate pharmacological treatment, such as incretin-based therapies. Further clinical trials using recently developed anti-diabetic treatments focusing on postprandial hyperglycemia are needed to evaluate the effectiveness of targeting postprandial hyperglycemia in order to prevent diabetes and diabetes complications.

α-Glucosidase Inhibitory Activity of 4-Aryl-N-(2,4-Thiazolidinedione-5-Acetyl)-1,3-Thiazol-2-Amines.

A series of N-(4-aryl-1,3-thiazol-2-yl)-2-(2,4-dioxo-1,3-thiazolidin-5-yl)acetamides 3a-k and N- (1,3-benzothiazol-2-yl)-2-(2,4-dioxo-1,3-thiazolidin-5-yl)acetamides 3l-n are synthesized and evaluated for their α-glucosidase inhibitory activity. N-[4-(m-Chlorophenyl)-1,3-thiazol-2yl]-2-(2,4-dioxo-1,3-thiazolidin-5- yl)acetamide (3g) and N-[4-(o-fluorophenyl)-1,3-thiazol-2-yl]-2-(2,4-dioxo-1,3-thiazolidin-5-yl)acetamide (3j) have shown very good inhibition. The remaining compounds have exhibited moderate to good activity ranging from 37- 63 % of α-glucosidase enzyme inhibition.

Insulin secreting and α-glucosidase inhibitory activity of hexane extract of Annona squamosa Linn. in streptozotocin (STZ) induced diabetic rats.

The hexane extract of A. squamosa (ASHE) in 100 and 400 mg/kg body weight dose raised the insulin level when compared with Glimepiride (1 mg/kg) and also inhibited α-glucosidase activity when compared with Acarbose (10 mg/kg) in streptozotocin induced diabetic rats. The ASHE significantly reduced peak blood glucose (Gp30) and area under curve (AUC) in diabetic rats in oral glucose (OGTT) and oral sucrose (OSTT) tolerance test, but there was more reduction of Gp30 value than AUC in OSTT. Thus, it can be suggested that the ASHE, has hypoglycemic role at 2 levels, i.e. it acts as secretagogue and also inhibits the intestinal enzymes, responsible for glucose metabolism.

Black Tea Inhibits Small Intestinal α-Glucosidase Activity in <i>db/db</i> Mouse / 日本補完代替医療学会誌

The inhibitory effects of the freeze-dried powder of the aqueous extract of black tea leaf (JAT) on α-glucosidase activity were investigated. We initially examined the effects of JAT addition on yeast α-glucosidase activity. JAT significantly and dose-dependently inhibited α-glucosidase activity and more strongly inhibited the activity than acarbose, the positive control. Then, we examined the effects of oral administration of JAT on sucrose tolerance in type 2 diabetes mellitus model <i>db/db</i> mice. Both JAT and acarbose administered groups showed a dose-dependent decrease in plasma glucose levels after the sucrose loading compared with the control group. Notable was that the plasma glucose levels of the 500 mg/kg JAT administered group exhibited a significant decrease 30 min or longer after the sucrose loading. On the other hand, no significant difference in plasma insulin levels was seen between the JAT administered group and the control group. We also measured small intestinal sucrase activity in <i>db/db</i> mouse at 30 min after JAT oral administration. Compared to control mice, small intestinal sucrase activity was significantly decreased in the 500 mg/kg JAT administered mice. These findings indicate that JAT may be a useful natural material for the prevention and therapy of type 2 diabetes mellitus.<br>

Quercetin attenuates fasting and postprandial hyperglycemia in animal models of diabetes mellitus

The objective of this study was to investigate the hypoglycemic effects of quercetin (QE) in animal models of diabetes mellitus (DM). A starch solution (1 g/kg) with and without QE (100 mg/kg) or acarbose (40 mg/kg) was orally administered to streptozotocin (STZ)-induced diabetic rats after an overnight fast. Postprandial plasma glucose levels were measured and incremental areas under the response curve were calculated. To study the effects of chronic feeding of QE, five-week-old db/db mice were fed an AIN-93G diet, a diet containing QE at 0.08%, or a diet containing acarbose at 0.03% for 7 weeks after 1 week of adaptation. Plasma glucose and insulin, blood glycated hemoglobin, and maltase activity of the small intestine were measured. Oral administration of QE (100 mg/kg) or acarbose (40 mg/kg) to STZ-treated rats significantly decreased incremental plasma glucose levels 30-180 min after a single oral dose of starch and the area under the postprandial glucose response, compared with the control group. QE (0.08% of diet) or acarbose (0.03% of diet) offered to db/db mice significantly reduced both plasma glucose and blood glycated hemoglobin compared to controls without significant influence on plasma insulin. Small intestine maltase activities were significantly reduced by consumption of QE or acarbose. Thus, QE could be effective in controlling fasting and postprandial blood glucose levels in animal models of DM.

Aterosclerosis coronaria subclínica detectada por tomografía axial multicorte y su asociación con la hiperglucemia / Subclinical coronary atherosclerosis by multi-scan axial tomography and its association with hyperglycemia

Se realizó un estudio que evaluó la utilidad de las técnicas de tomografía axial multicorte en la detección, en fase subclínica, del daño coronario en pacientes con diabetes mellitus (DM), con el objetivo de describir la frecuencia de afectación aterosclerótica asintomática y su probable asociación con la hiperglucemia de ayuno y posprandial. Se incluyeron 59 pacientes con diabetes tipo 2, en el estudio se compararon los resultados de la determinación de calcio coronario con los hallazgos de la angiografía por tomografía axial computarizada multicortes (TAC-M). Se registró concordancia de un 44,1 por ciento entre ambos estudios. Predominaron las placas blandas en el 55,9 por ciento de los pacientes. El 42,4 por ciento de los pacientes mostró estrechamiento de la luz arterial, lo que fue significativo en el 16,5 por ciento del total. Un mayor número de pacientes con hiperglucemia presentaron daño coronario al compararlos con los enfermos con buen control glucémico (p=0,024). Esta relación fue más evidente con la hiperglucemia posprandial (p=0,016). La hiperglucemia mostró una mayor probabilidad (5,99 veces) de detectar lesiones coronarias por TAC-M al compararla con otros factores de riesgo ateroscleróticos mayores, como la hipertensión arterial, el tabaquismo, las dislipidemias y la obesidad, lo que se expresó de manera significativa (p=0,045). Concluimos que las técnicas de angio TAC-M y de calcio score son útiles en detectar lesiones de las arterias coronarias, en pacientes con diabetes mellitus tipo 2 asintomáticos de isquemia miocárdica, lo que se asoció a la presencia de hiperglucemia, fundamentalmente posprandial

A study was conducted to assess the usefulness of multi-scan axial tomography techniques to detect, in a subclinical stage, the coronary damage in patients presenting with diabetes mellitus (DM) to describe the frequency of asymptomatic atherosclerotic affection and its potential association with the fasting and postprandial hyperglycemia. In study were included 59 patients with type 2 diabetes to compare the results of coronary calcium determination with the findings of angiography by multi-scan axial computed tomography (CAT-M). There was a concordance of a 44.1 percent between both studies, as well as a predominance of soft plaques in the 55.9 percent of patients. The 42.4 percent showed a narrowing of arterial lumen, which was significant in the 16.5 percent of total. A high figure of patients with hyperglycemia had coronary damage compared to those ills with a good glycemia control (p = 0.024). This relation was more evident with the postprandial hyperglycemia (= 0.016). Hyperglycemia had a high opportunity (5.99 times) to detect coronary lesions by TAC-C compared to other major atherosclerosis risk factors like the high blood pressure, smoking, dyslipemias expressed in a significant way (p = 0.045). We conclude that Angio TAC-C and Calcio Score techniques are useful to detect lesions of coronary arteries in patients with type 2 diabetes mellitus without symptoms of myocardial ischemia, which was associated to presence of a hyperglycemia, fundamentally postprandial

Effects of Twice-Daily Injections of Premixed Insulin Analog on Glycemic Control in Type 2 Diabetic Patients

PURPOSE: Premixed insulin is effective to improve glycemic control; however, clinicians may be less likely to know which premixed insulin is appropriate for which patients. This study aimed to evaluate the effects of twice-daily injections of premixed insulin lispro on glycemic control in type 2 diabetic patients. MATERIALS AND METHODS: Forty type 2 diabetic patients, who had been treated with twice-daily injections of human protamine mixture 30/70 insulin for at least 12 months, were divided into two groups; one group whose blood glucose 2 hours after breakfast was greater than 200 mg/dL, was switched to lispro mix50, and the other group whose blood glucose 2 hours after breakfast < 200 was switched to lispro mix25. RESULTS: Glycated haemoglobin (HbA1c) significantly improved in the Mix50 group from 8.3% to 7.5% (at 12 weeks; p < 0.05), and to 7.5% (at 24 weeks; p < 0.05). On the other hand, HbA1c levels in the Mix25 group were slightly decreased from 8.1% to 7.7% at 12 weeks (p < 0.05), and to 7.9% at 24 weeks (not significant). Both postprandial plasma glucose and fasting plasma glucose levels were significantly improved in the Mix50 group, but not in the Mix25 group. Overall, 95% of subjects preferred premixed lispro insulin from human insulin in the viewpoint of the timing of insulin injection by questionnaire analysis. CONCLUSION: Switching from human protamine mixture 30/70 insulin to lispro mix50 twice-daily injection therapy in patients with high postprandial plasma glucose could improve their glycemic control and quality of life.

The Association of Brachial-Ankle Pulse Wave Velocity with 30-Minute Post-Challenge Plasma Glucose Levels in Korean Adults with No History of Type 2 Diabetes / 당뇨병

BACKGROUND: Acute postprandial hyperglycemia is an important affector for atherosclerosis in subjects with glucose intolerance. We analyzed the relationship of brachial-ankle pulse wave velocity (baPWV) with fasting and post-challenge plasma glucose levels according to different time points during oral glucose tolerance test (OGTT). METHODS: In 663 subjects with fasting hyperglycemia, 75 g OGTT were performed to confirm the glucose tolerant status, and fasting, post-challenge 30-minute and 120-minute glucose levels were measured. Anthropometric measurements were done, and fasting lipid profiles were measured. baPWV were measured in all subjects and the relationship between fasting, 30- and 120-minute post-challenge glucose levels and baPWV were analyzed. RESULTS: Among the participants, 62.9% were prediabetes and 31.7% were diabetes. Mean baPWV value was significantly higher in subjects with diabetes compared with prediabetes group. In bivariate correlation analyses, age, blood pressure, total cholesterol, low density lipoprotein cholesterol, 30-minute and 120-minute post-challenge glucose levels showed significant positive correlation with baPWV value. In multiple regression analysis, 30-minute post-challenge glucose level was a weak but significant determinant for mean baPWV value even after adjustment for other confounding variables. CONCLUSIONS: Postprandial hyperglycemia, especially 30-minute glucose levels showed significant correlation with baPWV in subjects with fasting hyperglycemia. These results can imply the deleterious effect of acute hyperglycemic excursion on arterial stiffness in subjects with glucose intolerance.

Impact of postprandial hyperglycemia control on the treat-to-target blood glucose management / 中华内分泌代谢杂志

Different from fasting blood glucose reflecting the basal glucose level of the body, the post-prandial blood glucose gives us the information about the highest glucose level during a day. It has been proved that post-prandial hyperglycemia (PPG) is associated with cardiovascular diseases more closely, which may be caused by oxidative stress, hence the management of PPG is of great meanings. But what is the effect of PPG control on the treat-to-target blood glucose management? This is a question worth discussing.

A microplate-based screening method for alpha-glucosidase inhibitors / 中国临床药理学与治疗学

AIM: To establish a new sensitive microplate-based method to determine alpha-glucosidase inhibiting activity and provide a reliable high-throughput way for screening alpha-glucosidase inhibitors in vitro.METHODS: The fitting combination of enzyme and substrate in a certain reaction was tested.Acarbose,the most popular alpha-glucosidase inhibitor in clinical use was used to validate the established method.Calibration curve,wavelength fidelity and kinetic analysis,together with the effect of altered incubation time,temperature and pH were then studied.RESULTS:The details of assay procedure and evaluation of factors affecting the measurement are described.As little as 160 μl assay system was performed in a 96-well plate.The optimal action was finally achieved by incubated at 37 ℃,pH 7.0 for 15 min and measured at 400 nm.Results from the validation exercises by Acarbose strongly demonstrated the accuracy and reliability of the proposed approach.CONCLUSION: This method reported in the current paper makes it possible to rapidly examine large numbers of samples for the presence of alpha-glucosidase inhibitors in very small sample volumes.Such action may help to pace the development of potential oral medications from natural products protecting patients against postprandial hyperglycemic toxicity and therefore treating diabetes mellitus and the related complications.

Prevalence of hyperglycemia among patients taking atypical antipsychotics seen at the UP-Philippine General Hospital

OBJECTIVE: To determine the prevalence of hyperglycemia among patients taking anti-psychotics in a hospital setting. METHODOLOGY: Twenty-one patients seen at the out patient department and admitted to the in-patient service of UP-PGH, who were taking atypical anti-psychotics such as amisulpiride, clozapine, olanzapine, quetiapine, and risperidone, were screened for hyperglycemia using serum fasting glucose. RESULTS: None of the twenty-one patients taking any of the atypical anti-psychotics tested positive for hyperglycemia. CONCLUSION: Hyperglycemia was not prevalent among this sample of patients taking atypical anti-psychotics.

Cyto-protective Effects of Aqueous Extract from the Gall of Rhus chinensis on Pancreatic Beta-cell / 대한해부학회지

We have previously reported that aqueous extract of gall from Rhus chinensis, known as "Obaeja", inhibited rat intestinal alpha-glucosidase and suppressed postprandial hyperglycemia by delaying digestion and absorption of intestinal carbohydrate (Shim et al., 2003). This led us to speculate that obaeja could be involved in ameliorating beta-cell injury by lowering glucotoxicity. In the present study, we thus examined the protective effect of obaeja on pancreatic beta-cell damage along with its anti-diabetic effect in streptozotocin-induced animal models. Streptozotocin was administered to rat pups (neonate/STZ model), or to adult rats with a lower dose using osmotic pump (osmotic pump/STZ model) for inducing beta cell death and diabetes. Obaeja was given to those rat pups after weaning in neonate/STZ model, or 2 weeks before subcutaneous implantation of osmotic pump to rats of the other latter model. In the diabetic control rats of the neonate/STZ model, which were not fed with obaeja, some pancreatic islets demonstrated a destruction of beta cell mass with insulitis 2 weeks after weaning, while some larger and irregular islets were formed by proliferation of alpha cells. In particular, we found some pancreatic lobules showing a severe inflammation and degeneration of islet and acinar tissues in this model. Islets in these inflammatory lobules were smaller in size with only few cells. In contrast, any inflammatory responses and insulitis were not observed in pancreas of the rats fed obaeja in this model. The islets in those rats maintained their normal profiles and islet cell population. Such anti-cytotoxic effect was also monitored in the diabetic rats of osmotic pump/STZ model. Especially, occurrence of hyperglycemia in the obaeja fed rats was delayed by 25~30 days than that of diabetic control rats in this model. Taken together, these results imply that regulation of postprandial blood glucose level by obaeja feeding may ameliorate a secondary injury caused by glucotoxicity.