Improvement of beta-cell function in conjunction with glycemic control after medical nutrition therapy in newly-diagnosed type 2 diabetes mellitus.

BACKGROUND: The current study aimed to reveal the correlation of beta-cell function and insulin sensitivity with glycemic control and weight control before and after medical nutrition therapy (MNT) in patients with newly-diagnosed type 2 diabetes mellitus. METHODS: We retrospectively analyzed consecutive 68 patients with newly-diagnosed type 2 diabetes mellitus who started MNT without antihyperglycemic medications and underwent a 75-g oral glucose tolerance test (OGTT) before and after the therapy. Beta-cell function was evaluated by the OGTT-derived disposition index, whereas insulin sensitivity was evaluated by Matsuda's insulin sensitivity index. RESULTS: After 4.0 ± 1.5 months of MNT, mean HbA1c and body mass index significantly decreased from 9.6 ± 1.8% to 7.2 ± 1.0% and from 26.9 ± 4.1 to 25.4 ± 3.7 kg/m2 (both P < 0.001), while the median disposition index and Matsuda's index significantly increased from 0.34 (0.20-0.68) to 0.88 (0.53-1.52) (P < 0.001) and from 4.70 (2.95-5.93) to 5.17 (3.48-6.89) (P = 0.003), respectively. The disposition index was significantly correlated with HbA1c levels both before and after MNT (r = -0.61 and -0.68; both P < 0.001). The magnitude of the correlation after MNT was not different from that before MNT (P = 0.42). Matsuda's index was correlated not with HbA1c levels but with body mass index, both before (r = 0.07 [P = 0.57] and r = -0.58 [P < 0.001]) and after MNT (r = -0.01 [P = 0.95] and r = -0.52 [P < 0.001]). CONCLUSIONS: Beta-cell function was improved in conjunction with glycemic control after MNT in patients with newly-diagnosed type 2 diabetes mellitus. Insulin sensitivity was linked with weight control rather than glycemic control.

The impact of oral carbohydrate-rich supplement taken two hours before caesarean delivery on maternal and neonatal perioperative outcomes -- a randomized clinical trial.

BACKGROUND: To evaluate the impact of oral carbohydrate-rich (Ch-R) supplement taken 2 hours before an elective caesarean delivery (CD) on maternal and neonatal perioperative outcomes. METHODS: Ninety pregnant women undergoing elective CD were randomized into the Ch-R group, placebo group and fasting group equally. Participants' blood was drawn at three time points, before intervention, immediately after and 1 day after the surgery to measure maternal and neonatal biochemical indices. Meanwhile women's perioperative symptoms and signs were recorded. RESULTS: Eighty-eight pregnant women were finally included in the study. Women who had drunk Ch-R supplement had lower postoperative insulin level (ß = - 3.50, 95% CI - 5.45 to - 1.56), as well as postoperative HOMA-IR index (ß = - 0.74, 95% CI - 1.15 to - 0.34), compared with women who had fasted. Additionally, neonates of mothers who were allocated in the Ch-R group also had a higher glucose level, compared with neonates of mothers in the fasting group (ß = 0.40, CI 0.17 to 0.62). CONCLUSION: Oral Ch-R solution administered 2 hours before an elective CD may not only alleviate maternal postoperative insulin resistance, but also comfort women's preoperative thirst and hunger, compared to fasting. Additionally, it may increase neonatal glucose level as well. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2000033163 . Data of Registration: 2020-5-22.

Ovarian insufficiency impairs glucose-stimulated insulin secretion through activation of hypothalamic de novo ceramide synthesis.

Oestrogens regulate body weight through their action on hypothalamus to modulate food intake and energy expenditure. Hypothalamic de novo ceramide synthesis plays a central role on obesity induced by oestrogen deficiency. Depletion in oestrogens is also known to be associated with glucose intolerance, which favours type 2 diabetes (T2D). However, the implication of hypothalamic ceramide in the regulation of glucose homeostasis by oestrogen is unknown. Here, we studied glucose homeostasis and insulin secretion in ovariectomized (OVX) female rats. OVX induces body weight gain associated with a hypothalamic inflammation and impaired glucose homeostasis. Genetic blockade of ceramide synthesis in the ventromedial nucleus of the hypothalamus (VMH) reverses hypothalamic inflammation and partly restored glucose tolerance induced by OVX. Furthermore, glucose-stimulated insulin secretion (GSIS) is increased in OVX rats due to a raise of insulin secretion second phase, a characteristic of early stage of T2D. In contrast, GSIS from isolated islets of OVX rats is totally blunted. Inhibition of ceramide synthesis in the VMH restores GSIS from isolated OVX islets and represses the second phase of insulin secretion. Stimulation of oestrogen receptor α (ERα) by oestradiol (E2) down-regulates ceramide synthesis in hypothalamic neuronal GT1-7 cells but no in microglial SIM-A9 cells. In contrast, genetic inactivation of ERα in VMH upregulates ceramide synthesis. These results indicate that hypothalamic neuronal de novo ceramide synthesis triggers the OVX-dependent impairment of glucose homeostasis which is partly mediated by a dysregulation of GSIS.

Molecular mechanisms from insulin-mimetic effect of vitamin D: treatment alternative in Type 2 diabetes mellitus.

Diabetes mellitus is a complex and multifactorial disease with a global prevalence that exceeds 425 million people. Type 2 diabetes mellitus (T2DM) is characterized by a state of insulin resistance, which leads to metabolic alterations that aggravate the state of health of people. Vitamin D deficiency appears to play an important role in the triggering mechanisms of insulin resistance. In this review, an analysis is made of the biochemical mechanisms associated with the insulin-mimetic effect of vitamin D, its supplementation being a possible nutritional strategy for the T2DM treatment. The current scientific evidence is extensive regarding the dose of vitamin D used for an insulin-mimetic effect. However, clinical trials and systematic reviews show statistical differences on glucose, insulin, and glycated hemoglobin levels of patients with T2DM, associated with activation mechanisms of transcription factors related to genes of the glucide metabolism and the insulin receptor, and the regulation of intracellular Ca2+ insulin concentrations. Likewise, an indirect mechanism associated with antioxidant and anti-inflammatory effects has been shown that also leads to sensitivity to the insulin receptor. The use of a specific dose of vitamin D could be an effective alternative in the T2DM treatment, which would reduce the risk of complications derived from hyperglycemia.

The acute effects of vinyasa flow yoga on vascular function, lipid and glucose concentrations, and mood.

While the chronic effects of certain styles of yoga on cardiometabolic factors have been investigated, little is known about the acute effects of a single yoga session on these outcomes. Moreover, vinyasa yoga's potential to modulate cardiometabolic outcomes has not been established. The purpose of this study is to determine the acute effects of a vinyasa yoga session on arterial stiffness, wave reflection, lipid and glucose concentrations, and mood in adults with prior yoga experience. Thirty yoga practitioners with a minimum of 3 months of practice experience were enrolled into the study. Carotid-femoral pulse wave velocity (cf-PWV), augmentation index (AIx), lipid profile, glucose concentrations, and mood (Positive and Negative Affect Scale) were assessed at baseline and immediately following a 1 -h vinyasa yoga session. After the yoga session, participants had significantly lower AIx (p < 0.001), non-HDL cholesterol (p < 0.05), and negative affect (p < 0.01) compared to baseline. These results highlight the efficacy of a single bout of yoga in altering wave reflection while improving mood and lipid concentrations in healthy adults with a history of yoga practice.

Placental Inositol Reduced in Gestational Diabetes as Glucose Alters Inositol Transporters and IMPA1 Enzyme Expression.

CONTEXT: Perturbed inositol physiology in insulin-resistant conditions has led to proposals of inositol supplementation for gestational diabetes (GDM) prevention, but placental inositol biology is poorly understood. OBJECTIVE: Investigate associations of maternal glycemia with placental inositol content, determine glucose effects on placental expression of inositol enzymes and transporters, and examine relations with birthweight. DESIGN AND PARTICIPANTS: Case-control study of placentae from term singleton pregnancies (GDM n = 24, non-GDM n = 26), and culture of another 9 placentae in different concentrations of glucose and myo-inositol for 48 hours. MAIN OUTCOME MEASURES: Placental inositol was quantified by the Megazyme assay. Relative expression of enzymes involved in myo-inositol metabolism and plasma membrane inositol transport was determined by quantitative RT-PCR and immunoblotting. Linear regression analyses were adjusted for maternal age, body mass index, ethnicity, gestational age, and sex. RESULTS: Placental inositol content was 17% lower in GDM compared with non-GDM. Higher maternal mid-gestation glycemia were associated with lower placental inositol. Increasing fasting glycemia was associated with lower protein levels of the myo-inositol synthesis enzyme, IMPA1, and the inositol transporters, SLC5A11 and SLC2A13, the expression of which also correlated with placental inositol content. In vitro, higher glucose concentrations reduced IMPA1 and SLC5A11 mRNA expression. Increasing fasting glycemia positively associated with customized birthweight percentile as expected in cases with low placental inositol, but this association was attenuated with high placental inositol. CONCLUSION: Glycemia-induced dysregulation of placental inositol synthesis and transport may be implicated in reduced placental inositol content in GDM, and this may in turn be permissive to accelerated fetal growth.

Potato Preload Mitigated Postprandial Glycemic Excursion in Healthy Subjects: An Acute Randomized Trial.

This study investigated the preload effect of the medium and high glycemic index (GI) potato, as well as the combination of partially hydrolyzed guar gum (HG) and potato, when ingested prior to a rice meal, on the iso-carbohydrate basis. In a randomized crossover trial, 17 healthy female subjects consumed (1) rice; (2) co-ingestion of highly cooked potato (HP), and rice (HP + R); (3) co-ingestion of minimally cooked potato (MP) and rice (MP + R); (4) preload HP prior to rice meal (PHP + R); (5) preload MP prior to rice meal (PMP + R); (6) co-ingestion of partially hydrolyzed guar gum (HG), HP and rice (HG + HP + R); (7) preload HG prior to co-ingestion of HP and rice (PHG + HP + R); (8) co-preload of HG and HP prior to rice (PHG + PHP + R); and (9) preload of HP prior to co-ingestion of HG and rice (PHP + HG + R). Postprandial glycemic response (GR) tests and subjective satiety tests were conducted for each test food. Cooked potato as a preload to a rice meal could significantly cut the acute postprandial glycemic excursion by around 1.0 mmol/L, irrespective of the GI of the preload. Co-preload of partial hydrolyzed guar gum and highly cooked potato (PHG + PHP + R) resulted in improved acute GR in terms of peak glucose value and glycemic excursion compared with either HG preload or HP preload. All the meals with preload showed comparable or improved self-reported satiety. Within an equicarbohydrate exchange framework, both high-GI and medium-GI potato preload decreased the postprandial glycemic excursion in young healthy female subjects. The combination of HG and HP as double preload resulted in better GR than both single HG or HP preload did.

Glycemic and Insulinemic Responses of Vegetables and Beans Powders Supplemented Chapattis in Healthy Humans: A Randomized, Crossover Trial.

Vegetables and beans are nutrient-dense foods with innate potential to mediate diabetes in a variety of cultures. The present study aims at evaluating vegetables and beans for assessing their glycemic index and response in raising glucose levels in human model. Powdered formulations of vegetables and beans were designed to modulate glycemic response of carbohydrate-rich staples. A randomized, crossover trial was conducted in healthy young adults (n = 24) who were challenged with vegetable powder-supplemented chapatti (VPSC), bean powder-supplemented chapatti (BPSC) and all-purpose wheat flour chapatti (APFC) to evaluate their postprandial glucose (PPG) and postprandial insulin (PPI) responses. In comparison with APFC, feeding VPSC and BPSC to healthy volunteers anticipated significant reduction in PPG (44% reduction in incremental area under the curve (AUC) for VPSC and 46% reduction in incremental AUC for BPSC, p = 0.005). Likewise, significant reduction in PPI levels was observed for VPSC (59%, p = 0.012) and BPSC (47%, p = 0.002) compared to APFC-treated group. The study concludes wheat flour enrichment with vegetables and beans powder as a viable approach to develop cost effective and culturally acceptable low glycemic foods bearing acceptable sensory attributes.

Demographic, health behavior, and cardiometabolic risk factor profile in yoga and non-yoga participants: NHANES 1999-2006.

OBJECTIVE: To examine and compare the demographic, health behavior, and cardiometabolic risk factor characteristics of participants who report 1) participating in yoga, 2) not participating yoga, or 3) are inactive, using a nationally representative sample of U.S. adults. DESIGN: Study participants were from the 1999-2006 National Health and Nutrition Examination Survey (NHANES) who self-reported participation in yoga (n = 74), no-yoga (n = 3,753) or were inactive (n = 1,285). Participants in the no-yoga group did engage in other types of physical activity, while the inactive group reported no activity during the survey period. RESULTS: Yoga participants were primarily female (80.7%), college educated (51.9%), mostly non-smokers (46.9%), and reported moderate alcohol consumption (72.1%). Yoga participants were found to be significantly less likely to have an elevated waist circumference (OR = 0.40, p < 0.01; OR = 0.30, p < 0.01), and a low HDL (OR = 0.43, p = 0.03; OR = 0.34, p < 0.05) compared to both non-yoga participants and inactive individuals, respectively. Yoga participants were 61% less likely to have elevated blood glucose compared to non-yoga participants (OR = 0.39, p < 0.05). Compared to inactive individuals, yoga participants were 52% (OR = 0.48, p < 0.05) and 66% (OR = 0.34, p < 0.05) less likely have an elevated body mass index and have elevated triglyceride levels, respectively. CONCLUSIONS: Given the emergence of yoga as a common form of physical activity, it is imperative to understand the characteristics of those who participate in yoga to further understand its relationship with cardiovascular risk. This study was one of the first to use nationally-representative data and objectively measured cardiometabolic variables. Key Words: complementary medicine, epidemiology, survey, population, physical activity, cardiovascular disease.

The effects of passive stretching on the blood glucose levels of patients with type 2 diabetes.

BACKGROUND: Type 2 diabetes is characterized by poor glycemic control due to decreased insulin sensitivity. Physical activity plays an important role in the management of diabetes and reduces blood glucose level. The aim of this study was to evaluate the effectiveness of passive stretching (PS) on the blood glucose level (BGL) of diabetic patients. MATERIALS AND METHODS: In this randomized clinical trial, fifty patients with type 2 diabetes and mean age of 50.7 ±â€¯4.8 years were randomly and equally allocated into control and intervention groups. Patients in the intervention and control groups underwent 20 min of passive stretching (PS) and passive movement (PM), respectively. BGL was measured before and immediately after, 20 min after and 1 h after PS/PM in the two study groups. BGL at the mentioned times was compared between and within the groups. RESULTS: The findings showed that when compared with before the PS (195.7 ±â€¯30.1), BGL significantly reduced (p < 0.001) immediately after (178.9 ±â€¯29.7), 20 min after (183.2 ±â€¯29.1), and 1 h after (187.8 ±â€¯29.6) the PS. However, BGL after PM (immediately, 20 min and 1 h after PM) did not significantly change (p > 0.05). CONCLUSION: The findings of this study indicated that PS has a significant effect on the reduction of the immediate BGL in type 2 diabetic patients. The trend reduced even though the effect remained for 1 h after PS. It is therefore suggested that the effectiveness of these types of activities should be evaluated over a longer duration of study.

Spontaneous and transient hyperglycemia before sleep in a patient with glaucomatous blindness and diabetes: A case reprt.

RATIONALE: The peak of blood glucose was during 9 PM to 3 AM. There is a stable, spontaneous and short-term abnormal increase of blood glucose. The pathophysiological mechanism is unknown. It is speculated that the cause might be the imbalance of the glucose-regulating hormone that is caused by the disorder of the biological clock system. PATIENT CONCERNS: The case was a 73-year old man with bilateral glaucoma (only mild light perception) and was hospitalized to establish a viable hypoglycemic plan. He received 4 shots of insulin enhancement, oral meditation, pre-mixed insulin treatment during the 22 days. However, his blood glucose had been spontaneously increased from 9 PM to 3 AM which was the highest of the day, and then resumed by itself. Insulin intervention was effective. DIAGNOSIS: Glaucomatous blindness and diabetes, spontaneous and transient hyperglycemia before sleep. INTERVENTIONS: We used insulin aspart 3u when we found hyperglycemia three times at 9 PM and it was effective. Without intervention, blood sugar will automatically improve in the morning. OUTCOMES: During the late night and early morning, there is a stable, spontaneous and short-term transit abnormal increase in blood glucose, which suggests the complexity of blood glucose adjustment. LESSONS: Due to the case specialty, we could not do the systematic review of the study. However, it improves the awareness of the abnormal periodically increase of blood glucose during the special periods, and provides with a reference for clinical research of dawn and dusk phenomenon. Multi-point blood glucose monitoring or dynamic blood glucose monitoring throughout the day is of great significance for the detection of special types of hyperglycemia.

Different training durations and styles of tai chi for glucose control in patients with type 2 diabetes: a systematic review and meta-analysis of controlled trials.

BACKGROUND: Physical activity is an important part of the diabetes management plan. However, the effects caused by different training durations and styles of Tai Chi have not been evaluated. We conducted an updated systematic review of the effects of Tai Chi on patients with type 2 diabetes based on different training durations and styles. METHODS: We performed a search for Chinese and English studies in 8 databases. Two reviewers independently selected the eligible trials and conducted a critical appraisal of the methodological quality. RESULTS: Seventeen trials were included. Tai Chi was found to have reduced fasting blood glucose (FBG) [SMD = - 0.54, 95% CI (- 0.91, - 0.16), P = 0.005] and HbA1c [SMD = - 0.68, 95% CI (- 1.17, - 0.19), P = 0.006] overall, compared with a control group. Considering the subgroup analysis, the pooled results showed that 24 movements or Yang-style Tai Chi did not significantly reduce FBG after a duration of ≤3 months [SMD = - 0.46, 95% CI (- 1.42, 0.50), P = 0.35] or > 3 months [SMD = - 0.50, 95% CI (- 1.49, 0.49), P = 0.32], nor did it reduce HbA1c [SMD = - 1.22, 95% CI (- 2.90, 0.47), P = 0.16] after a duration > 3 months in all studies. However, other styles of Tai Chi significantly reduced FBG [SMD = - 0.90, 95% CI (- 1.28, - 0.52), P < 0.00001] and HbA1c [SMD = - 0.90, 95% CI (- 1.28, - 0.52), P < 0.00001] after a duration > 3 months, while no significant reduction in FBG [SMD = - 0.34, 95% CI (- 0.76, 0.08), P = 0.12] or HbA1c [SMD = - 0.34, 95% CI (- 0.76, 0.08), P = 0.12] was found after a duration ≤3 months. CONCLUSIONS: Tai Chi seems to be effective in treating type 2 diabetes. Different training durations and styles result in variable effectiveness. The evidence was insufficient to support whether long-term Tai Chi training was more effective.

Effects of nutritional nursing intervention based on glycemic load for patient with gestational diabetes mellitus.

OBJECTIVES: To determine the effects of nutritional nursing intervention based on glycemic load (GL) for patients with gestational diabetes mellitus. MATERIAL AND METHODS: One hundred thirty-four patients diagnosed with gestational diabetes mellitus at our hospital were selected from March 2015 to March 2017 and randomly divided into the observation (n = 67) and control groups (n = 67). All of the patients in the observation and control groups received conventional nutritional nursing. In addition, the patients in the observation group received nutritional nursing intervention based on GL. The changes in blood glucose levels and pregnancy outcomes were compared between the two groups after intervention. RESULTS: There were significant differences in fasting blood glucose (FBG) and the 2h postprandial glucose (2hPG) levels between the two groups (P < 0.05). There was a lower incidence of premature delivery, fetal macrosomia, eclampsia, preg- nancy hypertension syndrome, and fetal distress in the observation group. CONCLUSIONS: Nutritional nursing intervention based on GL is more effective than traditional nutritional nursing for patients with gestational diabetes, and can effectively control the blood glucose level, reduce the incidence of pregnant complica- tions, and improve the pregnancy outcome. Thus, nutritional nursing intervention based on GL deserves to be popularized.

Influence of Sodium Glucose Cotransporter 2 Inhibition on Physiological Adaptation to Endurance Exercise Training.

CONTEXT: The combination of two beneficial antidiabetes interventions, regular exercise and pharmaceuticals, is intuitively appealing. However, metformin, the most commonly prescribed diabetes medication, attenuates the favorable physiological adaptations to exercise; in turn, exercise may impede the action of metformin. OBJECTIVE: We sought to determine the influence of an alternative diabetes treatment, sodium glucose cotransporter 2 (SGLT2) inhibition, on the response to endurance exercise training. DESIGN, PARTICIPANTS, AND INTERVENTION: In a randomized, double-blind, repeated measures parallel design, 30 sedentary overweight and obese men and women were assigned to 12 weeks of supervised endurance exercise training, with daily ingestion of either a placebo or SGLT2 inhibitor (dapagliflozin: ≤10 mg/day). OUTCOME MEASUREMENTS AND RESULTS: Endurance exercise training favorably modified body mass, body composition (dual-energy x-ray absorptiometry), peak oxygen uptake (graded exercise with indirect calorimetry), responses to standardized submaximal exercise (indirect calorimetry, heart rate, and blood lactate), and skeletal muscle (vastus lateralis) citrate synthase activity (main effects of exercise training, all P < 0.05); SGLT2 inhibition did not influence any of these physiological adaptations (exercise training × treatment interaction, all P > 0.05). However, after endurance exercise training, fasting blood glucose was greater with SGLT2 inhibition, and increased insulin sensitivity (oral glucose tolerance test/Matsuda index) was abrogated with SGLT2 inhibition (exercise training × treatment interaction, P < 0.01). CONCLUSION: The efficacy of combining two beneficial antidiabetes interventions, regular endurance exercise and SGLT2 inhibition, was not supported. SGLT2 inhibition blunted endurance exercise training-induced improvements in insulin sensitivity, independent of effects on aerobic fitness or body composition.

Long-term effects of honey on cardiovascular parameters and anthropometric measurements of postmenopausal women.

OBJECTIVE: To investigate the long-term effects of Tualang Honey versus Honey Cocktail (mixture of honey, bee bread, and royal jelly) on cardiovascular markers and anthropometric measurements of postmenopausal women. METHODS: We conducted a randomised, double blinded, two-armed parallel study comparing 20 g/day of Tualang Honey versus 20 g/day Honey Cocktail among postmenopausal women aged 45-65 years. The cardiovascular parameters and anthropometrics measurements were assessed at baseline, 6 months, and 12 months of the intervention. RESULTS: 100 subjects were successfully randomised into the groups. There was a significant decrease in the diastolic blood pressure from 77.92 mmHg at baseline to 73.45 mmHg at 12 months (F-statistic = 2.55, p-value = 0.047) in the Tualang Honey group compared to Honey Cocktail. There was also a significant decrease in the fasting blood sugar from 6.11 mmol/L at baseline to 5.71 mmol/L at 12 months (F-statistic = 4.03, p-value = 0.021) in the Tualang Honey group compared to the Honey Cocktail group. The body mass index remained unchanged at 27 kg/m2 (F-statistic = 1.60, p-value = 0.010) throughout 12 months of the intervention in the Honey Cocktail group. CONCLUSION: Subjects who received Honey Cocktail showed remarkable effects on body mass index. However, Tualang Honey supplementation showed superior effect in lowering diastolic blood pressure and fasting blood sugar compared to Honey Cocktail. Further studies are required to ascertain the underlying mechanism(s) of Tualang Honey and Honey Cocktail on each observed parameter.

Capillary glycaemia responses to strength exercises performed before or after high-intensity interval exercise in Type 1 diabetes under real-life settings.

This study investigated the influence of performing strength exercises before or after high-intensity interval exercise on glycaemia during and postexercise in T1DM patients. Nine physically active adults with T1DM executed 30 min of strength exercises (SE) (3 sets at 10 RM) before 30 min of high-intensity interval exercise (HIIE) (10 × 60-s bout at ∼90% HRmax interspersed with 60 s recovery) (SE + HIIE) or performed the reverse order (HIIE + SE) or rested in this period. Capillary glucose levels were measured each 15 min during and 60 min postexercise recovery. Significant lower glucose levels were observed in SE + HIIE at 60, 75 and 90 min, in comparison with REST. HIIE + SE lowered glycaemia at 30, 45 and 60 min compared with baseline concentrations, while SE + HIIE postponed this glucose decayment to 60 min, when compared with baseline levels. An increased glycaemia at 105 min compared with end-exercise levels were also observed in HIIE + SE. Carbohydrates ingested during exercise to correct hypoglycemia, insulin dosage at same day before and after protocols, and nocturnal hypoglycemia episodes were similar among the three conditions. It is concluded that the performance of HIIE before SE decreases glycaemia already at the end of first exercise modality, while the reverse order postpones it to the end of second exercise, although HIIE + SE improves glycemic stability throughout recovery. T1DM patients who tend to develop exercise-associated hypoglycemia may perform strength exercises before high-intensity interval exercise in a single session.

Hyperglycemia elicits anxiety-like behaviors in zebrafish: Protective role of dietary diphenyl diselenide.

Diabetes mellitus (DM) is a chronic metabolic disease that may comorbid with various psychiatric disorders, such as anxiety and depression. The search for effective therapeutics to alleviate hyperglycemia and complications resulting from DM is continuous. Here we investigate the effects of diphenyl diselenide (DD), an organoselenium compound with several pharmacological properties, in a zebrafish model of hyperglycemia. Fish were fed for 74 days with a diet containing 3 mg/Kg DD, a concentration chosen after experiments based in a dose-response curve (DD 1, 2 and 3 mg/Kg) that did not cause overt toxicity (mortality, weight loss and neurobehavioral deficits). In the last 14 days of the experimental period, fish were concomitantly exposed to a glucose solution (111 mM). Afterwards, blood glucose levels, brain selenium (Se) content, and behavioral analysis aiming to assess anxiety-like behaviors and locomotor/exploratory activities were performed. In the novel tank diving test, glucose decreased vertical exploration and fish spent less time in the lit area when tested in the light-dark test, suggesting increased anxiety-like behavior. Moreover, DD decreased blood glucose levels in hyperglycemic fish as well as prevented the development of anxiety-related symptoms. DD diet alone did not change glycemia and behavioral parameters, but increased Se levels in the brain without affecting the cellular viability. Collectively, our findings highlight the growing utility of this zebrafish hyperglycemia model as a valuable strategy for further research in DM field and neuroprotective approaches.

Association between mindfulness and interoceptive accuracy in patients with diabetes: Preliminary evidence from blood glucose estimates.

OBJECTIVE: Mindfulness-based interventions, which increase dispositional mindfulness, may be useful adjunctive therapies for patients with chronic diseases, including diabetes. One way that mindfulness may benefit patients with diabetes is by fostering more accurate interoception, particularly in the form of blood glucose estimate accuracy. Many people with diabetes regulate their behavior based on estimates of their blood glucose levels from interoception, but they vary in estimate accuracy. Therefore, our objective was to conduct a preliminary test of the hypothesis that, in a sample of patients with diabetes, more mindful individuals would demonstrate greater blood glucose estimate accuracy. METHODS: In a cross-sectional study, patients (N=28) with type 2 diabetes estimated their blood glucose levels immediately before their actual levels were assessed. Participants also completed two measures of mindfulness: one assessing general dispositional mindfulness and another assessing mindfulness specifically in the face of difficulty. RESULTS: Although general dispositional mindfulness was unrelated to blood glucose estimate accuracy, individuals who reported more mindfulness during difficulties were approximately four times more likely to meet established accuracy criteria. CONCLUSIONS: Mindfulness specifically during difficulties might play a role in disease-relevant interoception for patients with diabetes. Future research should aim to replicate this finding in larger and different samples, and to examine the potential role of mindfulness during difficulties in mindfulness-based interventions for patients with diabetes.

Glucose Homeostasis and Effect of Chelation on ß Cell Function in Children With ß-Thalassemia Major.

OBJECTIVE: To assess the prevalence of impaired glucose tolerance in ß-thalassemia major and correlate it with chelation therapy. MATERIALS AND METHODS: Sixty-seven subjects with ß-thalassemia major, aged 1 to 20 years, were enrolled in our prospective cohort. Clinical details were recorded. Baseline oral glucose tolerance test, serum insulin, C peptide, and insulin resistance were measured. The biochemical profile was repeated after 6 months. RESULTS: The mean age of subjects was 7.43±4.48 years. Eight (11.9%) subjects had impaired fasting glucose, 7 (10.4%) had impaired glucose tolerance, and 1 (1.4%) subject had diabetes at baseline. Subjects with abnormal glucose profile had longer disease duration (95% confidence interval [CI] of difference=-6.64 to -0.68; P=0.019) and higher fasting blood glucose (95% CI of difference=-32.1 to -10.5; P=0.001) and serum ferritin (95% CI of difference=-219.8 to -3.4; P=0.001) than normoglycemic subjects. Insulin resistance and serum ferritin showed significant increase at 6 months (P<0.001 and P=0.001, respectively). Patients on deferiprone alone significantly improved glucose homeostasis on follow-up than those on desferrioxamine or combination therapy of desferrioxamine and deferiprone (P<0.05). CONCLUSIONS: Prolonged disease duration and higher serum ferritin adversely affects glucose homeostasis in thalassemic children. Deferiprone was the most effective chelator to improve glucose homeostasis in chronically transfused thalassemics.