Associations of phase angle obtained by bioelectrical impedance analysis with muscle mass and strength in Japanese patients with type 2 diabetes.

The age-dependent decrease in muscle mass and function is known as sarcopenia. The risk of sarcopenia is higher in patients with diabetes, and assessment of muscle mass and function is especially important in patients with diabetes. Recent reports suggest that the phase angle (PhA), which is obtained from bioelectrical impedance analysis (BIA), may be a good marker of not only muscle mass but also muscle function in healthy people. However, the clinical significance of PhA in patients with diabetes has not been fully investigated. Therefore, we evaluated the association of PhA with muscle mass, muscle strength, and physical performance in 159 patients with type 2 diabetes (male 102; female 57) aged 40 to 89 years. We measured PhA and appendicular skeletal muscle index (SMI) by BIA and handgrip and leg extension strength and performed the Short Physical Performance Battery (SPPB). In a simple correlation analysis, both right and left PhA correlated with SMI, handgrip and leg extension strength, and SPPB score, and in multiple regression analysis, PhA on each side correlated with SMI and ipsilateral handgrip strength. These data suggest that PhA may be a useful marker of muscle mass, muscle strength, and physical performance in patients with type 2 diabetes. A large-scale prospective study should be performed to confirm the results and clarify the clinical usefulness of PhA in patients with diabetes.

Effects of cooked rice containing high resistant starch on postprandial plasma glucose, insulin, and incretin in patients with type 2 diabetes.

BACKGROUND AND OBJECTIVES: Few studies exist on resistant starch in rice grains. The Okinawa Institute of Science and Technology Graduate University (OIST) has developed a new rice (OIST rice, OR) rich in resistant starch. This study aimed to clarify the effect of OR on postprandial glucose concentrations. METHODS AND STUDY DESIGN: This single-center, open, randomized, crossover comparative study included 17 patients with type 2 diabetes. All participants completed two meal tolerance tests using OR and white rice (WR). RESULTS: The median age of the participants was 70.0 [59.0-73.0] years, and the mean body mass index was 25.9±3.1 kg/m2. The difference in total area under the curve (AUC) of plasma glucose was -8223 (95% confidence interval [CI]: -10100 to -6346, p<0.001) mg·min/dL. The postprandial plasma glucose was significantly lower with OR than with WR. The difference in the AUC of insulin was -1139 (95% CI: -1839 to -438, p=0.004) µU·min/mL. The difference in the AUC of total gastric inhibitory peptide (GIP) and total glucagon-like peptide-1 (GLP-1) was -4886 (95% CI: -8456 to -1317, p=0.011) and -171 (95% CI: -1034 to 691, p=0.673) pmol·min/L, respectively. CONCLUSIONS: OR can be ingested as rice grains and significantly reduced postprandial plasma glucose compared to WR independent of insulin secretion in patients with type 2 diabetes. OR could have escaped absorption not only from the upper small intestine but also from the lower small intestine.

Correlation between blood ketones and exhaled acetone measured with a semiconducting gas sensor.

Breath acetone (BrAce) has been reported to be useful for monitoring the pathophysiology of patients with diabetes. However, devices that measure BrAce are expensive, complex and uncommon. The FM-001, originally designed to monitor a marker of weight loss in healthy people, is a device for measuring BrAce. The FM-001 is a loading semiconducting gas sensor that is a simple and reusable device. The aim of this study was to evaluate the correlation between blood total ketone bodies (TKB) and BrAce measured with the FM-001 in patients with diabetes. Furthermore, through evaluation of that correlation, we sought to detect patients at high risk of developing diabetic ketoacidosis (DKA). Thirty-five participants (age 52 [40-57], T2DM 32, T1DM 3) were enrolled. Scatter plots and linear regression lines relating BrAce to TKB and the correlation coefficients were calculated. Receiver-operating characteristic analysis was performed to determine the cut-off for predicting patients prone to DKA. The results showed that BrAce strongly correlates with TKB (R= 0.828), and the correlation was stronger in patients whose serum C-peptide was not low. The optimal BrAce cut-off for predicting risk of developing DKA was 3400 ppb (AUC 0.924, sensitivity 73.3%, specificity 100%), which corresponds to a TKB ⩾ 1000µmol l-1. BrAce also weakly correlated with free fatty acid. Thus, BrAce levels measured with the FM-001 strongly correlate with TKB, even in patients with diabetes. This suggests the FM-001 is a simple and potentially useful method for detecting diabetic ketosis. (UMIN-ID: UMIN000038086).