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1.
Food Chem ; 339: 127887, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32877815

RESUMO

The effect of yoghurt and curd cheese additions on pasting properties, starch digestibility and estimated glycemic index of wheat bread were studied. Yoghurt and curd cheese incorporations (6% up to 25% w/w) promoted considerable changes on starch performance based on gelatinization and final dough consistency properties. These changes led to a significant impact on starch digestibility, reducing significantly the rapidly digestible starch while increasing the resistant starch. The estimated glycemic index reflected the changes promoted on starch performance from both dairy products addition, at higher level tested (25%): a significant reduction of around 30% for yoghurt bread and 38% for curd cheese bread, was obtained, resulting in medium to low (55-69) glycemic index breads. Correlations were found between pasting properties, starch digestibility and glycemic index, revealing that the effects observed are proportional to the levels of dairy products added. Microstructure images of the starch granules supported these findings.


Assuntos
Pão/análise , Queijo/análise , Índice Glicêmico , Amido/metabolismo , Triticum/química , Iogurte/análise , Digestão , Farinha/análise , Reologia
2.
Diabetes Metab Syndr ; 14(6): 1963-1966, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33059299

RESUMO

BACKGROUND AND AIMS: A national lockdown to prevent the spread of coronavirus disease (COVID-19) in Turkey was introduced in March 2020. We think that lockdowns may lead to weight gain and worsening of glycemic parameters in patients with type 2 diabetes mellitus (DM). The purpose of this study was to investigate how type 2 DM patients were affected by the lockdown. METHOD: Type 2 DM patients unable to attend regular follow-ups due to lockdown over a 75-day period between March and June 2020 and who again attended polyclinic follow-up when the lockdown was lifted were included in the study. These patients' glycemic control and weight status were compared with the pre-lockdown period. In addition, patients' general habits, and adherence to diet and exercise were evaluated, while their general health was assessed using the Short-Form 36-item survey. RESULT: The research involved 101 type 2 DM patients, 57 men (56.5%) and 44 women (44.5%), with a mean age of 55 ± 13. Patients' mean pre-lockdown weight was 84.7 ± 16.4 kg, rising to 85.5 ± 16.8 kg post-lockdown, although the increase was not statistically significant (p = 0.781). In terms of glycemic parameters, Hba1c rose from 7.67 ± 1.76 to 8.11 ± 2.48, and fasting glucose from 157.9 (83-645) mg/dl to 163.2 (84-550) mg/dl, none of which were statistically significant (p = 0.253, p = 0.079, respectively). CONCLUSION: In addition to weight gain among type 2 DM patients during the Covid 19 lockdown, statistically insignificant increases were also observed in such glycemic parameters. This was a small sample and further studies with larger sample are needed.


Assuntos
Glicemia/metabolismo , /epidemiologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Quarentena/tendências , Adulto , Idoso , Feminino , Seguimentos , Índice Glicêmico/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Turquia/epidemiologia , Ganho de Peso/fisiologia
3.
Diabetes Metab Syndr ; 14(6): 1967-1972, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33059300

RESUMO

BACKGROUND AND AIMS: COVID-19 pandemic and lockdown measures to contain it have affected health care services globally. This study aims to assess the effect and urban-rural differences of COVID19 pandemic on diabetes care. METHODS: This cross-sectional study was conducted among persons with diabetes (PWDs) registered for care at a diabetes clinic of a tertiary care center in Southern India. We collected following information by telephonic interviews: physician consultations, access to diabetes medications and blood sugar tests, use of telemedicine services, out of pocket expenditure and psychological morbidity. RESULTS: A total of 350 PWDs were interviewed. Majority were male (78%) and from rural areas (79%). One fourth (24%) met any physician for diabetes care at least once during lockdown. PWDs from rural areas mainly consulted a physician in a private clinic (55%) compared to urban areas (26%). Two third (65%) availed medications from private medical shops. Almost half (46%) got their blood sugar tested during and majority of them (81%) reported unsatisfactory glycemic control. Only few (5%) was aware and three utilized telemedicine services. Almost all (99%) spent money (US $ 8.3) for diabetes care. One third (33%) had moderate or high psychological distress. CONCLUSIONS: Majority of PWDs did not consult a physician during lockdown. Cost of care was high. Measures to improve utilisation of telemedicine services and peripheral health facilities are needed.


Assuntos
/epidemiologia , Diabetes Mellitus/epidemiologia , Índice Glicêmico/fisiologia , Quarentena/tendências , População Rural/tendências , Centros de Atenção Terciária/tendências , Adulto , Idoso , /terapia , Estudos Transversais , Diabetes Mellitus/sangue , Diabetes Mellitus/terapia , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Quarentena/métodos , Comportamento de Redução do Risco , Telemedicina/métodos , Telemedicina/tendências
4.
Artigo em Inglês | MEDLINE | ID: mdl-33081057

RESUMO

Different lines of evidence indicate that knowledge of low-glycemic index (GI) foods and the practice of eating them play important roles in blood glucose management and preventing T2DM in women with prior gestational diabetes mellitus (GDM). According to the theory of planned behavior (TPB), intention is a critical factor in complying with health-related behaviors. However, an instrument for assessing the intention to eat low-GI foods is lacking in China. We aimed to (1) adapt and validate a Chinese version of the intentions to eat low-GI foods questionnaire (CIELQ) and (2) apply the CIELQ among rural Chinese women to explore the associations between CIELQ scores and glycemic status. A cross-sectional study was conducted on 417 nondiabetic, nonpregnant participants with a history of GDM in Hunan, China. After cultural adaptation and validation, the CIELQ was applied in a target population. Glycemic status, anthropometric variables, dietary intake, and physical activity were measured; a self-developed, standard questionnaire was applied to collect relevant information. The CIELQ showed good internal consistency; model fitness was acceptable based on the confirmatory factor analysis results. Awareness of the glycemic index was low among the study population. TPB factors were found to be associated with each other; education level and parents' diabetes history were associated with specific factors. The score for instrumental attitude showed a positive association with the risk for a high level of the 2-h 75-g oral glucose tolerance test (odds ratio, OR = 1.330), while the score for perceived behavior control (PBC) showed a negative association with the risk for a high level (OR = 0.793). The CIELQ was determined to be a valid instrument for assessing the intention to eat a low-GI diet among the study population. The awareness of the GI was poor among the study population. The score for instrumental attitude showed a positive association with the risk of a high level on the 2-h 75-g oral glucose tolerance test (OGTT), and the score for PBC showed a negative association with the risk for a high level on OGTT.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Diabetes Gestacional/prevenção & controle , Fibras na Dieta/administração & dosagem , Comportamento Alimentar/psicologia , Índice Glicêmico , Comportamentos Relacionados com a Saúde , Intenção , Inquéritos e Questionários/normas , Adulto , China , Estudos Transversais , Diabetes Gestacional/psicologia , Feminino , Alimentos , Humanos , Gravidez , População Rural
5.
Medicine (Baltimore) ; 99(40): e22337, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019410

RESUMO

At present, glycated hemoglobin (HbA1c) and glycated albumin (GA) are used to evaluate glycemic control in diabetic patients, but they cannot reflect insulin deficiency and/or insulin resistance.We investigated the feasibility of using estimated average glucose to fasting plasma glucose ratio (eAG/fPG ratio) to estimate insulin resistance in young adult diabetes. A total of 387 patients with type 2 diabetes were included and were stratified into 2 groups based on median values of the glycemic index ratio: the GA/A1c ratio <2.09 (n = 91) and ≥2.09 (n = 296); the eAG/fPG ratio <1.69 (n = 155) and ≥1.69 (n = 232). HbA1c, GA, fructosamine, insulin, and C-peptide levels were measured. The ratio of GA to HbA1c was calculated, and the homeostasis model assessment of ß-cell function and insulin resistance were determined. The homeostasis model assessment of insulin resistance level was significantly associated with the eAG/fPG ratio, but not with the ratio of GA to HbA1c, GA, HbA1c, and fructosamine levels. The ratio of estimated average glucose to fasting plasma glucose level correlates with insulin resistance in young adult diabetes.


Assuntos
Glicemia/análise , Diabetes Mellitus Tipo 2/sangue , Jejum/metabolismo , Resistência à Insulina/fisiologia , Adolescente , Adulto , Peptídeo C/sangue , Criança , Feminino , Frutosamina/sangue , Hemoglobina A Glicada/análise , Índice Glicêmico , Humanos , Insulina/sangue , Masculino , Albumina Sérica/análise , Adulto Jovem
6.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(7): 461-468, ago.-sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194703

RESUMO

INTRODUCCIÓN Y OBJETIVOS: La eficacia y seguridad de los protocolos de manejo de la hiperglucemia hospitalaria con pautas basal-bolo están ampliamente demostradas, pero su implementación es insuficiente. El objetivo del estudio fue valorar la implantación y determinar la eficacia y seguridad de un protocolo de manejo de la hiperglucemia hospitalaria basado en la terapia basal-bolo y la incorporación de una enfermera consultora. MATERIAL Y MÉTODOS: La evaluación se realizó en 10 unidades de hospitalización. Se revisaron retrospectivamente los datos durante la hospitalización y a los 90 días tras el alta de 400 pacientes postimplantación y 200 pacientes preimplantación del protocolo. El grado de satisfacción de los profesionales se valoró mediante un cuestionario a los 12 meses de la implantación. RESULTADOS: La proporción de pacientes con pauta basal-bolo en el ingreso fue superior en el grupo postimplantación (58% frente a 9%, p < 0,001). La media de las glucemias prepandiales y al acostarse durante el ingreso fue menor en el grupo postimplantación (164 ± 41mg/dl frente a 196 ± 50 mg/dl, p < 0,001). La proporción de pacientes con glucemias > 300 mg/dl fue menor (36,3% frente a 50,5%; p < 0,001) y con glucemias < 70 mg/dl fue superior (15% frente a 9%, p = 0,040) en el grupo postimplantación. La adición e intensificación de la insulina fue la principal modificación del tratamiento al alta y se observó reducción significativa de la HbA1c a los 3 meses del alta en la fase postimplantación (p = 0,04). La valoración del protocolo por parte de los profesionales fue de 4,5 en una escala de 1 a 5. CONCLUSIONES: La incorporación de una enfermera consultora experta en diabetes como elemento central del programa de manejo de la hiperglucemia consigue que la mayoría de los pacientes hospitalizados con hiperglucemia reciban tratamiento con una pauta basal-bolo y una mejora del control glucémico durante la hospitalización y tras el alta


BACKGROUND AND AIMS: The efficacy and safety of inpatient hyperglycemia management protocols using basal-bolus regimens have been widely demonstrated, but their implementation is insufficient. The aim of the study was to assess implementation and to establish the efficacy and safety of inpatient hyperglycemia management protocol based on a basal-bolus regimen and the incorporation of a nurse consultant. MATERIAL AND METHODS: Evaluation was performed at 10 hospital units. Data were retrospectively reviewed during hospital stay and 90 days after discharge in 400 patients after protocol implementation and 200 patients before implementation. The degree of satisfaction of professionals was assessed using a questionnaire 12 months after implementation. RESULTS: The proportion of patients with basal-bolus regimens upon admission was higher in the postimplementation group (58% vs. 9%, P < 0.001). Mean pre-prandial and bedtime blood glucose levels during admission were lower in the postimplementation group (164 ± 41 mg/L vs. 196 ± 50 mg/dL, P < 0.001). After implementation, there were less patients with blood glucose levels > 300 mg/dL (36.3% vs. 50.5%, P < 0.001) and more patients with values < 70mg/dL (15% vs. 9%, P = 0.040). Insulin addition and intensification was the main change in treatment at discharge, and a significant HbA1c reduction was seen three months after discharge in the postimplementation phase (P = 0.04). The professionals assigned the protocol a score of 4.5 on a 1 to 5 scale. CONCLUSIONS: Incorporation of a nurse consultant expert in diabetes as key component of a hyperglycemia management program ensures that a majority of patients admitted to hospital for hyperglycemia receive treatment with a basal-bolus regimen and improves blood glucose control during hospital stay and after discharge


Assuntos
Humanos , Masculino , Feminino , Diabetes Mellitus/terapia , Implementação de Plano de Saúde/métodos , Hiperglicemia/terapia , Enfermeiras Clínicas , Consultores , Resultado do Tratamento , Protocolos Clínicos , Hospitalização , Hiperglicemia/enfermagem , Administração Hospitalar , Índice Glicêmico
7.
Artigo em Inglês | MEDLINE | ID: mdl-32867226

RESUMO

Background: Inflammation is considered as a predictor of cardiovascular diseases in type 2 diabetes mellitus. No previous studies have investigated the effect of low glycemic index (LGI) recipes of South Indian cuisine on the risk factors of cardiovascular disease in patients with diabetes. Aim: The aim of this randomized controlled trial was to evaluate the improvement in cardiovascular risk factors and blood glucose control, in patients with type 2 diabetes, after intervention with recipes of Kerala cuisine, from locally available whole grain cereals, low in glycemic index. Method: This was a prospective and randomized controlled study that was conducted over a period of 24 weeks. A total of 80 participants were recruited from the Department of Endocrinology and Diabetes Outpatient in Kerala, South India. All 80 patients had type 2 diabetes, and were aged between 35 and 65 years. Participants were randomly assigned and advised to follow either a LGI diet plan (n = 40) or their usual diet, which served as a control group (n = 40). The advice was reinforced throughout the study period. Anthropometric, biochemical parameters which included glycemic and cardio-metabolic parameters were measured according to standard procedures. T-tests were conducted to compare the differences between intervention and control groups, and the Pearson correlation coefficient was used to evaluate associations between the variables. Results: There were significant differences (p < 0.05) between the intervention and control groups with respect to weight, HbA1c, insulin, triglycerides, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), high sensitivity C-reactive protein (hs-CRP) and apolipoprotein B (ApoB). There was also a positive correlation between weight and blood glucose variables. ApoB was positively correlated with lipid profile and insulin levels. Conclusions: The long-term implementation of LGI diet of Kerala cuisine has been found to promote weight loss, enhance insulin sensitivity and reduce the cardiovascular risk.


Assuntos
Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/dietoterapia , Hemoglobina A Glicada/metabolismo , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Glicemia , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Índice Glicêmico , Humanos , Índia/epidemiologia , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
8.
Diabetes Res Clin Pract ; 170: 108469, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32987041

RESUMO

AIMS: This study aimed to investigate the association between dietary GI and GL and risk of GDM in a group of pregnant women in Iran. METHODS: A number of 812 pregnant women were recruited in their first trimester in a prospective study. A validated 117-item semi-quantitative food frequency questionnaire was used to assess usual dietary intakes of participants at study baseline. Dietary GI and GL were calculated based on earlier publications. GDM was diagnosed based on the results of a fasting plasma glucose concentration and a 50-g, 1-h oral glucose tolerance test at 24-28 weeks of gestation. Cox proportional hazards model was used to compute relative risks (RRs) and 95% confidence intervals (CI) for GDM. RESULTS: Mean ± SD of age and BMI of study participants was 29.4 ± 4.84 y and 25.14 ± 4.08 kg/m2, respectively at study baseline. Mean ± SD of dietary GI was 58 ± 7 and that of dietary GL was 176 ± 42. Overall, 28.4% (n = 231) of study population developed GDM at weeks 24-28 of pregnancy. After adjustment for potential confounding variables, we found that women in the highest tertile of dietary GL were 43% more likely to develop GDM than those in the lowest tertile (95% CI: 1.01, 2.00; P-trend = 0.03). However, no significant association was seen between dietary GI (RR for the highest tertile compared to the lowest: 0.85; 95% CI: 0.61, 1.20; P-trend = 0.37), and risk of GDM. CONCLUSIONS: We found that women with the highest dietary GL were at a greater risk of developing GDM during pregnancy. No significant association was seen between dietary GI and risk of GDM.


Assuntos
Diabetes Gestacional/epidemiologia , Dieta/métodos , Índice Glicêmico , Carga Glicêmica , Adulto , Inquéritos sobre Dietas , Jejum , Feminino , Teste de Tolerância a Glucose , Humanos , Irã (Geográfico)/epidemiologia , Gravidez , Primeiro Trimestre da Gravidez , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco
9.
Cancer Causes Control ; 31(12): 1069-1077, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32915323

RESUMO

PURPOSE: Diets with a high glycemic load (GL) or glycemic index (GI) may increase cancer risk. Findings from prior studies on the relationship between GL, GI, and lung cancer risk are inconsistent. We investigated this relationship in a large prospective cohort. METHODS: We analyzed data from the Southern Community Cohort Study, a prospective cohort that includes diverse racial groups predominantly low-income adults aged 40-79 in 12 southeastern states of the USA. We estimated dietary GL and GI values using data collected from food frequency questionnaires at baseline. Dietary GL and GI were energy adjusted by residual method and categorized into sex-specific quintiles. Cox proportional hazard regression was used to assess the associations between dietary GL, GI, and lung cancer risk. We further performed stratified analyses by various factors. RESULTS: Intakes of individual food items or food groups that commonly contribute to GL were similar between blacks and whites in the cohort. After excluding the first two years of follow-up, 947 incident lung cancers were ascertained among 55,068 participants. Neither dietary GL nor GI was significantly associated with incident lung cancer risk in the overall population (GL: Q5 vs. Q1, HR = 0.88, 95% CI 0.72-1.07, ptrend = 0.29; GI: Q5 vs. Q1, HR = 1.06, 95% CI 0.86-1.30, ptrend = 0.71), nor in subgroups of populations (ptrend > 0.05), in multivariable-adjusted analyses. CONCLUSION: Dietary GL and GI were not independently associated with incident lung cancer risk in a large understudied population.


Assuntos
Índice Glicêmico , Carga Glicêmica , Neoplasias Pulmonares/epidemiologia , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia
10.
Plant Foods Hum Nutr ; 75(4): 547-552, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32815037

RESUMO

The aim of this study was to investigate the in vitro starch digestibility and estimated glycemic index (eGI) of mung bean (Vigna radiata L.) as affected by endogenous proteins and lipids, and exogenous heat-processing methods. Results showed that the in vitro starch digestibility and eGI were significantly increased after the removal of protein, lipid, or both (P < 0.05). Moreover, the effects of endogenous proteins and lipids on the in vitro starch digestibility and eGI of mung bean followed the order: both protein and lipid removal > protein removal > lipid removal. In addition, heat-processing could make the slowly digestible starch and resistant starch convert to the rapidly digestible starch. The effects of different exogenous heat-processing methods on in vitro starch digestibility and eGI in the present study showed the following order: germination combined with cooking > high-pressure cooking > extrusion cooking > ordinary cooking. This study provided a crucial reference for the human with potential hyperglycemia to choose mung bean treated with ordinary cooking and without further protein and/or lipid removal.


Assuntos
Amido , Vigna , Digestão , Índice Glicêmico , Temperatura Alta , Humanos , Lipídeos
12.
J Food Sci ; 85(10): 3141-3149, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32857867

RESUMO

Hull-less barley (HLB), especially waxy HLB, contains many physiologically active ingredients; however, its poor processing performance and end-product quality are unfavorable. In this study, 80% waxy or normal HLB wholegrain flour (WGF) and 20% wheat flour were used for baking bread. The farinograph and pasting properties of composite powders, and the nutritional value, textural properties, and in vitro hydrolysis of resultant breads were evaluated. The addition of a high proportion of HLB WGFs significantly increased the nutritional value of breads, especially the ß-glucan contents of waxy HLB breads. The addition of HLB WGFs and a suitable amount of wheat gluten led to a lower degree of softening of HLB bread flours but improved its farinograph characteristics, such as higher water absorption rate, development time, stability time, and farinograph quality number. Although the sensory profiles of HLB breads were considerably lower than those of wheat bread, they still received a good overall acceptability from a panel of sensory evaluators. HLB breads, particularly the waxy types, exhibited higher hardness, gumminess, chewiness, and lower specific volume, glycemic index and equilibrium concentration in starch hydrolysis. After baking, the starch crystallinity of dough changed from A to V type, and the relative crystallinity decreased. Overall, waxy HLB breads had more nutritional value than normal HLB breads. Higher ß-glucan and total dietary fiber content in HLB might have a positive effect on the nutritional value of the resultant breads. However, high ß-glucan and total dietary fiber was also accompanied by a negative effect on the sensory quality and processing performance of the end product. PRACTICAL APPLICATION: The composite flour with 80 g hull-less barley wholegrain flour, 20 g wheat flour, and 30 g wheat gluten can be substituted in breadmaking. Compared to wheat bread, hull-less barley bread exhibited different but acceptable sensory properties and had more nutritional value, particularly the waxy one. Therefore, a high proportion of hull-less barley could be recommended for bread production.


Assuntos
Pão/análise , Farinha/análise , Manipulação de Alimentos/métodos , Hordeum/química , Amido/análise , Fibras na Dieta/análise , Digestão , Aditivos Alimentares/análise , Manipulação de Alimentos/instrumentação , Glutens/análise , Índice Glicêmico , Dureza , Humanos , Valor Nutritivo , Triticum/química
13.
Diabetes Res Clin Pract ; 169: 108386, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32853685

RESUMO

AIMS: This study evaluated the impact of previous glycemic control and in-hospital use of antidiabetic/antihypertensive drugs on the prognosis of COVID-19 patients with diabetes. METHODS: In this retrospective cohort study, consecutive inpatients with laboratory confirmed COVID-19 were enrolled from Tongji Hospital (Wuhan, China). Patients without diabetes were matched to those with diabetes based on age, sex, and comorbidities. All patients were followed up to a clinical endpoint (discharge, worsening including transferring to ICU or immediate death). Data and outcomes were extracted from medical records and analyzed. RESULTS: 64 patients with pre-existing diabetes were included in this study, with 128 matched patients without diabetes included as a control group. Patients with diabetes had a higher rate of worsening (18.8% versus 7.8%, p = 0.025). Multivariable regression showed increased odds of worsening associated with previous glycemic control reflected by HbA1c (odds ratio 3.29, 95% CI 1.19-9.13, p = 0.022) and receiver-operating characteristics (ROC) curve identified HbA1c of 8.6% (70 mmol/mol) as the optimal cut-off value. Univariate analysis demonstrated the in-hospital use of antidiabetic/antihypertensive drugs were not associated with a higher risk of worsening. CONCLUSIONS: COVID-19 patients with diabetes had a higher risk of worsening, especially those with poorly-controlled HbA1c, with an optimal cut-off value of 8.6%. The in-hospital use of antidiabetic/antihypertensive drugs were not associated with increased odds of worsening in patients with diabetes.


Assuntos
Anti-Hipertensivos/uso terapêutico , Diabetes Mellitus/epidemiologia , Hipoglicemiantes/uso terapêutico , /isolamento & purificação , Idoso , /virologia , China/epidemiologia , Comorbidade , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/virologia , Feminino , Índice Glicêmico , Humanos , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Prognóstico , Curva ROC , Estudos Retrospectivos , Fatores de Risco
14.
J Anim Sci ; 98(8)2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32770217

RESUMO

This study adapted the established glycemic index (GI) methodology used in human research to perform two studies in sled dogs in order to assess the blood glucose-raising potential of pulse-based dog foods. The first was a pilot study (n = 6 dogs) to determine the GI of single starch sources (white bread, cooked white rice, and cooked green lentils) using a glucose solution as control. Next, the effect on glycemic and insulinemic meal responses and GI of commercial extruded dog foods containing different categories of starch sources (traditional grain, whole grain, grain-free, and vegan) were investigated on 11 dogs using a glucose control. Results were compared using repeated measures analysis of variance (ANOVA). Consumption of 10 g of available carbohydrate (Av CHO) was insufficient to elicit a measurable response in blood glucose for GI determination, and as such, the amount was increased to 25 g for the second study. The GI (±SE) of the single starch sources and dog foods was: white bread: 47 ± 11, cooked white rice: 71 ± 14, cooked green lentils: 60 ± 20 (P = 0.569), traditional grain: 83 ± 17, whole grain: 56 ± 8, grain-free: 41 ± 6, and vegan: 65 ± 15 (P = 0.154). No statistical differences in glycemic response over time were observed between the single starch sources or the extruded diets tested (P = 0.1412; P = 0.2651). The insulinemic response elicited by the extruded diets was also not different (P = 0.079); however, the traditional grain diet did have the slowest time to peak for insulin (P = 0.0078). Among single starch sources and extruded dog foods, there were no differences in the glycemic indices measured in this study. The GI methodology has not been validated for use in canine species, and it is likely that our results were due to higher interindividual variation or inadequate study power. Regardless, this study will serve to better define future studies to investigate the potential physiological benefits of low GI foods for dogs.


Assuntos
Glicemia/análise , Carboidratos da Dieta/análise , Cães/fisiologia , Insulina/sangue , Amido/metabolismo , Animais , Dieta/veterinária , Grão Comestível , Feminino , Índice Glicêmico , Humanos , Lens (Planta) , Masculino , Oryza , Projetos Piloto , Triticum
15.
Rev. clín. esp. (Ed. impr.) ; 220(5): 305-314, jun.-jul. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194971

RESUMO

La diabetes mellitus tipo2 (DM2) es una enfermedad progresiva cuyos cambios fisiopatológicos se producen varios años antes de su detección. Un abordaje basado en el desarrollo fisiopatológico de la DM2 y sus complicaciones enfatiza la importancia de una intervención temprana e intensiva, no solo para prevenir la disfunción de las células beta, sino también para actuar sobre los posibles factores de riesgo cardiovascular asociados antes de alcanzar los umbrales glucémicos fijados actualmente para el diagnóstico de la DM2. En el terreno de la DM2 de reciente diagnóstico, el estudio VERIFY ha mostrado que el tratamiento precoz combinado con metformina-vildagliptina proporciona mejoras relevantes en el control glucémico a largo plazo y puede influir positivamente en la evolución de la enfermedad


Type 2 diabetes mellitus (DM2) is a progressive disease whose pathophysiological changes occur several years before its detection. An approach based on the pathophysiological development of DM2 and its complications emphasises the importance of early and intensive intervention, not only to prevent beta-cell dysfunction but also to act on the potential associated cardiovascular risk factors before reaching the blood glucose thresholds currently set for diagnosing DM2. In the field of recently diagnosed DM2, the VERIFY study has shown that early treatment combined with metformin-vildagliptin provides relevant improvements in long-term glycaemic control and can positively affect the disease's progression


Assuntos
Humanos , Feminino , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Insulina/uso terapêutico , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Metformina/uso terapêutico , Hipoglicemiantes/uso terapêutico , Terapia Combinada , Fatores de Risco , Índice Glicêmico , Diagnóstico Precoce
16.
J Card Surg ; 35(8): 1811-1821, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32652723

RESUMO

OBJECTIVES: We aimed to investigate whether uncomplicated type A intramural hematoma (IMHA) patients with type 2 diabetes mellitus (DM) who underwent a "wait-and-watch strategy" and tight glycemic control had similar clinical outcomes as patients without DM who received the same treatment strategy. METHODS: Between January 2010 and December 2016, uncomplicated IMHA patients with and without diabetes mellitus were included and were propensity score-matched to improve the balance between the two groups. Cox proportional hazard models were constructed to identify the specific factors associated with aorta-related mortality. The Fine-Gray model for the competing risk analysis was used to estimate the aorta-related and nonaorta-related mortality in different groups during the follow-up period. RESULTS: A total of 109 IMHA patients were included in this study, and 66 patients were included after matching. Patients without DM experienced significantly more aorta-related adverse events (51.6% vs 13.3%; P = .001) and reinterventions than patients in the DM group (29.0% vs 6.7%; P = .023). Cox regression analysis revealed that a higher matrix metalloproteinase-9 level (hazard ratio [HR], 1.70; 95% confidence interval [CI], 1.39-2.09; P < .001) and larger maximum aortic diameter (HR, 1.41; 95% CI, 1.11-1.80; P = .005) were associated with higher aorta-related mortality. The competing risk analysis revealed a significantly higher aorta-related mortality during the follow-up period in the no DM group than in the DM group (36.4%; 95% CI, 11.6%-82.3%; P = .0294). CONCLUSIONS: Uncomplicated IMHA patients with DM (receiving the "wait-and-watch strategy" and tight glycemic control) may have lower aorta-related mortality and rates of aorta-related adverse events and reinterventions than the no DM group.


Assuntos
Doenças da Aorta/etiologia , Diabetes Mellitus Tipo 2/complicações , Hematoma/complicações , Aorta/patologia , Doenças da Aorta/mortalidade , Doenças da Aorta/prevenção & controle , Diabetes Mellitus Tipo 2/tratamento farmacológico , Seguimentos , Índice Glicêmico , Humanos , Metaloproteinase 9 da Matriz , Pontuação de Propensão , Modelos de Riscos Proporcionais , Risco
17.
Am J Clin Nutr ; 112(3): 631-643, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32619242

RESUMO

BACKGROUND: High carbohydrate intake raises blood triglycerides, glucose, and insulin; reduces HDLs; and may increase risk of coronary heart disease (CHD). Epidemiological studies indicate that high dietary glycemic index (GI) and glycemic load (GL) are associated with increased CHD risk. OBJECTIVES: The aim of this study was to determine whether dietary GI, GL, and available carbohydrates are associated with CHD risk in both sexes. METHODS: This large prospective study-the European Prospective Investigation into Cancer and Nutrition-consisted of 338,325 participants who completed a dietary questionnaire. HRs with 95% CIs for a CHD event, in relation to intake of GI, GL, and carbohydrates, were estimated using covariate-adjusted Cox proportional hazard models. RESULTS: After 12.8 y (median), 6378 participants had experienced a CHD event. High GL was associated with greater CHD risk [HR 1.16 (95% CI: 1.02, 1.31) highest vs. lowest quintile, p-trend 0.035; HR 1.18 (95% CI: 1.07, 1.29) per 50 g/day of GL intake]. The association between GL and CHD risk was evident in subjects with BMI (in kg/m2) ≥25 [HR: 1.22 (95% CI: 1.11, 1.35) per 50 g/d] but not in those with BMI <25 [HR: 1.09 (95% CI: 0.98, 1.22) per 50 g/d) (P-interaction = 0.022). The GL-CHD association did not differ between men [HR: 1.19 (95% CI: 1.08, 1.30) per 50 g/d] and women [HR: 1.22 (95% CI: 1.07, 1.40) per 50 g/d] (test for interaction not significant). GI was associated with CHD risk only in the continuous model [HR: 1.04 (95% CI: 1.00, 1.08) per 5 units/d]. High available carbohydrate was associated with greater CHD risk [HR: 1.11 (95% CI: 1.03, 1.18) per 50 g/d]. High sugar intake was associated with greater CHD risk [HR: 1.09 (95% CI: 1.02, 1.17) per 50 g/d]. CONCLUSIONS: This large pan-European study provides robust additional support for the hypothesis that a diet that induces a high glucose response is associated with greater CHD risk.


Assuntos
Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/etiologia , Índice Glicêmico , Carga Glicêmica , Adulto , Idoso , Estudos de Coortes , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco
18.
Cardiovasc Diabetol ; 19(1): 76, 2020 06 11.
Artigo em Inglês | MEDLINE | ID: covidwho-593567

RESUMO

A possible association could exist between type 2 diabetes mellitus (T2DM) and Coronavirus-19 (Covid-19) infection. Indeed, patients with T2DM show high prevalence, severity of disease and mortality during Covid-19 infection. However, the rates of severe disease are significantly higher in patients with diabetes compared with non-diabetes (34.6% vs. 14.2%; p < 0.001). Similarly, T2DM patients have higher rates of need for Intensive Care Unit (ICU, 37.0% vs. 26.7%; p = 0.028). Thus, about the pneumonia of Covid-19, we might speculate that the complicated alveolar-capillary network of lungs could be targeted by T2DM micro-vascular damage. Therefore, T2DM patients frequently report respiratory symptoms and are at increased risk of several pulmonary diseases. In addition, pro-inflammatory pathways as that involving interleukin 6 (IL-6), could be a severity predictor of lung diseases. Therefore, it looks intuitive to speculate that this condition could explain the growing trend of cases, hospitalization and mortality for patients with T2DM during Covid-19 infection. To date, an ongoing experimental therapy with monoclonal antibody against the IL-6 receptor in Italy seems to have beneficial effects on severe lung disease and prognosis in patients with Covid-19 infection. Therefore, should patients with T2DM be treated with more attention to glycemic control and monoclonal antibody against the IL-6 receptor during the Covid-19 infection?


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Betacoronavirus/metabolismo , Glicemia/metabolismo , Infecções por Coronavirus/sangue , Diabetes Mellitus Tipo 2/sangue , Pneumonia Viral/sangue , Anticorpos Monoclonais Humanizados/farmacologia , Glicemia/efeitos dos fármacos , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Índice Glicêmico/efeitos dos fármacos , Índice Glicêmico/fisiologia , Humanos , Pandemias , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Receptores de Interleucina-6/antagonistas & inibidores , Receptores de Interleucina-6/sangue , Resultado do Tratamento
19.
Food Chem ; 330: 127318, 2020 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-32569935

RESUMO

The objective of this study was to determine the biophysical properties of buckwheat (BW) endosperm and their influences on detachment of intact cells, starch gelatinization and digestibility. The intact cells were isolated from BW kernels by dry milling and sieving. The microscopy and texture analysis showed intact endosperm cells could be detached easily due to the fragile structure and low hardness of BW endosperm. More than 70% intact cells were found in commercial light flour. The starch granules entrapped in intact cells exhibited a delay gelatinization and restricted swelling behavior (2-3 â„ƒ higher onset gelatinization temperature than isolated starch). Starch in BW flour had a markedly lower extent of digestion compared to the broken cells and isolated starch. This study provided a new mechanistic understanding of low glycemic index of BW food, and could guide the processing of BW flour to retain slow digestion properties.


Assuntos
Endosperma/citologia , Fagopyrum/citologia , Fagopyrum/metabolismo , Farinha , Amido/farmacocinética , Culinária , Digestão , Endosperma/química , Endosperma/metabolismo , Fagopyrum/química , Farinha/análise , Gelatina , Índice Glicêmico , Tamanho da Partícula , Células Vegetais/química , Células Vegetais/metabolismo , Amido/química , Temperatura
20.
Food Chem ; 330: 127214, 2020 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-32521398

RESUMO

A high glycaemic index diet causes a rapid increase in blood sugar level and may lead to chronic metabolic disorders such as obesity and type 2 diabetes. Shiitake is rich in bioactive compounds. Wheat flour noodles were enriched with shiitake (Lentinus edodes) powder (cap, stem, whole) at different levels to investigate the effects of shiitake addition on the nutritional composition, physical and textural properties. In vitro digestion was conducted to determine the glycaemic glucose equivalents and bioaccessibility of antioxidants in digesta. The addition of 15% shiitake stem powder in the noodles resulted in a significant (p < 0.05) decrease in reducing sugars released after in vitro digestion. Digesta also exhibited cellular antioxidant ability on IEC-6 cells after H2O2-induced oxidative stress. These results show the potential beneficial use of shiitake, especially the stem, as a high-value ingredient to improve the nutritional profile and reduce the glycaemic index of foods.


Assuntos
Antioxidantes/metabolismo , Cogumelos Shiitake/metabolismo , Triticum/metabolismo , Linhagem Celular , Digestão , Farinha , Mucosa Gástrica , Índice Glicêmico , Humanos , Estômago
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