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Nine cyclists (age: 26 ± 5 years, height: 168 ± 5 cm and mass 58.5 ± 4.5 kg) were observed using continuous glucose monitoring devices throughout a training camp. Interstitial glucose [iG] data were captured via the Abbott libre sense biosensor (Abbott Laboratories) and paired with the Supersapiens software (TT1 Products Inc.). [iG] data were split into time ranges, that is, overall (24‐hourly), day‐time (06:00–23:59), night‐time (00:00–05:59) and exercise. [iG] data were stratified into percentage of time, below range ([TBR] < 70 mg/dl), in range ([TIR] 70–140 mg/dl) and above range ([TAR] ≥ 141 mg/dl). Differences in diurnal and nocturnal data were analysed via repeated measures analysis of variance and paired t‐tests where appropriate. p‐value of ≤0.05 was accepted as significant. Riders spent an average of 3 ± 1% TAR, 93 ± 2% TIR and 8 ± 3% TBR. Mean 24 h [iG] was 93 ± 2 mg/dl with a coefficient of variation (CV) of 18 ± 1%. Mean (day: 95 ± 3 vs. night: 86 ± 3 mg/dl and p < 0.001) and CV (day: 18 ± 1 vs. night: 9 ± 1% and p < 0.001) in [iG] were higher during the day‐time hours. TAR was greater during the day (day: 3 ± 1 vs. night: 0 ± 0% and p < 0.001) but TBR and TIR were similar. Glucose levels below the clinical range may have implications for those without diabetes and warrants further investigation. Highlights: The data provided in this study offer novel insight into the daily glycaemic responses of female cyclists engaged in consecutive days' worth of heavy exercise training as part of a performance camp.% Time above range was greatest during exercise whereas, the % time below range was at its lowest. This may offer some insight into the demands of exercise and glucose variability.Riders maintained a high percentage of time spent in range, yet displayed some time <70 mg/dl, that is, hypoglycaemia. A proportionate amount of time was spent with glucose levels below the clinical range, the potential health and/or sports performance implications of this in athletic individuals without diabetes warrants further investigation. [ABSTRACT FROM AUTHOR]

Context Due to the essential role of carnitine as an intermediary in amino acid, carbohydrate, and lipid metabolism, a detailed characterization of circulating and urinary carnitine concentrations will aid in elucidating the molecular basis of impaired maternal metabolic flexibility and facilitating timely intervention for expectant mothers. Objective To investigate the association of maternal plasma and urinary free carnitine and acylcarnitines with cardiometabolic risk factors. Methods Liquid chromatography tandem mass spectrometry–based quantification of free carnitine and acylcarnitines (C2-C18) was performed on 765 plasma and 702 urine samples collected at preconception, 26 to 28 weeks' pregnancy, and 3 months postpartum in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) cohort study. Results Plasma concentrations of free carnitine and acylcarnitines decreased coupled with increased renal clearance in pregnancy compared with preconception and postpartum. Renal clearance of carnitine increased with an increase in prepregnancy body mass index (ppBMI) and gestational weight gain. Plasma short-chain acylcarnitines were positively associated with ppBMI, irrespective of the physiological state, while medium- and long-chain acylcarnitines were negatively associated with ppBMI at preconception and postpartum but showed a positive association in pregnancy. Similarly, plasma short-chain acylcarnitines were positively associated with Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) whereas medium- and long-chain acylcarnitines were negatively associated with HOMA-IR at preconception and in pregnancy. Mothers who developed gestational diabetes mellitus during pregnancy had ∼10% higher plasma propionylcarnitine concentration and ∼18% higher urine tiglylcarnitine concentration than mothers with normal glucose metabolism at preconception. Conclusion This study provides the metabolic and physiological basis of maternal carnitine homeostasis, which can be used in assessment of maternal cardiometabolic health at preconception to improve pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Accurate measurements of glycaemic control and the underpinning regulatory mechanisms are vital in human physiology research. Glycaemic control is the maintenance of blood glucose concentrations within optimal levels and is governed by physiological variables including insulin sensitivity, glucose tolerance and β‐cell function. These can be measured with a plethora of methods, all with their own benefits and limitations. Deciding on the best method to use is challenging and depends on the specific research question(s). This review therefore discusses the theory and procedure, validity and reliability and any special considerations of a range common methods used to measure glycaemic control, insulin sensitivity, glucose tolerance and β‐cell function. Methods reviewed include glycosylated haemoglobin, continuous glucose monitors, the oral glucose tolerance test, mixed meal tolerance test, hyperinsulinaemic euglycaemic clamp, hyperglycaemic clamp, intravenous glucose tolerance test and indices derived from both fasting concentrations and the oral glucose tolerance test. This review aims to help direct understanding, assessment and decisions regarding which method to use based on specific physiology‐related research questions. [ABSTRACT FROM AUTHOR]

Abstract Accurate measurements of glycaemic control and the underpinning regulatory mechanisms are vital in human physiology research. Glycaemic control is the maintenance of blood glucose concentrations within optimal levels and is governed by physiological variables including insulin sensitivity, glucose tolerance and β‐cell function. These can be measured with a plethora of methods, all with their own benefits and limitations. Deciding on the best method to use is challenging and depends on the specific research question(s). This review therefore discusses the theory and procedure, validity and reliability and any special considerations of a range common methods used to measure glycaemic control, insulin sensitivity, glucose tolerance and β‐cell function. Methods reviewed include glycosylated haemoglobin, continuous glucose monitors, the oral glucose tolerance test, mixed meal tolerance test, hyperinsulinaemic euglycaemic clamp, hyperglycaemic clamp, intravenous glucose tolerance test and indices derived from both fasting concentrations and the oral glucose tolerance test. This review aims to help direct understanding, assessment and decisions regarding which method to use based on specific physiology‐related research questions.

Abstract Background Fruit consumption has been associated with a lower cardiovascular disease (CVD) risk but the underlying mechanisms are unclear. We investigated the cross-sectional and prospective associations of fruit consumption with markers of adiposity, blood pressure, lipids, low-grade inflammation, glycaemia, and oxidative stress. Methods The main analyses included 365 534 middle-aged adults from the UK Biobank at baseline, of whom 11 510, and 38 988 were included in the first and second follow-up respectively, free from CVD and cancer at baseline. Fruit consumption frequency at baseline was assessed using a questionnaire. We assessed the cross-sectional and prospective associations of fruit with adiposity (body mass index, waist circumference and %body fat), systolic and diastolic blood pressure, lipids (low-density and high-density lipoproteins, triglycerides and apolipoprotein B), glycaemia (haemoglobin A1c), low-grade inflammation (C-reactive protein) and oxidative stress (gamma-glutamyl-transferase) using linear regression models adjusted for socioeconomic and lifestyle factors. Analyses were repeated in a subset with two to five complete 24-h dietary assessments (n = 26 596) allowing for adjustment for total energy intake. Results Fruit consumption at baseline generally showed weak inverse associations with adiposity and biomarkers at baseline. Most of these relationships did not persist through follow-up, except for inverse associations with diastolic blood pressure, C-reactive protein, gamma-glutamyl transferase and adiposity. However, for most mechanisms, mean levels varied by less than 0.1 standard deviations (SD) between high and low fruit consumption (> 3 vs

High (free) sugar intakes can increase self-reported energy intake and are associated with unfavourable cardiometabolic health. However, sugar source may modulate the effects of sugars due to several mechanisms including the food matrix. The aim of this review was to assess the current state of evidence in relation to food source effects on the physiological responses to dietary sugars in humans relevant to cardiometabolic health. An additional aim was to review potential mechanisms by which food sources may influence such responses. Evidence from meta-analyses of controlled intervention trials was used to establish the balance of evidence relating to the addition of sugars to the diet from sugar-sweetened beverages, fruit juice, honey and whole fruit on cardiometabolic outcomes. Subsequently, studies which have directly compared whole fruit with fruit juices, or variants of fruit juices, were discussed. In summary, the sources of sugars can impact physiological responses, with differences in glycaemic control, blood pressure, inflammation, and acute appetite. Longer-term effects and mechanisms require further work, but initial evidence implicates physical structure, energy density, fibre, potassium and polyphenol content, as explanations for some of the observed responses. [ABSTRACT FROM AUTHOR]

To identify risk factors for nocturnal/morning hypo- and hyperglycaemia in type 1 diabetes. Data on self-management practices were obtained from 3-day records. We studied the associations between self-management practices on the first recording day and the self-reported blood glucose (BG) concentrations on the subsequent night/morning. Of the 1025 participants (39 % men, median age 45 years), 4.4 % reported nocturnal hypoglycaemia (<3.9 mmol/l), 9.8 % morning hypoglycaemia, 51.5 % morning euglycaemia, and 34.3 % morning hyperglycaemia (≥8.9 mmol/l). Within hypoglycaemic range, insulin pump use was associated with higher nocturnal BG concentration (B=0.486 [95 % Confidence Interval=0.121–0.852], p=0.009). HbA 1c was positively (0.046 [0.028–0.065], p<0.001), while antecedent fibre intake (-0.327 [-0.543 – -0.111], p=0.003) and physical activity (PA) (-0.042 [-0.075 – -0.010], p=0.010) were inversely associated with morning BG concentration. The odds of morning hypoglycaemia were increased by previous day hypoglycaemia (OR=2.058, p=0.002) and alcohol intake (1.031, p=0.001). Previous day PA (0.977, p=0.031) and fibre intake (0.848, p=0.017) were inversely, while HbA 1c (1.027, p<0.001) was positively associated with the risk of morning hyperglycaemia. Alcohol avoidance may prevent nocturnal hypoglycaemia, while PA and fibre intake may reduce hyperglycaemia risk. Avoidance of daytime hypoglycaemia and keeping HbA 1c in control may help maintain normoglycaemia also at night-time. • In nocturnal hypoglycamia insulin pump use associated with higher BG concentrations. • Previous day fibre intake and physical activity reduced morning BG concentrations. • The odds of morning hypo were increased by previous day hypo and alcohol intake. • Each 1 g/MJ increase in fibre intake reduced the odds of morning hypo by 15 % [ABSTRACT FROM AUTHOR]

Context The precise glycemic impact and clinical relevance of postprandial exercise in type 1 diabetes (T1D) has not been clarified yet. Objective This work aimed to examine acute, subacute, and late effects of postprandial exercise on blood glucose (BG). Methods A randomized, controlled trial comprised 4 laboratory visits, with 24-hour follow-up at home. Participants included adults with T1D (n = 8), aged 44 ± 13 years, with body mass index of 24 ± 2.1. Intervention included 30 minutes of rest (CONTROL), walking (WALK), moderate-intensity (MOD), or intermittent high-intensity (IHE) exercise performed 60 minutes after a standardized meal. Main outcome measures included BG change during exercise/control (acute), and secondary outcomes included the subacute (≤2 h after) and late glycemic effects (≤24 h after). Results Exercise reduced postprandial glucose (PPG) excursion compared to CONTROL , with a consistent BG decline in all patients for all modalities (mean declines −45 ± 24, −71 ± 39, and −35 ± 21 mg/dL, during WALK , MOD , and IHE, respectively (P <.001). For this decline, clinical superiority was demonstrated separately for each exercise modality vs CONTROL. Noninferiority of WALK vs MOD was not demonstrated, noninferiority of WALK vs IHE was demonstrated, and equivalence of IHE vs MOD was not demonstrated. Hypoglycemia did not occur during exercise. BG increased in the hour after exercise (more than after CONTROL ; P <.001). More than half of participants showed hyperglycemia after exercise necessitating insulin correction. There were more nocturnal hypoglycemic events after exercise vs CONTROL (P <.05). Conclusion Postprandial exercise of all modalities is effective, safe, and feasible if necessary precautions are taken (ie, prandial insulin reductions), as exercise lowered maximal PPG excursion and caused a consistent and clinically relevant BG decline during exercise while there was no hypoglycemia during or shortly after exercise. However, there seem to be 2 remaining challenges: subacute postexercise hyperglycemia and nocturnal hypoglycemia. [ABSTRACT FROM AUTHOR]

IntroductionThe alarming global increase in lifestyle-related disorders such as obesity and type 2 diabetes mellitus (T2DM) has increased during the last several decades. Poor dietary choices significantly contribute to this increase and prevention measures are urgently needed. Dietary intake of bioactive compounds found in foods are linked to a decrease likelihood of these disorders. For this purpose, a randomized crossover meal study was performed to compare the postprandial metabolic effects of lecithin and oat polar lipids in healthy subjects.Materials and methodsEighteen young healthy subjects ingested test meals enriched with lecithin, oat polar lipids (PLs) or rapeseed oil. There were four test meals (i) 15 g oat polar lipids: OPL, (ii) 18 g sunflower lecithin (of which 15 g were polar lipids): LPL, (iii) 18 g rapeseed oil: RSO, and (iv) reference white wheat bread: WWB. Lipid-enriched test meals contained equivalent amounts of total fat (18 g), and all breakfast meals contained 50 g available carbohydrates. The meals were served as breakfast followed by a standardised lunch (white wheat bread and meat balls) after 3.5 h. Test variables were measured at fasting and repeatedly during 5.5 h after ingestion of the breakfast.ResultsOur study demonstrated that both LPL and OPL had beneficial effects on postprandial glucose and insulin responses, and appetite regulating gut hormones, as compared to RSO and WWB. Significant increase in GLP-1, GIP, and PYY concentrations were seen after consuming breakfast meals with LPL and OPL, and ghrelin concentration was reduced compared to meals with RSO and WWB (p

Abstract Background The cereal fibre β-glucan reduces postprandial glycaemia, however, the underlying mechanisms are not fully understood. Thus, the aim of this study was to investigate the acute effect of a β-glucan-enriched oat bread on gastric emptying half-time (T 1/2 ), gastric emptying lag phase (T lag ), and gastric emptying rate (GER), and the secretion of glucagon-like peptide-1 (GLP-1) as potential means to influence postprandial glycaemia. Methods A randomised crossover trial was conducted in 22 healthy adults (age 24.6 ± 3.1 years, BMI 23.1 ± 2.7 kg/m2) receiving 25 g available carbohydrates from a β-glucan-enriched oat bread or a control whole-wheat bread at two non-consecutive days. T 1/2 , T lag , and GER were determined based on ultrasound measures of the cross-sectional gastric antrum area in the fasting state and 15, 30, 45, 60, 90, and 120 min postprandially. Capillary glucose, serum insulin, and plasma GLP-1 concentrations were measured at the same time points. Results A biphasic pattern of gastric emptying with a distinct T lag before the commencement of emptying was observed in most subjects for both bread types. While no differences in GER were evident (p = 0.562), consumption of the oat bread significantly increased T 1/2 by 18 min and T lag by 14 min compared with the whole-wheat bread (p = 0.005 and p = 0.010, respectively). In addition, the oat bread significantly reduced iAUC2h for glucose and insulin responses compared with the whole-wheat bread (p = 0.001 and p

Background: The cereal fibre β-glucan reduces postprandial glycaemia, however, the underlying mechanisms are not fully understood. Thus, the aim of this study was to investigate the acute effect of a β-glucan-enriched oat bread on gastric emptying half-time (T1/2), gastric emptying lag phase (Tlag), and gastric emptying rate (GER), and the secretion of glucagon-like peptide-1 (GLP-1) as potential means to influence postprandial glycaemia. Methods: A randomised crossover trial was conducted in 22 healthy adults (age 24.6 ± 3.1 years, BMI 23.1 ± 2.7 kg/m2) receiving 25 g available carbohydrates from a β-glucan-enriched oat bread or a control whole-wheat bread at two non-consecutive days. T1/2, Tlag, and GER were determined based on ultrasound measures of the cross-sectional gastric antrum area in the fasting state and 15, 30, 45, 60, 90, and 120 min postprandially. Capillary glucose, serum insulin, and plasma GLP-1 concentrations were measured at the same time points. Results: A biphasic pattern of gastric emptying with a distinct Tlag before the commencement of emptying was observed in most subjects for both bread types. While no differences in GER were evident (p = 0.562), consumption of the oat bread significantly increased T1/2 by 18 min and Tlag by 14 min compared with the whole-wheat bread (p = 0.005 and p = 0.010, respectively). In addition, the oat bread significantly reduced iAUC2h for glucose and insulin responses compared with the whole-wheat bread (p = 0.001 and p < 0.001, respectively). There were no significant differences in GLP-1 response between the two breads (p = 0.892). Conclusion: The increased T1/2 and Tlag could offer a potential mechanism for the observed attenuation of postprandial glycaemia and insulinemia after consumption of the β-glucan-enriched oat bread compared with the whole-wheat bread. Trial registration: The study is registered at clinicaltrails.gov (NCT04571866). [ABSTRACT FROM AUTHOR]

Introduction & Background Epochs of hyperglycaemia and hypoglycaemia may each increase risk of common chronic diseases and impair both cognitive and physical function even in people without diabetes. Older people may have greater frequency of adverse glycaemic excursions, partly due to disordered autonomic function and sleep quality. Data for older, non-diabetic people are however scant. Objectives & Approach 1) To describe blood glucose variability (completed) and 2) its socio-demographic and lifestyle correlates in a predominantly non-diabetic cohort of older adults (planned). Participants were recruited during 2021-2023 from an English birth cohort (the 1946 National Survey for Health and Development Study). They wore a continuous glucose monitor (Freestyle libre Abbott), which measured circulating glucose four times/hour, for seven days. Summary statistics and time outside range (4.4-7.8mmol/L) were calculated. Further information on glycaemic excursions and day-to-day variability will be gleaned using the R “iglu” package. For all CGM summary and excursion measures, future analyses will investigate: associations with HbA1c, socio-demographics, body composition, physical activity, diet and alcohol use. Results will be stratified by sleep/ wake time periods estimated from simultaneous actigraphy (Philips Actiwatch Spectrum Plus). Sensitivity analyses will exclude people taking hypo/ hyperglycaemic medications and those with diabetes. Relevance to Digital Footprints Derived summary measures can be used by future studies to give insights into glycaemic variability as a population-level risk factor. This work will bring together multiple data sources, i.e. from CGM, actigraphy and baseline cohort data. Results Participants were aged 75-76 years, 45% female and 10% had diagnosed diabetes; median (IQR) BMI was 26.8 (24.6-29.2) kg/m2. CGM data from 308 participants was collected, for a median (IQR) of 6.9 (6.7-7.6) days. Average glucose over the recording period was 5.7mmol/L (5.3-6.2mmol/L), standard deviation was 1.0mmol/L (0.8-1.3mmol/L), time outside range was 12.8% (6.2-24.7%) and 16% of participants spent ≥1 hour/day above and ≥1 hour/day below range. Conclusions & Implications CGM was feasible for this cohort of older adults, and demonstrated high levels of time outside range for a predominantly non-diabetic group. Future analysis will determine whether enhanced characterisation of glycaemic variability is a potentially more accurate tool for predicting future disease risk than isolated glucose measurements.

This study aimed to determine the effect of Bacillus Coagulans symbiotic supplementation on metabolic factors and inflammation in patients with type-2 diabetes. In this clinical trial, 50 patients with type-2 diabetes were randomly assigned to the symbiotic (containing Bacillus Coagulans + Lactobacillus rhamnosus + Lactobacillus acidophilus and fructooligosaccharide) or placebo groups to receive one sachet daily for 12 weeks. Glycaemic Index, lipid profile, and hs-CRP were measured at the beginning and end of the study. Analysis of covariance demonstrated that fasting blood glucose (FBG), insulin, homeostatic Model Assessment for Insulin Resistance (HOMA-IR), β-cell function (HOMA-β) (p <.05) and hs-CRP (p <.05) significantly declined in the treatment group compared with the placebo group. So, the current study indicated that Bacillus Coagulans symbiotic supplementation could improve metabolic factors and inflammation in patients with type-2 diabetes. [ABSTRACT FROM AUTHOR]

Summary: Background: Sweeteners and sweetness enhancers (S&SE) are used to replace energy yielding sugars and maintain sweet taste in a wide range of products, but controversy exists about their effects on appetite and endocrine responses in reduced or no added sugar solid foods. The aim of the current study was to evaluate the acute (1 day) and repeated (two-week daily) ingestive effects of 2 S&SE vs. sucrose formulations of biscuit with fruit filling on appetite and endocrine responses in adults with overweight and obesity. Methods: In a randomised crossover trial, 53 healthy adults (33 female, 20 male) with overweight/obesity in England and France consumed biscuits with fruit filling containing 1) sucrose, or reformulated with either 2) Stevia Rebaudioside M (StRebM) or 3) Neotame daily during three, two-week intervention periods with a two-week washout. The primary outcome was composite appetite score defined as [desire to eat + hunger + (100 − fullness) + prospective consumption]/4. Findings: Each formulation elicited a similar reduction in appetite sensations (3-h postprandial net iAUC). Postprandial insulin (2-h iAUC) was lower after Neotame (95% CI (0.093, 0.166); p

Abstract Background Metabolic syndrome (MetS) has become a growing risk factor of some non-communicable diseases. Increase of greenhouse gas emissions affects the planet. Aims To assess the association between MetS severity and amount of carbon dioxide (CO2) emitted in an adult population. Design Cross-sectional study (n = 6646; 55-76-year-old-men; 60-75-year-old-women with MetS). Methods Dietary habits were assessed using a pre-validated semi quantitative 143-item food frequency questionnaire. The amount of CO2 emitted due to the production of food consumed by person and day was calculated using a European database, and the severity of the MetS was calculated with the MetS Severity Score. Results Higher glycaemia levels were found in people with higher CO2 emissions. The risk of having high severe MetS was related to high CO2 emissions. Conclusions Low CO2 emissions diet would help to reduce MetS severity. Advantages for both health and the environment were found following a more sustainable diet. Trial registration ISRCTN, ISRCTN89898870 . Registered 05 September 2013.

An abnormal Zn status has been suggested to play a role in the pathogenesis of type 2 diabetes. However, epidemiological studies of the relationship between plasma Zn concentrations and diabetes are sparse and inconclusive. We aimed to investigate the association between plasma Zn concentrations and glycaemic markers (fasting glucose, 2-h glucose and homeostatic model assessment of insulin resistance) in rural and urban Cameroon. We studied 596 healthy adults (63·3 % women) aged 25–55 years in a population-based cross-sectional study. The mean plasma Zn concentration was 13·7 ± 2·7 µmol/L overall, with higher levels in men (14·4 ± 2·9 µmol/l) than in women (13·2 ± 2·6 µmol/l), P -value < 0·0001. There was an inverse relationship between tertiles of plasma Zn and 2-h glucose concentrations (P -value for linear trend = 0·002). The difference in 2-h glucose between those in the highest tertile of plasma Zn compared to the lowest was −0·63 (95 % CI − 1·02, −0·23) mmol/l. This remained significant after adjusting for age, sex, smoking status, alcohol intake, education level, area of residence, adiposity and objectively measured physical activity −0·43(–0·82, −0·04). Similar inverse associations were observed between plasma Zn concentrations and fasting glucose and homeostatic model assessment of insulin resistance when adjusted for socio-demographic and health-related behavioural characteristics. The current findings of an inverse association between plasma Zn concentrations and several markers of glucose homeostasis, together with growing evidence from intervention studies, suggest a role for Zn in glucose metabolism. If supported by further evidence, strategies to improve Zn status in populations may provide a cheap public health prevention approach for diabetes. [ABSTRACT FROM AUTHOR]

There is a high perinatal mortality rate in dogs, estimated at 20%, and one of the leading causes of this rate is hypoglycaemia. Therefore, we aimed to evaluate the efficacy of a hypercaloric supplement containing vitamins and amino acids in newborn puppies presenting hypoglycaemia at birth. Ninety‐nine pups were divided into four groups: normoglycaemic caesarean section (NORMOCS), hypoglycaemic caesarean section supplemented with the hypercaloric (SUPLCS), hypoglycaemic caesarean section supplemented with glucose (GLICCS) and eutocic delivery (EUT). We evaluated the following parameters glycaemia, Apgar score, neurological reflexes and rectal temperature of neonates at the following moments 5 min (M5), 30 min (M30) and 60 min (M60) after birth. Brachycephalic dogs were 73.3% (22/30) of caesarean sections (c‐sections). The puppy's average glycaemia represented about 90% of the maternal glycaemia, while 15.1% (14/99) of the neonates had hypoglycaemia (<90 mg/dL) at M0 and 46.5% (44/99) at M60. Only four neonates had glycaemia below 40 mg/dL at M30 but without showing any clinical signs. The puppy's fasting while waiting for the intraoperative period and the dam's anaesthetic recovery was considered risk factors for hypoglycaemia. There was no difference in mean blood glucose levels or vitality parameters among puppies from the SUPLCS and GLICCS. In conclusion, the hypercaloric supplement can be used as a replacement for glucose in hypoglycaemic puppies and it can also bring nutritional benefits for the puppy. The prepartum glycaemia of the dam is an important parameter to be measured, and the appropriate management of it reduces the chances of the puppies being born with hypoglycaemia. [ABSTRACT FROM AUTHOR]

It is unknown if fibre intake differs across diabetes status in USA adults and is associated with glycaemic outcomes. This cross-sectional analysis utilised National Health and Nutrition Examination Survey cycles 2013–2018 data to estimate usual total dietary fibre intake in USA adults and across diabetes status (no diabetes, prediabetes and type II diabetes (T2D)). Associations among dietary fibre intake and glycaemic outcomes were also reported across groups. Adults (≥ 19 years) with at least one dietary recall were included. Diabetes status was determined from self-report data and measured HbA1c. Independent samples t tests were used to compare mean (se) intake across sub-populations. 14 640 adults (51·3 % female) with 26·4 % and 17·4 % classified as having prediabetes and T2D, respectively. Adults with T2D reported greater mean (se) dietary fibre intake compared with no T2D for females (9·5 (0·13) v. 8·7 (0·11) g/1000 kcal/d and males (8·5 (0·12) v. 7·7 (0·11) g/1000 kcal/d; P < 0·01)). However, only 4·2 (0·50)% and 8·1 (0·90)% of males and females with T2D, respectively, met the adequate intake for fibre. Fibre intake was associated with lower insulin (β = −0·80, P < 0·01), serum glucose (β = −1·35, P < 0·01) and Homeostatic Model Assessment for Insulin Resistance (β = −0·22, P < 0·01) in adults without diabetes, and no relationships in adults with prediabetes or T2D were found. Although dietary fibre intake was highest among adults with T2D, intake was suboptimal across all groups. In adults without diabetes, dietary fibre intake was associated with improved glycaemic outcomes and insulin resistance; however, these associations were attenuated by anthropometric and lifestyle covariates. [ABSTRACT FROM AUTHOR]

Background: The pattern of the plasma glucose response curve during an oral glucose tolerance test (OGTT) is of prognostic significance with "biphasic" when compared with "monophasic" patterns being associated with greater insulin sensitivity/secretion and a reduced risk of progression to diabetes. The relationships of the glucose response curves with gastric emptying and incretin hormone secretion are not known. Methods: Thirty-six adults (age > 65 years) without known diabetes consumed a 300 mL drink containing 75 g glucose and 150 mg C13-acetate at baseline and follow-up after 5.8 ± 0.1 years. Plasma glucose, glucagon-like peptide-1 (GLP-1), glucose independent insulinotropic polypeptide (GIP) and insulin were measured, and participants classified according to the pattern of their glucose response. Gastric emptying was measured on breath samples (stable isotope breath test). Results: At baseline, 22 participants had a "monophasic" and 14 a "biphasic" glucose response. The 1 h plasma glucose response curve was greater and the GLP-1 AUC0–120 min and insulin secretion lower in the monophasic group. There were no differences in gastric emptying, GIP or insulin sensitivity. At the follow-up, the 1 h glucose response curve was greater again, while GLP-1 AUC0–120 min was lower in the monophasic group. Conclusions: A biphasic curve is associated with a higher 60 min glucose response curve and increases in GLP-1, but no difference in either GIP or gastric emptying. [ABSTRACT FROM AUTHOR]

Non-healing wounds are usually colonised and contaminated by different types of bacteria. An alternative to antibiotic treatment in patients with infected wounds with local signs of inflammation may be medical grade honey (MGH). MGH has antioxidant, antimicrobial, anti-inflammatory, and immunomodulatory features. This study aims to evaluate the effect of MGH therapy on infected non-healing wounds, especially for diabetic foot syndrome. Prospective, observational case series (n = 5) of patients with wounds of diabetic foot syndrome are presented. There were five males with an average age of 61.6 years. All wounds were treated with MGH, and the healing trajectory was rigorously and objectively monitored. In all cases, there was a gradual disappearance of odour, pain, and exudation. Moreover, the wound areas significantly reduced within 40 days and there was a decrease in glycated haemoglobin and glycaemia values. All these outcomes resulted in improved quality of life of the patients. Despite bacterial colonisation, antibiotic treatment was not necessary. All wounds were completely healed. MGH has antimicrobial, anti-inflammatory, and antioxidant effects in diabetic foot syndrome wounds, does not increase glycated haemoglobin or glycaemia levels, and thus constitutes an effective alternative to the use of antibiotics in the treatment of locally infected wounds. [ABSTRACT FROM AUTHOR]

Abstract Background Hypoglycaemia and hyperglycaemia may develop during anaesthesia and surgery in children and can lead to severe adverse clinical outcomes. No study, as far as we know, has investigated glucose homeostasis in children undergoing surgery in Malawi. The aim of this study was to assess perioperative glucose levels of the children undergoing anaesthesia at Mercy James Centre (MJC) for Paediatric Surgery, Blantyre, Malawi. Methodology This was an observational cross-sectional study. We looked at 100 children aged 1 day to 15 years anaesthetised at MJC. Data were analysed using SPSS 28. Student t test and Analysis of the variance (ANOVA) were used to compare means. The level of significance was 5%. Results Male children represented 68%. The median age was 2.2 years. Sixten percents of patient were underweight. Fasting times were prolonged for 87%. Maintenance IV fluid with 2.5% dextrose was given to 14%. Overall, there was a significant increase of glycaemia from induction of anaesthesia to the end of the procedure. Hypoglycaemia was rare. The mean fasting glycaemia was 99.04 mg/dL ± 1.8, 116.95 mg/dL ± 34.2 at 30 min into the procedure and 127.62 mg/dL ± 46.8 at the end of the procedure. The differences in means were statistically significant (p

Studies have demonstrated that pigment-epithelium-derived factor (PEDF) is a robust inhibitor of tumour growth and development, implying that this may serve as a promising target for therapeutic intervention. However, the precise impact of PEDF on cancerous cell metabolic pathways remains uncertain despite ongoing research. In this light, this study aimed to employ a metabolomics approach for understanding the metabolic reprogramming events in breast cancer across different glycaemic loads and their response to PEDF. Gas chromatography-quadrupole mass spectrometry (GC/Q-MS) analysis revealed metabolic alterations in ER+ human cell line MCF-7 cells treated with PEDF under varying glycaemic conditions. The identification of significantly altered metabolites was accomplished through MetaboAnalyst (v.5.0) and R packages, which enabled both multivariate and univariate analyses. Out of the 48 metabolites identified, 14 were chosen based on their significant alterations in MCF-7 cells under different glycaemic conditions and PEDF treatment (p < 0.05, VIP > 0.8). Dysregulation in pathways associated with amino acid metabolism, intermediates of the TCA cycle, nucleotide metabolism, and lipid metabolism were detected, and they exhibited different responses to PEDF. Our results suggest that PEDF has a diverse influence on the metabolism of MCF-7 cells in both normo- and hyperglycaemic environments, thereby warranting studies using patient samples to correlate our findings with clinical response in the future. [ABSTRACT FROM AUTHOR]

Summing glycaemic glucose equivalent (GGE) values of foods in a meal would be a practical way to predict the relative glycaemic impact (RGI) of the meal, without measuring the whole meal postprandial effect. However, as glycaemic response is non-linear, and glycaemic responsiveness per gram of glucose decreases with dose, addition accumulates inaccuracy. This research described determined inaccuracies accruing during addition of GGE values of foods and identifies approaches to reduce inaccuracy. By combining five published glucose dose–glycaemic response curves, the relationship between GGE dose and response was shown to be nearly quadratic (R2 = 0.98). This curve allowed determination of the divergence between the theoretically true glycaemic glucose equivalence of food intakes and estimates obtained by extrapolating linearly from zero through responses to glucose reference doses of 10, 20, 30, 40, 50 and 60 g. For each reference, the disparity between the linearly determined sum of GGE values of foods in 20 realistic meals, and true homeostasis-adjusted glucose equivalence for each whole meal, was calculated. Summation of the GGE values of individual foods could lead to inaccurate (>5 g GGE) estimates of the RGI of meals, depending on the GGE total, the number of foods, and the size of the glucose reference. Inaccuracy that accumulates during linear addition of GGE values of foods limits the range in which they can be used linearly in dietary management, public health and epidemiology. However, the steps discussed herein may be taken to allow for non-linearity. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) has become a growing risk factor of some non-communicable diseases. Increase of greenhouse gas emissions affects the planet. Aims: To assess the association between MetS severity and amount of carbon dioxide (CO2) emitted in an adult population. Design: Cross-sectional study (n = 6646; 55-76-year-old-men; 60-75-year-old-women with MetS). Methods: Dietary habits were assessed using a pre-validated semi quantitative 143-item food frequency questionnaire. The amount of CO2 emitted due to the production of food consumed by person and day was calculated using a European database, and the severity of the MetS was calculated with the MetS Severity Score. Results: Higher glycaemia levels were found in people with higher CO2 emissions. The risk of having high severe MetS was related to high CO2 emissions. Conclusions: Low CO2 emissions diet would help to reduce MetS severity. Advantages for both health and the environment were found following a more sustainable diet. Trial registration: ISRCTN, ISRCTN89898870. Registered 05 September 2013. [ABSTRACT FROM AUTHOR]

Poorly controlled type 2 diabetes mellitus progresses to several complications including nephropathy. While glycated hemoglobin demarcates severity, urinary microalbumin indicates renal involvement. Considering nephropathy is a late manifestation of the disease, here, we explored whether serum triacylglycerol (TAG) can be used as an early disease severity biomarker. About 100 Type 2 diabetes mellitus patients were recruited and categorized as moderate (n=43) and severe (n=57) based on glycated haemoglobin (8%) level. Duration of the disease, BMI, systolic and diastolic BP, fasting and Post Prandial plasma glucose, glycated haemoglobin, serum lipid profile and urinary microalbumin were measured. Results obtained were compared between the groups and correlated. Taking glycated haemoglobin as reference, receiver operating characteristic curves were constructed for serum triacylglycerol and urinary microalbumin excretion to check their efficacy as classifier of disease severity. Significant differences (P <0.001) were recorded for plasma glucose, glycated haemoglobin, triacylglycerol and microalbuminuria but not for other parameters. Significant association (P <0.001) of glycated haemoglobin was displayed with triacylglycerol (r=0.67), fasting (r=0.0.71) and Post Prandial (r=0.82) plasma glucose and urine microalbumin levels (r=0.54). Serum triacylglycerol and urinary microalbumin levels also showed significant correlation (P <0.001, r=0.44). ROC curve analysis showed better performance of triacylglycerol (AUC=0.97) than microalbuminuria (AUC=0.88) to demarcate severity of diabetes. The results indicate that serum triacylglycerol is a better classifier of Type 2 diabetes mellitus than urinary microalbumin level, and may help in early assessment of the disease progression. [ABSTRACT FROM AUTHOR]

People with type 1 diabetes experience challenges in managing blood glucose around exercise. Previous studies have examined glycaemic responses to different exercise modalities but paid little attention to participants' prandial state, although this is an important consideration and will enhance our understanding of the effects of exercise in order to improve blood glucose management around activity. This review summarises available data on the glycaemic effects of postprandial exercise (i.e. exercise within 2 h after a meal) in people with type 1 diabetes. Using a search strategy on electronic databases, literature was screened until November 2022 to identify clinical trials evaluating acute (during exercise), subacute (≤2 h after exercise) and late (>2 h to ≤24 h after exercise) effects of postprandial exercise in adults with type 1 diabetes. Studies were systematically organised and assessed by exercise modality: (1) walking exercise (WALK); (2) continuous exercise of moderate intensity (CONT MOD); (3) continuous exercise of high intensity (CONT HIGH); and (4) interval training (intermittent high-intensity exercise [IHE] or high-intensity interval training [HIIT]). Primary outcomes were blood glucose change and hypoglycaemia occurrence during and after exercise. All study details and results per outcome were listed in an evidence table. Twenty eligible articles were included: two included WALK sessions, eight included CONT MOD, seven included CONT HIGH, three included IHE and two included HIIT. All exercise modalities caused consistent acute glycaemic declines, with the largest effect size for CONT HIGH and the smallest for HIIT, depending on the duration and intensity of the exercise bout. Pre-exercise mealtime insulin reductions created higher starting blood glucose levels, thereby protecting against hypoglycaemia, in spite of similar declines in blood glucose during activity between the different insulin reduction strategies. Nocturnal hypoglycaemia occurred after higher intensity postprandial exercise, a risk that could be diminished by a post-exercise snack with concomitant bolus insulin reduction. Research on the optimal timing of postprandial exercise is inconclusive. In summary, individuals with type 1 diabetes exercising postprandially should substantially reduce insulin with the pre-exercise meal to avoid exercise-induced hypoglycaemia, with the magnitude of the reduction depending on the exercise duration and intensity. Importantly, pre-exercise blood glucose and timing of exercise should be considered to avoid hyperglycaemia around exercise. To protect against late-onset hypoglycaemia, a post-exercise meal with insulin adjustments might be advisable, especially for exercise in the evening or with a high-intensity component. [ABSTRACT FROM AUTHOR]

Background and Objectives: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease affecting an estimated 537 million individuals worldwide. 'Superfoods' can be integrated into the diet of T2DM patients due to their health benefits. Study Objectives: (i) To carry out a narrative review of 'superfoods' with the potential to reduce glycaemic levels in T2DM patients (2019 to 2022), (ii) to identify 'superfoods' with the potential to reduce HbA1c and (iii) to propose new guidance on the use of 'superfoods'. Materials and Methods: A narrative review was carried out using the databases PubMed, SciELO, DOAJ and Google Scholar. The keywords were ["type 2 diabetes" and ("food" or "diet" or "nutrition") and ("glycaemia" or "glycemia")]. Only review studies were included. Results: Thirty reviews were selected. The 'superfoods' identified as having a potential impact on glycaemic control were foods with polyphenols (e.g., berries), fermented dairy products, whole cereals/grains, nuts and proteins, among others. The possibility of an extensive reduction in Hb1Ac was reported for fermented dairy products, especially yoghurts enriched with vitamin D or probiotics (HbA1c reduction of around 1%) or by increasing the fibre intake by 15 g (or up to 35 g) (HbA1c reduction of around 2%). Conclusion: It is recommended that the identified 'superfoods' are included in the diet of T2DM patients, although this should not substitute an appropriate diet and exercise plan. In particular, yoghurts and an increased fibre intake (by 15 g or up to 35 g) can be used as nutraceuticals. New recommendations on the introduction of 'superfoods' in the diet of T2DM patients have been proposed. [ABSTRACT FROM AUTHOR]

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Summary: We investigated whether sleep health (each individual dimension and a composite measure) was associated with better glycaemia among a cohort of young adults with type 1 diabetes (mean age 21.5 years, mean body mass index 24.55 kg m−2). Multiple validated self‐report questionnaires were completed, and raw continuous glucose monitor data were shared. One self‐reported sleep characteristic for each of the five sleep health dimensions was selected. A composite score was calculated by summing the number of "good" sleep health dimensions. We evaluated the associations between sleep health and glycaemia, and whether covariates, including age, type 1 diabetes duration and sleep apnea risk, influenced the relationships among the study variables using multivariable linear regression. Individual dimensions of sleep satisfaction (β = 0.380, p = 0.019; β = −0.414, p = 0.010), timing (β = 0.392, p = 0.015; β = −0.393, p = 0.015) and sleep efficiency (β = 0.428, p = 0.007) were associated with higher achievement of glycaemic targets (J‐index and time in range); however, these associations did not persist after considering covariates. A better Sleep Health Composite score was associated with higher achievement of glycaemic targets even after considering covariates. Using a multidimensional framework can guide future research on causal pathways between sleep and diabetes health, interventions to target sleep health profiles, and may improve sleep screening in routine diabetes care. [ABSTRACT FROM AUTHOR]

Remote monitoring of biometric data in the elderly population is an important asset for improving the quality of life and level of independence of elderly people living alone. However, the design and implementation of health technological solutions often disregard the elderly physiological and psychological abilities, leading to low adoption of these technologies. We evaluate the usability of a remote patient monitoring solution, VITASENIOR-MT, which is based on the interaction with a television set. Twenty senior participants (over 64 years) and a control group of 20 participants underwent systematic tests with the health platform and assessed its usability through several questionnaires. Elderly participants scored high on the usability of the platform, very close to the evaluation of the control group. Sensory, motor and cognitive limitations were the issues that most contributed to the difference in usability assessment between the elderly group and the control group. The solution showed high usability and acceptance regardless of age, digital literacy, education and impairments (sensory, motor and cognitive), which shows its effective viability for use and implementation as a consumer product in the senior market. [ABSTRACT FROM AUTHOR]

Background: Hypoglycaemia and hyperglycaemia may develop during anaesthesia and surgery in children and can lead to severe adverse clinical outcomes. No study, as far as we know, has investigated glucose homeostasis in children undergoing surgery in Malawi. The aim of this study was to assess perioperative glucose levels of the children undergoing anaesthesia at Mercy James Centre (MJC) for Paediatric Surgery, Blantyre, Malawi. Methodology: This was an observational cross-sectional study. We looked at 100 children aged 1 day to 15 years anaesthetised at MJC. Data were analysed using SPSS 28. Student t test and Analysis of the variance (ANOVA) were used to compare means. The level of significance was 5%. Results: Male children represented 68%. The median age was 2.2 years. Sixten percents of patient were underweight. Fasting times were prolonged for 87%. Maintenance IV fluid with 2.5% dextrose was given to 14%. Overall, there was a significant increase of glycaemia from induction of anaesthesia to the end of the procedure. Hypoglycaemia was rare. The mean fasting glycaemia was 99.04 mg/dL ± 1.8, 116.95 mg/dL ± 34.2 at 30 min into the procedure and 127.62 mg/dL ± 46.8 at the end of the procedure. The differences in means were statistically significant (p < 0.001). Prolonged fasting times was associated with lower blood glucose means whereas nutrition status, type of the procedure, addition of dextrose in the fluid, and duration of procedure were associated with higher glycaemia means. Conclusion: Glycaemia increases under anaesthesia and surgery. Recommended fasting times, optimising nutritional status, when possible, no dextrose or lower than 2.5% dextrose in IV maintenance fluid are possible strategies to maintain blood sugar homeostasis during paediatric surgery and anaesthesia. [ABSTRACT FROM AUTHOR]

Type 2 diabetes (T2D) is a complex metabolic disease, which involves maintained hyperglycemia, mainly due to the development of an insulin resistance process. Metformin administration is the most prescribed treatment for diabetic patients. In a previously published study, we demonstrated that Pediococcus acidilactici pA1c® (pA1c) protects from insulin resistance and body weight gain in HFD-induced diabetic mice. The present work aimed to evaluate the possible beneficial impact of a 16-week administration of pA1c, metformin, or the combination of pA1c and metformin in a T2D HFD-induced mice model. We found that the simultaneous administration of both products attenuated hyperglycemia, increased high-intensity insulin-positive areas in the pancreas and HOMA-β, decreased HOMA-IR and also provided more beneficial effects than metformin treatment (regarding HOMA-IR, serum C-peptide level, liver steatosis or hepatic Fasn expression), and pA1c treatment (regarding body weight or hepatic G6pase expression). The three treatments had a significant impact on fecal microbiota and led to differential composition of commensal bacterial populations. In conclusion, our findings suggest that P. acidilactici pA1c® administration improved metformin beneficial effects as a T2D treatment, and it would be a valuable therapeutic strategy to treat T2D. [ABSTRACT FROM AUTHOR]

For centuries human civilization has cultivated oats, and now they are consumed in various forms of food, from instant breakfasts to beverages. They are a nutrient-rich food containing linear mixed-linkage (1 → 3) (1 → 4)-β-d-glucans, which are relatively well soluble in water and responsible for various biological effects: the regulation of the blood cholesterol level, as well as being anti-inflammatory, prebiotic, antioxidant, and tumor-preventing. Numerous studies, especially in the last two decades, highlight the differences in the biological properties of the oat β-d-glucan fractions of low, medium, and high molecular weight. These fractions differ in their features due to variations in bioavailability related to the rheological properties of these polysaccharides, and their association with food matrices, purity, and mode of preparation or modification. There is strong evidence that, under different conditions, the molecular weight may determine the potency of oat-extracted β-d-glucans. In this review, we intend to give a concise overview of the properties and studies of the biological activities of oat β-d-glucan preparations depending on their molecular weight and how they represent a prospective ingredient of functional food with the potential to prevent or modulate various pathological conditions. [ABSTRACT FROM AUTHOR]

Aims: Co‐management of weight and glycaemia is critical yet challenging in type 1 diabetes (T1D). We evaluated the effect of a hypocaloric low carbohydrate, hypocaloric moderate low fat, and Mediterranean diet without calorie restriction on weight and glycaemia in young adults with T1D and overweight or obesity. Materials and Methods: We implemented a 9‐month Sequential, Multiple Assignment, Randomized Trial pilot among adults aged 19‐30 years with T1D for ≥1 year and body mass index 27‐39.9 kg/m2. Re‐randomization occurred at 3 and 6 months if the assigned diet was not acceptable or not effective. We report results from the initial 3‐month diet period and re‐randomization statistics before shutdowns due to COVID‐19 for primary [weight, haemoglobin A1c (HbA1c), percentage of time below range <70 mg/dl] and secondary outcomes [body fat percentage, percentage of time in range (70‐180 mg/dl), and percentage of time below range <54 mg/dl]. Models adjusted for design, demographic and clinical covariates tested changes in outcomes and diet differences. Results: Adjusted weight and HbA1c (n = 38) changed by −2.7 kg (95% CI −3.8, −1.5, P <.0001) and −0.91 percentage points (95% CI −1.5, −0.30, P =.005), respectively, while adjusted body fat percentage remained stable, on average (P =.21). Hypoglycaemia indices remained unchanged following adjustment (n = 28, P >.05). Variability in all outcomes, including weight change, was considerable (57.9% were re‐randomized primarily due to loss of <2% body weight). No outcomes varied by diet. Conclusions: Three months of a diet, irrespective of macronutrient distribution or caloric restriction, resulted in weight loss while improving or maintaining HbA1c levels without increasing hypoglycaemia in adults with T1D. [ABSTRACT FROM AUTHOR]

Type-2 diabetes (T2D) is characterised by a dysregulation of metabolism, including skeletal muscle insulin resistance, mitochondrial dysfunction, and oxidative stress. Reactive species, such as methylglyoxal (MGO) and 4-hydroxynonenal (4-HNE), positively associate with T2D disease severity and can directly interfere with insulin signalling and glucose uptake in skeletal muscle by modifying cellular proteins. The multifunctional dipeptide carnosine, and its rate-limiting precursor β-alanine, have recently been shown to improve glycaemic control in humans and rodents with diabetes. However, the precise mechanisms are unclear and research in human skeletal muscle is limited. Herein, we present novel findings in primary human T2D and lean healthy control (LHC) skeletal muscle cells. Cells were differentiated to myotubes, and treated with 10 mM carnosine, 10 mM β-alanine, or control for 4-days. T2D cells had reduced ATP-linked and maximal respiration compared with LHC cells (p = 0.016 and p = 0.005). Treatment with 10 mM carnosine significantly increased insulin-stimulated glucose uptake in T2D cells (p = 0.047); with no effect in LHC cells. Insulin-stimulation increased MGO-modified proteins in T2D cells by 47%; treatment with carnosine attenuated this increase to 9.7% (p = 0.011). There was no effect treatment on cell viability or expression of other proteins. These findings suggest that the beneficial effects of carnosine on glycaemic control may be explained by its scavenging actions in human skeletal muscle. [ABSTRACT FROM AUTHOR]

This study investigated the potential health effects of consuming bread enriched with agave fructans, β-cyclodextrins, and probiotics on the health of growing mice. ICR mice (35 males and 35 females) in the growth stage were used. Five diets were administered: 1) Standard (S), 2) Bread with agave fructans (FB), 3) Bread with β-cyclodextrins (CBD), 4) Bread with agave fructans + β-cyclodextrins (FB-CD), and 5) Bread with agave fructans + β-cyclodextrins + probiotics (FB-CD-P). The results showed that the FB-CD-P diet showed a decrease in dietary intake in mice. FB-containing diets showed higher fecal excretion than diet S. Blood glucose levels of female mice fed FB, CBD, FB-CD, and FB-CD-P diets exhibited a hypoglycemic effect. Histological results showed that the FB-CD-P diet presented larger mucin vesicles than the other diets. The results suggest that bread enriched with the FB-CD-P diet can provide health benefits.

Some specific dietary patterns improve glycaemic levels and cardiovascular risk factors better than others. We aimed to identify the most effective dietary patterns using a food-focused approach to improve blood glucose management (primary outcome) and cardiovascular risk factors (secondary outcome) in people with type 2 diabetes. An umbrella review was conducted comparing dietary patterns for the management of these outcomes. Studies published between 2012 and 2022 were identified using PubMed Central, ProQuest, Web of Science, and the Cochrane Database of Systematic Reviews. Thirty systematic reviews met the inclusion criteria. Twenty-two of thirty reviews quantitated (via meta-analyses of over 212 randomised control trials) the effect size of different dietary patterns. Twelve reviews found Low-carbohydrate (LC), Mediterranean (M), Plant-based (PB), and/or Low-glycaemic Index (LGI) diets reduced HbA1c moderately more than control diets (typically a high-carbohydrate, low-fat diet) (i.e., LC: −0.1 to −0.5%; M: −0.3 to −0.5%; PB: −0.2 to −0.4%; LGI −0.2 to −0.5%; all p-value < 0.01). We conclude that Low-carbohydrate, Mediterranean, Plant-based, and Low-glycaemic Index dietary patterns are all clinically effective for people with type 2 diabetes as alternatives to high-carbohydrate, low-fat diets typically used for managing glycaemic levels and CVD risk. However, quality evidence about the sustainability of effects and safety remains limited, warranting future research. [ABSTRACT FROM AUTHOR]

Pigment epithelium-derived factor (PEDF) is a secreted glycoprotein that belongs to the serine protease inhibitor (serpin) family. An increase in PEDF activity has been shown to be a potent inhibitor of tumour progression and proliferation, suggesting a possible therapeutic target. There is still a great deal to learn about how PEDF controls metabolic pathways in breast cancer and its metastatic form. Given this, the primary purpose of this study was to use a metabolomics approach to gain a better understanding of the mechanisms driving the reprogramming of metabolic events involved in breast cancer pertaining to PEDF under various glycaemic loads. We employed gas chromatography–quadrupole mass spectrometry (GC-Q-MS) to investigate metabolic changes in the triple-negative breast cancer (TNBC) cell line MDA-MB-231 treated with PEDF under glycaemic loading. Multivariate and univariate analyses were carried out as indicative tools via MetaboAnalyst (V.5.0) and R packages to identify the significantly altered metabolites in the MDA-MB-231 cell line after PEDF exposure under glycaemic loading. A total of 61 metabolites were found, of which nine were selected to be distinctively expressed in MDA-MB-231 cells under glycaemic conditions and exhibited differential responses to PEDF (p < 0.05, VIP > 1). Abnormalities in amino acid metabolism pathways were observed. In particular, glutamic acid, glutamine, and phenylalanine showed different levels of expression across different treatment groups. The lactate and glucose-6-phosphate production significantly increased in high-glucose vs. normal conditions while it decreased when the cells were exposed to PEDF, confirming the positive influence on the Warburg effect. The TCA cycle intermediates, including malate and citric acid, showed different patterns of expression. This is an important finding in understanding the link of PEDF with metabolic perturbation in TNBC cells in response to glycaemic conditions. Our findings suggest that PEDF significantly influenced the Warburg effect (as evidenced by the significantly lower levels of lactate), one of the well-known metabolic reprogramming pathways in cancer cells that may be responsive to metabolic-targeted therapeutic strategies. Moreover, our results demonstrated that GC-MS-based metabolomics is an effective tool for identifying metabolic changes in breast cancer cells after glycaemic stress or in response to PEDF treatment. [ABSTRACT FROM AUTHOR]

The exponentially growing frequency of diagnosing diabetes mellitus means that a verification of the previous dietetic approach to treating the disease seems justified. The simultaneous growth of interest in the ketogenic diet and the development of knowledge in this field have contributed to the increasingly frequent application of the ketogenic diet in diabetes treatment. This paper also deals with that issue; its aim includes an extensive analysis of the influence of the ketogenic diet on the prophylaxis and treatment of diabetes. The paper has been prepared based on a wide, meticulous analysis of the available literature on the subject. Among other findings, a favorable effect of that nutrition model has been demonstrated on the values of glycated hemoglobin, glucose, insulin, or other metabolic parameters in diabetes patients. The effect of the ketogenic diet on the pharmacotherapy of type 1 and type 2 diabetes has been presented and compared with the standard nutritional management plan recommended for that disease. Further research is needed in this field, especially studies with a long follow-up period. The discussed articles report interesting therapeutic advantages to the ketogenic diet in comparison with standard diets. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) affects approximately one in six pregnancies, causing a significant burden on maternal and infant health. Lifestyle interventions are first-line therapies to manage blood glucose levels (BGLs) and prevent future cardiometabolic complications. However, women with GDM experience considerable barriers to lifestyle interventions; thus, the aim of this study was to determine how women with GDM manage their condition and to identify the primary supports and barriers to lifestyle intervention participation. Methods: An online cross-sectional survey of women in Australia with a history of GDM was conducted. Questions included participant demographics, strategies used to manage BGLs, physical activity and dietary habits, and barriers and supports to lifestyle interventions. Results: A total of 665 individuals consented and responded to the advertisement, of which 564 were eligible and provided partial or complete responses to the survey questions. Most respondents were between 35 and 39 years of age (35.5%), not pregnant (75.4%), working part-time (26.7%), university-educated (58.0%), and had only one child (40.1%). Most respondents managed their BGLs through diet (88.3%), with "low-carbohydrate" diets being the most popular (72.3%), and 46.2% of respondents were undertaking insulin therapy. Only 42.2% and 19.8% of respondents reported meeting the aerobic and strengthening exercise recommendations, respectively. Women with one child or currently pregnant expecting their first child were 1.51 times more likely (95% CI, 1.02, 2.25) to meet the aerobic exercise recommendations than those with two or more children. The most common reported barriers to lifestyle intervention participation were "lack of time" (71.4%) and "childcare" commitments (57.7%). Lifestyle interventions delivered between 6 and 12 months postpartum (59.0%), involving an exercise program (82.6%), and delivered one-on-one were the most popular (64.9%). Conclusion: Most women report managing their GDM with lifestyle strategies. The most common strategies reported involve approaches not currently included in the clinical practice guidelines such as reducing carbohydrate consumption. Furthermore, despite being willing to participate in lifestyle interventions, respondents report significant barriers, including lack of time and childcare commitments, whereas mentioned supports included having an online format. Lifestyle interventions for women with a history of GDM should be designed in a manner that is both tailored to the individual and considerate of existing barriers and supports to participation. [ABSTRACT FROM AUTHOR]

Aim: Emotional responses, such as feeling overwhelmed with diabetes‐related treatment, burnt‐out and anxiety, are known as 'diabetes distress'. This study aimed to determine diabetes distress among children, adolescents and parents/carers managing insulin‐requiring diabetes in a regional Australian setting, and to assess association with glycaemia. Methods: All children, adolescents and their parents/carers attending a regional hospital outpatient diabetes clinic between March 2018 and June 2019 were invited to complete a validated child, adolescent or parent/carer diabetes distress questionnaire. Demographics and time‐matched clinical data were obtained from hospital records. A cross‐sectional analysis was performed. Results: A total of 43 young people and 30 parents/carers completed a diabetes distress questionnaire during the study period. Diabetes distress was common, with 63% of young people and 67% of parents/carers nominating at least one serious concern. After adjustment for potential confounding factors, higher glycaemia (HbA1c%) was associated with higher distress scores among both young people (ß 6.2, 95% confidence interval (CI): 3.2–9.2, P < 0.001) and carers/parents (ß 5.6, 95% CI:1.5–9.8, P < 0.001). Diabetes distress did not differ by child age, duration of diagnosis or mode of insulin administration. For children, adolescents and carers, 'serious concerns' most commonly related to the impact of diabetes upon family and peer relationships. Conclusions: Diabetes distress was common and associated with sub‐optimal glycaemia. Routine screening for diabetes distress should be considered in paediatric services. Development of strategies to minimise diabetes distress for youth and families is required. [ABSTRACT FROM AUTHOR]

It is well known that the multiple factors contributing to the pathogenesis of type 2 diabetes (T2D) confer an increased risk of developing cardiovascular disease (CVD). Although the relationship between hyperglycaemia and increased microvascular risk is well established, the relative contribution of hyperglycaemia to macrovascular events has been strongly debated, particularly owing to the failure of attempts to reduce CVD risk through normalizing glycaemia with traditional therapies in high‐risk populations. The debate has been further fuelled by the relatively recent discovery of the cardioprotective properties of glucagon‐like peptide‐1 receptor agonists and sodium‐glucose cotransporter‐2 inhibitors. Further, as guidelines now recommend individualizing glycaemic targets, highlighting the importance of achieving glycated haemoglobin (HbA1c) goals safely, the previously observed negative influences of intensive therapy on CVD risk might not present if trials were repeated using current‐day treatments and individualized HbA1c goals. Emerging longitudinal data illuminate the overall effect of excess glucose, the impacts of magnitude and duration of hyperglycaemia on disease progression and risk of CVD complications, and the importance of glycaemic control at or early after diagnosis of T2D for prevention of complications. Herein, we review the role of glucose as a modifiable cardiovascular (CV) risk factor, the role of microvascular disease in predicting macrovascular risk, and the deleterious impact of therapeutic inertia on CVD risk. We reconcile new and old data to offer a current perspective, highlighting the importance of effective, early treatment in reducing latent CV risk, and the timely use of appropriate therapy individualized to each patient's needs. [ABSTRACT FROM AUTHOR]

Aim: The plant‐based polyphenol‐rich extract TOTUM‐63 improves glucose homeostasis in various preclinical models of obesity and type 2 diabetes (T2D). A pilot exploratory study showed that TOTUM‐63 has good safety and tolerability profiles, and beneficial effects on postprandial glucose control in healthy individuals with overweight. The aim of this study was to assess the effects of TOTUM‐63 on glycaemic control in individuals with prediabetes or early stage newly‐diagnosed T2D (which does not require pharmacological treatment). Materials and Methods: This study was a multicentre, randomized, double‐blind, placebo‐controlled trial. Individuals with prediabetes or early stage newly‐diagnosed T2D and with overweight/abdominal obesity received TOTUM‐63 (5 g/day) or placebo for 6 months. The primary outcome was the change in fasting blood glucose. Results: Fifty‐one participants (age: 57.1 ± 10 years; body mass index: 31.3 ± 5.7 kg.m2; 35 women and 16 men) completed the study (n = 38 TOTUM‐63, n = 13 placebo). After 6 months, blood glucose concentration after fasting and after the 2‐h oral glucose tolerance test was reduced in the TOTUM‐63‐treated group compared with the placebo group (placebo‐corrected difference between baseline and month 6: −0.71 mmol/L, p <.05, and −1.93 mmol/L, p <.05, respectively). TOTUM‐63 was safe and well tolerated and significantly reduced body weight gain (−1.9 kg; p <.05), waist circumference (−4.5 cm; p <.001), circulating triglycerides (−0.54 mmol/L; p <.01) and low‐density lipoprotein‐cholesterol (−0.38 mmol/L; p <.05) compared with placebo. Conclusions: TOTUM‐63 lowered fasting blood glucose in participants with impaired fasting glycaemia and glucose intolerance. Moreover, TOTUM‐63 showed a good safety and tolerability profile and improved several metabolic syndrome features. Therefore, TOTUM‐63 is a promising candidate for T2D prevention. [ABSTRACT FROM AUTHOR]

The current pilot study was conducted to compare the triple effect of garlic extract and metformin on hyperglycaemia, hypercholesterolaemia, and hypertriglyceridaemia in alloxan-induced type 1-like diabetic rats. Wistar rats were randomly divided into four groups. Control group included normal rats. The second group included alloxan-induced type 1-like diabetic rats, receiving no treatment. The other two groups of diabetic rats were orally treated with 0.75 g of garlic extract per kg of body weight and 0.05 of metformin g per kg of body weight respectively for four weeks. The pharmacological impact of garlic compounds on serum glucose and lipids as opposed to the glucose-lowering and lipid-lowering was highlighted in these experiments. These results revealed that garlic extract has a triple action on hyperglycaemia, hypertriglyceridemia, and hypercholesterolemia. Its effect on hyperglycaemia is long lasting, and more pronounced compared to the metformin. Interestingly, it had a regulatory effect on glycaemia as highlighted in the control group.

The aim of the research was to record body thermoregulation in piglet function of glycaemia, quantified by body weight at weaning. In order to a quick body thermoregulation of piglets after parturition Mistral and Mistral + Dexamethasone products were used. After their use a quicker dry is recorded in piglets (1 – 2 minutes), a slighter decrease in the body temperature, a smaller energy consumption, needed in thermoregulation, correlated to a higher glycaemia and stronger outlets, capable of colostrum consumption, and as a result, higher body mass at weaning.

The aim of the current research was to determine the effects of cornelian cherry (Cornus mas L.) stone in Zucker diabetic fatty (ZDF) rats and characterize antioxidant profile (antioxidant activity, total polyphenol, phenolic acids and flavonoids) in cornelian cherry stone. A total of 24 male ZDF rats were divided into three groups: lean (non-diabetic), control (diabetic) and E (experimental group treated with dose 250 mg/kg body weight of cornelian cherry stone). The blood glucose levels in E group (9.83 ± 1.5 mmol/L) were significantly lower (P < 0.001) compared to the control (18.83 ± 2.56 mmol/L) in the end of the experiment. The antioxidant activity tested by DPPH method in cornelian cherry stone showed 7.84 mg TEAC/g (TEAC – trolox equivalent antioxidant activity). The content of total polyphenols was 29.61 mg GAE/g (GAE – gallic acid equivalent), from which flavonoids represented 1.56 mg QE/g (QE – quercetin equivalent) and phenolic acids 6.66 mg CAE/g (CAE – caffeic acid equivalent). The obtained results confirmed that cornelian cherry stone is a good source of antioxidant compounds and is able to positively participate in the glucose regulation in ZDF rats.

Background: The pattern of the plasma glucose response curve during an oral glucose tolerance test (OGTT) is of prognostic significance with “biphasic” when compared with “monophasic” patterns being associated with greater insulin sensitivity/secretion and a reduced risk of progression to diabetes. The relationships of the glucose response curves with gastric emptying and incretin hormone secretion are not known. Methods: Thirty-six adults (age > 65 years) without known diabetes consumed a 300 mL drink containing 75 g glucose and 150 mg C13-acetate at baseline and follow-up after 5.8 ± 0.1 years. Plasma glucose, glucagon-like peptide-1 (GLP-1), glucose independent insulinotropic polypeptide (GIP) and insulin were measured, and participants classified according to the pattern of their glucose response. Gastric emptying was measured on breath samples (stable isotope breath test). Results: At baseline, 22 participants had a “monophasic” and 14 a “biphasic” glucose response. The 1 h plasma glucose response curve was greater and the GLP-1 AUC0–120 min and insulin secretion lower in the monophasic group. There were no differences in gastric emptying, GIP or insulin sensitivity. At the follow-up, the 1 h glucose response curve was greater again, while GLP-1 AUC0–120 min was lower in the monophasic group. Conclusions: A biphasic curve is associated with a higher 60 min glucose response curve and increases in GLP-1, but no difference in either GIP or gastric emptying.