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Diabetes with poor glycemic control is a growing health concern for many communities. Improving glycemic control for patients with diabetes can prevent complications, improve health outcomes, and reduce overall diabetes disease burden. Continuous glucose monitoring (CGM) can improve glycemic control and evidence supports expansion of CGM using shorter periods and to all patients with diabetes. This project implemented CGM for patients in a rural diabetes clinic and evaluated glycemic control before and after use. All participants had type 2 diabetes (T2DM) and 75% observed improvement in glycemic control. Before CGM implementation, the average hemoglobin HgbA1C was 8.2%. This decreased to 7.1% postintervention. Statistically significant improvements were observed in those patients with CGM active at least 79% of the intervention period and in those with higher baseline HgbA1C levels. Subjectively, several patients reported that the CGM information empowered them to make healthy lifestyle changes and was a key factor in glycemic control improvement. Sample size, population diversity, and inability to control for medication changes were major limitations of this project. Despite these limitations, implementing CGM led to an improvement in glycemic control for most patients. Most profound improvements were seen among patients who utilized CGM consistently. The influence of pharmacologic and lifestyle factors on project outcomes was not able to be determined within the project design. Further areas for investigation include assessing CGM use on a larger scale, focusing on CGM use with type 2 diabetes, and controlling for pharmacologic and lifestyle factors. CGM is an evidence-supported, sustainable, and practical intervention to improve glycemic control, particularly among patients with type 2 diabetes.

To study the blood glucose lowering effect of the aqueous leaf digest prepared from T. cordifolia and S. androgynus. Materials and methods : The effect of the aqueous leaf digest (10g/200ml water) of the two experimental plants on post-prandial blood glucose levels was determined separately, in non-insulin dependent diabetic (NIDDM) subjects using the method of glucose tolerance test (GTT). The effect was compared with the glycemic response elicited by the control (glucose=50g) and the hypoglycaemic activity was evaluated in terms of glycemic index (GI) score. Results : The rise in the blood glucose levels of the subjects administered with the experimental samples were lower than the levels observed after feeding glucose control, with the glucose levels reverting back to fasting levels after 2 h. of administration in experimental groups. The GI scores of T. cordifolia (GI=39) and S. androgynus (GI=55) were significantly lower than that of glucose control (GI=100). Conclusion: T. cordifolia is found to exhibit a significant ability to reduce blood sugar levels in human subjects. This corroborates with the results of earlier animal studies and its use as an anti-diabetic agent in ayurvedic medical system. The hypoglycaemic activity of S. androgynus indicated in the present study warrants investigation into the compounds/extracts with anti-diabetic activity.

Few studies have investigated the effects of pre-exercise meals with differing glycemic responses on substrate utilization and endurance performance in subsequent exercise. Those few which have been done have looked at foods of limited application to a pre-exercise meal consumed prior to a morning event. This study investigated the effects of commonly eaten breakfast cereals on exercise performance. Ten physically active male subjects participated in this study. The subjects reported to the performance laboratory in the morning following an overnight fast (10-12 hours). Upon arrival, the subjects were weighed and then fed either a high glycemic index (GI) meal (corn flakes, banana, 1% low-fat milk) or moderate glycemic index meal (oatmeal, banana, 1% low-fat milk) containing 100 grams of carbohydrate (77% carbohydrate). A third trial using a continued fast served as a control. Trials were performed in random order. After consumption of the meal, the subjects remained seated for one hour before beginning a one-hour submaximal cycling trial at 70% VO2 max followed immediately by a maximal performance test to exhaustion. Blood was sampled pre-meal, pre-exercise, every 15 minutes of exercise and at completion of the performance test and analyzed for plasma glucose, free fatty acids, and lactate. Metabolic measurements collected every 15 minutes of exercise and during the maximal performance test included heart rate (Ilk), pulmonary ventilation (VE), oxygen consumption (VO2), carbon dioxide production (VCO2), and respiratory exchange ratio (RER).