Endogenous triglyceride turnover has been measured in patients with normotriglyceridemia or with hypertriglyceridemia using the radioglycerol labelling technique. In parallel, a 50 g oral glucose tolerance test was performed (blood glucose, serum insulin, free fatty acids). Non-diabetics, borderline diabetics, and overt diabetics were included. In the non-diabetics, insulin levels were negatively correlated with fractional catabolic rates for triglycerides, whereas no correlation with triglyceride synthesis rates existed. Patients with low fractional catabolic rates for triglycerides have significantly higher insulin and free fatty acid concentrations, pointing to an association between impairment of triglyceride removal and insulin resistance. There is no typical kinetic pattern of triglyceride metabolism in non-insulin-dependent diabetes mellitus.Read more
Therapeutic effectiveness of 3 new extrusion foods was studied in control conditions of clinic of Institute of nutrition RAMS. The foods were produced by Institute of meat industry RAS on basis of meat resources and wheat brans. The samples of extrusion foods were differed by contents of protein (17-23 g%) and dietary fibers (up to 10%) and used in therapeutic diet for patients with insulin-dependent diabetes mellitus. It was shown that of all three extrusion foods caused decreasing of dyspeptic symptoms during first week of intake and normalisation of intestinal functions without using of laxatives unlike of control group of patients eating standard diabetic diet. It was shown also a decreasing of cholesterol in blood serum of patients received of extrusion foods No 1 and No 3. These samples are recommended for diet therapy and preventive nutrition of patients with metabolic disorders and hypomotoricity of intestinal tract as resources of dietary fibers and protein.Read more
The effectiveness of a specific educational programme involving the use of a real-time glucose-sensor system (Guardian RT) to improve glucose control was investigated in patients with poorly controlled type 2 diabetes despite insulin therapy. Ten patients participated in a randomized crossover study comparing two 3-month periods, during which glucose levels were monitored by either self-monitoring of blood glucose (SMBG) alone or by Guardian RT (restricted to 1 week per month) in addition to SMBG. Only four of the enrolled patients completed both periods, while dropouts were mainly due to technical difficulties in using the device. All six patients who completed the first 3-month period showed a reduction in glycated haemoglobin (HbA(1c)) level whatever the mode of glucose monitoring (study effect). A further reduction in HbA(1c) level was observed in two of the three patients using the Guardian RT during the second period. Less frequent symptomatic hypoglycaemic episodes were noted during the 3-month period with the device in the four patients who completed both study periods. These limited, but promising, results of this pilot study appear to justify the initiation of a larger study to assess the use of a real-time glucose sensor in carefully selected patients with type 2 diabetes.Read more
The glucagon-like peptide-1 (GLP-1) is a 30 amino acid incretin hormone synthesized by L cells of ileum and colon in response to a meal. Once secreted, it is rapidly inactivated by specific enzymes called dipeptidyl dipeptidase 4. The main actions of GLP-1 are (i) to stimulate insulin secretion; (ii) to inhibit glucagon secretion; (iii) to elicit a delay of gastric emptying time; and (iv) to stimulate neogenesis of insulin-secreting cells. Patients with type 2 diabetes show low GLP-1 concentrations in response to a meal, making treatment with incretin mimetics specifically indicated in this patient subset. Besides these effects on intermediary metabolism, GLP-1 also plays an important role in the cardiovascular system by reducing blood pressure, improving endothelial function, and increasing myocardial contractility. These mechanisms of action will be discussed in detail in this article.Read more
To investigate the secular trend of prevalence and risk factors for type 2 diabetes mellitus (T2DM) in the rural Chinese population.
16,953 participants aged 35 to 74 years old participated in a cross-sectional study in a Henan rural area in 2007-2008. The InterAsia study which is a nationally representative sample of rural Chinese residents was done in 2000 -2001. The rural Chinese adult participants in InterAsia study were compared with the 2007-2008 data to analyze the secular trend of prevalence and risk factors of T2DM.
In 2007-2008, the aged-adjusted prevalence of T2DM was 7.72% (male 7.71%, female 7.73%). The aged-adjusted prevalence of T2DM elevated from 5.27% to 7.72% during seven years. The prevalence of T2DM was progressively increased with age from 2000-2001, but the prevalence of T2DM for the participants aged from 55 to 64 was highest after seven years in 2007-2008. Compared two studies,the exposed rates of hypertension, abdominal obesity, dyslipidemia were increased from 26.82%, 26.39%, 20.45% to 29.82%, 46.1%, 44.20%.
The prevalence of T2DM and it's risk factors increase rapidly in the rural Chinese population, and the intervention program are urgently needed.Read more
Type 2 diabetes prevalence is rising rapidly in developing world especially in India in last few decades. 'Thrifty phenotype' and 'westernization of lifestyle' is used to explain this epidemic. Chromium is an important modulator in insulin and glucose metabolism. Preconceptional chromium exposure has been demonstrated to raise the corticosterone and glucose levels in offspring of rodent model. Chromium is chelated when acidic food is stored in the stainless steel utensils. Chromium levels are shown to be high in Asian Indians. The hyperinsulinemia and insulin resistance is demonstrated in Indians from the newborn stage. We hypothesize that increased exposure to chromium in preconceptional and/or fetal stage leads to altered epigenetic control and altered endocrine and metabolic functioning. Increasing urbanization has led to increasing use of stainless steel and resultant exposure to chromium is at the least partly responsible for rising prevalence of type 2 diabetes. If proven avoiding or modifying the use of stainless steel utensils will halt the present epidemic of type 2 diabetes.Read more
To study clinical risk factors of severe hypoglycemia in type II diabetes.
Fifty-one type II diabetes with severe hypoglycemia admitted between October 2006 and September 2008 and 359 nonhypoglycemic type II diabetes were evaluated in this case-control study. Medical records were retrospective reviewed for age, sex, duration of diabetes, previous diabetes registration, concomitant diseases, HbA1c level and current diabetes therapy in both groups. Acute illness, blood glucose, hypoglycemic episodes, symptoms and length of stay (LOS) were assessed in hypoglycemic group. Univariate and multivariate logistic regression were used to determine risk factors of severe hypoglycemia.
Fifty-one hypoglycemic and 359 nonhypoglycemic patients were analyzed. The authors found that 40% of severe hypoglycemic cases were recurrent. The average LOS was six days. Intercurrent illness was the major leading cause of hypoglycemia (54.9%). Mean blood glucose level was 37.2 mg/dl (SD = 13.5). Twenty-three of fifty-one (45%) patients presented with unconsciousness. Predisposing risk factors associated with severe hypoglycemia were old age (p = 0.026), insulin therapy (p = 0.001), cirrhosis (p = 0.020), cerebrovascular disease (p = 0.040), and no diabetes registry (p = 0.015). Sex, HbA1c level, hypertension and chronic kidney disease were not risk factors associated with severe hypoglycemia.
Risk factors associated with severe hypoglycemia in type II diabetes were elderly, insulin therapy, cirrhosis, previous cerebrovascular disease, lack of standard diabetic care and team approach. Self-monitoring of blood glucose and individual case management should be considered in those with previous hypoglycemic events.Read more
Exercise rehabilitation has traditionally been part of the management of patients with coronary artery disease, particularly in the recovery period from a myocardial infarction or after coronary artery bypass surgery. The benefits of exercise training and formal rehabilitation programs are not limited to patients with coronary artery disease, and special populations described in this article should be considered for rehabilitation services. Patients with PAD are frequently severely limited by claudication pain. Exercise rehabilitation is an effective means to improve exercise performance without the use of drugs or operation. In patients with NIDDM, an exercise program not only improves exercise performance (which is impaired as compared with age-matched controls) but also improves glucose metabolism and insulin sensitivity. Patients with left ventricular dysfunction have a severely limited peak exercise performance. In these patients, an exercise program can be conducted safely in a supervised setting and will result in a significant improvement in peak oxygen consumption.Read more
The incidence of type 2 diabetes mellitus is rising. It presently affects more than 150 million people worldwide, and 7.5% of the population of Europe suffer from this disease. This is partially explained by an increase in the prevalence of obesity. Less than 10% of the diabetic patients achieve appropriate control of their illness. For over a decade, it has been observed that the resolution of type 2 diabetes is an additional outcome of surgical treatment of morbid obesity. Moreover, it has unequivocally been shown that, postoperatively, diabetes-related morbidity and mortality have significantly declined. This improvement in diabetes control is long lasting, and was well documented postoperatively for at least 16 years. Two procedures, the Roux-en-Y gastric bypass (RYGB) and the biliopancreatic diversion (BPD), are more effective treatments for diabetes than other procedures. They are followed by normalization of concentrations of plasma glucose, insulin and glycosylated hemoglobin in 80-100% of morbidly obese patients. Studies have shown that results return to euglycemia and normal insulin levels occur within days after surgery, long before any significant weight loss occurs. This fact suggests that weight loss alone is not a sufficient explanation for this improvement. Other possible mechanisms effective in this phenomenon are decreased food intake, partial malabsorption of nutrients, and anatomical alteration of the gastrointestinal tract, that incites changes in the incretin system, which in turn, affect glucose balance. Better understanding of those mechanisms may lead to the discovery of new treatment modalities for diabetes and obesity.Read more