Modulation of Postprandial Glucose Bioavailability in a Cohort of Healthy and Pre-Diabetics Subjects during Ramadan Fasting in cote d'Ivoire

Objective: After the Ramadan fasting period, there is an increasing prevalence of diabetes in Cote d’Ivoire, in diabetes care centers. The objective of this study was to assess the consumption of sugary foods during this period and to determine the risks of diabetes in Muslim populations. Methods: Information was collected on the type and amount of sugary foods consumed. Methods for the preparation of these foods have been determined. Intake frequencies and postprandial glycemic responses were studied. The usual statistical methods were used. Results: Between 70% and 85% of the “fasters” consume plenty of these sugary foods during this period, with an average added sugar level varying between 10% and 35% and a daily consumption of between 250 cl and 0.5 l. The added sugar leads to hyperglycemia in both healthy subjects and pre diabetics. Conclusion: Regular consumption of these sugary foods results in significant hyperglycaemia throughout the month of fasting with a significantly higher blood glucose level in pre diabetic subjects. This makes pre diabetics people more at risk of diabetes among Muslim populations during Ramadan fasting.

Relationship Between Postprandial Blood Glucose,Fasting Insulin,and Glycated Hemoglobin Levels and Early Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus

Objective:To investigate the relationship between postprandial blood glucose(PBG),fasting insulin(FINS),and glycated hemoglobin(HbA1c)levels and early diabetic nephropathy in patients with type 2 diabetes.Methods:96 cases of type 2 diabetes mellitus treated in our hospital from May 2021 to May 2022 were selected as the research subjects.The patients were divided into two groups according to the urinary albumin excretion rate(UAER),with 53 cases in the type 2 diabetes group(UAER<30μg/min)and 43 cases in the early diabetic nephropathy group(30μg/min≤UAER<300μg/min).PBG,FINS,and HbA1c levels were detected in 87 healthy patients.Results:The levels of PBG,FINS,and HbA1c in the early diabetic nephropathy group were higher than those in the control group(P<0.01)and the type 2 diabetes group(P<0.01).Conclusion:PBG,FINS,and HbA1c are factors affecting the occurrence of diabetic nephropathy in patients with type 2 diabetes;thus,controlling the levels of PBG,FINS,and HbA1c can effectively prevent the occurrence of diabetic nephropathy in type 2 diabetes mellitus.

Ultra rapid lispro improves postprandial glucose control versus lispro in combination with insulin glargine/degludec in adults with type 2 diabetes:a prospective,randomized,double-blind,phase 3 trial

Ultra rapid lispro(URLi)is a novel formulation of insulin lispro designed to more closely match the physiological insulin response to a meal,with the aim of improving postprandial glucose(PPG)control.We conducted a multinational,multicenter,randomized,double-blind,treat-to-target,26-week,phase 3 trial to evaluate the efficacy and safety of URLi in adults with type 2 diabetes(T2D).After an 8-week lead-in period during which basal insulin glargine or degludec was optimized,adults with T2D were randomized(2:1)to prandial URLi(n=395)or lispro(n=200).The primary endpoint was non-inferiority of URLi versus lispro in glycated hemoglobin A1c(HbA_(1c))change from baseline to week 26.Multiplicity-adjusted analyses were performed to assess the superiority of URLi in 1-and 2-h PPG excursions during a mixed-meal tolerance test(MMTT)and HbA_(1c) change at week 26.URLi showed non-inferiority for Hb Achange at week 26 versus lispro(least-squares mean[LSM]difference,0.07%;95%confidence interval:-0.07,0.21).HbA_(1c) was reduced by 0.56%and 0.63%with URLi and lispro,respectively,with no significant treatment difference(P=0.321).URLi provided superior PPG excursion control versus lispro at1 h(LSM difference:-14.6 mg/d L,P<0.001)and 2 h(LSM difference:-21.8 mg/d L,P<0.001)as well as other time points(30–240 min)during the MMTT.Incremental area under the glucose curve during the MMTT was also significantly lower with URLi versus lispro.The safety profiles were generally similar between treatment groups.In conclusion,URLi was superior to lispro for PPG control,with noninferiority in HbA_(1c) improvement,in adults with T2D.

Prior or Concomitant Drinking of Vegetable Juice with a Meal Attenuates Postprandial Blood Glucose Elevation in Healthy Young Adults

Controlling postprandial blood glucose levels can prevent and improve lifestyle-related diseases. We aimed to evaluate the effects of a commercially available vegetable juice, which is a convenient alternative to vegetables, on postprandial glucose elevation. In test 1, we confirmed the appropriate timing to consume the vegetable juice (200 mL), and demonstrated that postprandial glucose elevation was attenuated by drinking the vegetable juice with or before the experimental meal. The change in maximum concentration (ΔCmax) of blood glucose was the lowest when the vegetable juice was consumed at 30 min before the meal. In test 2, we confirmed the necessary ingestion volumes of vegetable juice (range: 68.5 - 274 mL) for attenuating the response to 50 g of carbohydrates. After drinking 200 mL of vegetable juice, the ΔCmax and incremental area under the curve values for blood glucose were significantly lower than those for after drinking the same volume of water (p < 0.05). However, a greater volume of vegetable juice did not provide an additive effect. Our results suggest that approximately 200 mL of vegetable juice at 30 min before meals is the most effective method for using vegetable juice to suppress postprandial blood glucose elevation. Stimulation of insulin secretion due to the pre-meal vegetable juice intake may contribute to this effect, although further studies are needed to identify the detailed mechanism for the attenuation.

Ethanol extract of Annona muricata Linn fruit perform antidiabetic effect on type 2 diabetic mice through α-glucosidase inhibition

Objective:To explore the anti-diabetic effects and its underlying mechanism of Annona muricata Linn fruit ethanol extract(AME).Methods:Streptozotocin-induced type 2 diabetic(T2DM)mouse model was constructed.Those diabetic mice were randomly grouped and given 50 mg/kg acarbose or AME(200 mg/kg,100 mg/kg or 50 mg/kg)for four weeks.The body weight,postprandial blood glucose and glycosylated hemoglobin levels were measured during the administration.After the administration,a glucose tolerance test was performed,and the levels of triglycerides,cholesterol and low-density lipoproteins in mice were detected by biochemical test kits.The inhibitory activity of AME onα-glucosidase in vivo and in vitro was determined by enzyme inhibition tests.Results:AME significantly reduced weight gain,postprandial blood glucose,glycosylated hemoglobin and low-density lipoprotein levels in T2DM mice;enhanced glucose tolerance and pancreaticβ-cell function of T2DM mice;inhibitedα-glucosidase activity in mouse intestine in an noncompetitive manner.Conclusion:AME may noncompetitive inhibitα-glucosidase activity and reduce postprandial glucose intake to achieve a therapeutic and regulatory effect on type 2 diabetes.

A Review on the Management of Gestational Diabetes Mellitus(GDM):Pharmacological and Non-Pharmacological Interventions

Gestational diabetes mellitus(GDM)is defined as any degree of glucose or carbohydrate intolerance mainly during pregnancy.About 10%to 15%of pregnancies are affected and complicated by gestational diabetes.Due to hormonal changes during pregnancy,the requirement for insulin increases,and thus the usual concentration of insulin previously catered for glycemic control is ineffective.In order to meet the body’s demand,the islet cells secrete a higher amount of insulin.GDM occurs when this higher concentration is also unable to control blood glucose.This increased resistance toward insulin is most noticeable during the third trimester of pregnancy,which gradually normalizes after the termination of pregnancy.Various complications do arise,which affect both the mother and her developing fetus.In the mother,miscarriages,delivery of baby via caesarian section,and other complications may result,whereas the fetus may be affected with congenital abnormalities,neonatal hypoglycemia,and even death.Treatment of GDM includes both non-pharmacological and pharmacological interventions.Pharmacological agents are employed when non-pharmacological interventions fail to achieve the desired target.Glyburide,insulin,and metformin are the commonly used pharmacological agents.

Association of GYS1 and β_3-AR gene with postprandial hyperglycemia and serum uric acid in type 2 diabetes mellitus

Objective To determine the relationships of Met416Val and XbaI polymorphism of muscle glycogen synthase (GYS1) gene and Trg64Arg variant of the β 3 adrenergic receptor (β 3 AR) gene with type 2 diabetes mellitus (DM) and its intermediate phenotypes in the Chinese population Methods Polymerase chain reaction oligonucleotide ligation assay and restriction fragment length polymorphism assay were used to evaluate the GYS1 and β 3 AR gene polymorphisms in 102 pairs of case control Chinese spouses Results Subjects with Met416Val variant had a significantly higher 2 hour post glucose level than subjects without this variant had in diabetic group ( P =0 032) The Met416Val polymorphism of GYS1 gene was not significantly associated with the risk of type 2 DM (adjusted OR=1 67; 95% CI: 0 73-3 81, P =0 223) Subjects with Trp64Arg variant had a significantly higher serum uric acid level than subjects without this variant had in diabetic group ( P =0 034) The combination of BMI and Arg64 allele carrier of the β 3 AR gene increased the diabetic risk over four fold (adjusted OR=4 00; 95%CI: 1 53-10 45, P =0 005) Conclusions In the Chinese population, Met416Val polymorphism is identified in a subgroup of diabetic subjects with high 2 hour post glucose It will explain why some diabetic patients appear to be genetically predisposed to developing high postpradial glucose level The presence of the Arg64 allele in the β 3 AR gene may predispose patients to higher serum uric acid level