This double-blind, controlled, randomized, three-way cross-over study evaluates the effect of 40 g (D1 group) and 20 g (D2 group) of acacia gum (AG) versus no treatment (NT group) on post-prandial glucose (PPG) levels...This double-blind, controlled, randomized, three-way cross-over study evaluates the effect of 40 g (D1 group) and 20 g (D2 group) of acacia gum (AG) versus no treatment (NT group) on post-prandial glucose (PPG) levels in normal-weight and overweight subjects. Additionally, post-prandial insulin (PPI) levels as well as the safety and tolerability of gum acacia were assessed. 35 healthy subjects aged 25 - 60 years, body mass index 18.5 kg/m<sup>2</sup> - 29.9 kg/m<sup>2</sup>, received one treatment of 20 g, 40 g, or 0 g of AG each. Glucose and insulin values were determined at -15 min and prior to the intake (time “0”) as well as 15, 30, 45, 60, 90 120, and 180 min after the “0 min” blood draw. The mean PPG levels were lower (34% in D1 group, p = 0.003;35% in D2 group, p = 0.005) than in the NT group. PPI concentration was statistically significantly lower at all time points except baseline in both treatment groups compared to NT groups. Global benefit and tolerability were rated as “very good” or “good” by 100% of subjects in the treatment groups. This study provides robust evidence of the significant benefits of AG consumption on PPG and PPI levels in healthy subjects. Moreover, very good tolerability was demonstrated.展开更多
For type 1 and advanced type 2 diabetic patients, insulin replacement therapy with simulating on-demand prandial and basal insulin secretion is the best option for optimal glycemic control. However, there is no insuli...For type 1 and advanced type 2 diabetic patients, insulin replacement therapy with simulating on-demand prandial and basal insulin secretion is the best option for optimal glycemic control. However, there is no insulin delivery system yet could mimic both controlled basal insulin release and rapid prandial insulin release in response to real-time blood glucose changes. Here we reported an artificial insulin delivery system, mimicking physiological basal and prandial insulin secretion, to achieve real-time glycemic control and reduce risk of hypoglycemia. A phenylboronic acid(PBA)/galactosyl-based glucose-responsive insulin delivery system was prepared with insulin-loaded micelles embedded in hydrogel matrix. At the hyperglycemic state, both the hydrogel and micelles could swell and achieve rapid glucose-responsive release of insulin, mimicking prandial insulin secretion.When the glucose level returned to the normal state, only the micelles partially responded to glucose and still released insulin gradually. The hydrogel with increased crosslinking density could slow down the diffusion speed of insulin inside, resulting in controlled release of insulin and simulating physiological basal insulin secretion. This hydrogel-micelle composite insulin delivery system could quickly reduce the blood glucose level in a mouse model of type 1 diabetes, and maintain normal blood glucose level without hypoglycemia for about 24 h. This kind of glucose-responsive hydrogel-micelle composite may be a promising candidate for delivery of insulin in the treatment of diabetes.展开更多
目的:评价国内自我管理对糖尿病患者血糖影响的效果。方法:计算机检索维普数据库、万方数据库、中国知网数据库,检索时间为各数据库建库至2015年7月,同时辅助其他检索方式,纳入自我管理对糖尿病患者干预的随机对照试验(RCT),根据Coc...目的:评价国内自我管理对糖尿病患者血糖影响的效果。方法:计算机检索维普数据库、万方数据库、中国知网数据库,检索时间为各数据库建库至2015年7月,同时辅助其他检索方式,纳入自我管理对糖尿病患者干预的随机对照试验(RCT),根据Cochrane Handbook 5.0质量评价标准评价,采用Rev Man 5.0软件进行统计分析。结果:纳入17篇合格文献,包含2489例病例。分析结果显示:与糖尿病传统干预方式组相比,自我管理教育试验组患者空腹血糖在干预后3个月、6个月、12个月与相应对照组比较,差异具有统计学意义;干预后18个月与相应对照组比较差异无统计学意义。自我管理教育试验组患者餐后2小时血糖在干预后3个月与相应对照组比较,差异无统计学意义;6个月、12个月、18个月与相应对照组比较,差异具有统计学意义。结论:自我管理教育(干预6~12个月)对糖尿病患者空腹血糖和餐后2小时血糖的干预效果较好,值得临床推广。发表性偏倚的识别结果表明,该次Meta分析的结果稳定、可靠。展开更多
文摘This double-blind, controlled, randomized, three-way cross-over study evaluates the effect of 40 g (D1 group) and 20 g (D2 group) of acacia gum (AG) versus no treatment (NT group) on post-prandial glucose (PPG) levels in normal-weight and overweight subjects. Additionally, post-prandial insulin (PPI) levels as well as the safety and tolerability of gum acacia were assessed. 35 healthy subjects aged 25 - 60 years, body mass index 18.5 kg/m<sup>2</sup> - 29.9 kg/m<sup>2</sup>, received one treatment of 20 g, 40 g, or 0 g of AG each. Glucose and insulin values were determined at -15 min and prior to the intake (time “0”) as well as 15, 30, 45, 60, 90 120, and 180 min after the “0 min” blood draw. The mean PPG levels were lower (34% in D1 group, p = 0.003;35% in D2 group, p = 0.005) than in the NT group. PPI concentration was statistically significantly lower at all time points except baseline in both treatment groups compared to NT groups. Global benefit and tolerability were rated as “very good” or “good” by 100% of subjects in the treatment groups. This study provides robust evidence of the significant benefits of AG consumption on PPG and PPI levels in healthy subjects. Moreover, very good tolerability was demonstrated.
基金supported by the National Natural Science Foundation of China(51603105,51773099,51390483,91527306,21620102005)the Program for Changjiang Scholars and Innovative Research Team in University(IRT1257)
文摘For type 1 and advanced type 2 diabetic patients, insulin replacement therapy with simulating on-demand prandial and basal insulin secretion is the best option for optimal glycemic control. However, there is no insulin delivery system yet could mimic both controlled basal insulin release and rapid prandial insulin release in response to real-time blood glucose changes. Here we reported an artificial insulin delivery system, mimicking physiological basal and prandial insulin secretion, to achieve real-time glycemic control and reduce risk of hypoglycemia. A phenylboronic acid(PBA)/galactosyl-based glucose-responsive insulin delivery system was prepared with insulin-loaded micelles embedded in hydrogel matrix. At the hyperglycemic state, both the hydrogel and micelles could swell and achieve rapid glucose-responsive release of insulin, mimicking prandial insulin secretion.When the glucose level returned to the normal state, only the micelles partially responded to glucose and still released insulin gradually. The hydrogel with increased crosslinking density could slow down the diffusion speed of insulin inside, resulting in controlled release of insulin and simulating physiological basal insulin secretion. This hydrogel-micelle composite insulin delivery system could quickly reduce the blood glucose level in a mouse model of type 1 diabetes, and maintain normal blood glucose level without hypoglycemia for about 24 h. This kind of glucose-responsive hydrogel-micelle composite may be a promising candidate for delivery of insulin in the treatment of diabetes.
文摘目的:评价国内自我管理对糖尿病患者血糖影响的效果。方法:计算机检索维普数据库、万方数据库、中国知网数据库,检索时间为各数据库建库至2015年7月,同时辅助其他检索方式,纳入自我管理对糖尿病患者干预的随机对照试验(RCT),根据Cochrane Handbook 5.0质量评价标准评价,采用Rev Man 5.0软件进行统计分析。结果:纳入17篇合格文献,包含2489例病例。分析结果显示:与糖尿病传统干预方式组相比,自我管理教育试验组患者空腹血糖在干预后3个月、6个月、12个月与相应对照组比较,差异具有统计学意义;干预后18个月与相应对照组比较差异无统计学意义。自我管理教育试验组患者餐后2小时血糖在干预后3个月与相应对照组比较,差异无统计学意义;6个月、12个月、18个月与相应对照组比较,差异具有统计学意义。结论:自我管理教育(干预6~12个月)对糖尿病患者空腹血糖和餐后2小时血糖的干预效果较好,值得临床推广。发表性偏倚的识别结果表明,该次Meta分析的结果稳定、可靠。