Seminal vesicles and diabetic neuropathy： ultrasound evaluation in patients with couple infertility and different levels of glycaemic control

The aim of this study was to evaluate the ultrasound characteristics of the seminal vesicles （SVs） of infertile patients with diabetes mellitus （DM） and diabetic neuropathy （DN） and to investigate possible changes in ultrasound characteristics related to glycaemic control. To accomplish this, 45 infertile patients with type 2 DM and symptomatic DN were selected. Twenty healthy fertile men and 20 patients with idiopathic oligoasthenoteratozoospermia without DM represented the control groups. DM patients were arbitrarily divided into three groups according to glycaemic control level （A=glycosylated haemoglobin 〈7%; B =glycosylated haemoglobin between 7% and 10%; C=glycosylated haemoglobin 〉 10%）. Patients underwent prostate-vesicular transrectal ultrasonography and sperm analysis. The following SV ultrasound parameters were recorded： （i） body antero-posterior diameter （APD）; （ii） fundus APD; （iii） parietal thicknesses of the right and left SVs; and （iv） the number of polycyclic areas within both SVs. We then calculated the following parameters： （i） fundus/body （F/B） ratio; （ii） difference of the parietal thickness between the right and the left SV; and （iii） pre- and post-ejaculatory APD difference. All DM patients had a higher FIB ratio compared to controls （P〈0.05）. Group C had a higher FIB ratio compared to the other DM groups （P〈0.05）. All DM patients had a lower pre- and post-ejaculatory difference of the body SV APD compared to controls （P〈0.05）. Groups A and B had a similar pre- and post-ejaculatory difference of the body SV APD, whereas this difference was lower in Group C （P〈0.05）. In conclusion, infertile DM patients with DN showed peculiar SV ultrasound features suggestive of functional atony, and low glycaemic control was associated with greater expression of these features.

杂粮的有效利用——低GI(Glycaemic Index)食品的必要性(英文)

研究了在体重过多人群的食生活里导入杂粮的有效性以及杂粮食谱的营养价值。营养价值参考了日本厚生劳动省发表的"日本人食事摄取基准",这资料标示了目标热量、各种营养成分的目标摄取量以及许多项目的极限程度。因为极限程度与年龄、性别和生理状态有关,在此我们以普通生活的成人作为基准。杂粮中的营养成分,苋的热量358kcal、蛋白质12.7g、脂肪6.0g、糖质64.9g、食物纤维7.4g、Na 1.0mg、P540mg、Fe 9.4mg、Ca 160mg、K 600mg、Cu 0.92mg、Zn 5.8mg、Mn 6.14mg、维生素A 2.0ug以及微量的维生素C。经过研讨设计了营养平衡最佳的食谱为:糙米200g、苋50g、andeskinua50g、大豆110g、甘薯200g、绿黄色蔬菜(小青菜)300g、鸡蛋55g以及泥鳅100g。食用这个食谱可以摄取热量2007 kcal(是基准摄取量的100%),其他营养成分的摄取量与基准摄取量相比分别为:蛋白质173%、脂肪72%、碳水化物105%、K 332%、Ca262%、Mg 267%、P 250%、Fe 420%、Zn 183%、Cu 343%、VA 126%、VD 100%、VE 142%、VK 940%、VB1237%、VB2174%、烟碱酸201%、VB6218%、VB12375%、叶酸350%、泛酸160%、VC 176%、食物纤维185%、盐分5%以及Mn 273%。不足的盐分可以使用调味料来补充。氨基酸的摄取量推测是基准值的100%。蛋白质:脂肪:碳水化物的比例是19.0∶18.0∶63.0,与理想的平衡比接近。

Potential contributions of the methodology to the variability of glycaemic index of foods

Glycaemic index(GI)testing provides a useful point of comparison between carbohydrate sources.For this comparison to be meaningful,the methods used to determine GI values need to be rigorous and consistent between testing events.This requirement has led to increasing standardization of the GI methodology,with an international standard developed in joint consultation with FAO/WHO(ISO 26642:2010)currently the most up to date document.The purpose of this review is to compare the international standard to methods of published studies claiming to have performed a GI test.This analysis revealed that the international standard permits a wide range of choices for researchers when designing a GI testing plan,rather than a single standardized protocol.It has also been revealed that the literature contains significant variation,both between studies and from the international standard for critical aspects of GI testing methodology.The primary areas of variation include;what glucose specification is used,which reference food is used,how much reference food is given,what drink is given during testing,the blood sampling site chosen and what assay and equipment is used to measure blood glucose concentration.For each of these aspects we have explored some of the methodological and physiological implications of these variations.These insights suggest that whilst the international standard has assisted with framing the general parameters of GI testing,further standardization to testing procedures is still required to ensure the continued relevance of the GI to clinical nutrition.

“Medioglycaemia”: A new concept in glycaemic control in intensive care (ICU) units?

Introduction: Critically ill patients can experience stress-induced hyperglycaemia. Glycaemic control therapy (GCT) is administered to control patients’ blood glycaemic levels and reduce the incidence of infection, myocardial infarctions and organ failure. However, there are many factors influencing the effectiveness of glycaemic control for patients. This investigation aimed to review the method of Glycaemic Control Therapy (GCT) used in two hospital settings, to assess the effectiveness of glycaemic control on patients’ blood glycaemic levels and examine any barriers that may be in place. Method: A retnrospective audit was carried out on patients’ case notes in Intensive Care Units (ICU) within the East Midlands, UK. This method prevents the study outcomes being swayed because GCT has already taken place. To reduce selection bias the most recent available case notes were selected. All the patients who were admitted to these adult ICU’s between March and April 2010 had their case notes examined, those who were administered GCT were included in the study, this involved 79 from Hospital A and 50 from Hospital B. The patients’ notes were retrospectively audited. Results: Different glycaemic control protocols were being implemented in each hospital, despite both belonging to the same ICU network. In most incidences, regardless of age, diabetes status or diagnosis, patients were administered the same sliding scale insulin (SSI). It was also found that GCT commenced for 41.9% (n = 52) of ICU patients (across both Hospitals) when glycaemic levels were below the established threshold of 10mmol/L. Additionally, a new glycaemic range has been discovered, where 88.3% (n = 113) of patients (across both Hospitals) receiving GCT were not controlled in hypoglycaemia, normoglycaemia or hyperglycaemia. They had mean blood glycaemic levels maintained between 5.6 - 9.9 mmol/L, now being described as medioglycaemia. Conclusions: The majority of patients receiving GCT were controlled in medioglycaemia and therefore a new comprehensive guideline needs to be developed incorporating this new range. Recommendations also need to be established to adapt the titration regimen to individual patients, to improve the effectiveness and safety of glycaemic control.

Better Glycaemic Outcome, Low Levels of Acute Severe Complications, and High Patient Satisfaction in Routine Practice in Type 1 Diabetes Treated with an Insulin Pump

Treatment of patients with Type 1 diabetes with continuous subcutaneous insulin infusion (CSII) was re-introduced in Denmark in this millennium and initiated in the diabetes clinic, Fredericia Hospital, in 2005. The aim of the present study was to present yearly data of quality from 2005 to 2013 from a clinical database of patients treated with CSII in routine practice. Methods: A database was established in 2009-2010. Data from 2005 to 2009 are retrospective, data from 2009 to 2013 prospective. From 2009, patient satisfaction was measured by validated questionnaires. Results: By 31 December 2013, the database contained data from 143 active patients. HbA1C (median and range) decreased from 64 (40 - 126) mmol/mol (8.0 (5.8 - 13.7)%) (n = 104) to 60 (36 - 98) mmol/mol (7.6 (5.4 - 11.1)%) (n = 134) (p < 0.001) before and latest year on CSII. The improved glycaemic control was maintained each year until ≥5 years after initiation of CSII (p < 0.01). There was no change in weight. The number of attacks of severe hypoglycaemia was reduced from 60 attacks in 21 patients (n = 104) the year before CSII to only 5 attacks in 5 patients in 2013 (n = 134) (p < 0.01), corresponding to an incidence of 3.7 episodes per 100 patient years. Each year after initiation of CSII until ≥5 years, the number of episodes of severe hypoglycaemia was reduced (p < 0.01). Since 2005, nine episodes of ketoacidosis have been registered in eight patients corresponding to an incidence of 1.4 episodes per 100 patient years. Patient satisfaction was high one year after initiation of CSII (p < 0.01). Conclusion: Change of treatment to CSII is accompanied by an improvement in glycaemic control, very pronounced reduction in severe hypoglycaemia, low levels of diabetic ketoacidosis, and pronounced patient satisfaction.

Periodontitis:An often-neglected complication of diabetes

The bidirectional association between type 2 diabetes mellitus(T2DM)and periodontitis is now well established,resulting in periodontal disease being considered as the 6th major complication of diabetes mellitus(DM)after cardiovascular disease,eye disease,neuropathy,nephropathy,and peripheral vascular disease.DM can worsen the virulence and invasiveness of pathogenic oral microbial flora aggravating the local inflammation and infection in those with periodontal disease.On the other hand,the chemical and immunological mediators released into the circulation as part of periodontal inflammation worsen the systemic insulin resistance with worsening of T2DM.Periodontitis if undiagnosed or left untreated can also result in eventual tooth loss.A study by Xu et al in the World Journal of Diabetes examined the predictive factors associated with periodontitis in Chinese patients with T2DM.The prevalence of periodontitis was found to be 75.7%in this study.Based on logistic regression analysis,the predictive factors for higher risk were low tooth brushing frequency[odds ratio(OR)=4.3],high triglycerides(TG;OR=3.31),high total cholesterol(TC;OR=2.87),higher glycated hemoglobin(HbA1c;OR=2.55),and higher age(OR=1.05)while higher education level was protective(OR=0.53).However,the most influential variables were HbA1c followed by age,TC,TG,low education level,brushing frequency,and sex on the random forest model(this model showed higher sensitivity for predicting the risk).A good understanding of the predictors for periodontitis in T2DM patients is important in prevention,early detection of susceptible patients,and intervention to improve periodontal health and enable long-term glycaemic control as observed by Xu et al.

Continuous glucose monitoring metrics in pregnancy with type 1 diabetes mellitus

Managing diabetes during pregnancy is challenging,given the significant risk it poses for both maternal and foetal health outcomes.While traditional methods involve capillary self-monitoring of blood glucose level monitoring and periodic HbA1c tests,the advent of continuous glucose monitoring(CGM)systems has revolutionized the approach.These devices offer a safe and reliable means of tracking glucose levels in real-time,benefiting both women with diabetes during pregnancy and the healthcare providers.Moreover,CGM systems have shown a low rate of side effects and high feasibility when used in pregnancies complicated by diabetes,especially when paired with continuous subcutaneous insulin infusion pump as hybrid closed loop device.Such a combined approach has been demonstrated to improve overall blood sugar control,lessen the occurrence of preeclampsia and neonatal hypoglycaemia,and minimize the duration of neonatal intensive care unit stays.This paper aims to offer a comprehensive evaluation of CGM metrics specifically tailored for pregnancies impacted by type 1 diabetes mellitus.

Inadequate glycaemic control and antidiabetic therapy among inpatients with type 2 diabetes in Guangdong Province of China

Background Diabetes mellitus has become epidemic in recent years in China. We investigated the prevalence of hyperglycaemia and inadequate glycaemic control among type 2 diabetic inpatients from ten university teaching hospitals in Guangdong Province, China. Methods Inadequate glycaemic control in diabetic patients was defined as HbA1c 〉 6.5%. Therapeutic regimens included no-intervention, lifestyle only, oral antiglycemic agents （OA）, insulin plus OA （insulin＋OA）, or insulin only. Antidiabetic managements included monotherapy, double therapy, triple or quadruple therapy. Results Among 493 diabetic inpatients with known history, 75% had HbA1c ≥ 6.5%. inadequate glucose control rates were more frequently seen in patients on insulin＋OA regimen （97%） ,than on OA regimen （71%） （P 〈0.001）, and more frequent in patients on combination therapy （81%-96%） than monotherapy （7,5%） （P 〈0.0,5）. Patients on insulin differed significantly from patients on OA by mean HbA1c, glycemic control rate, diabetes duration, microvascular complications, and BMI （P 〈0.01）. Conclusions This study showed that glycaemic control of type 2 diabetic patients deteriorated for patients who received insulin and initiation time of insulin was usually delayed, it is up to clinicians to move from the traditional stepwise therapy to a more active and early combination antidiabetic therapy to provide better glucose control.

Self-monitoring of blood glucose improved glycaemic control and 10-year coronary heart disease risk profile of type 2 diabetic patients

Background The debate over the overall benefits of self-monitoring of blood glucose in type 2 diabetes patients is still continuing.We aimed to assess the difference in glycaemic control and coronary heart disease （CHD） risk levels of experimental type 2 diabetes patients provided with facilities for self-monitoring blood glucose and their counterparts without such facilities.Methods Sixty-one patients who had no prior experience in using glucometers were studied as intervention （n=30） and control （n=31） groups.The intervention group was trained in self-monitoring of blood glucose and documentation.Baseline blood glucose and fasting blood glucose were measured and the intervention patients were provided with glucometers and advised to self-monitor their fasting and postprandial blood glucose over six months.The 10-year CHD risk levels were determined with the United Kingdom Prospective Diabetes Study-derived risk engine calculator.Results The age and diabetes duration were similar in the two groups （P 〉0.05）.The majority of the patients were unemployed or retired females with only a primary level education.After 3 months,the haemogolbin A1c （HbA1c） levels of the control patients remained unchanged （（7.8±0.3）% vs.（7.9±0.4）%,P 〉0.05） whereas the HbA1c levels of the intervention patients were significantly reduced from the baseline at three （（9.6±0.3）% vs.（7.8±0.3）%,P 〈0.001） and six （（9.2±0.4）% vs.（7.5±0.3）%,P 〈0.001） months.Interestingly,while the 10-year CHD risk level of the control group remained unchanged after three months,that of the intervention group was remarkably reduced at three and six months from the baseline level （（7.4±1.3）% vs.（4.5±0.9）%,P=0.056）.Conclusion Self-monitoring of blood glucose in type 2 diabetes patients significantly improved glycaemic control and the CHD risk profile,suggesting that type 2 diabetes patients will potentially benefit from inclusion of glucose meters and testing strips in their health-care package.

Determinants for inadequate glycaemic control in Chinese patients with mild-to-moderate type 2 diabetes on oral antidiabetic drugs alone

Background Prevalence of inadequate glycaemic control among patients with type 2 diabetes mellitus （T2DM） remains high. We assessed glycaemic control in the real-life practice among people with T2DM in metropolises in China who were treated with oral antidiabetic drugs （OAD） alone and to determine factors associated with inadequate glycaemic control in this population. Methods An observational, cross-sectional multicentre study was conducted in 16 metropolitan medical centers. People with T2DM who had been followed-up before the index visit which occurred from January to September 2007 were included in the study. All subjects were 〉30 years of age at the time of T2DM diagnosis and had received monotherapy or combination therapy of OAD for at least 6 months. Demographic and clinical data were collected from medical records. The main study outcome was the inadequate glucose control rate, which was calculated by the proportion of patients with haemoglobin Alc （HbAlc） 〉6.5% detected on the index visit. Results In this cohort of 455 patients with T2DM whose mean age was 60.6 years and mean disease duration was 6.1 years, 45.5% had inadequate glycaemic control. The mean （SD） HbA1c was 6.7% （1.3）. Multivariate Logistic regression showed that physical inactivity, disease duration 〉10 years, body mass index （BMI） ≥24 kg/m2, low homeostasis model assessment of β-cell function （HOMA-13） index, less frequency of medical visit and hypertriglyceridaemia were independent determinants of inadequate glycaemic control. Higher incidence of self-reported hypoglycemia experience （47.1% vs. 34.8%, P=0.008） and more fear of hypoglycemia quantified by Worry subscale of the Hypoglycaemia Fear Survey （HFS） II were happened in subjects with good glycemic control. Conclusion Approximately one half of these outpatients with T2DM from the metropolitan medical centers in China had inadequate glycaemic control treated with OAD alone, which raises the need for more effective educational and therapeutic approaches on management of hypertriglycemia, enhancing physical exercise and weight control, and at the same time. Iowerina the hvooalvcemic risk and diminishina the hvooalvcemic fear of oatients.

Comparative study on nutrient composition,functional property and glycaemic index of“Ogi”in healthy rats prepared from selected cereal grains

One of the most common traditional fermented food products consumed by all class of people in Southern part of Nigeria is Ogi.Ogi is a gurel made from different types of cereal ranging from maize,sorghum,millet among others.Hence,this study was aimed to evaluate nutrient,phytochemicals,functional properties,and glycemic index of Ogi produced from different grains.Grains such as yellow maize(YM),white maize(WM),popcorn maize(PC),red sorghum(RS),white sorghum(WS)and finger millet(FM)were processed into Ogi samples,packaged in airtight container prior to analysis and stored at–20℃.Proximate results showed that Ogi sample produced from PC significantly contained the highest protein content followed by sample YM.Potassium was observed to be the most abundant mineral elements in Ogi(14.50–19.10 mg/100 g).The phytochemical composition(mg/g)of the experimental samples ranged from 0.34–1.62,53.82–177.09,0.00–0.10,3.71–69.22 and 2.08–6.08 mg/g in oxalate,saponin,flavonoid,phytate and tannin,respectively.The glycemic index ranged 48.83%in YM to 50.71%in WS,while the glycemic load ranged 31.96%in YM to 37.82%in WS,respectively.The result revealed that Ogi samples,especially YM was high in calcium,Ca/P ratio,iron,zinc but low in phytate and tannin content.Sample YM also exhibit lower glycemic index,when compared with other Ogi samples.Hence,YM may be a better grain for the production of Ogi samples.

Cinnamomum zeylanicum and Curcuma longa incorporated dairy yoghurts with hindered glycaemic properties for healthy people

This study mainly compare glycaemic responses of a control yoghurt(typical dairy yoghurt)against two novel yoghurt products with added spices oleoresins(Cinnamon yoghurt-Cinnamomum zeylanicum,turmeric yoghurt-Curcuma longa)using 16 healthy volunteers in a randomized crossover study.Blood glucose concentrations were measured at fasting state and 30,45,60,90,120 min following the ingestion,using a Blood Glucose Monitoring System and blood glucose response curves were plotted.Nutritional and physicochemical properties were also compared and no significant differences(P>0.05)were observed between novel yoghurts and the control within the storage period.Significant reductions in peak blood glucose concentration and area under the curve(AUC)(P<0.05)for both novel products compared to standard dairy yoghurt was observed;revealing the reduction of glycaemic impact by spice ingredients.Peak reductions of glucose concentration for cinnamon yoghurt was 9.61%,for turmeric yoghurt was 9.26%;they were considerably lower compared to the control.Mean peak serum glucose concentration for control,cinnamon yoghurt and turmeric yoghurt were(113.38±6.39),(102.50±6.00),(102.88±5.38)mg/dL respectively and mean AUC were(11951±523),(11012±611),(10941±530)(mg/dL)·min respectively.Hence novel yoghurt products are proven to be excellent sources in reducing postprandial blood glucose responses.©2021 Beijing Academy of Food Sciences.yoghuart products sae proven to be excellent sources in reducing postprandial blood ghncose Tesponses.

What,why and how to monitor blood glucose in critically ill patients

Critically ill patients are prone to high glycemic variations irrespective of their diabetes status.This mandates frequent blood glucose(BG)monitoring and regulation of insulin therapy.Even though the most commonly employed capillary BG monitoring is convenient and rapid,it is inaccurate and prone to high bias,overestimating BG levels in critically ill patients.The targets for BG levels have also varied in the past few years ranging from tight glucose control to a more liberal approach.Each of these has its own fallacies,while tight control increases risk of hypoglycemia,liberal BG targets make the patients prone to hyperglycemia.Moreover,the recent evidence suggests that BG indices,such as glycemic variability and time in target range,may also affect patient outcomes.In this review,we highlight the nuances associated with BG monitoring,including the various indices required to be monitored,BG targets and recent advances in BG monitoring in critically ill patients.

Diabetes mellitus and stroke: A clinical update

Cardiovascular disease including stroke is a major complication that tremendously increases the morbidity and mortality in patients with diabetes mellitus(DM). DM poses about four times higher risk for stroke. Cardiometabolic risk factors including obesity, hypertension, and dyslipidaemia often co-exist in patients with DM that add on to stroke risk. Because of the strong association between DM and other stroke risk factors, physicians and diabetologists managing patients should have thorough understanding of these risk factors and management. This review is an evidence-based approach to the epidemiological aspects, pathophysiology, diagnostic work up and management algorithms for patients with diabetes and stroke.

Update on pre-diabetes: Focus on diagnostic criteria and cardiovascular risk

Pre-diabetes, which is typically defined as blood glucose concentrations higher than normal but lower than thediabetes threshold, is a high-risk state for diabetes and cardiovascular disease development. As such, it represents three groups of individuals: Those with impaired fasting glucose(IFG), those with impaired glucose tolerance(IGT) and those with a glycated haemoglobin(HbA1c) between 39-46 mmol/mol. Several clinical trials have shown the important role of IFG, IGT and HbA1c -pre-diabetes as predictive tools for the risk of developing type 2 diabetes. Moreover, with regard to cardiovascular disease, pre-diabetes is associated with more advanced vascular damage compared with normoglycaemia, independently of confounding factors. In view of these observations, diagnosis of pre-diabetes is mandatory to prevent or delay the development of the disease and its complications; however, a number of previous studies reported that the concordance between pre-diabetes diagnoses made by IFG, IGT or HbA1c is scarce and there are conflicting data as to which of these methods best predicts cardiovascular disease. This review highlights recent studies and cur-rent controversies in the field. In consideration of the expected increased use of HbA1c as a screening tool to identify individuals with alteration of glycaemic homeo-stasis, we focused on the evidence regarding the ability of HbA1c as a diagnostic tool for pre-diabetes and as a useful marker in identifying patients who have an increased risk for cardiovascular disease. Finally, we reviewed the current evidence regarding non-traditional glycaemic biomarkers and their use as alternatives to or additions to traditional ones.

Age at diagnosis of type 2 diabetes and cardiovascular risk factor profile:A pooled analysis

BACKGROUND The diagnosis of type 2 diabetes(T2D)in younger adults,an increasingly common public health issue,is associated with a higher risk of cardiovascular complications and mortality,which may be due to a more adverse cardiovascular risk profile in individuals diagnosed at a younger age.AIM To investigate the association between age at diagnosis and the cardiovascular risk profile in adults with T2D.METHODS A pooled dataset was used,comprised of data from five previous studies of adults with T2D,including 1409 participants of whom 196 were diagnosed with T2D under the age of 40 years.Anthropometric and blood biomarker measurements included body weight,body mass index(BMI),waist circumference,body fat percentage,glycaemic control(HbA1c),lipid profile and blood pressure.Univariable and multivariable linear regression models,adjusted for diabetes duration,sex,ethnicity and smoking status,were used to investigate the association between age at diagnosis and each cardiovascular risk factor.RESULTS A higher proportion of participants diagnosed with T2D under the age of 40 were female,current smokers and treated with glucose-lowering medications,compared to participants diagnosed later in life.Participants diagnosed with T2D under the age of 40 also had higher body weight,BMI,waist circumference and body fat percentage,in addition to a more adverse lipid profile,compared to participants diagnosed at an older age.Modelling results showed that each one year reduction in age at diagnosis was significantly associated with 0.67 kg higher body weight[95%confidence interval(CI):0.52-0.82 kg],0.18 kg/m^(2) higher BMI(95%CI:0.10-0.25)and 0.32 cm higher waist circumference(95%CI:0.14-0.49),after adjustment for duration of diabetes and other confounders.Younger age at diagnosis was also significantly associated with higher HbA1c,total cholesterol,low-density lipoprotein cholesterol and triglycerides.CONCLUSION The diagnosis of T2D earlier in life is associated with a worse cardiovascular risk factor profile,compared to those diagnosed later in life.

Fifteen-year follow-up of quality of life in type 1 diabetes mellitus

AIM:To evaluate metabolic control and health-related quality of life(HRQOL)in a type 1 diabetes mellitus(T1DM)population.METHODS:As part of a prospective cohort study,283T1DM patients treated with various insulin treatment modalities including multiple daily injections(MDI)and continuous subcutaneous insulin infusion(CSII)were examined annually.HRQOL was measured using the SF-36 and EuroQol questionnaires.Data regarding HRQOL,glycaemic and metabolic control from baseline and follow-up measures in 2002 and 2010 were analysed.Linear mixed models were used to calculate estimated values and differences between the three moments in time and the three treatment modalities.RESULTS:Significant changes[meanΔ(95%CI)]in body mass index[2.4 kg/m2(1.0,3.8)],systolic blood pressure[-6.4 mmHg(-11.4,-1.3)]and EuroQol-VAS[-7.3(-11.4,-3.3)]were observed over time.In 2010,168 patients were lost to follow-up.Regarding mode of therapy,52 patients remained on MDI,28 remained on CSII,and 33 patients switched from MDI to CSII during follow-up.Among patients on MDI,HRQOL decreased significantly over time:mental component summary[-9.8(-16.3,-3.2)],physical component summary[-8.6(-15.3,-1.8)]and EuroQol-VAS[-8.1(-14.0,-2.3)],P<0.05 for all.For patients using CSII,the EuroQol-VAS decreased[-9.6(-17.5,-1.7)].None of the changes over time in HRQOL differed significantly with the changes over time within the other treatment groups.CONCLUSION:No differences with respect to metabolic and HRQOL parameters between the various insulin treatment modalities were observed after 15 years of follow-up in T1DM patients.

Add-on therapy of herbal formulation rich in standardized fenugreek seed extract in type 2 diabetes mellitus patients with insulin therapy: An efficacy and safety study

Objective: To assess the safety and efficacy of herbal formulation rich in standardized fenugreek seed extract(IND-2) add-on therapy in type 2 diabetes mellitus(T2DM) patients who were on insulin treatment in prospective, single arm, open-label, uncontrolled, multicentre trial.Methods: T2DM patients(n=30) with aged 18-80 years who were stabilized on insulin treatment with fasting blood sugar(FBS) level between 100-140 mg/dL received IND-2 capsules(700 mg, thrice a day) for 16 weeks.The primary endpoints were an assessment of FBS at week 2, 4, 6, 8, 12 and 16.Secondary end-points include post-prandial blood sugar level, glycosylated Hb(HbA1c), reduction in the dose of insulin and number of hypoglycemic attacks, and improvement in lipid profile at various weeks.Safety and adverse events(AEs) were also assessed during the study.Results: Study was completed in twenty T2DM patients, and there was no significant reduction in FBS and post-prandial blood sugar level after addon therapy of IND-2.However, add-on therapy of IND-2 significantly reduced(P<0.01) the HbA1c values, requirements of insulin and hypoglycemic events as compared with baseline.Total cholesterol, high-density lipoproteins-cholesterol, and low-density lipoproteincholesterol levels were significantly increased(P<0.01) after IND-2 add-on therapy.Body weight and safety outcomes did not differ significantly in IND-2 add-on therapy group at week 16.Additionally, add-on therapy of IND-2 did not produce any serious adverse events.Conclusions: The results of present investigation suggest that add-on therapy of IND-2 with insulin in T2DM patients improves glycaemic control through a decrease in levels of HbA1c and number of insulin doses needed per day without an increase in body weight and risk of hypoglycemia.Thus, IND-2 may provide a safe and well-tolerated add-on therapy option for the management of T2DM.

Effect of the degree of milling on the physicochemical properties,pasting properties and in vitro digestibility of Simiao rice

Simiao rice is a variety of long-grain Indica rice popular in South China.However,researches on the milling technology of Simiao rice are limited.The effect of different degrees of milling(DOMs)of Simiao rice(0-12%)were evaluated in terms of the physicochemical properties and in vitro starch digestibility of the rice.The results showed that,as the DOM increased from 0 to 12%,the head rice yield(HRY)and the content of protein,lipid,dietary fiber,vitamin B1,vitamin E and niacin nonlinearly decreased,while the content of total starch and amylose and paste viscosity parameters nonlinearly increased.The differences in chemical constituents between the brown and milled Simiao rice with different DOMs lead to the variation in their pasting properties and in vitro digestibility.Because of lower content of slowly digestible starch(SDS)and resistant starch(RS),milled Simiao rice exhibited greater digestibility and a higher estimated glycaemic index(EGI).The EGI of Simiao rice ranged from 77.98 to 85.55,and remained almost constant(approximately 84)when the DOM was above 4%.Correlation analysis indicated that the EGI had strong negative correlations with lipid,protein,dietary fiber and RS,but a positive correlation with amylose.These results provide theoretical guidance for the production of Simiao rice with desired physicochemical properties and digestibility by adjusting the DOM.

The Effect of Oat Bran on the Dough Rheology and Quality of Chinese Steamed Bread

The present study investigates the effects of incorporating oat bran(OB) into Chinese steamed bread(CSB). Different levels(5%, 10% and 15%) of OB were used to replace wheat flour in the manufacture of CSB. The rheological properties of the dough were measured(water absorption(WA), development time, mixing tolerance, extensibility and stickiness). The addition of OB significantly increased WA, development time and stickiness, whereas decreased extensibility of dough. The physical properties of CSB were determined using specific volume, loaf height, moisture, and texture analysis. The nutritional quality of the bread was also analysed using an in vitro digestion method mimicking intestinal digestion. The results illustrated that the incorporation of OB into wheat flour decreases specific volume and softness of CSB. The addition of OB decreased the glycaemic response of steamed bread.This study illustrates the potential addition of OB to improve the nutritional quality of CSB.