The Effect of Gum Acacia on Post-Prandial Glucose and Insulin Levels in Healthy Subjects

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/m2 - 29.9 kg/m2, 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.

Injectable dual glucose-responsive hydrogel-micelle composite for mimicking physiological basal and prandial insulin delivery

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.

德谷门冬双胰岛素与基础-餐时胰岛素短期强化治疗对新诊断2型糖尿病血糖控制的影响

目的 分析德谷门冬双胰岛素、基础-餐时胰岛素短期强化治疗对新诊断2型糖尿病(T2DM)患者血糖控制的影响。方法 选取60例新诊断T2DM患者为研究对象,依据随机数字法分为对照组(30例,德谷门冬双胰岛素治疗)、研究组(30例,基础-餐时胰岛素短期强化治疗)。对比两组患者的血糖指标[糖化血红蛋白(HbA1c)、空腹血糖(FPG)和餐后2 h血糖(2 h PBG)],血糖控制情况(血糖达标时间、血糖波动水平)和低血糖发生率,治疗效果。结果 两组治疗前HbA1c、FPG和2 h PBG水平对比无显著差异(P>0.05);治疗后,研究组HbA1c(6.08±0.76)%、FPG(5.71±0.59)mmol/L和2 h PBG(7.53±0.96)mmol/L比对照组的(8.19±1.14)%、(6.86±0.84)mmol/L、(9.38±1.33)mmol/L低,差异具有统计学意义(P<0.05)。研究组患者血糖达标时间为(6.95±1.61)d、血糖波动为(2.25±0.35)mmol/L、夜间低血糖发生率为0;对照组患者血糖达标时间为(8.26±1.56)d、血糖波动为(3.12±0.68)mmol/L、夜间低血糖发生率为20.00%;研究组患者的血糖达标时间、血糖波动水平和低血糖发生率均显著低于对照组,差异具有统计学意义(P<0.05)。研究组患者的治疗总有效率(100.00%)显著高于对照组(80.00%),差异具有统计学意义(P<0.05)。结论 对于新诊断T2DM患者来说,基础-餐时胰岛素短期强化治疗相对于德谷门冬双胰岛素疗效较好,值得推广。

基础-餐时胰岛素转换为预混胰岛素治疗2型糖尿病的胰岛素用量关系及预混胰岛素的早晚分配

目的探讨基础-餐时胰岛素(门冬胰岛素注射液+甘精胰岛素注射液)转换为预混胰岛素(门冬胰岛素30注射液)治疗2型糖尿病(T2DM)的胰岛素用量关系及预混胰岛素的早晚分配。方法选取2021年1月至7月西安医学院第一附属医院新诊断和口服药失效的T2DM患者34例,先接受基础-餐时胰岛素治疗,血糖控制达标后转换为预混胰岛素治疗。比较两种方案血糖控制达标时的日均胰岛素用量及日均血糖;分析两种方案日均胰岛素用量的关系及预混胰岛素治疗日均胰岛素用量与早餐前胰岛素用量的关系。结果两种方案血糖控制达标时的日均胰岛素用量比较,差异具有统计学意义(P<0.05);两种方案血糖控制达标时的日均血糖比较,差异无统计学意义(P>0.05)。基础-餐时胰岛素治疗日均胰岛素用量与预混胰岛素治疗日均胰岛素用量呈线性关系,线性回归方程为y_(1)=-1.848+0.907x_(1)(R^(2)=0.873,P<0.01);预混胰岛素治疗日均胰岛素用量与早餐前胰岛素用量呈线性关系,线性回归方程为y_(2)=1.387+0.56x_(2)(R^(2)=0.883,P<0.01)。结论治疗T2MD由基础-餐时胰岛素转换为预混胰岛素时,日均胰岛素用量可调整为90%,预混胰岛素的早晚剂量可按60%、40%分配。

上海市散打队运动员减体重期膳食营养状况的调查与评价

为了了解上海市散打队在赛前减体重期间的膳食营养状况,以指导运动员在减体重期间合理膳食及科学减体重提供依据,对上海市散打队15名队员在减体重期间的膳食状况进行了调查和分析。结果表明:降体重期间,运动员普遍存在膳食总热量摄入偏低,糖和蛋白质摄入不足,脂肪摄入过多,部分维生素和矿物质摄入不足,膳食制度不合理,三餐热能分配及加餐不合理的问题。

中南大学大学生营养知识态度行为对营养状况的影响

目的该研报告究旨在更好地了解中国大学生的营养状况,分析影响营养状况的因素。方法利用针对性方法对中南大学236名大学生营养知识-态度-行为及营养状况进行调查分析。所得数据经过电脑软件分析与处理在本研究报告中均有所体现。结果中南大学大学生营养不良率为19.9%,肥胖率为26.3%,膳食蛋白质、脂肪、碳水化合物和维生素A、B2、C、钙等摄入与标准相当。其中肥胖率比重较大。但大学生营养知识缺乏,20.64%的大学生不能保证每天吃早餐,22.85%经常吃零食,大部分有偏食行为,31.12%常食用营养保健品。结论他们接受营养知识的态度较好,说明在大学生中开展有针对性的营养健康教育是非常必要的。

优秀摔跤运动员赛前减(控)体重个性化研究

运用文献资料法、实验法、问卷调查法和膳食称重法,对优秀古典式摔跤运动员十运会前的体重控制过程进行了个案调查与分析。结果表明:体重的下降主要以减少体脂含量为主,瘦体重变化不明显;血红蛋白等几项生化指标较好地反映出训练负荷的变化和运动员赛前的身体机能状况;慢减体重可能会引起运动员心理状态的波动;赛前的膳食营养不够合理;称重后的体能恢复至关重要。

PDS型功能性消化不良患者胃排空研究

目的研究餐后不适综合征(PDS)型功能性消化不良(FD)患者与健康人胃排空的差异。方法按照罗马Ⅲ诊断标准,选择PDS型FD患者34例纳入试验组,健康志愿者21例纳入对照组。对所有受试者进行核素胃排空检测,观察胃半排空时间(GET1/2)和120min胃排空率(GE120)。结果试验组GET1/2(106±26)min高于对照组GET1/2(78±14)min,2组间差异有统计学意义(t=5.066,P<0.01);试验组GE120(56±13)min低于对照组GE120(71±11)min,2组间差异有统计学意义(t=-4.221,P<0.01)。但是试验组症状积分与胃排空之间无相关性(P>0.05)。结论PDS型FD患者较健康人易存在胃排空延迟。

糖化白蛋白在糖尿病伴贫血患者中检测的临床意义

目的探讨糖化白蛋白在糖尿病伴贫血患者中检测的临床意义。方法选取我院2012年12月-2014年12月住院的80例伴和不伴贫血的糖尿病患者作为研究对象,根据贫血不同程度将糖尿病患者分为四组(无贫血、轻度贫血、中度贫血和重度贫血),分别检测空腹血糖(FBG)、餐后两小时血糖(2h-PG)及糖化血红蛋白(HbA1c)和糖化白蛋白(GA)。实验数据采用单因素方差分析,进一步多重比较Dunentt-t检验;GA(%)和HbA1c(%)使用多个独立样本的非参数检验(Kruskal-Wallis H检验)分析4组间差异有无统计学意义,进一步两两比较Mann-Whitney U检验;Spearman分析GA与FBG和2h-PG的相关性。结果 (1)随着糖尿病患者贫血程度的加重,血红蛋白(HGB)水平逐渐下降,T2DM+轻度贫血、T2DM+中度贫血、T2DM+重度贫血显著低于T2DM组(P均<0.01);FBG和2hPG没有明显变化。(2)GA(%)4组间检验差别无统计学意义(χ~2=6.883,P=0.076)。HbA1c(%)经Kruskal-Wallis H检验,4组间差异有统计学意义(χ~2=8.928,P=0.03);与T2DM组比较,T2DM+轻度贫血组和T2DM+中度贫血组差异没有统计学意义(Z=-1.757,P=0.79;Z=-1.672,P=0.095);T2DM+重度贫血组有差异(Z=-2.95,P=0.003)。(3)GA与FBG和2h-PG均有相关性(r=0.274,P=0.014;r=0.422.P<0.01)。结论不同贫血程度对GA水平无影响,在糖尿病伴贫血患者中GA的检测较HbA1c更有优势。

代谢综合征患者餐后状态血压及脉压变化与靶器官损害的关系

目的探讨代谢综合征患者餐后状态血压和脉压变化及其与心血管及肾脏病变的关系。方法233例住院患者,分为高血压病(EH)组、2型糖尿病(DM)组和代谢综合征(MS)组,检测24h动态血压、颈动脉粥样斑块发生率(CAPR)、颈动脉内膜厚度(IMT)、左室重量指数(LVMI)、左室舒张早期充盈峰值流速(EPFV)与心房收缩期充盈峰值流速(APFV)比值(E/A值)和内生肌酐清除率(CcR)及24h尿微量白蛋白排泄量(MA)。结果(1)进餐前后SBP和PP差值≥10mm Hg(1mm Hg=0.133kPa)的高血压病患者,其CAPRI、MT、LVMI、MA明显高于差值<10mm Hg者(P<0.01),E/A和CcR明显低于差值<10mm Hg者(P<0.01)。(2)进餐前后PP差值≥10mm Hg代谢综合征患者,其CAPR、IMT、LVMI和MA均明显高于差值<10mm Hg者(P<0.01),而其E/A和CcR明显低于差值<10mm Hg者(P<0.01);进餐前后SBP差值≥10mm Hg、DBP差值≥5mm Hg者,其MA显著高于差值<10mm Hg和<5mm Hg者(P<0.05)。(3)进餐前后SBP差值≥10mm Hg、DBP差值≥5mm Hg的糖尿病患者,其MA明显高于差值<10mm Hg和<5mm Hg者(P<0.01)。(4)与靶器官损害相关分析显示:早餐后1h血压变化与心脏、颈动脉及肾脏病变呈显著相关。结论餐后血压和脉压是预测代谢综合征患者心脏、血管及肾脏损害的有价值指标。

江苏省摔跤队膳食营养状况的调查与评价

研究目的:膳食营养是保证运动员营养素的需要和维持体能的最重要的物质基础,对训练起重要的保证作用,与膳食营养在竞技体育中重要位置不相适应的是运动员膳食的不平衡现象普遍存在,它长期影响训练的效果和训练后的恢复。本研究通过调查备战十运会的江苏省摔跤队的膳食状况,对其做出评估,为平衡膳食提供依据。研究方法:采用食物称重法,称量并记录每个运动员所吃主副食的熟重、剩余重量,计算出所吃食物生重。记录运动员饮水量及营养品服用量,用软件计算出各种营养素摄入量及食物构成。将计算结果与运动员每日膳食营养供给标准,食物摄入供给标准进行比较做出合理评价。研究结果:江苏省摔跤运动员三大营养素的摄入比例多不合理,碳水化合物78%不足,56%的运动员脂肪和蛋白质超过推荐标准。中餐、晚餐的能量摄入比例超标比例较高,早餐不足。运动员各种矿物质摄入都超过推荐值,运动员的维生素摄入相对不足,VA、VC、VB1、VPP不同程度地缺乏。运动员每日的摄入量变化很大,最大幅度可达到83%。运动员进食的多少与运动量、运动强度、饭菜的内容以及个人的喜好有很大的关系。

中草药类保健食品中膳食纤维含量测定的研究

由于目前保健食品中有关膳食纤维的研究日益增多 ,其保健功能及含量测定方法的研究具有迫切的现实意义 ,该研究对用中性洗涤剂法测定保健食品中膳食纤维含量进行了重复性、平行性试验。发现该法重复性、平行性良好。重复性试验R .S .D .为 2 .2 8%～ 4.18% ,双平行试验的R .S .D .为 0 .3 7%～ 1.5 8%。另外还研究了方法中加入α -淀粉酶 (α -amylase)对测定结果的影响 ,认为淀粉类样品经洗涤剂处理后 ,需经淀粉酶来处理 ,用以水解残留淀粉 ,而非淀粉类样品 ,可省去用α -淀粉酶的处理步骤 ,对结果无明显影响。

国内自我管理对糖尿病患者血糖影响的Meta分析

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。

常见30对所谓相克食物的相克情况调查

目的:通过文献检索、现场调查和食谱查阅等方法对常见所谓相克食物的相克情况进行调查分析,为正确认识相克食物组合风险,保证人民群众的饮食安全提供依据。方法:选择中国学术期刊全文数据库(CNKI)作为文献统计数据源,查阅1994—2010年之间文献;随机抽取部队炊事人员进行问卷调查,问卷内容包括对食物相克的一般认知和常见30对所谓相克食物搭配情况的回顾调查;对20个单位100份连队周食谱和20份部队重大活动食谱进行逐一检索,查看有无所谓的相克食物组合。结果:(1)查阅174篇文献,仅有38篇属于反对食物相克的,支持"相克"的文献与质疑"相克"的文献比例约为4:1。(2)328名调查对象中有325人听说过食物相克,206人认为食物相克有科学根据,17人表示遇见过因食物相克而使食用者出现不适症状。(3)炊事人员对相克食物相互搭配的回顾性调查表明,搭配比例较高的食物组合有黄瓜和花生、黄瓜和西红柿、猪肉和黄豆、菠菜和豆腐、葱和豆腐、虾和西红胡萝卜和白萝卜,搭配比例依次为57.93%、37.50%、35.06%、32.93%、31.71%、30.18%、26.83%。(4)120份食谱中出现的食物组合有:黄瓜和西红柿、葱和豆腐、黄瓜和花生、豆浆和鸡蛋、菠菜和豆腐、黄豆和猪肉、牛奶和菜花、虾和西红柿、牛肉和韭菜、牛肉和栗子等。结论:调查对象对食物相克认知与普通人群存在一定差异;所调查的相克食物在部队食谱和膳食中经常出现,多数不会引起人体不良反应,相互搭配风险较低。

不同用穴方案针刺治疗餐后不适综合征型功能性消化不良的临床观察

目的比较不同用穴方案针刺治疗餐后不适综合征型功能性消化不良(PDS)患者的近期和远期疗效,为寻求合理的用穴方案提供部分理论依据。方法选择84例在我院消化科确诊并进行针刺治疗的PDS患者,其中29例患者进行基础穴位针刺,55例患者根据症型进行辨证针刺,均治疗2个疗程。比较两组患者疗程结束后和随访2个月后的临床疗效、症状疗效指数(FDI)、尼平消化不良指数(NDI)、健康相关生活质量评分(SF-36)。并在治疗前后,抽血检测患者血清胃泌素(GAS)和胃动素(MTL)水平。结果治疗2个疗程后,普通针刺组和辨证针刺组的总有效率差异有统计学意义(P<0.05)。治疗结束后和随访2个月后,辨证针刺组FDI分数与普通针刺组比较,差异有统计学意义(P<0.05)。治疗结束后和随访2个月后,辨证针刺组患者NDSI和NDLQI分别与普通针刺组比较,差异有统计学意义(P<0.05)。治疗2个疗程和随访2个月后,辨证针刺组患者SF-36与普通针刺组比较,差异有统计学意义(P<0.05)。治疗2个疗程后,辨证针刺组患者血清中GAS和MTL水平与治疗前和普通针刺组比较,差异均有统计学意义(P<0.05)。结论通过辨证分析餐后不适综合征型功能性消化不良患者的临床症型,合理选择用穴方案,可显著改善患者的症状,提高生活质量,同时也可以改善患者血清胃泌素和胃动素含量,具有较好的近期和远期疗效。

卫生学校在校生营养知识、态度及膳食行为调查

[目的]了解卫生学校在校生营养知识、态度及膳食行为的情况,为在卫生学校开展营养教育提供科学依据。[方法]对随机抽取的四川省某卫生学校在校生进行问卷调查。[结果]学习过营养课程的学生的营养知识主要来源于老师的为71.9%、杂志的为54.3%、家庭的为39.4%,未学习过营养课程的学生营养知识主要来源于家庭的为52.6%、同学朋友的为28.6%。学生的营养知识、态度与是否学习过营养课程有关,经统计处理差别均有显著性(P﹤0.05);未学习过营养课程的学生对营养与疾病的关系缺乏认识;所有调查对象均表现出有较好的有关营养、接受营养教育和营养服务态度;食物频度表显示各年级、专业和不同地区及性别的学生膳食结构差别不大,在未来的选择食物模式预测中,学习过营养课程的学生更趋于合理营养,其他学生对肉类有偏高的食用趋势、膳食结构明显单调。[结论]对卫生学校在校各专业学生进行营养教育是非常必要而且可行;教育途径应编入各专业教学的计划和大纲且作为必修课程进行教学才会收到良好的效果。

糖化血红蛋白检测在治疗复发性外阴阴道假丝酵母菌病中的意义

目的:探讨糖化血红蛋白A1(HBA1c)检测在治疗复发性外阴阴道假丝酵母菌病(RVVC)中的意义。方法:将符合RVVC诊断标准的非糖尿病患者65例作为实验组,真菌学阴性的健康体检者及复发性细菌性阴道病患者共60例为对照组。对所有入选者行血HBA1c、空腹及餐后2h血糖检测并计算体重指数。对HBA1c≥5%的58例RVVC患者随机分为试验1组和试验2组,试验1组进行糖代谢调整及抗真菌等综合治疗,试验2组仅抗真菌治疗,治愈后1年内统计复发率。结果:实验组HBA1c≥5%58例,占89.23%(58/65),而对照组仅5例,占8.33%(5/60),两组间差异非常显著(P<0.001)。实验组HBA1c、空腹血糖、体重指数均高于对照组,分别为(5.49±0.41)%与(4.36±0.66)%、(5.77±0.50)mmol/L与(5.27±0.41)mmol/L、(22.87±4.47)kg/m2与(20.47±1.62)kg/m2,两组间差异非常显著(P<0.001);餐后2h血糖实验组较对照组高,分别为(6.21±1.04)mmol/L与(5.86±0.95)mmol/L,但两组间无显著性差异(P>0.05)。HBA1c≥5%的RVVC患者治愈后1年内的复发率,试验1组为6.90%(2/29),试验2组48.28%(14/29),两组间差异非常显著(P<0.01)。结论:检测HBA1c并把血HBA1c≥5%作为限糖饮食的临界点,对指导复发性外阴阴道假丝酵母菌病患者临床治疗有一定的价值。

Prevalence of functional dyspepsia and its subgroups in patients with eating disorders

AIM:To study the prevalence of functional dyspepsia(FD)(Rome Ⅲ criteria) across eating disorders(ED),obese patients,constitutional thinner and healthy volunteers.METHODS:Twenty patients affected by anorexia nervosa,6 affected by bulimia nervosa,10 affected by ED not otherwise specified according to diagnostic and statistical manual of mental disorders,4th edition,nine constitutional thinner subjects and,thirtytwo obese patients were recruited from an outpatients clinic devoted to eating behavior disorders.Twentytwo healthy volunteers matched for age and gender were enrolled as healthy controls.All participants underwent a careful clinical examination.Demographic and anthropometric characteristics were obtained from a structured questionnaires.The presence of FD and,its subgroups,epigastric pain syndrome and postprandial distress syndrome(PDS) were diagnosed according to Rome Ⅲ criteria.The intensity-frequency score of broader dyspeptic symptoms such as early satiety,epigastric fullness,epigastric pain,epigastric burning,epigastric pressure,belching,nausea and vomiting were studied by a standardized questionnaire(0-6).Analysis of variance and post-hoc Sheffè tests were used for comparisons.RESULTS:90% of patients affected by anorexia nervosa,83.3% of patients affected by bulimia nervosa,90% of patients affected by ED not otherwise specified,55.6% of constitutionally thin subjects and 18.2% healthy volunteers met the Postprandial Distress Syndrome Criteria(χ 2,P < 0.001).Only one bulimic patient met the epigastric pain syndrome diagnosis.Postprandial fullness intensity-frequency score was significantly higher in anorexia nervosa,bulimia nervosa and ED not otherwise specified groups compared to the score calculated in the constitutional thinner group(4.15 ± 2.08 vs 1.44 ± 2.35,P = 0.003;5.00 ± 2.45vs 1.44 ± 2.35,P = 0.003;4.10 ± 2.23vs 1.44 ± 2.35,P = 0.002,respectively),the obese group(4.15 ± 2.08vs 0.00 ± 0.00,P < 0.001;5.00 ± 2.45vs 0.00 ± 0.00,P < 0.001;4.10 ± 2.23 vs 0.00 ± 0.00,P < 0.001,respectively) and healthy volunteers(4.15 ± 2.08 vs 0.36 ± 0.79,P < 0.001;5.00 ± 2.45 vs 0.36 ± 0.79,P < 0.001;4.10 ± 2.23 vs 0.36 ± 0.79,P < 0.001,respectively).Early satiety intensity-frequency score was prominent in anorectic patients compared to bulimic patients(3.85 ± 2.23 vs 1.17 ± 1.83,P = 0.015),obese patients(3.85 ± 2.23 vs 0.00 ± 0.00,P < 0.001) and healthy volunteers(3.85 ± 2.23 vs 0.05 ± 0.21,P < 0.001).Nausea and epigastric pressure were increased in bulimic and ED not otherwise specified patients.Specifically,nausea intensity-frequencyscore was significantly higher in bulimia nervosa and ED not otherwise specified patients compared to anorectic patients(3.17 ± 2.56 vs 0.89 ± 1.66,P = 0.04;2.70 ± 2.91 vs 0.89 ± 1.66,P = 0.05,respectively),constitutional thinner subjects(3.17 ± 2.56 vs 0.00 ± 0.00,P = 0.004;2.70 ± 2.91 vs 0.00 ± 0.00,P = 0.005,respectively),obese patients(3.17 ± 2.56 vs 0.00 ± 0.00,P < 0.001;3.17 ± 2.56 vs 0.00 ± 0.00,P < 0.001 respectively) and,healthy volunteers(3.17 ± 2.56 vs 0.17 ± 0.71,P = 0.002;3.17 ± 2.56 vs 0.17 ± 0.71,P = 0.001,respectively).Epigastric pressure intensityfrequency score was significantly higher in bulimic and ED not otherwise specified patients compared to constitutional thin subjects(4.67 ± 2.42 vs 1.22 ± 1.72,P = 0.03;4.20 ± 2.21 vs 1.22 ± 1.72,P = 0.03,respectively),obese patients(4.67 ± 2.42 vs 0.75 ± 1.32,P = 0.001;4.20 ± 2.21vs 0.75 ± 1.32,P < 0.001,respectively) and,healthy volunteers(4.67 ± 2.42 vs 0.67 ± 1.46,P = 0.001;4.20 ± 2.21vs 0.67 ± 1.46,P = 0.001,respectively).Vomiting was referred in 100% of bulimia nervosa patients,in 20% of ED not otherwise specified patients,in 15% of anorexia nervosa patients,in 22% of constitutional thinner subjects,and,in 5.6% healthy volunteers(χ 2,P < 0.001).CONCLUSION:PDS is common in eating disorders.Is it mandatory in outpatient gastroenterological clinics to investigate eating disorders in patients with PDS?

Initiation of Basal Insulin in Patients with Uncontrolled Type 2 Diabetes Mellitus

Type 2 diabetes mellitus is a growing health problem, characterized by insulin resistance progressing to beta cell dysfunction and insulin deficiency, most of these patients will need intensification of treatment and initiation of insulin to delay or prevent diabetic complications. Glycemic control is the most important aspect of management, and in reducing morbidity and mortality of the diseases. Control of plasma glucose in patients with diabetes can be assessed by HbA1c, FPG, PPG, but still HbA1c% remains the gold standard for assessment of glycemic control and follow up of diabetic patients. The aim of this study is to assess HbA1c% in patients on oral anti-diabetic drugs, with poor glycemic control before and after adding basal insulin, with titration of the dose of insulin depending on fasting blood sugar. 82 patients with uncontrolled type 2 diabetes (43.9% male, 56.1% female), with HbA1c more than 9%, on two types of oral diabetic medication or more, were started on basal insulin (glargine, lantus) and followed for three to six months. Overall 82 patients with type 2 diabetes mellitus were included in the study. The mean age of the study population was 58.4 years, the mean duration of the disease range was 13.4 years. All patients with HbA1c more than 9%, without organ failure, were included in the study. The mean HbA1c overall had decreased from mean of 11.15% before starting basal insulin to the mean of 8.43% within 3 to 6 month, after initiating basal insulin, this difference was significant at p < 0.001. There was no adverse effect on this medication in any of the study group. The addition of basal insulin to oral anti-diabetic medication in uncontrolled insulin-naïve type 2 diabetic patients resulted in significant improvement of glycemic control, with improved HbA1c level, without adverse effects.

Medical Nutritional Therapy for Pre-gestational and Gestational Diabetes Mellitus

Pregnancy causes a multitude of metabolic changes within a woman’s body in order to provide the proper nutrients to the developing fetus. In women with diabetes type 1, type 2, and GDM （gestational diabetes mellitus） these metabolic perturbations must be treated distinctly and aggressively to optimize fetal development and health. Pre-gestational diabetes （either type 1 or type 2） has the potential to subject the developing fetus to abnormal maternal glucose levels resulting in problems with organogenesis producing congenital abnormalities or spontaneous abortion. Furthermore, gestational diabetes mellitus presents after organogenesis in the second part of pregnancy, therefore the major risk for the fetus is macrosomia. Although the goal for dietary therapy for each of these disorders is the same which is euglycaemia, the means to achieve it are very different and somewhat controversial. In the case of gestational diabetes, the main stay of therapy is medical nutritional therapy whereas in insulin requiring diabetes, dietary therapy is compensated with pre-meal insulin injections. The metabolic changes in normal pregnancy will be presented followed by the general guidelines for pregnancy. Fetal complications associated with inadequate nutrition or metabolic perturbation will be briefly explored, followed by issues and treatment for gestational diabetes mellitus, with emphasis on specific dietary therapies for GDM.