No Dose Response Relationship in the Effects of Commonly Consumed Sugars on Risk Factors for Diabetes across a Range of Typical Human Consumption Levels

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=53163#.VLXiR8nQrzE

ABSTRACT

Questions have been raised as to whether dietary carbohydrate intake is directly related to the development of type 2 diabetes. Of particular importance, fructose-induced insulin resistance has been previously shown in animals. However, the implications of such findings for humans are unclear as these models typically use very high doses of sugars and from sources not commonly consumed. Little is known about how the typical consumption of sugar in humans affects risk factors for diabetes. 355 weight-stable (weight change < 3% in previous 30 days) individuals aged 20 – 60 years old drank sugar-sweetened low fat milk every day for 10 weeks as part of their usual diet. Added sugar was provided in the milk as either high fructose corn syrup or sucrose at 8%, 18% or 30% of the calories required to maintain body weight. Insulin resistance was measured using the Homeostasis Model Assessment (HOMA IR) on fasting measures and a standard Oral Glucose Tolerance Test (OGTT) was used to measure insulin and glucose areas under the curve resistance (AUC30 g * AUC30 I) and whole body insulin sensitivity and hepatic insulin resistance using the Matsuda Composite Insulin Sensitivity Index (ISI). There was a small increase in weight in the entire cohort (169.1 ± 30.6 vs 171.6 ± 31.8 lbs, p < 0.001), which was greater in the 30% level than in the 8% or 18% levels (p < 0.05). Glucose, insulin, HOMA, glucose AUC, insulin AUC, Matsuda insulin sensitivity index, and hepatic insulin resistance did not vary by sugar level (p > 0.05) nor by sugar type (p > 0.05). In the entire cohort insulin sensitivity decreased as evidenced by an increase in HOMA IR (1.8 ± 1.3 vs 2.3 ± 3.4, p < 0.01) and a decrease in the Matsuda ISI (13.1 ± 21.3 vs 11.6 ± 16.1, p < 0.05). Hepatic insulin resistance was unchanged (2.4 ± 1.7 vs 2.4 ± 1.7 p > 0.05). Neither sugar level nor sugar type had any effect on any of these three measures (interaction p > 0.05). These data show that risk factors for diabetes do not vary between the 8% (25th percentile), and the 30% group (95th percentile) although insulin sensitivity may be affected by sugar consumption across a wide range of typical consumption levels. Importantly, the type of sugar (HFCS versus sucrose) had no effect on any response.

Cite this paper

Lowndes, J. , Kawiecki, D. , Yu, Z. and Rippe, J. (2015) No Dose Response Relationship in the Effects of Commonly Consumed Sugars on Risk Factors for Diabetes across a Range of Typical Human Consumption Levels. Food and Nutrition Sciences, 6, 101-111. doi: 10.4236/fns.2015.61011.

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Free Care Is Not Enough: Barriers to Attending Free Clinic Visits in a Sample of Uninsured Individuals with Diabetes

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52124#.VIkIi8nQrzE

ABSTRACT

Free care does not always lead to improved outcomes. Attendance at free clinic appointments is unpredictable. Understanding barriers to care could identify innovative interventions. The purpose of this study was to examine patient characteristics, biophysical outcomes, and health care utilization in uninsured persons with diabetes at a free clinic. A sample of 3139 patients with at least one chronic condition was identified and comparisons were made between two groups: those who attended all scheduled appointments and those who did not. Geographic distance to clinic and multiple chronic conditions were identified as barriers to attendance. After one year, missing more than one visit had a positive correlation with increased weight, A1C, and lipids. Additionally, patients who missed visits had higher blood pressure, depression scores, and numbers of medications. Future research should further enhance understanding of barriers to care, build knowledge of how social and behavioral determinants contribute to negative outcomes in the context of rurality. Innovative methods to deliver more frequent and intensive interventions will not be successful if they are not accessible to patients.

Cite this paper

Mallow, J. , Theeke, L. , Barnes, E. , Whetsel, T. and Mallow, B. (2014) Free Care Is Not Enough: Barriers to Attending Free Clinic Visits in a Sample of Uninsured Individuals with Diabetes. Open Journal of Nursing, 4, 912-919. doi: 10.4236/ojn.2014.413097.

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Use of Oral Agents and/or Insulin in the Treatment of Diabetes during Pregnancy: An Examination of Outcomes in Pregestational versus Gestational Diabetics

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52160#.VIZQWWfHRK0

ABSTRACT

The management of diabetes in pregnancy varies depending on whether the condition was first diagnosed during pregnancy (gestational diabetes) or was diagnosed before pregnancy (pregestational diabetes). Little has been published comparing the relative efficacy of various oral agents for the treatment of gestational diabetes and the reported experience with the insulin pump in pregnancy for pregestational diabetes remains meager. We conducted a retrospective chart review of women managed in a specialized diabetic clinic to compare the results of treatment of gestational diabetes with oral agents, glyburide and acarbose, to those treated with split-mixed insulin and treatment of pregestational diabetes with either the insulin pump or conventional splitmixed insulin. Gestational diabetics treated with split-mixed insulin were hospitalized significantly more often (p < 0.001) than those treated with oral agents only. The incidence of several important pregnancy complications (growth restriction, preterm labor, preeclampsia, oligohydramnios) did not differ between groups. Pregestational diabetics managed with an insulin pump had comparable glycemic control, as measured by hemoglobin A1c, to those managed with split-mixed insulin. Infant birth weights and Apgar scores were similar in each group. There were no perinatal deaths in either group. Acarbose and glyburide showed comparable efficacy in treating gestational diabetics. In addition, our experience adds to the small number of pregnant women with pregestational diabetes who were managed with an insulin pump that have been reported in the literature.

Cite this paper

Henslee, E. , Hatton, A. , Welt, S. , Holmes, J. , Penrose, L. , Prien, S. and Farooqi, N. (2014) Use of Oral Agents and/or Insulin in the Treatment of Diabetes during Pregnancy: An Examination of Outcomes in Pregestational versus Gestational Diabetics. Open Journal of Obstetrics and Gynecology, 4, 1052-1057. doi: 10.4236/ojog.2014.416144.

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[12] Wollitzer, A.D., Zisser, B.A.H. and Jovanovic, L. (2010) Insulin Pumps and Their Use in Pregnancy. Diabetes Technology & Therapeutics, 12, S33-S36. http://dx.doi.org/10.1089/dia.2009.0187
[13] Lapolla, A., Masin, M., Bruttomesso, D., Piva, I., Crepaldi, C., Tortul, C., et al. (2003) Analysis of Outcome of Pregnancy in Type 1 Diabetics Treated with Insulin Pump or Conventional Insulin Therapy. Acta Diabetologica, 40, 143-149. http://dx.doi.org/10.1007/s00592-003-0103-1
[14] Gimenez, M., Conget, I., Nicolau, J., Pericot, A. and Levy, I. (2007) Outcome of Pregnancy in Women with Type 1 Diabetes Intensively Treated with Continuous Subcutaneous Insulin Infusion or Conventional Therapy. A Case-Control Study. Acta Diabetologica, 44, 34-37.
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[15] Bergenstal, R.M., Tamborlane, W.V., Ahmann, A., Buse, J.B., Dailey, G., Davis, S.N., et al. (2010) Effectiveness of Sensor-Augmented Insulin-Pump Therapy in Type 1 Diabetes. The New England Journal of Medicine, 363, 311-320. http://dx.doi.org/10.1056/NEJMoa1002853                                                             eww141209lx

Resveratrol—The “Chateau Hormone” for Cardio Diabetic Protection

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51838#.VHfGumfHRK0

ABSTRACT

Resveratrol is a naturally occurring phenolic compound abundantly found in grape skin and in wines. Resveratrol is a phytoalexin trans-3,5,4’-trihydroxystilbene that possesses diverse biochemical and physiological actions. It is effective in improving health and preventing or treating chronicdiseases. The cardiovascular protective effects of Resveratrol suggest the anti-atherogenic and anti-inflammatory activity of the compound on endothelial cells. Resveratrol attenuates myocardial ischemic reperfusion injury, atherosclerosis and reduces ventricular arrhythmias. Resveratrol has been widely studied and is shown to have anti-oxidant, anti-inflammatory, anti-proliferative and anti-angiogenic effects and many signalling pathways are among the molecular targets of Resveratrol. Based on these mechanistic considerations, the involvement of Resveratrol has been observed in cardiovascular diseases, cancer and neurodegenerative diseases. In type 2 diabetes patients, when Resveratrol was given along with anti-diabetic agents, it was found to lower blood glucose, HbA1C and increase the insulin sensitivity and the levels of HDL-C. Resveratrol acts on the SIRT1 gene and stimulates endogenous pathways to promote health and longevity.

Cite this paper

Maladkar, M. , Awatramani, M. and Bhong, K. (2014) Resveratrol—The “Chateau Hormone” for Cardio Diabetic Protection. Journal of Diabetes Mellitus, 4, 371-378. doi: 10.4236/jdm.2014.44050.

References

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Isolated Soy Protein-Based Diet Ameliorates Glycemia and Antioxidants Enzyme Activities in Streptozotocin-Induced Diabetes

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51573#.VG6LFmfHRK0

ABSTRACT

The objective of this study was to evaluate the changes induced by isolated soy protein (ISP)-based diet on glycemia and oxidative stress biomarkers in diabetic rats. Fifteen male Wistar rats (35 ± 4 g, aged 21 days) were assigned to three groups: Casein (C group), which received casein-based diet during experimental protocol; Diabetic treated with Casein (D + C group) that received casein-based diet before and after diabetes induction; Diabetic treated with ISP (D + S group) that received casein-based diet before diabetes induction and after received ISP-based diet for the experimental protocol. Diabetes was induced by a single dose of streptozotocin (50 mg/kg body weight i.v.). After three weeks of dietary treatment, total nitrates, lipid peroxidation, antioxidant enzyme activities of superoxide dismutase (SOD), catalase (CAT), glutathione-S-transferase (GST) were measured in heart homogenates. ISP-based diet promoted an improvement in the glycemic levels of diabetic rats compared with casein-based diet (362 ± 25 vs 461 ± 30 mg/dL). CAT activity demonstrated a significant decrease in D + C and D + S groups. D + S group presented a significant increase in SOD and GST activities. Lipid peroxidation was not different among experimental groups. The overall results suggested the potential benefits of ISP-based diet consumption to improve the life quality of diabetic patients.

Cite this paper

Mendes, R. , Hagen, M. , Barp, J. , de Jong, E. , Moreira, J. , Reischak-Oliveira, Á. , Irigoyen, M. and Belló-Klein, A. (2014) Isolated Soy Protein-Based Diet Ameliorates Glycemia and Antioxidants Enzyme Activities in Streptozotocin-Induced Diabetes. Food and Nutrition Sciences, 5, 2089-2096. doi: 10.4236/fns.2014.521221.

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http://dx.doi.org/10.3945/ajcn.111.032045                                                                                 eww141121lx

A Retrospective Analysis of the Capacity Built through a Community-Based Participatory Research Project Addressing Diabetes and Obesity in South and East Los Angeles

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=47112#.VGFu52fHRK0

ABSTRACT

Chronic diseases, such as diabetes and obesity, are more prevalent in low-income and minority communities. One promising method to understand and address these chronic conditions is through Community Based Participatory Research (CBPR). CBPR engages and empowers community members to identify risk factors and work toward solutions as equal partners with researchers. One positive and lasting outcome may be an increase in the community capacity which includes individual and community leadership development, policy making, creating connections and utilizing existing community resources. Evaluating community capacity created as a result of a CBPR project is one way to measure its effectiveness. This paper is a retrospective analysis of the capacity built during a CBPR study of diabetes and obesity in East and South Los Angeles which are two low-income and minority neighborhoods. Four people, who were heavily involved in the project, completed a retrospective analysis of the capacity built utilizing a validated instrument. There was consensus about the capacity built, which included: excellent participation by community members, inclusion of members’ ideas to leverage additional funding, and pride of community members in their participation in the project. One area that could have been strengthened was increased access for leadership and research experience among community members, especially since the project ended prematurely. There were differences among the two community groups with East Los Angeles members focusing more on tangible interventions and grant writing, while South Los Angeles members had a greater policy focus. Communities and researchers who are embarking on a CBPR project can learn from those who have implemented the strategy. Measuring capacity built during and after the project, can be one way to understanding the contributions of a project in a community. CBPR is an empowering research methodology which, done correctly, can build community capacity and have long-term impacts on individuals and communities.

Cite this paper

Hillstrom, K. , Ruelas, V. , Peters, A. , Gedebu-Wilson, T. and Iverson, E. (2014) A Retrospective Analysis of the Capacity Built through a Community-Based Participatory Research Project Addressing Diabetes and Obesity in South and East Los Angeles. Health, 6, 1429-1435. doi: 10.4236/health.2014.612175.

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Alcohol and Type 2 Diabetes: Results from Canadian Cross-Sectional Data

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51215#.VFwXbGfHRK0

Author(s)

ABSTRACT

Cross-section data from Canadian Community Health Surveys are used to examine the relationship between moderate alcohol use and type 2 diabetes. Results from these data are compared with those which have been obtained from prospective longitudinal studies. The major result is that both types of data yield similar conclusions with respect to this relationship. The reason why this occurs is because Canadian drinking behavior is quite stable once a respondent has become an adult and remains relatively stable thereafter. The only difference between the two types of survey is the time at which information on drinking behavior is obtained. Since this does not matter if drinking behavior is stable over large age ranges results from the two types of survey will be similar. Neither type of data can be used to support the proposition that the relationship between drinking behavior and the risk of diabetes is causal. Some advantages that sample survey data have over longitudinal data are also noted.

Cite this paper

McIntosh, J. (2014) Alcohol and Type 2 Diabetes: Results from Canadian Cross-Sectional Data. Journal of Diabetes Mellitus, 4, 316-323. doi: 10.4236/jdm.2014.44044.

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