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Diabetes, Obesity & Metabolism Dec 2023To provide a preliminary evaluation of the accuracy and safety of Gluclas decision support system suggestions in a hypoglycaemic clamp study.
AIM
To provide a preliminary evaluation of the accuracy and safety of Gluclas decision support system suggestions in a hypoglycaemic clamp study.
METHODS
This analysis was performed using data from 32 participants (four groups with different glucose-insulin regulation: post Roux-en-Y gastric bypass with and without postprandial hypoglycaemia syndrome, postsleeve gastrectomy and non-operated controls) undergoing Gluclas-assisted hypoglycaemic clamps (target: 2.5 mmol/L for 20 minutes at 150 minutes after oral glucose ingestion). Gluclas provided glucose infusion rate suggestions upon manual entry of blood glucose values (every 5 minutes), which were either followed or overruled by investigators after critical review. Accuracy and safety were evaluated by mean absolute error (MAE), mean absolute percentage error (MAPE), average glucose level, coefficient of variation (CV) and minimal glucose level during the 20-minute hypoglycaemic period.
RESULTS
Investigators accepted 84% of suggestions, with a mean deviation of 30.33 mg/min. During the hypoglycaemic period, the MAE was 0.16 (0.12-0.24) (median [interquartile range]) mmol/L and the MAPE was 6.12% (4.80%-9.29%). CV was 4.90% (3.58%-7.27%), with 5% considered the threshold for sufficient quality. The minimal glucose level was 2.40 (2.30-2.50) mmol/L.
CONCLUSIONS
Gluclas achieved sufficiently high accuracy with minimal safety risks in a population with differences in glucose-insulin dynamics, underscoring its applicability to various patient groups.
Topics: Humans; Blood Glucose; Glucose; Hypoglycemia; Hypoglycemic Agents; Insulin; Insulins
PubMed: 37681278
DOI: 10.1111/dom.15265 -
Frontiers in Veterinary Science 2023Cannabidiol (CBD)-containing products are widely commercially available for companion animals, mirroring popularity in human use. Although data on the safety and...
Cannabidiol (CBD)-containing products are widely commercially available for companion animals, mirroring popularity in human use. Although data on the safety and efficacy of long-term oral supplementation are increasing in dogs, evidence remains lacking in cats. The purpose of these studies was to address gaps in the knowledge around the long-term suitability and tolerance of a tetrahydrocannabinol (THC)-free CBD distillate in clinically healthy cats. The studies were randomized, blinded, and placebo-controlled. The first study supplemented cats with either a placebo oil ( = 10) or with 4 mg/kg body weight (BW) CBD in placebo oil ( = 9) daily, with a meal, for 4 weeks. The concentration of CBD in plasma was measured over 4 h at d0 (first dose) and again at d14 (after 2 weeks of daily dosing). The second study supplemented cats daily with either placebo oil ( = 10) or 4 mg/kg BW CBD in placebo oil ( = 10) for a period of 26 weeks. A comprehensive suite of physiological health measures was performed throughout the study at baseline (week 0) and after 4, 10, 18, and 26 weeks of feeding, followed by a 4-week washout sample (week 30). Postprandial plasma CBD time course data, at both d0 and d14, showed a peak plasma CBD concentration at 2 h after the dose. This peak was 251 (95% CI: 108.7, 393.4) and 431 (95% CI, 288.7, 573.4) ng/mL CBD at d0 and d14, respectively, and the area under the curve concentration was higher by 91.5 (95% CI, 33.1, 149.9) ng-h/mL after 2 weeks of supplementation ( = 0.002). While in the first study the CBD group displayed increased alanine aminotransferase (ALT; 68.7 (95% CI, 43.23, 109.2) U/L) at week 4 compared to the placebo control group [1.44-fold increase (95% CI, 0.813, 2.54)], statistical equivalence (at 2-fold limits) was found for ALT across the duration of the second, long-term study. All other biochemistry and hematology data showed no clinically significant differences between supplement groups. Data presented here suggest that a THC-free, CBD distillate fed at a dose of 4 mg/kg BW was absorbed into plasma and well tolerated by healthy cats when supplemented over a period of 26 weeks.
PubMed: 38327816
DOI: 10.3389/fvets.2023.1324622 -
Nutrients Nov 2023Aversive conditioning weakens the gratifying value of a comfort meal. The aim was to determine the effect of a cognitive intervention to reverse aversive conditioning... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Aversive conditioning weakens the gratifying value of a comfort meal. The aim was to determine the effect of a cognitive intervention to reverse aversive conditioning and restore hedonic postprandial response.
METHODS
This was a randomized, sham-controlled, single-blind, parallel study that was conducted on 12 healthy women ( = 6 in each group). The reward value of a comfort meal was measured on different days: at initial exposure, after aversive conditioning (administration of the same meal with a masked fat overload on the previous day) and after a cognitive intervention (disclosing the aversive conditioning paradigm in the test group vs. no explanation in the control group). The primary outcome, digestive wellbeing, was determined using graded scales at regular intervals before and after ingestion.
RESULTS
At initial exposure, the comfort meal produced a rewarding experience that was impaired using aversive conditioning; upon re-exposure to the original meal, the cognitive intervention increased meal wanting and liking; improved digestive wellbeing and mood; tended to reduce postprandial satiety, bloating/fullness; and abolished discomfort/pain, thereby restoring the hedonic value of the comfort meal. By contrast, sham intervention had no effects, and the postprandial sensations remained like the responses to the offending meal.
CONCLUSION
In this proof-of-concept study, we demonstrate that in healthy women, a mild, short-term acquired aversion to a comfort meal can be reversed using a cognitive intervention.
CLINICALTRIALS
gov ID: NCT05897411.
Topics: Humans; Female; Single-Blind Method; Eating; Satiation; Emotions; Postprandial Period; Cognition
PubMed: 38068820
DOI: 10.3390/nu15234962 -
Nutrients Jul 2023The aim of this study was to assess the effect of four isocaloric meals with different macronutrient compositions on postprandial blood glucose, lipids, and glucagon in... (Randomized Controlled Trial)
Randomized Controlled Trial
The aim of this study was to assess the effect of four isocaloric meals with different macronutrient compositions on postprandial blood glucose, lipids, and glucagon in adults with type 1 diabetes (T1D). Seventeen subjects tested four isocaloric meals in a randomized crossover design. The meal compositions were as follows: high-carbohydrate (HC); high-carbohydrate with extra fiber (HC-fiber); low-carbohydrate high-protein (HP); and low-carbohydrate high-fat (HF). Blood glucose and lipid measurements were collected up to 4 h and glucagon up to 3 h postprandially. Mean postprandial glucose excursions were lower after the HP compared to the HC ( = 0.036) and HC-fiber meals ( = 0.002). There were no differences in mean glucose excursions after the HF meal compared to the HC and HP meals. The HF meal resulted in higher triglyceride excursions compared to the HP meal ( < 0.001) but not compared to the HC or HC-fiber meals. Glucagon excursions were higher at 180 min after the HP meal compared to the HC and HF meals. In conclusion, the low-carbohydrate HP meal showed the most favorable glycemic and metabolic effects during a 4 h postprandial period in subjects with T1D.
Topics: Adult; Humans; Diabetes Mellitus, Type 1; Blood Glucose; Dietary Fats; Cross-Over Studies; Glucagon; Insulin; Postprandial Period; Meals
PubMed: 37513510
DOI: 10.3390/nu15143092 -
Journal of Veterinary Internal Medicine 2023Decreasing hyperinsulinemia is crucial in preventing laminitis in insulin dysregulated (ID) horses. Complementary pharmacological treatments that efficiently decrease...
BACKGROUND
Decreasing hyperinsulinemia is crucial in preventing laminitis in insulin dysregulated (ID) horses. Complementary pharmacological treatments that efficiently decrease postprandial hyperinsulinemia in ID horses are needed.
OBJECTIVES
Compare short-term effects of canagliflozin vs placebo on glucose and insulin responses to an oral sugar test (OST) as well as the effects on body weight and triglyceride concentrations in horses with ID.
ANIMALS
Sixteen privately-owned ID horses.
METHODS
A single-center, randomized, double-blind, placebo-controlled, parallel design study. The horses were randomized (ratio 1:1) to either once daily PO treatment with 0.6 mg/kg canagliflozin or placebo. The study consisted of an initial 3-day period for obtaining baseline data, a 3-week double-blind treatment period at home, and a 3-day follow-up period similar to the initial baseline period but with continued double-blind treatment. Horses were subjected to an 8-sample OST in the morning of the third day on both visits.
RESULTS
Maximal geometric least square (LS) mean insulin concentration (95% confidence interval [CI]) during the OST decreased after 3 weeks of canagliflozin treatment compared with placebo (83.2; 55.4-125.0 vs 215.2; 143.2-323.2 μIU/mL). The geometric LS mean insulin response (insulin AUC ) for canagliflozin-treated horses was >66% lower compared with placebo. Least square mean body weight decreased by 11.1 (4-18.1) kg and LS mean triglyceride concentrations increased by 0.99 (0.47-1.5) mmol/L with canagliflozin treatment.
CONCLUSIONS AND CLINICAL IMPORTANCE
Canagliflozin is a promising drug for treatment of ID horses that requires future studies.
Topics: Animals; Horses; Canagliflozin; Blood Glucose; Insulin; Hyperinsulinism; Horse Diseases; Triglycerides; Body Weight; Male; Female
PubMed: 37864426
DOI: 10.1111/jvim.16906 -
Nutrients Oct 2023High glycemic response (GR) is part of cardiometabolic risk factors. Dietary polyphenols, starch digestibility, and dietary fibers could play a role in modulating GR. We... (Randomized Controlled Trial)
Randomized Controlled Trial
High glycemic response (GR) is part of cardiometabolic risk factors. Dietary polyphenols, starch digestibility, and dietary fibers could play a role in modulating GR. We formulated cereal products with high dietary fibers, polyphenols, and slowly digestible starch (SDS) contents to test their impact on the glycemic index (GI) and insulin index (II). Twelve healthy subjects were randomized in a crossover-controlled study to measure the GI and II of four biscuits according to ISO-26642(2010). Two types of biscuits were enriched with dietary fibers and polyphenols and high in SDS, and two similar control biscuits with low levels of these compounds were compared. The subjects consumed 50 g of available carbohydrates from the biscuits or from a glucose solution (reference). Glycemic and insulinemic responses were monitored for 2 h after the start of the consumption. The two enriched biscuits led to low GI and II (GI: 46 ± 5 SEM and 43 ± 4 SEM and II: 54 ± 5 SEM and 45 ± 3 SEM) when controls had moderate GI and II (GI: 57 ± 5 SEM and 58 ± 5 SEM and II: 61 ± 4 SEM and 61 ± 4 SEM). A significant difference of 11 and 15 units between the GI of enriched and control products was obtained. These differences may be explained by the polyphenol contents and high SDS levels in enriched products as well as potentially the dietary fiber content. This study provides new proposals of food formulations to induce beneficial health effects which need to be confirmed in a longer-term study in the context of the SINFONI consortium.
Topics: Humans; Blood Glucose; Dietary Carbohydrates; Edible Grain; Glycemic Index; Starch; Dietary Fiber; Insulin; Postprandial Period
PubMed: 37892479
DOI: 10.3390/nu15204401 -
The Journal of Nutrition Feb 2024Postprandial metabolic responses following dairy consumption have mostly been studied using stand-alone dairy products or milk-derived nutrients. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Postprandial metabolic responses following dairy consumption have mostly been studied using stand-alone dairy products or milk-derived nutrients.
OBJECTIVE
Assessing the impact of ingesting dairy products as part of a common breakfast on postprandial aminoacidemia, glycemic control, markers of bone metabolism, and satiety.
METHODS
In this randomized, crossover study, 20 healthy young males and females consumed on 3 separate occasions an iso-energetic breakfast containing no dairy (NO-D), 1 dairy (ONE-D), or 2 dairy (TWO-D) products. Postprandial concentrations of amino acids, glucose, insulin, glucagon-like peptide-1 (GLP-1), calcium, parathyroid hormone (PTH), and markers of bone formation (P1NP) and resorption (CTX-I) were measured before and up to 300 min after initiating the breakfast, along with VAS-scales to assess satiety.
RESULTS
Plasma essential and branched-chained amino acids availability (expressed as total area under the curve (tAUC)) increased in a dose-dependent manner (P<0.05 for all comparisons). Plasma glucose tAUCs were lower in ONE-D and TWO-D compared with NO-D (P<0.05 for both comparisons). Plasma GLP-1 tAUC increased in a dose-dependent manner (P<0.05 for all comparisons), whereas no differences were observed in plasma insulin tAUC between conditions (P>0.05 for all comparisons). Serum calcium tAUCs were higher in ONE-D and TWO-D compared with NO-D (P<0.05 for both comparisons), along with lower PTH tAUCs in ONE-D and TWO-D compared with NO-D (P=0.001 for both comparisons). In accordance, serum CTX-I concentrations were lower in the late postprandial period in ONE-D and TWO-D compared with NO-D (P<0.01 for both comparisons). No differences were observed in P1NP tAUCs between conditions (P>0.05). The tAUC for satiety was higher in TWO-D compared with NO-D and ONE-D (P<0.05 for both comparisons).
CONCLUSIONS
Iso-energetic replacement of a carbohydrate-rich breakfast component with one serving of dairy improves postprandial amino acid availability, glycemic control, and bone metabolism. Adding a second serving of dairy in lieu of carbohydrates augments postprandial amino acid and GLP-1 concentrations while further promoting satiety. This study was registered at https://doi.org/10.1186/ISRCTN13531586 with Clinical Trial Registry number ISRCTN13531586.
Topics: Male; Female; Animals; Blood Glucose; Postprandial Period; Breakfast; Cross-Over Studies; Glycemic Control; Calcium; Dairy Products; Insulin; Milk; Glucagon-Like Peptide 1; Amino Acids
PubMed: 38092152
DOI: 10.1016/j.tjnut.2023.12.012 -
Nutrients Jan 2024We explored the association between macronutrient intake and postprandial glucose variability in a large sample of youth living with T1D and consuming free-living meals....
We explored the association between macronutrient intake and postprandial glucose variability in a large sample of youth living with T1D and consuming free-living meals. In the Type 1 Diabetes Exercise Initiative Pediatric (T1DEXIP) Study, youth took photographs before and after their meals on 3 days during a 10 day observation period. We used the remote food photograph method to obtain the macronutrient content of youth's meals. We also collected physical activity, continuous glucose monitoring, and insulin use data. We measured glycemic variability using standard deviation (SD) and coefficient of variation (CV) of glucose for up to 3 h after meals. Our sample included 208 youth with T1D (mean age: 14 ± 2 years, mean HbA1c: 54 ± 14.2 mmol/mol [7.1 ± 1.3%]; 40% female). We observed greater postprandial glycemic variability (SD and CV) following meals with more carbohydrates. In contrast, we observed less postprandial variability following meals with more fat (SD and CV) and protein (SD only) after adjusting for carbohydrates. Insulin modality, exercise after meals, and exercise intensity did not influence associations between macronutrients and postprandial glycemic variability. To reduce postprandial glycemic variability in youth with T1D, clinicians should encourage diversified macronutrient meal content, with a goal to approximate dietary guidelines for suggested carbohydrate intake.
Topics: Adolescent; Female; Humans; Child; Male; Glucose; Diabetes Mellitus, Type 1; Blood Glucose Self-Monitoring; Blood Glucose; Meals; Insulin
PubMed: 38201991
DOI: 10.3390/nu16010162 -
American Journal of Veterinary Research Nov 2023To compare plasma glucagon-like peptide-2 (GLP-2) concentrations in dogs with treatment-naïve chronic enteropathies to healthy dogs and describe changes over time in...
OBJECTIVE
To compare plasma glucagon-like peptide-2 (GLP-2) concentrations in dogs with treatment-naïve chronic enteropathies to healthy dogs and describe changes over time in dogs with chronic enteropathies (CE).
ANIMALS
18 client-owned dogs with treatment-naïve CE and 17 client-owned healthy control dogs.
METHODS
This was a prospective study. Fasting, 1-hour, and 3-hour postprandial plasma GLP-2 concentrations were measured using a commercial immunoassay in healthy dogs and dogs with uncontrolled, untreated CE. Repeated fasting and postprandial plasma concentrations were measured in dogs with CE after initiating directed treatment for gastrointestinal disease.
RESULTS
There was no significant difference between fasting and postprandial GLP-2 concentrations in either group. Dogs with treatment-naïve CE had lower fasting (mean, 424 ± SD 176 pg/mL) plasma GLP-2 concentrations than healthy dogs (1184 ± 435 pg/mL; P < .0001). Fasted plasma GLP-2 concentrations (624 ± 314 pg/mL) remained lower in dogs with CE than in healthy dogs at recheck.
CLINICAL RELEVANCE
Dogs with CE have disrupted GLP-2 secretion. Future studies are required to evaluate subsets of CE and changes in response to therapy.
Topics: Humans; Dogs; Animals; Glucagon-Like Peptide 2; Insulin; Glucagon-Like Peptide 1; Prospective Studies; Blood Glucose; Postprandial Period; Peptide Fragments
PubMed: 37657734
DOI: 10.2460/ajvr.23.06.0149 -
Food & Function Mar 2024: Interesterification is an industrial processing technique used widely where hard fats are essential for functionality and consumer acceptability, margarines and lower... (Randomized Controlled Trial)
Randomized Controlled Trial
Postprandial lipid and vascular responses following consumption of a commercially-relevant interesterified palmitic acid-rich spread in comparison to functionally-equivalent non-interesterified spread and spreadable butter: a randomised controlled trial in healthy adults.
: Interesterification is an industrial processing technique used widely where hard fats are essential for functionality and consumer acceptability, margarines and lower fat spreads. : The aim of this study was to compare acute cardiovascular effects of functionally equivalent spreads (similar solid fat content) made with interesterified (IE) or non-IE palm-based fats, or spreadable butter. : A randomised, controlled, 4-armed crossover, double-blind study (25 men, 25 women; 35-75 years; healthy; mean BMI 24.5, SD 3.8), compared effects of mixed nutrient meals containing 50 g fat from functionally equivalent products [IE spread, non-IE spread and spreadable butter (SB), with rapeseed oil (RO) as a reference treatment: with 16.7%, 27.9%, 19.3% and 4% palmitic acid, respectively] on 8 h postprandial changes in plasma triacylglycerol (TAG) and endothelial dysfunction (flow-mediated dilatation; FMD). Circulating reactive oxygen species (estimated using a neutrophil oxidative burst assay), glucose, insulin, NEFA, lipoprotein particle profiles, inflammatory markers (glycoprotein acetylation (Glyc-A) and IL-6), and biomarkers of endotoxemia were measured. : Postprandial plasma TAG concentrations after test meals were similar. However following RO the 3 spreads, there were significantly higher postprandial apolipoprotein B concentrations, and small HDL and LDL particle concentrations, and lower postprandial extra-large, large, and medium HDL particle concentrations, as well as smaller average HDL and LDL particle sizes. There were no differences following IE compared to the other spreads. Postprandial FMD% did not decrease after high-fat test meals, and there were no differences between treatments. Postprandial serum IL-6 increased similarly after test meals, but RO provoked a greater increase in postprandial concentrations of glycoprotein acetyls (GlycA), as well as 8 h sCD14, an endotoxemia marker. All other postprandial outcomes were not different between treatments. : In healthy adults, a commercially-available IE-based spread did not evoke a different postprandial triacylglycerol, lipoprotein subclass, oxidative stress, inflammatory or endotoxemic response to functionally-equivalent, but compositionally-distinct alternative spreads. Clinical trial registry number: NCT03438084 (https://ClinicalTrials.gov).
Topics: Adult; Male; Humans; Female; Palmitic Acid; Dietary Fats; Endotoxemia; Interleukin-6; Triglycerides; Butter; Lipoproteins; Glycoproteins; Postprandial Period; Cross-Over Studies
PubMed: 38380649
DOI: 10.1039/d3fo05324e