Yellow pea fiber improves glycemia and reduces Clostridium leptum in diet-induced obese rats

Numerous studies have demonstrated the impact of functional fibers on gut microbiota and metabolic health, but some less well-studied fibers and/or fractions of foods known to be high in fiber still warrant examination. The aim of this study was to assess the effect of yellow pea-derived fractions varying in fiber and protein content on metabolic parameters and gut microbiota in diet-induced obese rats. We hypothesized that the yellow pea fiber (PF) fraction would improve glycemia and alter gut microbiota. Rats were randomized to 1 of 5 isoenergetic dietary treatments for 6 weeks: (1) control; (2) oligofructose (OFS); (3) yellow PF; (4) yellow pea flour (PFL); or (5) yellow pea starch (PS). Glycemia, plasma gut hormones, body composition, hepatic triglyceride content, gut microbiota, and messenger RNA expression of genes related to hepatic fat metabolism were examined. Pea flour attenuated weight gain compared with control, PF, and PS (P < .05). Pea flour, PS, and OFS had significantly lower final percent body fat compared with control. Oligofructose but not the pea fraction diets reduced food intake compared with control (P < .05). Pea fiber resulted in lower fasting glucose and glucose area under the curve compared with control. Changes in gut microbiota were fraction specific and included a decrease in Firmicutes (percent) for OFS, PF, and PFL compared with control (P < .05). The Firmicutes/Bacteroidetes ratio was reduced with OFS, PF, and PFL when compared with PS (P < .05). Taken together, this work suggests that yellow pea-derived fractions are able to distinctly modulate metabolic parameters and gut microbiota in obese rats.     

Reflex insulin response associated to food intake in human subjects

The occurrence of a reflex insulin discharge at the beginning of a meal, and its possible influence on intake were studied in 7 normal weight humans. Each subject was tested twice under three standard meal conditions. The evolutions of insulinemia and glycemia were recorded over an 84 min observation period, starting 2 min before food presentation. Blood was drawn continuously from an antecubital vein, and collected in 1-min samples for the first 30 min, and then in 3-min samples. The average glycemia curve was stable until some 18-20 min after meal onset. By contrast, a significant rise in plasma insulin appeared as early as the 4th min after meal onset and it is hypothesized to be preabsorptive, of cephalic and/or gastric origin. However, inter-test variations were large even in the same person. Schematically, three types of early insulin responses were observed: high and/or sustained rise, moderate and/or short increase, moderate decrease in plasma insulin. The shape of the early insulin response was not related to any meal characteristic. The potential biological and behavioral significance of the early insulin release is discussed.     

重型颅脑损伤后高血糖与颅内压及预后的关系

目的 明确高血糖对重型颅脑损伤患者颅内压（intracranial pressure，ICP）及预后的影响。方法 回顾分析符合以下条件的重型颅脑损伤患者79例：无糖尿病史，均施行颅内血肿清除术，无重要颅外合并伤，有伤后6个月格拉斯哥预后评分（GOS）。根据GOS，将79例患者分为预后良好组及预后较差组，分析两组间伤后血糖与颅内压及预后的关系。结果 伤后血糖（包括入院及术后血糖）与颅内压呈正相关；预后良好组伤后血糖较预后较差组低，二组差异有统计学意义（P〈0．05）。结论 重型颅脑损伤后高血糖与颅内压呈线性相关，并且高血糖能够作为早期预测颅内压及预后的简便指标。     

Evidence for a different sensitivity to various central effects of interleukin-1 β in mice

Interleukin 1 (IL-1) induces a series of metabolic and endocrine effects. Activation of the hypothalamus-pituitary-adrenal axis, inhibition of food and water intake, elevation of serum interleukin-6 (IL-6) concentration and hypoglycemia are some of the effects induced by IL-1. The purpose of this study was to compare the sensitivity of these effects following central and peripheral administration of IL-1β. Different doses of IL-1β (0.1–1000 ng/mouse) were centrally (ICV) or peripherally (IP) injected to male mice two hours prior to sacrifice. The ICV administration was more efficacious than the IP injection in elevating serum corticosterone and IL-6 concentrations, whereas no difference was evident in the IL-1β-induced hypoglycemia. Central IL-1β administration was also more potent than IP injection in inhibiting overnight food and water intake. A dose-dependent effect was evident in all these cases. In summary, our data compare effects elicited by central or peripheral administration of different doses of IL-1β. This comparison suggests that the IL-1β stimulation of serum corticosterone and IL-6 and inhibition of food and water intake are events more centrally mediated than the IL-1β-induced hypoglycemia.     

A 10-s sprint performed prior to moderate-intensity exercise prevents early post-exercise fall in glycaemia in individuals with type 1 diabetes

Aims/hypothesis We investigated whether a 10-s maximal sprint effort performed immediately prior to moderate-intensity exercise provides another means to counter the rapid fall in glycaemia associated with moderate-intensity exercise in individuals with type 1 diabetes. Materials and methods Seven complication-free type 1 diabetic males (21.6 ± 3.6 years; mean±SD) with HbA_1c levels of 7.4 ± 0.7% injected their normal morning insulin dose and ate their usual breakfast. When post-meal glycaemia fell to ∼11 mmol/l, participants were asked to perform a 10-s all-out sprint (sprint trial) or to rest (control trial) immediately before cycling at 40% of peak rate of oxygen consumption for 20 min, with both trials conducted in a random counterbalanced order. Results Sprinting did not affect the rapid fall in glycaemia during the subsequent bout of moderate-intensity exercise (2.9 ± 0.4 mmol/l in 20 min; p = 0.00; mean±SE). However, during the following 45 min of recovery, glycaemia in the control trial decreased by 1.23 ± 0.60 mmol/l (p = 0.04) while remaining stable in the sprint trial, subsequently decreasing in this latter trial at a rate similar to that in the control trial. The large increase in noradrenaline (norepinephrine) (p = 0.005) and lactate levels (p = 0.0005) may have contributed to the early post-exercise stabilisation of glycaemia in the sprint trial. During recovery, adrenaline (epinephrine) and NEFA levels increased marginally in the sprint trial, but other counter-regulatory hormones did not change significantly (p < 0.05). Conclusions/interpretation A 10-s sprint performed immediately prior to moderate-intensity exercise prevents glycaemia from falling during early recovery from moderate-intensity exercise in individuals with type 1 diabetes.     

甘精胰岛素和地特胰岛素治疗2型糖尿病的经济学评估

目的:基于地特胰岛素和甘精胰岛素在国外进行2型糖尿病患者临床试验的结果,本研究应用该药在中国的成本进行经济学评估,为基础胰岛素的应用提供参考。方法:基于两者在血糖改善效果的相似,采用最小成本分析法进行经济学评估,并从医疗保险的角度进行成本的测量与分析。结果:在相同的血糖控制效果和低血糖发生率情况下,甘精胰岛素年平均成本比地特胰岛素节省40.77%。在调整一些关键因素后,甘精胰岛素的年治疗成本仍比地特胰岛素低。结论:与应用地特胰岛素比较,应用甘精胰岛素有可能降低2型糖尿病年平均治疗成本,这对控制卫生费用增长将有一定作用。     

Blood glucose and body temperature alterations induced by ethanol in rats submitted to different levels of food deprivation

The effects of 1.0, 3.0 and 5.0 g/kg of ethanol on blood glucose levels and body temperature were examined in rats submitted to either acute food deprivation (24 or 48 hr), chronic starvation, or to both chronic plus acute food deprivation. The results show that: (a) 3.0 and 5.0 g/kg produced either an increase or a decrease of glucose levels depending on the state of fasting; (b) rats not deprived of food presented hyperglycemia while being hypothermic; (c) a marked hypothermia was present when no substantial alterations in glycemia were observed; and (d) in cases where hypoglycemia and hypothermia occurred, the fall in body temperature paralleled or preceded the decrease in glucose levels.     

Hemoglobin A1c in Patients on Peritoneal Dialysis: How Should We Interpret It?

Almost half the patients on peritoneal dialysis are diabetic and glycemic control is essential to improve both patient and technique survival. Hemoglobin A1c (HbA1c) is widely used in the general population for diabetes diagnosis and monitoring as it highly correlates with blood glucose levels and outcomes. Its use has been extrapolated to the peritoneal dialysis population, despite HbA1c being commonly underestimated. In renal failure patients, HbA1c is influenced by variables affecting not only glycemia but also hemoglobin and the time of interaction between the two. Importantly, the impact of these variables differs in peritoneal dialysis compared to non‐dialysis chronic kidney disease and hemodialysis patients. Although HbA1c in peritoneal dialysis patients is less directly associated with blood glucose levels than in the general population, studies have confirmed its association with patient mortality. In this paper we review the variables that can influence HbA1c value emphasizing their impact in peritoneal dialysis patients. By providing clinicians with a comprehensive understanding of HbA1c results, we provide them with tools for a better patient management care and potential improved outcomes of peritoneal dialysis patients.     

Prevention of Nephropathy in Patients with type 2 Diabetes Mellitus

The rising incidence of type 2 diabetes mellitus and of its complications will make it the most important health care challenge in the first quarter of the 21st Century. Diabetic nephropathy left unchecked will overwhelm the renal resources. Simple methods (proper diet and exercise, prevention of obesity) are successful in preventing type 2 diabetes in the great majority of the persons at risk. In patients with established type 2 diabetes, nephropathy can be prevented or greatly delayed by strict metabolic control, strict control of blood pressure using angiotensin-converting enzyme inhibitors and angiotensin receptor blockers as the first line of drugs, tight control of serum lipids using statins as indicated, low protein diet, avoidance of smoking and other nephrotoxic influences, prevention of abnormalities in calcium/phosphorus metabolism, and prevention of renal anemia by the early use of erythropoietin. Current research offers the promise of definitive prevention of both type 2 diabetes and diabetic nephropathy.     

妊娠期糖尿病患者血糖及时干预对妊娠结局的影响

目的 探讨妊娠期糖尿病及时干预对妊娠结局的影响.方法 对确诊的100例GDM患者,根据血糖水平控制情况分为A组（血糖控制正常）50例和B组（血糖控制不良）50例,并选取同期在我院定期产检的非糖尿病产妇（50例）为正常对照组,比较3组母婴在分娩前后并发症情况.结果 B组的妊娠期高血压疾病、糖尿病酮症酸中毒、产后出血、羊水过多、剖宫产、早产、巨大儿、新生儿窒息、高胆红素血症及新生儿低血糖等发生率均明显高于A组及正常对照组（P＜0.05）,而A组与正常对照组相比,差异无统计学意义（P＞0.05）.结论 妊娠期糖尿病及时诊治对妊娠结局至关重要,及早干预能有效降低产妇及新生儿并发症的发生率,降低对妊娠结局的不良影响.