glycemic   163

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Low-glycemic index diets as an intervention for diabetes: a systematic review and meta-analysis. - PubMed - NCBI
We searched PubMed, the Cochrane Library, EMBASE, and clinical trials registries for published and unpublished studies up until 1 March, 2019. We included 54 randomized controlled trials in adults or children with impaired glucose tolerance, type 1 diabetes, or type 2 diabetes. Continuous data were synthesized using a random effects, inverse variance model, and presented as standardized mean differences with 95% CIs.

RESULTS:
Low-GI diets were effective at reducing glycated hemoglobin (HbA1c), fasting glucose, BMI, total cholesterol, and LDL, but had no effect on fasting insulin, HOMA-IR, HDL, triglycerides, or insulin requirements. The reduction in fasting glucose and HbA1c was inversely correlated with body weight. The greatest reduction in fasting blood glucose was seen in the studies of the longest duration.

CONCLUSIONS:
Low-GI diets may be useful for glycemic control and may reduce body weight in people with prediabetes or diabetes.
foods  low  GI  glycemic  index  diet  food  weight  loss  maintenance  body  fat  clinical  trial  meta-analysis  RCT  peer-reviewed  research  human  in  vivo  systematic  review  HbA1c  biomarkers  treatment  improvement  intervention  fasting  glucose  BMI  total  cholesterol  LDL 
5 weeks ago by Michael.Massing
Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: a pilot study. - PubMed - NCBI
Psychological distress is linked with impaired glycemic control among diabetics.

OBJECTIVE:
Estimate changes in glycemic control, weight, blood pressure, and stress-related psychological symptoms in patients with type 2 diabetes participating in a standard Mindfulness Based Stress Reduction (MBSR) program.

DESIGN:
Prospective, observational study.

SETTING:
Academic health center.

PATIENTS:
Adult patients with type 2 diabetes mellitus.

INTERVENTIONS:
Participation in MBSR program for heterogeneous patient population. Diet and exercise regimens held constant.

MAIN OUTCOME MEASURES:
Glycosylated hemoglobin A1c (HA1c), blood pressure, body weight, and Symptom Checklist 90-Revised (anxiety, depression, somatization, and general psychological distress scores).

RESULTS:
Eleven of 14 patients completed the intervention. At 1 month follow-up, HA1c was reduced by 0.48% (P = .03), and mean arterial pressure was reduced by 6 mmHg (P = .009). Body weight did not change. A decrease in measures of depression, anxiety, and general psychological distress was observed.
SMBG  diabetes  type  2  T2D  glycemic  control  glucose  management  blood  self  care  correlation  peer-reviewed  research  stress  distress  reduction  mindfulness  based 
april 2019 by Michael.Massing
Self-monitoring blood glucose improves glycemic control in type 2 diabetes without intensive treatment: A systematic review and meta-analysis. - PubMed - NCBI
SMBG was associated with a reduction of HbA1c at 12 weeks (-0.31%; 95% CI: -0.57 to -0.05) and 24 weeks (-0.34%; 95%CI: -0.52 to -0.17), but no difference was found for 1 year. Subgroup analysis including studies with baseline HbA1c greater than 8% showed a higher reduction of HbA1c: -0.83% (95% CI: -1.55 to -0.11) at 12 weeks, and -0.48% (95% CI: -0.77 to -0.19) at 24 weeks, with no difference for 1 year nor for the stratification for number the tests.
CONCLUSION:
SMBG seems to lead to a slightly better glycemic control in the short term in patients with T2D. Patients decompensated at baseline appear to have the greatest benefit.
SMBG  diabetes  type  2  T2D  glycemic  control  glucose  management  blood  self  monitoring  correlation  peer-reviewed  research  tight  frequency 
april 2019 by Michael.Massing
Meta-analysis of the benefits of self-monitoring of blood glucose on glycemic control in type 2 diabetes patients: an update. - PubMed - NCBI
SMBG was effective in reducing HbA(1c) in non-insulin-treated type 2 diabetes (pooled mean difference, -0.24%; 95% confidence interval, -0.34% to -0.14%; P < 0.00001). Glycemic control significantly improved among the subgroup of patients whose baseline HbA(1c) was >or=8%. In contrast, no significant effect of SMBG was detected in patients who had HbA(1c) <8%.
CONCLUSIONS:
The available evidence suggests the usefulness of SMBG in improving glycemic control in non-insulin-treated type 2 diabetes as demonstrated by the reduction of HbA(1c) levels. In particular, SMBG proved to be useful in the subgroup of patients whose baseline HbA(1c) was >or=8%.
SMBG  diabetes  type  2  T2D  glycemic  control  glucose  management  blood  self  monitoring  correlation  peer-reviewed  research  tight  frequency 
april 2019 by Michael.Massing
Using the Common Sense Model of Self-regulation to review the effects of self-monitoring of blood glucose on glycemic control for non-insulin-treat... - PubMed - NCBI
Results from the longitudinal studies and randomized control trials suggested that SMBG may improve glycemic control. The few studies investigating mediators or moderators reported mixed results. Few studies effectively measured the CSM.
CONCLUSION:
Data suggested that SMBG may help improve glycemic control. Future trials must be designed to test hypotheses and improve our understanding of when, how, and for whom SMBG can enhance glycemic control. Rigorously controlled repetitions of current 2-arm trials will yield little new knowledge of theoretical or practical value.
SMBG  diabetes  type  2  T2D  glycemic  control  glucose  management  blood  self  monitoring  correlation  peer-reviewed  research  tight  frequency 
april 2019 by Michael.Massing
Intensified blood glucose monitoring improves glycemic control in stable, insulin-treated veterans with type 2 diabetes: the Diabetes Outcomes in V... - PubMed - NCBI
A total of 201 subjects completed the monitoring period. The baseline HbA(1c) (8.10 +/- 1.67%) decreased during the monitoring period by 0.30 +/- 0.68% (P < 0.001) at 4 weeks and by 0.36 +/- 0.88% (P < 0.001) at 8 weeks. Although entry HbA(1c) and compliance independently predicted the week 8 HbA(1c) (r = 0.862, P < 0.001), standardized regression analysis found that compliance with the SMBG protocol influenced the week 8 HbA(1c) more than age, sex, BMI, exercise level, carbohydrate consumption, or treatment intensity at baseline. However, SMBG benefited only subjects whose testing compliance exceeded 75% or with an entry HbA(1c) >8.0%. Decreases in HbA(1c) (-0.31 +/- 1.17%, P = 0.001) persisted in the 159 subjects followed for 52 weeks.
CONCLUSIONS:
Intensified blood glucose monitoring improved glycemic control in a large cohort of stable, insulin-treated veterans with type 2 diabetes. SMBG provided a strong stimulus for improved self-care resulting in clinically important and sustained reductions in HbA(1c).
SMBG  diabetes  type  2  T2D  glycemic  control  glucose  management  blood  self  monitoring  correlation  peer-reviewed  research  insurance  tight  frequency 
april 2019 by Michael.Massing
Effects of health maintenance organization coverage of self-monitoring devices on diabetes self-care and glycemic control. - PubMed - NCBI
est strip consumption increased during the first 6 months after the policy by 17.9 strips per cohort member (75% relative increase by 6 months; 95% CI, 50% to 101%). Compared with noninitiators of SMBG, initiators (n = 593) showed sudden, significant improvements in regularity of medication use by 6 months after initiation (-19.5 days between dispensings among those with low refill regularity [95% CI, -27.7 to -11.3]; -9.7 days among those with moderate regularity [95% CI, -12.3 to -7.1]), and in glucose control (-0.63% mean HbA(1c) level [as percentage of total hemoglobin] among those with poor baseline glycemic control [HbA(1c) >10%; 95% CI, -1.14% to -0.12%]).
CONCLUSIONS:
Providing free glucose monitors improved rates of self-monitoring in this health maintenance organization population, possibly by offering an initial incentive for patients to engage in more desirable patterns of care. Initiating SMBG was associated with increased regularity of medication use and a reduction in high blood glucose levels.
SMBG  diabetes  type  2  T2D  glycemic  control  glucose  management  blood  self  monitoring  correlation  peer-reviewed  research  insurance  tight  frequency 
april 2019 by Michael.Massing
Lack of insurance coverage for testing supplies is associated with poorer glycemic control in patients with type 2 diabetes
Patients with insurance had significantly lower hemoglobin A1c concentrations than those without insurance coverage (7.1% v. 7.4%, p = 0.03). Patients with insurance were younger, had a higher income, were less likely to have a high school education and were less likely to be married or living with a partner. In multivariate analyses that controlled for these and other potential confounders, lack of insurance coverage for self-monitoring testing supplies was still significantly associated with higher hemoglobin A1c concentrations (adjusted difference 0.5%, p = 0.006).

Interpretation

Patients without insurance for self-monitoring test strips had poorer glycemic control.
SMBG  diabetes  type  2  T2D  glycemic  control  glucose  management  blood  self  monitoring  correlation  peer-reviewed  research  insurance  tight  frequency 
april 2019 by Michael.Massing
Glycemic Control in Nonpregnant Adults With Type 2 Diabetes | Guidelines | JAMA | JAMA Network
[As is so often the case, the discussion of treatment risk vs. benefit in glycemic control/management is distorted by an actually or effectively exclusive focus on drug therapy. —DMM]

In the United States, type 2 diabetes affects 30 million people and is a major cause of morbidity and mortality.1 Glycemic control has been shown to reduce diabetes complications, particularly for microvascular disease.2,3 However, increasing recognition of adverse events due to intensive diabetes treatments has prompted major disagreements about optimal glycemic targets.
glycemic  control  tight  management  glucose  complications  late-stage  symptoms  risk  mitigation  prevention  microvascular  diabetes  type  2  T2D  drug  therapy  treatment  peer-reviewed  research  in  vivo  situ  human  clinical  trial  blood  benefit  comorbidities  morbidity  self  care  behavioral 
july 2018 by Michael.Massing
Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature. - PubMed - NCBI
The intake of wholegrain foods clearly protects against heart disease and stroke but the exact mechanism is not clear. Fibre, magnesium, folate and vitamins B6 and vitamin E may be important. The intake of high GI carbohydrates (from both grain and non-grain sources) in large amounts is associated with an increased risk of heart disease in overweight and obese women even when fibre intake is high but this requires further confirmation in normal-weight women.
RECOMMENDATION:
Carbohydrate-rich foods should be wholegrain and if they are not, then the lowest GI product available should be consumed. Glycemic index is largely irrelevant for foods that contain small amounts of carbohydrate per serve (such as most vegetables).
antioxidant  GI  glycemic  index  load  GL  carbohydrates  vegetables  fiber  blood  glucose  lipids  management  risk  diet  self  care  peer-reviewed  research  zinc  magnesium  vitamin  E  supplements  cholesterol  harm  reduction  bran  CHD  cardiovascular  protection  in  vivo  human  review  overview  stroke  saelf  B6  folate 
november 2017 by Michael.Massing
Glycemic index and glycemic load: measurement issues and their effect on diet-disease relationships. - PubMed - NCBI
Meta-analyses suggest that foods with a low GI or GL may confer benefit in terms of glycemic control in diabetes and lipid management. However, low GI and GL foods can be energy dense and contain substantial amounts of sugars or undesirable fats that contribute to a diminished glycemic response. Therefore, functionality in terms of a low glycemic response alone does not necessarily justify a health claim. Most studies, which have demonstrated health benefits of low GI or GL involved naturally occurring and minimally processed carbohydrate containing cereals, vegetables and fruit. These foods have qualities other than their immediate impact on postprandial glycemia as a basis to recommend their consumption. When the GI or GL concepts are used to guide food choice, this should be done in the context of other nutritional indicators and when values have been reliably measured in a large group of individuals.
glycemic  index  load  whole  foods  grains  fruit  processed  food  vegetables  cereals  diet  choices  glucose  management  diabetes  sugars  fats  dietary  postprandial  blood 
november 2017 by Michael.Massing
The Effects of Breakfast Consumption and Composition on Metabolic Wellness with a Focus on Carbohydrate Metabolism. - PubMed - NCBI
Findings from epidemiologic studies indicate that there are associations between breakfast consumption and a lower risk of type 2 diabetes mellitus (T2DM) and metabolic syndrome, prompting interest in the influence of breakfast on carbohydrate metabolism and indicators of T2DM risk. The objective of this review was to summarize the available evidence from randomized controlled trials assessing the impact of breakfast on variables related to carbohydrate metabolism and metabolic wellness. Consuming compared with skipping breakfast appeared to improve glucose and insulin responses throughout the day. Breakfast composition may also be important. Dietary patterns high in rapidly available carbohydrate were associated with elevated T2DM risk. Therefore, partial replacement of rapidly available carbohydrate with other dietary components, such as whole grains and cereal fibers, proteins, and unsaturated fatty acids (UFAs), at breakfast may be a useful strategy for producing favorable metabolic outcomes. Consumption of fermentable and viscous dietary fibers at breakfast lowers glycemia and insulinemia. Fermentable fibers likely act through enhancing insulin sensitivity later in the day, and viscous fibers have an acute effect to slow the rate of carbohydrate absorption. Partially substituting protein for rapidly available carbohydrate enhances satiety and diet-induced thermogenesis, and also favorably affects lipoprotein lipids and blood pressure. Partially substituting UFA for carbohydrate has been associated with improved insulin sensitivity, lipoprotein lipids, and blood pressure. Overall, the available evidence suggests that consuming breakfast foods high in whole grains and cereal fiber, while limiting rapidly available carbohydrate, is a promising strategy for metabolic health promotion.
carbohydate  protein  breakfast  blood  whole  grain  unsaturated  fatty  acids  lipids  UFA  glucose  peer-reviewed  research  response  insulin  fiber  high  low  glycemic  index  correlation  type  2  T2D  effect  diet  self  care  management  long  term  short  viscous  soluble  fermentable  insoluble  metabolism  risk  reduction  harm  prevention  diabetes  metabolic  syndrome 
september 2017 by Michael.Massing
Effects of whole grain rye, with and without resistant starch type 2 supplementation, on glucose tolerance, gut hormones, inflammation and appetite... - PubMed - NCBI
Whole grain has shown potential to lower the risk of obesity, cardiovascular disease and type 2 diabetes. One possible mechanism behind the benefits of whole grain is the gut fermentation of dietary fiber (DF), e.g. non-starch polysaccharides and resistant starch (RS), in whole grain. The purpose of the study is to investigate the effect of whole grain rye-based products on glucose- and appetite regulation.
METHOD:
Twenty-one healthy subjects were provided four rye-based evening test meals in a crossover overnight study design. The test evening meals consisted of either whole grain rye flour bread (RFB) or a 1:1 ratio of whole grain rye flour and rye kernels bread (RFB/RKB), with or without added resistant starch (+RS). White wheat flour bread (WWB) was used as reference evening meal. Blood glucose, insulin, PYY, FFA, IL-6 as well as breath H2 and subjective rating of appetite were measured the following morning at fasting and repeatedly up to 3.5 h after a standardized breakfast consisting of WWB. Ad libitum energy intake was determined at lunch, 14.5 h after evening test and reference meals, respectively.
RESULTS:
The evening meal with RFB/RKB + RS decreased postprandial glucose- and insulin responses (iAUC) (P < 0.05) and increased the gut hormone PYY in plasma the following morning 0-120 min after the standardized breakfast, compared to WWB (P = 0.01). Moreover, RFB increased subjective satiety and decreased desire to eat, and both RFB and RFB/RKB decreased feeling of hunger (AUC 0-210 min). All rye-based evening meals decreased or tended to decrease fasting FFA (P < 0.05, RFB/RKB: P = 0.057) and increased breath hydrogen concentration (0-120 min, P < 0.001). No effects were noted on energy intake at lunch or inflammatory marker IL-6 (0 + 180 min) after the rye-based evening meals, compared to WWB.
CONCLUSION:
Whole grain rye bread has the potential to improve cardiometabolic variables in an 11-14.5 h perspective in healthy humans. The combination RFB/RKB + RS positively affected biomarkers of glucose- and appetite regulation in a semi-acute perspective. Meanwhile, RFB and RFB/RKB improved subjective appetite ratings. The effects probably emanate from gut fermentation events.
blood  whole  grain  rye  glucose  metabolism  peer-reviewed  research  response  insulin  fiber  high  low  glycemic  index  correlation  comparison  type  2  T2D  second-meal  phenomenon  effect  diet  self  care  management 
september 2017 by Michael.Massing

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