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- Title
- United Kingdom Prospective Diabetes
Study 24: a 6-year, randomized,
controlled trial comparing sulfonylurea,
insulin, and metformin therapy in
patients with newly diagnosed type 2
diabetes that could not be controlled
with diet therapy. United Kingdom
Prospective Diabetes Study Group [see
comments]
- Address
-
- Source
- Ann Intern Med, 1998 Feb, 128:3,
165-75
- Abstract
- BACKGROUND: Uncertainty exists about
the suitability of oral hypoglycemic
drugs and insulin therapy for patients
with newly diagnosed type 2 diabetes.
OBJECTIVE: To assess and compare
response to sulfonylurea, insulin, or
metformin over 6 years in patients with
newly diagnosed type 2 diabetes in whom
disease could and could not be
controlled with diet therapy alone.
DESIGN: Multicenter, randomized,
controlled trial. SETTING: Outpatient
diabetes clinics of 15 hospitals in the
United Kingdom. INTERVENTION:
Sulfonylurea (chlorpropamide or
glyburide), insulin, or metformin (if
patients were obese). PATIENTS: 458
patients with newly diagnosed type 2
diabetes that could not be controlled
with diet and had hyperglycemic symptoms
or fasting plasma glucose levels greater
than 15 mmol/L during the initial 3
months of diet therapy (primary diet
failure group) and 1620 patients in whom
disease was controlled by diet therapy
and who had fasting plasma glucose
levels of 6 to 15 mmol/L and no
hyperglycemic symptoms while receiving
diet therapy alone. MEASUREMENTS:
Fasting plasma levels of glucose and
insulin, hemoglobin A1c concentrations,
body weight, and therapy required.
RESULTS: Compared with the
diet-controlled group, the primary diet
failure group was younger and less obese
and had more retinopathy, lower fasting
plasma insulin levels, and reduced
beta-cell function. At 6 years, patients
allocated to insulin had lower fasting
plasma glucose levels than did patients
allocated to oral agents, but hemoglobin
A1c concentrations were similar.
Forty-eight percent (95% CI, 37% to 58%)
of patients in the primary diet failure
group maintained hemoglobin A1c
concentrations less than 0.08. By 6
years, 51% of patients (CI, 42% to 62%)
allocated to ultralente insulin required
additional short-acting insulin and 66%
of patients (CI, 58% to 73%) allocated
to sulfonylurea required additional
therapy with metformin or insulin to
control symptoms and maintain fasting
plasma glucose levels less than 15 mmol/L.
Patients allocated to insulin gained
more weight and had more hypoglycemic
attacks than did patients allocated to
sulfonylurea. Obese patients allocated
to metformin gained the least weight and
had the fewest hypoglycemic attacks. For
all therapies, control achieved at 6
years was worse in the primary diet
failure group than in the
diet-controlled group. CONCLUSIONS:
Because initial insulin therapy induced
more hypoglycemic reactions and weight
gain without necessarily providing
better control, it may be reasonable to
start with oral agents and change to
insulin if goals for glycemic levels are
not achieved.
- Language of Publication
- English
- Unique Identifier
- 98108431
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- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|BL/CO/DH/*DT;
Hypoglycemic Agents|*TU; Insulin|*TU;
Metformin|*TU; Sulfonylurea Compounds|*TU
- MeSH Heading
- Adult; Aged; Blood Glucose|ME;
Combined Modality Therapy; Comparative
Study; Female; Follow-Up Studies; Great
Britain; Hemoglobin A, Glycosylated|ME;
Human; Hypoglycemia|ET; Male; Middle
Age; Obesity|BL/CO; Prospective Studies;
Statistics; Support, Non-U.S. Gov't;
Support, U.S. Gov't, P.H.S.
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
MULTICENTER STUDY; RANDOMIZED CONTROLLED
TRIAL
- ISSN
- 0003-4819
- Country of Publication
- UNITED STATES
Record 2 from database: MEDLINE
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- Title
- Comparison of a high-carbohydrate diet
with a high-monounsaturated-fat diet in
patients with non-insulin-dependent
diabetes mellitus.
- Author
- Garg A; Bonanome A; Grundy SM; Zhang
ZJ; Unger RH
- Address
- Center for Human Nutrition, University
of Texas Southwestern Medical Center,
Dallas 75235-9052.
- Source
- N Engl J Med, 1988 Sep, 319:13, 829-34
- Abstract
- We compared a high-carbohydrate diet
with a high-fat diet (specifically, a
diet high in monounsaturated fatty
acids) for effects on glycemic control
and plasma lipoproteins in 10 patients
with non-insulin-dependent diabetes
mellitus (NIDDM) receiving insulin
therapy. The patients were randomly
assigned to receive first one diet and
then the other, each for 28 days, in a
metabolic ward. In the high-carbohydrate
diet, 25 percent of the energy was in
the form of fat and 60 percent in the
form of carbohydrates (47 percent of the
total energy was in the form of complex
carbohydrates); the
high-monounsaturated-fat diet was 50
percent fat (33 percent of the total
energy in the form of monounsaturated
fatty acids) and 35 percent
carbohydrates. The two diets had the
same amounts of simple carbohydrates and
fiber. As compared with the
high-carbohydrate diet, the
high-monounsaturated-fat diet resulted
in lower mean plasma glucose levels and
reduced insulin requirements, lower
levels of plasma triglycerides and
very-low-density lipoprotein cholesterol
(lower by 25 and 35 percent,
respectively; P less than 0.01), and
higher levels of high-density
lipoprotein (HDL) cholesterol (higher by
13 percent; P less than 0.005). Levels
of total cholesterol and low-density
lipoprotein (LDL) cholesterol did not
differ significantly in patients on the
two diets. These preliminary results
suggest that partial replacement of
complex carbohydrates with
monounsaturated fatty acids in the diets
of patients with NIDDM does not increase
the level of LDL cholesterol and may
improve glycemic control and the levels
of plasma triglycerides and HDL
cholesterol.
- Language of Publication
- English
- Unique Identifier
- 88318869
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- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*DH; Dietary
Carbohydrates|*AD; Dietary Fats|*AD;
Fatty Acids, Monounsaturated|*AD
- MeSH Heading
- Adult; Aged; Blood Glucose|AN;
Cholesterol|BL; Comparative Study;
Energy Intake; Human; Insulin|AD;
Lipoproteins, LDL Cholesterol|BL;
Lipoproteins, VLDL|BL; Middle Age;
Random Allocation; Support, Non-U.S.
Gov't; Support, U.S. Gov't, Non-P.H.S.;
Support, U.S. Gov't, P.H.S.;
Triglycerides|BL
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0028-4793
- Country of Publication
- UNITED STATES
Record 3 from database: MEDLINE
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- Title
- Diet only or diet and sulfonylureas in
mild type II diabetes (NIDDM)?
Pathophysiologic and therapeutic
implications.
- Author
- Sinay IR; Arias P; Schnitman MA;
Damilano SA; Faingold MC; Moguilevsky JA
- Address
- Servicio de Endocrinologia, Hospital
FrancÆes, Buenos Aires, Argentina.
- Source
- Acta Diabetol Lat, 1988 Oct, 25:4,
289-97
- Abstract
- Plasma glucose, insulin and C-peptide
responses to a test meal were studied in
7 nonobese patients with type II
diabetes mellitus (NIDDM) treated with
diet alone and after 6 months of
gliclazide therapy, as well as in 6
matched controls. The glycemic levels
were significantly higher (p less than
0.05) in patients under diet alone than
in controls and after gliclazide
treatment (peak: 12.8 +/- 1.0; 7.9 +/-
0.4 and 10.0 +/- 0.5 mmol/l,
respectively; means +/- SEM). Diet and
gliclazide treated patients showed a
reduced B-cell response during the first
hour after the meal as indicated by
insulin and C-peptide values and areas
(insulin areas 0-60 min: controls 57.9
+/- 10.9; p less than 0.01 vs diet alone
14.2 +/- 2.7 and vs gliclazide 22.1 +/-
2.8 microU/ml/min). The hypoinsulinemic
phase lasted from 20 to 60 min before
gliclazide, and from 20 to 45 min after
gliclazide. The first significant
C-peptide increase, detected at 10 min
in controls and at 30 min under diet
alone, was advanced to 15 min after
gliclazide treatment. In conclusion:
patients with mild, diet-treated NIDDM
show a sluggish and attenuated B-cell
response to a physiologic challenge
(test meal); this secretory impairment
is present even after a complete post-prandial
glycemic normalization, supporting the
idea of a persistent defect.
Nevertheless, the slight improvement
observed in insulin secretion after
gliclazide treatment may be promoting,
at least partially, the normalization of
prandial hyperglycemia. The benefits of
this normalization in diabetic patients
previously controlled by diet only await
further investigation.
- Language of Publication
- English
- Unique Identifier
- 89224955
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- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|BL/*DT/UR;
Diabetic Diet|*; Hypoglycemic Agents|*TU
- MeSH Heading
- Aged; Blood Glucose|AN; C-Peptide|BL/UR;
Combined Modality Therapy; Comparative
Study; Female; Hemoglobin A,
Glycosylated|AN; Human; Hypoglycemia|ET;
Insulin|BL; Male; Middle Age; Reference
Values
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0001-5563
- Country of Publication
- ITALY
Record 4 from database: MEDLINE
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- Title
- UK Prospective Diabetes Study (UKPDS).
IX: Relationships of urinary albumin and
N-acetylglucosaminidase to glycaemia and
hypertension at diagnosis of type 2
(non-insulin-dependent) diabetes
mellitus and after 3 months diet
therapy.
- Address
-
- Source
- Diabetologia, 1993 Sep, 36:9, 835-42
- Abstract
- In 672 newly-diagnosed, Type 2
(non-insulin-dependent) diabetic
patients without urinary infection, aged
51 (9) years, mean (1 SD), 28% of
patients had raised albuminuria, defined
as albumin excretion greater than 25
mg/l and 66% raised urinary N-acetylglucosaminidase
excretion defined as greater than 300
mumol.h-1.l-1 (both urinary analytes
corrected by linear regression on
urinary creatinine to 10 mmol/1). In a
univariate analysis, urinary N-acetylglucosaminidase
and albumin excretion correlated with
each other (rs = 0.42, p < 0.001),
and with fasting plasma glucose (rs =
0.46 and rs = 0.27, p < 0.001,
respectively). The association of
urinary albumin and N-acetylglucosaminidase
remained significant after taking the
fasting plasma glucose levels into
account, partial rs = 0.34, p <
0.001. After 3 months of dietary therapy
BMI decreased from 29.7 (5.9) kg/m2 to
28.8 (5.8) kg/m2, fasting plasma glucose
levels from 12.2 (3.8) mmol/l to 9.8
(3.8) mmol/l, and systolic blood
pressure from 143 (21.8) mmHg to 131
(20.3) mmHg, p < 0.001 for each
variable. There were concomitant
decreases in urinary N-acetylglucosaminidase,
geometric mean (1 SD interval), 397
mumol.h-1.l-1 (216 to 728) to 291
mumol.h-1.l-1 (160 to 528), p < 0.001
and in albumin excretion 16 mg/l (5 to
51) to 13 mg/l (4 to 40), p < 0.001.
The decrease in urinary N-acetylglucosaminidase,
but not the decrease in urinary albumin
excretion, was associated with the
initial degree of glycaemia and the
decrease in glycaemia in response to
diet.(ABSTRACT TRUNCATED AT 250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 94010013
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- MeSH Heading (Major)
- Acetylglucosaminidase|BL/*UR;
Albuminuria|*; Blood Glucose|*ME;
Diabetes Mellitus,
Non-Insulin-Dependent|*CO/DH/*PP;
Diabetic Diet|*; Hypertension|CO/*PP
- MeSH Heading
- Biological Markers|BL/UR; Blood
Pressure; Female; Great Britain;
Hemoglobin A, Glycosylated|AN; Human;
Male; Middle Age; Prospective Studies;
Regression Analysis; Support, Non-U.S.
Gov't; Support, U.S. Gov't, P.H.S.; Time
Factors
- Publication Type
- JOURNAL ARTICLE; MULTICENTER STUDY
- ISSN
- 0012-186X
- Country of Publication
- GERMANY
Record 5 from database: MEDLINE
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- Title
- Effects of diet composition and
ketosis on glycemia during
very-low-energy-diet therapy in obese
patients with non-insulin-dependent
diabetes mellitus.
- Author
- Gumbiner B; Wendel JA; McDermott MP
- Address
- Department of Medicine, Monroe
Community Hospital, Rochester, NY 14620,
USA.
- Source
- Am J Clin Nutr, 1996 Jan, 63:1, 110-5
- Abstract
- To determine whether high-ketogenic
very-low-energy diets (VLEDs) can reduce
hepatic glucose output (HGO) and
hyperglycemia more effectively than can
low-ketogenic VLEDs in obese patients
with non-insulin-dependent diabetes
mellitus (NIDDM), seven patients were
treated with a high-ketogenic VLED for 3
wk and were compared with six patients
treated with a low-ketogenic VLED. All
patients were then crossed over and
treated with the alternate diet for
another 3 wk. Basal HGO, fasting ketone
bodies, and glycemia, insulin, and
C-peptide after fasting and an
oral-glucose-tolerance test (OGTT) were
measured. Before treatment, prediet
weight and fasting, OGTT, and HGO
measurements were not different between
groups. After dieting, weight loss was
not different between the groups.
However, fasting and OGTT glycemia were
lower during treatment with the high-ketogenic
VLED than with the low-ketogenic VLED
(treatment effect: P < 0.05, by
analysis of variance). Moreover, there
was a strong correlation between basal
HGO and fasting plasma ketone bodies (r
= -0.71 at 3 wk, r = -0.67 at 6 wk; both
P < 0.05). In contrast, fasting and
OGTT plasma insulin and C-peptide
concentrations were not different
between treatment groups. These data
indicate that in obese patients with
NIDDM, high-ketogenic VLEDs have a more
clinically favorable effect on glycemia
than do low-ketogenic VLEDs.
- Language of Publication
- English
- Unique Identifier
- 96112784
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- MeSH Heading (Major)
- Blood Glucose|*ME; Diabetes Mellitus,
Non-Insulin-Dependent|BL/*CO; Diet,
Reducing|*; Ketosis|*CO; Obesity|BL/CO/*DH
- MeSH Heading
- C-Peptide|BL; Comparative Study;
Cross-Over Studies; Energy Metabolism;
Female; Glucose|ME; Glucose Tolerance
Test; Human; Insulin|BL; Ketone
Bodies|BL; Liver|ME; Male; Middle Age;
Support, Non-U.S. Gov't; Support, U.S.
Gov't, P.H.S.
- Publication Type
- CLINICAL TRIAL; CONTROLLED CLINICAL
TRIAL; JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 6 from database: MEDLINE
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- Title
- Body fat distribution and
non-insulin-dependent diabetes:
comparison of a fiber-rich,
high-carbohydrate, low-fat (23%) diet
and a 35% fat diet high in
monounsaturated fat [see comments]
- Author
- Walker KZ; ODea K; Johnson L; Sinclair
AJ; Piers LS; Nicholson GC; Muir JG
- Address
- School of Nutrition and Public Health,
Deakin University, Victoria, Australia.
- Source
- Am J Clin Nutr, 1996 Feb, 63:2, 254-60
- Abstract
- The effects of a fiber-rich,
high-carbohydrate, low-fat (HCLF) diet
and a modified-fat (MF) diet high in
monounsaturated fat on body fat
distribution were examined by
dual-energy X-ray absorptiometry (DXA)
in 16 subjects with
non-insulin-dependent diabetes (NIDDM)
during a randomized crossover study.
Subjects lost similar amounts of body
fat consuming the HCLF and MF diets
(-0.83 +/- 0.37 and -0.87 +/- 0.40 kg,
respectively) despite a marked
difference in total fat consumption.
With the MF diet, the ratio of upper- to
lower-body fat (UF:LF) remained
unchanged because fat was lost
proportionately from the upper and lower
body. In contrast, with the HCLF diet, a
disproportionate loss of lower-body fat
caused the UF:LF to increase. The
effects of diet on regional body fat
loss were significant (P < 0.05,
two-factor repeated-measures ANOVA).
- Language of Publication
- English
- Unique Identifier
- 96148840
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- MeSH Heading (Major)
- Adipose Tissue|*AH/ME; Diabetes
Mellitus, Non-Insulin-Dependent|BL/*DH/ME;
Dietary Carbohydrates|*AD; Dietary Fats,
Unsaturated|*AD; Dietary Fiber|*AD
- MeSH Heading
- Anthropometry; Body Composition; Body
Mass Index; Body Weight; Comparative
Study; Cross-Over Studies; Densitometry,
X-Ray; Fatty Acids|BL; Female; Human;
Male; Middle Age; Patient Compliance;
Support, Non-U.S. Gov't
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 7 from database: MEDLINE
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- Title
- Randomized trial of diet versus diet
plus cardiovascular conditioning on
glucose levels in gestational diabetes.
- Author
- Jovanovic Peterson L; Durak EP;
Peterson CM
- Address
- Sansum Medical Research Foundation,
Santa Barbara, CA 93105.
- Source
- Am J Obstet Gynecol, 1989 Aug, 161:2,
415-9
- Abstract
- We studied the impact of a training
program on glucose tolerance in
gestational diabetes mellitus. Women
with gestational diabetes mellitus (N =
19) were randomized into either group I,
a 6-week diet alone group (24 to 30
kcal/kg/24 hours; 20% protein, 40%
carbohydrate, 40% fat), or group II,
which followed the same diet plus
exercise (20 minutes three times a week
for 6 weeks). An arm ergometer was used
to maintain heart rate in the training
range. Glycemic response was monitored
by glycosylated hemoglobin, a 50 gm oral
glucose challenge with a fasting and
1-hour plasma glucose, and blood glucose
self-monitoring, fasting and 1 hour
after meals. Week 1 glycemic parameters
were the same for both groups. Week 6
data (mean +/- SD) were as follows:
group I glycosylated hemoglobin, 4.7% +
0.2% versus group II, 4.2% +/- 0.2%; p
less than 0.001. The group I glucose
challenge fasting value was 87.6 +/- 6.2
versus 70.1 +/- 6.6 mg/dl, p less than
0.001 for group II. The group I 1-hour
plasma glucose challenge result was
187.5 +/- 12.9 mg/dl versus 105.9 +/-
18.9 mg/dl for group II, p less than
0.001. The glycemic levels diverged
between the groups at week 4. We
conclude that arm ergometer training is
feasible in women with gestational
diabetes mellitus and results in lower
glycosylated hemoglobin, fasting, and
1-hour plasma glucose concentrations
than diet alone. Arm ergometer training
may provide a useful treatment option
for women with gestational diabetes
mellitus and may obviate insulin
treatment.
- Language of Publication
- English
- Unique Identifier
- 89349274
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- MeSH Heading (Major)
- Blood Glucose|*AN; Cardiovascular
System|*PP; Diabetic Diet|*; Exercise
Therapy|*; Pregnancy in Diabetes|BL/*DH
- MeSH Heading
- Blood Glucose Self-Monitoring;
Combined Modality Therapy; Comparative
Study; Evaluation Studies; Female;
Glucose Tolerance Test; Human;
Pregnancy; Random Allocation; Time
Factors
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0002-9378
- Country of Publication
- UNITED STATES
Record 8 from database: MEDLINE
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- Title
- Glycemic control with diet,
sulfonylurea, metformin, or insulin in
patients with type 2 diabetes mellitus:
progressive requirement for multiple
therapies (UKPDS 49). UK Prospective
Diabetes Study (UKPDS) Group.
- Author
- Turner RC; Cull CA; Frighi V; Holman
RR
- Address
- Radcliffe Infirmary, Oxford, England.
robert.turner@drl.ox.ac.uk
- Source
- JAMA, 1999 Jun, 281:21, 2005-12
- Abstract
- CONTEXT: Treatment with diet alone,
insulin, sulfonylurea, or metformin is
known to improve glycemia in patients
with type 2 diabetes mellitus, but which
treatment most frequently attains target
fasting plasma glucose (FPG)
concentration of less than 7.8 mmol/L
(140 mg/dL) or glycosylated hemoglobin
A1c (HbA1c) below 7% is unknown.
OBJECTIVE: To assess how often each
therapy can achieve the glycemic control
target levels set by the American
Diabetes Association. DESIGN: Randomized
controlled trial conducted between 1977
and 1997. Patients were recruited
between 1977 and 1991 and were followed
up every 3 months for 3, 6, and 9 years
after enrollment. SETTING: Outpatient
diabetes clinics in 15 UK hospitals.
PATIENTS: A total of 4075 patients newly
diagnosed as having type 2 diabetes
ranged in age between 25 and 65 years
and had a median (interquartile range)
FPG concentration of 11.5 (9.0-14.4)
mmol/L [207 (162-259) mg/dL], HbA1c
levels of 9.1% (7.5%-10.7%), and a mean
(SD) body mass index of 29 (6) kg/m2.
INTERVENTIONS: After 3 months on a
low-fat, high-carbohydrate, high-fiber
diet, patients were randomized to
therapy with diet alone, insulin,
sulfonylurea, or metformin. MAIN OUTCOME
MEASURES: Fasting plasma glucose and
HbA1c levels, and the proportion of
patients who achieved target levels
below 7% HbA1c or less than 7.8 mmol/L
(140 mg/dL) FPG at 3, 6, or 9 years
following diagnosis. RESULTS: The
proportion of patients who maintained
target glycemic levels declined markedly
over 9 years of follow-up. After 9 years
of monotherapy with diet, insulin, or
sulfonylurea, 8%, 42%, and 24%,
respectively, achieved FPG levels of
less than 7.8 mmol/L (140 mg/dL) and 9%,
28%, and 24% achieved HbA1c levels below
7%. In obese patients randomized to
metformin, 18% attained FPG levels of
less than 7.8 mmol/L (140 mg/dL) and 13%
attained HbA1c levels below 7%. Patients
less likely to achieve target levels
were younger, more obese, or more
hyperglycemic than other patients.
CONCLUSIONS: Each therapeutic agent, as
monotherapy, increased 2- to 3-fold the
proportion of patients who attained
HbA1c below 7% compared with diet alone.
However, the progressive deterioration
of diabetes control was such that after
3 years approximately 50% of patients
could attain this goal with monotherapy,
and by 9 years this declined to
approximately 25%. The majority of
patients need multiple therapies to
attain these glycemic target levels in
the longer term.
- Language of Publication
- English
- Unique Identifier
- 99285922
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- MeSH Heading (Major)
- Blood Glucose|*ME; Diabetes Mellitus,
Non-Insulin-Dependent|*DH/*DT;
Hypoglycemic Agents|*TU; Insulin|*TU;
Metformin|*TU; Sulfonylurea Compounds|*TU
- MeSH Heading
- Adult; Combined Modality Therapy;
Diet, Fat-Restricted; Dietary
Carbohydrates; Dietary Fiber; Female;
Hemoglobin A, Glycosylated|ME; Human;
Logistic Models; Male; Middle Age;
Multivariate Analysis; Prospective
Studies; Support, Non-U.S. Gov't;
Support, U.S. Gov't, P.H.S.
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0098-7484
- Country of Publication
- UNITED STATES
Record 9 from database: MEDLINE
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- Title
- United Kingdom Prospective Diabetes
Study (UKPDS). 13: Relative efficacy of
randomly allocated diet, sulphonylurea,
insulin, or metformin in patients with
newly diagnosed non-insulin dependent
diabetes followed for three years [see
comments]
- Address
-
- Source
- BMJ, 1995 Jan, 310:6972, 83-8
- Abstract
- OBJECTIVE--To assess the relative
efficacy of treatments for non-insulin
dependent diabetes over three years from
diagnosis. DESIGN--Multicentre,
randomised, controlled trial allocating
patients to treatment with diet alone or
additional chlorpropamide, glibenclamide,
insulin, or metformin (if obese) to
achieve fasting plasma glucose
concentrations < or = 6 mmol/l.
SETTING--Outpatient diabetic clinics in
15 British hospitals. SUBJECTS--2520
subjects who, after a three month
dietary run in period, had fasting
plasma glucose concentrations of
6.1-14.9 mmol/l but no hyperglycaemic
symptoms. MAIN OUTCOME MEASURES--Fasting
plasma glucose, glycated haemoglobin,
and fasting plasma insulin
concentrations; body weight; compliance;
and hypoglycaemia. RESULTS--Median
fasting plasma glucose concentrations
were significantly lower at three years
in patients allocated to chlorpropamide,
glibenclamide, or insulin rather than
diet alone (7.0, 7.6, 7.4, and 9.0 mmol/l
respectively; P < 0.001) with lower
mean glycated haemoglobin values (6.8%,
6.9%, 7.0%, and 7.6%, respectively; P
< 0.001). Mean body weight increased
significantly with chlorpropamide,
glibenclamide, and insulin but not diet
(by 3.5, 4.8, 4.8, and 1.7 kg; P <
0.001). A similar pattern was seen for
mean fasting plasma insulin
concentration (by 0.9, 1.2, 2.4, and
-0.1 mU/l; P < 0.001). In obese
subjects metformin was as effective as
the other drugs with no change in mean
body weight and significant reduction in
mean fasting plasma insulin
concentration (-2.5 mU/l; P < 0.001).
More hypoglycaemic episodes occurred
with sulphonylurea or insulin than with
diet or metformin. CONCLUSION--The drugs
had similar glucose lowering efficacy,
although most patients remained
hyperglycaemic. Long term follow up is
required to determine the risk-benefit
ratio of the glycaemic improvement, side
effects, changes in body weight, and
plasma insulin concentration.
- Language of Publication
- English
- Unique Identifier
- 95135213
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- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|BL/DH/*TH;
Insulin|BL/*TU; Metformin|*TU;
Sulfonylurea Compounds|*TU
- MeSH Heading
- Adult; Aged; Blood Glucose|ME; Body
Weight|PH; Chlorpropamide|TU;
Comparative Study; Female; Follow-Up
Studies; Glyburide|TU; Hemoglobin A,
Glycosylated|ME; Human; Male; Middle
Age; Obesity in Diabetes|BL; Patient
Compliance; Support, Non-U.S. Gov't;
Support, U.S. Gov't, P.H.S.
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
MULTICENTER STUDY; RANDOMIZED CONTROLLED
TRIAL
- ISSN
- 0959-8138
- Country of Publication
- ENGLAND
Record 10 from database: MEDLINE
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10 records
- Title
- High-fat, low-carbohydrate diet and
the etiology of non-insulin-dependent
diabetes mellitus: the San Luis Valley
Diabetes Study.
- Author
- Marshall JA; Hamman RF; Baxter J
- Address
- Department of Preventive Medicine and
Biometrics, University of Colorado
Health Sciences Center, Denver 80262.
- Source
- Am J Epidemiol, 1991 Sep, 134:6,
590-603
- Abstract
- Diet has long been believed to be an
important risk factor for
non-insulin-dependent diabetes. Animal
studies generally support a relation
between high-fat diets and development
of insulin resistance. However,
conclusive epidemiologic evidence is
lacking. To further investigate the role
of dietary fat and carbohydrate as
potential risk factors for the onset of
non-insulin-dependent diabetes mellitus,
current diet was assessed among a
geographically based group of 1,317
subjects without a prior diagnosis of
diabetes who were seen in the period
from 1984 to 1988 in two countries in
southern Colorado. In this study,
24-hour diet recalls were reported prior
to an oral glucose tolerance test.
Persons with previously undiagnosed
diabetes (n = 70) and impaired glucose
tolerance (n = 171) were each compared
with confirmed normal controls (n =
1,076). The adjusted odds ratios
relating a 40-g/day increase in fat
intake to non-insulin-dependent diabetes
mellitus and impaired glucose tolerance
were 1.51 (95% confidence interval
0.85-2.67) and 1.62 (95% confidence
interval 1.09-2.41), respectively.
Restricting cases to diabetic persons
with fasting glucose greater than 140
mg/dl and persons with impaired glucose
tolerance confirmed on follow-up, the
odds ratios increased to 3.03 (95%
confidence interval 1.07-8.62) and 2.67
(95% confidence interval 1.33-5.36),
respectively. The findings support the
hypothesis that high-fat,
low-carbohydrate diets are associated
with the onset of non-insulin-dependent
diabetes mellitus in humans.
- Language of Publication
- English
- Unique Identifier
- 92058931
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- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*ET/ME; Diet|*AE;
Dietary Carbohydrates|*AE; Dietary
Fats|*AE/ME
- MeSH Heading
- Adult; Aged; Comparative Study;
Confidence Intervals; Cross-Sectional
Studies; Dietary Proteins|AE; Female;
Glucose Tolerance Test; Hispanic
Americans; Human; Logistic Models; Male;
Middle Age; Odds Ratio; Risk; Support,
U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9262
- Country of Publication
- UNITED STATES
Record 11 from database: MEDLINE
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- Title
- Determinants of diet glycemic index
calculated retrospectively from diet
records of 342 individuals with
non-insulin-dependent diabetes mellitus.
- Author
- Wolever TM; Nguyen PM; Chiasson JL;
Hunt JA; Josse RG; Palmason C; Rodger
NW; Ross SA; Ryan EA; Tan MH
- Address
- Department of Nutritional Sciences,
Faculty of Medicine, University of
Toronto, Ontario, Canada.
- Source
- Am J Clin Nutr, 1994 Jun, 59:6, 1265-9
- Abstract
- Controlled trials have shown that a
diet with a low glycemic index improves
blood glucose and lipid control in
patients with diabetes. To study the
distribution and determinants of diet
glycemic index, we obtained two 3-d diet
records from 342 free-living subjects
with non-insulin-dependent diabetes.
Mean +/- SD 24-h intakes were as
follows: energy, 7170 +/- 1890 kJ; fat,
33.6 +/- 6.5% of energy; protein, 20.1
+/- 3.2% of energy; available
carbohydrate, 45.3 +/- 7.2% of energy;
and dietary fiber, 17.2 +/- 6.4 g. Diet
glycemic index values (85.4 +/- 4.55,
range, 70-97.8) were normally
distributed. Diet glycemic index was
inversely associated with intake of
simple sugars, whether expressed in
grams (r = -0.426), percent of energy (r
= -0.446), or percent of carbohydrate (r
= -0.453, P < 0.001). By
step-wise-multiple-linear regression,
grams carbohydrate and percent protein
were also independently related to diet
glycemic index. Differences in diet
glycemic index between men and women,
and between subjects on different types
of diabetes therapy were explained by
differences in intake of simple sugars.
- Language of Publication
- English
- Unique Identifier
- 94256407
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- MeSH Heading (Major)
- Blood Glucose|*ME; Diabetes Mellitus,
Non-Insulin-Dependent|*ME; Diet
Records|*; Dietary Carbohydrates|*ME
- MeSH Heading
- Female; Human; Male; Models,
Theoretical; Reference Values;
Retrospective Studies; Support, Non-U.S.
Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 12 from database: MEDLINE
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- Title
- Carbohydrate and lipid metabolism in
patients with non-insulin-dependent
diabetes mellitus: effects of a low-fat,
high-carbohydrate diet vs a diet high in
monounsaturated fatty acids.
- Author
- Bonanome A; Visonà A; Lusiani L;
Beltramello G; Confortin L; Biffanti S;
Sorgato F; Costa F; Pagnan A
- Address
- Department of Internal Medicine,
University of Padova, Italy.
- Source
- Am J Clin Nutr, 1991 Sep, 54:3, 586-90
- Abstract
- Nineteen patients affected by
non-insulin dependent diabetes mellitus
(NIDDM), in good glycemic control
(fasting plasma glucose 7.2 +/- 0.3 mmol/L,
glycosylated hemoglobin 6.3 +/- 0.2%),
underwent three isocaloric dietary
phases. In phases 1 and 3 the diet was
rich in complex carbohydrates (Carbo)
whereas in phase 2 it was rich in
monounsaturated fatty acids (Mono).
Plasma glucose concentrations were 7.1
+/- 0.3 and 7.2 +/- 0.3 mmol/L for the
two Carbo phases and 7.5 +/- 0.4 mmol/L
for the Mono phase (NS). Plasma total
cholesterol values for the Carbo phases
were 6.2 +/- 0.2 and 6.4 +/- 0.2 mmol/L,
respectively, and 6.5 +/- 0.2 mmol/L on
the Mono phase (NS). Similarly, no
significant changes were noticed for
plasma triglycerides and
high-density-lipoprotein (HDL)
cholesterol. Thus, both diets were
well-tolerated and did not alter glucose
homeostasis or worsen plasma lipid
concentrations. Consequently, these
results suggest that a wider dietary
choice can be made available to NIDDM
patients without producing unwanted side
effects.
- Language of Publication
- English
- Unique Identifier
- 91344918
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- MeSH Heading (Major)
- Carbohydrates|*ME; Diabetes Mellitus,
Non-Insulin-Dependent|DH/*ME; Dietary
Carbohydrates|*PD; Dietary Fats|*AD/PD;
Lipids|BL/*ME
- MeSH Heading
- Adult; Fatty Acids, Monounsaturated|AD/PD;
Female; Human; Male; Middle Age;
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 13 from database: MEDLINE
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- Title
- Diet and lifestyle guidelines and
desirable levels of risk factors for the
prevention of diabetes and its vascular
complications in Indians: a scientific
statement of The International College
of Nutrition. Indian Consensus Group for
the Prevention of Diabetes.
- Author
- Singh RB; Rastogi SS; Rao PV; Das S;
Madhu SV; Das AK; Sahay BK; Fuse SM;
Beegom R; Sainani GS; Shah NA
- Address
- Centre of Nutrition, Medical Hospital
and Research Centre, Moradabad, India.
- Source
- J Cardiovasc Risk, 1997 Jun, 4:3,
201-8
- Abstract
- BACKGROUND: There has been a rapid
increase in the prevalence of diabetes
and cardiovascular disease in India, in
association with rapid changes in diet
and lifestyle. In adults, the prevalence
of diabetes, hypertension and coronary
artery disease is two- to threefold
greater in the urban population than in
rural populations; it is associated with
modest insulin resistance in urban
groups. METHODS: In response to a
proposal by the International College of
Nutrition that specialist experts should
develop consensus recommendations for
the prevention of chronic diseases,
Indian specialists in diabetes and
vascular disease have collaborated to
produce guidelines relevant to the
population of India. RECOMMENDATIONS:
Because Indian urban populations have a
modest increase in overweight and low
rates of obesity in association with the
rapid emergence of diabetes and
cardiovascular risk, a body mass index
of 21 kg/m2 should be considered safe,
with a range of 19-23 kg/m2 acceptable;
> 23 kg/m2 should be considered
overweight, and > 25 kg/m2 should be
taken to indicate obesity. A waist:hip
ratio > 0.88 in males and > 0.85
in females should be considered to
indicate central obesity, because the
prevalence of coronary disease,
hypertension and associated disturbances
of insulin resistance are more common
above these limits. For the prevention
of vascular disease, there is general
international consensus that the
desirable serum concentration of
cholesterol should be < 170 mg/dl
(> 4.42 mmol/l), which may also be
optimal for Indians; values between 170
and 200 mg/dl (4.42-5.2 mmol/l) should
be considered borderline. The critical
values for low density lipoprotein
cholesterol may be < 90 mg/dl
(ideal), 90-110 mg/dl (borderline high)
and > 110 mg/dl (high) (< 2.32,
2.32-2.84 and > 2.84 mmol/l,
respectively). Fasting triglycerides
should be < 150 mg/dl (< 1.69 mmol/l)
and high-density lipoprotein cholesterol
> 35 mg/dl (> 0.9 mmol/l). The
limit for the total energy derived from
fat intake should be < 21%/day (7%
each for saturated, polyunsaturated and
mono-unsaturated fatty acids). The
carbohydrate intake should provide more
than 65% of daily energy, mainly from
complex carbohydrates. A daily dietary
intake of 400 g fruits, vegetables and
legumes, 400 g cereals, in conjunction
with 25 g soya bean or mustard or canola
oils (rich in n-3 fatty acids) in place
of fats rich in saturated fat, may be
protective against diabetes and vascular
disease. Moderate physical activity with
the aim of burning 300 Kcal/day (>
1255 KJ/day), and cessation of tobacco
and alcohol consumption, may provide an
effective programme for prevention of
diabetes and its vascular complications
in Indians.
- Language of Publication
- English
- Unique Identifier
- 98133822
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- MeSH Heading (Major)
- Cardiovascular Diseases|EP/ET/*PC;
Diabetes Mellitus, Non-Insulin-Dependent|CO/EP/*PC;
Diabetic Angiopathies|EP/ET/*PC; Diet|*;
Life Style|*
- MeSH Heading
- Adult; Body Mass Index; Decision
Making; Female; Human; Hypertension|CO;
Incidence; India|EP; International
Cooperation; Male; Risk Factors
- Publication Type
- GUIDELINE; JOURNAL ARTICLE; PRACTICE
GUIDELINE; REVIEW; REVIEW, TUTORIAL
- ISSN
- 1350-6277
- Country of Publication
- ENGLAND
Record 14 from database: MEDLINE
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- Title
- Diet and day-to-day variability in a
sample of Spanish adults with IDDM or
NIDDM. The Diabetes and Nutrition Study
Group of the Spanish Diabetes
Association (GSEDNu).
- Address
-
- Source
- Horm Metab Res, 1997 Sep, 29:9, 450-3
- Abstract
- OBJECTIVE: To ascertain the
nutritional pattern, including the
day-to-day variability in the
macronutrients consumption, in Spanish
adults with IDDM or NIDDM. RESEARCH
DESIGN AND METHODS: The diabetes
Nutrition and Complications Trial (DNCT)
is a prospective multicentre study
designed for finding out which is the
nutritional behaviour of diabetic
subjects in Spain, based on a diet
record that patients prospectively fill
in for 7 days. Day-to-day variability in
nutrients intake is given as the mean of
the mean standard deviations of the
daily macronutrients intake, as well as
the mean of the mean coefficients of
variation. Glycaemic control was
assessed by measuring the HbA1c during
the study period and the mean of the 3
previous determinations. Data of the
first 60 patients (30 IDDM, M/F 15/15,
30 NIDDM, M/F 15/15) are shown in this
paper. RESULTS: The overall energy
intake of Spanish subjects with IDDM or
NIDDM, expressed as median, are 1978 and
1707 Kcal/ day, respectively, were
distributed as follows (IDDM and NIDDM):
Carbohydrate 36.5 and 37.4%, protein
17.9 and 20.0%, fat 41.7 and 36.8%
(saturated 14.7 and 11.6%,
polyunsaturated 5.0 and 4.2%,
monounsaturated 22.1 and 20.8%,
saturated/total fat ratio 0.29 and 0.26,
cholesterol 279 and 245 mg), alcohol 2.6
and 4.2%, dietary fibre 19 and 15 gr.
Women received less energy than men and
subjects with NIDDM ate less than
subjects with IDDM (both p < 0.05).
The means of the standard deviations of
the average carbohydrate intake were
37.0 +/- 20.1 and 28.9 +/- 20.9 g.,
whereas the means of the coefficients of
variation were 18.3 +/- 8.5 and 15.5%,
expressed as the average percentage of
carbohydrates intake for both IDDM and
NIDDM subjects, respectively. There was
no correlation between the day-to-day
variability in carbohydrate intake and
HbA1c. CONCLUSIONS: Diet of diabetic
patients in Spain is low in carbohydrate
and high in fat content, mainly
monounsaturated fat. Day-to-day
variability in carbohydrate intake is
not associated with the glycaemic
control.
- Language of Publication
- English
- Unique Identifier
- 98037082
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- MeSH Heading (Major)
- Diabetes Mellitus,
Insulin-Dependent|*/BL/DH; Diabetes
Mellitus, Non-Insulin-Dependent|*/BL/DH;
Diet|*
- MeSH Heading
- Adult; Aged; Blood Glucose|ME; Dietary
Carbohydrates|AD; Dietary Fats|AD;
Dietary Proteins|AD; Energy Intake;
Female; Hemoglobin A, Glycosylated|ME;
Human; Male; Middle Age; Nutrition;
Spain; Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0018-5043
- Country of Publication
- GERMANY
Record 15 from database: MEDLINE
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- Title
- Gestational diabetes mellitus (GDM).
Comparative evaluation of two treatment
regimens, diet versus insulin and diet.
- Author
- Persson B; Stangenberg M; Hansson U;
Nordlander E
- Address
-
- Source
- Diabetes, 1985 Jun, 34 Suppl 2:, 101-5
- Abstract
- Two-hundred and two pregnant women
with impaired glucose tolerance were
randomized to treatment with diet or
diet and insulin by stratified
selection. Self-monitoring of blood
glucose was performed six times a day, 3
days/wk. Dietary treatment was
considered inappropriate if fasting and
postprandial blood glucose values
exceeded 7 and 9 mmol/L, respectively,
in which case insulin therapy was
instituted. Insulin doses were adjusted
according to blood glucose values,
aiming at fasting and postprandial
values below 5 and 6.5 mmol/L,
respectively. There were no perinatal
deaths. The two treatment regimens
disclosed no differences regarding
achieved degree of maternal blood
glucose control, hemoglobin A1c at
delivery, obstetric or neonatal
complications, infant's size at birth
including skin-fold thickness, or
C-peptide concentration in cord serum.
Routine treatment of pregnant women with
mild carbohydrate intolerance with
insulin seems unnecessary. However, 15
patients (14%) in the diet group needed
insulin to achieve acceptable blood
glucose control, underlining the
importance of monitoring blood glucose
to detect those who are at risk of
developing overt diabetes.
- Language of Publication
- English
- Unique Identifier
- 85204937
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- MeSH Heading (Major)
- Insulin|*TU; Pregnancy in Diabetes|BL/*DH/DT
- MeSH Heading
- Adolescence; Adult; Blood Glucose|ME;
C-Peptide|BL; Comparative Study;
Evaluation Studies; Female; Fetal
Blood|ME; Hemoglobin A, Glycosylated|ME;
Human; Hypoglycemia|EP; Infant, Newborn;
Infant, Newborn, Diseases|EP; Middle
Age; Pregnancy; Random Allocation;
Support, Non-U.S. Gov't
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0012-1797
- Country of Publication
- UNITED STATES
Record 16 from database: MEDLINE
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- Title
- UK Prospective Diabetes Study (UKPDS).
IX: Relationships of urinary albumin and
N-acetylglucosaminidase to glycaemia and
hypertension at diagnosis of type 2
(non-insulin-dependent) diabetes
mellitus and after 3 months diet
therapy.
- Address
-
- Source
- Diabetologia, 1993 Sep, 36:9, 835-42
- Abstract
- In 672 newly-diagnosed, Type 2
(non-insulin-dependent) diabetic
patients without urinary infection, aged
51 (9) years, mean (1 SD), 28% of
patients had raised albuminuria, defined
as albumin excretion greater than 25
mg/l and 66% raised urinary N-acetylglucosaminidase
excretion defined as greater than 300
mumol.h-1.l-1 (both urinary analytes
corrected by linear regression on
urinary creatinine to 10 mmol/1). In a
univariate analysis, urinary N-acetylglucosaminidase
and albumin excretion correlated with
each other (rs = 0.42, p < 0.001),
and with fasting plasma glucose (rs =
0.46 and rs = 0.27, p < 0.001,
respectively). The association of
urinary albumin and N-acetylglucosaminidase
remained significant after taking the
fasting plasma glucose levels into
account, partial rs = 0.34, p <
0.001. After 3 months of dietary therapy
BMI decreased from 29.7 (5.9) kg/m2 to
28.8 (5.8) kg/m2, fasting plasma glucose
levels from 12.2 (3.8) mmol/l to 9.8
(3.8) mmol/l, and systolic blood
pressure from 143 (21.8) mmHg to 131
(20.3) mmHg, p < 0.001 for each
variable. There were concomitant
decreases in urinary N-acetylglucosaminidase,
geometric mean (1 SD interval), 397
mumol.h-1.l-1 (216 to 728) to 291
mumol.h-1.l-1 (160 to 528), p < 0.001
and in albumin excretion 16 mg/l (5 to
51) to 13 mg/l (4 to 40), p < 0.001.
The decrease in urinary N-acetylglucosaminidase,
but not the decrease in urinary albumin
excretion, was associated with the
initial degree of glycaemia and the
decrease in glycaemia in response to
diet.(ABSTRACT TRUNCATED AT 250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 94010013
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- MeSH Heading (Major)
- Acetylglucosaminidase|BL/*UR;
Albuminuria|*; Blood Glucose|*ME;
Diabetes Mellitus,
Non-Insulin-Dependent|*CO/DH/*PP;
Diabetic Diet|*; Hypertension|CO/*PP
- MeSH Heading
- Biological Markers|BL/UR; Blood
Pressure; Female; Great Britain;
Hemoglobin A, Glycosylated|AN; Human;
Male; Middle Age; Prospective Studies;
Regression Analysis; Support, Non-U.S.
Gov't; Support, U.S. Gov't, P.H.S.; Time
Factors
- Publication Type
- JOURNAL ARTICLE; MULTICENTER STUDY
- ISSN
- 0012-186X
- Country of Publication
- GERMANY
Record 17 from database: MEDLINE
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- Title
- Antilipolytic effect of insulin in
non-insulin-dependent diabetes mellitus
after conventional treatment with diet
and sulfonylurea.
- Author
- Bolinder J; Arner P
- Address
- Department of Medicine, Huddinge
University Hospital, Karolinska
Institute, Sweden.
- Source
- Acta Med Scand, 1988, 224:5, 451-9
- Abstract
- Insulin-induced antilipolysis was
investigated in fat cells obtained after
an overnight fast and 60 min after
glucose ingestion in seven non-obese
patients with non-insulin-dependent
diabetes mellitus (NIDDM). The study was
performed before and after long-term
therapy with diet and glibenclamide.
After treatment, the antilipolytic
potency of insulin in fat cells was
threefold enhanced (p less than 0.05) in
the fasting state and remained unaltered
after glucose ingestion. In untreated
NIDDM oral glucose induced a significant
(p less than 0.01) increase in insulin
sensitivity. In consequence, in the
glucose-fed state insulin sensitivity
was similar before and after therapy.
Adipocyte insulin receptor binding was
comparable before and after therapy,
both in the fasting state and following
glucose intake. In untreated NIDDM,
despite relative hypoinsulinemia, plasma
glycerol was markedly reduced after oral
glucose. After therapy, plasma glycerol
was significantly reduced both in the
fasting state and following glucose
ingestion. At the same time, fasting and
glucose-stimulated circulating insulin
were significantly (p less than 0.01)
increased. It is concluded that
conventional antidiabetes therapy in
NIDDM mediates a suppression of adipose
tissue lipolysis. This seems to be due
to an improvement in insulin secretion
in combination with a potentiation of
the antilipolytic effectiveness of
insulin in fat cells in the fasting
state, the latter being secondary to
post-binding alterations in insulin
action.
- Language of Publication
- English
- Unique Identifier
- 89074319
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- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|ME/*TH;
Diabetic Diet|*; Glyburide|*TU;
Insulin|*BL; Lipolysis|*DE; Receptor,
Insulin|*ME
- MeSH Heading
- Adipose Tissue|ME; Adult; Female;
Glucose Tolerance Test; Glycerol|ME;
Human; Male; Middle Age; Support,
Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0001-6101
- Country of Publication
- SWEDEN
Record 18 from database: MEDLINE
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- Title
- Changes in insulin receptor functions
of the erythrocyte by treatment of
non-insulin-dependent diabetes mellitus
(NIDDM) patients with glibenclamide and
diet control.
- Author
- Agarwal VR; Rastogi AK; Agarwal CG;
Sagar P
- Address
-
- Source
- Acta Diabetol Lat, 1986 Jul, 23:3,
233-8
- Abstract
- The insulin binding of erythrocytes
from: (i) fifteen age-matched normal
subjects, (ii) ten untreated NIDDM
patients and (iii) fifteen treated (glibenclamide
+ hypocaloric diet) NIDDM patients (all
males) has been studied. A significant
decrease in specific insulin binding was
observed in group (ii) which improved in
cases controlled after treatment (group
iii). Scatchard analysis of the results
suggested that changes in insulin
binding were due to alteration in the
number of insulin receptors on
erythrocytes. The number of insulin
receptors/cell was 471 in normals, 160
in diabetics and 282 in treated diabetic
subjects. No significant change in the
binding affinity was observed in the
three groups (1.0 X 10(8), 1.2 X 10(8)
and 1.1 X 10(8) M-1 in normal subjects,
untreated diabetics and treated
diabetics, respectively).
- Language of Publication
- English
- Unique Identifier
- 87072360
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- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*BL/DH/DT;
Erythrocytes|*ME; Glyburide|*TU;
Receptor, Insulin|*PH
- MeSH Heading
- Adult; Aged; Human; Insulin|BL; Male;
Middle Age; Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0001-5563
- Country of Publication
- ITALY
Record 19 from database: MEDLINE
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- Title
- The effect of diet and insulin on
metabolic profiles of women with
gestational diabetes mellitus.
- Author
- Maresh M; Gillmer MD; Beard RW;
Alderson CS; Bloxham BA; Elkeles RS
- Address
-
- Source
- Diabetes, 1985 Jun, 34 Suppl 2:, 88-93
- Abstract
- Twenty women with abnormal glucose
tolerance, detected from a routine
program of antenatal screening for
gestational diabetes mellitus (GDM) at
28 wk, were admitted for 24-h metabolic
profiles. They were then alternately
allocated to either insulin and dietary
restriction or dietary restriction alone
and then retested 4 wk later while on
therapy. Ten normal controls were
assessed twice at similar gestations to
the study group. Before treatment, the
20 gestational diabetic subjects had
higher mean concentrations of plasma
glucose and 3-hydroxybutyrate than the
controls for most of the profile, but
mean insulin values were similar.
Insulin therapy was associated with a
reduction in mean glucose concentrations
so that the profile was similar to the
controls, while in the diet-alone group
the reduction was less. The
3-hydroxybutyrate concentrations rose
between profiles in the normal group and
also rose in those treated by diet
alone, but still remained within the
upper range of normal even at night.
Insulin therapy resulted in a similar
3-hydroxybutyrate profile to the
controls. The C-peptide response to
breakfast was reduced in both groups to
levels below that of the controls.
Neonatal outcome indices were similar in
the two treatment groups, despite the
differences in maternal metabolites, but
because of the size of this study,
conclusions about the neonate must be
tentative.
- Language of Publication
- English
- Unique Identifier
- 85204959
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- MeSH Heading (Major)
- Insulin|BL/*TU; Pregnancy in
Diabetes|BL/*DH/DT
- MeSH Heading
- Adult; Birth Weight; Blood Glucose|ME;
Body Weight; C-Peptide|BL; Circadian
Rhythm; Comparative Study; Female;
Gestational Age; Human;
Hydroxybutyrates|BL; Pregnancy; Support,
Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0012-1797
- Country of Publication
- UNITED STATES
Record 20 from database: MEDLINE
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10 records
- Title
- Lipids: impact on dietary prescription
in diabetes [published erratum appears
in J Am Diet Assoc 1990 Feb;90(2):202]
- Author
- Hagan J; Wylie Rosett J
- Address
- Department of Epidemiology and Social
Medicine, Albert Einstein College of
Medicine, Bronx, New York 10461.
- Source
- J Am Diet Assoc, 1989 Aug, 89:8,
1104-8, 1111
- Abstract
- The rate of death from coronary artery
disease is two to three times higher
among individuals with diabetes than
among their age- and sex-matched peers.
In diabetes, many factors may affect
blood lipid levels and complicate
formulating an effective dietary
prescription. Both Type I and Type II
diabetes may have an independent effect
on lipids. This article discusses
metabolic derivations in carbohydrate
and lipid metabolism that contribute to
lipid abnormalities. The National
Cholesterol Education Program
Guidelines, which include dietary
recommendations for lowering blood lipid
levels by modifying fat intake, are
discussed in regard to their effect on
blood lipids in diabetes and their
effect on other variables, such as blood
glucose control. Other treatment
approaches common in diabetes and lipid
management include low-calorie diets and
weight reduction, a change in the fatty
acid composition of the diet, and
high-carbohydrate diets. An evaluation
of the etiologies of lipid abnormalities
and interventions directed toward lipid
levels and other indexes of diabetes
management may lead to improved lipid
levels, improved blood glucose control,
and avoidance of unnecessary,
ineffective, or deleterious dietary
prescriptions for individuals with
diabetes.
- Language of Publication
- English
- Unique Identifier
- 89341195
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- MeSH Heading (Major)
- Diabetes Mellitus|BL/CO/*DT;
Lipids|*BL
- MeSH Heading
- Coronary Disease|ET; Diet, Reducing;
Dietary Carbohydrates|AD; Dietary
Fats|AD; Dietary Proteins|AD; Ethanol|AE;
Human; Hyperlipidemia|DH/ET; Support,
Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW,
TUTORIAL
- ISSN
- 0002-8223
- Country of Publication
- UNITED STATES
Record 21 from database: MEDLINE
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- Title
- Lipoprotein subfraction composition in
non-obese newly diagnosed non-insulin
dependent diabetes after treatment with
diet and glibenclamide.
- Author
- Billingham MS; Milles JJ; Bailey CJ;
Hall RA
- Address
- Department of Biochemistry, Good Hope
Hospital, Birmingham, UK.
- Source
- Diabetes Res, 1989 May, 11:1, 13-20
- Abstract
- The composition and concentrations of
fasting plasma lipoproteins were
determined in a prospective study of 11
+/- 2 (mean +/- 1 SD) months in 16
non-obese (body mass index less than or
equal to 30) patients with Type 2
(non-insulin dependent) diabetes
mellitus at diagnosis, treated by diet
alone or diet plus glibenclamide
(2.5-7.5 mg/day). Compared with normal
subjects matched for sex, age, body mass
index, exercise, alcohol consumption and
smoking, Type 2 patients at diagnosis
showed increased concentrations of non-esterified
and esterified cholesterol,
triglyceride, phospholipid and protein
in the very low density lipoprotein (VLDL)
fraction. The apolipoprotein (apo) B
concentrations was also raised, but low
density lipoprotein (LDL) cholesterol
concentrations were not significantly
altered in Type 2 patients at diagnosis.
Plasma concentrations of high density
lipoprotein (HDL) non-esterified and
esterified cholesterol, HDL phospholipid
and apo AI were lower in Type 2 patients
at diagnosis. This was largely accounted
for by a reduced number of HDL2
molecules of normal composition. After
treatment of Type 2 patients with diet
alone, there was a marginal increase in
plasma HDL cholesterol and phospholipid,
and in plasma HDL2 cholesterol,
phospholipid, protein and apo AI
concentrations, in association with
reductions of VLDL component
concentrations, body mass index and
glycaemia. Type 2 patients treated with
diet plus glibenclamide exhibited
similar abnormalities of plasma
lipoprotein concentrations before and
after treatment, except for a small
reduction in VLDL component
concentrations and a slight increase in
the apo AI:B ratio. Institution of diet
alone and diet plus glibenclamide
generally failed to restore VLDL, HDL
and HDL2 component concentrations and
the apo AI:B ratio to normal.(ABSTRACT
TRUNCATED AT 250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 90150973
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- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*BL/DT; Diabetic
Diet|*; Glyburide|*TU; Lipoproteins|*BL
- MeSH Heading
- Alcohol Drinking; Apolipoproteins|BL;
Blood Glucose|AN; Blood Pressure; Body
Mass Index; Cholesterol|BL; Comparative
Study; Female; Hemoglobin A,
Glycosylated|AN; Hexosamines|BL; Human;
Insulin|BL; Male; Middle Age; Reference
Values; Smoking; Triglycerides|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0265-5985
- Country of Publication
- SCOTLAND
Record 22 from database: MEDLINE
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- Title
- Very low calorie diet therapy in obese
non-insulin dependent diabetes patients.
- Author
- Hanefeld M; Weck M
- Address
- Lipid Research Unit, Medical Clinic,
Dresden, German Democratic Republic.
- Source
- Int J Obes, 1989, 13 Suppl 2:, 33-7
- Abstract
- VLCD is an effective and safe measure
to reduce overweight in NIDDM. It
substantially improves glucose control
and corrects associated coronary risk
factors, in particular
dyslipoproteinaemia and hypertension.
Both insulin secretion and insulin
resistance were ameliorated by perfect
glucose control with VLCD. Reliable data
on long term efficacy and factors
determining weight loss and success in
permanent glucose control are urgently
needed.
- Language of Publication
- English
- Unique Identifier
- 90129537
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- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*DH; Diet,
Reducing|*; Energy Intake|*; Obesity in
Diabetes|*DH
- MeSH Heading
- Blood Glucose|ME; Blood Pressure;
Cholesterol|BL; Female; Human;
Insulin|SE; Male; Middle Age; Risk
Factors; Triglycerides|BL; Weight Loss
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0307-0565
- Country of Publication
- ENGLAND
Record 23 from database: MEDLINE
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- Title
- The effects of diet differing in fat,
carbohydrate, and fiber on carbohydrate
and lipid metabolism in type II
diabetes.
- Author
- ODea K; Traianedes K; Ireland P; Niall
M; Sadler J; Hopper J; De Luise M
- Address
- Department of Medicine (University of
Melbourne) Repatriation General
Hospital, Heidelberg, Victoria,
Australia.
- Source
- J Am Diet Assoc, 1989 Aug, 89:8,
1076-86
- Abstract
- This study was designed to determine
the effects of varying the proportions
of carbohydrate, fiber, and fat on
metabolic control in Type II diabetes.
Ten men, aged 50 to 69 years, with Type
II diabetes participated. Four
isocaloric diets were consumed for 2
weeks each, with a break of 6 to 14
weeks between diets to ensure no
carryover effects. Two of the diets were
high in carbohydrate (63% to 65% energy)
and low in fat (10% to 12% energy) but
differed in their fiber contents (20 vs.
45 gm/day). The other two diets were low
in carbohydrate (23% to 27% energy) with
either a low or a high fat content (15%
vs. 55% energy) and a high or normal
protein content (62% vs. 18% energy).
The composition of the subjects' usual
diets in the week before each of the
experimental diets did not vary
significantly: carbohydrate 47% to 50%
energy, protein 22% to 25% energy, fat
27% to 31% energy, and fiber 24 to 25
gm/day. A 75-gm oral glucose tolerance
test and a 12-hour metabolic profile in
response to 3 meals typical of the
particular diet were conducted before
and at the conclusion of each 2-week
dietary period. The most significant
improvements in metabolic control (as
assessed by the effects of the diets on
fasting glucose and on lipids, and on
the glucose and insulin responses to
oral glucose and the mixed meals) were
obtained with the high-fiber,
high-carbohydrate, low-fat diet and with
the low-carbohydrate, high-protein,
low-fat diet. Metabolic control was not
significantly affected by the low-fiber,
high-carbohydrate, low-fat diet, but it
deteriorated significantly on the
low-carbohydrate, high-fat diet. The
results of this study confirmed the
importance of high fiber and low fat in
improving metabolic control in Type II
diabetes. In conclusion, if
high-carbohydrate, low-fat diets are to
be recommended to patients with
diabetes, it is essential that the type
of carbohydrate recommended be unrefined
and high in fiber.
- Language of Publication
- English
- Unique Identifier
- 89341191
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- MeSH Heading (Major)
- Carbohydrates|*ME; Diabetes Mellitus,
Non-Insulin-Dependent|*DH/ME; Dietary
Carbohydrates|*AD; Dietary Fats|*AD;
Dietary Fiber|*AD; Lipids|*BL
- MeSH Heading
- Blood Glucose|ME; Cholesterol|BL;
Dietary Proteins|AD; Energy Intake;
Glucose Tolerance Test; Human;
Insulin|BL; Lipoproteins|BL; Male;
Middle Age; Support, Non-U.S. Gov't;
Triglycerides|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-8223
- Country of Publication
- UNITED STATES
Record 24 from database: MEDLINE
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- Title
- Effect of fat-free diet on insulin
requirements in type I diabetes
controlled with artificial beta-cell.
- Author
- Dunn FL; Carroll PB
- Address
- Joslin Diabetes Center, New England
Deaconess Hospital, Boston,
Massachusetts.
- Source
- Diabetes Care, 1988 Mar, 11:3, 225-9
- Abstract
- We investigated the effect of
eliminating calories derived from fat
sources on postprandial and basal
insulin requirements in five patients
with type I (insulin-dependent) diabetes
mellitus. The patients were studied on a
metabolic ward on two solid-food diets
with similar quantities of carbohydrate
and protein with or without the addition
of fat. Diet A was isocaloric (weight
maintenance) with calories distributed
as 45% carbohydrate, 15% protein, and
40% fat. Diet B contained the same
carbohydrate and protein content as diet
A but was virtually fat free and
therefore hypocaloric (1233 +/- 106 vs.
1830 +/- 99 cal, mean +/- SE). The diets
were given as five equal meals each day
on consecutive days. Insulin
requirements and blood glucose
measurements were determined by use of
the artificial beta-cell. During the
study, mean (+/- SE) preprandial blood
glucose levels were maintained at 85 +/-
11 mg/dl, and peak postprandial blood
glucose levels were less than 180 mg/dl.
The elimination of fat calories had no
effect on total (68.9 +/- 10.3 vs. 69.3
+/- 4.9 U/day), postprandial (9.8 +/-
3.8 vs. 10.3 +/- 3.7 U/meal), or basal
(1.9 +/- 0.2 vs. 1.8 +/- 0.2 U/h)
insulin requirements. Thus, despite a
hypocaloric diet, no change in insulin
requirements was noted when fat-derived
calories were deleted from the diet. We
conclude that fat-derived calories do
not alter short-term basal or
postprandial insulin requirements in
type I diabetes.
- Language of Publication
- English
- Unique Identifier
- 88328597
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- MeSH Heading (Major)
- Diabetes Mellitus, Insulin-Dependent|BL/*DT;
Dietary Fats|*PD; Insulin Infusion
Systems|*
- MeSH Heading
- Adult; Blood Glucose|AN; Energy
Intake; Fatty Acids, Nonesterified|BL;
Female; Hemoglobin A, Glycosylated|AN;
Human; Insulin|BL; Male; Support,
Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0149-5992
- Country of Publication
- UNITED STATES
Record 25 from database: MEDLINE
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- Title
- Is diet in diabetes important?
- Author
- Clothier C
- Address
- Department of Nutrition &
Dietetics, Royal Liverpool Children's
Hospital, Alder Hey.
- Source
- Nutr Health, 1987, 5:3-4, 189-96
- Abstract
- Theoretical recommendations for
dietary prescriptions with the aim of
providing optimum nutrition for diabetic
control have been made. What are the
practical implications of some of these
recommendations for diabetic children?
Children should be encouraged to select
most of their carbohydrate allowance
from unrefined carbohydrate, this will
increase their fibre intake. The policy
to discourage the use of refined
carbohydrate on a regular basis is
generally accepted although practically
this is not always possible. Excessive
amounts of dietary fat are to be
discouraged and this happens naturally
if sufficient carbohydrate is prescribed
since it limits the intake of
"fillers" such as meat, eggs
and cheese. Whilst these principles are
generally accepted analysis of sample
low fat, high fibre menus for children
show these to be low in calories which
could be detrimental since normal growth
and development is the cornerstone of
paediatric dietetics. In addition it
should be remembered that diabetes
places much stress on a child and too
rigid management increases this. Whilst
recognising the need for improved
nutrition theoretical principles should
not be overemphasized. A dietary regimen
must be practical and acceptable as well
as theoretically sound.
- Language of Publication
- English
- Unique Identifier
- 88175735
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- MeSH Heading (Major)
- Diabetes Mellitus|*DH
- MeSH Heading
- Child; Child, Preschool; Dietary
Carbohydrates|AD; Dietary Fats|AD;
Dietary Fiber|AD; Energy Intake; Human;
Male
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0260-1060
- Country of Publication
- ENGLAND
Record 26 from database: MEDLINE
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- Title
- Intensive insulin therapy justifies
simplification of the diabetes diet: a
prospective study in insulin-dependent
diabetic patients.
- Author
- Chantelau EA; Frenzen A; Gösseringer
G; Hansen I; Berger M
- Address
-
- Source
- Am J Clin Nutr, 1987 May, 45:5, 958-62
- Abstract
- Dietary and metabolic variables were
investigated in 48 unselected, nonobese
Type 1 (insulin-dependent) diabetic
patients before and 3 mo after changing
from (a) traditional insulin and diet
therapy to (b) intensified insulin plus
simplified diet therapy. HbA1c levels
declined significantly from 9.04 +/-
0.25% with therapy (a) to 8.34 +/- 0.16%
with therapy (b) (p less than 0.005).
During (a), 58% of all patients used a
personal diet plan, but only 15% of them
performed food exchange according to the
traditional diet prescription. Their
eating habits remained unchanged during
(b). Since improved metabolic control in
this study could be obtained without
adherence to traditional diet schedules,
a simplification of the traditional
diabetes diet prescription seems
justified for nonobese Type 1 diabetic
patients on intensified insulin therapy.
- Language of Publication
- English
- Unique Identifier
- 87209837
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- MeSH Heading (Major)
- Diabetes Mellitus, Insulin-Dependent|*TH;
Diabetic Diet|*; Insulin|*TU
- MeSH Heading
- Adult; Combined Modality Therapy;
Energy Intake; Female; Food Habits;
Human; Male; Prospective Studies;
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 27 from database: MEDLINE
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- Title
- Diet and exercise in noninsulin-dependent
diabetes mellitus: implications for
dietitians from the NIH Consensus
Development Conference.
- Author
- Wheeler ML; Delahanty L; Wylie Rosett
J
- Address
-
- Source
- J Am Diet Assoc, 1987 Apr, 87:4, 480-5
- Abstract
- Noninsulin-dependent diabetes mellitus
is a major health problem, highly
correlated with obesity and, therefore,
overeating. Diet continues as the
cornerstone of therapy, with oral
hypoglycemic agents or insulin added, if
needed, to maintain normal blood glucose
values. The diet prescription should be
implemented in stages, with caloric
restriction the first priority, as
weight loss itself diminishes
hyperglycemia to or toward normal.
Combinations of foods and even different
processing or cooking of the same food
may produce different glucose responses.
These factors minimize the role of the
glycemic index in overall diabetes
management. Foods with high soluble
fiber content may diminish glucose
elevations after meals; however,
high-fiber foods appear to be less
important for the obese diabetic person
than adhering to a calorie-restricted
diet and achieving weight loss. Attempts
should be made to alter life-style
within an acceptable degree for any
given patient to encourage weight
reduction. For example, although
exercise may have a small but transient
direct effect in lowering blood glucose
and insulin resistance, it can be
considered an adjunct to decreased
calorie diets for weight reduction.
Finally, it appears prudent to prevent
or reverse obesity, especially in
individuals with a family history of
diabetes, in the hope that the onset of
diabetes may be prevented or postponed.
- Language of Publication
- English
- Unique Identifier
- 87167201
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- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|DH/*PP;
Diet, Reducing|*; Exertion|*
- MeSH Heading
- Adipose Tissue; Blood Glucose; Body
Weight; Energy Intake; Human; Obesity|PC;
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-8223
- Country of Publication
- UNITED STATES
Record 28 from database: MEDLINE
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- Title
- Beneficial effect of vegetable protein
diet supplemented with psyllium plantago
in patients with hepatic encephalopathy
and diabetes mellitus.
- Author
- Uribe M; Dibildox M; Malpica S;
Guillermo E; Villallobos A; Nieto L;
Vargas F; Garcia Ramos G
- Address
-
- Source
- Gastroenterology, 1985 Apr, 88:4,
901-7
- Abstract
- A controlled crossover study was
performed in 8 diabetic patients with
chronic portal-systemic encephalopathy.
After a basal period the patients were
treated during periods A and B. During
period A, a meat protein diet (0.8 g/kg
body wt, approximately 1800 kcal/day)
was consumed and neomycin plus laxatives
were given. During period B patients
received vegetable protein (0.8 g/kg
body wt, 1800 kcal/day). This diet was
supplemented with psyllium fiber to
reach 35 g of fiber per day. Four
patients were randomly assigned to
receive the treatments in the order A-B
and the other 4 patients in the order
B-A. At the end of the first
experimental period, fasting glucose
levels were 204 +/- 86 mg% in the meat
protein diet group and 127 +/- 8 mg% in
the vegetable protein diet group (p less
than 0.014). The patients were receiving
2.5 +/- 0.2 g/day and 2.1 +/- 0.5 g/day
of tolbutamide at the end of the meat
protein diet and vegetable protein diet,
respectively. In all cases, fasting
glucose levels decreased at the end of
the vegetable diet period regardless of
the previous treatment. An improvement
of greater than or equal to 25 mg% of
fasting glucose levels was observed in 7
of the 8 patients after the vegetable
protein diet and in no case after the
meat protein diet (p less than 0.0078).
The parameters of encephalopathy were
comparable at the end of both the meat
protein diet and the vegetable protein
diet. A significant increase in the
number of bowel movements was noticed
after the vegetable diet plus fiber (p
less than 0.01). We propose the use of
vegetable diet plus fiber to facilitate
the treatment of patients with both
diabetes and hepatic encephalopathy.
- Language of Publication
- English
- Unique Identifier
- 85128315
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- MeSH Heading (Major)
- Diabetes Mellitus|BL/*DH; Dietary
Proteins|*AD; Hepatic Encephalopathy|BL/*DH;
Plant Proteins|*AD; Psyllium|*AD
- MeSH Heading
- Adult; Amino Acids|AN; Bilirubin|BL;
Dietary Fiber|AD; Energy Intake; Female;
Food, Fortified; Glucagon|BL; Human;
Insulin|BL; Liver Cirrhosis|DH; Male;
Middle Age; Neomycin|AD; Tolbutamide|AD
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0016-5085
- Country of Publication
- UNITED STATES
Record 29 from database: MEDLINE
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- Title
- Absence of diabetes in a rural West
African population with a high
carbohydrate/cassava diet.
- Author
- Teuscher T; Baillod P; Rosman JB;
Teuscher A
- Address
-
- Source
- Lancet, 1987 Apr, 1:8536, 765-8
- Abstract
- 1028 (99%) of the 1038 inhabitants of
the West African village of Agbave and a
random sample of 353 (12.4%) of the
population of 2850 in Kati, another West
African village, were screened for
diabetes. Also recorded were their
anthropometric data, dietary habits,
possession of antibodies to malaria, and
serum IgG concentrations. About 85% of
the study population consumed cassava
root at least once a day. The mean (SD)
capillary random blood glucose
concentration was 5.1 (1.1) mmol/l in
men and 5.1 (0.6) in women. The mean
(SD) body mass index was 20.2 (1.8) in
men and 20.7 (2.3) in women. The mean
blood glucose was similar whether
cassava was consumed once daily, more
than once daily, or less than once
daily. None of the 1381 subjects
examined had diabetes. This finding
suggests that a high
carbohydrate/cassava intake (84% of a
mean daily supply of 1916 calories)
combined with a low protein consumption
(8% of caloric supply) does not cause
diabetes. This does not support the
World Health Organisation hypothesis
that malnutrition-related diabetes
exists, at least not in this West
African rural population.
- Language of Publication
- English
- Unique Identifier
- 87171755
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- MeSH Heading (Major)
- Cassava|*; Diabetes Mellitus|*EP;
Dietary Carbohydrates|*AD; Plants,
Edible|*
- MeSH Heading
- Adolescence; Adult; Africa, Western;
Blood Glucose|AN; Diet; Female; Human;
Male; Rural Population
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0140-6736
- Country of Publication
- ENGLAND
Record 30 from database: MEDLINE
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Back
10 records
- Title
- UKPDS 18: estimated dietary intake in
type 2 diabetic patients randomly
allocated to diet, sulphonylurea or
insulin therapy. UK Prospective Diabetes
Study Group.
- Author
- Eeley EA; Stratton IM; Hadden DR;
Turner RC; Holman RR
- Address
- Diabetes Research Laboratories,
Radcliffe Infirnary, Oxford, UK.
- Source
- Diabet Med, 1996 Jul, 13:7, 656-62
- Abstract
- Self-reported dietary intake was
estimated from 3-day prospective food
diaries completed by Type 2 diabetic
patients in the UK Prospective Diabetes
Study. All patients had received
individual dietary advice and had been
randomly allocated to diet,
sulphonylurea or insulin therapy 3
months after diagnosis. A total of 132
patients (120 white Caucasian, 12 Asian)
stratified for gender, obesity and
allocated therapy with mean age 55 years
(SD 8), body mass index 28 kg m-2 (SD
4), and with a diabetes duration of 3 to
6 years were selected at random from 5
of 23 clinical centres. Patients
reported a similar proportion of their
energy intake as carbohydrate (43%) to
the general population and had not
increased to the recommended 50-55%.
Their protein intake (21%) was higher
than the advised 10-15%. Estimated
energy intake from fat (37%) was close
to that recommended for diabetic
patients (30-35%) and was lower than
that reported for the UK population
(40%). The estimated
polyunsaturated/saturated fat intake
ratio (0.48) was higher than that
reported for the UK population (0.35)
compared with the recommended 1.0. Mean
fibre intake at 22 g day-1 was less than
the recommended 30 g day-1. The 8 male
Asian patients took a higher proportion
of their dietary intake as fat (46% vs
37%) and lower as protein (14% vs 21%)
than the male white Caucasian patients.
No significant differences were seen in
estimated nutrient constituents between
patients allocated to diet,
sulphonylurea or insulin therapy as part
of the UK Prospective Diabetes Study and
followed for mean 4.2 years (SD1.6).
This suggests that dietary factors will
not confound UK Prospective Diabetes
Study treatment related analyses.
- Language of Publication
- English
- Unique Identifier
- 96437310
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- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*/DH/DT/ME; Diet
Records|*
- MeSH Heading
- Cross-Sectional Studies; Dietary
Carbohydrates|AD; Dietary Fats|AD;
Dietary Fiber|AD; Dietary Proteins|AD;
Energy Intake; Female; Great Britain;
Human; Insulin|PD/TU; Male; Middle Age;
Prospective Studies; Sulfonylurea
Compounds|PD/TU
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
MULTICENTER STUDY; RANDOMIZED CONTROLLED
TRIAL
- ISSN
- 0742-3071
- Country of Publication
- ENGLAND
Record 31 from database: MEDLINE
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- Title
- The high-carbohydrate diet in diabetes
management.
- Author
- Nuttall FQ
- Address
- University of Minnesota, Minneapolis.
- Source
- Adv Intern Med, 1988, 33:, 165-83
- Abstract
- In summary, the best diet for an
insulin-requiring diabetic person is a
diet that can be best integrated into
the person's lifestyle, one that is best
matched to an insulin regimen acceptable
to that person, and one that leads to
the best control of the 24-hour
integrated blood glucose concentration.
Should future research indicate that a
very high-CHO, low-fat diet is of
additional benefit to the patient, then
the dietary recommendations to the
patient should be altered accordingly.
It should be understood that diabetes is
a chronic disease that requires
intensive effort by the patient if
reasonable management is to be attained.
We should not complicate this management
unnecessarily by dietary intervention
unless clear benefits can be observed.
For the type II, noninsulin-requiring
diabetic person, dietary recommendations
are even less certain. Obese patients
should be encouraged to lose weight and
to maintain a more ideal body weight,
but one should not be disappointed if
the patient is unable to accomplish
this. Medical indications for weight
loss rarely have been sufficient
motivation for patients to remain on a
semistarvation diet. Should safe,
effective anorexigenic drugs become
available, they clearly would be the
treatment of choice for these patients.
The best weight-maintenance diet for
type II diabetic persons remains to be
determined. A high-CHO, low-fat diet
would appear to be best, provided it
results in a more normal average level
of blood glucose. An increase in dietary
soluble fiber also may be useful in
reducing the serum cholesterol
concentration. In such a diet, those CHO
foods that raise the postprandial
glucose concentration the least should
be emphasized.
- Language of Publication
- English
- Unique Identifier
- 88147532
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- MeSH Heading (Major)
- Diabetes Mellitus,
Insulin-Dependent|*DH; Diabetes
Mellitus, Non-Insulin-Dependent|*DH;
Diabetic Diet|*TD; Dietary
Carbohydrates|*AD/ME
- MeSH Heading
- Blood Glucose|ME; Dietary Fats|AD;
Dietary Fiber|AD; Human; Obesity in
Diabetes|DH
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW,
TUTORIAL
- ISSN
- 0065-2822
- Country of Publication
- UNITED STATES
Record 32 from database: MEDLINE
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- Title
- Long-term high fibre, low fat diet in
gestational diabetes.
- Author
- Paisey RB; Savage P; Marsland I; Cooke
P
- Address
-
- Source
- Diabet Med, 1985 Jul, 2:4, 286-7
- Abstract
- A 30-year-old Caucasian who developed
gestational diabetes in her first
pregnancy requiring 58 U insulin daily
and who subsequently adopted a high
fibre, low fat diet and who was able to
maintain normal glucose tolerance
throughout a second pregnancy is
reported.
- Language of Publication
- English
- Unique Identifier
- 87160433
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- MeSH Heading (Major)
- Dietary Fats|*AD; Dietary Fiber|*AD;
Pregnancy in Diabetes|*DH
- MeSH Heading
- Adult; Case Report; Diabetic Diet;
Female; Human; Pregnancy; Time Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0742-3071
- Country of Publication
- ENGLAND
Record 33 from database: MEDLINE
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- Title
- The roles of diet and exercise in the
management of patients with
insulin-dependent diabetes mellitus.
- Author
- Jensen MD; Miles JM
- Address
-
- Source
- Mayo Clin Proc, 1986 Oct, 61:10, 813-9
- Abstract
- Current dietary recommendations for
patients with diabetes are similar to
those for the US population in general,
including a moderate intake of sucrose.
Awareness of the carbohydrate content of
meals will allow adjustments of the dose
of meal-related short-acting insulin
when the size of the meal is altered;
thus, meal planning can be flexible
without sacrificing glycemic control.
Although exercise may have potential
benefits for patients with diabetes, it
is also associated with greater risk in
these persons than in their nondiabetic
counterparts and frequently complicates
the management of their disease. If
there are no contraindications to
regular, vigorous exercise and the
patient desires to participate, careful
self-monitoring of blood glucose,
combined with snacks and insulin dose
adjustment, should enable the
intensively treated patient to exercise
safely.
- Language of Publication
- English
- Unique Identifier
- 86309641
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to the top
- MeSH Heading (Major)
- Diabetes Mellitus, Insulin-Dependent|ME/*TH;
Diabetic Diet|*; Exertion|*
- MeSH Heading
- Absorption; Blood Glucose|ME; Cookery;
Dietary Carbohydrates|AD; Dietary
Fiber|PD; Human; Insulin|AD/ME/TU;
Muscles|ME; Nutrition|ED; Oxygen
Consumption; Patient Education
- Publication Type
- JOURNAL ARTICLE; REVIEW
- ISSN
- 0025-6196
- Country of Publication
- UNITED STATES
Record 34 from database: MEDLINE
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to the top
- Title
- Diet therapy for poorly controlled
type 2 (non-insulin-dependent) diabetes
mellitus.
- Author
- Vessby B; Karlström B; Boberg M;
Lithell H; Gustafsson IB; Berne C
- Address
-
- Source
- Acta Paediatr Scand Suppl, 1985, 320:,
44-9
- Abstract
- Poorly controlled type 2 diabetes
represents a major therapeutic problem.
A classification of the disease, based
on body weight and presence or absence
of adequate insulin-secretion capacity,
may be helpful in the choice of correct
treatment. Calorie reduction is the most
important therapeutic intervention in
overweight patients. In the diabetic
diet digestible carbohydrates should
comprise at least 50 energy%, while the
fat content should be reduced below 30
energy%. Controlled clinical studies
show that the blood glucose control can
be improved and the urinary glucose
excretion be diminished by addition of
dietary fibre. In obese type 2 diabetics
supplemented fasting may be useful to
achieve a rapid weight loss and an
improved metabolic control. Although our
knowledge with regard to the patho-physiology
of type 2 diabetes and the effects of
dietary treatment has increased during
recent years, several important
questions remain unanswered. Also there
is a great need for education and
training programmes to achieve improved
compliance to the dietary advice given.
- Language of Publication
- English
- Unique Identifier
- 86211175
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to the top
- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*DH/ME; Diabetic
Diet|*
- MeSH Heading
- Blood Glucose|ME; Body Weight; Diet,
Reducing; Dietary Carbohydrates|AD;
Dietary Fats|AD; Dietary Fiber|AD;
Fasting; Human; Patient Compliance;
Patient Education; Support, Non-U.S.
Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0300-8843
- Country of Publication
- SWEDEN
Record 35 from database: MEDLINE
Back
to the top
- Title
- Effect of treatment with insulin or
diet on intermediary metabolites in
pregnant women with chemical diabetes in
the third trimester of pregnancy.
- Author
- Stangenberg M; Persson B; Lunell NO;
Hanson U
- Address
-
- Source
- Acta Diabetol Lat, 1984 Jan, 21:1,
55-61
- Abstract
- The diurnal (07(30) - 16(00) profiles
of glucose, 3-hydroxybutyrate (3-HB),
non-esterified fatty acids (NEFA), and
glycerol were studied in 19 pregnant
women with gestational diabetes and
eight pregnant non-diabetic controls.
Nine of the gestational diabetic women
were treated with intermediate and in
some cases with fast acting insulin and
diet and 10 were treated with diet
alone. Although fasting plasma glucose
levels were normal (less than 6.0 mmol/l)
in 8 insulin-treated and 9 diet-treated
gestational diabetics before the start
of treatment, the profiles of glucose,
NEFA and glycerol were generally higher
in gestational diabetic compared to
non-diabetic pregnant women. The
insulin-treated group had lower, but not
normal, plasma glucose and higher levels
of glycerol than the women treated with
diet only. The levels of 3-HB and NEFA
were not significantly influenced by the
type of therapy. It is suggested that
treatment of gestational diabetes should
consist of multiple injections of fast
acting insulin.
- Language of Publication
- English
- Unique Identifier
- 84226915
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to the top
- MeSH Heading (Major)
- Diabetes Mellitus|*BL/DH/DT; Insulin|*TU;
Pregnancy Complications|*BL; Pregnancy
Trimester, Third|*
- MeSH Heading
- Adult; Birth Weight; Blood Glucose|AN;
Fatty Acids, Nonesterified|BL; Female;
Glycerol|BL; Human; Hydroxybutyrates|BL;
Pregnancy; Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0001-5563
- Country of Publication
- ITALY
Record 36 from database: MEDLINE
Back
to the top
- Title
- The effect of diet on intermediary
metabolite concentrations in Type 2
(non-insulin-dependent) diabetes
mellitus.
- Author
- Sheppard MC; Burrin J; Alberti KG;
Nattrass M
- Address
-
- Source
- Diabetologia, 1983 May, 24:5, 333-5
- Abstract
- The metabolic response to a standard
meal was studied in six Type 2
(non-insulin-dependent) diabetic
patients at diagnosis and following 4-6
weeks of dietary treatment. The fall in
blood glucose concentration following
treatment was accompanied by significant
reductions in circulating concentrations
of lactate, pyruvate, alanine and
glycerol. Blood 3-hydroxybutyrate
concentrations also fell with treatment.
- Language of Publication
- English
- Unique Identifier
- 83262854
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to the top
- MeSH Heading (Major)
- Diabetes Mellitus|BL/*DH
- MeSH Heading
- Adult; Aged; Alanine|BL; Female;
Glycerol|BL; Human; Hydroxybutyrates|BL;
Lactates|BL; Male; Middle Age;
Pyruvates|BL; Time Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0012-186X
- Country of Publication
- GERMANY, WEST
Record 37 from database: MEDLINE
Back
to the top
- Title
- Lipoprotein compositional changes in
the fasting and postprandial state on a
high-carbohydrate low-fat and a high-fat
diet in subjects with noninsulin-dependent
diabetes mellitus.
- Author
- OBrien T; Nguyen TT; Buithieu J;
Kottke BA
- Address
- Atherosclerosis Research Unit,
Division of Cardiovascular Disease and
Internal Medicine, Mayo Clinic,
Rochester, Minnesota 55905.
- Source
- J Clin Endocrinol Metab, 1993 Nov,
77:5, 1345-51
- Abstract
- Our aims were 1) to examine the
effects of a high-carbohydrate low-fat
diet on fasting and postprandial plasma
lipids, apolipoproteins (apo), and
lipoprotein composition in noninsulin-dependent
diabetes mellitus, and 2) to determine
whether postprandial shift of apo
between triglyceride-rich lipoproteins (TRLP)
and high density lipoproteins (HDL) is
affected by diet. A cross-over study, of
4 weeks duration, of a high-carbohydrate
(60% carbohydrate, 20% fat) and a
high-fat (40% carbohydrate, 40% fat)
diet was performed in seven subjects
with noninsulin-dependent diabetes
mellitus. TRLP, low density lipoproteins
(LDL), and HDL were separated by fast
protein liquid chromatography. The
high-carbohydrate diet resulted in a
decrease of fasting total, HDL, and LDL
cholesterol and a trend toward an
increase in plasma triglycerides. The
apo composition of fasting TRLP and HDL
was similar on both diets. TRLP apo CII,
CIII, and E increased whereas HDL apo
CII, CIII, and E decreased
postprandially on both diets. In
contrast, TRLP apo CI increased, and HDL
apo CI decreased only after the
high-carbohydrate diet. We conclude that
1) a high carbohydrate diet results in a
decrease in total, LDL, and HDL
cholesterol and a trend toward an
increase in plasma triglycerides; 2)
fasting TRLP and HDL apo composition was
similar on a high-carbohydrate or a
high-fat diet; and 3) on both diets, apo
CII, CIII, and E transfer from HDL to
TRLP postprandially. However, only the
high-carbohydrate diet induced
postprandial transfer of apo CI from HDL
to TRLP. This may explain in part the
changes in lipoproteins observed with
this diet.
- Language of Publication
- English
- Unique Identifier
- 94358045
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to the top
- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*BL; Dietary
Carbohydrates|*AD; Dietary Fats|*AD;
Eating|*; Fasting|*; Lipoproteins|*BL/CH
- MeSH Heading
- Aged; Apolipoproteins|ME; Human;
Lipids|BL; Male; Middle Age; Support,
Non-U.S. Gov't; Support, U.S. Gov't,
P.H.S.
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE
- ISSN
- 0021-972X
- Country of Publication
- UNITED STATES
Record 38 from database: MEDLINE
Back
to the top
- Title
- Sweet taste and diet in type II
diabetes.
- Author
- Tepper BJ; Hartfiel LM; Schneider SH
- Address
- Department of Food Science, Rutgers
University, New Brunswick, NJ 08903,
USA.
- Source
- Physiol Behav, 1996 Jul, 60:1, 13-8
- Abstract
- The relationship between sweet taste
function and dietary intake was studied
in 21 patients with type II diabetes
mellitus and 16 age-, weight-, and
sex-matched controls. Subjects rated the
sweetness intensity and pleasantness of
a series of beverage samples sweetened
with sucrose: 1.5-24%, fructose: 1-18%,
or aspartame: 0.25-4%. They also kept
7-day food records. No group differences
were found in sweet taste perception,
pleasantness ratings, daily energy
intakes, or macronutrient composition of
the diets. However, subjects with
diabetes consumed less sucrose but 3.5
times more alternative sweeteners than
did controls. Peak pleasantness ratings
for the beverage samples were positively
correlated with dietary sweetness
content in the subjects with diabetes
but not the controls. These findings
suggest that in diabetes, hedonic
ratings for a sweetened beverage were
related to dietary sweetness intake
rather than changes in sweet taste
perception.
- Language of Publication
- English
- Unique Identifier
- 96397743
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to the top
- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|DH/PP/*PX;
Diabetic Diet|*PX; Sweetening Agents|*;
Taste|*
- MeSH Heading
- Adult; Aged; Blood Glucose|ME; Female;
Hemoglobin A, Glycosylated|ME; Human;
Male; Middle Age; Taste Threshold|PH
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0031-9384
- Country of Publication
- UNITED STATES
Record 39 from database: MEDLINE
Back
to the top
- Title
- Glomerular filtration rate
measurements in clinical trials.
Modification of Diet in Renal Disease
Study Group and the Diabetes Control and
Complications Trial Research Group.
- Author
- Levey AS; Greene T; Schluchter MD;
Cleary PA; Teschan PE; Lorenz RA;
Molitch ME; Mitch WE; Siebert C; Hall
PM; et al
- Address
- National Institute of Diabetes and
Digestive and Kidney Diseases, National
Institutes of Health, Bethesda, MD.
- Source
- J Am Soc Nephrol, 1993 Nov, 4:5,
1159-71
- Abstract
- To assess the utility and precision of
GFR measurements in multicenter trials,
the test performance and variability of
GFR were analyzed in 2,250 patients
enrolled in 44 clinical centers
participating in either the Modification
of Diet in Renal Disease (MDRD) Study or
the Diabetes Control and Complications
Trial (DCCT). GRF was measured as the
renal clearance of [125I]iothalamate
after an sc injection without
epinephrine. The studies used similar
protocols for obtaining blood and urine,
training clinical center staff, and
processing specimens in central
laboratories. The performance of GFR
measurements, assessed from adherence to
protocol and quality control analyses,
was excellent. The variability among the
four clearance periods (intratest
coefficient of variation [CV]) was
acceptable; the median intratest CV for
GFR was 9.4% in the MDRD Study and 11.7%
in the DCCT. The pattern of decline in
serum counts was better approximated by
an exponential rather than a linear
relationship. The cause of the intratest
variability in GFR measurements was
explored by univariate and multivariate
analysis. The intratest CV was highest
at the extremes of GFR. Among patients
with a high GFR (> 90 mL/min per 1.73
m2), most of whom were participants in
the DCCT, the higher intratest GFR was
due, in part, to a systematic decline in
GFR during the test. Among patients with
a very low GFR (< 13 mL/min per 1.73
m2), technical difficulties in urine
collections contributed substantially to
the higher intratest CV. Other patient
characteristics, including age, gender,
weight, serum glucose, renal diagnosis,
and use of diuretics, were not strongly
correlated with the intratest CV. The
precision of GFR measurements was
assessed from the variability from
measurement to measurement (interest
CV). Among MDRD Study subjects, in whom
two measurements of GFR were performed
over a 3-month interval, the median
interest CV was relatively low (6.3%)
and was only weakly related to the
intratest CV. Thus, GFR measurements are
reasonably precise, even if the
intratest CV is high. Given the
relatively high intratest CV that is
characteristic of GFR measurements, the
estimate of GFR in an individual is more
precise if multiple clearance periods,
rather than a single period, are
included. Similarly, the estimate of
mean GFR for a population is also more
precise if multiple clearance periods
are included. In conclusion, by the use
of standardized methods, an acceptable
precision of GFR results can be obtained
in multicenter trials. The same methods
can be applied in clinical
practice.(ABSTRACT TRUNCATED AT 400
WORDS)
- Language of Publication
- English
- Unique Identifier
- 94137947
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to the top
- MeSH Heading (Major)
- Glomerular Filtration Rate|*; Kidney
Function Tests|*MT/SN/ST; Multicenter
Studies|*MT/SN; Randomized Controlled
Trials|*MT/SN
- MeSH Heading
- Adolescence; Adult; Aged; Analysis of
Variance; Clinical Protocols; Diabetes
Mellitus, Insulin-Dependent|CO/DT/PC;
Female; Human; Kidney Failure,
Chronic|DH/PP; Male; Middle Age;
Multivariate Analysis; Quality Control;
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 1046-6673
- Country of Publication
- UNITED STATES
Record 40 from database: MEDLINE
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Back
10 records
- Title
- The role of diet behaviors in
achieving improved glycemic control in
intensively treated patients in the
Diabetes Control and Complications
Trial.
- Author
- Delahanty LM; Halford BN
- Address
- Department of Dietetics, Massachusetts
General Hospital, Boston 02114.
- Source
- Diabetes Care, 1993 Nov, 16:11, 1453-8
- Abstract
- OBJECTIVE--To determine whether
specific diet-related behaviors
practiced by IDDM patients in the
intensive treatment group of the
Diabetes Control and Complications Trial
were associated with lower HbA1c values.
RESEARCH DESIGN AND METHODS--A
questionnaire addressing various aspects
of their dietary behavior during the
previous year in the DCCT was completed
by 623 DCCT intensive treatment group
subjects. The association between
self-reported diet behaviors and the
subject's mean HbA1c during the previous
year was evaluated using a linear rank
test for trend. The goal of intensive
treatment was to achieve blood glucose
and HbA1c levels as close to the
nondiabetic range as possible without
hypoglycemia. RESULTS--Adherence to the
prescribed meal plan and adjusting food
and/or insulin in response to
hyperglycemia were significantly
associated with lower HbA1c levels.
Over-treating hypoglycemia and consuming
extra snacks beyond the meal plan were
associated with higher HbA1c levels.
Adjusting insulin dose for meal size and
content and consistent consumption of an
evening snack were associated, albeit to
a lesser degree, with lower HbA1c.
CONCLUSIONS--The average HbA1c among
intensively managed patients who
reported that they followed specific
diet-related behaviors was 0.25 to 1.0
lower than among subjects who did not
follow these behaviors. Health-care
providers may wish to use these results
to focus clinical care for intensively
treated IDDM patients by emphasizing
counseling on meal plans, prompt
response to high blood glucose levels,
appropriate treatment of hypoglycemia,
and consistent snacking behaviors.
- Language of Publication
- English
- Unique Identifier
- 94130624
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- MeSH Heading (Major)
- Behavior|*PH; Blood Glucose|*AN;
Diabetes Mellitus,
Insulin-Dependent|*CO/*DH/DT; Eating|*PH
- MeSH Heading
- Combined Modality Therapy;
Dose-Response Relationship, Drug;
Double-Blind Method; Hemoglobin A,
Glycosylated|AN; Human; Hyperglycemia|BL/DH/DT;
Hypoglycemia|BL/DH/DT; Insulin|TU;
Intensive Care; Prospective Studies;
Questionnaires
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
MULTICENTER STUDY; RANDOMIZED CONTROLLED
TRIAL
- ISSN
- 0149-5992
- Country of Publication
- UNITED STATES
Record 41 from database: MEDLINE
Back
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- Title
- Impaired endothelium-dependent and
independent dilatation of forearm
resistance arteries in men with
diet-treated non-insulin-dependent
diabetes: role of dyslipidaemia.
- Author
- Watts GF; OBrien SF; Silvester W;
Millar JA
- Address
- University Department of Medicine,
University of Western Australia, Perth,
Australia.
- Source
- Clin Sci (Colch), 1996 Nov, 91:5,
567-73
- Abstract
- 1. We measured endothelium-dependent
and independent dilatation of forearm
resistance arteries in 29 men with
diet-treated non-insulin-dependent
diabetes mellitus and 18 age- and
sex-matched control subjects. None of
the diabetic patients had
hypercholesterolaemia, overt
hypertension or microproteinuria. 2. We
examined endogenous and exogenous nitric
oxide-mediated vasodilatation by
measuring forearm blood flow with venous
occlusive plethysmography after
administration of acetylcholine (7.5 and
15 micrograms/min) and sodium
nitroprusside (3 and 10 micrograms/min),
respectively, into the brachial artery.
NG-monomethyl-L-arginine was also
infused to study the inhibition of basal
and stimulated release of nitric oxide.
3. The vasodilatory response to
acetylcholine, expressed as area under
curve, was significantly decreased in
the diabetic patients compared with the
control subjects (P = 0.019). NG-monomethyl-L-arginine
significantly reduced basal (P <
0.001) and acetylcholine-stimulated
blood flow (P < 0.02) in both groups.
The vasodilatory response (also
expressed as area under curve) to sodium
nitroprusside was significantly less (P
= 0.044) in the diabetic patients than
in the control subjects. 4. In the
diabetic patients, impaired vasodilatory
responses to acetylcholine were
significantly correlated with higher
serum triacylglycerols (P = 0.048) and
lower high-density
lipoprotein-cholesterol concentrations
(P = 0.007); the association with
high-density lipoprotein was independent
of age, glycated haemoglobin and blood
pressure. Sodium nitroprusside responses
were not correlated with lipid and
lipoprotein concentrations. 5. We
conclude that there is impaired
endothelial and smooth muscle cell
function in men with diet-treated
non-insulin-dependent diabetes mellitus
uncomplicated by overt hypertension or
microproteinuria. Endothelial
dysfunction may be related to diabetic
dyslipidaemia and associated metabolic
disturbances.
- Language of Publication
- English
- Unique Identifier
- 97097853
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- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|CO/DH/*PP;
Endothelium, Vascular|*PP;
Hyperlipidemia|ET/*PP; Vasodilation|*PH
- MeSH Heading
- omega-N-Methylarginine|DU;
Acetylcholine|DU; Adult; Forearm|BS;
Human; Lipoproteins, HDL Cholesterol|BL;
Male; Middle Age; Nitroprusside|DU;
Regional Blood Flow; Support, Non-U.S.
Gov't; Triglycerides|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0143-5221
- Country of Publication
- ENGLAND
Record 42 from database: MEDLINE
Back
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- Title
- Low incidence of chlorpropamide-alcohol
flushing in diet-treated,
non-insulin-dependent diabetes.
- Author
- deSilva NE; Tunbridge WM; Alberti KG
- Address
-
- Source
- Lancet, 1981 Jan, 1:8212, 128-31
- Abstract
- 50 diet-treated, non-insulin-dependent
diabetics were tested subjectively and
objectively for chlorpropamide-alcohol
flushing (CPAF) with a single challenge
test. Of the 12 (24%) who reported a
subjective flush, 9 (18%) also flushed
when a placebo was given instead of
chlorpropamide, so the true incidence of
chlorpropamide-alcohol flushing was 4%
(1 patient was not retested with
placebo). In a control group of 21
non-diabetics, 2 showed the specific
CPAF phenomenon. Temperature measurement
did not improve discrimination, but it
did show a faster rise in facial
temperature in CPAF-positive subjects
than in alcohol flushers. This study
does not confirm previous higher
estimates of the incidence of the CPAF
phenomenon in non-insulin-dependent
diabetes.
- Language of Publication
- English
- Unique Identifier
- 81121303
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to the top
- MeSH Heading (Major)
- Chlorpropamide|*PD; Diabetes
Mellitus|*DH/PP; Ethanol|*PD; Face|*BS;
Skin|*BS
- MeSH Heading
- Adult; Aged; Double-Blind Method;
Female; Human; Male; Middle Age; Skin
Temperature|DE; Support, Non-U.S. Gov't;
Vasodilation|DE
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0140-6736
- Country of Publication
- ENGLAND
Record 43 from database: MEDLINE
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- Title
- UK Prospective Diabetes Study (UKPDS).
X. Urinary albumin excretion over 3
years in diet-treated type 2,
(non-insulin-dependent) diabetic
patients, and association with
hypertension, hyperglycaemia and
hypertriglyceridaemia.
- Address
-
- Source
- Diabetologia, 1993 Oct, 36:10, 1021-9
- Abstract
- Urinary albumin excretion has been
assessed in 585 newly-presenting Type 2
(non-insulin-dependent) diabetic
patients (aged 53 (8) years, 67% male)
at diagnosis with fasting plasma glucose
10.3 (3.2) mmol/l and over 3 years of
dietary treatment. Urinary albumin at
diagnosis, geometric mean (1 SD
interval) corrected for dilution by
regression on urine creatinine
concentration of 10 mmol/l, was 17
(5-58) mg/l compared with 8 (3-18) mg/l
in an age-matched non-diabetic reference
population. Values greater than 50 mg/l
were found in 17% of diabetic patients
compared with 4% in the reference group.
After diet therapy for 3 months, fasting
plasma glucose decreased to 6.9 mmol/l
and urinary albumin to 12 (4-31) mg/l (p
< 0.0001). This suggests that
increased urinary albumin excretion at
diagnosis is in part functional,
possibly secondary to glomerular
hyperfiltration caused by hyperglycaemia
and raised blood pressure. Over the next
3 years, mean fasting plasma glucose was
7.2 mmol/l, albumin excretion changed
little, without significant increase
either in patients with raised or normal
albumin at diagnosis. Both at diagnosis
and over 3 years, urinary albumin
excretion was independently associated
with fasting plasma glucose and
triglyceride levels and with systolic
blood pressure, but the combination of
these factors only explained 10% of the
total variance. This suggests the
presence of additional pathological
processes in patients with increased
urinary albumin. Urinary albumin was not
associated with other variables included
in syndrome X, such as HDL cholesterol,
fasting plasma insulin, obesity or
central adiposity.(ABSTRACT TRUNCATED AT
250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 94063288
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to the top
- MeSH Heading (Major)
- Albuminuria|*; Diabetes Mellitus,
Non-Insulin-Dependent|DH/*PP/*UR;
Diabetic Diet|*; Hyperglycemia|ET/*UR;
Hypertension|CO/*UR;
Hypertriglyceridemia|CO/*UR
- MeSH Heading
- Blood Glucose|AN/ME; Blood Pressure;
Body Mass Index; Female; Follow-Up
Studies; Great Britain; Human;
Lipoproteins, HDL Cholesterol|BL;
Lipoproteins, LDL Cholesterol|BL; Male;
Middle Age; Prospective Studies;
Reference Values; Support, Non-U.S.
Gov't; Support, U.S. Gov't, P.H.S.;
Systole; Time Factors; Triglycerides|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0012-186X
- Country of Publication
- GERMANY
Record 44 from database: MEDLINE
Back
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- Title
- Diet and Type 2 diabetes. Guidelines
for general practice.
- Author
- Stratil M; Phillips P; Holmwood C;
Popplewell P
- Address
- Southern Fleurieu Health Services,
Victor Harbor, South Australia.
- Source
- Aust Fam Physician, 1993 Sep, 22:9,
1591-3, 1596, 1598-600
- Abstract
- Type 2 diabetes (NIDDM) is common and
increasing and results in enormous costs
to all concerned. The average Australian
diet is inappropriate for this
condition, which regular exercise and
healthy eating could delay or prevent
even in high risk groups (family
history, age over 50 years,
over-weight). This article outlines a
practical programme that general
practitioners can use for people with,
and people at risk of, Type 2 Diabetes
and provides a comprehensive Further
reading list.
- Language of Publication
- English
- Unique Identifier
- 94058851
Back
to the top
- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*DH
- MeSH Heading
- Food; Guidelines; Health Education;
Human
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0300-8495
- Country of Publication
- AUSTRALIA
Record 45 from database: MEDLINE
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- Title
- Non-insulin-dependent diabetes:
10-year outcome in relation to initial
response to diet and subsequent
sulfonylurea therapy.
- Author
- Sönksen PH; Lowy C; Perkins JR; Lim
HS
- Address
-
- Source
- Diabetes Care, 1984 May, 7 Suppl 1:,
59-66
- Abstract
- Thirty-eight non-insulin-dependent
diabetic patients within 130% of
desirable body weight were given a 100-g
oral glucose tolerance test (OGTT) at
diagnosis and after at least 1 mo of
dietary treatment with energy and
carbohydrate restriction. Thirteen
"responders" showed an
improvement in fasting blood glucose,
glucose tolerance, and insulin
secretion, with near-normalization of
plasma, lactate, pyruvate, free fatty
acids, glycerol, and ketone bodies.
There were no significant changes in the
25 "non-responders." The
responders were, at diagnosis, heavier
than the non-responders (75.5 versus
64.3 kg, P less than 0.01). Twenty
non-responders subsequently completed a
prospective controlled study of
glibenclamide, chlorpropamide, and
placebo lasting for 16 mo with OGTTs at
the end of each 4-mo treatment phase.
The results showed that there were no
significant differences between the
metabolic effects of glibenclamide and
chlorpropamide. On active treatment,
insulin levels rose coincident with a
fall in fasting blood glucose and an
improvement in glucose tolerance and
near-normalization of plasma lactate,
pyruvate, free fatty acids, glycerol,
and ketone bodies, all of which relapsed
to initial values after placebo. Ten
years after the initial study, 29 of the
original patients were traced and
reviewed and the outcome related to
their earlier tests. Twenty-two percent
of the responders and 70% of the
non-responders were now on insulin (P
less than 0.02); the initial insulin
response to OGTT at the end of the diet
treatment was significantly lower in
those subsequently treated with insulin
(P less than 0.01).(ABSTRACT TRUNCATED
AT 250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 84235383
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- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|DH/DT/*TH;
Hypoglycemic Agents|*TU; Sulfonylurea
Compounds|*TU
- MeSH Heading
- Adolescence; Adult; Aged; Blood
Glucose|ME; Body Weight; Combined
Modality Therapy; Female; Follow-Up
Studies; Glucose Tolerance Test; Human;
Insulin|BL; Lactates|BL; Lipids|BL;
Male; Middle Age; Pyruvates|BL;
Somatotropin|BL; Support, Non-U.S.
Gov't; Time Factors
- Publication Type
- CLINICAL TRIAL; CONTROLLED CLINICAL
TRIAL; JOURNAL ARTICLE
- ISSN
- 0149-5992
- Country of Publication
- UNITED STATES
Record 46 from database: MEDLINE
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- Title
- Thermic and metabolic responses to
oral glucose in obese subjects with
non-insulin-dependent diabetes mellitus
treated with insulin or a
very-low-energy diet.
- Author
- Gougeon R
- Address
- McGill Nutrition and Food Science
Centre, Royal Victoria Hospital,
Montreal, Canada.
- Source
- Am J Clin Nutr, 1996 Jul, 64:1, 78-86
- Abstract
- Increased resting energy expenditure (REE)
and a blunted thermic effect of glucose
(TEF) have been reported in obese
subjects with non-insulin-dependent
diabetes mellitus (NIDDM). I questioned
whether the abnormal REE and TEF would
be corrected by normalizing glycemia
with insulin or a very-low-energy diet (VLED).
Three male and four female obese
subjects with NIDDM [weighing 108 +/- 6
kg and with body mass index (in kg/m2)
of 39 +/- 2] received a weight-maintaing
formula diet containing 95 g protein/d
for 15 d then a 1.7-MJ, 93-g-protein
VLED for 27 d. Insulin was given from
days 1 to 8 in doses sufficient to
normalize glycemia. REE was measured
weekly and TEF was measured on days 8
and 15 of isoenergetic feeding and 28 d
after the VLED by using a
ventilated-hood indirect calorimeter.
Weight decreased 9.8 +/- 1 kg during the
VLED. REE was 3% lower with insulin
treatment than during hyperglycemia
(7878 +/- 364 compared with 8125 +/- 381
kJ/d, P = 0.002). REE decreased by 20%
to 6494 +/- 280 kJ/d by week 4 of the
VLED. After 112 g oral glucose,
increments in energy expenditure were
significantly greater during
isoenergetic feeding with insulin than
without (7.5 +/- 1.3% compared with 4.3
+/- 0.9% above REE) and after the VLED
(10.5 +/- 1.0% above REE, P < 0.05).
Plasma glucose excursions were greatest
without exogenous insulin (peak 21.5 +/-
1.8 mmol/L at 120 min, 16.3 +/- 1.9 mmol/L
at 225 min). Plasma fatty acid
excursions were the lowest with insulin
treatment. The integrated plasma glucose
and fatty acid responses above baseline
did not differ among studies; the
integrated insulin and C-peptide
responses were greater after the VLED.
Cumulative nonoxidative glucose disposal
(stored glucose) was higher with insulin
therapy than without (52 +/- 6 compared
with 35 +/- 7 g/210 min, P < 0.05)
and increased significantly to 66 +/- 6
g after the VLED (compared with the
isoenergetic diet without insulin). TEF
correlated significantly with integrated
C-peptide and insulin responses. The
percentage increase in TEF with
euglycemia (with insulin and VLED)
correlated with the percentage increase
in stored glucose (P < 0.05). The
greater TEF was associated with a
greater insulin response, which was
probably responsible for the greater
stored glucose.
- Language of Publication
- English
- Unique Identifier
- 96282504
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- MeSH Heading (Major)
- Body Temperature Regulation|*;
Diabetes Mellitus,
Non-Insulin-Dependent|*PP/TH; Energy
Intake|*; Glucose Tolerance Test|*;
Insulin|*TU; Obesity in Diabetes|*PP
- MeSH Heading
- Adult; Basal Metabolism; Blood
Glucose|ME; C-Peptide|BL; Calorimetry,
Indirect; Energy Metabolism; Female;
Human; Kinetics; Male; Middle Age;
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 47 from database: MEDLINE
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to the top
- Title
- The role of diet in managing diabetes
in children.
- Author
- Sondel SA; MacDonald MJ
- Address
-
- Source
- Prim Care, 1983 Dec, 10:4, 595-616
- Abstract
- The steps used to construct an
appropriate food plan for the diabetic
child and to educate the patient and his
family in the goals and implementation
of the plan are outlined. Factors that
should be considered in constructing a
flexible and workable plan include age,
family situation, activity level, degree
of motivation, extent of knowledge, and
dietary history.
- Language of Publication
- English
- Unique Identifier
- 84194753
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- MeSH Heading (Major)
- Diabetes Mellitus,
Insulin-Dependent|*DH/ME
- MeSH Heading
- Adolescence; Age Factors; Body Weight;
Case Report; Child; Child, Preschool;
Dietary Carbohydrates|AD; Dietary
Fats|AD; Dietary Fiber|AD; Energy
Intake; Energy Metabolism; Female; Food
Labeling|ST; Human; Infant; Infant,
Newborn; Male; Sweetening Agents|AD/AE
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0095-4543
- Country of Publication
- UNITED STATES
Record 48 from database: MEDLINE
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to the top
- Title
- Sustained reduction of proteinuria in
type 2 (non-insulin-dependent) diabetes
following diet-induced reduction of
hyperglycaemia.
- Author
- Vasquez B; Flock EV; Savage PJ;
Nagulesparan M; Bennion LJ; Baird HR;
Bennett PH
- Address
-
- Source
- Diabetologia, 1984 Feb, 26:2, 127-33
- Abstract
- To determine whether sustained control
of hyperglycaemia in Type 2
(non-insulin-dependent) diabetic
patients would diminish proteinuria, the
effect of hypocaloric diet therapy (500
kcal/day) on proteinuria was assessed in
obese, Type 2 diabetic patients (n = 24)
and compared with results obtained for
obese subjects with normal glucose
tolerance (n = 7) and impaired glucose
tolerance (n = 6). Diet therapy of
similar mean duration resulted in
similar percentage weight loss (mean
percentage of original weight +/- SEM)
in diabetic (13.6 +/- 1.6%), glucose
intolerant (16.4 +/- 3.3%) and obese
non-diabetic (11.0 +/- 1.0%) subjects.
Following therapy, plasma glucose
concentrations 2h after an oral glucose
load declined in the diabetic (18.34 +/-
0.81 to 10.67 +/- 0.50 mmol/l, mean +/-
SEM; p less than 0.001) and in the
glucose intolerant subjects (10.2 +/-
0.3 to 7.3 +/- 0.4 mmol/l, p less than
0.01) while remaining unchanged in the
obese non-diabetic subjects (7.09 +/-
0.23 to 6.77 +/- 0.32 mmol/l, NS).
Concentrations of total protein of
plasma origin and albumin in 24-h urine
collections were quantified by a
sensitive immunonephelometric assay
using specific antisera. Initially, 24-h
excretion of total protein and albumin
were elevated in the diabetic [mg
protein/24 h; (median +/- 95% confidence
limits): 63 (42-138), p less than 0.05;
albumin: 26 (14-56), p less than 0.05]
and glucose intolerant subjects
[protein: 52 (13-92), NS; albumin: 24
(3-61), NS] compared with the
non-diabetic subjects [protein: 20
(5-38); albumin: 6.2
(3.5-9.5)].(ABSTRACT TRUNCATED AT 250
WORDS)
- Language of Publication
- English
- Unique Identifier
- 84183359
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- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*DH/UR; Energy
Intake|*; Hyperglycemia|*DH/UR;
Obesity|*DH/UR; Proteinuria|*DH/ME
- MeSH Heading
- Adult; Albuminuria|DH/ME;
Creatinine|UR; Diabetic Angiopathies|PC;
Diabetic Diet; Diabetic Nephropathies|PC;
Female; Human; Male
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0012-186X
- Country of Publication
- GERMANY, WEST
Record 49 from database: MEDLINE
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- Title
- Starvation diet and very-low-calorie
diets may induce insulin resistance and
overt diabetes mellitus.
- Author
- Koffler M; Kisch ES
- Address
- Diabetes Unit, Tel-Aviv University
Medical Center, Ichilov Hospital,
Israel.
- Source
- J Diabetes Complications, 1996 Mar,
10:2, 109-12
- Abstract
- We have observed seven initially obese
individuals who, during the course of a
strenuous weight-reduction program,
developed diabetes mellitus:
non-insulin-dependent diabetes mellitus
in five cases and insulin-dependent
diabetes mellitus in two cases. None had
any sign of prior diabetic symptoms.
Although weight reduction is encouraged
in obesity, crash diets without proper
medical surveillance may have
deleterious effects. This sequence of
induction of diabetes has not previously
been reported in the medical literature.
The metabolic situation in extremely
low-calorie diets may be comparable to
that in starvation. An attempt is made
to explain our observation concerning
the induction of a diabetic state during
such diets, on the basis of increased
insulin resistance in states of
starvation and anorexia nervosa, with a
concomitant role in stress hormones.
- Language of Publication
- English
- Unique Identifier
- 96255063
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- MeSH Heading (Major)
- Diabetes Mellitus|*ET; Diet,
Reducing|*AE; Insulin Resistance|*PH;
Starvation|*
- MeSH Heading
- Adult; Case Report; Energy Intake;
Female; Human; Male; Middle Age;
Obesity|TH
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 1056-8727
- Country of Publication
- UNITED STATES
Record 50 from database: MEDLINE
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Back
10 records
- Title
- Diet and pump-treated diabetes: a
long-term follow-up.
- Author
- Chantelau EA; Bockholt M; Lie KT;
Broermann C; Sonnenberg GE; Berger M
- Address
-
- Source
- Diabete Metab, 1983 Dec, 9:4, 277-82
- Abstract
- Long-term effects of a liberalized
diabetes diet without meal-planning and
food-exchange were investigated in lean
type-I diabetic patients treated by
continuous subcutaneous insulin infusion
(CSII). Food intake, body weight, HbA1c
levels and serum lipids were recorded
during conventional s.c. insulin
injection treatment (CIT) and after 1
month or 14 months of CSII,
respectively. During CSII plus
liberalized diet, metabolic control
improved significantly (compared to
previous CIT plus conventional diet) as
indicated by a decrease of HbA1c from
9.5% to 7.9% (p less than 0.005). Serum
lipids remained unchanged. Body weight
did not change significantly during CSII
plus liberalized diet; mean body mass
index increased from 21.5 to 22.4 kg/m2
(CIT vs. CSII, n.s.). During CSII,
eating habits were similar to those of
the general West Germany population
regarding the number of meals and the
nutrients composition. We conclude that
during CSII, meal-planning and
food-exchange that during CSII,
meal-planning and food-exchange can be
omitted provided the patients maintain
(near-) normoglycaemia by appropriately
adjusting the s.c. insulin delivery.
Lean type-I diabetics on CSII do not
require specific restrictions as to
their caloric intake in order to prevent
weight gain.
- Language of Publication
- English
- Unique Identifier
- 84132870
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- MeSH Heading (Major)
- Diabetes Mellitus,
Insulin-Dependent|*DH/DT; Diabetic
Diet|*; Insulin Infusion Systems|*
- MeSH Heading
- Adolescence; Adult; Body Weight;
Dietary Carbohydrates|AD; Dietary
Fats|AD; Dietary Proteins|AD; Energy
Intake; Female; Follow-Up Studies;
Human; Male; Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0338-1684
- Country of Publication
- FRANCE
Record 51 from database: MEDLINE
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- Title
- Evidence for a critical role of diet
in the development of insulin-dependent
diabetes mellitus.
- Author
- Scott FW; Daneman D; Martin JM
- Address
- Nutrition Research Division, Health
and Welfare Canada, Ottawa.
- Source
- Diabetes Res, 1988 Apr, 7:4, 153-7
- Abstract
- The role of diet in human
insulin-dependent diabetes mellitus (IDDM)
has not been properly examined, mainly
due to a lack of reliable markers to
identify prospective diabetics and the
difficulties in obtaining accurate and
representative dietary information.
Nonetheless, there is some
circumstantial evidence suggesting a
role for diet in human IDDM. The
validity of this relationship in humans
must await a sufficiently large, well
designed prospective study or the
discovery of better markers for diabetes
predisposition. The recent availability
of the spontaneously diabetic BB rat has
permitted prospective studies under
controlled conditions which indicate
diet, particularly dietary proteins,
such as wheat gluten or cow's milk
proteins may be prerequisites for
maximum expression of the
insulin-dependent syndrome in these
animals. The early suckling and/or
post-weaning period appears to be
important and may be the crucial time
when these proteins or portions of them
pass the gastrointestinal barrier and
initiate a process, possibly
immunological, which results in
destruction of the beta cells of the
pancreas.
- Language of Publication
- English
- Unique Identifier
- 88295637
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- MeSH Heading (Major)
- Diabetes Mellitus,
Insulin-Dependent|*ET; Diet|*AE
- MeSH Heading
- Animal; Diabetes Mellitus,
Experimental|PP; Human; Rats
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW,
TUTORIAL
- ISSN
- 0265-5985
- Country of Publication
- SCOTLAND
Record 52 from database: MEDLINE
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- Title
- Diet therapy for minority patients
with diabetes.
- Author
- Gohdes D
- Address
- Indian Health Service Diabetes
Program, Albuquerque, NM 87102.
- Source
- Diabetes Care, 1988 Feb, 11:2, 189-91
- Abstract
- Diet therapy for minority diabetic
patients must be directed to NIDDM, the
most prominent form of diabetes in
minority populations. Diet programs must
be tailored to the cultural framework,
and traditional foods with desirable
characteristics can be encouraged. To
teach patients about diet, educators
must use educational techniques
appropriate to culture and literacy of
the patient and family. Single-concept
messages such as "eat less
fat" or "eat less food"
promote learning and minimize failure.
Nutrition information can be divided
into sequenced manageable steps that can
then be individualized to the patient's
setting. No single set of exchange lists
will suffice for all minority groups,
nor are exchange lists themselves
appropriate for all situations. To meet
the needs of minority patients,
nutrition educators must use a variety
of tools and techniques relating to the
foods of a particular ethnic group.
Sound education strategies and
simplified materials for NIDDM patients
should also be employed.
- Language of Publication
- English
- Unique Identifier
- 88254451
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- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|DH/*RH;
Diabetic Diet|*; Minority Groups|*
- MeSH Heading
- Human; Patient Education; United
States
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW,
TUTORIAL
- ISSN
- 0149-5992
- Country of Publication
- UNITED STATES
Record 53 from database: MEDLINE
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- Title
- Diabetes and diet. We are still
learning.
- Author
- Quinn S
- Address
- Department of Internal Medicine,
University of Florida Health Science
Center, Jacksonville.
- Source
- Med Clin North Am, 1993 Jul, 77:4,
773-82
- Abstract
- A diagnosis of diabetes mellitus can
be overwhelming at first to any patient
who faces it. Although most patients
initially feel that learning to
administer insulin by injection is
diabetes' most difficult aspect,
altering life-time eating habits to
provide ideal nutrition is in actuality
more challenging. Despite this, dieting
is becoming easier every day. Research
now tells us that caloric restriction to
maintain normal weight improves glucose
tolerance as well as weight control.
Complex carbohydrates should comprise
50% to 60% of total calories.
Concentrated sweets and simple sugars
are to be avoided. Dietary protein
should account for no more than 20% of
total calories although some individuals
may require further protein restriction
or increased protein in the case of
catabolic states. The Recommended Daily
Allowance of protein is 0.8 g/kg per
day. The remaining calories are ingested
as fat and make up 20% to 30% of the
total. Further fat restriction may be
necessary in diabetics with
dyslipidemias. Saturated fats are to be
avoided with a polyunsaturated:saturated
fat ratio of at least 0.8 and preferably
1.0. Though specifically designed for
the diabetic, these recommendations
provide good nutrition for healthy
people as well. The many low-fat,
low-cholesterol, and low-calorie
alternatives provided by today's food
industry provide ample variety making
compliance easier all the time. After
mastering the basics of glucose control
and diabetic nutrition, most patients
can expand their skills to include
restaurant dining and travel by
anticipating potential problems and
preparing ahead.(ABSTRACT TRUNCATED AT
250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 93309220
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- MeSH Heading (Major)
- Diabetes Mellitus|*DH
- MeSH Heading
- Diabetic Diet; Human
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW,
TUTORIAL
- ISSN
- 0025-7125
- Country of Publication
- UNITED STATES
Record 54 from database: MEDLINE
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- Title
- Cardiology. Diet, fat and diabetes.
- Author
- Warwood A
- Address
-
- Source
- Nurs Stand, 1996 Feb, 10:23, 55
- Abstract
- Cardiovascular and cerebrovascular
disease are the principle causes of
death in people with non-insulin
dependent diabetes. This is thought to
be due to insulin resistance, which is
particularly associated with obesity
where the fat is deposited in the
abdomen, commonly in men and
post-menopausal women. High fat diets,
usually also high in saturated fatty
acids in the UK, are associated with
higher blood cholesterol concentrations,
a major risk for cerebrovascular
disease.
- Language of Publication
- English
- Unique Identifier
- 96335596
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- MeSH Heading (Major)
- Cardiovascular Diseases|*ET/MO;
Cerebrovascular Disorders|*ET/MO;
Diabetes Mellitus,
Non-Insulin-Dependent|*CO; Dietary
Fats|*
- MeSH Heading
- Cause of Death; Female; Great
Britain|EP; Human; Male
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0029-6570
- Country of Publication
- ENGLAND
Record 55 from database: MEDLINE
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- Title
- The maintenance of improved metabolic
control after intensified diet therapy
in recent type 2 diabetes.
- Author
- Uusitupa M; Laitinen J; Siitonen O;
Vanninen E; Pyörälä K
- Address
- Department of Clinical Nutrition,
University of Kuopio, Finland.
- Source
- Diabetes Res Clin Pract, 1993 Mar,
19:3, 227-38
- Abstract
- Altogether 86 patients with recently
diagnosed NIDDM, aged 40-64 years were
randomised after 3 months of basic
education to intensified diet (Int.
group, 21 men, 19 women) or conventional
treatment groups (Conv. group, 28 men,
18 women). The aim was to examine
whether an intensified diet education
would result in a better metabolic
control and greater reduction in
cardiovascular risk factors than
conventional treatment for obese
patients with recently diagnosed type 2
diabetes mellitus. Furthermore, both
groups were re-examined after a second
year of observation period to find out
the maintenance of the results after
intervention. After basic education,
Int. group participated in 12-months
diet education, while Conv. group was
treated in local health centres. During
the intervention period, only Int. group
showed further weight reduction. Only
20% of patients in Int. and 6% of
patients in Conv. group had BMI < 27
kg/m2 at the end of the intervention,
while 75% of patients in Int. and 52% of
patients in Conv. group had achieved a
good metabolic control (fasting blood
glucose < 6.7 mmol/l; P = 0.005
between groups). Serum total cholesterol
did not change significantly, but the
changes in HDL-cholesterol,
triglycerides and apolipoprotein B level
were significant in Int. group only. The
proposed acceptable values for serum
lipids were achieved by 52 to 88% of
patients without major differences
between the two groups. During the
second year of observation, weight
gained in both groups and a
deterioration was seen in metabolic
control. Despite that a greater
proportion of patients in the Int. group
still was in good metabolic control
(55.3% vs. 31.8%, P = 0.016),
furthermore Int. group was receiving
less frequently oral drugs for
hyperglycaemia than Conv. group. No
differences in serum lipids were
observed between the groups after the
observation period. HDL-cholesterol
showed a persistent improvement in both
groups.
- Language of Publication
- English
- Unique Identifier
- 93307030
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- MeSH Heading (Major)
- Blood Glucose|*ME; C-Peptide|*BL;
Diabetes Mellitus, Non-Insulin-Dependent|BL/DH/*PP;
Diabetic Diet|*; Hemoglobin A,
Glycosylated|*AN
- MeSH Heading
- Adult; Apolipoprotein A-I|ME;
Apolipoproteins B|ME; Blood Pressure;
Cardiovascular Diseases|CO/DT;
Cholesterol|BL; Diabetic Angiopathies|DT/PP;
Female; Follow-Up Studies; Glucagon|DU;
Human; Lipoproteins, HDL Cholesterol|BL;
Male; Middle Age; Sex Factors; Support,
Non-U.S. Gov't; Triglycerides|BL
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0168-8227
- Country of Publication
- IRELAND
Record 56 from database: MEDLINE
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- Title
- A meta-analysis of infant diet and
insulin-dependent diabetes mellitus: do
biases play a role?
- Author
- Norris JM; Scott FW
- Address
- Department of Preventive Medicine and
Biometrics, University of Colorado
Health Sciences Center, Denver, 80262,
USA.
- Source
- Epidemiology, 1996 Jan, 7:1, 87-92
- Abstract
- We evaluated the relation between
early infant diet and insulin-dependent
diabetes risk with a meta-analysis of 17
case-control studies. A summary of all
studies indicated a moderate effect for
exposure to breast-milk substitutes
[odds ratio (OR) = 1.38; 95% confidence
interval (CI) = 1.18-1.61] and cow's
milk-based substitutes (OR = 1.61; 95%
CI = 1.31-1.98) before 3 months of age.
Fourteen studies relied on
retrospectively collected infant diet
data based on long-term maternal recall,
which may be biased or inaccurate; three
studies used existing infant diet
records to assess exposure, thus
lessening the possibility of recall bias
or inaccurate data. The studies using
existing records demonstrated little
association compared with the studies
relying on long-term recall. Studies in
which the controls had a participation
rate that was more than 20% lower than
that of the cases showed a stronger
diabetogenic effect of never being
breast-fed (OR = 1.58) than studies
whose cases and controls had similar
participation rates (OR = 1.06). Thus,
differences in the participation rates
of cases and controls may have biased
the results of these studies. This
meta-analysis indicates that the weak
association between infant diet and risk
of diabetes mellitus may have
methodologic explanations.
- Language of Publication
- English
- Unique Identifier
- 96245848
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- MeSH Heading (Major)
- Bias (Epidemiology)|*; Breast
Feeding|*; Diabetes Mellitus,
Insulin-Dependent|*EP; Infant Food|*
- MeSH Heading
- Australia; Europe; Human; Infant;
Infant, Newborn; North America; Odds
Ratio; Recall; Support, U.S. Gov't,
P.H.S.; Time Factors
- Publication Type
- JOURNAL ARTICLE; META-ANALYSIS
- ISSN
- 1044-3983
- Country of Publication
- UNITED STATES
Record 57 from database: MEDLINE
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- Title
- Comparison of acarbose and metformin
in patients with Type 2 diabetes
mellitus insufficiently controlled with
diet and sulphonylureas: a randomized,
placebo-controlled study.
- Author
- Willms B; Ruge D
- Address
- Diabetesklinik Bad Lauterberg,
Germany.
- Source
- Diabet Med, 1999 Sep, 16:9, 755-61
- Abstract
- AIMS: To compare the efficacy and
safety of acarbose and metformin when
added to sulphonylurea therapy in
diabetic patients insufficiently
controlled with sulphonylureas alone.
METHODS: A 12-week, single-centre,
placebo-controlled study, with 89
patients randomized to receive acarbose
(100 mg t.d.s.), metformin (850 mg b.d.)
or placebo in addition to their
sulphonylurea therapy. The study was
double-blinded with respect to acarbose/placebo
and single-blinded for metformin/
acarbose and metformin/placebo. Patients
started a strict dietary regimen 1 week
before receiving their first dose of
acarbose, metformin or placebo. This
regimen was individually adjusted to
metabolic status and energy
requirements. RESULTS: The primary
endpoint, HbA1c, decreased from baseline
in all three groups after 12 weeks. The
decrease was greater in the two groups
receiving active therapy compared with
placebo (acarbose -2.3+/-0.32%;
metformin -2.5+/-0.16%; placebo
-1.3+/-0.34%). There was no significant
difference between acarbose and
metformin (P=0.65). Differences between
both active therapies and placebo were
statistically significant (acarbose P
< or = 0.01; metformin P < or =
0.004). Reductions in body weight over
the treatment period were seen in all
three groups and were greatest in the
acarbose group (median weight reduction:
acarbose 3.5 kg; metformin, 1.0 kg;
placebo 1.4 kg). There were no
significant differences in the incidence
of gastrointestinal side-effects between
the three groups and all regimens were
generally well tolerated. CONCLUSION:
The results of the study demonstrate the
equivalence of acarbose and metformin
for improving metabolic control in
patients insufficiently controlled with
diet and sulphonylureas.
- Language of Publication
- English
- Unique Identifier
- 99438970
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- MeSH Heading (Major)
- Acarbose|AE/*TU; Diabetes Mellitus,
Non-Insulin-Dependent|BL/DH/*DT;
Hypoglycemic Agents|*TU; Metformin|AE/*TU;
Sulfonylurea Compounds|*TU
- MeSH Heading
- Aged; Blood Glucose|ME; Cholesterol|BL;
Comparative Study; Female; Food;
Hemoglobin A, Glycosylated|ME; Human;
Male; Middle Age; Placebos; Support,
Non-U.S. Gov't; Triglycerides|BL; Weight
Loss
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0742-3071
- Country of Publication
- ENGLAND
Record 58 from database: MEDLINE
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- Title
- The athlete with type I diabetes:
managing insulin, diet and exercise.
- Author
- Fahey PJ; Stallkamp ET; Kwatra S
- Address
- Ohio State University College of
Medicine, Columbus, USA.
- Source
- Am Fam Physician, 1996 Apr, 53:5,
1611-24
- Abstract
- The numerous benefits of exercise for
patients with insulin-dependent (type I)
diabetes mellitus include an increase in
insulin sensitivity and a reduction of
blood glucose levels. However,
competitive athletes with type I
diabetes must be careful when planning
to exercise. The most common potential
complications in these athletes include
exercise-induced hypoglycemia or
hyperglycemia and postexercise
hypoglycemia due to increased insulin
sensitivity. With proper modifications
of insulin dose and diet, plus careful
blood glucose monitoring, athletes with
type I diabetes can exercise safely and
regularly. To prevent hypoglycemia, the
insulin dose may need to be reduced by
30 or 50 percent before exercise.
Avoiding regular insulin at bedtime and
reducing the evening insulin dose may
help prevent nocturnal hypoglycemia
after exercise. A tailored diet should
reduce the chance of hypoglycemia.
- Language of Publication
- English
- Unique Identifier
- 96209646
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- MeSH Heading (Major)
- Diabetes Mellitus,
Insulin-Dependent|*/CO/DH/DT; Diet|*;
Exercise|*; Insulin|*AD
- MeSH Heading
- Human; Hypoglycemia|ET
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW,
TUTORIAL
- ISSN
- 0002-838X
- Country of Publication
- UNITED STATES
Record 59 from database: MEDLINE
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- Title
- Associations of serum lipids with
metabolic control and diet in young
subjects with insulin-dependent diabetes
mellitus in Finland.
- Author
- Virtanen SM; Räsänen L; Virtanen M;
Sippola H; Rilva A; Kaprio EA; Mäenpää
J; Akerblom HK
- Address
- Department of Applied Chemistry and
Microbiology, Aurora Hospital, Helsinki,
Finland.
- Source
- Eur J Clin Nutr, 1993 Feb, 47:2, 141-9
- Abstract
- Association of serum lipids with
metabolic control and diet were studied
in 72 young subjects with
insulin-dependent diabetes mellitus (IDDM).
Data on food consumption were collected
by the 48-h recall method. Glycosylated
haemoglobin (Hb) A1 was used as a
measure of metabolic control. There were
no differences between males and females
in the mean values for serum total
cholesterol (TC, 4.5 and 4.9 mmol/l,
respectively), low density lipoprotein
cholesterol (LDL-C, 2.7 and 3.0 mmol/l),
high density lipoprotein cholesterol
(HDL-C, 1.3 and 1.4 mmol/l), or serum
triglycerides (TG, 1.1 and 1.0 mmol/l).
Diabetic subjects who were in better
metabolic control (HbA1 < 10.5%),
when compared with those in poorer
control (HbA1 > or = 10.5%) had lower
TC and TG values and a higher HDL-C/TC
ratio. HbA1 level and intake of
saturated fatty acids were positively
associated with serum TC and LDL-C
values and explained 14% and 15% of the
variation in TC and LDL-C, respectively.
HbA1 level and insulin dose per kg of
body weight were positively associated
with serum TG values and explained 30%
of the variation in TG. Serum TC and
LDL-C levels of young subjects with IDDM
could be lowered by improving their
metabolic control and decreasing their
saturated fatty acid intake.
- Language of Publication
- English
- Unique Identifier
- 93170241
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- MeSH Heading (Major)
- Cholesterol|*BL; Diabetes Mellitus,
Insulin-Dependent|*BL/DH/ME; Hemoglobin
A, Glycosylated|*AN; Triglycerides|*BL
- MeSH Heading
- Adolescence; Adult; Body Mass Index;
Dietary Fats|AD; Energy Metabolism;
Female; Finland; Hospitals, Pediatric;
Hospitals, University; Human; Insulin|AD;
Lipoproteins, HDL Cholesterol|BL;
Lipoproteins, LDL Cholesterol|BL; Male;
Nutrition Surveys; Outpatient Clinics,
Hospital; Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0954-3007
- Country of Publication
- ENGLAND
Record 60 from database: MEDLINE
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Back
10 records
- Title
- In vivo insulin action and muscle
glycogen synthase activity in type 2
(non-insulin-dependent) diabetes
mellitus: effects of diet treatment.
- Author
- Bak JF; M‡ller N; Schmitz O; Saaek
A; Pedersen O
- Address
- Medical Endocrinological Department C,
Aarhus Amtssygehus, Denmark.
- Source
- Diabetologia, 1992 Aug, 35:8, 777-84
- Abstract
- Insulin resistant glucose metabolism
is a key element in the pathogenesis of
Type 2 (non-insulin-dependent) diabetes
mellitus. Insulin resistance may be of
both primary (genetic) and secondary
(metabolic) origin. Before and after
diet-induced improvement of glycaemic
control seven obese patients with
newly-diagnosed Type 2 diabetes were
studied with the euglycaemic clamp
technique in combination with indirect
calorimetry and forearm glucose balance.
Muscle biopsies were obtained in the
basal state and again after 3 h of
hyperinsulinaemia (200 mU/l) for studies
of insulin receptor and glycogen
synthase activities. Similar studies
were performed in seven matched control
subjects. Insulin-stimulated glucose
utilization improved from 110 +/- 11 to
183 +/- 23 mg.m-2.min-1 (p less than
0.03); control subjects: 219 +/- 23
mg.m-2.min-1 (p = NS, vs post-diet Type
2 diabetes). Non-oxidative glucose
disposal increased from 74 +/- 17 to 138
+/- 19 mg.m-2.min-1 (p less than 0.03),
control subjects: 159 +/- 22
mg.m-2.min-1 (p = NS, vs post-diet Type
2 diabetic patients). Forearm blood
glucose uptake during hyperinsulinaemia
increased from 1.58 +/- 0.54 to 3.35 +/-
0.23 mumol.l-1.min-1 (p less than 0.05),
control subjects: 2.99 +/- 0.86
mumol.l-1.min-1 (p = NS, vs post-diet
Type 2 diabetes). After diet therapy the
increase in insulin sensitivity
correlated with reductions in fasting
plasma glucose levels (r = 0.97, p less
than 0.001), reductions in serum
fructosamine (r = 0.77, p less than
0.05), and weight loss (r = 0.78, p less
than 0.05).(ABSTRACT TRUNCATED AT 250
WORDS)
- Language of Publication
- English
- Unique Identifier
- 92380361
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- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|ME/*PP;
Diabetic Diet|*; Glycogen Synthase|*ME;
Insulin|BL/*PD; Muscles|DE/PH/*PP;
Obesity in Diabetes|EN/*PP; Receptor,
Insulin|*ME
- MeSH Heading
- Aged; Biological Markers|BL; Blood
Glucose|ME; Body Mass Index; C-Peptide|BL;
Calorimetry; Fatty Acids,
Nonesterified|BL; Female; Hexosamines|BL;
Human; Male; Reference Values; Support,
Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0012-186X
- Country of Publication
- GERMANY
Record 61 from database: MEDLINE
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- Title
- A high-wheat bran diet in
insulin-treated diabetes mellitus:
assessment with the artificial pancreas.
- Author
- McMurry JF Jr; Baumgardner B
- Address
-
- Source
- Diabetes Care, 1984 May, 7:3, 211-4
- Abstract
- The acute effects of adding a large
amount of wheat bran to a mixed meal was
examined with the artificial pancreas in
seven insulin-dependent diabetic
patients. The timing of the peak blood
glucose concentration and its magnitude
were similar with both low- and
high-wheat fiber meals. The total and
net areas under the glucose curve were
comparable. After adjusting for
individual basal needs, the insulin
requirements for the test meals were
nearly identical. We observed no
beneficial effect of added wheat bran
from this study. We could not
demonstrate any need for diabetic
patients to adjust insulin dosage for
occasional differences in meal wheat
bran content.
- Language of Publication
- English
- Unique Identifier
- 84235345
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- MeSH Heading (Major)
- Diabetes Mellitus, Insulin-Dependent|BL/*DH/DT;
Dietary Fiber|*TU
- MeSH Heading
- Adult; Blood Glucose|ME; Evaluation
Studies; Female; Human; Insulin Infusion
Systems; Male; Middle Age; Support,
Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0149-5992
- Country of Publication
- UNITED STATES
Record 62 from database: MEDLINE
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- Title
- Decreased insulin requirement and
improved control of diabetes in pregnant
women given a high-carbohydrate,
high-fiber, low-fat diet.
- Author
- Ney D; Hollingsworth DR; Cousins L
- Address
-
- Source
- Diabetes Care, 1982 Sep, 5:5, 529-33
- Abstract
- Five quantitative measures of diabetic
control [HbA1c determinations, mean 24-h
plasma glucose values, mean amplitude of
glycemic excursions (MAGE), mean 24-h
urinary loss of glucose, and daily
exogenous insulin requirement] were
compared in 20 pregnant women who were
randomly assigned to either a
high-carbohydrate, high-fiber diet (HCF)
that was low in fat or to a control diet
commonly prescribed for pregnancy.
Eleven women followed the HCF diet and
nine subjects, the control diet, from
baseline entry into the study until
delivery. Dietary compliance was
excellent, with 78% of the women in each
group rated good or acceptable. HbA1c
values were similar in both groups at
baseline (HCF: 11.0 +/- 0.5% versus
control: 10.2 +/- 0.6%), with no
different predelivery values (8.6 +/-
0.4%). Mean 24-h plasma glucose levels
improved in patients on both diets, with
lower values noted in the HCF group at
predelivery. MAGE values and standard
deviations did not differ significantly
in the two groups. Glycosuria decreased
markedly in both dietary groups, but
differences between groups were not
significant. Improved control of
diabetes on the HCF diet was achieved
with significantly lower increments in
insulin dose during gestation (HCF
baseline: 32 +/- 8 U/24 h to 66 +/- 10
U/24 h versus control baseline: 27 +/- 9
U/24 h to 108 +/- 12 U/24 h, P less than
0.03). Outcome of pregnancy did not
differ in the two groups of patients,
but women on the HCF diet gained less
weight than those on the control diet
(26 +/- 3 lb versus 35 +/- 5 lb, P less
than 0.05). Mean newborn gestational age
was similar in the two groups (HCF: 37.2
+/- 0.7 wk versus control: 36.5 +/- 0.7
wk). Mean birth weight in infants of HCF
mothers was 3809 +/- 248 g versus 3313
+/- 278 g in infants of control mothers
(P less than 0.05). We conclude that
although marked improvement of diabetic
control occurred on both regimens,
patients on the HCF diet achieved better
control of diabetes with significantly
lower increments in exogenous insulin.
- Language of Publication
- English
- Unique Identifier
- 84235309
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- MeSH Heading (Major)
- Insulin|*AD; Pregnancy in Diabetes|*DH
- MeSH Heading
- Adult; Blood Glucose|AN; Comparative
Study; Dietary Carbohydrates|AD; Dietary
Fats|AD; Dietary Fiber|AD; Female;
Human; Pregnancy; Support, U.S. Gov't,
P.H.S.
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0149-5992
- Country of Publication
- UNITED STATES
Record 63 from database: MEDLINE
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- Title
- Comparison of acarbose and metformin
in patients with Type 2 diabetes
mellitus insufficiently controlled with
diet and sulphonylureas: a randomized,
placebo-controlled study.
- Author
- Willms B; Ruge D
- Address
- Diabetesklinik Bad Lauterberg,
Germany.
- Source
- Diabet Med, 1999 Sep, 16:9, 755-61
- Abstract
- AIMS: To compare the efficacy and
safety of acarbose and metformin when
added to sulphonylurea therapy in
diabetic patients insufficiently
controlled with sulphonylureas alone.
METHODS: A 12-week, single-centre,
placebo-controlled study, with 89
patients randomized to receive acarbose
(100 mg t.d.s.), metformin (850 mg b.d.)
or placebo in addition to their
sulphonylurea therapy. The study was
double-blinded with respect to acarbose/placebo
and single-blinded for metformin/
acarbose and metformin/placebo. Patients
started a strict dietary regimen 1 week
before receiving their first dose of
acarbose, metformin or placebo. This
regimen was individually adjusted to
metabolic status and energy
requirements. RESULTS: The primary
endpoint, HbA1c, decreased from baseline
in all three groups after 12 weeks. The
decrease was greater in the two groups
receiving active therapy compared with
placebo (acarbose -2.3+/-0.32%;
metformin -2.5+/-0.16%; placebo
-1.3+/-0.34%). There was no significant
difference between acarbose and
metformin (P=0.65). Differences between
both active therapies and placebo were
statistically significant (acarbose P
< or = 0.01; metformin P < or =
0.004). Reductions in body weight over
the treatment period were seen in all
three groups and were greatest in the
acarbose group (median weight reduction:
acarbose 3.5 kg; metformin, 1.0 kg;
placebo 1.4 kg). There were no
significant differences in the incidence
of gastrointestinal side-effects between
the three groups and all regimens were
generally well tolerated. CONCLUSION:
The results of the study demonstrate the
equivalence of acarbose and metformin
for improving metabolic control in
patients insufficiently controlled with
diet and sulphonylureas.
- Language of Publication
- English
- Unique Identifier
- 99438970
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- MeSH Heading (Major)
- Acarbose|AE/*TU; Diabetes Mellitus,
Non-Insulin-Dependent|BL/DH/*DT;
Hypoglycemic Agents|*TU; Metformin|AE/*TU;
Sulfonylurea Compounds|*TU
- MeSH Heading
- Aged; Blood Glucose|ME; Cholesterol|BL;
Comparative Study; Female; Food;
Hemoglobin A, Glycosylated|ME; Human;
Male; Middle Age; Placebos; Support,
Non-U.S. Gov't; Triglycerides|BL; Weight
Loss
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0742-3071
- Country of Publication
- ENGLAND
Record 64 from database: MEDLINE
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- Title
- High-carbohydrate, high-fiber diet in
children with type I diabetes mellitus.
- Author
- Lindsay AN; Hardy S; Jarrett L;
Rallison ML
- Address
-
- Source
- Diabetes Care, 1984 Jan, 7:1, 63-7
- Abstract
- The effects of a high-carbohydrate,
high-fiber (HCHF) diet on glucose
control was evaluated in 12 children
with type I diabetes mellitus. The
children had had diabetes for an average
of 5.25 yr; their mean glycosylated
hemoglobin was 12.4% (normal 5-9%), and
C-peptide was virtually undetectable in
all but one. They were followed on a
regular diabetic diet for 10 days at
home and in the hospital and then were
studied on a HCHF diet for 14 days. The
HCHF diet contained 60% carbohydrate and
30 g of fiber per 1000 cal provided
through grains, fruits, vegetables, and
high-fiber crackers. Capillary blood
glucose levels were monitored at home
before meals and at bedtime, and venous
plasma glucose levels were measured in
the hospital before and after each meal
and during the night. Plasma glucose was
measured serially after test meals with
each diet. There was no significant
difference in blood glucose levels
preprandially, postprandially, and while
fasting on the two diets. The 24-h
glucose profiles and posttest meal
profiles obtained during both diets were
remarkably similar. We conclude that a
diet high in fiber and carbohydrate has
limited application in children with
type I diabetes mellitus who have no
residual beta-cell function.
- Language of Publication
- English
- Unique Identifier
- 84158086
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- MeSH Heading (Major)
- Diabetes Mellitus, Insulin-Dependent|BL/*DH;
Dietary Carbohydrates|*AD; Dietary
Fiber|*AD
- MeSH Heading
- Adolescence; Blood Glucose|AN; Child;
Hemoglobin A, Glycosylated|AN; Human;
Support, U.S. Gov't, P.H.S.; Time
Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0149-5992
- Country of Publication
- UNITED STATES
Record 65 from database: MEDLINE
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- Title
- Apolipoprotein assays: methodological
considerations and studies in
non-insulin-dependent diabetes treated
by diet, glibenclamide and insulin.
- Author
- Billingham MS; Milles JJ; Green A;
Bailey CJ; Hall RA
- Address
- Department of Clinical Chemistry, Good
Hope General Hospital, Birmingham, UK.
- Source
- Scand J Clin Lab Invest, 1989 May,
49:3, 239-47
- Abstract
- The effect of sample pre-treatment as
a source of variability of
apolipoprotein (apo) AI, AII and B
assays was demonstrated with lipid
dissociating agents. The average mean
percentage change ranged from -58 to
+133% compared with untreated samples.
The apolipoprotein method selected was
validated by comparing their
concentrations with their corresponding
lipoprotein lipid or protein in normal
controls and Type 2
(non-insulin-dependent) diabetic
patients. The coefficient of variation
was maintained below 3.5% for apo AI,
AII, B and HDL2-apo AI. The
apolipoprotein concentrations of fasting
plasma lipoproteins were determined in a
cross-sectional study of non-obese
(body-mass index less than or equal to
30) patients with Type 2 diabetes
mellitus. Compared with normal subjects
matched for sex, age, body-mass index,
exercise, alcohol consumption and
smoking. Type 2 patients at diagnosis
showed reduced apo AI and HDL2-apo AI
concentrations, lowered apo AI:B ratio
and increased concentrations of apo B.
Type 2 patients treated by diet alone
(for 6-72 months) and diet plus
glibenclamide (2.5-15 mg/day for 6-48
months) exhibited similar abnormalities
of plasma apolipoprotein concentration
to Type 2 patients at diagnosis.
However, in Type 2 patients treated with
insulin (25-65 U/day for 8-144 months)
concentrations of apo AI and HDL2-apo
AI, and the apo AI:B ratio were normal.
Apo B concentrations were generally
lower compared with all groups of
non-insulin treated patients. These
abnormalities of apolipoprotein
metabolism, which are associated with
premature coronary disease, are still
evident in patients treated by diet and
diet plus glibenclamide, but are not
seen in Type 2 patients treated with
insulin.
- Language of Publication
- English
- Unique Identifier
- 89298229
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- MeSH Heading (Major)
- Apolipoproteins A|*BL; Apolipoproteins
B|*BL; Diabetes Mellitus,
Non-Insulin-Dependent|*BL/DH/DT
- MeSH Heading
- Adult; Diabetic Diet; Female;
Glyburide|TU; Human; Insulin|TU; Male;
Middle Age
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0036-5513
- Country of Publication
- ENGLAND
Record 66 from database: MEDLINE
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- Title
- Metabolic effects of adding sucrose
and aspartame to the diet of subjects
with noninsulin-dependent diabetes
mellitus.
- Author
- Colagiuri S; Miller JJ; Edwards RA
- Address
- Department of Endocrinology and
Metabolism, Prince of Wales Hospital,
Randwick, NSW, Australia.
- Source
- Am J Clin Nutr, 1989 Sep, 50:3, 474-8
- Abstract
- This study compared the effects of
adding sucrose and aspartame to the
usual diet of individuals with
well-controlled noninsulin-dependent
diabetes mellitus (NIDDM). A
double-blind, cross-over design was used
with each 6-wk study period. During the
sucrose period, 45 g sucrose (9% of
total daily energy) was added, 10 g with
each main meal and 5 g with each
between-meal beverage. An equivalent
sweetening quantity of aspartame (162
mg) was ingested during the aspartame
period. The addition of sucrose did not
have a deleterious effect on glycemic
control, lipids, glucose tolerance, or
insulin action. No differences were
observed between sucrose and aspartame.
Sucrose added as an integral part of the
diabetic diet does not adversely affect
metabolic control in well-controlled
NIDDM subjects. Aspartame is an
acceptable sugar substitute for diabetic
individuals but no specific advantage
over sucrose was demonstrated.
- Language of Publication
- English
- Unique Identifier
- 89371567
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- MeSH Heading (Major)
- Aspartame|*PD; Diabetes Mellitus,
Non-Insulin-Dependent|DH/*ME; Diabetic
Diet|*; Dipeptides|*PD; Sucrose|*PD
- MeSH Heading
- Aged; Blood Chemical Analysis; Blood
Glucose|ME; Female; Glucose Clamp
Technique; Human; Insulin|ME; Male;
Middle Age; Support, Non-U.S. Gov't
- Publication Type
- CLINICAL TRIAL; CONTROLLED CLINICAL
TRIAL; JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 67 from database: MEDLINE
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- Title
- Lipoprotein subfraction composition in
non-insulin-dependent diabetes treated
by diet, sulphonylurea, and insulin.
- Author
- Billingham MS; Milles JJ; Bailey CJ;
Hall RA
- Address
- Department of Biochemistry, Good Hope
Hospital, Birmingham, UK.
- Source
- Metabolism, 1989 Sep, 38:9, 850-7
- Abstract
- Lipoprotein abnormalities may
predispose to an increased risk of
coronary heart disease in type II
(non-insulin-dependent) diabetes
mellitus. To investigate the effects of
different treatment modalities, the
composition and concentrations of
fasting plasma lipoproteins were
determined in a cross-sectional study of
patients with type II diabetes at
diagnosis, treated by diet alone,
treated by diet + glibenclamide (2.5 to
15 mg/d for 6 to 48 months), and treated
by diet + insulin (25 to 65 U/d for 8 to
144 months). Compared with normal
subjects matched for sex, age, body mass
index, exercise, alcohol consumption and
smoking, type II patients at diagnosis
showed increased concentrations of
nonesterified and esterified
cholesterol, triglyceride, phospholipid,
and protein in the very low density
lipoprotein (VLDL) fraction. However,
the only alteration in VLDL composition
was a small decrease in the relative
proportion of phospholipid.
Apolipoprotein-B and low density
lipoprotein (LDL) cholesterol
concentrations were also raised in type
II patients at diagnosis. Plasma
concentrations of high density
lipoprotein (HDL) nonesterified and
esterified cholesterol, phospholipid,
and apo-AI were lower in type II
patients at diagnosis. This was largely
accounted for by reduced concentrations
of these components in the HDL2
subfraction, which retained a normal
composition. Type II patients treated by
diet alone and diet + glibenclamide
exhibited similar abnormalities of
plasma lipoprotein concentrations, which
are associated with premature coronary
disease, to the type II patients at
diagnosis. However, in type II patients
treated with insulin, plasma lipoprotein
concentrations and composition were
normal, except LDL cholesterol, which
was lower than normal in insulin-treated
patients.(ABSTRACT TRUNCATED AT 250
WORDS)
- Language of Publication
- English
- Unique Identifier
- 89364273
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- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|DH/DT/*ME;
Diabetic Diet|*; Insulin|BL/*TU;
Lipoproteins|*AN; Sulfonylurea
Compounds|*TU
- MeSH Heading
- Apolipoproteins B|BL; C-Peptide|AN;
Cholesterol|BL; Human; Lipoproteins,
HDL|BL; Lipoproteins, LDL|BL;
Lipoproteins, VLDL|BL; Middle Age;
Triglycerides|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0026-0495
- Country of Publication
- UNITED STATES
Record 68 from database: MEDLINE
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- Title
- Interventions based on
microalbuminuria screening and
low-protein diet in the treatment of
kidney disease of diabetes mellitus.
- Author
- Viberti GC
- Address
- Unit for Metabolic Medicine, UMDS,
Guy's Hospital, London, England.
- Source
- Am J Kidney Dis, 1989 Jan, 13:1, 41-4
- Abstract
- Microalbuminuria in insulin-dependent
diabetics appears to indicate early
renal damage rather than susceptibility
to it, yet a series of relatively small,
short-term intervention studies in
insulin-dependent diabetes mellitus
patients have already demonstrated
reduction in albumin excretion rates or
arrest in the increase of fractional
clearance of albumin. Treatments have
ranged from the use of angiotensin-converting
enzyme inhibitors aimed at lowering BP
to the use of diets restricted to 0.5 to
0.6 g/kg protein and strict blood
glucose control by intensified insulin
treatment. Large, long-term intervention
studies of cohorts of insulin-dependent
and non-insulin-dependent diabetic
patients with microalbuminuria are now
needed to assess the effects of the
different modalities of care on the
development of persistent proteinuria,
end-stage renal disease, and
cardiovascular mortality as well as
associated quantitative changes in the
renal structure.
- Language of Publication
- English
- Unique Identifier
- 89103302
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- MeSH Heading (Major)
- Albuminuria|*UR; Diabetes Mellitus,
Insulin-Dependent|*TH/UR; Diabetic
Nephropathies|*TH/UR
- MeSH Heading
- Angiotensin-Converting Enzyme
Inhibitors|TU; Diabetic Diet; Dietary
Proteins|AD; Human; Kidney Failure,
Chronic|TH
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW,
TUTORIAL
- ISSN
- 0272-6386
- Country of Publication
- UNITED STATES
Record 69 from database: MEDLINE
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- Title
- Influence of treatment with diet alone
on oral glucose-tolerance test and
plasma sugar and insulin levels in
patients with maturity-onset diabetes
mellitus.
- Author
- Doar JWH; Wilde CE; Thompson ME;
Sewell PFJ
- Address
-
- Source
- Lancet, 1975 Jun, 1:7919, 1263-6
- Abstract
- Oral glucose-tolerance test (O.G.T.T.)
plasma sugar and insulin levels were
measured in 118 newly diagnosed
maturity-onset diabetic patients before
and after treatment with diet alone for
periods of 2 and 6 months. The results
of glucose-tolerance tests carried out
during treatment could be predicted from
the initial test and the weight
reduction between the tests. This
prediction was not improved by the
addition of further variables, including
age, obesity, and plasma-insulin levels
during the first test. The change in
O.C.T.T. plasma-insulin between the
first and second tests was predicted by
the result of the initial tests, the
improvement of glucose tolerance between
the two tests, and the degree of weight
reduction. 95% of the group achieved
some improvement of glucose tolerance
after 2 months of dietary treatment, and
59% of the group achieved adequate
diabetic control by this time. It is
concluded that treatment with diet alone
should be the first-line management for
patients with newly diagnosed
maturity-onset diabetes mellitus.
- Language of Publication
- English
- Unique Identifier
- 75173885
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- MeSH Heading (Major)
- Blood Glucose|*AN; Diabetes
Mellitus|BL/*DH/DI; Diabetic Diet|*;
Insulin|*BL
- MeSH Heading
- Adult; Age Factors; Aged; Body Weight;
Glucose Tolerance Test; Human; Middle
Age; Remission, Spontaneous; Time
Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0140-6736
- Country of Publication
- ENGLAND
Record 70 from database: MEDLINE
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10 records
- Title
- Diet, diabetes, hypertension and
blacks.
- Author
- Gaskin R
- Address
- Geriatric Hospital, St. Michael,
Barbados, West Indies.
- Source
- Ethn Dis, 1999 Spr, 9:2, 272-7
- Abstract
- The prevalence of non insulin
dependent diabetes mellitus (NIDDM) is
increasing in all populations. This
increment has been correlated with
changes in lifestyle, particularly in
eating behavior. Migration studies
strongly suggest that NIDDM becomes more
common when lifestyle factors interact
with genetic susceptibility. Blacks have
a higher prevalence of NIDDM than
whites. In this study, it is suggested
that persistent hyperglycemia mediated
through the main carbohydrate of the
Western diet-wheat, as white flour and
whole wheat-in combination with partial
or complete glucose 6-phosphate
dehydrogenase deficiency are possible
factors for the higher prevalence of
NIDDM in blacks.
- Language of Publication
- English
- Unique Identifier
- 99347458
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- MeSH Heading (Major)
- Blacks|*; Diabetes Mellitus,
Non-Insulin-Dependent|*EH/GE/ME; Dietary
Carbohydrates|*AD
- MeSH Heading
- Glucose-6-Phosphate|DF; Glycosylation
End Products, Advanced|BL; Human;
Hyperglycemia|EH/ME; Hypertension|EH/ME;
Prevalence; Risk Factors
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW,
TUTORIAL
- ISSN
- 1049-510X
- Country of Publication
- UNITED STATES
Record 71 from database: MEDLINE
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- Title
- Diet and diabetes in the elderly.
- Author
- Fonseca V; Wall J
- Address
- Diabetic Clinic, University of
Arkansas for Medical Sciences, Little
Rock, USA.
- Source
- Clin Geriatr Med, 1995 Nov, 11:4,
613-24
- Abstract
- This article draws attention to some
of the unique aspects of diabetes
mellitus in the elderly and outlines the
principles of management of diabetes in
this age group with emphasis on diet
therapy. The implications of the
Diabetes Control and Complications Trial
for the elderly person with diabetes is
also briefly discussed. The new
nutrition recommendations of the
American Diabetes Association are
summarized, and the evolving enhanced
role of the dietitian in the management
of diabetes is highlighted.
- Language of Publication
- English
- Unique Identifier
- 96165609
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- MeSH Heading (Major)
- Diabetes Mellitus|*DH/DI/PC; Diet,
Reducing|*
- MeSH Heading
- Aged; Female; Human; Male
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW,
TUTORIAL
- ISSN
- 0749-0690
- Country of Publication
- UNITED STATES
Record 72 from database: MEDLINE
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- Title
- Diet, obesity, and metabolic control
in girls with insulin dependent diabetes
mellitus.
- Author
- Pietiläinen KH; Virtanen SM; Rissanen
A; Rita H; Mäenpää J
- Address
- Department of Applied Chemistry and
Microbiology, University of Helsinki,
Finland.
- Source
- Arch Dis Child, 1995 Nov, 73:5,
398-402
- Abstract
- OBJECTIVE--To investigate whether
girls with insulin dependent diabetes
mellitus (IDDM) were more overweight
than nondiabetic girls, and how diet,
insulin treatment, metabolic control,
age, and pubertal status were related to
body weight and fat content.
DESIGN--Case-control study. SUBJECTS AND
METHODS--48 IDDM girls aged 10-19 years
and controls matched for age and social
class participated in the study.
Overweight was assessed by body mass
index (BMI), relative weight, and body
fat from skinfold thicknesses. Food
consumption data were collected by a 48
hour recall method. RESULTS--The girls
with IDDM were more overweight than
control girls according to all measures
of obesity (for example, mean BMI 20.3 v
18.9 kg/m2). The daily insulin dose/body
weight correlated positively with BMI
and per cent body fat.
CONCLUSIONS--Girls with IDDM are more
overweight than their peers, which
indicates that a more effective
prevention of obesity is needed in the
treatment of diabetes.
- Language of Publication
- English
- Unique Identifier
- 96148408
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- MeSH Heading (Major)
- Diabetes Mellitus, Insulin-Dependent|DT/*PA;
Diet|*; Obesity in Diabetes|DT/*PA
- MeSH Heading
- Adipose Tissue|PA; Adolescence; Body
Mass Index; Body Weight; Case-Control
Studies; Child; Female; Human;
Insulin|AD
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0003-9888
- Country of Publication
- ENGLAND
Record 73 from database: MEDLINE
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- Title
- Influence of imaginative teaching of
diet on compliance and metabolic control
in insulin dependent diabetes.
- Author
- McCulloch DK; Mitchell RD; Ambler J;
Tattersall RB
- Address
-
- Source
- Br Med J (Clin Res Ed), 1983 Dec,
287:6408, 1858-61
- A
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