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Record 1
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- Title
- Prospective comparison of modified
fat-high-carbohydrate with standard
low-carbohydrate dietary advice in the
treatment of diabetes: one year
follow-up study.
- Author
- Hockaday TD; Hockaday JM; Mann JI;
Turner RC
- Address
-
- Source
- Br J Nutr, 1978 Mar, 39:2, 357-62
- Abstract
- 1. A prospective randomized study of
two dietary regimens has been started in
newly-diagnosed diabetics to determine
their effect on circulating metabolites
and on diabetic complications. 2. During
the first year of treatment the fasting
plasma glucose concentrations on both
the low-carbohydrate diet and the
high-carbohydrate, modified-fat (MF)
diet showed a similar decrease. 3.
Plasma cholesterol showed a sustained
decrease only in patients recommended a
MF diet. Transient changes in plasma
triglyceride concentrations occurred in
patients on both dietary regimens. 4.
Increased plasma cholesterol levels are
associated with atheromatous disease
which is common in diabetics in Europe
and North America. A MF diet may
therefore have an advantage in that it
lowers the plasma cholesterol as well as
being effective in lowering the plasma
glucose.
- Language of Publication
- English
- Unique Identifier
- 78124119
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- MeSH Heading (Major)
- Diabetes Mellitus|BL/*DH; Dietary
Carbohydrates|*AD
- MeSH Heading
- Adult; Aged; Blood Glucose|AN; Body
Weight; Cholesterol|BL; Dietary Fats|AD;
Human; Middle Age; Prospective Studies;
Time Factors; Triglycerides|BL
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0007-1145
- Country of Publication
- ENGLAND
Record 2
from database: MEDLINE
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- Title
- High carbohydrate-high fibre diets in
poorly controlled diabetes.
- Author
- Lousley SE; Jones DB; Slaughter P;
Carter RD; Jelfs R; Mann JI
- Address
-
- Source
- Diabet Med, 1984 May, 1:1, 21-5
- Abstract
- Fifteen non-insulin-dependent diabetic
patients with persistently elevated
blood glucoses despite high doses of
oral hypoglycaemic agents, were randomly
allocated to a high carbohydrate-high
fibre diet (HC) or a reinforced low
carbohydrate diet (LC). After six weeks
the diets were reversed for a similar
period. Immediately preceding the study
and at the end of each dietary period
24-h biochemical profiles were
performed. In the 11 patients who
completed the study, fasting and
preprandial glucose, percentage
glycosylated haemoglobin, VLDL
cholesterol and mean 24-h triglycerides
were significantly lower on HC than on
LC or during the initial profile on
their usual diet. There was no
significant difference in any of the
measurements on LC compared with the
usual diet. Previous studies of high
carbohydrate-high fibre diets in
diabetes have been carried out in
relatively well-controlled patients.
These data show that poorly controlled
non-insulin-dependent patients have an
even more striking response.
- Language of Publication
- English
- Unique Identifier
- 87274655
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- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|BL/*DH/PP;
Dietary Carbohydrates|*AD; Dietary
Fiber|*AD
- MeSH Heading
- Aged; Blood Glucose|AN/ME;
Cholesterol|BL; Comparative Study;
Hemoglobin A, Glycosylated|AN; Human;
Lipoproteins, HDL Cholesterol|BL;
Lipoproteins, LDL Cholesterol|BL;
Lipoproteins, VLDL|BL; Middle Age;
Random Allocation; Support, Non-U.S.
Gov't; Triglycerides|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0742-3071
- Country of Publication
- ENGLAND
Record 3 from database: MEDLINE
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- Title
- Lente carbohydrate: a newer approach
to the dietary management of diabetes.
- Author
- Jenkins DJ
- Address
-
- Source
- Diabetes Care, 1982 Nov, 5:6, 634-41
- Abstract
- The dietary fiber hypothesis has
stimulated interest in the possibility
that the glycemic response to
carbohydrate foods may be reduced by
modifying gastrointestinal events to
produce sustained-release or "lente"
carbohydrate. Associated with this
interest, a new branch of pharmacology
has been developed involving the use of
purified fiber preparations and enzyme
inhibitors. These measures, together
with the selection of diets containing
foods that naturally release their
carbohydrate products of digestion
slowly, may contribute a useful facet to
diabetic management in the future.
- Language of Publication
- English
- Unique Identifier
- 87132860
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- MeSH Heading (Major)
- Diabetes Mellitus,
Insulin-Dependent|*DH; Diabetes
Mellitus, Non-Insulin-Dependent|*DH;
Diabetic Diet|*; Dietary
Carbohydrates|*AD; Dietary Fiber|*AD
- MeSH Heading
- Galactans|AD; Human; Mannans|AD;
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0149-5992
- Country of Publication
- UNITED STATES
Record 4 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 5 from database: MEDLINE
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- Title
- Separate influence of dietary
carbohydrate and fibre on the metabolic
control in diabetes.
- Author
- Riccardi G; Rivellese A; Pacioni D;
Genovese S; Mastranzo P; Mancini M
- Address
-
- Source
- Diabetologia, 1984 Feb, 26:2, 116-21
- Abstract
- To clarify the separate influences of
digestible carbohydrate and of dietary
fibre on blood glucose control and serum
lipoproteins, 14 diabetic patients (six
Type 1 and eight Type 2) were submitted
to three weight-maintaining diets for 10
days each: (1) low carbohydrate/low
fibre diet with 42% carbohydrate and 20
g fibre; (2) high carbohydrate/low fibre
diet (carbohydrate 53%, fibre 16 g); (3)
high carbohydrate/ high fibre diet
(carbohydrate 53%, fibre 54 g). In
comparison with the low carbohydrate/low
fibre diet, the 2-h post-prandial blood
glucose and the daily blood glucose
profile decreased significantly on the
high carbohydrate/high fibre diet,
without significant changes during the
high carbohydrate/low fibre diet. The
diet-induced modifications of blood
glucose control were similar in both
types of diabetic patients (two-way
analysis of variance: F = 5.86, p less
than 0.02 for dietary treatment and F =
2.09, NS for type of diabetes). Total
and low-density lipoprotein cholesterol
were also decreased after the high
carbohydrate/high fibre diet in
comparison with the low carbohydrate/low
fibre diet (p less than 0.001 for both),
while they were not significantly
modified after the high carbohydrate/low
fibre diet. Again the modifications of
low density lipoprotein cholesterol
induced by diet were similar in both
types of diabetic patients (F = 10.02, p
less than 0.005 for dietary treatment
and F = 0.14 for type of diabetes, NS).
High-density lipoprotein cholesterol was
lower after the two test diets than
after the low carbohydrate/low fibre
diet.(ABSTRACT TRUNCATED AT 250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 84183357
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus, Insulin-Dependent|BL/DH/*ME;
Diabetes Mellitus, Non-Insulin-Dependent|BL/DH/*ME;
Dietary Carbohydrates|*AD; Dietary
Fiber|*AD
- MeSH Heading
- Adult; Blood Glucose|ME; Body Weight;
Cholesterol|BL; Comparative Study;
Diabetic Diet; Human; Lipoproteins,
HDL|BL; Lipoproteins, LDL|BL;
Lipoproteins, VLDL|BL; Middle Age;
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0012-186X
- Country of Publication
- GERMANY, WEST
Record 6 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 7 from database: MEDLINE
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- Title
- Rationale for changes in the dietary
management of diabetes. Fat,
carbohydrate, and fiber.
- Author
- El Beheri Burgess BR
- Address
-
- Source
- J Am Diet Assoc, 1982 Sep, 81:3,
258-61
- Abstract
- Roughly three-quarters of Americans
with diabetes die from atherosclerosis.
Although the pathogenesis of
cardiovascular disease in diabetes is
not completely understood, diabetes is
frequently associated with
hyperlipidemia, often considered a major
determinant of atherosclerosis, and with
hyperglycemia, which may function as an
independent risk factor. The new higher
carbohydrate diets for management of
diabetes facilitate reduction in the
proportion of fat kilocalories. When
total kilocalories are controlled,
improvement in glucose tolerance also
occurs in individuals with diabetes who
have available endogenous or exogenous
insulin. It has recently been
demonstrated in subjects with diabetes
that a mixture of carbohydrate and fiber
and a high, rather than low, level of
carbohydrate facilitate glycemic
control. Inclusion of fiber-rich foods
in meal plans for patients with diabetes
augments established modes of therapy,
which focus on weight control for Type
II diabetes while synchronizing food
intake and insulin for Type I diabetes.
- Language of Publication
- English
- Unique Identifier
- 82266712
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- MeSH Heading (Major)
- Diabetes Mellitus|CO/*DH; Diabetic
Diet|*TD
- MeSH Heading
- Atherosclerosis|ET/PC; Cardiovascular
Diseases|ET; Dietary Carbohydrates|ME;
Dietary Fats|ME; Dietary Fiber|ME;
Female; Human; Male
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-8223
- Country of Publication
- UNITED STATES
Record 8 from database: MEDLINE
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- Title
- The effects of energy and carbohydrate
restriction in patients with chronic
diabetes mellitus.
- Author
- Perkins JR; West TE; Sönksen PH; Lowy
C; Iles C
- Address
-
- Source
- Diabetologia, 1977 Dec, 13:6, 607-14
- Abstract
- Thirty-five freshly presenting,
diabetic patients received 5 hour, 100 g
oral glucose tolerance tests when first
seen and after a period of carbohydrate
and energy restriction. After treatment,
the significant improvement in glucose
tolerance was accompanied by increased
insulin secretion and lower
concentrations of blood ketone bodies,
lactate, glycerol, FFA, triglycerides,
cholesterol and pre-beta lipoprotein.
There were no significant changes in
serum growth hormone or blood pyruvate
concentrations. Improvement in glucose
tolerance was greater in patients who
were obese (greater than 115% of
desirable body weight for height) on
presentation and was related to the
improvement in insulin secretion and the
diminished lipolysis. An hypothesis to
explain the changes in insulin secretion
is prosposed. Eleven out of the 35
patients showed sufficient improvement
in glucose tolerance to require no
treatment other than diet.
- Language of Publication
- English
- Unique Identifier
- 78065134
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- MeSH Heading (Major)
- Diabetes Mellitus|BL/*DH; Diet|*;
Dietary Carbohydrates|*; Energy Intake|*
- MeSH Heading
- Adolescence; Adult; Aged; Blood
Glucose|AN; Body Weight; Chronic
Disease; Female; Glucose Tolerance Test;
Human; Insulin|BL; Ketone Bodies|BL;
Lipids|BL; Male; Middle Age;
Somatotropin|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0012-186X
- Country of Publication
- GERMANY, WEST
Record 9 from database: MEDLINE
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- Title
- Unrefined carbohydrate and dietary
fibre in treatment of diabetes mellitus.
- Author
- Manhire A; Henry CL; Hartog M; Heaton
KW
- Address
-
- Source
- J Hum Nutr, 1981 Apr, 35:2, 99-101
- Abstract
- Sixteen diabetics were studied over
six-week periods on two diets--a
conventional carbohydrate-restricted
diet and a diet which excluded all
refined (fibre-depleted) carbohydrate
but which allowed unrefined (fibre-intact)
carbohydrate freely. On the latter,
there was a substantial increase in
dietary fibre intake. Despite this,
there was no change in 24-h urinary
excretion of glucose nor in blood
glycosylated haemoglobin concentration,
and there was only a modest improvement
in post-prandial plasma glucose
concentration. We suggest that simply
switching from refined to unrefined
cereal foods without increasing total
carbohydrate intake is unlikely to
produce much improvement in diabetic
control.
- Language of Publication
- English
- Unique Identifier
- 81193042
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- MeSH Heading (Major)
- Cellulose|*TU; Diabetes Mellitus|*DH;
Dietary Carbohydrates|*TU; Dietary
Fiber|*TU
- MeSH Heading
- Adult; Aged; Blood Glucose|AN; Female;
Glycosuria|DH; Hemoglobins|AN; Human;
Male; Middle Age
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0308-4329
- Country of Publication
- ENGLAND
Record 10 from database: MEDLINE
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- Title
- Influence of somatostatin on
carbohydrate disposal and absorption in
diabetes mellitus.
- Author
- Wahren J
- Address
-
- Source
- Lancet, 1976 Dec, 2:7997, 1213-6
- Abstract
- Infusion of somatostatin, an inhibitor
of glucagon secretion, in
insulin-dependent diabetics resulted in
a 75-100% reduction in the blood-glucose
rise after oral glucose administration,
but did not improve intravenous glucose
tolerance. Somatostatin reduced blood-xylose
levels by 50-90% after ingestion of this
pentose and delayed the peak increment
in blood-xylose by 1-2 h. Similar
effects on blood-xylose levels and a 30%
reduction in splanchnic blood-flow were
observed in normal subjects during
infusion of somatostatin. Glucagon
administration (3 ng per kg per min) or
intraduodenal administration of xylose
did not reverse somatostatin's effect on
xylose tolerance. Somatostatin reduces
postprandial hyperglycaemia in diabetes
primarily by decreasing and/or delaying
carbohydrate absorption rather than
enhancing carbohydrate disposal. This
effect may be mediated, in part, but a
reduction in splanchnic blood-flow.
These findings indicate that
postprandial hyperglycaemia in diabetes
is due primarily to insulin deficiency
rather than glucagon excess.
- Language of Publication
- English
- Unique Identifier
- 77055186
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- MeSH Heading (Major)
- Carbohydrates|*ME; Diabetes
Mellitus|*BL/DT; Hyperglycemia|DT/*ET;
Intestinal Absorption|*DE; Somatostatin|*PD/TU
- MeSH Heading
- Administration, Oral; Adult; Blood
Glucose|AN; Drug Evaluation; Glucagon|AI/BL;
Glucose|AD; Glucose Tolerance Test;
Human; Injections, Intravenous;
Insulin|DF; Middle Age; Support, U.S.
Gov't, P.H.S.; Xylose|AD/BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0140-6736
- Country of Publication
- ENGLAND
Record 11 from database: MEDLINE
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- Title
- Magnesium and potassium in diabetes
and carbohydrate metabolism. Review of
the present status and recent results.
- Author
- Durlach J; Collery P
- Address
-
- Source
- Magnesium, 1984, 3:4-6, 315-23
- Abstract
- Diabetes mellitus is the most common
pathological state in which secondary
magnesium deficiency occurs. Magnesium
metabolism abnormalities vary according
to the multiple clinical forms of
diabetes: plasma magnesium is more often
decreased than red blood cell magnesium.
Plasma Mg levels are correlated mainly
with the severity of the diabetic state,
glucose disposal and endogenous insulin
secretion. Various mechanisms are
involved in the induction of Mg
depletion in diabetes mellitus, i.e.
insulin and epinephrine secretion,
modifications of the vitamin D
metabolism, decrease of blood P, vitamin
B6 and taurine levels, increase of
vitamin B5, C and glutathione turnover,
treatment with high levels of insulin
and biguanides. K depletion in diabetes
mellitus is well known. Some of its
mechanisms are concomitant to those of
Mg depletion. But their hierarchic
importance is not the same: i.e.,
insulin hyposecretion is more important
versus K+ than versus Mg2+. Insulin
increases the cellular inflow of K+ more
than that of Mg2+ because there is more
free K+ (87%) than Mg2+ (30%) in the
cell. The consequences of the double
Mg-K depletion are either antagonistic:
i.e. versus insulin secretion (increased
by K+, decreased by Mg2+) or agonistic
i.e. on the membrane: (i.e. Na+K+ATPase),
tolerance of glucose oral load, renal
disturbances. The real importance of
these disorders in the diabetic
condition is still poorly understood.
Retinopathy and microangiopathy are
correlated with the drop of plasma and
red blood cell Mg. K deficiency
increases the noxious cardiorenal
effects of Mg deficiency. The treatment
should primarily insure diabetic
control.(ABSTRACT TRUNCATED AT 250
WORDS)
- Language of Publication
- English
- Unique Identifier
- 85266398
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- MeSH Heading (Major)
- Carbohydrates|*ME; Diabetes
Mellitus|CO/*ME; Magnesium|*ME;
Potassium|*ME
- MeSH Heading
- Biological Transport, Active|DE;
Diabetes Mellitus, Insulin-Dependent|DT;
Human; Insulin|TU; Magnesium
Deficiency|ET; Potassium Deficiency|ET
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0252-1156
- Country of Publication
- SWITZERLAND
Record 12 from database: MEDLINE
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- Title
- Effect of source of dietary
carbohydrate on plasma glucose, insulin,
and gastric inhibitory polypeptide
responses to test meals in subjects with
noninsulin-dependent diabetes mellitus.
- Author
- Coulston AM; Hollenbeck CB; Liu GC;
Williams RA; Starich GH; Mazzaferri EL;
Reaven GM
- Address
-
- Source
- Am J Clin Nutr, 1984 Nov, 40:5, 965-70
- Abstract
- Previous reports have documented the
fact that plasma glucose and insulin
responses can vary in response to the
ingestion of different carbohydrate-rich
foods. This has led to the creation of a
"glycemic index," a
classification of dietary carbohydrates
on the basis of the relative rise in
plasma glucose after the administration
of the food in question as compared to a
standard glucose challenge. In order to
test the clinical utility of these
observations, we evaluated plasma
glucose, insulin, and gastric inhibitory
polypeptide responses to four major
sources of carbohydrate (potato, rice,
spaghetti, lentil) as part of a
conventional mixed meal in patients with
noninsulin-dependent diabetes mellitus.
Each test meal provided 40% of the
subjects' calculated caloric requirement
and contained 15% of total calories as
protein, 40% as fat, and 45% as
carbohydrate. The test carbohydrate
represented 66% of total carbohydrate.
The results indicated that plasma
glucose concentrations after meals
containing equal amounts of carbohydrate
as rice, spaghetti, or lentil were
similar and somewhat lower than meals
containing potato. The plasma insulin
responses to the four carbohydrate foods
paralleled the glucose responses.
Changes in gastric inhibitory
polypeptide levels did not account for
the effect of potato. These results are
totally disparate from what would have
been predicted by previously published
values for the "glycemic
index" of the four foods studied,
and suggest that a "glycemic
index" based on isolated challenges
would have minimal clinical utility in
efforts aimed at reducing postprandial
hyperglycemia in patients with
noninsulin-dependent diabetes mellitus.
- Language of Publication
- English
- Unique Identifier
- 85043647
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- MeSH Heading (Major)
- Blood Glucose|*ME; Diabetes Mellitus,
Non-Insulin-Dependent|*BL; Dietary
Carbohydrates|*PD; Gastric Inhibitory
Polypeptide|*BL; Gastrointestinal
Hormones|*BL; Insulin|*BL
- MeSH Heading
- Cereals; Comparative Study; Female;
Human; Legumes; Male; Middle Age; Rice;
Support, U.S. Gov't, Non-P.H.S.;
Support, U.S. Gov't, P.H.S.; Vegetables
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 13 from database: MEDLINE
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- Title
- Abnormal meal carbohydrate disposition
in insulin-dependent diabetes. Relative
contributions of endogenous glucose
production and initial splanchnic uptake
and effect of intensive insulin therapy.
- Author
- Pehling G; Tessari P; Gerich JE;
Haymond MW; Service FJ; Rizza RA
- Address
-
- Source
- J Clin Invest, 1984 Sep, 74:3, 985-91
- Abstract
- Postprandial hyperglycemia in
insulin-deficient, insulin-dependent
diabetic subjects may result from
impaired suppression of endogenous
glucose production and/or abnormal
disposition of meal-derived glucose. To
investigate the relative contributions
of these processes and to determine
whether 2 wk of near normoglycemia
achieved by using intensive insulin
therapy could restore the pattern of
glucose disposal to normal, meal-related
and endogenous rates of glucose
appearance were measured isotopically
after ingestion of a mixed meal that
contained deuterated glucose in seven
lean insulin-dependent and five lean
nondiabetic subjects. Diabetic subjects
were studied once when insulin deficient
and again during intensive insulin
therapy after 2 wk of near normoglycemia.
Total glucose production was determined
by using tritiated glucose and the
contribution of meal-related glucose was
determined by using the plasma
enrichment of deuterated glucose. The
elevated basal and peak postprandial
plasma glucose concentrations (252 +/-
33 and 452 +/- 31 mg/dl) of diabetic
subjects when insulin deficient were
decreased by intensive insulin therapy
to values (82 +/- 6 and 193 +/- 10
mg/dl, P less than 0.01) that
approximated those of nondiabetic
subjects (93 +/- 3 and 140 +/- 15 mg/dl,
respectively). Total and endogenous
rates of glucose appearance (3,091 +/-
523 and 1,814 +/- 474 mg/kg per 8 h) in
the diabetic subjects were significantly
(P less than 0.02) greater than those in
non-diabetic subjects (1,718 +/- 34 and
620 +/- 98 mg/kg per 8 h, respectively),
whereas meal-derived rates of glucose
appearance did not differ. Intensive
insulin therapy decreased (P less than
0.01) both total (1,581 +/- 98 mg/kg per
8 h) and endogenous (478 +/- 67 mg/kg
per 8 h) glucose appearance to rates
that approximated those observed in the
nondiabetic subjects, but did not alter
meal-related glucose appearance. Thus,
excessive entry of glucose into the
peripheral circulation in
insulin-deficient diabetic patients
after ingestion of a mixed meal resulted
from a lack of appropriate suppression
of endogenous glucose production rather
than impairment of initial splanchnic
glucose uptake. Intensive insulin
therapy restored postprandial
suppression of endogenous glucose
production to rates observed in
nondiabetic subjects.
- Language of Publication
- English
- Unique Identifier
- 84289964
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus, Insulin-Dependent|DT/*ME;
Dietary Carbohydrates|*ME; Insulin|AD/BL/*TU;
Splanchnic Circulation|*
- MeSH Heading
- Adult; Blood Glucose|ME; Comparative
Study; Female; Human; Infusions,
Parenteral; Kinetics; Male; Middle Age;
Reference Values; Support, Non-U.S.
Gov't; Support, U.S. Gov't, P.H.S.; Time
Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0021-9738
- Country of Publication
- UNITED STATES
Record 14 from database: MEDLINE
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- Title
- Effects of physical training and diet
therapy on carbohydrate metabolism in
patients with glucose intolerance and
non-insulin-dependent diabetes mellitus.
- Author
- Bogardus C; Ravussin E; Robbins DC;
Wolfe RR; Horton ES; Sims EA
- Address
-
- Source
- Diabetes, 1984 Apr, 33:4, 311-8
- Abstract
- The effects of 12 wk of physical
training in addition to hypocaloric diet
(DPT group, N = 10) on body composition,
carbohydrate (CHO) tolerance, and
insulin secretion and action were
compared with the effects of diet
therapy alone (D group, N = 8) in CHO-intolerant
and non-insulin-dependent diabetic
subjects. Fat mass, fat-free mass (FFM),
mean fasting plasma glucose, serum
C-peptide, and insulin concentrations
decreased similarly in both groups. The
mean plasma glucose response to a mixed
meal decreased approximately 20% in both
treatment groups, and, after i.v.
glucose, decreased 12% in the D group (P
less than 0.05), but did not change in
the DPT group (NS between groups). The
acute serum insulin response (0-6 min)
after IG increased significantly in the
DPT group only (NS between groups). The
mean basal endogenous glucose production
(BEGP) decreased 17% (P less than 0.025)
in the DPT group and by 31% (P less than
0.01) in the D group (NS between
groups). Hepatic sensitivity to insulin,
estimated by BEGP suppression during the
euglycemic clamp, increased
significantly by 25% in both groups.
Total glucose disposal during the
euglycemic clamp increased from 3.51 +/-
0.04 milligrams of glucose per kilogram
of fat-free mass per minute
(mg/kg-FFM/min) to 4.45 +/- 0.54
mg/kg-FFM/min (P less than 0.05) in the
DPT group, but no change occurred in the
D group (NS between groups).(ABSTRACT
TRUNCATED AT 250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 84159234
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full text for this document
- MeSH Heading (Major)
- Carbohydrates|*ME; Diabetes Mellitus,
Non-Insulin-Dependent|*DH/ME/PP/TH;
Exertion|*; Glucose|*ME
- MeSH Heading
- Adult; Blood Glucose|AN; Body
Composition; C-Peptide|BL; Female;
Glucose Tolerance Test; Human;
Insulin|BL; Male; Middle Age; Oxygen
Consumption; Support, Non-U.S. Gov't;
Support, U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0012-1797
- Country of Publication
- UNITED STATES
Record 15 from database: MEDLINE
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full text for this document
- Title
- The composition and nutritional
adequacy of subject-selected high
carbohydrate, low fat diets in
insulin-dependent diabetes mellitus.
- Author
- Hollenbeck CB; Leklem JE; Riddle MC;
Connor WE
- Address
-
- Source
- Am J Clin Nutr, 1983 Jul, 38:1, 41-51
- Abstract
- The composition and nutritional
adequacy of subject-selected high
carbohydrate, low fat diets were
investigated in six women with
insulin-dependent diabetes mellitus.
Subjects were randomly assigned to begin
either the experimental diet with 65%
carbohydrate, 20% fat, and 15% protein
for 6 wk, or a control diet with 45%
carbohydrate, 40% fat, and 15% protein
for 4 wk. All subjects completed both
dietary periods in a cross-over
experimental design. Subjects were
allowed free selection in their choice
of carbohydrate-rich foods. The
resulting selections produced diets with
51% simple and 49% complex carbohydrates
and 50 g of dietary fiber during the
experimental diet. Similar proportions
were also selected during the control
diet. Blood chemistries revealed no
significant changes in thiamin,
riboflavin, vitamin B6, pyridoxal
5'-phosphate, ascorbate, vitamin E,
calcium, selenium, or zinc
concentrations between the two dietary
periods. With the exception of vitamin
B6, all vitamin and mineral values were
within normal respective ranges. Vitamin
B6 status, as assessed by pyridoxal
5'-phosphate, were below or just above
the levels of marginal deficiency (2.2
nmol/100 ml) in four of the six
individuals, but the lower level
observed occurred independent of the
dietary treatments. The present study
demonstrates that subject-selected high
carbohydrate, low fat diets were much
lower in complex carbohydrates and fiber
than diets previously tested. In
addition, the concentration of several
nutrients did not appear to be adversely
affected by these diets.
- Language of Publication
- English
- Unique Identifier
- 83227964
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full text for this document
- MeSH Heading (Major)
- Diabetic Diet|*; Dietary
Carbohydrates|*AD; Dietary Fats|*AD
- MeSH Heading
- Adult; Consumer Satisfaction; Diabetes
Mellitus|BL/DT; Female; Human;
Insulin|TU; Nutritive Value;
Pyridoxine|BL; Support, Non-U.S. Gov't;
Support, U.S. Gov't, P.H.S.
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 16 from database: MEDLINE
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full text for this document
- Title
- The effect of aging on carbohydrate
metabolism: a review of the English
literature and a practical approach to
the diagnosis of diabetes mellitus in
the elderly.
- Author
- Davidson MB
- Address
-
- Source
- Metabolism, 1979 Jun, 28:6, 688-705
- Abstract
- There seems little doubt that the
disposal of a glucose load is
progressively impaired during aging. The
mechanism(s) for this alteration remains
unclear. Five possibilities have been
raised: (1) poor diet, (2) physical
inactivity, (3) decreased lean body mass
in which to store the carbohydrate load,
(4) decreased insulin secretion, and (5)
insulin antagonism. Although poor diet
and physical inactivity may contribute
to some of the abnormal glucose
tolerance tests of the older population,
these two factors do not provide a full
explanation. Diminished lean body mass
may play some role but there is almost
certainly an additional effect due to
aging. A few papers have suggested that
glucose-induced insulin secretion may be
impaired as the population ages, but the
bulk of studies in this area conclude
that normal or increased amounts of
insulin are released by the pancreatic
beta-cell during aging. If abnormalities
of insulin secretion exist, either in
degree or timing, they are subtle and
would not seem sufficient to account for
the great number of older subjects who
manifest impaired glucose tolerance. The
evidence for insulin antagonism seems
the strongest but the data are certainly
not conclusive. In actuality, the aging
effect on carbohydrate metabolism may be
heterogeneous in nature. Either some or
all of these five factors may contribute
to the aging effect to varying degrees
in individual subjects. Alternatively,
the glucose intolerance of aging may
represent a heterogeneous group of
disorders. In any event, until better
methods to identify possible subgroups
of these subjects and/or a marker for
diabetes mellitus independent of glucose
concentration become available, this
problem will remain difficult to
resolve. Based on the currently
available data, it seems prudent to
diagnose diabetes mellitus only if
fasting hyperglycemia is present.
- Language of Publication
- English
- Unique Identifier
- 79198957
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full text for this document
- MeSH Heading (Major)
- Aged|*; Carbohydrates|*ME; Diabetes
Mellitus|*DI
- MeSH Heading
- Blood Glucose; Fasting; Fatty Acids,
Nonesterified|ME; Female; Fructose|ME;
Galactose|ME; Glucose Tolerance Test;
Human; Insulin|ME/SE; Islets of
Langerhans|SE; Male; Tolbutamide|DU
- Publication Type
- JOURNAL ARTICLE; REVIEW
- ISSN
- 0026-0495
- Country of Publication
- UNITED STATES
Record 17 from database: MEDLINE
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full text for this document
- Title
- Treatment of borderline diabetes:
controlled trial using carbohydrate
restriction and phenformin.
- Author
- Jarrett RJ; Keen H; Fuller JH;
McCartney M
- Address
-
- Source
- Br Med J, 1977 Oct, 2:6091, 861-5
- Abstract
- A five-year therapeutic trial of
carbohydrate restriction with or without
phenformin (50 mg/day) was performed in
men with borderline diabetes. The aim of
treatment was to diminish the enhanced
risk of cardiovascular disease and
deterioration of glucose tolerance.
Cardiovascular morbidity and mortality
were not significantly affected by any
form of treatment, alone or in
combination. The predominant risk factor
for cardiovascular morbidity and
mortality and for overall mortality was
the initial blood pressure level. The
baseline plasma cholesterol
concentration significantly predicted
the onset of intermittent claudication.
One implication of the results is that
hypotensive treatment, supplemented when
necessary with hypolipidaemic treatment,
may be more effective in preventing the
progression of arterial disease in
people with mild to moderate glucose
intolerance than conventional
antidiabetic therapy.
- Language of Publication
- English
- Unique Identifier
- 78041027
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus|CO/*TH; Diabetic
Diet|*; Dietary Carbohydrates|*AD;
Phenformin|AD/PD/*TU
- MeSH Heading
- Blood Glucose; Blood Pressure|DE; Body
Weight|DE; Cardiovascular Diseases|ET;
Clinical Trials; Human; Male; Pulse|DE;
Risk
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0007-1447
- Country of Publication
- ENGLAND
Record 18 from database: MEDLINE
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full text for this document
- Title
- Somatostatin. Its possible role in
carbohydrate homeostasis and the
treatment of diabetes mellitus.
- Author
- Gerich JE
- Address
-
- Source
- Arch Intern Med, 1977 May, 137:5,
659-66
- Abstract
- Somatostatin, a peptide inhibitor of
growth hormone release originally
isolated from the hypothalamus, is also
present in D cells of pancreatic islets.
Its ability to inhibit the secretion of
insulin and glucagon suggests that it
may be a local regulator of pancreatic
A- and B-cell function. Studies using
synthetic somatostatin have provided
evidence that glucagon is a
physiologically important hormone that
exacerbates the consequences of insulin
deficiency in human diabetes mellitus.
The ability of somatostatin to diminish
both fasting and post-prandial
hyperglycemia and to forestall the
development of ketoacidosis after
withdrawal of insulin in
insulin-dependent diabetics suggests a
potential therapeutic use of this agent
in diabetes. Presently, however, its
short half-life and diverse actions
preclude such use and have prompted the
search for more specific and
longer-acting analogs.
- Language of Publication
- English
- Unique Identifier
- 77180620
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus|*DT; Somatostatin|PH/*TU
- MeSH Heading
- Acidosis|PC; Fasting; Glucagon|PH;
Half-Life; Human; Hyperglycemia|DT;
Insulin|DF; Islets of Langerhans|PH
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0003-9926
- Country of Publication
- UNITED STATES
Record 19 from database: MEDLINE
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full text for this document
- Title
- The effect of lynestrenol and
norethindrone on the carbohydrate and
lipid metabolism in subjects with
gestational diabetes.
- Author
- Pyörälä T; Vähäpassi J; Huhtala M
- Address
-
- Source
- Ann Chir Gynaecol, 1979, 68:2, 69-74
- Abstract
- The aim of this study was to
investigate the effect of two different
low-dose progestogens--norethindrone 0.3
mg per day and lynestrenol 0.5 mg per
day--on carbohydrate and lipid
metabolism in women who have had
gestational diabetes. Fifteen patients
were treated with norethindrone and 17
with lynestrenol, over a period of one
year. The control group consisted of 13
women using an IUD. In both treatment
groups all the women had normal OGTT
curves during the use of norethindrone
or lynestrenol. A very slight
deterioration in the glucose tolerance
was observed in the norethindrone group.
There was no deterioration in the
glucose tolerance in the lynestrenol and
the IUD groups. We could not find any
significant changes in mean fasting
plasma cholesterol and triglyceride
values.
- Language of Publication
- English
- Unique Identifier
- 80063626
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full text for this document
- MeSH Heading (Major)
- Carbohydrates|*ME; Lipids|BL/*ME;
Lynestrenol|AD/*AE; Norethindrone|AD/*AE;
Pregnancy in Diabetes|*BL
- MeSH Heading
- Adult; Blood Glucose|AN;
Cholesterol|BL; Female; Glucose
Tolerance Test; Human; Insulin|BL;
Intrauterine Devices; Pregnancy; Time
Factors; Triglycerides|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0355-9521
- Country of Publication
- FINLAND
Record 20 from database: MEDLINE
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full text for this document
- Title
- High-carbohydrate, high-fiber diets
for insulin-treated men with diabetes
mellitus.
- Author
- Anderson JW; Ward K
- Address
-
- Source
- Am J Clin Nutr, 1979 Nov, 32:11,
2312-21
- Abstract
- The effects of high-carbohydrate, high
plant fiber (HCF) diets on glucose and
lipid metabolism of 20 lean men
receiving insulin therapy for diabetes
mellitus were evaluated on a metabolic
ward. All men received control diets for
an average of 7 days followed by HCF
diets for an average of 16 days. Diets
were designed to be weight-maintaining
and there were no significant
alterations in body weight. The daily
dose of insulin was lower for each
patient on the HCF diet than on the
control diet. The average insulin dose
was reduced from 26 +/- 3 units/day
(mean +/- SEM) on the control diets to
11 +/- 3 (P less than 0.001) on the HCF
diets. On the HCF diets, insulin therapy
could be discontinued in nine patients
receiving 15 to 20 units/day and in two
patients receiving 32 units/day. Fasting
and 3-hr postprandial plasma glucose
values were lower in most patients on
the HCF diets than on the control diets
despite lower insulin doses. Serum
cholesterol values dropped from 206 +/-
10 mg/dl on the control diets to 147 +/-
5 (P less than 0.001) on the HCF diet;
average fasting serum triglyceride
values were not significantly altered on
the HCF diets. These studies suggest
that HCF diets may be the dietary
therapy of choice for certain patients
with the maturity-onset type of
diabetes.
- Language of Publication
- English
- Unique Identifier
- 80039657
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full text for this document
- MeSH Heading (Major)
- Blood Glucose|*ME; Cellulose|*AD;
Diabetes Mellitus|*ME/TH; Dietary
Carbohydrates|*AD/TU; Dietary Fiber|*AD/TU;
Lipids|*BL
- MeSH Heading
- Adult; Aged; Cholesterol|BL; Dietary
Fats; Human; Insulin|TU; Male; Middle
Age; Support, U.S. Gov't, P.H.S.;
Triglycerides|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 21 from database: MEDLINE
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- Title
- High carbohydrate, high fiber diets
for patients with diabetes.
- Author
- Anderson JW
- Address
-
- Source
- Adv Exp Med Biol, 1979, 119:, 263-73
- Abstract
- Thirty-three insulin-treated men with
diabetes were hospitalized on a
metabolic ward and fed control diets
(43% carbohydrate) for 6 to 11 days
followed by high carbohydrate (70%),
high fiber (HCF) diets for 12-35 days.
Fasting blood glucose, cholesterol and
triglyceride values were significantly
lower on HCF diets than on control diets
despite significantly (p less than 0.01)
lower insulin doses on the HCF diets.
HCF diets were accompanied by increased
insulin sensitivity and by binding of
insulin by monocytes. Patients who
responded well to the diet in the
hospital have maintained comparable
glucose, cholesterol and triglyceride
values as well as lower insulin doses
for an average of 20 months on
maintenance diets (60% carbohydrate).
The high carbohydrate and low fat
content of these HCF diets seem to play
the predominant role in the improved
glucose metabolism of these patients
whereas the high plant fiber content may
be responsible for the reduction in
serum cholesterol and triglyceride
values. These studies suggest that HCF
diets may have an important place in the
management of patients with the
maturity-onset type of diabetes.
- Language of Publication
- English
- Unique Identifier
- 80039126
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full text for this document
- MeSH Heading (Major)
- Cellulose|*; Diabetic Diet|*; Dietary
Carbohydrates|*; Dietary Fiber|*
- MeSH Heading
- Blood Glucose|AN; Diabetes Mellitus|DT;
Fasting; Glycosuria; Human; Insulin|TU
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0065-2598
- Country of Publication
- UNITED STATES
Record 22 from database: MEDLINE
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full text for this document
- Title
- Improved glucose control in
maturity-onset diabetes treated with
high-carbohydrate-modified fat diet.
- Author
- Simpson RW; Mann JI; Eaton J; Moore
RA; Carter R; Hockaday TD
- Address
-
- Source
- Br Med J, 1979 Jun, 1:6180, 1753-6
- Abstract
- Fourteen patients with established
maturity-onset diabetes were treated as
outpatients with a
high-carbohydrate-(about 60% of total
daily energy requirements)-modified fat
diet (ratio of polyunsaturated fatty
acids to other fatty acids greater than
or equal to 1:1) for six weeks.
Commercially available and acceptable
cereal foods and tuberous vegetables
high in both digestible and
non-digestible carbohydrates were used.
Simple sugars were restricted. Compared
with their usual, low-carbohydrate
diabetic diet this diet resulted in a
fall in basal plasma glucose
concentration (average of values
measured at 0300, 0500, and 0700), mean
preprandial plasma glucose concentration
(average of values measured at 0800,
1230, and 1730), and percentage of
glycosylated haemoglobin. Modifying
dietary fat also decreased the fasting
plasma cholesterol concentration. The
findings suggest that it is no longer
justifiable to prescribe a
low-carbohydrate diet for maturity-onset
diabetes.
- Language of Publication
- English
- Unique Identifier
- 79233820
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full text for this document
- MeSH Heading (Major)
- Diabetic Diet|*; Dietary
Carbohydrates|*AD/TU; Dietary Fats|*AD/TU
- MeSH Heading
- Blood Glucose|AN; Cholesterol|BL;
Comparative Study; Diabetes Mellitus|BL;
Female; Hemoglobin A|AN; Human; Male;
Middle Age; Random Allocation
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0007-1447
- Country of Publication
- ENGLAND
Record 23 from database: MEDLINE
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- Title
- Relationship between body fat mass,
carbohydrate tolerance and IRI response
during glucose infusion in subjects with
early diabetes.
- Author
- Ratzmann KP; Knospe S; Heinke P;
Schulz B
- Address
-
- Source
- Acta Diabetol Lat, 1979 Jan, 16:1,
67-75
- Abstract
- We have studied the interrelationship
of total body fat mass, carbohydrate
tolerance and IRI response in 17
non-obese and obese subjects, who were
suspected of having early diabetes. We
carried out an i.v. glucose infusion
test consisting of a priming injection
of 0.33 g/kg followed by constant
glucose infusion of 12 mg/kg/min in all
persons. Total body fat mass was
estimated by the tritium dilution
method. There was a positive correlation
of body fat mass, fasting glucose
concentration and blood glucose
concentration at 150 min as well as a
strong correlation between body fat mass
and BG area 60--120 min as parameters of
carbohydrate tolerance in all subjects,
i.e. the degree of carbohyrate
intolerance was directly related to the
quantity of total body fat mass. A
similar correlation was found when the
non-obese and obese groups were analyzed
separately. In neither group did total
body fat mass correlate with parameters
of IRI response. In obese subjects with
pathological carbohydrate tolerance,
however, a positive correlation of basal
IRI concentration and total body fat
mass was found. Furthermore, a close
relation between basal IRI level and
parameters of carbohydrate tolerance
could be demonstrated in obese subjects.
The present study failed to demonstrate
any correlation of parameters of
carbohydrate tolerance and
glucose-induced IRI response in either
group. Thus, the significant
relationship between body fat mass and
degree of carbohydrate intolerance
indicates that body fat mass plays an
important role in the disturbance of
blood glucose homeostasis in early
diabetes with and without obesity.
- Language of Publication
- English
- Unique Identifier
- 79205781
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full text for this document
- MeSH Heading (Major)
- Carbohydrate Metabolism, Inborn
Errors|*ME; Diabetes Mellitus|*ME;
Obesity|*ME; Obesity in Diabetes|*ME;
Pancreas|*ME
- MeSH Heading
- Adipose Tissue|ME; Antigens|SE; Blood
Glucose|SE; Body Weight; Glucose
Tolerance Test; Human; Insulin|SE
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0001-5563
- Country of Publication
- ITALY
Record 24 from database: MEDLINE
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full text for this document
- Title
- HLA antigens, cytoplasmic islet cell
antibodies, and carbohydrate tolerance
in families of children with
insulin-dependent diabetes mellitus.
- Author
- Ginsberg Fellner F; Dobersen MJ; Witt
ME; Rayfield EJ; Rubinstein P; Notkins
AL
- Address
-
- Source
- Diabetes, 1982 Apr, 31:4 Pt 1, 292-8
- Abstract
- Cytoplasmic pancreatic islet cell
antibodies were found in 21% of 244
unaffected first degree relatives of
type I diabetic patients. Twenty-five
percent of HLA-identical, 35% of
HLA-haploidentical, 16% of
HLA-nonidentical siblings, and 14% of
parents were ICA-positive. In the HLA-identical
sibs, irrespective of ICA, and in the 18
ICA-positive parents but not the other
groups, increased plasma glucose levels
were observed after the administration
of glucose. In most children, these were
associated with reduced insulin levels,
while in the adults elevated insulin
responses were noted. In 48% of the ICA-positive
children and 84% of the ICA-positive
parents, other evidence of
"autoimmunity" was obtained
either by history or by testing for
specific autoantibodies. Two of the
originally unaffected HLA-identical and
ICA-positive siblings developed diabetes
during the course of the study. These
findings, plus previously reported data
in families with two diabetic sibs
demonstrating that the empiric risk for
developing IDDM is of the order of 30%
for HLA-identical sibs but less than 5%
for those that are HLA-haploidentical,
suggest that HLA-identity may be a
useful predictor of potential type I
diabetes. The presence of ICA may, at
times, portend the need for future
antidiabetic therapy but prospective
studies must be continued to fully
elucidate this relationship.
- Language of Publication
- English
- Unique Identifier
- 83106108
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full text for this document
- MeSH Heading (Major)
- Antibodies|GE/*IM; Diabetes
Mellitus|GE/*IM; HLA Antigens|GE/*IM;
Islets of Langerhans|*IM
- MeSH Heading
- Adolescence; Adult; Autoimmune
Diseases|GE/IM; Blood Glucose|AN; Child;
Child, Preschool; Female; Glucose
Tolerance Test; Human; Infant;
Insulin|BL; Male; Middle Age; Support,
U.S. Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0012-1797
- Country of Publication
- UNITED STATES
Record 25 from database: MEDLINE
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full text for this document
- Title
- Insulin production rate, hepatic
insulin retention and splanchnic
carbohydrate metabolism after oral
glucose ingestion in hyperinsulinaemic
Type 2 (non-insulin-dependent) diabetes
mellitus.
- Author
- Waldhäusl W; Bratusch Marrain P;
Gasic S; Korn A; Nowotny P
- Address
-
- Source
- Diabetologia, 1982 Jul, 23:1, 6-15
- Abstract
- To differentiate peripheral and
hepatic insulin resistance in
hyperinsulinaemic overweight Type 2
(non-insulin-dependent) diabetic
patients (n = 17; 143 +/- 4% ideal body
weight; mean +/- SEM) arterial
concentrations and splanchnic exchange
of glucose, pyruvate, lactate, non-esterified
fatty acids, beta-hydroxybutyrate and
acetoacetate, as well as the insulin
production rate, were determined before
and during oral glucose loads of 25 g or
100 g. Insulin production rate, hepatic
insulin retention and splanchnic
exchange of glucose and metabolites were
estimated by means of the hepatic venous
catheter technique. In the basal state
insulin production rate was greater in
overweight Type 2 diabetic patients
(2.57 +/- 0.28 pmol.kg-1. min-1) than in
healthy control subjects (1.68 +/- 0.17
pmol.kg-1.min-1; p less than 0.01).
After ingestion of 25 g glucose, the
cumulative insulin production rate
exceeded normal values (p less than
0.05), but was below normal with 100 g
glucose (p less than 0.01). Relative
insulin trapping by the splanchnic bed
in the diabetic patients was 54 +/- 3%,
not different from normal. Following a
100 g glucose load, splanchnic insulin
retention fell by 20% in the patients,
and less consistently so in healthy
controls. Splanchnic glucose output was
normal in the diabetic patients both in
the basal state and after glucose
ingestion although the induced arterial
blood glucose levels were greater in the
diabetic patients than in control
subjects (p less than 0.005). Splanchnic
output of pyruvate (p less than 0.025),
lactate (p less than 0.01), and beta-hydroxybutyrate
(p less than 0.005) were greater in the
basal state in the diabetic patients
than in healthy subjects. However, no
difference in splanchnic exchange was
seen between the two groups in their
metabolites' respective response to
glucose ingestion. These data suggest
that obese hyperinsulinaemic Type 2
diabetic patients may represent a
subgroup of diabetic patients with
predominantly peripheral, but
compensated hepatic, insulin resistance
being associated with an increased basal
insulin production rate which only
exhausts after ingestion of a large
glucose load.
- Language of Publication
- English
- Unique Identifier
- 83004701
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus|*ME; Glucose|*ME;
Insulin|BI/*ME; Liver|*ME; Splanchnic
Circulation|*
- MeSH Heading
- Aged; Blood Glucose|AN; C-Peptide|ME;
Female; Glucose Tolerance Test; Human;
Hyperinsulinism|ME; Insulin Resistance;
Male; Middle Age; Obesity in Diabetes|ME;
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0012-186X
- Country of Publication
- GERMANY, WEST
Record 26 from database: MEDLINE
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- Title
- Insulin resistance and carbohydrate
oxidation in patients with chemical
diabetes.
- Author
- Chevaux F; Curchod B; Felber JP; Jéquier
E
- Address
-
- Source
- Diabete Metab, 1982 Jun, 8:2, 105-8
- Abstract
- In six patients with chemical
diabetes, insulin resistance was
assessed by the steady-state plasma
glucose (SSPG) level during a constant
infusion of epinephrine, propranolol,
glucose and insulin. During the
infusion, the patients had elevated SSPG
levels (174 +/- 20 mg/100 ml), compared
with six control subjects (96 +/- 3
mg/100 ml, p less than 0.005),
demonstrating increased insulin
resistance. However, during the
infusion, the rate of carbohydrate
oxidation was similar in both groups.
These results suggest that when
insulinemia is controlled, the plasma
glucose concentration in chemical
diabetics during glucose infusion
reaches hyperglycemic levels allowing
normalisation of carbohydrate oxidation.
Hyperglycemia can thus be considered to
be a regulatory mechanism favouring
glucose uptake and oxidation in patients
with chemical diabetes.
- Language of Publication
- English
- Unique Identifier
- 82262309
Order
full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus|*BL; Dietary
Carbohydrates|*ME; Insulin Resistance|*
- MeSH Heading
- Adult; Blood Glucose|AN;
Epinephrine|PD; Female; Glucose|PD;
Human; Insulin|PD; Male;
Oxidation-Reduction; Propranolol|PD;
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0338-1684
- Country of Publication
- FRANCE
Record 27 from database: MEDLINE
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full text for this document
- Title
- Effect of physical form of
carbohydrate on the postprandial
glucose, insulin, and gastric inhibitory
polypeptide responses in type 2
diabetes.
- Author
- Collier G; ODea K
- Address
-
- Source
- Am J Clin Nutr, 1982 Jul, 36:1, 10-4
- Abstract
- In the present study we measured the
postprandial glucose, insulin, and
gastric inhibitory polypeptide responses
to 75 g carbohydrate administered either
as glucose, unpolished (brown) rice, or
ground brown rice to six recently
diagnosed type 2 diabetics and six
healthy subjects. The diabetic and
normal subjects responded in a
qualitatively similar manner to the
three meals although there were major
quantitative differences. Brown rice
elicited significantly lower
postprandial glucose, insulin, and
gastric inhibitory polypeptide responses
than either ground brown rice or glucose
in both groups. There were no
significant differences in the metabolic
responses to ground brown rice (complex
carbohydrate) and glucose (simple
carbohydrate) in either diabetic or
normal subjects. These data highlight
the role of the physical form of complex
carbohydrate in determining metabolic
responses to it in both diabetic and
normal subjects, and provide a rationale
for designing diabetic diets containing
complex carbohydrate in a form which is
slowly digested and absorbed.
- Language of Publication
- English
- Unique Identifier
- 82227486
Order
full text for this document
- MeSH Heading (Major)
- Blood Glucose|*ME; Diabetes
Mellitus|*BL; Dietary Carbohydrates|*ME;
Gastric Inhibitory Polypeptide|*BL;
Gastrointestinal Hormones|*BL;
Insulin|*BL
- MeSH Heading
- Adult; Female; Food Handling;
Glucose|ME; Human; Male; Middle Age;
Particle Size; Rice; Support, Non-U.S.
Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 28 from database: MEDLINE
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full text for this document
- Title
- Long-term effects of
high-carbohydrate, high-fiber diets on
glucose and lipid metabolism: a
preliminary report on patients with
diabetes.
- Author
- Anderson JW; Ward K
- Address
-
- Source
- Diabetes Care, 1978 Mar, 1:2, 77-82
- Abstract
- High-carbohydrate, high-fiber (HCF)
diets have beneficial therapeutic
effects for selected patients with
diabetes mellitus. We have treated 10
patients with HCF diets on a metabolic
ward and followed them for an average of
15 months while they were on maintenance
diets at home. The HCF diets containing
70 per cent of calories as carbohydrate
were accompanied by significant
reductions in requirements for insulin
or sulfonylureas. Fasting plasma
glucose, serum cholesterol, and
triglyceride values were significantly
lower on the HCF diet than on a 43 per
cent carbohydrate diet. On the HCF diet,
insulin therapy was discontinued for
five patients and sulfonylurea therapy
for three. After an average of 15 months
on the maintenance diet containing 55
per cent to 60 per cent carbohydrate,
seven patients were still managed
without insulin or sulfonylureas.
Average fasting plasma glucose values
during maintenance diets at home were
identical to values on the HCF diets in
the hospital. On the maintenance diet,
serum cholesterol values were similar to
initial values but serum triglyceride
values were significantly lower than
values on the 43 per cent carbohydrate
diet. These studies indicate that
moderately high-carbohydrate, high-fiber
diets can be successfully followed at
home and that improvements in glucose
metabolism achieved in the hospital can
be sustained outside the hospital.
- Language of Publication
- English
- Unique Identifier
- 79085353
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full text for this document
- MeSH Heading (Major)
- Cellulose|*TU; Diabetes
Mellitus|*DH/DT/ME; Dietary
Carbohydrates|*TU; Dietary Fiber|*TU;
Glucose|*ME; Lipids|*ME
- MeSH Heading
- Adult; Blood Glucose; Follow-Up
Studies; Human; Insulin|TU; Male; Middle
Age; Sulfonylurea Compounds|TU; Support,
U.S. Gov't, P.H.S.; Time Factors;
Triglycerides|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0149-5992
- Country of Publication
- UNITED STATES
Record 29 from database: MEDLINE
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full text for this document
- Title
- Hyperparathyroidism and coexisting
diabetes mellitus. Altered carbohydrate
metabolism.
- Author
- Akgun S; Ertel NH
- Address
-
- Source
- Arch Intern Med, 1978 Oct, 138:10,
1500-2
- Abstract
- Hyperparathyroidism was diagnosed in a
67-year-old diabetic man treated for 20
years with isophane insulin suspension,
40 to 45 units/day. It was also
diagnosed in a 64-year-old diabetic with
severe retinopathy and vascular disease,
who was not dependent on insulin. In the
first case, removal of a parathyroid
adenoma resulted in frequent
hypoglycemic attacks, which led to a
reduction of the administration of
insulin isophane suspension to 20
units/day. In the second case, there was
a notable improvement in the glucose
tolerance testing that followed surgery,
accompanied by a decrease in total
plasma insulin response from 17,838 to
5,605 units, by planimetry. These
observations suggest that
hyperparathyroidism worsens coexisting
diabetes mellitus and that one must be
aware of increased insulin sensitivity
and the possibility of severe
hypoglycemia in cases that require
insulin after surgical correction of the
hypercalcemic state.
- Language of Publication
- English
- Unique Identifier
- 79040966
Order
full text for this document
- MeSH Heading (Major)
- Carbohydrates|*ME; Diabetes
Mellitus|*CO/ME; Hyperparathyroidism|*CO/ME
- MeSH Heading
- Aged; Case Report; Human;
Hypercalcemia|CO; Insulin|AD; Male;
Middle Age
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0003-9926
- Country of Publication
- UNITED STATES
Record 30 from database: MEDLINE
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full text for this document
- Title
- Effect of carbohydrate restriction and
high carbohydrates diets on men with
chemical diabetes.
- Author
- Anderson JW
- Address
-
- Source
- Am J Clin Nutr, 1977 Mar, 30:3, 402-8
- Abstract
- The influence of low carbohydrate (CHO)
diets, starvation, and high CHO diets on
glucose tolerance tests (GTT) and plasma
insulin response of men with chemical
diabetes was studied. The GTT and
insulin responses of these seven lean
diabetic men were unchanged when the
carbohydrate content of the diet was
reduced from 44 to 20% of calories.
After a 48-hr fast a significant
deterioration of the GTT was observed in
these diabetic men but the percentage
change was identical to that reported
previously for normal men. Thus these
studies indicate that changes in glucose
mtes are quite similar to those reported
previously for normal men. The fasting
plasma glucose values of seven lean and
four obese men with chemical diabetes
were significantly lower after one week
on a 75% CHO diet than values on a 44%
CHO diet. The 75% CHO diet also was
accompanied by slight improvements in
the oral and intravenous GTT and by
slightly lower plasma insulin responses.
The improvement in glucose metabolism on
high CHO diets appears to results from
increased insulin sensitivity. Serum
triglyceride values were approximately
55% higher on the 75% CHO diet than
values on the 44% CHO diet for the 11
men but these differences were not
statistically significant. These studies
support previous observations and
suggest that high CHO diets may be
beneficial in the management of certain
diabetic patients. However, further
studies are required to determine the
long-term effects of high CHO diets
containing natural foods on the glucose
and lipid metabolism of diabetic
patients.
- Language of Publication
- English
- Unique Identifier
- 77131701
Order
full text for this document
- MeSH Heading (Major)
- Dietary Carbohydrates|*; Glucose|*ME;
Obesity in Diabetes|*ME; Prediabetic
State|*ME
- MeSH Heading
- Adult; Aged; Blood Glucose|ME; Glucose
Tolerance Test; Human; Insulin|BL; Male;
Middle Age; Starvation; Triglycerides|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 31 from database: MEDLINE
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full text for this document
- Title
- Is glucose a reliable index of
carbohydrate metabolism? Report on the
joint workshop conference
"Glucose" of the German
Society for Clinical Chemistry and the
German Diabetes Society held on May
15-16, 1981 in Stuttgart, Germany.
- Author
- Guder W; Kruse Jarres JD
- Address
-
- Source
- J Clin Chem Clin Biochem, 1982 Mar,
20:3, 135-40
- Abstract
- The determination of glucose
concentration is the most frequently
used clinical laboratory test. It was
the current vehemence in discussions
about the judgement criteria for the
diagnosis and monitoring of diabetes
that motivated this discussion of
pathobiochemical and analytical aspects
in a circle of 38 experts. The
composition of the working group made it
possible to compare the needs of
clinical diabetologists and diabetics
with the analytical possibilities.
Pathobiochemistry, sampling problems,
diabetic self control, analytical
methods and their standardisation,
glucose monitoring, glucose sensors and
glycosylated proteins were the topics of
this glucose workshop.
- Language of Publication
- English
- Unique Identifier
- 82191443
Order
full text for this document
- MeSH Heading (Major)
- Blood Glucose|*AN; Carbohydrates|*ME
- MeSH Heading
- Diabetes Mellitus|BL; Fasting; Food;
Gluconeogenesis; Glucose|ME; Glucose
Oxidase; Glucosephosphate Dehydrogenase;
Hemoglobin A, Glycosylated|AN;
Hexokinase; Human; Lipoproteins|BL;
Methods; Self Care|MT; Specimen
Handling|MT; Time Factors
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0340-076X
- Country of Publication
- GERMANY, WEST
Record 32 from database: MEDLINE
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full text for this document
- Title
- Carbohydrate homeostasis in chronic
lymphocytic thyroiditis: increased
incidence of diabetes mellitus.
- Author
- Winter RJ; Green OC
- Address
-
- Source
- J Pediatr, 1976 Sep, 89:3, 401-5
- Abstract
- Twenty-one patients were seen with the
diagnosis of chronic lymphocytic
thyroiditis in the Endocrine Clinic
during 1965-1972. Three patients
developed clinical diabetes mellitus at
intervals from one month to three years
after the diagnosis of thyroiditis was
confirmed. An additional patient, a
member of the study group reported here,
had asymptomatic glucose intolerance
initially and developed
insulin-dependent diabetes mellitus six
months after the diagnosis of
thyroiditis was established. Standard
glucose tolerance tests were performed
on 12 additional patients. One of these
patients had unequivocal evidence of
chemical diabetes; one other had a
borderline abnormal oral glucose
tolerance test. The remaining ten
patients had normal glucose and insulin
values during the OGTT. These studies
indicate that children with chronic
lymphocytic thyroiditis are at increased
risk of developing diabetes mellitus
when compared with the normal childhood
population.
- Language of Publication
- English
- Unique Identifier
- 76263953
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus|BL/*EP; Thyroiditis,
Autoimmune|BL/*CO
- MeSH Heading
- Blood Glucose|AN; Child; Chronic
Disease; Glucose Tolerance Test; Human;
Illinois; Risk
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0022-3476
- Country of Publication
- UNITED STATES
Record 33 from database: MEDLINE
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full text for this document
- Title
- Effect of carbohydrate restriction on
lipoprotein abnormalities in
maturity-onset diabetes mellitus.
- Author
- Thomson JE; Scobie IN; Ballantyne F;
Smith A; Manderson WG; MacCuish AC
- Address
-
- Source
- Acta Diabetol Lat, 1980 Jan, 17:1,
33-9
- Abstract
- Hyperlipoproteinemia occurs commonly
in diabetics and may contribute to early
atherosclerosis in these patients. The
effect of dietary carbohydrate
restriction on lipid abnormalities has
been examined in 42 newly diagnosed
maturity-onset diabetics, in whom plasma
lipoproteins were measured before
treatment was started and at regular
intervals during ten months of dietary
therapy. Twenty-four patients (57%) had
abnormal lipids when diabetes was first
diagnosed. Nine were classed as Type II
and 15 as Type IV hyperlipoproteinemia.
Plasma lipids reverted to normal in half
these patients after dietary treatment
for one month. Only 8 diabetics (19%)
showed persistent lipid abnormality
after ten months' treatment: all had
been unable to diet satisfactorily as
judged by persisting obesity and
hyperglycemia. The common lipoprotein
abnormalities of maturity-onset diabetes
can usually be returned to normal by the
simplest possible
carbohydrate-restricted diet, if
patients adhere to this. Specialized and
complex diets or lipid-lowering drugs
are unncessary in the majority of
patients.
- Language of Publication
- English
- Unique Identifier
- 81018237
Order
full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus|*BL/CO; Diabetic
Diet|*; Dietary Carbohydrates|*PD;
Hyperlipoproteinemia|*BL/CO;
Lipoproteins|*BL
- MeSH Heading
- Adult; Cholesterol|BL; Human;
Lipoproteins, HDL|BL; Lipoproteins,
LDL|BL; Lipoproteins, VLDL|BL; Middle
Age; Triglycerides|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0001-5563
- Country of Publication
- ITALY
Record 34 from database: MEDLINE
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full text for this document
- 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
Order
full text for this document
- 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 35 from database: MEDLINE
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full text for this document
- Title
- Impact of increasing carbohydrate
intolerance on maternal-fetal outcomes
in 3637 women without gestational
diabetes. The Toronto Tri-Hospital
Gestational Diabetes Project.
- Author
- Sermer M; Naylor CD; Gare DJ; Kenshole
AB; Ritchie JW; Farine D; Cohen HR;
McArthur K; Holzapfel S; Biringer A; et
al
- Address
- Department of Obstetrics and
Gynecology, University of Toronto,
Ontario, Canada.
- Source
- Am J Obstet Gynecol, 1995 Jul, 173:1,
146-56
- Abstract
- OBJECTIVE: Our purpose was to assess
maternal-fetal outcomes in patients with
increasing carbohydrate intolerance not
meeting the current criteria for the
diagnosis of gestational diabetes. STUDY
DESIGN: We conducted a prospective
analytic cohort study in which
nondiabetic women aged > or = 24
years, receiving prenatal care in three
Toronto teaching hospitals, were
eligible for enrollment. A glucose
challenge test and an oral glucose
tolerance test were administered at 26
and 28 weeks' gestation, respectively;
risk factors for unfavorable
maternal-fetal outcomes were recorded.
Caregivers and patients were blinded to
glucose values except when test results
met the current criteria for gestational
diabetes. RESULTS: Of 4274 patients
screened, 3836 (90%) continued to the
diagnostic oral glucose tolerance test.
The study cohort was formed by the 3637
(95%) patients without gestational
diabetes, carrying singleton fetuses.
Increasing carbohydrate intolerance in
women without overt gestational diabetes
was associated with a significantly
increased incidence of cesarean
sections, preeclampsia, macrosomia, and
need for phototherapy, as well as an
increased length of maternal and
neonatal hospital stay. Multivariate
analysis showed that increasing
carbohydrate intolerance is an
independent predictor for various
unfavorable outcomes. CONCLUSION:
Increasing maternal carbohydrate
intolerance in pregnant women without
gestational diabetes is associated with
a graded increase in adverse
maternal-fetal outcomes.
- Language of Publication
- English
- Unique Identifier
- 95358187
Order
full text for this document
- MeSH Heading (Major)
- Glucose Intolerance|*PP; Pregnancy
Complications|*PP; Pregnancy Outcome|*
- MeSH Heading
- Adult; Blood Glucose|AN; Cesarean
Section; Cohort Studies; Female; Fetal
Macrosomia|ET; Glucose Tolerance Test;
Human; Infant, Newborn; Pre-Eclampsia|ET;
Pregnancy; Prospective Studies; Risk
Factors; Support, Non-U.S. Gov't
- Publication Type
- CLINICAL TRIAL; CONTROLLED CLINICAL
TRIAL; JOURNAL ARTICLE
- ISSN
- 0002-9378
- Country of Publication
- UNITED STATES
Record 36 from database: MEDLINE
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full text for this document
- Title
- Acute metabolic response to
high-carbohydrate, high-starch meals
compared with moderate-carbohydrate,
low-starch meals in subjects with type 2
diabetes.
- Author
- Gannon MC; Nuttall FQ; Westphal SA;
Fang S; Ercan Fang N
- Address
- Veterans Affairs Medical Center, and
the Department of Food Science and
Nutrition, University of Minnesota,
Minneapolis 55417, USA. ganno004@maroon.tc.umn.edu
- Source
- Diabetes Care, 1998 Oct, 21:10,
1619-26
- Abstract
- OBJECTIVE: The monosaccharides
resulting from the digestion of ingested
carbohydrates are glucose, fructose, and
galactose. Of these three
monosaccharides, only ingested glucose
resulted in a large increase in the
plasma glucose concentration. Fructose
(Metabolism 41:510-517, 1992) and
galactose (Metabolism 42:1560-1567,
1993) had only a minor effect.
Therefore, we were interested in
determining whether we could design a
mixed meal, using foods of known
monosaccharide, disaccharide, and starch
composition, the ingestion of which
would result in only a small rise in
plasma glucose concentration. RESEARCH
DESIGN AND METHODS: The experimental
meal was composed of very little readily
digestible starch but rather large
amounts of fruits and vegetables. It
contained 43% carbohydrate, 22% protein,
and 34% fat. The results were compared
with a second type of meal that
contained 55% carbohydrate, 15% protein,
and 30% fat, with an emphasis on complex
carbohydrates (starch). It also was
compared with a third meal that
contained 40% carbohydrate, 20% protein,
and 40% fat, typical of that consumed by
the average American. The test meals
were ingested in random order by people
with type 2 diabetes who were not
treated with oral hypoglycemic agents or
insulin. Each subject ingested each type
of meal. The same identical meal was
ingested at 0800, 1200, and 1700.
RESULTS: The integrated 24-h plasma
glucose area response was statistically
significantly smaller (P < 0.05)
after ingestion of the low-starch meals
compared with the high-starch,
high-carbohydrate meals or the typical
American meals. The 24-h integrated
serum insulin area response also was
statistically significantly less (P <
0.05) after ingestion of the low-starch
meals compared with the high-starch
meals or the typical American meals. The
serum triglyceride area response was
similar after ingestion of all three
test diets. CONCLUSIONS: A diet in which
fruits, nonstarch vegetables, and dairy
products are emphasized may be useful
for people with type 2 diabetes.
- Language of Publication
- English
- Unique Identifier
- 98444704
Order
full text for this document
- MeSH Heading (Major)
- Blood Glucose|*ME; Diabetes Mellitus,
Non-Insulin-Dependent|*BL/*DH/UR;
Dietary Carbohydrates|*; Glucagon|*BL/SE;
Insulin|*BL/SE; Starch|*
- MeSH Heading
- Aged; Blood Urea Nitrogen; Comparative
Study; Energy Intake; Fatty Acids,
Nonesterified|BL; Fructose; Galactose;
Glucose; Glycosuria; Human; Middle Age;
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
- 0149-5992
- Country of Publication
- UNITED STATES
Record 37 from database: MEDLINE
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full text for this document
- 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
Order
full text for this document
- 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 38 from database: MEDLINE
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full text for this document
- 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
Order
full text for this document
- 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 39 from database: MEDLINE
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full text for this document
- Title
- Delaying carbohydrate absorption in
noninsulin-dependent diabetes mellitus:
useful therapy?
- Author
- Füessl HS
- Address
-
- Source
- Klin Wochenschr, 1987 May, 65:9, 395-9
- Abstract
- Epidemiological and psychological
studies have revealed major difficulties
in motivating diabetic patients to
observe a long-term dietary regimen.
Therefore, manipulation of intestinal
digestion or absorption appears to be a
feasible therapeutic approach in the
management of diabetes. The addition of
natural or chemically processed fiber
has been shown to decrease both the
postprandial and fasting blood glucose
in type-2 diabetics by delaying
carbohydrate absorption. Recently,
selective enzyme inhibitors of glycoside
hydrolases in the upper intestine have
been found which create a moderate
degree of malabsorption of
carbohydrates. The postprandial blood
sugar response can be reduced by 50%.
However, both these forms of treatment
may not be accepted by patients because
of impalatability or gastrointestinal
side effects. At present only short-term
studies with each group of substances
are available. Whether the reduction of
hyperglycemia is sufficient for the
prevention of complications must be
clarified in long-term trials.
- Language of Publication
- English
- Unique Identifier
- 87255607
Order
full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*DH; Dietary
Carbohydrates|*ME; Dietary Fiber|*AD;
Intestinal Absorption|*/DE
- MeSH Heading
- Biguanides|AD; Blood Glucose|ME;
Combined Modality Therapy; Glycoside
Hydrolases|AI; Human; Hypoglycemic
Agents|AD; Obesity in Diabetes|DH;
Somatostatin|AD; Support, Non-U.S.
Gov't; Trisaccharides|AD
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0023-2173
- Country of Publication
- GERMANY, WEST
Record 40 from database: MEDLINE
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full text for this document
- 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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full text for this document
- 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 41 from database: MEDLINE
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full text for this document
- Title
- Dietary carbohydrate, a Big Mac, and
insulin requirements in type I diabetes.
- Author
- Vlachokosta FV; Piper CM; Gleason R;
Kinzel L; Kahn CR
- Address
- E.P. Joslin Research Laboratory,
Joslin Diabetes Center, Boston, MA
02215.
- Source
- Diabetes Care, 1988 Apr, 11:4, 330-6
- Abstract
- Using the artificial beta-cell (Biostator),
we determined the insulin requirements
in five nonobese type I
(insulin-dependent) diabetic subjects
who received isocaloric 40 and 60%
mixed-carbohydrate diets in a crossover
randomized fashion for 4 days, each day
consisting of four equal meals. This was
followed on day 5 by a "Big Mac
Attack" lunch consisting of a Big
Mac, french fries, and milk shake.
Insulin requirements to maintain
normoglycemia were calculated for each
24-h period and for the 2 h after each
meal. The mean 24-h insulin requirements
to maintain normoglycemia was greater
for the 60% carbohydrate diet than the
40% diet. Although the four meals were
of equal size, in all patients the
insulin required to cover breakfast
greater than lunch greater than dinner
greater than or equal to snack.
Expressed as milliunits per kilocalorie,
the amount of insulin to cover breakfast
was greater for the 60% (P less than
.05) than the 40% carbohydrate diet and
greater for breakfast than the other
meals (P less than .01). Insulin
requirements for the Big Mac (43%
carbohydrate) were 58% greater than for
the 40% carbohydrate diet, even after
correction for caloric differences. In
summary, 1) increasing dietary
carbohydrate from 40 to 60% results in
an increased insulin requirement for
meals only; 2) insulin requirements are
greater in the morning than in the
evening, even when meal size is
constant; and 3) very large meals with
high fat and carbohydrate content result
in a major increase in insulin
requirement. These data indicate that
diet has an important impact on insulin
requirements in diabetes.
- Language of Publication
- English
- Unique Identifier
- 88296046
Order
full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus,
Insulin-Dependent|*BL/DT; Diet|*;
Dietary Carbohydrates|*; Insulin
Infusion Systems|*
- MeSH Heading
- Adult; Blood Glucose|ME; Clinical
Trials; Comparative Study; Energy
Intake; Female; Human; Insulin|BL; Male;
Middle Age; Random Allocation; Support,
Non-U.S. Gov't; 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 42 from database: MEDLINE
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full text for this document
- Title
- Nutritional risk of high-carbohydrate,
guar gum dietary supplementation in
non-insulin-dependent diabetes mellitus.
- Author
- Van Duyn MA; Leo TA; McIvor ME; Behall
KM; Michnowski JE; Mendeloff AI
- Address
-
- Source
- Diabetes Care, 1986 Sep, 9:5, 497-503
- Abstract
- Dietary supplementation with
high-carbohydrate, guar gum fiber (HCF)
is effective in acutely blunting
postprandial blood glucose levels. We
report the effect of such
supplementation on the diet and
nutritional status of a group of 16
subjects with non-insulin-dependent
diabetes mellitus (NIDDM) who
incorporated either HCF bars (35.7 g
carbohydrate and 6.6 g guar gum/bar) or
placebo bars (identical except for the
absence of guar gum) into the diet for 6
mo as part of a double-blind, randomized
clinical trial. The HCF subjects
achieved mean daily intake of 4.8 +/-
0.4 bars, constituting 51.2 +/- 3.1% of
total calories and providing 29.7 +/-
2.6 g guar gum daily. Energy intakes and
body weight did not change significantly
in either group. Food consumption
patterns and nutrient intakes did
change, although not enough to impair
the nutritional integrity of the diet
because the bars themselves served as a
source of nutrients. The bars were rich
in thiamin, B6, folacin, phosphorus,
iron, zinc, and copper, adequately
replacing any decrease in nutrient
intake as a result of foods being
dropped from the diet. In fact, daily
intakes of B6, folacin, and copper
actually increased due to contributions
from the bars. Nutrients in which the
bars were poor (vitamins A, C and B12)
resulted in suboptimal intakes (less
than 66% RDA). Although no significant
change in nutritional status of the HCF
group occurred as determined by arm
muscle area, arm fat area, hemoglobin,
hematocrit, or serum albumin,
transferrin, iron, ferritin, calcium,
phosphate, B12, and magnesium levels,
these indicators of nutritional status
are rather insensitive.(ABSTRACT
TRUNCATED AT 250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 87029783
Order
full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*DH; Dietary
Carbohydrates|*; Dietary Fiber|*; Food,
Fortified|*; Galactans|*; Mannans|*;
Obesity in Diabetes|*DH
- MeSH Heading
- Clinical Trials; Comparative Study;
Energy Intake; Human; Nutritional
Status; Risk; Support, Non-U.S. Gov't;
Support, U.S. Gov't, Non-P.H.S.
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0149-5992
- Country of Publication
- UNITED STATES
Record 43 from database: MEDLINE
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full text for this document
- Title
- A prospective comparison of
'conventional' and high
carbohydrate/high fibre/low fat diets in
adults with established type 1
(insulin-dependent) diabetes.
- Author
- McCulloch DK; Mitchell RD; Ambler J;
Tattersall RB
- Address
-
- Source
- Diabetologia, 1985 Apr, 28:4, 208-12
- Abstract
- Diabetic associations throughout the
world are recommending high
carbohydrate/high fibre/low fat diets
for diabetic patients as a means of
improving general health and metabolic
control. We have previously shown that
the efficacy of a 'conventional' low
carbohydrate diet can be greatly
increased by improving the method of
dietary education. To test whether
further improvement in metabolic control
could be achieved by changing to a high
carbohydrate/high fibre/low fat diet we
have followed a group of 40 Type 1
(insulin dependent) diabetic adults for
up to 19 months. They had all been
prescribed a conventional low
carbohydrate diet taught by one of three
methods (dietician only, practical
lunchtime demonstration or videotape).
Those taught by dietician only were left
as a control group for follow-up (group
A). The others were randomized either to
continue on their present diet (group B)
or to change to a high carbohydrate/high
fibre/low fat diet (group C). At final
assessment those in groups B and C were
more knowledgeable, compliant and better
controlled than group A. Those in group
C achieved a change from 38%
carbohydrate/43% fat/20 g fibre daily to
45% carbohydrate/34% fat/32 g fibre
daily. However, metabolic control in
group C deteriorated while taking the
high carbohydrate/high fibre/low fat
diet (haemoglobin A1 went from 9.4 +/-
0.5% to 11.2 +/- 0.5%, p less than 0.01,
over 4 months). None of the patients in
group C changed their eating habits or
those of their families nearly as much
as was recommended.(ABSTRACT TRUNCATED
AT 250 WORDS)
- Language of Publication
- English
- Unique Identifier
- 85258709
Order
full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus, Insulin-Dependent|BL/*DH;
Diabetic Diet|*; Dietary
Carbohydrates|*AD; Dietary Fats|*AD;
Dietary Fiber|*AD
- MeSH Heading
- Adolescence; Adult; Comparative Study;
Energy Intake; Female; Hemoglobin A,
Glycosylated|ME; Human; Male; Middle
Age; Patient Compliance; Patient
Education; Prospective Studies; Support,
Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0012-186X
- Country of Publication
- GERMANY, WEST
Record 44 from database: MEDLINE
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full text for this document
- Title
- The effects of subject-selected high
carbohydrate, low fat diets on glycemic
control in insulin dependent diabetes
mellitus.
- Author
- Hollenbeck CB; Riddle MC; Connor WE;
Leklem JE
- Address
-
- Source
- Am J Clin Nutr, 1985 Feb, 41:2, 293-8
- Abstract
- In the present study, six women with
insulin dependent diabetes mellitus (IDDM)
were assigned to begin either a control
diet containing 45% of the calories as
carbohydrate, 40% fat, and 15% protein
for four weeks, or a high carbohydrate,
low fat diet with 65% carbohydrate, 20%
fat, and 15% protein for six weeks. All
subjects completed both periods in a
cross-over experimental design.
Individual menus varied, and were
subject-selected from a calculated
exchange list consisting of conventional
food items. Subjects selected an equal
distribution of carbohydrate from simple
and complex sources during both dietary
periods, and dietary fiber intake was
only modestly greater during the high
carbohydrate diet (50 g) than in the
control diet period (28 g). No
significant changes occurred in any
measures of glycemic control between the
control and high carbohydrates diets;
fasting serum glucose 215 vs 213 mg/100
ml; preprandial serum glucose 214 vs 200
mg/100 ml; 24 hour urine glucose 36 vs
31 g/day; and glycosylated hemoglobin
10.3 vs 10.5% Hb A1, respectively.
Similarly, insulin dose was unchanged
during the control (38 IU/day) and
experimental (38 IU/day) periods. These
findings indicate that the application
of present dietary recommendations to
persons with IDDM in a realistic
clinical setting led to neither an
improvement nor a deterioration of
glycemic control.
- Language of Publication
- English
- Unique Identifier
- 85119118
Order
full text for this document
- MeSH Heading (Major)
- Blood Glucose|*ME; Diabetes Mellitus,
Insulin-Dependent|BL/*DH; Dietary
Carbohydrates|*AD; Dietary Fats|*AD
- MeSH Heading
- Adult; Dietary Proteins|AD; Energy
Intake; Female; Glycosuria; Hemoglobin
A, Glycosylated|ME; Human; Insulin|AD;
Support, Non-U.S. Gov't; Support, U.S.
Gov't, P.H.S.
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-9165
- Country of Publication
- UNITED STATES
Record 45 from database: MEDLINE
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full text for this document
- 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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full text for this document
- 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 46 from database: MEDLINE
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full text for this document
- Title
- Characteristics that enhance adherence
to high-carbohydrate/high-fiber diets by
persons with diabetes.
- Author
- Kouris A; Wahlqvist ML; Worsley A
- Address
- Department of Human Nutrition, Deakin
University, Geelong, Victoria,
Australia.
- Source
- J Am Diet Assoc, 1988 Nov, 88:11,
1422-5
- Abstract
- This study sought to characterize 40
clients with diabetes, 19 of whom
adhered to a high-carbohydrate/fiber
diet and 21 of whom did not, in
accordance with the adherence pattern.
There would seem to be distinct
differences in the characteristics of
adherers and non-adherers. Dietary
adherence was found to be independent
for sex, age, occupation, marital
status, ethnicity, and education.
However, comparison of the groups'
health and dietary perceptions showed
that non-adherers, as opposed to
adherers, were not concerned about
reaching their ideal body weight; needed
to be motivated to exercise by family or
friends; did not perceive diabetes as a
threat to their health; were not
satisfied with their knowledge about
diabetes; were not content with their
nutrient status but believed they were
consuming adequate amounts of
carbohydrate; and believed that they did
not need to change their intake of
fruit, vegetables, and
bread--liking/disliking of these foods
being the most important barrier to
dietary change. Such patients,
identified in screening for potential
dietary non-adherence, may benefit from
the use of educational strategies
different from those used with patients
who are more oriented toward health.
- Language of Publication
- English
- Unique Identifier
- 89035235
Order
full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus|*DH; Dietary
Carbohydrates|AD/*TU; Dietary Fiber|AD/*TU;
Patient Compliance|*
- MeSH Heading
- Adult; Aged; Aged, 80 and over;
Attitude to Health; Body Weight;
Exercise; Human; Middle Age; Patient
Education; Questionnaires; Smoking|PC
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0002-8223
- Country of Publication
- UNITED STATES
Record 47 from database: MEDLINE
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full text for this document
- Title
- Ketoacidosis and hyperosmolarity as
first symptoms of type 1 diabetes
mellitus following ingestion of
high-carbohydrate-containing fluids.
- Author
- Vanelli M; Chiari G; Ghizzoni L;
Capuano C; Bonetti L; Costi G; Giacalone
T; Chiarelli F
- Address
- Department of Pediatric, Diabetes
Regional Unit, University of Parma,
Italy.
- Source
- J Pediatr Endocrinol Metab, 1999, 12:5
Suppl 2, 691-4
- Abstract
- The concomitant occurrence of diabetic
ketoacidosis and hyperosmolarity is
reported in two children, as early
symptoms of misdiagnosed type 1 diabetes
mellitus. The precipitating factor for
both severe metabolic abnormalities was
the ingestion of a large amount of
high-carbohydrate-containing fluids, a
few days before admission. A similar
situation has never been reported before
in the literature. A successful
therapeutic scheme is described.
- Language of Publication
- English
- Unique Identifier
- 20311263
Order
full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus,
Insulin-Dependent|*PP; Diabetic
Ketoacidosis|*PP; Dietary
Carbohydrates|AD/*AE
- MeSH Heading
- Case Report; Child; Human; Male;
Osmolar Concentration
- Publication Type
- JOURNAL ARTICLE
- Country of Publication
- ENGLAND
Record 48 from database: MEDLINE
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full text for this document
- 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
Order
full text for this document
- 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 49 from database: MEDLINE
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- Title
- High-carbohydrate and fibre diets in
the treatment of diabetes.
- Author
- Hockaday TD
- Address
-
- Source
- Scand J Gastroenterol Suppl, 1987,
129:, 124-31
- Abstract
- After Kinsell and collaborators (1970)
demonstrated a smaller glycaemic rise in
diabetic subjects given larger rather
than smaller nutrient loads (because of
the more complicated composition of the
intakes) notions that one can usefully
prescribe diabetic diets from crude
chemical composition of foods 'on the
shelf' have been abandoned, with greater
consideration of the varied
gastro-intestinal handling of foods, how
they are changed by cooking, etc., the
way different food interact within the
gastro-intestinal tract, and the
importance of specific chemical
constitution, both of the classical
nutrients as well as fibre contents. In
practice, high-carbohydrate diets are
usually entwined with high-fibre intake.
Apart from the observations on the
practicability of high-carbohydrate
diets in obtaining successful glycaemic
control of diabetics outside the 'First
World', doubts were voiced in the late
1920s concerning the wisdom of the
high-fat intake accompanying
low-carbohydrate diets. In the next
decade Himsworth showed in normal
subjects that high-carbohydrate intake
improved glucose tolerance, and this has
been repeated in Seattle. Data
concerning complete meals or, much
better, dietary regimes persisted with
over long periods of time are more
relevant than those from single intakes
of liquid homogenates. We present
observations on 6-week intakes of
particular dietary regimes (in
free-living patients) from which the
main conclusions would seem: a
high-carbohydrate intake does no harm to
glycaemic control in diabetics,
providing it is predominantly of
polysaccharides; a high-fibre intake has
various beneficial effects, and in
particular high viscous fibre intake
reduces post-prandial
glycaemia.(ABSTRACT TRUNCATED AT 250
WORDS)
- Language of Publication
- English
- Unique Identifier
- 87319514
Order
full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus|BL/*DH; Diabetic
Diet|*; Dietary Carbohydrates|*AD;
Dietary Fiber|*AD
- MeSH Heading
- Blood Glucose|ME; Human; Insulin|BL
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0085-5928
- Country of Publication
- NORWAY
Record 50 from database: MEDLINE
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- Title
- Outpatient management of diabetes
mellitus with patient education to
increase dietary carbohydrate and fiber.
- Author
- Stevens J; Burgess MB; Kaiser DL;
Sheppa CM
- Address
-
- Source
- Diabetes Care, 1985 Jul, 8:4, 359-66
- Abstract
- The impact of patient education on
dietary fiber intake, diabetes control,
and serum lipids was examined in
patients with non-insulin-dependent
diabetes mellitus. Customary outpatient
personnel and procedures were used to
teach three diet plans: the American
Diabetes Association (ADA) diet, the ADA
diet modified to increase high-fiber,
high-carbohydrate foods (IF), and the IF
diet supplemented with oat bran (IFOB).
A control group was instructed on foot
care to provide teaching visits.
Fifty-two patients were recruited from
an outpatient clinic and studied over a
6-wk period. Subjects were of low
socioeconomic status and had completed a
mean of 8.3 yr of education. Patients
instructed to increase their intake of
high-fiber foods reported a doubling of
fiber intake and tolerated the diets
well. Increased fiber and carbohydrate
intake and decreased fat intake were
associated with reductions in fasting
plasma glucose levels. Increased fiber
intake was also associated with
reductions in total serum cholesterol
and high-density lipoprotein cholesterol
levels. Changes in fiber, carbohydrate,
and fat intake were unrelated to changes
in weight, serum insulin levels, or
hemoglobin A1c levels over the study
period.
- Language of Publication
- English
- Unique Identifier
- 86004021
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|BL/*DH;
Dietary Carbohydrates|*AD; Dietary
Fiber|*AD; Patient Education|*
- MeSH Heading
- Adult; Aged; Ambulatory Care; Blood
Glucose|ME; Cholesterol|BL; Diabetic
Diet; Female; Hemoglobin A,
Glycosylated|ME; Human; Male; Middle
Age; Patient Compliance; Support,
Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0149-5992
- Country of Publication
- UNITED STATES
Record 51 from database: MEDLINE
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full text for this document
- Title
- Serum trehalase activities in
controlled and uncontrolled diabetes and
the impact of oral glucose, high
carbohydrate and glycosuria on serum
levels.
- Author
- Isichei UP; Gorecki T
- Address
- Department of Clinical Chemical
Pathology, Faculty of Medical Sciences,
University of Jos.
- Source
- Afr J Med Med Sci, 1993 Jun, 22:2,
5-11
- Abstract
- Nineteen healthy volunteers, made up
of two groups were subjected to an
extended oral glucose tolerance study.
In one group, each had 50g glucose and
in the other a high carbohydrate meal.
Blood glucose and serum trehalase
activities were determined on fasting
blood samples and specimens collected
half-hourly for 4 hours. The values
obtained for both at each stage of the
investigations were compared with one
another. Correlation coefficient (r)
between blood glucose and serum
trehalase were 0.4923 for the fasting
samples and 0.4762 at 1 hr. The impact
of diabetes and glycosuria on serum
trehalase activities in 50 diabetics
consisting of treated (controlled) and
untreated (uncontrolled) cases was also
studied. Our study reveals a slight fall
in serum trehalase values from the
initial fasting level, but thereafter a
gradual and progressive rise during the
course of the glucose tolerance
investigations. Serum trehalase values
were higher in diabetics compared to
normal subjects (t = 7.0168, P = 0.005).
Diabetics with glycosuria had a
significantly higher mean serum
trehalase compared to the controlled
group (t = 5.233, P = 0.005). High serum
trehalase values were seen in diabetics
with renal glycosuria at comparatively
low levels of blood glucose. The
significance of these findings is
discussed in relation to the possible
place of serum trehalase assay in the
management of diabetes, especially when
this is made difficult by renal
glycosuria.
- Language of Publication
- English
- Unique Identifier
- 95141867
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus|BL/CO/*EN/*TH;
Dietary Carbohydrates|*PD; Glucose|*PD;
Trehalase|*BL
- MeSH Heading
- Administration, Oral; Blood Glucose|AN;
Fasting; Glucose Tolerance Test;
Glycosuria|ET/UR; Human
- Publication Type
- CLINICAL TRIAL; CONTROLLED CLINICAL
TRIAL; JOURNAL ARTICLE; REVIEW; REVIEW
LITERATURE
- ISSN
- 0309-3913
- Country of Publication
- NIGERIA
Record 52 from database: MEDLINE
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full text for this document
- 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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full text for this document
- 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 53 from database: MEDLINE
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full text for this document
- Title
- Ketoacidosis and hyperosmolarity as
first symptoms of type 1 diabetes
mellitus following ingestion of
high-carbohydrate-containing fluids.
- Author
- Vanelli M; Chiari G; Ghizzoni L;
Capuano C; Bonetti L; Costi G; Giacalone
T; Chiarelli F
- Address
- Department of Pediatrics, University
of Parma, Italy.
- Source
- J Pediatr Endocrinol Metab, 1999 Sep,
12:5, 691-4
- Abstract
- The concomitant occurrence of diabetic
ketoacidosis and hyperosmolarity is
reported in two children, as early
symptoms of misdiagnosed type 1 diabetes
mellitus. The precipitating factor for
both severe metabolic abnormalities was
the ingestion of a large amount of
high-carbohydrate-containing fluids, a
few days before admission. A similar
situation has never been reported before
in the literature. A successful
therapeutic scheme is described.
- Language of Publication
- English
- Unique Identifier
- 20168189
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full text for this document
- MeSH Heading (Major)
- Carbohydrates|*DU; Diabetes Mellitus,
Insulin-Dependent|*DI/TH; Diabetic
Ketoacidosis|CI/*ME/TH;
Water-Electrolyte Imbalance|CI/*ME/TH
- MeSH Heading
- Blood Glucose|ME; Case Report; Child;
Fluid Therapy; Human; Hypoglycemic
Agents|AD/TU; Insulin|AD/TU; Insulin
Infusion Systems; Male; Solutions
- Publication Type
- JOURNAL ARTICLE
- Country of Publication
- ENGLAND
Record 54 from database: MEDLINE
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full text for this document
- Title
- Prescribed versus unrestricted
carbohydrate diets in children with type
1 diabetes.
- Author
- Price KJ; Lang JD; Eiser C; Tripp JH
- Address
- Department of Child Health,
Postgraduate Medical School, University
of Exeter, UK.
- Source
- Diabet Med, 1993 Dec, 10:10, 962-7
- Abstract
- The diets of 53 children over 8 years
of age with diabetes mellitus were
examined by 24 h recall. Thirty-seven
had been on prescribed carbohydrate
diets while 16 had been on an
unrestricted carbohydrate diet since
diagnosis. The mean intakes of energy
(prescribed 9.1 MJ, unrestricted 9.0 MJ,
p = 0.66), carbohydrate (prescribed 259
g, unrestricted 251 g, p = 0.64), fat
(prescribed 99.8 g, unrestricted 98.2 g,
p = 0.84) and fibre (prescribed 29.2 g,
unrestricted 31.0 g, p = 0.42) were not
significantly different between the two
groups. Both groups showed similar
distribution of carbohydrate through the
day and considerable day to day
variation in their carbohydrate intake
(coefficient of variation, prescribed
14.5%, unrestricted 14.1%, p = 0.87).
Those on prescribed diet had a mean
carbohydrate intake which exceeded their
prescription by 36%. Both groups had
above average fibre intake suggesting
that qualitative advice was being
followed. There were no significant
differences between the two groups in
metabolic control (HbA1 prescribed
12.4%, unrestricted 11.9%, p = 0.23),
body mass index (prescribed 19.8 kg m-2,
unrestricted 20.4 kg m-2) or insulin
dosage (prescribed 1 unit kg-1 day-1,
unrestricted 0.9 units kg-1 day-1). This
study has shown no differences between
prescribed and unrestricted carbohydrate
diets. Qualitative, rather than
quantitative advice may be more
appropriate in the management of Type 1
diabetic children.
- Language of Publication
- English
- Unique Identifier
- 94139225
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus, Insulin-Dependent|BL/*DH/DT;
Diabetic Diet|*; Dietary Carbohydrates|*
- MeSH Heading
- Adolescence; Age Factors; Body Mass
Index; Child; Comparative Study; Dietary
Fiber; Female; Hemoglobin A,
Glycosylated|AN; Human; Insulin|TU;
Male; Patient Education; Sex Factors;
Support, Non-U.S. Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0742-3071
- Country of Publication
- ENGLAND
Record 55 from database: MEDLINE
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- Title
- Alcohol-associated diabetes mellitus.
A review of the impact of alcohol
consumption on carbohydrate metabolism.
- Author
- Greenhouse L; Lardinois CK
- Address
- Ioannis A. Lougaris Veterans Affairs
Medical Center, Reno, USA.
- Source
- Arch Fam Med, 1996 Apr, 5:4, 229-33
- Abstract
- Most cases of diabetes mellitus result
from decreased insulin secretion (type
I, insulin-dependent) or altered insulin
action (type II, insulin-independent).
Another category, namely,
"other" diabetes
mellitus-associated conditions, is
usually mentioned to distinguish this
type of diabetes from the other two
categories; this category includes
drugs, genetic and endocrine syndromes,
and pancreatic disorders. The most
common pancreatic disease that causes
diabetes mellitus is chronic
pancreatitis that results from alcohol
abuse. The clinical observation of
patients at our institution with long
histories of heavy alcohol intake and
diabetes mellitus prompted us to review
the impact of alcohol on carbohydrate
metabolism. In many of these patients,
it was notable that they were not obese
and they had no immediate family members
with diabetes mellitus, raising the
possibility that alcohol-associated
diabetes mellitus may be a distinct
subset of non-insulin-dependent diabetes
mellitus that is distinct from type II
diabetes mellitus.
- Language of Publication
- English
- Unique Identifier
- 96365735
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full text for this document
- MeSH Heading (Major)
- Alcoholism|*CO; Carbohydrates|*ME;
Diabetes Mellitus,
Non-Insulin-Dependent|*ET; Pancreatitis|*ET
- MeSH Heading
- Blood Glucose|ME; Case Report; Disease
Susceptibility|GE; Human; Insulin|SE;
Male; Middle Age; Pancreas|PP; Time
Factors
- Publication Type
- JOURNAL ARTICLE; REVIEW; REVIEW,
TUTORIAL
- ISSN
- 1063-3987
- Country of Publication
- UNITED STATES
Record 56 from database: MEDLINE
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full text for this document
- Title
- Effects of vanadyl sulfate on
carbohydrate and lipid metabolism in
patients with non-insulin-dependent
diabetes mellitus.
- Author
- Boden G; Chen X; Ruiz J; van Rossum GD;
Turco S
- Address
- Division of
Endocrinology/Diabetes/Metabolism and
the General Clinical Research Center,
Temple University Schools of Medicine
and Pharmacy, Philadelphia, PA, USA.
- Source
- Metabolism, 1996 Sep, 45:9, 1130-5
- Abstract
- The safety and efficacy of vanadyl
sulfate (VS) was tested in a
single-blind, placebo-controlled study.
Eight patients (four men and four women)
with non-insulin-dependent diabetes
mellitus (NIDDM) received VS (50 mg
twice daily orally) for 4 weeks. Six of
these patients (four men and two women)
continued in the study and were given a
placebo for an additional 4 weeks.
Euglycemic-hyperinsulinemic clamps were
performed before and after the VS and
placebo phases. VS was associated with
gastrointestinal side effects in six of
eight patients during the first week,
but was well tolerated after that. VS
administration was associated with a 20%
decrease in fasting glucose
concentration (from 9.3 +/- 1.8 to 7.4
+/- 1.4 mmol/L, P < .05) and a
decrease in hepatic glucose output (HGO)
during hyperinsulinemia (from 5.0 +/-
1.0 pre-VS to 3.1 +/- 0.9 micromol/kg x
min post-VS, P < .02). The
improvement in fasting plasma glucose
and HGO that occurred during VS
treatment was maintained during the
placebo phase. VS had no significant
effects on rates of total-body glucose
uptake, glycogen synthesis, glycolysis,
carbohydrate (CHO) oxidation, or
lipolysis during
euglycemic-hyperinsulinemic clamps. We
conclude that VS at the dose used was
well tolerated and resulted in modest
reductions of fasting plasma glucose and
hepatic insulin resistance. However, the
safety of larger doses and use of
vanadium salts for longer periods
remains uncertain.
- Language of Publication
- English
- Unique Identifier
- 96374919
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full text for this document
- MeSH Heading (Major)
- Carbohydrates|*BL; Diabetes Mellitus,
Non-Insulin-Dependent|*BL; Hypoglycemic
Agents|AE/*TU; Lipids|*BL; Vanadium
Compounds|AE/*TU
- MeSH Heading
- Blood Glucose|AN; Female; Glucose
Clamp Technique; Human; Insulin|BL/ME;
Male; Middle Age; Placebos; Support,
Non-U.S. Gov't
- Publication Type
- CLINICAL TRIAL; CONTROLLED CLINICAL
TRIAL; JOURNAL ARTICLE
- ISSN
- 0026-0495
- Country of Publication
- UNITED STATES
Record 57 from database: MEDLINE
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- Title
- Large variations of sucrose in
constant carbohydrate diets in type II
diabetes.
- Author
- Abraira C; Derler J
- Address
- Medical Service, Hines Veterans
Administration Hospital, Illinois 60141.
- Source
- Am J Med, 1988 Feb, 84:2, 193-200
- Abstract
- Several studies show that sucrose does
not aggravate hyperglycemia in type II
diabetes mellitus, but sucrose is still
restricted in dietary recommendations.
Since sucrose in high carbohydrate diets
elevates fasting triglyceride levels,
the effects of sucrose were evaluated in
diets with fixed carbohydrate levels.
Eighteen diabetic volunteers receiving
no medication were given weight
maintenance diets with 50 percent
carbohydrate, 35 percent fat, 15 percent
protein, and 120 g of sucrose for 10
days as inpatients. They were then
randomly assigned diets of similar
composition with either 220 g of sucrose
(high sucrose diet) or less than 3 g of
sucrose daily (complex carbohydrate [CHO]
diet) for one additional month. There
were no differences in fasting, one-,
two-, and three-hour post-lunch serum
glucose levels; 24-hour glycosuria;
glycohemoglobin levels; fasting and
postprandial serum triglyceride levels,
or fasting high-density
lipoprotein-cholesterol levels. Twelve
patients with preexisting higher
triglyceridemia had similar trends, but
the postprandial triglyceride levels
were lower in the high sucrose diet
group of this subset (p less than 0.05
in the third week). Postprandial serum
insulin levels declined in the second
week on the complex CHO diet. More than
75-fold difference in sucrose intake
with constant carbohydrate and fat did
not affect glycemic or triglyceridemic
control in type II diabetic patients.
The reported high
sucrose-carbohydrate-induced rise in
fasting triglyceridemia was not present
when a diet high in sucrose was given
without changing total carbohydrate.
- Language of Publication
- English
- Unique Identifier
- 88307372
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus, Non-Insulin-Dependent|BL/*DH;
Diabetic Diet|*; Dietary
Carbohydrates|*AD; Sucrose|*AD
- MeSH Heading
- Blood Glucose|AN; Cholesterol|BL;
Comparative Study; Female; Human;
Insulin|BL; Male; Random Allocation;
Support, Non-U.S. Gov't; Support, U.S.
Gov't, Non-P.H.S.; Triglycerides|BL
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0002-9343
- Country of Publication
- UNITED STATES
Record 58 from database: MEDLINE
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full text for this document
- Title
- Carbohydrate digestion and release of
pancreatic polypeptide in health and
diabetes mellitus.
- Author
- Layer P; Go VL; DiMagno EP
- Address
- Division of Gastroenterology, Mayo
Clinic, Rochester, MN.
- Source
- Gut, 1989 Sep, 30:9, 1279-84
- Abstract
- The effects of meal volume and luminal
digestion of carbohydrates on the
release of pancreatic polypeptide (HPP)
were investigated in eight healthy
subjects and in six patients who had
non-insulin dependent diabetes mellitus.
On one occasion each subject ingested a
placebo with 200 ml water and a starch
(50 g) pudding meal (400 ml) 30 minutes
later. On another occasion an amylase
inhibitor that retards intraluminal
starch digestion was given with the
water and starch. In normal subjects,
water caused a moderate rise in HPP
plasma levels (16.9 (10.9) pg/ml; p less
than 0.02) and ingestion of starch
increased HPP in a double peaked
pattern. The mean increments of the
peaks were 45.0 (15.2) pg/ml (p less
than 0.02) and 41.1 (17.3) pg/ml (p less
than 0.05), respectively. In the
diabetic subjects, the HPP
concentrations did not increase in
response to water. After ingestion of
starch the diabetics had two peaks of
HPP that were similar in magnitude, but
the early postprandial peak was delayed
significantly compared to normal
subjects (37.5 (5.1) min v 23.4 (3.9)
min; p less than 0.05). The amylase
inhibitor (5 or 10 g) reduced the early
postprandial HPP peak by 79% (p less
than 0.05) in normal subjects and 4 g of
the inhibitor reduced the early HPP peak
by 58% (p less than 0.05) in the
diabetics. In both groups ingestion of
the amylase inhibitor abolished the late
HPP peak (p less than 0.05). In
conclusion, carbohydrate induced HPP
release is dependent on undisturbed
intraluminal starch digestion.
- Language of Publication
- English
- Unique Identifier
- 90034348
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*ME; Dietary
Carbohydrates|*ME; Pancreatic
Polypeptide|*ME
- MeSH Heading
- Adult; Aged; Amylases|AI; Digestion;
Human; Male; Middle Age; Reference
Values; Starch|ME; Support, Non-U.S.
Gov't; Support, U.S. Gov't, P.H.S.
- Publication Type
- CLINICAL TRIAL; CONTROLLED CLINICAL
TRIAL; JOURNAL ARTICLE
- ISSN
- 0017-5749
- Country of Publication
- ENGLAND
Record 59 from database: MEDLINE
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- Title
- Carbohydrate metabolism in gestational
diabetes: effect of chronic
hypertension.
- Author
- Caruso A; Ferrazzani S; De Carolis S;
Lucchese A; Lanzone A; Paradisi G
- Address
- Department of Obstetrics and
Gynecology, Catholic University, Rome,
Italy.
- Source
- Obstet Gynecol, 1999 Oct, 94:4, 556-61
- Abstract
- OBJECTIVE: To evaluate whether the
coexistence of chronic hypertension and
gestational diabetes mellitus (GDM) is
characterized by a greater impairment of
carbohydrate metabolism than GDM alone.
METHODS: Carbohydrate metabolism of
eight women with chronic hypertensive
GDM and 15 normotensive women with GDM
was evaluated in the third trimester
using the oral glucose tolerance test (GTT)
and hyperinsulinemic-euglycemic clamp
technique. Controls were ten
normotensive, glucose-tolerant, pregnant
women in the third trimester. RESULTS:
Insulin sensitivity of women with
chronic hypertension and GDM was
approximately twofold lower than those
with GDM only (1.54+/-0.35 versus
4.15+/-0.31, P < .001) and
approximately fivefold lower than
controls (1.54+/-0.35 versus
7.65+/-0.66, P < .001). Women with
chronic hypertension and concomitant GDM
had higher insulin levels in response to
GTT than controls (P < .001 repeated
measures analysis of variance). In all
subjects, mean arterial pressure (MAP)
had a strong negative correlation with
maternal insulin sensitivity (r = -0.62,
P < .001). Significant correlation
was also found between percent of body
fat and insulin sensitivity (r = -0.53,
P < .002). Those regressions were
still significant when adjusted for
percent of body fat and MAP. CONCLUSION:
Gravidas with chronic hypertension and
GDM are more insulin resistant than
those with GDM alone. Blood pressure, in
a population of pregnant women with
normal and abnormal carbohydrate
metabolism, is a stronger predictor of
insulin resistance than adiposity.
- Language of Publication
- English
- Unique Identifier
- 99439376
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full text for this document
- MeSH Heading (Major)
- Carbohydrates|*ME; Diabetes,
Gestational|*ME; Hypertension|*ME;
Pregnancy Complications,
Cardiovascular|*ME
- MeSH Heading
- Adult; Chronic Disease; Female; Human;
Insulin|BL; Pregnancy; Support, Non-U.S.
Gov't
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0029-7844
- Country of Publication
- UNITED STATES
Record 60 from database: MEDLINE
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- Title
- Effect of a purified amylase inhibitor
on carbohydrate tolerance in normal
subjects and patients with diabetes
mellitus.
- Author
- Layer P; Rizza RA; Zinsmeister AR;
Carlson GL; DiMagno EP
- Address
-
- Source
- Mayo Clin Proc, 1986 Jun, 61:6, 442-7
- Abstract
- Slowing starch digestion by inhibiting
amylase activity in the intestinal lumen
should improve postprandial carbohydrate
tolerance in patients with diabetes
mellitus. Crude bean-derived amylase
inhibitor ("starch blocker")
that contains only minimal antiamylase
activity, however, does not modify
carbohydrate assimilation. To test the
validity of the "starch
blockade" concept, we assessed the
effect of a partially purified
bean-derived amylase inhibitor with
increased antiamylase activity on
carbohydrate tolerance in normal
subjects and in patients with
non-insulin-dependent diabetes mellitus.
In comparison with a placebo, ingestion
of this inhibitor with 50 g of starch
substantially reduced postprandial
increases in plasma concentrations of
glucose and insulin in both normal
subjects and those with diabetes. We
conclude that a purified amylase
inhibitor is effective and potentially
beneficial in the treatment of diabetes
mellitus.
- Language of Publication
- English
- Unique Identifier
- 86229262
Order
full text for this document
- MeSH Heading (Major)
- Amylases|*AI; Blood Glucose|*AN;
Diabetes Mellitus, Non-Insulin-Dependent|BL/*ME/TH;
Dietary Carbohydrates|*ME
- MeSH Heading
- Adult; Breath Tests; C-Peptide|AN;
Female; Human; Hydrogen|AN; Insulin|BL;
Intestinal Absorption; Lactulose|ME;
Male; Middle Age; Starch|ME; Support,
Non-U.S. Gov't; Support, U.S. Gov't,
P.H.S.
- Publication Type
- CLINICAL TRIAL; CONTROLLED CLINICAL
TRIAL; JOURNAL ARTICLE
- ISSN
- 0025-6196
- Country of Publication
- UNITED STATES
Record 61 from database: MEDLINE
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- Title
- Use of a plastic insulin dosage guide
to correct blood glucose levels out of
the target range and for carbohydrate
counting in subjects with type 1
diabetes.
- Author
- Kaufman FR; Halvorson M; Carpenter S
- Address
- Childrens Hospital Los Angeles,
Department of Pediatrics, University of
Southern California, School of Medicine,
California, USA. fkaufman@chla.usc.edu.
- Source
- Diabetes Care, 1999 Aug, 22:8, 1252-7
- Abstract
- OBJECTIVE: To improve glycemic
control, a hand-held plastic Insulin
Dosage Guide was developed to correct
blood glucose levels outside of the
target range. RESEARCH DESIGN AND
METHODS: Protocol 1: Some 40 children
(mean age 10.6+/-4.6 years) were
randomly assigned for 3 months to use a
written-on-paper algorithm or the
Insulin Dosage Guide to correct abnormal
blood glucose levels. Mean HbA1c and
blood glucose levels and time to teach
insulin dosage correction were compared.
Protocol 2: The Insulin Dosage Guide was
used by 83 subjects (mean age 11.4+/-4.3
years) for 1 year, and mean HbA1c
levels, blood glucose levels, and number
of consecutive high blood glucose values
taken before and after the year were
compared. Protocol 3: Some 20 patients
(mean age 10.1+/-3.7 years) using
rapid-acting insulin and 64 patients
(mean age 15.9+/-3.6 years) using an
insulin pump and rapid-acting insulin
used the Insulin Dosage Guide and had
mean blood glucose levels, HbA1c, and
percentage of blood glucose levels
outside of the target range determined.
RESULTS: Protocol 1: There was a
significant reduction in mean HbA1c (P =
0.04) and blood glucose levels (P =
0.05) and in the time needed to teach
how to correct blood glucose values
using the Insulin Dosage Guide compared
with the paper algorithm. Protocol 2:
There was a decrease in mean HbA1c
levels (P = 0.0001) and a decrease in
the mean number of consecutive blood
glucose levels (P = 0.001) over the
1-year time period. Protocol 3: With
rapid-acting insulin, there was a
significant increase in the percentage
of blood glucose levels within the
target range (1 month, P = 0.04; at 3
months, P = 0.03). With the insulin
pump, there was a high rate (90%) of
blood glucose levels in the target range
during pump initiation when the Insulin
Dosage Guide was used. CONCLUSIONS: This
inexpensive hand-held plastic card,
which is portable and easy to use, may
help patients improve glycemia and
successfully manage diabetes.
- Language of Publication
- English
- Unique Identifier
- 99408643
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus,
Insulin-Dependent|*DT/ME; Dietary
Carbohydrates|*PD
- MeSH Heading
- Adolescence; Adult; Blood Glucose|ME;
Child; Child, Preschool; Dose-Response
Relationship, Drug; Human; Support,
Non-U.S. Gov't
- Publication Type
- CLINICAL TRIAL; GUIDELINE; JOURNAL
ARTICLE; PRACTICE GUIDELINE; RANDOMIZED
CONTROLLED TRIAL
- ISSN
- 0149-5992
- Country of Publication
- UNITED STATES
Record 62 from database: MEDLINE
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full text for this document
- Title
- Effect of variations in dietary fat
and carbohydrate intake on postprandial
lipemia in patients with noninsulin
dependent diabetes mellitus.
- Author
- Chen YD; Swami S; Skowronski R;
Coulston AM; Reaven GM
- Address
- Department of Medicine, Stanford
University School of Medicine,
California.
- Source
- J Clin Endocrinol Metab, 1993 Feb,
76:2, 347-51
- Abstract
- The effect of dietary composition on
concentrations of postprandial
lipoproteins was studied in eight
sulfonylurea-treated patients with
noninsulin dependent diabetes mellitus.
Two diets were consumed by each patient
for 2 weeks in random order, one
contained (as percent of total calories)
15% protein, 40% fat, and 45%
carbohydrate (CHO), whereas the other
consisted of 15% protein, 25% fat, and
60% CHO. At the end of each dietary
period, patients were given Vitamin A
(60,000 U/m2) with their noon meal, and
the concentration of triglyceride (TG)
and retinyl esters in plasma and two
lipoprotein fractions (Sf > 400 and
Sf 20-400) determined over the next 12
h. The results indicated that both
postprandial TG and retinyl ester
concentrations were higher in plasma (Sf
> 400, and Sf 20-400 lipoproteins),
when patients ate the 25% fat/60% CHO
diet. Thus, replacing saturated fat with
CHO accentuates the magnitude of
postprandial lipemia. Since TG-rich
lipoproteins may be atherogenic,
appropriate dietary advice for patients
with type 2 diabetes may deserve
reappraisal.
- Language of Publication
- English
- Unique Identifier
- 93163203
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full text for this document
- MeSH Heading (Major)
- Diabetes Mellitus,
Non-Insulin-Dependent|*BL; Dietary
Carbohydrates|*AD; Dietary Fats|*AD;
Food|*; Lipids|*BL
- MeSH Heading
- Aged; Blood Glucose|ME; Dietary
Proteins|AD; Human; Insulin|BL;
Lipoproteins|BL; Male; Middle Age;
Support, Non-U.S. Gov't; Support, U.S.
Gov't, P.H.S.; Triglycerides|BL; Vitamin
A|AA/AD/BL
- Publication Type
- CLINICAL TRIAL; JOURNAL ARTICLE;
RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0021-972X
- Country of Publication
- UNITED STATES
Record 63 from database: MEDLINE
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full text for this document
- Title
- Carbohydrate metabolism during
pregnancy in control subjects and women
with gestational diabetes.
- Author
- Catalano PM; Tyzbir ED; Wolfe RR;
Calles J; Roman NM; Amini SB; Sims EA
- Address
- Department of Obstetrics and
Gynecology, University of Vermont
College of Medicine, Burlington 05405.
- Source
- Am J Physiol, 1993 Jan, 264:1 Pt 1,
E60-7
- Abstract
- The purpose of this study was to
characterize carbohydrate metabolism
associated with the development of
gestational diabetes. Six control (Ctl)
and ten women with gestational diabetes
mellitus (GDM) were evaluated using an
intravenous glucose tolerance test and
hyperinsulinemic-euglycemic clamp with
[6,6-2H2]glucose prior to conception (P)
and at 12-14 (E), and 34-36 wk of
gestation (L). There was an increase (P
= 0.0001) in first-phase insulin
response in Ctl (P 174 +/- 133, E 388
+/- 120, and L 587 +/- 303 microU/ml)
and GDM (P 197 +/- 94, E 267 +/- 77, and
L 376 +/- 162 microU/ml) but a
significant (P = 0.02) lag in change in
GDM with advancing gestation. Basal
endogenous glucose production increased
during gestation [Ctl: P 2.74 +/- 0.23,
E 2.62 +/- 0.38, and L 3.14 +/- 0.36;
GDM: P 2.68 +/- 0.51, E 2.78 +/- 0.45,
and L 2.98 +/- 0.48 mg.kg fat-free mass
(FFM)-1 x min-1; P = 0.02], but there
was resistance to suppression by insulin
infusion (P = 0.03) in late gestation (GDM:
0.61 +/- 0.44 vs. Ctl: 0.16 +/- 0.17
mg.kg FFM-1 x min-1). Insulin
sensitivity decreased during gestation (Ctl:
P 10.78 +/- 2.78, E 8.34 +/- 2.36, and L
4.75 +/- 1.22; GDM: P 7.49 +/- 2.13, E
7.40 +/- 1.45, and L 4.21 +/- 1.01 mg.kg
FFM-1 x min-1; P = 0.0001) and was
primarily decreased (P = 0.04) in GDM
compared with Ctl from P through E.
These findings closely resemble those of
non-insulin-dependent, predominantly
insulin-resistant diabetes, which is
often a sequel of GDM.
- Language of Publication
- English
- Unique Identifier
- 93158729
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full text for this document
- MeSH Heading (Major)
- Carbohydrates|*ME; Diabetes,
Gestational|*ME; Pregnancy|*ME
- MeSH Heading
- Adult; Female; Glucose|BI; Glucose
Clamp Technique; Glucose Tolerance Test;
Human; Hyperinsulinism|ME; Injections,
Intravenous; Insulin|PD; Insulin
Resistance; Reference Values; Support,
U.S. Gov't, P.H.S.
- Publication Type
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