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  • 1
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    Evaluation of New Computerized Method for Recording 7-Day Food Intake in IDDM Patients
    American Diabetes Association ; 1991
    In:  Diabetes Care Vol. 14, No. 7 ( 1991-07-01), p. 602-604
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 14, No. 7 ( 1991-07-01), p. 602-604
    Abstract: To evaluate a new computerized method for recording 7-day food intake. Research Design and Methods Randomized crossover trial was conducted with patients recording the amount and type of every food and drink consumed during a week by either a computerized device (Food-meter) or recording the data in a diary. Each method was applied twice. Twenty-one insulin-dependent diabetic patients (mean ± SD age 25 ± 9 yr) were studied. Results The two methods showed very good agreement in the evaluation of the patients' diets (1792 ± 408 vs. 1764 ± 436 kcal∕day, 84 ± 19 vs. 82 ± 21 g∕day protein, 68 ± 22 vs. 67 ± 23 g∕day fat, 210 ± 60 vs. 207 ± 58 g∕day carbohydrate with the conventional and computerized methods, respectively). The variability between the methods and the variability within each method were of similar magnitude. Conclusions The Food-meter represents a useful tool for computerizing the 7-day food record. The method is easy, reliable, and time saving. Moreover, it minimizes the risk of transcriptional errors.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.14.7.602
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1991
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  • 2
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    Extra-Virgin Olive Oil Reduces Glycemic Response to a High–Glycemic Index Meal in Patients With Type 1 Diabetes: A Randomized Controlled Trial
    American Diabetes Association ; 2016
    In:  Diabetes Care Vol. 39, No. 4 ( 2016-04-01), p. 518-524
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 39, No. 4 ( 2016-04-01), p. 518-524
    Abstract: To evaluate whether fat quality, in the context of meals with high– (HGI) or low–glycemic index (LGI), influences postprandial blood glucose (PPG) response in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS According to a randomized crossover design, 13 patients with type 1 diabetes on insulin pump consumed two series (HGI or LGI) of meals with the same carbohydrate quantity while differing for amount and quality of fat: 1) low in fat (“low fat”), 2) high in saturated fat (butter), or 3) high in monounsaturated fat (extra-virgin olive oil) (EVOO). Premeal insulin doses were based on insulin–to–glycemic load ratios. Continuous glucose monitoring was performed and 6-h PPG evaluated. RESULTS PPG was significantly different between HGI and LGI meals (P = 0.005 for time × glycemic index interaction by repeated-measures analysis [RMA]), being significantly higher during the first 3 h after the HGI meals with a later tendency to an opposite pattern. In the context of HGI meals, PPG was significantly lower after EVOO than after low fat or butter (P & lt; 0.0001 for time × meal interaction by RMA), with a marked difference in the 0- to 3-h glucose incremental area under the curve between EVOO (mean ± SD 198 ± 274 mmol/L × 180 min) and either low fat (416 ± 329) or butter (398 ± 355) (P & lt; 0.05). No significant differences were observed in PPG between the three LGI meals. CONCLUSIONS Carbohydrate quality of a mixed meal influences shape and extent of PPG. Besides, using EVOO in a HGI meal attenuates the early postprandial glucose response observed when this meal is consumed with either low fat or butter. Therefore, an optimal prandial insulin administration would require considering, in addition to the quantity of carbohydrates, the quality of both carbohydrate and fat.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc15-2189
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2016
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  • 3
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    Insulin and Sulfonylurea Therapy in NIDDM Patients: Are the Effects on Lipoprotein Metabolism Different Even With Similar Blood Glucose Control?
    American Diabetes Association ; 1997
    In:  Diabetes Vol. 46, No. 10 ( 1997-10-01), p. 1601-1606
    Details
    In: Diabetes, American Diabetes Association, Vol. 46, No. 10 ( 1997-10-01), p. 1601-1606
    Abstract: This study evaluates the effects of insulin versus glibenclamide on lipoprotein metabolism at comparable levels of blood glucose control, in particular on the concentration and distribution of VLDL subfractions and lipolytic enzyme activities in nine NIDDM men (aged 56 ± 3 years, BMI 26.5 ± 0.9 kg/m2) (means ± SE) participating in a crossover study. After a 3-week washout period, patients were randomly assigned to 2-month treatment periods (insulin or glibenclamide); thereafter, each patient crossed to the other treatment. At the end of each period, mean daily blood glucose (MDBG), HbA1c, plasma lipids, lipoproteins (VLDL, LDL, HDL), lipoprotein subfractions (VLDL1, 2, 3; HDL2) HDL3), and post-heparin lipase activities (lipoprotein lipase [LPL] , hepatic lipase [HL]) were evaluated. Although glucose control was similar at the end of both periods (MDBG 8.3 ± 0.3 vs. 7.9 ± 0.3 mmol/l HbA1c 7.4 ± 0.3 vs. 7.0 ± 0.2%, insulin versus glibenclamide), insulin compared with glibenclamide induced a significant reduction in plasma triglycerides (0.9 ± 0.1 vs. 1.1 ± 0.1 mmoH, P & lt; 0.05), VLDL triglycerides (50.1 ± 12.2 vs. 63.6 ± 12.3 mg/dl, P & lt; 0.02), VLDL1 lipid concentration (24.9 ± 7.5 vs. 39.9 ± 9.5 mg/dl, P & lt; 0.006), and increased HDL2 cholesterol (25.2 ± 1.6 vs. 20.3 ± 1.3 mg/dl, P & lt; 0.03). In terms of VLDL percentage subfraction distribution, with insulin, there was a decrease in the larger subfractions (VLDL1 26.5 ± 3.0 vs. 37.8 ± 3.4%, P & lt; 0.02) and an increase in the smallest (VLDL3 47.3 ± 3.8 vs. 37.3 ± 3.3%, P & lt; 0.05). Moreover, HL activity was significantly lower after insulin than after glibenclamide (HL 247.2 ± 22.3 vs. 263.5 ± 22.6 mU/ml, P & lt; 0.05). In conclusion, compared with glibenclamide, insulin treatment (independent of variations in glucose control) is able to decrease significantly plasma triglycerides, to increase HDL2 cholesterol, and to reduce only the concentration of the larger VLDL subfractions, with a consequent redistribution of their profile.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/diacare.46.10.1601
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1997
    detail.hit.zdb_id: 1501252-9
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  • 4
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    Plasma Fibrinogen: A New Factor of the Metabolic Syndrome: A population-based study
    American Diabetes Association ; 1998
    In:  Diabetes Care Vol. 21, No. 4 ( 1998-04-01), p. 649-654
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 21, No. 4 ( 1998-04-01), p. 649-654
    Abstract: To evaluate whether hyperfibrinogenemia represents a component of the metabolic syndrome. RESEARCH DESIGN AND METHODS A cross-sectional study was conducted on the relation between fibrinogen and the metabolic syndrome in a working population of 1,252 nondiabetic men, aged 35–64 years, randomly selected among all men participating in a health screening. We measured anthropometric characteristics, blood pressure, fasting plasma fibrinogen, cholesterol (total, LDL, and HDL), triglycerides, glucose, and insulin. Individuals with two or more metabolic abnormalities (defined as being in the highest quartile of the distribution of diastolic blood pressure, plasma glucose, or triglycerides or being in the lowest quartile of HDL cholesterol) were considered to have the metabolic syndrome. RESULTS Age-adjusted fibrinogen levels correlated significantly with BMI, waist-to-hip ratio, systolic and diastolic blood pressure, plasma total cholesterol, LDL cholesterol, triglycerides, insulin, and HDL cholesterol (inversely). Subjects with the metabolic syndrome had significantly higher plasma fibrinogen levels than those without (285.1 ± 1.9 vs. 300.2 ± 3.0 mg/dl, mean ± SE, P = 0.0001). Plasma fibrinogen concentrations and the prevalence of hyperfibrinogenemia (defined as ≥350 mg/dl) increased progressively from 279 to 307 mg/dl (P = 0.0001) and from 9 to 22% (P = 0.0024), respectively, across categories with an increasing number of metabolic disorders characterizing the syndrome (only one, any two, three or more). In multivariate analyses, both plasma insulin and the metabolic syndrome were significantly and independently associated with plasma fibrinogen. CONCLUSIONS The finding suggests that hyperfibrinogenemia may be considered a component of the metabolic syndrome. This may also explain the increased cardiovascular risk associated with hyperinsulinemia/insulin resistance.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.21.4.649
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1998
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  • 5
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    Pro12Ala Polymorphism of the PPARγ2 Locus Modulates the Relationship Between Energy Intake and Body Weight in Type 2 Diabetic Patients
    American Diabetes Association ; 2007
    In:  Diabetes Care Vol. 30, No. 5 ( 2007-05-01), p. 1156-1161
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 30, No. 5 ( 2007-05-01), p. 1156-1161
    Abstract: OBJECTIVE—We explore the relationship among BMI, habitual diet, and the Pro12Ala polymorphism in the peroxisome proliferator–activated receptor (PPAR)γ2. RESEARCH DESIGN AND METHODS—The Pro12Ala variant was characterized in 343 unrelated type 2 diabetic patients who were consecutively seen at the outpatient clinic of a health district of the province of Naples. Anthropometric and laboratory parameters were measured; habitual diet was assessed by a validated semiquantitative food frequency questionnaire. RESULTS—The overall frequency of Ala12 was 12% (n = 42). BMI was significantly higher in Ala carriers than non-Ala carriers, whereas total daily energy intake or macronutrient composition of the diet were similar in the two groups. For further analysis, participants were stratified according to genotype and sex-specific quartiles of energy intake. BMI increased in both genotype groups with increasing energy intake (P & lt; 0.03). BMI was similar in Ala carriers and non-Ala carriers (30.0 vs. 30.1 kg/m2, P & gt; 0.10) in the lower quartile of energy intake but significantly higher in Ala carriers in the upper quartile (36.0 vs. 32.1 kg/m2, P & lt; 0.001). Average daily energy intake and diet composition were comparable within each quartile for carriers or noncarriers of the Ala allele. Relative to the noncarriers, Ala carriers had a significantly lower energy intake per kilogram body weight, thus suggesting that the Ala allele is associated with a higher food efficiency. The confounding role of medications, glucose control, and physical exercise was ruled out. CONCLUSIONS—This study provides evidence of a differential susceptibility to fat accumulation, and, hence, weight gain, in response to habitual high energy intake for Ala carriers compared with Pro/Pro homozygotes.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc06-1153
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2007
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  • 6
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    Effects of Dietary Fiber and Carbohydrate on Glucose and Lipoprotein Metabolism in Diabetic Patients
    American Diabetes Association ; 1991
    In:  Diabetes Care Vol. 14, No. 12 ( 1991-12-01), p. 1115-1125
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 14, No. 12 ( 1991-12-01), p. 1115-1125
    Abstract: Dietary recommendations for the treatment of diabetic patients issued by national and international diabetes associations consistently emphasize the need to increase carbohydrate consumption. However, these recommendations have been questioned on the basis of growing evidence that, in both insulin-dependent and non-insulin-dependent diabetic patients, a high-carbohydrate diet does not offer any advantage in terms of blood glucose and plasma lipid concentrations compared with a high-fat (mainly unsaturated) diet. It has been shown repeatedly that a high-carbohydrate diet increases plasma insulin and triglyceride levels and can deteriorate blood glucose control in the postprandial period. However, much of the controversy between advocates and detractors of dietary carbohydrate can be settled by taking into account dietary fiber. Several studies have shown that the adverse metabolic effects of high-carbohydrate diets are neutralized when fiber and carbohydrate are increased simultaneously in the diet for diabetic patients. In particular, these studies demonstrated that a high-carbohydrate/high-fiber diet significantly improves blood glucose control and reduces plasma cholesterol levels in diabetic patients compared with a low-carbohydrate/low-fiber diet. In addition, a high-carbohydrate/high-fiber diet does not increase plasma insulin and triglyceride concentrations, despite the higher consumption of carbohydrates. Unfortunately, dietary fiber represents a heterogenous category, and there is still much to understand as to which foods should be preferred to maximize the metabolic effects of fiber. There are indications that only water-soluble fiber is active on plasma glucose and lipoprotein metabolism in humans. Therefore, in practice, the consumption of legumes, vegetables, and fruits–rich in water-soluble fiber–should be particularly encouraged. The mechanisms by which dietary fiber exerts its hypoglycemic and hypolipidemic activities are unknown. However, the ability of dietary fiber to retard food digestion and nutrient absorption certainly has an important influence on lipid and carbohydrate metabolism. The beneficial effects of high-fiber foods are also exerted by some foods not particularly rich in fiber. The fiber content and physical form of the food can influence the accessibility of nutrients by digestive enzymes, thus delaying digestion and absorption. The identification of these foods with a low-glycemic response would help enlarge the list of foods particularly suitable for diabetic patients. In conclusion, a diet low in cholesterol and saturated fat should be recommended to all diabetic patients to prevent cardiovascular disease. A balanced increase in consumption of fiber-rich foods and unsaturated fat is the most rational way to replace foods rich in saturated fat and cholesterol in the diabetic diet.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.14.12.1115
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1991
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  • 7
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    An Isoenergetic Multifactorial Diet Reduces Pancreatic Fat and Increases Postprandial Insulin Response in Patients With Type 2 Diabetes: A Randomized Controlled Trial
    American Diabetes Association ; 2022
    In:  Diabetes Care Vol. 45, No. 9 ( 2022-09-01), p. 1935-1942
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 45, No. 9 ( 2022-09-01), p. 1935-1942
    Abstract: To compare the effect of an isocaloric multifactorial diet with a diet rich in monounsaturated fatty acids (MUFA) and similar macronutrient composition on pancreatic fat (PF) and postprandial insulin response in type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS According to a randomized controlled parallel-group design, 39 individuals with T2D, 35–75 years old, in satisfactory blood glucose control, were assigned to an 8 week isocaloric intervention with a multifactorial diet rich in MUFA, polyunsaturated fatty acids, fiber, polyphenols, and vitamins (n = 18) or a MUFA-rich diet (n = 21). Before/after the intervention, PF content was measured by the proton-density fat fraction using a three-dimensional mDIXON MRI sequence, and plasma insulin and glucose concentrations were measured over a 4 h test meal with a similar composition as the assigned diet. RESULTS After 8 weeks, PF significantly decreased after the multifactorial diet (from 15.7 ± 6.5% to 14.1 ± 6.3%; P = 0.024), while it did not change after the MUFA diet (from 17.1 ± 10.1% to 18.6 ± 10.6%; P = 0.139) with a significant difference between diets (P = 0.014). Postprandial glucose response was similar in the two groups. Early postprandial insulin response (incremental postprandial areas under the curve [iAUC0–120] ) significantly increased with the multifactorial diet (from 36,340 ± 34,954 to 44,138 ± 31,878 pmol/L/min; P = 0.037), while it did not change significantly in the MUFA diet (from 31,754 ± 18,446 to 26,976 ± 12,265 pmol/L/min; P = 0.178), with a significant difference between diets (P = 0.023). Changes in PF inversely correlated with changes in early postprandial insulin response (r = −0.383; P = 0.023). CONCLUSIONS In patients with T2D, an isocaloric multifactorial diet, including several beneficial dietary components, markedly reduced PF. This reduction was associated with an improved postprandial insulin response.
    Type of Medium: Online Resource
    ISSN: 0149-5992
    URL: Article
    DOI: 10.2337/dc22-0605
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
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  • 8
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    Potato Dumplings Elicit a Low Plasma Glucose Response in NIDDM Patients
    American Diabetes Association ; 1997
    In:  Diabetes Care Vol. 20, No. 3 ( 1997-03-01), p. 460-460
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 20, No. 3 ( 1997-03-01), p. 460-460
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.20.3.460a
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1997
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  • 9
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    Effects of Changing Amount of Carbohydrate in Diet on Plasma Lipoproteins and Apolipoproteins in Type II Diabetic Patients
    American Diabetes Association ; 1990
    In:  Diabetes Care Vol. 13, No. 4 ( 1990-04-01), p. 446-448
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 13, No. 4 ( 1990-04-01), p. 446-448
    Abstract: Eight type II (non-insulin-dependent) normolipidemic diabetic patients (aged 45 ± 15 yr, body mass index 22 ± 2 kg/m2, means ± SD) treated with diet alone or diet plus oral hypoglycemic agents were given, in random order for periods of 15 days, two diets with different carbohydrate (CHO) (40 vs. 60% of total calories) and fat (20 vs. 40%) levels. Simple CHO, fiber, saturated fat, cholesterol, and polyunsaturated-saturated fat ratio were similar in the two diets. Total plasma cholesterol was not significantly affected by dietary changes; conversely, plasma triglyceride (1.38 ± 0.59 vs. 1.11 ± 0.39 mM, P & lt; 0.05) and apolipoprotein Cll (3.8 ± 1 · 4 vs, 3.3 ± 0.8 mg/dl) increased significantly after the high-CHO low-fat diet. Among the various lipoproteins, very-low-density lipoprotein (VLDL) was the most affected by diet: VLDL cholesterol concentrations increased from 0.30 ± 0.19 to 0.43 ± 0.28 mM (P & lt; 0.05), and triglyceride concentrations increased from 0.62 ± 0.33 to 0.88± 0.53 mM (P & lt;0.05). In conclusion, increasing the amount of complex CHO in the diet induces an elevation of VLDL in normolipidemic, nonobese, mildly type II diabetic patients.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.13.4.446
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1990
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  • 10
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    The TOSCA.IT Trial: A Study Designed to Evaluate the Effect of Pioglitazone Versus Sulfonylureas on Cardiovascular Disease in Type 2 Diabetes
    American Diabetes Association ; 2012
    In:  Diabetes Care Vol. 35, No. 12 ( 2012-12-01), p. e82-e82
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 35, No. 12 ( 2012-12-01), p. e82-e82
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc12-0954
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2012
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