PubMed Health⌕ Search

Biomedical subjects

G Slama

Publications and source records attributed to G Slama.

At least 19 recordsLinked to original sources
PubMed2006

Effect of baking process on postprandial metabolic consequences: randomized trials in normal and type 2 diabetic subjects.

OBJECTIVE: To determine the impact of the form, fibre content, baking and processing on the glycaemic, insulinaemic and lipidaemic responses of different French breads. DESIGN AND SUBJECTS: First study: Nine healthy subjects were randomized to consume in a crossover design one of six kinds of French bread (each containing 50 g available carbohydrate): classic baguette, traditional baguette, loaf of wholemeal bread (WM-B), loaf of bread fermented with yeast or with leaven, a sandwich and a glucose challenge as reference. RESULTS: The glycaemic index (GI) values ranged from 57+/-9% (mean+/-s.e.m.), for the traditional baguette, to 85+/-27% for the WM-B. No significant difference was found among the different tested bread. The insulinaemic index (II), however, of the traditional baguette and of the bread fermented with leaven were lower than the other breads (analysis of variance: P<0.01). Postprandial plasma triglycerides showed similar profiles. The traditional baguette tended to decrease postprandial free fatty acids compared to levels after the classic baguette. RESULTS: The GI of the traditional baguette was lower than that of the classic baguette (n=8, venous blood: 70+/-4 vs 75+/-4, P=0.002; capillary blood: 69+/-5 vs 83+/-6, P=0.028, respectively). CONCLUSIONS: Some varieties of French bread (the TB) have lower II, in healthy subjects, and lower GI, in type 2 diabetic subjects, than that of the other varieties. These results might be due to bread processing difference rather than fibre content. SPONSORSHIPS: Supported by grants from the National French Milling Association.

Adult↗
PubMed2006

Postprandial glycaemia: a plea for the frequent use of delta postprandial glycaemia in the treatment of diabetic patients.

Postprandial hyperglycaemia is a phenomenon often neglected by patients as well as doctors. While patients only voluntarily measure morning and preprandial capillary glycaemia, physicians do not encourage the measurement of anything further. The specific role of postprandial hyperglycaemia in the determination of late diabetes complications, such as micro- and macroangiopathy, remains controversial. It is however undeniable that the postprandial glycaemic excursion plays an important role in total hyperglycaemia reflected by an increase in glycated haemoglobin. The postprandial glycaemia measurement or, more appropriately, the postprandial glycaemic excursion (the difference between postprandial and preprandial glycaemia, also called the postprandial delta glycaemia), is important to measure and there are specific tools to correct it when abnormal. Postprandial delta glycaemia should lie between 30 and 50 mg/dl. It is thus suggested to measure it not necessarily on a daily basis, but when it is expected that the glycaemic couple, or "pre-postprandial couple", is high. The specific tools for treatment of postprandial hyperglycaemia can be dietetic (carbohydrate quantity reduction or ingestion of fiber-rich and/or low glycaemic index foods) or medicinal. Among the specific medicinal treatments are the alpha-glucosidase-inhibitors (which can be used for both type 1 and type 2 diabetic patients), glinides and fast-acting insulins. Rather than first treating fasting and interprandial hyperglycaemia, as has been commonly done by physicians, the authors recommend the simultaneous treatment of pre-, inter- and postprandial hyperglycaemia. The optimal time at which to evaluate postprandial glycaemia is approximately 1 h and 15 minutes for type 1 and type 2 diabetic patients.

Blood Glucose↗
PubMed2004

Non food-related environmental stimuli induce increased meal intake in healthy women: comparison of television viewing versus listening to a recorded story in laboratory settings.

The objective of the present study, performed under laboratory conditions, was to assess the impact of two non food-related environmental stimuli (television and auditory stimulus) on meal intake. Normal weight women (N = 48) ate lunch in the laboratory once a week for four weeks. All lunches were identical and included popular traditional foods, of which participants could eat ad libitum. The first and last lunches were eaten in the absence of the environmental stimuli (control conditions); in the other two tests, presented in random order, subjects ate while either watching television or listening to a recorded story. Energy intakes were determined for each meal, as were ratings of hunger, satiety and meal palatability. Subjects filled out the Three Factor Eating Questionnaire at the end of the meal series. Meal size was significantly larger in the presence of both environmental stimuli than in both control conditions (+11.6%, 280 kJ, p < 0.01). Television viewing induced a significant stimulation of intake, equal to, but not greater than the effect of the auditory stimulus. Ratings of hunger, satiety, and palatability were not significantly different between conditions, despite the differences in intake. These results suggest that environmental, non food-related stimuli could stimulate intake regardless of hunger-satiety or palatability conditions. Environmental stimulation of eating should be tested in other populations, eg subjects with weight control problems, and other conditions, e.g. free-living.

Adolescent↗
PubMed2003

The potential of metformin for diabetes prevention.

Well designed intervention trials, such as the Diabetes Prevention Program (DPP), have demonstrated the potential of lifestyle interventions or pharmacologic treatments for the prevention or delay of type 2 diabetes in subjects with impaired glucose tolerance (IGT). Lifestyle interventions are likely to form the cornerstone of the management of IGT in the future, as they do in the management of type 2 diabetes today. However, it remains to be seen whether the intensive lifestyle interventions employed in trials such as the DPP can be transferred successfully from the highly structured environment of a randomised trial to routine, day-to-day management within the primary care sector. Thus, pharmacologic treatment may provide an important additional option where subjects are unwilling or unable to improve their diet and levels of physical activity. Treatment with metformin significantly reduced the incidence of diabetes in subjects with IGT and high-normal fasting plasma glucose in the DPP. Moreover, metformin was well tolerated, and health economic analyses suggest that metformin treatment is cost-effective in the US and Europe. The DPP investigators found that the protective effect of metformin persisted beyond the end of the study, and estimated that only one quarter of the protection arose from a short-lived pharmacological effect. The results of the DPP identify metformin as an effective option for the prevention of diabetes in subjects with IGT and impaired fasting glucose.

Diabetes Mellitus, Type 2↗
PubMed2003

Accuracy of the continuous glucose monitoring system in inpatient and outpatient conditions.

OBJECTIVE: To evaluate in inpatient and outpatient conditions, using only non-calibration data, the accuracy of the Continuous Glucose Monitoring System (CG-MS). RESEARCH DESIGN AND METHODS: Twelve, 21 and 20 type 1 diabetic patients participated in 3- day inhospital, 6-day ambulatory (i.e., 2 sensors worn consecutively) and 3-day ambulatory studies. Capillary glucose tests (7-8/day) served as comparisons. Pairs of data (excluding the 4 daily pairs used automatically by the CGMS for calibrations) were analyzed using correlation coefficient, error -grid analysis, and mean of absolute differences. RESULTS: Two third and half of the sensing days were qualified as "optimal", i.e., interpretable by the CGMS program in the inpatient and outpatient studies, respectively. Correlation coefficient was 0.92, 0.81 and 0.73 in the inpatient, 6 day outpatient and 3-day outpatient studies. 98%, 93% and 96% of the data fell in the A or B error-grid "clinically acceptable" zones. Mean absolute differences between sensor and glucometer values were 25 +/- 2, 34 +/- 5 and 32 +/- 5 mg/dl. CONCLUSION: CGMS may be used for assessment of glycemic trends, though accuracy is more in the range of glucometers than of laboratory tests. Inhospital utilisation improved accuracy and 6-day rather than 3-day sessions may be more appropriate to evaluate day to day reproducibility of glucose profile.

Automation↗
PubMed2003

Effects of dipeptide administration on hypoglycaemic counterregulation in type 1 diabetes.

OBJECTIVES: To investigate if a dipeptide made of glutamine and alanine is able to contribute to the recovery from insulin-induced hypoglycaemia in type 1 diabetes. RESEARCH DESIGN AND METHODS: Fifteen adult type 1 patients were randomly assigned to study group (n=7): intravenous infusion of 20 g Dipeptiven in normal saline (i.e., 8 g alanine and 13 g glutamine), or control group (n=8): same infusion, normal saline only. A 150 min gradual hypoglycaemic hyperinsulinemic clamp was administered after 2 h of infusion. Counterregularory hormones, symptoms, and cognitive function (4 choice reaction test) were regularly measured during the study. RESULTS: Blood glucose and glucose infusion rates were similar in the 2 groups. Circulating levels of alanine and glutamine peaked at 90 min and remained elevated throughout the test. This was associated with significant differences in: glucagonemia 107 +/- 20 vs 58 +/- 8 pg/ml, and neuroglycopenic symptoms scores: 7 +/- 3 vs 18 +/- 13, at t 150 min, in study and control group, p<0.05. Dysautonomic symptoms, cognitive tests as well as epinephrine, norepinephrine, cortisol and growth hormone were similar between groups. CONCLUSION: Intravenous infusion of a dipeptide made of alanine and glutamine is capable to reactivate glucagon secretion during insulin-induced hypoglycaemia and to reduce hypoglycaemic symptoms.

Adult↗
PubMed2003

[Metabolic syndrome: to observe or to act?].

Type 2 diabetes is characterized by a very high cardiovascular risk. This risk has usually been present for a very long time when diabetes is diagnosed. The combination of several metabolic abnormalities known as metabolic syndrome seems to be responsible for this increased risk. Insulin resistance is a major component of metabolic syndrome, which also includes clinical abnormalities such as increased waist circumference, hypertriglyceridemia, high blood pressure. It is very important to screen subjects with metabolic syndrome because of their high risk. Furthermore, some pharmaceutical agents could be effective in reducing the risk related to insulin resistance. Metformin effectiveness has been shown for the reduction of diabetes related complications and mortality, mainly in the cardiovascular field. Its place among the other potentially active agents remains to be determined as well as how it should be used in combination to lifestyle changes and how effective it is on a long-term basis.

Body Constitution↗
PubMed2003

[To observe, or to observe and to act?].

The UKPDS Study has clearly shown that diagnosis and therapeutic management of type 2 diabetes and its complications occur lately in the course of the disease, and that diabetes control deteriorates and micro- and macrovascular complications risk increase with the duration of the disease. Recent data from the STENO-2 study demonstrate the cardiovascular benefit of an intensified multifactorial management of diabetes and associated cardiovascular risk factors in type 2 diabetic patients at high cardiovascular risk. This paper advocates for an early intensive management of type 2 diabetes from the diagnosis in order to maintain glycaemia and glycosylated haemoglobin at the lowest possible level (even less than the current recommended levels) and for an early aggressive management of all known risk factors (including overweight and obesity, elevated arterial blood pressure, dyslipidaemias, etc.). This implies the early use of multiple therapy at adequate doses and a dramatic change in conventional medical habits, from a late and delayed management of diabetes and its complications to their early prevention using all therapeutic resources.

Blood Glucose↗
PubMed2002

Taq I polymorphism of the vitamin D receptor and risk of severe diabetic retinopathy.

AIMS/HYPOTHESIS: Vitamin D, a molecule with antiproliferative, antiangiogenic, antioxidant and immunosuppressive effects, could play a role in the pathogenesis of severe diabetic retinopathy. We examined whether Taq I polymorphism of the vitamin D receptor is involved in the development of severe diabetic retinopathy. METHODS: 200 unrelated C-peptide-negative French Type I diabetic patients were randomly selected (male:female, 103:97, age 44.4 +/- 12.4 years, diabetes duration: 27.7 +/- 10.0 years, BMI: 24.3 +/- 3.4 kg/m(2), HbA(1c): 8.6 +/- 1.3 %). The Taq I site was analysed by PCR followed by digestion with Taq I enzyme. Diabetic retinopathy was assessed by retinal angiography and classified as presence (n = 101) or absence (n = 99) of severe (preproliferative or proliferative) diabetic retinopathy. RESULTS: Frequency of wild-type genotype TT was lower in patients with severe diabetic retinopathy (n = 27) when compared with control subjects (n = 42, OR = 0.5, p = 0.028). Allele frequencies were not different between patients (T: n = 112 and t: n = 90) and control subjects (T: n = 128, and t: n = 70, p = 0.075). Global chi(2) (df = 2): p = 0.064. In subjects with diabetes duration of more than 25 years, TT was lower in severe diabetic retinopathy (n = 14) than control subjects (n = 18, OR = 0.3, p = 0.01). Allele frequencies were different between patients (T: n = 68 and t: n = 66) and control subjects (T: n = 52, OR = 0.5, and t: n = 26, OR = 1.9, p = 0.034). Global chi(2) (df = 2): p = 0.024. In subjects with HbA(1c) over 9 %, Tt was higher in patients (n = 28) than control subjects (n = 15, OR = 3.1, p = 0.019). Allele frequencies were not different between patients (T: n = 52 and t: n = 38) and control subjects (T: n = 57, and t: n = 29, p = 0.31). Global chi(2) (df = 2): p = 0.035. CONCLUSION/INTERPRETATION: In French Type I (insulin-dependent) diabetic patients, we demonstrate an association between TT form (VDR) and low risk for severe diabetic retinopathy, especially in patients with long duration, and between Tt variant and high risk for severe diabetic retinopathy in subjects with poor glycaemic control.

Adult↗
PubMed2002

eNOS4 polymorphism of the endothelial nitric oxide synthase predicts risk for severe diabetic retinopathy.

BACKGROUND: Genetic factors may be involved in the development, and particularly in the severity, of diabetic retinopathy (DR), in addition to chronic hyperglycaemia. Increased nitric oxide generation has been suggested to play a significant role in the pathogenesis of DR. AIMS AND METHODS: To examine whether the eNOS4 is involved in the risk of severe DR, 200 unrelated Caucasian Type 1 diabetic patients of long duration were randomly selected (M/F 103/97, age 44.4 +/- 12.4 years, diabetes duration 27.7 +/- 10.0 years, body mass index 24.3 +/- 3.4 kg/m2, HbA1c 8.6 +/- 1.3%). The eNOS4 polymorphism was analysed by polymerase chain reaction, and DR by retinal angiography and classified as presence (n = 101) or absence (n = 99) of severe (proliferative or pre-proliferative) DR. RESULTS: The genotype distribution of eNOS4b/b (wild-type), eNOS4b/a (heterozygous) and eNOS4a/a (homozygous) was 72%, 24.5% and 3.5%, respectively. Frequency of eNOS4a/a was significantly lower in patients with severe DR (n = 0) when compared with controls (n = 7, odds ratio (OR) = 0 (95% confidence interval (CI) = 0.5-0.74), P = 0.02). eNOS4b/b was more frequent in patients with severe DR (n = 80) when compared with controls (n = 64, OR = 2.1 (95% CI = 1.1-4.12), P = 0.032). Frequency of eNOS4b/a was not different between the study (n = 21) and control groups (n = 28, ns). The allelic frequencies between the study and control groups were different (4b: n = 181 vs. n = 156, respectively, OR = 2.3 (95% CI = 1.27-4.25), P = 0.005; 4a: n = 21 vs. n = 42, respectively, OR = 0.4 (95% CI = 0.24-0.79), P = 0.005). CONCLUSIONS: We demonstrate in Caucasians with Type 1 diabetes that (i) eNOS4a/a is associated with absent or non-severe DR, and (ii) eNOS4b/b is associated with severe DR.

Adult↗