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PubMed2004

Short-term effect of a protein load on appetite and food intake in diseased mildly undernourished elderly people.

BACKGROUND & AIMS: Malnutrition is a risk factor for mortality and various morbidities in the elderly. A low-energy intake often prevails and therapeutic interventions include the administration of dietary supplements, sometimes rich in proteins. We have tested the hypothesis that a protein-rich supplement inhibits appetite and decreases voluntary food intake. METHODS: Twelve mildly undernourished (BMI 21.3 +/- 2.4 kg/m2) elderly (84 +/- 7.8 yr) diseased persons were each studied under 3 conditions, in which they were given in random order at breakfast, and on consecutive days: either no supplement, a 250 kcal, 20 g protein supplement or a 250 kcal, 3.5 g protein supplement. Hunger, fullness, and desire to eat sensations were monitored half-hourly from before breakfast until lunch, and hourly from lunch until dinner. Food intake was assessed by weighing food before and after meals. Total energy and macronutrient intakes were calculated over 24 h. RESULTS: Both supplements increased energy intake (+185 kcal protein supplement, +176 kcal). Protein supplementation induced a net 17 g increase in protein intake (P < or = 0.0003). Neither supplement affected spontaneous food intake at lunch, dinner, or over the 24 h. Protein supplementation significantly depressed appetite in the breakfast to lunch period. CONCLUSION: A 250 kcal, 20 g protein supplement depresses hunger without affecting food intake in elderly diseased mildly undernourished persons.

Aged↗

PubMed2006

Daytime variations in glucose tolerance in people with impaired glucose tolerance.

To determine whether glucose tolerance varies throughout the day in people with impaired glucose tolerance (IGT). We studied 15 healthy IGT, and 18 matched normal glucose tolerant (NGT) individuals. Blood samples were taken every 30-120 min during a 24h period in which all individuals had three mixed meals and nocturnal sleep. We measured glucose, free fatty acids, specific insulin, intact proinsulin, cortisol and growth hormone. Variable responses were considered as concentrations and areas under the curves. Comparison between the groups was by Student's t-test, Mann-Whitney, and analysis of variance. Higher total glucose response, inappropriate normal total insulin response, and unproportionally increased proinsulin total response were observed in the IGT group. Lower glucose tolerance occurred in IGT after dinner, as in the NGT, and after breakfast associated with increased insulin response after breakfast, and similar proinsulin response after all three meals. IGT had higher glucose response than NGT after breakfast and lunch, similar insulin responses, and increased proinsulin-insulin ratio after all three meals. Data from this study demonstrate that IGT individuals present lower glucose tolerance in the evening, as those with NGT, and in the morning, as reported in patients with type 2 diabetes.

Adult↗

PubMed2004

Children's meal patterns have changed over a 21-year period: the Bogalusa Heart Study.

OBJECTIVE: The objective of this study was to analyze children's meal patterns over 2 decades. DESIGN: One 24-hour dietary recall was collected on each child who participated in one of seven cross-sectional surveys. SUBJECTS/SETTING: Dietary intake data were collected on 1,584 10-year-old children (65% white, 35% African American), in Bogalusa, LA, from 1973 to 1994. STATISTICAL ANALYSES: Descriptive statistics and one-way analysis of variance adjusting for gender and ethnicity. RESULTS: From 1973 to 1978, there was a marked increase (P<.0001) in the percentage of children who skipped breakfast, from 8.2% to 29.6%. When school breakfast was introduced in 1981, the proportion of children skipping breakfast declined to 12.5% (P<.01). From 1973-1974 to 1993-1994, the percentage of children eating a school lunch declined from 89.7% (1973-1974) to 78.2% (1993-1994) (P<.001); eating lunch brought from home increased from 5.9% to 11.1% (P<.01); consuming a home dinner decreased from 89.2% to 75.9% (P<.01); eating a dinner prepared outside the home increased from 5.4% to 19.0% (P<.01); consuming a meal at a restaurant increased from 0.3% to 5.4% (P<.0001); consuming snacks decreased (P<.0001); total eating episodes decreased from 6.6 to 5.2 (P<.0001); and eating time span significantly decreased from 12.4 hours to 11.5 hours (P<.0001). Despite these changes in meal patterns, no associations were found between meal patterns and overweight status. CONCLUSIONS: Striking alterations in the meal patterns of children occurred over the 2-decade period. These changes may have implications for the changes in the dietary intakes of children during the same time. However, data from this study do not support an association between meal patterns and children's overweight status. Further research with multiple days of assessment is needed to better understand the complexity of diet as it relates to childhood obesity.

Analysis of Variance↗

PubMed2006

Portion distortion: typical portion sizes selected by young adults.

OBJECTIVE: The incidence of obesity has increased in parallel with increasing portion sizes of individually packaged and ready-to-eat prepared foods as well as foods served at restaurants. Portion distortion (perceiving large portion sizes as appropriate amounts to eat at a single eating occasion) may contribute to increasing energy intakes and expanding waistlines. The purpose of this study was to determine typical portion sizes that young adults select, how typical portion sizes compare with reference portion sizes (based in this study on the Nutrition Labeling and Education Act's quantities of food customarily eaten per eating occasion), and whether the size of typical portions has changed over time. SUBJECTS: Young adults (n=177, 75% female, age range 16 to 26 years) at a major northeastern university. METHODS: Participants served themselves typical portion sizes of eight foods at breakfast (n=63) or six foods at lunch or dinner (n=62, n=52, respectively). Typical portion-size selections were unobtrusively weighed. A unit score was calculated by awarding 1 point for each food with a typical portion size that was within 25% larger or smaller than the reference portion; larger or smaller portions were given 0 points. Thus, each participant's unit score could range from 0 to 8 at breakfast or 0 to 6 at lunch and dinner. Analysis of variance or t tests were used to determine whether typical and reference portion sizes differed, and whether typical portion sizes changed over time. RESULTS: Mean unit scores (+/-standard deviation) were 3.63+/-1.27 and 1.89+/-1.14, for breakfast and lunch/dinner, respectively, indicating little agreement between typical and reference portion sizes. Typical portions sizes in this study tended to be significantly different from those selected by young adults in a similar study conducted 2 decades ago. CONCLUSIONS: Portion distortion seems to affect the portion sizes selected by young adults for some foods. This phenomenon has the potential to hinder weight loss, weight maintenance, and/or health improvement efforts. Thus, to ensure more effective nutrition counseling, food and nutrition professionals must develop ways to "undistort" what clients perceive to be typical portion sizes and help them recognize what is an appropriate amount to eat at a single eating occasion.

Adolescent↗

PubMed2004

Television, video, and computer game usage in children under 11 years of age.

OBJECTIVE: To conduct a population-based survey of television and other media usage in young children to determine (1) total media usage; (2) the proportion of children who have televisions in their bedrooms and who eat breakfast or dinner in front of the television; and (3) predictors of parental concern about the amount of television their child watches. STUDY DESIGN: Telephone survey administered to 1454 parents of children <11 years old derived from a diverse clinic population. RESULTS: The mean age of the index child was 5.05 years. Mean daily reported child media use was as follows: television (1.45 hours; SD, 1.5); videos (1.1 hours; SD, 1.30); and computer games (0.54 hours; SD, 0.96). Thirty percent of parents reported that their child ate breakfast or dinner in front of the television in the past week, and 22% were concerned about the amount of television that their child watched. In multivariate linear regression, eating breakfast or dinner in front of the television in the past week was associated with increased hours of television viewing (0.38 hours [0.21, 0.54]) and video (0.19 hours [0.04, 0.34]). Having a television in a child's bedroom was associated with increased hours of television (0.25 hours [0.07, 0.43]), video viewing (0.31 hours [0.16, 0.47]), and computer games (0.21 hours [0.10, 0.32]). In general, higher parental education was associated with decreased hours of television and video but not computer games. Older children were 2 to 3 times more likely than younger children to have a television in their bedroom and to have eaten a meal in front of it in the past week. More educated parents were less likely to report that their child had a television in their bedroom and more likely to be concerned about the amount of television their child viewed. CONCLUSIONS: Combined video and computer game usage exceeded television usage. Both children of low- and high-income parents are at risk for certain behaviors associated with television usage. Parents whose children watched more television were more likely to be concerned about the amount of television their child viewed.

Child↗

PubMed2004

Comparison of energy and nutrient intakes among meals and snacks of adolescent males.

BACKGROUND: Eating behaviors developed during adolescence can have immediate health implications and influence future chronic disease risk. The objectives of this study were to determine and compare the distribution of energy and nutrient intakes among meals and snacks, and relate eating occasion frequency to body mass index (BMI) of adolescent males. METHODS: Healthy adolescent males (n = 180) completed 3-day food records. Following analysis for energy and nutrient intakes, 3-day averages and frequencies were computed for all meals and snacks. RESULTS: Dinner was the largest contributor of energy, macronutrients, cholesterol, dietary fiber, and sodium, whereas both dinner and breakfast were the largest contributors of calcium and iron. On average, subjects consumed 1.63 snacks/day, with 77% consuming > or = 1 snack/day. BMI was significantly greater and energy intake was significantly lower in subjects having < or = 3 eating occasions/day relative to 4 or > or = 6 eating occasions/day. The 26% of subjects classified as inconsistent breakfast consumers had significantly higher BMIs and lower iron intakes relative to consistent breakfast consumers. CONCLUSIONS: This study provides valuable information regarding eating occasion frequency and contribution of meals and snacks to energy and nutrient intakes in adolescent males. Such information could be used to improve nutrition education programs for adolescents aimed at chronic disease prevention.

Adolescent↗

PubMed1990

Prevalence and consequences of nocturnal hypoglycemia among conventionally treated children with diabetes mellitus.

To determine the prevalence and predictors of, and the glucose responses after, nocturnal hypoglycemia, we studied 135 pediatric patients with insulin-dependent diabetes mellitus on 388 nights. The frequencies of blood glucose values less than 60, 50, and 40 mg/dl (3.3, 2.8, and 2.2 mmol/L) at 2 AM were 14.4%, 7.0%, and 2.1%, and at 6 AM were 6.7%, 2.6%, and 0.5%, respectively. Longer duration of diabetes, higher daily insulin doses, and lower glycosylated hemoglobin values were all significant but weak predictors of 2 AM hypoglycemia (glucose less than or equal to 60 mg/dl (less than or equal to 3.3 mmol/L). A 10 PM glucose concentration less than or equal to 100 mg/dl (less than or equal to 5.6 mmol/L) was present on 48% of nights with 2 AM glucose values less than or equal to 60 mg/dl (less than or equal to 3.3 mmol/L), but only 24% of nights with 10 PM blood glucose values less than or equal to 100 mg/dl (less than or equal to 5.6 mmol/L) were followed by 2 AM hypoglycemia. After treatment of 70 episodes of 2 AM glucose concentrations less than or equal to 60 mg/dl (less than or equal to 3.3 mmol/L), mean 6 AM glucose concentration was 95 +/- 6 mg/dl (5.7 +/- 0.3 mmol/L) and less than or equal to 100 mg/dl in 68.6%. In only 4.3% of these cases was the 6 AM glucose concentration greater than 200 mg/dl (greater than 11.1 mmol/L). Among patients who experienced 2 AM hypoglycemia, after-breakfast glucose values were not greater on days with 2 AM hypoglycemia than on days without it. These data indicate that 2 AM hypoglycemia is relatively common in patients with insulin-dependent diabetes mellitus, is frequently preceded by a 10 PM glucose value less than or equal to 5.6 mmol/L, and is less well predicted by other factors. Appropriate treatment of 2 AM hypoglycemia seldom results in either before-breakfast or after-breakfast blood glucose values greater than 200 mg/dl (greater than 11.1 mmol/L). Early-morning hypoglycemia is an uncommon cause of otherwise unexplained, prebreakfast hyperglycemia in children with insulin-dependent diabetes mellitus.

Adolescent↗

PubMed1997

Incidence and predictive criteria of nocturnal hypoglycemia in young children with insulin-dependent diabetes mellitus.

OBJECTIVE: To determine the incidence of significant nocturnal hypoglycemia occurring at home in young children with insulin-dependent diabetes mellitus using conventional therapy. DESIGN: Sixty-one children (aged 2.6 to 8.5 years) were studied on one night, at home, with blood collection occurring at dinner, bedtime/supper, 11 PM, 2 AM, and breakfast, with subsequent laboratory analysis. RESULTS: The proportion of subjects with blood glucose levels less than 64, 55, 45, and 36 mg/dl (3.5, 3.0, 2.5, and 2.0 mmol/L) was 37.8%, 17%, 13%, and 8%, respectively. Nocturnal hypoglycemia was associated with younger age (< 5 years 57% vs 5 to 8.5 years 36%; p < 0.001) and lowered glycosylated hemoglobin levels (HbA1c) with a greater than 50% incidence of hypoglycemia seen in subjects with HbA1c levels of less than 8.5%. The average HbA1c concentration was lower in the hypoglycemic group than in the nonhypoglycemic group (7.8 vs 8.3%; p < 0.02). Nocturnal hypoglycemia occurred with increasing frequency throughout the night in subjects less than 5 years of age (dinner, supper, 11 PM, 2 AM, and breakfast incidences being 0%, 12.5%, 26%, 33%, and 30%, respectively) but not in those older than 5 years. Carbohydrate intake at supper did not prevent subsequent hypoglycemia. Blood glucose levels at 11 PM were poor predictors of subsequent hypoglycemia at 2 AM in either the group as a whole or in the children less than 5 years of age. Symptom recognition of nocturnal hypoglycemia was decreased in younger children (< 5 years (36%) > 5 years (58%)), in those with a lower HbA1c, and when hypoglycemia occurred at breakfast rather than at dinner (0% vs 50%). CONCLUSIONS: The incidence of nocturnal hypoglycemia in young children with insulin-dependent diabetes mellitus receiving conventional therapy is unacceptably high and is increased with lowered age and HbA1c concentration; the condition is often asymptomatic. Early-morning hypoglycemia is poorly predicted by a blood glucose determination at 11 PM and is not prevented by carbohydrate intake at supper. In younger children, blood glucose profiles should include early-morning measurements.

Age Factors↗

PubMed1999

Leucine kinetics in reference to the effect of the feeding mode as three discrete meals.

In a recent study, we observed that the 24-hour leucine oxidation measured when three equal meals providing a generous intake of leucine (approximately 90 mg x kg(-1) x d(-1)) are eaten during the day is 16% lower (P < .01) than that for the same diet given as 10 hourly, equal meals. We hypothesized that the pattern of meal intake at a lower level of dietary leucine would affect the 24-hour rate of leucine oxidation and possibly improve the retention of dietary leucine. A total of 11 healthy adults participated in this investigation. The daily leucine intake was 182 micromol x kg(-1) x d(-1) (38 mg x kg(-1) x d(-1)) given with an L-amino acid diet. All subjects received three discrete meals daily for 6 days prior to a 24-hour intravenous (IV) tracer infusion of L-[1-13C]-leucine on day 7 (study 1). Four of these subjects participated in two additional studies of similar design. Study 2 involved giving [1-13C]-leucine as a constant IV infusion together with tracer added to the amino acid mixture at each meal time. In study 3, subjects received the three meals with added [1-13C]-leucine tracer while [2H3]-leucine was given as a constant IV infusion. Total leucine oxidation in studies 1 and 2 was 238+/-66 and 231+/-85 micromol x kg(-1) x d(-1), respectively. Leucine balance was positive, amounting to 18% of the total (diet + tracer) intake. The estimated mean nitrogen balance was +8 mg x kg(-1) x d(-1). Leucine oxidation was higher (P < .01) for breakfast than for the lunch meal. This difference was associated with lower insulin and higher plasma leucine concentrations at breakfast versus lunch periods. The results from study 3 suggest that the higher rate of leucine oxidation observed at breakfast as compared with lunch is not due to a difference in the immediate splanchnic fate of absorbed leucine from each meal. In comparison to our previous small frequent-meal studies, the pattern of meal feeding influences overall leucine utilization at both generous and limiting leucine intakes. Hence, it is possible that the pattern of meal feeding may affect estimations of amino acid requirements using the tracer-balance approach. Longer-term dietary studies will be needed to establish whether and the extent to which this is so.

Adult↗

PubMed1999

The influence of a glucose drink on a demanding working memory task.

A group of young adult females, who had or had not eaten breakfast, drank either a glucose drink or a placebo. Fasting was associated with poorer performance on the Brown-Petersen task, a test of memory. A glucose drink improved the memory of those who had fasted, although it did not influence those who had eaten breakfast. In those who had fasted, the glucose drink resulted in memory comparable to those who had consumed breakfast. Those with higher levels of blood glucose upon arrival in the laboratory had better memories. In those taking a glucose drink, after an initial rise, rapidly falling levels of blood glucose were associated with better memory.

Adult↗

PubMed1986

Treatment of autonomic neuropathy with a somatostatin analogue SMS-201-995.

Eight patients with postprandial hypotension and orthostatic hypotension were treated with the somatostatin analogue SMS-201-995. Low doses of this drug (0.2-0.4 microgram/kg) raised the blood pressure after breakfast in all six patients with postprandial hypotension. 60 min after breakfast the mean sitting blood pressure was 35 +/- 10 (SEM) mm Hg higher after administration of SMS-201-995 0.4 microgram/kg than after placebo (p less than 0.001). Larger doses (up to 1.6 micrograms/kg) raised upright blood pressure during the postprandial period in five of seven patients. Before therapy three patients were unable to stand after eating; after an injection of SMS-201-995 0.8 microgram/kg at the beginning of breakfast they were able to walk for 35-100 min. The duration of therapeutic effect of each injection was 3-6 h. Treatment was followed by abdominal cramps and nausea in two patients with gastroparesis diabeticorum. SMS-201-995 holds promise as a treatment for postprandial hypotension and orthostatic hypotension.

Adult↗

PubMed2002

Different effects of acarbose and glibenclamide on proinsulin and insulin profiles in people with Type 2 diabetes.

AIM: In a double-blind, placebo-controlled study, we compared the effect of acarbose (A) and glibenclamide (G) on post-prandial (pp) and 24-h profiles of proinsulin and insulin. METHODS: Twenty-seven patients with Type 2 diabetes mellitus insufficiently controlled with diet alone were randomised to receive acarbose, 100 mg thrice daily, glibenclamide, 1 mg thrice daily, or placebo. Before and after 16 weeks of treatment, 24-h profiles of proinsulin, insulin and glucose (fasting, 1 h after breakfast and every 3-h for a 24-h period) were measured under metabolic ward conditions with standardised meals. RESULTS: With acarbose, a reduced 24-h level of proinsulin was observed compared with glibenclamide (AUC 1096 +/- 118 vs. 1604 +/- 174 pmol/l per h, P<0.05) at 16 weeks. The breakfast increment of proinsulin was lower with acarbose than glibenclamide (6.8 vs. 19.3 pmol/l, P<0.05) as was the level at that time (37.3 +/- 5.3 vs. 56.4 +/- 7.5 pmol/l, P<0.05). A lower AUC of insulin after treatment was also observed with acarbose than glibenclamide (7.9 +/- 0.9 vs. 14.8 +/- 4.5 nmol/l per h, P<0.05), as also for 1-h increment (81 +/- 26, vs. 380 +/- 120 pmol/l, P<0.01) and 1-h level (325 +/- 30 vs. 621 +/- 132 pmol/l, P<0.01). Acarbose reduced 1-h breakfast glucose increment (baseline 6.3 +/- 0.6, 16-week 3.5 +/- 0.6 mmol/l, P<0.01) and 1-h glucose level (18.1 +/- 1.1 and 14.5 +/- 1.3 mmol/l, P<0.01), whereas glibenclamide did not (6.6 +/- 0.7 vs. 5.4 +/- 0.6 mmol/l and 18.9 +/- 1.5 vs. 15.3 +/- 1.3 mmol/l). CONCLUSIONS: Measurement of circadian excursions of proinsulin and insulin reveals distinct differences in meal-time proinsulin and insulin increment and level between acarbose and glibenclamide whereas fasting levels of these insulin fractions remained unaffected.

Acarbose↗

PubMed1988

Effect of two new alpha-glucosidase inhibitors in insulin-dependent diabetic patients.

The delay in glucose absorption at the intestinal level obtained with the administration of alpha-glucosidase inhibitors may contribute to an improved metabolic control in diabetic patients. We have examined the effects of two new compounds, BAY m 1099 (short acting) and BAY o 1248 (long acting), on the postprandial glycemic changes, the insulin requirements and the meal-induced hormone responses in nine insulin-dependent diabetics (IDD). The investigation was conducted according to a protocol in which medication and placebo were administered in a double-blind randomized manner. Twelve hours before each experimental day, the patients were connected to the Biostator GCIIS (Ames-Miles) to maintain stabilized normoglycemic levels for the whole period of study. The results showed that: (1) BAY m 1099 decreased the 4-h postprandial glycemic excursions compared to placebo both at dinner and breakfast (P less than 0.05), (2) BAY o 1248 when compared with placebo showed a significant lowering of the peak glycemic levels at breakfast (P less than 0.001) and at lunch (P less than 0.0025), (3) the 2-h and 4-h post-breakfast insulin requirements fell significantly after either drug (P less than 0.02), (4) the plasma levels of contrainsular hormones were not affected by drugs or placebo at any time during the period of study, and (5) no side effects with either drug could be detected. We conclude from our study that both drugs may be useful adjuncts to insulin therapy in insulin-dependent diabetics by reducing postprandial glycemic fluctuations as well as by decreasing insulin requirements with no modification of the meal-induced hormone responses.

1-Deoxynojirimycin↗

PubMed1987

The influence of food on the pharmacokinetics of itraconazole in patients with superficial fungal infection.

Itraconazole in a new, orally active triazole, which is related to ketoconazole and which is active against dermatophytes and Candida and Cryptococcus organisms. It is more potent than ketoconazole, is better absorbed with food, and does not suppress testosterone or cortisol synthesis. In previous studies, daily 200 mg doses of itraconazole for 5 days cleared 80% of cases of pityriasis versicolor, and 90% of dermatophyte infections were cleared by daily 100 mg doses administered for 1 month. Twenty patients with superficial dermatophyte, Candida albicans, and pityriasis versicolor infections were treated with doses of 50 or 100 mg per day; in the first group of 10 patients, the drug was administered before breakfast and the other 10 patients were given their dose with breakfast. Itraconazole concentration was determined by high-performance liquid chromatography 3 hours after administration of first and last doses. Our findings showed that although treatment with 50-mg doses led to poorer results and lower plasma levels than 100-mg doses, taking the drug with breakfast gave much better results than taking it before.

Adolescent↗

PubMed1984

Time of day influences food acceptability.

To determine whether a food's acceptability changes with time of day and degree to which a food is appropriate for a given mealtime, preferences were obtained both in the morning and the afternoon for a set of foods which included items appropriate "for breakfast", "for dinner", or for either mealtime. A second purpose of the study was to determine whether such cultural rules regarding food appropriateness had been acquired by preschool children and whether the pattern of shifting acceptability with time of day predicted for adult subjects would also appear in the preference data of the children. Participants included 25 adults and 30 three- and four-year-old children. All subjects were seen twice, once in the morning and once in the late afternoon for two identical sessions. Half of the subjects in each age group were seen first in the morning, half were seen first in the afternoon. In these sessions food preferences for the set of foods varying in mealtime appropriateness were assessed and the foods were categorized as "for breakfast" of "for dinner". The preference data of both the adults and the children showed significant preference shifts with time of day, with breakfast items more preferred in the morning than the afternoon and dinner items more preferred in the morning than the afternoon. These shifts were larger for adults than for children but not significantly so.

Adult↗

PubMed2003

Metabolic effects of an enteral nutrition formula for diabetes: comparison with standard formulas in patients with type 1 diabetes.

AIM: To evaluate the metabolic response (glucose, cholesterol, triglycerides and beta-hydroxy-butyrate) in patients with type 1 diabetes after a trial breakfast with an enteral nutrition formula designed for patients with diabetes and compare it with standard formulas (with and without fibre). MATERIAL AND METHODS: Each of 11 patients with type 1 diabetes consumed three types of liquid breakfast with a 1 week interval between each. (1). A standard diet (SD) with 49% carbohydrates, 35% lipids, 16% proteins-casein-and without fibre; (2). A fibre-enriched diet (FD): with 49% carbohydrates, 35% lipids, 16% casein and 15 g/1000 ml fibre; (3). A diet designed for patients with diabetes (DD) with 45% carbohydrates, 38% lipids, 16% soy protein and 15 g/1000 ml fibre. Each subject consumed 250 ml of each preparation at 9.00 AM after having administered their usual insulin dose, which was the same for each diet. Blood samples were taken at baseline and each 30 min, up to 150 min. RESULTS: The increase in postprandial glycaemia was lower with DD than with the standard preparations, reaching statistical significance at 60 min. There were no significant variations in the levels of cholesterol, triglycerides or beta-hydroxy-butyrate between the three preparations. CONCLUSIONS: After a trial breakfast, a diet designed for patients with diabetes provoked lower increases in postprandial glycaemia (with no changes in lipid or beta-hydroxy-butyrate levels) compared to the standard diets evaluated (with and without fibre).

Adult↗

PubMed2002

Calibration of a subcutaneous amperometric glucose sensor implanted for 7 days in diabetic patients. Part 2. Superiority of the one-point calibration method.

UNLABELLED: Calibration, i.e. the transformation in real time of the signal I(t) generated by the glucose sensor at time t into an estimation of glucose concentration G(t), represents a key issue for the development of a continuous glucose monitoring system. OBJECTIVE: To compare two calibration procedures. In the one-point calibration, which assumes that I(o) is negligible, S is simply determined as the ratio I/G, and G(t) = I(t)/S. The two-point calibration consists in the determination of a sensor sensitivity S and of a background current I(o) by plotting two values of the sensor signal versus the concomitant blood glucose concentrations. The subsequent estimation of G(t) is given by G(t) = (I(t)-I(o))/S. RESEARCH DESIGN AND METHODS: A glucose sensor was implanted in the abdominal subcutaneous tissue of nine type 1 diabetic patients during 3 (n = 2) and 7 days (n = 7). The one-point calibration was performed a posteriori either once per day before breakfast, or twice per day before breakfast and dinner, or three times per day before each meal. The two-point calibration was performed each morning during breakfast. RESULTS: The percentages of points present in zones A and B of the Clarke Error Grid were significantly higher when the system was calibrated using the one-point calibration. Use of two one-point calibrations per day before meals was virtually as accurate as three one-point calibrations. CONCLUSION: This study demonstrates the feasibility of a simple method for calibrating a continuous glucose monitoring system.

Biosensing Techniques↗

PubMedDate not supplied

Effects of a large supper on glucose levels the following morning in patients with type 2 diabetes.

Seventeen patients were studied to test the hypothesis that a large evening meal influences the fasting glucose level and glucose tolerance the following morning in patients with type 2 diabetes. Oral hypoglycemic agents were discontinued for 2 weeks. The baseline fasting plasma glucose levels were 12.3 +/- 0.9 mmol/L. Fasting and postprandial (post-Sustacal) glucose, insulin, and C-peptide measurements were performed the morning after the patients received three separate meal protocols spaced 1 week apart. The caloric distribution of the meal protocols was (1) 7 kcal/kg of ideal body weight breakfast and lunch and 14 kcal/kg supper (small supper); (2) 7 kcal/kg breakfast and lunch and 28 kcal/kg for supper (large supper); and (3) 14 kcal/kg breakfast and lunch (no supper). Fasting glucose level were higher the morning after the large supper compared to no supper (13.6 +/- 0.7 versus 12.3 +/- 0.5 mmol/L, p < 0.05) and also to the small supper (13.6 +/- 0.7 versus 12.5 +/- 0.6 mmol/L, p = 0.05). No difference was observed in the fasting glucose levels between the small supper and no supper (p > 0.2). The fasting insulin and C-peptide levels, and the post-Sustacal areas under the curve of glucose, insulin, and C-peptide did not differ among the meals. In patients with type 2 diabetes, a large evening meal is associated with a modest elevation in fasting glucose the following morning.

Blood Glucose↗