Nutrients

Research

15 pages, 659 KiB

Open AccessArticle

Enhancing the Impact of Individualized Nutrition Therapy with Real-Time Continuous Glucose Monitoring Feedback in Overweight and Obese Individuals with Prediabetes

by Raedeh Basiri and Lawrence J. Cheskin

Nutrients 2024, 16(23), 4005; https://doi.org/10.3390/nu16234005 - 22 Nov 2024

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Abstract

Background/Objectives: prediabetes is a significant risk factor for the development of type 2 diabetes, cardiovascular diseases, chronic kidney disease, and other complications. Early diagnosis of prediabetes, coupled with education on lifestyle changes that support blood glucose management, are crucial for the prevention or [...] Read more.

Background/Objectives: prediabetes is a significant risk factor for the development of type 2 diabetes, cardiovascular diseases, chronic kidney disease, and other complications. Early diagnosis of prediabetes, coupled with education on lifestyle changes that support blood glucose management, are crucial for the prevention or delay of type 2 diabetes and related complications. This study aimed to evaluate the impact of incorporating real-time feedback from continuous glucose monitoring (CGM) into individualized nutrition therapy (INT) on blood glucose control in individuals with prediabetes who are overweight or obese. Methods: participants (mean age ± SD: 55 ± 6 years; BMI: 31.1 ± 4.1 kg/m²) were randomly assigned to either the treatment group (n = 15) or the control group (n = 15). Both groups received INT and CGM, but the control group was blinded to the CGM data until the end of this study. Participants were followed for 30 days and visited the lab every 10 days for CGM replacement, study measurements, and dietary consultations. Results: the treatment group showed a significant increase in the percentage of time spent in the target blood glucose range (p = 0.02) and a significant decrease in the mean blood glucose concentration (p < 0.05), glucose management indicator (p = 0.02), percent coefficient of variation for blood glucose (p = 0.01), and percent time spent in the high or very high blood glucose ranges (p= 0.04). These changes were not statistically significant for the control group. Conclusions: adding CGM feedback to INT resulted in better management of blood glucose levels in overweight or obese individuals with prediabetes. Full article

(This article belongs to the Special Issue Nutrition Intervention in Glycaemic Control and Diabetes)

14 pages, 304 KiB

Open AccessArticle

The Evaluation of Selected Trace Elements in Blood, Serum and Blood Cells of Type 2 Diabetes Patients with and without Renal Disorder

by Marcin Kosmalski, Rafał Frankowski, Joanna Leszczyńska, Monika Różycka-Kosmalska, Tadeusz Pietras and Iwona Majak

Nutrients 2024, 16(17), 2989; https://doi.org/10.3390/nu16172989 - 4 Sep 2024

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Abstract

Background: An appropriate diet is the basis for the treatment of type 2 diabetes (T2DM). However, there are no strict recommendations regarding the content of micronutrients and their modifications in the presence of chronic kidney disease (CKD). Therefore, we decided to investigate whether [...] Read more.

Background: An appropriate diet is the basis for the treatment of type 2 diabetes (T2DM). However, there are no strict recommendations regarding the content of micronutrients and their modifications in the presence of chronic kidney disease (CKD). Therefore, we decided to investigate whether T2DM patients, including those with CKD, have different levels of chromium, nickel, cobalt, magnesium, and zinc in various blood elements compared to healthy individuals. Methods: We divided our subjects into three groups: the control group (individuals without T2DM and proper renal function), those with T2DM and proper renal function, and those with T2DM and GFR < 60 mL/min/1.73 m². Results: We observed higher levels of chromium in all materials examined in patients with T2DM and impaired renal function. Both study groups found higher levels of nickel in samples of whole blood and red blood cells. Patients with T2DM and proper renal function had higher levels of serum manganese. Both study groups had lower levels of serum zinc. We observed higher levels of chromium in all materials examined in patients with T2DM and impaired renal function. Both study groups found higher levels of nickel in samples of whole blood and red blood cells. Patients with T2DM and proper renal function had higher levels of serum manganese. Both study groups had lower levels of serum zinc. Conclusions: In order to ensure effective care for patients with T2DM, it is necessary to improve the standard diet, including the content of micronutrients and their modification in patients with concomitant CKD. Full article

(This article belongs to the Special Issue Nutrition Intervention in Glycaemic Control and Diabetes)

9 pages, 253 KiB

Open AccessArticle

Factor Associated with Adherence to the Protein and Fat Counting Strategy by Adults with Type 1 Diabetes Mellitus

by Gabriela Correia Uliana, Juliana Carvalho da Costa, Ayla Rocha Quaresma, Arthur Andrade da Fonseca, Kaory Brito Ohaze, Layla Sandia Cezário Alves and Daniela Lopes Gomes

Nutrients 2024, 16(12), 1930; https://doi.org/10.3390/nu16121930 - 18 Jun 2024

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Abstract

Carbohydrate counting is one of the dietary strategies used for the management of type 1 diabetes (T1DM), and counting proteins and fats allows individuals to achieve better glycemic and metabolic control, reducing glycemic variability and long-term complications. The aim of this paper is [...] Read more.

Carbohydrate counting is one of the dietary strategies used for the management of type 1 diabetes (T1DM), and counting proteins and fats allows individuals to achieve better glycemic and metabolic control, reducing glycemic variability and long-term complications. The aim of this paper is to analyze the factors associated with adherence to the protein- and fat-counting strategy in adults with T1DM. This cross-sectional study was conducted from November 2021 to June 2022 through an online questionnaire. We applied Pearson’s Chi-square test with adjusted residual analysis and a binomial logistic regression test using SPSS software, version 24.0, considering p < 0.05 as indicative of statistical significance. There was an association between performing protein and lipid counting and having a higher education level, income exceeding three minimum wages, and having adequate glycated hemoglobin. Performing protein and lipid counting increased the chances of having adequate HbA1c by 4.3 times. Protein and lipid counting was a predictor of having adequate HbA1c. The results suggest that considering the practice of counting proteins and fats is important as a strategy to optimize glycemic control. Full article

(This article belongs to the Special Issue Nutrition Intervention in Glycaemic Control and Diabetes)

13 pages, 653 KiB

Open AccessArticle

Understanding the Impact of Different Doses of Reducose^® Mulberry Leaf Extract on Blood Glucose and Insulin Responses after Eating a Complex Meal: Results from a Double-Blind, Randomised, Crossover Trial

by Pariyarath Sangeetha Thondre, Isabel Butler, Jonathan Tammam, Ifunanya Achebe, Elysia Young, Michael Lane and Andrew Gallagher

Nutrients 2024, 16(11), 1670; https://doi.org/10.3390/nu16111670 - 29 May 2024

Cited by 1 | Viewed by 4112

Abstract

Non-communicable diseases (NCDs) are becoming an increasingly important health concern due to a rapidly ageing global population. The fastest growing NCD, type 2 diabetes mellitus (T2DM), is responsible for over 2 million deaths annually. Lifestyle changes, including dietary changes to low glycemic response [...] Read more.

Non-communicable diseases (NCDs) are becoming an increasingly important health concern due to a rapidly ageing global population. The fastest growing NCD, type 2 diabetes mellitus (T2DM), is responsible for over 2 million deaths annually. Lifestyle changes, including dietary changes to low glycemic response (GR) foods, have been shown to reduce the risk of developing T2DM. The aim of this study was to investigate whether three different doses of Reducose^®, a mulberry leaf extract, could lower the GR and insulinemic responses (IR) to a full meal challenge in healthy individuals. A double-blind, randomised, placebo-controlled, repeat-measure, crossover design trial was conducted by the Oxford Brookes Centre for Nutrition and Health; 37 healthy individuals completed the study. Participants consumed capsules containing either 200 mg, 225 mg, 250 mg Reducose^® or placebo before a test meal consisting of 150 g white bread and egg mayo filler. Capillary blood samples were collected at 15-min intervals in the first hour and at 30-min intervals over the second and third hours to determine glucose and plasma insulin levels. The consumption of all three doses of Reducose^® resulted in significantly lower blood glucose and plasma insulin levels compared to placebo. All three doses of Reducose^® (200 mg, 225 mg, 250 mg) significantly lowered glucose iAUC 120 by 30% (p = 0.003), 33% (p = 0.001) and 32% (p = 0.002), respectively, compared with placebo. All three doses of Reducose^® (200 mg, 225 mg, 250 mg) significantly lowered the plasma insulin iAUC 120 by 31% (p = 0.024), 34% (p = 0.004) and 38% (p < 0.001), respectively. The study demonstrates that the recommended dose (250 mg) and two lower doses (200 mg, 225 mg) of Reducose^® can be used to help lower the GR and IR of a full meal containing carbohydrates, fats and proteins. Full article

(This article belongs to the Special Issue Nutrition Intervention in Glycaemic Control and Diabetes)

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12 pages, 870 KiB

Open AccessArticle

Tailored Meal-Type Food Provision for Diabetes Patients Can Improve Routine Blood Glucose Management in Patients with Type 2 Diabetes: A Crossover Study

by Dong Hoon Jung, Jae Won Han, Hyeri Shin and Hee-Sook Lim

Nutrients 2024, 16(8), 1190; https://doi.org/10.3390/nu16081190 - 17 Apr 2024

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Abstract

This study aimed to determine whether patients with type 2 diabetes can benefit from a meal plan designed based on diabetes management guidelines to improve blood glucose levels. Participants were divided into intervention and control groups. The intervention group consumed a diabetic diet [...] Read more.

This study aimed to determine whether patients with type 2 diabetes can benefit from a meal plan designed based on diabetes management guidelines to improve blood glucose levels. Participants were divided into intervention and control groups. The intervention group consumed a diabetic diet for 2 weeks, while the control group consumed their normal diet. After 2 weeks, the groups switched their dietary regimens. The participants’ demographic and clinical characteristics were evaluated, including factors such as blood pressure, blood lipid levels, weight and waist circumference, blood glucose levels (self-monitored and continuously monitored), nutritional status, and blood-based markers of nutrient intake. The dietary intervention group improved waist circumference, body fat percentage, low-density lipoprotein cholesterol, triglyceride levels, and glucose. The energy composition ratio of carbohydrates and proteins changed favorably, and sugar intake decreased. In addition, the proportion of continuous glucose monitoring readings within the range of 180–250 mg/dL was relatively lower in the intervention group than that of the control group. Meals designed based on diabetes management guidelines can improve clinical factors, including stable blood glucose levels in daily life, significantly decrease the carbohydrate energy ratio, and increase the protein energy ratio. This study can help determine the role of dietary interventions in diabetes management and outcomes. Full article

(This article belongs to the Special Issue Nutrition Intervention in Glycaemic Control and Diabetes)

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16 pages, 5330 KiB

Open AccessArticle

Timing and Nutrient Type of Isocaloric Snacks Impacted Postprandial Glycemic and Insulinemic Responses of the Subsequent Meal in Healthy Subjects

by Xinling Lou, Zhihong Fan, Jinjie Wei, Xiyihe Peng, Jiahui Hu, Xuejiao Lu and Anshu Liu

Nutrients 2024, 16(4), 535; https://doi.org/10.3390/nu16040535 - 14 Feb 2024

Viewed by 2065

Abstract

The aim of the study was to explore the impact of both the macronutrient composition and snacking timing on the postprandial glycemic insulinemic responses and food intake. Seventeen healthy female volunteers completed the randomized crossover trials. The volunteers were provided a standard breakfast [...] Read more.

The aim of the study was to explore the impact of both the macronutrient composition and snacking timing on the postprandial glycemic insulinemic responses and food intake. Seventeen healthy female volunteers completed the randomized crossover trials. The volunteers were provided a standard breakfast and lunch at 8:00 and 13:00, respectively, and an ad libitum dinner at 18:00. Provided at either 10:30 (midmorning) or 12:30 (preload), the glycemic effects of the three types of 70 kcal snacks, including chicken breast (mid-C and pre-C), apple (mid-A and pre-A), and macadamia nut (mid-M and pre-M), were compared with the non-snack control (CON), evaluated by continuous glucose monitoring (CGM). The mid-M showed increased insulin resistance after lunch compared with CON, while the pre-M did not. The pre-A stabilized the glycemic response in terms of all variability parameters after lunch, while the mid-A had no significant effect on postprandial glucose control. Both the mid-C and pre-C improved the total area under the glucose curve, all glycemic variability parameters, and the insulin resistance within 2 h after lunch compared with CON. The pre-C attained the lowest energy intake at dinner, while the mid-A and the mid-M resulted in the highest. In conclusion, the chicken breast snack effectively stabilized postprandial glycemic excursion and reduced insulin resistance while the macadamia snack did not, regardless of ingestion time. Only as a preload could the apple snack mitigate the glucose response after the subsequent meal. Full article

(This article belongs to the Special Issue Nutrition Intervention in Glycaemic Control and Diabetes)

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16 pages, 2136 KiB

Open AccessArticle

Diabetes-Specific Complete Smoothie Formulas Improve Postprandial Glycemic Response in Obese Type 2 Diabetic Individuals: A Randomized Crossover Trial

by Pichanun Mongkolsucharitkul, Bonggochpass Pinsawas, Apinya Surawit, Tanyaporn Pongkunakorn, Thamonwan Manosan, Suphawan Ophakas, Sophida Suta, Sureeporn Pumeiam and Korapat Mayurasakorn

Nutrients 2024, 16(3), 395; https://doi.org/10.3390/nu16030395 - 30 Jan 2024

Viewed by 3367

Abstract

This study aimed to compare newly developed diabetes-specific complete smoothie formulas with a standard diabetes-specific nutritional formula (DSNF) regarding their effects on glucose homeostasis, insulin levels, and lipid metabolism in obese type 2 diabetes (T2DM) patients. We conducted a randomized, double-blind, crossover study [...] Read more.

This study aimed to compare newly developed diabetes-specific complete smoothie formulas with a standard diabetes-specific nutritional formula (DSNF) regarding their effects on glucose homeostasis, insulin levels, and lipid metabolism in obese type 2 diabetes (T2DM) patients. We conducted a randomized, double-blind, crossover study with 41 obese T2DM participants to compare two developed diabetes-specific complete smoothie formulas, a soy-based regular smoothie (SM) and a smoothie with modified carbohydrate content (SMMC), with the standard DSNF, Glucerna. Glycemic and insulin responses were assessed after the participants randomly consumed 300 kilocalories of each formulation on three separate days with a 7-day gap between. Postprandial effects on glycemic control, insulin levels, and lipid metabolism were measured. SMMC resulted in a significantly lower glucose area under the curve (AUC_0–240) compared to Glucerna and SM (p < 0.05 for both). Insulin AUC_0–240 after SMMC was significantly lower than that after SM and Glucerna (p < 0.05). During the diets, the suppression of NEFA was more augmented on SM, resulting in a less total AUC_0–240 of NEFA compared to the SMMC diet (p < 0.05). C-peptide AUC_0–240 after SMMC was significantly lower than that after Glucerna (p < 0.001). Conversely, glucagon AUC_0–240 after SMMC was significantly higher than that after SM and Glucerna (p < 0.05). These results highlight SMMC as the better insulin-sensitive formula, potentially achieved through increased insulin secretion or a direct reduction in glucose absorption. The unique composition of carbohydrates, amino acids, and fats from natural ingredients in the smoothies may contribute to these positive effects, making them promising functional foods for managing diabetes and obesity. Full article

(This article belongs to the Special Issue Nutrition Intervention in Glycaemic Control and Diabetes)

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11 pages, 529 KiB

Open AccessArticle

Sensor-Based Glucose Metrics during Different Diet Compositions in Type 1 Diabetes—A Randomized One-Week Crossover Trial

by Kasper B. Kristensen, Ajenthen G. Ranjan, Olivia M. McCarthy, Richard M. Bracken, Kirsten Nørgaard and Signe Schmidt

Nutrients 2024, 16(2), 199; https://doi.org/10.3390/nu16020199 - 8 Jan 2024

Cited by 2 | Viewed by 3154

Abstract

By reducing carbohydrate intake, people with type 1 diabetes may reduce fluctuations in blood glucose, but the evidence in this area is sparse. The aim of this study was to investigate glucose metrics during a one-week low-carbohydrate-high-fat (HF) and a low-carbohydrate-high-protein (HP) diet [...] Read more.

By reducing carbohydrate intake, people with type 1 diabetes may reduce fluctuations in blood glucose, but the evidence in this area is sparse. The aim of this study was to investigate glucose metrics during a one-week low-carbohydrate-high-fat (HF) and a low-carbohydrate-high-protein (HP) diet compared with an isocaloric high-carbohydrate (HC) diet. In a randomized, three-period cross-over study, twelve adults with insulin-pump-treated type 1 diabetes followed an HC (energy provided by carbohydrate: 48%, fat: 33%, protein: 19%), HF (19%, 62%, 19%), and an HP (19%, 57%, 24%) diet for one week. Glucose values were obtained during intervention periods using a Dexcom G6 continuous glucose monitoring system. Participant characteristics were: 33% females, median (range) age 50 (22–70) years, diabetes duration 25 (11–52) years, HbA1c 7.3 (5.5–8.3)% (57 (37–67) mmol/mol), and BMI 27.3 (21.3–35.9) kg/m². Glycemic variability was lower with HF (30.5 ± 6.2%) and HP (30.0 ± 5.5%) compared with HC (34.5 ± 4.1%) (P_HF-HC = 0.009, P_HP-HC = 0.003). There was no difference between groups in mean glucose (HF: 8.7 ± 1.1, HP: 8.2 ± 1.0, HC: 8.7 ± 1.0 mmol/L, P_Overall = 0.08). Time > 10.0 mmol/L was lower with HP (22.3 ± 11.8%) compared with HF (29.4 ± 12.1%) and HC (29.5 ± 13.4%) (P_HF-HP = 0.037, P_HC-HP = 0.037). In conclusion, a one-week HF and, specifically, an HP diet improved glucose metrics compared with an isocaloric HC diet. Full article

(This article belongs to the Special Issue Nutrition Intervention in Glycaemic Control and Diabetes)

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