This study was intended to assess the effects of low glycemic index (LGI) nutrition education on dietary management and glycemic control of patients with type 2 diabetes mellitus. The subjects were 48 sex-matched patients with type 2 diabetes mellitus, aged 66.5 +/- 6.2 years, visiting a public health center. They were divided into two groups: the control group (males 10, females 14) and the educated group (males 10, females 14). The educated group was provided with a LGI nutrition education program for 7 weeks. The control group was educated only one time for general diabetic education. Anthropometric indices, knowledge and perception of efficacy of low glycemic index carbohydrates, dietary glycemic index (DGI) and glycemic load (DGL), fasting blood glucose, and HbA1c were assessed. In the educated group body weight, body mass index and systolic blood pressure (from 138.0 +/- 18.9 mmHg to 130.6 +/- 15.0 mmHg) were significantly reduced after the nutrition education (p < 0.05). The scores of knowledge and perception of efficacy of low glycemic index carbohydrates increased significantly in the educated group. Dietary glycemic index and glycemic load of the educated group decreased significantly from 103.4 +/- 67.6 to 45.4 +/- 27.1 (p < 0.001), and from 173.3 +/- 135.9 to 66.8 +/- 50.4 (p < 0.001), respectively. Also fasting blood glucose and HbA1c levels of the educated group significantly decreased from 124.5 +/- 28.8 mg/dL to 96.7 +/- 21.6 mg/dL (p < 0.001) and from 7.1 +/- 1.3% to 6.4 +/- 1.2% (p < 0.05), respectively. The score of knowledge and perception of efficacy of low glycemic index significantly correlated with fasting blood glucose and HbA1c levels negatively. DGI, DGL and duration of diabetes significantly correlated with HbA1c level positively. From stepwise multiple linear regression analysis, DGI, DGL and the duration of diabetes were extracted as factors influencing HbA1c level of the subjects. The results of this study suggest that low glycemic index nutrition education programs is an effective intervention measure for the glycemic control in type 2 diabetic patients.
Aged ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Body Weight ; Carbohydrates ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Dietary Carbohydrates ; Fasting ; Female ; Glycemic Index ; Humans ; Linear Models ; Public Health

PURPOSE: The objective of this study was to compare the effects of three different levels of xylobiose containing sucrose on glycemic indices based on oral glucose tolerance test (OGTT) and blood glucose response in healthy adults. METHODS: Healthy adults (six male and five female participants, n = 11) underwent 14~16 hr of fasting. Subsequently, all participants took 50 g of available carbohydrates from glucose, sucrose containing 7% xylobiose (XB 7), sucrose containing 10% xylobiose (XB 10), or sucrose containing 14% xylobiose (XB 14) every week on the same day for 8 weeks. Finger prick blood was taken before and 15, 30, 45, 60, 90, and 120 min after starting to eat. RESULTS: We observed reduction of the glycemic response to sucrose containing xylobiose. The glycemic indices of XB 7, XB 10, and XB 14 were 57.0, 53.6, and 49.7, respectively. The GI values of XB 7 were similar to those of foods with medium GI, and the GI values of XB 10 and XB 14 were similar to those of foods with low GI. The postprandial maximum blood glucose rise (Cmax) of XB 14 was the lowest among the test foods. XB 7, XB 10, and XB 14 showed significantly lower areas under the glucose curve (AUC) for 0~30 min, 0~60 min, 0~90 min and 0~120 min compared to glucose. CONCLUSION: The results of this study suggest that sucrose containing xylobiose has an acute suppressive effect on GI and postprandial maximum blood glucose rise. In addition, levels of xylobiose in sugar may allow more precise assessment of carbohydrate tolerance despite lower glycemic responses in a dose-dependent manner.
Adult* ; Blood Glucose* ; Carbohydrates ; Fasting ; Female ; Fingers ; Glucose ; Glucose Tolerance Test ; Glycemic Index* ; Humans ; Male ; Sucrose

BACKGROUNDThe consumption of carbohydrate-electrolyte beverages (CEs) has been known to be more effective than plain water for recovery from dehydration. This phenomenon suggests that the ingestion of CEs after dehydration is better than water for maintaining body fluid and plasma volume, and for the recovery from hemoconcentration and high blood viscosity as well. High blood viscosity causes infarction and other cardiovascular events. In this study, CE was compared with water and tea for the ability to reduce increased blood viscosity after dehydration.

METHODSA crossover random control study was conducted to assess the effectiveness of three beverages for rehydration and decreasing of blood viscosity. Following exercise-induced dehydration of 2.2% of body weight in a permanent warm environment, 10 male subjects rested in a thermoneutral environment for 3 hours (rehydration period, REP). The subjects ingested test beverages equal to their body weight loss during the first 20 minutes in REP. Blood and urine samples were obtained throughout the experiments to assess the rehydration effect.

RESULTSThe change in blood viscosity at a shear rate of 5/s was significantly lower in CE ((-1.66 ± 0.21) mPa×s) in comparison to water ((-0.95 ± 0.26) mPa×s) or tea ((-0.92 ± 0.14) mPa×s) at 60th minute during the REP. The fluid retention rate was significantly greater for CE ((77.0 ± 3.9)%) than water ((61.2 ± 3.4)%) and tea ((60.5 ± 3.7)%) for 3 hours of rest in REP.

CONCLUSIONSThe recovery from high blood viscosity induced by dehydration was higher with CE consumption than with water or tea. These results suggest that CE is useful for normalizing increased blood viscosity due to exercise-induced dehydration.

Beverages ; adverse effects ; Blood Viscosity ; drug effects ; Carbohydrates ; Dehydration ; Electrolytes ; adverse effects ; Humans ; Male

The aim of this study was to investigate the effect of loading some small molecule carbohydrates into human platelets on ultrastucture and function. The ultrastructure of platelets were observed by transmission electron microscope (TEM); the platelet counts and mean platelet volume (MPV) were measured by hemocytometer, the maximal platelet aggregation rate was measured optically in an aggregometer; the surface marker of platelet membranes CD62p and phosphatidyl serine were analyzed by flow cytometry. The results showed that no significant changes of the ultrastructure of platelets loaded with small molecule carbohydrates were seen. The aggregation responsiveness of platelets loaded with small molecule carbohydrates reached to 60% of the fresh control platelets. The values of platelet counts and MPV showed no significant differences. The expression level of CD62p and the binding rate with Annexin V before and after loading small molecule carbohydrates into platelets were no different. It is concluded that the platelets after loading with small molecule carbohydrates remained fine ultrastructure and function.
Blood Platelets ; physiology ; ultrastructure ; Blood Preservation ; methods ; Carbohydrates ; pharmacology ; Freeze Drying ; Humans ; P-Selectin ; blood ; Platelet Aggregation

The purpose of this study was to compare nutrient intakes and blood lipids of middle-aged women according to the obesity index by %Fat. Subjects were assigned to one of the following groups based on percentage of body fat (%Fat): normal weight (18% ~ < 28%), overweight (28% ~ < 33%) and obesity (over 33%). Nutrient intakes were evaluated based on questionnaires of 24 hours recall method and blood lipids were analyzed by blood analyzer. The results were as follows. 1) Nutrient intakes were that carbohydrates and fat intakes in obesity group were higher than normal and overweight group but the difference was not significant, and protein intake rate was similar all groups. The intake rate of calcium was higher in normal group than obesity group (p < 0.05), and obesity group ingested under dietary reference intakes. The intake rate of iron was higher in obesity group than normal group (p < 0.05). 2) TG, TC, VLDL and TC/HDL in obesity group were higher than normal group (p < 0.001). The attack rate of coronary heart disease in obesity group is higher than normal group (p < 0.01), LDL, blood glucose and blood pressure in obesity group were higher than normal group (p < 0.01), and HDL was a little higher in normal group than obesity group, but the difference was not significant. 3) The correlation of anthropometric measurements, blood glucose, blood lipid, and blood pressure had significant results. Weight was associated positive level with blood glucose, blood lipid and blood pressure. Waist and WHR were associated positive level with blood glucose and blood lipid but weren't associated with blood pressure. BMI was associated positive level with blood glucose, blood lipid and blood pressure, %Fat was associated positive level with blood lipid and blood pressure, but wasn't associated with blood glucose. These results suggest that the decrease of waist on blood glucose control is better than decrease of % Fat and BMI, the decrease of %Fat and BMI on blood pressure control is better than decrease of waist, and the decrease of %Fat on blood lipid control is better than waist and BMI. The nutritional education for obesity treatment must perform to analyze the blood and assess the obesity degree by %Fat, waist and BMI before nutritional education, so the obesity treatment will be effectively.
Adipose Tissue ; Blood Glucose ; Blood Pressure ; Calcium ; Carbohydrates ; Coronary Disease ; Female ; Humans ; Iron ; Obesity ; Overweight ; Surveys and Questionnaires

OBJECTIVETo investigate the effects of a high-carbohydrate diet on the lipid and apolipoprotein ratios in healthy young adults with different genotypes of the polymorphism at -75 site in the promoter region of the gene of apolipoprotein AI (APOA1).

METHODSFifty-six subjects aged (22.89 +/- 1.80) years were given a wash-out diet for 7 days, followed by a high-carbohydrate diet for 6 days. The wash-out diet contained 15% protein, 31% fat, and 54% carbohydrate. The high-carbohydrate diet contained 15% protein, 15% fat, and 70% carbohydrate. Twelve-hour fasting serum lipids and apolipoproteins B100 and AI were measured on the mornings of the 1st, the 8th, and the 14th days from the beginning of the wash-out diet. The ratios of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC)/HDL-C, low-density lipoprotein cholesterol (LDL-C)/HDL-C, and apolipoprotein B100 (APOB100)/apolipoprotein AI (APOAI) were calculated. The genome DNA was extracted and the polymorphism of APOA1 -75 G/A was determined by polymerase chain reaction followed by restriction fragment length polymorphism assay.

RESULTSAt baseline, the lipid and apolipoprotein ratios showed no significant differences between the GG genotype and the A carriers in males (P > 0.05), whereas the female A carriers had a significantly higher ratio of LDL-C/ HDL-C compared with the female subjects with the GG genotype (P < 0.05). Following the high-carbohydrate diet, significant decreases of TC/HDL-C were found in all the groups, regardless of sex and genotype (P < 0.01). LDL-C/HDL-C experienced significant decreases in both the genotypes in males (P < 0.05), while in females, significant decrease of LDL-C/HDL-C was only observed in A carriers (P < 0.01).

CONCLUSIONThe A allele of the -75 G/A polymorphism in APOA1 may have specific effects on the LDL-C/HDL-C ratio in females.

Adult ; Apolipoprotein A-I ; genetics ; Apolipoproteins ; blood ; Dietary Carbohydrates ; metabolism ; Female ; Genotype ; Humans ; Lipids ; blood ; Male ; Polymorphism, Genetic ; Young Adult

In order to study the relationship between the serum ferritin level and the components of the insulin resistance syndrome in type 2 diabetic patients, we evaluated fifty type 2 diabetic patients who were selected according to NDDG/WHO criteria from those patients attending Korea University Hospital from 1997 to 1998. Twenty-five healthy non-diabetic subjects of comparable age and sex distribution acted as a control group. The results showed that the value of log ferritin was higher in the type 2 diabetes patients than the control subjects, but not at a statistically significant level (p = 0.09). Log ferritin was correlated with fasting blood sugar level (r = 0.235, p = 0.048) and body mass index (BMI) (r = 0.285, p = 0.05). In the type 2 diabetic patients, log ferritin was correlated with fasting C-peptide (r = 0.478, p = 0.009). In the control subjects, log ferritin was correlated only with BMI (r = 0.477, p = 0.012). In a stepwise multiple regression analysis, the diabetic group showed a significant correlation between fasting C-peptide and log ferritin (p = 0.001). In the control group, the fasting sugar level was significantly correlated with log ferritin (p = 0.034). These results suggest that serum ferritin can be employed as a marker of not only glucose homeostasis but also insulin resistance both in type 2 diabetic and control subjects.
Aged ; Body Mass Index ; C-Peptide/blood ; Carbohydrates/blood ; Diabetes Mellitus, Non-Insulin-Dependent/blood* ; Female ; Ferritin/blood* ; Human ; Male ; Middle Age ; Reference Values

The implementation of effective dietary strategies is important for diabetes management. Dietary carbohydrate is the main factor determining blood sugar level, especially in the postprandial period. Carbohydrate-rich diets can have deleterious effects on glycemic control in diabetic patients and may play an important role in the development of cardiovascular diseases. Low glycemic diets have been reported to have beneficial effects for diabetes control and cardiovascular risk factors. However, according to the American Diabetes Association recommendations for medical nutrition therapy, monitoring carbohydrate intake, whether by carbohydrate counting, exchange, or experience-based estimation, remains a key strategy for achieving glycemic control, with the use of the glycemic index and glycemic load recommended only as an auxiliary method that may provide a modest additional benefit for glycemic control over the effects observed when total carbohydrate is considered alone. Recently, an increasing amount of clinical evidence supports the efficacy of low glycemic diets for the management of diabetes. The development of practical methods to apply the glycemic index and glycemic load to the management of diabetes in clinical settings is warranted.
Blood Glucose ; Cardiovascular Diseases ; Diet ; Dietary Carbohydrates ; Glycemic Index ; Humans ; Hyperglycemia ; Nutrition Therapy ; Postprandial Period ; Risk Factors

HbA1c was recently adopted as a reliable indicator for screening diabetes. This study investigated the ability of nutrition consultation to prevent diabetes in overweight women (BMI 23 kg/m2 or more) using HbA1c as an indicator. Twenty overweight and obese women (with HbA1c> or =5.7%) completed the 12-week nutritional study, with individual and personalized nutrition counseling performed every 2 weeks. The main study guidelines involved the following: 1) reducing the intake of high fat foods and alcohol, 2) consuming a large amount of vegetables, 3) reducing the intake of simple sugars and empty-calorie foods, and 4) increasing physical activity to > or =30 min/day. Anthropometric (height, weight, BMI, body muscle (kg), body fat (%), waist and hip circumference, blood pressure) and biochemical parameters (fasting blood sugar (FBS), HbA1c, lipid profiles, hs-CRP) were measured before and after the nutrition consultation. After 12 weeks, the HbA1c<5.7% group had significant decreases in BMI, WC, HC, WHR, HbA1c, hs-CRP and also dietary intake of energy (P<0.01), carbohydrates, lipids (P<0.01), proteins (P<0.01) and cholesterol was significantly decreased (P<0.05). In the HbA1c > or =5.7% group, HbA1c, TC, LDL, NON-HDL, hs-CRP and dietary intake of energy, carbohydrate, lipid, protein, and cholesterol significantly decreased (P<0.05). These results suggest that nutrition consultation effectively helps to prevent diabetes in overweight and obese women after applying HbA1c standards. Overall, the improvement in all markers measured suggest that HbA1c is a good indicator for blood glucose regulation, helping to prevent diabetes.
Adipose Tissue ; Blood Glucose ; Carbohydrates ; Cholesterol ; Counseling ; Female ; Hip ; Humans ; Mass Screening ; Motor Activity ; Muscles ; Overweight ; Proteins ; Vegetables

Carbohydrate(CHO) counting is a meal planning approach used with diabetic patients that focuses on carbohydrate as the primary nutrient affecting post-prandial glycemic response. However, it has not been used in meal management of diabetic patients in Korea. CHO counting can be used by clients with type 1 and 2 diabetes. The purpose of the study was to determine the barriers to utilize the CHO counting when three levels of CHO counting were educated to type 2 diabetic patients who started continuous subcutaneous insulin infusion (CSII) therapy by nutrition lectures and counseling. And the CHO-to-insulin ratios were determined for the individual patients who followed the carbohydrate counting as a meal management, and the factors to influence the CHO-to-insulin ratios were selected through the stepwise regression analysis. Twenty- four subjects were received three lectures, and one or two nutritional counseling for a month. The average age of the subjects was 50.7 years, and the duration of diabetes was 9.4 years. Their body mass index (BMI) was 21.5 kg/m2. The difficulties of using CHO counting were 1) confusing the CHO exchange system to diabetic food exchange system, 2) lack of basic nutrition and not distinguishing nutrients such as CHO, fat and calorie, and 3) lack of motivation to make effort to count and record the amount of carbohydrates eaten. Nutritional counseling replenished the nutrition education and made patients practice CHO counting. Average CHO-to-insulin ratios at breakfast, lunch and dinner were 4.1+/-3.3, 2.9+/-2.6 and 2.9+/-3.0units/23g of CHO, respectively. CHO-to-insulin ratios were influenced by gender, age, BMI, post-prandial blood glucose levels and post-prandial c-peptide levels. The effective education and nutritional counseling of CHO counting can make CHO counting applicable to type 2 diabetic patients as meal management for improving glycemic control with less hypoglycemic episode.
Blood Glucose ; Body Mass Index ; Breakfast ; C-Peptide ; Carbohydrates ; Counseling ; Education ; Humans ; Insulin ; Korea ; Lectures ; Lunch ; Meals* ; Motivation