BACKGROUND: Rebaudioside A and erythritol are nonnutritive sweeteners. There have been several studies of their glycemic effects, but the outcomes remain controversial. The purpose of this study was to evaluate the glycemic effects of rebaudioside A and erythritol as a sweetener in people with glucose intolerance. METHODS: This trial evaluated the glycemic effect after 2 weeks of consumption of rebaudioside A and erythritol as sweeteners in a pre-diabetic population. The patients were evaluated for fructosamine, fasting plasma glucose, C-peptide, insulin, and 2-hour plasma glucose before and after consumption of sweetener. The primary outcome was a change in fructosamine levels from the baseline to the end of treatment. Secondary outcomes were the changes in levels of fasting plasma glucose and 2-hour plasma glucose. RESULTS: From the baseline to the end of experiment, the changes in fructosamine levels after consumption of rebaudioside A and erythritol, did not differ significantly (244.00±19.57 vs. 241.68±23.39 µmol/L, P=0.366). The change in levels from the baseline to end of the study for rebaudioside A and erythritol were fasting plasma glucose (102.56±10.72 vs. 101.32±9.20 mg/dL), 2-hour plasma glucose (154.92±54.53 vs. 141.92±42.22 mg/dL), insulin (7.56±4.29 vs. 7.20±5.12 IU/mL), and C-peptide (2.92±1.61 vs. 2.73±1.31 ng/mL), respectively, and also did not differ significantly (P>0.05 for all). CONCLUSION: Our study suggests that consumption of rebaudioside A and erythritol does not alter the glucose homeostasis in people with glucose intolerance.
Blood Glucose ; C-Peptide ; Erythritol* ; Fasting ; Fructosamine ; Glucose Intolerance* ; Glucose* ; Homeostasis ; Humans ; Insulin ; Sweetening Agents

PURPOSE: Diabetic complications are a major concern to manage progression of diabetes. Production of advanced glycation end products (AGEs) due to high blood glucose is one of the mechanisms leading to diabetic complications. Multiple pharmacologic AGE inhibitory agents are currently under development, but clinical applications are still limited due to safety issues. Thus, it is necessary to identify a safe anti-glycation agent. It is known that burdock roots have antioxidant, anti-inflammatory, and anti-cancer activities. The objective of the present study was to investigate the inhibitory role of burdock roots on the formation of high glucose-induced glycation of bovine serum albumin (BSA). METHODS: In this study, glycation of BSA by glucose, galactose, or fructose at 37℃ for 3 weeks was assessed based on levels of α-dicarbonyl compounds (early-stage glycation products), fructosamine (intermediate products of glycation), and fluorescent AGEs (late-stage glycation products). In order to compare the inhibitory actions of burdock root extract in AGE formation, aminoguanidine (AG), a pharmacological AGE inhibitor, was used as a positive control. RESULTS: BSA glycation by glucose, fructose, and galatose was dose- and time-dependently produced. Burdock root extract at a concentration of 4 mg/mL almost completely inhibited glucose-induced BSA glycation. The results demonstrate that burdock root extract inhibited AGE formation with an IC₅₀ value of 1.534 mg/mL, and inhibitory activity was found to be more effective than the standard anti-glycation agent aminoguanidine. This study identified a novel function of burdock root as a potential anti-glycation agent. CONCLUSION: Our findings suggest that burdock root could be beneficial for preventing diabetic complications.
Arctium* ; Blood Glucose ; Diabetes Complications ; Fructosamine ; Fructose ; Galactose ; Glucose ; Glycosylation End Products, Advanced ; Hyperglycemia ; Serum Albumin, Bovine

BACKGROUND: 1,5-Anhydroglucitol(1,5-AG) has shown to be a better indicator for current status of glycemia than HbA1c or fructosamine. The concentration of 1,5-AG is stable because of large storage pool and metabolic inertness, little influenced by assay variation with broad range of values. Since its reabsorption is competitively inhibited by glucosuria, plasma 1,5-AG decreases with increasing hyperglycemia in diabetic patients. But impairment of renal function may also affect its concentration. We introduced 1,5-AG as a new marker of glycemic control and evaluated the clinical usefulness and the effect of renal function. METHODS: We assayed plasma concentration of 1,5-AG using gas chromatography mass spectrometry in 36 healthy controls, 39 diabetic patients with normal renal function, 19 nondiabetic patients with chronic renal failure. We examined the relationship bewteen 1,5-AG and HbA1c or glucose. Correlation between 1,5-AG and serum creatinine was also investigated. RESULTS: 1,5-AG concentrations were significantly reduced in diabetic patients and in patients with chronic renal failure, compared to healthy controls. 1,5-AG had negative correlation with plasma glucose and HbA1c in healthy controls and diabetic patients with normal renal function, but not in patients with chronic renal failure. The value of 1,5-AG varies wider than that of HbA1c. CONCLUSIONS: 1,5-AG showed close correlation with glucose and HbA1c and detected subtle changes in glycemia. Therefore, measurement of 1,5-AG would be useful in monitoring glycemic control in diabetic patients with normal renal fucntion. But it would be inappropriate to use 1,5-AG for the evaluation of glycemic control in patients with renal failure.
Blood Glucose ; Creatinine ; Fructosamine ; Gas Chromatography-Mass Spectrometry ; Glucose ; Humans ; Hyperglycemia ; Kidney Failure, Chronic ; Plasma ; Renal Insufficiency

BACKGROUND: There have been many reports that 1,5-Anhydroglucitol (1,5-AG) was a better marker than the hemoglobin A1c (HbA1c) or fructosamine for monitoring the control of glucose in patients with Diabetes Mellitus (DM). However, there was difficulty in performing the tests on the patient's samples in the hospital laboratory because the measurement was possible only with gas chromatog-raphy or high performance chromatography. Recently, a reagent that can measure 1,5-AG on the automatic chemistry analyzer was introduced. We evaluated the analytical and clinical characteris-tics of the reagent. METHODS: We measured the 1,5-AG with the Lana(TM) (Japan Chemistry Medicine, Tokyo, Japan) on the automatic chemistry analyzer, TBA-30FR (Toshiba, Otawara, Japan). We evaluated the pre-cision, the recovery rate, the lower detection limit, the reference value, and the correlation with other clinical markers for glucose control of the DM patient. RESULTS: The within-run precisions of abnormal and normal samples were 1.27% and 1.41%. The between-day precisions were 2.34% and 4.56%, respectively. The recovery rate was 100.1% and 100.7% in abnormal and normal samples, respectively. The lower detection limit was 0.05 mg/L. The reference value from the healthy people was from 12.7 to 50.9 mg/L. The correlation coefficients of the 1,5-AG with glucose and HbA1c were -0.45 and -0.63, respectively. CONCLUSIONS: The newly introduced reagent for 1,5-AG that could be applied with the automatic chemistry analyzer was enough to satisfy the analytical features and it showed better correlation with HbA1c than with the fasting blood glucose. We expect that the Lana(TM) can be used in hospital lab-oratories to monitor the blood glucose control of DM patients and more studies on the clinical value of the 1,5-AG can be done with the convenient reagent such as this.
Biomarkers ; Blood Glucose ; Chemistry ; Chromatography ; Diabetes Mellitus ; Fasting ; Fructosamine ; Glucose ; Humans ; Laboratories, Hospital ; Limit of Detection ; Reference Values

BACKGROUND: It is known that chronic sustained hyperglycemia and its consequent oxidative stress causes diabetic complication in type 2 diabetes. It has been further proven that glycemic variability causes oxidative stress. The aim of this study is to measure the average daily risk range (ADDR)-index of glycemic variability, and to evaluate relevant variables. METHODS: We measured the blood glucose level of type 2 diabetic patients who were treated with multiple daily injections from January to July, 2008. The blood glucose levels were checked four times a day for 14 days and were conversed according to the ADRR formula. The degree of glycemic variability was categorized into non-fluctuation and fluctuation groups. We collected patient data on age, sex, duration of diabetes, body mass index, HOMA(IR), HOMA(betacell) and HbA1c. RESULTS: A total of 97 patients were enrolled in this study. The mean age, duration of diabetes, HbA1c and mean ADRR were 57.6 +/- 13.4, 11.5 +/- 8.5 years, 10.7 +/- 2.5%, and 26.6 +/- 9.8, respectively. We classified 18.5% of the patients to the non-fluctuation group, and 81.5% to the fluctuation group. ADRR was significantly correlated with duration of diabetes, fasting and postprandial glucose, fructosamine, HbA1c and BMI and HOMAbetacell. In addition, this study confirmed that BMI, HOMAbetacell and HbA1c were ADRR-related independent variables. CONCLUSION: ADRR can be used as an index for blood glucose fluctuation in type 2 diabetic patients. Measuring ADRR in patients with low BMI and a long duration of diabetes is helpful to improve the effectiveness of their care.
Blood Glucose ; Body Mass Index ; Diabetes Complications ; Diabetes Mellitus, Type 2 ; Fasting ; Fructosamine ; Glucose ; Humans ; Hyperglycemia ; Inpatients ; Oxidative Stress

BACKGROUNDThe concentration of serum fructosamine is correlated with plasma glucose level. The aim of this study was to determine whether the level of serum fructosamine can be diagnostic for abnormal glucose tolerance in pregnant women.

METHODSSerum samples were collected from 161 pregnant women between November 2004 and April 2005. The women were divided into three groups according to the gestational age (16 - 20 weeks group, 56 patients; 28 - 34 weeks group, 72; and 37 - 41 weeks group, 33). Each group was subdivided into normal and abnormal glucose tolerance subgroups. The levels of serum fructosamine were measured. Differences among the groups were assessed by ANOVA and Student-Newman-Keuls test. Correlations between the level of fructosamine and other variables including the results of glucose challenge test (GCT), oral glucose tolerance test (OGTT), and glycosylated hemoglobin (HbA1c) test, and infant's birth weight were analyzed by Pearson correlation.

RESULTSThe level of serum fructosamine decreased with gestational age [(223.25 +/- 48.90) micromol/L, (98.44 +/- 29.57) micromol/L, and (53.99 +/- 29.94) micromol/L, respectively. P < 0.05]. It was higher in women with abnormal glucose tolerance than that in women with normal glucose tolerance, however, the difference reached statistical significance only in the 28 - 34 weeks group (P < 0.05). In this group, the level of serum fructosamine correlated positively with the GCT result (r = 0.28, P < 0.05). No correlation was found between fructosamine level and OGTT result, HbA1c level, or neonatal weight.

CONCLUSIONSFructosamine can be used to monitor the glucose level of pregnant women with abnormal glucose tolerance, and to identify the patients at high risk of abnormal glucose tolerance, but can not be used to predict gestational diabetes mellitus (GDM) in early stage of pregnancy.

Adult ; Case-Control Studies ; Diabetes, Gestational ; blood ; Female ; Fructosamine ; blood ; Glucose Intolerance ; blood ; Glucose Tolerance Test ; Humans ; Pregnancy ; Pregnancy Complications ; blood

BACKGROUND: With respect to the risk of developing diabetic vascular complications, the central purpose of most screening and detection program, is to identify people with diabetes at early stage so they might have advantages of early treatment to prevent complication of the disease. Oral glucose tolerence test(OGTT) is widely used for diagnosis of diabetes and impaired glucose tolerence, bit the performance of a complete OGTT is not only time consuming and expensive but physically demanding on the individual being tested. Determination of HbA1 and more recently of glycosylated total serum proteins(fructosamine) has been proposed as an alternative method of screening and diagnosis. The aim of our cross-sectional study is to compare the values of fructosamine and HbA1, for the ourpose of diabetes diagnosis with the OGTT as reference method. METHODS: In the study, from January 1996 to August 1996, we included 55 consecutive subjects in Kyeungssang Hospital. Blood samples for HbA1 and fructosamone determination were drawn at the same time as a fasting plasma glucose sample, and then all subjects underwent a standard 2-hour OGTT according to the World Health Organization recom-mandations, The subjects were classified according to the American Diabetes Association classification. RESULTS: In our study, we observed fasting plasma glucose of 145.32+/-75.00mg/deciliter, two-hour plasma glucose of 245.83+/-155.22mg/deciliter, HbA1 of 7.06+/-2.77%, and fructosamine of 308.77+/-128.23 micromol/liter. The correlation coefficient between FPG and HbA1 was 0.9098(p<.05), between FPG and fructosamine 0.7953(pfructosamine 0.7770(p<.05), and between HbA1 and fructosamine with OGTT as a reference. After combination of FPG ir 2h-PG and HbA1 especially fructosamine, sensitivity was increased, Receiver operating characteristic curves showed the cutoff point of HbA1 7.0mg/deciliter, of fructosamine 290 micromol/liter. CONCLUSION: As observed in our study, HbA1 and fructosamine were highly correlated with FPG and 2h-PG. Combination of HbA1 or fructosamine and FPG or 2h-PG improve prediction over FPG or 2h-PG alone, especially fructosamine and FPG or 2h-PG combination. We conclude that measurement of HbA1 or fructosamine may be a useful diagnostic test for diabetes.
Blood Glucose ; Classification ; Cross-Sectional Studies ; Diabetic Angiopathies ; Diagnosis* ; Diagnostic Tests, Routine ; Fasting ; Fructosamine* ; Glucose ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated* ; Mass Screening ; ROC Curve ; World Health Organization

This case report describes the long-term follow-up of a 22-year-old, female patient with type 1 diabetes managed by conservative oral care and glycemic control measures. She is on a twice a day insulin regimen. Tooth numbers 13 and 37 had pockets less than 6 mm while all remaining teeth had greater than 6 mm. Periodontal management consisted of root planing combined with instructions on diabetes self-management skills at home. Nine weeks after the first sextant was treated, pocket depth measurements in 93 (81.6%) out of 114 sites and bleeding on probing (BOP) scores in 11 (57.9%) out of 19 teeth decreased. There was a 50% reduction in the C reactive Protein and a 46.7% decrease in the fructosamine assay levels. Initial glycohemoglobin level of 8.3% decreased substantially to 7.1%. The goal of the dentist is no longer just the improvement of oral health but ultimately the overall health of the patient and the physician's goal is to include oral health in the promotion of overall health.

Human ; Female ; Adult ; Young Adult ; Blood Glucose ; C-reactive Protein ; Clinical Protocols ; Dentists ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus ; Fructosamine ; Insulin ; Oral Health ; Self Care ; Tooth Root ; Periodontitis

An 8-year-old male Austrian Pinscher and a 14-year-old male Golden Retriever were presented for evaluation due to unexplainable high fructosamine values despite euglycemia and epistaxis in combination with polydipsia/polyuria, respectively. Blood analysis revealed severe hyperglobulinemia, hypoalbuminemia and markedly elevated fructosamine concentrations in both dogs. Multiple myeloma with IgA-monoclonal gammopathy was diagnosed by serum and urine electrophoresis including immunodetection with an anti-dog IgA antibody and bone marrow aspirations. Diabetes mellitus was excluded by repeated plasma and urine glucose measurements. Fructosamine values were positively correlated with globulin, but negatively correlated with albumin concentrations. These cases suggest that, as in human patients, monoclonal IgA gammopathy should be considered as a possible differential diagnosis for dogs with high fructosamine concentrations.
Animals ; Blood Proteins/analysis ; Dog Diseases/*blood/drug therapy ; Dogs ; Fructosamine/*blood ; Immunoglobulin A/*metabolism ; Male ; Melphalan/therapeutic use ; Multiple Myeloma/complications/drug therapy/*veterinary ; Myeloablative Agonists/therapeutic use ; Paraproteinemias/blood/complications/drug therapy/*veterinary

The hypoglycemic effects after oral administration of vanadium have been studied previously in many species such as rats, mice and even humans. However, there has been no prior report on the glucose lowering effect of vanadium on diabetic dogs. Therefore, the purpose of this study was to evaluate the hypoglycemic effects of oral vanadium on diabetic dogs. Diabetes mellitus in the dogs studied was induced by alloxan monohydrate intravenous injection. The dogs were divided into two groups, one was the diabetic control (DC) group (n = 4) and the other was the vanadium treated (DV) group (n = 6). Fresh water was supplied to the dogs in the DC group, but sodium metavanadate solution (0.1~0.2 mg/ml) was given to the dogs in DV group from one week after the alloxan injection. The fasting glucose levels, fructosamine and serum chemistry profiles were compared between the two groups weekly for three weeks. The fasting blood glucose levels in DV group were significantly lower than those in the DC group (p < 0.01). Fructosamine levels in the DV group were also lower than those in the DC group (p < 0.05). The serum chemistry profiles were not significantly different in comparisons between the two groups. However, the cholesterol levels were significantly lower in the DV group compared to the DC group (p < 0.05). Our findings showed that oral vanadium administration had a hypoglycemic effect on chemically induced diabetic dogs.
Alanine Transaminase/blood ; Alkaline Phosphatase/blood ; Animals ; Aspartate Aminotransferases/blood ; Blood Glucose/metabolism ; Blood Urea Nitrogen ; Chlorides/blood ; Cholesterol/blood ; Creatinine/blood ; Diabetes Mellitus, Experimental/blood/*drug therapy ; Dog Diseases/blood/*drug therapy ; Dogs ; Female ; Fructosamine/blood ; Hypoglycemic Agents/*pharmacology ; Male ; Pancreas/drug effects/pathology ; Potassium/blood ; Random Allocation ; Sodium/blood ; Triglycerides/blood ; Vanadates/*pharmacology