Objective: To systematically review the available evidence on the association of HBA1c levels and development of sensorineural hearing loss and to quantitatively analyze the available data on HBA1c levels in patients with type 2 diabetes mellitus and sensorineural hearing loss to determine an HbA1c level that may be associated with the risk of having sensorineural hearing loss. Methods: Design: Systematic Review and Meta-analysis Eligibility Criteria: Cross-sectional studies, or cohort studies which were limited to English language that investigated the correlation of glycemic index using HBA1c and sensorineural hearing loss among adult type 2 diabetic patients which were done from January 2010 to December 2021. Studies with no published outcome, incomplete data or that were ongoing as of August 1, 2022 were also excluded. Information Sources: MEDLINE (through PubMed), Cochrane Library, Scopus, Embase (through OVID@journal), Directory of Open Access Journals (DOAJ), Google Scholar and HERDIN Plus Risk of Bias: Risk of Bias was assessed using the Guidelines for Cochrane Collaboration Synthesis of Results: Results were presented using forest plots for representation. Results: A total of 8 studies were reviewed with 2,103 participants in all. Six articles compared hearing loss incidence between diabetic and non-diabetic patients. Overall, there were a total of 881 diabetic patients and 1222 non-diabetic patients. There was a significantly lower incidence of sensorineural hearing loss in non-diabetic patients with a risk ratio of 1.89, 95% CI [1.65, 2.16]. Three articles compared the HbA1c levels of diabetic patients with or without sensorineural hearing loss. Diabetic patients without sensorineural hearing loss had significantly lower HbA1c levels compared to those with sensorineural hearing loss with mean difference of 1.04, 95%CI [0.82, 1.25]. Conclusion In conclusion, this meta-analysis showed a higher prevalence rate of sensorineural hearing loss among patients with diabetes mellitus compared to non-diabetic patients. Moreover, poor glycemic control among diabetic patients with a glycemic index based on HbA1c of more than 8.3 (6.97-9.6) is associated with sensorineural hearing loss.
diabetes mellitus ; glycemic index ; sensorineural hearing loss ; pure tone audiometry ; deafness

Objective: The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population. Methods: The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models. Results: A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices). Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.
Aged ; Asian Continental Ancestry Group ; Blood Glucose/analysis* ; China/epidemiology* ; Cohort Studies ; Diabetes Mellitus/blood* ; Female ; Glucose Tolerance Test ; Glycated Hemoglobin A/analysis* ; Glycemic Index ; Humans ; Male ; Middle Aged ; Uric Acid/blood*

BACKGROUND/OBJECTIVES: The glycemic index (GI) is a measure of the postprandial glucose response (PPGR) to food items, and glycemic load (GL) is a measure of the PPGR to the diet. For those who need to maintain a healthy diet, it is beneficial to regulate appropriate levels of blood glucose. In reality, what influences the meal GI or GL depends on the macronutrient composition and the physical chemistry reactions in vivo. Thus, we investigated whether different macronutrients in a meal significantly affect the PPGR and the validity of calculated GI and GL values for mixed meals. SUBJECTS/METHODS: 12 healthy subjects (6 male, 6 female) were recruited at a campus setting, and subjects consumed a total of 6 test meals one by one, each morning between 8:00 and 8:30 am after 12 h of fasting. PPGR was measured after each consumed meal and serial finger pricks were performed at indicated times. Test meals included 1) 68 g oral glucose, 2) 210 g rice, 3) rice plus 170 g egg white (RE), 4) rice plus 200 g bean sprouts (RS), 5) rice plus 10 g oil (RO), and 6) rice plus, egg white, bean sprouts, and oil (RESO). The incremental area under the curve (iAUC) was calculated to assess the PPGR. Mixed meal GI and GL values were calculated based on the nutrients the subjects consumed in each of the test meals. RESULTS: The iAUC for all meals containing two macronutrients (RS, RO, or RE) were not significantly different from the rice iAUC, whereas, the RESO iAUC (2,237.5 ± 264.9) was significantly lower (P < 0.05). The RESO meal's calculated GI and GL values were different from the actual GI and GL values measured from the study subjects (P < 0.05). CONCLUSIONS: The mixed meal containing three macronutrients (RESO) decreased the PPGR in healthy individuals, leading to significantly lower actual GI and GL values than those derived by nutrient-based calculations. Thus, consuming various macronutrient containing meals is beneficial in regulating PPGR.
Blood Glucose ; Chemistry, Physical ; Diet ; Egg White ; Fasting ; Fingers ; Glucose ; Glycemic Index ; Glycemic Load ; Healthy Volunteers ; Humans ; Male ; Meals

Over the last decade, genome-wide association studies (GWASs) have provided an unprecedented amount of genetic variations that are associated with various phenotypes. However, previous GWAS were mostly conducted in European populations, and these biased results for non-Europeans may result in a significant reduction in risk prediction for non-Europeans. An issue with the early GWAS was the winner's curse problem, which led to misleading results when constructing the polygenic risk scores (PRS). Therefore, more non-European population-based studies are needed to validate reported variants and improve genetic risk assessment across diverse populations. In this study, we validated 422 variants independently associated with glycemic indexes, liver enzymes, and type 2 diabetes in 125,872 samples from a Korean population, and further validated the results by assessing publicly available summary statistics from European GWAS (n = 898,130). Among the 422 independently associated variants, 284, 320, and 361 variants were replicated in Koreans, Europeans, and either one of the two populations. In addition, the effect sizes for Koreans and Europeans were moderately correlated (r = 0.33–0.68). However, 61 variants were not replicated in both Koreans and Europeans. Our findings provide valuable information on effect sizes and statistical significance, which is essential to improve the assessment of disease risk using PRS analysis.
Asian Continental Ancestry Group ; Bias (Epidemiology) ; Genetic Variation ; Genome-Wide Association Study ; Glycemic Index ; Humans ; Liver ; Phenotype ; Polymorphism, Single Nucleotide ; Risk Assessment

The purpose of this research was to provide basic information for cookies made with black soybeans, chick peas, lentils, oatmeal, and brewer's yeast and to establish the optimum formula for the development of low glycemic index (GI) cookies with high biotin content for lactating women. This study was performed to determine the optimal composite recipe of oatmeal cookies with two different concentrations levels of bean powder (black soybeans, chick peas, lentils) and brewer's yeast using a central composite design. In addition, the mixing conditions of oatmeal cookies were optimized using response surface methodology of sensory evaluation and mechanical and physicochemical analysis. As a result, mechanical and physicochemical analyses showed significant values for lightness, redness, yellowness, hardness, and water content (P < 0.05), while sensory evaluation showed significant values for flavor, taste, crispness, and overall acceptability (P < 0.05). The optimal sensory combination was suggested to be 3.73 g of bean powder and 1.59 g of brewer's yeast. Considering all outcomes obtained throughout the experiments, brewer's yeast, black soybeans, chick peas, lentils, and oatmeal are suitable ingredients for increasing functionality and consumer acceptability of cookies. In addition, these results are expected to be useful in producing cookies of optimal quality, contributing to the development of various nutritious foods, and improving the food industry for lactating women.
Biotin ; Female ; Food Industry ; Glycemic Index ; Hardness ; Humans ; Lens Plant ; Peas ; Saccharomyces cerevisiae ; Skin ; Soybeans ; Water

PURPOSE: The aim of study was to determine the effects of carbohydrate, fat, protein, and fiber contents on glycemic responses in a single food item or meal. METHODS: Glycemic responses were measured in 30 healthy young adults (17 males and 13 females) with various test foods, including rice, egg whites, bean sprouts, olive oil, noodles, prune, broccoli, Korean dishes, Western dishes, and salad dishes, etc. Test foods were designed to contain various carbohydrate, fat, protein, and fiber contents in single or mixed foods or dishes. After 12 hours of fasting, participants consumed test foods, and the glycemic response was measured for a subsequent 120 min (0, 15, 30, 60, 90, and 120 min). Three hundred and fifty three glycemic responses from 62 foods were collected. The incremental area under the curve (AUC) was calculated for each test food for each subject to examine glycemic responses. Statistical analysis was conducted to identify which macronutrient (carbohydrate, fat, protein and fiber) affected the AUC using a mixed model. RESULTS: Carbohydrates (β= 37.18, p < 0.0001) significantly increased while fat (β= −32.70, p = 0.0054) and fiber (β= −32.01, p = 0.0486) significantly reduced the glycemic response. CONCLUSION: It can be concluded that the glycemic response of a meal can be modified depending on the fat and fiber contents of ingredient foods, even though carbohydrate content is maintained.
Area Under Curve ; Brassica ; Carbohydrates ; Egg White ; Fasting ; Glycemic Index ; Humans ; Male ; Meals ; Olive Oil ; Young Adult

BACKGROUND AND PURPOSE: Elevated postprandial blood glucose is a critical risk factor for stroke. The dietary glycemic load (GL) and glycemic index (GI) are frequently used as markers of the postprandial blood glucose response to estimate the overall glycemic effect of diets. We hypothesized that high dietary GL, GI, or total carbohydrate intake is associated with a poor functional outcome in patients with acute ischemic stroke. METHODS: We prospectively included 263 first-ever ischemic stroke patients who completed a semiquantitative food-frequency questionnaire. The dietary GL, GI, and total carbohydrate intake were investigated by examining the average frequency of intake during the previous year based on reference amounts for various food items. Poor functional outcome was defined as a score on the modified Rankin Scale (mRS) of ≥3 at 3 months after stroke. RESULTS: The patients were aged 65.4±11.7 years (mean±standard deviation), and 58.2% of them were male. A multivariate analysis adjusted for age, sex, marital status, prestroke mRS score, diabetes mellitus, hyperlipidemia, body mass index, triglycerides, low-density lipoprotein, hemoglobin A1c, stroke classification, and National Institutes of Health Stroke Scale score, early neurological deterioration, and high-grade white-matter hyperintensities revealed that the dietary GL and total carbohydrate intake were associated with a poor functional outcome, with odds ratios for the top quartile relative to the bottom quartile of 28.93 (95% confidence interval=2.82–296.04) and 36.84 (95% confidence interval=2.99–453.42), respectively (p for trend=0.002 and 0.002, respectively). In contrast, high dietary GI was not associated with a poor functional outcome (p for trend=0.481). CONCLUSIONS: Increased dietary GL and carbohydrate intake were associated with a poor short-term functional outcome after an acute ischemic stroke.
Blood Glucose ; Body Mass Index ; Cerebral Infarction* ; Classification ; Diabetes Mellitus ; Diet ; Glycemic Index ; Glycemic Load* ; Humans ; Hyperlipidemias ; Lipoproteins ; Male ; Marital Status ; Multivariate Analysis ; National Institutes of Health (U.S.) ; Odds Ratio ; Prospective Studies ; Risk Factors ; Stroke ; Triglycerides

PURPOSE: To compare the extent to which three different levels of D-ribose in sugar reduce the glycemic index (GI) and blood glucose response in healthy adults. METHODS: Healthy adults (eight male and six female participants, n = 14) fasted for 14~16 h after eating the same dinner. Participants were then randomized to receive glucose, sucrose, sucrose containing 5% D-ribose (RB5), sucrose containing 10% D-ribose (RB10), or sucrose containing 14% D-ribose (RB14) every week on the same day for 10 weeks (repeating the sample twice). Blood samples were collected by finger prick before and 15, 30, 45, 60, 90, and 120 min after starting to eat. RESULTS: We observed a decreased glycemic response to sucrose containing D-ribose. GIs for sucrose, RB5, RB10, and RB14 were 67.39, 67.07, 47.57, and 45.62, respectively. GI values for sucrose and RB5 were similar to those for foods with a medium GI, and GI values for RB10 and RB14 were similar to those for foods with a low GI. The postprandial maximum blood glucose rise (Cmax) with RB14 was the lowest among the test foods. Cmax values for RB10 and RB14 were significantly lower than that for sucrose. CONCLUSION: The results of this study suggest that sucrose containing D-ribose has an acute suppressive effect on GI and Cmax. In addition, D-ribose active elements in sugar may be effective in preventing blood glucose spikes induced by sucrose intake.
Adult* ; Blood Glucose* ; Eating ; Female ; Fingers ; Glucose ; Glycemic Index* ; Humans ; Male ; Meals ; Ribose* ; Sucrose

PURPOSE: This study primarily aimed to investigate the short- and long-term remission rates of type 2 diabetes (T2D) in patients who underwent surgical treatment for gastric cancer, especially patients who were non-obese, and secondarily to determine the potential factors associated with remission. MATERIALS AND METHODS: We retrospectively reviewed the clinical records of patients with T2D who underwent radical gastrectomy for gastric cancer, from January 2008 to December 2012. RESULTS: T2D improved in 39 out of 70 (55.7%) patients at the postoperative 2-year follow-up and 21 of 42 (50.0%) at the 5-year follow-up. In the 2-year data analysis, preoperative body mass index (BMI) (P=0.043), glycated hemoglobin (A1C) level (P=0.039), number of anti-diabetic medications at baseline (P=0.040), reconstruction method (statistical difference was noted between Roux-en-Y reconstruction and Billroth I; P=0.035) were significantly related to the improvement in glycemic control. Unlike the results at 2 years, the 5-year data analysis revealed that only preoperative BMI (P=0.043) and A1C level (P=0.039) were statistically significant for the improvement in glycemic control; however, the reconstruction method was not. CONCLUSIONS: All types of gastric cancer surgery can be effective in short- and long-term T2D control in non-obese patients. In addition, unless long-limb bypass is considered in gastric cancer surgery, the long-term glycemic control is not expected to be different between the reconstruction methods.
Body Mass Index ; Diabetes Mellitus, Type 2* ; Follow-Up Studies* ; Gastrectomy* ; Gastroenterostomy ; Glycemic Index ; Hemoglobin A, Glycosylated ; Humans ; Illegitimacy* ; Methods ; Retrospective Studies ; Statistics as Topic ; Stomach Neoplasms*

Gestational diabetes mellitus (GDM) is commonly defined a frequent metabolic condition associated with pregnancy that leads to substantial maternal and perinatal complications. Medical nutrition therapy (MNT) is the cornerstone treatment on patients with GDM, and accordingly, it has a significant impact in women and newborns. The main purpose of MNT in GDM is carbohydrates because they are the major nutrient affecting postprandial euglycemia. Recent epidemiological studies suggest that low-carbohydrate intake is related to beneficial effects on maternal and newborn outcomes. Current evidence consistently supports the advantages of using the glycemic index for additional benefit. Therefore in this context, we will discuss from summarize studies involving carbohydrate in GDM. In addition, this article describes the efficacy of low glycemic index diet for the management of GDM.
Carbohydrates* ; Diabetes, Gestational* ; Diet ; Epidemiologic Studies ; Female ; Glycemic Index ; Humans ; Infant, Newborn ; Nutrition Therapy ; Pregnancy