Two traditional fermented food 'tapai' (fermented tapioca) and 'tempoyak' (fermented durian flesh), chilli puree and fresh goat's milk were used as sources for the isolation of lactic acid bacteria (LAB). A total of 126 isolates were obtained and by sequential screening for catalase activity and Gram-staining, 55 were determined to be LAB out of which 16 were established to be homofermentative by the gel plug test. Seven isolates were identified by use of the API 50CHL kit and two lactobacilli strains and one lactococci strain were selected to study their growth and lactic acid production profiles in a time course experiment. The lactobacilli strains, both isolated from 'tapai', produced higher amounts of cells and lactic acid from glucose as compared to the lactococci strain isolated from fresh goat's milk.
AIMS: The incidence of type 1 diabetes is increasing in many parts of Asia, where resources may not enable targets for glycemic control to be achieved. The aims of this study were to describe glycemic control, diabetes care, and complications in youth with type 1 diabetes from the Western Pacific Region and to identify factors associated with glycemic control and hypoglycemia.
METHODS: A cross-sectional clinic-based study on 2312 children and adolescents (aged <18 years; 45% males) from 96 pediatric diabetes centers in Australia, China, Hong Kong, Indonesia, Japan, Malaysia, Philippines, Singapore, South Korea, Taiwan, and Thailand was conducted. Clinical and management details were recorded, and finger-pricked blood samples were obtained for central glycated hemoglobin (HbA(1c)).
RESULTS: The median age of the patients was 12.5 years [interquartile range (IQR)=9.4-15.3 years]; diabetes duration, 4.4 years (IQR=2.5-7.2 years); and HbA(1c) level, 8.3% (IQR 7.4%-9.7%). Insulin treatment consisted of one or two daily injections in 61% of the patients (range=22%-90% by country), and home blood glucose monitoring (range=67%-100%) was practiced by 96%. HbA(1c) level was significantly associated with country, age, diabetes duration, sex, insulin dose per kilogram, insulin regimen, and frequency of home blood glucose measurement in multiple regression analysis. The incidence of severe hypoglycemia, defined as any episode requiring assistance in the previous 3 months, was 73 per 100 patient-years and was associated with country, male sex, higher HbA(1c) level, an insulin regimen with three or more injections, and more frequent home blood glucose testing. The incidence of diabetic ketoacidosis was 10 per 100 patient-years and was associated with country, higher HbA(1c) level, and higher insulin dose per kilogram.
CONCLUSIONS: There is marked variability in glycemic control, hypoglycemia, complication rates, and diabetes care among children from the Western Pacific Region. Most are not achieving adequate glycemic control, placing them at high risk of microvascular complications.
The mechanisms involving insulin and anti-hypertensive drugs regulation for in vivo cerebral glucose metabolism are not well-understood. This might be due to lack of direct means of measuring cerebral glucose. It is known that the continuous delivery of glucose to the brain is critical for its normal metabolic function. In this study, we report the effect of insulin and anti-hypertensive drugs on glucose level in the striatum of rats. The rats were divided into two groups, i.e. hyperglycemia (14.8+/-0.3mM plasma glucose) and diabetic (10.8+/-0.2mM plasma glucose). A custom-built glucose microsensor was implanted at coordinates A/P 1.0 from bregma, M/L +2.5 and D/V -5.0 (from dura) in the striatum. The amperometric response obtained at +0.23 V vs. Ag|AgCl corresponded to the glucose level in striatum. By varying the concentrations of protaminc zinc insulin infused into the rats, striatum glucose level was found to remain constant throughout, i.e. 9.8+/-0.1 and 4.7+/-0.1mM for hyperglycemic rats and for diabetic rats, respectively. However, infusion of valsartan and felodipine has lowered the striatum glucose level significantly. These findings agreed with the hypothesis that suggested striatum glucose uptake do not depend on insulin but is clearly dependant on anti-hypertensive drugs administration.
OBJECTIVE: To investigate the self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control.
METHODS: Using a one-to-one interviewing approach, data were collected from 126 diabetic adults from four settings. A 75-item questionnaire was used to assess diabetes-related knowledge and self-care practices regarding, diet, medication, physical activity and self-monitoring of blood glucose (SMBG).
RESULTS: Most subjects had received advice on the importance of self-care in the management of their diabetes and recognised its importance. Sixty-seven subjects (53%) scored below 50% in their diabetes-related knowledge. Subjects who consumed more meals per day (80%), or who did not include their regular sweetened food intakes in their daily meal plan (80%), or who were inactive in daily life (54%), had higher mean fasting blood glucose levels (p=0.04). Subjects with medication non-adherence (46%) also tended to have higher fasting blood glucose levels. Only 15% of the subjects practiced SMBG. Predictors of knowledge deficit and poor self-care were low level of education (p = <0.01), older subjects (p=0.04) and Type 2 diabetes subjects on oral anti-hyperglycaemic medication (p = <0.01).
CONCLUSION: There were diabetes-related knowledge deficits and inadequate self-care practices among the majority of diabetic patients with sub-optimal glycaemic control.
PRACTICE IMPLICATIONS: This study should contribute to the development of effective education strategies to promote health for adults with sub-optimal diabetes control.
The aim of this study was to investigate the influence of some environmental factors on bacterial metabolism. Fermentative hydrogen production by C. acetobutylicum, using glucose as the substrate. The effect of initial pH (4-8), inoculum size (1-20% (v/v)) and glucose concentration (1-30 g L(-1)) on hydrogen production were studied. The optimum cultivation temperature for hydrogen production was at 30 degrees C. The results show that substrate concentration and inoculum size resulted in hydrogen yield (Y(P/S)) of 391 mL g(-1) glucose utilized with maximum hydrogen productivity of 77.5 mL/L/h. Higher substrate concentration or inoculum size adversely affects hydrogen production, which decreases hydrogen yield by 15% to 334 mL g(-1) glucose utilized when 30% (v/v) inoculum size was used. The use of 30 g L(-1) substrate concentration resulted in a 75% decrease to 97 mL g(-1) glucose supplied. Concluded that proper Xo/So enhanced the hydrogen production.
In this present study, we investigated the effects of cocoa extract containing polyphenols and methylxanthines prepared from cocoa powder on the biochemical parameters of obese-diabetic (Ob-db) rats. Obese-diabetic (Ob-db) rats were developed using a high-fat diet (49% fat, 32% carbohydrate, and 19% protein from total energy, kcal) for 3 months, followed by a low dose (35 mg/kg body weight) streptozotocin (STZ) injection. Cocoa extract (600 mg/kg body weight/day) was given to the rats for 4 weeks. The results indicated that there were no significant differences in fasting plasma glucose and insulin level after 4 weeks of cocoa extract administration. Oral glucose tolerance test revealed that cocoa supplementation in Ob-db rats significantly (p < 0.05) reduced plasma glucose at 60 and 90 min compared to unsupplemented Ob-db rats. Plasma free fatty acid and oxidative stress biomarker (8-isoprostane) were significantly (p < 0.05) reduced after cocoa supplementation. Superoxide dismutase activity was enhanced in Ob-db compared to that in nonsupplemented rats. However, no change was observed in catalase activity. The results showed that cocoa supplementation had an effect on postprandial glucose control but not for long term (4 weeks). Moreover, cocoa supplementation could reduce circulating plasma free fatty acid and 8-isoprostane and may enhance the antioxidant defense system.
The objective of this study is to investigate the effect of salts addition to fermentation medium on hydrogen production, under anaerobic batch culture system. In this study, batch experiments were conducted to investigate the inhibitory effect of both NaCl and sodium acetate on hydrogen production. The optimum pH and temperature for hydrogen production were at initial pH of 7.0 and 30 degrees C. Enhanced production of hydrogen, using glucose as substrate was achieved. In the absence of Sodium Chloride and Sodium Acetate enhanced hydrogen yield (Y(P/S)) from 350 mL g(-1) glucose utilized to 391 mL g(-1) glucose utilized with maximum hydrogen productivity of 77.5 ml/L/h. Results also show that sodium chloride and sodium acetate in the medium adversely affect growth. Hydrogen yield per biomass (Y(P/X)) of 254 ml/L/g, biomass per substrate utilized (Y(X/S)) of 0.268 and (Y(H2/S) of 0.0349. The results suggested that Sodium at any concentration resulted to inhibit the bacterial productivity of hydrogen.
The objective of the present study was to measure the glycemic index of durian, papaya, pineapple and water-melon grown in Malaysia. Ten (10) healthy volunteers (5 females, 5 males; body mass index 21.18+/-1.7 kg/m2) consumed 50 g of available carbohydrate portions of glucose (reference food) and four test foods (durian, papaya, pineapple and watermelon) in random order after an overnight fast. Glucose was tested on three separate occasions, and the test foods were each tested once. Postprandial plasma glucose was measured at intervals for two hours after intake of the test foods. Incremental areas under the curve were calculated, and the glycemic index was determined by expressing the area under the curve after the test foods as a percentage of the mean area under the curve after glucose. The results showed that the area under the curve after pineapple, 232+/-24 mmolxmin/L, was significantly greater than those after papaya, 147+/-14, watermelon, 139+/-8, and durian, 124+/-13 mmolxmin/L (p<0.05). Similarly, the glycemic index of pineapple, 82+/-4, was significantly greater than those of papaya, 58+/-6, watermelon, 55+/-3, and durian, 49+/-5 (p<0.05). The differences in area under the curve and glycemic index among papaya, watermelon and durian were not statistically significant. We conclude that pineapple has a high glycemic index, whereas papaya is intermediate and watermelon and durian are low glycemic index foods. The validity of these results depends on the accuracy of the data in the food tables upon which the portion sizes tested were based.
There has been an enormous interest in the development of alternative medicines for type 2 diabetes, specifically screening for phytochemicals with the ability to delay or prevent glucose absorption. The goal of the present study was to provide in vitro evidence for potential inhibition of alpha-glucosidase and alpha-amylase enzymes, followed by a confirmatory in vivo study on rats to generate a stronger biochemical rationale for further studies on the ethanolic extract of Andrographis paniculata and andrographolide. The extract showed appreciable alpha-glucosidase inhibitory effect in a concentration-dependent manner (IC(50)=17.2+/-0.15 mg/ml) and a weak alpha-amylase inhibitory activity (IC(50)=50.9+/-0.17 mg/ml). Andrographolide demonstrated a similar (IC(50)=11.0+/-0.28 mg/ml) alpha-glucosidase and alpha-amylase inhibitory activity (IC(50)=11.3+/-0.29 mg/ml). The positive in vitro enzyme inhibition tests paved way for confirmatory in vivo studies. The in vivo studies demonstrated that A. paniculata extract significantly (P<0.05) reduced peak blood glucose and area under curve in diabetic rats when challenged with oral administration of starch and sucrose. Further, andrographolide also caused a significant (P<0.05) reduction in peak blood glucose and area under the curve in diabetic rats. Hence alpha-glucosidase inhibition may possibly be one of the mechanisms for the A. paniculata extract to exert antidiabetic activity and indicates that AP extract can be considered as a potential candidate for the management of type 2 diabetes mellitus.
A five-month-old Indian girl, product of consanguineous marriage, presented with diarrhoea with an onset within two days after birth, severe malnutrition and metabolic acidosis. The diarrhoea persisted even with lactose-free formula, amino acid-based formula and glucose-containing oral rehydration solution, but stopped when fasted. She required prolonged parenteral nutrition. Fructose and glucose tolerance tests were performed, confirming the child was able to absorb and metabolize fructose but not glucose, indicating a diagnosis of glucose-galactose malabsorption. This case illustrate how simple and pertinent clinical observations and laboratory investigations is sufficient to allow a firm diagnosis to be made.
AIMS: The aim of this study is to compare the efficacy of low glycaemic index (GI) vs. conventional carbohydrate exchange (CCE) dietary advice on glycaemic control and metabolic parameters in patients with type 2 diabetes.
METHODS: A total of 104 patients with type 2 diabetes were randomly assigned to either a low GI (GI) or CCE dietary advice over a 12-week period. The primary end-point was glycaemic control as assessed by glycated haemoglobin A1c (HbA1c), fructosamine level and plasma glucose. The secondary end-points were anthropometric measurements and metabolic parameters that include blood pressure, lipid profile and insulin levels. The oral antidiabetic medications remained unchanged throughout the duration of the study.
RESULTS: A low-GI diet was associated with significant changes in the fructosamine level (DeltaGI = -0.20 +/- 0.03; DeltaCCE = -0.08 +/- 0.03 mmol/l, p < 0.01) and waist circumference (DeltaGI group = -1.88 +/- 0.30 cm; DeltaCCE group: -0.36 +/- 0.4 cm, p < 0.05) at week 4. At week 12, the changes in fasting glucose (DeltaGI = -0.03 +/- 0.3; DeltaCCE = 0.7 +/- 0.3 mmol/l; p < 0.05) and waist circumference (DeltaGI = -2.35 +/- 0.47 cm; DeltaCCE group = -0.66 +/- 0.46 cm; p < 0.05) in the GI group was significantly lower than the CCE group. With the low-GI diet, the changes in postprandial glycaemia at time 0, 60, 150 and 180 min after consuming the standard test meal was lower than with the CCE diet (p < 0.05). No significant differences were found between the groups for the remaining parameters that were measured.
CONCLUSIONS: Use of a low-GI diet resulted in significant changes of serum fructosamine level, plasma glucose and waist circumference in Asian patients with type 2 diabetes over a 12-week period compared with those following a CCE diet. The effect on HbA1c and other metabolic parameters was not significantly different between the two study groups but the improvement within the GI group was more pronounced and of clinical benefit.
A model of glucose regulation system was combined with a model of insulin-signaling pathways in this study. A feedback loop was added to link the transportation of glucose into cells (by GLUT4 in the insulin-signaling pathways) and the insulin-dependent glucose uptake in the glucose regulation model using the Michaelis-Menten kinetic model. A value of K(m) for GLUT4 was estimated using Genetic Algorithm. The estimated value was found to be 25.3 mM, which was in the range of K(m) values found experimentally from in vivo and in vitro human studies. Based on the results of this study, the combined model enables us to understand the overall dynamics of glucose at the systemic level, monitor the time profile of components in the insulin-signaling pathways at the cellular level and gives a good estimate of the K(m) value of glucose transportation by GLUT4. In conclusion, metabolic modeling such as displayed in this study provides a good predictive method to study the step-by-step reactions in an organism at different levels and should be used in combination with experimental approach to increase our understanding of metabolic disorders such as type 2 diabetes.
Sago (Metroxylin sagu) is one of the main sources of native starch. In Malaysia sago dishes are commonly eaten with sugar. However, other societies use sago as a staple food item instead of rice or potato. The study was undertaken to investigate the effect of ingestion of different physical forms of sago supplementation on plasma glucose and plasma insulin responses, as compared to the white bread supplementation in man, during resting condition.
This study was carried out to determine the blood glucose response and glycaemic index (GI) values of four types of commercially available breads in Malaysia. Twelve healthy volunteers (six men, six women; body mass index, 21.9±1.6 kg/m(2); age, 22.9±1.7 years) participated in this study. The breads tested were multi-grains bread (M-Grains), wholemeal bread (WM), wholemeal bread with oatmeal (WM-Oat) and white bread (WB). The subjects were studied on seven different occasions (four tests for the tested breads and three repeated tests of the reference food) after an overnight fast. Capillary blood samples were taken immediately before (0 min) and 15, 30, 45, 60, 90 and 120 min after consumption of the test foods. The blood glucose response was obtained by calculating the incremental area under the curve. The GI values were determined according to the standardized methodology. Our results showed that the M-Grains and WM-Oat could be categorized as intermediate GI while the WM and WB breads were high GI foods, respectively. The GI of M-Grains (56±6.2) and WM-Oat (67±6.9) were significantly lower than the reference food (glucose; GI = 100) (P < 0.05). No significant difference in GI value was seen between the reference food and the GI of WM (85±5.9) and WB (82±6.5) (P > 0.05). Among the tested breads, the GI values of M-Grains and WM-Oat were significantly lower (P < 0.05) than those of WM and WB. There was no relationship between the dietary fibre content of the bread with the incremental area under the curve (r = 0.15, P = 0.15) or their GI values (r = 0.17, P = 0.12), indicating that the GI value of the test breads were unaffected by the fibre content of the breads. The result of this study will provide useful nutritional information for dieticians and the public alike who may prefer low-GI over high-GI foods.
A two-stage fermentation process consisting of dark and photo-fermentation periods was carried out in a batch reactor. In the first stage, glucose was fermented in the dark stage using Clostridium saccharoperbutylacetonicum N1-4 (ATCC 13564; CSN1-4) to produce acetate, CO2 and H2. The acetate produced in the first stage is fermented to H2 and CO2 by Rhodobacter sphaeroides NCIMB 8253 for further hydrogen production in the second, illuminated stage. The yield of hydrogen in the first stage was about 3.10 mol H2 (mol glucose)(-1) at a glucose concentration of 10 g L(-1), pH 6 +/- 0.2 and 37 degrees C and the second stage yield was about 1.10-1.25 mol H2 (mol acetic acid)(-1) at pH 6.8 +/- 0.2 and 32 degrees C, without removal of the Clostridium CSN1-4. The overall yield of hydrogen in the two-stage process, with glucose as the main substrate was higher than single-stage fermentation.
PREMISES AND OBJECTIVES: Antioxidant plays an important role in preventing the progression of diabetes mellitus (DM) complications. The aim of the present study was to investigate the effect of alpha lipoic acid (ALA) supplementation on plasma lipid, oxidative stress and vascular changes in diabetic rats.
Bax is essential for apoptosis in normal cells. However, overexpression of Bcl-2 enhances cell survival by suppressing apoptosis in cells subjected to apoptosis-inducing stimuli. The aim of this study was to examine the expression of apoptotic (Bax and Bcl-2) and biochemical markers in type 2 diabetics mellitus.
INTRODUCTION: This study aimed to compare the quality of life based on the Short Form-36 (SF-36) between two different groups of type 2 diabetes mellitus patients with glycaemic control: those with a glycosylated haemoglobin (HbA1c) level at or below 7.5 percent and those above 7.5 percent.
METHODS: In this cross-sectional study, a generic SF-36 questionnaire was self-administered to patients with type 2 diabetes mellitus. Based on the HbA1c level, the mean SF-36 scale scores were compared. The analysis of covariance was used to obtain the adjusted mean scores of the SF-36 scales while controlling for age and duration of type 2 diabetes mellitus.
RESULTS: 150 patients with type 2 diabetes mellitus were analysed. There were 63 (42 percent) women and 87 (58 percent) men, and their mean HbA1c level was 8.9 percent (SD 2.4 percent). When comparing the two groups of patients with different HbA1c levels, the adjusted means of four scales: physical health functioning, general health, social functioning and mental health, differed significantly between the two. The SF-36 scale scores in type 2 diabetes mellitus patients were also lower than those of the SF-36 norms for the Malaysian population.
CONCLUSION: Type 2 diabetes mellitus patients with poor glycaemic control had lower mean SF-36 scores in physical functioning, general health, social functioning and mental health, and the SF-36 scores in these patients were also lower than the SF-36 norms of the Malaysian population.