METHOD: Neonatal streptozotocin-induced non-obese type 2 diabetic rats were treated with a methanolic extract of EO (250 or 500 mg/kg) for 28 days, and blood glucose, serum insulin, and plasma antioxidant status were measured. Insulin and glucagon immunostaining and morphometry were performed in pancreatic section, and liver TBARS and GSH levels were measured. Additionally, EA was tested for glucose-stimulated insulin secretion and glucose tolerance test.
RESULTS: Treatment with EO extract resulted in a significant decrease in the fasting blood glucose in a dose- and time-dependent manner in the diabetic rats. It significantly increased serum insulin in the diabetic rats in a dose-dependent manner. Insulin-to-glucose ratio was also increased by EO treatment. Immunostaining of pancreas showed that EO250 increased β-cell size, but EO500 increased β-cells number in diabetic rats. EO significantly increased plasma total antioxidants and liver GSH and decreased liver TBARS. EA stimulated glucose-stimulated insulin secretion from isolated islets and decreased glucose intolerance in diabetic rats.
CONCLUSION: Ellagic acid in EO exerts anti-diabetic activity through the action on β-cells of pancreas that stimulates insulin secretion and decreases glucose intolerance.
METHODS: Twenty healthy subjects were enrolled in a randomized, 3-way, blinded cross-over trial. The study was registered under ClinicalTrials.gov Identifier no. NCT00123456. At each test day, the subjects received one of three meals comprising 30 g of starch with 5 g of LD or UP or an energy-adjusted control meal containing pea protein. Fasting and postprandial blood glucose, insulin, C-peptide and glucagon-like peptide-1 (GLP-1) concentrations were measured. Subjective appetite sensations were scored using visual analogue scales (VAS).
RESULTS: Linear mixed model (LMM) analysis showed a lower blood glucose, insulin and C-peptide response following the intake of LD and UP, after correction for body weight. Participants weighing ≤ 63 kg had a reduced glucose response compared to control meal between 40 and 90 min both following LD and UP meals. Furthermore, LMM analysis for C-peptide showed a significantly lower response after intake of LD. Compared to the control meal, GLP-1 response was higher after the LD meal, both before and after the body weight adjustment. The VAS scores showed a decreased appetite sensation after intake of the seaweeds. Ad-libitum food intake was not different three hours after the seaweed meals compared to control.
CONCLUSIONS: Concomitant ingestion of brown seaweeds may help improving postprandial glycaemic and appetite control in healthy and normal weight adults, depending on the dose per body weight.
CLINICAL TRIAL REGISTRY NUMBER: Clinicaltrials.gov (ID# NCT02608372).
METHODS: This was a quasi-experimental study conducted in two sub-urban communities in Seremban, Malaysia. A total of 268 participants with prediabetes aged between 18 to 65 years old were assigned to either the community-based lifestyle intervention (Co-HELP) (n = 122) or the usual care (n = 146) groups. The Co-HELP program was delivered in partnership with the existing community volunteers to incorporate diet, physical activity, and behaviour modification strategies. Participants in the Co-HELP group received twelve group-based sessions and two individual counselling to reinforce behavioural change. Participants in the usual care group received standard health education from primary health providers in the clinic setting. Primary outcomes were fasting blood glucose, 2-hour plasma glucose, and HbA1C. Secondary outcomes included weight, BMI, waist circumference, total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, systolic and diastolic blood pressure, physical activity, diet, and health-related quality of life (HRQOL).
RESULTS: An intention-to-treat analysis of between-groups at 12-month (mean difference, 95% CI) revealed that the Co-HELP participants' mean fasting plasma glucose reduced by -0.40 mmol/l (-0.51 to -0.28, p<0.001), 2-hour post glucose by -0.58 mmol/l (-0.91 to -0.24, p<0.001), HbA1C by -0.24% (-0.34 to -0.15, p<0.001), diastolic blood pressure by -2.63 mmHg (-3.79 to -1.48, p<0.01), and waist circumference by -2.44 cm (-4.75 to -0.12, p<0.05) whereas HDL cholesterol increased by 0.12 mmol/l (0.05 to 0.13, p<0.01), compared to the usual care group. Significant improvements were also found in HRQOL for both physical component (PCS) by 6.51 points (5.21 to 7.80, p<0.001) and mental component (MCS) by 7.79 points (6.44 to 9.14, p<0.001). Greater proportion of participants from the Co-HELP group met the clinical recommended target of 5% or more weight loss from the initial weight (24.6% vs 3.4%, p<0.001) and physical activity of >600 METS/min/wk (60.7% vs 32.2%, p<0.001) compared to the usual care group.
CONCLUSIONS: This study provides evidence that a culturally adapted diabetes prevention program can be implemented in the community setting, with reduction of several diabetes risk factors and improvement of HRQOL. Collaboration with existing community partners demonstrated a promising channel for the wide-scale dissemination of diabetes prevention at the community level. Further studies are required to determine whether similar outcomes could be achieved in communities with different socioeconomic backgrounds and geographical areas.
TRIAL REGISTRATION: IRCT201104106163N1.
METHODS: Data of 328 eligible housewives who participated in the MyBFF@Home study was used. Intervention group of 169 subjects were provided with an intervention package which includes physical activity (brisk walking, dumbbell exercise, physical activity diary, group exercise) and 159 subjects in control group received various health seminars. Physical activity level was assessed using short-International Physical Activity Questionnaire. The physical activity level was then re-categorized into 4 categories (active intervention, inactive intervention, active control and inactive control). Physical activity, blood glucose and lipid profile were measured at baseline, 3rd month and 6th month of the study. General Linear Model was used to determine the effect of physical activity on glucose and lipid profile.
RESULTS: At the 6th month, there were 99 subjects in the intervention and 79 control group who had complete data for physical activity. There was no difference on the effect of physical activity on the glucose level and lipid profile except for the Triglycerides level. Both intervention and control groups showed reduction of physical activity level over time.
CONCLUSION: The effect of physical activity on blood glucose and lipid profile could not be demonstrated possibly due to physical activity in both intervention and control groups showed decreasing trend over time.
OBJECTIVES: This review focuses on the current status of diabetes in Malaysia, including epidemiology, complications, lifestyle, and pharmacologic treatments, as well as the use of technologies in its management and the adoption of the World Health Organization chronic care model in primary care clinics.
METHODS: A narrative review based on local available health care data, publications, and observations from clinic experience.
FINDINGS: The prevalence of diabetes varies among the major ethnic groups in Malaysia, with Asian Indians having the highest prevalence of T2D, followed by Malays and Chinese. The increase prevalence of overweight and obesity has accompanied the rise in T2D. Multidisciplinary care is available in tertiary and primary care settings with integration of pharmacotherapy, diet, and lifestyle changes. Poor dietary adherence, high consumption of carbohydrates, and sedentary lifestyle are prevalent in patients with T2D. The latest medication options are available with increasing use of intensive insulin regimens, insulin pumps, and continuous glucose monitoring systems for managing glycemic control. A stepwise approach is proposed to expand the chronic care model into an Innovative Care for Chronic Conditions framework to facilitate implementation and realize better outcomes in primary care settings.
CONCLUSIONS: A comprehensive strategy and approach has been established by the Malaysian government to improve prevention, treatment, and control of diabetes as an urgent response to this growing chronic disease.