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  1. Fulltext A web-based dietary intervention for people with type 2 diabetes: development, implementation, and evaluation
    Ramadas A, Chan CK, Oldenburg B, Hussien Z, Quek KF
    Int J Behav Med, 2015 Jun;22(3):365-73.
    PMID: 25274015 DOI: 10.1007/s12529-014-9445-z
    BACKGROUND: Diabetes is becoming a very important health issue in rapidly developing nations and there is an urgent need to improve overall diabetes self-management education in these countries. Although e-health is an emerging theme, only a few successful web-based studies on diabetes self-management have been reported.
    PURPOSE: We describe the development, implementation, and process evaluation of an Internet-delivered dietary intervention program (myDIDeA) for diabetic patients in a developing country.
    METHOD: Specific dietary components to be included in the intervention module were first identified through a comprehensive review of literature and guidelines. The lesson plans and the study website were then developed based on the evidence, Transtheoretical Model's Stages of Change and user-centered design approach. Finally, the effectiveness of the website was tested through a randomized-controlled trial to promote dietary change in patients with type 2 diabetes. The participants in the intervention group (n = 66) were given access to myDIDeA for 6 months. Process evaluation in form of intervention adherence and program reception were conducted at post intervention.
    RESULTS: The response rate for the process evaluation was 89%. On average, each participant logged in at least once for each lesson plan and spent almost 12 min on the site. The participants' content satisfaction, acceptability, and usability scores were satisfactory. The primary outcome of the trial, Dietary Knowledge, Attitude, and Behavior score was strongly correlated with content satisfaction (r = 0.826, p 
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  2. Patient Perspective on Factors Contributing to Nonadherence to Dietary Therapy: A Qualitative Study in Multicultural Population of Kedah, Malaysia
    Mohd Suan MA, Asli SE, Abdullah WM, Shafie Z, Johari NH
    Int Q Community Health Educ, 2019 Jul;39(4):217-223.
    PMID: 30587080 DOI: 10.1177/0272684X18821306
    The purpose of this study is to explore diabetes patients' views on various factors contributing to nonadherence to dietary therapy. Using a qualitative approach, 17 in-depth interviews were conducted with type 2 diabetes mellitus patients at Hospital Sultanah Bahiyah, Kedah state, Malaysia. All interviews were audio recorded, transcribed verbatim, and translated before analysis. Thematic content analysis was used and three main themes emerged. The main factors that affect diabetes patients' dietary adherence were "individual preference," "family support," and "social and cultural activities." Difficulty to change the existing meals, poor family support, practice of eating out, and social and cultural gatherings were among the factors that influenced diabetes patients' adherence toward dietary therapy. Most challenges were related to the social role of food in the multicultural population. Therefore, in addition to the family and community involvement, dietary therapy should be individualized to improve patient adherence.
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy
  3. Dietary self-management practices among persons with T2DM: An exploratory qualitative study from western-coast of India
    Matpady P, Maiya AG, Saraswat PP, Mayya SS, Pai MS, S AD, et al.
    Diabetes Metab Syndr, 2020 11 04;14(6):2161-2167.
    PMID: 33395776 DOI: 10.1016/j.dsx.2020.10.033
    BACKGROUND: Diabetes is a significant public health challenge for India. Self-management, including dietary management, physical activity, stress management, and adherence to medication, is critical in glycaemic control. Though data concerning self-management, in general, are available among persons with Type 2 Diabetes Mellitus (T2DM), exclusive research on dietary self-management was limited.

    AIMS: A qualitative study to explore the knowledge, current dietary practices, and the barriers and enablers for dietary self-care management in persons with T2DM.

    METHODS: In this qualitative study, in-depth interviews were conducted among 35 participants with T2DM who scored minimally and optimally in the Diabetes Self-Management Questionnaire (DSMQ). Interviews were conducted using a validated interview guide. In-depth interviews were audio-recorded, transcribed to verbatim and thematically analysed.

    RESULTS: The study included 20 males and 15 females. The three major themes derived in the study. Firstly, "Knowledge, Interpretation and Information" the majority of the participants have understood the influence of diet on control of blood glucose level includes food choices and quantum of food. Secondly, "Current Dietary Practices-Preferences, Availability of food and Convenience influence dietary practices': All participants had their own belief on the side effects and benefits of certain food items. Most of the participants followed a three-meal pattern: breakfast, lunch and dinner. Finally, Barriers and Enablers in dietary self-management practice. Knowledge, physical and emotional factors, behaviour, planning were the intrinsic factors. Elements of the research, social support, season and climate, food environment were the extrinsic factors and communication, and financial management was the intermediate influences observed.

    CONCLUSION: The themes generated by this research provide insight into self-management and patient expectations in dietary matters. It would be desirable for physicians and health care providers to be aware of these practices when advising people with T2DM on dietary self - management.

    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  4. Interesterified palm olein lowers postprandial glucose-dependent insulinotropic polypeptide response in type 2 diabetes
    Mo SY, Lai OM, Chew BH, Ismail R, Bakar SA, Jabbar NA, et al.
    Eur J Nutr, 2019 Aug;58(5):1873-1885.
    PMID: 29872922 DOI: 10.1007/s00394-018-1738-6
    PURPOSE: We aim to investigate the postprandial effects of palm olein (PO) and chemically interesterified palm olein (IPO) with different proportions of palmitic acid at the sn-2 position using high oleic sunflower oil (HOS) as control fat on concentrations of gut hormones, glucose homeostasis, satiety, lipid and inflammatory parameters in type 2 diabetic (T2D) subjects.

    METHODS: Using a randomised double-blind crossover design, 21 (men = 6, women = 15) T2D subjects consumed test meals (3.65 MJ) consisting of a high fat muffin (containing 50 g test fats provided as PO, IPO or HOS) and a milkshake. Postprandial changes in gut hormones, glucose homeostasis, satiety, lipid and inflammatory parameters after meals were analysed. Some of the solid fractions of the IPO were removed and thus the fatty acid composition of the PO and IPO was not entirely equal (PO vs IPO: palmitate 39.8 vs 38.7; oleate 43.6 vs 45.1). PO, IPO and HOS contained 9.7, 38.9 and 0.2 g/100 g total fatty acids of palmitic acid at the sn-2 position, respectively. At 37 °C, IPO contained 4.2% SFC whereas PO and HOS were completely melted.

    RESULTS: Our novel observation shows that the incremental area under curve (iAUC) 0-6 h of plasma GIP concentration was on average 16% lower following IPO meal compared with PO and HOS (P 

    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  5. Fulltext The Need to Calculate Target Glucose Levels When Measuring Changes in Insulin Sensitivity During Interventions for Individuals With Type 2 Diabetes
    Othman NA, Docherty PD, Krebs JD, Bell DA, Chase JG
    J Diabetes Sci Technol, 2018 05;12(3):665-672.
    PMID: 29295634 DOI: 10.1177/1932296817750402
    BACKGROUND: Physiological models that are used with dynamic test data to assess insulin sensitivity (SI) assume that the metabolic target glucose concentration ( GTARGET) is equal to fasting glucose concentration ( G0). However, recent research has implied that irregularities in G0 in diabetes may cause erroneous SI values. This study quantifies the magnitude of these errors.

    METHODS: A clinically validated insulin/glucose model was used to calculate SI with the standard fasting assumption (SFA) G0 = GTARGET. Then GTARGET was treated as a variable in a second analysis (VGT). The outcomes were contrasted across twelve participants with established type 2 diabetes mellitus that were recruited to take part in a 24-week dietary intervention. Participants underwent three insulin-modified intravenous glucose tolerance tests (IM-IVGTT) at 0, 12, and 24 weeks.

    RESULTS: SIVGT had a median value of 3.36×10-4 L·mU-1·min-1 (IQR: 2.30 - 4.95×10-4) and were significantly lower ( P < .05) than the median SISFA (6.38×10-4 L·mU-1·min-1, IQR: 4.87 - 9.39×10-4). The VGT approach generally yielded lower SI values in line with expected participant physiology and more effectively tracked changes in participant state over the 24-week trial. Calculated GTARGET values were significantly lower than G0 values (median GTARGET = 5.48 vs G0 = 7.16 mmol·L-1 P < .001) and were notably higher in individuals with longer term diabetes.

    CONCLUSIONS: Typical modeling approaches can overestimate SI when GTARGET does not equal G0. Hence, calculating GTARGET may enable more precise SI measurements in individuals with type 2 diabetes, and could imply a dysfunction in diabetic metabolism.

    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy
  6. Fulltext Randomised-controlled trial of a web-based dietary intervention for patients with type 2 diabetes mellitus: study protocol of myDIDeA
    Ramadas A, Quek KF, Chan CK, Oldenburg B, Hussein Z
    BMC Public Health, 2011;11:359.
    PMID: 21599990 DOI: 10.1186/1471-2458-11-359
    The potential of web-based interventions in dietary behaviour modification of the diabetics has not been fully explored. We describe the protocol of a 12-month match-design randomised controlled trial of a web-based dietary intervention for type 2 diabetic patients with primary aim to evaluate the effect of the intervention on their dietary knowledge, attitude and behaviour (KAB). The secondary objective of this study is to improve the participants' dietary practices, physical measurements and biomarkers.
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  7. Fulltext Comparison of Structured Nutrition Therapy for Ramadan with Standard Care in Type 2 Diabetes Patients
    Mohd Yusof BN, Wan Zukiman WZHH, Abu Zaid Z, Omar N, Mukhtar F, Yahya NF, et al.
    Nutrients, 2020 Mar 19;12(3).
    PMID: 32204476 DOI: 10.3390/nu12030813
    (1) Background: Structured nutrition therapy (NT) is essential for the management of type 2 diabetes (T2D), but the optimal delivery during Ramadan fasting remains unclear. The present study aimed to evaluate the effect of structured NT program versus standard care in patients with T2D during Ramadan. (2) Methods: The present study was an 8-week, parallel, non-randomized study with patients' preference design involving 64 patients with T2D. The participants were asked to choose their preferred group, i.e., structured NT (Structured Ramadan NT, sRNT) or standard care (SC). The participants in the sRNT group received a Ramadan-focused nutrition plan, including a diabetes-specific formula throughout the study, whereas the patients in the SC group received standard nutrition care. Study outcomes included clinical outcomes and quality of life (QoL). Data was analyzed using two-way repeated-measures ANOVA and linear mixed-effects model. (3) Results: More than half of the participants (n = 38, 63%) chose sRNT as their preferred group. Both groups had comparable baseline characteristics. After 8-weeks of the respective intervention, participants in the sRNT group had lower levels of fasting plasma glucose (-0.9 ± 0.3 mmol/L vs. 0.2 ± 0.3 mmol/L, p < 0.05), triglycerides (-0.21 ± 0.08 mmol/L vs. 0.20 ± 0.17 mmol/L, p < 0.05), and self-monitoring glucose at pre-dawn (6.9 mmol/L vs. 7.8 mmol/L, p < 0.05) and pre-bedtime (7.6 mmol/L vs. 8.6 mmol/L, p < 0.05) than participants in the SC group. Although not different between groups, HbA1c levels decreased significantly in the sRNT (-0.72 ± 0.16%, p < 0.001) but not in the SC group (-0.35 ± 0.24%, p = 0.155). QoL and satisfaction scores improved significantly in sRNT group, but not in SC group. (4) Conclusions: The structured NT regimen for Ramadan is a feasible and beneficial program for T2D patients observing Ramadan fasting as it showed an improvement in clinical outcomes and QoL.
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  8. Fulltext Randomised-controlled trial of a web-based dietary intervention for patients with type 2 diabetes: changes in health cognitions and glycemic control
    Ramadas A, Chan CKY, Oldenburg B, Hussein Z, Quek KF
    BMC Public Health, 2018 06 08;18(1):716.
    PMID: 29884161 DOI: 10.1186/s12889-018-5640-1
    BACKGROUND: Increasing prevalence and disease burden has led to an increasing demand of programs and studies focused on dietary and lifestyle habits, and chronic diseases such as type 2 diabetes mellitus (T2DM). We evaluated the effects of a 6-month web-based dietary intervention on Dietary Knowledge, Attitude and Behaviour (DKAB), Dietary Stages of Change (DSOC), fasting blood glucose (FBG) and glycosylated haemoglobin (HbA1c) in patients with uncontrolled HbA1c (> 7.0%) in a randomised-controlled trial (myDIDeA) in Malaysia.

    METHODS: The e-intervention group (n = 62) received a 6-month web-delivered intensive dietary intervention while the control group (n = 66) continued with their standard hospital care. Outcomes (DKAB and DSOC scores, FBG and HbA1c) were compared at baseline, post-intervention and follow-up.

    RESULTS: While both study groups showed improvement in total DKAB score, the margin of improvement in mean DKAB score in e-intervention group was larger than the control group at post-intervention (11.1 ± 0.9 vs. 6.5 ± 9.4,p 

    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  9. Fulltext Factors associated with dietary diversity score among individuals with type 2 diabetes mellitus
    Tiew KF, Chan YM, Lye MS, Loke SC
    J Health Popul Nutr, 2014 Dec;32(4):665-76.
    PMID: 25895200
    Studies on diet quality among individuals with type 2 diabetes mellitus (T2DM) are scarce. This crosssectional study aimed to assess the diet quality and to determine its associated factors among individuals with T2DM at the Medical Outpatients Department, Serdang Hospital, Selangor, Malaysia, from July 2010 to March 2011. Subjects were interviewed for sociodemographic data. Diabetes history was retrieved from the hospital's e-database. Usual dietary intake was measured using a food frequency questionnaire, from which a dietary diversity score was obtained with two measures: Food Group Score and Serving Score were constructed based on the Malaysian Dietary Guidelines. Food Group Score was computed from the number of food groups consumed from five major food groups (grains, vegetables, fruits, meat, and dairy products) whereas Serving Score was computed from the number of servings consumed from the various food groups. Anthropometric measures, including weight, height, waist- and hip-circumference were examined. For data analyses, descriptive statistics, simple and multiple linear regression were conducted using IBM SPSS Statis- tics 20.0. A total of 113 subjects (50.4% female), with mean?SD age of 54.05 +/- 10.30 years and duration of diabetes of 11.25?9.05 years were studied. The mean Food Group Score and Serving Score were 4.12 +/- 0.79 and 12.75+3.50 respectively. Slightly more than one-third of the subjects achieved five food groups a day while less than 2% consumed a desirable number of servings from all food groups. Among the five food groups, dairy, and fruits were the least-frequently consumed foods. Lower education, lower personal income, working, non-insulin, overweight and obese subjects had significantly lower Food Group Score than their counterparts [F (6,106)=4.924, p<0.0001] whereas lower education, lower waist-to-hip ratio, overweight and obese subjects had significantly lower Serving Score than their counterparts [F (4,108)=7.520, p<0.0001]. There was a high proportion of individuals with T2DM, who failed to adhere to the national dietary guidelines. The importance of taking a well-balanced diet in accordance with the guidelines should be emphasized, especially among those with lower educational level through a simple and easy-to-understand approach.
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  10. Effectiveness of medical nutrition treatment delivered by dietitians on glycaemic outcomes and lipid profiles of Arab, Omani patients with Type 2 diabetes
    Al-Shookri A, Khor GL, Chan YM, Loke SC, Al-Maskari M
    Diabet Med, 2012 Feb;29(2):236-44.
    PMID: 21824187 DOI: 10.1111/j.1464-5491.2011.03405.x
    In this randomized controlled trial we evaluated the effectiveness of medical nutritional therapy on Arab patients with Type 2 diabetes in Oman delivered by a dietitian.
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  11. Improvement of dietary quality with the aid of a low glycemic index diet in Asian patients with type 2 diabetes mellitus
    Barakatun Nisak MY, Ruzita AT, Norimah AK, Gilbertson H, Nor Azmi K
    J Am Coll Nutr, 2010 Jun;29(3):161-70.
    PMID: 20833988 DOI: 10.1080/07315724.2010.10719830
    OBJECTIVES: This randomized controlled study was conducted to determine the effect of low glycemic index (GI) dietary advice on eating patterns and dietary quality in Asian patients with type 2 diabetes (T2DM).

    METHODS: Asian patients with T2DM (N  =  104) were randomized into 2 groups that received either low GI or conventional carbohydrate exchange (CCE) dietary advice for 12 weeks. Nutritional prescriptions were based on the medical nutrition therapy for T2DM, with the difference being in the GI component of the carbohydrates. Dietary intake and food choices were assessed with the use of a 3-day food record.

    RESULTS: At week 12, both groups achieved the recommendations for carbohydrate (52 ± 4% and 54 ± 4% of energy) and fat (30 ± 4% and 28 ± 5% of energy) intake. There were no significant differences in the reported macronutrient intake in both groups. With the low GI diet, crude fiber and dietary calcium intake increased, while the dietary GI reduced. Subjects in the lowest dietary glycemic index/glycemic load (GI/GL) quartile consumed more parboiled/basmati rice, pasta, milk/dairy products, fruits, and dough, which are foods from the low GI category. There was a significant reduction in the hemoglobin A(1c) level at week 12 for patients in the lowest GI/GL quartile (Δ  =  -0.7 ± 0.1%) compared with those in the highest GI/GL quartile (Δ  =  -0.1 ± 0.2%).

    CONCLUSIONS: These results demonstrate the ability of low GI dietary advice to improve the dietary quality of Asian patients with T2DM.
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  12. A low-GI diet is associated with a short-term improvement of glycaemic control in Asian patients with type 2 diabetes
    Yusof BN, Talib RA, Kamaruddin NA, Karim NA, Chinna K, Gilbertson H
    Diabetes Obes Metab, 2009 Apr;11(4):387-96.
    PMID: 19175374 DOI: 10.1111/j.1463-1326.2008.00984.x
    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.
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  13. Fulltext Effects of nutrition therapy on HbA1c and cardiovascular disease risk factors in overweight and obese patients with type 2 diabetes
    Mottalib A, Salsberg V, Mohd-Yusof BN, Mohamed W, Carolan P, Pober DM, et al.
    Nutr J, 2018 04 07;17(1):42.
    PMID: 29626933 DOI: 10.1186/s12937-018-0351-0
    BACKGROUND: Nutrition Therapy (NT) is essential in type 2 diabetes (T2D) management. Standards of care recommend that each patient engages with a nutritionist (RDN) to develop an individualized eating plan. However, it is unclear if it is the most efficient method of NT. This study evaluates the effects of three different methods of NT on HbA1c and cardiovascular disease risk factors in overweight and obese patients with T2D.

    METHODS: We randomized 108 overweight and obese patients with T2D (46 M/62F; age 60 ± 10 years; HbA1c 8.07 ± 1.05%; weight 101.4 ± 21.1 kg and BMI 35.2 ± 7.7 kg/m2) into three groups. Group A met with RDN to develop an individualized eating plan. Group B met with RDN and followed a structured meal plan. Group C did similar to group B and received weekly phone support by RDN.

    RESULTS: After 16 weeks, all three groups had a significant reduction of their energy intake compared to baseline. HbA1c did not change from baseline in group A, but decreased significantly in groups B (- 0.66%, 95% CI -1.03 to - 0.30) and C (- 0.61%, 95% CI -1.0 to - 0.23) (p value for difference among groups over time 

    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy
  14. Fulltext Dietary compliance and its association with glycemic control among poorly controlled type 2 diabetic outpatients in Hospital Universiti Sains Malaysia
    Tan SL, Juliana S, Sakinah H
    Malays J Nutr, 2011 Dec;17(3):287-99.
    PMID: 22655451 MyJurnal
    Introduction: Compliance with medical nutrition therapy is important to improve patient outcomes. The purpose of this study was to determine dietary compliance and its association with glycemic control among outpatients with poorly controlled type 2 diabetes mellitus (T2DM) in Hospital Universiti Sains Malaysia (HUSM).
    Methods: In this cross-sectional study, patients who had a glycosylated hemoglobin (HbA1c) level of at least 6.5%, after attending a diet counseling session at the Outpatient Dietetic Clinic, HUSM, were enrolled. Out of 150 diabetic patients reviewed between 2006 and 2008, 61 adults (32 men and 29 women) agreed to participate in this study. A questionnaire-based interview was used to collect socio-demographic, clinical and diabetes self-care data. The patient’s dietary compliance rate was determined by the Summary of Diabetes Self-Care Activities (SDSCA) measure. Anthropometric and biological measurements were also taken.
    Results: Only 16.4% of the respondents adhered to the dietary regimen provided by dietitians. Among the 7 dietary self-care behaviours, item number 6 (eat lots of food high in dietary fibre such as vegetable or oats) had the highest compliant rate (54.1%); whereas item number 3 (eat five or more servings of
    fruits and vegetables per day) had the lowest compliant rate (23.0%). There was a significant association between gender (p=0.037) and fasting blood sugar (FBS) (p=0.007) with the compliance status. Conclusion: Dietary non-compliance is still common among T2DM patients. Dietitians need to improve their skills and use more effective intervention approaches in providing dietary counseling to patients.
    Keywords: Dietary compliance, diet counseling, type 2 diabetes mellitus
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  15. Glycemic responses of patients with type 2 diabetes to individual carbohydrate-rich foods and mixed meals
    Robert SD, Ismail AA
    Ann Nutr Metab, 2012;60(1):27-32.
    PMID: 22212476 DOI: 10.1159/000335224
    Our purpose was to determine whether the glycemic index (GI) of individual foods applies to mixed meals.
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy
  16. Evaluating the toxic and beneficial effects of jering beans (Archidendron jiringa) in normal and diabetic rats
    Shukri R, Mohamed S, Mustapha NM, Hamid AA
    J Sci Food Agric, 2011 Nov;91(14):2697-706.
    PMID: 21744354 DOI: 10.1002/jsfa.4516
    Jering (Archidendron jiringa) is eaten in the tropics and traditionally extolled for treating diabetes, high blood pressure and eliminating bladder stones. Jering contains an unusual amino acid-djenkolic acid (S,S'-methylenebiscysteine)-which may form sharp crystals in the urinary tract, causing pain and haematuria. This study evaluates the beneficial and toxic effects of dietary jering on tissues and organs in normal and diabetic rats.
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  17. Nutrigenomic effects of germinated brown rice and its bioactives on hepatic gluconeogenic genes in type 2 diabetic rats and HEPG2 cells
    Imam MU, Ismail M
    Mol Nutr Food Res, 2013 Mar;57(3):401-11.
    PMID: 23307605 DOI: 10.1002/mnfr.201200429
    SCOPE: Chronic sustained hyperglycemia underlies the symptomatology and complications of type 2 diabetes mellitus, and dietary components contribute to it. Germinated brown rice (GBR) improves glycemic control but the mechanisms involved are still the subject of debate. We now show one mechanism by which GBR lowers blood glucose.

    METHODS AND RESULTS: Effects of GBR, brown rice, and white rice (WR) on fasting plasma glucose and selected genes were studied in type 2 diabetic rats. GBR reduced plasma glucose and weight more than metformin, while WR worsened glycemia over 4 weeks of intervention. Through nutrigenomic suppression, GBR downregulated gluconeogenic genes (Fbp1 and Pck1) in a manner similar to, but more potently than, metformin, while WR upregulated the same genes. Bioactives (gamma-amino butyric acid, acylated steryl glycoside, oryzanol, and phenolics) were involved in GBR's downregulation of both genes. Plasma glucose, Fbp1 and Pck1 changes significantly affected the weight of rats (p = 0.0001).

    CONCLUSION: The fact that GBR downregulates gluconeogenic genes similar to metformin, but produces better glycemic control in type 2 diabetic rats, suggests other mechanisms are involved in GBR's antihyperglycemic properties. GBR as a staple could potentially provide enhanced glycemic control in type 2 diabetes mellitus better than metformin.

    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  18. Diabetes telemonitoring reduces the risk of hypoglycaemia during Ramadan: a pilot randomized controlled study
    Lee JY, Lee SW, Nasir NH, How S, Tan CS, Wong CP
    Diabet Med, 2015 Dec;32(12):1658-61.
    PMID: 26103794 DOI: 10.1111/dme.12836
    AIM: This pilot study evaluated the short-term benefits of a telemonitoring-supplemented focused diabetic education compared with education alone in participants with Type 2 diabetes who were fasting during Ramadan.
    METHODS: In this pilot mixed-method study, we identified 37 participants and randomly allocated them to either a telemonitoring group (n = 18) or a group receiving Ramadan-focused pre-education only (usual care; n = 19). The telemonitoring group received goal-setting and personalized feedback.
    RESULTS: The telemonitoring group was less likely to experience hypoglycaemia than the usual care group (odds ratio: 0.1273; 95% confidence interval: 0.0267-0.6059). No significant differences were noted in glycaemic control at the end of study. Participants viewed telemedicine as a more convenient alternative although technological barriers remain a concern.
    CONCLUSIONS: The results of this study reinforce the need for monitoring as well as educational initiatives for Muslims with diabetes who fast during Ramadan. Telemonitoring offers an attractive option requiring further research. (Clinical Trial Registry No. NCT02189135).
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  19. Fulltext Impact of Diabetes-Specific Nutritional Formulas versus Oatmeal on Postprandial Glucose, Insulin, GLP-1 and Postprandial Lipidemia
    Mottalib A, Mohd-Yusof BN, Shehabeldin M, Pober DM, Mitri J, Hamdy O
    Nutrients, 2016 Jul 22;8(7).
    PMID: 27455318 DOI: 10.3390/nu8070443
    Diabetes-specific nutritional formulas (DSNFs) are frequently used as part of medical nutrition therapy for patients with diabetes. This study aims to evaluate postprandial (PP) effects of 2 DSNFs; Glucerna (GL) and Ultra Glucose Control (UGC) versus oatmeal (OM) on glucose, insulin, glucagon-like peptide-1 (GLP-1), free fatty acids (FFA) and triglycerides (TG). After an overnight fast, 22 overweight/obese patients with type 2 diabetes were given 200 kcal of each of the three meals on three separate days in random order. Blood samples were collected at baseline and at 30, 60, 90, 120, 180 and 240 min. Glucose area under the curve (AUC0-240) after GL and UGC was lower than OM (p < 0.001 for both). Insulin positive AUC0-120 after UGC was higher than after OM (p = 0.02). GLP-1 AUC0-120 and AUC0-240 after GL and UGC was higher than after OM (p < 0.001 for both). FFA and TG levels were not different between meals. Intake of DSNFs improves PP glucose for 4 h in comparison to oatmeal of similar caloric level. This is achieved by either direct stimulation of insulin secretion or indirectly by stimulating GLP-1 secretion. The difference between their effects is probably related to their unique blends of amino acids, carbohydrates and fat.
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
  20. Fulltext Natural Phyto-Bioactive Compounds for the Treatment of Type 2 Diabetes: Inflammation as a Target
    Gothai S, Ganesan P, Park SY, Fakurazi S, Choi DK, Arulselvan P
    Nutrients, 2016 Aug 04;8(8).
    PMID: 27527213 DOI: 10.3390/nu8080461
    Diabetes is a metabolic, endocrine disorder which is characterized by hyperglycemia and glucose intolerance due to insulin resistance. Extensive research has confirmed that inflammation is closely involved in the pathogenesis of diabetes and its complications. Patients with diabetes display typical features of an inflammatory process characterized by the presence of cytokines, immune cell infiltration, impaired function and tissue destruction. Numerous anti-diabetic drugs are often prescribed to diabetic patients, to reduce the risk of diabetes through modulation of inflammation. However, those anti-diabetic drugs are often not successful as a result of side effects; therefore, researchers are searching for efficient natural therapeutic targets with less or no side effects. Natural products' derived bioactive molecules have been proven to improve insulin resistance and associated complications through suppression of inflammatory signaling pathways. In this review article, we described the extraction, isolation and identification of bioactive compounds and its molecular mechanisms in the prevention of diabetes associated complications.
    Matched MeSH terms: Diabetes Mellitus, Type 2/diet therapy*
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