Re: Critical review of the Dietary Guidelines for Americans


"Susan" <susan@xxxxxxxxxxxx> wrote in message news:8hk7erF7mbU1@xxxxxxxxxxxxxxxxxxxxx
x-no-archive: yes

On 10/12/2010 4:50 PM, Alan S wrote:

Just a trivial side issue, but if post-prandial trigs are as bad as
post-prandial BG spikes, and post-prandial BG spikes are harmless,
then both are harmless :)

Inflammation markers and metabolic characteristics of subjects with one-hour plasma glucose levels
1. Gianluca Bardini, MD, PhD,
2. Ilaria Dicembrini, MD,
3. Barbara Cresci, MDand
4. Carlo Maria Rotella, MD (c.rotella@xxxxxxxxxxxx)
+Author Affiliations
1. Section of Endocrinology, Department of Clinical Pathophysiology, University of Florence, Italy
Abstract
Objective: To assess the association of 1-h plasma glucose (1hPG) and inflammation with normal glucose tolerance (NGT) and pre-diabetes (pre-DM).
Research Design And Methods: A cohort of 1062 subjects was enrolled. After oral glucose load (OGTT), we compared NGT and pre-DM subjects above and below the 1hPG cut point (155 mg/dl). Fibrinogen and leucocytes count (WBC) for subclinical inflammation, lipid ratios, insulin sensitivity (Matsuda Index), were determined.
Results: NGT and pre-DM patients 1hPG>155 mg/dl showed a significant increase of inflammatory markers and lipid ratios (for all, p<0.05). In age-sex-BMI-adjusted analysis, 1hPG is associated with a significant higher WBC count and fibrinogen (p<0.05). Patients with elevated 1hPG showed a highly significant lower insulin sensitivity than subjects below 1hPG (p<0.01).

Conclusions: Elevated 1hPG in NGT and pre-DM subjects is associated to subclinical inflammation, high lipid ratios and insulin resistance. Therefore, 1hPG >155 mg/dl could be considered a new “marker” for cardiovascular risk.

Journal of Clinical Endocrinology & Metabolism , doi:10.1210/jc.2007-2000
Postmeal glucose peaks at home associate with carotid intima-media thickness in type 2 diabetes
Katherine Esposito, Miryam Ciotola, Diego Carleo, Bruno Schisano, Luigi Sardelli, Domenico Di Tommaso, Lucio Misso, Franco Saccomanno, Antonio Ceriello, and Dario Giugliano*
Chair and Division of Metabolic Diseases, Second University of Naples, Naples, Italy; Warwick Medical School (Dr Ceriello), University of Warwick, Coventry, UK
* To whom correspondence should be addressed. E-mail: dario.giugliano@xxxxxxxxxx
Context Two-hour postprandial hyperglycemia is related to chronic complications of diabetes and is currently used in the international guidelines to drive the therapy.
Objective To assess size and timing of postmeal glucose peaks in every day life of type 2 diabetic patients, and the relationship with carotid atherosclerosis
Design, Setting, and Patients: This was an observational study carried out in 644 outpatients with type 2 diabetes attending Diabetes Clinics located in the area of the Campania County, South Italy, who provided complete home blood glucose profiles and centralized carotid intima-media thickness (CIMT) assessment. The study was conducted from 2001 to 2005.
Main Outcomes Measures Incremental glucose peak (IGP) was the maximal incremental increase in blood glucose obtained at any point following the meal. CIMT was assessed by carotid sonography.
Results The level of hemoglobin A1c and CIMT progressively increased across quintiles of IGP (P for trend = 0.01 for both). In univariate analysis, all examined glycemic parameters were significantly correlated with CIMT. IGP (r = 0.40, P = 0.006) showed the strongest correlation with CIMT which remained significant in multiple linear regression analysis (R2 = 0.26, P = 0.01). IGP was associated with a significant rise of CIMT in tertiles of HbA1c. IGP occurred within one hour from the start of the meal in 95% of the entire diabetic population.


Conclusions IGPs are frequent in every day life of type 2 diabetes, occur for the most (95%) within one hour after meal and timing is not influenced by treatment (diet or drugs), and correlate with CIMT.

Wow, that second study is quite a bombshell.

.

Relevant Pages

  • Re: Critical review of the Dietary Guidelines for Americans
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  • Re: Critical review of the Dietary Guidelines for Americans
    ... To assess the association of 1-h plasma glucose and inflammation with normal glucose tolerance and pre-diabetes. ... Context Two-hour postprandial hyperglycemia is related to chronic complications of diabetes and is currently used in the international guidelines to drive the therapy. ... This was an observational study carried out in 644 outpatients with type 2 diabetes attending Diabetes Clinics located in the area of the Campania County, South Italy, who provided complete home blood glucose profiles and centralized carotid intima-media thickness (CIMT) assessment. ...
    (alt.support.diabetes)
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  • Re: What cxercise, vitamins, or food needed for diabetes/cardio risk individual?
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