RESUMEN
BACKGROUND: Data on the blood glucose response of diabetic patients to mixed meals containing food both rich in fiber and with a low glycemic index, such as dried peas, is scarce. Thus, the extent to which type 2 diabetic patients should take into account low-glycemic, high-fiber foods for their daily carbohydrate intake is uncertain. OBJECTIVE: We compared the glycemic and insulinemic responses to 3 different meals based on dried peas, potatoes, or both in patients with type 2 diabetes undergoing dietary treatment. DESIGN: The meals, prepared according to local recipes and consumed at weekly intervals in random order at lunchtime, contained comparable amounts of carbohydrate, fat, protein, and water. The carbohydrate source of the meals differed and was supplied from either dried peas (meal 1), potatoes (meal 3), or a combination thereof (meal 2). Peripheral and venous blood was sampled over 180 min. RESULTS: The increases in postprandial plasma glucose and insulin concentrations were delayed and significantly smaller after the pea meal than after the potato meal. The areas under the glucose curve were 164 +/- 40, 257 +/- 57, and 381 +/- 40 mmol x 180 min/L for meals 1, 2, and 3, respectively (P < 0.01). The areas under the insulin curve were 13.8 +/- 4.3, 15.4 +/- 3.9, and 31.2 +/- 6.9 nmol x 180 min/L, respectively (P = 0.0514). CONCLUSION: These findings suggest that carbohydrates in dried peas may be largely disregarded in carbohydrate counting and that type 2 diabetic patients should probably increase their consumption of low-glycemic, high-fiber foods at the expense of high-glycemic, low-fiber foods.
Asunto(s)
Glucemia/análisis , Diabetes Mellitus Tipo 2/sangre , Insulina/sangre , Pisum sativum , Periodo Posprandial , Solanum tuberosum , Anciano , Área Bajo la Curva , Estudios Cruzados , Femenino , Conservación de Alimentos , Humanos , Masculino , Persona de Mediana Edad , Concentración OsmolarRESUMEN
There is some evidence for the efficacy of acupuncture in chronic low-back pain (LBP), but it remains unclear whether acupuncture is superior to placebo. In a randomized, blinded, placebo-controlled trial, we evaluated the effect of traditional acupuncture in chronic LBP. A total of 131 consecutive out-patients of the Department of Orthopaedics, University Goettingen, Germany, (age=48.1 years, 58.5% female, duration of pain: 9.6 years) with non-radiating LBP for at least 6 months and a normal neurological examination were randomized to one of three groups over 12 weeks. Each group received active physiotherapy over 12 weeks. The control group (n=46) received no further treatment, the acupuncture group (n=40) received 20 sessions of traditional acupuncture and the sham-acupuncture group (n=45) 20 sessions of minimal acupuncture. Changes from baseline to the end of treatment and to 9-month follow-up were assessed in pain intensity and in pain disability, and secondary in psychological distress and in spine flexion, compared by intervention groups. Acupuncture was superior to the control condition (physiotherapy) regarding pain intensity (P=0.000), pain disability (P=0.000), and psychological distress (P=0.020) at the end of treatment. Compared to sham-acupuncture, acupuncture reduced psychological distress (P=0.040) only. At 9-month follow-up, the superiority of acupuncture compared to the control condition became less and acupuncture was not different to sham-acupuncture. We found a significant improvement by traditional acupuncture in chronic LBP compared to routine care (physiotherapy) but not compared to sham-acupuncture. The trial demonstrated a placebo effect of traditional acupuncture in chronic LBP.
Asunto(s)
Analgesia por Acupuntura , Dolor de la Región Lumbar/terapia , Adolescente , Adulto , Anciano , Enfermedad Crónica , Evaluación de la Discapacidad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Especialidad de Fisioterapia , Estudios Prospectivos , Resultado del TratamientoRESUMEN
BACKGROUND/AIMS: Primary biliary cirrhosis (PBC) is an autoimmune disease of the liver with inflammation of small and middle-sized bile ducts. Serum lipids are frequently elevated, but the use of a lipid lowering drug therapy in PBC is still a matter of debate. Application of an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase in hypercholesterolemic PBC patients was therefore the subject of the present study. METHODS: Six female patients (aged 46.5 (32-61) years; median (range)) were treated with the HMG-CoA reductase inhibitor simvastatin (5 or 20 mg/day). Levels of serum total cholesterol, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol were determined prior to and after 2 months of treatment. Concentrations of serum markers of cholestasis, antimitochondrial antibodies (AMA), and immunoglobulins A, G and M were also assessed. RESULTS: Simvastatin significantly (P<0.05) reduced serum levels of total cholesterol, LDL cholesterol, alkaline phosphatase, -glutamyltransferase, and immunoglobulin M (by 19, 26, 12, 37 and 14%, respectively). CONCLUSIONS: The lipid lowering potency of the HMG-CoA reductase inhibitor simvastatin was confirmed in hypercholesterolemic patients with PBC. The drug might also prove useful as modulator of cholestasis and of immune response in this disease.