المؤلفون: Ludvik, B.¹ bernhard.ludvik@meduniwien.ac.at, Hanefeld, M.², Pacini, G.³

المصدر: Diabetes, Obesity & Metabolism. Jul2008, Vol. 10 Issue 7, p586-592. 7p. 2 Charts, 1 Graph.

مصطلحات موضوعية: *SWEET potatoes, *TYPE 2 diabetes, *GLUCOSE tolerance tests, *C-reactive protein, *CARBOHYDRATE intolerance

مستخلص: Aim: The extract of the white-skinned sweet potato Ipomoea batatas (Caiapo) has been shown to ameliorate glucose control by improving insulin sensitivity in patients with type 2 diabetes mellitus (T2DM). The present study was designed to further evaluate its mode of action on insulin sensitivity over an extended period of time as well as the effects on fibrinogen and other markers of low-grade inflammation. Methods: In this randomized trial, 27 patients with T2DM on diet only received 4 g of Caiapo daily for 5 months; 34 patients placebo. Before and after therapy, insulin sensitivity [oral glucose insulin sensitivity (OGIS), as glucose clearance from oral glucose tolerance test], parameters of diabetes control, lipids, plasma adiponectin, high-sensitivity C-reactive protein (hs-CRP) and fibrinogen were measured. Results: Following Caiapo, we observed an increase in OGIS (293 ± 15 vs. 321 ± 12 ml/m2/min, p = 0.0072) and adiponectin (5.97 ± 0.65 to 6.63 ± 0.70 μg/ml, p = 0.013), while fibrinogen decreased from 3.83 ± 0.16 to 3.64 ± 0.18 mg/ml (p = 0.02). This was associated with an improvement in glycated haemoglobin (HbA1c: 6.46 ± 0.12 vs . 6.25 ± 0.11%, p = 0.008), fasting glucose (138 ± 4 vs . 128 ± 5 mg/dl, p = 0.039) and triglycerides (2.36 ± 0.22 vs. 2.07 ± 0.25 mmol/l, p = 0.032). Body weight, lipid levels and hs-CRP were not altered. No changes were observed in the placebo group except for HbA1c, which significantly increased from 6.25 ± 0.10 to 6.50 ± 0.12% (p = 0.0001). Conclusions: This study confirms the beneficial effects of Caiapo on glucose and HbA1c control in patients with T2DM after 5 months follow-up. Improvement of insulin sensitivity was accompanied by increased levels of adiponectin and a decrease in fibrinogen. Thus, Caiapo can be considered as natural insulin sensitizer with potential antiatherogenic properties. [ABSTRACT FROM AUTHOR]

المؤلفون: Kautzky-Willer, A., Tura, A., Winzer, C., Wagner, O. F., Ludvik, B., Hanusch-Enserer, U., Prager, R., Pacini, G.

المصدر: Diabetes, Obesity & Metabolism; Sep2006, Vol. 8 Issue 5, p561-567, 7p, 2 Charts, 2 Graphs

مصطلحات موضوعية: INSULIN, GLUCOSE tolerance tests, TYPE 2 diabetes, HYPOGLYCEMIC agents, CELL adhesion molecules, SELECTINS, BLOOD sugar monitoring

مستخلص: Aim: This study was designed to assess the usefulness of a model-based index of insulin sensitivity during an oral glucose tolerance test (OGTT) in the identification of possible changes in this metabolic parameter produced by pharmacological agents known to be potent insulin sensitizers, that is metformin (M) and thiazolidinedione (T). The association of these agents with several other factors related to glucose metabolism was also investigated, as well as the relation of insulin sensitivity and secretion with markers of endothelial function such as different adhesion molecules (cAMs), that is vascular cell adhesion molecule-1, intercellular adhesion molecule-1 and E-Selectin. Methods: Twenty type 2 diabetic patients treated with diet only underwent a 3-h OGTT for measurement of plasma glucose, insulin, proinsulin, C-peptide and cAMs before and after administration of randomly given M (n = 9; 1700 mg/day) or T (n = 11; 600 mg/day). After 16 weeks of treatment, a second OGTT was performed. Insulin sensitivity was calculated with homeostasis model assessment and with oral glucose insulin sensitivity (OGIS), which quantifies dynamic glucose clearance per unit change of insulin. Insulin secretion was assessed by modelling technique. Differences in these parameters before and after treatment, as well as possible relationships with cAMs, were assessed. Results: Basal and stimulated plasma glucose decreased after therapy in both the groups by approximately 20%. Basal insulin resistance also decreased. Insulin sensitivity in dynamic conditions (OGIS: ml/min/m²) increased with M (289.3 ± 18.8 vs. 234.7 ± 18.1, p < 0.02) and tended to improve with T (323.5 ± 18.1 vs. 286.8 ± 22.1, p = 0.09). Total insulin secretion over the OGTT [TIS: nmol/l(3 h)] tended to decrease with M (17.1 ± 2.5 vs. 27.3 ± 0.3, p = 0.08) but not with T (23.6 ± 3.5 vs. 22.5 ± 2.7). Plasma concentrations of E-Selectin decreased in T (38.0 ± 2.3 vs. 51.2 ± 6.1 ng/ml, p < 0.05). No correlation was found between insulin sensitivity and cAMs. Conclusions: Model-based indices of insulin sensitivity and secretion during an OGTT can be able to detect changes observed in patients under treatment with pharmacological agents such as M or T. Both the drugs improved glucose control similarly. Decreased plasma E-Selectin concentrations were seen in patients on T therapy only. [ABSTRACT FROM AUTHOR]

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