Introduction: Gestational diabetes mellitus (GDM) increases risks for type 2
diabetes and cardiovascular diseases. Low glycaemic index (GI) diets improve
cardio-metabolic outcomes in insulin-resistant individuals. We examined the
feasibility of lowering GI through GI-based-education among Asian post-GDM
women. Methods: A 3-month investigation was carried out on 60 Malaysian
women with a mean age of 31.0±4.5 years and a history of GDM. Subjects were
randomised into two groups: LGIE and CHDR. The CHDR group received
conventional healthy dietary recommendations only. The LGIE group received
GI based-education in addition to conventional healthy dietary recommendations.
At baseline and after 3-months, dietary intake of energy and macronutrient
intakes including GI diet and glycaemic load was assessed using 3-day food
records. Diabetes-Diet and GI-concept scores and physical activity levels were
assessed using a questionnaire. Adherence to dietary instructions was measured
at the end of 3 months. Results: At the end of 3 months, the LGIE group had
significant reductions in energy intake (241.7±522.4Kcal, P=0.037, ES=0.463), total
carbohydrate (48.7±83.5g, P=0.010, ES=0.583), GI (3.9±7.1, P=0.017, ES=0.549) and
GL (39.0±55.3, P=0.003, ES=0.705) and significant increases in protein (3.7±5.4g,
0.003, ES=0.685) and diet fibre (4.6±7.3g, P=0.06). The CHDR group had a significant
reduction in fat only (5.7±9.4g, P=0.006, ES=0.606). There was a 30% increase in
GI-concept scores in the LGIE group (p< 0.001). Changes in GI-concept scores
correlated significantly to the reduction in dietary GI (r = -0.642, P=0.045). Dietary
adherence was comparable in both groups. Conclusion: GI-education improves
GI-concept knowledge and helps lower dietary glycaemic index among women
with a history of GDM.
Keywords: Diet, gestational diabetes mellitus, glycaemic index, glycaemic load,
prevention, type 2 diabetes
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.
In recent years, many efforts have been directed to explore the methods to reduce the production costs of industrial lipase by improving the yield and the use of low-cost agricultural wastes. Coconut dregs, which is a lignocellulosic by-product from coconut oil and milk processing plants, is rich in cellulose (36%) and crude fat (9%). A newly isolated Bacillus stratosphericus has been demonstrated to perform cellulose hydrolysis on coconut dregs producing fermentable sugars. The highest extracellular lipase activity of 140 U/mL has been achieved in submerged fermentation with acid pre-treated coconut dregs. The lipase was found to be active over a wide range of temperatures and pHs. The activity of lipase can be generally increased by the presence of detergent ingredients such as Tween-80, cetyltrimethylammonium bromide, hydrogen peroxide and phosphate per sulphate. The great compatibility of lipase in commercial detergents has also underlined its potential as an additive ingredient in biodetergent formulations.
Umbilical cord-derived mesenchymal stem cells for regenerative therapy are a promising treatment option for chronic illnesses. Umbilical cord-derived mesenchymal stem cells offer several advantages over other sources, which makes them an attractive option in tissue repair and regeneration. This clinical study describes a 1-year follow-up on the safety and tolerance of umbilical cord-derived mesenchymal stem cell therapy on nine patients in Malaysia. Patients were assessed for adverse effects, and liver function tests were carried out on both pre- and post-treatments. Umbilical cord-derived mesenchymal stem cells' effectiveness and safety were assessed by follow-up evaluations. All nine patients responded positively towards umbilical cord-derived mesenchymal stem cell therapy, without any adverse effects. After umbilical cord-derived mesenchymal stem cell therapy, a significant improvement was observed in liver functioning test outcomes, as haematological parameters and tumour markers were stable. The present study concludes that umbilical cord-derived mesenchymal stem cell therapy is well tolerated by Malaysian patients; however, further clinical screening must be done over a large number of patients population.