Relationship of insulin secretion and glycemic response to dietary intervention in non-insulin-dependent diabetes

Article Abstract:

Non-insulin-dependent diabetes mellitus (NIDDM) is a form of sugar intolerance not requiring injections of insulin, the hormone needed to metabolize glucose. Patients with NIDDM are either resistant to insulin, do not produce enough insulin, or both. Therapy is based on increasing the body's sensitivity to insulin, which can be achieved by diet and weight reduction. It is theorized that obese patients with NIDDM are more likely to benefit from dietary measures and weight reduction because of their decreased sensitivity to insulin. Oral glucose tolerance testing (OGTT) and the measurement of glycosylated hemoglobin A(sub 1) (HbA-sub 1), two methods used to determine sugar tolerance, were used to assess the results of three different diet and weight-reducing programs. The body's resistance to insulin was determined by measuring blood insulin, C peptide release (a protein necessary to make insulin in the body), and glucose (a simple sugar) levels. To identify the patients more likely to respond to diet and weight reduction regimens, patients were divided into two groups, those with normal HbA and those with high HbA. Before diet therapy, the group with normal HbA had insulin levels two to three times higher. Although both groups lost similar amounts of weight after diet therapy, the group having high HbA did not show any improvement in sugar control. Although weight can be reduced regardless of insulin secretion, the success of diet therapy in NIDDM patients (ie. sugar control) is better in patients who are able to secrete significant amounts of insulin. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Measurement, Diabetes, Diabetes mellitus, Insulin resistance, Diet in disease, Glycosylated hemoglobin

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The hypertension prevention trial: three-year effects of dietary changes on blood pressure

Article Abstract:

Excess weight, high dietary sodium (salt) and low potassium contribute to the development of high blood pressure. In an effort to reduce death from cardiovascular disease, measures to reduce high blood pressure are suggested. To study the relationship between the sodium-to-potassium ratio and blood pressure, five groups of patients were given dietary counseling regarding low sodium intake, low sodium and potassium intake, reduced calorie intake, reduced calorie and sodium intake or no dietary counseling at all. A total of 841 men and women with diastolic blood pressures of 78 to 89 mm Hg were assigned to one dietary group. After six months, overall sodium was reduced by 13 percent, potassium was increased by eight percent and body weight was reduced by seven percent. After three years, sodium was reduced by 10 percent and weight was reduced by four percent, with no change in potassium. Blood pressure was lowered in all the groups receiving dietary counseling but not in the group receiving no counseling. Those counseled to reduce caloric intake exhibited consistently lower blood pressures and had fewer high blood pressure events than the groups receiving no dietary counseling. The group counseled on low sodium intake had the fewest high blood pressure events. Reduced calories and sodium are recommended in the prevention of cardiovascular disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Hypertension, Prevention, Coronary heart disease, Blood pressure, Salt-free diet, Sodium restricted diet

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Long-term glycemic control in patients with type II diabetes

Article Abstract:

A study in the July 1991 issue of the Archives of Internal Medicine reports that blood sugar control was improved considerably in people with type II (noninsulin-dependent) diabetes who had undergone brief treatment with a very-low-calorie diet (VLCD). Control was achieved even though the patients regained significant amounts of weight, and was not achieved in a control group of patients who lost weight while following a conventional diet. The particular elements of the VLCD that led to better glycemic control (low carbohydrates versus low calories) have not been identified. The patients who followed the VLCD regained 55 percent of their lost weight in the year after treatment, but they might have regained less if more attention had been paid to the behavioral aspects of weight control. It is now known that the rewards and behaviors associated with weight loss are different from those that maintain weight loss. Patients on both the VLCD and the conventional diet had improvements in their fasting blood sugar levels when they lost weight initially, even when they still remained 20 to 30 kilograms overweight. Treatment of markedly obese patients should aim at helping them set realistic and limited, rather than excessive, weight loss goals. (Consumer Summary produced by Reliance Medical Information, Inc.)

Management, Weight loss, Blood sugar, Blood glucose, editorial

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