Influence of a β-Glucan–Enriched Bedtime Snack on Nocturnal Blood Glucose Levels in Diabetic Children

Rami, Birgit; Zidek, Thomas; Schober, Edith

doi:10.1097/00005176-200101000-00011

Cited by 14 publications

(12 citation statements)

References 24 publications

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“…Viscous fibre, a type of undigestibe carbohydrates, has been studied because it increases the viscosity of the food in the intestine and thus may delay absorption of carbohydrates . In a crossover study among children (n = 38, insulin regimen not specified), Rami et al compared a bedtime snack of yoghurt (12 g carbohydrate, 2.9–5.5 g protein and 1.5–2.9 g fat) to a snack enriched in beta‐glucan fibres (12 g carbohydrate including 1.4–1.8 g beta‐glucan fibres, 3.1–4.3 g protein and 2.3–2.9 g fat from crackers or bars) during a summer camp. The beta‐glucan snack did not reduce the frequency of NH, which occurred during 27% of the nights regardless of the condition.…”

Section: Resultsmentioning

confidence: 99%

“…Alpha‐glucosidase inhibitors may have some beneficial effects on BG control, but available data on the improvement of NH occurrence are inconsistent . Similarly, the consumption of food with high fibre content is already encouraged for patients with diabetes as part of a healthy diet, but bedtime snack rich in fibre did not provide additional benefits against NH . In order to provide a substrate for neoglucogenesis and increase glucagon response , oral alanine (40 g) combined with glucose has shown to reduce NH frequency .…”

Section: Discussionmentioning

confidence: 99%

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Are bedtime nutritional strategies effective in preventing nocturnal hypoglycaemia in patients with type 1 diabetes?

Desjardins

Brazeau

Strychar

et al. 2013

Diabetes Obesity Metabolism

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Hypoglycaemia remains the major limiting factor for adequate diabetes control for patients with type 1 diabetes (T1D), especially during the night-time. Although nutritional strategies for nocturnal hypoglycaemia (NH) prevention are regularly suggested in clinical practice, there is no evidence-based recommendation for the usefulness and optimal composition of a bedtime snack. The aim of this narrative review was to analyse the current state of knowledge on nutritional strategies to prevent NH in individuals with T1D. A literature search was conducted, using PubMed and Medline (1946 to 2013); 16 studies were retrieved. Overall, the level of evidence was low. Results indicated that a calibrated bedtime snack based on bedtime blood glucose (BG) level could be effective to reduce NH occurrence for patients treated with human or animal insulin (short-acting combined with lente, ultralente and/or intermediate-acting insulin), but there is no evidence for patients treated with insulin analogues as part of multiple daily injections or insulin pump regimen. Some evidence suggests that including uncooked cornstarch or alanine in the bedtime snack composition could provide some benefits for the prevention of NH. Individualized recommendations of a bedtime snack intake for patients or situations at high risk for NH (long standing diabetes, hypoglycaemia unawareness, prior physical activity, alcohol consumption, bedtime BG close to hypoglycaemia threshold) appear as a prudent recommendation. On the basis of the available evidence, a bedtime snack cannot be recommended systematically but it might be useful if prescribed in an individualized fashion; further research is needed to evaluate these strategies.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Are bedtime nutritional strategies effective in preventing nocturnal hypoglycaemia in patients with type 1 diabetes?

Desjardins

Brazeau

Strychar

et al. 2013

Diabetes Obesity Metabolism

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show abstract

“…Um estudo (2000) realizado com 38 crianças, durante 12 noites consecutivas, avaliou a influência de um lanche noturno acrescido de beta-glucana, na forma de biscoitos e barras, comparado a um lanche convencional contendo iogurte. Os resultados demonstraram uma ligeira melhora na resposta glicêmica apenas até as 2 horas da manhã (p<0,05), ou seja, 5 horas após o lanche, mas não houve diferença na prevalência de hipoglicemias noturnas, que foi de 27% (Rami, Zidek, Schober, 2000).…”

Section: Fibras Solúveisunclassified

Visão retrospectiva em fibras alimentares com ênfase em beta-glucanas no tratamento do diabetes

Mira

Graf

Cândido

2009

Braz. J. Pharm. Sci.

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Fibra alimentar refere-se aos componentes de plantas ou carboidratos análogos que são resistentes à digestão e absorção no intestino delgado humano. A American Dietetic Association recomenda ingestão de 20-35g de fibras ao dia. Evidências sugerem que uma dieta rica em fibras traz benefícios à manutenção da saúde, redução de risco e tratamento de doenças crônicas como a obesidade, doenças cardiovasculares, diverticulite e diabetes. As fibras são classificadas de acordo com a sua solubilidade em solúveis e insolúveis, com efeitos fisiológicos distintos. As insolúveis são responsáveis pelo aumento do bolo fecal e diminuição do tempo de trânsito intestinal. As solúveis retardam o esvaziamento gástrico e a absorção de glicose diminuindo a glicemia pós-prandial e reduzem o colesterol sérico devido à sua característica física de conferir viscosidade ao conteúdo luminal. As beta-glucanas são fibras altamente viscosas e seu consumo está relacionado à atenuação da resposta glicêmica e insulínica pós-prandial. A beta-glucana tem efeito sobre a degradação do amido e sobre o carboidrato disponível e conseqüentemente, sobre o índice glicêmico dos alimentos ingeridos. Recomenda-se sua ingestão com o objetivo de modular a glicemia e a necessidade de insulina, no tratamento da obesidade, doenças cardiovasculares e do diabetes. Este trabalho visa fornecer uma visão geral sobre beta-glucanas no tratamento do diabetes.Unitermos: Fibras alimentares. Beta-glucanas. Diabetes/tratamento. Glicemia.Dietary fibers are defined as the component of the plants or analog carbohydrates that are resistant to digestion and absorption in the human small bowel. The America Dietetic Association recommends an ingestion of 20-30g of fiber per day. Evidences suggest that a diet rich in fibers brings benefits to health maintenance, by reducing the risk and the time of treatment of chronic diseases such as obesity, cardiovascular diseases, diverticulitis and diabetes. Fibers are classified as a soluble and insoluble with distinct physiological effects. Ingestion of insoluble fibers increases the fecal bolus and reduces the transit time of food through the bowel. Soluble fibers delay gastric emptying and glucose absorption reducing the post prandial glycemia and reduce blood cholesterol levels due to a physic characteristic that confers viscosity to the luminal content. Beta-glucans are highly viscous and their consumption has been related to the attenuation of post-prandial glycemic and insulin response. Dietary beta-glucans have impact on starch degradation and carbohydrates availability and consequently at the glycemic index of the ingested food. Consumption of beta-glucans is recommended aiming to modulate the glycemia and the insulin needs, to manage the obesity, cardiovascular diseases and diabetes. This paper brings information about dietary fibers and the use of beta-glucans on the treatment of diabetes.

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“…Glucans have a solid history in reducing the diabetes and insulitis. In human studies, glucan in food reduced glycemic index in DM2, reduced postprandial blood glucose and insulin,and,when used as glucan-enriched bedtime snacks, it reduced nocturnal blood glucose levels in diabetic children [37][38][39]. In addition, glucan improved wound healing in diabetic mice and prevented diabetes and insulitis in rats [40,41].…”

Section: Discussionmentioning

confidence: 99%

IgG4-Related orbital disease in patients with diabetic retinopathy: Effects of glucan and vitamin D supplementation

Richter¹,

Zahradnicka²,

Větvička³

et al. 2018

Pathol Discov

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Background: Diabetic retinopathy represents a serious complication of diabetes. Methods: In our group of 52 patients, we identified 7 individuals (13%) with elevated levels of IgG4. Results: Detailed examination revealed significant clinical changes, resulting in a diagnosis of probable IgG4-RD. Conclusions: Long-term evaluation and beta glucan supplementation, combined with vitamin D supplementation, during general treatment of these patients significantly improved both health and mental conditions.

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Influence of a β-Glucan–Enriched Bedtime Snack on Nocturnal Blood Glucose Levels in Diabetic Children

Cited by 14 publications

References 24 publications

Are bedtime nutritional strategies effective in preventing nocturnal hypoglycaemia in patients with type 1 diabetes?

Are bedtime nutritional strategies effective in preventing nocturnal hypoglycaemia in patients with type 1 diabetes?

Visão retrospectiva em fibras alimentares com ênfase em beta-glucanas no tratamento do diabetes

IgG4-Related orbital disease in patients with diabetic retinopathy: Effects of glucan and vitamin D supplementation

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