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ABSTRACT: This study aimed to determine whether educating diabetic patients to 'eat vegetables before carbohydrate' was as effective on long-term glycemic control as a traditional exchange-based meal plan. To test this hypothesis, we carried out a randomized, controlled trial in patients with type 2 diabetes that compared changes in HbA1c as the primary outcome. A total of 101 patients were stratified according to sex, age, BMI, duration of diabetes, and HbA1c, and then randomized to receive instructions to eat either vegetables before carbohydrate (VBC, n=69) or an exchange-based meal plan (EXB, n=32). The impact of the two plans on glycemic control was compared over 24 months of follow-up. Significant improvements in HbA1c over 24 months were observed in both groups (VBC, 8.3 to 6.8% vs EXB, 8.2 to 7.3%). HbA1c levels were significantly lower in the VBC group than in the EXB group after 6, 9, 12 and 24 months of the study. Both groups exhibited similar improvements in dietary practices with respect to intake of carbohydrate, fats and sweets, while the VBC group had a significant increase in consumption of green vegetables and a significant decrease in fruit consumption. A simple meal plan of 'eating vegetables before carbohydrate' achieved better glycemic control than an exchange-based meal plan in Japanese patients with type 2 diabetes over a 24-month period.
Asia Pacific Journal of Clinical Nutrition 01/2011; 20(2):161-8. · 1.13 Impact Factor
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Saeko Imai,
Hana Kozai,
Yuko Naruse,
Kanji Watanabe,
Michiaki Fukui,
Goji Hasegawa,
Hiroshi Obayashi,
Naoto Nakamura,
Yuji Naito,
Toshikazu Yoshikawa, Shizuo Kajiyama
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ABSTRACT: The aim of this study was to determine the effectiveness of education on diabetes prevention in subjects with impaired glucose tolerance. A total of 100 subjects of impaired glucose tolerance with hemoglobin A1c (HbA1c) levels >/=5.5 to <6.1% were assigned randomly to either support or control groups. All subjects received education in 8 sessions over a 6-month period. The support group consisted of 10 members collaborating with a dietitian or a nurse who learned coping skills by employing a participant-centered approach. Participants in the support group were required to keep a diary that monitored weight, food intake and blood glucose levels, while the control group attended several lectures. Subjects assigned to the support group had a reduction in mean HbA1c levels from 5.77 +/- 0.36% at baseline to 5.39 +/- 0.24% at the endpoint (p<0.01). Weight, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) levels also decreased (p<0.01) in the support group, whereas subjects in the control group had no observable reduction in these indices. After intervention, participants of the support group had improvements in their 2-h post-meal blood glucose levels. Support group education can be effective for improving glycemic control in participants when carried out in collaboration with educators and other team members.
Journal of Clinical Biochemistry and Nutrition 10/2008; 43(2):82-7. · 1.98 Impact Factor
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Yasunori Sato, Shizuo Kajiyama,
Akiko Amano,
Yoshitaka Kondo,
Toru Sasaki,
Setsuko Handa,
Ryoya Takahashi,
Michiaki Fukui,
Goji Hasegawa,
Naoto Nakamura,
Hikohito Fujinawa,
Toyotaka Mori,
Mitsuhiro Ohta,
Hiroshi Obayashi,
Naoki Maruyama,
Akihito Ishigami
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ABSTRACT: Hydrogen is an established anti-oxidant that prevents acute oxidative stress. To clarify the mechanism of hydrogen's effect in the brain, we administered hydrogen-rich pure water (H(2)) to senescence marker protein-30 (SMP30)/gluconolactonase (GNL) knockout (KO) mice, which cannot synthesize vitamin C (VC), also a well-known anti-oxidant. These KO mice were divided into three groups; recipients of H(2), VC, or pure water (H(2)O), administered for 33 days. VC levels in H(2) and H(2)O groups were <6% of those in the VC group. Subsequently, superoxide formation during hypoxia-reoxygenation treatment of brain slices from these groups was estimated by a real-time biography imaging system, which models living brain tissues, with Lucigenin used as chemiluminescence probe for superoxide. A significant 27.2% less superoxide formed in the H(2) group subjected to ischemia-reperfusion than in the H(2)O group. Thus hydrogen-rich pure water acts as an anti-oxidant in the brain slices and prevents superoxide formation.
Biochemical and Biophysical Research Communications 10/2008; 375(3):346-50. · 2.48 Impact Factor
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Goji Hasegawa, Shizuo Kajiyama,
Toru Tanaka,
Saeko Imai,
Hana Kozai,
Aya Fujinami,
Mitsuhiro Ohta,
Hiroshi Obayashi,
Hyohun Park,
Koji Nakano,
Muhei Tanaka,
Emi Shiraishi,
Michiaki Fukui,
Toshikazu Yoshikawa,
Naoto Nakamura
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ABSTRACT: Several epidemiological studies have shown that postprandial hyperglycemia is associated with an increased risk of cardiovascular disease (CVD). The present study was conducted in order to compare the effects of acarbose and glimepiride treatment on serum lipoprotein profiles in patients with type 2 diabetes.
A total of 37 patients with newly diagnosed type 2 diabetes were studied. The patients were assigned randomly to treatment for 12 weeks with either acarbose (n=13, 100 mg x 3/day, group A), glimepiride (n=13, 2 mg/day, group G) or diet only (n=11, group D). Lipid and lipoprotein profiles before and after each treatment were evaluated.
A significant reduction in the net electronegative charge of low-density lipoprotein (emLDL) was observed in group A (-1.8, P<0.01), whereas no significant change in emLDL was observed in groups G and D. In group A, small VLDL and very small LDL levels were also decreased significantly (P<0.05). The change in emLDL levels correlated significantly with changes in very small LDL (r=0.751, P<0.01) and oxidized LDL levels (r=0.623, P<0.05).
These results suggest that measurement of serum emLDL may be a sensitive and clinically useful marker for determining qualitative lipoprotein abnormalities in diabetes, and that acarbose treatment lowers CVD risk by decreasing production of emLDL.
Clinica Chimica Acta 05/2008; 390(1-2):110-4. · 2.54 Impact Factor
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Saeko Imai,
Hana Kozai,
Mikuko Matsuda,
Goji Hasegawa,
Hiroshi Obayashi,
Chikako Togawa,
Toyomi Yamamura,
Kanji Watanabe,
Syuichi Miyatani,
Toshikazu Yoshikawa, Shizuo Kajiyama
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ABSTRACT: The aim of this study was to investigate the effects of a diabetic meal delivery system on glycemic control over a 12 month period in patients with type 2 diabetes. A total of 77 patients with type 2 diabetes were assigned randomly into three dietary intervention groups: group M, diabetic meal delivery; group D, individual dietary counseling; and group C, conventional dietary education. In group M, HbA(1c) levels decreased significantly from 8.2 +/- 1.2% to 7.4 +/- 0.8% after 12 months (p<0.05), while in group D, HbA(1c) levels decreased significantly throughout the entire 12 month period, from 8.5 +/- 1.7% at baseline to 7.4 +/- 1.1% at the endpoint. Similarly, fasting blood glucose (FBG) levels decreased significantly between 1 and 12 months in group M (p<0.05), and decreased significantly during the entire 12 month period in group D (p<0.01). There were no significant changes in either HbA(1c) or FBG levels in group C. This study provides evidence that intervention with delivery of diabetic meals to patients with type 2 diabetes can be equally effective for achieving glycemic control as individual dietary counselling by a dietitian. Diabetic meal delivery can therefore be used successfully to provide diabetes education to outpatients.
Journal of Clinical Biochemistry and Nutrition 02/2008; 42:59-63. · 1.98 Impact Factor
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