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Purpose: Dietary modification in association with life style changes is important in the management of the diabetes. Cereals account for as much as 77% of total caloric consumption in most African diets. Corn which is the largest cultivated cereal crop in Nigeria is prepared as a meal in many forms. The objective of this study was to assess the glycaemic responses to different preparations of corn meals. Material and Method: The design was a quasi-experimental with a total of 32 participants, 16 subjects with type diabetes and 16 age-and sex-matched non-diabetic control subjects. After an overnight fast, the participants were given corn meals to eat and had their blood sample collected every 30 minutes for over a 2 hour period for the assessment of blood sugar level and estimation of glycaemic responses. This was repeated weekly till the glycaemic index (GI) and plasma sugar level response to the different test corn meal preparation, such as boiled corn, roasted corn, pap and cornflakes had been assessed. Results: All the different corn meal preparations had high GI, with corn flakes having the highest GI and pap the lowest. The GI for the corn meals in the non-diabetic were; pap 71.7±14.4%, roasted corn 76.5±14.9%, boiled corn 82.2±14.9% and cornflakes 88.1±14.4%. Discussion: Methods of preparing a meal from corn affect glycaemic response. Turk Jem 2015; 19: 79-82
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Introduction
Diabetes mellitus (DM) is a metabolic disorder of multiple aetiology,
characterised by chronic hyperglycemia which is associated with
disturbances of carbohydrate, fat and protein metabolism. This
disorder results from a defect in insulin secretion, insulin action
or both (1).
Diet in combination with lifestyle changes such as regular exercise
helps patients with diabetes to lose weight and to also improve
their overall metabolic control (2,3,4). The rst documented dietary
prescription in the treatment of presumed diabetes appeared in
the Papyrus Ebers, written around 1500 BC (5). High carbohydrate
diets produce a marked rise in post-prandial glucose, especially
if rened or if it has a low bre (6). Complex carbohydrate,
Turkish Journal of Endocrinology and Metabolism, published by Galenos Publishing.
Original Article
Purpose: Dietary modication in association with life style changes is important in the management of the diabetes. Cereals account for as much
as 77% of total caloric consumption in most African diets. Corn which is the largest cultivated cereal crop in Nigeria is prepared as a meal in many
forms. The objective of this study was to assess the glycaemic responses to different preparations of corn meals.
Material and Method: The design was a quasi-experimental with a total of 32 participants, 16 subjects with type diabetes and 16 age-and
sex-matched non-diabetic control subjects. After an overnight fast, the participants were given corn meals to eat and had their blood sample
collected every 30 minutes for over a 2 hour period for the assessment of blood sugar level and estimation of glycaemic responses. This was
repeated weekly till the glycaemic index (GI) and plasma sugar level response to the different test corn meal preparation, such as boiled corn,
roasted corn, pap and cornakes had been assessed.
Results: All the different corn meal preparations had high GI, with corn akes having the highest GI and pap the lowest. The GI for the corn meals
in the non-diabetic were; pap 71.7±14.4%, roasted corn 76.5±14.9%, boiled corn 82.2±14.9% and cornakes 88.1±14.4%.
Discussion: Methods of preparing a meal from corn affect glycaemic response.
Turk Jem 2015; 19: 79-82
Key words: Glycaemic index, corn meal, type 2 diabetes, Nigeria
Amaç: Yaşam tarzı değişiklikleri ile birlikte diyet değişiklikleri diyabet tedavisinde büyük öneme sahiptir. Tahıl çoğu Afrika diyetinde toplam kalori
tüketiminin %77 kadarını oluşturmaktadır. Mısır Nijerya’da en çok ekilen tahıl türüdür ve çeşitli biçimlerde yemek olarak hazırlanır. Bu çalışmanın
amacı, farklı mısır yemek tarzlarına glisemi yanıtlarını değerlendirmektir.
Gereç ve Yöntem: On altı diyabetik hasta ve 16 yaş ve cins uyumlu non-diyabetik kişi olmak üzere toplam 32 hasta yarı-deneysel tasarımlı bu
çalışmaya alındı. Bir gecelik açlığı takiben katılımcılara mısır yemekleri verildi ve kan şekerini ve glisemik cevabı tespit etmek için 2 saat boyunca
her 30 dakikada bir kan örnekleri alındı. Haftada bir bu işlem haşlanmış mısır, kavrulmuş mısır, pap ve mısır gevreği gibi farklı mısır yemekleri
için tekrarlandı.
Bulgular: Mısır gevreği en yüksek, pap en düşük glisemik indekse (GI) sahip olmak üzere tüm mısır yemek çeşitleri de yüksek glisemik indekse
sahipti. Non-diyabetiklerde mısır yemeklerinin GI’leri şöyleydi; pap %71,7±14,4, kavrulmuş mısır %76,5±14,9, haşlanmış mısır %82,2±14,9 ve mısır
gevreği %88,1±14,4.
Tartışma: Mısırdan hazırlanan farklı yemekler mısırın glisemik cevabını etkileyebilir.
Turk Jem 2015; 19: 79-82
Anah tar ke li me ler: Glisemik indeks, mısır unu, tip 2 diyabet, Nijerya
Address for Correspondence: Akinola Dada MD, Lagos State University Faculty of Medicine, Department of Internal Medicine, Lagos, Nigeria
Phone: +234 802 309 64 27 E-mail: akindudu2004@yahoo.ca
Received:
16/11/2014
Accepted:
14/02/2015
Akinola Dada, Anthonia Ogbera, Sunday Ogundele*, Olufemi Fasanmade, Augustine Ohwovoriole**
Lagos State University Faculty of Medicine, Department of Internal Medicine, Lagos, Nigeria
*Lagos State University Faculty of Medicine, Department of Pharmacology, Lagos, Nigeria
** Lagos University Faculty of Medicine, Department of Internal Medicine, Lagos, Nigeria
Glycaemic Responses to Corn Meals in Type 2 Diabetics and
Non-Diabetic Controls
Tip 2 Diyabetikler ve Non-Diyabetik Kontrollerde Mısır Yemeklerine Glisemik
Cevaplar
DOI: 10.4274/tjem.2877
Abs tract
Özet
79
vegetables, fruits and soluble and viscous bers like pectin found
in legumes are more effective in achieving normal plasma glucose
and lipid levels than the insoluble ber such as cellulose found in
cereals (6,7). Cereals account for as much as 77% of total caloric
consumption in most African diets (8,9). Cereal grains include
wheat, rice, corn, barely, millet, oat and rye; of these, corn is by far
the largest cultivated cereal crop in Nigeria (10). Corn is prepared
as a meal in many forms; it can be boiled, roasted or processed
and then prepared as pap or as cornakes. Corn meals serve as
an important source of carbohydrate. Studies have shown that
the metabolic response to various foods in patients with type 2
diabetes differs from that in non-diabetic persons (7).
Corn as a meal has a high glycemic index (GI) (11), but studies
have shown that when meals are prepared in different forms from
a major ingredient they produce different glycemic responses.
We therefore decided to assess the glycemic responses to the
different forms of preparations of corn meal (12,13). The main
objective of this study was to assess the potential role of corn
meals in the dietary management of DM, by determining the
glycemic response of various corn meals preparation in patients
with type 2 diabetes and compare this to the response in non-
diabetic controls.
Materials and Methods
The study was carried out at the Endocrinology and Metabolism
Unit of Medicine Department of Lagos University Teaching
Hospital. The study design was quasi-experimental interventional
study with a total of 32 subjects. Sixteen subjects with type 2
diabetes attending the endocrinology clinic of the hospital that
consented and met the inclusion criteria were matched for age
and sex with sixteen non-diabetic controls who were members of
staff in the hospital, including medical students. The study had a
cross-over period of one week during which each subjects served
as their own internal control for the different preparation of corn
meals that were assessed. The different corn meal preparations
were boiled corn, roasted corn, cornakes and pap.
At enrollment, all subjects were clinically examined and their
anthropometric measurements were recorded. Male and female
type 2 diabetics with good glycemic control on diet alone or diet
with oral hypoglycemic agents and aged between 20 and 50
years were included in the study. Subjects, who were obese,
with BMI ≥30 kg/m2, type 1 diabetic, all insulin-treated type 2
diabetics, patients with history or evidence of chronic complication
like gastro-paresis were all excluded. Healthy volunteers who
were not currently on any drug known to affect carbohydrate
metabolism, with no known family history of diabetes mellitus,
BMI <30 kg/m2 and aged between 20 and 50 years were
also included in the study. The protocol was submitted to the
institutional ethics committee for review and approval.
The test meals were prepared by the dietetics unit of the hospital.
The meals and ingredients were bought at the same time,
from the same source and prepared by the same dietitian. The
components of the meals were calculated from food tables to
provide equivalent 50 g of carbohydrate (13). Pap was prepared
from corn our. A single brand of cornakes was bought from
open market and about 50 g carbohydrate equivalent portion was
calculated from the food table on the pack. Boiled and roasted
corn meals were prepared from fresh corn as appropriate.
All the 32 participants, 16 type 2 diabetics and 16 non-diabetics
subjects took different meal each test day of the week till all the
different meals had been tested over a four week period. All the 16
non-diabetic subjects took an oral glucose tolerance test (OGTT) with
50 g of anhydrous glucose at the start of the study after they had been
on unrestricted diet containing at least 150 g of carbohydrates per
day for at least 72 hours prior to the test. They were also requested
to abstain from smoking, strenuous physical activity and ingestion
of alcohol 2 days before the test. All participants were requested
to observe an overnight fast before taking the test meal, diabetic
subjects were told to take their usual doses of oral hypoglycemic
agents during the study period. Subjects on glibenclamide or
rosiglitazone took the medication 30 minutes before study meals
consumption while those on metformin took the drug at the end of
meal consumption. The participants were made to sit and rest for
at least 30 minutes before commencement of the test procedures.
An indwelling cannula was kept patent with heparinized saline
was introduced into a forearm vein of each participants. Baseline
blood samples for fasting blood glucose were then taken from each
subject. Test meals were served warm in disposable plates and
consumed over a period of 10-15 minutes followed by drinking 250
ml of water. Blood samples were collected at half hourly intervals for
two hours for the measurement of plasma glucose.
The software used for the analysis was SPSS (version 16),
quantitative variables were expressed as mean + standard error
of mean (mean + SEM). The differences between means were
tested with Student’s t test. The level of statistical signicance was
taken as p value ≤0.05.
Results
The results showed that the participants in the two groups were
similar in their demographic and anthropometric proles except
for the mean waist circumference which was signicantly higher in
participants with diabetes compared with non-diabetics subjects.
Two female diabetics and two female non-diabetics dropped
out during the study period due to discomfort from repetitive
venipuncture and the inconvenience of follow-up (Table 1).
The mean fasting plasma glucose (FPG) level for non-diabetic
subjects assessed before serving them the test meals were within
the normal limits (<110 mg/dl), the levels among the diabetic
subjects were higher compared with non-diabetics. Cornakes
had the highest post-prandial glucose response among all the
corn meals. The plasma glucose levels peaked at 60 minutes
for all test meals in the non-diabetics and the 2 hour postload
glucose (2HPPG) levels were comparable to the corresponding
FPG levels, see Figure 1.
The calculated GI for the corn meals in the non-diabetic was as
follows: pap: 71.7% (±14.4), roasted corn: 76.5% (±14.9), boiled corn:
82.2% (±14.9) and cornakes: 88.1% (±14.4). The plasma glucose
response indices showed that pap has best prole with the least
maximum increase in plasma glucose and least incremental area
under glucose curve (IAUC) among subjects with diabetes (Table 2).
80
Turk Jem 2015; 19: 79-82
Dada et al.
Glycaemic Responses to Corn Meals in Type 2 Diabetics and Non-Diabetic Controls
81
Discussion
The study demonstrated that corn meal in its different forms has a
high GI and that the GI for corn meal differs according to how the
meal is prepared. This nding is important because it will guide
health care workers involved in the management of patients with
diabetes to make appropriate recommendation on the best way
to prepare corn meals for dietary control and management of
diabetes. GI is the extent to which a test food raises the blood
glucose level compared to how much the level is raised by an
equivalent amount of pure glucose (14,15). GI is determined by
calculating the ratio of the IAUC for a reference meal (usually 50
g of pure glucose) to that of an equivalent amount of a test meal
(16,17). A food is considered to have a high GI if its response is
more than half the value of that of glucose (12). The classication
of GI is as follows; low GI: <55%, medium GI: 55-69% and high
GI: >70%.
Knowing the GI of a food is important because diet has been
implicated in the aetiology of type 2 diabetes among people
with high risks for the disease (18). Caloric intake in excess of
requirements is known to contribute to developing obesity which
is a known risk factor for the disease (18). The different GI of various
corn meal preparations is lowest for pap, this is prepared from a
processed corn our and highest for cornakes another processed
corn product. Cornakes have the highest peak plasma glucose
and the highest maximum increase in plasma glucose which
suggests that cornakes are not ideal meal for diabetics. Among
the non-diabetics, cornakes also had worse glycemic prole. The
better GI of pap compared to the other corn meal preparations
may be explained by the fact that it has a low fat, calorie and ber
content. This may be due to the various steps in its processing such
as steeping, milling and sieving which lead to substantial nutrient
loss. Much of the protein in cereal grains is located in the testa and
germ which are usually sieved off during processing. Studies have
shown that processing grains modies their glycemic index proles
(19,20). Milling of wheat serves to separate them into different
components such as bran, germ and endosperm producing a
nely ground our (21,22). Bread made from nely ground whole-
meal our has a GI of 71±2%, this average was from 13 different
studies, and it is not different from the GI of white bread (23). In
contrast, bread containing a substantial proportion of whole or
cracked wheat kernels has a GI some 20-30% lower than white
bread (23). In a study by Fasanmade and his co-worker in Ibadan,
South-Western Nigeria, they reported that the GI for maize our
Turk Jem 2015; 19: 79-82
Dada et al.
Glycaemic Responses to Corn Meals in Type 2 Diabetics and Non-Diabetic Controls
Table 2. Glycemic response indices of corn meals in persons
among diabetic and non-diabetic participants
Mean (SEM)
PGRI Non-diabetic Type 2 diabetics P value
Cornakes
PPG (mg/dl) 129.6 (5.4) 199.8 (5.4) 0.00001`
MIPG (mg/dl) 45 (5.4) 73.8 (5.4) 0.00172
IAUGC (mmol*min/l) 157.4 (26.2) 292.6 (26.3) 0.00089
Roasted Corn
PPG (mg/dl) 115.2 (5.4) 160.2 (9) 0.00005
MIPG (mg/dl) 36 (3.6) 55.8 (9) 0.00127
IAUGC (mmol*min/l) 125.3 (19) 217.4 (27) 0.00199
Boiled Corn
PPG (mg/dl) 111.6 (9) 1692 (9) 0.00007
MIPG (mg/dl) 37.8 (5.4) 48.6 (5.4) 0.18911
IAUGC (mmol*min/l) 114.3 (16.2) 181 (16.2) 0.00746
Pap
PPG (mg/dl) 117 (5.4) 169.2 (7.2) 0.00001
MIPG (mg/dl) 37.8 (5.4) 48.6 (5.4) 0.02717
IAUGC (mmol*min/l) 121 (12.7) 186 (25) 0.02022
PGRI: Plasma glucose response indices, MIPG: Maximum increase in plasma
glucose, PPG: Peaked plasma glucose, IAUGC: Incremental area under glucose
curve
Table 1. Baseline characteristics of diabetics and non-diabetics
participants
Characteristics Means (SEM)
Non diabetic Type 2 diabetic P value
Sex
Male 6 5
Female 10 11 0.7
Age (years) 44.9 (1.7) 44.6 (1.7) 0.9
BMI (kg/m2)26.1 (0.8) 25.3 (0.8) 0.5
Waist circumference (cm) 82.7 (2.4) 93.1 (2.4) 0.001
WHR 0.88 (0.02) 0.9 (0.02) 0.3
Duration of DM (months) -78.8 (19.6)
BMI: Body mass index, WHR: Waist circumference to hip ratio, DM: Diabetes
mellitus
Figure 1. Baseline and the timed glycaemic proles of subjects with
diabetes and non-diabetics to different preparation of corn meal
82
was 54.83±26.74% and 26.61±11.33% in diabetic and non-diabetic
subjects, respectively (16). The GI was lower than the 71±14.4%
recorded in non-diabetics in our study. This may be explained by
the fact that the meal prepared from maize our in their study was
served with a soup of a vegetable leaf specie (Corchorus olithorus),
tomato sauce and 25 g of boiled beef meat (16). In another study
in Philippines on healthy volunteers, the GI for boiled corn meal
prepared from a variety of maize known as the quality protein
maize was 80.29±17.11%. The nding in the Philippines study is
similar to the result of GI for boiled corn in our study which was
82.2±14.9% (24). Ekpebegh in his work on assessment of glycemic
response to meals prepared from sorghum and maize among
Nigerian males reported that glycemic response to these meals
was attenuated because they were prepared mixed with bean
products (25). These effects are probably due to the high ber
content in the bean covering like in all legumes (13,26).
The nding that the FPG and the 2HPPG levels in all the non-
diabetic subjects were within normal range conrmed that they
were all glucose tolerant. The mean fasting glucose levels in
subjects with diabetes were also within normal range. This is
explained by the fact that they were all well-controlled on their
regular doses of oral hypoglycemic agents.
Different methods of preparing corn meal affect its glycemic
response. This study showed that cornakes may not be an
ideal corn meal preparation for diabetics; it had the highest
glycemic response among all the tested corn meal preparations.
Its consumption should be in a measured quantity. Pap had the
lowest GI and we therefore recommend it as the ideal corn meal
preparation. In line with the reports from other studies, taking corn
meal mixed with vegetables lowers their glycemic response and
should be the preferred form of serving the meal.
Acknowledgments
This work was part of a dissertation submitted to the National
Postgraduate Medical College of Nigeria in partial fulllment of
the requirements for the award its Fellowship in Internal Medicine
with sub-specialization in Endocrinology and Metabolism.
Ethics Committee Approval: It was taken, Informed Consent: It
was taken, Concept: Akinola Dada, Sunday Ogundele, Olufemi
Fasanmade, Anthonia Ogbera, Augustine Ohwovoriole, Design:
Akinola Dada, Olufemi Fasanmade, Anthonia Ogbera, Augustine
Ohwovoriole, Data Collection or Processing: Akinola Dada,
Sunday Ogundele, Olufemi Fasanmade, Augustine Ohwovoriole,
Analysis or Interpretation: Akinola Dada, Sunday Ogundele,
Olufemi Fasanmade, Anthonia Ogbera, Prof Ohwovoriole,
Literature Search: Akinola Dada, Sunday Ogundele, Writing:
Akinola Dada, Sunday Ogundele, Olufemi Fasanmade, Augustine
Ohwovoriole, Anthonia Ogbera, Peer-review: External and
Internal peer-reviewed, Conict of Interest: No conict of interest
was declared by the authors, Financial Disclosure: The authors
declared that this study has received no nancial support.
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Turk Jem 2015; 19: 79-82
Dada et al.
Glycaemic Responses to Corn Meals in Type 2 Diabetics and Non-Diabetic Controls
... This could be attributed to the rate of release of carbohydrates within the fruits. Dada et al. [11] reported higher PPG levels after corn meals in nondiabetic participants. The difference in the PPG of the bean meals compared to the corn meals may be attributed to the higher content of fibers in bean meals [11] and the method of cooking or processing of the corn meals. ...
... Dada et al. [11] reported higher PPG levels after corn meals in nondiabetic participants. The difference in the PPG of the bean meals compared to the corn meals may be attributed to the higher content of fibers in bean meals [11] and the method of cooking or processing of the corn meals. ...
... It is encouraging to note that there were similarities in the PPG levels of the bean meals of the diabetic participants when compared with the PPG levels after boiled corn and pap meal consumption by diabetic participants [11] and after consumption of pineapple meal in Edo et al.'s study. [12] However, Ohwovoriole and Johnson [9] reported higher PPG in the diabetic group. ...
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This study has shown the Glycaemic responses such as maximum increase in plasma glucose, peak plasma glucose and two hours post prandial to bean meals and their impact on glycaemic control in people with non communicable diseases such as diabetes mellitus.
... This could be attributed to the rate of release of carbohydrates within the fruits. Dada et al. [11] reported higher PPG levels after corn meals in nondiabetic participants. The difference in the PPG of the bean meals compared to the corn meals may be attributed to the higher content of fibers in bean meals [11] and the method of cooking or processing of the corn meals. ...
... Dada et al. [11] reported higher PPG levels after corn meals in nondiabetic participants. The difference in the PPG of the bean meals compared to the corn meals may be attributed to the higher content of fibers in bean meals [11] and the method of cooking or processing of the corn meals. ...
... It is encouraging to note that there were similarities in the PPG levels of the bean meals of the diabetic participants when compared with the PPG levels after boiled corn and pap meal consumption by diabetic participants [11] and after consumption of pineapple meal in Edo et al.'s study. [12] However, Ohwovoriole and Johnson [9] reported higher PPG in the diabetic group. ...
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Background: Medical nutrition therapy is an important aspect of managing diabetes mellitus (DM). Foods with low glycemic index are encouraged in individuals with DM. Despite the good glycemic indices associated with beans, glycemic responses of bean meals in persons with DM is unknown. The aim of this study is to determine whether there are differences in the glycemic responses of local beans (Vigna unguiculata [Linn Walp] varieties) in persons with Type 2 DM (T2DM) and healthy controls. Methods: This was an experimental study done at Lagos University Teaching Hospital over 12 weeks. Twelve consenting T2DM persons and 12 healthy controls participated in this study. Peak plasma glucose (PPG), the maximum increase in plasma glucose (MIPG), 2‑h postprandial glucose (2HPPG), and incremental area under glucose curve (IAUGC) of three different varieties (V. unguiculata [Linn Walp] varieties) “oloyin,” “drum” and “sokoto white” were measured. Results: Among healthy participants “Oloyin” bean meal had the lowest values of PPG, MIPG, and IAUGC, while “drum” bean meal had the highest values of MIPG and IAUGC (P = 0.039). Among persons with DM, “Oloyin” bean meal had the highest 2HPPG, PPG but lowest MIPG values when compared with other bean meals while “drum” bean meal had the highest MIPG and IAUGC with the lowest 2HPPG of the three‑bean meals. Conclusion: There were differences in the glycaemic responses of V. unguiculata (Linn Walp) varieties studied in persons with T2DM and controls. Glycaemic responses, in addition to glycemic indices of meals, should be considered in the management of persons with DM. Key words: Beans (Vigna unguiculata [Linn Walp] varieties), diabetes mellitus, glycemic index, glycaemic response
... A study was using boiled corn showed that healthy respondents who consumed boiled corn had lower blood glucose elevation compared to eat white rice 30-180 min after eating [15]. The other study showed different result that some corn meal preparation such us pap, roasted corn, boiled corn, and cornflakes can increase GI between 71 and 88 [16]. ...
... All studies about the effect of corn product in human in the form of rice corn, mix rice, flour, and muffin showed lowering glycemic response of the subject [16], [21], [22], [24], [26]. The same thing was also shown from giving corn to experimental animals [23], [25], [27], [28]. ...
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BACKGROUND: Staple foods as a source of carbohydrates contribute most of human energy needs. Based on Perkeni’s recommendation, diabetic patients can consume at least 45–60% of carbohydrate sources. In addition, several previous studies have shown that increasing the adequacy of dietary fiber above 20–25 g/day can improve glycemic control. AIM: Our scoping review investigated the potential of Indonesian food sources, namely, sorghum and corn as a source of carbohydrates and also fiber as a substitute rice for diabetic patients. METHODS: We systematically used electronic databases searched such as PubMed, Science Direct, Web of Science, Portal Garuda, Sinta Ristekbrin, and Google Scholar. We choose the relevant documents used experimental animals and humans’ studies then published between 2011 and 2021. RESULTS: In total, 17 relevant articles discuss the relationship between giving corn or sorghum with blood glucose levels of animal studies and human. Some studies showed that the effect of eating sorghum or its derivatives can reduce blood glucose. As well as, the other articles indicated eating corn or its derivatives also decrease glycemic response of healthy people and experimental animals. Corn and sorghum contain dietary fiber in the form of resistant starch and have low glycemic index compare with white rice. Furthermore, corn also contains essential fat, mineral, β-Carotene, and isoflavone, while sorghum also includes phenolic components such as phenolic acids and flavonoids. CONCLUSIONS: Sorghum and corn have the potential as an alternative staple food to achieve a better glycemic response in diabetic patients.
... Since the prevalence of this disease is increasing exponentially all over the world, it has been accepted as the epidemic of the 21st century 3,4 . Medical attention is required because those affected by DM cannot adequately utilize carbohydrates, fats and proteins due to insulin deficiency or problems with insulin use 5 . According to the IDF Diabetes Atlas published by the International Diabetes Federation (IDF) in 2021, there are currently 643 million people living with diabetes worldwide, which is expected to rise to 783 million by 2043 (ref. ...
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The primary goal of this study was to assess the oxidant/ antioxidant balance of children and adolescents with type 1 diabetes mellitus (T1DM). It was an experimental case-control study with 38 children and adolescents diagnosed with T1DM. We found that the fasting blood glucose, haemoglobinA1c, malondialdehyde, total oxi-dant status, and total and native thiol values of the type-1 diabetes group were significantly higher than the control group, while total antioxidant status was significantly lower. Our results corroborate other studies showing diabetic patients are more vulnerable to oxi-dative stress.
... Since the prevalence of this disease is increasing exponentially all over the world, it has been accepted as the epidemic of the 21st century 3,4 . Medical attention is required because those affected by DM cannot adequately utilize carbohydrates, fats and proteins due to insulin deficiency or problems with insulin use 5 . According to the IDF Diabetes Atlas published by the International Diabetes Federation (IDF) in 2021, there are currently 643 million people living with diabetes worldwide, which is expected to rise to 783 million by 2043 (ref. ...
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Full-text available
The primary goal of this study was to assess the oxidant/ antioxidant balance of children and adolescents with type 1 diabetes mellitus (T1DM). It was an experimental case-control study with 38 children and adolescents diagnosed with T1DM. We found that the fasting blood glucose, haemoglobinA1c, malondialdehyde, total oxidant status, and total and native thiol values of the type-1 diabetes group were significantly higher than the control group, while total antioxidant status was significantly lower. Our results corroborate other studies showing diabetic patients are more vulnerable to oxidative stress.
... In addition, gum Arabic has prebiotic properties that also supports the growth of Gut microbiota (Calame et al. 2008) and promote the production of short-chain fatty acids (Cherbut et al. 2003). Interestingly, gum Arabic having a low glycemic index (Castellani 2005;Chawla and Patil 2010) also reduces the risk of cardiovascular disease and modulates adipose tissue dysfunction in type 2 diabetic patients (Babiker et al. 2018;Dada et al. 2015;Lavi et al. 2009). ...
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Cereal flakes are the most popular breakfast choices in the segment of ready-to-eat food products and generally consumed with hot milk. Fortification of cereal flakes with probiotics may increase the value addition, but the high temperature of milk limits the use of live microorganisms. The present work aims to develop the thermo-stable probiotic cereal flakes, which can withstand in hot milk up to 80 °C temperature. A coating blend containing Saccharomyces boulardii (109 CFU/mL) and gum Arabic (6% w/v) was applied on various cereal flakes, and the survivability was evaluated in the hot milk. Cornflakes showed better compatibility with the coating mixture by showing maximum survivability of S. boulardii (7.30 log CFU/g) over the control (2.61 log CFU/g). Further, the addition of nutraceuticals such as trehalose, glutathione, and oryzanol in different concentrations to coating mixture was also assessed. The cornflakes containing trehalose (0.4 mg/g) in its coating have resulted in maximum survivability of 7.99 log CFU/g and showed 3.26-fold higher thermo-protective role as compared to control. Sensory analysis showed an increased acceptability of gum Arabic coated cornflakes over the control due to change in viscosity of milk after its addition. SEM analysis clearly differentiated the surface based on treatments given to cornflakes. Modified atmosphere packaging of probiotic cornflakes using a vacuum, nitrogen gas, and air was done and then storage studies were done for 90 days.
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The upsurge in the incidence and prevalence of diabetes worldwide and in Nigeria in particular is a challenge for urgent action in the adoption of appropriate dietary management in patients with diabetes and also in the prevention of diabetes. Knowledge of the glycemic index (GI) of food types is essential for rational advice on calorie recommendation. Unfortunately, the GI of many food types in Nigeria is not known and so this study was undertaken to determine the GI of four staple and predominantly carbohydrate-based food types in Nigeria (yam, cassava, maize and wheat) by an open-labeled method, and to assess the variability of the GI of the tested food types in healthy subjects and those with diabetes. A total of twenty subjects were included in the study, i.e. ten type 2 diabetes mellitus (DM type 2) patients and ten healthy subjects serving as controls. They were given measured portions of the food containing 50 g of digestible carbohydrate. Blood glucose concentrations were determined from capillary blood drawn half hourly with a portable glucometer for two hours after ingestion of the food. Blood glucose curves were constructed to calculate the GI of the food. Values of the GI of the foods were compared using appropriate statistical methods of Microsoft Excel and SPSS v. 11. The results showed that there was wide variability of the GI in all the foods tested in both groups. In healthy subjects, maize four meal had the lowest GI and cassava flour meal the highest GI. This was in contrast to patients with diabetes, where yam flour had the lowest GI and wheat flour the highest GI. While the method of meal preparation may have an effect on the overall acceptability of the food to our patients with diabetes, it is apparent that carbohydrate from yam should be allowed freely in the menu while that from wheat flour (white bread) should only be allowed sparingly. The results from this study should serve as an encouragement for further studies on the local staple food types in Nigeria to ascertain their suitability or otherwise in their incorporation into the recommended menu in the dietary management of diabetes.
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It is not known which of the commonly consumed fruits in Nigeria are suitable for persons with diabetes mellitus especially with regards to the attendant plasma glucose response (PGR) to consumption of such fruits. To determine and compare the PGR to commonly eaten fruits in patients with diabetes mellitus. Ten persons with type 2 diabetes mellitus were studied. Fifty-gram portions of five fruits containing 50 g carbohydrate [ banana, Musa paradisiaca; orange, Citrus sinensis; pineapple, Ananus comosus; mango, Magnifera indica; pawpaw, Carica papaya], and glucose were randomly fed to the study subjects at one-week intervals. Blood samples were collected in the fasting state and half-hourly over a 2- hour period post-ingestion of the fruits or glucose for plasma glucose determination. Plasma glucose responses were assessed by the peak plasma glucose concentration (PPPG), maximum increase in postprandial plasma glucose (MIPG), two-hour postprandial plasma glucose level (2hPG) and incremental area under the glucose curve (IAUGC). The mean ± SEM PPPG in mmol/L were: banana, 9.0± 1.6; orange, 8.1± 0.8; pineapple, 9.2±1.1; mango, 8.0 ± 1.1; and pawpaw, 7.8±0.9. The mean ±SEM IAUGC in mmol.min/L were: banana, 131.7±53.4; orange, 108.7±29.8; pineapple, 115.3±33.2; mango, 101.6 ± 28.7; and pawpaw, 124.1± 46.1. However, mango showed the least MIPG (1.8 ± 0.5 mmol/l) followed by orange and pawpaw. The IAUGC also followed this pattern. There were no significant differences among the glycaemic indices of the fruits. Glucose load produced a significantly higher IAUGC than the fruits (orange, pineapple, mango, pawpaw, p<0.005; banana, p<0.025). The plasma glucose response to consumption of Nigeria fruits are similar. The PGR indices to all fruits were less than the PGR after an equivalent carbohydrate load of glucose. It appears safe to recommend these Nigerian fruits to persons with diabetes within the prescribed daily total calorie intake.
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Background. Carbohydrates have varied rates of digestion and absorption that induces different hormonal and metabolic responses in the body. Given the abundance of carbohydrate sources in the Philippines, the determination of the glycaemic index (GI) of local foods may prove beneficial in promoting health and decreasing the risk of diabetes in the country. Methods. The GI of Quality Protein Maize (QPM) grits, milled rice, and the mixture of these two food items were determined in ten female subjects. Using a randomized crossover design, the control bread and three test foods were given on separate occasions after an overnight fast. Blood samples were collected through finger prick at time intervals of 0, 15, 30, 45, 60, 90, and 120 min and analyzed for glucose concentrations. Results. The computed incremental area under the glucose response curve (IAUC) varies significantly across test foods (P < .0379) with the pure QPM grits yielding the lowest IAUC relative to the control by 46.38. Resulting GI values of the test foods (bootstrapped) were 80.36 (SEM 14.24), 119.78 (SEM 18.81), and 93.17 (SEM 27.27) for pure QPM grits, milled rice, and rice-QPM grits mixture, respectively. Conclusion. Pure QPM corn grits has a lower glycaemic response compared to milled rice and the rice-corn grits mixture, which may be related in part to differences in their dietary fibre composition and physicochemical characteristics. Pure QPM corn grits may be a more health beneficial food for diabetic and hyperlipidemic individuals.
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Glycaemic index (GI) was determined in 36 non-insulin-dependent diabetes mellitus (NIDDM) patients. The subjects were fed 50g carbohydrate portions of six foods consumed widely in India including Varagu (Plaspalum scorbiculatum) alone and in combination with whole and dehusked greengram (Phaseolus aureus Roxb), Bajra (Penniseteum typhoideum), Jowar (Sorghum vulgare) and Ragi (Eleusine coracana). The GI of Varagu alone, Varagu in combination with whole greengram and Bajra was significantly lower than that of Ragi which produced a glycaemic response equivalent to that of the glucose load.
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The rarity of diabetes mellitus in rural Africans and the increased incidence in urban Africans suggested that high-fiber, high-carbohydrate diets might protect against diabetes. Conversely it has been suggested that low-fiber starchy food is a diabetogenic factor in susceptible human phenotypes. Many years ago experimental studies demonstrated that carbohydrate tolerance was increased in healthy adults if they ate high-carbohydrate diets but was decreased if they ate high-fat diets. From 1940 in England and Wales, diabetes death rates reported only those who died directly from diabetes mellitus; all cardiovascular complication deaths were excluded. Standardized diabetes mellitus death rates in England and Wales fell from 1941 until 1954 to 1957 by 55% in men and 54% in women. These years coincided with the production of high-fiber National flour. These data suggested the dietary fiber hypothesis of the etiology of diabetes mellitus, namely that fiber-depleted starchy foods were diabetogenic and conversely that high-fiber starchy foods were protective. Recent experimental studies of diabetic hyperglycemic men have shown that high-fiber, high-carbohydrate diets cause remission of diabetes mellitus in many men who had been treated previously by oral agents of moderate doses of insulin, but not those who had previously received large amounts of insulin.
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The glycaemic index is a measure of the extent to which the carbohydrate in a food can raise the blood glucose concentration and helps to identify foods which may be beneficial to a diabetic patient. This paper reviews the results that have been obtained so far with the glycaemic index approach, the factors that affect the glycaemic response, the problems that are associated with its measurement and its value in planning diabetic diets. Individual variation and variation among individuals in glycaemic responses are also discussed.