N Wilson Rodger's research while affiliated with The University of Western Ontario and other places
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Publications (40)
Objectives:
To determine the long-term effects of changing the amount or source of dietary carbohydrate on quality of life (QOL), symptoms and dietary satisfaction in people with type 2 diabetes.
Methods:
Subjects with diabetes treated by diet alone (n=162) were randomly assigned to high-carbohydrate/high-glycemic-index (HGI) diets; high-carbohy...
Background and aims:
Nutrition recommendations for type 2 diabetes (T2DM) are partly guided by the postprandial responses elicited by diets varying in carbohydrate (CHO). We aimed to explore whether long-term changes in postprandial responses on low-glycemic-index (GI) or low-CHO diets were due to acute or chronic effects in T2DM.
Methods and res...
To compare the effectiveness of a theory-based lifestyle physical activity (PA) program delivered to individuals with type 2 diabetes in diabetes education centers by professionals and peers.
Changes over 16 weeks in PA (steps/day) and related variables (weight, waist girth, resting heart rate, systolic and diastolic blood pressures) were compared...
The purpose of this prospective before-and-after study was to determine whether there are psychosocial and physical benefits of a self-awareness intervention for adults with type 1 diabetes and hypoglycemia unawareness (HU). A total of 29 adults participated in the self-awareness intervention of 8 sessions, each lasting 3 hours. Psychosocial (integ...
We recently found that oral glucose tolerance over 1 year in type 2 diabetic patients declined to a significantly lesser degree on a low-glycaemic-index than on a reduced-carbohydrate diet. Here, we examined whether that finding was associated with an improvement in disposition index, an index of beta cell function defined as the product of insulin...
The purpose of this prospective before-and-after study was to determine whether there are psychosocial and physical benefits of a self-awareness intervention for adults with type 1 diabetes and hypoglycemia unawareness (HU). A total of 29 adults participated in the self-awareness intervention of 8 sessions, each lasting 3 hours. Psychosocial (integ...
The optimal source and amount of dietary carbohydrate for managing type 2 diabetes (T2DM) are unknown.
We aimed to compare the effects of altering the glycemic index or the amount of carbohydrate on glycated hemoglobin (HbA1c), plasma glucose, lipids, and C-reactive protein (CRP) in T2DM patients.
Subjects with T2DM managed by diet alone (n=162) we...
Heterogeneity in circulating lipid concentrations in response to dietary polyunsaturated fatty acids (PUFAs) may be due, in part, to genetic variations. Tumor necrosis factor-alpha (TNF-alpha) is a proinflammatory cytokine that can induce hyperlipidemia and is known to be modulated by dietary PUFAs.
The objective was to determine whether TNF-alpha...
Tumor necrosis factor alpha (TNF-alpha) is a proinflammatory cytokine that impairs insulin action and alters lipid metabolism. We investigated the effects of genetic polymorphisms of TNF-alpha on circulating biomarkers of insulin resistance and lipid metabolism during an 8-hour metabolic profile test and a 2-hour oral glucose tolerance test in subj...
The etiology of acquired partial lipodystrophy (APL, also called "Barraquer-Simons syndrome") is unknown. Genomic DNA mutations affecting the nuclear lamina protein lamin A cause inherited partial lipodystrophy but are not found in patients with APL. Because it also encodes a nuclear lamina protein (lamin B2) and its genomic structure was recently...
To conduct a randomised trial of a physical activity (PA) intervention, The First Step Program (FSP) for adults with type II diabetes.
A 16-week intervention study and 24-week follow-up assessment.
A total of 47 overweight/obese, sedentary individuals (age=52.7 +/- 5.2 y; BMI=33.3 +/- 5.6 kg/m2) recruited through a diabetes education centre.
Primar...
The purpose of this pilot study was to evaluate the effectiveness of a self-awareness intervention in promoting increased awareness of body cues associated with various levels of glycemia and in enhancing well-being in persons with Type I diabetes and hypoglycemia unawareness. Study results indicated that participants could identify more cues of no...
To study the effect of acarbose, an alpha-glucosidase inhibitor, on glycemic control in elderly patients with type 2 diabetes.
Elderly patients with type 2 diabetes treated with diet alone were randomly treated in a double-blind fashion with placebo (n=99) or acarbose (n=93) for 12 months.
After 12 months of therapy, there was a statistically signi...
The First Step Program uses simple and inexpensive pedometers to incrementally increase walking behaviors in sedentary individuals with type 2 diabetes. The pilot sample consisted of nine individuals (six women, three men; group mean age 53+/-6; group mean body mass index=32.9+/-3.4kg/m(2)). A timed self-paced walk while wearing the pedometer allow...
This cross-sectional study presents the first normative data on pedometer-determined ambulatory activity, defined as steps/day, in 160 (98 males, 62 females; age=52.4 +/- 5.3 years; BMI=32.3 +/- 5.7) free-living individuals with type 2 diabetes. Participants took 6662 +/- 3077 steps per day, less than that reported in nondiabetic samples and more t...
This article describes a theory-driven approach to developing a physical activity intervention for sedentary individuals with type 2 diabetes.
Development of the intervention was based on 6 essential elements of program theory: problem definition, critical inputs, mediating processes, expected outcomes, extraneous factors, and implementation issues...
Since folate and vitamin B12 absorption may be increased by colonic bacterial activity, their status may be improved by miglitol, an α-glucosidase inhibitor of potential use in the treatment of diabetes. To test this, subjects with type 2 diabetes were treated for 9 months in a double-blind, randomized controlled fashion with either placebo (n=45),...
The study compared valsartan 80 mg or 160 mg o.d. with captopril 25 mg t.i.d. or placebo on plasma lipids in normotensive and treated hypertensive patients with type II diabetes and microalbuminuria. One hundred and twenty-two adult outpatients were randomised to receive either valsartan 80 mg or 160 mg, captopril 25 mg or placebo for 360 days. Cha...
This multicenter, randomized, double-blind, placebo- and captopril-controlled, parallel-group trial evaluated the efficacy and safety of valsartan 80 and 160 mg in patients with incipient diabetic nephropathy. Patients were randomized to receive either valsartan 80 mg or 160 mg once daily, captopril 25 mg 3 times daily, or placebo. The study compri...
This research was the first phase of a study designed to develop and pilot test an educational program to increase self-awareness of salient body cues in adults with Type 1 diabetes. The purpose of this study was to identify (1) the cues, sensations, and circumstances that people with diabetes and their families associate with hypoglycemia, euglyce...
To determine if a relationship exists between blood glucose control and variability in nutrient intake from day-to-day in subjects with type 1 diabetes.
Two three-day diet records and one measurement of glycated hemoglobin (HbA1c) were obtained from 272 subjects with type 1 diabetes treated with a mixture of regular and NPH insulins before breakfas...
To determine the relationship between carbohydrate intake and the effect of acarbose on HbA1c in subjects with type 2 diabetes treated with acarbose alone, acarbose plus sulfonylurea, acarbose plus metformin, or acarbose plus insulin.
We conducted a double-blind randomized placebo-controlled study in which subjects with diabetes in four treatment s...
To see if the long-term treatment of non-insulin dependent diabetes (NIDDM) with the alpha-glucosidase inhibitor acarbose affects food intake and body weight.
Randomized, double-blind, placebo-controlled, parallel design clinical trial of 12 months duration.
Subjects with NIDDM in four treatment strata: 77 on diet alone, 83 also treated with metfor...
In this study, 31P nuclear magnetic resonance spectroscopy was used to monitor muscle metabolism in Type II diabetic subjects (n = 10) during an incremental exercise test. Also the exercise responses of diabetic subjects (n = 4) following submaximal endurance training were assessed and compared to healthy controls (n = 5). Responses to incremental...
Current therapeutic options for the treatment of non-insulin-dependent diabetes mellitus (NIDDM) focus on regimens that primarily lower fasting blood glucose concentrations. In several short-term studies, the alpha-glucosidase inhibitor, acarbose, has been reported to significantly lower post-prandial plasma glucose levels as well as HbA1c. The pri...
The relationships (adjusted for age, sex, diabetes duration and BMI) between habitual diet and blood glucose and lipids in NIDDM subjects from 7 cities in Canada were studied using duplicate 3-day diet records and measurements of fasting plasma glucose (FPG), glycosylated haemoglobin (HbAlc), serum total (TC) and HDL cholesterol and triglycerides (...
alpha-Glucosidase inhibitors such as acarbose improve blood glucose control in diabetes by delaying or reducing carbohydrate absorption. The fermentation of malabsorbed carbohydrate in the colon is associated with the production of gas, leading to flatulence, and short chain fatty acids such as acetate, which may have systemic effects. To see if ac...
To evaluate the long-term efficacy of acarbose, an alpha-glucosidase inhibitor, in improving glycemic control in patients with non-insulin-dependent diabetes mellitus.
A 1-year, multicenter, randomized, double-blind, placebo-controlled study.
Seven university-affiliated, community-based, tertiary care diabetes clinics.
354 patients with non-insulin...
Controlled trials have shown that a diet with a low glycemic index improves blood glucose and lipid control in patients with diabetes. To study the distribution and determinants of diet glycemic index, we obtained two 3-d diet records from 342 free-living subjects with non-insulin-dependent diabetes. Mean +/- SD 24-h intakes were as follows: energy...
A 45-year-old woman presented with clinical symptoms of hypoglycemia of 4 months duration. Laboratory testing confirmed hyperinsulinemia;
mild hypercalcemia and hypergastrine-mia were also documented. At the time of operation, 3 pancreatic endocrine neoplasms
were found, and a diagnosis of multiple endocrine neoplasia type I was made. Immunohistoch...
We have studied the endocrine-metabolic status of patients in non-insulin-receiving (NIR) remission of insulin-dependent diabetes mellitus (IDDM) within 6-60 mo of diagnosis during administration of cyclosporine, in comparison with nondiabetic subjects. IDDM patients in NIR remission were recognized when target glycemic control (plasma glucose and...
Background: The optimal source and amount of dietary carbohy- drate for managing type 2 diabetes (T2DM) are unknown. Objective:Weaimedtocomparetheeffectsofalteringtheglycemic index or the amount of carbohydrate on glycated hemoglobin (HbA1c), plasma glucose, lipids, and C-reactive protein (CRP) in T2DM patients. Design:SubjectswithT2DMmanagedbydiet...
Background: Heterogeneity in circulating lipid concentrations in responsetodietarypolyunsaturatedfattyacids(PUFAs)maybedue, in part, to genetic variations. Tumor necrosis factor- (TNF- )i s a proinflammatory cytokine that can induce hyperlipidemia and is known to be modulated by dietary PUFAs. Objective: The objective was to determine whether TNF-...
Citations
... The largest proportion of PLL undergo amputations due to vascular disease with or without diabetes 1 and face the challenge of recovering while dealing with an underlying progressive and chronic systemic disease. 2 The challenge of restoring sufficient physical activity capacity to reintegrate into community life after amputation may be complicated by lower physical activity levels prior to amputation in people with diabetes or peripheral artery disease. 3,4 People who have lost limbs due to trauma also face secondary health issues such as arthritis, 5 low back pain, 6 and the incidence of age-related chronic medical conditions such as obesity, diabetes, peripheral artery disease, or heart and lung disease linked to reduced physical activity in people as they age. 6 Regardless of amputation etiology, PLL require more energy to walk compared with able-bodied individuals, 7 and face challenges in community life due to slower walking speeds 8 and limited physical activity. ...
... Deficiencies in decision-making may contribute to treatment nonadherence and poorer metabolic control [61]. Depression has been reliably associated with increased everyday decisional conflict (i.e., the aversive experience accompanying indecisiveness) [65], an inward focus that may impair ability to engage in collaboration/ alliance [66], limitations in ability to shift behavior under changing contingencies [67], and altered reward processing [68]. Interestingly, in a cross-sectional study that examined communication between patients with diabetes and providers, as compared to patients with diabetes without possible major depression (n = 76; mean HbA1c of 7.4%), patients with diabetes and possible major depression (n = 19) had greater HbA1c levels (mean 9.3%), lower diabetes self-efficacy scores, and lower numeracy skills (i.e., abilities needed to interpret glucose meters, administer medications, follow dietary guidelines, etc.) [69]. ...
... A lowcarbohydrate diet implies a higher protein intake and a reduced sugar consumption, and therefore more satiety (73). A HFLC diet may be associated with an higher secretion of the anorexigenic peptide YY hormone (74,75), and a higher energy expenditure, compared with other diets (76). Furthermore, the carbohydrateinsulin model of obesity favors a low carbohydrate and a low glycemic index diet, allowing less fat deposition and higher energy expenditure, compared to a traditional low fat diet (77). ...
... The FSP was originally conceived and created after extensive consultation with individuals with type 2 diabetes and their health care providers, particularly diabetes educators, where both groups indicated a need for practical, sustainable, effective programs to help increase PA in this population. 15 Results from the current study provide convincing evidence that the FSP addresses these issues in a real-life setting, specifically diabetes education centers representing diverse geographical and cultural settings. This study highlights the fact that Participants' PA and related health outcome changes were similar when two different groups of interveners, Professionals and Peers, acted as leaders to deliver the program. ...
... One beneficial outcome of wearing a wireless pedometer seems to be that it is also a motivating factor towards an increase in physical activity. This motivation can be further maximised when physical activities goals are set, reflected on, and refined (Tudor-Locke, Myers, & Rodger, 2000). Since there are only a handful of studies that are focusing on the use of pedometers to promote physical activity among young children, there is a need to increase the body of knowledge in this particular field. ...
... The mean reduction (95% CI) in serum total vitamin B-12 for all 6 trials was -54 pmol/L (-81, -26 pmol/L). In a subgroup analysis, 4 of the 6 studies included doses of metformin <2000 mg/d (35)(36)(37)(38), whereas the other 2 studies included doses ≥2000 mg/d (37,39); the mean decrease in total vitamin B-12 was ∼2-fold greater in the high-dose studies compared with the low-dose studies. ...
... Consequently, an update to a Cochrane systematic review 15 performed by the Evidence Review Team (ERT) concurred with the original findings that the use of ACEi or ARB treatment in patients with diabetes and CKD was associated with a reduction in the progression of CKD with regard to the development of severely increased albuminuria ( Tables S4 11,12,16-48 and S5 13,34,40,[49][50][51][52][53] ACEi and ARBs are generally well-tolerated. The systematic reviews performed suggested that ACEi and ARB treatment may cause little or no difference in the occurrence of serious adverse events. ...
... Low GI diet may favourably affect pregnancy outcomes (Scholl et al., 2001Scholl et al., , 2004) through ameliorating postprandial glucose levels, which in turns reduces hyperinsulinemia (Galgani et al., 2006; Yusof et al., 2009a) and oxidative stress (Hu et al., 2006). In individuals with impaired glucose tolerance (Wolever & Mehling, 2002) and type 2 diabetes (Wolever et al., 2008a,b), a low GI diet has been shown to improve the insulin resistant state by increasing b-cell function (Wolever et al., 2008b), eventually leading to reducing C-reactive protein (CRP) levels (Magon and Seshiah, 2011; Mora and Nestel, 2000; Wolever et al., 2008a). A similar finding has been observed in women with GDM (). ...
... Compared with subjects who were homozygous for the-238G allele, carriers of the-238A allele had an altered ability to suppress postprandial FFA. This effect was observed in obese but not in non-obese individuals with type 2 diabetes (men, n ¼ 56 and women, n ¼ 67) (Fontaine-Bisson et al., 2007). Patients with coronary artery disease showed a higher frequency of the TNF-308A allele than healthy controls, while coronary artery disease patients with diabetes had a higher frequency of the TNF-308AA genotype compared with healthy controls ( Sbarsi et al., 2007). ...
... It is crucial to examine efficacy and outcome expectations again, whether it is true that self-efficacy and outcome expectations are correlated in the elderly population, especially the elderly population in Indonesia. These two constructs are the two main predictors of physical activity behavior, while other constructs such as self-regulation and social support are supporting constructs [13][14][15]. ...