Useful meal tolerance test (MTT) for carbohydrate amount and post-prandial blood glucose

Background: Low carbohydrate diet (LCD) has been effective for type 2 diabetes mellitus (T2DM), because of less post-prandial increase of blood glucose. Case presentation: The case is 62-year-old male with T2DM, who had experience of LCD a few years ago. He developed diabetic exacerbation as HbA1c 10.7% in autumn 2021. Results: He began super-LCD with 12% of carbohydrate in calorie ratio, and recorded the pictures of detail food intake every day and 45-minunte post-prandial blood glucose for long. His HbA1c decreased to 7.1% for 9 weeks. For breakfast, carbohydrate amount varies from 19.7 g to 51.1g, and 45-min post-prandial blood glucose distribute 121mg/dL to 226mg/dL. The relationship between carbohydrate amount in breakfast and 45-min post-prandial blood glucose was investigated. As a result, significant correlation was observed between them (R2=0.46, p<0.05). Regression curve revealed y=2.5897x+73.226, in which the slope of the straight line is 2.6. Discussion and Conclusion: Obtained data may suggest that carbohydrate 1g can increase post-prandial glucose 2.6mg/dL. As to the standard fact of carbohydrate metabolism in the textbook, 3.0mg/dL glucose increase per carbohydrate 1g has been observed. Restricted carbohydrate intake would be beneficial for improving glucose variability in T2DM

Improved Insulin Resistance and Glucose Variability by Super-Low Carbohydrate Diet

Background Diabetes mellitus (DM) has been more prevalent. American Diabetes Association (ADA) proposed the Standards of Medical Care in Diabetes-2022. For nutritional therapy, low carbohydrate diet (LCD) has been recognized for its benefits. Authors have continued diabetic research concerning LCD and meal tolerance test (MTT). Case Presentation The case is 61-year-old male with type 2 diabetes mellitus (T2DM) for years. His hemoglobin A1c (HbA1c) increased to 7.8% in autumn 2021, and further evaluation and treatment was conducted including LCD, daily check of meal and carbohydrate amount, 75 g OGTT, glucagon stimulation test (GST) and others. Results He was on super-LCD method including 12% of carbohydrate. His carbohydrate intake amount and 45-minutes post-prandial blood glucose showed significant correlation. The results of 75 g OGTT twice in May 2020 and December 2021 showed that similar pattern of glucose and insulin responses and insulinogenic index (IGI). In contrast, they showed decreased fasting immuno-reactive insulin (IRI) and Homeostasis model assessment insulin resistance (HOMA-R). For GST, C-peptide showed normal response. Discussion and Conclusion Judging from the results of MTT, OGTT, GST and IGI, he seems to show rather decreased insulin resistance by LCD associated with preserved insulin secretion ability to some degree. Further investigation would be required from pathophysiological point of view

学生による授業評価の意義と課題(第7回月例研究会記録)

この論文は国立情報学研究所の学術雑誌公開支援事業により電子化されました

Additional file 3: Supplemental dataset S1. of Genome sequencing of the staple food crop white Guinea yam enables the development of a molecular marker for sex determination

List of the 26,198 protein coding genes predicted in the D. rotundata genome. (XLSX 1480 kb

Additional file 2: Figures S1–S22. of Genome sequencing of the staple food crop white Guinea yam enables the development of a molecular marker for sex determination

Supplementary figures including a summary of world yam production and photos of yam markets in West Africa (Figure S1), summary of BAC-end sequencing used for genome scaffolding (Figure S2), summary of k-mer analysis of Guinea yam genome (Figure S3), flowchart of Guinea yam genome assembly (Figure S4), summary of Guinea yam mitochondrial genome (Figure S5), flowchart of RAD-seq for linkage analysis (Figure S6), summary of RAD-seq analysis (Figure S7), summary of RAD-seq DNA markers used for linkage mapping and anchoring of scaffolds (Figure S8), procedure of linkage analysis and split of scaffolds depending on recombination fraction between RAD markers (Figure S9), RAD-seq-based linkage maps of D. rotundata generated by pseudo-testcross method (Figure S10), a matrix showing scaffolds shared between two linkage groups generated for two parents (Figure S11), schematic diagram for developing physical map of D. rotundata (Figure S12), frequency of distances of BAC-end sequences in the genome (Figure S13), scheme showing pipeline of genome annotation of D. rotundata (Figure S14), self-self syntenic dot plot of D. rotundata pseudo-chromosomes (Figure S15), SyMAP dot plot analysis of whole genome synteny between three monocot species (Figure S16), explanation of QTL-seq analysis to identify sex-linked genome regions in D. rotundata (Figure S17), QTL-seq results (Figure S18), sp1 DNA marker genotypes of F1 progeny and their association with sex (Figure S19), explanation of method for identification of putative W-region of D. rotundata genome (Figure S20), identification of female- and male-specific genomic regions (Figure S21), method of calculation of confidence interval of QTL-seq analysis (Figure S22). (PPTX 15700 kb

National trends in the outcomes of subarachnoid haemorrhage and the prognostic influence of stroke centre capability in Japan: retrospective cohort study

Objectives To examine the national, 6-year trends in in-hospital clinical outcomes of patients with subarachnoid haemorrhage (SAH) who underwent clipping or coiling and the prognostic influence of temporal trends in the Comprehensive Stroke Center (CSC) capabilities on patient outcomes in Japan.Design Retrospective study.Setting Six hundred and thirty-one primary care institutions in Japan.Participants Forty-five thousand and eleven patients with SAH who were urgently hospitalised, identified using the J-ASPECT Diagnosis Procedure Combination database.Primary and secondary outcome measures Annual number of patients with SAH who remained untreated, or who received clipping or coiling, in-hospital mortality and poor functional outcomes (modified Rankin Scale: 3–6) at discharge. Each CSC was assessed using a validated scoring system (CSC score: 1–25 points).Results In the overall cohort, in-hospital mortality decreased (year for trend, OR (95% CI): 0.97 (0.96 to 0.99)), while the proportion of poor functional outcomes remained unchanged (1.00 (0.98 to 1.02)). The proportion of patients who underwent clipping gradually decreased from 46.6% to 38.5%, while that of those who received coiling and those left untreated gradually increased from 16.9% to 22.6% and 35.4% to 38%, respectively. In-hospital mortality of coiled (0.94 (0.89 to 0.98)) and untreated (0.93 (0.90 to 0.96)) patients decreased, whereas that of clipped patients remained stable. CSC score improvement was associated with increased use of coiling (per 1-point increase, 1.14 (1.08 to 1.20)) but not with short-term patient outcomes regardless of treatment modality.Conclusions The 6-year trends indicated lower in-hospital mortality for patients with SAH (attributable to better outcomes), increased use of coiling and multidisciplinary care for untreated patients. Further increasing CSC capabilities may improve overall outcomes, mainly by increasing the use of coiling. Additional studies are necessary to determine the effect of confounders such as aneurysm complexity on outcomes of clipped patients in the modern endovascular era