Publications by authors named "Christopher K Rayner"
Individuals with type 2 diabetes are at high risk of postprandial falls in blood pressure (BP) (i.e., a reduction in systolic BP of ≥20mmHg, termed postprandial hypotension (PPH)), which increases the risk of falls and mortality.
View Article and Find Full Text PDFBackground: Limited literature exists on nutrition practices for long-stay patients in the intensive care unit (ICU). We aimed to compare nutrition practices in the first and second weeks of an ICU admission.
Method: A post hoc exploratory analysis of The Augmented vs Routine Approach to Giving Energy Trial (TARGET) randomized controlled trial (RCT) was undertaken.
Glucagon-like peptide-1 (GLP-1) receptor agonists and the dual GLP-1- and glucose-dependent insulinotropic polypeptide receptor co-agonist tirzepatide (referred to here collectively as "GLP-1-based therapy") are incretin-based therapies being used increasingly in the management of both type 2 diabetes and obesity. They are now recognized to have beneficial effects beyond improved glycemic control and weight loss, including cardiovascular and renal protection. GLP-1-based therapy also slows gastric emptying, which has benefits (lowering postprandial glucose), but also potential risks (eg, hypoglycemia in individuals on insulin or sulphonylurea therapy).
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- - The study investigates the effects of non-nutritive sweeteners (NNS) on glucose absorption and gut microbiota in mice, revealing that NNS increases glucose absorption without relying on gut microbiota.
- - Mice given antibiotics to reduce gut microbiota showed improved glucose tolerance, suggesting that gut bacteria play an important role in glycemic responses.
- - Results indicate that while NNS enhances glucose absorption, it does not negatively affect glycemic responses, and gut microbiota depletion positively impacts glucose tolerance through the activity of GLP-1.
Article Synopsis
- Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are commonly used to manage type 2 diabetes and obesity, helping to slow gastric emptying which can help control blood sugar levels but may lead to issues like retained gastric contents during medical procedures.
- A review of studies indicates that while retained gastric contents during endoscopy is more common with GLP-1 RA usage, serious complications like pulmonary aspiration are rare, but guidelines for managing these medications during procedures are limited and not well-defined.
- To enhance patient safety, further research is needed on strategies such as extended fasting before procedures, ultrasound checks for gastric contents, and the potential use of prokinetic drugs like erythromycin.
Article Synopsis
- - The study explored the effects of injecting phosphorus-32 (P) microparticles into pancreatic tumors during chemotherapy (FOLFIRINOX) to improve poor blood flow—which hinders treatment responses—in patients with locally advanced pancreatic cancer (LAPC).
- - Out of 20 patients, the results showed a significant decrease in tumor size and increased vascularity after P implantation, with 25% achieving tumor downstaging and four patients opting for surgery.
- - Most patients (75%) remained alive after an average follow-up of 11.2 months, but the study found no significant difference in overall survival between patients who showed increased tumor blood flow and those who did not.
Aim: To examine the associations of tea consumption (both frequency and type) with (1) prediabetes and diabetes and (2) urinary glucose and sodium excretion in Chinese community-dwelling adults.
Materials And Methods: In 1923 participants (457 with diabetes, 720 with prediabetes, and 746 with normoglycaemia), the frequency (occasional, frequent, daily, or nil) and type (green, black, dark, or other) of tea consumption were assessed using a standardized questionnaire. Morning spot urinary glucose and urine glucose-to-creatinine ratios (UGCRs) were assessed as markers of urinary glucose excretion.
Gestational diabetes mellitus (GDM) represents one of the most common medical complications of pregnancy and is important to the well-being of both mothers and offspring in the short and long term. Lifestyle intervention remains the mainstay for the management of GDM. The efficacy of nutritional approaches ( calorie restriction and small frequent meals) to improving the maternal-neonatal outcomes of GDM was attested to by Chinese population data, discussed in two articles in recent issues of this journal.
View Article and Find Full Text PDFElevated fasting glucagon concentrations and/or attenuated postprandial glucagon suppression are characteristics of type 2 diabetes (T2D) and contribute to hyperglycaemia. This study shows that hyperglucagonaemia is more prominent in males than females after a nutrient load in T2D, adding insights into sex differences in relation to the pathophysiology of T2D.
View Article and Find Full Text PDFAim: To evaluate insulin and glucagon sensitivity in Han Chinese women with and without gestational diabetes mellitus (GDM).
Methods: In total, 81 women with GDM and 81 age-matched healthy controls were evaluated with a 75 g oral glucose tolerance test (OGTT) at gestational weeks 24-28. Plasma glucose concentrations were measured at fasting and 1 h and 2 h post-OGTT.
Aim: To perform a direct, double-blind, randomised, crossover comparison of subcutaneous and intravenous glucagon-like peptide-1 (GLP-1) in hyperglycaemic subjects with type 2 diabetes naïve to GLP-1-based therapy.
Materials And Methods: Ten fasted, hyperglycaemic subjects (1 female, age 63 ± 10 years [mean ± SD], glycated haemoglobin 73.5 ± 22.
Article Synopsis
- A study measured how fast a glucose drink empties from the stomach in people with type 2 diabetes who took either lixisenatide or a placebo for 8 weeks.
- Those taking lixisenatide showed significantly less gastric emptying after 240 minutes compared to those on the placebo (2% vs 48%).
- This suggests that lixisenatide can greatly delay the process of liquid gastric emptying.
Background And Aim: Rates of antimicrobial-resistant Helicobacter pylori infection are rising globally, but little is known about contemporary resistance patterns, virulence factors, and phylogenetic patterns of isolates within Australia. We aimed to characterize antimicrobial resistance and genetic mutations associated with adverse clinical outcomes.
Methods: Whole genome sequencing, culturing, and antibiotic sensitivity data for refractory H.
Article Synopsis
- The study aimed to investigate sex differences in gastric emptying and glycaemic responses in patients with type 2 diabetes (T2D).
- Involving two cohorts of T2D patients, findings indicated that gastric emptying was slower in women compared to men, and initial glycaemic responses were higher in women, but adjusted responses differed.
- The results underscore significant sex differences in how post-meal glucose levels are managed, emphasizing the need for personalized treatment approaches in T2D.
Aim: To evaluate gastric emptying (GE) and the glycaemic response to a 75-g oral glucose load in newly diagnosed, treatment-naïve Han Chinese with type 2 diabetes (T2D) before insulin pump therapy, after 4 weeks of insulin pump therapy, and 12-15 months after insulin pump therapy.
Materials And Methods: Twenty participants with T2D (baseline glycated haemoglobin [± SD] 10.7% [± 1.
Background: Gastric emptying (GE), with wide inter-individual but lesser intra-individual variations, is a major determinant of postprandial glycaemia in health and type 2 diabetes (T2D). However, it is uncertain whether GE of a carbohydrate-containing liquid meal is predictive of the glycaemic response to physiological meals, and whether antecedent hyperglycaemia influences GE in T2D. We evaluated the relationships of (i) the glycaemic response to both a glucose drink and mixed meals with GE of a 75 g glucose drink, and (ii) GE of a glucose drink with antecedent glycaemic control, in T2D.
View Article and Find Full Text PDFIntroduction: To use the 'gold standard' technique of scintigraphy to quantify gastric emptying (GE) as soon as practicable during an admission with diabetic ketoacidosis (DKA) and following its resolution at least 7 days later.
Research Design And Methods: Five patients with type 1 diabetes, age 29±12 years; Body Mass Index 23±3 kg/m; hemoglobin A1c 11.3%±1.
Article Synopsis
- - The study aims to understand how the timing of metformin administration affects blood sugar responses in individuals with type 2 diabetes, particularly focusing on its role in stimulating GLP-1, a hormone that helps control glucose metabolism.
- - Sixteen participants, well-managed on metformin, were tested in a controlled experiment where metformin was given at different times before a glucose infusion, measuring glucose, insulin, and GLP-1 levels throughout the process.
- - Results showed that taking metformin earlier (60 or 30 minutes before) lowered blood glucose levels more effectively and increased GLP-1 levels, while insulin responses remained consistent, indicating timing can significantly impact the effectiveness of metformin.
Effects of a bitter substance, denatonium benzoate, on pancreatic hormone secretion.
Am J Physiol Endocrinol Metab
April 2024
There is increasing evidence linking bitter taste receptor (BTR) signaling to gut hormone secretion and glucose homeostasis. However, its effect on islet hormone secretion has been poorly characterized. This study investigated the effect of the bitter substance, denatonium benzoate (DB), on hormone secretion from mouse pancreatic islets and INS-1 832/13 cells.
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