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Gavrieli A.,Harokopio University | Fragopoulou E.,Harokopio University | Mantzoros C.S.,Endocrinology Section | Mantzoros C.S.,Beth Israel Deaconess Medical Center | Yannakoulia M.,Harokopio University
Metabolism: Clinical and Experimental | Year: 2013

Objective To examine the effects of different coffee amounts on blood glucose and insulin concentrations of healthy volunteers, and to assess potential effect modification by sex and body mass index category. Materials/Methods Thirty-three volunteers [16♀/ 17â™", 16 normal-weight and 17 overweight/obese, 27.3 ± 7.2 (19-44) y] took part in this randomized, crossover study. Ιn the morning of each experimental day volunteers received a standardized meal along with 200 mL of water or instant coffee containing either 3 or 6 mg of caffeine/kg body weight. Blood samples were obtained and analyzed for glucose and insulin concentrations in the fasting state, immediately after meal/drink consumption and at standard time points for the next 3 h thereafter. Results Coffee delayed the rise of insulin in response to the standardized meal and the fall of glucose concentrations from its maximum levels in the entire study sample. Glucose incremental area under the curve (IAUC) was significantly different between interventions (P =.009) with both coffee amounts inducing a greater area compared to water. Secondary, subgroup analysis at the nominal level showed that this might be more evident among females (PIAUC =.05) and overweight/obese participants (PIAUC =.03). Furthermore, coffee, mainly the 6 mg dose, could be lowering insulin concentrations the first 30 min after its consumption compared to water in men and overweight/obese participants. Conclusions Coffee exerts an acute effect on postprandial glucose and insulin concentrations. This effect may be modified by sex and overweight/obese status. Future research is necessary to elucidate underlying mechanisms. © 2013 Elsevier Inc. Source

Gosmanov A.R.,Endocrinology Section
Journal of Clinical and Translational Endocrinology | Year: 2016

Inpatient diabetes is a common medical problem encountered in up to 25-30% of hospitalized patients. Several prospective trials showed benefits of structured insulin therapy in managing inpatient hyperglycemia albeit in the expense of high hypoglycemia risk. These approaches, however, remain underutilized in hospital practice. In this review, we discuss clinical applications and limitations of current therapeutic strategies. Considerations for glycemic strategies in special clinical populations are also discussed. We suggest that given the complexity of inpatient glycemic control factors, the "one size fits all" approach should be modified to safe and less complex patient-centered evidence-based treatment strategies without compromising the treatment efficacy. © 2016 Published by Elsevier B.V. Source

Shah S.N.,S.L. Raheja Hospital | Litwak L.,Hospital Italiano de Buenos Aires | Haddad J.,Endocrinology Section | Chakkarwar P.N.,Novo Nordisk AS | Hajjaji I.,National Center for Diabetes and Endocrinology
Diabetes Research and Clinical Practice | Year: 2010

While evidenced-based guidelines promote glycated hemoglobin (HbA1c) targets <7.0% in order to reduce the long-term risk of diabetic complications, many individuals with type 2 diabetes do not achieve these targets. Fear of hypoglycemia provides a major barrier to improving blood glucose control as a result of delayed insulin initiation and failure to appropriately titrate insulin following initiation. Modern insulin analogs were designed to achieve improved blood glucose control with similar hypoglycemic risk compared with non-analog insulins (or similar blood glucose control with reduced hypoglycemic risk). While this has been demonstrated in randomized controlled trials, there is a need to confirm these findings in an everyday clinical setting. The A1chieve study will evaluate adverse events and effectiveness of premix (biphasic insulin aspart 30 [NovoMix 30]), basal (insulin detemir [Levemir]), and meal-time (insulin aspart [NovoRapid]) insulin analogs in people with type 2 diabetes in near-routine clinical practice. A1chieve is an international, prospective, multi-center, open-label, non-interventional, 24-week study of people with type 2 diabetes using an insulin analog. The study will recruit 60 000 people from 30 countries across four continents (Asia, Africa, South America, and Europe). The primary aim of the study is to assess the adverse event profile of the study insulins in routine clinical practice, including rates of hypoglycemia. In addition, effectiveness (HbA1c, fasting plasma glucose, and postprandial plasma glucose) and patient quality of life outcomes will be measured. Comprehensive epidemiological data will be collected at baseline, including recent plasma glucose results and hypoglycemic episodes, prevalence of diabetes-related complications, and measures of current standards of care. Thus, A1chieve should provide important information about how insulin analogs perform in daily clinical practice. © 2010 Elsevier Ireland Ltd. Source

Gavrieli A.,Harokopio University | Karfopoulou E.,Harokopio University | Kardatou E.,Harokopio University | Spyreli E.,Harokopio University | And 4 more authors.
Obesity | Year: 2013

Objective To investigate the effects of different coffee amounts on dietary intake and appetite feelings in normal-weight and overweight/obese individuals. Design and Methods Thirty-three volunteers (16 normal-weight, 17 overweight/obese) participated in three trials: they consumed a standard breakfast along with 200 ml of either coffee with 3 or 6 mg caffeine/kg body weight (Coffee 3 and Coffee 6, respectively), or water. At fasting and at standard time points for the 3 h following breakfast/drink consumption participants recorded their appetite feelings on visual analogue scales. At 180 min, participants consumed an ad libitum meal and the next day they recalled their food intake during the experimental day. Results A significant intervention effect was found for the energy intake of the ad libitum meal (P = 0.05) and of the whole day (P = 0.02) only in overweight/obese individuals. Specifically, Coffee 6 resulted in a reduced energy intake during the ad libitum meal compared to Coffee 3 (P = 0.03) and in the total day compared to both water (P = 0.04) and Coffee 3 (P = 0.008). No effect was observed for the appetite feelings. Conclusions A moderate coffee amount can effectively reduce energy intake in the following meal and in the total day compared to lower or no coffee intake in overweight/obese participants. Copyright © 2013 The Obesity Society. Source

Comino-Mendez I.,Hereditary Endocrine Cancer Group | Comino-Mendez I.,Research Center Biomedica En Red Of Enfermedades Raras Ciberer | Gracia-Aznarez F.J.,Research Center Biomedica En Red Of Enfermedades Raras Ciberer | Gracia-Aznarez F.J.,Human Genetics Group | And 33 more authors.
Nature Genetics | Year: 2011

Hereditary pheochromocytoma (PCC) is often caused by germline mutations in one of nine susceptibility genes described to date, but there are familial cases without mutations in these known genes. We sequenced the exomes of three unrelated individuals with hereditary PCC (cases) and identified mutations in MAX, the MYC associated factor X gene. Absence of MAX protein in the tumors and loss of heterozygosity caused by uniparental disomy supported the involvement of MAX alterations in the disease. A follow-up study of a selected series of 59 cases with PCC identified five additional MAX mutations and suggested an association with malignant outcome and preferential paternal transmission of MAX mutations. The involvement of the MYC-MAX-MXD1 network in the development and progression of neural crest cell tumors is further supported by the lack of functional MAX in rat PCC (PC12) cells and by the amplification of MYCN in neuroblastoma and suggests that loss of MAX function is correlated with metastatic potential. © 2011 Nature America, Inc. All rights reserved. Source

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