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Management of gestational diabetes mellitus via nutritional interventions:The relevance of gastric emptying

World Journal of Diabetes 2024年第7期15卷 1394-1397页

作者： Wei-kun Huang Ryan J Jalleh christopher k rayner Tong-Zhi Wu Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health The University of AdelaideAdelaide 5000Australia Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health The University of Adelaide and Department of Gastroenterology and HepatologyRoyal Adelaide HospitalAdelaide 5000Australia

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 *** intervention remains the mainstay for the management of *** efficacy of nutritional approaches(*** 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 ***,a specific focus on the relevance of postprandial glycaemic control was *** rather than fasting hyperglycaemia often represents the predominant manifestation of disordered glucose homeostasis in Chinese women with *** is now increasing appreciation that the rate of gastric emptying,which controls the delivery of nutrients for digestion and absorption in the small intestine,is a key determinant of postprandial glycaemia in both health,type 1 and 2 *** remains to be established whether gastric emptying is abnormally rapid in GDM,particularly among Chinese women,thus contributing to a predisposition to postprandial hyperglycaemia,and if so,how this influences the therapeutic response to nutritional *** is essential that we understand the role of gastric emptying in the regulation of postprandial glycaemia during pregnancy and the potential for its modulation by nutritional strategies in order to improve postprandial glycaemic control in GDM.

关键词： Gastric emptying Postprandial glycaemia Diet Nutritional interventions Gestational diabetes mellitus

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Quality of colonoscopy performed by medical or surgical specialists and trainees in five Australian hospitals

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World Journal of Gastrointestinal Endoscopy 2022年第11期14卷 672-683页

作者： Tsai-Wing Ow Olga A Sukocheva Vy Tran Richard Lin Shawn Zhenhui Lee Matthew Chu Bianca Angelica christopher k rayner Edmund Tse Guru Iyngkaran Peter A Bampton Department of Gastroenterology and Hepatology Royal Adelaide HospitalAdelaide 5000SAAustralia Department of Gastroenterology and Hepatology Flinders Medical CentreBedford Park 5042SAAustralia Department of Gastroenterology and Hepatology The Queen Elizabeth HospitalWoodville South 5011SAAustralia Department of Gastroenterology Royal Darwin HospitalDarwin 0810NTAustralia Department of Gastroenterology and Hepatology Royal Melbourne HospitalParkville 3050VICAustralia

BACkGROUND Ensuring colonoscopy procedure quality is vital to the success of screening and surveillance programmes for bowel cancer in Australia. However, the data on the performance of quality metrics, through adequate adenoma detection, bowel preparation, and procedure completion rates, in the Australian public sector is limited. Understanding these can inform quality improvement to further strengthen our capacity for prevention and early detection of colorectal *** To determine the quality of colonoscopy in Australian teaching hospitals and their association with proceduralist specialty, trainee involvement, and *** We retrospectively evaluated 2443 consecutive colonoscopy procedure reports from 1 January to 1 April, 2018 from five public teaching tertiary hospitals in Australia(median 60 years old, 49% male). Data for bowel preparation quality,procedure completion rates, and detection rates of clinically significant adenomas, conventional adenomas, and serrated lesions was collected and compared to national criteria for quality in colonoscopy. Participating hospital, proceduralist specialty, and trainee involvement indicators were used for stratification. Data was analysed using Chi-squared tests of independence, MannWhitney U, One-way ANOVA, and multivariate binary logistic *** Fifty-two point two percent(n = 1276) and 43.3%(n = 1057) were performed by medical and surgical proceduralists respectively, whilst 29.8%(n = 728) involved a trainee. Inadequate bowel preparation affected 7.3% of all procedures. The procedure completion rate was 95.1%, which increased to 97.5% after adjustment for bowel preparation quality. The pooled cancer, adenoma, and serrated lesion detection rates for all five hospitals were 3.5%, 40%, and 5.9% respectively. Assessed hospitals varied significantly by patient age(P k-force composition(P < 0.001), adequacy of bowel preparation(P < 0.001), and adenoma detection rate(P < 0.001). Two hosp

关键词： Colonoscopy Quality of health care Adenoma detection rate Bowel preparation quality Hospital-based teaching

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Development of innovative tools for investigation of nutrient-gut interaction

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World Journal of Gastroenterology 2020年第25期26卷 3562-3576页

作者： Wei-kun Huang Cong Xie Richard L Young Jiang-Bo Zhao Heike Ebendorff-Heidepriem karen L Jones christopher k rayner Tong-Zhi Wu Adelaide Medical School Centre of Research Excellence in Translating Nutritional Science to Good Healththe University of AdelaideAdelaideSA 5005Australia Institute for Photonics and Advanced Sensing School of Physical SciencesUniversity of AdelaideAdelaideSA 5005Australia The ARC Centre of Excellence for Nanoscale BioPhotonics AdelaideSA 5005Australia Diabetes Nutrition and Gut HealthLifelong HealthSouth Australia Health and Medical Research InstituteAdelaideSA 5005Australia Department of Gastroenterology and Hepatology Royal Adelaide HospitalAdelaideSA 5000Australia Department of Endocrinology Zhongda HospitalInstitute of DiabetesSchool of MedicineSoutheast UniversityNanjing 210009Jiangsu ProvinceChina

The gastrointestinal tract is the key interface between the ingesta and the human *** is wide recognition that the gastrointestinal response to nutrients or bioactive compounds,particularly the secretion of numerous hormones,is critical to the regulation of appetite,body weight and blood *** concept has led to an increasing focus on“gut-based”strategies for the management of metabolic disorders,including type 2 diabetes and *** the underlying mechanisms and downstream effects of nutrient-gut interactions is fundamental to effective translation of this knowledge to clinical *** this end,an array of research tools and platforms have been developed to better understand the mechanisms of gut hormone secretion from enteroendocrine *** review discusses the evolution of in vitro and in vivo models and the integration of innovative techniques that will ultimately enable the development of novel therapies for metabolic diseases.

关键词： Nutrient-gut interaction Metabolic disorders Incretin hormones Enteroendocrine cells Enteroids Intestinal intubation Intestine-on-a-chip

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Upper gastrointestinal function and glycemic control in diabetes mellitus

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World Journal of Gastroenterology 2006年第35期12卷 5611-5621页

作者： Reawika Chaikomin christopher k rayner karen L Jones Michael Horowitz University of Adelaide Department of Medi-cine Royal Adelaide Hospital North Terrace Adelaide South Australia 5000 Australia

Recent evidence has highlighted the impact of glycemic control on the incidence and progression of diabetic micro- and macrovascular complications, and on cardiovascular risk in the non-diabetic population. Postprandial blood glucose concentrations make a major contribution to overall glycemic control, and are determined in part by upper gastrointestinal function. Conversely, poor glycemic control has an acute, reversible effect on gastrointestinal motility. Insights into the mechanisms by which the gut contributes to glycemia have given rise to a number of novel dietary and pharmacological strategies designed to lower postprandial blood glucose concentrations.

关键词：胃肠道功能糖尿病治疗病理

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Whey protein: The “whey” forward for treatment of type 2 diabetes?

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World Journal of Diabetes 2015年第14期6卷 1274-1284页

作者： Linda E Mignone Tongzhi Wu Michael Horowitz christopher k rayner Discipline of Medicine the University of Adelaide Centre of Research Excellence in Translating Nutritional Science to Good Health the University of Adelaide

A cost-effective nutritional approach to improve postprandial glycaemia is attractive considering the rising burden of diabetes throughout the world. Whey protein, a by-product of the cheese-making process, can be used to manipulate gut function in order to slow gastric emptying and stimulate incretin hormone secretion, thereby attenuating postprandial glycaemic excursions. The function of the gastrointestinal tract plays a pivotal role in glucose homeostasis, particularly during the postprandial period, and this review will discuss the mechanisms by which whey protein slows gastric emptying and stimulates release of gut peptides, including the incretins. Whey protein is also a rich source of amino acids, and these can directly stimulate beta cells to secrete insulin, which contributes to the reduction in postprandial glycaemia. Appetite is suppressed with consumption of whey, due to its effects on the gut-brain axis and the hypothalamus. These properties of whey protein suggest its potential in the management of type 2 diabetes. However, the optimal dose and timing of whey protein ingestion are yet to be defined, and studies are required to examine the long-term benefits of whey consumption for overall glycaemic control.

关键词： Whey protein Postprandial glycaemia Type 2 diabete

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乳清蛋白对于2型糖尿病患者胃排空速率,血糖水平及肠促胰素分泌的影响

乳清蛋白对于2型糖尿病患者胃排空速率,血糖水平及肠促胰素分泌的...

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中华医学会第十一次全国内分泌学学术会议

作者：麻静 David R Jesudason Antonietta Russo,Julie E Stevens Jennifer keogh Judith M Wishart karen L Jones Peter M Clifton Michael Horowitz christopher k rayner 上海市仁济医院 Centre of Clinical Research Excellence in Nutritional Physiology Interventions and OutcomesUniversity of AdelaideAdelaideAustralia Endocrine & Metabolic Unit Royal Adelaide HospitalAdelaideAustralia

目的:进食高碳水化合物之前,单次给予2型糖尿病患者少量的乳清蛋白可减慢胃排空速率,刺激肠促胰素分泌从而降低餐后血糖水平。然而长期乳清蛋白摄入是否会造成小肠对于胃排空速率的反馈抑制及肠促胰素的分泌发生适应性的改变尚不清楚。...

目的:进食高碳水化合物之前,单次给予2型糖尿病患者少量的乳清蛋白可减慢胃排空速率,刺激肠促胰素分泌从而降低餐后血糖水平。然而长期乳清蛋白摄入是否会造成小肠对于胃排空速率的反馈抑制及肠促胰素的分泌发生适应性的改变尚不清楚。此项研究目的在于评价2型糖尿病患者口服小量乳清蛋白4周对于胃排空速率,血糖水平及肠促胰素的分泌的影响。

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Effects of rectal administration of taurocholic acid on glucagon-like peptide-1 and peptide YY secretioin in healthy humans

Effects of rectal administration of taurocholic acid on gluc...

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中华医学会糖尿病学分会第十六次全国学术会议

作者： WU Tong-zhi Michelle Bound Bronislava Gedulin Michael Horowitz christopher rayner Discipline of Medicine the University of AdelaideRoyal Adelaide HospitalAdelaideAustralia Satiogen Pharmaceuticals INC.San Diego CaliforniaUSA

Objective Glucagonlike peptide-1(GLP-1) and peptide YY(PYY) are secreted by enteroendocrine L-cellsfound most densely in the colon and rectum,and are of fundamental importance in blood glucose and appetite *** vitro and animal studies suggest that bile salts can stimulate GLP-1 and PYY secretion by TGR5 receptor *** sought to evaluate the effects of rectal infusion of taurocholic acid(TCA) on the release of GLP-1 and PYYin healthy humans.

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