Characterizing the dynamic interaction among gastric emptying, glucose absorption, and glycemic control in nondiabetic obese adults

Engineering digital biomarkers of interstitial glucose from noninvasive smartwatches

Prediabetes affects one in three people and has a 10% annual conversion rate to type 2 diabetes without lifestyle or medical interventions. Management of glycemic health is essential to prevent progression to type 2 diabetes. However, there is currently no commercially-available and noninvasive method for monitoring glycemic health to aid in self-management of prediabetes. There is a critical need for innovative, practical strategies to improve monitoring and management of glycemic health. In this study, using a dataset of 25,000 simultaneous interstitial glucose and noninvasive wearable smartwatch measurements, we demonstrated the feasibility of using noninvasive and widely accessible methods, including smartwatches and food logs recorded over 10 days, to continuously detect personalized glucose deviations and to predict the exact interstitial glucose value in real time with up to 84% and 87% accuracy, respectively. We also establish methods for designing variables using data-driven and domain-driven methods from noninvasive wearables toward interstitial glucose prediction.

Postprandial Blood Glucose and Insulin Responses of Horses to Feeds Differing in Soluble Fiber Concentration

In humans, the consumption of soluble fibers reduces glycemic response after a meal. We hypothesized high soluble fiber diets would reduce and delay postprandial glucose and insulin responses in horses. In a 4 × 4 Latin square design experiment, four Quarter Horse geldings were adapted to diets containing orchardgrass hay (ORCH) or ORCH with 1 of 3 treatment ingredients: molassed sugar beet pulp (BEET), almond hulls (HULL), or steam-crimped oats (OATS). Blood was serially sampled for 6 hours after feeding 0.15% body weight (BW) of the treatment ingredient (meal test) or 1.1 g starch/kg BW from oats plus the treatment ingredient (starch test) to evaluate glycemic and insulinemic responses. Glycemic response during the meal test peaked between 60 and 90 min after feeding (P < .05) and tended to be altered by diet (P = .071) and diet × time (P = .076). Serum insulin was affected by diet (P = .008), time (P < .001), and diet × time (P < .001) during the meal test, with concentrations lower in ORCH compared with BEET and OATS (P < .05). In the starch test, glucose was lower (P < .05) in ORCH and HULL compared with BEET and insulin was lower (P = .046) in ORCH compared with BEET. In both tests, horses took longer (P < .05) to consume HULL, likely influencing postprandial responses. Future research integrating the functional properties of feeds with physiological responses will be necessary to elucidate how soluble fiber affects postprandial glucose metabolism in horses.

Traditional Malian Solid Foods Made from Sorghum and Millet Have Markedly Slower Gastric Emptying than Rice, Potato, or Pasta

From anecdotal evidence that traditional African sorghum and millet foods are filling and provide sustained energy, we hypothesized that gastric emptying rates of sorghum and millet foods are slow, particularly compared to non-traditional starchy foods (white rice, potato, wheat pasta). A human trial to study gastric emptying of staple foods eaten in Bamako, Mali was conducted using a carbon-13 (13C)-labelled octanoic acid breath test for gastric emptying, and subjective pre-test and satiety response questionnaires. Fourteen healthy volunteers in Bamako participated in a crossover design to test eight starchy staples. A second validation study was done one year later in Bamako with six volunteers to correct for endogenous 13C differences in the starches from different sources. In both trials, traditional sorghum and millet foods (thick porridges and millet couscous) had gastric half-emptying times about twice as long as rice, potato, or pasta (p < 0.0001). There were only minor changes due to the 13C correction. Pre-test assessment of millet couscous and rice ranked them as more filling and aligned well with postprandial hunger rankings, suggesting that a preconceived idea of rice being highly satiating may have influenced subjective satiety scoring. Traditional African sorghum and millet foods, whether viscous in the form of a thick porridge or as non-viscous couscous, had distinctly slow gastric emptying, in contrast to the faster emptying of non-traditional starchy foods, which are popular among West African urban consumers.