Browsing by Author "Pacaud, Danièle"
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- ItemOpen AccessAcute Impaired Glucoregulation and Disrupted Gastrointestinal Hormone Secretion in Adolescents in Response to Caffeine-Containing and Nutritionally Fortified “Energy Shots”(2017) Virtanen, Heidi; Shearer, Jane; Ho, Josephine; Pacaud, Danièle; Reimer, Raylene; Michelle, JackmanCaffeine-containing energy drinks (CCED) are beverages containing simple sugars, caffeine and mixtures of vitamin, mineral and/or herbal preparations which are aggressively marketed to adolescents and young adults. This study analyzed the metabolic impact of acute, non-nutritive sweetener-containing CCED consumption on glucoregulation and gut peptide response in adolescents, and how it is affected by genetic variance. CCED consumption induced acute insulin resistance following an oral glucose tolerance test when compared with placebo, with glucose and insulin concentrations rising by 15.8% and 73.0%, respectively. Glucagon-like peptide-1, gastric inhibitory peptide, C-peptide, and pancreatic peptide YY concentrations rose following caffeine and decaffeinated treatments when compared with placebo. Genetically fast caffeine metabolizers had exaggerated glucose and insulin curves following caffeine trials, while slow metabolizers were relatively unchanged. This response to CCED consumption could be detrimental to individuals predisposed to metabolic deficits. Results provoke further exploration into the mechanisms involved in this transient insulin resistance.
- ItemOpen AccessCardiovascular Magnetic Resonance Imaging in Cardiometabolic Disease(2016-01-26) Schmidt, Anna; Anderson, Todd; Friedrich, Matthias; White, James; Pacaud, Danièle; Lau, DavidThe unrelenting incidence of obesity and type 2 diabetes has become a global public health concern. Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in these cohorts. Cardiovascular Magnetic Resonance (CMR) imaging is a robust imaging modality with techniques to provide sensitive detection of early cardiovascular changes in obesity and diabetes. In a prospective study of obese adolescents (n=11, 10 to 20 years old) and a healthy weight control group (n=14), we found obesity was associated with increases in Left ventricular (LV) mass, LV wall thickness and mass:volume ratio. In this “early stage” of remodeling, these structural changes were not associated with elevations in Native T1, a surrogate marker of tissue fibrosis. Strain analysis, by novel CMR tissue tracking analysis, revealed a hyper-contractile state, likely representing a combined contribution of elevated systolic blood pressure with compensatory myocyte hypertrophy. Obese subjects were additionally enrolled in a comprehensive 6-month lifestyle intervention; subjects did not experience weight loss or any change in cardiac parameters after 6 months. Further along the natural history of CVD as related to metabolic disease, the second study looked to examine possible sub-clinical changes in the hearts of otherwise healthy diabetic patients. This study examined twenty-eight healthy type 2 diabetic patients without any observable vascular complications. The complementary use of CMR-based T1 mapping and 3-dimensional strain analysis demonstrated expansion of the extracellular matrix and a reduction in global longitudinal strain. In the endpoint of the cardiometabolic disease spectrum, we analyzed individuals with known or suspected Coronary Artery Disease. This study explored the relationship between intra-thoracic fat volume (ITFV) and 4D myocardial strain-based markers of adverse remodeling. In non-infarcted myocardium, ITFV is associated with reductions in myocardial strain. These findings suggest ITFV to be a potentially important marker of adverse ventricular remodeling. The findings of these three studies suggest a capacity of contemporary CMR to identify early changes in cardiometabolic disease and also lend insight into the progression of diabetic heart disease. CMR provides a non-invasive, accurate and reproducible imaging modality with the potential to be useful in screening and CVD risk-stratification.
- ItemOpen AccessEvaluation of a Targeted Video for Transition from Pediatric To Adult Care For Patients with Type 1 Diabetes Mellitus(2016) Winston, Karin; Dewey, Deborah; Pacaud, Danièle; Rabi, Doreen; Hebert, Marilynne; Ho, JosephineTransition from pediatric to adult care is challenging for patients with complex, chronic illnesses such as type 1 diabetes mellitus. To optimize successful transition of care, providers put great efforts into preparing patients for the change. This thesis evaluated the use of videos for patient decision-making in general and one video in particular that was designed to facilitate transition of care. The scoping review demonstrated that there is a vast amount of published data, which show that videos are effective in helping patients make decisions. The focus group study affirmed that patients appreciate the incorporation of a video in their transition preparation. These participants also noted that the process of transition required then to deal with complex emotional ambiguity as well as navigate logistic challenges. Video resources, which may be particularly useful to prepare in youth and young adults for important junctions in care, are valuable tools that should continue to be developed and refined.
- ItemOpen AccessInsulin detemir in a twice daily insulin regimen versus a three times daily insulin regimen in the treatment of type1diabetes in children: A pilot randomized controlled trial(BioMed Central, 2011-11) Ho, Josephine; Huang, Carol; Nettel-Aguirre, Alberto; Pacaud, Danièle