ABSTRACT
Resumo Objetivo A adição de frutooligossacarídeos e galactooligossacarídeos a fórmulas infantis pode diminuir a consistência fecal e aumentar a frequência das evacuações. O objetivo do presente estudo foi determinar o efeito do galactooligossacarídeo em crianças com constipação crônica. Métodos Entre 2010 e 2012, 20 pacientes constipados (4-16 anos), atendidos numa unidade básica de saúde, completaram ensaio clínico duplo cego, placebo-controlado e de delineamento crossover. Onze pacientes receberam galactooligossacarídeo (1,7 g) por 30 dias, seguidos por 15 dias de washout, e, após, placebo (maltodextrina) por 30 dias; nove pacientes receberam placebo 30 dias, seguidos de 15 dias de washout e 30 dias de galactooligossacarídeo (1,7 g). Os desfechos primários foram frequência semanal de evacuações, esforço evacuatório e consistência fecal, classificada por escala numérica elaborada para este estudo e compilada no primeiro, 15̊ e 30̊ dias de cada período de crossover. Análise estatística foi feita por método de análise de variância (Anova) para medidas repetidas. Resultados Intensidade dos sintomas nos grupos foi semelhante no início do estudo (p = 0,45). Durante a ingestão de galactooligossacarídeo constatou-se maior frequência de evacuações, p < 0,0001, menor dificuldade evacuatória, p < 0,0001 e diminuição da consistência fecal, p = 0,0014. Efeitos colaterais não foram referidos durante a ingestão do prebiótico. Conclusão Durante a ingestão de galactooligossacarídeo os sintomas clínicos da constipação em crianças e adolescentes foram significantemente aliviados.
Abstract Objective Fructooligosacharides and galactooligosacharides soften fecal bolus and increase frequency of depositions when added to infant formula. This study aimed to determine the effects of galactooligosaccharide in pediatric patients with chronic constipation. Methods From 2010 to 2012, 20 constipated patients (4-16 years of age) attended to at a primary healthcare unit were enrolled in a double-blinded, placebo-controlled crossover trial. Eleven children ingested galactooligosaccharide (1.7 g) for 30 days, followed by a 15-day washout period, and a 30-day period of placebo (maltodextrin). Nine patients ingested maltodextrin for 30 days, followed by 15-day washout period, and galactooligosaccharide (1.7 g) for 30 days. Constipation symptoms were considered as primary outcomes: bowel movements/week, straining during defecation, and stool consistency. Outcome symptoms were ranked according to a numerical scale elaborated for this study. Data were recorded at baseline, and on days 15 and 30 of each 30-day crossover period. Repeated-measures analysis of variance (ANOVA) was used to analyze symptoms along time. Results At baseline, there was no significant difference in symptoms severity between groups (p = 0.45). Galactooligosaccharide ingestion was related to increase of the bowel movement frequency, p < 0.0001; relief of defecation straining, p < 0.0001; and decrease in stool consistency, p = 0.0014, compared to placebo ingestion. Patients reported no side effects from galactooligosaccharide. Conclusion Galactooligosaccharide was effective at improving clinical symptoms in this group of constipated children.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Constipation/drug therapy , Trisaccharides/therapeutic use , Chronic Disease , Cross-Over Studies , Double-Blind Method , Treatment OutcomeABSTRACT
Background. Astudy was designed to evaluate the effect o acarbose and Plantago psyllium mucilage on glycemic index (GI) of bread. Methods. Twelve patients with non-insulin-dependent diabetes mellitus (NIDDM) and ten healthy volunteers were studied. Three meal tests with an intake of 90 g of white bread (50 g of carbohydrates) were performed on each subject. In one test, 200 mg of acarbose was given, while 15 g of P. psyllium mucilage was given in another test, and only bread was ingested in the control test. Serum glucose and insulin concentrations were measured every 30 min from 0-180 min. Net area under curve (AUC) concentrations of glucose and insulin, GI and insulinic index were calculated. Results. In NIDDM patients, AUC-glucose in the test with acarbose (1.9 ñ 0.7 mmol/L) and with P. psyllium (4.3 ñ 1.2 mmol/L) were significantly lower than in the control test (7.4 ñ 1.5 mmol/L= (p<0.01). GI of bread plus acarbose was 26 ñ 13, and of bread plus P. psyllium, 59 ñ 10 (p<0.05). AUC-insulin and insulinic index behave similarly. In healthy individuals, AUC-glucose and GI did not significantly change with the treatments; however, insulinic index with acarbose was 17 ñ 16, and with P. syllium decreased GI of bread in NIDDM patients and siminished insulinic index in NIDDM ad in healthy subjects. Conclusions. Adding acarbose or P. syllium to meals may reduce glycemic index of carbohydrate foods and may help diabetic control
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Blood Glucose/metabolism , Bread , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/drug therapy , Dietary Fiber , Hypoglycemic Agents/therapeutic use , Enzyme Inhibitors/therapeutic use , Plantago , Trisaccharides/therapeutic useABSTRACT
Até ha algum tempo atras, as únicas opçoes de tratamento farmacológico do diabetes melito nao-insulinodependente eram as sulfoniluréias, as biguanidas e a insulina. Apenas recentemente se introduziu no mercado uma droga com princípio de açao farmacológica diverso, a acarbose, inibidor competitivo das alpha-glicosidases. A acarbose, ao que tudo indica, tem desempenho ao mínimo similar aos farmacos ja existentes, com atuaçao de destaque na reduçao dos níveis de hemoglobina glicosilada. Portanto, surge como uma opçao alternativa na monoterapia dos diabéticos controlados apenas com dieta e como reforço terapêutico bastante efetivo em associaçoes medicamentosas.