Objectives Some patients with type 2 diabetes mellitus (T2DM) have high expression of dipeptidyl peptidase 4 (DPP4) enzymes that breaks down glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP1) hormones. In the process of eating carbohydrates, K and L cells in the human small intestine produce GIP and GLP1 respectively that stimulate pancreatic β cells to release insulin. Recent evidence has revealed that fruit consumption before meals reduces fasting blood glucose level in patients with T2DM. Therefore, this study aimed to investigate the effect of fruit consumption before meals on DPP4 activity among patients with T2DM.MethodsA randomized control trial study with pre-posttest control group design was performed in 18 T2DM patients. They were randomly divided into 2 groups: 10 in the control (C) group eating a standardized diet and the other in the treatment (T) group eating fruit before consumption of standardized diet. Fasting and postprandial serum DPP4 activities in 30 min were measured using an H-Gly-Pro-pNA substrate in the 1st and 7th day's intervention. Paired Sample t-Tests and Wilcoxon were used to analyze mean DPP4 activity in both groups with p value < 0.05. ResultsIn 1st day intervention, mean fasting DPP4 activity in the C group (189.42+116.27 nmol/ min/ mg protein) was higher than mean fasting DPP4 activity in the T group (121.75±74.86 nmol/ min/ mg protein). Reduced postprandial DPP4 activity was found in the T group (116,86+61.44) and increased in the C group (287,15+146.72). After 7 days intervention, reduction of fasting and postprandial DPP4 activities was observed in the C and T groups respectively. Meanwhile, mean fasting DPP4 activity in the T group remained unchanged but followed by increasing postprandial DPP4activity.Conclusions Fruit consumption before meals reduces fasting and increases postprandial DPP4 activities in patients with T2DM.

Prevalence of diabetes mellitus in the world has increased significantly in the last decades. Post meal physical exercise studies could improves blood glucose levels in diabetic patients. Plyometric exercise is a simple body movement that usually uses in body weight management. Therefore the aim of this study was to investigate the effect of combination of diet and post meal plyometric exercise on blood glucose levels of diabetic patients. A total of 19 diabetic patients were participated in this randomized control trial study. The control (C) group (10 patients) only received a standardized diet was determine using the IEA recommendation and the treatment (T) group (9 patients) received the same diet and post meal jumping jack for 2 min. Fasting and postprandial blood glucose levels were measured in the 1 st and 7 th days of intervention. Mean BMI in C and T groups was > 25 kg/m 2. Reduced mean blood glucose levels in 0 min of the C group (146.90±68.34 mg/dL) in 7 th day intervention were significant lower than 1st day (198.70±91.64 mg/dL). While mean blood glucose levels of the T group in 0, 30 and 60 min at 7 th day intervention (143±53.95; 203.78±79.64; 237±72.76 mg/dL) were significanly lower than 1 st day intervention (179.78±74.17; 254.67±102.73; 287.89±109.44 mg/dL) respectively. Standardized diet and post meal plyometric exercise can decrease postprandial blood glucose levels in diabetic patients. Further investigation are required to find appropriate type and duration of post meal exercise, based on individual patients with diabetes.

Objectives. Type 2 diabetes mellitus (T2DM) is a major global public health issue. Diet and physical exercise are modifiable factors that influence the glycaemic status of patients with T2DM. We aimed to investigate the acute effects of breakfast fruits meal sequence and postprandial exercise on the blood glucose level and dipeptidyl peptidase 4 (DPP4) activity among type 2 diabetes mellitus patients. Methods. A randomized pilot study recruited patients with T2DM who attended two primary health care centres in Tasikmadu District, Karanganyar Regency, and Kartasura District, Sukoharjo Regency, Central Java, Indonesia, from July to October 2016. Eligible patients (4 men and 32 women) were randomly divided into four treatment groups. Venous blood samples were analyzed for fasting and one-hour postprandial blood glucose (FBG and 1 h PPG) levels and DPP4 activity. Blood glucose levels were measured using a routine hexokinase method, and serum DPP4 activity was determined spectrophotometrically after incubation with the Gly-Pro-p-nitroanilide substrate. Results. Fruits last meal decreased FBG level whilst fruits first meal did not significantly decrease 1 h PPG level. Both treatments had no acute effects on DPP4 activity but the addition of postprandial exercise helped lower DPP4 activity. Fruit last and first meals showed significant opposite effects on mean changes of FBG level ( p < 0.05 ). Conclusions. This preliminary report of fruits meal sequence is potentially involved in acute regulation of blood glucose levels and that it might be independent of DPP4 activity in Indonesian patients with T2DM. Moreover, postprandial exercise may be an important intervention for T2DM through the mediation of DPP4 but has no acute effects on the regulation of blood glucose levels. Further studies are required to investigate whether or not different types of fruits and longer treatment intervals can affect blood glucose levels and DPP4 activity differently. This study also gives an insight into the feasibility of conducting food order modification with or without the combination of postprandial exercise in a primary health setting for our next studies.

BACKGROUND: Staple foods as a source of carbohydrates contribute most of human energy needs. Based on Perkeni’s recommendation, diabetic patients can consume at least 45–60% of carbohydrate sources. In addition, several previous studies have shown that increasing the adequacy of dietary fiber above 20–25 g/day can improve glycemic control. AIM: Our scoping review investigated the potential of Indonesian food sources, namely, sorghum and corn as a source of carbohydrates and also fiber as a substitute rice for diabetic patients. METHODS: We systematically used electronic databases searched such as PubMed, Science Direct, Web of Science, Portal Garuda, Sinta Ristekbrin, and Google Scholar. We choose the relevant documents used experimental animals and humans’ studies then published between 2011 and 2021. RESULTS: In total, 17 relevant articles discuss the relationship between giving corn or sorghum with blood glucose levels of animal studies and human. Some studies showed that the effect of eating sorghum or its derivatives can reduce blood glucose. As well as, the other articles indicated eating corn or its derivatives also decrease glycemic response of healthy people and experimental animals. Corn and sorghum contain dietary fiber in the form of resistant starch and have low glycemic index compare with white rice. Furthermore, corn also contains essential fat, mineral, β-Carotene, and isoflavone, while sorghum also includes phenolic components such as phenolic acids and flavonoids. CONCLUSIONS: Sorghum and corn have the potential as an alternative staple food to achieve a better glycemic response in diabetic patients.