Patient-Wise Methodology to Assess Glycemic Health Status: Applications to Quantify the Efficacy and Physiological Targets of Polyphenols on Glycemic Control

Abstract

A growing body of evidence indicates that dietary polyphenols could be used as an early intervention to treat glucose-insulin (G-I) dysregulation. However, studies report heterogeneous information, and the targets of the intervention remain largely elusive. In this work, we provide a general methodology to quantify the effects of any given polyphenol-rich food or formulae over glycemic regulation in a patient-wise manner using an Oral Glucose Tolerance Test (OGTT). We use a mathematical model to represent individual OGTT curves as the coordinated action of subsystems, each one described by a parameter with physiological interpretation. Using the parameter values calculated for a cohort of 1198 individuals, we propose a statistical model to calculate the risk of dysglycemia and the coordination among subsystems for each subject, thus providing a continuous and individual health assessment. This method allows identifying individuals at high risk of dysglycemia—which would have been missed with traditional binary diagnostic methods—enabling early nutritional intervention with a polyphenol-supplemented diet where it is most effective and desirable. Besides, the proposed methodology assesses the effectiveness of interventions over time when applied to the OGTT curves of a treated individual. We illustrate the use of this method in a case study to assess the dose-dependent effects of Delphinol® on reducing dysglycemia risk and improving the coordination between subsystems. Finally, this strategy enables, on the one hand, the use of low-cost, non-invasive methods in population-scale nutritional studies. On the other hand, it will help practitioners assess the effectiveness of an intervention based on individual vulnerabilities and adapt the treatment to manage dysglycemia and avoid its progression into disease.

Physiologic effects of the maqui berry (Aristotelia chilensis): a focus on metabolic homeostasis

“…138 In a more recent study using the same three doses of Delphinol® administered 15 minutes prior to an oGTT to 36 subjects with mild impairments in glucose-insulin dynamics significant improvements in glycemic control were reported. 139 Furthermore, the study generated a mathematical model to assess the risk of development of dysglycemia, which was found to be reduced by Delphinol®. 139 Finally, consistent with these effects, in response to HFM consumption, CDRE reduced overall glycemia and attenuated the 30 min spike in insulin levels.…”

“…139 Furthermore, the study generated a mathematical model to assess the risk of development of dysglycemia, which was found to be reduced by Delphinol®. 139 Finally, consistent with these effects, in response to HFM consumption, CDRE reduced overall glycemia and attenuated the 30 min spike in insulin levels. 137 Interestingly, these beneficial effects were independent of changes in incretin hormone secretion, with no changes in GIP and GLP-1 secretion with CDRE being reported.…”