Search Results (45)

Background/Objectives: To examine the association between body composition and glucose tolerance in young adults with normal weight, overweight, or obesity. Methods: This observational case–control study included 154 healthy individuals aged 18–25 years. Participants were categorized into three BMI-based groups and underwent anthropometric and body composition assessments using bioelectrical impedance. Glucose tolerance was evaluated via oral glucose tolerance testing, with capillary blood samples collected at baseline and at 30, 60, 90, and 120 min post load. Results: Compared to the normal-weight group, overweight and obese individuals exhibited significantly higher body weight, BMI, visceral and total fat percentages, and reduced muscle mass. Obese participants also showed a significantly greater glucose area under the curve (AUC) and higher fasting and post-load glucose levels. Visceral fat was positively correlated with metabolic impairment. These results indicate a progressive decline in glucose tolerance associated with increasing adiposity and reduced lean mass. Conclusions: Young adults with elevated BMI already demonstrate marked alterations in body composition and impaired glucose tolerance, even in the absence of overt metabolic disease. These findings underscore the importance of the early identification of at-risk individuals using simple, non-invasive tools. Preventive strategies promoting healthy body composition in early adulthood may reduce the future risk of diabetes and its associated complications. Full article

Background/Objectives: Dietary protein and carbohydrate affect postprandial glycemia in individuals with type 1 diabetes (T1D). This paper aimed to determine the relationship between the types of dietary protein (Study 1) and carbohydrate (glycemic index; GI, Study 2) and postprandial glycemia. Methods: Two acute randomized crossover trials were conducted in adults with T1D comparing postprandial glycemia for test meals varying by protein type (n = 16 adults; 5 meals: egg, beef, chicken, salmon or whey (all 30 g protein), each served with fried rice (45 g carbohydrate) or GI (n = 8 adults, high or low GI bread, GI 52% vs. 76%) with peanut butter (19 g protein, 30 g fat). Insulin was dosed based on usual individualized insulin: carbohydrate ratio and capillary blood glucose levels (BGL) measured from 30 min pre- to 5 h postprandially in 15–30 min intervals. Results: Study 1: Postprandial glycemia varied over an almost 2-fold range, however responses were highly variable and there were no significant differences between sources (iAUCglucose Chicken: 203 ± 66 mmol·min/L, Egg: 263 ± 100 mmol·min/L, Beef: 309 ± 89 mmol·min/L, Salmon: 338 ± 83 mmol·min/L and Whey: 397 ± 115 mmol·min/L respectively, p > 0.05). Hypoglycemia (≤3.5 mmol/L) occurred at least once per protein type (chicken: 6/16 participants, egg 2/16, beef 3/16, salmon 1/16, whey 2/16). However, there were no statistically significant differences in the risk of hypoglycemia between protein sources (p > 0.05). Study 2: Postprandial glucose response curves were virtually identical for high GI and low GI, and the incremental area under the curve (iAUC) for glucose was not statistically significant after 1 h (p = 0.185), 3 h (p = 0.538) or 5 h (p = 0.694) following the meal. Conclusions: Clinical practice guidelines and insulin dosing algorithms likely do not need to consider differences in protein sources or in GI in the context of a high fat, high protein meals, for individuals with T1D. Full article

Background/Objectives: Older adults with type 2 diabetes mellitus (T2DM) often experience impaired physical function and metabolic control. This study aimed to evaluate the effectiveness of a 12-week Pilates-based intervention on blood glucose concentration and physical function in this population. Methods: A randomized controlled trial was conducted with 104 older adults (mean age: 70.6 ± 3.15 years; 70.2% women), all diagnosed with T2DM. The participants were assigned to a control group (CG, n = 52) or a Pilates training group (PG, n = 52). The intervention included 24 Pilates sessions over 12 weeks (2 sessions/week, 60 min each). Outcomes were assessed pre- and post-intervention and included capillary blood glucose, handgrip strength, functional mobility (Timed Up and Go), balance (Berg Balance Scale), and flexibility (Chair Sit-and-Reach Test and Back Scratch Test). Results: Compared to the control group, the Pilates group showed statistically significant improvements in blood glucose levels (−4.06 mg/dL (p < 0.001; d = 0.68)), handgrip strength (+1.76 kg (p < 0.001; d = 0.48)), gait speed (p < 0.001; d = 0.53), balance (Berg score) (+2.37 points (p < 0.001; d = 0.66)), and flexibility (improvements in upper limbs (BST, d = 0.78–0.98) and lower limbs (CSRT, d = 1.07 right; d = 0.63 left)). Conclusions: A 12-week Pilates program led to significant improvements in glycemic control, muscular strength, gait speed, balance, and flexibility in older adults with T2DM. These findings support Pilates as a safe, effective, and adaptable non-pharmacological intervention to promote functional and metabolic health in this population. Full article

Objective: This study assessed the utility of capillary blood cartridge-based analysis in evaluating neonatal jitteriness (NJ). Methods: In this retrospective study, we compared outcomes between neonates (37–41 weeks of gestation) diagnosed with neonatal jitteriness (NJ) within the first 72 h of life and a control group of healthy neonates (GA 37–41 weeks) with an uneventful perinatal course and no signs of jitteriness. Results: Each group included 101 neonates. Jittery neonates had a higher proportion of males (70.3% vs. 50.5%, p = 0.004), a lower mean gestational age (38.8 vs. 39.2 weeks, p = 0.002), and a higher rate of emergency cesarean deliveries (14.9% vs. 3.0%, p = 0.003). The logistic regression identified male sex (OR = 2.5, p = 0.007) and in utero selective serotonin reuptake inhibitor (SSRI) exposure (OR = 9.0, p = 0.005) as significant risk factors for NJ. The capillary blood parameters, except glucose levels, did not differ significantly between the neonates admitted to the NICU and those discharged. Hypoglycemic jittery neonates were 10 times more likely to require NICU admission compared to their non-hypoglycemic counterparts (OR = 10.9, 95% CI: 2–59.5, p = 0.006). Conclusions: Point-of-care glucose testing using a bedside glucometer may be sufficient for the evaluation of neonatal jitteriness, as capillary blood cartridge-based testing did not offer an additional diagnostic value. What is Known: NJ is often viewed as a self-resolving benign phenomenon; however, in certain cases, it can be an indicator of an underlying pathology. There is substantial evidence linking the maternal use of SSRIs or SNRIs during pregnancy with the occurrence of NJ in newborns as well as an association between hypoglycemia and NJ. What is New: This study is the first to evaluate the clinical utility of systematic capillary blood cartridge-based testing in jittery neonates using a relatively large cohort. Male neonates were disproportionately represented among cases of NJ. Healthy neonates with jitteriness had normal electrolytes, with hypoglycemia as the only concern. A glucometer test may suffice for evaluation, but those who are small for their gestational age or have initial hypoglycemia require a routine follow-up due to a higher risk of NICU admission. Full article

The growing use of microfluidic-based devices necessitates an analysis of flow characteristics through both experimental methods and computational fluid dynamic (CFD) simulations. CFD simulations facilitate the investigation of various devices, including medical sensors, by providing detailed insights into flow behavior. In this study, we conducted experimental and CFD analysis of the microfluidic flow in three devices: a COVID-19 rapid test kit, a blood glucose kit, and a PDMS kit. Our findings revealed that the changes in wall adhesion (contact angles) during the capillary flow could cause significant deviation from theoretical flow speed predictions. A hemodynamic analysis of the blood glucose kit and PDMS kit showed that capillary filling decreased in length, and flow speed could depend on the microchannel diameter. CFD results indicated the prominent role of porosity in the simulation of porous media material such as the COVID-19 test kit, as well as surface tension coefficients and wall adhesion (contact angles) in blood glucose kits and PDMS kits. Therefore, considering adaptive dynamic contact angles in CFD simulation software such as Ansys-Fluent 2024 could result in a more accurate prediction than simplified theoretical techniques, which is useful for sensor optimization and development. Full article

Background/Objectives: The interest in creating new products to decrease the risk of developing non-communicable chronic diseases such as type 2 diabetes (T2D) is increasing. These products include traditional food sources used as part of diverse cultures around the world, such as dragon fruit. The aim of this study was to investigate the effects of a frozen red dragon fruit (FRDF) beverage on blood pressure, glycaemic response (GR) and insulinaemic response (IR), lipid profile (LP), total antioxidant status (TAS), and C-reactive protein (CRP) levels in healthy subjects and individuals at risk of T2D. Methods: A parallel design trial (UREC registration number 211527; ClinicalTrials.gov registration number NCT05199636/19 January 2022) lasting four weeks and involving three testing sessions was conducted; participants were randomly assigned to one of two treatments (following general health guidance or consuming FRDF beverage). Systolic and diastolic blood pressures were taken; venous blood samples were collected to determine the LP and CRP levels; and capillary blood samples were taken before and after consuming a standard glucose drink to evaluate GR and IR at 15 min intervals (first hour) and 30 min intervals (second hour). Results: Eighteen participants completed this study, nine healthy (28.44 ± 5.20 years) and nine at risk (31.78 ± 12.11 years). The daily consumption of an FRDF-based beverage for four weeks by individuals at risk of T2D resulted in a reduction in blood pressure and IR–incremental area under the curve. The LP showed a downward trend, and a significant difference between treatments (p = 0.009) was found for CRP levels. Conclusions: Beverages based on FRDF may have the potential to decrease the risk of T2D. Full article

Background/Objectives: Ethnocultural differences between Jewish and Arab communities in Northern Israel may contribute to disparities in type 2 diabetes prevalence. Widespread screening strategies, including hospital-based initiatives, are crucial for early detection of hyperglycemia. This study aimed to determine the prevalence of postprandial hyperglycemia and identify its associated factors in a diverse population of non-diabetic adults visiting the Galilee Medical Center, a tertiary care hospital in Northern Israel. Methods: Participants were recruited between November 2017 and July 2023 through a voluntary screening program for non-diabetic adult visitors to the hospital. Capillary blood glucose measurements were obtained 1–4 h after a meal using a standardized glucometer. Postprandial hyperglycemia was defined as a blood glucose level ≥147 mg/dL, while postprandial normoglycemia was defined as ≤133 mg/dL. Individuals with glucose levels between 134–146 mg/dL were excluded from the analysis. Additional exclusion criteria included known diabetes, acute illness, corticosteroid use, and pregnancy. Demographic data, lifestyle factors, and health status were recorded. Propensity score matching was employed to ensure comparability between religious groups based on age, gender, and body mass index. Logistic regression analyses were conducted to identify independent predictors of postprandial hyperglycemia. Results: 3457 adult visitors underwent postprandial glucose testing and met eligibility criteria. Following propensity score matching, 1845 participants (615 each from Druze, Jewish, and Muslim religious groups) were included in the final analysis. The prevalence of postprandial hyperglycemia was 9.4% in Druze, 6.0% in Jews, and 8.0% in Muslims (p = 0.08). Age >50 years was significantly associated with postprandial hyperglycemia in all groups. Obesity was associated with postprandial hyperglycemia in Muslims, with a similar non-significant trend in the Jewish cohort. Self-reported poor health was also associated with postprandial hyperglycemia in Muslims. In the Druze cohort, a low daily intake of daily fresh vegetable consumption was significantly associated with postprandial hyperglycemia. Conclusions: This study highlights the feasibility of hospital-based screening for postprandial hyperglycemia among adult visitors and reveals ethnic variations in prevalence and associated risk factors. Full article

In recent years, the use of electronic cigarettes (e-cigs) has increased. However, their long-term effects on oral health and saliva remain poorly understood. Therefore, this study aimed to evaluate the saliva of e-cig users and investigate possible biomarkers. Participants were divided into two groups: the Electronic Cigarette Group (EG)—25 regular and exclusive e-cig users—and Control Group (CG)—25 non-smokers and non-e-cig users, matched in sex and age to the EG. The clinical analysis included the following parameters: age, sex, heart rate, oximetry, capillary blood glucose, carbon monoxide (CO) concentration in exhaled air, and alcohol use disorder identification test (AUDIT). Qualitative and quantitative analyses of saliva included sialometry, viscosity, pH, and cotinine concentrations. Furthermore, the EG and CG salivary metabolomes were compared using gas chromatography coupled with mass spectrometry (GC-MS). Data were analyzed using the Mann–Whitney test. The MetaboAnalyst 6.0 software was used for statistical analysis and biomarker evaluation. The EG showed high means for exhaled CO concentration and AUDIT but lower means for oximetry and salivary viscosity. Furthermore, 10 metabolites (isoleucine, 2-hydroxyglutaric acid, 3-phenyl-lactic acid, linoleic acid, 3-hydroxybutyric acid, 1,6-anhydroglucose, glucuronic acid, valine, stearic acid, and elaidic acid) were abundant in EG but absent in CG. It was concluded that e-cig users had high rates of alcohol consumption and experienced significant impacts on their general health, including increased cotinine and CO concentration in exhaled air, decreased oximetry, and low salivary viscosity. Furthermore, they showed a notable increase in salivary metabolites, especially those related to inflammation, xenobiotic metabolism, and biomass-burning pathways. Full article

Continuous Glucose Monitoring (CGM) not only can be used for glycemic control in chronic diseases (e.g., diabetes), but is increasingly being utilized by individuals and athletes to monitor fluctuations in training and everyday life. However, it is not clear how accurately CGM reflects plasma glucose concentration in a healthy population in the absence of chronic diseases. In an oral glucose tolerance test (OGTT) with forty-four healthy male subjects (25.5 ± 4.5 years), the interstitial fluid glucose (ISFG) concentration obtained by a CGM sensor was compared against finger-prick capillary plasma glucose (CPG) concentration at fasting baseline (T0) and 30 (T30), 60 (T60), 90 (T90), and 120 (T120) min post OGTT to investigate differences in measurement accuracy. The overall mean absolute relative difference (MARD) was 12.9% (95%-CI: 11.8–14.0%). Approximately 100% of the ISFG values were within zones A and B in the Consensus Error Grid, indicating clinical accuracy. A paired t-test revealed statistically significant differences between CPG and ISFG at all time points (T0: 97.3 mg/dL vs. 89.7 mg/dL, T30: 159.9 mg/dL vs. 144.3 mg/dL, T60: 134.8 mg/dL vs. 126.2 mg/dL, T90: 113.7 mg/dL vs. 99.3 mg/dL, and T120: 91.8 mg/dL vs. 82.6 mg/dL; p < 0.001) with medium to large effect sizes (d = 0.57–1.02) and with ISFG systematically under-reporting the reference system CPG. CGM sensors provide a convenient and reliable method for monitoring blood glucose in the everyday lives of healthy adults. Nonetheless, their use in clinical settings wherein implications are drawn from CGM readings should be handled carefully. Full article

Carbohydrate (CHO) metabolism is crucial for short-duration, high-intensity exercise performance, but the effects of variations in glycogen availability have not been investigated in field trials of trained athletes. This study was designed to test how 1500 m time trial (TT) performance is affected by the manipulation of pre-race glycogen reserves. Competitive middle-distance runners (n = 11 (4 females)) completed a 1500 m individually paced indoor TT after abundant (high, >5 g/kg/d) or restricted (low, <1.5 g/kg/d) dietary CHO intake for 2 days after a glycogen-depleting session. Stride pattern, heart rate (HR), capillary blood lactate, and glucose and plasma malondialdehyde (MDA) response were determined. The TT was slower in low vs. high condition by 4.5 (4.5) s (~2%; p < 0.01), with a tendency toward shorter stride length. Blood lactate and glucose were lower before the TT in low vs. high condition (1.8 (0.5) vs. 2.2 (0.7) mmol/L and 5.4 (0.7) vs. 5.9 (0.8) mmol/L, p = 0.022 and 0.007, respectively), and peak lactate was higher in high vs. low condition (16.8 (3.1) vs. 14.5 (4.2) mmol/L, p = 0.039). Plasma MDA was the same before the TT, and 15 min after the TT, it increased similarly by 15% in low (p = 0.032) and high (p = 0.005) conditions. The restriction of pre-test CHO intake impaired 1500 m TT performance and reduced baseline and peak blood lactate concentrations but not blood glucose or MDA response. Full article

Non-communicable diseases (NCDs) are becoming an increasingly important health concern due to a rapidly ageing global population. The fastest growing NCD, type 2 diabetes mellitus (T2DM), is responsible for over 2 million deaths annually. Lifestyle changes, including dietary changes to low glycemic response (GR) foods, have been shown to reduce the risk of developing T2DM. The aim of this study was to investigate whether three different doses of Reducose^®, a mulberry leaf extract, could lower the GR and insulinemic responses (IR) to a full meal challenge in healthy individuals. A double-blind, randomised, placebo-controlled, repeat-measure, crossover design trial was conducted by the Oxford Brookes Centre for Nutrition and Health; 37 healthy individuals completed the study. Participants consumed capsules containing either 200 mg, 225 mg, 250 mg Reducose^® or placebo before a test meal consisting of 150 g white bread and egg mayo filler. Capillary blood samples were collected at 15-min intervals in the first hour and at 30-min intervals over the second and third hours to determine glucose and plasma insulin levels. The consumption of all three doses of Reducose^® resulted in significantly lower blood glucose and plasma insulin levels compared to placebo. All three doses of Reducose^® (200 mg, 225 mg, 250 mg) significantly lowered glucose iAUC 120 by 30% (p = 0.003), 33% (p = 0.001) and 32% (p = 0.002), respectively, compared with placebo. All three doses of Reducose^® (200 mg, 225 mg, 250 mg) significantly lowered the plasma insulin iAUC 120 by 31% (p = 0.024), 34% (p = 0.004) and 38% (p < 0.001), respectively. The study demonstrates that the recommended dose (250 mg) and two lower doses (200 mg, 225 mg) of Reducose^® can be used to help lower the GR and IR of a full meal containing carbohydrates, fats and proteins. Full article

Recently, the vascular protective effect of anti-diabetic agents has been receiving much attention. Sodium glucose cotransporter 2 (SGLT2) inhibitors had demonstrated reductions in cardiovascular (CV) events. However, the therapeutic effect of dapagliflozin on angiogenesis in peripheral arterial disease was unclear. This study aimed to explore the effect and mechanism of dapagliflozin on angiogenesis after hindlimb ischemia. We first evaluated the effect of dapagliflozin on post-ischemic angiogenesis in the hindlimbs of rats. Laser doppler imaging was used to detect the hindlimb blood perfusion. In addition, we used immunohistochemistry to detect the density of new capillaries after ischemia. The relevant signaling pathways of dapagliflozin affecting post-ischemic angiogenesis were screened through phosphoproteomic detection, and then the mechanism of dapagliflozin affecting post-ischemic angiogenesis was verified at the level of human umbilical vein endothelial cells (HUVECs). After subjection to excision of the left femoral artery, all rats were randomly distributed into two groups: the dapagliflozin group (left femoral artery resection, receiving intragastric feeding with dapagliflozin (1 mg/kg/d), for 21 consecutive days) and the model group, that is, the positive control group (left femoral artery resection, receiving intragastric feeding with citric acid–sodium citrate buffer solution (1 mg/kg/d), for 21 consecutive days). In addition, the control group, that is the negative control group (without left femoral artery resection, receiving intragastric feeding with citric acid–sodium citrate buffer solution (1 mg/kg/d), for 21 consecutive days) was added. At day 21 post-surgery, the dapagliflozin-treatment group had the greatest blood perfusion, accompanied by elevated capillary density. The results showed that dapagliflozin could promote angiogenesis after hindlimb ischemia. Then, the ischemic hindlimb adductor-muscle tissue samples from three rats of model group and dapagliflozin group were taken for phosphoproteomic testing. The results showed that the PI3K-Akt-eNOS signaling pathway was closely related to the effect of dapagliflozin on post-ischemic angiogenesis. Our study intended to verify this mechanism from the perspective of endothelial cells. In vitro, dapagliflozin enhanced the tube formation, migration, and proliferation of HUVECs under ischemic and hypoxic conditions. Additionally, the dapagliflozin administration upregulated the expression of angiogenic factors phosphorylated Akt (p-Akt) and phosphorylated endothelial nitric oxide synthase (p-eNOS), as well as vascular endothelial growth factor A (VEGFA), both in vivo and in vitro. These benefits could be blocked by either phosphoinositide 3-kinase (PI3K) or eNOS inhibitor. dapagliflozin could promote angiogenesis after ischemia. This effect might be achieved by promoting the activation of the PI3K-Akt-eNOS signaling pathway. This study provided a new perspective, new ideas, and a theoretical basis for the treatment of peripheral arterial disease. Full article

Background and objectives: National authorities and WHO recommend limiting consumption of added sugars from different foods. Polyols like isomalt can be used as bulk sweetener and thus help the food industry to replace sugar. Isomalt is a naturally sourced sugar replacer and the only one in its kind made from pure beet sugar. It has low physiological energy value (approximately 8.4 kJ/g), is non-cariogenic, and has low glycaemic properties as well as a very limited effect on insulin response. The present investigation aims to provide evidence from a series of recent randomized human intervention trials in which the respective effects of isomalt as low-digestible carbohydrate replacing sugar in various sweets were tested. Methods: Blood glucose and insulin response of different sweets were tested according to standardized test procedure. The sweets (i.e., chocolate, candies, mints and jam) were provided in realistic portion sizes and either contained sugar or sugar was replaced 1:1 by isomalt. Products were comparable in appearance, taste, and sweetness. 10 healthy adults (mean age: 40.6 ± 7.0 years, BMI: 23.5 ± 3.2 kg/m²) were randomly assigned to consume the sweets in the morning after an overnight fast. Capillary blood samples were taken at baseline up to 180 min to determine blood glucose and insulin levels. Results: Replacing sugar by isomalt led to significantly lower blood glucose response for all products. This was characterized by a significantly reduced incremental glucose peak (iCmax) ranging from −46% to −83% (all p < 0.05) and a reduction of the two-hour incremental area under the curve (iAUC2h) by 5% to 71% (p < 0.05 for candies, mints and jam). The lower glycaemic profile was accompanied by lower insulin levels. Accordingly, iCmax and iAUC2h following isomalt variants were remarkably reduced by 70 to 92% (all p < 0.05) and 58 to 87% (all p < 0.05), respectively. Discussion: With a series of RCTs conducted according to international standards in blood glucose response testing, we demonstrate reduced postprandial glycaemic and insulin response to various sweets in which sugar was replaced by isomalt. Hence, using isomalt as a naturally sourced sugar replacer is a viable strategy to support a low glycaemic diet. Full article

Background: The tooth is a repository of stem cells, garnering interest in recent years for its therapeutic potential. The aim of this systematic review and meta-analysis was to test the hypothesis that dental stem cell administration can reduce blood glucose and ameliorate polyneuropathy in diabetes mellitus. The scope of clinical translation was also assessed. Methods: PubMed, Cochrane, Ovid, Web of Science, and Scopus databases were searched for animal studies that were published in or before July 2023. A search was conducted in OpenGrey for unpublished manuscripts. Subgroup analyses were performed to identify potential sources of heterogeneity among studies. The risk for publication bias was assessed by funnel plot, regression, and rank correlation tests. Internal validity, external validity, and translation potential were determined using the SYRCLE (Systematic Review Center for Laboratory Animal Experimentation) risk of bias tool and comparative analysis. Results: Out of 5031 initial records identified, 17 animal studies were included in the review. There was a significant decrease in blood glucose in diabetes-induced animals following DSC administration compared to that observed with saline or vehicle (SMD: −3.905; 95% CI: −5.633 to −2.177; p = 0.0004). The improvement in sensory nerve conduction velocity (SMD: 4.4952; 95% CI: 0.5959 to 8.3945; p = 0.035) and capillary-muscle ratio (SMD: 2.4027; 95% CI: 0.8923 to 3.9132; p = 0.0095) was significant. However, motor nerve conduction velocity (SMD: 3.1001; 95% CI: −1.4558 to 7.6559; p = 0.119) and intra-epidermal nerve fiber ratio (SMD: 1.8802; 95% CI: −0.4809 to 4.2413; p = 0.0915) did not increase significantly. Regression (p < 0.0001) and rank correlation (p = 0.0018) tests indicated the presence of funnel plot asymmetry. Due to disparate number of studies in subgroups, the analyses could not reliably explain the sources of heterogeneity. Interpretation: The direction of the data indicates that DSCs can provide good glycemic control in diabetic animals. However, methodological and reporting quality of preclinical studies, heterogeneity, risk of publication bias, and species differences may hamper translation to humans. Appropriate dose, mode of administration, and preparation must be ascertained for safe and effective use in humans. Longer-duration studies that reflect disease complexity and help predict treatment outcomes in clinical settings are warranted. This review is registered in PROSPERO (number CRD42023423423). Full article

Introduction: The health benefits of eating fruits have been well established. Fruit juice is the product of the extraction or pressing of the natural liquid contained in fruits. The glycemic index (GI) is a tool developed to systematically classify carbohydrate-containing foods according to the time-integrated effects on postprandial glycemic responses. This study aimed to determine the effects of consuming a mixed commercial fruit juice (containing apples, oranges, grapes, and pomegranates) fortified either with two probiotic strains (Lacticaseibacillus casei Shirota and Lacticaseibacillus rhamnosus GG), or with vitamin D3, or with n-3 polyunsaturated fatty acids (PUFA), or with a combination of all of the aforementioned biofunctional ingredients versus the same control fruit juice without biofunctional ingredients on the postprandial glycemic and insulinemic responses. Methods: Eleven healthy, normal-weight volunteers (25—2 years; five females; BMI = 23 ± 1 kg/m²) participated in this randomized, double-blind, crossover clinical trial and were randomly assigned to receive five types of fruit juices (the fruit juice control, fruit juice with 50 μg vitamin D3, fruit juice with 8.33 g n-3 PUFA, fruit juice with 10⁸ cfu/mL probiotics, and fruit juice with vitamin D3, n-3 PUFA, and probiotics, all tested once) and D-glucose as a reference drink, which was tested two times. They all contained 50 g available carbohydrates, and the fruit juices were administered at different weeks in a random sequence according to the recommended glycemic index methodology. Capillary blood glucose and salivary insulin samples were collected at the baseline and for 180 min post consumption. Results: All the fruit juices provided low GI values (control: 54; vitamin D3: 52; n-3: 51; probiotics: 50; vitamin D3-n-3 PUFA-probiotics combination: 52, on the glucose scale). All the fruit juice types provided lower peak glucose values, smaller mean glycemic and insulinemic responses, and were more pleasurable than glucose was. Discussion: All the fruit juice types, regardless of the added biofunctional ingredients, attenuated the postprandial glycemic responses, which may offer advantages for glycemic control. Full article