Significant Reduction In Fasting Blood Glucose Research Articles

Inflammatory markers and noncoding-RNAs responses to low and high compressions of HIIT with or without berberine supplementation in middle-aged men with prediabetes.

This study compared the capacity of two different models of HIIT [high-(HC) and low-(LC) compression], with or without the use of berberine (BBR), on NOD-like receptor pyrin domain-containing protein-3 (NLRP3), H19, interleukin (IL)-1β, high-sensitivity C-reactive protein (hs-CRP), and insulin resistance markers. Fifty-four middle-aged men with overweight or obesity and prediabetes [fasting blood glucose (FBG) 110-180 mg/dL] were randomly and equally assigned to the HC, LC, HC + BBR, LC + BBR, BBR, and non-exercising control (CON) groups. The HC (2:1 work-to-rest) and LC (1:1 work-to-rest) home-based training programs included 2-4 sets of 8 exercises at 80%-95% HRmax, twice a week for 8 weeks. Participants in the berberine groups received approximately 1000 mg daily. All exercise interventions led to a significant reduction in hs-CRP, IL-1β, insulin, FBG, and insulin resistance index (HOMA-IR) versus CON. Notably, there was a significant reduction in FBG and HOMA-IR with the BBR group compared to the baseline. Both NLRP3 and H19 experienced a significant drop only with LC in comparison to the baseline. While both exercise protocols were beneficial overall, LC uniquely exhibited more anti-inflammatory effects, as indicated by reductions in H19 and NLRP3. However, the addition of berberine to the exercise programs did not demonstrate additional benefits.

Effect of Vitamin C on Blood Glucose Levels, Glycosylated Hemoglobin, and Serum Lipid Profile in Patients with Type 2 Diabetes Mellitus: A Prospective Study

Abstract Background: Vitamin C reduces oxidative stress as well as prevents nonenzymatic glycosylation of proteins because of its structural similarity to glucose. This prospective study was conducted to investigate the impact of vitamin C supplementation on glycemic control and serum lipid profile in newly diagnosed patients with type 2 diabetes mellitus (T2DM). Materials and Methods: Adult patients attending the outpatient department of a tertiary care hospital, diagnosed with T2DM within the last 3 months, with fasting blood glucose (FBG) levels exceeding 126 mg/dL, were randomly assigned to either control group (n = 98) or study group (n = 102). The study group received oral vitamin C (1 g/day) in addition to metformin 500 mg twice daily, while the control group received metformin 500 mg twice daily alone. Baseline characteristics, including age, gender, and comorbidities, were recorded. The parameters FBG, postprandial blood glucose (PPBG), glycosylated hemoglobin (HbA1c), and serum lipid profile were measured at baseline and at the 12th week. Results: Both the control and study groups experienced significant reductions in FBG, PPBG, and HbA1c levels after 12 weeks. However, the study group exhibited greater improvements, with FBG decreasing by 22.42 ± 2.7 mg/dL (P < 0.05), PPBG decreasing by 33.25 ± 4.9 mg/dL (P < 0.05), and HbA1c decreasing by 1.33 ± 0.3 g% (P < 0.05). Additionally, both groups demonstrated significant improvements in serum lipid profile parameters, with the study group showing more significant improvements in high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol levels compared to the control group. Conclusion: Vitamin C supplementation as an adjuvant therapy with metformin for 12 weeks produces beneficial effects in T2DM patients, including improved glycemic control and significant improvement in the lipid profile.

Effect of probiotics on pregnancy outcomes in gestational diabetes: systematic review and meta-analysis.

Gestational diabetes mellitus (GDM) is a prevalent complication during pregnancy associated with numerous adverse outcomes. There is emerging evidence suggesting the potential of probiotics as a therapeutic measure for GDM; however, existing studies have yielded contradictory results. This meta-analysis assessed the efficacy of probiotics on blood glucose management and pregnancy outcomes in patients with GDM. A comprehensive search of the PubMed, Embase, and Cochrane databases was conducted up to August 22, 2023, to identify relevant studies. The primary outcomes focused on fasting blood glucose (FBG), fasting serum insulin (FSI), homeostasis model assessment of insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI). The secondary outcomes included various maternal and neonatal outcomes. This meta-analysis included 15 randomized controlled trials (RCTs), encompassing 1006 patients with GDM. The results showed that, compared to a placebo, probiotics demonstrated a significant reduction in FBG (MD - 2.58, 95% CI - 4.38 to - 0.79, p < 0.01), FSI (MD - 2.29, 95% CI - 3.40 to - 1.18, p < 0.01), HOMA-IR (MD - 0.56, 95% CI - 0.81 to - 0.32, p < 0.01), and birth weight (MD - 101.20, 95% CI - 184.62 to - 17.77, p = 0.02). Furthermore, it resulted in fewer neonatal intensive care unit (NICU) admissions (RR 0.60, 95% CI 0.40-0.89, p = 0.01), instances of hyperbilirubinemia (RR 0.31, 95% CI 0.16-0.61, p < 0.01), and elevated QUICKI (MD 0.01, 95% CI 0.00-0.01, p < 0.01). No significant impact was observed in the other analyzed outcomes. In conclusion, probiotics improve FBG, FSI, and HOMA-IR, and reduce the occurrence of neonatal hyperbilirubinemia, NICU admissions, and birth weight in the offspring of patients with GDM. However, the quality of the evidence, as per the GRADE approach, varies from high to low, necessitating further studies to consolidate these findings.

Association between frequency of self-monitoring of blood glucose and glycemic control in patients with type 2 diabetes

AimTo determine the association between the frequency of self-monitoring of blood glucose (SMBG) and glycemic control in patients with type 2 diabetes. MethodsThe retrospective study analyzed data from 3,630 patients with type 2 diabetes who were enrolled between August 2020 and July 2021. 2456 non-insulin-treated patients were divided into SMBG ≤ 6 times/week and > 6 times/week groups. 1174 insulin-treated patients were divided into SMBG ≤ 9 times/week and > 9 times/week groups. Propensity score matching was used to generate groups with well-balanced covariates. Primary outcomes were changes in fasting blood glucose (FBG) and postprandial blood glucose (PBG) from baseline to 6 months. ResultsIn the non-insulin-treated group, a comparison in FBG and PBG reduction between the SMBG > 6 times/week and ≤ 6 times/week groups was statistically significant (−0.59 vs. −0.18 mmol/l, P < 0.001; −0.91 vs. −0.36 mmol/l, P < 0.001). In the insulin-treated group, there was no statistically significant reduction in FBG or PBG, patients with baseline FBG > 8 or 9 mmol/l and SMBG > 9 times/week had a significant FBG reduction than the ≤ 9 times/week group. ConclusionFrequent SMBG was associated with better glycemic control in non-insulin-treated patients. Insulin-treated patients with poor glycemic control may benefit from frequent SMBG.

Effect of Yoga and Walking on Glycemic Control for the Management of Type 2 Diabetes: A Systematic Review and Meta-analysis.

A daily habit of yogic practice or walking, along with an oral hypoglycemic agent (OHA) could be beneficial for better control of type 2 diabetes mellitus (T2DM). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to find out the efficiency of yoga or walking on glycemic control in T2DM. The present systematic review and meta-analysis were completed according to the PRISMA guidelines. The risk of bias in included studies was evaluated, by using the revised Cochrane risk-of-bias tool for randomized trials. Meta-analysis was implemented using RevMan software. Forest plots were used to illustrate the study findings and meta-analysis results. Sixteen studies were included in this systematic review, where 1820 participants were allocated to one of the following interventions: yoga, walking, and without any regular exercise (control group). Participants were between 17-75 years of age. Compared to the control group, the yoga group had a significant reduction in fasting blood glucose (FBG) by 31.98 mg/dL (95% CI = -47.93 to -16.03), postprandial blood glucose (PPBG) by 25.59 mg/dL (95% CI = -44.00 to -7.18], glycosylated hemoglobin (HbAlc) by 0.73% (95% CI = -1.24 to -0.22), fasting insulin by 7.19 μIU/mL (95% CI = -12.10 to -2.28), and homeostatic model assessment for insulin resistance (HOMA-IR) by 3.87 (95% CI = -8.40 to -0.66). Compared to the control group, the walking group had a significant reduction in FBG by 12.37 mg/dL (95% CI = -20.06 to -4.68) and HbA1c by 0.35% (95% CI = -0.70 to -0.01). Compared to the walking group, the yoga group had a significant reduction in FBG by 12.07 mg/dL (95% CI = -24.34 to - 0.20), HbA1c by 0.20% (95% CI = -0.37 to -0.04), fasting insulin by 10.06 μIU/mL (95% CI = -23.84 to 3.71) and HOMA-IR by 5.97 (95% CI = -16.92 to 4.99). Yoga or walking with OHA has positive effects on glycemic control. For the management of T2DM, yoga has relatively more significant effects on glycemic control than walking.Review registration number: PROSPERO registration number CRD42022310213.

Effects of turmeric (Curcuma longa) supplementation on glucose metabolism in diabetes mellitus and metabolic syndrome: An umbrella review and updated meta-analysis.

This study aims to comprehensively review the existing evidence and conduct analysis of updated randomized controlled trials (RCTs) of turmeric (Curcuma longa, CL) and its related bioactive compounds on glycemic and metabolic parameters in patients with type 2 diabetes (T2DM), prediabetes, and metabolic syndrome (MetS) together with a sub-group analysis of different CL preparation forms. An umbrella review (UR) and updated systematic reviews and meta-analyses (SRMAs) were conducted to evaluate the effects of CL compared with a placebo/standard treatment in adult T2DM, prediabetes, and MetS. The MEDLINE, Embase, The Cochrane Central Register of Control Trials, and Scopus databases were searched from inception to September 2022. The primary efficacy outcomes were hemoglobin A1C (HbA1C) and fasting blood glucose (FBG). The corrected covered area (CCA) was used to assess overlap. Mean differences were pooled across individual RCTs using a random-effects model. Subgroup and sensitivity analyses were performed for various CL preparation forms. Fourteen SRMAs of 61 individual RCTs were included in the UR. The updated SRMA included 28 studies. The CCA was 11.54%, indicating high overlap across SRMAs. The updated SRMA revealed significant reduction in FBG and HbA1C with CL supplementation, obtaining a mean difference (95% confidence interval [CI]) of -8.129 (-12.175, -4.084) mg/dL and -0.134 (-0.304, -0.037) %, respectively. FBG and HbA1C levels decreased with all CL preparation forms as did other metabolic parameters levels. The results of the sensitivity and subgroup analyses were consistent with those of the main analysis. CL supplementation can significantly reduce FBG and HbA1C levels and other metabolic parameters in T2DM and mitigate related conditions, including prediabetes and MetS. PROSPERO (CRD42016042131).

EFFECTIVENESS OF LIRAGLUTIDE IN REDUCING BODY WEIGHT AND IMPROVING GLYCEMIC CONTROL IN PATIENTS WITH T2DM

Objective: This study aimed to determine the effects of Liraglutide on glycosylated hemoglobin (HbA1c) and body weight in patients with type 2 diabetes. Material and Methods: A prospective observational study was conducted in a private tertiary healthcare setting. A total of 58 adult patients with T2DM using oral anti-diabetic agents with or without insulin were enrolled in the study from November 2020 to April 2022. Liraglutide was administered at a dose of 0.6 mg/day which was raised to 1.2 mg/day after 1 week and later to 1.8 mg/day depending upon patient preferences and tolerability. Patients were assessed for changes in their body weight, fasting blood glucose (FBG) level, random blood glucose (RBG) level, and HbA1c at the 1st and 2nd follow-up visits of the 8th and 16th week, respectively. Results: At the 16th week, the mean weight was 100.78±17.56 vs 102.74±17.26 and 104.11±17.95 at the 8th week and baseline visit, revealing a significant difference across three-time points [F(1.4, 36.45)=8.57, p=0.003]. A post hoc pairwise analysis showed that weight significantly decreased from baseline and 16th-week follow-up visits (p=0.011). Similarly, a significant decrease was observed in mean HbA1c across three-time points [F (2, 39.40) =8.81, p=0.001]. Mean HbA1c at 16th week was 6.61±1.13% vs 8.09±1.43% at baseline (P = 0.001). No significant reduction in FBG, RBG, blood pressure, and serum lipid profile were observed. Moreover, no major side effects occurred in any patient. Conclusion: Liraglutide is an effective and well-tolerable drug in improving glycemic control, causing significant weight loss in the study population when used as a monotherapy or in combination therapy. KEYWORDS: Liraglutide, Glucagon-like peptide-1 agonist, Type 2 diabetes mellitus, Glycemic control, Weight loss

Washed microbiota transplantation improves patients with metabolic syndrome in South China.

Metabolic syndrome (MS) is a growing public health problem worldwide. The clinical impact of fecal microbiota transplantation (FMT) from healthy donors in MS patients is unclear, especially in southern Chinese populations. This study aimed to investigate the effect of washed microbiota transplantation (WMT) in MS patients in southern China. The clinical data of patients with different indications receiving 1-3 courses of WMT were retrospectively collected. The changes of BMI, blood glucose, blood lipids, blood pressure and other indicators before and after WMT were compared, such as fasting blood glucose (FBG), glycated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c)), high-density lipoprotein cholesterol (HDL-c), non-high-density lipoprotein (non-HDL-c), systolic blood pressure (SBP), diastolic blood pressure (DBP), etc. At the same time, comprehensive efficacy evaluation and atherosclerotic cardiovascular disease (ASCVD) grade assessment were performed on MS patients. Finally, 16S rRNA gene amplicon sequencing was performed on fecal samples of MS patients before and after transplantation. A total of 237 patients were included, including 42 in the MS group and 195 in the non-MS group. For MS patients, WMT significantly improved the comprehensive efficacy of MS in short term 40.48% (p<0.001), medium term 36.00% (p=0.003), and long term 46.15% (p=0.020). Short-term significantly reduced FBG (p=0.023), TG (p=0.030), SBP (p=0.026) and BMI (p=0.031), and increased HDL-c (p=0.036). The medium term had a significant reduction in FBG (p=0.048), TC (p=0.022), LDL-c (p=0.043), non-HDL-c (p=0.024) and BMI (p=0.048). WMT had a significant short term (p=0.029) and medium term (p=0.011) ASCVD downgrading effect in the high-risk group of MS patients. WMT improved gut microbiota in MS patients. WMT had a significant improvement effect on MS patients and a significant downgrade effect on ASCVD risk in the high-risk group of patients with MS. WMT could restore gut microbiota homeostasis in MS patients. Therefore, the regulation of gut microbiota by WMT may provide a new clinical approach for the treatment of MS.

The effect of Glucomannan on fasting and postprandial blood glucose in adults: a systematic review and meta-analysis of randomized controlled trials.

Glucomannan is a dietary fiber that slows the absorption of carbohydrates and suppresses appetite, thereby reducing blood glucose. This meta-analysis sought to examine the effect of glucomannan supplementation on Fasting Blood Glucose (FBG) and Postprandial Glucose (PPG) in adults. We searched PubMed, and SCOPUS databases, and Google Scholar from inception to May 2020, using relevant keywords. All randomized controlled clinical trials (RCTs) that examined the effect of glucomannan supplementation on FBG and PPG in adults were included. Weighted mean differences (WMD) and their 95% confidence interval (CI) were calculated using Stata. Subgroup analysis was used to discern possible sources of heterogeneity. Overall, 6 trials were included, consisting of 124 participants. We found that glucomannan supplementation significantly reduced FBG (WMD): -0.60 mmol/L, 95% CI: -1.16, -0.05; P=0.03, but not PPG (WMD: -2.07mmol/L ; 95% CI: -5.09, 0.95; P=0.18), compared with controls group. We conducted subgroup analysis based on dosage and duration of intervention and health status of the population. Findings from subgroup analysis revealed a significant effect of glucomannan supplementation on FBG in diabetic patients (WMD: -1.28 mmol/L, 95% CI: -2.54, -0.02; P=0.04). Glucomannan supplementation can elicit significant reductions in FBG, but has no significant impact on PPG, in adults. More RCTs may find the exact effect of glucomannan on FBG and PPG. The online version contains supplementary material available at 10.1007/s40200-022-00993-6.

Folic Acid Supplementation Improves Glycemic Control for Diabetes Prevention and Management: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials.

Background: There is a growing interest in the considerable benefits of dietary supplementations, such as folic acid, on the glycemic profile. We aimed to investigate the effects of folic acid supplementation on glycemic control markers in adults. Methods: Randomized controlled trials examining the effects of folic acid supplementation on glycemic control markers published up to March 2021 were detected by searching online databases, including Scopus, PubMed, Embase, and ISI web of science, using a combination of related keywords. Mean change and standard deviation (SD) of the outcome measures were used to estimate the mean difference between the intervention and control groups at follow-up. Meta-regression and non-linear dose-response analysis were conducted to evaluate the association between pooled effect size and folic acid dosage (mg/day) and duration of the intervention (week). From 1814 detected studies, twenty-four studies reported fasting blood glucose (FBG), fasting insulin, hemoglobin A1C (HbA1C), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) as an outcome measure. Results: Results revealed significant reductions in FBG (weighted mean difference (WMD): −2.17 mg/dL, 95% CI: −3.69, −0.65, p = 0.005), fasting insulin (WMD: −1.63 pmol/L, 95% CI: −2.53, −0.73, p < 0.001), and HOMA-IR (WMD: −0.40, 95% CI: −0.70, −0.09, p = 0.011) following folic acid supplementation. No significant effect was detected for HbA1C (WMD: −0.27%, 95% CI: −0.73, 0.18, p = 0.246). The dose-response analysis showed that folic acid supplementation significantly changed HOMA-IR (r = −1.30, p-nonlinearity = 0.045) in non-linear fashion. However, meta-regression analysis did not indicate a linear relationship between dose, duration, and absolute changes in FBG, HOMA-IR, and fasting insulin concentrations. Conclusions: Folic acid supplementation significantly reduces some markers of glycemic control in adults. These reductions were small, which may limit clinical applications for adults with type II diabetes. Further research is necessary to confirm our findings.

Utilizing Technology-Enabled Intervention to Improve Blood Glucose Self-Management Outcome in Type 2 Diabetic Patients Initiated on Insulin Therapy: A Retrospective Real-World Study.

Background The aim of this study was to assess the benefits of a mobile-enabled app through Lilly Connected Care Program (LCCP) in achieving blood glucose control and adhering to self-monitoring of blood glucose in patients with type 2 diabetes mellitus (T2DM). Methods This retrospective study included T2DM patients who were initiated on insulin therapy (mostly premixed insulin) after failure to respond to oral antidiabetic drugs. Patients were provided with glucometers enabled with synchronous data transmission to healthcare providers and family members. The primary objective was to assess the benefits of LCCP based on changes in fasting blood glucose (FBG) and postprandial glucose (PPG) levels from baseline to 12 weeks. Paired t-test was used to assess the change in blood glucose (BG) from baseline to week 12. Results In total, 14,085 T2DM patients were recruited. Compared with baseline, significant reductions in FBG and PPG were evident at week 12 (FBG: -0.39 mmol/L; PPG: −0.79 mmol/L; both P < 0.001). Furthermore, at week 12, the proportion of patients attaining a target glucose level of FBG <7.0 mmol/L and PPG <10.0 mmol/L was 25.37% and 59.68%, respectively, with a statistically significant increase compared with that at baseline (6.74% and 45.59%, respectively, both P < 0.001). The frequent monitoring of patients could gain a higher target achievement of FBG (28.1% vs 24.2%) and PPG (64.4% vs 55.1%) than the occasional monitoring patients. Additionally, the incidence of hypoglycemia gradually decreased and was significantly lower than the baseline level. Conclusions In T2DM patients with poor glycemic control, the application of mobile enabled intervention (LCCP) along with insulin significantly reduced the hypoglycemia while improving glycemic control during period of naïve initiating insulin therapy. Additionally, the high frequency of BG self-monitoring was associated with better glycemic control.

Effect of zinc supplement on glycemic control and lipid abnormalities in Type 2 diabetic patients.

To evaluate the effects of zinc on glycemic control and lipid profile in type 2 diabetic patients. Objectives: The zinc deficiency is reported in with diabetes, which increases oxidative stresses leading to complications of diabetes. Previous studies demonstrated that zinc supplementation improved glucose control in patients with diabetes, but limited data is available and single blind trials. Study Design: Randomized Controlled study. Setting: Combined Military Hospital (CMH) Malir Cantt, Karachi. Period: 1st December 2018 to 30th June, 2019. Material &amp; Methods: Patients (n=350) were randomly divided into two groups. The first group (n=175) was supplemented with oral zinc sulfate 30 mg/day and second group (n=175) received placebo for a period of 3 months. Blood samples were taken at baseline and after 3 months to assess fasting blood glucose (FBS), glycosylated hemoglobin (HbA1C %) and serum lipid levels and BMI which were compared by t test for paired samples. Results: The mean age of all subjects was 51.80+10.281 years and male to female ratio was 1.08:1. The mean BMI was 31.74+5.806. There was no statistical difference in age and gender between two groups but more obese patient received placebo. The zinc supplemented group had a significant reduction in FBS (p= 0.032) compared to placebo (p= 0.158). The HbA1C% level reduced significantly in zinc supplemented group (p&lt;0.001).compared to the placebo group (p=0.273). Serum lipid levels reduced significantly in the zinc supplemented group (p&lt;0.001) but no significant changes observed in the placebo group (p=0.395). Conclusions: Zinc supplementation improved glycemic control and decreased levels of serum cholesterol, LDL and triglyceride.

Vitamin D Supplementation in Overweight/obese Asian Indian Women with Prediabetes Reduces Glycemic Measures and Truncal Subcutaneous Fat: A 78 Weeks Randomized Placebo-Controlled Trial (PREVENT-WIN Trial)

Vitamin D deficiency may contribute to etiology of type 2 diabetes in Asian Indians. The objectives of this study was to evaluate effect of vitamin D supplementation on glycemic profile and body composition in prediabetic and vitamin D deficient overweight/obese Asian Indian women. In this open-label randomized placebo-controlled trial (78 weeks duration), 121 females (aged 20–60 years) with prediabetes and vitamin D deficiency were randomly allocated in intervention (n, 61) and placebo (n, 60) groups. The primary outcome variables were fasting blood glucose (FBG), 2-h blood glucose post OGTT (2-h BG), hemoglobin A1c (HbA1C), and reversal to normoglycemia. In Intention-to-treat analysis, at the end of intervention, we observed significant decrease in FBG [−5.0 (−12.6–2.4), p = 0.04], 2-h blood glucose post OGTT [−11(−49.3–26.9), p = 0.02], hemoglobin A1c [−0.41 (5.89, 6.55), p = 0.05] and increase in 25(OH) D [7.5 (−6.0–20.9), p = 0.002] levels in intervention as compared to the placebo group. Changes in glycemic category based on FBG were as follows; intervention group: normal FBG, 58.6%; impaired fasting glucose (IFG), 39%; and type 2 diabetes mellitus (T2DM), 2.4%; placebo group: normal FBG, 48.8%; IFG, 46.3%; and T2DM, 4.9%. Changes in category of 2-hour glucose post OGTT after intervention were as follows; intervention group: normal glucose tolerance (NGT) 51.2% and prediabetes, 48.8%; placebo group: NGT, 43.9%; prediabetes, 53.7% and T2DM, 2.4%. After intervention, subscapular skinfold (visit Ist compared to visit IIIrd) and suprailiac skinfold (visit IInd compared to visit IIIrd) were significantly lower in intervention group vs. control group. In conclusion, we observed significant reduction in FBG, 2-hour glucose post OGTT, HbA1c, and truncal subcutaneous fat and reversal to normoglycemia in overweight/obese prediabetic vitamin D deficient Asian Indian women after 78 weeks of vitamin D supplementation.

Implantation of Left Ventricular Assist Device Results in Immediate Improvement of Glucose Metabolism in Patients With and Without Diabetes Mellitus

Several studies demonstrated improvement in diabetes mellitus (DM) following left ventricular assist device (LVAD) implantation, but the timing of these changes has not been identified. We sought to determine if favourable metabolic changes occur immediately, within the initial hospitalisation following LVAD implantation. We also wanted to see whether favourable changes in glucose metabolism occur in patients without diabetes. This is a retrospective analysis of patients receiving LVADs at our institution. We collected the data on fasting blood glucose (FBG) and total daily insulin requirements before the LVAD implantation and before the discharge. Patients served as their own controls. We studied 70 consecutive patients, half of them diabetic. In both diabetics and non-diabetics there was a significant reduction in FBG after LVAD implantation. In diabetic patients, there was an overall reduction in insulin requirements from the average 29.2 units of insulin per day before the LVAD to 16.2 units per day (p=0.038) before discharge. Specifically, insulin requirement decreased in 16 patients by a median of 25.2 units per day (the interquartile range [IQR)]: -47.8 to -9.2), increased in 10 patients (by 7.3 units/day, IQR 0.7 to 15.3), and remained unchanged in six patients. Favourable metabolic changes on LVAD support occurred almost immediately, within initial hospitalisation, in diabetics and non-diabetics alike. Decline in insulin requirements should be considered when managing diabetics following LVAD implantation.

Protective effect of wax apple (Syzygium samarangense (Blume) Merr. &amp; L.M. Perry) against streptozotocin-induced pancreatic ß-cell damage in diabetic rats

The purpose of this study was to investigate the protective properties and mechanisms of wax apple (Syzygium samarangense (Blume)) against streptozotocin (STZ)-induced pancreatic ß-cell apoptosis in diabetic rats. Diabetes was induced by STZ (65 mg/kg; i.p.) injection and wax apple (100 mg/kg) was orally administered to diabetic rats for a period of 30 days. During this time, fasting blood glucose (FBG) and body weight were measured weekly. At the end of the experiment, serum insulin, HOMA-B, and pancreatic insulin expression were assessed. The expression of apoptosis-related proteins along with the nitrotyrosine level, antioxidant activities, and pro-inflammatory cytokine TNF-α in the pancreas were also determined. STZ-induced diabetic rats exhibited an increase in FBG, and a decrease in body weight, serum and pancreatic insulin, as well as HOMA-B. Pancreatic apoptosis was noted in diabetic rats and indicated by enhancing the expression of cleaved caspase-3 and Bax proteins and downregulating the expression of Bcl-2 and Bcl-xl proteins. The activities of antioxidant CAT and SOD in the pancreas of the diabetic rats was also reduced. Importantly, wax apple treatment resulted in a significant reduction of FBG and increased body weight in diabetic rats. Wax apple also improved pancreatic ß-cell function, this was clearly evidenced by increased HOMA-B and pancreatic and serum insulin levels in diabetic rats. Moreover, pancreatic ß-cell apoptosis was alleviated with significantly down-regulated cleaved caspase-3 and Bax protein expression, and upregulated Bcl-2 and Bcl-xl protein expression in wax apple treated diabetic rats. These were related to the induction of CAT and SOD activities, and reduction of nitrotyrosine and TNF-α levels in wax apple administration. Overall, these results provide evidence that wax apple protects against STZ-induced pancreatic β-apoptosis and dysfunction in diabetic rats, possibly through inhibiting oxidative stress and pro-inflammatory cytokine, and activating anti-apoptotic proteins.

Study of the effect of pantoprazole on glycemic control of type-2 diabetes mellitus in tertiary care center and hospital in North India

Context: Type 2 diabetes mellitus (type 2 DM) is a heterogeneous and complex combination of metabolic condition caused by high levels of blood glucose and insulin resistance or insulin deficiency. Some studies suggest the increased levels of gastrin following the administration of proton pump inhibitors (PPIs), which seek to improve glycemic status and increased pancreatic insulin content. Aim: We determined the effect of pantoprazole on glycemic control in patients with type 2 DM. Material and Methods: Two groups, each with 30 patients of type 2 DM under treatment with oral hypoglycemic agent, were considered for this study. Patients were treated for 24 weeks with placebo or 40 mg pantoprazole tablets twice daily. Fasting blood glucose (FBG), postprandial blood glucose (PP blood glucose), as well as glycated hemoglobin (HbA1C) before and after treatment were measured. Study: Duration 1 year. Statistical Analysis: A hospital-based, randomized, double-blind, placebo-controlled study was used. Data were expressed as mean with standard deviation, numbers, and percentage. Baseline parameters and laboratory safety parameters were compared using appropriate parametric and nonparametric tests. A P value Results: The mean FBG readings at baseline in the intervention and control groups were 170.47 ± 16.65 and 163.39 ± 14.95 mg/dL, respectively, and those at the end of intervention were 157.95 ± 14.37 and 165.32 ± 12.40 mg/dL. The within-group changes in the intervention group were statistically significant (P = 0.003). The statistical analysis between groups after intervention showed a significant differences (P = 0.03). HbA1C changes in the intervention and control groups in the study were 0.53 ± 0.03% and 0.20 ± 0.08%, respectively, but a decrease in the intervention group was statistically significant (P = 0.005). In the end, the change between the two groups was also statistically significant (P = 0.005). Conclusions: There is a significant reduction in FBG, PP blood glucose, and HbA1C after 24 weeks of pantoprazole (40 mg BID) administration, which improved glycemic control in type 2 DM patients. PPI such as pantoprazole may be a new therapeutic approach in type 2 DM in future.

EFFECTS OF METHANOLIC STEM BARK EXTRACT OF Cassia sieberiana DC ON FASTING BLOOD GLUCOSE AND SERUM LIPID PROFILE OF ALLOXAN INDUCED DIABETIC RATS

This study evaluated the effects of methanolic stem bark extract of Cassia sieberiana (MSBECS) on fasting blood glucose (FBG) and serum lipid profile (SLP) of alloxan-induced diabetic albino rats. The extract was prepared by cold maceration and administered orally at the dose of 12.5, 25, 50, 100 and 200 mg/kg body weight to evaluate the effects on fasting blood glucose (FBG) of the diabetic rats, and at 50, 100 and 200 mg/kg body weight (bw) for the serum lipid profile (SLP) assay. A total of 78 male albino rats (Rattus norvegicus) of 12 weeks of age were used for the study; 42 were used to evaluate the effects of the extract on FBG, while 36 were used for the SLP assay. Data from the study showed that the optimum anti-hyperglycemic activity of the C. sieberiana extract on the diabetic rats was recorded in the rat group given 50 mg/kg bw of MSBECS, and this did not differ significantly (p>0.05) from that of glibenclamide-treated rats. Treatment of the diabetic rats with the extract at the doses of 100 and 200 mg/kg bw produced a significant (p<0.05) increase/improvement in the serum high density lipoprotein cholesterol (HDLC), while rat groups given 50, 100 and 200 mg/kg bw of the extract had a significantly (p<0.05) lower serum triglyceride and very low density lipoprotein cholesterol (VLDLC). It was concluded the administration of MSBECS at 50 mg/kg bw led to significant reduction in FBG of diabetic rats comparable to that obtained in the control group treated with a standard anti-hyperglycaemic drug (glibenclamide), while treatment at doses of 50, 100, and 200 mg/kg bw led to favorable effects on the lipid profile of the diabetic rats. These findings validate the traditional use of the stem bark of C. sieberiana in the management of diabetes mellitus and its dyslipidaemia complications.

Glucose and Lipid Lowering Potentials of Heliotropium indicum L. Leaves in Alloxan-Induced Hyperglycaemic Rats

The antidiabetic potentials of Heliotropium indicum L. leaf aqueous (HILA) extract used for the management of diabetes by Traditional Medicinal Practitioners (TMPs) in Nigeria was assessed. Alloxan (ALX)-induced hyperglycaemic rats were orally administered with known folkloric dosage of 30 and 75 mg/kg b. wt. of HILA extract, once a day, for 14 days. Fasting blood glucose (FBG) levels were monitored and pancreatic histology was examined. Net hepatic glycogen (GLY) concentration and lipid profiles were also determined. Prior to treatment, ALX-induced hyperglycaemia (&gt;250 mg/dL) was established in rats. Oral administration of 30 and 75 mg/kg b. wt. HILA extract to diabetic rats for 14 days caused significant reduction in FBG to baseline values observed in non-diabetic conditions. Treatment with HILA extract also showed improvement in lipid abnormalities observed in hyperglycaemic condition, levels of triglyceride, total cholesterol and LDL-cholesterol were significantly reduced and HDL-cholesterol increased resulting in improved artherogenic index. Hepatic GLY concentration was significantly increased in diabetic rat treated with the extract. Histological examinations showed degenerated and sparse pancreatic islets β-cells in non-treated diabetic rat, whereas microscopy of treated rats showed mild to normal architecture with enriched β-cells. Preliminary phytochemical profiling of the extract revealed the presence of alkaloids (2.54 mg/g), saponins (0.28 mg/g), phenols (0.04 mg/g) and anthraquinones (0.01 mg/g). Results from this study revealed that the aqueous leaf extract of H. indicum possesses not only antihyperglycaemic, but also antidyslipidemic activities, that may prove to be of clinical importance in the management of diabetes and associated secondary complications.

Effect of probiotics and synbiotics on blood glucose: a systematic review and meta-analysis of controlled trials.

High fasting blood glucose (FBG) can lead to chronic diseases such as diabetes mellitus, cardiovascular and kidney diseases. Consuming probiotics or synbiotics may improve FBG. A systematic review and meta-analysis of controlled trials was conducted to clarify the effect of probiotic and synbiotic consumption on FBG levels. PubMed, Scopus, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature databases were searched for relevant studies based on eligibility criteria. Randomized or non-randomized controlled trials which investigated the efficacy of probiotics or synbiotics on the FBG of adults were included. Studies were excluded if they were review articles and study protocols, or if the supplement dosage was not clearly mentioned. A total of fourteen studies (eighteen trials) were included in the analysis. Random-effects meta-analyses were conducted for the mean difference in FBG. Overall reduction in FBG observed from consumption of probiotics and synbiotics was borderline statistically significant (-0.18mmol/L 95% CI -0.37, 0.00; p=0.05). Neither probiotic nor synbiotic subgroup analysis revealed a significant reduction in FBG. The result of subgroup analysis for baseline FBG level ≥7mmol/L showed a reduction in FBG of 0.68mmol/L (-1.07, -0.29; ρ<0.01), while trials with multiple species of probiotics showed a more pronounced reduction of 0.31mmol/L (-0.58, -0.03; ρ=0.03) compared to single species trials. This meta-analysis suggests that probiotic and synbiotic supplementation may be beneficial in lowering FBG in adults with high baseline FBG (≥7mmol/L) and that multispecies probiotics may have more impact on FBG than single species.

Rice Cakes Containing Dietary Fiber Supplemented with or without Artemisia Annua and Gynura Procumbens Merr. Alleviated the Risk Factors of Metabolic Syndrome.

We investigated whether the consumption of Korean rice cakes enriched with dietary fiber with or without polyphenol rich plants might decrease the risk factors of metabolic syndrome (MetS). Rice cakes were manufactured using fructooligosaccharides, resistant starch, and psyllium as sources of dietary fibers with and without polyphenol rich Artemisia annua and Gynura procumbens Merr. (RC+FP and RC+F, respectively), and prepared in three forms (songpyeon, seolgidduk, and chaldduk). Ninety subjects with at least one MetS risk factor were recruited for 6 weeks of dietary intervention. Sixty subjects were finally included for the analysis. Compared to the initial values, RC+FP group had decreased levels of fasting blood glucose (FBG), HOMA-IR and blood pressure after 6 weeks, whereas RC+F group didn't have significant changes in them. Regarding the improvement of individual MetS risk factors, RC+FP group showed significant reduction in FBG and blood pressures but RC+F group only had reduction in systolic blood pressure. After the intervention, a reduction in the number of MetS risk factors was greatert in the RC+FP group than in the RC+F group. In conclusion, Dietary fiber enriched rice cakes with or without polyphenols decreased the number and/or the levels of MetS risk factors. Polyphenol rich plant components may provide additional health benefits in controlling FBG and blood pressure.