Diabetes; causes, prophylactics & treatments!

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Diabetes; causes, prophylactics & treatments!

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♦ The Diabetes Epidemic

The consequences of a 'modern, western diet', full of denatured, sweetened foods, drinks and snacks!

Glucose response curves of different foods
Every five seconds someone dies from diabetes globally due to its debilitating consequences, 50% of these 6.7 million people die under the age of 60! The Prevalence globally of Diabetes is over 9.5% (standardized for ages 20 to 79 years.) External Link

In Thailand the prevalence of Diabetes has risen to above 10% and well over 100 people die daily from Diabetes in this country alone.

However this degenerative disease is entirely preventable if a prudent, healthy diet is adhered to during one's lifetime!
A balanced, healthy diet consists of naturally sweet foods like fruits, vegetables, tubers, legumes and wholegrain rice, wheat, barley, rye and oats.

Correlation of white rice consumption
and incidence of Type 2 Diabetes

While many foods in the Table below are listed as having a zero Glycemic Index, and as such are said to be 'safe' for diabetics, they also are high in lipids (fats), growth hormones and purines, etc, and thus greatly contribute to other degenerative diseases like:
Atherosclerosis, Heart Disease, Kidney Disease, Stroke, Heart Attacks, Hypertension/High Blood Pressure, etc. [See 'GI Table' below!]

Adhering to an overall healthy diet is a balancing act between mostly low, some medium and even high GI foods, as long as the medium and high GI foods are eaten infrequently and in moderation.
Their adverse effects can also be mitigated by including high fiber, low GI foods which will reduce the overall GI and GL of the meal.

Gangrene caused by diabetes!

Since rice is an essential ingredient of the Thai staple diet, special care must taken on how to mitigate its possible contribution to the incidence of Diabetes. [See 'Rice' below!]

♦ Causes of Diabetes:
  • Artificially sweetened Beverages, Sugar sweetened Beverages, Fruit Juice [η]
  • Artificial Sweeteners [Ε]
  • Anti Depressant Medication, ADM [Δ]
  • Bisphenol A; Chemical found in plastics which migrates into food. [δ]
  • Nateglinide; Starlix Pharmaceutical drug to 'treat' T2 Diabets [μ]
  • Pesticides, Herbicides: Dioxin, Polychlorinated biphenyl [PCB], Chlorinated pesticide, Bisphenol A [BPA], Phthalate [κ]
  • Sucrose, HFCS High Fructose Corn Syrup; added to everything from Soft Drinks, Sauces (Ketchup, Soy Sauce, Apple Sauce etc) Meat preservative, Instant Foods, Peanut Butter, Fruit Juices, etc [ε]
  • Sweetened Drinks: All sweetened drinks including Sodas (Coke, Fanta, M150, etc), Fruit Juice, Coffee, Tea, sweetened Soy Milk, are contributing factors for the development of diabetes. [α]
  • Statin Drugs [ι][μ]
  • TV viewing [λ]
  • White Rice, high, daily intake [β][γ]

♦ Prophylactic and therapeutic compounds for Diabetes:

People with T2 Diabetes should be very careful when choosing treatment and management options:

» Rosiglitazone an 'anti-diabetic' drug sold under the trade name Avandia, for instance, as most all pharmaceutical drugs, is associated with severe side effects such as myocardial infarction and an increased risk of death from cardiovascular causes. [1Δ]
» Starlix (Nateglinide), a 'blood glucose-lowering drug', was found to significantly increase the risk of biochemical conversion to Type 2 Diabetes Mellitis (T2DM). [μ]
» Metformin, sold under the brand-name Glucophage etc, and Sulfonylureas, sold under the brand-names Glucotrol, Glipizidem Glimepiride, Amaryl and Glynase etc cause a massive increase in all-cause mortality. [1δ]

Prophylactics and treatment options of natural compounds and their 'active ingredients' shown to be effective as per cited research papers:
  • Aloe Vera; plant, sap, extract [22] [34]
  • Apple Cider Vinegar [23]
  • Bay Leaves; Laurus Nobilis [35]
  • Berberine; alkaloid extracted from Barberry, Phellodendron, Oregon Grape, Goldenseal, goldthread etc [36]
  • Bitter Melon; Peptide mcIRBP-19, Vegetable [37]
  • Black Seed Oil, Black Caraway, Black Cumin, Nigella, Kalonji. (Nigella Sativa) [7] [8]
  • Brown Rice; substituting whole grains for polished Rice [2]
  • Brown Seaweed Undaria pinnatifida (Wakame), Dictyota dichotoma (Branching Brown Algae), Hizikia (Hijiki) [3]
  • Cinnamon Whole or extract [4][5]
  • Cocoa; Cocoa products as a diet [28]
  • Coffee, Tea [14]
  • Embelia Ribes, Embelin; Ayurvedic medicine/herbs [27]
  • Exercise: Physical exercise reduces the diabetes symptoms of high blood pressure.[1][10]
  • Fenugreek Seed [40]
  • Flaxseed Oil; Flaxseed lignan, powder [39]
  • Fructo-oligosaccharides, Oligofructose, Oligofructan: alternative sweetener [12]
  • Garlic Allicin [6]
  • Ginko Biloba [13]
  • Herbs Psyllium Fiber, Aloe Vera, Dragon Fruit, Cinnamon, Urtica Diolca (Stinging Nettle), Nigella Sativa, Fenugreek Seeds [9] [22]
  • Kefir; Probiotic fermented milk, soymilk [38]
  • Mangiferin; Molecule isolated from the Mango Tree [17]
  • Moringa Oleifera Lam [16]
  • Passion Fruit Peel, Turmeric Powder [18]
  • Probiotic, Synbiotic* Supplementation *Nutritional supplements combining Probiotics & Prebiotics to form synergism [19] [20]
  • Propolis [30]
  • Resveratrol; 'active ingredient' found in Berries etc. See Tab/Post on 'Berries' [25]
  • Rhizoma Coptidis (Huang Lian) [23]
  • Spirulina [24]
  • Stinging Nettle; Urtica dioica [26]
  • Thymoquinone; active ingredient found in Nigella Sativa (Black Caraway, Black Cumin, Nigella) etc [21]
  • Vegan Diet; low fat [33]
  • Vegetables, Fruit [15]
  • Vitamin C (very low Confidence Interval studies) [11]
  • Vitamin D [29]
  • Whole Grains, Cereal Fibre [31]
  • Zinc; supplementation [32]

    Glycemic Index, GI              Glycemic Load, GL

  •    <55 low
  • 56-69 medium
  •    >70 high
  •    <10 low
  • 11-19 medium
  •    >20 high

♦ Glycemic Index, GI, and Glycemic Load, GL

Foodstuffs GI Serving Size GL PRAL Score
Bacon 0 0 16.56
Beef Liver 0 0 22.73
Beef Topside 0 0 12.5
Cheese 0 0 34.0
Chicken Breast 0 0 16.5
Chicken Liver 0 0 20.49
Chicken Wing 0 0 13.93
Fish, Carp 0 0 11.75
Mackerel 0 0 7.28
Octopus 0 0 8.69
Oyster 0 0 1.88
Pork, Rump 0 0 7.9
Processed Fish; Fish Balls 0 0 7.72
Rainbow Trout 0 0 10.8
Salmon 0 0 11.5
Salmon; canned 0 0 14.0
Sausage, Vienna 0 0 10.6
Seaweed 0 0 -4.8
Sheep, Lamb, Mutton 0 0 11.58
Shrimp 0 0 12.56
Squid, Spear Squid 0 0 9.37
Textured Vegetable, Protein 0 0 -10.58
Tuna Canned 0 0 10.09
Wine 0 0 -
Avocado 10 200 grams 0.2 -8.2
Chinese Cabbage 12 200 grams 2.5 -5.0
Peanut 13 25 grams 0.26 6.2
Beans, Pinto 14-45 50 grams 0.26 -9.6
Asparagus 15 200 grams 0.6 -2.2
Bamboo Shoots 15 50 grams 0.075 -8.0
Broccoli 15 100 grams 0.45 -3.6
Cabbage 15 200 grams 1.2 -4.3
Cauliflower 15 50 grams 0.5 -1.3
Cucumber 15 200 grams 0.6 -5.0
Mushrooms, fresh 15 100 grams 0.15 -1.4
Onion 15 50 grams 0.375 -2.0
Tofu 15 100 grams 0.3 2.25
Beans, Black 17-31 50 grams 0.05 -13.6
Eggplant 20 100 grams 0.6 -3.4
Beans; Kidney 9-70 50 grams 0-0.08 -8.4
Tamarind, raw 23 35 grams 6 -11
Tomato 23 100 grams 0.875 -4.1
Chocolate; dark 25 50 grams 5.75 -
Strawberry 25 200 grams 2.5 6.8
Bread; barley wholemeal 28-67 156 grams 4 3.5
Garlic 30 20 grams 1.68 -2.6
Lentils 30 50 grams 6.17 -
Soymilk 30 200 grams 1.8 -1.6
Milk; Cow's 31 1 Cup 2.7 -
Parsley 32 100 grams 0.97 -11.13
Apple 35 125 grams 4.8 -
Carrot 35 200 grams 3.5 -5.7
Fig; fresh 35 50 grams 2.3 -4.88
Sesame 35 10 grams 0.35 0.3
Fig; dried 40 30 grams 6.6 -4.88
Oats 40 50 grams 11.25 -
Longan; fresh 45 125 grams 8.46 -
Pineapple 45 125 grams 6.8 -2.21
Spaghetti/Pasta 46 1 Cup 20 -
Banana 48 100 grams 9.6 -6.9
Durian 49 50 grams 5.5 -
Clam, Mussels, Shellfish 50 50 grams 1.85 11.1
Mango 50 200 grams 12 -3.01
Sweet Potato 50 150 grams 17.25 -8.15
Rice, brown/whole grain 51-78 30 grams 11.32 2.3
Papaya 55 200 grams 7.7 -4.03
Rice; Basmati, polished 57 - 80 30 grams 13.92 1.7
Honey 60 10 grams 4.5 -
Ice Cream 60 100 grams 12.64 28.7
Wheat Bread; white 60 40 grams 3.8 -3.55
Pumpkin 64 150 grams 4.8 -
Corn 65 150 grams 15.5 *
Raisins 65 25 grams 11 -21
Rice; Jasmine, polished 68-116 100 grams 58.4 -
Potato 70 200 grams 21 -6.08
Beer 90 ½ Liter 13.5 -
Rice; glutinous/sticky 92-98 100 grams 19.41 -
Sugar; brown 98 5 grams 3.4 -
Dates 100 12.5 grams 8.125 -11.9
Sugar; white 100 5 grams 4.8 -

Please note that while most foods only list one value for GI and GL, they may in fact vary widely depending on variety, growing conditions and degree of processing of the food.
Foods in green are deemed to be much more conducive to overall health, even if they show a higher GI than red colored foods.
Unless you are on a strict low glycemic diet and not diagnosed with diabetes, it is best to select foods from the green category and combine these with beans, bean products and other low GI foods for an overall healthy, low GI meal. [1β][β]

♦ Rice given special attention!

Different varieties of rice have varying
Glycemic Indices

As in Thailand, Rice is a staple diet in many countries around the world, and as such can contribute to the incidence of Type 2 Diabetes if the consumption is not managed correctly.

The Glycemic Index of Rice varies widely in different varieties, which is mainly due to the varying Amylose content.
Studies have shown that the consumption of beans and bean products like soy foods lowers the overall Glycemic Index of a meal consisting of white rice as the main carbohydrate. [1β]

200 grams of
cooked rice

"In a study of middle-aged Chinese women, type II diabetes risk was 78% greater in those consuming more than 300 g rice/day relative to those eating <200 g/day.
Whereas white rice has been shown to adversely affect metabolic health, brown rice may be protective."

Variety   Brand Origin  GI Portion in grams * GL   h/l
Jasmine Double FP, Thai, Double FP brand, NTUC Fairprice
Co-operative Ltd., Singapore
Thailand 68 - 31 medium
Jasmine Double FP Thai Hom Mali premium quality
fragrant rice
Thailand 90-92 63.6 41 high
Jasmine Jazzmen, Jazzmen Rice,
Inc., USA
USA 106 68.8 48 high
Jasmine Mahatma, Riviana Foods
Thailand 115 62.5 52 high
Jasmine Reindeer, Oriental
Jasmine Rice Co.
Thailand 116 62.5 52 high
Glutinous Bangsue Chia
Meng Rice Co., Bangkok
Thailand 94-98 65.5 42 high
Glutinous (waxy) low-amylose, boiled for 20 min Thailand 75 - 34 high
Black Adan Indonesia 64 29 medium
Black waxy, Oryza sativa China 100 66.1 45 high
Brown Doongara, SunRice; Ricegrowers Ltd., NSW Australia 51-72 69.9 23 low-medium
Brown Oryza Sativa, India India 50 96 23 low
Brown high amylose, rice, boiled 30 min Philippines 40-59 - 18-27 low-medium
Red Red rice, Thai, unpolished Thailand 76 67.4 34 medium
Broken Rice Lion foods,
Thailand 68 63.2 39 medium
White No Brand, high-amylose Philippines 43-67 - 28 low-medium
* Grams of rice required to serve a net 50 grams of carbohydrates for test purposes.

♦ Various Carbohydrates and their GI
Sugars GI
Maltose 105
Glucose 100
Rice Syrup 98
Sucrose/Table Sugar 65
Lactose 46
Fructose 23

♦ Sources of various Carbohydrates
Mono-saccharides      Source GI Di-saccharides      Source GI
Glucose Blood Sugar, Whole Grains, Legumes, Vegetables 100 Sucrose Table Sugar, Sweetened processed Foods 65
Galactose Milk/Dairy Foods, Legumes, Figs 25 Lactose Milk, Milk Products 45
Fructose Fruits, Honey, Vegetables, Soft Drinks, Corn Syrup 25 Maltose Malt, Malted Products, Beer, Lollies 105
Polysaccharides Source GI
Starch Potatoes, Pasta, Corn, White Bread, White Rice, 92-101
Glycogen Form of body's energy storage; to be re-converted to glucose. Found in some plants, Microorganisms
Cellulose Structural molecule of plants

  • [1α] Role of aspirin in the primary prevention of cardiovascular disease in diabetes mellitus: a meta-analysis.
    OBJECTIVE: To evaluate the benefits of aspirin in people with diabetes mellitus for the primary prevention of cardiovascular disease.
    Aspirin therapy did not reduce the risk of cardiovascular events.
    Existing trials were limited by small patient numbers and low cardiovascular event rates.
    The use of aspirin cannot be routinely recommended for primary prevention of cardiovascular events in diabetes.
    Expert Opin Pharmacother. 2010 Jun;11(9):1459-66. PMID: 20429671
  • [1β] Bean and rice meals reduce postprandial glycemic response in adults with type 2 diabetes: a cross-over study
    Around the world, beans and rice are commonly consumed together as a meal. With type 2 diabetes increasing, the effect of this traditional diet pattern on glycemic response has not been studied fully.
    We evaluated the glycemic response of bean and rice traditional meals compared to rice alone in adults with type 2 diabetes.
    Postprandial net glucose values were significantly lower for the three bean/rice treatments in contrast to the rice control at 90, 120 and 150 minutes.
    Incremental area under the curve values were significantly lower for the pinto and black bean/rice meals compared to rice alone, but not for kidney beans.
    Pinto, dark red kidney and black beans with rice attenuate the glycemic response compared to rice alone.
    Promotion of traditional foods may provide non-pharmaceutical management of type 2 diabetes and improve dietary adherence with cultural groups.
    PMCID: PMC3489574 PMID: 22494488
  • [1γ] Identification of a Major Genetic Determinant of Glycaemic Index in Rice
    For the majority of the world’s population, polished rice is a dietary staple and has been since its domestication many thousands of years ago (Sweeney and McCouch 2007).
    It serves as the primary source of dietary energy and carbohydrates for most Asians, and increasingly for Africans, especially those in poorer urban and rural communities (www.irri.org).
    However, prospective cohort studies in genetically divergent populations show that white rice consumption is associated with increased risk of developing type II diabetes independent of ethnicity (Murakami et al. 2006; Sun et al. 2010).
    In a study of middle-aged Chinese women, type II diabetes risk was 78% greater in those consuming more than 300 g rice/day relative to those eating <200 g/day (Villegas et al. 2007).
    Whereas white rice has been shown to adversely affect metabolic health, brown rice may be protective. In a study of US men and women, a moderate inverse association between diabetes risk and brown rice consumption was observed (Sun et al. 2010); however, varietal differences were not taken into account.
    Identification of a Major Genetic Determinant of Glycaemic Index in Rice.
  • [1Δ] Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes.
    Rosiglitazone is widely used to treat patients with type 2 diabetes mellitus, but its effect on cardiovascular morbidity and mortality has not been determined.
    In the rosiglitazone group, as compared with the control group, the odds ratio for myocardial infarction was 1.43 (95% confidence interval [CI], 1.03 to 1.98; P=0.03),
    and the odds ratio for death from cardiovascular causes was 1.64 (95% CI, 0.98 to 2.74; P=0.06).
    Rosiglitazone was associated with a significant increase in the risk of myocardial infarction and with an increase in the risk of death from cardiovascular causes that had borderline significance.
    N Engl J Med. 2007 Jun 14;356(24):2457-71. Epub 2007 May 21. PMID: 17517853
  • [1δ] All-cause mortality in diabetic patients treated with combinations of sulfonylureas and biguanides.
    After adjusting for other potential confounders (including age, duration of diabetes, BMI, hypertension, lipid profile, HbA1c, and insulin treatment), mortality was significantly higher in patients treated with combinations of sulfonylureas and biguanides than in the rest of the sample, (relative risk, RR: 2.08; 95% confidence interval, CI 1.18-3.67, and RR: 1.68; 95%CI 1.01-2.79 among women and men, respectively).
    A higher mortality was observed in patients treated with combinations of sulfonylureas and biguanides, even at low doses.
    Safety of such combinations deserves further investigation.

    Diabetes Metab Res Rev. 2004 Jan-Feb;20(1):44-7. PMID: 14737744

♦ References: Causes
  • [α] Intake of fruit juice and incidence of type 2 diabetes: a systematic review and meta-analysis.
    A total of four studies (191,686 participants, including 12,375 with type 2 diabetes) investigated the association between sugar-sweetened fruit juice and risk of incident type 2 diabetes, and four studies (137,663 participants and 4,906 cases) investigated the association between 100% fruit juice and risk of incident type 2 diabetes.
    A higher intake of sugar-sweetened fruit juice was significantly associated with risk of type 2 diabetes (RR = 1.28, 95%CI = 1.04-1.59, p = 0.02), while intake of 100% fruit juice was not associated with risk of developing type 2 diabetes (RR = 1.03, 95% CI = 0.91-1.18, p = 0.62).
    Our findings support dietary recommendations to limit sugar-sweetened beverages, such as fruit juice with added sugar, to prevent the development of type 2 diabetes.PLoS One. 2014 ;9(3):e93471. Epub 2014 Mar 28. PMID: 24682091
  • [β] A higher ratio of beans to white rice is associated with lower cardiometabolic risk factors in Costa Rican adults
    A high intake of white rice is associated with the metabolic syndrome and type 2 diabetes.
    Costa Ricans follow a staple dietary pattern that includes white rice and beans, yet the combined role of these foods on cardiometabolic risk factors has not been studied.
    An increase in daily servings of white rice was positively associated with systolic blood pressure (BP), triglycerides, and fasting glucose and inversely associated with HDL cholesterol (P-trend <0.01 for all).
    An increase in servings of beans was inversely associated with diastolic BP (P = 0.049). Significant trends for higher HDL cholesterol and lower BP and triglycerides were observed for 1:3, 1:2, 1:1, and 2:1 ratios of beans to white rice.
    Substituting one serving of beans for one serving of white rice was associated with a 35% (95% CI: 15%, 50%) lower risk of the metabolic syndrome.
    Increasing the ratio of beans to white rice, or limiting the intake of white rice by substituting beans, may lower cardiometabolic risk factors.
    PMCID: PMC3155926 PMID: 21813808
  • [γ] White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review.
    To summarise evidence on the association between white rice consumption and risk of type 2 diabetes and to quantify the potential dose-response relation.
    Asian (Chinese and Japanese) populations had much higher white rice consumption levels than did Western populations (average intake levels were three to four servings/day versus one to two servings/week).
    The pooled relative risk was 1.55 (95% confidence interval 1.20 to 2.01) comparing the highest with the lowest category of white rice intake in Asian populations, whereas the corresponding relative risk was 1.12 (0.94 to 1.33) in Western populations (P for interaction=0.038).
    In the total population, the dose-response meta-analysis indicated that for each serving per day increment of white rice intake, the relative risk of type 2 diabetes was 1.11 (1.08 to 1.14) (P for linear trend<0.001).
    Higher consumption of white rice is associated with a significantly increased risk of type 2 diabetes, especially in Asian (Chinese and Japanese) populations.
    DOI: 10.1136/bmj.e1454 PMID: 22422870 PMCID: PMC3307808
  • [Δ] Use of antidepressant medication and risk of type 2 diabetes: results from three cohorts of US adults.
    The results of several studies have suggested a potential positive association between use of antidepressant medication (ADM) and incident type 2 diabetes mellitus.
    During 1,644,679 person-years of follow-up, we documented 6,641 new cases of type 2 diabetes.
    ADM use was associated with an increased risk of diabetes in all three cohorts in age-adjusted models (pooled HR 1.68 [95% CI 1.27, 2.23]).
    Diabetologia. 2011 Aug 3. Epub 2011 Aug 3. PMID: 21811871
  • [ε] High fructose corn syrup and diabetes prevalence: A global perspective.
    The overall aim of this study was to evaluate, from a global and ecological perspective, the relationships between availability of high fructose corn syrup (HFCS) and prevalence of type 2 diabetes.
    Diabetes prevalence was 20% higher in countries with higher availability of HFCS compared to countries with low availability, and these differences were retained or strengthened after adjusting for country-level estimates of body mass index (BMI), population and gross domestic product (adjusted diabetes prevalence=8.0 vs. 6.7%, p=0.03; fasting plasma glucose=5.34 vs. 5.22 mmol/L, p=0.03) despite similarities in obesity and total sugar and calorie availability.
    These results suggest that countries with higher availability of HFCS have a higher prevalence of type 2 diabetes independent of obesity.
    Glob Public Health. 2012 Nov 27. Epub 2012 Nov 27. PMID: 23181629
  • [η] Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction.
    Higher consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes,
    by 18% per one serving/day (95% confidence interval 9% to 28%, I(2) for heterogeneity = 89%) and 13% (6% to 21%, I(2) = 79%) before and after adjustment for adiposity;
    artificially sweetened beverages, 25% (18% to 33%, I(2) = 70%) and 8% (2% to 15%, I(2) = 64%);
    and for
    fruit juice, 5% (-1% to 11%, I(2) = 58%) and 7% (1% to 14%, I(2) = 51%).
    BMJ. 2015 Jul 21 ;351:h3576. Epub 2015 Jul 21. PMID: 26199070
  • [ι] Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis.
    In 5 statin trials with 32,752 participants without diabetes at baseline, 2749 developed diabetes (1449 assigned intensive-dose therapy, 1300 assigned moderate-dose therapy, representing 2.0 additional cases in the intensive-dose group per 1000 patient-years) and 6684 experienced cardiovascular events (3134 and 3550, respectively, representing 6.5 fewer cases in the intensive-dose group per 1000 patient-years) over a weighted mean (SD) follow-up of 4.9 (1.9) years.
    Odds ratios were 1.12 (95% confidence interval [CI], 1.04-1.22; I(2) = 0%) for new-onset diabetes and 0.84 (95% CI, 0.75-0.94; I(2) = 74%) for cardiovascular events for participants receiving intensive therapy compared with moderate-dose therapy.
    As compared with moderate-dose statin therapy, the number needed to harm per year for intensive-dose statin therapy was 498 for new-onset diabetes while the number needed to treat per year for intensive-dose statin therapy was 155 for cardiovascular events.
    JAMA. 2011 Jun 22;305(24):2556-64. PMID: 21693744
  • [κ] Endocrine-disrupting chemicals, risk of type 2 diabetes, and diabetes-related metabolic traits: A systematic review and meta-analysis.
    METHODS: MEDLINE was searched for cross-sectional and prospective studies published before 8 March 2014 into the association between EDCs (dioxin, polychlorinated biphenyl [PCB], chlorinated pesticide, bisphenol A [BPA], phthalate) and T2D and related metabolic traits. Three investigators independently extracted information on study design, participant characteristics, EDC types and concentrations, and association measures.
    Forty-one cross-sectional and eight prospective studies from ethnically diverse populations were included in the analysis.
    Serum concentrations of dioxins, PCBs, and chlorinated pesticides were significantly associated with T2D risk; comparing the highest to lowest concentration category, the pooled relative risks (RR) were
    » 1.91 (95% confidence interval [CI] 1.44-2.54) for dioxins,
    » 2.39 (95% CI 1.86-3.08) for total PCBs, and
    » 2.30 (95% CI 1.81-2.93) for chlorinated pesticides.
    Urinary concentrations of BPA and phthalates were also associated with T2D risk; comparing the highest to lowest concentration categories, the pooled RR were
    » 1.45 (95% CI 1.13-1.87) for BPA and
    » 1.48 (95% CI 0.98-2.25) for phthalates.
    Further, EDC concentrations were associated with indicators of impaired fasting glucose and insulin resistance.
    J Diabetes. 2015 Jun 29. Epub 2015 Jun 29. PMID: 26119400
  • [λ] Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a meta-analysis.
    The pooled relative risks per 2 hours of TV viewing per day were
    » 1.20
    (95% CI, 1.14-1.27) for type 2 diabetes,
    » 1.15 (95% CI, 1.06-1.23) for fatal or nonfatal cardiovascular disease, and
    » 1.13 (95% CI, 1.07-1.18) for all-cause mortality.
    While the associations between time spent viewing TV and risk of type 2 diabetes and cardiovascular disease were linear, the risk of all-cause mortality appeared to increase with TV viewing duration of greater than 3 hours per day.
    The estimated absolute risk differences per every 2 hours of TV viewing per day were 176 cases of type 2 diabetes per 100,000 individuals per year, 38 cases of fatal cardiovascular disease per 100,000 individuals per year, and 104 deaths for all-cause mortality per 100,000 individuals per year.
    Prolonged TV viewing was associated with increased risk of type 2 diabetes, cardiovascular disease, and all-cause mortality.
    JAMA. 2011 Jun 15;305(23):2448-55. PMID: 21673296
  • [μ] Medications affecting the biochemical conversion to type 2 diabetes: A systematic review and meta-analysis.
    The extent to which some pharmacological interventions reduce or increase the risk of biochemical conversion to T2DM in at-risk individuals is unclear.
    We included 43 trials with 192,156 subjects (mean age 60 years; 56% men; mean BMI 30.4 kg/m2).
    Alpha-glucosidase inhibitors, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, metformin, orlistat, phentermine-topiramate and pioglitazone significantly reduced the risk of biochemical conversion to T2DM, whereas statins and nateglinide increased the risk.
    There was insufficient direct evidence regarding the effects of sulfonylureas, glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors and sodium-glucose cotransporter-2 inhibitors.
    J Clin Endocrinol Metab. 2019 Jul 31. Epub 2019 Jul 31. PMID: 31365088
  • [δ] Bisphenol A exposure and type 2 diabetes mellitus risk: a meta-analysis.
    A total of 41,320 subjects were included.
    Fourteen of the sixteen studies included in the analysis provided measurements of urine bisphenol A levels and two study provided serum bisphenol A levels.
    Bisphenol A concentrations in human bio-specimens showed positive associations with T2DM risk (OR 1.28, 95% CI 1.14, 1.44).
    A sensitivity analysis indicated that urine bisphenol A concentrations were positively associated with T2DM risk (OR 1.20, 95% CI 1.09, 1.31).
    This meta-analysis indicated that Bisphenol A exposure is positively associated with T2DM risk in humans.
    BMC Endocr Disord. 2018 Nov 6 ;18(1):81. Epub 2018 Nov 6. PMID: 30400886
  • [Ε] Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence from the E3N-European Prospective Investigation into Cancer and Nutrition Study.
    The influence of artificial sweeteners on metabolic diseases is controversial. Artificially sweetened beverages have been associated with an increased risk of type 2 diabetes (T2D) but biases and reverse causation have been suspected to have influenced the observed association. In addition, it has been suggested that investigation into the relationship between the frequency and duration of the consumption of packet or tablet artificial sweeteners and T2D risk is necessary.
    Compared to "never or rare" consumers of artificial sweeteners, those using them "always or almost always" had an increased risk of T2D (HR = 1.83 [95% CI 1.66-2.02] in the multivariate model [MM], HR = 1.33 [95% CI 1.20-1.47] when further adjusted for body mass index, BMI).
    Women consuming artificial sweeteners in packets or tablets for more than 10 years also had an increased risk of T2D compared to never or rare users (HR = 2.10 [95% CI 1.83-2.40] in the MM and HR = 1.15 [95% CI 1.00-1.33] when adjusted for BMI, respectively).
    Our data suggest that both a higher frequency and a longer consumption of artificial sweeteners in packets or tablets was associated with T2D risk, independently of major T2D risk factors, but partially mediated by adiposity.
    Ann Nutr Metab. 2017 Feb 18 ;70(1):51-58. Epub 2017 Feb 18. PMID: 28214853

♦ References: Prophylactics & Treatments
  • [1] Association between physical activity advice only or structured exercise training with blood pressure levels in patients with type 2 diabetes: a systematic review and meta-analysis.
    BACKGROUND: Diabetes is associated with marked cardiovascular morbidity and mortality.
    OBJECTIVE: The aim of this systematic review and meta-analysis of randomized controlled clinical trials (RCTs) was to determine the effects of structured exercise training (aerobic [AER], resistance [RES], or combined [COMB]) and physical activity (PA) advice only on BP changes in patients with type 2 diabetes.
    AER, RES, and high-intensity combined training are associated with BP reduction in patients with type 2 diabetes, especially in exercise programs lasting more than 150 min/week.
    Physical Activity advice only is also associated with lower Blood Pressure levels.
    Sports Med. 2014 Nov ;44(11):1557-72. PMID: 25047852
  • [2] White Rice, Brown Rice, and Risk of Type 2 Diabetes in US Men and Women
    Because of a different degree of processing and nutrient contents, brown rice and white rice may have different effects on risk of type 2 diabetes.
    During 3,318,196 person-years of follow-up, we documented 10,507 incident cases of type 2 diabetes. After multivariate adjustment for age and other lifestyle and dietary risk factors, higher intake of white rice was associated with a higher risk of type 2 diabetes.
    The pooled relative risk (95% confidence interval) of type 2 diabetes comparing ≥5 servings/week with <1 serving/month of white rice was 1.17 (1.02, 1.36). In contrast, high brown rice intake was associated with a lower risk of type 2 diabetes: The pooled multivariate relative risk (95% confidence interval) was 0.89 (0.81, 0.97) for ≥ 2 servings/week of brown rice as compared with <1 serving/month.
    We estimated that replacing 50 grams/day (cooked, equivalent to ⅓ serving/day) intake of white rice with the same amount of brown rice was associated with a 16% (95% confidence interval: 9%, 21%) lower risk of type 2 diabetes, whereas the same replacement with whole grains as a group was associated with a 36% (95% confidence interval: 30%, 42%) lower diabetes risk.
    Substitution of whole grains, including brown rice, for white rice may lower risk of type 2 diabetes.
    These data support the recommendation that most carbohydrate intake should come from whole grains rather than refined grains to facilitate the prevention of type 2 diabetes.
    DOI: 10.1001/archinternmed.2010.109 PMID: 20548009 PMCID: PMC3024208
  • [3] Effect of brown seaweed on plasma glucose in healthy, at-risk, and type 2 diabetic individuals: systematic review and meta-analysis.
    CONTEXT: Sustained hyperglycemia triggers chronic disease, including type 2 diabetes.
    Meta-analyses showed a significant effect, favoring the intervention group for both fasting (mean difference -4.6 [95% CI -7.88, -1.33]) and postprandial (mean difference -7.1 [95% CI -7.4, -6.9]) plasma glucose.
    Brown seaweed and its extracts show potential for preventing and managing hyperglycemia.
    Our meta-analysis confirms that brown seaweed positively affects plasma glucose homeostasis, with particularly promising postprandial plasma glucose effects.
    Nutr Rev. 2021 Sep 21. Epub 2021 Sep 21. PMID: 34549293
  • [4] Cinnamon intake lowers fasting blood glucose: meta-analysis.
    Cinnamon, the dry bark and twig of Cinnamomum spp., is a rich botanical source of polyphenolics that has been used for centuries in Chinese medicine and has been shown to affect blood glucose and insulin signaling.
    Cinnamon intake, either as whole cinnamon or as cinnamon extract, results in a statistically significant lowering in Fasting Blood Glucose (-0.49±0.2 mmol/L; n=8, P=.025) and intake of cinnamon extract only also lowered FBG (-0.48 mmol/L±0.17; n=5, P=.008).
    Thus cinnamon extract and/or cinnamon improves Fasting Blood Glucose in people with type 2 diabetes or prediabetes.
    J Med Food. 2011 Sep ;14(9):884-9. Epub 2011 Apr 11. PMID: 21480806
  • [5] Effect of cinnamon supplementation on blood pressure and anthropometric parameters in patients with type 2 diabetes: A systematic review and meta-analysis of clinical trials.
    This meta-analysis found a significant reduction in systolic blood pressure (SBP) (SMD: -0.532, 95% CI: [-1.032, -0.033], P = 0.037) and diastolic blood pressure (DBP) (SMD: -0.681, 95% CI: [-1.297, -0.065], P = 0.030) of patients with type 2 diabetes following cinnamon supplementation.
    Cinnamon supplementation significantly decreased SBP and DBP of patients with type 2 diabetes.
    Diabetes Metab Syndr. 2020 Jan 30 ;14(2):119-125. Epub 2020 Jan 30. PMID: 32032898
  • [6] Effect of garlic supplement in the management of type 2 diabetes mellitus (T2DM): a meta-analysis of randomized controlled trials.
    The present study was designed to systematically evaluate the clinical efficacy and safety of garlic supplement in the management of type 2 diabetes mellitus (T2DM).
    Nine RCTs involving 768 T2DM patients were included in the meta-analysis, and the dose of daily garlic (allicin) supplement ranged from 0.05g to 1.5g.
    A significant reduction in the level of fasting blood glucose in 1-2 weeks [SMD = -1.61, 95%CI (-2.89, -0.32)], 3-4 weeks [SMD = -2.87, 95%CI (-4.74, -1.00)], 12 weeks [SMD = -9.57, 95%CI (-12.39, -6.75)], and 24 weeks [SMD = -21.02, 95%CI (-32.47, -9.57)] was achieved in favour of the garlic group rather than the control group. Significantly decreased fructosamine and glycated hemoglobin (both in 12 and 24 weeks) were also found in garlic group.
    Meanwhile, significantly improved blood liquids of total cholesterol [SMD = -1.93, 95%CI (-2.98, -0.87), 3-4 weeks], high density lipoprotein [SMD = -0.41, 95%CI (-0.83, -0.00), 3-4 weeks] and low density lipoprotein [SMD = -3.47, 95%CI (-5.76, -1.18), 12 weeks] were confirmed after garlic administration.
    Current data confirms that garlic supplement plays positive and sustained roles in blood glucose, total cholesterol, and high/low density lipoprotein regulation in the management of T2DM.
    Food Nutr Res. 2017 ;61(1):1377571. Epub 2017 Sep 27. PMID: 29056888
  • [7] Nigella sativa improves glucose homeostasis and serum lipids in type 2 diabetes: A systematic review and meta-analysis.
    Seven trials were included in the meta-analysis of glycemic and serum lipid profile end points.
    Supplementation with N. sativa significantly improved fasting blood sugar (FBS) [-17.84mg/dl, 95% CI: -21.19 to -14.49, p<0.001], HbA1c [-0.71%, 95% CI: -1.04 to -0.39, p<0.001], total-cholesterol (TC) [WMD: -22.99mg/dl, 95% CI: -32.16 to -13.83, p<0.001] and LDL-cholesterol (LDL-c) [-22.38mg/dl, 95% CI: -33.60 to -11.15, p<0.001].
    Subgroup analysis revealed significant reduction on Triglyceride (TG) with N. sativa seed oil [-14.8mg/dl, 95% CI: -23.1 to -6.5, p<0.001], while TG was increased with seed powder [29.4mg/dl, 95% CI: 16.9-42.0, p<0.001].
    Complement Ther Med. 2017 Dec ;35:6-13. Epub 2017 Aug 30. PMID: 29154069
  • [8] Effect of Nigella sativa seeds on the glycemic control of patients with type 2 diabetes mellitus
    The Effect of N. sativa seeds on the glycemic control of patients with type 2 diabetes mellitus was investigated in 2010.
    N. sativa seeds were used as an adjuvant therapy in patients with diabetes mellitus type 2 added to their anti-diabetic medications.
    N. sativa at a dose of 2 gm/day caused significant reductions in fasting blood glucose, 2 h postprandially (2 hPG), and glycosylated hemoglobin (HbA1c) without significant change in body weight.
    The results indicate that a dose of 2 gm/day of black seed might be a beneficial adjuvant to oral hypoglycemic agents in type 2 diabetic patients[53].
    PMID: 21675032
  • [9] Effectiveness of Medicinal Plants for Glycaemic Control in Type 2 Diabetes: An Overview of Meta-Analyses of Clinical Trials
    Aims: To rank the effectiveness of medicinal plants for glycaemic control in Type 2 Diabetes (T2DM).
    Twenty five meta-analyses reported the effects of 18 plant-based remedies.
    Aloe vera leaf gel
    Psyllium fibre
    Fenugreek seeds

    had the largest effects on HbA1c: mean difference -0.99% [95% CI-1.75, -0.23], -0.97% [95% CI -1.94, -0.01] and -0.85% [95% CI -1.49, -0.22] respectively.

    Herbs most effective treating Diabetes
    (highlighted, green)
    Four other remedies reduced HbA1c by at least 0.5%:
    Nigella sativa,
    Astragalus membranaceus,

    and the traditional Chinese formulae
    Jinqi Jiangtang and
    Gegen Qinlian.

    No serious adverse effects were reported. Several other herbal medicines significantly reduced FPG.
    Front Pharmacol. 2021 ;12:777561. Epub 2021 Nov 26. PMID: 34899340
  • [10] Influence of the intervention of exercise on obese type II diabetes mellitus: A meta-analysis.
    A subset of 13 eligible studies was selected.
    Exercise significantly reduced the concentration of high sensitivity C reactive protein (4 months:
    WMD=-1.03, 95% CI: -1.77 to -0.29, P<0.01),
    triglyceride (6 months: WMD=-24.75, 95% CI: -27.67 to -21.83, P<0.01),
    diastolic blood pressure (6 months: WMD=-2.70, 95% CI: -4.12 to -1.28, P=0.0002),
    systolic blood pressure (WMD=-7.98, 95% CI: -9.87 to -6.08, P<0.01)),
    HbA1c (4 months: WMD=-0.25, 95% CI: -0.49 to -0.02, P=0.04) and
    homeostasis model assessment-insulin resistance (3 months:
    WMD=-0.19, 95% CI: -0.37 to -0.01, P=0.04); and a pronounced increase of HDL-C (12 months: WMD=3.57, 95% CI: 1.92 to 5.21, P<0.01).
    Exercise was beneficial to obese T2DM patients.
    Prim Care Diabetes. 2015 Nov 6. Epub 2015 Nov 6. PMID: 26553963
  • [11] Effects of Vitamin C Supplementation on Glycemic Control and Cardiovascular Risk Factors in People With Type 2 Diabetes: A GRADE-Assessed Systematic Review and Meta-analysis of Randomized Controlled Trials.
    Evidence suggests that vitamin C supplementation could be a potential therapy in type 2 diabetes.
    Twenty-eight studies (= 1,574 participants) were included in the review.
    Outcomes that changed to a statistically and clinically significant extent with vitamin C were systolic BP (mean difference -6.27 [95% CI -9.60, -2.96] mmHg;= 0.0002), with moderate evidence certainty, and HbA(-0.54% [-0.90, -0.17];= 0.004) and diastolic BP (-3.77 [-6.13, -1.42] mmHg;= 0.002) with very low evidence certainty.
    Studies were predominantly short term (<6 months) with a small number of participants (<100).
    While evidence from short-term studies suggests that vitamin C supplementation may improve glycemic control and BP in people with type 2 diabetes, vitamin C supplementation cannot currently be recommended as a therapy until larger, long-term, and high-quality trials confirm these findings.
    Diabetes Care. 2021 Feb ;44(2):618-630. PMID: 33472962
  • [12] Fructo-oligosaccharides and glucose homeostasis: a systematic review and meta-analysis in animal models.
    The aim of this systematic review was to assess the effect of fructo-oligosaccharide supplementation on glucose homeostasis.
    The consumption of fructo-oligosaccharides decreased fasting blood glycaemia levels, whatever the metabolic status (healthy, obese or diabetic) and diet (low-fat or high-fat) throughout the experiment.
    This reduction was linear with prebiotic dose (from 0 to 13% of the feed).
    Fasting insulinaemia also decreased linearly with fructo-oligosaccharide supplementation but the reduction was only significant in rodents fed a low-fat diet. Potential underlying mechanisms include gut bacterial fermentation of fructo-oligosaccharides to short-chain fatty acids (SCFA) and bacterial modulation of bile acids, both interacting with host metabolism.
    This systemic review, followed by the meta-analysis, provides evidence that fructo-oligosaccharide supplementation has a significant effect on glucose homeostasis whatever the health status and diet consumed by animals.
    Nutr Metab (Lond). 2018 ;15:9. Epub 2018 Jan 25. PMID: 29416552
  • [13] Effects of Ginkgo biloba intake on cardiometabolic parameters in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of clinical trials.
    Seven studies comprising 768 subjects were included in the present meta-analysis which resulted in a significant effect of GKB on hemoglobin A1c (HbA1c) (WMD = 0.26, 95% CI = [0.02, 0.50], p = .034) and serum HDL-cholesterol levels (WMD = 1.99, 95% CI = [0.19, 3.79], p = .030) with no significant publication bias.
    GKB can significantly modulate HbA1c and HDL-cholesterol levels.
    However, due to uncertainties related to the limited number of studies, it is too early to conclude whether GKB has any potential effects on the cardiometabolic factors in patients with T2DM or not.
    Phytother Res. 2020 Oct 8. Epub 2020 Oct 8. PMID: 33090588
  • [14] Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus: a systematic review with meta-analysis.
    Coffee consumption has been reported to be inversely associated with risk of type 2 diabetes mellitus.
    Similar associations have also been reported for decaffeinated coffee and tea.
    We found an inverse log-linear relationship between coffee consumption and subsequent risk of diabetes such that every additional cup of coffee consumed in a day was associated with a 7% reduction in the excess risk of diabetes relative risk, 0.93 [95% confidence interval, 0.91-0.95]) after adjustment for potential confounders.
    Owing to the presence of small-study bias, our results may represent an overestimate of the true magnitude of the association.
    Similar significant and inverse associations were observed with decaffeinated coffee and tea and risk of incident diabetes.
    High intakes of coffee, decaffeinated coffee, and tea are associated with reduced risk of diabetes.
    The putative protective effects of these beverages warrant further investigation in randomized trials.
    Arch Intern Med. 2009 Dec 14 ;169(22):2053-63. PMID: 20008687
  • [15] Fruit and vegetable intake and risk of type 2 diabetes mellitus: meta-analysis of prospective cohort studies.
    The summary relative risk of type 2 diabetes for an increase of 1 serving fruit consumed/day was 0.93 (95% CI 0.88 to 0.99) without heterogeneity among studies (p=0.477, I(2)=0%).
    For vegetables, the combined relative risk of type 2 diabetes for an increase of 1 serving consumed/day was 0.90 (95% CI 0.80 to 1.01) with moderate heterogeneity among studies (p=0.002, I(2)=66.5%).
    For green leafy vegetables, the summary relative risk of type 2 diabetes for an increase of 0.2 serving consumed/day was 0.87 (95% CI 0.81 to 0.93) without heterogeneity among studies (p=0.496, I(2)=0%).
    Higher fruit or green leafy vegetables intake is associated with a significantly reduced risk of type 2 diabetes.
    BMJ Open. 2014 ;4(11):e005497. Epub 2014 Nov 5. PMID: 25377009
  • [16] Moringa Oleifera Lam. in Diabetes Mellitus: A Systematic Review and Meta-Analysis
    The present meta-analyses demonstrated that blood glucose, TG, and TC levels were significantly reduced in diabetic rodent models treated with MO extracts.
    The outcome of animal studies might not be immediately translated into the human condition because of the biophysiological diversity between species.
    However, our analyses could shed light on a future more practical use of the MO for the prevention and treatment of DM and its associated dyslipidemia in humans.
    Finally, it could have a profound impact on an increasing number of pre-diabetic patients worldwide, in particular, if herbal extracts such as MO could be developed as natural nutraceuticals for prevention, delayed onset, or progress of DM.
    PMCID: PMC8229498 PMID: 34207664
  • [17] Oral administration of mangiferin ameliorates diabetes in animal models: a meta-analysis and systematic review.
    The overall pooled estimate of standardized mean difference (SMD) of mangiferin's effect on blood glucose was -1.27 (95% confidence interval [CI]: -1.71, -0.82, P<.00001).
    Body weight increased in lean diabetic animals with an SMD of 1.41 (95% CI: 0.57, 2.25; P = .001), while it decreased in obese diabetic animals with an SMD of -0.92 (95% CI: -1.69, -0.14; P = .02).
    Mangiferin intake reduced serum total cholesterol and triglycerides levels with SMDs of -1.02 (95% CI: -1.43, -0.61; P<.001) and -1.24 (95% CI: -1.70, -0.79; P<.001), respectively.
    The meta-analysis suggests that oral intake of mangiferin has a significant antidiabetic effect in animal models, and the systematic review suggested that this function might be attributed to its anti-inflammatory and antioxidative properties, as well as to its function of improving glycolipid metabolism and enhancing insulin signaling.
    Nutr Res. 2021 03 ;87:57-69. Epub 2020 Dec 25. PMID: 33601215
  • [18] Effectiveness of passion fruit peel flour (passiflora edulis l.) Versus turmeric flour (curcuma longa l.) On glycemic control: systematic review and meta-analysis.
    A total of 565 studies were identified from which 11 met the inclusion and exclusion criteria.
    Through isolated analysis, the effectiveness of turmeric flour on glycemic control was in the order of 0.73 CI (Confidence Interval) (from 0.68 to 0.79) and the effectiveness of passion fruit peel flour was 0.32 CI (0.23 to 0.45).
    The joint analysis resulted in 0.59 CI (0.52 to 0.68).
    The assessment of blood glucose was by glycated hemoglobin levels. All values were significant at a p<0.05 level.
    Both interventions showed significant effects on glycemic control.
    Curr Diabetes Rev. 2019 Oct 26. Epub 2019 Oct 26. PMID: 31738145
  • [19] The effect of probiotic and synbiotic supplementation on biomarkers of inflammation and oxidative stress in diabetic patients: a systematic review and meta-analysis of randomized controlled trials.
    The role of gut microbiota in the management of diabetes has been shown.
    Pooled data from these trials demonstrated that
    probiotic and synbiotic consumption significantly decreased
    » hs-CRP (high-sensitivity C-reactive protein) level
    (standardized mean difference) [SMD]=-0.38; 95% confidence interval [CI]:-0.51,-0.24; P = 0.000) and MDA (SMD=-0.61; 95% CI: -0.89, -0.32; P = 0.000) in diabetic patients compared to those in subjects receiving placebos.
    In addition, probiotic and synbiotic supplementation was found to
    » increase Total Antioxidant Capacity (TAC) (SMD = 0.31; 95% CI: 0.09, 0.52; P = 0.006),
    » Nitric Oxide (NO) (SMD, 0.62; 95% CI, 0.25 to 0.99; P = 0.001) and
    » Glutathione (GSH) (SMD = 0.41; 95% CI: 0.26, 0.55, P = 0.000) levels.
    The results of this systematic review and meta-analysis suggest that probiotic and synbiotic supplementation may help to improve biomarkers of inflammation and oxidative stress in diabetic patients.
    Pharmacol Res. 2019 Feb 19. Epub 2019 Feb 19. PMID: 30794924
  • [20] Effect of Probiotics on Glucose and Lipid Metabolism in Type 2 Diabetes Mellitus: A Meta-Analysis of 12 Randomized Controlled Trials.
    This meta-analysis aimed to summarize the effect of probiotics on glucose and lipid metabolism and C-reactive protein (CRP) from 12 randomized controlled trials (RCTs).
    A total of 12 studies (684 patients) were entered into the final analysis.
    The effect of probiotics was significant on reducing
    » HbA1c level
    (standardized mean difference [SMD], -0.38; confidence interval [CI], -0.62 to -0.14, P=0.002; I²=0%, P=0.72 for heterogeneity),
    » fasting insulin level (SMD, -0.38; CI -0.59 to -0.18, P=0.0003; I²=0%, P=0.81 for heterogeneity), and
    » HOMA-IR (SMD, -0.99; CI -1.52 to -0.47, P=0.0002; I²=86%, P<0.00001 for heterogeneity).
    Pooled results on effects of probiotics on FPG, CRP, or lipid profile were either non-significant or highly heterogeneous.
    This meta-analysis demonstrated that probiotics supplementation was associated with significant improvement in HbA1c and fasting insulin in type 2 diabetes patients.
    Med Sci Monit. 2017 Jun 22 ;23:3044-3053. Epub 2017 Jun 22. PMID: 28638006
  • [21] The antidiabetic effect of thymoquinone: A systematic review and meta-analysis of animal studies.
    Thymoquinone (2-isopropyl-5-methylbenzo-1, 4-quinone) (TQ) is a quinone derivative with a yellow crystalline appearance, abundantly found in black cumin, Nigella sativa L. TQ has diverse pharmacological properties.
    In the meta-analysis it was found that with an overall pooled standardized mean difference (SMD) of -9.176 mg/dl (95%CI: -10.759, -7.593; p = 0.000);
    Thymoquinone (TQ) reduced the Serum Glucose (SG) level (-9.176 mg/dl) significantly in the STZ-induced diabetes model.
    Moreover, a meta-analysis of the effect of TQ on Body Weight (BW) demonstrated that TQ has a statistically significant effect on the Body Weight (BW) of diabetic animals with an overall pooled SMD of 4.509 (95%CI: 3.234, 5.784; p = 0.000).
    In addition, the overall pooled estimate of the level of serum insulin was significant with SMD of 1.681 (95%CI: 0.858, 2.503; p = 0.000).
    Therefore, the meta-analysis showed that TQ has a significant antidiabetic effect through its action on the SG, serum insulin level, and BW of the animals.
    Food Res Int. 2020 Jan ;127:108736. Epub 2019 Oct 15. PMID: 31882078
  • [22] Effect of Aloe vera on glycaemic control in prediabetes and type 2 diabetes: a systematic review and meta-analysis.
    WHAT IS KNOWN AND OBJECTIVE: Aloe vera (Aloe vera (L.) Burm.f., Xanthorrhoeaceae family) has long been used in folk or traditional medicine for diabetes.
    Eight trials involving 470 patients (235 each for prediabetes and type 2 diabetes) were included.
    In prediabetes, Aloe vera significantly improved FPG (mean difference -0·22 mmol/L, 95% CI -0·32 mmol/L to -0·12 mmol/L, P<0·0001), with no effect on HbA1c (mean difference -2 mmol/mol, 95% CI -5 mmol/mol to 1 mmol/mol).
    Aloe vera may improve glycaemic control in type 2 diabetes, with a marginal
    improvement in Fasting Plasma Glucose (FPG) (mean differences -1·17 mmol/L, 95% CI -2·35 mmol/L to 0·00 mmol/L, P = 0·05) and a
    significant improvement in Haemoglobin A1c (HbA1c) (mean difference -11 mmol/mol, 95% CI -19 mmol/mol to -2 mmol/mol, P = 0·01).
    J Clin Pharm Ther. 2016 Apr ;41(2):180-8. Epub 2016 Mar 23. PMID: 27009750
  • [23] The effect of apple cider vinegar (ACV) on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials.
    Elevated lipid profiles and impaired glucose homeostasis are risk factors for several cardiovascular diseases (CVDs), which, subsequently, represent a leading cause of early mortality, worldwide.
    Overall, nine studies, including 10 study arms, were included in this meta-analysis.
    We found that ACV consumption significantly decreased
    » serum total cholesterol (- 6.06 mg/dL
    ; 95% CI: - 10.95, - 1.17; I: 39%),
    » fasting plasma glucose (- 7.97 mg/dL; 95% CI: - 13.74, - 2.21; I: 75%), and
    » HbA1C concentrations (- 0.50; 95% CI: - 0.90, - 0.09; I: 91%).
    The stratified analysis revealed a significant reduction of serum TC and TG in a subgroup of patients with type 2 diabetes, those who took≤15 mL/day of ACV, and those who consumed ACV for> 8-weeks, respectively.
    Furthermore, ACV consumption significantly decreased Fasting Plasma Glucose (FPG) levels in a subgroup of studies that administered ACV for> 8-weeks.
    Further, ACV intake appeared to elicit an increase in Fasting Plasma Glucose (FPG) and HDL-C concentrations in apparently healthy participants.
    We found a significant favorable effect of ACV consumption on FPG and blood lipid levels.
    BMC Complement Med Ther. 2021 Jun 29 ;21(1):179. Epub 2021 Jun 29. PMID: 34187442
  • [24] The Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
    Objective: Rhizoma Coptidis (Huang Lian) is an herb that has been frequently used in many traditional formulas for the treatment of diabetic mellitus (DM) over thousands of years. Berberine, the main active component of, has been demonstrated to have the potential effect of hypoglycemia.
    Forty-six trials were assessed.
    Analysis of berberine applied alone or with standard diabetic therapies versus the control group revealed significant reductions in HbA1c (MD = -0.73; 95% CI (-0.97, -0.51)),
    FPG (MD = -0.86, 95% CI (-1.10, -0.62)), and
    2hPG (MD = -1.26, 95% CI (-1.64, -0.89)).
    Improved insulin resistance was assessed by lowering FINS (MD = -2.05, 95% CI (-2.62, -1.48)), HOMA-IR (MD = -0.71, 95% CI (-1.03, -0.39)), and BMI (MD = -1.07, 95% CI (-1.76, -0.37)).
    Lipid metabolisms were also ameliorated via the reduction of TG (MD = -0.5, 95% CI (-0.61, -0.39)), TC (MD = 0.64, 95% CI (-0.78, -0.49)), and LDL (MD = 0.86, 95% CI (-1.06, -0.65)) and the upregulation of HDL (MD = 0.17, 95% CI (0.09, 0.25)).
    Additionally, berberine improved the inflammation factor.
    There is strong evidence supporting the clinical efficacy and safety of berberine in the treatment of DM, especially as an adjunctive therapy.
    Oxid Med Cell Longev. 2021 ;2021:2074610. Epub 2021 Dec 15. PMID: 34956436
  • [24] The effect of spirulina on type 2 diabetes: a systematic review and meta-analysis.
    Eight studies (9 arms) were included in the meta-analysis.
    We found a significant reduction in
    » fasting blood glucose (-17.88 mg/dl
    ; 95% CI: -26.99, -8.78;: 25%),
    » triglyceride (-30.99 mg/dl; 95% CI: -45.20, -16.77;: 50%),
    » total-cholesterol (-18.47 mg/dl; 95% CI: -33.54, -3.39;: 73%),
    » LDL-C (-20.04 mg/dl; 95%
    » CI: -34.06, -6.02;: 75%),
    » VLDL (-6.96 mg/dl; 95% CI: -9.71, -4.22;: 33%),
    in addition to a significant increase in HDL-C (-6.96 mg/dl; 95% CI: -9.71, -4.22;: 33%), after spirulina administration.
    No significant effect was observed on HbA1C or post prandial blood sugar following spirulina consumption.
    The present study suggests that spirulina supplementation can elicit beneficial effects on fasting blood glucose and blood lipid profiles.
    J Diabetes Metab Disord. 2021 Jun ;20(1):883-892. Epub 2021 Mar 2. PMID: 34178867
  • [25] The effects of resveratrol on glycemic control and cardiometabolic parameters in patients with T2DM: A systematic review and meta-analysis.
    This systematic review and meta-analysis, including 17 RCTs with total 871 patients with T2DM, showed that resveratrol was superior to placebo on fasting blood glucose (FBG) and total cholesterol (TC) with doses≥500mg {MD=-13.34, 95%CI [-22.73, -3.95], P=0.005}, {MD=-5.64, 95%CI [-6.95, -4.33], P<0.00001} respectively. Moreover, it improved HbA1c at three months {MD=-0.41, 95%CI [-0.65, -0.16], P=0.001 and systolic blood pressure {MD: -7.91, 95%CI [-10.44, -5.37], P<0.00001}.
    We concluded that resveratrol beneficially modulates glycemic control as well as cardiometabolic parameters in patients with T2DM.
    Med Clin (Barc). 2021 Oct 16. Epub 2021 Oct 16. PMID: 34666902
  • [26] The effect of nettle (Urtica dioica) supplementation on the glycemic control of patients with type 2 diabetes mellitus: A systematic review and meta-analysis.
    The results of the meta-analysis revealed a significant reduction in fasting blood sugar, FBS concentrations (weighted mean difference [WMD]: -18.01 mg/dl, 95% confidence interval [CI]: -30.04 to -5.97, p<.001, I= 94.6%) following nettle supplementation.
    The findings of the present study suggest that nettle supplementation may be effective in controlling FBS for T2DM patients.
    Phytother Res. 2019 Dec 4. Epub 2019 Dec 4. PMID: 31802554
  • [27] Antidiabetic activity of Embelia ribes, embelin and its derivatives: A systematic review and meta-analysis.
    Embelia ribes (ER) has been documented in Ayurveda for treating various diseases, including diabetes mellitus (DM).
    » Embelia Ribes and embelin significantly (P≤0.01) restored blood glucose (MD, -231.30; CI, -256.79, -205.82; and MD, -154.70; CI, -168.65, -140.74) and
    » glycosylated haemoglobin (MD, -6.36; CI, -8.33, -4.39; and
    MD,-4.68; CI, -7.76, -1.60), respectively.
    Meta-analysis findings also reported considerable restoration of insulin, lipid profile, haemodynamic parameters, serum and oxidative stress markers.
    The derivatives of embelin, 6-bromoembelin and vilangin, also improved diabetic condition.
    In addition, treatments also ameliorated body weight changes due to diabetes.
    The present systematic review and meta-analysis supports scientific evidence for the antidiabetic activity of ER/embelin/derivatives of embelin.
    Biomed Pharmacother. 2017 Feb ;86:195-204. Epub 2016 Dec 13. PMID: 27984799
  • [28] Effects of cocoa products intake on cardiometabolic biomarkers of type 2 diabetes patients: a systematic review and meta-analysis based on both long-term and short-term randomised controlled trials.
    Cocoa consumption as a diet has been shown to improve cardiometabolic biomarkers for T2D, but results were inconsistent.
    The cocoa products significantly decreased low
    » density lipoprotein-cholesterol
    (WMD: -9.955 mg/dL, 95% CI: -17.408, -2.501, = 0.009),
    » triglyceride (WMD: -15.364 mg/dL, 95% CI: -23.383, -7.346, < 0.001),
    » blood glucose (WMD: -9.105 mg/dL, 95% CI: -15.022, -3.189, = 0.003), and
    » C-reactive protein (WMD: -0.978 mg/L, 95% CI: -1.687, -0.269, = 0.007) in long-term.
    The results indicated the beneficial long-term effects of cocoa products intake on cardiometabolic biomarkers for T2D, especially on blood glucose, lipid metabolism (LDL-C and TG), and inflammation (CRP).
    Int J Food Sci Nutr. 2022 Mar 6:1-17. Epub 2022 Mar 6. PMID: 35253583
  • [29] The effects of vitamin D supplementation on indices of glycemic control in Iranian diabetics: A systematic review and meta-analysis.
    Vitamin D supplementation was associated with a significant improvement in
    Fasting Blood Glucose (FBG) (p = 0.001 and 95% CI: -0.526 to -0.136) and
    HbA1C (p = 0.003 and 95% CI: 1.719 to -0.361) in individuals with type 2 diabetes mellitus (T2DM); while in women with gestational diabetes mellitus (GDM) the reduction in FBG (p = 0.071 and 95% CI: -0.873 to -0.035) and HbA1C (p = 0.199 and95% CI: 3.270 to 0.681) failed to reach statistical significance.
    Treatment with vitamin D supplements was associated with an improvement in HOMA-IR in pregnant diabetic women (p = 0.028 and 95% CI: 0.924 to -0.053) and for individuals with diabetes mellitus (p = 0.005 and 95% CI: 1.772 to-0.319). The pooled result of the cross-sectional meta-analysis indicated that serum vitamin D concentrations were significantly lower in diabetic patients than in healthy controls (p = 0.018 and 95% CI: 0.587 to -0.054).
    This meta-analysis suggests that vitamin D supplementation improves indices of glycemic control (FBG, HOMA-IR, and HbA1C) in patients with diabetes mellitus. Hence, vitamin D supplements may be of potential therapeutic value in diabetic patients, as an adjuvant therapy along with other treatments.
    Complement Ther Clin Pract. 2019 Feb ;34:294-304. Epub 2018 Dec 19. PMID: 30712741
  • [30] The efficacy of propolis on markers of glycemic control in adults with type 2 diabetes mellitus: A systematic review and meta-analysis.
    Six randomized controlled trials comprising 373 participants were included in the systematic review and meta-analysis.
    The results of the meta-analysis revealed significant reductions in
    fasting plasma glucose (-13.51 mg/dl
    ; 95% CI [-24.98, -2.04]) and
    hemoglobin A1C (-0.52%; 95% CI [-0.94, -0.10]) concentrations following propolis supplementation. However, no significant lowering effect was observed in fasting insulin levels (-0.53 pmol/L; 95% CI [-1.69, 0.63]) or homeostasis model assessment of insulin resistance (-0.543; 95% CI [-1.72, 0.64]).
    This systematic review and meta-analysis suggested that propolis supplementation may be effective in controlling glycemic levels for T2DM patients.
    Phytother Res. 2019 Jun ;33(6):1616-1626. Epub 2019 Apr 5. PMID: 30950136
  • [31] Whole grain and cereal fiber intake and the risk of type 2 diabetes: a meta-analysis.
    To evaluate whole grain or cereal intake on the risk of type 2 diabetes, we collected related literature on the relationship between whole grain or cereal fiber intake and the risk of type 2 diabetes.
    A total of three studies on whole grains were included, three studies about cereal fiber, and two on both whole grains and cereal fiber.
    Eight studies contained 14,728 type 2 diabetes cases out of 434,903 subjects.
    Whole grain or cereal fiber intake is associated with type 2 diabetes (the overall RR was 0.68; 95% CI was 0.64-0.73) with significant heterogeneity in study-specific estimates (=0%,=0.452).
    Whole grain and cereal fiber intake are inversely associated with the risk of type 2 diabetes.
    Int J Mol Epidemiol Genet. 2019 ;10(3):38-46. Epub 2019 Jun 15. PMID: 31333812
  • [32] Zinc supplementation improves glycemic control for diabetes prevention and management: a systematic review and meta-analysis of randomized controlled trials.
    Overall, compared with their respective control groups, the subjects in the zinc-supplementation group had a statistically significant reduction in fasting glucose
    [FG, weighted mean difference (WMD): -14.15 mg/dL; 95% CI: -17.36, -10.93 mg/dL], 2-h
    postprandial glucose (WMD: -36.85 mg/dL; 95% CI: -62.05, -11.65 mg/dL),
    fasting insulin (WMD: -1.82 mU/L; 95% CI: -3.10, -0.54 mU/L),
    homeostasis model assessment for insulin resistance (WMD: -0.73; 95% CI: -1.22, -0.24),
    glycated hemoglobin (WMD: -0.55%; 95% CI: -0.84, -0.27%), and
    high-sensitivity C-reactive protein (WMD: -1.31 mg/L; 95% CI: -2.05, -0.56 mg/L) concentrations.
    Moreover, subgroup analyses revealed that the effects of zinc supplementation on FG are significantly influenced by diabetic status and the formulation of the zinc supplement.
    Our analysis revealed that several key glycemic indicators are significantly reduced by zinc supplementation, particularly the FG in subjects with diabetes and in subjects who received an inorganic zinc supplement. Together, these findings support the notion that zinc supplementation may have clinical potential as an adjunct therapy for preventing or managing diabetes.
    Am J Clin Nutr. 2019 Jun 4. Epub 2019 Jun 4. PMID: 31161192
  • [33] A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial.
    Low-fat vegetarian and vegan diets are associated with weight loss, increased insulin sensitivity, and improved cardiovascular health.
    Free-living individuals with type 2 diabetes were randomly assigned to a low-fat vegan diet (n = 49) or a diet following 2003 American Diabetes Association guidelines (conventional, n = 50) for 74 wk.
    Glycated hemoglobin (Hb A(1c)) and plasma lipids were assessed at weeks 0, 11, 22, 35, 48, 61, and 74.
    Weight was measured at weeks 0, 22, and 74.
    Weight loss was significant within each diet group but not significantly different between groups (-4.4 kg in the vegan group and -3.0 kg in the conventional diet group, P = 0.25) and related significantly to Hb A(1c) changes (r = 0.50, P = 0.001).
    » Hb A(1c) changes from baseline to 74 wk or last available values were -0.34 and -0.14 for vegan and conventional diets, respectively (P = 0.43).
    » Hb A(1c) changes from baseline to last available value or last value before any medication adjustment were -0.40 and 0.01 for vegan and conventional diets, respectively (P = 0.03).
    In analyses before alterations in lipid-lowering medications,
    » total cholesterol decreased by 20.4 and 6.8 mg/dL in the vegan and conventional diet groups, respectively (P = 0.01);
    » LDL cholesterol decreased by 13.5 and 3.4 mg/dL in the vegan and conventional groups, respectively (P = 0.03).
    Both diets were associated with sustained reductions in weight and plasma lipid concentrations. In an analysis controlling for medication changes, a low-fat vegan diet appeared to improve glycemia and plasma lipids more than did conventional diabetes diet recommendations.
    Am J Clin Nutr. 2009 May;89(5):1588S-1596S. Epub 2009 Apr 1. PMID: 19339401
  • [34] The antidiabetic activity of aloes: preliminary clinical and experimental observations.
    The dried sap of the aloe plant (aloes) is one of several traditional remedies used for diabetes in the Arabian peninsula.
    Its ability to lower the blood glucose was studied in 5 patients with non-insulin-dependent diabetes and in Swiss albino mice made diabetic using alloxan.
    During the ingestion of aloes, half a teaspoonful daily for 4-14 weeks, the fasting serum glucose level fell in every patient from a mean of 273 +/- 25 (SE) to 151 +/- 23 mg/dl (p less than 0.05) with no change in body weight.
    In normal mice, both glibenclamide (10 mg/kg twice daily) and aloes (500 mg/kg twice daily) induced hypoglycaemia after 5 days, 71 +/- 6.2 and 91 +/- 7.6 mg/dl, respectively, versus 130 +/- 7 mg/dl in control animals (p less than 0.01); only glibenclamide was effective after 3 days.
    In the diabetic mice, fasting plasma glucose was significantly reduced by glibenclamide and aloes after 3 days.
    Thereafter only aloes was effective and by day 7 the plasma glucose was 394 +/- 22.0 versus 646 +/- 35.9 mg/dl, in the controls and 726 +/- 30.9 mg/dl in the glibenclamide treated group (p less than 0.01).
    We conclude that aloes contains a hypoglycaemic agent which lowers the blood glucose by as yet unknown mechanisms.
    Horm Res. 1986;24(4):288-94. PMID: 3096865
  • [35] Bay leaves improve glucose and lipid profile of people with type 2 diabetes.
    Bay leaves (Laurus nobilis) have been shown to improve insulin function in vitro but the effects on people have not been determined.
    Forty people with type 2 diabetes were divided into 4 groups and given capsules containing 1, 2 or 3 g of ground bay leaves per day for 30 days or a placebo followed by a 10 day washout period.
    All three levels of bay leaves reduced serum glucose with significant decreases ranging from 21 to 26% after 30 d.
    Total cholesterol decreased, 20 to 24%,after 30 days with larger decreases in low density lipoprotein (LDL) cholesterol of 32 to 40%.
    High density lipoprotein (HDL) cholesterol increased 29 and 20% in the groups receiving 1 and 2 g of bay leaves, respectively.
    Triglycerides also decreased 34 and 25% in groups consuming 1 and 2 g of bay leaves, respectively, after 30 d.
    There were no significant changes in the placebo group.
    In summary, this study demonstrates that consumption of bay leaves, 1 to 3 g/d for 30 days, decreases risk factors for diabetes and cardiovascular diseases and suggests that bay leaves may be beneficial for people with type 2 diabetes.
    J Clin Biochem Nutr. 2009 Jan;44(1):52-6. Epub 2008 Dec 27. PMID: 19177188
  • [36] Efficacy of berberine in patients with type 2 diabetes mellitus.
    Berberine has been shown to regulate glucose and lipid metabolism in vitro and in vivo. This pilot study was to determine the efficacy and safety of berberine in the treatment of type 2 diabetes mellitus patients.
    Significant decreases in hemoglobin A1c (from 9.5%+/-0.5% to 7.5%+/-0.4%, P<.01), fasting blood glucose (from 10.6+/-0.9 mmol/L to 6.9+/-0.5 mmol/L, P<.01), postprandial blood glucose (from 19.8+/-1.7 to 11.1+/-0.9 mmol/L, P<.01), and plasma triglycerides (from 1.13+/-0.13 to 0.89+/-0.03 mmol/L, P<.05) were observed in the berberine group.
    In study B, 48 adults with poorly controlled type 2 diabetes mellitus were treated supplemented with berberine in a 3-month trial.
    Berberine acted by lowering fasting blood glucose and postprandial blood glucose from 1 week to the end of the trial.
    Hemoglobin A1c decreased from 8.1%+/-0.2% to 7.3%+/-0.3% (P<.001).
    Fasting plasma insulin and homeostasis model assessment of insulin resistance index were reduced by 28.1% and 44.7% (P<.001), respectively.
    Total cholesterol and low-density lipoprotein cholesterol were decreased significantly as well.
    During the trial, 20 (34.5%) patients experienced transient gastrointestinal adverse effects. Functional liver or kidney damages were not observed for all patients.
    In conclusion, this pilot study indicates that berberine is a potent oral hypoglycemic agent with beneficial effects on lipid metabolism.
    Metabolism. 2008 May;57(5):712-7. PMID: 18442638
  • [37] mcIRBP-19 of Bitter Melon Peptide Effectively Regulates Diabetes Mellitus (DM) Patients' Blood Sugar Levels.
    This study was conducted to test the effectiveness of a particular bitter melon peptide (BMP), with a specific sequence of 19 amino acids (mcIRBP-19), in regulating diabetic patients' blood glucose.
    The clinical results showed that BMP started to improve the subjects' glycated hemoglobin (HbA1c) levels at the end of the second month (T2), with mean values being significantly lowered from 7.8± 1.4% (T0) to 7.5 ± 1.4% (T2) (= 0.004).
    The values reduced continuously, eventually reaching 7.4± 1.1% (= 0.000) at the end of the experiment (T3).
    HbA1c levels for the control group were 7.5± 1.2% in T0 and 7.5 ± 1.1% (T3), and not significantly different (= 0.852) over the same period.
    This study provides clinical evidence that helps to verify the effectiveness of the new BMP product in regulating diabetic patients' blood sugar levels.
    Nutrients. 2020 Apr 28 ;12(5). Epub 2020 Apr 28. PMID: 32354072
  • [38] Effect of probiotic fermented milk (kefir) on glycemic control and lipid profile in type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial.
    Probiotic group consumed 600 ml/day probiotic fermented milk containing Lactobacillus casei, Lactobacillus acidophilus and Bifidobacteria and control group consumed 600 ml/day conventional fermented milk.
    Blood samples tested for fasting blood glucose, HbA1C, triglyceride (TG), total cholesterol, HDL-C and LDL-C at the baseline and end of the study.
    The comparison of fasting blood glucose between two groups after intervention was statistically significant (P=0.01).
    After intervention, reduced HbA1C compared with the baseline value in probiotic fermented milk group was statistically significant (P=0.001), also the HbA1C level significantly decreased in probiotic group in comparison with control group (P=0.02) adjusting for serum levels of glucose, baseline values of HbA1c and energy intake according to ANCOVA model.
    Serum triglyceride, total cholesterol, LDL-cholesterol and HDL- cholesterol levels were not shown significant differences between and within the groups after intervention.
    Probiotic fermented milk can be useful as a complementary or adjuvant therapy in the treatment of diabetes.
    Iran J Public Health. 2015 Feb ;44(2):228-37. PMID: 25905057
  • [39] Efficacy of flaxseed oil compared with fish oil supplementation in the treatment of coronary heart disease: a retrospective study.
    Background: Many studies have demonstrated the beneficial effects of omega-3 fatty acids in animal models and human diseases. Compared with commonly used fish oil, flaxseed oil has better palatability.
    A total of 120 patients were enrolled in the present study: 60 in the flaxseed oil group and 60 in the fish oil group.
    After a median follow-up of 10.0 weeks (95% CI: 8.4-11.6 weeks), flaxseed oil was found to be significantly better at reducing serum insulin levels and high-sensitivity C-reactive protein (hs-CRP) levels than fish oil (P=0.03 and P=0.02, respectively).
    The effects of flaxseed oil and fish oil on homeostatic model assessment for insulin resistance (HOMA-IR), fasting plasma glucose (FPG); body weight, and body mass index (BMI) were found to be similar.
    Moreover, patients who received flaxseed oil tended to have a better overall survival than those who received fish oil, although the difference was not statistically significant (P=0.067).
    Compared with fish oil, flaxseed oil was more effective in reducing serum insulin levels and hs-CRP levels for T2DM patients with CHD. For these patients, flaxseed oil might become a novel choice.
    J Thorac Dis. 2022 Feb ;14(2):396-404. PMID: 35280463
  • [40] The effect of fenugreek seed supplementation on serum irisin levels, blood pressure, and liver and kidney function in patients with type 2 diabetes mellitus: A parallel randomized clinical trial.
    In an 8-week randomized controlled clinical trial, T2DM patients (n = 50) were assigned to the intervention (5 g FS powder, 3 times a day) or control group.
    Compared to the control group, FS consumption resulted in a significant decrease in fasting plasma glucose (FPG) (p = 0.024), as well as a significant change in serum alanine aminotransferase (ALT) (p = 0.02) and alkaline phosphatase (ALP) (p = 0.001).
    Within-group analysis showed a significant decrease in aspartate aminotransferase (AST) (p = 0.014), systolic blood pressure (SBP) (p = 0.001), and irisin (p = 0.001) in the FS group, and a significant increase in creatinine (Cr) (p = 0.001) and decrease in estimated glomerular filtration rate (eGFR) (p = 0.001) in the control group.
    FS consumption did not have any significant effect on diastolic blood pressure (DBP) and blood urea nitrogen (BUN).
    FS intake has some beneficial effects on FPG, SBP, and some liver and kidney function tests in patients with T2DM.
    Complement Ther Med. 2020 Mar ;49:102315. Epub 2020 Feb 1. PMID: 32147060

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Hуgιєια; Goddess of Health!
It's incumbent upon every individual to take responsibility for their own health!
Real Healthcare is where the underlying causes are addressed.
The Body can heal itself, but only if given the right conditions!
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