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Effects of high-protein diet on glycemic control, insulin resistance and blood pressure in type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials.
Yu, Z, Nan, F, Wang, LY, Jiang, H, Chen, W, Jiang, Y
Clinical nutrition (Edinburgh, Scotland). 2020;(6):1724-1734
Abstract
BACKGROUND Obesity is a well-known risk factor of type 2 diabetes mellitus (T2DM), and it is commonly accompanied by T2DM. It is estimated that almost two thirds of the population with T2DM is also affected by hypertension. Elevated arterial blood pressure would increase the risk for diabetes development. Recently some studies indicated that a high-protein diet was effective for weight loss, and therefore we hypothesized that a high-protein diet could help control blood glucose, mitigate insulin resistance (IR) and improve blood pressure by weight management in T2DM patients. AIM: The study aimed to systematically review the effects of a high-protein diet on glycemic control, IR and blood pressure in T2DM patients. METHODS We searched four electronic databases until May 1st 2018 and included all randomized clinical trials comparing a high-protein diet with other diets. Two reviewers independently identified the trials for inclusion and independently extracted data. Either a fixed- or a random-effects model was used to combine the changes in each outcome from baseline to the end of the intervention. The meta-analysis was performed with RevMan 5.3 software. RESULTS Twelve articles (thirteen studies) including 1138 T2DM patients met our inclusion criteria. Glycemic control was not significantly different between the high-protein diet and control group, with the changes in fasting plasma glucose (FPG) (-0.13 (95% CI (-0.46, 0.19), p = 0.43) mmol/L) and HbA1c% (-0.05 (95% CI (-0.18, 0.08, p = 0.92))) from baseline to the end of intervention. However, the difference in IR between the two groups was statistically significant. Most changes in lipids profiles were favorable. The changes in HDL, LDL, TC, and TG were +0.03 (95% CI (-0.04,0.11), p = 0.35) mmol/L, -0.10 (95% CI (-0.18, -0.02), p = 0.02) mmol/L, -0.21 (95% CI (-0.31, -0.12), p < 0.01) mmol/L and -0.19 (95% CI (-0.33, -0.05), p < 0.01) mmol/L, respectively. The result of HOMA-IR was -0.27 (95% CI (-0.47, -0.06), p < 0.01). Additionally, the difference in blood pressure in terms of systolic blood pressure (-0.57 (95% CI (-2.45, 1.32), p = 0.55)) and diastolic blood pressure (-0.73 (95% CI (-2.48, 1.02), p = 0.41)) was not significant. CONCLUSION This review showed that a high-protein diet does not significantly improve glycemic control and blood pressure, but can lower LDL, TC, TG and HOMA-IR levels in T2DM patients. Further studies are needed to clarify the effects of a high-protein diet on glycemic control, IR and blood pressure control in T2DM patients.
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Effect of herbal tea on glycemic control in patients with type 2 diabetes: Protocol for a systematic review and meta-analysis.
Zhang, B, Yue, R, Huang, X, Wang, Y, Jiang, Y, Chin, J
Medicine. 2019;(50):e18346
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Abstract
BACKGROUND Type 2 diabetes (T2D) is a significant health concern worldwide, and good glycemic control is the basis of avoiding disease progression. Herbal tea, as a convenient and effective medication method, has gained popularity among many diabetic patients. However, there are no systematic reviews or meta-analyses to evaluate the clinical efficacy of herbal tea on T2D. METHODS Four English electronic databases and 4 Chinese electronic databases were searched for randomized controlled trials (RCTs) meeting inclusion criteria; Clinical trials were searched to explore the relevant unpublished data. Fasting blood glucose and glycated hemoglobin will be measured as primary outcomes. Secondary outcomes include 2-hour postprandial blood glucose, fasting insulin, and homeostasis model assessment-insulin resistance. The heterogeneity of data will be investigated by Chi-square and I test; subgroup analysis and sensitivity analysis will be conducted to explore the sources of heterogeneity; funnel plot will be used to evaluate publication bias; finally, we will use grading of recommendations assessment, development, and evaluate system method to evaluate the quality of evidence. Merging analysis of data will be performed using Rev Man 5.3 software. RESULTS The results will be published in a peer-reviewed journal. CONCLUSIONS The systematic review will confirm whether herbal tea consumption is benefit to the glycemic control in patients with T2D. PROSPERO REGISTRATION NUMBER CRD42019129863.
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Decreased insulin sensitivity and abnormal glucose metabolism start in preadolescence in low-birth-weight children-Meta-analysis and systematic review.
Xu, Y, Chen, S, Yang, H, Gong, F, Wang, L, Jiang, Y, Yan, C, Zhu, H, Pan, H
Primary care diabetes. 2019;(5):391-398
Abstract
AIMS: Our meta-analysis aimed to analyze glucose and insulin abnormalities in small-for-gestational-age (SGA) or low-birth-weight (LBW) young people. METHODS Our data were collected from several databases, including PubMed, AMED and so on. Cohort studies in English were included. SGA or LBW participants comprised the case group, while non-SGA or non-LBW participants comprised the control group. All subjects were younger than 45 years old. RESULTS Sixteen studies and 10,060 subjects were included in this meta-analysis. The case group showed higher levels of oral glucose tolerance test (OGTT) 2-h glucose (mean difference (MD) = 0.32 mmol/L, 95% confidence interval (CI) 0.13-0.52 mmol/L, P = 0.0009) and fasting and OGTT 2-h insulin than the control group (respectively, MD = 7.47 pmol/L, 95% CI 1.77-13.17 pmol/L, P = 0.01 and MD = 105.55 pmol/L, 95% CI 65.43-145.66 pmol/L, P < 0.00001). In the preadolescence group (maximum age or 95% CI of age ≤10 years old), the OGTT 2-h glucose in the case group had an upward tendency compared to the control group, while the OGTT 2-h insulin in the case group was significantly higher than that in the control group (MD = 118.51 pmol/L, 95% CI 56.80-180.22 pmol/L, P = 0.0002). In the adolescence group (minimum age >10 years old and maximum age≤20 years old or 10 years old<95% CI of age≤20 years old), subjects in the case group showed significantly higher fasting and OGTT 2-h glucose than did the control group (respectively, MD = 0.14 mmol/L, 95% CI 0.04-0.24 mmol/L, P = 0.005 and MD = 0.40 mmol/L, 95% CI 0.08-0.71 mmol/L, P = 0.01). However, fasting and OGTT 2-h insulin in the case group were not significantly different from those in the control group (respectively, MD = 6.56 pmol/L, 95% CI -4.54-17.65 pmol/L, P = 0.25 and MD = 65.89 pmol/L, 95% CI -50.00-181.78 pmol/L, P = 0.27). CONCLUSIONS Decreased insulin sensitivity and abnormal glucose metabolism began early in preadolescence. Furthermore, glucose tolerance was worse in adolescence. LBW or SGA status affects glucose metabolism and insulin sensitivity beginning in preadolescence.
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Multiple Linear Regression and Artificial Neural Network to Predict Blood Glucose in Overweight Patients.
Wang, J, Wang, F, Liu, Y, Xu, J, Lin, H, Jia, B, Zuo, W, Jiang, Y, Hu, L, Lin, F
Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association. 2016;(1):34-8
Abstract
BACKGROUND Overweight individuals are at higher risk for developing type II diabetes than the general population. We conducted this study to analyze the correlation between blood glucose and biochemical parameters, and developed a blood glucose prediction model tailored to overweight patients. METHODS A total of 346 overweight Chinese people patients ages 18-81 years were involved in this study. Their levels of fasting glucose (fs-GLU), blood lipids, and hepatic and renal functions were measured and analyzed by multiple linear regression (MLR). Based the MLR results, we developed a back propagation artificial neural network (BP-ANN) model by selecting tansig as the transfer function of the hidden layers nodes, and purelin for the output layer nodes, with training goal of 0.5×10(-5). RESULTS There was significant correlation between fs-GLU with age, BMI, and blood biochemical indexes (P<0.05). The results of MLR analysis indicated that age, fasting alanine transaminase (fs-ALT), blood urea nitrogen (fs-BUN), total protein (fs-TP), uric acid (fs-BUN), and BMI are 6 independent variables related to fs-GLU. Based on these parameters, the BP-ANN model was performed well and reached high prediction accuracy when training 1 000 epoch (R=0.9987). CONCLUSIONS The level of fs-GLU was predictable using the proposed BP-ANN model based on 6 related parameters (age, fs-ALT, fs-BUN, fs-TP, fs-UA and BMI) in overweight patients.
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[Effect of lifestyle interventions on reduction of cardiovascular disease events and its mortality in pre-diabetic patients:long-term follow-up of Da Qing Diabetes Prevention Study].
Chen, Y, Wang, J, An, Y, Gong, Q, He, Y, Zhang, B, Li, H, Shuai, Y, Tang, X, Jiang, Y, et al
Zhonghua nei ke za zhi. 2015;(1):13-7
Abstract
OBJECTIVE To investigate if a six-year intensive lifestyle intervention in people with pre-diabetes lead to reduction of cardiovascular events and cardiovascular disease (CVD) mortality in subsequent 23 years. METHODS Five hundreds and nineteen subjects with normal glucose tolerance (NGT) and 577 subjects with impaired glucose tolerance (IGT) in Da Qing city were recruited in the study in 1986. The IGT subjects randomly assigned to either the no-intervention group or one of three lifestyle intervention groups (diet, exercise, or diet plus exercise) to receive a 6-year lifestyle intervention. In 2009, the participants were followed up to assess the primary outcomes of cardiovascular events and CVD mortality by a questionnaire and medical records. RESULTS Subjects in IGT no-intervention group had the highest incidences of cardiovascular events (44.44%) and CVD mortality (20.00%), while those in NGT group had the lowest incidences of cardiovascular events (29.59%) and CVD mortality (7.52%) after 23-year follow-up. The incidences of cardiovascular events and CVD mortality in IGT intervention subjects were 37.84% and 12.53%, respectively. The multivariable analyses showed that, after controlling of age, gender, BMI smoking, blood pressure and cardiovascular event at baseline, the CVD mortality and incidence of cardiovascular events in IGT no-intervention group was 1.89 (HR = 1.89, 95%CI 1.11-3.22, P = 0.02) and 1.38 (HR = 1.38, 95%CI 1.01-1.90, P = 0.04) times of those in NGT group. However, the CVD mortality and incidence of cardiovascular events were not different in the IGT intervention group compared with those in the NGT group (HR = 1.39, 95%CI 0.89-2.18, P = 0.15 and HR = 1.25, 95%CI 0.98-1.59, P = 0.07, respectively). CONCLUSIONS Subjects with IGT were at high risk for cardiovascular events and mortality. A six-year lifestyle intervention in this population can reduce both the incidence of cardiovascular event and CVD mortality.