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Type 2 diabetes prevention diet and the risk of pancreatic cancer: A large prospective multicenter study.
Huang, Y, Liu, F, Chen, AM, Yang, PF, Peng, Y, Gong, JP, Li, Z, Zhong, GC
Clinical nutrition (Edinburgh, Scotland). 2021;(11):5595-5604
Abstract
BACKGROUND & AIMS Type 2 diabetes prevention diet confers a lower risk of type 2 diabetes, which exhibits overlapping mechanisms with pancreatic cancer. We performed a prospective study to examine whether adherence to this dietary pattern is associated with a reduced risk of pancreatic cancer. METHODS A population-based cohort of 101,729 American adults was identified. A dietary diabetes risk reduction score was computed to reflect adherence to this dietary pattern, with higher scores representing greater adherence. Cox regression was used to compute hazard ratios (HRs) for pancreatic cancer incidence. Prespecified subgroup analyses were used to identify the potential effect modifiers. RESULTS After an average follow-up of 8.86 years (900,871.67 person-years), a total of 402 pancreatic cancer cases were observed. In the fully adjusted model, participants in the highest quartile of dietary diabetes risk reduction score were found to have a reduced risk of pancreatic cancer compared with those in the lowest quartile [HRquartiles 4versus1: 0.62; 95% confidence interval (CI): 0.44, 0.86; Ptrend = 0.004], which remained in a series of sensitivity analyses. Subgroup analyses further found that this favorable association was more pronounced in current or former smokers (HRquartiles 4versus1: 0.48; 95% CI: 0.30, 0.77) than in never smokers (HRquartiles 4versus1: 0.71; 95% CI: 0.44, 1.15), although the interaction test did not reach statistical significance (Pinteraction = 0.095). CONCLUSIONS Greater adherence to type 2 diabetes prevention diet is associated with a lower risk of pancreatic cancer in this US population. More studies are needed to confirm our findings.
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Comparison of the Effects of a Bean-Based and a White Rice-Based Breakfast Diet on Postprandial Glucose and Insulin Levels in Chinese Patients with Type 2 Diabetes.
Xiong, Q, Li, Z, Nie, R, Meng, X, Yang, XJ
Medical science monitor : international medical journal of experimental and clinical research. 2021;:e930349
Abstract
BACKGROUND This study compared the effects of a bean-based and a white rice-based breakfast diet on postprandial glucose and insulin levels in Chinese patients with type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS We recruited 63 patients with T2DM. The patients participated in the randomized 2×2 crossover trial. The bean-based diet group and white rice control group were matched for 50 g of available carbohydrate at breakfast. The patients followed the diets for 3 days. Vein blood samples were collected at 0, 30, 60, 120, and 180 min after eating. Data were analyzed using a repeated-measures analysis of variance. The results are expressed as the mean±standard error of mean (SEM) or as the median with interquartile range values. RESULTS Compared with the white rice control, postprandial glucose was significantly lower with the bean-based diet treatments at 60 min (P=0.004), 120 min (P=0.000), and 180 min (P=0.000). The insulin levels of the bean-based diet group were significantly higher at 60 min (P=0.013). The C-peptide levels of the bean-based diet group were significantly higher at 30 min (P=0.042) and 60 min (P=0.005) postprandial. The glucose area under the curve (AUC) showed a similar trend (P=0.000). There were no statistically significant differences in the AUC of insulin and C-peptide, except C-peptide AUC at 0 to 60 min (P=0.027). CONCLUSIONS Compared with a white rice-based breakfast, a bean-based diet significantly reduced postprandial glucose levels and promoted insulin secretion. These results support a dietary approach to reduce postprandial hyperglycemia.
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Association between Normal Thyroid Hormones and Diabetic Retinopathy in Patients with Type 2 Diabetes.
Zou, J, Li, Z, Tian, F, Zhang, Y, Xu, C, Zhai, J, Shi, M, Wu, G, Zhang, Z, Yang, C, et al
BioMed research international. 2020;:8161797
Abstract
The relationship between normal thyroid function and type 2 diabetes mellitus (T2DM) has been a particular focus for concern. The present study determined the relationship between thyroid hormone levels and the prevalence of diabetic retinopathy (DR) in T2DM patients. A cross-sectional study (n = 633) was performed in Xi'an, Shaanxi Province, China. Subjects were evaluated for anthropometric measurements, thyroid function, and diabetic retinopathy. Logistic regression models were used to assess the relationships between thyroid hormones and DR. Of 633 patients, 243 (38.4%) patients suffered from DR. The prevalence of DR showed a significantly decreasing trend across the quartiles based on free triiodothyronine (FT3) (FT3 quartile 1 group [FT3-Q1] <4.35 pmol/L, FT3 quartile 2 group [FT3-Q2] 4.35-4.70 pmol/L, FT3 quartile 3 group [FT3-Q3] 4.70-5.08 pmol/L, and FT3 quartile 4 group [FT3-Q4] ≥5.08 pmol/L) (56.7%, 42.5%, 33.1%, 23.8%, P < 0.001). In comparison with all participants categorized in FT3-Q1, the multivariable adjusted odds ratios (95% confidence interval) of DR in FT3-Q2, FT3-Q3, and FT3-Q4 were 0.587 (0.340-1.012), 0.458 (0.258-0.813), and 0.368 (0.201-0.673), (P = 0.055, P = 0.008, P = 0.001), respectively. FT3 levels within the normal range are negatively associated with DR in euthyroid patients with type 2 diabetes. Further studies should be aimed at clarifying the relationship between thyroid hormones and T2DM.
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Impact of whole cereals and processing on type 2 diabetes mellitus: a review.
Wu, W, Qiu, J, Wang, A, Li, Z
Critical reviews in food science and nutrition. 2020;(9):1447-1474
Abstract
The prevalence of type 2 diabetes mellitus (T2DM) has been increasing throughout the world. The cereals, as the high carbohydrate food and dominant portion of diet, have crucial impacts on glycemic control, especially for T2DM. Both components in whole cereals and processing are closely related to their glycemic response. The consumption of whole cereals is shown to reduce the risk of T2DM. The starch characteristic of cereal determines its hydrolysis rate and glycemic response. The soluble and insoluble dietary fiber, phenolic compounds, and other bioactive constituents may slow down the starch hydrolysis. Besides, they have other physiological mechanisms in regulation of T2DM, such as amelioration of lipid disorder, antioxidant, anti-inflammation, and regulation of gut microbiota, which contribute to further improvement of metabolic symptoms. Cereals are subjected to processing before consumption, which is involved in mechanical force, bioprocessing, thermal treatment, and cooling. The processing induces changes in nutritional composition and physical structure compared to the raw kernels. The key influences of processing on glycemic response are the starch gelatinization and starch retrogradation. However, physical structure of cereal and interactions among starch and other compounds greatly contribute to various glycemic responses of cereal products. This review highlights recent findings on the influences of both bioactive constituents and processing on the antidiabetic effects and physiological properties of cereals.
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Does synbiotic supplementation affect body weight, body mass index, and high-sensitivity C-reactive protein levels in patients with type 2 diabetes? Protocol for a systematic review and meta-analysis.
Chen, Y, Li, Z, Yang, M, Shui, J, Yue, R
Medicine. 2019;(49):e18197
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Abstract
BACKGROUND The number of patients with type 2 diabetes mellitus (T2DM) is surging currently. Synbiotic as a supplement based on gut microbiota may be beneficial to improve the metabolism of T2DM. However, the results of clinical studies show that the role of synbiotic in weight management in patients with T2DM is controversial. In this context, we have formulated this protocol. The study will evaluate the effects of synbiotic supplementation on body weight, body mass index (BMI), and high-sensitivity C-reactive protein (hs-CRP) levels in patients with T2DM. METHODS The electronic databases PubMed, Embase, and the Cochrane Library will be searched for relevant literature from inception. Literature search, data extraction, and methodological quality assessment will be carried out independently by two researchers. All randomized controlled trials (RCTs) that met the criteria will be included. A meta-analysis will be conducted using weighted mean difference (WMD) and 95% confidence interval (CI) as effect measures. RESULTS This systematic review and meta-analysis will mainly assess the effects of synbiotic supplementation on body weight and BMI in T2DM patients. Secondary outcome indicators will include hs-CRP. CONCLUSION This systematic review and meta-analysis will quantify the value of synbiotic supplement in weight management of patients with T2DM through a comprehensive evaluation of the current clinical evidence, so as to provide a basis for clinical application. PROSPERO REGISTRATION NUMBER CRD42019132974.
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High-Resistant Starch, Low-Protein Flour Intervention on Patients With Early Type 2 Diabetic Nephropathy: A Randomized Trial.
Meng, Y, Bai, H, Yu, Q, Yan, J, Zhao, L, Wang, S, Li, Z, Wang, Q, Chen, L
Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation. 2019;(5):386-393
Abstract
OBJECTIVE The objective of this study is to explore the effect of high-resistant starch (RS), low-protein flour as a source of RS on patients with early type 2 diabetic nephropathy (DN) through the clinical intervention trial. DESIGN This was a single center, randomized, comparative, open-label trial. Seventy-five patients with early DN, aged 18 to 80 y, were recruited and randomly assigned to two groups. During the 12-week intervention, the control group patients (38 cases) followed protein-restriction diet daily with a common staple. The intervention group (37 cases) received 50 g of high-RS, low-protein flour instead of a common staple of equal quality at lunch and dinner each day. The blood glucose, blood lipids, nutritional parameters, indicators of renal function, oxidative stress, and inflammatory markers were measured. RESULTS Compared with the control group, high-RS, low-protein flour intake led to a significant reduction in fasting blood glucose, HbA1c, total cholesterol, and triglycerides levels (P < .05 for all). The changes in serum uric acid (UA) and β2-microglobulin (β2-MG) level were observed after high-RS, low-protein flour intervention (uric acid [mean ± standard deviation]: -24.7 ± 38.5 μmol/L, P = .001; β2-MG: 0.5 ± 0.9 mg/L, P = 0.018). In addition, high-RS, low-protein flour intake increased serum superoxide dismutase level by 10.1 ± 27.7 U/mL (P < .05); however, it did not change the interleukin-6 and Tumor Necrosis Factor α (TNF-α) concentration. CONCLUSIONS Twelve-week intervention with high-RS, low-protein flour improved the blood glucose and blood lipid levels, decreased the serum uric acid (UA) and urine β2-MG, and enhanced the ability to prevent antioxidative stress in patients with early DN.
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[Effect of moderate exercise for 30 min at 30 min versus 60 min after dinner on glycemic control in patients with type 2 diabetes: a randomized, crossover, self-controlled study].
Li, Z, Hu, Y, Ma, J
Nan fang yi ke da xue xue bao = Journal of Southern Medical University. 2018;(10):1165-1170
Abstract
OBJECTIVE To compare the effectiveness of moderate exercise for 30 min at 30 min and 60 min after dinner on glycemic control in patients with type 2 diabetes. METHODS This randomized, crossover, self-controlled pilot study was conducted in 15 inactive patients with type 2 diabetes without serious complications or use of exogenous insulin. The participants completed two randomly ordered exercise protocols (brisk walking for 30 min at 30 min or 60 min after dinner on the exercise day) spaced 1 week apart. All the exercise was performed while maintaining a heart rate reserve of 40%. The interstitial glucose level was monitored using a continuous glucose monitor (CGM) for all the participants, who maintained a standardized diet with routine medications. The 2-h postprandial mean glucose, peak glucose, and glucose area under the curve (AUC) were measured. The mean amplitude of glycemic excursions (MAGE) and other plasma glucose fluctuation parameters in 12 h after dinner, including the mean blood glucose (MBG) and the coefficient variation (CV) of glucose, were also calculated. The incidence of nocturnal hypoglycemia was recorded in all the participants. RESULTS The participants had a mean age of 46±11 years with a mean BMI of 25.8±3.1 kg/m2 and a mean HbA1c of 7.7%. No significant differences were found between postprandial 30 min exercise group and postprandial 60 min exercise group in terms of 2-h postprandial mean glucose, peak glucose, glucose AUC, or in MBG, CV and MAGE during the 12-h period after dinner. No nocturnal hypoglycemia occurred in the participants after exercise at 30 or 60 min after dinner. However, significant reductions in the 2-h postprandial glucose levels were detected after exercise at 60 min after dinner as compared to exercise at 30 min. CONCLUSIONS The timing (30 min vs 60 min after dinner) of moderate exercises for 30 min does not produce significant difference in the improvement of postprandial hyperglycemia in type 2 diabetic patients, and both exercise protocols are safe without a potential risk of hypoglycemia. Nevertheless, exercise at 60 min after dinner can be more effective to lower 2-h postprandial glucose, while exercise at 30 min after dinner might be safer for patients with a high risk of hypoglycemia.
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Efficacy of low carbohydrate diet for type 2 diabetes mellitus management: A systematic review and meta-analysis of randomized controlled trials.
Meng, Y, Bai, H, Wang, S, Li, Z, Wang, Q, Chen, L
Diabetes research and clinical practice. 2017;:124-131
Abstract
AIMS: The objective of this systematic review and meta-analysis is to assess the efficacy of Low Carbohydrate Diet (LCD) compared with a normal or high carbohydrate diet in patients with type 2 diabetes. METHODS We searched MEDLINE, EMBASE, and Cochrane Library database for randomized controlled trials. Researches which reported the change in weight loss, blood glucose, and blood lipid levels were included. RESULTS A total of 9 studies with 734 patients with diabetes were included. Pooled results suggested that LCD had a significantly effect on HbA1c level (WMD: -0.44; 95% CI: -0.61, -0.26; P=0.00). For cardiovascular risk factors, the LCD intervention significantly reduced triglycerides concentration (WMD: -0.33; 95% CI: -0.45, -0.21; P=0.00) and increased HDL cholesterol concentration (WMD: 0.07; 95% CI: 0.03, 0.11; P=0.00). But the LCD was not associated with decreased level of total cholesterol and LDL cholesterol. Subgroup analyses indicated that short term intervention of LCD was effective for weight loss (WMD: -1.18; 95% CI: -2.32, -0.04; P=0.04). CONCLUSIONS The results suggested a beneficial effect of LCD intervention on glucose control in patients with type 2 diabetes. The LCD intervention also had a positive effect on triglycerides and HDL cholesterol concentrations, but without significant effect on long term weight loss.
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An Overview of Plant Phenolic Compounds and Their Importance in Human Nutrition and Management of Type 2 Diabetes.
Lin, D, Xiao, M, Zhao, J, Li, Z, Xing, B, Li, X, Kong, M, Li, L, Zhang, Q, Liu, Y, et al
Molecules (Basel, Switzerland). 2016;(10)
Abstract
In this paper, the biosynthesis process of phenolic compounds in plants is summarized, which include the shikimate, pentose phosphate and phenylpropanoid pathways. Plant phenolic compounds can act as antioxidants, structural polymers (lignin), attractants (flavonoids and carotenoids), UV screens (flavonoids), signal compounds (salicylic acid, flavonoids) and defense response chemicals (tannins, phytoalexins). From a human physiological standpoint, phenolic compounds are vital in defense responses, such as anti-aging, anti-inflammatory, antioxidant and anti-proliferative activities. Therefore, it is beneficial to eat such plant foods that have a high antioxidant compound content, which will cut down the incidence of certain chronic diseases, for instance diabetes, cancers and cardiovascular diseases, through the management of oxidative stress. Furthermore, berries and other fruits with low-amylase and high-glucosidase inhibitory activities could be thought of as candidate food items in the control of the early stages of hyperglycemia associated with type 2 diabetes.