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Efficacy of Intermittent or Continuous Very Low-Energy Diets in Overweight and Obese Individuals with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analyses.
Huang, YS, Zheng, Q, Yang, H, Fu, X, Zhang, X, Xia, C, Zhu, Z, Liu, YN, Liu, WJ
Journal of diabetes research. 2020;:4851671
Abstract
OBJECTIVE This study is aimed at investigating the efficacy of a very low-energy diet (VLED) in overweight and obese individuals with type 2 diabetes mellitus (T2DM). METHODS We thoroughly searched eight electronic resource databases of controlled studies concerning the efficacy and acceptability of intermittent or continuous VLEDs in patients with T2DM compared with other energy restriction interventions. RESULTS Eighteen studies (11 randomized and seven nonrandomized controlled trials) with 911 participants were included. The meta-analyses showed that compared with a low-energy diet (LED) and mild energy restriction (MER), VLED is superior in the reduction of body weight (mean difference (MD) MDLED = -2.77, 95% confidence interval (CI) CILED = -4.81 to - 0.72, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39, I 2 = 0%) and TG level (MD = -0.25, 95%CI = -0.55 to 0.06, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39, I 2 = 0%) and TG level (MD = -0.25, 95%CI = -0.55 to 0.06, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39, P LED = 0.008; MDMER = -6.72, 95%CIMER = -10.05 to - 3.39. CONCLUSION Dietary intervention through VLEDs is an effective therapy for rapid weight loss, glycemic control, and improved lipid metabolism in overweight and obese individuals with T2DM. Thus, VLEDs should be encouraged in overweight and obese individuals with T2DM who urgently need weight loss and are unsuitable or unwilling to undergo surgery. As all outcome indicators have low or extremely low quality after GRADE evaluation, further clinical trials that focus on the remission effect of VLEDs on T2DM are needed.
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Inulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials.
Wang, L, Yang, H, Huang, H, Zhang, C, Zuo, HX, Xu, P, Niu, YM, Wu, SS
Journal of translational medicine. 2019;(1):410
Abstract
BACKGROUND Currently, many clinical trials have shown that inulin-type fructans (ITF) supplementation is associated with glycemic control; nevertheless, the results are inconclusive. The aim of this meta-analysis of randomized controlled trials was to assess the effects of ITF supplementation on glycemic control. METHODS PubMed, EMBASE and the Cochrane Library were searched for eligible articles up to March 6, 2019. A random-effects model was used to analyze the pooled results, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was applied to assess the quality of evidence. The dose-response model was used to recommend the daily dose and duration for ITF supplementation. RESULTS Thirty-three trials involving 1346 participants were included. Overall, ITF supplementation could significantly reduce concentrations of fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS) and homeostasis model assessment-insulin resistance (HOMA-IR). In the prediabetes and type 2 diabetes (T2DM) population, a more significant reduction in FBG [weighted mean difference (WMD): - 0.60 mmol/l; 95% CI - 0.71, - 0.48 mmol/l; high rate], HbA1c (WMD: - 0.58%; 95% CI - 0.83, - 0.32%; high rate), FINS (WMD: - 1.75 µU/ml; 95% CI - 2.87, - 0.63 µU/ml; low rate), and HOMA-IR (WMD: - 0.69; 95% CI - 1.10, - 0.28; low rate) were observed, and ITF supplementation with a daily dose of 10 g for a duration of 6 weeks and longer was recommended. Moreover, subgroup analyses suggested that the effects of glycemic control were significantly influenced by the sex of the subjects and the type and the method of intake of ITF. CONCLUSIONS Our analyses confirmed that these four main glycemic indicators were significantly reduced by ITF supplementation, particularly in the prediabetes and T2DM population. Evidence supports that reasonable administration of ITF supplementation may have potential clinical value as an adjuvant therapy for prediabetes and T2DM management. Trial registration The trial was registered at PROSPERO as CRD42018115875 on November 23, 2018.
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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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Noninvasive blood glucose monitoring during oral intake of different sugars with optical coherence tomography in human subjects.
Zhang, Y, Wei, H, Yang, H, He, Y, Wu, G, Xie, S, Zhu, Z, He, R
Journal of biophotonics. 2013;(9):699-707
Abstract
The potential of OCT applied to noninvasive blood glucose monitoring has attracted significant efforts. In this work we investigated the feasibility of OCT in monitoring blood glucose during oral intake of different sugars in humans. Five groups of experiments were performed, in which different sugars were used. The OCT signal slope (OCTSS) changed with variation of blood glucose concentration (BGC). A good correlation between OCTSS and BGC was observed in these experiments. The averaged correlation coefficients R between OCTSS and BGC are 0.900, 0.836, 0.895 and 0.884, corresponding to oral administration of glucose, fructose, sucrose and mixed sugar, respectively. Our studies demonstrated the capability and accuracy of the OCT system in monitoring BGC noninvasively and it could become a powerful tool in daily blood glucose monitoring for patients.
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Humalog Mix25 offers better mealtime glycemic control in patients with type 1 or type 2 diabetes.
Malone, JK, Yang, H, Woodworth, JR, Huang, J, Campaigne, BN, Halle, JP, Yale, JF, Grossman, LD
Diabetes & metabolism. 2000;(6):481-7
Abstract
To compare the postprandial glucodynamics of Humalog Mix25, (Humalog Mix75/25 in the US; Mix25), to human insulin 30/70 (Humulin 70/30 in the US; 30/70) in patients with type 1 or type 2 diabetes. Ninety-three patients with type 1 diabetes and 84 patients with type 2 diabetes were evaluated in two separate but identical protocols using a randomized, multicenter, double-blind, crossover design. Patients consumed test meals 5 minutes after equal doses of Mix25 or 30/70. Plasma glucose was measured at baseline and 15 minute intervals for 4 hours after the meal. Two-hour postprandial glucose (2pp), 2-hour glucose excursion (2pp(ex) ), glucose versus time area under the curve 0 to 4 hours (AUC(0-4) ) and glucose excursion area under the curve 0 to 2 and 0 to 4 hours (AUCex(0-2), AUCex(0-4) ) were calculated. For the combined patient population, Mix25 resulted in significantly lower 2pp (12.45 +/- 3.59 vs. 13.47 +/- 3.62 mmol/L; p <0.001), AUC(0-4) (44.45 +/- 12.20 vs. 47.25 +/- 11.97 mmol x h/L; p <0.001), and glucose excursion parameters: 2pp(ex) (3.20 +/- 2.72 vs. 4.40 +/- 2.81 mmol/L; p <0.001), AUCex(0-2) (5.45 +/- 3.15 vs 6.60 +/- 3.13 mmol x h/L; p <0.001), and AUCex(0-4) (7.57 +/- 8.37 vs. 11.02 +/- 8.47 mmol x h/L; p <0.001) compared to 30/70. Further analysis of the treatment by type of diabetes indicated that Mix25 provided nearly identical glucose excursion responses in type 1 and type 2 diabetes up to 2 hours after the test meal, in contrast to 30/70. Pre-meal injection of Mix25 resulted in lower postprandial blood glucose levels compared to 30/70. The postprandial blood glucose response following Mix25 was similar in patients with either type 1 or type 2 diabetes.