Restoration of acute insulin response in T2DM subjects 1 month after biliopancreatic diversion. Structural Alteration of Gut Microbiota during the Amelioration of Human Type 2 Diabetes with Hyperlipidemia by Metformin and a Traditional Chinese Herbal Formula: a Multicenter, Randomized, Open Label Clinical Trial Pre-teen insulin resistance predicts weight gain, impaired fasting glucose, and type 2 diabetes at age 18-19 y: a 10-y prospective study of black and white girls. An observational study of reduction of insulin resistance and prevention of development of type 2 diabetes mellitus in women with polycystic ovary syndrome treated with metformin and diet. A Novel Fasting Blood Test for Insulin Resistance and Prediabetes Docosahexaenoic acid supplementation improved lipocentric but not glucocentric markers of insulin sensitivity in hypertriglyceridemic men. The Effect of 12 Weeks Aerobic, Resistance, and Combined Exercises on Omentin-1 Levels and Insulin Resistance among Type 2 Diabetic Middle-Aged Women Sleeve gastrectomy and Roux-en-Y gastric bypass are equally effective in correcting insulin resistance. Supplementation of α-linolenic acid improves serum adiponectin levels and insulin sensitivity in patients with type 2 diabetes. Replacement of glycaemic carbohydrates by inulin-type fructans from chicory (oligofructose, inulin) reduces the postprandial blood glucose and insulin response to foods: report of two double-blind, randomized, controlled trials Eicosapentaenoic acid improves insulin sensitivity and blood sugar in overweight type 2 diabetes mellitus patients: a double-blind randomised clinical trial. Effect of alpha-lipoic acid on blood glucose, insulin resistance and glutathione peroxidase of type 2 diabetic patients. Effects of insulin resistance and insulin secretion on the efficacy of interventions to retard development of type 2 diabetes mellitus: the DA Qing IGT and Diabetes Study. Orlistat and L-carnitine compared to orlistat alone on insulin resistance in obese diabetic patients. Rosiglitazone and carotid IMT progression rate in a mixed cohort of patients with type 2 diabetes and the insulin resistance syndrome: main results from the Rosiglitazone Atherosclerosis Study. The effects of pioglitazone and metformin on plasma visfatin levels in patients with treatment naive type 2 diabetes mellitus. Metformin for overweight women at midlife: a double-blind, randomized, controlled trial Effect of Camel Milk on Blood Sugar and Lipid Profile of Patients With Type 2 Diabetes: A Pilot Clinical Trial PPARG2 Pro12Ala and ADAMTS9 rs4607103 as “insulin resistance loci” and “insulin secretion loci” in Italian individuals. The GENFIEV study and the Verona Newly Diagnosed Type 2 Diabetes Study (VNDS) 4 Homeostasis Model Assessment-Adiponectin: the role of different types of physical exercise in obese adolescents. Association analysis of SLC30A8 rs13266634 and rs16889462 polymorphisms with type 2 diabetes mellitus and repaglinide response in Chinese patients Defects in insulin receptor signaling in vivo in the polycystic ovary syndrome (PCOS). Comparison between orlistat plus l-carnitine and orlistat alone on inflammation parameters in obese diabetic patients.
OBJECTIVE Biliopancreatic diversion ( BPD ) restores normal glucose tolerance in a few weeks in morbid obese subjects with type 2 diabetes , improving insulin sensitivity . However , there is less known about the effects of BPD on insulin secretion . We tested the early effects of BPD on insulin secretion in obese subjects with and without type 2 diabetes . METHODS AND PROCEDURES Twenty-one consecutive morbid obese subjects , 9 with type 2 diabetes ( T2DM ) and 12 with normal fasting glucose ( NFG ) were evaluated , just before and 1 month after BPD , by measuring body weight ( BW ) , glucose , adipocitokines , homeostasis model assessment of insulin resistance ( HOMA-IR ) , acute insulin response ( AIR ) to e.v . glucose and the insulinogenic index adjusted for insulin resistance ( [DeltaI5/DeltaG5]/HOMA-IR ) . RESULTS Preoperatively , those with T2DM differed from those with NFG in showing higher levels of fasting glucose , reduced AIR ( 57.9 + /- 29.5 vs. 644.9 + /- 143.1 pmol/l , P < 0.01 ) and reduced adjusted insulinogenic index ( 1.0 + /- 0.5 vs. 17.6 + /- 3.9 1/mmol(2 ) , P < 0.001 ) . One month following BPD , in both groups BW was reduced ( by approximately 11 % ) , but all subjects were still severely obese ; HOMA-IR and leptin decreased significanlty , while high-molecular weight ( HMW ) adiponectin and adjusted insulinogenic index increased . In the T2DM group , fasting glucose returned to non-diabetic values . AIR did not change in the NFG group , while in the T2DM group it showed a significant increase ( from 58.0 + /- 29.5 to 273.8 + /- 47.2 pmol/l , P < 0.01 ) . In the T2DM group , the AIR percentage variation from baseline was significantly related to changes in fasting glucose ( r = 0.70 , P = 0.02 ) , suggesting an important relationship exists between impaired AIR and hyperglycaemia . DISCUSSION BPD is able to restore AIR in T2DM even just 1 month after surgery . AIR restoration is associated with normalization of fasting glucose concentrations ABSTRACT Accumulating evidence implicates gut microbiota as promising targets for the treatment of type 2 diabetes mellitus ( T2DM ) . With a r and omized clinical trial , we tested the hypothesis that alteration of gut microbiota may be involved in the alleviation of T2DM with hyperlipidemia by metformin and a specifically design ed herbal formula ( AMC ) .  Four hundred fifty patients with T2DM and hyperlipidemia were r and omly assigned to either the metformin- or AMC-treated group . After 12 weeks of treatment , 100 patients were r and omly selected from each group and assessed for clinical improvement . The effects of the two drugs on the intestinal microbiota were evaluated by analyzing the V3 and V4 regions of the 16S rRNA gene by Illumina sequencing and multivariate statistical methods . Both metformin and AMC significantly alleviated hyperglycemia and hyperlipidemia and shifted gut microbiota structure in diabetic patients . They significantly increased a coabundant group represented by Blautia spp . , which significantly correlated with the improvements in glucose and lipid homeostasis . However , AMC showed better efficacies in improving homeostasis model assessment of insulin resistance ( HOMA-IR ) and plasma triglyceride and also exerted a larger effect on gut microbiota . Furthermore , only AMC increased the coabundant group represented by Faecalibacterium spp . , which was previously reported to be associated with the alleviation of T2DM in a r and omized clinical trial . Metformin and the Chinese herbal formula may ameliorate type 2 diabetes with hyperlipidemia via enriching beneficial bacteria , such as Blautia and Faecalibacterium spp . IMPORTANCE Metabolic diseases such as T2DM and obesity have become a worldwide public health threat . Accumulating evidence indicates that gut microbiota can causatively arouse metabolic diseases , and thus the gut microbiota serves as a promising target for disease control . In this study , we evaluated the role of gut microbiota during improvements in hyperglycemia and hyperlipidemia by two drugs : metformin and a specifically design ed Chinese herbal formula ( AMC ) for diabetic patients with hyperlipidemia . Both drugs significantly ameliorated blood glucose and lipid levels and shifted the gut microbiota . Blautia spp . were identified as being associated with improvements in glucose and lipid homeostasis for both drugs . AMC exerted larger effects on the gut microbiota together with better efficacies in improving HOMA-IR and plasma triglyceride levels , which were associated with the enrichment of Faecalibacterium spp . In brief , these data suggest that gut microbiota might be involved in the alleviation of diabetes with hyperlipidemia by metformin and the AMC herbal formula . Metabolic diseases such as T2DM and obesity have become a worldwide public health threat . Accumulating evidence indicates that gut microbiota can causatively arouse metabolic diseases , and thus the gut microbiota serves as a promising target for disease control . In this study , we evaluated the role of gut microbiota during improvements in hyperglycemia and hyperlipidemia by two drugs : metformin and a specifically design ed Chinese herbal formula ( AMC ) for diabetic patients with hyperlipidemia . Both drugs significantly ameliorated blood glucose and lipid levels and shifted the gut microbiota . Blautia spp . were identified as being associated with improvements in glucose and lipid homeostasis for both drugs . AMC exerted larger effects on the gut microbiota together with better efficacies in improving HOMA-IR and plasma triglyceride levels , which were associated with the enrichment of Faecalibacterium spp . In brief , these data suggest that gut microbiota might be involved in the alleviation of diabetes with hyperlipidemia by metformin and the AMC herbal formula BACKGROUND Identifying early pre-teen predictors of  adolescent weight gain and the development of impaired fasting glucose ( IFG ) and type 2 diabetes ( T2DM ) at age 18 - 19 y could provide avenues for prevention . OBJECTIVE We evaluated possible pre-teen predictors for development of IFG , T2DM , and changes in body mass index at age 18 - 19 y in black and white girls . DESIGN In a prospect i ve cohort study , body habitus and fasting insulin and glucose were measured at ages 9 - 10 and 18 - 19 y , and multiple 3-d diet records were collected . Factors predicting 10-y change in body mass index and development of IFG and T2DM together were assessed . RESULTS In multivariate analyses , 10-y change in homeostatic model assessment of insulin resistance ( HOMA-IR ) and the age 9 - 10 y HOMA-IR x percentage of calories from fat interaction were positive predictors of 10-y changes in body mass index . At age 18 - 19 y , there were 5 incident cases of T2DM , 37 cases of IFG , and 597 noncases . Age 9 - 10 y IFG and HOMA-IR ( or insulin ) , 10-y change in HOMA-IR ( or insulin ) , and the age 9 - 10 y insulin x total caloric intake interaction predicted IFG and T2DM at age 18 - 19 y. CONCLUSIONS Pre-teen IFG , insulin resistance ( and insulin ) , and rapidly increasing insulin resistance during adolescence identifies girls who are at greater risk of future IFG and T2DM . In addition , insulin resistance , interacting with high-fat diets , identifies girls who are at risk of greater weight gain . These findings could open avenues to primary prevention of obesity , IFG , and T2DM in children Our first specific aim in an observational study of 431 nondiabetic women with polycystic ovary syndrome ( PCOS ) , aged > or=20 years and with > or=11 months follow-up on metformin diet  , was to prospect ively assess relationships between pretreatment glucose and insulin resistance ( IR ) and the development of type 2 diabetes mellitus ( T2DM ) or gestational diabetes ( GD ) . Our second specific aim was to determine whether development of T2DM and GD was independently associated with lesser reduction of IR on metformin diet when compared with women who remained free of T2DM and GD . Women with body mass index < 25 kg/m(2 ) and those with body mass index > or=25 kg/m(2 ) were , respectively , instructed in a 2000- or 1500-cal/d , high-protein ( 26 % of calories ) , low-carbohydrate ( 44 % ) diet , with 30 % of calories as fat and a polyunsaturate-saturate ratio of 2:1 . Three groups of women with PCOS were categorized : ( a ) 17 with no previous GD , who developed T2DM on metformin diet ( mean + /- SD follow-up , 49 + /- 33 months ) , ( b ) 401 with no previous GD and free of T2DM on metformin diet ( follow-up , 38 + /- 25 months ) , and ( c ) 13 with either previous GD or GD on metformin diet ( follow-up , 38 + /- 25 months ) . On metformin diet , women who developed T2DM vs those who remained free of T2DM had higher pretreatment glucose ( odds ratio [ OR ] , 1.09 ; 95 % confidence interval [ CI ] , 1.03 - 1.16 ; P = .003 ) and homeostasis model assessment of insulin resistance ( HOMA-IR ) ( OR , 1.22 ; 95 % CI , 1.04 - 1.42 ; P = .01 ) , and less reduction of HOMA-IR ( OR , 0.82 ; 95 % CI , 0.72 - 0.92 ; P = .0008 ) . On metformin diet , women either with previous GD or who developed GD vs those who remained free of T2DM had less reduction of HOMA-IR ( OR , 0.88 ; 95 % CI , 0.78 - 0.99 ; P = .03 ) . By repeated- measures analysis , on metformin diet , women who did not develop T2DM had reduction in HOMA-IR ( P < .0001 ) , with the slope of this curve different ( P = .002 ) from the unchanged IR exhibited by women who developed T2DM and different ( P = .017 ) from an increased IR slope ( P = .049 ) in women who had GD . In women with PCOS , pretreatment glucose and IR , and lesser reduction in IR on metformin diet were associated with T2DM and GD Background : Insulin resistance ( IR ) can precede the dysglycemic states of prediabetes and type 2 diabetes mellitus ( T2DM ) by a number of years and is an early marker of risk for metabolic and cardiovascular disease . There is an unmet need for a simple method to measure IR that can be used for routine screening , prospect i ve study , risk assessment , and therapeutic monitoring . We have reported several metabolites whose fasting plasma levels correlated with insulin sensitivity . These metabolites were used in the development of a novel test for IR and prediabetes . Methods : Data from the Relationship between Insulin Sensitivity and Cardiovascular Disease Study were used in an iterative process of algorithm development to define the best combination of metabolites for predicting the M value derived from the hyperinsulinemic euglycemic clamp , the gold st and ard measure of IR . Subjects were divided into a training set and a test set for algorithm development and validation . The result ing calculated M score , MQ , was utilized to predict IR and the risk of progressing from normal glucose tolerance to impaired glucose tolerance ( IGT ) over a 3 year period . Results : MQ correlated with actual M values , with an r value of 0.66 . In addition , the test detects IR and predicts 3 year IGT progression with areas under the curve of 0.79 and 0.70 , respectively , outperforming other simple measures such as fasting insulin , fasting glucose , homeostatic model assessment of IR , or body mass index . Conclusions : The result , Quantose ™ , is a simple test for IR based on a single fasting blood sample and may have value as an early indicator of risk for the development of prediabetes and T2DM BACKGROUND Increase in obesity and metabolic syndrome are associated with increases in insulin resistance ( IR ) and type 2 diabetes mellitus . Results from animal intervention studies and human epidemiological studies suggest that n-3 polyunsaturated fatty acids can prevent and reverse IR , but results from human intervention studies have varied . Results from some human and animal studies suggest that docosahexaenoic acid ( 22:6n-3 ; DHA ) may be more effective than eicosapentaenoic acid ( 20:5n-3 ; EPA ) in the prevention of IR . METHODS By using a placebo-controlled , parallel study design , we examined the effects of DHA supplementation ( 3 grams/day , 90 days ) in the absence of EPA on glucocentric and lipocentric markers of IR in hypertriglyceridemic men ( n=14 - 17/group ) . RESULTS DHA supplementation increased fasting plasma glucose concentration by 4.7 % ( P<0.05 ) , but did not alter other indices of IR based on fasting ( insulin and homeostasis model assessment of insulin resistance [ HOMA-IR ] ) or postpr and ial insulin and glucose concentrations ( areas under curves for insulin and glucose , Matsuda index ) . Glucose increased by 2.7 % in the placebo group and was not significant ; increases in glucose in the two groups did not differ from each other . DHA decreased circulating concentrations of several lipocentric markers of IR , including plasma concentrations of nonesterified fatty acids ( 13.0 % ) , small , dense low-density lipoprotein ( LDL ) particles ( 21.7 % ) , and ratio of tryglycerides to high-density lipoprotein cholesterol ( TG/HDL-C ) ( 34.0 % ) ( P<0.05 ) . None of the variables changed in the placebo group . CONCLUSIONS Our results suggest that lipocentric markers of IR are more responsive to DHA supplementation than the glucocentric markers . Future studies with  DHA  in prediabetic subjects and direct measures of insulin sensitivity are needed Background Recent studies have shown that omentin-1 derived from adipokines can affect physiological regulations and some metabolic dis-eases such as type 2 diabetes mellitus ( T2DM ) . Methods The purpose of this study was to examine the impact of 12 weeks of aerobic ( cycle ergometer ) , resistance , and combined exercises on omentin-1 level , glucose and insulin resistance indices in overweight middle age women with T2DM . In this study , 60 overweight middle age diabetic women were selected using simple r and om sampling and they were assigned to three groups of aerobic exercise ( n=12 ) , resistant exercise ( n=12 ) and combined exercise ( n=13 ) , and one control group ( n=15 ) . Exercises were done in a three times per week sessions for a total of 12 weeks . Blood sample s were collected before each exercise session and 24 hours after of the last session . Results Present study showed that fasting blood sugar decreased significantly in all intervention groups , while homeostasis model assessment of insulin resistance ( HOMA-IR ) decreased only in the aerobic and combined exercises groups . Furthermore , there was a significant increase in the omentin-1 level only in the combined exercise group . Conclusion Compared to aerobic and resistance exercises , 12 weeks of combined exercise was more efficient in improving HOMA-IR and increasing serum omentin-1 among women with T2DM BACKGROUND Laparoscopic Roux-en-Y gastric bypass ( LRYGB ) and laparoscopic sleeve gastrectomy ( LSG ) are associated with glucose metabolism improvement although data on insulin resistance remission rates after these procedures are lacking . AIMS Primary aim was to compare insulin resistance remission rates achieved after LRYGB and LSG , using population -specific HOMA-IR cut-off points . Secondary objectives were to analyze factors associated with type 2 diabetes mellitus ( T2DM ) complete remission according to the new American Diabetes Association criteria and to examine changes in HOMA-B during follow-up . METHODS Non-r and omized , prospect i ve cohort study of patients undergoing LRYGB or LSG with a minimal follow-up of 24 months . Patients on insulin therapy were excluded . RESULTS At baseline , 56 ( 48.7 % ) of the 115 LRYGB group and 48 ( 61.5 % ) of the 78 LSG group had insulin resistance , and 29 ( 25.2 % ) and 20 ( 25.6 % ) T2DM , respectively . No differences were detected in insulin resistance remission rate ( 92.9 % LRYGB and 87.5 % LSG , p = 0.355 ) nor in T2DM complete remission at 2 years ( 62.1 vs 60 % respectively , p = 0.992 ) . Factors independently associated with T2DM complete remission were diabetes treatment and a greater decrease in 3-month HOMA-IR index . The HOMA-B index showed a progressive decline during follow-up . CONCLUSION Both surgical techniques are equally effective in achieving insulin resistance normalization in the majority of severely obese patients . Three-month HOMA-IR reduction after surgery was the main predictor of T2DM complete remission OBJECTIVE ω-3 Polyunsaturated α-linolenic acid ( ALA ) supplementation has not been studied in the setting of adiponectin levels and insulin sensitivity ( IS ) improvements in patients with type 2 diabetes mellitus ( T2DM ) by hyperinsulinemic-euglycemic clamp ( HEC ) . The aim of this study was to examine the influence of ω-3 ALA on IS and adiponectin . METHODS We conducted a r and omized study in patients with T2DM and assessed IS using HEC . Twenty patients with T2DM were included and r and omly assigned to receive 3 g/d of ALA or placebo for 60 d , in a double-blind design . The assessment of IS by HEC was performed at baseline and after 60 d in all patients ; blood sample s were taken for the measurement of serum lipids , glucose , insulin , adiponectin , and cytokines . The primary outcome variables were an increase of both glucose infusion rate ( GIR ) in steady state and glucose metabolization ( M ) by HEC . The secondary outcomes were an increase in adiponectin levels and a decrease in fasting plasma glucose , glycated hemoglobin , homeostasis model assessment -estimated insulin resistance ( HOMA-IR ) index , lipids and cytokines . The study was conducted at an academic medical center . RESULTS The ALA group improved IS corrected for fat-free mass ( M/FFM ; P = 0.04 ) . Both groups showed increased adiponectin after 60 d ( P = 0.01 ) , however , the increase for the ALA group was greater ( P = 0.04 ) . In the ALA group , adiponectin was positively correlated with GIR ( r = 0.76 ; P = 0.01 ) and M/FFM ( r = 0.62 ; P = 0.06 ) , and negatively correlated with HOMA-IR ( r = -0.61 ; P = 0.03 ) . CONCLUSION ω-3 ALA supplementation improved glucose homeostasis and was associated with an increase in adiponectin . Improvement in the overall metabolic profile with ω-3 ALA suggests a potential clinical utility for this agent and requires further investigation Purpose Inulin-type fructans are recognized as prebiotic dietary fibres and classified as non-digestible carbohydrates that do not contribute to glycaemia . The aim of the present studies was to investigate the glycaemic response ( GR ) and insulinaemic response ( IR ) to foods in which sucrose was partially replaced by inulin or oligofructose from chicory . Methods In a double-blind , r and omized , controlled cross-over design , 40–42 healthy adults consumed a yogurt drink containing oligofructose or fruit jelly containing inulin and the respective full-sugar variants .  Capillary blood glucose and insulin were measured in fasted participants and at 15 , 30 , 45 , 60 , 90 , and 120 min after starting to drink/eat . For each test food , the incremental area under the curve ( iAUC ) for glucose and insulin was calculated and the GR and IR determined . Results Consumption of a yogurt drink with oligofructose which was 20 % reduced in sugars significantly lowered the glycaemic response compared to the full-sugar reference ( iAUC120min 31.9 and 37.3 mmol/L/min , respectively ; p < 0.05 ) . A fruit jelly made with inulin and containing 30 % less sugars than the full-sugar variant likewise result ed in a significantly reduced blood glucose response ( iAUC120min 53.7 and 63.7 mmol/L/min , respectively ; p < 0.05 ) . In both studies , the postpr and ial insulin response was lowered in parallel ( p < 0.05 ) . The reduction of postpr and ial glycaemia was positively correlated to the proportion of sugars replaced by inulin-type fructans ( p < 0.001 ) . Conclusions In conclusion , the studies confirmed that substitution of glycaemic sugars by inulin or oligofructose from chicory may be an effective strategy to reduce the postpr and ial blood glucose response to foods INTRODUCTION Diabetes mellitus is the most common metabolic disorder in humans , and its incidence is increasing rapidly worldwide . Although polyunsaturated fatty acids have beneficial effects on diabetes mellitus , previous data regarding the possible positive effects of n-3 fatty acids on glycaemic indices were inconclusive . We conducted a double-blind r and omised clinical trial to determine the effects of eicosapentaenoic acid ( EPA ) , an n-3 polyunsaturated fatty acid , on overweight patients with type 2 diabetes mellitus ( T2DM ) . METHODS This double-blind , placebo-controlled r and omised clinical trial was conducted on a total of 67 overweight patients with T2DM for a duration of three months . Of these 67 patients , 32 received 2 g purified EPA daily , while 35 received a placebo of 2 g corn oil daily . The patients ' fasting plasma glucose ( FPG ) , serum insulin , glycated haemoglobin ( HbA1c ) and insulin sensitivity indices were assessed . RESULTS After three months of EPA supplementation , the group that received EPA showed significant decreases in FPG ( p < 0.001 ) , HbA1c ( p = 0.01 ) and homeostasis model assessment of insulin resistance ( HOMA-IR ) ( p = 0.032 ) , when compared to the placebo group . EPA supplementation result ed in decreased serum insulin levels , with the levels between the EPA and placebo groups showing a significant difference ( p = 0.004 ) . CONCLUSION The results of our study indicate that EPA supplementation could improve insulin sensitivity . It was able to decrease serum insulin , FPG , HbA1c and HOMA-IR .  EPA could have beneficial effects on glycaemic indices in patients with T2DM OBJECTIVE To examine the effects of alpha-lipoic acid ( ALA ) treatment over a period of 2 months on fasting blood glucose ( FBG ) , insulin resistance ( IR ) , and glutathione peroxidase ( GH-Px ) activity in type 2 diabetes ( T2DM ) patients . METHODS This study took place in Motahari Clinic , Shiraz , Iran , which is affiliated to Shiraz University of Medical Sciences from May to October 2006 . Type 2 DM patients ( n=57 ) were divided into 2 groups to receive either ALA ( 300 mg daily ) or placebo by systematic r and omization , and were followed-up for 8 weeks . After an overnight fasting and 2 hours after breakfast , patients ' blood sample s were drawn and tested for FBG , 2 hours  PPG , serum insulin level , and GH-Px activity .  RESULTS The result of the study showed a significant decrease in FBG and PPG levels , IR-Homeostasis Model Assessment ( IR-HOMA index ) and GH-Px level in the ALA group . The comparison of differences between FBG and IR at the beginning and at the end of study in the ALA treated group and the placebo group were also significant . CONCLUSION This study supports the use of ALA as an antioxidant in the care of diabetic patients OBJECTIVE To investigate the effects of insulin resistance ( IR ) and insulin secretion ( IS ) on the development of diabetes mellitus in individuals with impaired glucose tolerance ( IGT ) who underwent lifestyle interventions .  METHODS 284 out of 577 individuals with IGT identified by population -based screening in Da Qing , China , who were r and omized to undergo diet change and /or increased physical activity  had baseline fasting and 2 h post-load insulin determinations . They were followed for 6 years for the development of diabetes . IR and IS were assessed using calculated indices based on fasting plasma insulin and glucose . The interactions of IR , IS , obesity and plasma glucose and the effects of the lifestyle interventions were evaluated using Cox Proportional Hazards analysis . RESULTS Both IR and IS were significantly associated with the development of diabetes . Lifestyle interventions were more effective in those with lower IT and higher IS at baseline . Diet plus exercise interventions result ed in significantly lower incidence of diabetes , even after controlling for IR , IS , BMI and 2hrPG . CONCLUSION Both IR and beta-cell function were predictors of diabetes in Chinese with IGT . Lifestyle intervention reduced the incidence of DM and these interventions were more effective in those with less IR Our study wants to evaluate the effects of one year treatment with orlistat plus L-carnitine compared to orlistat alone on body weight , glycemic and lipid control , and insulin resistance state in type 2 diabetic patients . Two hundred and fifty-eight patients with uncontrolled type 2 diabetes mellitus ( T2DM ) [ glycated hemoglobin ( HbA(1c ) ) > 8.0 % ] in therapy with different oral hypoglycemic agents or insulin  were enrolled in this study and r and omised to take orlistat 120 mg three times a day plus L-carnitine 2 g one time a day or orlistat 120 mg three times a day . We evaluated at baseline , and after 3 , 6 , 9 , and 12 months these parameters : body weight , body mass index ( BMI ) , HbA(1c ) , fasting plasma glucose ( FPG ) , post-pr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance index ( HOMA-IR ) , total cholesterol ( TC ) , low density lipoprotein-cholesterol ( LDL-C ) , high density lipoprotein-cholesterol ( HDL-C ) , triglycerides ( Tg ) , retinol binding protein-4 ( RBP-4 ) , resistin , visfatin , high sensitivity-C reactive protein ( Hs-CRP ) . We observed a faster , and better decrease of body weight , HbA(1c ) , FPG , PPG , LDL-C , HOMA-IR with orlistat plus L-carnitine compared to orlistat . A faster improvement of TC , Tg , FPI , resistin , RBP-4 , visfatin , and Hs-CRP was reached with orlistat plus L-carnitine compared to orlistat . We can safely conclude that the association of orlistat plus L-carnitine was better than orlistat in improving body weight , glycemic and lipid profile , insulin resistance , and inflammatory parameters and no significant adverse events were recorded OBJECTIVE Insulin resistance is associated with progression of atherosclerosis . We assessed the effect of 12 months of treatment with rosiglitazone ( RSG ) on the progression of carotid intima-media thickness ( IMT ) in people with type 2 diabetes mellitus ( T2DM ) or the insulin resistance syndrome ( IRS ) . DESIGN R and omized , double-blind , placebo-controlled trial . SETTING Malmö University Hospital , Malmö , Sweden . SUBJECTS 555 subjects ( 200 with T2DM and 355 nondiabetics with IRS according to EGIR criteria ) , aged 35 - 80 years . 447 subjects ( 165 T2DM and 282 IRS ) completed the study . INTERVENTION Participants were allocated to placebo or RSG 4 mg for 2 months and then 8 mg daily . MAIN OUTCOME MEASURE Change in composite IMT [ mean IMT in the common carotid artery ( CCA ) and maximal IMT in the bulb ] was the primary and various other IMT measures were secondary outcome variables . RESULTS There was no effect of RSG treatment in the mixed population . In T2DM patients there was a reduced progression of the composite IMT ( mean change : 0.041 vs. 0.070 mm , P = 0.07 ) , and of the mean IMT CCA ( mean change : -0.005 mm vs. 0.021 mm , P = 0.007 ) . RSG treatment led to significant reductions of HOMA-IR , fasting plasma glucose , HbA1c , PAI-1 activity , fibrinogen , C-reactive protein and matrix metalloproteinase-9 . CONCLUSIONS In a mixed study population of patients with T2DM and IRS RSG treatment was not associated with a statistically significant reduction of carotid IMT progression rate . Separate analyses of these two patient groups indicated , however , a significant beneficial effect on CCA IMT in T2DM patients but no similar effect in subjects with IRS AIMS Circulating visfatin levels are altered in insulin resistant states . We evaluated the effects of two insulin-sensitizing hypoglycemic agents on plasma visfatin and adiponectin levels in patients with newly diagnosed and untreated type 2 diabetes mellitus ( T2DM ) . METHODS Forty-four patients with T2DM were r and omized to treatment either with pioglitazone ( 15 - 45mg/day ) or metformin ( 1000 - 2000mg/day ) . Plasma visfatin and adiponectin levels and homeostasis model assessment of insulin resistance ( HOMA-IR ) scores were determined at baseline and at 12th week of treatment . RESULTS By the end of the 12th week , fasting plasma glucose , HbA1c , HOMA-IR scores and waist circumferences improved equally in both treatment arms . HDL cholesterol and adiponectin levels increased only in the pioglitazone group ( p=0.01 and p=0.003 , respectively ) . On the other h and , metformin treatment had additional regulatory effects on BMI , blood pressure and total and LDL-cholesterol levels ( p=0.002 , p=0.01 , p=0.004 , p=0.001 and p<0.001 , respectively ) . Neither pioglitazone nor metformin displayed a significant effect on circulating visfatin concentration . CONCLUSIONS Despite improvements in insulin sensitivity and glycemic regulation , either pioglitazone or metformin treatment did not result in any effect on blood visfatin levels in patients with treatment naïve T2DM Abstract Aim This study was undertaken to determine whether metformin would ameliorate insulin resistance , reduce weight and waist circumference and improve lipids in obese , but not morbidly obese , euglycemic women . Methods Obese women ( body mass index ( BMI ) ≥ 30 and < 40 kg/m2 and /or waist circumference > 88 cm ) , aged 35–65 were r and omized ( 1:1 ) to metformin 850 mg or identical placebo , twice daily for 26 weeks . The primary outcome was the change in insulin resistance determined by the homeostasis model of assessment ( HOMA-IR ) . Secondary outcomes included fasting insulin , glucose , weight , waist circumference and BMI . Results Of the 125 women screened , 117 enrolled and 100 women , mean age 53 years , were included in the primary intention-to-treat analysis . Metformin result ed in statistically significant between-group difference in the change in HOMA-IR ( change in median − 0.04 vs. placebo + 0.1 , p = 0.018 ) and BMI ( mean change − 1.00 kg/m2 ; 95 % confidence interval ( CI ) 1.37 to − 0.62 vs. placebo mean change 0.00 ; 95 % CI − 0.29 to 0.28 , p < 0.001 ) . Statistically significant reductions in HbA1c ( p = 0.008 ) and fasting insulin ( p = 0.03 ) and a borderline decrease in high density lipoprotein cholesterol ( p = 0.07 ) were also observed for metformin , compared with placebo . No effects were seen for waist circumference , fasting glucose or other lipids . Conclusion Treatment of euglycemic , obese , middle-aged women  with metformin 1700 mg per day reduced insulin resistance and weight compared with placebo . Further studies are needed to determine whether the use of metformin will prevent the progression of insulin resistance to type 2 diabetes mellitus in obese women Background : It has been shown that camel milk consumption has a definite decreasing effect on the prevalence of diabetes . However , most of these studies were conducted on patients with type 1 diabetes , whereas studies on patients with type 2 diabetes mellitus ( T2DM ) are limited . In vitro experiments have shown that camel milk was able to decrease blood glucose concentration . Objectives : The purpose of this study was to investigate effects of camel and cow milk on blood sugar , lipid profile , and blood pressure of patients with T2DM . Patients and Methods : In a r and omized single-blinded controlled clinical trial , 20 patients with T2DM were r and omly allocated into two groups . Participants consumed 500 mL of either camel milk ( intervention group ) or cow milk ( control group ) daily for two months . Results : Mean of insulin concentration was significantly increased from 64.59 to 84.03 pmol/L in the camel milk group during the study ( P < 0.05 ) . No significant differences were shown in fasting blood sugar , lipid profile , and blood pressure between the two groups at the end of study . There was significant increase in homeostasis model assessment of insulin resistance ( HOMA-IR ) during the study in both groups , but no significant difference was seen between the two groups . Conclusions : Camel milk increased insulin level in patients with T2DM and might contribute to glycemic control in T2DM We investigated cross-sectionally whether the type 2 diabetes ( T2DM ) risk alleles of rs1801282 ( PPARG2 ) and rs4607103 ( ADAMTS9 ) were associated with T2DM and /or insulin sensitivity ( IS ) and beta cell function ( βF ) in Italians without and with newly diagnosed T2DM . In 676 nondiabetic subjects ( 336 NGR and 340 IGR ) from the GENFIEV study and in 597 patients from the Verona Newly Diagnosed Type 2 Diabetes Study ( VNDS ) , we ( 1 ) genotyped rs1801282 and rs4607103 , ( 2 ) assessed βF by C-peptide/glucose modeling after OGTT , and ( 3 ) assessed IS by HOMA-IR in both studies and by euglycemic insulin clamp in VNDS only . Logistic , linear , and two-stage least squares regression analyses were used to test ( a ) genetic associations with T2DM and with pathophysiological phenotypes , ( b ) causal relationships of the latter ones with T2DM by a Mendelian r and omization design . Both SNPs were associated with T2DM . The rs4607103 risk allele was associated to impaired βF ( p < 0.01 ) in the GENFIEV study and in both cohorts combined . The rs1801282 genotype was associated with IS both in the GENFIEV study ( p < 0.03 ) and in the VNDS ( p < 0.03 ) , whereas rs4607103 did so in the VNDS only ( p = 0.01 ) . In a Mendelian r and omization design , both HOMA-IR ( instrumental variables : rs1801282 , rs4607103 ) and βF ( instrumental variable : rs4607103 ) were related to T2DM ( p < 0.03–0.01 and p < 0.03 , respectively )  . PPARG2 and ADAMTS9 variants are both associated with T2DM and with insulin resistance , whereas only ADAMTS9 may be related to βF. Thus , at least in Italians , they may be considered bona fide “ insulin resistance genes ” BACKGROUND Homeostasis Model Assessment -Adiponectin ( HOMA-AD ) is suggesting a new biomarker of insulin resistance in obese population . In this way , the purpose of this study was to investigate the effects of different kinds of exercise in the sensitive index predictor of insulin resistance . METHODS A total of 148 obese adolescents were enrolled in the program . They aged 15 - 19 y , with Body Mass Index ( BMI ) ≥P95th and were su bmi tted to 1 year of interdisciplinary weight loss therapy , r and omized in two groups , aerobic training ( AT ) ( N.=51 ) and aerobic plus resistance training ( N.=97 ) . Blood sample s were collected to analyze adiponectin , glucose and insulin concentrations . The insulin resistance was measured by HOMA-AD and Homeostasis Model Assessment Insulin Resistance Index ( HOMA-IR ) . RESULTS Both kinds of exercise training promoted a decrease in body mass , body mass index , fat mass , visceral and subcutaneous fat . However , only aerobic plus resistance training was effective to reduce HOMA-AD , insulin and glucose concentration ; and increase insulin sensibility and adiponectin concentration . CONCLUSIONS The aerobic plus resistance training was more effective than AT alone to improve the HOMA-AD , suggesting clinical application on obesity , diabetes , atherosclerosis and metabolic syndrome control in the pediatric population Objective Genome-wide association studies ( GWASs ) identified that SLC30A8 genetic polymorphism was a risk of type 2 diabetes mellitus ( T2DM ) in several population s. This study aim ed to investigate whether the SLC30A8 rs13266634 and rs16889462 polymorphisms were associated with T2DM susceptibility and repaglinide therapeutic efficacy in Chinese T2DM patients . Methods We conducted a case – control study of 443 T2DM patients and 229 healthy volunteers to identify SLC30A8 rs13266634 and rs16889462 genotypes by polymerase chain reaction – restriction fragment length polymorphism ( PCR-RFLP ) assay . Forty-eight patients were r and omly selected and underwent an 8-week repaglinide treatment ( 3 mg/d ) . Fasting plasma glucose ( FPG ) , postpr and ial plasma glucose ( PPG ) , glycated hemoglobin ( HbAlc ) , fasting serum insulin ( FINS ) , postpr and ial serum insulin ( PINS ) , homeostasis model assessment for insulin resistance ( HOMA-IR ) , serum triglyceride , total cholesterol ( TC ) , low-density lipoprotein-cholesterol ( LDL-c ) and high-density lipoprotein-cholesterol ( HDL-c ) were determined before and after repaglinide treatment . Results SLC30A8 rs13266634 risk C allele frequency was higher in T2DM patients than in healthy controls ( P < 0.05 ) . There was a better repaglinide response on FINS ( P < 0.05 ) and PINS ( P < 0.01 ) in patients with rs13266634 CT+TT genotypes compared with CC genotype carriers . Patients with rs16889462 GA genotype showed an enhanced repaglinide efficacy on FPG ( P < 0.01 ) , PPG ( P < 0.01 ) and HbAlc ( P < 0.05 ) compared with GG genotype individuals . Conclusions SLC30A8 rs13266634 and rs16889462 polymorphisms were associated with repaglinide therapeutic efficacy in Chinese T2DM patients Women with polycystic ovary syndrome ( PCOS ) are insulin resistant secondary to a postbinding defect in insulin signaling . Sequential euglycemic glucose clamp studies at 40 and 400 mU. m(-2 ) . min(-1 ) insulin doses with serial skeletal muscle biopsies were performed in PCOS and age- , weight- , and ethnicity-matched control women .  Steady-state insulin levels did not differ , but insulin-mediated glucose disposal was significantly decreased in PCOS women ( P < 0.05 ) . Insulin receptor substrate (IRS)-1-associated phosphatidylinositol 3-kinase ( PI 3 K ) activity was significantly decreased in PCOS ( n = 12 ) compared with control skeletal muscle ( n = 8 ; P < 0.05 ) . There was no significant difference in the abundance of IR , IRS-1 , or the p85 regulatory subunit of PI 3 K in PCOS ( n = 14 ) compared with control ( n = 12 ) muscle . The abundance of IRS-2 was significantly increased ( P < 0.05 ) in PCOS skeletal muscle , suggesting a compensatory change . We conclude that there is a physiologically relevant defect in insulin receptor signaling in PCOS that is independent of obesity and type 2 diabetes mellitus To evaluate the effects of 1-year treatment with orlistat plus L-carnitine compared to orlistat alone on body weight , glycemic and lipid control , and inflammatory parameters in obese type 2 diabetic patients . Two hundred and fifty-eight patients with uncontrolled type 2 diabetes mellitus ( T2DM ) [ glycated hemoglobin ( HbA(1c ) ) > 8.0 % ] in therapy with different oral hypoglycemic agents or insulin  were enrolled in this study and r and omized to take orlistat 120 mg three times a day plus L-carnitine 2 g one time a day or orlistat 120 mg three times a day . We evaluated the following parameters at baseline and after 3 , 6 , 9 , and 12 months : body weight , body mass index ( BMI ) , glycated hemoglobin ( HbA(1c ) ) , fasting plasma glucose ( FPG ) , postpr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance index ( HOMA-IR ) , total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , triglycerides ( Tg ) , adiponectin ( ADN ) , leptin , tumor necrosis factor-α ( TNF-α ) , vaspin , and high-sensitivity C-reactive protein ( Hs-CRP ) . We observed a better decrease in body weight , glycemic profile , HOMA-IR , LDL-C , and ADN and a faster improvement in FPI , TC , Tg , leptin , TNF-α , Hs-CRP  with orlistat plus L-carnitine compared to orlistat alone . We also recorded an improvement in vaspin  with orlistat plus l-carnitine not reached with orlistat alone . Orlistat plus L-carnitine gave a better improvement in body weight , glycemic and lipid profile compared to orlistat alone ; furthermore , a faster and better improvement in inflammatory parameters was observed with orlistat plus L-carnitine compared to orlistat alone
However , it can significantly decrease postintervention and reduction data of FPG , FI , HbA1c , and HOMA-IR .
Heterogeneity was eliminated by subgroup analysis according to baseline BMI .
There was no significant difference in the amelioration of QUICKI between the ITC and control groups .
However , the difference was statistically significant and the heterogeneity was eliminated after subgroup analysis according to intakes of ITC .
Conclusion Supplementation of ITC can ameliorate IR in T2DM , especially in obese T2DM patients , but the effects are controversial in obese patients
Background Insulin resistance ( IR ) is a physiological condition related to type 2 diabetes mellitus ( T2DM ) and obesity , which is associated with high blood insulin and glucose .
Inulin-type carbohydrate ( ITC ) is a kind of fermentable fructan that can reduce glucose and ameliorate IR in an animal model , but the effect in clinical trials is controversial .
Objective The authors conducted a systematic literature review to evaluate the effect of ITC supplementation in ameliorating IR in T2DM and obese patients .