Effect of pharmaceutical care on clinical outcomes of outpatients with type 2 diabetes mellitus Ginseng Therapy in Non-Insulin-Dependent Diabetic Patients: Effects on psychophysical performance, glucose homeostasis, serum lipids, serum aminoterminalpropeptide concentration, and body weight Randomized controlled clinical trial of a combination therapy of vildagliptin plus an α-glucosidase inhibitor for patients with type II diabetes mellitus A randomized controlled clinical trial of vildagliptin plus metformin combination therapy in patients with type II diabetes mellitus Glycemic and lipid responses to glucomannan in Thais with type 2 diabetes mellitus. Therapeutic comparison of metformin and sulfonylurea, alone and in various combinations. A double-blind controlled study. Low dose chromium-polynicotinate or policosanol is effective in hypercholesterolemic children only in combination with glucomannan. Konjac Supplement Alleviated Hypercholesterolemia and Hyperglycemia in Type 2 Diabetic Subjects—A Randomized Double-Blind Trial Chinese herbal medicine for impaired glucose tolerance: a randomized placebo controlled trial Safety and Efficacy of Glucomannan for Weight Loss in Overweight and Moderately Obese Adults Impact of Periodic Follow-Up Testing Among Urban American Indian Women With Impaired Fasting Glucose Influence of squalene feeding on plasma leptin, testosterone & blood pressure in rats. The effect of nano-curcumin on HbA1c, fasting blood glucose, and lipid profile in diabetic subjects: a randomized clinical trial A pilot study of open label sesame oil in hypertensive diabetics. Efficacy and safety of canagliflozin compared with placebo in older patients with type 2 diabetes mellitus: a pooled analysis of clinical studies Insulin versus glipizide treatment in patients with non-insulin-dependent diabetes mellitus. Effects on blood pressure and glucose tolerance. Effects of a healthy Nordic diet on cardiovascular risk factors in hypercholesterolaemic subjects: a randomized controlled trial (NORDIET). Effect of vildagliptin on hsCRP and arterial stiffness in patients with type 2 diabetes mellitus Effect of weight loss on inflammatory and endothelial markers and FMD using two low-fat diets Efficacy and safety of twice-daily treatment with canagliflozin, a sodium glucose co-transporter 2 inhibitor, added on to metformin monotherapy in patients with type 2 diabetes mellitus☆ Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial. Effect of plant sterols and glucomannan on lipids in individuals with and without type II diabetes Natural Honey and Cardiovascular Risk Factors; Effects on Blood Glucose, Cholesterol, Triacylglycerole, CRP, and Body Weight Compared with Sucrose
Background In the People ’s Republic of China , out patients have limited time with their physicians . Thus , compared to in patients , out patients have lower medication adherence and are less knowledgeable about their disease . Objective The objective of this study was to evaluate the effect of pharmaceutical care on clinical outcomes of out patients with type 2 diabetes mellitus ( T2DM ) . Patients and methods A r and omized , controlled , prospect i ve clinical trial was conducted recruiting a total of 240 T2DM out patients from Zhongda Hospital , Southeast University . The control group ( CG ) received only common care from medical staff , whereas the inter vention group ( IG ) received extra pharmaceutical care from clinical pharmacists . Biochemical data such as  blood pressure ( BP ) , fasting blood glucose ( FBG ) , glycosylated hemoglobin A1 ( HbA1c ) , and blood lipid  were collected before and after 6-month intervention . The primary end points in this study were FBG and HbA1c . Results After the intervention , most of the baseline clinical outcomes of the patients in IG significantly improved , while only body mass index , diastolic BP , low-density lipoprotein cholesterol , and total cholesterol ( TC ) improved significantly in patients in the CG . Compared to CG , in IG , there were significant improvements in FBG , HbA1c , TC , the target attainment rates of HbA1c , and BP . Conclusion Pharmaceutical care provided by clinical pharmacists could improve the control of diabetes of out patients , and clinical pharmacists could play an important role in diabetes management OBJECTIVE To investigate the effect of ginseng on newly diagnosed non-insulin-dependent diabetes mellitus ( NIDDM ) patients . RESEARCH DESIGN AND METHODS In this double-blind placebo-controlled study , 36 NIDDM patients were treated for 8 weeks with ginseng ( 100 or 200 mg ) or placebo . Efficacy was evaluated with psychophysical tests and measurements of glucose balance , serum lipids , aminoterminalpropeptide ( PIIINP ) concentration , and body weight . RESULTS Ginseng therapy elevated mood , improved psychophysical performance , and reduced fasting blood glucose ( FBG ) and body weight . The 200-mg dose of ginseng improved glycated hemoglobin , serum PIIINP , and physical activity . Placebo reduced body weight and altered the serum lipid profile but did not alter FBG . CONCLUSIONS Ginseng may be a useful therapeutic adjunct in the management of NIDDM The aim of this study was to assess the efficacy of a combination therapy of vildagliptin plus an α-glucosidase inhibitor for patients with type II diabetes mellitus . Type II diabetic patients exhibiting poor glycemic control following α-glucosidase inhibitor treatment for at least two months were selected and r and omly distributed into vildagliptin and placebo groups . The body weight , fasting blood glucose ( FBG ) , postpr and ial glucose ( PPG ) , glycated hemoglobin ( HBA1c ) and blood lipid levels and hepatorenal functions of the patients were determined before and 12 weeks after the trial . Following the trial , the FBG , PPG , HbA1c , cholesterol ( CHOL ) and triglyceride ( TG ) levels in the vildagliptin group were significantly decreased compared with the pretreatment levels ( P<0.05 ) , whereas only the PPG level in the placebo group decreased ( P<0.05 ) . The FBG , PPG and HbA1c levels in the vildagliptin group were markedly lower than those in the placebo group 12 weeks after the trial . A comparison of the body weights and hepatorenal functions before and after the trial or between groups did not show statistically significant differences . The combination therapy of vildagliptin plus an α-glucosidase inhibitor effectively reduced the FBG , PPG and HbA1c levels in patients without inducing weight gain or hepatorenal dysfunction . However , the therapy may have caused a reduction in the blood lipid levels The aim of the present study was to assess the efficacy and safety of vildagliptin plus metformin combination therapy in patients with type II diabetes mellitus . Type II diabetic patients with poor glycemic control following at least three months of metformin treatment were selected and r and omized into two groups . Vildagliptin or placebo was administered with metformin .  Body weight , fasting blood glucose ( FBG ) , postpr and ial glucose ( PPG ) , glycated hemoglobin ( HbA1c ) , blood lipid and hepatorenal function levels were analyzed in the patients prior to and 24-weeks after the trial . FBG , PPG and HbA1c levels of the patients in the vildagliptin group significantly decreased following the trial , whereas no statistically significant differences were observed in the various indicators of the placebo group prior to and following the trial . The FBG , PPG and HbA1c levels in the vildagliptin group were significantly lower compared with the placebo group 24-weeks after the trial . Comparisons of body weight , blood lipid and hepatorenal function between the groups prior to and following the trial exhibited no statistically significant differences . Therefore , vildagliptin plus metformin combination therapy effectively reduced FBG , PPG and HbA1c levels in patients with no risk of weight gain or hepatorenal dysfunction OBJECTIVE To evaluate the benefits of glucomannan supplement on glycemic and lipid controls in type 2 diabetic patients . MATERIAL AND METHOD A single-blind , placebo-controlled , crossover trial with two treatments separated by a 2-week washout period was performed in 10 men and 10 women with type 2 diabetes mellitus . Two separated protocol s of experiments were sequentially followed . Initially , purified glucomannan ( 1 g ) or placebo was ingested 30 min before 75-g glucose load to evaluate their effects on glucose absorption and insulin secretion in oral glucose tolerance test ( OGTT ) . Later , the glycemic and lipid changes after 4-week intervention with 3 g/day glucomannan comparing to the placebo were determined . The st and ard OGTT was performed before and after ending of each intervention . RESULTS Glucomannan taken before performing the OGTT can lower the rise of blood glucose and insulin from 1 to 2 hour in comparison with the placebo , though a statistically significance of insulin was not achieved . Long-term glucomannan supplement significantly reduced the 120-min glucose area under the curve of OGTT . Glucomannan also decreased the rise of low-density lipoprotein cholesterol ( LDL-C ) . Reductions of HOMA-insulin resistance index and body mass index were detected in glucomannan-treated group though the former was shown only in females . No within- and between-group differences of insulin , fructosamine , and other lipids were observed in glucomannan- nor placebo- treated groups . CONCLUSION In type 2 diabetes , pre-pr and ial glucomannan ingestion attenuated a rise of blood glucose without significantly affecting insulin levels . Long-term supplement of glucomannan to the regular diabetic regimen lessened post challenge glucose AUC and impeded the rise of LDL-C. Supplement of glucomannan may be beneficial to the glycemic and lipid controls in type 2 diabetes mellitus OBJECTIVE To assess and compare the therapeutic efficacy and safety of metformin ( M ) and sulfonylurea ( glyburide , G ) , alone and in various combinations , in patients with non-insulin-dependent diabetes mellitus ( NIDDM ) . RESEARCH DESIGN AND METHODS Of 165 patients ( fasting blood glucose [ FBG ] > or = 6.7 mmol/l ) initially treated with diet alone , 144 ( FBG still > or = 6.7 mmol/l ) were r and omized to double-blind , double-dummy controlled treatment with M , G , or primary combination therapy ( MG ) . The dose was titrated , with FBG < 6.7 mmol/l as target , using , at most , six dose levels . The first three dose levels comprised increasing single-drug therapy ( M or G ) or primary combination at increasing but low dosage ( MGL ) , and the second three levels were composed of various high-dose combinations , i.e. , add-on therapy ( M/G or G/M ) and primary combination escalated to high dosage ( MGH ) . Medication was maintained for 6 months after completed dose titration . RESULTS The FBG target was achieved in 9 % of patients after diet alone . Single-drug therapy  was insufficient in 36 % and MGL in 25 % ( NS ) of the r and omized patients . There was further improvement in glucose control by the high-dose combinations . Mean FBG + /- SE was reduced ( P = 0.001 ) from 9.1 + /- 0.4 to 7.0 + /- 0.2 mmol/l in those maintained on single-drug treatment or low-dose primary combination . Those treated with different high-dose combinations had a large mean FBG reduction , from 13.3 + /- 0.8 to 7.8 + /- 0.6 mmol/l . HbA1c levels showed corresponding reductions , and glycemic levels rose after drug discontinuation . Fasting C-peptide rose during treatment with G and MGL but not with M , while fasting insulin was not significantly changed . Meal-stimulated C-peptide and insulin levels were unchanged by M but increased by G and , to a lesser extent , by MGL . There were no significant insulin or C-peptide differences between the different high-dose combinations ( M/G , G/M , and MGH ) . Body weight did not change following treatment with M or combination but increased by 2.8 + /- 0.7 kg following G alone . Blood pressure was unchanged . Overall effects on plasma lipids were small , with no significant differences between groups . Drug safety was satisfactory , even if the reporting of ( usually modest ) adverse events was high ; the profile , but not the frequency , differed between groups . CONCLUSIONS Dose-effect titrated treatment with either metformin or glyburide promotes equal degrees of glycemic control . The former , but not the latter , is able to achieve this control without increasing body weight or hyperinsulinemia . Near-normal glycemia can be obtained by a combination of metformin and sulfonylurea , even in advanced NIDDM OBJECTIVE A low-fat , fiber-rich diet is the first step in the management for hypercholesterolemic children .  Glucomannan ( GM ) is a natural fiber that has been demonstrated to lower total and LDL-cholesterol . The use of high-dose chromium-polynicotinate ( CP ) and policosanol ( PC ) has also shown cholesterol-lowering benefits . We aim ed at investigating the effects of low-dose CP or PC and their GM combination in hypercholesterolemic children . METHODS A double-blind trial was conducted in 120 children ( 60 M , 60 F , 9 ± 4 years , median 9.6 years , range : 3 - 16 years ) r and omly assigned to 5 neutraceutical and 1 placebo ( only resistant starch ) 8-week treatment groups . Fasting blood glucose ( FBG ) , total cholesterol ( CholT ) , triglycerides ( TG ) , HDL and LDL cholesterol were considered . RESULTS GM combination of low-dose CP or PC  reduced CholT and LDL without changing HDL , TG and FBG . The highest post-treatment changes were seen after GM combination with CP ( CholT 85 ± 3 % and LDL 85 ± 5 % , of pretreatment ) which was significantly ( p < 0.01 ) less than with low-dose CP or PC and starch . When GM was associated with starch , there was no lipid lowering effect , which was an unexpected finding as compared to previous data with GM and no starch . No adverse effects were reported . CONCLUSION This is the first report to show the cholesterol-lowering efficacy  of GM combined treatment with low-dose CP or PC . Further studies are needed to investigate the best combinations and doses of nutraceutics to be added to the st and ard GM treatment . The potential negative association of GM and nutraceutics with starch is clearly shown Objectives : The present study was design ed to evaluate effects of konjac glucomannan ( KGM ) supplement ( 3.6 g/day ) for 28 days on blood lipid and glucose levels in hyperlipidemic type 2 diabetic patients and the possible mechanism for the reductions in blood lipid levels . Methods : Twenty-two diabetic subjects ( age 64.2 + 8.4 years , BMI 25.5 + 3.2 kg/m2 ) with elevated blood cholesterol levels ( fasting glucose between 6.7–14.4 mmol/L ) , but currently not taking lipid-lowering medication , were recruited to participate in a two 28-day period , r and omized , double-blind , crossover clinical trial . Fasting blood sample s drawn on the initial and final days of each period were determined for plasma lipids and glucose levels . Feces collected at the end of each experimental period were analyzed for neutral sterol and bile acid contents . Results : Compared with placebo , KGM effectively reduced plasma cholesterol ( 11.1 % , p = 0.0001 , adjusted α = 0.006 ) , LDL-cholesterol ( 20.7 % , p = 0.0004 , adjusted α = 0.006 ) , total/HDL cholesterol ratio ( 15.6 % , p = 0.0005 , adjusted α = 0.007 ) , ApoB ( 12.9 % , p = 0.0001 , adjusted α = 0.006 ) and fasting glucose ( 23.2 % , p = 0.002 , adjusted α = 0.008 ) . Plasma triglyceride , HDL-cholesterol , LDL/HDL cholesterol , postpr and ial glucose and body weight were not significant after adjustment by the Bonferroni-Hochberg procedure . Fecal neutral sterol and bile acid concentrations were increased by 18.0 % ( p = 0.004 ) and 75.4 % ( p < 0.001 ) , respectively , with KGM supplement . Conclusions : The KGM supplement improved blood lipid levels by enhancing fecal excretion of neutral sterol and bile acid and alleviated the elevated glucose levels in diabetic subjects . KGM could be an adjunct for the treatment of hyperlipidemic diabetic subjects Background Diabetes remains a major health problem worldwide . Low-risk low-cost alternatives to pharmaceutical interventions are needed where lifestyle modifications have failed . We conducted a double-blind r and omised placebo controlled trial to investigate the efficacy of a Chinese herbal formula , Jiangtang Xiaozhi , in treating impaired glucose control and insulin resistance in persons with prediabetes and controlled diabetes . Methods Seventy-one patients with prediabetes or ‘ controlled ’ diabetes were r and omised to receive 3 capsules of Jiangtang Xiaozhi ( n = 39 ) or placebo ( n = 32 ) three times daily for 16 weeks with a follow up eight weeks later ( week 24 ) . The primary outcome was change in glycaemic control as evidence d by fasting blood glucose ( FBG ) , post-pr and ial plasma glucose and glycosylated haemoglobin ( HbA1c ) . Other measures included change in fasting insulin , insulin resistance and sensitivity , lipids , C-reactive protein ( CRP ) , body mass index ( BMI ) , waist girth , blood pressure ( BP ) , health related quality of life ( HRQoL ) and safety . Analysis of covariance ( ANCOVA ) was used to model outcomes at 16 weeks , by treatment group corrected for baseline level of the outcome variable . Results In patients receiving Jiangtang Xiaozhi , FBG was not significantly different ( p = 0.73 ) compared to placebo after 16 weeks of treatment ( 6.3 ± 1.1 mmol/L vs 6.7 ± 1.3 mmol/L ) . There was a significant difference ( p = 0.04 ) in the mean levels of fasting insulin between the treatment group ( 11.6 ± 5.5 mmol/L ) and the placebo group ( 22.1 ± 25.9 mmol/L ) . Insulin resistance slightly decreased in the treatment group ( 1.58 ± 0.74 ) compared to that of the placebo group ( 2.43 ± 1.59 ) but this change did not reach statistical significance ( p = 0.06 ) . Patients taking Jiangtang Xiaozhi had a significant improvement in high-density lipoprotein ( HDL ) level compared to the placebo group at week 16 ( p = 0.03 ) . Mean levels of cholesterol , triglycerides , BMI , waist-girth , HRQoL , BP , CRP and insulin sensitivity were not significantly different between the two groups . The herbal medicine was well tolerated . Conclusions In the current study , the 16 week Jiangtang Xiaozhi treatment did not lower fasting blood glucose , but it improved serum  insulin and HDL cholesterol in a Western population with prediabetes or controlled diabetes . Our trial may have been underpowered . Dosage needs to be considered before commencing a longer adequately powered trial . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12612000128897;https://www.anzctr.org.au/Trial/ Registration /Trial Review Background . Few safe and effective dietary supplements are available to promote weight loss . We evaluated the safety and efficacy of glucomannan , a water-soluble fiber supplement , for achieving weight loss in overweight and moderately obese individuals consuming self-selected diets . Methods . Participants were r and omly assigned to take 1.33 grams of glucomannan or identically looking placebo capsules with 236.6 mL ( 8 ounces ) of water one hour before breakfast , lunch , and dinner for 8 weeks . The primary efficacy outcome was change in body weight after 8 weeks . Other efficacy outcomes were changes in body composition , hunger/fullness , and lipid and glucose concentrations . Safety outcomes included gastrointestinal symptoms/tolerance and serum liver enzymes and creatinine levels . Results . A total of 53 participants ( 18–65 years of age ; BMI 25–35 kg/m2 ) were enrolled and r and omized . The two groups did not differ with respect to baseline characteristics and compliance with the study supplement . At 8 weeks , there was no significant difference between the glucomannan and placebo groups in amount of weight loss ( −.40 ± .06 and −.43 ± .07 , resp . ) or other efficacy outcomes or in any of the safety outcomes . Conclusions . Glucomannan supplements administered over 8 weeks were well tolerated but did not promote weight loss or significantly alter body composition , hunger/fullness , or lipid and glucose parameters . This trial is registered with NCT00613600 Introduction Impaired fasting glucose ( IFG ) often progresses to type 2 diabetes . Given the severity and prevalence of this disease , primary prevention is important . Intensive lifestyle counseling interventions have delayed or prevented the onset of type 2 diabetes , but it is not known whether less intensive , more easily replicable efforts can also be effective . Methods In a lifestyle intervention study design ed to reduce risks for type 2 diabetes , 200 American Indian women without diabetes , aged 18 to 40 years , were recruited from an urban community without regard to weight or IFG and block-r and omized into intervention and control groups on the basis of fasting blood glucose ( FBG ) . Dietary and physical activity behaviors were reported , and clinical metabolic , fitness , and body composition measures were taken at baseline and at periodic follow-up through 18 months . American Indian facilitators used a group- discussion format during the first 6 months to deliver a culturally influenced educational intervention on healthy eating , physical activity , social support , and goal setting . We analyzed a subset of young American Indian women with IFG at baseline ( n = 42 ) , selected from both the intervention and control groups . Results Among the women with IFG , mean FBG significantly decreased from baseline to follow-up ( P < .001 ) and converted to normal ( < 5.6 mmol/L or < 100 mg/dL ) in 62.0 % of the 30 women who completed the 18-month follow-up , irrespective of participation in the group educational sessions . Other improved metabolic values included significant decreases in mean fasting blood total cholesterol and low-density lipoprotein cholesterol levels . The women reported significant overall mean decreases in intake of total energy , saturated fat , total fat , total sugar , sweetened beverages , proportion of sweet foods in the diet , and hours of TV watching . Conclusion Volunteers with IFG in this study benefited from learning their FBG values and reporting their dietary patterns ; they made dietary changes and improved their FBG and lipid profiles . If confirmed in larger sample s , these results support periodic dietary and body composition assessment , as well as glucose monitoring among women with IFG BACKGROUND & OBJECTIVES Obesity , hyperlipidaemia and hypercholesterolaemia are known risk factors in the pathogenesis of hypertension . Squalene has been shown to reduce serum cholesterol and triglycerides in dogs although its therapeutic use in high BP and obese patients has not been established . This study evaluates the effect of feeding high doses of squalene on plasma leptin , glucose , testosterone , blood pressure ( BP ) and body fat in rats . METHODS Wistar rats ( male , 22 days old ) were r and omly divided into two groups receiving either regular control diet or a squalene-containing diet . After feeding squalene for 4 wk , 10 rats each from the squalene and control groups were sacrificed and blood sample s were collected for measurement of leptin , cholesterol , triglycerides and testosterone . Blood pressure was monitored weekly . RESULTS Following squalene feeding , BP and body weight gain were lower in the squalene group . BP was significantly lower from 47 days of age in squalene fed group compared to controls . The levels of plasma leptin , glucose , cholesterol and triglycerides were significantly lower in squalene fed rats than those from the control group at 51 and 75 days of age . However , testicular weights ( only 75 days ) and testosterone levels were significantly higher in rats from the squalene group than those from the control group at days 51 and 75 . INTERPRETATION & CONCLUSION Our results suggested that squalene may counteract the increase in body fat , BP and levels of plasma leptin , glucose , cholesterol and triglycerides . These effects of squalene may be further explored as a likely new approach for clinical management of high BP and obesity Objective : Diabetes mellitus is defined as a group of metabolic diseases characterized by hyperglycemia result ing from defects in insulin secretion , insulin action , or both or insulin resistance . Curcumin inhibits NF-κB signaling pathway . The aim of this study is evaluation of the effect of Nano-curcumin on HbA1C , fast blood glucose and lipid profile in diabetic patients . Material s and Methods : Seventy type-2 diabetic patients ( fasting blood glucose ( FBG ) ≥ 126 mg/dL or 2-hr postpr and ial blood glucose ≥200 mg/dl ) r and omly receivedeither Curcumin ( as nano-micelle 80 mg/day ) or placebo  for 3 months in a double blind r and omized clinical trial . Fasting blood glucose , HbA1C , and lipids profile were checked before and after the intervention . Data analyses , including parametric and nonparametric tests were done using the SPSS 11.5 software . A p value < 0.05 was regarded as statistically significant . ( RCT registration code : I RCT 2013081114330N1 ) Results : Mean age , BMI , FBG , total cholesterol ( TC ) , triglyceride ( TG ) , LDL , HDL , HbA1c , and sex and had no significant difference at the baseline between the groups . In Nano-curcumin group , a significant decrease was found in HbA1C , FBG , TG , and BMI comparing results of each subject before and after the treatment ( p<0.05 ) . By comparing pre- and post-treatment values among the groups , HbA1c , eAG , LDL-C , and BMI variables showed significant differences ( p<0.05 ) . Conclusion : These findings suggest an HbA1c lowering effect  for Nano-curcumin in type-2 diabetes ; also , it is partially decrease in serum LDL-C and BMI The objective of this study was to investigate the effect of sesame oil in hypertensive diabetics medicated with atenolol ( beta-blocker ) and glibenclamide ( sulfonylurea ) .  This open label trial with two intervention periods comprised 22 male and 18 female patients , 45 - 65 years old , with mild to moderate hypertension and diabetes .  Sesame oil ( Idhayam Gingelly oil , V.V.V. & Sons , Virudhunagar , Tamilnadu , India ) was supplied to the patients , who were instructed to use it in place of other cooking oils for 45 days . Blood pressure ( BP ) , anthropometric measurements , plasma glucose , glycated hemoglobin ( HbA1c ) , lipid profiles [ total cholesterol , low-density lipoprotein cholesterol ( LDL-C ) , and high-density lipoprotein cholesterol , and triglycerides ( TG ) ] , lipid peroxidation [ thiobarbituric acid-reactive substances ( TBARS ) ] , electrolytes ( sodium , potassium , and chloride ) , and enzymic ( superoxide dismutase , glutathione peroxidase , and catalase ) and nonenzymic ( vitamin C , vitamin E , beta-carotene , and reduced glutathione ) antioxidants were measured at baseline and after 45 days of sesame oil substitution . The same patients were then switched over to other oils like palm or groundnut oils as their regular oils at r and om for another 45 days , and the investigations were carried out again at the end . Systolic and diastolic BP decreased remarkably . When oil substitution was withdrawn , BP values rose again . Body weight , body mass index , girth of waist , girth of hip , and waist : hip ratio were reduced upon substitution of sesame oil .  Plasma glucose , HbA1c , TC , LDL-C , and TG were decreased . TBARS level was reduced , while the activities of enzymic and the levels of nonenzymic antioxidants were increased . Plasma sodium levels were reduced , while potassium levels were elevated . These results indicate that substitution of sesame oil as the sole edible oil has an additive effect in further lowering BP and plasma glucose in hypertensive diabetics Background Canagliflozin is a sodium glucose co-transporter 2 inhibitor developed for the treatment of patients with type 2 diabetes mellitus ( T2DM ) . The efficacy and safety of canagliflozin were evaluated in patients with T2DM < 65 and ≥65 years of age . Methods Pooled data from 4 r and omised , placebo-controlled , 26-week , Phase 3 studies ( N = 2,313 ) evaluating canagliflozin 100 and 300 mg were analysed by age : < 65 years ( n = 1,868 ; mean age , 52.8 years ) or ≥65 years ( n = 445 ; mean age , 69.3 years ) . Efficacy evaluations included change from baseline in glycaemic parameters and systolic blood pressure ( BP ) , and percent change from baseline in body weight . Assessment of safety/tolerability included adverse event ( AE ) reports , incidence of documented hypoglycaemia , and percent change from baseline in fasting plasma lipids . Results Canagliflozin 100 and 300 mg reduced HbA1c and fasting plasma glucose relative to placebo in patients < 65 and ≥65 years of age . Both canagliflozin doses reduced body weight and systolic BP relative to placebo in patients < 65 and ≥65 years of age . Incidence of overall AEs was similar across all treatment groups in patients < 65 and ≥65 years of age . Incidences of serious AEs and AE-related discontinuations were similar across all treatment groups in patients < 65 years of age and higher with canagliflozin 100 mg than other groups in patients ≥65 years of age . As in patients < 65 years of age , incidences of genital mycotic infections and osmotic diuresis-related AEs were higher with canagliflozin relative to placebo in those ≥65 years of age . Incidences of urinary tract infections ( UTIs ) , renal-related AEs , AEs related to volume depletion , and documented hypoglycaemia episodes were similar across all treatment groups in patients ≥65 years of age ; no notable trends were observed with canagliflozin 100 and 300 mg relative to placebo in these AEs among patients < 65 years of age . Changes in lipid parameters  with canagliflozin were similar in both age subsets . Conclusions Canagliflozin  improved glycaemic control , body weight , and systolic BP , and was generally well tolerated in older patients with T2DM.Trial registration Clinical Trials.gov , NCT01081834 ; NCT01106677 ; NCT01106625 ; NCT01106690 Insulin resistance that exists in patients with essential hypertension and in those with non-insulin-dependent diabetes mellitus ( NIDDM ) may be the common denominator for the impaired glucose homeostasis and elevated blood pressure ( BP ) levels in patients with NIDDM . Therefore , treatment that improves insulin action may also improve BP levels . Consequently , a four-phase ( glipizide v insulin ) cross-over design study was conducted to determine a better effect of glipizide treatment on insulin sensitivity and the effect this has on BP in 19 NIDDM patients . Patients were subjected to 1 month of diet only ( phase I ) followed by 3 months of glipizide treatment ( phase II ) , then an additional 1 month of diet only ( phase III ) , and finally 3 months of insulin treatment ( phase IV ) . At the end of phases I , II , and IV oral glucose tolerance tests ( OGTT ) were performed and plasma glucose , insulin , and C-peptide levels were analyzed . Fasting plasma glucose , insulin , total cholesterol , high density lipoprotein cholesterol , low density lipoprotein cholesterol and triglycerides , glycated hemoglobin , fructosamine , and 2-h postpr and ial plasma glucose were also analyzed at each phase . Supine and sitting BP levels and body weights were determined biweekly during the study . With the exception of higher plasma insulin and C-peptide levels during the OGTT ( area under the curve ) in phase IV ( insulin ) v phase II ( glipizide ) ( both P < .05 ) , and higher fasting plasma insulin levels ( P < .06 ) , there were no consistently significant metabolic differences between phases IV and II . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVE the aim of this study was to investigate the effects of a healthy Nordic diet ( ND ) on cardiovascular risk factors . DESIGN AND SUBJECTS in a r and omized controlled trial ( NORDIET ) conducted in Sweden , 88 mildly hypercholesterolaemic subjects were r and omly assigned to an ad libitum ND or control diet ( subjects ' usual Western diet ) for 6 weeks . Participants in the ND group were provided with all meals and foods . Primary outcome measurements were low-density lipoprotein ( LDL ) cholesterol , and secondary outcomes were blood pressure ( BP ) and insulin sensitivity ( fasting insulin and homeostatic model assessment -insulin resistance ) . The ND was rich in high-fibre plant foods , fruits , berries , vegetables , whole grains , rapeseed oil , nuts , fish and low-fat milk products , but low in salt , added sugars and saturated fats . RESULTS the ND contained 27 % , 52 % , 19 % and 2 % of energy from fat , carbohydrate , protein and alcohol , respectively . In total , 86 of 88 subjects r and omly assigned to diet completed the study . Compared with controls , there was a decrease in plasma cholesterol ( -16 % , P < 0.001 ) , LDL cholesterol ( -21 % , P < 0.001 ) , high-density lipoprotein ( HDL ) cholesterol ( -5 % , P < 0.01 ) , LDL/HDL ( -14 % , P < 0.01 ) and apolipoprotein (apo)B/apoA1 ( -1 % , P < 0.05 ) in the ND group . The ND reduced insulin ( -9 % , P = 0.01 ) and systolic BP by -6.6 ± 13.2 mmHg ( -5 % , P < 0.05 ) compared with the control diet . Despite the ad libitum nature of the ND , body weight decreased after 6 weeks in the ND compared with the control group ( -4 % , P < 0.001 ) . After adjustment for weight change , the significant differences between groups remained for blood lipids , but not for insulin sensitivity or BP . There were no significant differences in diastolic BP or triglyceride or glucose concentrations . CONCLUSIONS a healthy ND improves blood lipid profile and insulin sensitivity and lowers blood pressure at clinical ly relevant levels in hypercholesterolaemic subjects OBJECTIVE : To evaluate the effect of dipeptidyl-peptidase-4 ( DPP-4 ) inhibitor vildagliptin on high sensitivity C-reactive protein ( hsCRP ) and arterial stiffness ( AS ) in patients with type 2 diabetes ( T2DM ) . DESIGN : Sixty-four drug-naive diabetic patients , with inadequate glycemic control , participated in this r and omized , open-label study . Half of the patients received metformin 1700 mg/d and the other half of them received metformin 1700 mg/d plus vildagliptin 100 mg/d . AS was measured by carotid-femoral Pulse Wave Velocity ( cfPWV ) . Body weight ( BW ) , body mass index ( BMI ) , blood pressure ( BP ) , hsCRP , glycosylated hemoglobin ( HbA1c ) , fasting plasma glucose ( FPG ) , lipid profile , albumin/creatinine ratio ( ACR ) , fasting insulin , C-peptide , homeostasis model assessment of insulin resistance ( HOMA-IR ) and homeostasis model assessment of β-cell function ( HOMA-β ) were also assessed at baseline and after 6 months . RESULTS : Vildagliptin in combination with metformin had a beneficial influence on hsCRP , HbA1c , C-peptide and HOMA-β index ( p < 0.05 ) but had no effect on cfPWV , BP , BW , BMI , lipid profile , ACR and HOMA-IR compared with metformin alone ( p = NS ) . CONCLUSIONS : We have found that the addition of vildagliptin to metformin for a period of six months decreased hsCRP , improved glycemic control and β-cell function but had no effect on AS in drug-naive patients with T2DM OBJECTIVE : Cardiovascular disease is strongly associated with obesity and there is evidence that weight loss has positive effects on cardiovascular disease risk . The aims of this study were to compare meal replacements ( MR ) with a conventional low-fat diet as weight loss strategies and to examine the effect of weight loss on flow-mediated dilatation ( FMD ) and other markers of endothelial function in overweight Australians with raised triglycerides ( TG ) ( > 2 mmol/l ) . RESEARCH METHODS : Subjects matched for age , gender , fasting plasma TG and body mass index were r and omized to two low- fat high- carbohydrate weight loss strategies ( both < 6000 kJ ) , one using MR and the other a structured eating plan , control ( C ) . Subjects followed both diets for 3 months . In total , 55 subjects completed the study .  FMD , pulse wave velocity and blood pressure ( BP ) were measured at baseline and at 3 months , as were fasting blood sample s for lipids , glucose , insulin , C reactive protein ( CRP ) and endothelium-derived factors . RESULTS : Mean weight loss was 6.3±3.7 kg ( 6.0±4.2 vs 6.63±3.35 kg , MR vs C ) with no difference between diet groups . TG , insulin , CRP , plasminogen activator inhibitor 1 ( PAI-1 ) and soluble intracellular adhesion molecule-1 ( sICAM1 ) fell after weight loss , but FMD did not change . Systolic BP fell by 8 mmHg and pulse wave velocity improved . DISCUSSION : In subjects with elevated TG , weight loss result ed in significant improvements in cardiovascular risk markers , particularly endothelium-derived factors ( PAI-1 and sICAM1 ) . However , FMD did not improve with weight loss Aim To evaluate the efficacy/safety of canagliflozin twice daily ( BID ) compared with placebo in patients with type 2 diabetes mellitus ( T2DM ) on metformin . Methods In this 18-week , r and omized , double-blind , placebo-controlled study , patients ( N = 279 ) at 60 centers in 7 countries received canagliflozin 50 or 150 mg or placebo BID . The pre-specified primary endpoint was change from baseline in HbA1c at Week 18 . Pre-specified secondary endpoints included proportion of patients reaching HbA1c < 7.0 % , change in fasting plasma glucose ( FPG ) , and percent change in body weight ; changes in systolic blood pressure ( BP ) and fasting plasma lipids were also evaluated . Adverse events ( AEs ) were recorded throughout the study . Results From a mean baseline HbA1c of 7.6 % ( 60 mmol/mol ) , canagliflozin 50 and 150 mg BID significantly reduced HbA1c compared with placebo at Week 18 ( −0.45 % , −0.61 % , −0.01 % [ −5 , −7 , −0.1 mmol/mol ] , respectively ; P < 0.001 ) . More patients achieved HbA1c < 7.0 % with canagliflozin than placebo ( P < 0.05 ) . Relative to placebo , both canagliflozin doses significantly lowered FPG and body weight ( P < 0.001 ) , and reduced systolic BP . Overall AE incidence was 35.5 % , 40.9 % , and 36.6 % with canagliflozin 50 and 150 mg BID and placebo , respectively . Canagliflozin was associated with increased incidences of urinary tract infections , female genital mycotic infections , and osmotic diuresis-related AEs ; these led to few discontinuations . The incidence of documented hypoglycemia was low across groups . Conclusions Canagliflozin 50 and 150 mg BID provided significant glycemic efficacy and body weight reduction , and were generally well tolerated in patients with T2DM on background metformin . Clinical Trials.gov Identifier : CONTEXT Regular intake of cocoa-containing foods is linked to lower cardiovascular mortality in observational studies . Short-term interventions of at most 2 weeks indicate that high doses of cocoa can improve endothelial function and reduce blood pressure ( BP ) due to the action of the cocoa polyphenols , but the clinical effect of low habitual cocoa intake on BP and the underlying BP-lowering mechanisms are unclear . OBJECTIVE To determine effects of low doses of polyphenol-rich dark chocolate on BP . DESIGN , SETTING , AND PARTICIPANTS R and omized , controlled , investigator-blinded , parallel-group trial involving 44 adults aged 56 through 73 years ( 24 women , 20 men ) with untreated upper-range prehypertension or stage 1 hypertension without concomitant risk factors . The trial was conducted at a primary care clinic in Germany between January 2005 and December 2006 . INTERVENTION Participants were r and omly assigned to receive for 18 weeks either 6.3 g ( 30 kcal ) per day of dark chocolate containing 30 mg of polyphenols or matching polyphenol-free white chocolate . MAIN OUTCOME MEASURES Primary outcome measure was the change in BP after 18 weeks . Secondary outcome measures were changes in plasma markers of vasodilative nitric oxide ( S-nitrosoglutathione ) and oxidative stress ( 8-isoprostane ) , and bioavailability of cocoa polyphenols . RESULTS From baseline to 18 weeks , dark chocolate intake reduced mean ( SD ) systolic BP by -2.9 ( 1.6 ) mm Hg ( P < .001 ) and diastolic BP by -1.9 ( 1.0 ) mm Hg ( P < .001 ) without changes in body weight , plasma levels of lipids , glucose , and 8-isoprostane . Hypertension prevalence declined from 86 % to 68 % . The BP decrease was accompanied by a sustained increase of S-nitrosoglutathione by 0.23 ( 0.12 ) nmol/L ( P < .001 ) , and a dark chocolate dose result ed in the appearance of cocoa phenols in plasma . White chocolate intake caused no changes in BP or plasma biomarkers . CONCLUSIONS Data in this relatively small sample of otherwise healthy individuals with above-optimal BP indicate that inclusion of small amounts of polyphenol-rich dark chocolate as part of a usual diet efficiently reduced BP and improved formation of vasodilative nitric oxide . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00421499 Objective : The purpose of this study was to determine whether supplements of plant sterols and /or glucomannan improve lipid profile and cholesterol bio synthesis in mildly hypercholesterolemic type II diabetic and non-diabetic subjects and to compare the response of these two subject groups to the treatments . Design : A r and omized , crossover study consisting of four phases of 21 days , with each phase separated by a 28-day washout . Setting : The Mary Emily Clinical Nutrition Research Unit of McGill University . Subjects : Eighteen non-diabetic individuals and 16 type II diabetic individuals aged 38–74 years . Interventions : Subjects were supplemented with plant sterols ( 1.8 g/day ) , glucomannan ( 10 g/day ) , a combination of glucomannan and plant sterols , and a placebo , provided in the form of bars . Results : Overall plasma cholesterol concentrations were lowered ( P<0.05 ) after combination treatment ( 4.72±0.20 mmol/l ) compared to control ( 5.47±0.18 mmol/l ) . Plasma low-density lipoprotein ( LDL ) cholesterol concentrations were decreased ( P<0.05 ) after glucomannan ( 3.16±0.14 mmol/l ) and combination treatments ( 2.95±0.16 mmol/l ) compared to control ( 3.60±0.16 mmol/l ) . The results of lipid profiles did not differ between subject groups . Overall plasma lathosterol concentrations , an index of cholesterol bio synthesis , were lowered ( P<0.05 ) after the combination treatment compared to the plant sterol treatment . Conclusions : The results suggest that glucomannan and a combination of glucomannan and plant sterols substantially improves plasma LDL cholesterol concentrations . Sponsorship : Forbes Medi-Tech Inc. , Vancouver , British Columbia , Canada It has been found that honey ameliorates cardiovascular risk factors in healthy individuals and in patients with elevated risk factors . The present study investigated the effect of natural honey on total cholesterol , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , triacylglycerole , C-reactive protein ( CRP ) , fasting blood glucose ( FBG ) , and body weight in overweight individuals . There were 55 patients , overweight or obese , who were r and omly recruited into the study and assigned into two groups : control group ( 17 subjects ) and experimental group ( 38 subjects ) . Patients in the control group received 70 g of sucrose daily for a maximum of 30 days and patients in the experimental group received 70 g of natural honey for the same period . In the control and experimental groups , body weight , body mass index , body fat weight , total cholesterol , LDL-C , HDL-C , triacylglycerole , FBG , and CRP were measured before treatment and at day 31 after the commencement of treatment . Results showed that honey caused a mild reduction in body weight ( 1.3 % ) and body fat ( 1.1 % ) . Honey reduced total cholesterol ( 3 % ) , LDL-C ( 5.8 ) , triacylglycerole ( 11 % ) , FBG ( 4.2 % ) , and CRP ( 3.2 % ) , and increased HDL-C ( 3.3 % ) in subjects with normal values , while in patients with elevated variables , honey caused reduction in total cholesterol by 3.3 % , LDL-C by 4.3 % , triacylglycerole by 19 % , and CRP by 3.3 % ( p < 0.05 ) . It is our conclusion that consumption of natural honey reduces cardiovascular risk factors , particularly in subjects with elevated risk factors , and it does not increase body weight in overweight or obese subjects
The use of glucomannan did not appear to significantly alter any other study endpoints .
Pediatric patients , patients receiving dietary modification , and patients with impaired glucose metabolism did not benefit from glucomannan to the same degree .
Glucomannan appears to beneficially affect total cholesterol , LDL cholesterol , triglycerides , body weight , and FBG , but not HDL cholesterol or BP
BACKGROUND Several clinical trials have investigated the impact of glucomannan on plasma lipids , body weight , fasting blood glucose ( FBG ) , and blood pressure ( BP ) , but have yielded conflicting results and had only modest sample sizes .
OBJECTIVE The objective was to perform a meta- analysis of r and omized controlled trials of glucomannan to better characterize its impact on plasma lipids , FBG , body weight , and BP .