Effects of azilsartan medoxomil compared with olmesartan and valsartan on ambulatory and clinic blood pressure in patients with type 2 diabetes and prediabetes Curcumin attenuates urinary excretion of albumin in type II diabetic patients with enhancing nuclear factor erythroid-derived 2-like 2 (Nrf2) system and repressing inflammatory signaling efficacies. [Long-term intensive glycemic and lipid control ameliorates the carotid intima medial thickness in type 2 diabetes mellitus]. Impact of prebiotic supplementation on T-cell subsets and their related cytokines, anthropometric features and blood pressure in patients with type 2 diabetes mellitus: A randomized placebo-controlled Trial. Vitamin D 20,000 IU per Week for Five Years Does Not Prevent Progression From Prediabetes to Diabetes. Lack of effect of subtherapeutic vitamin D treatment on glycemic and lipid parameters in Type 2 diabetes: A pilot prospective randomized trial. 
The effect of consumption of low-glycemic-index and low-glycemic-load desserts on anthropometric parameters and inflammatory markers in patients with type 2 diabetes mellitus ForgIng New paths in DIabetes PrevenTion (FINDIT): Study Protocol for a Randomized Controlled Trial Effect of diacerein as an add-on to metformin in patients with type 2 diabetes mellitus and inadequate glycemic control. Effect of Camel Milk on Blood Sugar and Lipid Profile of Patients With Type 2 Diabetes: A Pilot Clinical Trial Nonpharmacological interventions to prevent type 2 diabetes in women diagnosed with gestational diabetes mellitus: a systematic overview Early Improvement Predicts Reduced Risk of Incident Diabetes and Improved Cardiovascular Risk in Prediabetic Asian Indian Men Participating in a 2-Year Lifestyle Intervention Program The effect of nano-curcumin on HbA1c, fasting blood glucose, and lipid profile in diabetic subjects: a randomized clinical trial The impact of aerobic exercise training on novel adipokines, apelin and ghrelin, in patients with type 2 diabetes Efficacy and Safety of the Dietary Supplement DBCare® in Patients With Type 2 Diabetes Mellitus and Inadequate Glycemic Control The influence of prehypertension, hypertension, and glycated hemoglobin on the development of type 2 diabetes mellitus in prediabetes: the Korean Genome and Epidemiology Study (KoGES) Cumulative incidence and risk factors of prediabetes and type 2 diabetes in a Singaporean Malay cohort. Effect of vildagliptin on hsCRP and arterial stiffness in patients with type 2 diabetes mellitus Efficacy and safety of canagliflozin by baseline HbA1c and known duration of type 2 diabetes mellitus. Evaluation of the effect of curcumin capsules on glyburide therapy in patients with type-2 diabetes mellitus. Effects of high performance inulin supplementation on glycemic status and lipid profile in women with type 2 diabetes: a randomized, placebo-controlled clinical trial. Comparison between orlistat plus l-carnitine and orlistat alone on inflammation parameters in obese diabetic patients. Resveratrol supplementation improves glycemic control in type 2 diabetes mellitus.
Background : Angiotensin receptor blockers ( ARBs ) are preferred antihypertensive therapies in patients with type 2 diabetes mellitus ( T2DM ) .  Azilsartan medoxomil ( AZL-M ) is a potent ARB for the treatment of stages 1 - 2 hypertension . We compared the efficacy , safety , and metabolic effects of AZL-M to both valsartan ( VAL ) and olmesartan ( OLM ) , separately in patients with impaired fasting glucose ( prediabetes mellitus ) and T2DM . Methods : A pooled analysis of 3821 patients from three separate r and omized placebo-controlled trials comparing the effects of AZL-M ( 40 and 80 mg ) , OLM ( 40 mg ) , VAL ( 320 mg ) , and placebo on changes in ambulatory and clinic blood pressure ( BP ) among patients with hypertension and prediabetes mellitus or T2DM was performed . Two analysis pools were created to facilitate comparisons : Pool A included patients who received placebo , AZL-M or OLM and Pool B included those who received AZL-M or VAL . Within each pool , patients were stratified by glycemic subgroups ( normoglycemic , prediabetes mellitus , or T2DM ) based on hemoglobin A1c values . Changes from baseline in both 24-h and clinic SBP were the primary efficacy assessment s. Results : Baseline 24-h mean SBPs were approximately 145 and 146 mmHg in the prediabetes mellitus and T2DM subgroups , respectively ; corresponding clinic SBPs were approximately 158 and 159 mmHg . Baseline hemoglobin A1c values for each subgroup ( both pools ) were normoglycemic , 5.3 % ; prediabetes mellitus , 6.0 % ; and T2DM , 6.9 % . Changes from baseline in 24-h or clinic SBP were significantly greater with AZL-M , 80 mg compared with either OLM 40 mg or VAL 320 mg in all subgroups in each pool . Safety and tolerability were similar among the active treatment and placebo subgroups . Conclusion : These analyses indicate that AZL-M , 80 mg/day lowers SBP by a greater magnitude than OLM or VAL at maximally approved doses in patients with prediabetes mellitus and T2DM . These findings have important clinical implication s for this high-risk patient group Curcumin has a therapeutic potential in treating diabetic kidney disease ( DKD ) while potential mechanisms underlining this beneficial effect remain to be eluci date d. In the present study , curcumin intervention was performed in patients with Type II diabetes mellitus ( T2DM ) by oral intake of curcumin at the dose of 500 mg/day for a period of 15 - 30 days .  Nephritic excretion of urinary micro-albumin ( U-mAlb ) and blood metabolic indexes were assessed before and after this intervention . In addition , the lipid oxidation index , malondialdehyde ( MDA ) in plasma and the status of anti-oxidative Nrf2 system in blood lymphocytes were measured . The effect of curcumin on inflammation was assessed by measuring plasma lipopolysaccharide ( LPS ) content and inflammatory signaling protein in blood lymphocytes . A self-comparison method was used for assessing statistical significance s of these measurements . Here we show that curcumin intervention markedly attenuated U-mAlb excretion without affecting metabolic control of participated patients . In addition , curcumin  reduced plasma MDA level with enhanced the Nrf2 system specifically regulated protein , NAD(P)H quinone oxidoreductase 1 ( NQO-1 ) together with other anti-oxidative enzymes in patients ' blood lymphocytes . Furthermore , we observed reduced plasma LPS content and increased IκB , an inhibitory protein on inflammatory signaling in patient 's lymphocytes after curcumin administration . Finally , several gut bacterials important for maintaining gut barrier integrity and function were upregulated by curcumin . In conclusion , short-term curcumin intervention ablates DKD progress with activating Nrf2 anti-oxidative system and anti-inflammatory efficacies in patients with T2DM OBJECTIVE To investigate whether long-term intensive glycemic and lipid control would ameliorate the carotid intima medial thickness ( IMT ) in patients with type 2 diabetes mellitus ( T2DM ) . METHODS IMT was evaluated on B-mode ultrasonography in 116 patients with T2DM .  Body mass index ( BMI ) , waist-to-hip ratio ( WHR ) , fasting blood glucose ( FBG ) , 2 hour postpr and ial glucose ( 2hPG ) , hemoglobin A(1)c(HbA(1)c ) , total cholesterol(TC ) , triglycerides ( TG ) , low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol ( HDL-C ) were also measured . Of all the patients 89 were divided r and omly into group of intensive glycemic and lipid control and group of conventional treatment and underwent 1 year clinical interview . RESULTS ( 1 ) IMT in patients with T2DM was significantly correlated with age(r = 0.515,P = 0.000 ) , SBP ( r = 0.208 , P = 0.025 ) , TC(r = 0.213,P = 0.022 ) , LDL-C(r = 0.253 , P = 0.006 ) and no correlations were found between IMT and BMI , WHR , FBG , 2hPG , HbA(1)c , TG and HDL-C. In multivariate regression analysis , age ( Beta = 0.527 , P = 0.000 ) and TC(Beta = 0.243 , P = 0.002 ) were significant independent determinants for IMT . ( 3 ) After 1 year the change of IMT in the group of intensive glycemic and lipid control was significantly different compared with the group of conventional treatment [ (-0.044+/-0.148)mm vs ( 0.056+/-0.178 ) , P<0.05 ] . The change of IMT was not significantly associated with the use of Metformin , Sulphonylurea and Aspirin , but significantly associated with the use of  statins  . The change of IMT in the group using statins was significantly different compared with that in the group without using statins[(-0.053+/-0.153)mm vs (0.042+/-0.165)mm , P < 0.05 ] . CONCLUSION Carotid IMT appears to be closely related to age and TC in the patients with T2DM . long-term intensive glycemic control and lipid control could ameliorate the IMT in patients with T2DM . The improvement of IMT may be associated with the use of statin drug BACKGROUND S AND AIMS Type 2 diabetic mellitus ( T2DM ) asone of the main causes of morbidity and mortality is associated with immune system disturbances and metabolic abnormalities . In the current study we aim ed to evaluate the effects of oligofructose-enriched inulin on T-cell subsets and their related cytokines , anthropometric and metabolic parameters in patients with T2DM . METHODS Forty-six diabetic females patients were r and omly allocated into intervention ( n=27 ) and control ( n=22 ) groups . Subjects in the intervention group received a daily dose of 10 g of oligofructose-enriched inulin and subjects in control group received a placebo for two months . Anthropometric variables , metabolic parameters including fasting serum glucose ( FSG ) , hemoglobin A1c ( HbA1c ) , lipid profile and blood pressure were measured at the beginning and after two months . Immune markers also included serum interleukin (IL)-4 , IL-12 and interferon (IFN)-γ concentrations were assessed and CD3(+ ) , CD4(+ ) , CD8(+ ) and CD11b(+)T-cell counts were determined by flow cytometry at baseline and end of the trial . RESULTS After two months intervention , significant improvements in anthropometric variables , blood pressure and serum lipids occurred in prebiotic-treated group ( P<0.001 ) . Serum IL-4 , IL-12 and IFN-γ concentrationsalso significantly decreased in intervention group ( P<0.001 ) . No significant changes in CD3(+ ) , CD4(+ ) , CD8(+ ) and CD11b(+ ) T-cell counts were observed in treatment groups after intervention . CONCLUSION The present study showed several beneficial effects of oligofructose-enriched inulin on the improvement of the glycemic status , lipid profile , and immune markers in patients with T2DM . Further studies are needed to confirming our findings and to better clarify the underlying mechanisms CONTEXT Vitamin D deficiency is associated with insulin resistance and risk of future diabetes . OBJECTIVE The objective of the study was to test whether supplementation with vitamin D to subjects with prediabetes will prevent progression to type 2 diabetes mellitus ( T2DM ) . DESIGN This was a r and omized controlled trial performed in 2008 through 2015 . SETTING The study was conducted at the clinical research unit at a teaching hospital . PATIENTS Five hundred eleven subjects ( mean age 62 y , 314 males ) with prediabetes diagnosed with an oral glucose tolerance test as part of the Tromsø Study 2007–2008 were included . A total of 256 were r and omized to vitamin D and 255 to placebo .  Twenty-nine subjects in the vitamin D and 24 in the placebo group withdrew because of adverse events . INTERVENTIONS Interventions included vitamin D ( cholecalciferol ) 20 000 IU/wk vs placebo for 5 years . Annual oral glucose tolerance tests were performed . MAIN OUTCOME MEASURE Progression to T2DM was the main outcome measure . Secondary outcomes were change in glucose levels , insulin resistance , serum lipids , and blood pressure . RESULTS The mean baseline serum 25-hydroxyvitamin D level was 60 nmol/L ( 24 ng/mL ) . One hundred three in the vitamin D and 112 in the placebo group developed T2DM ( hazard risk 0.90 ; 95 % confidence interval 0.69–1.18 , Cox regression , P = .45 , intention to treat analysis ) . No consistent significant effects on the other outcomes were seen . Subgroup analyses in subjects with low baseline 25-hydroxyvitamin D yielded similar results . No serious side effects related to the intervention were recorded . CONCLUSIONS In subjects without vitamin D deficiency , vitamin D supplementation is unlikely to prevent progression from prediabetes to diabetes . Very large studies with inclusion of vitamin D-deficient subjects will probably be needed to show such a putative effect . This study tested if supplementation with  vitamin D to subjects with prediabetes will prevent progression to type 2 diabetes ( T2DM ) BACKGROUND Epidemiological studies suggest a higher prevalence of metabolic syndrome and its components among individuals with vitamin D deficiency . The aim of the present study was to determine whether vitamin D treatment  improves glucose control and insulin sensitivity in Type 2 diabetes mellitus ( T2DM ) . METHODS Subjects with T2DM and serum 25-hydroxyvitamin D ( 25(OH)D ) concentrations < 25 ng/mL were r and omized to receive 400 IU ( Group 1 ) or 1200 IU ( Group 2 ) cholecalciferol for 4 months . Fasting plasma glucose , glycosylated hemoglobin ( HbA1c ) , Quantitative Insulin Sensitivity Check Index ( QUICKI ) , serum lipid levels and serum adiponectin were measured at baseline and at 4 months . RESULTS Mean 25(OH)D levels increased in both groups ( from 17.6±1.5 to 25.5±1.8 ng/mL in Group 1 and from 15.6±1.4 to 27.4±2.4 ng/mL in Group 2 ; P≤0.001 vs baseline for each group ) . No significant differences were noted in fasting plasma glucose , HbA1c , QUICKI , serum adiponectin , and lipid levels compared with baseline within groups or between the two groups . CONCLUSIONS In the present pilot study , conventional vitamin D treatment at a level improving , but not optimizing , serum 25(OH)D did not improve glycemia , insulin sensitivity , or lipid profile . However , diabetes and lipids were relatively well controlled at baseline . Future studies should be design ed to achieve optimal concentrations of serum 25(OH)D ( at least > 32 ng/mL ) and should include subjects showing more abnormal parameters of glycemia , lipid , and insulin sensitivity at baseline Abstract Purpose The aim of the present study was to examine the effects of consumption of desserts with low glycemic index ( GI ) and low glycemic load ( GL ) , as part of a balanced hypo-caloric diet , on anthropometric and biochemical parameters in patients with type 2 diabetes mellitus ( T2DM ) . Methods A total of 61 subjects with T2DM were r and omly assigned to the intervention ( n = 30 ) or to the control group ( n = 31 ) . Both groups followed the same hypo-caloric ( −500 kcal ) diet for 12 weeks . Consumption of four portions of low-GI/low-GL desserts/week was included in the diet in the intervention group while one portion of a favorite usual sweet/week was allowed to be consumed in the control group . Results Thirty subjects in the control and 28 subjects in the intervention group completed the trial . Body weight , body mass index , and waist circumference were reduced significantly in both groups . Arterial blood pressure , fasting blood glucose , glycosylated hemoglobin , insulin , and γ-GT were reduced significantly only in the intervention group ; however , there were no significant differences between the two groups at endpoint . C-reactive protein was reduced in the intervention , and HDL cholesterol was also reduced in the control group ; the reductions were significantly different at the end of the trial . No significant changes were observed in the other plasma lipids , uric acid , leptin , adiponectin , and interleukin-6 in either study group . Conclusions Consumption of desserts with low GI/GL in a balanced hypo-caloric diet has a positive impact on anthropometric and metabolic parameters of patients with T2DM Background Prediabetes is an asymptomatic condition in which patients ’ blood glucose levels are higher than normal but do not meet diagnostic criteria for type 2 diabetes mellitus ( T2DM ) . A key window of opportunity to increase engagement of patients with prediabetes in strategies to prevent T2DM is when they are screened for T2DM and found to have prediabetes , yet the effects of this screening and brief counseling are unknown . Methods In this parallel- design r and omized controlled trial we will recruit 315 non-diabetic patients from the Ann Arbor VA Medical Center ( AAVA ) who have one or major risk factors for T2DM and an upcoming primary care appointment at the AAVA , but have not had a hemoglobin A1c ( HbA1c ) test to screen for T2DM in the previous 12 months . After informed consent , participants will complete a baseline survey and be r and omly assigned to , at the time of their next primary care appointment , one of two arms : ( 1 ) to have a hemoglobin A1c ( HbA1c ) test to screen for T2DM and receive brief , st and ardized counseling about these results or ( 2 ) to review a brochure about clinical preventive services . Participants will complete surveys 2 weeks , 3 months , and 12 months after their primary care appointment , and a weight measurement 12 months after their primary care appointment . The primary outcome is weight change after 12 months . The secondary outcomes are changes in perception of risk for T2DM ; knowledge of T2DM prevention ; self-efficacy and motivation to prevent T2DM ; use of pharmacotherapy for T2DM prevention ; physical activity ; participation in weight management programs ; and mental health . Quantitative analyses will compare outcomes among participants in the HbA1c test arm found to have prediabetes with participants in the brochure arm . Among participants in the HbA1c test arm found to have prediabetes we will conduct semi-structured interviews about their underst and ing of and reactions to receiving a prediabetes diagnosis . Discussion This trial will generate foundational data on the effects of a prediabetes diagnosis and brief counseling on patients ’ preventive behaviors and mediators of these behaviors that will enable the development of novel strategies to improve patient engagement in T2DM prevention . Trial registration Clinical Trials.gov , NCT02747108 . Registered on 18 April 2016 Objective To evaluate the effect of diacerein as an add-on to metformin in patients with type 2 diabetes mellitus ( T2DM ) and inadequate glycemic control . Material s and methods A r and omized , double-blind , placebo-controlled clinical trial was carried out on 12 patients with T2DM and inadequate glycemic control [ glycated hemoglobin A1c ( A1C ) ≥ 7 % ] with metformin as monotherapy ( ≥ 1500 mg per day ) for at least the previous 90 days . Fasting and postpr and ial glucose were measured before and after the pharmacological intervention . A1C , lipid profile , creatinine and uric acid were also evaluated . After r and omization , all patients continued with their dose of metformin . Six subjects received placebo and the other six volunteers took diacerein . Data were tested using the Wilcoxon signed-rank , Mann-Whitney U and chi-square tests . The Institutional Ethics Committee approved the study protocol . Results After 90 days of diacerein as an add-on to metformin , there was a significant decrease in fasting glucose ( 196 ± 79 vs. 149 ± 70 mg/dL , p < 0.05 ) , postpr and ial glucose ( 262 ± 99 vs. 187 ± 70 mg/dlL , p < 0.05 ) and A1C ( 8.4 ± 2.0 vs. 6.7 ± 1.7 % , p < 0.05 ) . Conclusions Diacerein as an add-on to metformin in patients with T2DM  improved their glycemic control 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 This systematic overview summarizes the relevant evidence from multiple systematic review s of the benefits of nonpharmacological interventions for preventing  type 2 diabetes mellitus ( T2MD ) in women diagnosed with gestational diabetes mellitus ( GDM ) . A comprehensive search using the Cochrane Library , CINAHL , EMBASE and MEDLINE via Ovid SP , and PubMed data bases was completed on 18 November 2015 . Any systematic review s that evaluated r and omized controlled trials ( RCTs ) with defined nonpharmacological interventions for preventing T2DM in women diagnosed with GDM were eligible for inclusion . The authors independently performed critical appraisal s and quality assessment s of the included review s using the AMSTAR tool , and extracted data were converted to coherent values for tabular summarization . Six eligible review s of diet and /or exercise , breastfeeding , and reminder interventions were identified ; however , the method ologies of the review s varied greatly , and the majority of the evidence suggested unclear bias . We found inconsistent reporting on the rates at which diet and exercise interventions reduced the risk of T2DM progression , but these interventions were found to be effective at reducing glycemic load . Combined diet , exercise , and breastfeeding interventions proved to be effective at returning women to their postpartum weight . Neither diet alone nor exercise alone proved to be effective at lowering the risk of T2DM . Overall , there was no robust evidence to support the hypothesis that nonpharmacological interventions are effective at lowering the risk of T2DM in women diagnosed with GDM , and there was no consistent evidence showing that these interventions improved the predictor outcomes of T2DM , such as glycemic load or anthropometric changes OBJECTIVE Objectives of this ancillary analysis of a prospect i ve , prevention study among Asian Indians with impaired glucose tolerance ( IGT ) were a ) to quantify the reduction in incident diabetes at 24 months in participants who achieved normal glucose tolerance ( NGT ) at 6 months ( NGT-6 m ) compared with the other participants , b ) the factors influencing the reversal to NGT at the end of the study at 24 months ( NGT-24 m ) , and c ) to assess changes in cardiometabolic risk factors in different categories of dysglycemia at 24 months . RESEARCH DESIGN AND METHODS Data from a 2-year primary prevention trial were used . Effect of reversion to NGT-6 m on incidence of type 2 diabetes mellitus ( T2DM ) was analyzed using the Cox proportional hazards model . Predictive variables for reversal to NGT were identified using multiple logistic regression analysis . Changes in cardiometabolic risk factors were estimated according to the final glycemic status using fixed-effect , mixed-linear regression modeling . RESULTS The risk of T2DM in 2 years was lower by 75 % in NGT-6 m group ( hazard ratio 0.25 [ 95 % CI 0.12–0.52 ] ) . Predictive variables for reversal to NGT-24 m were good baseline β-cell function ( odds ratio [ OR ] 2.79 [ 95 % CI 2.30–3.40 ] ) and its further improvement ( OR 5.70 [ 95 % CI 4.58–7.08 ] ) , and NGT-6 m ( OR 2.10 [ 95 % CI 1.14–3.83 ] ) . BMI decreased in those who reverted to NGT . Deterioration to T2DM was associated with an increase in the levels of cardiometabolic risk factors . CONCLUSIONS Early reversion to NGT by lifestyle intervention in prediabetic men was associated with a significant reduction in subsequent incidence of diabetes . Good baseline β-cell function and its further improvement and NGT-6 m were associated with reversion to NGT-24 months . Reversion to NGT was associated with modest improvements , whereas conversion to T2DM was associated with significant worsening of the cardiometabolic risk profile 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 Summary Background Accumulating data support the atheroprotective role of the novel adipokines , apelin and ghrelin . The aim of the present r and omized study was to investigate the effects of aerobic exercise training on these adipokines in patients with type 2 diabetes mellitus ( T2DM ) . Material / Methods Fifty-four overweight ( BMI > 25 kg/m2 ) patients with T2DM , but without vascular complications , were r and omized to either the aerobic exercise training group ( EG , N=27 ) , 4 times/week , 45–60 min/session ; or to the control group ( CG , N=27 ) , orally instructed to increase physical activity .  Clinical glycemic and lipid parameters , exercise capacity ( VO2peak ) , insulin , HOMA-IR , and serum levels of apelin and ghrelin were assessed at baseline and after 12 weeks . Results Aerobic exercise significantly improved lipid and glycemic profile and insulin sensitivity compared to CG ( p<0.05 ) . Furthermore , between-groups comparison showed a considerable exercise-induced upregulation in apelin ( p=0.007 ) and VO2peak ( p<0.001 ) levels . Negligible changes in body-weight , waist-hip ratio and ghrelin concentrations were detected within and between groups after the completion of the study ( p>0.05 ) . However , subgroup analysis revealed a considerable increment in ghrelin levels only in the exercise-treated women compared to their control counterparts ( p=0.038 ) . LDL and HOMA-IR reduction were found to be independent predictors of apelin increment in multiple regression analysis ( R2=0.391 , p=0.011 ) . Conclusions In patients with T2DM , systemic , long-term , aerobic exercise exerts positive effects on apelin and ghrelin ( only in women ) , even in the absence of significant weight loss , suggesting its pleiotropic effects Aims : DBCare ® ( Ace Continental Exports Inc. , London , UK ) is a traditional Indian herbal food supplement marketed as an antidiabetes remedy . This study evaluated the efficacy and safety of DBCare in patients with inadequately controlled type 2 diabetes mellitus ( T2DM ) despite oral hypoglycemic treatment . Methods : A 12-week r and omized double-blind placebo-controlled trial was conducted . Patients with T2DM on oral hypoglycemic agents with HbA1C > 7.0 % were r and omized to receive DBCare or placebo tablets . Results : Thirty-five patients ( 20 male/15 female ; mean age 61.2 ± 7.6 years ) , with a mean baseline HbA1C of 7.9 % ± 0.6 % , received DBCare ( N = 18 ) or placebo ( N = 17 ) . During the study period , HbA1C declined 0.4 ± 0.7 % in the DBCare ® group and 0.2 % ± 0.8 % in the placebo group ( p = 0.806 ) . No significant changes occurred in fasting plasma glucose , lipid profile , or homeostasis model assessment throughout the study or in body mass index , waist circumference , or blood pressure values . Hypoglycemic episodes ( glucose < 70 mg/dL ) were more frequent in the treatment group ( 7 vs 1 , p = 0.043 ) , necessitating a decrease in other hypoglycemic medications in 2 patients . DBCare was generally well tolerated , with mild side effects that were not different from those of the placebo group . Conclusions : This preliminary study did not demonstrate that DBCare was efficacious in improving glycemic control in inadequately controlled patients with T2DM on oral hypoglycemics . A trend toward improved glycemic control was noted in the DBCare group , which correlates with more frequent hypoglycemic episodes . Further studies are needed to eluci date DBCare 's hypoglycemic effect in patients with T2DM in general and in specific clinical setting s , such as HbA1C ≥ 8 % , short ( ≤10-year ) duration of diabetes , or young age in particular Background It has been reported that elevated blood pressure ( BP ) was significantly associated with the increased risk for type 2 diabetes mellitus ( T2DM ) . However , there is still limited information about the influence of BP on the risk for T2DM across the level of glycated hemoglobin ( HbA1c ) . Method In a cohort of the Korean Genome and Epidemiology Study ( KoGES ) , 2830 non-diabetic Korean adults with prediabetes defined by HbA1c level of 5.7–6.4 % were followed-up for 10 years . Multivariate cox proportional hazards assumption was used to assess the risk for T2DM according to the baseline BP categories ( normal , prehypertension and hypertension ) and HbA1c level ( low : 5.7–5.9 % and high : 6.0–6.4 % ) . Results The risk for T2DM significantly increased proportionally to BP categories ( adjusted HR ; reference in normal BP , 1.32 [ 1.10–1.59 ] in prehypertension and 1.61 [ 1.35–1.92 ] in hypertension ) . Subgroup analysis indicated that individuals with high HbA1c had the higher risk for T2DM than individuals with low HbA1c regardless of BP . Additionally , combined presence of hypertension and high HbA1c had the highest risk for T2DM ( adjusted HR : 3.82 [ 3.00–4.87 ] ) . In each systolic and diastolic BP level , the risk for T2DM significantly increased from systolic BP ≥ 130 mmHg ( adjusted HRs : 1.39 ( [ 1.15–1.71 ] ) and diastolic BP ≥ 80 mmHg ( adjusted HRs : 1.30 ( [ 1.07–1.58 ] ) . Conclusion BP and HbA1c may be useful tools in identifying individuals with prediabetes more potentially predisposed to T2DM . Prospect i ve studies should be considered to examine whether controlling BP actually lowers the risk for T2DM AIMS The aim of this work was to determine the cumulative incidence and independent risk factors of prediabetes and type 2 diabetes ( T2DM ) in a well-characterized cohort of Malays in Singapore . METHODS We included 1137 participants ( mean age [ SD ] : 55 ( 10 ) years ; 53.6 % female ) without diabetes ( DM ) at baseline from the Singapore Malay Eye Study , a population -based longitudinal study with baseline ( 2004 - 2006 ) , and follow-up ( 2010 - 2013 ) examinations . Prediabetes was defined as an HbA1c between 5.7 % and 6.4 % , with no self-reported DM history or insulin/DM medication use . T2DM was defined as a r and om glucose level ≥200mg/dL or HbA1c>6.4 % or use of insulin/DM medication . Age-st and ardized cumulative incidence was calculated as the crude 6-year cumulative incidence st and ardized to Singapore 's Malay population census . Multivariable modified poisson regression models were utilized to determine the risk factors of incident prediabetes and T2DM . RESULTS The age-st and ardized 6-year cumulative incidence was 11.2 % ( 95 % CI 9.5 , 13.1 % ) for T2DM , and 20.4 % ( 95 % CI 16.4 , 25.2 % ) for prediabetes . Hypertension , higher body mass index ( BMI ) and higher Hba1c levels were associated with increased risk of T2DM , while older age and higher high density lipoprotein ( HDL ) cholesterol were protective ( all P<0.05 ) . Only higher BMI and HbA1c levels were independently associated with incident prediabetes ( all P≤0.001 ) . CONCLUSIONS While only one in ten adult Malays developed T2DM over 6-years , one in five developed prediabetes over the same time period . Our results suggest that evidence -based interventions addressing modifiable risk factors ( obesity , prediabetes , hypertension , low HDL cholesterol ) are needed to delay or prevent their onset 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 AIMS Canagliflozin , a sodium glucose co-transporter 2 inhibitor , has demonstrated glycemic improvements across studies of patients with type 2 diabetes mellitus ( T2DM ) . The impact of canagliflozin on HbA1c lowering was assessed by baseline HbA1c and known duration of T2DM . METHODS This post hoc analysis pooled data from patients with T2DM enrolled in four 26-week , placebo-controlled , Phase 3 studies of canagliflozin ( N=2313 ) . Change in HbA1c from baseline to Week 26 was assessed in the overall population and in subgroups by baseline HbA1c ( < 8.0 % , 8.0%-<9.0 % , and ≥9.0 % ) and known duration of T2DM ( < 5 years , 5-<10 years , and ≥10 years ) . RESULTS Relative to placebo , canagliflozin 100 and 300 mg provided greater HbA1c reductions in the overall population . Progressively larger placebo-subtracted reductions in HbA1c  with canagliflozin 100 and 300 mg were seen with increasing baseline HbA1c . HbA1c reductions were similar across subgroups based on known duration of T2DM . Both canagliflozin doses were generally well tolerated across subgroups , with a safety and tolerability profile consistent with that seen in Phase 3 studies . CONCLUSIONS Canagliflozin provided glycemic improvements in patients with T2DM across a range of baseline HbA1c and known duration of T2DM This study aim ed to assess the possible beneficial effects of curcumin capsules as lipid-lowering effects and as a permeability glycoprotein ( P-gp ) inhibitor on the pharmacokinetics and pharmacodynamics of glyburide and as a P-gp substrate with glyburide in patients with type-2 diabetes mellitus . Open-label , r and omized control trial was carried out for 11 days on eight type-2 diabetic patients on glyburide therapy .  On the first day of the study , following the administration of 5 mg of glyburide , blood sample s were collected from the patients at various time intervals ranging from 0.5 to 24 h. Blood sampling was repeated on the 11th day of the study , after treating the patients with curcumin for ten consecutive days . Glyburide concentrations changed at the second hour , Cmax was unchanged , the glucose levels were decreased , Area Under first Movement Curre ( AUMC ) was increased , and no patient has experienced the hypoglycaemia . The low-density lipoprotein , very-low-density lipoprotein and triglycerides were decreased significantly , and the high-density lipoprotein content increased . The co-administration of curcumin capsules with glyburide may be beneficial to the patients in better glycaemic control . The lipid lowering and antidiabetic properties of the curcumin show as a potential future drug molecule BACKGROUND Type 2 diabetes mellitus , as a noncommunicable disease , is the main public health challenge in the 21st century . The prevalence of diabetes mellitus adjusted for the world population in Iran was 8 % until the year 2010.Lipid levels are considered as important parameters to be evaluated , as high serum lipid levels are often reported as a complication in patients with diabetes mellitus . It is cl aim ed that functional foods may improve complications of diabetes mellitus , so this study was design ed to evaluate the effects of high performance inulin on glycemic status and lipid profile of women with type 2 diabetes . METHODS The study was a r and omized controlled clinical trial . Forty-nine type 2 diabetic females ( fiber intake < 30g/d , 25 < BMI < 35 kg/m2 ) were divided into two groups . Patients in the intervention group ( n=24 ) received 10g/d inulin and patients in the control group ( n=25 ) received 10g/d maltodextrin for 8 weeks .  Glycemic status and lipid profile indices were measured pre and post intervention . Data were analyzed using SPSS software ( verision11.5 ) . Paired , unpaired t-test and ANCOVA were used to compare quantitative variables . RESULTS Supplementation with inulin caused a significant reduction in FBS ( 8.50 % ) , HbA1c ( 10.40 % ) , total cholesterol ( 12.90 % ) , triglyceride ( 23.60 % ) , LDL-c ( 35.30 % ) , LDL-c/HDL-c ratio ( 16.25 % ) and TC/HDL-c ratio ( 25.20 % ) and increased HDL-c ( 19.90 % ) . The changes for the control group parameters were not significant at the end of study . CONCLUSION Inulin may help to control diabetes and its complications via improving glycemic and lipid parameters 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 Resveratrol is a naturally occurring polyphenolic compound . Numerous animal studies have been reported on its wide-ranging beneficial effects in the biological system including diabetes mellitus ( DM ) . We hypothesized , therefore , that oral supplementation of resveratrol would improve the glycemic control and the associated risk factors in patients with type 2 diabetes mellitus ( T2DM ) . The present clinical study was therefore carried out to test the hypothesis . Sixty-two patients with T2DM were enrolled from Government Headquarters Hospital , Ootacamund , India , in a prospect i ve , open-label , r and omized , controlled trial . Patients were r and omized into control and intervention groups . The control group received only oral hypoglycemic agents , whereas the intervention group received resveratrol ( 250 mg/d ) along with their oral hypoglycemic agents for a period of 3 months . Hemoglobin A(1c ) , lipid profile , urea nitrogen , creatinine , and protein were measured at the baseline and at the end of 3 months . The results reveal that supplementation of resveratrol for 3 months significantly improves the mean hemoglobin A(1c ) ( means ± SD , 9.99 ± 1.50 vs 9.65 ± 1.54 ; P < .05 ) , systolic blood pressure ( mean ± SD , 139.71 ± 16.10 vs 127.92 ± 15.37 ; P < .05 ) , total cholesterol ( mean ± SD , 4.70 ± 0.90 vs 4.33 ± 0.76 ; P < .05 ) , and total protein ( mean ± SD , 75.6 ± 4.6 vs 72.3 ± 6.2 ; P < .05 ) in T2DM . No significant changes in body weight and high-density lipoprotein and low-density lipoprotein cholesterols were observed . Oral supplementation of resveratrol is thus found to be effective in improving glycemic control and may possibly provide a potential adjuvant for the treatment and management of diabetes
Conclusion Our findings may encourage curcumin supplementation based on its meaningful effect on glycemic control and positive trend on lipid outcomes in prediabetes and T2DM
Scope Studies have demonstrated inconsistent effects of curcumin on glycemic outcomes and lipid parameters in patients with prediabetes and type 2 diabetes mellitus ( T2DM ) .
This study aim ed to assess the effect of curcumin on glycemic control and lipid profile in prediabetes and T2DM .