Impact of Vitamin E Supplementation on Blood Pressure and Hs-CRP in Type 2 Diabetic Patients | doi: 10.5681/hpp.2012.009. Nonpharmacological interventions to prevent type 2 diabetes in women diagnosed with gestational diabetes mellitus: a systematic overview Effect of vitamin D supplementation on inflammation: protocol for a systematic review The effectiveness of yoga to prevent diabetes mellitus type 2 Vitamin D 20,000 IU per Week for Five Years Does Not Prevent Progression From Prediabetes to Diabetes. A systematic review protocol examining the effect of vitamin D supplementation on endothelial function Multivariate Path Analysis of Serum 25-Hydroxyvitamin D Concentration, Inflammation, and Risk of Type 2 Diabetes Mellitus Effect of vitamin D on insulin resistance and anthropometric parameters in Type 2 diabetes; a randomized double-blind clinical trial Effects of metformin plus gliclazide versus metformin plus glimepiride on cardiovascular risk factors in patients with type 2 diabetes mellitus. Effect of vitamin D supplementation on glycemic control in patients with type 2 diabetes: a systematic review of interventional studies Resveratrol supplementation improves glycemic control in type 2 diabetes mellitus. Cost-effectiveness of interventions to control cardiovascular diseases and type 2 diabetes mellitus in South Asia: protocol for a systematic review Ngāti and healthy: translating diabetes prevention evidence into community action Docosahexaenoic Acid-Rich Fish Oil Supplementation Improves Body Composition without Influence of the PPARγ Pro12Ala Polymorphism in Patients with Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial Taking a Low Glycemic Index Multi-Nutrient Supplement as Breakfast Improves Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial Physical activity and sedentary behaviors associated with risk of progression from gestational diabetes mellitus to type 2 diabetes mellitus: a prospective cohort study. Effectiveness of Systematic Health Education Model for Type 2 Diabetes Patients A Short-Term Evaluation of the Relationship Between Plasma Ascorbic Acid Levels and Periodontal Disease in Systemically Healthy and Type 2 Diabetes Mellitus Subjects Effects of azilsartan medoxomil compared with olmesartan and valsartan on ambulatory and clinic blood pressure in patients with type 2 diabetes and prediabetes Oral L-arginine and vitamins E and C improve endothelial function in women with type 2 diabetes Efficacy of vitamin D supplementation in depression in adults: a systematic review protocol The effect of enriched chicory inulin on liver enzymes, calcium homeostasis and hematological parameters in patients with type 2 diabetes mellitus: A randomized placebo-controlled trial. Glucagon-like peptide-1 receptor agonists as add-on therapy to basal insulin in patients with type 2 diabetes: a systematic review
BACKGROUND Type 2 diabetes mellitus ( T2DM ) is a major public health problem worldwide . Hypertension and inflammation are well recognized as risk factors for the macrovascular complications of diabetes . The aim of this study was to assess the impact of vitamin E supplementation on blood pressure ( BP ) , serum high-sensitivity C-reactive protein ( hs-CRP ) and fasting blood glucose in patients with T2DM . METHODS In a double blind , r and omized , controlled clinical trial , 83 patients with T2DM were divided r and omly into two groups of vitamin E ( 400 mg/d , n=42 ) and placebo ( n=41 ) . All patients received the pearls for 8 weeks . Baseline and eighth week BP , serum hs-CRP , fasting blood glucose , anthropometric and dietary intake data were obtained from each patient . Data were analyzed using SPSS version 11.5 . RESULTS Vitamin E supplementation significantly increased serum levels of vitamin E  ( P < 0.001 ) and decreased mean arterial pressure and fasting blood glucose ( P = 0.047 , P = 0.028 , respectively ) in vitamin E group as compared with placebo group . A significant decrease in systolic blood pressure and diastolic blood pressure was observed in the vitamin E group comparing with baseline values ( all P < 0.01 ) . There were no significant changes in serum hs-CRP in both of the studied groups . CONCLUSION Vitamin E had beneficial effects on serum vitamin E , BP and blood glucose in patients with T2DM . Improvement in BP and glucose control may contribute to reducing complications of diabetes including cardiovascular risk in these patients 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 Introduction The extraskeletal role of vitamin D is being increasingly recognised . This has important clinical implication s , as vitamin D deficiency has reached epidemic proportions worldwide . Vitamin D has proposed anti-inflammatory properties , yet the role of vitamin D supplementation in reducing inflammation remains largely unknown . The purpose of this review is to investigate the impact of vitamin D supplementation on inflammation , and to identify relevant knowledge gaps in the field . Methods and analysis Medline , CINAHL , EMBASE and All EBM will be systematic ally search ed for r and omised controlled trials ( RCTs ) and systematic review s of RCTs , comparing vitamin D supplementation with placebo , usual care or other pharmacological or non-pharmacological interventions . One review er will assess articles for eligibility according to prespecified selection criteria , after which 2 independent review ers will perform data extraction and quality appraisal . Meta-analyses will be conducted where appropriate . Ethics and dissemination Formal ethical approval is not required as no primary data is collected . This systematic review will identify potential clinical implication s of vitamin D deficiency and supplementation , and will be disseminated through a peer- review ed publication and at conference meetings , to inform future research on the efficacy of vitamin D supplementation for inflammation and inflammatory diseases . PROSPERO registration number CRD42016037104 Background : Type 2 diabetes mellitus ( T2DM ) is becoming a leading problem worldwide . Emerging reports reveal alarming evidence of increasing prevalence of T2DM that has reached p and emic levels . Despite the significant incidence , there are limited reliable data re sources and comprehensive systematic review and meta- analysis on the effects of yoga on people who are a prediabetic or high risk for developing T2DM . Objective : The objective of this protocol is to conduct a full-scale systematic review and meta-analyses on the effects of yoga on people who are prediabetes or high risk of developing T2DM . Methods : The articles enrolled in the study will be retrieved from the online data bases between 2002 and the date the search es are executed . The search es will be repeated just before the final analyses and further relevant studies for inclusion . We will conduct a bibliographic search in data bases : Medline / PubMed , Scopus , Cochrane Library , EBSCO , and IndMED using keywords including prediabetes state , high risk for diabetes , metabolic syndrome , and yoga . A defined search strategy will be implemented along with selection criteria to obtain full-text articles of relevant studies . This study protocol was prepared according to the Preferred Reporting Items for Systematic Review s and Meta- Analysis for Protocol s 2015 guidelines . There will be no language restrictions . Ethics and dissemination : The proposed study will be based on published studies and publicly available anonymized data without directly involving human participants and therefore requires neither formal human ethical review nor approval by a human research ethics committee . We published an outline of the protocol in the International Prospect i ve Register of Systematic Review s ( PROSPERO ) in 2018 . We plan to disseminate the findings of this systematic review and meta- analysis through publication in a peer- review ed journal and presentation at relevant conference proceedings . In addition , we believe the results of the systematic review will have implication s for policy and practice . We will prepare policymaker summary using a vali date d format , disseminate through social media and email discussion groups . Review registration number : PROSPERO registration number CRD 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 ) Introduction Vitamin D has potential benefits for extraskeletal health . These could include an anti-inflammatory effect as well as a reduction in endothelial dysfunction . We aim to provide quality evidence for the hypothesis that supplementation with vitamin D will improve endothelial function ( EF ) , possibly through the abrogation of systemic inflammation . Methods and analysis We will conduct a systematic review of all r and omised controlled trials on  vitamin D supplementation and EF lasting 12 weeks or more . The search will cover the period 2000–2015 and include studies that describe direct measures of EF  , markers of endothelial cell ( EC ) activation  and if concurrently reported , indicators of systemic inflammation  . Study selection will follow the Preferred Reporting Items for Systematic Review s and Meta-Analyses ( PRISMA ) guidelines and study quality will be assessed by the Jadad score in addition to an evaluation of allocation concealment and data analysis . If sufficient data are available , a meta- analysis will be conducted . The effect sizes will be generated using Hedges ’ g score , for both fixed and r and om effect models . I2 statistics and Galbraith plots will be used to assess heterogeneity and identify their potential sources . Potential publication and small sample size bias will be assessed by visual inspections of funnel plots and also Egger 's test . Meta-regression analysis ( if feasible ) will be conducted with restricted maximum likelihood ( REML ) estimation method , controlling for potential confounders ( demographics , study methods , location , etc ) . A backward elimination process will be applied in the regression modelling procedure . Subgroup analysis , conditional on number of studies retrieved and their sample size , will be stratified on participant disease category , total dose administered , degree of 25(OH)D change and type of supplement used . Ethics and dissemination Formal ethical approval is not required as primary data will not be collected . The results will be disseminated through a peer- review ed publication , conference presentation and the popular press . Trial registration number International Prospect i ve Register for Systematic Review s ( PROSPERO ) number CRD42014013523 Background and Aims . Despite growing interest in the protective role that vitamin D may have in health outcomes , little research has examined the mechanisms underlying this role . This study aim ed to test two hypotheses : ( 1 ) serum 25-hydroxyvitamin D [ 25(OH)D ] is inversely associated with type 2 diabetes mellitus ( T2DM ) and elevated hemoglobin A1c ; ( 2 ) these associations are mediated by serum C-reactive protein ( CRP ) . Methods . Participants aged 20 and older in 2001–2006 National Health and Nutrition Examination Surveys ( n = 8,655 ) with measures of serum 25(OH)D , CRP , hemoglobin A1c , and other important covariates were included in the present study . Logistic regression and path analysis methods were applied to test the study hypotheses . Results . Decreased serum 25(OH)D concentration was significantly associated with increased odds of T2DM .  In males , an estimated 14.9 % of the association between 25(OH)D and hemoglobin A1c was mediated by serum CRP . However , this mediation effect was not observed in females . Conclusion . Using a nationally representative sample , the present study extends previous research and provides new evidence that the effect of  decreased serum vitamin D concentration on T2DM may proceed through increased systemic inflammation in males . Longitudinal studies and r and omized control trials are needed to confirm the present findings Background & the purpose of the study Prevalence of type 2 diabetes mellitus ( T2DM ) is increasing worldwide . To reduce its risk and progression , preventive strategies are needed . Vitamin supplementation such as vitamin D is one of the strategies . This study was design ed to investigate the effect of injection of vitamin D on insulin resistance and anthropometric parameters in T2DM . Methods This r and omized double-blind clinical trial was conducted with 42 diabetic patients in two groups ; intervention group with  single intramuscular injection of 300,000 International Unit ( IU ) of vitamin D3 and the placebo group . After recording demographic and anthropometric factors ( waist circumference , blood pressure and body mass index ) , fasting blood sample s was taken for measurement of blood glucose , 25-hydroxyvitamin D3 ( 25-OHD3 ) , insulin , glycosylated hemoglobin A1c ( HbA1c ) and estimation of Homeostasis Model Assessment Index ( HOMA ) in two times ; before study and after three months . Results Two groups had similar baseline characteristics ( each group = 21 subjects ) . Three months after vitamin D injection , HbA1c , anthropometric factors and HOMA index in intervention group stayed constant , however , serum 25- OHD3 was significantly increased ( p = 0.007 ) . Conclusion The present data is not convincing and further studies with large sample sizes are needed to show the definite effect of injection of vitamin D on control of diabetes and its risk High blood glucose level , lipid profile disturbances and plasma homocysteine ( Hcy ) are important risk factors for cardiovascular diseases in patients with type 2 diabetes . This study was conducted to evaluate and compare effects of glimepiride/metformin combination versus gliclazide/metformin combination on cardiovascular risk factors in type-2 diabetes mellitus ( T2DM ) patients . One hundred and eighty T2DM patients were r and omly allocated for treatment with placebo ( control ) , metformin ( 500 mg twice daily ) , glimepiride ( 3 mg once daily ) , gliclazide ( 80 mg once daily ) , metformin plus glimepiride or metformin plus gliclazide for 3 months . We evaluated plasma levels of glucose ( PG ) , glycated hemoglobin ( HbA1C ) , Hcy , vitamin B12 , folic acid and lipid profile before treatment and 3 months post treatment . Compared to metformin treated patients , glimepiride plus metformin induced significant reductions in : fasting plasma glucose , postpr and ial PG level , HbA1C % and Hcy level . Conversely , plasma folic acid and vitamin B12 were significantly increased . The levels of total cholesterol and triglyceride were significantly decreased ; low-density lipoprotein was markedly decreased , whereas high-density lipoprotein was significantly increased and hence risk ratio was signiﬁcantly decreased . Similar results but with lower values were obtained using combination of metformin plus gliclazide on glycemic control only . Combination of glimepiride with metformin was superior to gliclazide plus metformin in alleviating the cardiovascular risk factors in type 2 diabetes mellitus patients Background Diabetes and vitamin D deficiency are global epidemics . Research ers have long been exploring the role of potentially modifiable factors to manage type 2 diabetes . We conducted a systematic review of prospect i ve studies and r and omized controlled trials that involved vitamin D supplementation and specifically intended to study glycemic outcomes related to type 2 diabetes . Methods Two authors independently search ed Medline and PubMed for longitudinal studies that had assessed the effect of vitamin D supplements on glycemic control , insulin resistance and beta-cell dysfunction in patients with diabetes . Results Seventeen r and omized control trials and seven longitudinal studies with a minimum follow-up of one month were included . Results of the various short-term studies ( follow up ≤ 3 months ) suggested that vitamin D supplementation had a positive impact on glycemic control and metabolic parameters such as insulin resistance and beta cell dysfunction . However , the evidence was weak due to the low method ological quality of the studies . There was no significant effect on HbA1c , beta cell function and insulin resistance in the long-term studies ( follow up > 3 months ) . There existed heterogeneity in the methodology of the studies , inclusion criteria , mode of supplementation of vitamin D and the duration of follow up . Conclusions Current evidence based on r and omized controlled trials and longitudinal studies do not support the notion that vitamin D supplementation can improve hyperglycemia , beta cell secretion or insulin sensitivity in patients with type 2 diabetes . Large-scale trials with proper study design , optimal vitamin D supplementation and longer follow up need to be conducted 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 Introduction While a number of strategies are being implemented to control cardiovascular diseases ( CVDs ) and type 2 diabetes mellitus ( T2DM ) , the cost-effectiveness of these in the South Asian context has not been systematic ally evaluated . We aim to systematic ally review the economic ( cost-effectiveness ) evidence available on the individual- , group- and population -level interventions for control of CVD and T2DM in South Asia . Methods and analysis This review will consider all relevant economic evaluations , either conducted alongside r and omised controlled trials or based on decision modelling estimates . These studies must include participants at risk of developing CVD/T2DM or with established disease in one or more of the South Asian countries ( India , Bangladesh , Pakistan , Sri Lanka , Nepal , Maldives , Bhutan and Afghanistan ) . We will identify relevant papers by systematic ally search ing all major data bases and registries . Selected articles will be screened by two independent research ers . Method ological quality of the studies will be assessed using a modified Drummond and a Phillips checklist . Cochrane guidelines will be followed for bias assessment in the effectiveness studies . Results Results will be presented in line with the PRISMA ( Preferred Reporting Items for Systematic review and Meta- analysis ) checklist , and overall quality of evidence will be presented as per the GRADE ( Grade s of Recommendation , Assessment , Development and Evaluation ) approach . Ethics and dissemination The study has received ethics approval from the All India Institute of Medical Sciences , New Delhi , India . The results of this review will provide policy-relevant recommendations for the uptake of cost-effectiveness evidence in prioritising decisions on essential chronic disease care packages for South Asia . Study registration number PROSPERO CRD42013006479 Introduction : Type 2 diabetes mellitus ( T2DM ) is a major health issue in New Zeal and Māori . Clinical trials have demonstrated potential for the prevention of T2DM , but whether community public health programmes aim ing to prevent diabetes are effective is untested . Objective : To describe the planning and design of an intervention aim ing to translate T2DM prevention clinical trial evidence into a community-wide population health intervention in a high risk predominantly Māori community . Approach : Community concerns about the diabetes burden were heard by the local diabetes nurse , herself a tribal member , and discussed with a locally raised academic . Project planning ensued . The intervention and its evaluation were design ed using a participatory community development model . The planned intervention had three components : community-wide health promotion initiatives conveying healthy lifestyle messages , community education and monitoring for identified high-risk individuals and their extended families , and a structural strategy aim ed at adapting local environments to support lifestyle changes . The evaluation plan involved interrupted time series surveys coupled with formative and process evaluations rather than a r and omised control trial design . Discussion : Consulting communities , validating community concerns and prioritising cultural and ethical issues were key steps . Time spent developing good relationships amongst the health provider and academic research team members at the outset proved invaluable , as the team were united in addressing the project planning and implementation challenges , such as funding obstacles that arose because of our ethically and culturally appropriate non-r and omised control trial evaluation design . The pre-intervention survey demonstrated high rates of diabetes ( 13 % ) , insulin resistance ( 33 % ) and risk factors , and provided evidence for positive , as opposed to negative , lifestyle intervention messages . Conclusion : Community-wide lifestyle interventions have the potential to reduce rates of type 2 diabetes and other chronic diseases in high-risk communities , but require a high level of commitment from the health sector and buy-in from the community . Adequate commitment , leadership , planning and re sources are essential Background : The aims of this research were to investigate ( 1 ) the impact of docosahexaenoic acid (DHA)-rich fish oil supplementation on body composition , plasma adiponectin level , and peroxisome proliferator-activated receptor γ ( PPARγ ) gene expression , and ( 2 ) whether the effect of DHA-rich fish oil supplementation on the aforementioned variables is modulated by PPARγ Pro12Ala polymorphism . Methods : We genotyped PPARγ Pro12Ala polymorphism in subjects with type 2 diabetes mellitus ( T2DM ) . Ala carriers and non-Ala carriers were r and omly assigned to DHA-rich fish oil or placebo intake for 8 weeks . Results : Glycemic control was not affected by the intervention . The supplementation with DHA-rich fish oil decreased waist circumference ( p < 0.001 ) , body fat mass ( p = 0.01 ) , body fat percent ( p = 0.04 ) , and visceral fat rating ( p = 0.02 ) as well as trunk fat mass ( p = 0.04 ) . Weight , body mass index , fat-free mass , adiponectin level , and PPARγ gene expression changes showed no significant difference . No gene-diet interaction was found on body composition , adiponectin level , and PPARγ gene expression . Conclusions : DHA-rich fish oil supplementation favorably modulated body composition in patients with T2DM and could be useful to reduce visceral obesity . However , the PPARγ Pro12Ala polymorphism did not influence the changes in the desired variables Dietary therapy is the mainstay of treatment for diabetes . This study examined the effect of a low glycemic index ( GI ) multi-nutrient supplement , consumed in place of breakfast , on glycemic control in patients with type 2 diabetes mellitus ( T2DM ) . A total of 71 participants were r and omized at a 2:1 ratio into either a breakfast replacement group or a normal breakfast group for a 12-week interventional study . The primary outcome measure was change in hemoglobin A1c ( HbA1c ) . Nutrition status and somatometry were studied as secondary outcomes . The breakfast replacement group displayed a −0.2 % absolute reduction in HbA1c ( 95 % CI ( confidence interval ) , −0.38 % to −0.07 % , p = 0.004 ) , while the HbA1c of the control group increased 0.3 % ( 95 % CI , 0.1 % to 0.5 % , p = 0.005 ) . The baseline Mini Nutritional Assessment score for both groups was 26.0 and no significant changes occurred following intervention . However , there was a statistically significant difference in body mass index between the treatment and control groups ( p = 0.032 ) due to the weight gain in the control group ( increased 0.5 kg , 95 % CI was 0.2 to 0.9 , p = 0.007 ) . These data suggest that breakfast replacement with a low GI multi-nutrient supplement can improve glycemic and weight control in T2DM IMPORTANCE Women with a history of gestational diabetes mellitus ( GDM ) are at substantially increased risk of type 2 diabetes mellitus ( T2DM ) . The identification of important modifiable factors could help prevent T2DM in this high-risk population . OBJECTIVE To examine the role of physical activity and television watching and other sedentary behaviors  , and changes in these behaviors in the progression from GDM to T2DM . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study of 4554 women from the Nurses ' Health Study II who had a history of GDM , as part of the ongoing Diabetes & Women 's Health Study . These women were followed up from 1991 to 2007 . EXPOSURES Physical activity and television watching and other sedentary behaviors  were assessed in 1991 , 1997 , 2001 , and 2005 . MAIN OUTCOMES AND MEASURE Incident T2DM identified through self-report and confirmed by supplemental question naires . RESULTS We documented 635 incident T2DM cases during 59,287 person-years of follow-up . Each 5-metabolic equivalent hours per week ( MET-h/wk ) increment of total physical activity , which is equivalent to 100 minutes per week of moderate-intensity physical activity , was related to a 9 % lower risk of T2DM ( adjusted relative risk [ RR ] , 0.91 ; 95 % CI , 0.88 - 0.94 ) ; this inverse association remained significant after additional adjustment for body mass index ( BMI ) . Moreover , an increase in physical activity was associated with a lower risk of developing T2DM . Compared with women who maintained their total physical activity levels , women who increased their total physical activity levels by 7.5 MET-h/wk or more ( equivalent to 150 minutes per week of moderate-intensity physical activity ) had a 47 % lower risk of T2DM ( RR , 0.53 ; 95 % CI , 0.38 - 0.75 ) ; the association remained significant after additional adjustment for BMI . The multivariable adjusted RRs ( 95 % CIs ) for T2DM associated with television watching of 0 to 5 , 6 to 10 , 11 to 20 , and 20 or more hours per week were 1 ( reference ) , 1.28 ( 1.04 - 1.59 ) , 1.41 ( 1.11 - 1.79 ) , and 1.77 ( 1.28 - 2.45 ) , respectively ( P value for trend < .001 ) ; additional adjustment for BMI attenuated the association . CONCLUSIONS AND RELEVANCE Increasing physical activity may lower the risk of progression from GDM to T2DM . These findings suggest a hopeful message to women with a history of GDM , although they are at exceptionally high risk for T2DM , promoting an active lifestyle may lower the risk Background Health education is considered to be essential in the overall care of patients with type 2 diabetes mellitus ( T2DM ) ;  systematic health education integrates individual education not only during hospitalization but also extended care outside of a hospital . To test effectiveness of the systematic health education model for T2DM , we conducted a r and omized study with a control group among patients with T2DM living in Nanjing , China . Methods 998 eligible patients completed the enrollment and were r and omized to systematic health education model and conventional model groups ( 498 and 500 patients , resp . ) . The systematic health education model was based on the following aspects : image education , visitation of the exhibition hall , dissemination of educational material s , individualized medical nutrition therapy and exercise programs , WeChat group and regular health lectures , evaluation of complications , lifestyle modification , systematic treatment scheme , self-monitoring of glycemic control , monthly evaluation of the therapeutic effect , proposed improvement measures , and individualized follow-up scheme . The main outcome measures were glycated hemoglobin A1c ( HbA1c ) , blood pressure , body mass index ( BMI ) , and lipids during the 2-year follow-up . Results The systematic health education model led to a favorable variation in HbA1c , LDL cholesterol , and systolic blood pressure ( SBP ) ( P < 0.05 ) . After adjusted analysis , the HbA1c decreased by 0.67 % ( P < 0.01 ) in the systematic health education model , SBP decreased by 10.83 mmHg ( P < 0.01 ) , and the level of diastolic blood pressure ( DBP ) , HDL cholesterol , and total cholesterol decreased slightly and was not significant . The BMI did not change significantly during the study in either of the two groups . Conclusions The systematic health education model is a useful method in the treatment of T2DM because it contributes to decrease in HbA1c , LDL cholesterol , and SBP levels , as well as helps in increasing the compliance with the control criteria , except for DBP and BMI ABSTRACT Background : Deficient ascorbic acid levels ( AALs ) and Type 2 diabetes mellitus ( T2DM ) are associated with periodontal disease . This study evaluated the relationship between plasma AAL and periodontitis in systemically healthy and T2DM subjects , which to the best of our knowledge is being reported for the first time . Methods : One hundred twenty subjects were categorized into four groups of 30 each as group 1 : without periodontal disease ; group 2 : chronic gingivitis ; group 3 : chronic periodontitis , and group 4 : chronic periodontitis and freshly diagnosed T2DM .  Plaque index ( PlI ) , sulcus bleeding index ( SBI ) , and probing pocket depths ( PPDs ) were evaluated . Venous blood was evaluated for plasma AAL spectrophotometrically . R and omized subjects were subgrouped within groups 2–4 , to receive either scaling and root planing ( SRP ) with dietary supplementation ( 450 mg ) of ascorbic acid ( AA ) for two weeks or only SRP . After two weeks , the clinical parameters were reassessed . Tukey 's multiple post hoc procedures and paired t test were used with the level of statistical significance adjusted to p ≤ .05 . Results : AAL plasma levels were significantly greater in group 1 than in group 2 ( p = .0007 ) and in group 4 ( p = .0003 ) . A significant reduction in the SBI was seen in the subgroups that received dietary supplementation of vitamin C within group 2 ( p = .0012 ) and group 4 ( p = .036 ) . Conclusions : Plasma AAL is below the normal range in systemically healthy subjects with gingivitis and diabetics with periodontitis  . Dietary AA supplementation with SRP improves the SBI in subjects with gingivitis and diabetics with periodontitis 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 Endothelial dilator function is impaired in people with type 2 diabetes mellitus ( T2DM ) . Prior research indicates that this can be improved with intravenous administration of ascorbate or L-arginine , but whether these agents have this effect when administered by the clinical ly practical oral route is unknown . To investigate this question , 10 premenopausal women with T2DM and 10 healthy , premenopausal , non-diabetic women received , in r and om sequence , a 1-week administration of oral L-arginine ( 9 g daily ) or vitamins E ( 1800 mg ) and C ( 1000 mg ) with an intervening 1-week washout period . Flow-mediated brachial artery dilation ( FMD ) was measured by ultrasonography and forearm blood flow was measured by plethysmography before and following blood pressure cuff-induced forearm ischemia before and after each week of treatment . At baseline , the women with T2DM had lesser FMD responses ( 0.028 ± 0.006 cm vs 0.056 ± 0.008 cm , p , 0.05 ) . Post-ischemic forearm hyperemia was reduced at baseline in T2DM compared with controls ( 16.4 ± 1.8 vs 26.0 ± 1.4 ml 100 ml- 1 min- 1 , p < 0.05 ) . Administration of L-arginine caused a 50 ± 12 % increase in FMD in T2DM ( p < 0.05 ) and raised post-ischemic forearm blood flow by 29 ± 8 % ( p < 0.05 ) . No significant changes were seen in controls . Administration of vitamins E and C in women with T2DM produced an increase in the brachial artery diameter response of 79 ± 15 % ( p < 0.05 ) , but did not significantly increase the hyperemic blood flow response ( p = NS ) . No significant changes in the responses of controls from pre to post vitamin administration were observed . We concluded that administration of two types of oral agents improved measures of endothelial function in people with T2DM Background The role of vitamin D in management of depression is unclear . Results from observational and emerging r and omized controlled trials ( RCTs ) investigating the efficacy of vitamin D in depression lack consistency - with some suggesting a positive association while others show a negative or inconclusive association . Methods / Design The primary aim of this study is to conduct a systematic review of RCTs to assess the effect of oral vitamin D supplementation versus placebo on depression symptoms measured by scales and the proportion of patients with symptomatic improvement according to the authors ’ original definition . Secondary aims include assessing the change in quality of life , adverse events and treatment discontinuation . We will conduct the systematic review and meta- analysis according to the recommendations of the Cochrane H and book for Systematic Review s of Interventions . We will search the Cochrane Central Register of Controlled Trials ( CENTRAL ) , MEDLINE ( 1966 to present ) , EMBASE ( 1980 to present ) , CINAHL ( 1982 to present ) , PsychINFO ( 1967 to present ) and Clinical Trials.gov . Unpublished work will be identified by search ing two major conferences : the International Vitamin Conference , the Anxiety Disorders and Depression Conference , while grey literature will be acquired by contacting authors of included studies . We will use the r and om-effects meta- analysis to synthesize the data by pooling the results of included studies . Discussion The results of this systematic review will be helpful in clarifying the efficacy of vitamin D supplementation and providing evidence to establish guidelines for implementation of vitamin D for depression in general practice and other relevant setting s. Study registration Unique identifier : CRD42013003849 BACKGROUND S AND AIMS Type 2 diabetic mellitus ( T2DM ) as one 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 enriched chicory inulin supplementation on liver enzymes , serum calcium and phosphorous concentrations and hematological 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 chicory and subjects in control group received a placebo for two months . Anthropometric variables , glucose homeostasis , hematological parameters and metabolic indices including serum alanine aminotransfersae ( ALT ) , aspartate aminotransferase ( AST ) , alkaline phosphatase ( ALP ) , calcium and phosphorous as well as creatinine concentrations , glomerular filtration rate ( GFR ) and blood pressure were assessed at the beginning and end of the trial . RESULTS Significant reductions in fasting serum glucose ( FSG ) , Hb A1C , AST and ALP concentrations were observed in chicory-treated group . Systolic and diastolic blood pressures were also reduced in chicory-treated group . Serum calcium significantly increased after chicory supplementation but no change in placebo treated group has been occurred ( P=0.014 ) . Supplementation with enriched chicory for two months significantly reduced hematocrit and mean corpuscular volume ( MCV ) values ( P<0.05 ) . Changes in serum insulin , creatinine and GFR were not significant . CONCLUSION The present study showed beneficial effects of oligofructose-enriched chicory on the improvement of the glucose and calcium homeostasis , liver function tests , blood pressure and reduction in hematologic risk factors of diabetes in female patients with T2DM . Further studies in both genders are needed to generalize these findings to total population The prevalence of obesity and diabetes continues to rise in the US . Glucagon-like peptide-1 receptor agonist ( GLP-1RA ) is an effective treatment option for type 2 diabetes mellitus ( T2DM ) that promotes weight loss . Common and effective treatment options added to metformin therapy ( basal insulin , sulfonylureas , and pioglitazone ) contribute to weight gain , which makes the addition of GLP-1RAs advantageous . Exenatide was the first agent in this class and has recently been approved for use in combination with insulin glargine by the US Food and Drug Administration and the European Medicines Agency . Until recently , there was a lack of data examining basal insulin combined with these agents . The main purpose of this article is to review the prospect i ve interventional data on the safety and efficacy of GLP-1RAs ( exenatide , liraglutide , albiglutide , lixisenatide ) combined with basal insulin therapy in nonpregnant adults with T2DM . Data bases search ed were PubMed , Cochrane Central Register of Controlled Trials and the Data base of Systematic Review s ( inception to January 2012 ) . Abstract s presented at relevant diabetes and endocrine meetings from 2009 to 2011 were also review ed , as were reference lists of identified publications . A total of five studies met the criteria and were included in the review . Data from these studies demonstrated that this combination therapy offers advantages for the treatment of diabetes , such as additional lowering of A1c without major risk for hypoglycemia , lower basal insulin requirements , decreased postpr and ial glucose levels ( with or without fasting plasma glucose decreases ) , and weight loss , or at the very least , less weight gain . However , the gastrointestinal side effects and high cost of these agents may limit their use . This review demonstrates that adding a GLP-1RA to an existing basal insulin regimen is a reasonable treatment strategy in nonpregnant adult patients with T2DM
Sensitivity analysis showed that overall estimates were not affected by elimination of any study .
We did not observe any evidence regarding publication bias .
In conclusion , vitamin K supplementation had no signiﬁcant effect on glycemic control in healthy subjects .
Type 2 diabetes mellitus ( T2DM ) is one of the most important public health issues .
Vitamin K supplementation might have favorable effect on risk factors of T2DM .
The aim of this study was to perform a systematic review and meta- analysis of interventional studies to examine the effect of vitamin K supplementation on glycemic indices .