Six months of resveratrol supplementation has no measurable effect in type 2 diabetic patients. A randomized, double blind, placebo-controlled trial. Resveratrol improves insulin sensitivity, reduces oxidative stress and activates the Akt pathway in type 2 diabetic patients. Effects of resveratrol in patients with type 2 diabetes mellitus on skeletal muscle SIRT1 expression and energy expenditure. The Impact of Resveratrol Supplementation on Blood Glucose, Insulin, Insulin Resistance, Triglyceride, and Periodontal Markers in Type 2 Diabetic Patients with Chronic Periodontitis Acute Resveratrol Consumption Improves Neurovascular Coupling Capacity in Adults with Type 2 Diabetes Mellitus The effects of pioglitazone and metformin on plasma visfatin levels in patients with treatment naive type 2 diabetes mellitus. Resveratrol supplementation improves glycemic control in type 2 diabetes mellitus. The Therapeutic Potential of Resistant Starch in Modulation of Insulin Resistance, Endotoxemia, Oxidative Stress and Antioxidant Biomarkers in Women with Type 2 Diabetes: A Randomized Controlled Clinical Trial Resveratrol Ameliorates Arterial Stiffness Assessed by Cardio-Ankle Vascular Index in Patients With Type 2 Diabetes Mellitus. Effect of Camel Milk on Blood Sugar and Lipid Profile of Patients With Type 2 Diabetes: A Pilot Clinical Trial Treatment of hypogonadism with testosterone in patients with type 2 diabetes mellitus. Effect of Linagliptin on Glycemic Control in Chinese Patients with Newly-Diagnosed, Drug-Naïve Type 2 Diabetes Mellitus: A Randomized Controlled Trial Eicosapentaenoic acid improves insulin sensitivity and blood sugar in overweight type 2 diabetes mellitus patients: a double-blind randomised clinical trial. Restoration of acute insulin response in T2DM subjects 1 month after biliopancreatic diversion. Supplementation of α-linolenic acid improves serum adiponectin levels and insulin sensitivity in patients with type 2 diabetes. Risk of T2DM and impaired fasting glucose among pcos subjects: Results of an 8-year follow-up Effect of vildagliptin on hsCRP and arterial stiffness in patients with type 2 diabetes mellitus Assessing progression to impaired glucose tolerance and type 2 diabetes mellitus. Proposed trial: safety and efficacy of resveratrol for the treatment of non-alcoholic fatty liver disease (NAFLD) and associated insulin resistance in adolescents who are overweight or obese adolescents - rationale and protocol. Sugar-sweetened product consumption alters glucose homeostasis compared with dairy product consumption in men and women at risk of type 2 diabetes mellitus. The effects of resveratrol supplementation on cardiovascular risk factors in patients with non-alcoholic fatty liver disease: a randomised, double-blind, placebo-controlled study. Efficacy of increased resistant starch consumption in human type 2 diabetes The Effect of Real-Time Continuous Glucose Monitoring on Glycemic Control in Patients with Type 2 Diabetes Mellitus
The polyphenol resveratrol is considered to exert many beneficial actions , such as antioxidant , anti-inflammatory , insulin-sensitizer and anticancer effects . Its benefits in patients with type 2 diabetes mellitus ( T2DM ) are controversial . Our aims were to determine whether resveratrol supplementation at two different dosages ( 500 and 40mg/day ) for 6 months i ) reduced the concentrations of C-reactive-protein ( CRP ) and ii ) ameliorated the metabolic pattern of T2DM patients .  In the present double-blind , r and omized , placebo-controlled trial , 192 T2DM patients were r and omized to receive resveratrol 500mg/day ( Resv500arm ) , resveratrol 40mg/day ( Resv40arm ) or placebo for 6-months . At baseline and at the trial end , CRP values , anthropometric , metabolic and liver parameters were determined . No serious adverse event occurred . A dose-dependent , though not significant , CRP decrease of 5.6 % ( Resv40arm ) and 15.9 % ( Resv500arm ) was observed vs placebo . We failed to detect significant differences in weight , BMI , waist circumference , and values of arterial blood pressure , fasting glucose , glycated hemoglobin , insulin , C-peptide , free fatty acids , liver transaminases , uric acid , adiponectin , interleukin-6 , in both the Resv500 and Resv40 arms vs placebo . Total cholesterol and triglycerides slightly increased in the Resv500arm . Subgroup analyses revealed that lower diabetes duration ( in both Resv500 and Resv40arms ) , and , in the Resv500arm , younger age , aspirin use and being a smoker were associated with a significantly higher CRP reduction vs placebo . The supplementations with 40mg/day or 500mg/day resveratrol did neither reduce CRP concentrations , nor improve the metabolic pattern of T2DM patients Although resveratrol has widely been studied for its potential health benefits , little is known about its metabolic effects in humans . Our aims were to determine whether the polyphenol resveratrol improves insulin sensitivity in type 2 diabetic patients and to gain some insight into the mechanism of its action . After an initial general examination ( including blood chemistry ) , nineteen patients enrolled in the 4-week-long double-blind study were r and omly assigned into two groups : a resveratrol group receiving oral 2 × 5 mg resveratrol and a control group receiving placebo . Before and after the second and fourth weeks of the trial , insulin resistance/sensitivity , creatinine-normalised ortho-tyrosine level in urine sample s ( as a measure of oxidative stress ) , incretin levels and phosphorylated protein kinase B (pAkt):protein kinase B ( Akt ) ratio in platelets were assessed and statistically analysed . After the fourth week , resveratrol  significantly decreased insulin resistance ( homeostasis model of assessment for insulin resistance ) and urinary ortho-tyrosine excretion , while it increased the pAkt : Akt ratio in platelets . On the other h and , it had no effect on parameters that relate to β-cell function ( i.e. homeostasis model of assessment of β-cell function ) . The present study shows for the first time that resveratrol  improves insulin sensitivity in humans , which might be due to a resveratrol-induced  decrease in oxidative stress that leads to a more efficient insulin signalling via the Akt pathway OBJECTIVES The primary aims of the study were to examine the effect of resveratrol on skeletal muscle SIRT1 expression and energy expenditure in subjects with Type 2 diabetes mellitus ( T2DM ) . BACKGROUND Animal and in vivo studies indicate that resveratrol increases SIRT1 expression that stimulates PGC1α activity . Subsequent upregulation of AMPK and GLUT4 expression are associated with improved insulin sensitivity in peripheral tissues . METHODS Ten subjects with T2DM were r and omized in a double-blind fashion to receive 3 g resveratrol or placebo daily for 12 weeks . Secondary outcomes include measures of AMPK , p-AMPK and GLUT4 expression levels , energy expenditure , physical activity levels , distribution of abdominal adipose tissue and skeletal muscle fiber type composition , body weight , HbA1c , plasma lipid subfraction , adiponectin levels , and insulin sensitivity . RESULTS There was a significant increase in both SIRT1 expression ( 2.01 vs. 0.86 arbitrary units [ AU ] , p = .016 ) and p-AMPK to AMPK expression ratio ( 2.04 vs. 0.79 AU , p = .032 ) in the resveratrol group compared with the placebo group . Although the percentage of absolute change ( 8.6 vs. -13.9 % , p = .033 ) and percentage of predicted resting metabolic rate ( RMR ; 7.8 vs. -13.9 % , p = .013 ) were increased following resveratrol , there was a significant reduction in average daily activity ( -38 vs. 43.2 % , p = .028 ) and step counts ( -39.5 vs. 11.8 % , p = .047 ) when compared with placebo . CONCLUSIONS In patients with T2DM , treatment with resveratrol regulates energy expenditure through increased skeletal muscle SIRT1 and AMPK expression . These findings indicate that resveratrol may have beneficial exercise-mimetic effects in patients with T2DM The aim of this study was to investigate the impact of resveratrol supplementation along with non-surgical periodontal treatment on blood glucose , insulin , insulin resistance , triglyceride ( TG ) , and periodontal markers in patients with type 2 diabetes with periodontal disease . In this double-blind clinical trial study , 43 patients with diabetes with chronic periodontitis were participated . Subjects were r and omly allocated to intervention and control groups . The intervention and control groups received either 480 mg/day of resveratrol or placebo capsules ( two pills ) for 4 weeks . Fasting blood glucose , insulin , insulin resistance ( homeostasis model assessment of insulin resistance ) , TGs , and pocket depth were measured in all subjects ' pre-intervention and post-intervention . The mean serum levels of fasting insulin and insulin resistance ( homeostasis model assessment of insulin resistance ) were significantly lower in the intervention group compared with control group ( 10.42 ± 0.28 and 10.92 ± 0.9 ; 3.66 ± 0.97 and 4.49 ± 1.56 , respectively ) . There was a significant difference in the mean pocket depth between intervention and control groups ( 2.35 ± 0.6 and 3.38 ± 0.5 , respectively ) following intervention . No significant differences were observed in the mean levels of fasting blood glucose and TGs between two groups ' post-intervention . It is recommended that resveratrol supplementation may be beneficial as adjuvant therapy along with non-surgical periodontal treatment in insulin resistance and improving periodontal status among patients with diabetes with periodontal disease . Copyright © 2016 John Wiley & Sons , Background : Poor cerebral perfusion may contribute to cognitive impairment in type 2 diabetes mellitus ( T2DM ) . We conducted a r and omized controlled trial to test the hypothesis that resveratrol can enhance cerebral vasodilator function and thereby alleviate the cognitive deficits in T2DM . We have already reported that acute resveratrol consumption improved cerebrovascular responsiveness ( CVR ) to hypercapnia . We now report the effects of resveratrol on neurovascular coupling capacity ( CVR to cognitive stimuli ) , cognitive performance and correlations with plasma resveratrol concentrations . Methods : Thirty-six T2DM adults aged 40–80 years were r and omized to consume single doses of resveratrol ( 0 , 75 , 150 and 300 mg ) at weekly intervals . Transcranial Doppler ultrasound was used to monitor changes in blood flow velocity ( BFV ) during a cognitive test battery . The battery consisted of dual-tasking ( finger tapping with both Trail Making task and Serial Subtraction 3 task ) and a computerized multi-tasking test that required attending to four tasks simultaneously . CVR to cognitive tasks was calculated as the per cent increase in BFV from pre-test basal to peak mean blood flow velocity and also as the area under the curve for BFV . Results : Compared to placebo , 75 mg resveratrol significantly improved neurovascular coupling capacity , which correlated with plasma total resveratrol levels . Enhanced performance on the multi-tasking test battery was also evident following 75 mg and 300 mg of resveratrol . Conclusion : a single 75 mg dose of resveratrol was able to improve neurovascular coupling and cognitive performance in T2DM . Evaluation of benefits of chronic resveratrol supplementation is now warranted AIMS Circulating visfatin levels are altered in insulin resistant states . We evaluated the effects of two insulin-sensitizing hypoglycemic agents on plasma visfatin and adiponectin levels in patients with newly diagnosed and untreated type 2 diabetes mellitus ( T2DM ) . METHODS Forty-four patients with T2DM were r and omized to treatment either with pioglitazone ( 15 - 45mg/day ) or metformin ( 1000 - 2000mg/day ) . Plasma visfatin and adiponectin levels and homeostasis model assessment of insulin resistance ( HOMA-IR ) scores were determined at baseline and at 12th week of treatment . RESULTS By the end of the 12th week , fasting plasma glucose , HbA1c , HOMA-IR scores and waist circumferences improved equally in both treatment arms . HDL cholesterol and adiponectin levels increased only in the pioglitazone group ( p=0.01 and p=0.003 , respectively ) . On the other h and , metformin treatment had additional regulatory effects on BMI , blood pressure and total and LDL-cholesterol levels ( p=0.002 , p=0.01 , p=0.004 , p=0.001 and p<0.001 , respectively ) . Neither pioglitazone nor metformin displayed a significant effect on circulating visfatin concentration . CONCLUSIONS Despite improvements in insulin sensitivity and glycemic regulation , either pioglitazone or metformin treatment did not result in any effect on blood visfatin levels in patients with treatment naïve T2DM 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 Aims : This trial aims to determine the effects of resistant starch ( RS ) subtype 2 ( RS2 ) on glycemic status , metabolic endotoxemia and markers of oxidative stress . Methods : A r and omized , controlled , parallel-group clinical trial group of 56 females with type 2 diabetes mellitus ( T2DM ) was divided to 2 groups . The intervention group ( n = 28 ) and control group ( n = 28 ) received 10 g/day RS2 or placebo for 8 weeks , respectively . Fasting blood sample s were taken to determine glycemic status , endotoxin , high sensitivity C-reactive protein ( hs-CRP ) , malondialdehyde ( MDA ) , total antioxidant capacity ( TAC ) , antioxidant enzymes concentrations as well as uric acid at baseline and after the intervention . Results : After 8 weeks , RS2 caused a significant decrease in the levels of MDA ( -34.10 % ) , glycosylated hemoglobin ( -9.40 % ) , insulin ( -29.36 % ) , homeostasis model of insulin resistance ( -32.85 % ) and endotoxin ( -25.00 % ) , a significant increase in TAC ( 18.10 % ) and glutathione peroxidase ( 11.60 % ) as compared with control . No significant changes were observed in fasting plasma glucose , quantitative insulin sensitivity check index , hs-CRP , superoxide dismutase , catalase and uric acid in the RS2 group as compared with the control group . Conclusion : Supplementation with RS2 may be improved glycemic status , endotoxemia and markers of oxidative stress in patients with T2DM Resveratrol has been reported to have potent anti-atherosclerotic effects in animal studies . However , there are few interventional studies in human patients with atherosclerogenic diseases . The cardio-ankle vascular index ( CAVI ) reflects arterial stiffness and is a clinical surrogate marker of atherosclerosis . The aim of the present study was to investigate the effect of resveratrol on arterial stiffness assessed by CAVI in patients with type 2 diabetes mellitus (T2DM).In this double-blind , r and omized , placebo-controlled study , 50 patients with T2DM received supplement of a 100 mg resveratrol tablet ( total resveratrol : oligo-stilbene 27.97 mg/100 mg/day ) or placebo daily for 12 weeks . CAVI was assessed at baseline and the end of study . Body weight ( BW ) , blood pressure ( BP ) , glucose and lipid metabolic parameters , and diacron-reactive oxygen metabolites ( d-ROMs ; an oxidative stress marker ) were also measured . Resveratrol supplementation decreased systolic BP ( -5.5 ± 13.0 mmHg ) , d-ROMs ( -25.6 ± 41.8 U.CARR ) , and CAVI ( -0.4 ± 0.7 ) significantly ( P < 0.05 ) and decreased BW ( -0.8 ± 2.1 kg , P = 0.083 ) and body mass index ( -0.5 ± 0.8 kg/m2 , P = 0.092 ) slightly compared to baseline , while there were no significant changes in the placebo group . Decreases in CAVI and d-ROMs were significantly greater in the resveratrol group than in the placebo group . Multivariate logistic regression analysis identified resveratrol supplementation as an independent predictor for a CAVI decrease of more than 0.5.In conclusion , 12-week resveratrol supplementation may improve arterial stiffness and reduce oxidative stress in patients with T2DM . Resveratrol may be beneficial in preventing the development of atherosclerosis induced by diabetes . However , a large-scale cohort study is required to vali date the present findings 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 OBJECTIVE To investigate the effect of testosterone treatment on insulin resistance , glycemic control , and dyslipidemia in Asian Indian men with type 2 diabetes mellitus ( T2DM ) and hypogonadism . METHODS We conducted a double-blind , placebo-controlled , crossover study in 22 men , 25 to 50 years old , with T2DM and hypogonadism . Patients were treated with intramuscularly administered testosterone ( 200 mg every 15 days ) or placebo for 3 months in r and om order , followed by a washout period of 1 month before the alternative treatment phase . The primary outcomes were changes in fasting insulin sensitivity ( as measured by homeostasis model assessment [ HOMA ] in those patients not receiving insulin ) , fasting blood glucose , and hemoglobin A1c . The secondary outcomes were changes in fasting lipids , blood pressure , body mass index , waist circumference , waist-to-hip ratio , and and rogen deficiency symptoms . Statistical analysis was performed on the delta values , with the treatment effect of placebo compared with the effect of testosterone . RESULTS Treatment with testosterone did not significantly influence insulin resistance measured by the HOMA index ( mean treatment effect , 1.67 + /- 4.29 ; confidence interval , -6.91 to 10.25 ; P>.05 ) . Mean change in hemoglobin A1c ( % ) ( -1.75 + /- 5.35 ; -12.46 to 8.95 ) and fasting blood glucose ( mg/dL ) ( 20.20 + /- 67.87 ; -115.54 to 155.94 ) also did not reach statistical significance . Testosterone treatment did not affect fasting lipids , blood pressure , and anthropometric determinations significantly . CONCLUSION In this study , testosterone treatment showed a neutral effect on insulin resistance and glycemic control and failed to improve dyslipidemia , control blood pressure , or reduce visceral fat significantly in Asian Indian men with T2DM and hypogonadism Background This study aim ed to evaluate the efficacy and safety of linagliptin ( a novel dipeptidyl peptidase (DPP)-4 inhibitor ) on glucose metabolism and β-cell function in Chinese patients with newly-diagnosed , drug-naïve type 2 diabetes mellitus ( T2DM ) . Material / Methods Newly-diagnosed and drug-naïve T2DM patients were enrolled . After 4-week lifestyle modulation and 2-week placebo run-in , 57 patients were r and omized to double-blind treatment with linagliptin ( n=34 ) or placebo ( n=23 ) . The primary endpoint was the change from baseline in glycosylated hemoglobin A1c ( HbA1c ) after 24 weeks . Fasting plasma glucose ( FPG ) , 2-h postpr and ial plasma glucose ( 2h-PPG ) , fasting insulin , proinsulin-to-insulin ratio , homeostasis model assessment of insulin resistance ( HOMA-IR ) , and homeostasis model assessment of β-cell function ( HOMA-β ) were also evaluated . Results Baseline characteristics were similar between the 2 groups . Compared with placebo , linagliptin therapy result ed in a significant decrease in HbA1C ( −1.2±0.7 % vs. −0.4±0.4 % , P<0.001 ) , FBG ( −0.98±1.17 vs. −0.32±0.51 mmol/L , P=0.011 , and 2h-PPG ( −2.02±0.94 vs. −0.97±0.63 mmol/L , P<0.001 ) . Significant differences were observed for the proinsulin/insulin ratio ( P<0.001 ) and HOMA-β index ( P=0.001 ) . Rates of adverse events were similar between the 2 groups ( 30.3 % vs. 27.3 % ) . All adverse events were mild . One patient discontinued participation due to pregnancy . Conclusions Linagliptin treatment result ed in a significant and clinical ly meaningful improvement of glycemic control in drug-naïve Chinese patients with T2DM , as well as improved parameters of β-cell function . Linagliptin had an excellent safety profile INTRODUCTION Diabetes mellitus is the most common metabolic disorder in humans , and its incidence is increasing rapidly worldwide . Although polyunsaturated fatty acids have beneficial effects on diabetes mellitus , previous data regarding the possible positive effects of n-3 fatty acids on glycaemic indices were inconclusive . We conducted a double-blind r and omised clinical trial to determine the effects of eicosapentaenoic acid ( EPA ) , an n-3 polyunsaturated fatty acid , on overweight patients with type 2 diabetes mellitus ( T2DM ) . METHODS This double-blind , placebo-controlled r and omised clinical trial was conducted on a total of 67 overweight patients with T2DM for a duration of three months . Of these 67 patients , 32 received 2 g purified EPA daily , while 35 received a placebo of 2 g corn oil daily . The patients ' fasting plasma glucose ( FPG ) , serum insulin , glycated haemoglobin ( HbA1c ) and insulin sensitivity indices were assessed . RESULTS After three months of EPA supplementation , the group that received EPA showed significant decreases in FPG ( p < 0.001 ) , HbA1c ( p = 0.01 ) and homeostasis model assessment of insulin resistance ( HOMA-IR ) ( p = 0.032 ) , when compared to the placebo group . EPA supplementation result ed in decreased serum insulin levels , with the levels between the EPA and placebo groups showing a significant difference ( p = 0.004 ) . CONCLUSION The results of our study indicate that EPA supplementation could improve insulin sensitivity . It was able to decrease serum insulin , FPG , HbA1c and HOMA-IR .  EPA could have beneficial effects on glycaemic indices in patients with T2DM OBJECTIVE Biliopancreatic diversion ( BPD ) restores normal glucose tolerance in a few weeks in morbid obese subjects with type 2 diabetes , improving insulin sensitivity . However , there is less known about the effects of BPD on insulin secretion . We tested the early effects of BPD on insulin secretion in obese subjects with and without type 2 diabetes . METHODS AND PROCEDURES Twenty-one consecutive morbid obese subjects , 9 with type 2 diabetes ( T2DM ) and 12 with normal fasting glucose ( NFG ) were evaluated , just before and 1 month after BPD , by measuring body weight ( BW ) , glucose , adipocitokines , homeostasis model assessment of insulin resistance ( HOMA-IR ) , acute insulin response ( AIR ) to e.v . glucose and the insulinogenic index adjusted for insulin resistance ( [DeltaI5/DeltaG5]/HOMA-IR ) . RESULTS Preoperatively , those with T2DM differed from those with NFG in showing higher levels of fasting glucose , reduced AIR ( 57.9 + /- 29.5 vs. 644.9 + /- 143.1 pmol/l , P < 0.01 ) and reduced adjusted insulinogenic index ( 1.0 + /- 0.5 vs. 17.6 + /- 3.9 1/mmol(2 ) , P < 0.001 ) . One month following BPD , in both groups BW was reduced ( by approximately 11 % ) , but all subjects were still severely obese ; HOMA-IR and leptin decreased significanlty , while high-molecular weight ( HMW ) adiponectin and adjusted insulinogenic index increased . In the T2DM group , fasting glucose returned to non-diabetic values . AIR did not change in the NFG group , while in the T2DM group it showed a significant increase ( from 58.0 + /- 29.5 to 273.8 + /- 47.2 pmol/l , P < 0.01 ) . In the T2DM group , the AIR percentage variation from baseline was significantly related to changes in fasting glucose ( r = 0.70 , P = 0.02 ) , suggesting an important relationship exists between impaired AIR and hyperglycaemia . DISCUSSION BPD is able to restore AIR in T2DM even just 1 month after surgery . AIR restoration is associated with normalization of fasting glucose concentrations OBJECTIVE ω-3 Polyunsaturated α-linolenic acid ( ALA ) supplementation has not been studied in the setting of adiponectin levels and insulin sensitivity ( IS ) improvements in patients with type 2 diabetes mellitus ( T2DM ) by hyperinsulinemic-euglycemic clamp ( HEC ) . The aim of this study was to examine the influence of ω-3 ALA on IS and adiponectin . METHODS We conducted a r and omized study in patients with T2DM and assessed IS using HEC . Twenty patients with T2DM were included and r and omly assigned to receive 3 g/d of ALA or placebo for 60 d , in a double-blind design . The assessment of IS by HEC was performed at baseline and after 60 d in all patients ; blood sample s were taken for the measurement of serum lipids , glucose , insulin , adiponectin , and cytokines . The primary outcome variables were an increase of both glucose infusion rate ( GIR ) in steady state and glucose metabolization ( M ) by HEC . The secondary outcomes were an increase in adiponectin levels and a decrease in fasting plasma glucose , glycated hemoglobin , homeostasis model assessment -estimated insulin resistance ( HOMA-IR ) index , lipids and cytokines . The study was conducted at an academic medical center . RESULTS The ALA group improved IS corrected for fat-free mass ( M/FFM ; P = 0.04 ) . Both groups showed increased adiponectin after 60 d ( P = 0.01 ) , however , the increase for the ALA group was greater ( P = 0.04 ) . In the ALA group , adiponectin was positively correlated with GIR ( r = 0.76 ; P = 0.01 ) and M/FFM ( r = 0.62 ; P = 0.06 ) , and negatively correlated with HOMA-IR ( r = -0.61 ; P = 0.03 ) . CONCLUSION ω-3 ALA supplementation improved glucose homeostasis and was associated with an increase in adiponectin . Improvement in the overall metabolic profile with ω-3 ALA suggests a potential clinical utility for this agent and requires further investigation Women with polycystic ovary syndrome ( PCOS ) often develop type 2 diabetes mellitus ( T2DM ) . To determine the magnitude of risk of developing T2DM among women with PCOS , development of T2DM was prospect ively assessed among women who had T2DM ( n = 97 ) and controls ( n = 95 ) using Kaplan-Meier survival analysis and Cox proportional hazards modeling . The women with T2DM had higher baseline weight ( body mass index , P < 0.01 ) and lower insulin sensitivity ( homeostasis assessment model of insulin resistance , P < 0.01 ) . The 8-year incidence rate among cases and controls was 13.4 % and 5.8 % , respectively ( relative risk = 2.3 ) . Obese cases had a fivefold risk of T2DM developing ( P < 0.01 ) compared with age-adjusted obese controls , indicating significant interaction between PCOS and obesity to effect T2DM risk 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 BACKGROUND A prospect i ve evaluation of the relationship between insulin secretion and insulin sensitivity , derived from the fasting state , is needed in clinical practice in order to identify the worsening of glucose metabolism . In this study the authors examine whether the product of insulin sensitivity and insulin secretion , assessed from the fasting state , predicts progression from normal glucose tolerance ( NGT ) to impaired fasting glucose ( IFG ) and from impaired glucose tolerance ( IGT ) to type 2 diabetes mellitus ( T2DM ) . MATERIAL S AND METHODS A cohort of 300 subjects with NGT and 75 subjects with IGT were followed up over a 5-year period . Insulin sensitivity was calculated using the Belfiore index ( B ) and insulin secretion by the homeostasis model analysis beta-cell ( HOMA-beta cell ) index : the product of B-beta is expressed as : ( 40 x Ins(0 ) pmol L(-1))/Glu(0 ) mmol L(-1){[(Glu(0 ) mmol L(-1)x Ins(0 ) pmol L(-1 ) ) + 1 ] - 3.5[(Glu(0 ) mmol L(-1 ) x Ins(0 ) pmol L(-1 ) ) - 1 ] } , where Glu(0 ) is fasting glucose and Ins(0 ) is fasting insulin . RESULTS From baseline at the end of the follow-up period , the product B-beta decreased 10.7 % and 52.2 % in progressors to IGT and T2DM , respectively . The product B-beta predicts the progression from NGT to IGT [ relative risk ( RR ) 2.7 , CI(95 % ) 1.2 - 9.1 ] and from IGT to T2DM ( RR 5.3 , CI(95 % ) 1.3 - 8.55 ) . The cut-off point for the product B-beta that better predicts progression from NGT to IGT is 0.25 ( sensitivity 88 % , specificity 92 % ) and from IGT to T2DM 0.15 ( sensitivity 92 % , specificity 95 % ) . CONCLUSIONS Adaptation of insulin secretion to compensate for decreased insulin sensitivity during transition to IGT and T2DM can be successfully assessed with simple measures derived from the fasting state . The product B-beta predicts the development to IGT and T2DM Non-alcoholic fatty liver ( NAFL ) disease ( NAFLD ) affects 30 % of overweight adolescents and increases the risk of type 2 diabetes mellitus ( T2D ) . Resveratrol is a naturally occurring compound with potential to reverse NAFL and its associated insulin resistance in adults . The use of resveratrol to reduce risk for T2D through its effect on NAFL has not been examined to date in youth . This paper provides a literature review and protocol for a 30 day proof of principle trial of resveratrol in a population of adolescents at risk for T2D . This r and omized double-blind controlled trial is design ed with the primary objective of evaluating a twice daily supplementation of 75 mg of resveratrol for safety and tolerability in overweight and obese adolescent subjects ( 13 to < 18 years of age ) with NAFL . Secondary objectives are to determine the effect size of the intervention on hepatic steatosis and whole body insulin sensitivity .  Adolescents in the intervention arm ( n = 10 ) will receive oral supplementation of resveratrol 75 mg twice daily ( with breakfast and dinner ) for a total daily dose of 150 mg for the duration of 30 days . The comparison group ( n = 10 ) will receive a placebo twice daily for 30 days . Both cases and controls will receive a st and ardized lifestyle intervention program . Subjects in both groups will be followed for an additional 30 days post intervention for total study duration of approximately 60 days . Primary outcome measures include a primary side effect profile determined by participant interview , a side effect profile determined by serum biochemistry and vital signs . Secondary outcome measures include an oral glucose tolerance test , liver and cardiac fat content measured by magnetic resonance spectroscopy , anthropometric measures of overweight/obesity , inflammatory markers , and cardiac function and morphology measured with ultrasonography . Additional outcome measures include serum concentrations of resveratrol , compliance to protocol , physical activity , and nutritional assessment . This study will determine the safety and tolerability of resveratrol in an overweight adolescent population and inform the design of a larger r and omized controlled trial BACKGROUND Dietary patterns characterized by high intakes of fruits and vegetables , whole grains , low-fat dairy products , and low glycemic load have been associated with lower type 2 diabetes mellitus ( T2DM ) risk . In contrast , dietary patterns that include high intakes of refined grains , processed meats , and high amounts of added sugars have been associated with increased T2DM risk . OBJECTIVE This r and omized , 2-period crossover trial compared the effects of dairy and sugar-sweetened product ( SSP ) consumption on insulin sensitivity and pancreatic β-cell function in men and women at risk of the development of T2DM who habitually consume sugar-sweetened beverages . METHODS In a r and omized , controlled crossover trial , participants consumed dairy products ( 474 mL/d 2 % milk and 170 g/d low-fat yogurt ) and SSPs ( 710 mL/d nondiet soda and 108 g/d nondairy pudding ) , each for 6 wk , with a 2-wk washout between treatments . A liquid meal tolerance test ( LMTT ) was administered at baseline and the end of each period . RESULTS Participants were 50 % female with a mean age and body mass index of 53.8 y and 32.2 kg/m(2 ) , respectively . Changes from baseline were significantly different between dairy product and SSP conditions for median homeostasis model assessment 2-insulin sensitivity ( HOMA2-%S ) ( 1.3 vs. -21.3 % , respectively , P = 0.009 ; baseline = 118 % ) , mean LMTT disposition index ( -0.03 vs. -0.36 , respectively , P = 0.011 ; baseline = 2.59 ) , mean HDL cholesterol ( 0.8 vs. -4.2 % , respectively , P = 0.015 ; baseline = 44.3 mg/dL ) , and mean serum 25-hydroxyvitamin D [ 25(OH)D ] ( 11.7 vs. -3.3 , respectively , P = 0.022 ; baseline = 24.5 μg/L ) . Changes from baseline in LMTT Matsuda insulin sensitivity index ( -0.10 vs. -0.49 , respectively ; baseline = 4.16 ) and mean HOMA2-β-cell function ( -2.0 vs. 5.3 % , respectively ; baseline = 72.6 % ) did not differ significantly between treatments . CONCLUSION These results suggest that SSP consumption is associated with less favorable values for HOMA2-%S , LMTT disposition index , HDL cholesterol , and serum 25(OH)D in men and women at risk of T2DM vs. baseline values and values during dairy product consumption . This trial was registered at clinical trials.gov as NCT01936935 Non-alcoholic fatty liver disease ( NAFLD ) is usually associated with insulin resistance , central obesity , reduced glucose tolerance , type 2 diabetes mellitus and hypertriacylglycerolaemia . The beneficial effects of resveratrol on metabolic disorders have been shown previously . The aim of this study was to evaluate the effects of resveratrol supplementation on cardiovascular risk factors in patients with NAFLD . In this r and omised double-blinded placebo-controlled clinical trial , fifty NAFLD patients were supplemented with either a 500-mg resveratrol capsule or a placebo capsule for 12 weeks . Both groups were advised to follow an energy-balanced diet and physical activity recommendations . resveratrol supplementation reduced alanine aminotransferase ( ALT ) and hepatic steatosis significantly more than placebo ( P0·05 ) . There were no significant changes in blood pressure , insulin resistance markers and TAG in either group ( P>0·05 ) . Our data have shown that 12-week supplementation of 500 mg resveratrol does not have any beneficial effect on anthropometric measurements , insulin resistance markers , lipid profile and blood pressure ; however , it reduced ALT and hepatic steatosis in patients with NAFLD Resistant starch ( RS ) has been shown to beneficially affect insulin sensitivity in healthy individuals and those with metabolic syndrome , but its effects on human type 2 diabetes ( T2DM ) are unknown . This study aim ed to determine the effects of increased RS consumption on insulin sensitivity and glucose control and changes in postpr and ial metabolites and body fat in T2DM . Seventeen individuals with well-controlled T2DM ( HbA1c 46.6±2 mmol/mol ) consumed , in a r and om order , either 40 g of type 2 RS ( HAM-RS2 ) or a placebo  , daily for 12 weeks with a 12-week washout period in between . At the end of each intervention period , participants attended for three metabolic investigations : a two-step euglycemic – hyperinsulinemic clamp combined with an infusion of [ 6,6 - 2H2 ] glucose , a meal tolerance test ( MTT ) with arterio-venous sampling across the forearm , and whole-body imaging . HAM-RS2 result ed in significantly lower postpr and ial glucose concentrations ( P=0.045 ) and a trend for greater glucose uptake across the forearm muscle ( P=0.077 ) ; however , there was no effect of HAM-RS2 on hepatic or peripheral insulin sensitivity , or on HbA1c . Fasting non-esterified fatty acid ( NEFA ) concentrations were significantly lower ( P=0.004 ) and NEFA suppression was greater during the clamp with HAM-RS2 ( P=0.001 ) . Fasting triglyceride ( TG ) concentrations and soleus intramuscular TG concentrations were significantly higher following the consumption of HAM-RS2 ( P=0.039 and P=0.027 respectively ) . Although fasting GLP1 concentrations were significantly lower following HAM-RS2 consumption ( P=0.049 ) , postpr and ial GLP1 excursions during the MTT were significantly greater ( P=0.009 ) . HAM-RS2 did not improve tissue insulin sensitivity in well-controlled T2DM , but demonstrated beneficial effects on meal h and ling , possibly due to higher postpr and ial GLP1 Background : Real-time continuous glucose monitoring ( RT-CGM ) improves hemoglobin A1c ( A1C ) and hypoglycemia in people with type 1 diabetes mellitus and those with type 2 diabetes mellitus ( T2DM ) on pr and ial insulin ; however , it has not been tested in people with T2DM not taking pr and ial insulin .  We evaluated the utility of RT-CGM in people with T2DM on a variety of treatment modalities except pr and ial insulin . Methods : We conducted a prospect i ve , 52-week , two-arm , r and omized trial comparing RT-CGM ( n = 50 ) versus self-monitoring of blood glucose ( SMBG ) ( n = 50 ) in people with T2DM not taking pr and ial insulin . Real-time continuous glucose monitoring was used for four 2-week cycles ( 2 weeks on/1 week off ) . All patients were managed by their usual provider . This article reports on changes in A1C 0–12 weeks . Results : Mean ( ±st and ard deviation ) decline in A1C at 12 weeks was 1.0 % ( ±1.1 % ) in the RT-CGM group and 0.5 % ( ±0.8 % ) in the SMBG group ( p = .006 ) . There were no group differences in the net change in number or dosage of hypoglycemic medications . Those who used the RT-CGM for ±48 days ( per protocol ) reduced their A1C by 1.2 % ( ±1.1 % ) versus 0.6 % ( ±1.1 % ) in those who used it < 48 days ( p = .003 ) . Multiple regression analyses statistically adjusting for baseline A1C , an indicator for usage , and known confounders confirmed the observed differences between treatment groups were robust ( p = .009 ) . There was no improvement in weight or blood pressure . Conclusions : Real-time continuous glucose monitoring significantly improves A1C compared with SMBG in patients with T2DM not taking pr and ial insulin . This technology might benefit a wider population of people with diabetes than previously thought
The drug also reduced homeostasis model assessment of insulin resistance ( HOMA-IR ) index , systolic blood pressure , and diastolic blood pressure among participants with T2DM .
The changes in hemoglobin A1c ( HbA1c ) , low-density lipoprotein cholesterol , and high-density lipoprotein cholesterol were negligible .
Subgroup analysis comparing the resveratrol supplementation doses of < 100 mg/d versus ≥ 100 mg/d revealed a significant difference in fasting plasma glucose .
In particular , the latter dose presented more favorable results .
This meta- analysis provides evidence that supplementation of resveratrol may benefit management of T2DM
Although the regular consumption of resveratrol has been known to improve glucose homeostasis and reverse insulin resistance in type 2 diabetes mellitus ( T2DM ) , the reported results are inconsistent .
Thus , we aim ed to assess the effects of resveratrol on glycemic control and insulin sensitivity among patients with T2DM .