The effect of ginger powder supplementation on insulin resistance and glycemic indices in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Use of fasting blood to assess the prevalence of insulin resistance in women with polycystic ovary syndrome. The association between adipocytokines and glycemic control in women with gestational diabetes mellitus Effect of high-dose pitavastatin on glucose homeostasis in patients at elevated risk of new-onset diabetes: insights from the CAPITAIN and PREVAIL-US studies Effects of a single post-partum injection of a high dose of vitamin D on glucose tolerance and insulin resistance in mothers with first-time gestational diabetes mellitus. The effects of synbiotic supplementation on insulin resistance/sensitivity, lipid profile and total antioxidant capacity in women with gestational diabetes mellitus: A randomized double blind placebo controlled clinical trial. Lack of effect of subtherapeutic vitamin D treatment on glycemic and lipid parameters in Type 2 diabetes: A pilot prospective randomized trial. A double-blind, randomized, placebo-controlled trial of the short-term effect of vitamin D3 supplementation on insulin sensitivity in apparently healthy, middle-aged, centrally obese men. Determinants of changes in blood glucose response to short-term exercise training in patients with Type 2 diabetes. The effects of rosiglitazone and metformin on oxidative stress and homocysteine levels in lean patients with polycystic ovary syndrome. Effect of vildagliptin on hsCRP and arterial stiffness in patients with type 2 diabetes mellitus Clinical trial of the effects of coenzyme Q10 supplementation on glycemic control and markers of lipid profiles in diabetic hemodialysis patients Chromium Nicotinate Has No Effect on Insulin Sensitivity, Glycemic Control, and Lipid Profile in Subjects with Type 2 Diabetes Effect of Linagliptin on Glycemic Control in Chinese Patients with Newly-Diagnosed, Drug-Naïve Type 2 Diabetes Mellitus: A Randomized Controlled Trial Sitagliptin added to previously taken antidiabetic agents on insulin resistance and lipid profile: a 2-year study evaluation. Effect of Chinese Herbal Medicine Jinlida Granule in Treatment of Patients with Impaired Glucose Tolerance Effects of a Multispecies Probiotic Mixture on Glycemic Control and Inflammatory Status in Women with Gestational Diabetes: A Randomized Controlled Clinical Trial Effect of vitamin D on insulin resistance and anthropometric parameters in Type 2 diabetes; a randomized double-blind clinical trial Serum vitamin-D predicts insulin resistance in individuals with prediabetes Long-term monitoring of insulin sensitivity in growth hormone-deficient adults on substitutive recombinant human growth hormone therapy. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. Vitamin D and Evening Primrose Oil Administration Improve Glycemia and Lipid Profiles in Women with Gestational Diabetes Treatment of hypogonadism with testosterone in patients with type 2 diabetes mellitus.
OBJECTIVE To identify the effect of some herbal products on insulin resistance . Regarding the scientific evidence s existing about ginger , this research was therefore carried out to identify the effect of ginger supplementation on insulin resistance and glycemic indices in diabetes mellitus . METHODS This is a r and omized , double-blind , placebo-controlled trial in which 88 participants affected by diabetes were r and omly assigned into ginger ( GG ) and placebo ( PG ) groups . The GG received 3 one-gram capsules containing ginger powder whereas the PG received 3 one-gram microcrystalline-containing capsules daily for 8 weeks . HbA1c , fructosamine , fasting blood sugar ( FBS ) , fasting insulin , homeostasis model assessment insulin resistance index ( HOMA-IR ) , β-cell function ( β% ) , insulin sensitivity ( S% ) and the quantitative insulin sensitivity check index ( QUICKI ) were assessed before and after the intervention . RESULTS FBS mean showed a decrease of 10.5 % ( p=0.003 ) in the GG whereas the mean had an increase of 21 % in the PG ( p=0.01 ) . Variation in HbA1c mean was in line with that of FBS . Statistical difference was found in the two groups before and after the intervention in terms of median of fasting insulin level , S% and HOMA-IR ( P<0.005 ) . Moreover QUICKI mean increased significantly in the two groups , the mean difference , however , was significantly higher in the GG . CONCLUSIONS The study demonstrated that daily consumption of 3 one-gram capsules of ginger powder for 8 weeks is useful for patients with type 2 diabetes due to FBS and HbA1c reduction and improvement of insulin resistance indices such as QUICKI index OBJECTIVE To determine the prevalence of insulin resistance ( IR ) in women with polycystic ovary syndrome ( PCOS ) using baseline fasting blood measurements of glucose and insulin . DESIGN Prospect i ve clinical study . SETTING Academic endocrinology unit in Palermo , Italy . PATIENT(S ) Two hundred and sixty-seven women with PCOS , consecutively evaluated , and 50 consecutively selected ovulating controls . INTERVENTION(S ) Fasting blood was obtained for glucose and insulin measurements from all women . For 60 women with PCOS and 20 controls an insulin tolerance test ( ITT ) was also performed . MAIN OUTCOME MEASURE(S ) Assessment of normal and abnormal values for fasting insulin , glucose/insulin ratio , and the calculated indices of the homeostasis model assessment ( HOMA ) , quantitative sensitivity check index ( QUICKI ) , as well as Kitt ( kinetic disappearance of glucose ) values after ITT . Evaluation was performed of the ability to detect IR using these methods in obese and nonobese women with PCOS . RESULT ( S ) Normal insulin sensitivity was defined by insulin levels < 12 mU/mL , glucose/insulin ratios of > 6.4 , HOMA values of < 47 , and QUICKI values of > 0.333 . In the entire PCOS groups , IR was diagnosed in 65.4 % of women using glucose/insulin ratios and in 77 % and 79.2 % using HOMA and QUICKI . In obese women ( body mass index > 28 in 48 % of group ) , IR was present in 76.7 % as measured by glucose/insulin ratios but was significantly higher ( 95.3 % ) using values of either HOMA or QUICKI ( P<.01 ) . All indices correlated with Kitt values with QUICKI showing the best correlation . CONCLUSION ( S ) Insulin resistance was detected in approximately 80 % of women with PCOS , and in 95 % of obese women . The detection of IR is superior using the calculated indices HOMA and QUICKI Abstract Objective : To evaluate the relationship between adipocytokines and glycemic control . Study design : Prospect i ve observational trial of gestations with gestational diabetes mellitus ( GDM ) .  Fasting glucose ( FG ) , insulin , adiponectin , leptin , chemerin , retinol-binding protein 4 ( RBP-4 ) , osteocalcin , and resistin were measured . HomeOstasis model assessment of insulin resistance ( HOMA-IR ) and QUantitative insulin sensitivity ChecK Index ( QUICKI ) were calculated . Women who required medications for glycemic control were compared to women using nutritional therapy only . Results : Overall , 75 women were included −26 ( 34.7 % ) required medications to achieve good glycemic control . Factors associated with poor control are as follows : low resistin ( aOR 0.84 ) , HOMA-IR ( aOR 1.96 ) , QUICKI ( aOR 0.62 ) , first trimester FG ( aOR 1.43 ) , and maternal age ( aOR 1.26 ) . HOMA-IR and QUICKI performed highest for prediction . Resistin , first trimester FG , maternal age , and QUICKI had an AUC of 0.878 , sensitivity and specificity of 87.5 % for the prediction of the need for medications . Conclusions : Low resistin is associated with poor control . A model utilizing maternal age , first trimester fasting glucose , and first visit QUICKI yields good predictability Abstract Aims : Statin treatment may impair glucose homeostasis and increase the risk of  new-onset diabetes mellitus  , although this may depend on the statin , dose and patient population . We evaluated the effects of pitavastatin 4 mg/day on glucose homeostasis in patients with metabolic syndrome in the CAPITAIN trial . Findings were vali date d in a subset of patients enrolled in PREVAIL-US . Methods : Participants with a well defined metabolic syndrome phenotype were recruited to CAPITAIN to reduce the influence of confounding factors . Validation and comparison data sets were selected comprising phenotypically similar subsets of individuals enrolled in PREVAIL-US and treated with pitavastatin or pravastatin , respectively . Mean change from baseline in parameters of glucose homeostasis ( fasting plasma glucose [ FPG ] , glycated hemoglobin [ HbA1c ] , insulin , quantitative insulin-sensitivity check index [ QUICKI ] and homeostasis model of assessment –insulin resistance [ HOMA-IR ] ) and plasma lipid profile were assessed at 6 months ( CAPITAIN ) and 3 months ( PREVAIL-US ) after initiating treatment . Results : In CAPITAIN ( n = 12 ) , no significant differences from baseline in HbA1c , insulin , HOMA-IR and QUICKI were observed at day 180 in patients treated with pitavastatin . A small ( 4 % ) increase in FPG from baseline to day 180 ( P < 0.05 ) , was observed . In the validation data set ( n = 9 ) , no significant differences from baseline in glycemic parameters were observed at day 84 ( all comparisons P > 0.05 ) . Similar results were observed for pravastatin in the comparison data set ( n = 14 ) . Conclusions : Other than a small change in FPG in the CAPITAIN study , neutral effects of pitavastatin on glucose homeostasis were observed in two cohorts of patients with metabolic syndrome , independent of its efficacy in reducing levels of atherogenic lipoproteins . The small number of patients and relatively short follow-up period represent limitations of the study . Nevertheless , these data suggest that statin-induced diabetogenesis may not represent a class effect AIM This study was performed to determine the effect of a single , large , intramuscular injection of vitamin D post-partum on glucose tolerance and insulin resistance in women with gestational diabetes . METHODS Forty-five participants in a r and omized controlled trial on gestational diabetes mellitus were divided into an intervention group and a control group . Only subjects in the intervention group received one intramuscular injection of 300,000 IU of vitamin D3 .  HbA(1c ) , serum 25-hydroxyvitamin D3 , fasting insulin and blood glucose , C-peptide , homeostasis model assessment insulin resistance index ( HOMA-IR ) , β-cell function , insulin sensitivity and the Quantitative Insulin Sensitivity Check Index ( QUICKI ) were measured at baseline and after 3 months of intervention . RESULTS Approximately 80 % of the mothers had a degree of vitamin D deficiency . Post-intervention , this was found in 4.2 and 71.4 % in the intervention and control groups , respectively . The medians of HOMA-IR indices before and after intervention were 0.6 and 0.5 ( P = 0.7 ) , respectively , in subjects in the intervention group , and 0.5 and 0.9 ( P = 0.01 ) in subjects in the control group . The mean of the QUICKI fell only in the control group ( P = 0.008 ) . In the control group , β-cell function increased by ~8 % ( P = 0.01 ) and insulin sensitivity decreased after 3 months ( P = 0.002 ) . Post-intervention , the median C-peptide decreased in the intervention group and increased in the control group , but the change was significant only in the control group ( P = 0.03 ) . CONCLUSIONS A single injection of 300,000 IU of vitamin D3 achieves a 3-month serum 25-hydroxyvitamin D range of 50 - 80 nmol/l and is an efficient , effective and safe procedure for improving the vitamin status and indices of insulin resistance in mothers with gestational diabetes after delivery AIMS The role of gut microbiota in the management of diabetes is shown . In this r and omized clinical trial we assessed the effects of synbiotic supplementation on insulin , lipid profile and antioxidative status among women with gestational diabetes mellitus ( GDM ) . METHODS Ninety pregnant women with GDM were r and omly assigned into two groups to receive either a daily synbiotic capsule - consisting of L. acidophilus , L. plantarum , L. fermentum , L. gasseri ( 1.5 - 7.0 × 109 - 10 CFU/g ) - with fructooligosaccharide ( 38.5 mg ) , or placebo for 6 weeks . Fasting plasma glucose ( FPG ) , insulin , homeostasis model assessment -insulin resistance ( HOMA-IR ) , quantitative insulin sensitivity check index ( QUICKI ) , high- and low density lipoprotein cholesterol ( HDL-C , LDL-C ) , total cholesterol ( TC ) , triglycerides ( TG ) , total antioxidant capacity ( TAC ) , and systolic and diastolic blood pressure ( SBP , DSP ) were assessed before and after the intervention . RESULTS No significant changes in FPG , insulin resistance/sensitivity , lipid profile and TAC indices were seen in synbiotic group compared to the placebo one ( p > 0.05 ) . Significant within group increases for HDL-C and TAC levels in synbiotic group were observed ( p < 0.05 ) . LDL-C showed significant increment in the placebo group compared to the baseline of the study ( 6.9 mg/dL , p < 0.05 ) . Between group comparison showed significant decrease in SBP and DBP in synbiotic group compared to placebo ( -2.5 vs. 8.6 mmHg , and -1.8 vs. 2.1 mmHg , p < 0.05 ) . CONCLUSIONS The results showed that , in women with GDM , synbiotic supplementation had no effect on FPG and insulin resistance/sensitivity indices . Lipid profile and TAC status may be affected by synbiotic supplementation . Synbiotic is effective in reducing of blood pressure in women with GDM 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 AIM To determine the short-term effect of vitamin D(3 ) supplementation on insulin sensitivity in apparently healthy , middle-aged , central ly obese men . SUBJECTS AND METHODS A double-blind r and omized controlled trial was conducted at a tertiary care facility in which 100 male volunteers aged > or = 35 years received three doses of vitamin D(3 ) ( 120,000 IU each ; supplemented group ) fortnightly or placebo ( control group ) . Hepatic fasting insulin sensitivity [ homeostasis model assessment ( HOMA ) , quantitative insulin-sensitivity check index , HOMA-2 ] , postpr and ial insulin sensitivity [ oral glucose insulin sensitivity ( OGIS ) ] , insulin secretion ( HOMA%B , HOMA2-%B ) , lipid profile and blood pressure were measured at baseline and at 6 weeks ' follow-up . RESULTS Seventy-one of the recruited subjects completed the study ( 35 in supplemented group , 36 in control group ) . There was an increase in OGIS with supplementation by per protocol analysis ( P = 0.038 ; intention-to-treat analysis P = 0.055 ) . The age- and baseline 25-hydroxyvitamin D level-adjusted difference in change in OGIS was highly significant ( mean difference 41.1 + /- 15.5 ; P = 0.01 ) . No changes in secondary outcome measures ( insulin secretion , basal indices of insulin sensitivity , blood pressure or lipid profile ) were found with supplementation . CONCLUSION The trial indicates that vitamin D(3 ) supplementation improves postpr and ial insulin sensitivity ( OGIS ) in apparently healthy men likely to have insulin resistance ( central ly obese but non-diabetic ) The aim of the present study was to determine the effects of a 4-week exercise training intervention on blood glucose , insulin sensitivity , BMI ( body mass index ) and cardiorespiratory fitness in patients with Type 2 diabetes , and to identify and establish criteria for patients who are more likely to improve their blood glucose  from short-term exercise training . A r and omized , controlled trial of exercise training , comprising two supervised and one non-supervised sessions of individualized cardiorespiratory and resistance exercise per week , was performed in 132 healthy patients with Type 2 diabetes ( exercise training group , n=68 ) , with the aim of accumulating a minimum of 150 min of moderate-intensity exercise for 4 weeks . BMI , waist circumference , blood pressure , blood lipid profile , blood glucose , insulin , insulin sensitivity [ calculated by HOMA(IR ) ( homoeostasis model assessment of insulin resistance ) and QUICKI ( quantitative insulin check index ) ] , beta-cell function ( calculated by HOMA(beta-Cell ) ) , HbA(1c ) ( glycated haemoglobin ) and VO(2max ) ( maximal oxygen consumption ) were measured at baseline and at 4 weeks . The exercise training group had significant improvements in VO(2max ) , BMI and triacylglycerols ( triglycerides ) . There were no significant changes in blood glucose , HOMA(IR ) , QUICKI or HOMA(beta-Cell ) . Decreases in blood glucose were significantly predicted by baseline blood glucose and HbA(1c ) , with these variables accounting for 15.9 % of the change in blood glucose ( P<0.001 ) . ROC ( receiver operator characteristic ) curve analysis revealed that patients with a blood glucose > 8.85 mmol/l ( sensitivity=73 % , specificity=78 % ) and HbA(1c ) > 7.15 % ( sensitivity=79 % , specificity=60 % ) were more likely to achieve a clinical ly significant decrease in blood glucose . In conclusion , in apparently healthy patients with Type 2 diabetes , a 4-week exercise intervention improved cardiorespiratory fitness , BMI and triacylglycerols . Elevated blood glucose and HbA(1c ) predicted improvements in blood glucose BACKGROUND Oxidative stress and hyperhomocysteinaemia are risk factors for cardiovascular diseases . The aim of this study was to assess the effects of rosiglitazone and metformin on cardiovascular disease risk factors such as insulin resistance , oxidative stress and homocysteine levels in lean patients with polycystic ovary syndrome ( PCOS ) . METHODS Fifty lean patients ( BMI < 25 kg/m2 ) with PCOS and 35 healthy subjects were included this study . Serum homocysteine , sex steroids , fasting insulin , fasting glucose and lipid levels were measured . Total antioxidant status ( TAS ; combines concentrations of individual antioxidants ) and malonyldialdehyde concentration ( MDA ) were determined . Insulin resistance was evaluated by using the homeostasis model insulin resistance index ( HOMA-IR ) , quantitative insulin sensitivity check index ( QUICKI ) , Area under the curve insulin ( AUCI ) and the insulin sensitivity index ( ISI ) . Patients were divided into two groups . One group was treated with metformin ( n = 25 ) and the other received rosiglitazone ( n = 25 ) for 12 weeks . All measurements were repeated at the end of 12 weeks . RESULTS Compared with healthy women , those with PCOS had significantly elevated serum MDA , homocysteine , HOMA-IR , AUCI and lipoprotein a levels , and significantly decreased serum TAS , QUICKI and ISI . Serum free testosterone levels showed a significant positive correlation with MDA , AUCI and HOMA-IR , and a negative correlation with TAS , ISI and QUICKI in PCOS patients . HOMA-IR and AUCI significantly decreased , while QUICKI and ISI significantly increased after treatment in both groups . Serum TAS level increased and serum MDA level decreased after the rosiglitazone treatment , but these parameters did not change after the metformin treatment . Serum homocysteine and lipid levels did not change in either group , while serum and rogen levels and LH/FSH ratio significantly decreased after the treatment period in only the rosiglitazone-treated group . CONCLUSION Elevated insulin resistance , oxidative stress and plasma homocysteine levels and changes in serum lipid profile ( risk factors for cardiovascular disease ) were observed in lean PCOS patients .  Rosiglitazone seemed to decrease elevated oxidative stress when compared with metformin treatment in lean PCOS patients 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 Purpose The current study was conducted to determine the effects of coenzyme Q10 ( CoQ10 ) supplementation on glycemic control and markers of lipid profiles risk in diabetic hemodialysis ( HD ) patients . Methods This r and omized , double blind , placebo-controlled clinical trial was performed among 60 diabetic HD patients . Subjects were r and omly allocated into two groups to take either 120 mg/day of CoQ10 supplements or placebo ( n = 30 each group ) for 12 weeks . Results After 12 weeks of intervention , CoQ10 supplementation , compared with the placebo , result ed in a significant decrease in serum insulin concentrations ( − 2.5 ± 4.0 vs. + 2.8 ± 5.3 µIU/mL , P < 0.001 ) , homeostasis model of assessment -estimated insulin resistance ( − 0.9 ± 2.1 vs. + 1.2 ± 3.0 , P = 0.002 ) , and significant increase in the quantitative insulin sensitivity check index ( + 0.009 ± 0.01 vs. − 0.02 ± 0.05 , P = 0.003 ) . In addition , a trend toward a greater decrease in serum triglycerides ( − 5 ± 53 vs. + 17 ± 44 , P = 0.078 ) and VLDL-cholesterol levels ( − 0.9 ± 10 vs. + 3 ± 9 , P = 0.078 ) was observed in the CoQ10 group compared to the placebo group . We did not observe any significant effect of CoQ10 supplementation on fasting glucose , HbA1c and other lipid profiles compared with the placebo . Conclusions Overall , our study supported that CoQ10 supplementation to diabetic HD patients for 12 weeks had beneficial effects on markers of insulin metabolism , but did not affect fasting glucose , HbA1c , and lipid profiles . Clinical registration http://www.i rct .ir : I RCT 2016081811763N30 Objective : To investigate the effect of chromium nicotinate supplementation on insulin sensitivity , glycemic control , and lipid profile in subjects with type 2 diabetes . Material s and Methods : In a double-blind clinical trial , 56 overweight individuals with type 2 diabetes were r and omized into 3 groups : placebo ( NC0 ) , 50 μg ( NC50 ) , and 200 μg ( NC200 ) of chromium as chromium nicotinate .  Chromium status , sensitivity to insulin , glycemic control , and lipid profile were assessed at the beginning of the study and 45 days and 90 days after . Results : In the beginning , most subjects showed low concentrations of serum chromium ( 71.88 % ) , regular levels of urinary chromium ( 80.65 % ) , and insulin resistance ( 73.80 % ) . The serum chromium concentrations did not differ among the groups over time ( p = 0.2549 ) . The changes in serum chromium and urine concentrations did not relate to changes in fasting glucose ( p > 0.05 ) . At 90 days of intervention , there was no significant difference between groups in fasting glucose , glycosylated hemoglobin , homeostasis model assessment insulin resistance ( HOMA-IR ) , total cholesterol , and low-density lipoprotein ( LDL ) ; there was increase in homeostasis model assessment β-cell function ( HOMA-β ; p = 0.0349 ) and high-density lipoprotein ( HDL ; p = 0.0425 ) in the NC0 group and a reduction of triglycerides in the NC0 ( p = 0.0177 ) and NC50 ( p = 0.0336 ) groups . Conclusion : Supplementation at 50 and 200 μg of chromium as chromium nicotinate did not promote glycemic control , increase insulin sensitivity , or change the lipid profile of subjects with diabetes 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 The aim of this study was to evaluate whether the positive effects of sitagliptin on glycemic control and insulin resistance were maintained also after 2 years of therapy and whether sitagliptin could be effective also in improving lipid profile . In this r and omized , double-blind , placebo-controlled trial , 205 patients with type 2 diabetes in therapy with different antidiabetic drugs were r and omized to add sitagliptin 100 mg once a day or placebo to their current therapy . We evaluated at the baseline and after 6 , 12 , 18 , and 24 months the following parameters : body mass index , glycated hemoglobin ( HbA1c ) , 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 ) , high-density lipoprotein cholesterol ( HDL-C ) , low-density lipoprotein cholesterol ( LDL-C ) , triglycerides ( Tg ) .  Sitagliptin , added to previously taken antidiabetic agents , proved to be effective in improving glycemic profile , reducing HbA1c by -17.5 % , FPG by -12.7 % , PPG by -20.5 % . Regarding insulin resistance , sitagliptin decreased FPI by -8.3 % and HOMA-IR by -20.0 % , confirming that what have been already reported in short-term studies can be applied also after 2 years of treatment . Sitagliptin also reduced body weight by -4.3 % . Our study also showed the positive effect of sitagliptin on lipid profile ; in particular , sitagliptin decreased TC by -13.3 % , LDL-C by -20.4 % , and Tg by -32.3 % , and also increased HDL-C by + 13.6 % . Sitagliptin proved to be effective on glycemic profile and insulin resistance even after 2 years of therapy and to be effective in improving body weight and lipid profile Background : Diabetes mellitus ( DM ) remains a major health problem worldwide . Several clinical trials have shown the superiority of the Traditional Chinese Medicine in delaying or reversing the development and progression of DM . This study aim ed to evaluate the efficacy of Jinlida ( JLD ) granule , a Chinese herbal recipe , in the treatment of impaired glucose tolerance ( IGT ) and its effect on the prevention of DM . Methods : Sixty-five IGT patients were r and omized to receive one bag of JLD granules three times daily ( JLD group , n = 34 ) or no drug intervention ( control group , n = 31 ) for 12 weeks . Oral glucose tolerance test , glycated hemoglobin A1c ( HbA1c ) , body mass index , blood lipids levels , fasting insulin , and insulin resistance calculated using homeostatic model assessment ( HOMA-IR ) of all the patients were observed and compared before and after the treatment . Results : Sixty-one participants completed the trial ( 32 in JLD group and 29 in the control group ) . There were statistically significant decreases in HbA1c ( P < 0.001 ) , 2-h plasma glucose ( P < 0.001 ) , and HOMA-IR ( P = 0.029 ) in JLD group compared with the control group after 12 weeks of treatment . After 12 weeks of treatment , two ( 6.9 % ) patients returned to normal blood glucose , and five ( 17.2 % ) patients turned into DM in control group , while in the JLD group , 14 ( 43.8 % ) returned to normal blood glucose and 2 ( 6.2 % ) turned into DM . There was a significant difference in the number of subjects who had normal glucose at the end of the study between two groups ( P = 0.001 ) . Conclusions : JLD granule effectively improved glucose control , increased the conversion of IGT to normal glucose , and improved the insulin resistance in patients with IGT . This Chinese herbal medicine may have a clinical value for IGT Objective . This trial aims to examine the effects of a Probiotic Mixture ( VSL#3 ) on glycemic status and inflammatory markers , in women with GDM . Material s and Methods . Over a period of 8 weeks , 82 women with gestational diabetes were r and omly assigned to either an intervention group ( n = 41 ) which were given VSL#3 capsule or to a control group which were given placebo capsule ( n = 41 ) . Fasting plasma glucose , homeostatic model assessment of insulin resistance , glycosylated hemoglobin , high-sensitivity C-reactive protein , tumor necrosis factor-α , interleukin-6 , Interferon gamma , and interleukin-10 were measured before and after the intervention . Results . After 8 wk of supplementation FPG , HbA1c , HOMA-IR , and insulin levels remained unchanged in the probiotic and placebo groups . The comparison between the two groups showed no significant differences with FPG and HbA1c , but there were significant differences in insulin levels and HOMA-IR ( 16.6 ± 5.9 ; 3.7 ± 1.5 , resp . ) . Unlike the levels of IFN-g ( 19.21 ± 16.6 ) , there was a significant decrease in levels of IL-6 ( 3.81 ± 0.7 ) , TNF-α ( 3.10 ± 1.1 ) , and hs-CRP ( 4927.4 ± 924.6 ) . No significant increase was observed in IL-10 ( 3.11 ± 5.7 ) in the intervention group as compared with the control group . Conclusions . In women with GDM , supplementation with probiotics ( VSL#3 ) may help to modulate some inflammatory markers and may have benefits on glycemic control 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 Background & objectives : Patients with diabetes and vitamin-D insufficiency have increased insulin resistance . Similar observations among individuals with prediabetes are not well documented . The aim of this study was to find the occurrence of vitamin-D insufficiency/deficiency among individuals with prediabetes and to evaluate the relationship between vitamin-D status and insulin resistance . Methods : One hundred fifty seven individuals with prediabetes who fulfilled all the inclusion and exclusion criteria underwent clinical examination , anthropometric measurements ( waist circumference , waist-hip ratio , waist-height ratio ) and blood sampling after overnight fast for estimation of fasting blood glucose , fasting insulin , 25(OH)vitamin-D , intact parathyroid hormone ( iPTH ) and lipid profile . One hour post 75 g glucose ( 1hPG ) blood glucose during oral glucose tolerance test was measured . Results : Vitamin-D deficiency/insufficiency was found in 115 ( 73.25 % ) individuals with prediabetes .  Severe vitamin-D deficiency ( < 10 ng/ml ) was seen in 14.65 per cent individuals . Individuals with the lowest vitamin-D levels ( < 10 ng/ml ) had the highest insulin resistance ( HOMA2-IR : 2.04 ± 0.67 ) . Serum 25(OH)D had a statistically significant inverse correlation with insulin resistance ( HOMA2-IR ; r=-0.33 ; P=0.008 ) , and positive correlation with insulin sensitivity ( QUICKI ; r=0.39 ; P=0.002 ) , after adjusting for BMI and HbA1c . There was no correlation between vitamin-D status and estimated beta cell mass ( HOMA-β ) . The mean waist-height ratio among individuals with prediabetes was 0.57 ( normal<0.5 ) indicating a high risk of cardiovascular morbidity . Individuals with elevated 1hPG>155 mg/dl had significantly higher BMI and worse insulin resistance , and 1hPG correlated well with 2 hour post glucose blood glucose ( r=0.57 ; P<0.001 ) . Interpretations & conclusions : Vitamin-D deficiency/insufficiency may have some role in the development/worsening of insulin resistance in individuals with prediabetes in our country who have a high cardiovascular risk . Prospect i ve studies on a large group of individuals need to be done to confirm the findings Since the effects of recombinant human growth hormone ( rhGH ) replacement therapy on glucose metabolism are still a matter of debate , the aim of the present study was to evaluate the impact of long-term rhGH treatment on insulin sensitivity . Simple indices of insulin resistance ( IR ) and insulin sensitivity ( IS ) , based on fasting glucose and insulin , such as the homeostasis model assessment of insulin resistance ( HOMA-IR ) and the quantitative insulin check index ( QUICKI ) , were used to estimate the degree of IR and IS in 20 normoglycemic patients ( 11 men and 9 women ; mean age , 44 + /- 14 years ) with severe adult-onset GH deficiency ( GHD ) . Measurements were determined at baseline and after 1 and 5 years of continuous rhGH therapy . Basal values were compared to those obtained in 20 healthy sex- and age-matched controls . Starting rhGH dose ranged from 3 to 8 microg/kg/d in keeping with sex and age , then doses were titrated according to insulin-like growth factor-I ( IGF-I ) levels . At baseline all patients had low IGF-I levels ( 10 + /- 5.4 nmol/L ) , high body mas index ( BMI ; 27.5 + /- 4 kg/m(2 ) ) , and elevated body fat percentage ( BF% ; 31.8 + /- 9.6 ) . Fasting glucose and insulin levels , as well as HOMA-IR and QUICKI , did not differ significantly from those recorded in the control group . After 1 year of rhGH replacement therapy , normalization in IGF-I levels and a significant reduction in BF% were observed ( P < .001 ) , and these effects were maintained after 5 years of treatment . Fasting glucose increased from 79 + /- 10 to 87 + /- 13 , and 87 + /- 12 mg/dL ( P < .05 ) after 1 and 5 years of therapy , respectively . Fasting insulin significantly increased after 1 year , without further modifications in the long-term follow-up . HOMA-IR significantly increased from 2.1 + /- 1.7 to 2.5 + /- 1.7 ( P < .05 ) after 1 year , then decreased to 2.3 + /- 1.5 ( P = not significant [ NS ] v basal ) after 5 years . A specular decrease in QUICKI from 0.37 + /- 0.05 to 0.34 + /- 0.03 ( P < .01 ) occurred after 1 year , with a trend to increase ( 0.35 + /- 0.04 ; P = NS v basal ) after 5 years . No patient developed impaired fasting glucose . In conclusion , rhGH therapy determined an increase in fasting glucose and insulin levels , causing in the short-term period a worsening of IS . The sustained reduction in BF% , without further deterioration of IS , suggests that long-term beneficial effects on body composition may overcome the negative influence of GH on glucose metabolism Insulin resistance plays an important role in the pathophysiology of diabetes and is associated with obesity and other cardiovascular risk factors . The " gold st and ard " glucose clamp and minimal model analysis are two established methods for determining insulin sensitivity in vivo , but neither is easily implemented in large studies . Thus , it is of interest to develop a simple , accurate method for assessing insulin sensitivity that is useful for clinical investigations . We performed both hyperinsulinemic isoglycemic glucose clamp and insulin-modified frequently sample d iv glucose tolerance tests on 28 nonobese , 13 obese , and 15 type 2 diabetic subjects . We obtained correlations between indexes of insulin sensitivity from glucose clamp studies ( SI(Clamp ) ) and minimal model analysis ( SI(MM ) ) that were comparable to previous reports ( r = 0.57 ) . We performed a sensitivity analysis on our data and discovered that physiological steady state values [ i.e. fasting insulin ( I(0 ) ) and glucose ( G(0 ) ) ] contain critical information about insulin sensitivity . We defined a quantitative insulin sensitivity check index ( QUICKI = 1/[log(I(0 ) ) + log(G(0 ) ) ] ) that has substantially better correlation with SI(Clamp ) ( r = 0.78 ) than the correlation we observed between SI(MM ) and SI(Clamp ) . Moreover , we observed a comparable overall correlation between QUICKI and SI(Clamp ) in a totally independent group of 21 obese and 14 nonobese subjects from another institution . We conclude that QUICKI is an index of insulin sensitivity obtained from a fasting blood sample that may be useful for clinical research Abstract Limited data are available assessing the effects of vitamin D and evening primrose oil ( EPO ) administration on markers of insulin resistance and lipid concentrations in gestational diabetes mellitus ( GDM ) . This study was design ed to evaluate the effects of vitamin D and EPO administration on insulin resistance and lipid concentrations among women with GDM . In this prospect i ve r and omized , double-blind , placebo-controlled clinical trial , 60 participants with GDM were divided into 2 groups of either 1000 IU vitamin D3 and 1000 mg EPO or placebo for 6 weeks . At the beginning and end of the study , fasting blood sample s were obtained from the participants to measure related variables . After 6 weeks of intervention , changes in fasting plasma glucose ( −3.6 ± 7.5 vs. + 1.5 ± 11.4 mg/dL , P = 0.04 ) , serum insulin concentrations ( −2.0 ± 5.3 vs. + 4.6 ± 10.7 µIU/mL , P = 0.004 ) , homeostasis model of assessment ( HOMA ) insulin resistance ( −0.5 ± 1.1 vs. + 1.1 ± 2.5 , P = 0.003 ) , HOMA-B cell function ( −7.7 ± 23.3 vs. + 17.4 ± 42.9 , P = 0.007 ) and the quantitative insulin sensitivity check index ( + 0.01 ± 0.02 vs. −0.01 ± 0.02 , P = 0.007 ) in the vitamin D plus EPO group were significantly different from the placebo group . In addition , compared with the placebo , vitamin D and EPO supplementation result ed in significant reductions in serum TAG ( −20.0 ± 54.3 vs. + 34.3 ± 38.2 mg/dL , P < 0.001 ) , VLDL ( −4.0 ± 10.9 vs. + 6.9 ± 7.6 mg/dL , P < 0.001 ) , TC ( −22.1 ± 32.6 vs. + 5.3 ± 20.1 mg/dL , P < 0.001 ) , LDL concentrations ( −18.0 ± 25.5 vs. + 1.8 ± 15.7 mg/dL , P = 0.001 ) and TC/HDL ( −0.3 ± 0.4 vs. + 0.3 ± 0.5 mg/dL , P < 0.001 ) . We did not observe any significant effect of vitamin D and EPO supplementation on serum HDL concentrations . Clinical trial registration number : http://www.i rct .ir : I RCT 201509115623N52 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
This meta- analysis suggests that vitamin D supplementation improves indices of glycemic control ( FBG , HOMA-IR , and HbA1C ) in patients with diabetes mellitus .
Hence , vitamin D supplements may be of potential therapeutic value in diabetic patients , as an adjuvant therapy along with other treatments
BACKGROUND AND PURPOSE This systematic review and meta- analysis aim ed to assess the effects of vitamin D supplements on indices of glycemic control [ homeostatic model assessment -insulin resistance ( HOMA-IR ) , hemoglobin A1C ( HbA1C ) , fasting blood glucose ( FBG ) , and quantitative insulin-sensitivity check index ( QUICKI ) and lipid profile in diabetic patients .