Insight into the prebiotic concept: lessons from an exploratory, double blind intervention study with inulin-type fructans in obese women The use of inulin-type fructans improves stool consistency in constipated children. A randomised clinical trial: pilot study Inulin supplementation prevents high fructose diet-induced hypertension in rats. A combination of prebiotic short- and long-chain inulin-type fructans enhances calcium absorption and bone mineralization in young adolescents. Effects of High Performance Inulin Supplementation on Glycemic Control and Antioxidant Status in Women with Type 2 Diabetes Effects of high performance inulin supplementation on glycemic status and lipid profile in women with type 2 diabetes: a randomized, placebo-controlled clinical trial. Effect of Butyrate and Inulin Supplementation on Glycemic Status, Lipid Profile and Glucagon-Like Peptide 1 Level in Patients with Type 2 Diabetes: A Randomized Double-Blind, Placebo-Controlled Trial. Assessing the Effect of High Performance Inulin Supplementation via KLF5 mRNA Expression in Adults with Type 2 Diabetes: A Randomized Placebo Controlled Clinical Trail Long-term administration of inulin-type fructans has no significant lipid-lowering effect in normolipidemic humans. Posterior Lumbar Interbody Fusion versus Intertransverse Fusion in the Treatment of Lumbar Spondylolisthesis Milk Powder Co‐Supplemented with Inulin and Resistant Dextrin Improves Glycemic Control and Insulin Resistance in Elderly Type 2 Diabetes Mellitus: A 12‐Week Randomized, Double‐Blind, Placebo‐Controlled Trial Iron protein succinylate in the treatment of iron deficiency: controlled, double-blind, multicenter clinical trial on over 1,000 patients. Controlled, double-blind, multicenter clinical trial of iron protein succinylate in the treatment of iron deficiency in children. Impact of prebiotic supplementation on T-cell subsets and their related cytokines, anthropometric features and blood pressure in patients with type 2 diabetes mellitus: A randomized placebo-controlled Trial. Effects of a Flaxseed-Derived Lignan Supplement in Type 2 Diabetic Patients: A Randomized, Double-Blind, Cross-Over Trial The effect of the daily intake of inulin on fasting lipid, insulin and glucose concentrations in middle-aged men and women. Labour analgesia with intrathecal fentanyl decreases maternal stress Effect of vitamin D supplementation on glycemic control in patients with type 2 diabetes: a systematic review of interventional studies Replacement of glycaemic carbohydrates by inulin-type fructans from chicory (oligofructose, inulin) reduces the postprandial blood glucose and insulin response to foods: report of two double-blind, randomized, controlled trials Effect of oligofructose supplementation on body weight in overweight and obese children: a randomised, double-blind, placebo-controlled trial. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized trial. Oligofructose Provides Laxation for Irregularity Associated with Low Fiber Intake Glycemic and lipid responses to glucomannan in Thais with type 2 diabetes mellitus.
Objective To highlight the contribution of the gut microbiota to the modulation of host metabolism by dietary inulin-type fructans ( ITF prebiotics ) in obese women . Methods A double blind , placebo controlled , intervention study was performed with 30 obese women treated with ITF prebiotics ( inulin/oligofructose 50/50 mix ; n=15 ) or placebo ( maltodextrin ; n=15 ) for 3 months ( 16 g/day ) .  Blood , faeces and urine sampling , oral glucose tolerance test , homeostasis model assessment and impedancemetry were performed before and after treatment . The gut microbial composition in faeces was analysed by phylogenetic microarray and qPCR analysis of 16S rDNA . Plasma and urine metabolic profiles were analysed by 1H-NMR spectroscopy . Results Treatment with ITF prebiotics , but not the placebo , led to an increase in Bifidobacterium and Faecalibacterium prausnitzii ; both bacteria negatively correlated with serum lipopolysaccharide levels .  ITF prebiotics also decreased Bacteroides intestinalis , Bacteroides vulgatus and Propionibacterium , an effect associated with a slight decrease in fat mass and with plasma lactate and phosphatidylcholine levels . No clear treatment clustering could be detected for gut microbial analysis or plasma and urine metabolomic profile analyses . However , ITF prebiotics led to subtle changes in the gut microbiota that may importantly impact on several key metabolites implicated in obesity and /or diabetes . Conclusions ITF prebiotics selectively changed the gut microbiota composition in obese women , leading to modest changes in host metabolism , as suggested by the correlation between some bacterial species and metabolic endotoxaemia or metabolomic signatures Abstract Background : Constipation is a common disorder in children . Objective : The objective of this study is to assess the beneficial effects of a daily supplementation with Orafti ® inulin‐type fructans in 2–5 year old constipated children . Methods : Double‐blind , r and omised , placebo‐controlled parallel group trial where constipated children received two doses of 2 g Orafti ® inulin‐type fructans ( OF : IN ) or placebo ( maltodextrin ) for 6 weeks . Primary outcome was stool consistency . Secondary outcomes were stool frequency and gastrointestinal symptoms . Results : Twenty-two children were included , 17 completed the study protocol ( nine and eight for the control and the OF : IN group , respectively ) . Results showed that Orafti ® inulin‐type fructans supplemented children had softer stools ( p = .003 ) . The longitudinal analysis showed no significant changes in controls , whereas supplemented children increased their stool consistency from 2.2 to 2.6 on the modified Bristol scale for children ( five items instead of seven ) ( p = .040 ) . Conclusions : Prebiotic inulin‐type fructans supplementation  improves stool consistency in constipated 2–5-year old children . Clinical trials.gov , with number NCT02863848 BACKGROUND & AIMS The aim of this experiment was to evaluate the potential beneficial effect of supplementation with different inulin-type fructan fractions against common features of the metabolic syndrome in a rat model of this syndrome ( fructose-fed rat ) . METHODS Forty Wistar rats were r and omly divided into five groups and the animals received for 4 weeks either a semi-purified starch or fructose-based diet , or diets in which fructose was partially substituted with various fructans : 10 g/100 g of long-chain inulin or oligofructose , or an oligofructose-enriched inulin . After this period , blood pressure was measured and sample s of blood and tissues were collected for selected biochemical analyses . RESULTS As compared to the starch-fed group , the fructose-fed rats presented : hypertriglyceridemia , hypertension , increased susceptibility to heart peroxidation and renal damages . Long-chain inulin and oligofructose-enriched inulin supplementation prevented fructose induced elevated blood pressure , susceptibility to heart peroxidation and renal damages . All inulin-type fructans containing diets prevented fructose induced hypertriglyceridemia . CONCLUSIONS These results suggest that supplementation with inulin-type fructans is efficient against fructose induced hypertension and that effects are most pronounced for long-chain inulin and oligofructose-enriched inulin . We hypothesize that the anti-hypertensive effect of inulin could be explained by the reduction of the high fructose induced oxidative stress BACKGROUND Short-term studies in adolescents have generally shown an enhancement of calcium absorption by inulin-type fructans ( prebiotics ) . Results have been inconsistent ; however , and no studies have been conducted to determine whether this effect persists with long-term use . OBJECTIVE The objective was to assess the effects on calcium absorption and bone mineral accretion after 8 wk and 1 y of supplementation with an inulin-type fructan . DESIGN Pubertal adolescents were r and omly assigned to receive 8 g/d of a mixed short and long degree of polymerization inulin-type fructan product ( fructan group ) or maltodextrin placebo ( control group ) .  Bone mineral content and bone mineral density were measured before r and omization and after 1 y. Calcium absorption was measured with the use of stable isotopes at baseline and 8 wk and 1 y after supplementation . Polymorphisms of the Fok1 vitamin D receptor gene were determined . RESULTS Calcium absorption was significantly greater in the fructan group than in the control group at 8 wk ( difference : 8.5 + /- 1.6 % ; P < 0.001 ) and at 1 y ( difference : 5.9 + /- 2.8 % ; P = 0.04 ) . An interaction with Fok1 genotype was present such that subjects with an ff genotype had the least initial response to fructan . After 1 y , the fructan group had a greater increment in both whole-body bone mineral content ( difference : 35 + /- 16 g ; P = 0.03 ) and whole-body bone mineral density ( difference : 0.015 + /- 0.004 g/cm(2 ) ; P = 0.01 ) than did the control group . CONCLUSION Daily consumption of a combination of prebiotic short- and long-chain inulin-type fructans significantly increases calcium absorption and enhances bone mineralization during pubertal growth . Effects of dietary factors on calcium absorption may be modulated by genetic factors , including specific vitamin D receptor gene polymorphisms Background The purpose of this study was to evaluate the effects of high performance inulin supplementation on blood glycemic control and antioxidant status in women with type 2 diabetes . Methods In a r and omized , triple-blind controlled trial , 49 females ( fiber intake < 30 g/day , 25<body mass index < 35 kg/m2 ) with type 2 diabetes were recruited from the Iran Diabetes Society and from endocrinology and metabolism clinics associated with the Tabriz University of Medical Science . The participants were divided into one of two groups in which the participants either received 10 g/day of inulin ( intervention , n=24 ) or maltodextrin ( control , n=25 ) for 2 months . Fasting blood sample s were obtained and both glycemic control and antioxidant status were determined at baseline and at the end of the study . Results At the end of the study period , there were significant decreases in fasting plasma glucose ( 8.47 % ) , glycosylated hemoglobin ( 10.43 % ) , and malondialdehyde ( 37.21 % ) levels and significant increases in total antioxidant capacity ( 18.82 % ) and superoxide dismutase activity ( 4.36 % ) in the inulin group when compared to the maltodextrin group ( P<0.05 ) . Changes in fasting insulin , homeostasis model assessment of insulin resistance , and catalase activity were not significant in the inulin group when compared with the maltodextrin group . Glutathione peroxidase activity remained unchanged in both groups . Conclusion Inulin supplementation may improve some glycemic and antioxidant indices and decrease malondialdehyde levels in women with type 2 diabetes . Further investigations are needed in order to confirm the positive effects that inulin may have on the glycemic and antioxidant indices of patients with type 2 diabetes BACKGROUND Type 2 diabetes mellitus , as a noncommunicable disease , is the main public health challenge in the 21st century . The prevalence of diabetes mellitus adjusted for the world population in Iran was 8 % until the year 2010.Lipid levels are considered as important parameters to be evaluated , as high serum lipid levels are often reported as a complication in patients with diabetes mellitus . It is cl aim ed that functional foods may improve complications of diabetes mellitus , so this study was design ed to evaluate the effects of high performance inulin on glycemic status and lipid profile of women with type 2 diabetes . METHODS The study was a r and omized controlled clinical trial . Forty-nine type 2 diabetic females ( fiber intake < 30g/d , 25 < BMI < 35 kg/m2 ) were divided into two groups . Patients in the intervention group ( n=24 ) received 10g/d inulin and patients in the control group ( n=25 ) received 10g/d maltodextrin for 8 weeks .  Glycemic status and lipid profile indices were measured pre and post intervention . Data were analyzed using SPSS software ( verision11.5 ) . Paired , unpaired t-test and ANCOVA were used to compare quantitative variables . RESULTS Supplementation with inulin caused a significant reduction in FBS ( 8.50 % ) , HbA1c ( 10.40 % ) , total cholesterol ( 12.90 % ) , triglyceride ( 23.60 % ) , LDL-c ( 35.30 % ) , LDL-c/HDL-c ratio ( 16.25 % ) and TC/HDL-c ratio ( 25.20 % ) and increased HDL-c ( 19.90 % ) . The changes for the control group parameters were not significant at the end of study . CONCLUSION Inulin may help to control diabetes and its complications via improving glycemic and lipid parameters Studies on humans with diabetes mellitus showed that the crosstalk between the intestinal microbiota and the host has a key role in controlling the disease . The aim of this study was to evaluate the effects of sodium butyrate and high performance inulin supplementation simultaneously or singly on glycemic status , lipid profile , and glucagon-like peptide 1 level in adults with type 2 diabetes mellitus . Sixty patients were recruited for the study . The participants were r and omly allocated , using r and omized block procedure , to one of the four treatment groups ( A , B , C , or D ) . Group A received sodium butyrate capsules , group B received inulin supplement powder , group C was exposed to the concomitant use of inulin and sodium butyrate , and group D consumed placebo for 45 consecutive days . Markers of glycemia , lipid profile , and glucagon-like peptide 1 were measured pre- and post-intervention . Dietary supplementation in groups A , B , and C significantly reduced diastolic blood pressure in comparison with the placebo group ( p<0.05 ) . Also , intra-group statistical analysis showed that only treatment with sodium butyrate + inulin ( group C ) significantly reduced fasting blood sugar ( p=0.049 ) and waist to hip ratio ( p=0.020 ) . Waist circumference in groups B and C reduced significantly after the intervention ( p=0.007 and p=0.011 ; respectively ) . The post hoc Tukey tests showed significant increase in glucagon-like peptide 1 concentration in groups A and C in comparison with group D ( p<0.05 ) . The results suggest that inulin supplementation may be useful to diabetic patients and these effects could be increased with butyrate supplement Purpose : The worldwide prevalence of metabolic disorders such as diabetes is increasing rapidly . Currently , the complications of diabetes are the major health concern . The aim of this study was to investigate the effect of high performance ( HP ) inulin supplementation on glucose homeostasis via KLF5 mRNA expression in adults with type 2 diabetes . Methods : In the present clinical trial conducted for a duration of 6 weeks , 46 volunteers diabetic patients referring to diabetes clinic in Tabriz , Iran , were r and omly assigned into intervention ( n= 23 , consuming 10 gr/d HP inulin ) and control groups ( n= 23 , consuming 10 gr/ d starch ) . We assessed glycemic and anthropometric indices , blood lipids and plasmatic level of miR-375 as well as KLF5 mRNA expression before and after the intervention . Results : Findings indicated that inulin supplementation significantly decreased fasting plasma glucose ( FPG ) in comparison to the placebo group ( P<0.001 ) . Also Intra-group and between group results showed that inulin supplementation result ed in significant decrease in KLF5 mRNA expression in peripheral blood mononuclear cells ( P BMC s ) ( Fold change : 0.61± 0.11 ; P-value= 0.001 ) and significant increase in plasmatic level of miR-375 ( Fold change : 3.75± 0.70 ; P-value=0.004 ) . Conclusion : Considering the improvements of FPG level in diabetic patients , it seems that HP inulin supplementation may be beneficial in controlling diabetes via the expression of some genes . However , further studies are needed to achieve concise conclusions Short-term studies have shown that the addition to diet of inulin-type fructans , a nondigestible carbohydrate , may have a plasma lipid-lowering effect in humans . Whether this beneficial effect persists during long-term administration has not been determined . The study was aim ed at determining whether a prolonged ( 6 months ) administration of inulin-type fructans to healthy subjects has a lipid-lowering action . In a double-blind , r and omized , placebo-controlled study , 17 healthy subjects were studied before and after 6 months of daily administration of placebo ( 8 subjects ) or 10 g of a mix of inulin and oligofructose ( 9 subjects ) . During this 6-month period , they consumed their usual diet and did not modify their everyday way of life . We measured plasma lipid concentrations ; cholesterol synthesis and hepatic lipogenesis ; and adipose tissue and circulating mononuclear cell messenger RNA concentrations of key regulatory genes of cholesterol metabolism . Compared with the administration of placebo , the administration of inulin-type fructans had no effect on plasma triacylglycerol concentrations and hepatic lipogenesis and induced only a nonsignificant trend for decreased plasma total and low-density lipoprotein cholesterol levels and increased high-density lipoprotein cholesterol concentration . Cholesterol synthesis was not significantly modified . Of all the messenger RNA concentrations measured , none was significantly modified by the administration of inulin-type fructans . In conclusion , contrary to what was observed in short-term studies , we observed no significant beneficial effect of a long-term ( 6-month ) administration of inulin-type fructans on plasma lipids in healthy human subjects Purpose . To compare 2 methods of fusion in the treatment of lumbar spondylolisthesis :  posterior lumbar interbody fusion ( PLIF ) and intertransverse fusion ( ITF ) . Methods . 20 patients with lumbar spondylolisthesis were r and omly allocated to one of 2 groups : decompression , posterior instrumentation , and PLIF ( n=10 ) or decompression , posterior instrumentation , and ITF ( n=10 ) . The Oswestry low back pain disability question naire was used for clinical assessment . Radiography was performed preoperatively and postoperatively to assess the reduction of spondylolisthesis or slip . Results . In the PLIF and ITF groups , 87.5 % and 100 % had a satisfactory clinical result , and 48 % and 39 % had reduced spondylolisthesis , respectively . Both had a fusion rate of 100 % . PLIF showed better reduction of spondylolisthesis , although ITF achieved a better subjective and clinical outcome . Conclusion . Morbidity and complications are much higher following PLIF than ITF . ITF is recommended because of the simplicity of the procedure , lower complication rate , and good clinical and radiological results SCOPE The objective of the present study is to evaluate the effects of milk powder co-supplemented with inulin and resistant dextrin ( MPCIR ) on elderly patients with type 2 diabetes mellitus ( T2DM ) . METHODS AND RESULTS A r and omized , double-blind , placebo-controlled clinical trial is carried out among elderly T2DM patients . The subjects recruited from the community are r and omly assigned to either the MPCIR group or placebo group for 12 weeks intervention . Each group receives 45 g milk powder with or without inulin and resistant dextrin .  Anthropometric and metabolic variables are measured . For the MPCIR group , systolic blood pressure ( BP ) and diastolic BP are reduced significantly by 5.45 and 4.56 mm Hg ( p < 0.001 , vs placebo group ) , respectively . Compared with the placebo group , the fasting and 2-h postpr and ial plasma glucose levels , glycosylated serum protein , and insulin resistance index of the MPCIR group are significantly decreased by 0.96 mmol L-1 , 1.47 mmol L-1 , 16.33 μmol L-1 , and 0.65 respectively ( p < 0.001 ) . The MPCIR group shows an increase by 7.09 μIU mL-1 and 20.43 in 2-h postpr and ial insulin ( p = 0.016 ) and β-cell function index ( p < 0.001 ) , respectively . CONCLUSION MPCIR supplementation helps to improve glycemic control , insulin resistance , and blood pressure A prospect i ve , controlled , double-blind , double-dummy , multicenter clinical trial was made to assess the efficacy and tolerability of iron-protein-succinylate ( ITF 282 ) in comparison with a well known iron preparation in the treatment of iron deficiency or iron deficient anemia . One thous and and ninety-five patients affected with iron deficiency or overt iron deficient anemia were r and omized to receive either two ITF 282 tablets/day ( 60 mg iron each ) or a commercially available ferrous sulphate controlled release tablet ( one tablet containing 105 mg iron/day ) . Five hundred and forty-nine patients received ITF 282 ; 546 patients were treated with ferrous sulphate . Both treatments lasted 60 days . The treatment outcome was checked by evaluating special hematology , symptomatology , safety hematology and hematochemistry . After two months of treatment , the normalization of the main hematologic parameters in both groups was detected . Although in the first month the reference treatment appears to provide somewhat faster results , at the end of the observation , the values of hematocrit , hemoglobin and ferritin were greater in the ITF 282 group , indicating a more progressive and steady therapeutic effect . The overall clinical rating was significantly in favor of ITF 282 , with 78.9 % of favorable results vs 67.6 % . By dividing the patient population according to pathological conditions ( iron deficiency or overt anemia ) , or according to the etiopathogenesis of the iron deficiency ( increased requirement , or increased loss in adults and in the elderly ) , separate analyses on the treatment outcome were made ( and have been included ) . The general tolerability , although favorable with both treatments , was significantly more favorable with ITF 282 . With this medication , 63 patients ( 11.5 % ) complained of 69 adverse reactions ( 25 heartburn , 19 constipation , 25 abdominal pain ) vs 141 events reported by 127 patients ( 26.3 % ) with the reference medication ( 33 heartburn , 31 epigastric pain , 23 constipation , 32 abdominal pain , 8 skin rash , 14 nausea ) . These observations confirm that , although the most modern preparations of ferrous sulphate exhibit a relatively low frequency of adverse events of limited clinical concern , it is nevertheless possible to decrease both the prevalence and the duration of such events without prejudice for the clinical efficacy , with the use of more " physiological " preparations in which the iron is reversibly bound to a protein carrier , thus effectively removing one of the main obstacles to the correct compliance with treatments that must be administered for prolonged periods of time A total of 502 children up to the age of 14 years were treated for iron deficiency or overt anemia .  ITF 282 was prescribed to 256 children , and a commercially available ferrous polystyrene sulphonate preparation to 246 , in a r and omized double-blind , double-dummy , ten-center trial . One oral vial of ITF 282 ( 60 mg iron ) was administered once a day to children weighing up to 40 kg ; and twice a day to children with body weight equal or superior to 40 kg . In the reference group , oral vials of polystyrene sulphonate ( 52.5 mg iron ) were administered once a day to children weighing up to 40 kg , and twice a day to children weighing 40 kg or more . Treatments lasted 60 days . The treatments ' efficacy and tolerability were evaluated taking into consideration : special hematology , symptomatology , safety hematology and hematochemistry , urinalysis . At the end of treatment , the trend was detected to the normalization of the main hematologic parameters in both groups ( hemoglobin , hematocrit , ferritin , blood iron , transferrin saturation , MCHC ) . Although in the first month the reference treatment appears to provide somewhat faster results , significantly greater values of blood iron are observed at the end of the observation in the ITF 282 group , indicating a more progressive and steady therapeutic effect . The overall clinical rating was , although not significant , in favor of ITF 282 , with a failure rate of 18.0 vs 24.0 % . The general tolerance , although favorable with both treatments , was significantly more favorable with ITF 282 . With this medication , 13 patients complained of 13 events ( 1 heartburn , 6 constipation , 6 abdominal pain ) vs 48 events reported by 43 patients with the reference medication ( 1 heartburn , 2 epigastric pain , 14 constipation , 14 abdominal pain , 3 skin rash , 14 vomiting ) . These observations confirm that , although the most modern preparations of ferrous ions exhibit a relatively low frequency of adverse events of limited clinical concern , it is nevertheless possible to decrease ( with the use of more " physiologic " preparations in which the iron is reversibly bound to a protein carrier ) the prevalence and , tendentially , duration and intensity of such events without prejudice for the clinical efficacy . Therefore , the good clinical tolerability of ITF 282 effectively removed one of the main obstacles to the correct compliance with iron treatments ( necessarily to be taken long-term ) , as reduced the risks of undesired events in a particularly susceptible population subgroup , such as children BACKGROUND S AND AIMS Type 2 diabetic mellitus ( T2DM ) asone of the main causes of morbidity and mortality is associated with immune system disturbances and metabolic abnormalities . In the current study we aim ed to evaluate the effects of oligofructose-enriched inulin on T-cell subsets and their related cytokines , anthropometric and metabolic parameters in patients with T2DM . METHODS Forty-six diabetic females patients were r and omly allocated into intervention ( n=27 ) and control ( n=22 ) groups . Subjects in the intervention group received a daily dose of 10 g of oligofructose-enriched inulin and subjects in control group received a placebo for two months . Anthropometric variables , metabolic parameters including fasting serum glucose ( FSG ) , hemoglobin A1c ( HbA1c ) , lipid profile and blood pressure were measured at the beginning and after two months . Immune markers also included serum interleukin (IL)-4 , IL-12 and interferon (IFN)-γ concentrations were assessed and CD3(+ ) , CD4(+ ) , CD8(+ ) and CD11b(+)T-cell counts were determined by flow cytometry at baseline and end of the trial . RESULTS After two months intervention , significant improvements in anthropometric variables , blood pressure and serum lipids occurred in prebiotic-treated group ( P<0.001 ) . Serum IL-4 , IL-12 and IFN-γ concentrationsalso significantly decreased in intervention group ( P<0.001 ) . No significant changes in CD3(+ ) , CD4(+ ) , CD8(+ ) and CD11b(+ ) T-cell counts were observed in treatment groups after intervention . CONCLUSION The present study showed several beneficial effects of oligofructose-enriched inulin on the improvement of the glycemic status , lipid profile , and immune markers in patients with T2DM . Further studies are needed to confirming our findings and to better clarify the underlying mechanisms Background Flaxseed consumption has been shown to improve blood lipids in humans and flaxseed-derived lignan has been shown to enhance glycemic control in animals . The study aim ed to investigate the effect of a flaxseed-derived lignan supplement on glycemic control , lipid profiles and insulin sensitivity in type 2 diabetic patients . Methodology /Principal Findings This was a r and omized , double-blind , placebo-controlled , cross-over trial and it was conducted between April and December 2006 in Shanghai , China . Seventy-three type 2 diabetic patients with mild hypercholesterolemia were enrolled into the study . Patients were r and omized to supplementation with flaxseed-derived lignan capsules ( 360 mg lignan per day ) or placebo for 12 weeks , separated by an 8-week wash-out period . HbA1c , lipid profiles , insulin resistance index and inflammatory factors were measured . Sixty-eight completed the study and were included in the analyses . The lignan supplement significantly improved glycemic control as measured by HbA1c ( -0.10±0.65 % vs. 0.09±0.52 % , P = 0.001 ) compared to placebo ; however , no significant changes were observed in fasting glucose and insulin concentrations , insulin resistance and blood lipid profiles . Urinary excretion of lignan metabolites ( enterodiol and enterolactone ) was significantly higher after the lignan supplement intervention compared to baseline ( 14.2±18.1 vs. 1.2±2.4 µg/mL , P<0.001 ) . Data also suggested minimal competition between lignan and isoflavones for bioavailability when measured by the excretion concentrations . Conclusions / Significance Daily lignan supplementation result ed in modest , yet statistically significant improvements in glycemic control in type 2 diabetic patients without apparently affecting fasting glucose , lipid profiles and insulin sensitivity . Further studies are needed to vali date these findings and explore the efficacy of lignans on type 2 diabetes . Trial Registration Clinical Trials.gov The present study was carried out to examine the effect of the daily intake of 10 g inulin on fasting blood lipid , glucose and insulin levels in healthy middle-aged men and women with moderately raised total plasma cholesterol ( TC ) and triacylglycerol ( TAG ) levels .  This study was a double-blind r and omized placebo-controlled parallel study in which fifty-four middle-aged subjects received either inulin or placebo for a period of 8 weeks . Fasting blood sample s were collected before the supplementation period ( baseline sample s 1 and 2 , separated by 1 week ) and at weeks 4 and 8 , with a follow-up at week 12 . Compared with baseline values , insulin concentrations were significantly lower at 4 weeks ( P < 0.01 ) in the inulin group . There was a trend for TAG values , compared with baseline , to be lower in the inulin group at 8 weeks ( P < 0.08 ) returning to baseline concentrations at week 12 . On comparison of the inulin and placebo groups , the fasting TAG responses over the 8-week test period were shown to be significantly different ( P < 0.05 , repeated measures ANOVA ) , which was largely due to lower plasma TAG levels in the inulin group at week 8 . The percentage change in TAG levels in the inulin group during the 8-week study was shown to correlate with the initial TAG level of the subjects ( rs -0.499 , P = 0.004 ) . We therefore conclude that the daily addition of 10 g inulin to the diet significantly reduced fasting insulin concentrations during the 8-week test period and result ed in lower plasma TAG levels , particularly in subjects in whom fasting TAG levels were greater than 1.5 mmol/l . These data support findings from animal studies that fructans influence the formation and /or degradation of TAG-rich lipoprotein particles , and the insulin data are also consistent with recent studies showing attenuation of insulin levels in fructan-treated rats Purpose Lumbar epidural analgesia ( LEA ) decreases maternal stress as measured by maternal circulating plasma catecholamine concentrations . Intrathecal fentanyl ( ITF ) provides effective labour analgesia but its effect on maternal epinephnne ( Epi ) and norepinephnine ( NE ) concentrations is not known . This study assesses whether ITF reduces maternal stress in the same manner as conventional LEA . Methods Twenty-four healthy women in active labour received either 25 μ/g ITF ( n = 12 ) or epidural lidocaine 1.5 % ( n = 12 ) for analgesia . Venous blood sample s were collected before anaesthesia and at five minute intervals for 30 mm following anaesthesia for the measurement of plasma Epi and NE by high performance liquid chromatography . Maternal blood pressure ( BP ) , heart rate ( HR ) , visual analog scores ( VAS ) to pain and pruntus were recorded at the same time . Results Both ITF and LEA  decreased pain VAS scores , maternal BP , and plasma Epi concentrations with only minimal effects on plasma NE concentrations . Intrathecal fentanyl ( ITF ) and LEA  reduced plasma epi to a similar extent , with ITF reducing the levels slightly faster than LEA . Intrathecal fentanyi(ITF ) and LEA  reduced plasma Epi concentrations by 52 % and 51 % , respectively ( P value < 0.01 ) . Conclusion We conclude that ITF is as effective as LEA in producing pain relief in the labounng patient . Intrathecal Fentanyl ( ITF ) is also capable of reducing maternal plasma epmephnne concentration , thus avoiding the possibly deleterious side effects of excess amounts of this catecholamme during labour . RésuméObjectifL’analgésie épidurale lombaire ( AÉL ) diminue le stress maternel déterminé par le dosage des concentrations plasmatiques de catécholamines . Le fentanyl sous-arachnoïdien ( FSA ) procure une analgésie efficace pendant le travail mais on ne connaît pas son influence sur les concentrations maternelles d’épinéphnne ( ÉPI ) et de norépinéphnne ( NÉ ) . Cette étude visait à déterminer si le FSA diminuait le stress de la même façon que l’AÉL.MéthodesVingt-quatre partunentes bien portantes en travail ont reçu pour l’analgésie soit du FSA 25 μg ( n = 12 ) soit de la lidocaïne épidurale 1,5 % ( n = 12 ) . Des échantillons de sang veineux ont été recueillis avant l’anesthésie et à des intervalles de cinq minutes pendant 30 min après l’anesthésie dans le but de mesurer l’ÉPI et la NF plasmatiques par Chromatographie en phase liquide à haute performance . En même temps , la pression artérielle ( PA ) . la fréquence cardiaque et les scores d’une échelle visuelle analogique ( ÉVA ) pour la douleur et le prurit étaient enregistrés . RésultatsLe FSA et l’AÉL diminuent les scores d’ÉVA , la PA et les concentrations d’ÉPI avec des effets minimes sur les concentrations plasmatiques de NÉ . Le FSA et l’AÉL réduisent également l’ÉPI plasmatique . mais la réduction est un peu plus rapide avec le FSA . Le FSA et l’AÉL diminuent respectivement les concentrations de 51 % et 52 % ( P < 0,01 ) . Conclusion Le FSA est aussi efficace que l’AÉL pour soulager la douleur chez la partunente en travail . Le fentanyl sous-arachnoïdien diminue aussi les concentrations maternelles d’épinéphnne . protégeant ainsi la partunente en travail des effets nocifs de concentrations excessives de catécholamines 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 Purpose Inulin-type fructans are recognized as prebiotic dietary fibres and classified as non-digestible carbohydrates that do not contribute to glycaemia . The aim of the present studies was to investigate the glycaemic response ( GR ) and insulinaemic response ( IR ) to foods in which sucrose was partially replaced by inulin or oligofructose from chicory . Methods In a double-blind , r and omized , controlled cross-over design , 40–42 healthy adults consumed a yogurt drink containing oligofructose or fruit jelly containing inulin and the respective full-sugar variants .  Capillary blood glucose and insulin were measured in fasted participants and at 15 , 30 , 45 , 60 , 90 , and 120 min after starting to drink/eat . For each test food , the incremental area under the curve ( iAUC ) for glucose and insulin was calculated and the GR and IR determined . Results Consumption of a yogurt drink with oligofructose which was 20 % reduced in sugars significantly lowered the glycaemic response compared to the full-sugar reference ( iAUC120min 31.9 and 37.3 mmol/L/min , respectively ; p < 0.05 ) . A fruit jelly made with inulin and containing 30 % less sugars than the full-sugar variant likewise result ed in a significantly reduced blood glucose response ( iAUC120min 53.7 and 63.7 mmol/L/min , respectively ; p < 0.05 ) . In both studies , the postpr and ial insulin response was lowered in parallel ( p < 0.05 ) . The reduction of postpr and ial glycaemia was positively correlated to the proportion of sugars replaced by inulin-type fructans ( p < 0.001 ) . Conclusions In conclusion , the studies confirmed that substitution of glycaemic sugars by inulin or oligofructose from chicory may be an effective strategy to reduce the postpr and ial blood glucose response to foods Limited evidence suggests that the dietary inclusion of oligofructose , an inulin-type fructan with prebiotic properties , may increase satiety and , thus , reduce energy intake and body weight in overweight and obese adults . The aim of the present study was to assess the effect of oligofructose supplementation for 12 weeks on the BMI of overweight and obese children . A total of ninety-seven children aged 7 - 18 years who were overweight and obese ( BMI > 85th percentile ) were r and omly assigned to receive placebo ( maltodextrin ) or oligofructose ( both at an age-dependent dose : 8 g/d for children aged 7 - 11 years and 15 g/d for children aged 12 - 18 years ) for 12 weeks . Before the intervention , all children received dietetic advice and they were encouraged to engage in physical activity . The primary outcome measure was the BMI -for-age z-score difference between the groups at the end of the intervention . Data from seventy-nine ( 81 % ) children were available for analysis . At 12 weeks , the BMI -for-age z-score difference did not differ between the experimental ( n 40 ) and control ( n 39 ) groups ( mean difference 0.002 , 95 % CI - 0.11 , 0.1 ) . There were also no significant differences between the groups with regard to any of the secondary outcomes , such as the mean BMI -for-age z-score , percentage of body weight reduction and the difference in total body fat . Adverse effects were similar in both groups . In conclusion , oligofructose supplementation for 12 weeks has no effect on body weight in overweight and obese children BACKGROUND Pre clinical studies have shown that the combination of chromium picolinate and biotin significantly enhances glucose uptake in skeletal muscle cells and enhances glucose disposal . The present pilot study was conducted to determine if supplementation with chromium picolinate and biotin can improve glycemic control in patients with type 2 diabetes mellitus with suboptimal glycemic control despite use of oral antihyperglycemic agents . METHODS Forty-three subjects with impaired glycemic control ( 2-h glucose > 200 mg/dL ; glycated hemoglobin > or=7 % ) , despite treatments with oral antihyperglycemic agents  , were r and omized to receive 600 microg of chromium as chromium picolinate and biotin ( 2 mg/day ) ( Diachrome ( , Nutrition 21 , Inc. , Purchase , NY ) in addition to their pre study oral antihyperglycemic agent therapy . Measurements of glycemic control and blood lipids were taken at baseline and after 4 weeks . RESULTS After 4 weeks , there was a significantly greater reduction in the total area under the curve for glucose during the 2-h oral glucose tolerance test for the treatment group ( mean change -9.7 % ) compared with the placebo group ( mean change + 5.1 % , P < 0.03 ) . Significantly greater reductions were also seen in fructosamine ( P < 0.03 ) , triglycerides ( P < 0.02 ) , and triglycerides/ high-density lipoprotein cholesterol ratio ( P < 0.05 ) in the treatment group . No significant adverse events were attributed to chromium picolinate and biotin supplementation . CONCLUSIONS This pilot study demonstrates that supplementation with a combination of chromium picolinate and biotin in poorly controlled patients with diabetes receiving antidiabetic therapy improved glucose management and several lipid measurements .  Chromium picolinate/ biotin supplementation may represent an effective adjunctive nutritional therapy to people with poorly controlled diabetes with the potential for improving lipid metabolism Inadequate dietary fiber intake contributes to the prevalent irregularity and constipation in Western countries . Although eating adequate amounts of fibers from fiber-rich foods , foods with added fibers and dietary fiber supplements is considered the first option for improving laxation , the efficacy can vary among types of fibers . The present study is a r and omized control trial that included healthy adult participants with ≤3 bowel movements/week and a habitual low dietary fiber intake in a parallel design to evaluate the benefits for laxation by supplementing the daily diet with oligofructose ( Orafti ® P95 ; OF ) , a fermentable source of fiber and established prebiotic ( n = 49 ) ; maltodextrin was the placebo ( n = 48 ) . After a run-in phase , OF was initially provided at 5 g/day , then increased to 10 and 15 g/day with four weeks for each phase . Stool frequency ( bowel movements per week ) for the OF and maltodextrin ( MD ) groups were initially similar ( 3.98 ± 1.49 vs. 4.06 ± 1.48 ) , did not change for the placebo group , but increased for the OF group with the difference significant at 15 g/day ( p = 0.023 ) . Stool consistency was similar and remained unchanged at all doses for both groups . Gastrointestinal sensations were low for both groups . Laxation benefits were especially pronounced for participants with > 13 g/day habitual dietary fiber intake , with significant laxation at 10 g and 15 g OF/day ( p = 0.04 and p = 0.004 , respectively ) A daily supplement with a short-chain inulin-type fructan derived from chicory roots , i.e. , oligofructose ( Orafti ® P95 ) provided a laxation effect without causing gastrointestinal ( GI ) distress for healthy participants with irregularity associated with low dietary fiber intake OBJECTIVE To evaluate the benefits of glucomannan supplement on glycemic and lipid controls in type 2 diabetic patients . MATERIAL AND METHOD A single-blind , placebo-controlled , crossover trial with two treatments separated by a 2-week washout period was performed in 10 men and 10 women with type 2 diabetes mellitus . Two separated protocol s of experiments were sequentially followed . Initially , purified glucomannan ( 1 g ) or placebo was ingested 30 min before 75-g glucose load to evaluate their effects on glucose absorption and insulin secretion in oral glucose tolerance test ( OGTT ) . Later , the glycemic and lipid changes after 4-week intervention with 3 g/day glucomannan comparing to the placebo were determined . The st and ard OGTT was performed before and after ending of each intervention . RESULTS Glucomannan taken before performing the OGTT can lower the rise of blood glucose and insulin from 1 to 2 hour in comparison with the placebo , though a statistically significance of insulin was not achieved . Long-term glucomannan supplement significantly reduced the 120-min glucose area under the curve of OGTT . Glucomannan also decreased the rise of low-density lipoprotein cholesterol ( LDL-C ) . Reductions of HOMA-insulin resistance index and body mass index were detected in glucomannan-treated group though the former was shown only in females . No within- and between-group differences of insulin , fructosamine , and other lipids were observed in glucomannan- nor placebo- treated groups . CONCLUSION In type 2 diabetes , pre-pr and ial glucomannan ingestion attenuated a rise of blood glucose without significantly affecting insulin levels . Long-term supplement of glucomannan to the regular diabetic regimen lessened post challenge glucose AUC and impeded the rise of LDL-C. Supplement of glucomannan may be beneficial to the glycemic and lipid controls in type 2 diabetes mellitus
Moreover , subgroup analyses suggested that the effects of glycemic control were significantly influenced by the sex of the subjects and the type and the method of intake of ITF .
Conclusions Our analyses confirmed that these four main glycemic indicators were significantly reduced by ITF supplementation , particularly in the prediabetes and T2DM population .
Evidence supports that reasonable administration of ITF supplementation may have potential clinical value as an adjuvant therapy for prediabetes and T2DM management .
Background Currently , many clinical trials have shown that inulin-type fructans ( ITF ) supplementation is associated with glycemic control ; nevertheless , the results are inconclusive .
The aim of this meta- analysis of r and omized controlled trials was to assess the effects of ITF supplementation on glycemic control .