Conclusions /interpretationPooled analyses demonstrated that pulses , alone or in low-GI or high-fibre diets , improve markers of longer term glycaemic control in humans , with the extent of the improvements subject to significant inter- study heterogeneity .
Aims /hypothesisDietary non-oil-seed pulses ( chickpeas , beans , peas , lentils , etc . )
are a good source of slowly digestible carbohydrate , fibre and vegetable protein and a valuable means of lowering the glycaemic-index ( GI ) of the diet .
To assess the evidence that dietary pulses may benefit glycaemic control , we conducted a systematic review and meta- analysis of r and omised controlled experimental trials investigating the effect of pulses , alone or as part of low-GI or high-fibre diets , on markers of glycaemic control in people with and without diabetes .
Effects of intensive glucose lowering in type 2 diabetes.
BACKGROUND Epidemiologic studies have shown a relationship between glycated hemoglobin levels and cardiovascular events in patients with type 2 diabetes . We investigated whether intensive therapy to target normal glycated hemoglobin levels would reduce cardiovascular events in patients with type 2 diabetes who had either established cardiovascular disease or additional cardiovascular risk factors . METHODS In this r and omized study , 10,251 patients ( mean age , 62.2 years ) with a median glycated hemoglobin level of 8.1 % were assigned to receive intensive therapy ( targeting a glycated hemoglobin level below 6.0 % ) or st and ard therapy ( targeting a level from 7.0 to 7.9 % ) . Of these patients , 38 % were women , and 35 % had had a previous cardiovascular event . The primary outcome was a composite of nonfatal myocardial infa rct ion , nonfatal stroke , or death from cardiovascular causes . The finding of higher mortality in the intensive-therapy group led to a discontinuation of intensive therapy after a mean of 3.5 years of follow-up . RESULTS At 1 year , stable median glycated hemoglobin levels of 6.4 % and 7.5 % were achieved in the intensive-therapy group and the st and ard-therapy group , respectively . During follow-up , the primary outcome occurred in 352 patients in the intensive-therapy group , as compared with 371 in the st and ard-therapy group ( hazard ratio , 0.90 ; 95 % confidence interval [ CI ] , 0.78 to 1.04 ; P=0.16 ) . At the same time , 257 patients in the intensive-therapy group died , as compared with 203 patients in the st and ard-therapy group ( hazard ratio , 1.22 ; 95 % CI , 1.01 to 1.46 ; P=0.04 ) . Hypoglycemia requiring assistance and weight gain of more than 10 kg were more frequent in the intensive-therapy group ( P<0.001 ) . CONCLUSIONS As compared with st and ard therapy , the use of intensive therapy to target normal glycated hemoglobin levels for 3.5 years increased mortality and did not significantly reduce major cardiovascular events . These findings identify a previously unrecognized harm of intensive glucose lowering in high-risk patients with type 2 diabetes . ( Clinical Trials.gov number , NCT00000620 .
Conclusions /interpretationPooled analyses demonstrated that pulses , alone or in low-GI or high-fibre diets , improve markers of longer term glycaemic control in humans , with the extent of the improvements subject to significant inter- study heterogeneity .
Aims /hypothesisDietary non-oil-seed pulses ( chickpeas , beans , peas , lentils , etc . )
are a good source of slowly digestible carbohydrate , fibre and vegetable protein and a valuable means of lowering the glycaemic-index ( GI ) of the diet .
To assess the evidence that dietary pulses may benefit glycaemic control , we conducted a systematic review and meta- analysis of r and omised controlled experimental trials investigating the effect of pulses , alone or as part of low-GI or high-fibre diets , on markers of glycaemic control in people with and without diabetes .