Efficacy and Sustainability of Diabetes-Specific Meal Replacement on Obese and Overweight Type-2 Diabetes Mellitus Patients: Study Approaches for a Randomised Controlled Trial and Impact of COVID-19 on Trial Progress.

Meal replacement (MR) is widely used in weight and diabetes management programs due to its ease of compliance and handling. However, little is known about its impact on outcomes other than glycaemic control and weight loss. Furthermore, not many studies evaluate its cost-effectiveness and sustainability. This study aimed to evaluate the efficacy of a diabetes-specific MR for the weight reduction and glycaemic controls of overweight and obese T2DM patients, as compared to routine dietary consultation. Other health outcomes, the cost effectiveness, and the sustainability of the MR will also be evaluated. Materials and Methods: This randomised controlled clinical trial will involve 156 participants who have been randomised equally into the intervention and control groups. As a baseline, both groups will receive diet consultation. Additionally, the intervention group will receive an MR to replace one meal for 5 days a week. The duration of intervention will be 12 weeks, with 36 weeks of follow-up to monitor the sustainability of the MR. The primary endpoints are weight and Hemoglobin A1c (HbA1c) reduction, while the secondary endpoints are anthropometry, biochemical measurements, satiety, hormone changes, quality of life, and cost-effectiveness. The impact of the COVID-19 pandemic on study design is also discussed in this paper. This study has obtained human ethics approval from RECUKM (JEP-2019-566) and is registered at the Thai Clinical Trials Registry (TCTR ID: TCTR20210921004).

Pterostilbene Inhibits the Melanogenesis Activity in UVB-Irradiated B164A5 Cells.

Pterostilbene is a potent antioxidant and anti-inflammatory agent. However, its chemopreventive effects via anti-tyrosinase activity and inhibitory effects on melanin content have not been reported previously. Hence, this study aimed to investigate the anti-melanogenic activity of pterostilbene on UVB-irradiated B164A5 mouse melanoma cells. The effects of pterostilbene and resveratrol on cell viability were determined by MTT assay, whereas melanin content and tyrosinase assay were employed to assess melanogenesis activity. Western blot analysis was performed to determine the tyrosinase expression. Based on the MTT assay, the IC50 value of pterostilbene on UVB-irradiated B164A5 cells was 34.0 ± 3.43 µM, in comparison to resveratrol (>100 µM). Next, 5 and 10 µM pterostilbene showed a significant dose-dependent inhibition (P < .01) of tyrosinase activity in UVB-irradiated B164A5 cells at 37.14 ± 2.71% and 58.36 ± 6.8%, respectively. The findings from the tyrosinase assay also confirmed the downregulation of tyrosinase expression in UVB-irradiated B164A5 cells as measured by Western blot analysis. Finally, 10 µM pterostilbene showed a significantly decreased melanin content (P < .01) in UVB-irradiated B164A5 cells, at 27.34 ± .98 µg/mL. In conclusion, pterostilbene showed anti-melanogenic activity that was 10 times more potent than resveratrol in the UVB-irradiated B164A5 cell.

A 16-Week Home-Based Progressive Resistance Tube Training Among Older Adults With Type-2 Diabetes Mellitus: Effect on Glycemic Control.

Research has proven that aerobic exercise improves glucose homeostasis among patients with type 2 diabetes mellitus (T2DM). Elastic resistance (tube or band) is suggested as a good alternative for home-based strength training among older adults including those with T2DM due to its low cost, simplicity, portability, and versatility. This study aimed to measure the effects of 16-week home-based progressive resistance training (PRT), using a resistance tube on glucose homeostasis and cardiovascular risk factors among older adults with T2DM. A total of 70 participants aged 61.68 (5.50) years with T2DM were assigned to the intervention (n = 35) and control (n = 35) groups in this quasi-experimental trial. The intervention group underwent 16 weeks of home-based PRT using a resistance tube. Significant improvements in HbA1c (-1.34% point, p < 0.001), fasting blood glucose (-1.30 mmol/L, p < 0.001), and systolic blood pressure (-1.42 mmHg, p < 0.05) were observed after 16 weeks of intervention. However, no significant changes were observed in lipid profile, diastolic blood pressure, resting heart rate, and ankle-brachial index. The finding suggests that 16 weeks of home-based PRT using a resistance tube has the potential to improve glycemic control and reduce systolic blood pressure among older adults with T2DM and caused no adverse events.