The impact of mulberry leaf extract at three different levels on reducing the glycemic index of white bread.

In this study, the influences of mulberry leaf extract (MLE) addition on the physicochemical properties including the specific volume, texture and sensory features of white bread (WB) were evaluated by the sensory analysis technology. A double-blind, randomised, repeat-measure design was used to study the impact of MLE addition on the postprandial blood glucose response as well as the satiety index of WB. Results showed that the addition of MLE showed no significant effects on the physicochemical properties of WB except for the slight changes of color and bitterness. The addition of MLE significantly reduced the total blood glucose rise after ingestion of WB over 120 minutes, and reduced the GI value of WB in a dose-effect relationship. When the concentration of MLE reached 1.5 g per 100 g available carbohydrate, the GI value of WB could be reduced from 77 to 43. This study provides important information in terms of the appropriateness of MLE when added to more complex real food, the dose-dependent relationship could supply a reference for the application of MLE.

Musa paradisiaca L. leaf and fruit peel hydroethanolic extracts improved the lipid profile, glycemic index and oxidative stress in nicotinamide/streptozotocin-induced diabetic rats.

This study aimed to assess antihyperlipidemic, cardiac and antioxidant effects as well as mode of actions of Musa paradisiaca (M. paradisiaca) leaf and fruit peel hydroethanolic extracts in nicotinamide (NA)/streptozotocin (STZ)-induced diabetic rats. Experimental diabetes mellitus was induced by a single intraperitoneal injection of STZ (60 mg/kg body weight), 15 min after intraperitoneal injection of NA (120 mg/kg body weight). NA/STZ-induced diabetic rats were orally supplemented with M. paradisiaca leaf and fruit peel hydroethanolic extracts in a dose of 100 mg/kg body weight/day for 28 days. The treatment of NA/STZ-induced diabetic rats with M. paradisiaca leaf and fruit peel extracts significantly decreased the elevated fasting and post-prandial serum glucose, total cholesterol, triglycerides, LDL-cholesterol and vLDL-cholesterol levels and significantly increased the lowered serum insulin level, liver glycogen content, serum HDL-cholesterol level, homeostasis model assessment-insulin resistance (HOMA-IS) and HOMA-ß cell function. The elevated cardiovascular risk indices in diabetic rats were significantly improved due to treatment with M. paradisiaca extracts. Concomitant with the increase in liver glycogen content, the glucose-6-phosphatase activity significantly decreased reflecting the decrease in hepatic glucose output. The heart function was potentially ameliorated as manifested by decrease in the elevated serum creatine kinase-MB, lactate dehydrogenase and aspartate aminotransferase activities after treatments of diabetic rats with M. paradisiaca extracts. The elevated liver lipid peroxidation and the decline in liver glutathione content and superoxide dismutase, glutathione peroxidase and glutathione-S-transferase activities were significantly reversed by treatments. Thus, it can be concluded that M. paradisiaca leaf and fruit peel hydroethanolic extracts may have antihyperlipidemic and cardioprotective potentials in NA/STZ-induced diabetic rats. These effects may be mediated via improvements in the glycemic state, ß-cell function, tissue insulin sensitivity, and antioxidant defense mechanism.

Effects of Cynara scolymus L. on glycemic indices:A systematic review and meta-analysis of randomized clinical trials.

OBJECTIVES: Cynara scolymus L. (common artichoke) and its products have been considered as potential phytotherapeutic agents for various conditions, such as cardiovascular, hepatic and gastric diseases, among others. Until now, the effects of artichoke and artichoke products administration on glycemic indices have not been sufficiently appraised. The present study evaluated the effects of artichoke and artichoke products administration on the glycemic indices. METHODS: Clinical trials were identified in the Cochrane Library, PubMed, Embase and Scopus databases; to infinity until 15 March 2020. Weighted mean differences (WMD) were pooled using a random-effects model. Heterogeneity, sensitivity analysis and publication bias were reported using standard methods. RESULTS: Pooled analysis of nine Randomized controlled trials (RCTs), demonstrated that the administration of artichoke and artichoke products led to a significant reduced fasting blood sugar (FBS) (WMD: -5.28 mg/dl, 95 % CI: -8.95, -1.61; p = 0.005). However, other glycemic indeces including fasting insulin (WMD: -0.45 µIU/dL, 95 % CI: -1.14, 0.25; p = 0.20), HOMA-IR (MD: -0.25, 95 % CI: -0.57, 0.07; p = 0.12) or Hemoglobin A1c (HbA1c) (WMD: -0.09, 95 % CI: -0.20, 0.02; p = 0.09) did not alter after the administration of artichoke and artichoke products. A subgroup analysis comparing the kind of intervention, revealed that just the supplementation of artichoke and artichoke products, in a noco-supplementation form, was efficacy for the reduction of Homeostatic model assessment of insulin resistance (HOMA-IR) (WMD: -0.52, 95 % CI: -0.85, -0.19; p = 0.002). CONCLUSIONS: The supplementation of artichoke and artichoke products can significantly reduce the FBS concentrations in humans. Moreover, these outcomes suggested that just the supplementation of artichoke and artichoke products is more effective in the reduction of HOMA-IR levels than the co-supplementation form. However, additional clinical trials with longer study periods are necessitated to obtain a robust conclusion for producing new guidelines as part of a healthy diet.

Starch composition, glycemic indices, antioxidant properties and carbohydrate hydrolyzing enzymes activities of African star apple fruit parts.

BACKGROUND: African star apple (Chrysophyllum albidum) is a traditonal fruit, which is predominant in tropical regions with the fruit parts consumed by the populace and used in folklore to manage diabetes. However, the likely activity mechanism is still undetermined. The current study examined and compared the inhibitory abilities of African star apple fruit parts on selected key enzymes related to diabetes mellitus in the pancreas tissue of rat. METHODS: Inhibitory effect of aqueous extract (1:10 w/v) of African star apple fruit parts (pulp, cotyledon, seed coat and pulp coat) on the activities of α-amylase, α-glucosidase, as well as their starch composition, phenolic constituents, estimated glycemic index, and antioxidant properties were assessed. RESULTS: The fruit parts showed low sugar, eGI, amylose, and amylopectin contents. The analysis also showed that the fruit parts inhibited α-glucosidase and α-amylase activities and exhibited antioxidant properties. Furthermore, the fruit parts contain high concentrations of beta-amyrin acetate, eleagine, epicatechin, epigallocatechin, skatole, stigmasterol and tetrahydro - 2- methylharman as revealed by HPLC-DAD. CONCLUSION: The fruit part low estimated glycemic indices, strong antioxidant properties, inhibition of α-amylase and α-glucosidase activities exhibited might be related to the bioactive compounds contained in the extract. This could also be a potential mechanism for the use in the prevention and management of type-2 diabetes. Nevertheless, the African star apple pulp coat displayed the highest property in comparison to other parts of the fruit.

Effect of weight-loss diet combined with taurine supplementation on body composition and some biochemical markers in obese women: a randomized clinical trial.

Taurine (Tau), an endogenous non-protein and sulfuric-amino acid, is involved in various biological pathways including anti-inflammatory, anti-oxidation, insulin resistance inhibition, and lipid profile improvement. According to some experimental and clinical studies, insulin resistance and excess body weight are associated with reduced serum level of Tau. Therefore, this study was aimed to evaluate Tau supplementation and a diet-induced weight-loss intervention on body composition and some biochemical indices of obese women. Participants were divided randomly into the intervention (standard weight-loss group + cap Tau 3 g/day for 8 weeks, n = 20) and control (standard weight-loss group + cap placebo for 8 weeks, n = 18) groups. To achieve weight loss, all participants received an individualized diet that included a 30% reduction in their total energy intake. Chi-square test was applied to compare categorical variables between two groups at baseline. Paired t test and independent-sample t test were also used to analyze the parametric continuous data within and between the two groups, respectively. Analysis of covariance was run for controlling the confounding variables. At the post-intervention, the mean changes of total cholesterol (p = 0.03), low-density lipoprotein cholesterol (p = 0.03), leptin (p = 0. 006), total adiponectin (p = 0.04), and high sensitivity C-reactive protein (p = 0.03) decreased significantly in Tau group compared with the control group. No significant results were found in the mean changes of high-density lipoprotein cholesterol, anthropometric measurements, glycemic indices, and liver enzymes between the two groups (p > 0.05). The findings showed that Tau supplementation along with a weight-loss diet may be more effective in improving the lipid profile and metabolic risk factors compared with a weight-loss diet alone.

The effect of okra (Abelmoschus esculentus) on lipid profiles and glycemic indices in Type 2 diabetic adults: Randomized double blinded trials.

The aim of the present study was to investigate the effect of okra consumption on serum levels of lipid profiles and glycemic indices in Type 2 diabetic (T2D) patients. The present study was a randomized, double-blinded clinical trial, carried out in Kerman, Iran. Sixty T2D patients were randomized into intervention and control groups and received 10 g okra powder blended in 150 g conventional yogurt or conventional yogurt alone, along with dinner and lunch, for 8 weeks. Glycemic markers and lipid profile were assessed, as well as anthropometric measures, at the beginning and end of study. The findings showed that 8 weeks okra consumption resulted in a significant decrease in fasting plasma glucose (-15.61 ± 19.44 vs. -3.40 ± 24.78; p = .02), homeostatic model of assessment for insulin resistance (-1.17 ± 1.61 vs. -0.14 ± 1.64; p = .01), quantitative insulin sensitivity check index (0.01 ± 0.007 vs. 0.00 ± 0.01; p = .004), triacylglycerol (-22.30 ± 32.46 vs. -3.86 ± 30.57; p = .001), total cholesterol (-10.23 ± 10.36 vs. -2.03 ± 13.94; p = .004), low-density lipoprotein cholesterol (LDL-C; -8.15 ± 10.01 vs. -2.31 ± 9.37; p = .02), and LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (-0.28 ± 0.37 vs. -0.08 ± 0.24; p = .01). No significant difference was observed between groups in HDL-C, glycated hemoglobin, fasting insulin levels, and anthropometric measures. The present study suggests that okra consumption can elicit improvements in lipid profile, as well as glycemic markers, among T2D patients.

Association of Potentially Modifiable Diabetes Care Factors With Glycemic Control in Patients With Insulin-Treated Type 2 Diabetes.

Importance: Numerous factors are associated with the ability of patients with type 2 diabetes to achieve optimal glycemic control. However, many of these factors are not modifiable by quality improvement interventions. In contrast, the structure of how diabetes care is delivered, such as whether patients visit an endocrinologist or how prescriptions are filled, is potentially modifiable, yet its associations with glycemic control have not been rigorously evaluated. Objective: To investigate the association of diabetes care delivery with glycemic control in patients with type 2 diabetes using insulin. Design, Setting, and Participants: This retrospective cohort study used baseline claims and laboratory insurer data within a large pragmatic trial to identify individuals with type 2 diabetes using insulin with data for at least 1 hemoglobin A1c (HbA1c) test result from before trial randomization (July 1, 2014, to October 5, 2016) and for key nonmodifiable patient factors as well as diabetes care delivery and behavioral factors measured before the HbA1c test. Analyses were conducted from February 4, 2017, to November 13, 2018. Main Outcomes and Measures: Multivariable modified Poisson regression was used to evaluate the independent associations of nonmodifiable patient factors and potentially modifiable diabetes care delivery and patient behavioral factors with achieving adequate diabetes control (ie, HbA1c level <8%). The extent of measured variation explained in glycemic control by these factors was also explored using pseudo R2 and C statistics. Results: Of 1423 patients included, 565 (39.7%) were women, and the mean (SD) age was 56.4 (9.0) years. In total, 690 (48.5%) had HbA1c levels less than 8%. Age (relative risk [RR] per 1-unit increase, 1.01; 95% CI, 1.00-1.02), persistent use of basal insulin (RR, 1.20; 95% CI, 1.00-1.43), more frequent filling of glucose self-testing supplies (RR, 1.01; 95% CI, 1.01-1.02), visiting an endocrinologist (RR, 1.41; 95% CI, 1.19-1.67), and receipt of insulin prescriptions by mail order (RR, 1.23; 95% CI, 1.03-1.48) were all independently associated with adequate control. Measured potentially modifiable diabetes care factors explained more variation in adequate glycemic control than measured nonmodifiable patient factors (C statistic, 0.661 vs 0.598; pseudo R2 = 0.11 vs 0.04). Conclusions and Relevance: These findings suggest that for patients with type 2 diabetes using insulin, the way in which care is delivered may be more strongly associated with achieving adequate control of HbA1c levels than patient factors that cannot be altered are. Given the potential for intervention, these care delivery factors could be the focus of efforts to improve diabetes outcomes.

All-trans retinoic acid improves pancreatic cell proliferation on induced type 1 diabetic rats.

All-trans retinoic acid (ATRA) has been extensively studied as an integrating component of endocrine functions in the pancreas. The aim of this study was to evaluate the effects of ATRA on physiopathological biomarkers in an experimental model of rat with type 1 diabetes induced by alloxan (T1D). Twenty Wistar rats were divided equally into five groups, each receiving a different treatment: a control group (CG), a diabetic group without T1D treatment, a diabetic group treated with ATRA, a diabetic group supplemented with vitamin E (VIT E), and a group that was given olive oil (V). The administration of ATRA for 17 days produced a significant reduction in weight and glucose levels, compared to the T1D and VIT E groups. The evaluation of total antioxidant capacity (TAC) and lipoperoxidation showed no relevant difference among the groups. The results of the histological analysis showed similarities both in the size and in the number of islets of Langerhans in the pancreatic tissue obtained from the ATRA group and the CG. ATRA displayed a significant reduction of glycemic values in diabetic rats. Ultrastructurally, ß-cells, acinar, and ductal cells restored their normal appearance. ATRA can contribute to the recovery of pancreatic damage due to alloxan induction. It seems that the antioxidant effect of ATRA is not responsible for the differences observed.

Effects of mango peel powder on starch digestion and quality characteristics of bread.

This study investigated effects of mango peel powder on starch digestion properties and quality characteristics of bread, and discussed underneath mechanisms. Starch digestion rate and extent of bread were evaluated in vitro, and bread quality characteristics, including moisture content, volume, color and texture, were evaluated. The results showed that adding mango peel powder could significantly reduce starch digestion rate and digestion extent in bread, and the reduction degree was positively related to the amount of mango peel powder applied. Bread moisture content was improved by mango peel powder, while bread volume was reduced. Bread color was also impacted, showing increased L*, a* and b* values. And incorporation of mango peel powder apparently affected bread texture, resulting in increased hardness and chewiness, as well as decreased cohesiveness. These influences were generally proportional to the amount of mango peel powder applied. When <5% of mango peel powder was incorporated, bread quality was not dramatically changed, although starch digestibility was significantly inhibited. More mango peel powder could further reduce starch digestion; however, bread quality might be deteriorated. These results would provide guidelines for the development of low glycemic index foods, and be beneficial in facilitating comprehensive application of mango peel.

Intranasal Administration of Proinsulin C-Peptide Enhances the Stimulating Effect of Insulin on Insulin System Activity in the Hypothalamus of Diabetic Rats.

In type 1 diabetes mellitus, the levels of insulin and C-peptide decrease at the periphery and in CNS. C-peptide potentiates the regulatory effects of insulin. We studied the effects of single and repeated (over 7 days) individual and combined nasal administration of C-peptide (10 µg/day) and insulin (20 µg/day) on activity of Akt kinase and kinase-3ß-glycogen synthase (GSK3ß), the components of 3-phosphoinositide pathway, in the hypothalamus of intact rats and rats with mild streptozotocin-induced type 1 diabetes mellitus. Phosphorylation of Akt kinase at Thr308 and Ser473 (stimulation) and GSK3ß at Ser9 (inhibition) was evaluated. In diabetes, phosphorylation of Akt kinase and, to a lesser extent, GSK3ß, is reduced. A single injection of insulin or C-peptide and insulin increased this process. Long-term combined treatment with C-peptide and insulin normalized activity of Akt kinase and GSK3ß in diabetic rats, treatment with insulin alone produced less pronounced effect; monotherapy with C-peptide was ineffective. Intranasal co-administration of C-peptide and insulin effectively stimulates the insulin system in the hypothalamus that is weakened at diabetes mellitus type 1, which can be used in the treatment of this disease.

Comparative study on effects of citric and lactic acid treatment on morphological, functional, resistant starch fraction and glycemic index of corn and sorghum starches.

The present study isolated starch from corn and sorghum grains through wet milling procedure. Sorghum starch is considered an alternative to corn starch in future, due to similar functional properties. However, agronomically sorghum is a cheap input cost crop compared to sorghum and can grow in drought hit areas. Lactic acid and citric acid modifications along with heat-moisture treatments were performed on both sorghum and corn grains followed by their comparison in terms of functional, textural, thermal, pasting and digestibility characteristics. For both corn and sorghum starches, the resistant starch increased after chemical modifications. The RS content of acid and acid-heat moisture treated starches were in the range of 77.9-90%, significantly higher than those of native starches (64.6-68.8%). The modifications increased the gelatinization temperature, decreased the peak and cold paste viscosity of starches. Chewiness significantly reduced after lactic and citric acid treatment along with heat-moisture treatments. The crystallinity to amorphous ratio measured through Fourier Transform infrared reduced after all chemical treatments. Percent light transmittance was further reduced after heat-moisture treatments, however the effect on corn starch was more pronounced i.e. it declined from 16.5 to 5.2%. The acid-heat moisture treatments had considerably lowered the glycemic index of starch. The GI reduced from 74 to 49.7 and 60 to 48.5 when treated with acid in the presence of heat and moisture. Thus, these starches could be used in production of low-calorie foods.

Comparative Glycaemic Indices of a Four Herbal Combinatorial Formulation Administered On Wistar Rats.

OBJECTIVE: The effect of dietary incorporation of ethanolic extracts of single and combinatorial formulations of Acanthus montanus (ACMO), Asystaciagangetica (ASGA), Gongronemalatifolium (GOLA) and Solanummelongena (SOME) on glucose tolerance was studied in normoglycaemicWistar rats. METHODS: A total of 128 Wistar rats were used for the research work. The rats were divided into 32 groups of 4 rats each. One group was the normal control group and 15 groups were orally administered 200mg/kg body weight extract(s) for the single and combinatorial formulations. Another group (negative control) was given oral glucose load (4g/100ml) of 200mg/kg body weight alone and the remaining 15 groups were given oral glucose load (4g/100ml) of 200mg/kg body weight before giving the test extract(s) of 200mg/kg body weight. RESULTS: Post-prandial serum glucose response at 30 minutes interval was plotted and the area under the curve (AUC) used to determine glycaemic index (GI) of each herbs. The herbs (ACMO, ASGA, GOLA and SOME) resulted in a marked improvement in oral glucose tolerance in rats after 10 days of treatment at an interval of 2 days. Blood glucose concentration (mmol/l) of rats administered with the combinations; ACMO+GOLA, ACMO+SOME, SOME+GOLA, ACMO+SOME+GOLA+GLU, ACMO+ASGA+GOLA, ACMO+SOME+GOLA and ACMO+ASGA+GOLA+SOME was found to belowered, with ACMO+ASGA+GOLA combination having the best result. This might be a result of hypoglycaemic synergy promoted by the various bioactive principles present in the combined extracts thereby lowering the GI. These findings revealed that the listed combinations have hypoglycaemic potentials and habitual consumption could positively modulate oral glucose tolerance. CONCLUSION: The herbs could be useful in the dietary management of diabetes as they could help regulate blood glucose level when consumed with normal meals and could also be incorporated into meals to prevent or delay the onset of diabetes or reverse the same in its early stages.

Effect of pomegranate seed oil supplementation on the GLUT-4 gene expression and glycemic control in obese people with type 2 diabetes: A randomized controlled clinical trial.

Abnormality in glucose transporter type 4 (GLUT-4) function and insulin secretion are the main causes of type 2 diabetes mellitus (T2DM). Due to adverse effects of antidiabetic drugs, nowadays, nutraceuticals have been of much interest to investigators. The aim of the present study was to determine the effect of pomegranate seed oil (PSO) on the GLUT-4 gene expression and glycemic control in obese people with T2DM. This randomized clinical trial was conducted on 52 obese type 2 diabetic patients for 8 weeks in Tabriz, Iran, in 2018. Patients were divided into the intervention group (n = 26; who consumed daily three capsules containing 1 g PSO) and the placebo group (n = 26; the same amounts paraffin). GLUT-4 gene expression and glycemic indices were evaluated by standard methods. GLUT-4 gene expression was increased significantly in the PSO group. Within-group changes in fasting blood sugar (FBS) and quantitative insulin sensitivity check index were significant in the PSO group. After adjusting the age, gender, and baseline values, FBS was significantly decreased. Insulin concentration, HbA1C, HOMA-IR, and HOMA-ß did not manifest significant changes. PSO increased the GLUT-4 gene expression in diabetic patients without any side effects. However, future clinical studies are needed to confirm the obtained results.

The Antidiabetic Potential of Black Mulberry Extract-Enriched Pasta through Inhibition of Enzymes and Glycemic Index.

In the present work, pasta enriched in different formulations by black mulberry extract in order to inhibit enzymes related to starch hydrolyzation. Total phenol content (TPC), antioxidant activity and anthocyanin components of ethanol/water black mulberry extract were investigated. TPC of the black mulberry extract was found 65.61 ± 0.07 mg GAE/g. Black mulberry extract could scavenge the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals more effectively than tertiary butylhydroquinone (TBHQ) also vitamin C due to its detected polyphenolic compounds (cyanidin-3-glucoside, cyanidin-3-rutinoside, and cyanidin-3-xyloside). The IC50 value of the black mulberry extract was obtained 8.31 µg/mL while it was measured 59.62 and 62.64 µg/mL for TBHQ and vitamin C, respectively. The pasta-enriched with freeze-dried black mulberry extract showed effective inhibition against applied α-amylases (α-amylase from porcine pancreas, Bacillus sp, and human saliva) and α-glucosidase originated from Saccharomyces cerevisiae. The IC50 values of tested enzymes exhibited that black mulberry effectively act as an inhibitory agent comparing with acarbose because of its antioxidant activity. Results revealed that starch hydrolysis index (HI) and predicted glycemic index (GIpredicted) of cooked pasta-enriched with various concentration levels of black mulberry extract were significantly decreased especially when 1.5% of the extract was incorporated. In addition, The IC50 value of the black mulberry extract obtained from cooked pasta was increased against α-amylase and α-glucosidase. The results obviously presented that diabetes mellitus type 2 could be resolved by enrichment of polyphenolic compounds into the pasta.

Comparative Effectiveness of Metformin Dosage Uptitration Versus Adding Another Antihyperglycemic Medication on Glycemic Control in Type 2 Diabetes Patients Failing Initial Metformin Monotherapy: A Retrospective Cohort Study.

Metformin is recommended as first-line treatment for type 2 diabetes (T2D). A disadvantage of metformin is the possibility of gastrointestinal adverse effects in some patients. Many T2D patients are not able to achieve/maintain glycemic control from initial metformin treatment and receive treatment intensification by means of metformin dosage uptitration or addition of a T2D drug. This retrospective study evaluated the comparative effectiveness of these 2 treatment intensification strategies. The study cohort included T2D patients at a US integrated health care system who: were initiated on metformin monotherapy (MM) during January 2009 - September 2013; had an uncontrolled HbA1c (≥7%) after at least 90 days of MM; and received metformin dosage uptitration or an additional T2D medication within 6 months of the uncontrolled HbA1c reading. Statistical techniques included Kaplan-Meier curves and Cox proportional hazards regression. The study cohort included 1167 patients, 52.4% male and 65.1% white, with a mean age of 55.3 (±11.9) years. Of these, 49.1% received metformin dosage uptitration and 50.9% received an additional T2D medication. Metformin dosage uptitration was as effective as adding another T2D medication with the probability of not achieving glycemic control (P = 0.599) and rate of glycemic control (adjusted hazard ratio = 1.28, 95% confidence interval = 0.98-1.68) within 6 months of intensification not significantly different between the 2 groups. Metformin dosage uptitration could be a preferable initial intensification strategy in patients failing initial MM unless there is a concern for gastrointestinal adverse effects, in which case adding a T2D medication might be preferable.

Efficacy of cinnamon in patients with type II diabetes mellitus: A randomized controlled clinical trial.

BACKGROUND & AIMS: Multiple studies have evaluated the hypoglycemic effect of cinnamon in patients with diabetes mellitus (DM) type II, with conflicting results. Differences in Baseline Body Mass Index (BMI) of patients may be able to explain the observed differences in the results. This study was designed to evaluate the effect of cinnamon supplementation on anthropometric, glycemic and lipid outcomes of patients with DM type II based on their baseline BMI. METHODS: The study was designed as a triple-blind placebo-controlled randomized clinical trial, using a parallel design. One hundred and forty patients referred to Diabetes Clinic of Yazd University of Medical Sciences with diagnosis of DM type II were randomly assigned in four groups: cinnamon (BMI ≥ 27, BMI < 27) and Placebo (BMI ≥ 27, BMI < 27). Patients received cinnamon bark powder or placebo in 500 mg capsules twice daily for 3 months. Anthropometric, glycemic and lipid outcomes were measured before and after the intervention. RESULT: Cinnamon supplementation led to improvement of all anthropometric (BMI, body fat, and visceral fat), glycemic (FPG, 2hpp, HbA1C, Fasting Insulin, and Insulin Resistance), and lipids (Cholesterol Total, LDL-c and HDL-c) outcomes (except for triglycerides level). All observed changes (except for Cholesterol Total and LDL-c) were significantly more prominent in patients with higher baseline BMI (BMI ≥ 27). CONCLUSION: Based on the study findings, cinnamon may improve anthropometric parameters, glycemic indices and lipid profile of patients with type II diabetes. These benefits are significantly more prominent in patients with higher baseline BMI (BMI ≥ 27). The trial protocol was registered in Iranian Registry of Clinical Trials database (registration ID: IRCT2017031133015N1).

Phytomodulatory proteins promote inhibition of hepatic glucose production and favor glycemic control via the AMPK pathway.

Phytomodulatory proteins from the latex of the medicinal plant Calotropis procera has been shown to be implicated in many pharmacological properties. However there is no current information about their activity on glucose metabolism, although the latex is used in folk medicine for treating diabetes. In this study the phytomodulatory proteins (LP) from C. procera latex were assessed on glycemic homeostasis. Control animals received a single intravenous dose (5 mg/kg) of LP or saline solution (CTL). Four hours after treatment, the animals were euthanized and their livers were excised for analysis by western blot and RT-PCR AMP-activated protein kinase (AMPK), phosphoenolpyruvate carboxykinase (PEPCK) and tumor necrosis factor alpha (TNF-α). In vivo tests of intraperitoneal tolerance to insulin, glucose and pyruvate were also performed, and the effect of LP administration on fed glycemia was studied followed by blood analysis to determine serum insulin levels. Treatment with LP reduced glycemia two hours after glucose administration (LP: 87.2 ± 3.70 mg/dL versus CTL: 115.6 ± 8.73 mg/dL). However, there was no change in insulin secretion (CTL: 14.16 ± 0.68 mUI/mL and LP: 14.96 ± 0.55 mUI/mL). LP improved the insulin sensitivity, represented by a superior glucose decay constant during an insulin tolerance test (kITT) (4.17 ± 0.94%/min) compared to the CTL group (0.82 ± 0.72%/min), and also improved glucose tolerance at 30 min (105.2 ± 12.4 mg/dL versus 154.2 ± 18.51 mg/dL), while it decreased hepatic glucose production at 15 and 30 min (LP: 75.5 ± 9.31 and 52.5 ± 12.05 mg/dL compared to the CTL: 79.0 ± 3.02 and 84.5 ± 7.49 mg/dL). Furthermore, there was a significant inhibition of gene expression of PEPCK (LP: 0.66 ± 0.06 UA and CTL: 1.14 ± 0.22 UA) and an increase of phosphorylated AMPK (LP: 1.342 ± 0.21 UA versus CTL: 0.402 ± 0.09 UA). These findings confirm the effect of LP on glycemic control and suggest LP may be useful in diabetes treatment. However, the pharmacological mechanism of LP in PEPCK modulation still needs more clarification.

Potato consumption and risk of type 2 diabetes: A dose-response meta-analysis of cohort studies.

BACKGROUND & AIMS: High potato intake has been suggested as a risk factor for the development of type 2 diabetes. We aimed to investigate the association between potato consumption and risk of type 2 diabetes. METHODS: A systematic review was conducted on PubMed and Embase from the database commencement until September 2017 (updated by June 2018) following the MOOSE guidelines. The random effect model dose-response meta-analysis method of Greenland and Longneck was used to estimate the maximally adjusted log hazard ratio (HR) for a unit (serving per day) increment of potato consumption. A restricted cubic spline model with three knots was used to evaluate the potential non-linear relationship. RESULTS: A total of 3544 citations were retrieved from the databases, of which six prospective cohort studies including 4545230 person-year of follow-up and 17,758 diabetes cases met the inclusion criteria. The pooled dose-response HR per an increment of 1 serving/day of total potato consumption was 1.20 (95% CI 1.13 to 1.127, P < 0.001, I2 = 27.1%, P for heterogeneity = 0.23) both in men and women. The larger risk were observed for 2 serving/day (HR 1.44, 95% CI 1.28 to 1.63) and 3 serving/day (HR 1.74, 95% CI 1.45 to 2.09). We found significant evidence of a non-linear association between total potato consumption and risk of type 2 diabetes (X2 = 17.5, P for linearity < 0.001). CONCLUSION: Long-term high consumption of potato (each serving a day increase) may be strongly associated with increased risk of diabetes. These findings suggest that diet-health policy may be of importance in the prevention of diabetes.

Mulberry leaf extract reduces the glycemic indexes of four common dietary carbohydrates.

BACKGROUND: 1-Deoxynojirimycin (DNJ), a component of mulberry leaf extract (MLE), reduces postprandial hyperglycemia by inhibiting intestinal a-glycosidase. The aim of this exploratory study was to investigate the effects of MLE on the glycemic indexes (GI) of common dietary carbohydrates. METHODS: This single-center, randomized, open-label, 7-cycle self-controlled crossover study enrolled 15 healthy volunteers at the National Drug Clinical Trial Institution, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine (June 2014 to December 2014). The participants were randomized to receive glucose (3 occasions), glucose+MLE, sucrose+MLE, maltose+MLE, and maltodextrin+MLE orally during 7 visits (every 3 days). Blood glucose level was tested at 15 minutes before and at 15, 30, 45, 60, 90, and 120 minutes after carbohydrate intake. The GI of each carbohydrate relative to glucose (GI = 100) was calculated using the incremental area under the curve method. Safety was assessed at each visit. RESULTS: All participants completed the protocol. After carbohydrate ingestion, blood glucose level peaked at 30 minutes (glucose, glucose+MLE, sucrose+MLE, and maltose+MLE) or 45 minutes (maltodextrin+MLE) before returning to preprandial levels at 120 minutes. At 30 minutes, the change in blood glucose level was lower for sucrose+MLE, maltose+MLE, and maltodextrin+MLE than for glucose or glucose+MLE (P < .05). GI was lowest for sucrose+MLE (43.22 ±â€Š17.47) and maltose+MLE (49.23 ±â€Š22.39), intermediate for maltodextrin+MLE (75.90 ±â€Š26.01), and higher for glucose+MLE (91.88 ±â€Š27.24). MLE reduced the GIs for maltose, sucrose, maltodextrin, and glucose by 53.11%, 33.51%, 31.00%, and 8.12%, respectively. MLE was well tolerated. CONCLUSIONS: Coconsumption of MLE with sucrose, maltose, or maltodextrin can reduce the GI values of these carbohydrates. TRIAL REGISTRATION: Chinese Clinical Trial Registry Platform, no. ChiCTR-IPR-15006484. Registered on May 28, 2015.