Efficacy of Melissa officinalis L. (lemon balm) extract on glycemic control and cardiovascular risk factors in individuals with type 2 diabetes: A randomized, double-blind, clinical trial.

Melissa officinalis is a plenteous source of antioxidant flavonols and flavonoids that contain health-promoting and antidiabetic properties, so this study was undertaken to provide the first assessment of the antidiabetic properties of hydroalcoholic extract of M. officinalis in type 2 diabetic patients. We did a randomized, placebo-controlled trial which included 62 patients, receiving either M. officinalis capsules (700 mg/d; n = 31) or the placebo (n = 31) twice daily for 12 weeks. There were significant differences in serum FBS (P = 0.007), HbA1c (P = 0.002), ß-cell activity (P = 0.05), TG (P = 0.04), HDL-c (P = 0.05), hs-CRP (P = 0.001), and systolic blood pressure (P = 0.04) between the two groups at the end of the study; but total cholesterol, LDL-c, insulin, and HOMA-IR showed no significant changes between the groups. In M. officinalis group, there was a significant change in HDL-c (P = 0.009) and QUICKI (P = 0.005) compared with baseline values. No adverse effects were observed. It seems that M. officinalis is safe and effective in improvement of lipid profile, glycemic control, and reduction of inflammation.

High-cocoa polyphenol-rich chocolate improves blood pressure in patients with diabetes and hypertension.

BACKGROUND: The aim was to examine the effects of high-cocoa polyphenol-rich chocolate on lipid profiles, weight, blood pressure, glycemic control, and inflammation in individuals with Type 2 diabetes and hypertension. METHODS: Sixty individuals [32 in dark chocolate group (DCG) and 28 in white chocolate group (WCG)] with Type 2 diabetes on stable medication were enrolled in a randomized, placebo-controlled double-blind study. Subjects were randomized to consume 25 g DCG or WCG for 8 weeks. Changes in weight, blood pressure, glycemic control, lipid profile, and high sensitive C-reactive protein (hsCRP) were measured at the beginning and end of the intervention. This clinical trial was registered at the Iranian registry of clinical trials. RESULTS: In DCC group, compared with baseline, serum levels of Apo A-1 (P = 0.045) was increased and fasting blood sugar (FBS) (P = 0.027), hemoglobin A1c (HbA1c) (P = 0.025), Apo B (P = 0.012) and Log of hsCRP (P = 0.043) levels were decreased at the end of study. No changes were seen within the WCG in studied parameters. High polyphenol chocolate consumption compared to white chocolate resulted in significant decrease in of systolic (-5.93 ± 6.25 vs. -1.07 ± 7.97 mmHg, P = 0.004) and diastolic blood pressure (-6.4 ± 6.25 vs. 0.17 ± 7.9 mmHg, P = 0.002), FBS (-7.84 ± 19.15 vs. 4.00 ± 20.58 mg/dl, P = 0.019) over the course of 8 weeks of daily chocolate consumption neither weight nor body mass index and TG levels altered from baseline. CONCLUSION: High polyphenol chocolate is effective in improving TG levels in hypertensive patients with diabetes and decreasing blood pressure and FBS without affecting weight, inflammatory markers, insulin resistance or glycemic control.

The Effects of Tocotrienols Added to Canola Oil on Microalbuminuria, Inflammation, and Nitrosative Stress in Patients with Type 2 Diabetes: A Randomized, Double-blind, Placebo-controlled Trial.

BACKGROUND: Tocotrienols (T3) were neglected in the past; today, get attentions due to their antioxidant and none-antioxidant activity. The objective of this study was to evaluate the effects of the daily intake of 200 mg T3 added in canola oil over 8 weeks on microalbuminuria, inflammation, and nitrosative stress in type 2 diabetic patients. METHODS: This study was a double-blinded, placebo-controlled, randomized trial. A total of 50 patients with T2DM and FBS >126 mg/dl treated by non-insulin hypoglycemic drugs were randomly assigned to receive either 15 ml T3-enriched canola oil (200 mg/day T3) or pure canola oil for 8 weeks. Urine microalbumin, volume and creatinine levels, serum hs-CRP, and nitric oxide (NO) levels were measured before and after intervention. RESULTS: From 50 patients participated in this study, 44 completed the study. There were no significant differences in baseline characteristics, dietary intake, and physical activity between groups. Urine microalbumin and serum hs-CRP were declined significantly in T3-treated group. At the end of the study, patients who treated with T3 had lower urine microalbumin (11 (9, 25) vs. 22 (15, 39.75) nmol/dl, P = 0.003) and hs-CRP changes (-10.91 ± 15.5 vs. -9.88 ± 27.5 Pg/ml, P = 0.048) than control group. A non-significant decrease was also observed in serum NO level in T3-treated group with no changes in urine volume and creatinine levels. CONCLUSIONS: These findings indicate that T3 leads to ameliorate proteinuria and can protect the kidney against inflammation (hs-CRP) and nitrosative stress (NO).

Effects of pure eicosapentaenoic and docosahexaenoic acids on oxidative stress, inflammation and body fat mass in patients with type 2 diabetes.

BACKGROUND: N-3 Fatty acids reduce the risk of cardiovascular disease. Previous studies have shown that they may reduce inflammation, oxidative stress, and fat mass in patients with type 2 diabetes, but the results are inconclusive, due, in part, to type of omega-3 fatty acids used. The aim of this study was to determine the effects of pure eicosapentaenoic (EPA) and docosahexaenoic acids (DHA), the two major omega-3 fatty acids, on inflammation, oxidative stress, and fat mass in patients with type 2 diabetes. METHODS: Sixty patients with DM-II were randomly allocated to receive daily either ~1 gr EPA or ~1 gr DHA, or a canola oil as placebo for 12 weeks in a randomized triple-blind, placebo-controlled trial. Serum MDA, CRP, body weight, BMI, and fat mass were measured at baseline and after intervention. RESULTS: Forty-five patients with a mean (±SD) age of 54.9 ± 8.2 years with BMI of 27.6 ± 4.1 kg/m(2) and fasting blood glucose 96.0 ± 16.2 mg/dl completed the intervention. Neither EPA nor DHA had significant effects on serum FBS, C-reactive protein, body weight, BMI, and fat mass after intervention (P > 0.05). In addition, while MDA increased 18% in the placebo group (P = 0.009), it did not change in the EPA or DHA group (P > 0.05). CONCLUSIONS: Twelve weeks of supplementation with 1gr/d EPA or DHA prevent increasing oxidative stress without changing marker of inflammation. This study is the first report demonstrating that neither EPA nor DHA have effects on body fat mass in type 2 diabetic patients.

Effects of cinnamon consumption on glycemic status, lipid profile and body composition in type 2 diabetic patients.

OBJECTIVE: Type 2 diabetes is the most common metabolic disorder worldwide. Traditional herbs and spices can be used to control blood glucose concentrations. The objective of this study was to evaluate the effects of the daily intake of three grams cinnamon over eight weeks on glycemic status, lipid profiles and body composition in type 2 diabetic patients. METHODS: A double blind, randomized, placebo controlled clinical trial was conducted on 44 patients with type 2 diabetes. Participants were randomly assigned to take either a three g/day cinnamon supplement (n=22) or a placebo (n=22) for eight weeks. Weight, height, body fat mass and systolic and diastolic blood pressure were measured at baseline and after intervention. The fasting blood glucose, insulin, HbA1c, total cholesterol, LDL C, HDL C, Apo lipoprotein A I and B were measured at baseline and endpoint. RESULTS: From 44 subjects participated in this study 37 completed the study. There were no significant differences in baseline characteristics, dietary intake and physical activity between groups. In the treatment group, the levels of fasting blood glucose, HbA1c, triglyceride, weight, BMI and body fat mass decreased significantly compared to baseline, but not in placebo group. No significant differences were observed in glycemic status indicators, lipid profile and anthropometric indicators between the groups at the end of intervention. CONCLUSION: These data suggest that cinnamon may have a moderate effect in improving glycemic status indicators.

Distribution of fatty acids in adipose tissue of patients with type 2 diabetes.

BACKGROUND: It is not known whether alterations of adipose tissue fatty acid compositions predict type 2 diabetes. Our goal was to characterize the relationship between the adipose tissue fatty acid compositions and type 2 diabetes. METHODS: We evaluated the fatty acid compositions of subcutaneous adipose tissue. These analyses were carried out on samples from 76 normal and 98 diabetic adults. Analysis was performed on a gas chromatograph. RESULTS: The adipose tissue palmitic acid composition of diabetic subjects (24.9% +/- 0.3) was significantly higher (p = 0.01) than in the controls (23.3% +/- 1.6). A significant negative correlation (r = -0.276, p = 0.001) was found between adipose tissue polyunsaturated fatty acids (PUFAs) and the Chol/HDL-C ratio of all the subjects studied (controls plus diabetic patients). A similar negative correlation (r = -0.429, p = 0.001) was identified only for control group, whereas no significant correlation (p > 0.05) was found for diabetic populations. The correlation between fatty acid compositions and serum lipid profiles (TG, HDL-C, Chol/HDL-C, LDL-C/HDL-C proportion) and fasting blood sugar (FBS) with HbAlc concentrations of people with diabetes and controls was not significant. CONCLUSIONS: A high amount of palmitic acid in adipose tissue may increase the risk of the type 2 diabetes and it seems that a high intake of PUFAs can lead to lowering of the Chol/HDL-C ratio.

Fatty acid composition of serum lipids in patients with type 2 diabetes.

BACKGROUND: Serum fatty acid content mainly reflects dietary fat intake. It is not known whether alterations of serum fatty acid compositions predict type 2 diabetes risk. METHODS: We evaluated fatty acid contents in serum of the 76 normal and 98 diabetic adults taking part in a cross sectional study, using a gas chromatography method. RESULTS: The contents of total saturated (SFAs) and monounsaturated fatty acids (MUFAs) of the diabetic subjects were significantly higher when compared to the controls (p = 0.006, p = 0.02 respectively). Serum linoleic and polyunsaturated fatty acid (PUFAs) contents of subjects with diabetes were significantly lower than the control group (p = 0.02). There was a negative correlation (p = 0.001, r = -0.429) between serum PUFAs contents and cholesterol/HDL-C ratio in the control group, whereas this correlation in people with diabetes was not significant (p = 0.12). The correlation between serum TG (triglyceride) and SFAs contents of the diabetic patients was significantly positive (p = 0.01, r = 0.252). A significant negative correlation (p = 0.001, r = -0.421) was found between PUFA contents and serum TG levels of people with diabetes; however, the same correlation for the control group was not significant (p = 0.56). CONCLUSIONS: Diabetes incidence was significantly and positively associated with the proportions of serum palmitic, total saturated and monounsaturated fatty acid contents. Our findings with the use of this biomarker suggest that the dietary fat profile, particularly that of saturated and monounsaturated fatty acids, may contribute to the etiology of diabetes. It seems that patients with type 2 diabetes can have good control on lipid parameters with a higher intake of polyunsaturated fatty acids than saturated fatty acids.

Bilateral versus unilateral thyroid eye disease.

AIMS: The aim of this study was to compare demographics, clinical manifestations, associated systemic and ocular factors, severity and activity of patients with unilateral thyroid eye disease (U-TED) versus bilateral thyroid eye disease (B-TED). MATERIALS AND METHODS: In a cross-sectional study, all patients with Graves' hyperthyroidism and primary hypothyroidism seen in an endocrinology clinic were included from September 2003 to July 2006. Demographics, complete eye examination, severity score (NOSPECS, total eye score), and clinical activity score were recorded and compared in the B-TED and U-TED groups of patients. RESULTS: From 851 patients with thyroid disorders, 303 (35.6%) had TED. Thirty-two patients (32/ 303, 10.56%) were found to have U-TED. Patients with U-TED (mean age 31.6 ± 11.6 years) were significantly younger than patients with B-TED (mean age 37.7 ± 14.7 years). Monovariate analysis (Chi-square and independent sample t-test) showed a significantly higher severity score in B-TED (U-TED 4.09±4.05, B-TED: 6.7±6.3; P= 0.002) and more activity score in B-TED (U-TED= 1.03±0.96, B-TED: 1.74±1.6, P= 0.001). However, multivariate analysis did not show any significant difference between the two groups in terms of age, gender, type of thyroid disease, duration of thyroid disease and TED, severity and activity of TED, smoking habit, and presentation of TED before or after the presentation of thyroid disease (0.1

Change in quality of life after medical and surgical treatment of graves' ophthalmopathy.

PURPOSE: To assess the changes in quality of life (QOL) of patients after treatment of their Graves' ophthalmopathy (GO). MATERIALS AND METHODS: In this prospective, cross-sectional study, the GO-QOL questionnaire was completed by 67 subjects before and at least 6 months after steroid treatment (61 subjects, group 1) or optic neuropathy orbital decompression (6 subjects, group 2). Visual, psychosocial, education and counseling scores (higher score = better health), GO severity and clinical activity scores and minimal clinically important difference (MCID) were recorded and analyzed for correlation and statistical significance. A P-value <0.05 was considered statistically significant. RESULTS: The mean age of patient enrolled in the study was 38.3 years, with 43 females (64.2%). The mean duration of thyroid dysfunction and GO were 40.1 and 26.5 months, respectively. Two treatment groups were similar for all the variables (0.06 < P < 0.9), except for higher mean age in the orbital decompression group (45.2 versus 37.7 years) (P = 0.03). Mean severity, activity, visual function and psychosocial function scores significantly improved in group 1 (steroid group) (P < 0.05, all cases). A significant improvement in clinical activity score and psychosocial scores occurred in group 2 (decompression group) (P < 0.05). MCID was achieved in two-thirds of the patients, with no significant difference between groups (P > 0.05). There was no significant effect of duration of thyroid disease and GO and severity and activity of GO on QOL scores either before or after treatment (P > 0.05, all cases). CONCLUSION: Steroid treatment and orbital decompression significantly improve the QOL in GO. Duration, severity and activity of GO did not have a significant impact on the QOL.