CYBERMED LIFE - ORGANIC  & NATURAL LIVING

Diabetes Mellitus: Type 2

Diabetes mellitus type 2 (also known as type 2 diabetes) is a long-term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, and unexplained weight loss. Symptoms may also include increased hunger, feeling tired, and sores that do not heal. Often symptoms come on slowly. Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations. The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.

Type 2 diabetes primarily occurs as a result of obesity and lack of exercise. Some people are more genetically at risk than others. Type 2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to diabetes mellitus type 1 and gestational diabetes. In diabetes mellitus type 1 there is a lower total level of insulin to control blood glucose, due to an autoimmune induced loss of insulin-producing beta cells in the pancreas. Diagnosis of diabetes is by blood tests such as fasting plasma glucose, oral glucose tolerance test, or glycated hemoglobin (A1C).

Type 2 diabetes is partly preventable by staying a normal weight, exercising regularly, and eating properly. Treatment involves exercise and dietary changes. If blood sugar levels are not adequately lowered, the medication metformin is typically recommended. Many people may eventually also require insulin injections. In those on insulin, routinely checking blood sugar levels is advised; however, this may not be needed in those taking pills. Bariatric surgery often improves diabetes in those who are obese.

Rates of type 2 diabetes have increased markedly since 1960 in parallel with obesity. As of 2015 there were approximately 392 million people diagnosed with the disease compared to around 30 million in 1985. Typically it begins in middle or older age, although rates of type 2 diabetes are increasing in young people. Type 2 diabetes is associated with a ten-year-shorter life expectancy. Diabetes was one of the first diseases described. The importance of insulin in the disease was determined in the 1920s.

  • Don’t just count calories—where they come from makes a big difference

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    Don’t just count calories—where they come from makes a big difference image The idea that all calories are equal is at the heart of many weight-loss programmes—but it's a myth. There's an enormous difference between a calorie in a sugar-sweetened drink and in starch, for instance, researchers have confirmed this week.

    The calories in the drink could make you obese and increase your risk of type 2 diabetes and heart disease while those in starch won't have any harmful effect at all, say researchers from the University of California at Davis.

  • A combination of nutriments improves mitochondrial biogenesis and function in skeletal muscle of type 2 diabetic Goto-Kakizaki rats. 📎

    Abstract Title:

    A combination of nutriments improves mitochondrial biogenesis and function in skeletal muscle of type 2 diabetic Goto-Kakizaki rats.

    Abstract Source:

    PLoS One. 2008;3(6):e2328. Epub 2008 Jun 4. PMID: 18523557

    Abstract Author(s):

    Weili Shen, Jiejie Hao, Chuan Tian, Jinmin Ren, Lu Yang, Xuesen Li, Cheng Luo, Carl W Cotma, Jiankang Liu

    Abstract:

    BACKGROUND: Recent evidence indicates that insulin resistance in skeletal muscle may be related to reduce mitochondrial number and oxidation capacity. However, it is not known whether increasing mitochondrial number and function improves insulin resistance. In the present study, we investigated the effects of a combination of nutrients on insulin resistance and mitochondrial biogenesis/function in skeletal muscle of type 2 diabetic Goto-Kakizaki rats. METHODOLOGY/PRINCIPAL FINDINGS: We demonstrated that defect of glucose and lipid metabolism is associated with low mitochondrial content and reduced mitochondrial enzyme activity in skeletal muscle of the diabetic Goto-Kakizaki rats. The treatment of combination of R-alpha-lipoic acid, acetyl-L-carnitine, nicotinamide, and biotin effectively improved glucose tolerance, decreased the basal insulin secretion and the level of circulating free fatty acid (FFA), and prevented the reduction of mitochondrial biogenesis in skeletal muscle. The nutrients treatment also significantly increased mRNA levels of genes involved in lipid metabolism, including peroxisome proliferator-activated receptor-alpha (Ppar alpha), peroxisome proliferator-activated receptor-delta (Ppar delta), and carnitine palmitoyl transferase-1 (Mcpt-1) and activity of mitochondrial complex I and II in skeletal muscle. All of these effects of mitochondrial nutrients are comparable to that of the antidiabetic drug, pioglitazone. In addition, the treatment with nutrients, unlike pioglitazone, did not cause body weight gain. CONCLUSIONS/SIGNIFICANCE: These data suggest that a combination of mitochondrial targeting nutrients may improve skeletal mitochondrial dysfunction and exert hypoglycemic effects, without causing weight gain.

  • A high-score Mediterranean dietary pattern is associated with a reduced risk of peripheral arterial disease in Italian patients with Type 2 diabetes📎

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    Abstract Title:

    A high-score Mediterranean dietary pattern is associated with a reduced risk of peripheral arterial disease in Italian patients with Type 2 diabetes.

    Abstract Source:

    J Thromb Haemost. 2003 Aug;1(8):1744-52. PMID: 12911588

    Abstract Author(s):

    E Ciccarone, A Di Castelnuovo, M Salcuni, A Siani, A Giacco, M B Donati, G De Gaetano, F Capani, L Iacoviello,

    Abstract:

    BACKGROUND: The 'Mediterranean diet' is considered to exert protective effects on cardiovascular disease, although a wide range of dietary patterns exists among subjects living even in the same Mediterranean country.

    OBJECTIVE: To investigate the association between specific dietary patterns and peripheral arterial disease (PAD) in Italian Type 2 diabetes patients.

    DESIGN: From a cohort of 944 patients with Type 2 diabetes, 144 patients with PAD were selected, and matched for age and sex with 288 Type 2 diabetic control patients without macrovascular complications. A dietary score was elaborated from a semiquantitative food frequency questionnaire. The higher the final score, the healthier the eating habit.

    RESULTS: In multivariate analysis, a higher score was independently associated with a significant reduction in PAD risk [odds ratio (OR) = 0.44; 95% confidence interval (CI) 0.24, 0.83]. Diabetes duration (OR>15 years = 2.49; 95% CI 1.45, 4.25), hypertension (OR = 2.12; 95% CI 1.31, 3.45) and butter consumption (OR = 2.6; 95% CI 1.15, 3.68) were also significantly associated with PAD. The dietary score significantly improved the predictive value of models based on duration of diabetes and hypertension. (LSR = 2.19, DF = 7, P<0.001). The effect of a high dietary score on the risk of PAD was independent of diabetes duration and hypertension.

    CONCLUSION: In Italian Type 2 diabetics, a higher dietary score has a protective role against PAD. The use of butter increases the risk of PAD even in patients regularly consuming olive oil. Dietary advice may be helpful for the prevention of PAD in diabetics even in populations traditionally accustomed to a Mediterranean dietary habit.

  • A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial📎

    Abstract Title:

    A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial.

    Abstract Source:

    Am J Clin Nutr. 2009 May;89(5):1588S-1596S. Epub 2009 Apr 1. PMID: 19339401

    Abstract Author(s):

    Neal D Barnard, Joshua Cohen, David J A Jenkins, Gabrielle Turner-McGrievy, Lise Gloede, Amber Green, Hope Ferdowsian

    Abstract:

    BACKGROUND: Low-fat vegetarian and vegan diets are associated with weight loss, increased insulin sensitivity, and improved cardiovascular health.

    OBJECTIVE: We compared the effects of a low-fat vegan diet and conventional diabetes diet recommendations on glycemia, weight, and plasma lipids.

    DESIGN: Free-living individuals with type 2 diabetes were randomly assigned to a low-fat vegan diet (n = 49) or a diet following 2003 American Diabetes Association guidelines (conventional, n = 50) for 74 wk. Glycated hemoglobin (Hb A(1c)) and plasma lipids were assessed at weeks 0, 11, 22, 35, 48, 61, and 74. Weight was measured at weeks 0, 22, and 74.

    RESULTS: Weight loss was significant within each diet group but not significantly different between groups (-4.4 kg in the vegan group and -3.0 kg in the conventional diet group, P = 0.25) and related significantly to Hb A(1c) changes (r = 0.50, P = 0.001). Hb A(1c) changes from baseline to 74 wk or last available values were -0.34 and -0.14 for vegan and conventional diets, respectively (P = 0.43). Hb A(1c) changes from baseline to last available value or last value before any medication adjustment were -0.40 and 0.01 for vegan and conventional diets, respectively (P = 0.03). In analyses before alterations in lipid-lowering medications, total cholesterol decreased by 20.4 and 6.8 mg/dL in the vegan and conventional diet groups, respectively (P = 0.01); LDL cholesterol decreased by 13.5 and 3.4 mg/dL in the vegan and conventional groups, respectively (P = 0.03).

    CONCLUSIONS: Both diets were associated with sustained reductions in weight and plasma lipid concentrations. In an analysis controlling for medication changes, a low-fat vegan diet appeared to improve glycemia and plasma lipids more than did conventional diabetes diet recommendations. Whether the observed differences provide clinical benefit for the macro- or microvascular complications of diabetes remains to be established. This trial was registered at clinicaltrials.gov as NCT00276939.

  • A MUFA-rich diet improves posprandial glucose, lipid and GLP-1 responses in insulin-resistant subjects.

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    Abstract Title:

    A MUFA-rich diet improves posprandial glucose, lipid and GLP-1 responses in insulin-resistant subjects.

    Abstract Source:

    J Am Coll Nutr. 2007 Oct;26(5):434-44. PMID: 17914131

    Abstract Author(s):

    Juan A Paniagua, Angel Gallego de la Sacristana, Esther Sánchez, Inmaculada Romero, Antonio Vidal-Puig, Francisco J Berral, Antonio Escribano, Maria José Moyano, Pablo Peréz-Martinez, José López-Miranda, Francisco Pérez-Jiménez

    Article Affiliation:

    Lipids and Atherosclerosis Research Unit, University Hospital Reina Sofía, Córdoba, Spain. This email address is being protected from spambots. You need JavaScript enabled to view it.

    Abstract:

    OBJECTIVE:To study the effects of three weight-maintenance diets with different macronutrient composition on carbohydrate, lipid metabolism, insulin and incretin levels in insulin-resistant subjects.

    METHODS:A prospective study was performed in eleven (7 W, 4 M) offspring of obese and type 2 diabetes patients. Subjects had a BMI>25 Kg/m2, waist circumference (men/women)>102/88, HBA1c<6.5% and were regarded as insulin-resistant after an OGTT (Matsuda ISIm<4). They were randomly divided into three groups and underwent three dietary periods each of 28 days in a crossover design: a) diet high in saturated fat (SAT), b) diet rich in monounsaturated fat (MUFA; Mediterranean diet) and c) diet rich in carbohydrate (CHO).

    RESULTS:Body weight and resting energy expenditure did not changed during the three dietary periods. Fasting serum glucose concentrations fell during MUFA-rich and CHO-rich diets compared with high-SAT diets (5.02 +/- 0.1, 5.03 +/- 0.1, 5.50 +/- 0.2 mmol/L, respectively. Anova<0.05). The MUFA-rich diet improved insulin sensitivity, as indicated by lower homeostasis model analysis-insulin resistance (HOMA-ir), compared with CHO-rich and high-SAT diets (2.32 +/- 0.3, 2.52 +/- 0.4, 2.72 +/- 0.4, respectively, Anova<0.01). After a MUFA-rich and high-SAT breakfasts (443 kcal) the postprandial integrated area under curve (AUC) of glucose and insulin were lowered compared with isocaloric CHO-rich breakfast (7.8 +/- 1.3, 5.84 +/- 1.2, 11.9 +/- 2.7 mmol . 180 min/L, Anova<0.05; and 1004 +/- 147, 1253 +/- 140, 2667 +/- 329 pmol . 180 min/L, Anova<0.01, respectively); while the integrated glucagon-like peptide-1 response increased with MUFA and SAT breakfasts compared with isocaloric CHO-rich meals (4.22 +/- 0.7, 4.34 +/- 1.1, 1.85 +/- 1.1, respectively, Anova<0.05). Fasting and postprandial HDL cholesterol concentrations rose with MUFA-rich diets, and the AUCs of triacylglycerol fell with the CHO-rich diet. Similarly fasting proinsulin (PI) concentration fell, while stimulated ratio PI/I was not changed by MUFA-rich diet.

    CONCLUSIONS:Weight maintenance with a MUFA-rich diet improves HOMA-ir and fasting proinsulin levels in insulin-resistant subjects. Ingestion of a virgin olive oil-based breakfast decreased postprandial glucose and insulin concentrations, and increased HDL-C and GLP-1 concentrations as compared with CHO-rich diet.

  • A multicenter, double-blind, safety study of QR-333 for the treatment of symptomatic diabetic peripheral neuropathy. A preliminary report.

    Abstract Title:

    A multicenter, double-blind, safety study of QR-333 for the treatment of symptomatic diabetic peripheral neuropathy. A preliminary report.

    Abstract Source:

    J Diabetes Complications. 2005 Sep-Oct;19(5):247-53. PMID: 16112498

    Abstract Author(s):

    Paul Valensi, Claude Le Devehat, Jean-Louis Richard, Cherifo Farez, Taraneh Khodabandehlou, Richard A Rosenbloom, Carolyn LeFante

    Article Affiliation:

    Service d'Endocrinologie, Diabetologie, Nutrition, Hopital Jean Verdier, AP-HP, Avenue du 14 Juillet, Bondy, France.

    Abstract:

    BACKGROUND: QR-333, a topical compound that contains quercetin, a flavonoid with aldose reductase inhibitor effects, ascorbyl palmitate, and vitamin D(3), was formulated to decrease the oxidative stress that contributes to peripheral diabetic neuropathy and thus alleviate its symptoms. This proof-of-principle study assessed the efficacy and safety of QR-333 against placebo in a small cohort of patients with diabetic neuropathy. METHODS: This randomized, placebo-controlled, double-blind trial included 34 men and women (21-71 years of age) with Type 1 or 2 diabetes and diabetic neuropathy who applied QR-333 or placebo (2:1 ratio), three times daily for 4 weeks, to each foot where symptoms were experienced. Five-point scales were used to determine changes from baseline to endpoint in symptoms and quality of life (efficacy). Safety was assessed through concomitant medications, adverse events, laboratory evaluations, and physical examinations. RESULTS: QR-333 reduced the severity of numbness, jolting pain, and irritation from baseline values. Improvements were also seen in overall and specific quality-of-life measures. QR-333 was well tolerated. Eleven patients in the QR-333 group reported 23 adverse events (all mild or moderate); 4 in the placebo group reported 5 events (all moderate). One patient who applied QR-333 noted a pricking sensation twice, the only adverse event considered possibly related to study treatment. CONCLUSIONS: From this preliminary safety study, it appears that QR-333 may safely offer relief of symptoms of diabetic neuropathy and improve quality of life. These findings warrant further investigation of this topical compound.

  • A narrative review on role of Yoga as an adjuvant in the management of risk factor, disease progression and the complications of type 2 diabetes mellitus.

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    Abstract Title:

    A narrative review on role of Yoga as an adjuvant in the management of risk factor, disease progression and the complications of type 2 diabetes mellitus.

    Abstract Source:

    Diabetes Metab Syndr. 2017 Mar 6. Epub 2017 Mar 6. PMID: 28283397

    Abstract Author(s):

    A Mooventhan

    Article Affiliation:

    A Mooventhan

    Abstract:

    Type 2 diabetes mellitus (T2DM) is one of the major health problems in the world as well as in India that greatly affects the health care sector and economy. Use of drugs has its own drawbacks and in recent days the use of non-medical measures were reported not only to manage T2DM, but also to prevent its complications. Through there are various review articles that are dealing with the effect of Yoga on risk profiles, management along with the mechanisms of action of yoga in T2DM separately, there is a lack of comprehensive review on the effect of Yoga in combination with all the above mentioned including the effect of Yoga in the management of T2DM complications. Hence, we performed a narrative review in Medline/PubMed using keyword"Yoga and diabetes". All the relevant articles published till 08th November 2016 were included. Based on the available literature, it could be concluded that Yoga plays a vital role as an adjuvant in the management of risk factors, disease progression and the complications of the T2DM. Further studies are warranted using standard research designs and variables to find out the various mechanisms of effects of Yoga in detail.

  • A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease.

    Abstract Title:

    A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease.

    Abstract Source:

    Diabetologia. 2007 Sep ;50(9):1795-807. Epub 2007 Jun 22. PMID: 17583796

    Abstract Author(s):

    S Lindeberg, T Jönsson, Y Granfeldt, E Borgstrand, J Soffman, K Sjöström, B Ahrén

    Article Affiliation:

    Department of Medicine, Hs 32, University of Lund, SE-221 85, Lund, Sweden. This email address is being protected from spambots. You need JavaScript enabled to view it.

    Abstract:

    AIMS/HYPOTHESIS:Most studies of diet in glucose intolerance and type 2 diabetes have focused on intakes of fat, carbohydrate, fibre, fruits and vegetables. Instead, we aimed to compare diets that were available during human evolution with more recently introduced ones.

    METHODS:Twenty-nine patients with ischaemic heart disease plus either glucose intolerance or type 2 diabetes were randomised to receive (1) a Palaeolithic ('Old Stone Age') diet (n = 14), based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts; or (2) a Consensus (Mediterranean-like) diet (n = 15), based on whole grains, low-fat dairy products, vegetables, fruits, fish, oils and margarines. Primary outcome variables were changes in weight, waist circumference and plasma glucose AUC (AUC Glucose(0-120)) and plasma insulin AUC (AUC Insulin(0-120)) in OGTTs.

    RESULTS:Over 12 weeks, there was a 26% decrease of AUC Glucose(0-120) (p = 0.0001) in the Palaeolithic group and a 7% decrease (p = 0.08) in the Consensus group. The larger (p = 0.001) improvement in the Palaeolithic group was independent (p = 0.0008) of change in waist circumference (-5.6 cm in the Palaeolithic group, -2.9 cm in the Consensus group; p = 0.03). In the study population as a whole, there was no relationship between change in AUC Glucose(0-120) and changes in weight (r = -0.06, p = 0.9) or waist circumference (r = 0.01, p = 1.0). There was a tendency for a larger decrease of AUC Insulin(0-120) in the Palaeolithic group, but because of the strong association between change in AUC Insulin(0-120) and change in waist circumference (r = 0.64, p = 0.0003), this did not remain after multivariate analysis.

    CONCLUSIONS/INTERPRETATION:A Palaeolithic diet may improve glucose tolerance independently of decreased waist circumference.

  • A Periodic Diet that Mimics Fasting Promotes Multi-System Regeneration, Enhanced Cognitive Performance, and Healthspan. 📎

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    Abstract Title:

    A Periodic Diet that Mimics Fasting Promotes Multi-System Regeneration, Enhanced Cognitive Performance, and Healthspan.

    Abstract Source:

    Cell Metab. 2015 Jul 7 ;22(1):86-99. Epub 2015 Jun 18. PMID: 26094889

    Abstract Author(s):

    Sebastian Brandhorst, In Young Choi, Min Wei, Chia Wei Cheng, Sargis Sedrakyan, Gerardo Navarrete, Louis Dubeau, Li Peng Yap, Ryan Park, Manlio Vinciguerra, Stefano Di Biase, Hamed Mirzaei, Mario G Mirisola, Patra Childress, Lingyun Ji, Susan Groshen, Fabio Penna, Patrizio Odetti, Laura Perin, Peter S Conti, Yuji Ikeno, Brian K Kennedy, Pinchas Cohen, Todd E Morgan, Tanya B Dorff, Valter D Longo

    Article Affiliation:

    Sebastian Brandhorst

    Abstract:

    Prolonged fasting (PF) promotes stress resistance, but its effects on longevity are poorly understood. We show that alternating PF and nutrient-rich medium extended yeast lifespan independently of established pro-longevity genes. In mice, 4 days of a diet that mimics fasting (FMD), developed to minimize the burden of PF, decreased the size of multiple organs/systems, an effect followed upon re-feeding by an elevated number of progenitor and stem cells and regeneration. Bi-monthly FMD cycles started at middle age extended longevity, lowered visceral fat, reduced cancer incidence and skin lesions, rejuvenated the immune system, and retarded bone mineral density loss. In old mice, FMD cycles promoted hippocampal neurogenesis, lowered IGF-1 levels and PKA activity, elevated NeuroD1, and improved cognitive performance. In a pilot clinical trial, three FMD cycles decreased risk factors/biomarkers for aging, diabetes, cardiovascular disease, and cancer without major adverse effects, providing support for the use of FMDs to promote healthspan.

  • A plant-based diet for the prevention and treatment of type 2 diabetes📎

    Abstract Title:

    A plant-based diet for the prevention and treatment of type 2 diabetes.

    Abstract Source:

    J Geriatr Cardiol. 2017 May ;14(5):342-354. PMID: 28630614

    Abstract Author(s):

    Michelle McMacken, Sapana Shah

    Article Affiliation:

    Michelle McMacken

    Abstract:

    The prevalence of type 2 diabetes is rising worldwide, especially in older adults. Diet and lifestyle, particularly plant-based diets, are effective tools for type 2 diabetes prevention and management. Plant-based diets are eating patterns that emphasize legumes, whole grains, vegetables, fruits, nuts, and seeds and discourage most or all animal products. Cohort studies strongly support the role of plant-based diets, and food and nutrient components of plant-based diets, in reducing the risk of type 2 diabetes. Evidence from observational and interventional studies demonstrates the benefits of plant-based diets in treating type 2 diabetes and reducing key diabetes-related macrovascular and microvascular complications. Optimal macronutrient ratios for preventing and treating type 2 diabetes are controversial; the focus should instead be on eating patterns and actual foods. However, the evidence does suggest that the type and source of carbohydrate (unrefined versus refined), fats (monounsaturated and polyunsaturated versus saturated and trans), and protein (plant versus animal) play a major role in the prevention and management of type 2 diabetes. Multiple potential mechanisms underlie the benefits of a plant-based diet in ameliorating insulin resistance, including promotion of a healthy body weight, increases in fiber and phytonutrients, food-microbiome interactions, and decreases in saturated fat, advanced glycation endproducts, nitrosamines, and heme iron.

  • A Randomized controlled trial of the effect of yoga and peer support on glycaemic outcomes in women with type 2 diabetes mellitus: a feasibility study. 📎

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    Abstract Title:

    A Randomized controlled trial of the effect of yoga and peer support on glycaemic outcomes in women with type 2 diabetes mellitus: a feasibility study.

    Abstract Source:

    BMC Complement Altern Med. 2017 Feb 7 ;17(1):100. Epub 2017 Feb 7. PMID: 28173786

    Abstract Author(s):

    Aswathy Sreedevi, Unnikrishnan Ambika Gopalakrishnan, Sundaram Karimassery Ramaiyer, Leelamoni Kamalamma

    Article Affiliation:

    Aswathy Sreedevi

    Abstract:

    BACKGROUND:Type two diabetes is a complex and demanding chronic disease and its impact in a state (Kerala) which leads India in terms of the number of people with Diabetes is profound. Though the male to female ratio among the people with diabetes is roughly equal, women are uniquely and more severely affected. Management of type two Diabetes requires considerable dexterity on the part of the patient to manage drugs, diet and exercise. Therefore, in a low middle-income country like India it is necessary to look at low cost interventions that can empower the patient and build on available resources to help manage diabetes. Hence, we studied the feasibility and effect of two low cost interventions; yoga and peer support on glycaemic and other outcomes among women with type two diabetes.

    METHODS:An open label parallel three armed randomized control trial was conducted among 124 recruited women with Diabetes for three months. Block randomization with a block length of six was carried out with each group having at least 41 women. In the Yoga arm, sessions by an instructor, consisting of a group of postures coordinated with breathing were conducted for an hour, two days a week. In the peer support arm each peer mentor after training visited 13-14 women with diabetes every week followed by a phone call. The meeting was about applying disease management or prevention plans in daily life.

    RESULTS:There was a trend in decline of fasting plasma glucose in the peer and yoga group and of glycosylated haemoglobin (HbA1c) in the yoga group only, though not significant. A significant decrease was observed in diastolic blood pressure and hip circumference in the yoga group. The process indicated that most (80%) of the women in the yoga group attended classes regularly and 90% of the women in the peer group reported that peer mentoring was useful.

    CONCLUSION:The effect of yoga and peer support on glycaemic outcomes was incremental. Longer term studies are necessary to ascertain the benefits shown by this feasibility study.

    TRIAL REGISTRATION:CTRI/2011/12/002227 dated 14/12/2011.

  • A yoga intervention for type 2 diabetes risk reduction: a pilot randomized controlled trial. 📎

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    Abstract Title:

    A yoga intervention for type 2 diabetes risk reduction: a pilot randomized controlled trial.

    Abstract Source:

    BMC Complement Altern Med. 2014 ;14:212. Epub 2014 Jul 1. PMID: 24980650

    Abstract Author(s):

    Kelly A McDermott, Mohan Raghavendra Rao, Raghuram Nagarathna, Elizabeth J Murphy, Adam Burke, Ramarao Hongasandra Nagendra, Frederick M Hecht

    Article Affiliation:

    Kelly A McDermott

    Abstract:

    BACKGROUND:Type 2 diabetes is a major health problem in many countries including India. Yoga may be an effective type 2 diabetes prevention strategy in India, particularly given its cultural familiarity.

    METHODS:This was a parallel, randomized controlled pilot study to collect feasibility and preliminary efficacy data on yoga for diabetes risk factors among people at high risk of diabetes. Primary outcomes included: changes in BMI, waist circumference, fasting blood glucose, postprandial blood glucose, insulin, insulin resistance, blood pressure, and cholesterol. We also looked at measures of psychological well-being including changes in depression, anxiety, positive and negative affect and perceived stress. Forty-one participants with elevated fasting blood glucose in Bangalore, India were randomized to either yoga (n = 21) or a walking control (n = 20). Participants were asked to either attend yoga classes or complete monitored walking 3-6 days per week for eight weeks. Randomization and allocation was performed using computer-generated random numbers and group assignments delivered in sealed, opaque envelopes generated by off-site study staff. Data were analyzed based on intention to treat.

    RESULTS:This study was feasible in terms of recruitment, retention and adherence. In addition, yoga participants had significantly greater reductions in weight, waist circumference and BMI versus control (weight -0.8 ± 2.1 vs. 1.4 ± 3.6, p = 0.02; waist circumference -4.2 ± 4.8 vs. 0.7 ± 4.2, p < 0.01; BMI -0.2 ± 0.8 vs. 0.6 ± 1.6, p = 0.05). There were no between group differences in fasting blood glucose, postprandial blood glucose, insulin resistance or any other factors related to diabetes risk or psychological well-being. There were significant reductions in systolic and diastolic blood pressure, total cholesterol, anxiety, depression, negative affect and perceived stress in both the yoga intervention and walking control over the course of the study.

    CONCLUSION:Among Indians with elevated fasting blood glucose, we found that participation in an 8-week yoga intervention was feasible and resulted in greater weight loss and reduction in waist circumference when compared to a walking control. Yoga offers a promising lifestyle intervention for decreasing weight-related type 2 diabetes risk factors and potentially increasing psychological well-being.

    TRIAL REGISTRATION:ClinicalTrials.gov Identified NCT00090506.

  • Active Commuting and Multiple Health Outcomes: A Systematic Review and Meta-Analysis.

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    Abstract Title:

    Active Commuting and Multiple Health Outcomes: A Systematic Review and Meta-Analysis.

    Abstract Source:

    Sports Med. 2019 Mar ;49(3):437-452. PMID: 30446905

    Abstract Author(s):

    Monica Dinu, Giuditta Pagliai, Claudio Macchi, Francesco Sofi

    Article Affiliation:

    Monica Dinu

    Abstract:

    BACKGROUND:Active commuting is associated with greater physical activity, but there is no consensus on the actual beneficial effects of this type of physical activity on health outcomes.

    OBJECTIVE:To examine the association between active commuting and risk of all-cause mortality, incidence and mortality from cardiovascular diseases, cancer and diabetes through meta-analysis.

    METHODS:A comprehensive search of MEDLINE, Embase, Google Scholar, Web of Science, The Cochrane Library, Transport Research International Documentation database, and reference lists of included articles was conducted. Only prospective cohort studies were included.

    RESULTS:Twenty-three prospective studies including 531,333 participants were included. Participants who engaged in active commuting had a significantly lower risk of all-cause mortality [relative risk (RR) 0.92, 95% CI 0.85-0.98] and cardiovascular disease incidence (RR 0.91; 95% CI 0.83-0.99). There was no association between active commuting and cardiovascular disease mortality and cancer. Participants who engaged in active commuting had a 30% reduced risk of diabetes (RR 0.70; 95% CI 0.61-0.80) in three studies after removal of an outlying study that affected the heterogeneity of the results. Subgroup analyses suggested a significant risk reduction (- 24%) of all-cause mortality (RR 0.76; 95% CI 0.63-0.94) and cancer mortality (- 25%; RR 0.75; 95% CI 0.59-0.895) among cycling commuters.

    CONCLUSION:People who engaged in active commuting had a significantly reduced risk of all-cause mortality, cardiovascular disease incidence and diabetes.

  • Acupuncture Combined with Hydrotherapy in Diabetes Patients with Mild Lower-Extremity Arterial Disease: A Prospective, Randomized, Nonblinded Clinical Study📎

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    Abstract Title:

    Acupuncture Combined with Hydrotherapy in Diabetes Patients with Mild Lower-Extremity Arterial Disease: A Prospective, Randomized, Nonblinded Clinical Study.

    Abstract Source:

    Med Sci Monit. 2018 May 8 ;24:2887-2900. Epub 2018 May 8. PMID: 29735963

    Abstract Author(s):

    Zhengqin Qi, Yan Pang, Lin Lin, Bing Zhang, Juntao Shao, Xiaodong Liu, Xin Zhang

    Article Affiliation:

    Zhengqin Qi

    Abstract:

    BACKGROUND The aim of this pragmatic study was to explore the intervention of acupuncture combined with hydrotherapy and perceived effects in type 2 diabetic patients with recently diagnosed, mild, lower-extremity arterial disease (LEAD) in comparison with a control group. MATERIAL AND METHODS One hundred twenty-six diabetes patients who were diagnosed mild LEAD according to ankle-brachial blood pressure index (ABPI) and peripheral neuropathy symptom were randomly assigned to either an experimental (n=64) or control group (n=62). The experimental group attended and completed (1) a 30-min session of acupuncture in certain selected points, and (2) a 30-min hydrotherapy exercise every 2 days for 15 weeks. The outcome parameters were assessed at baseline, after intervention, and at 6-week follow-up. RESULTS The intervention was associated with an improvement in leg flow conductance and partial physical capacities, including chair-sit-and-reach, the walking impairment questionnaire (WIQ), and physical component summary score (PCS), compared to the control group. The treatment benefits were sustained throughout the 6-week follow-up endpoint. There was no difference in fasting glucose levels, Hb1Ac, blood pressure, or BMI after the intervention. At the endpoint of 6-week follow-up, acupuncture plus hydrotherapy appeared to reduce inflammatory response by decreasing IL-6, TNF-α, malondialdehyde, and SOD, and increasing glutathione. CONCLUSIONS Acupuncture plus hydrotherapy, without significant glycemic-controlling effects in the type 2 diabetic patients with mild LEAD, exerts a measurable benefit in disease-specific physical functions and health-related quality of life.Our results suggest that the combined therapy regulates the inflammatory process and oxidative stress and contributes to immune protection.

  • Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study📎

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    Abstract Title:

    Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study.

    Abstract Source:

    BMJ. 2008 Jun 14;336(7657):1348-51. Epub 2008 May 29. PMID: 18511765

    Abstract Author(s):

    M A Martínez-González, C de la Fuente-Arrillaga, J M Nunez-Cordoba, F J Basterra-Gortari, J J Beunza, Z Vazquez, S Benito, A Tortosa, M Bes-Rastrollo

    Abstract:

    OBJECTIVE: To assess the relation between adherence to a Mediterranean diet and the incidence of diabetes among initially healthy participants.

    DESIGN: Prospective cohort study with estimates of relative risk adjusted for sex, age, years of university education, total energy intake, body mass index, physical activity, sedentary habits, smoking, family history of diabetes, and personal history of hypertension. SETTING: Spanish university department.

    PARTICIPANTS: 13 380 Spanish university graduates without diabetes at baseline followed up for a median of 4.4 years.

    MAIN OUTCOME MEASURES: Dietary habits assessed at baseline with a validated 136 item food frequency questionnaire and scored on a nine point index. New cases of diabetes confirmed through medical reports and an additional detailed questionnaire posted to those who self reported a new diagnosis of diabetes by a doctor during follow-up. Confirmed cases of type 2 diabetes.

    RESULTS: Participants who adhered closely to a Mediterranean diet had a lower risk of diabetes. The incidence rate ratios adjusted for sex and age were 0.41 (95% confidence interval 0.19 to 0.87) for those with moderate adherence (score 3-6) and 0.17 (0.04 to 0.75) for those with the highest adherence (score 7-9) compared with those with low adherence (score<3). In the fully adjusted analyses the results were similar. A two point increase in the score was associated with a 35% relative reduction in the risk of diabetes (incidence rate ratio 0.65, 0.44 to 0.95), with a significant inverse linear trend (P=0.04) in the multivariate analysis.

    CONCLUSION: Adherence to a Mediterranean diet is associated with a reduced risk of diabetes.

  • Adherence to yoga and its resultant effects on blood glucose in Type 2 diabetes: A community-based follow-up study. 📎

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    Abstract Title:

    Adherence to yoga and its resultant effects on blood glucose in Type 2 diabetes: A community-based follow-up study.

    Abstract Source:

    Int J Yoga. 2017 Jan-Apr;10(1):29-36. PMID: 28149065

    Abstract Author(s):

    Praveen Angadi, Aarti Jagannathan, Arun Thulasi, Vinod Kumar, K Umamaheshwar, Nagarathna Raghuram

    Article Affiliation:

    Praveen Angadi

    Abstract:

    AIM:To study the adherence to yoga and its effects on blood glucose parameters in patients with Type 2 Diabetes Mellitus.

    METHODS:A single group longitudinal study over 6 months was conducted at VASK yoga centre, Bangalore. Fasting Blood Sugar, Post Prandial Blood Sugar Levels and Glycosylated Hemoglobin and qualitative in-depth interview of the participants and therapist was conducted at baseline, end of 3(rd) month and end of 6 months; intermediate observations was conducted at the end of every month.

    RESULTS:Adherence to yoga in the community in Bangalore is around 50% over 6 months. Participants who completed the yoga programme had significantly lower HbA1c (end of 3(rd) month). At the end of 6 months yoga adherence was significantly negatively correlated with FBS and stress. Further there was a trend towards those who dropped out having higher FBS, controlling for medication intake, stress levels and diet pattern (OR = 1.027, P = 0.07). Qualitative data revealed that most of the participants joined and completed the yoga programme to help cure their diabetes. Participants who dropped out from the yoga programme gave reasons of travel, ill-health and increased work-load at office.

    CONCLUSIONS:Adherence to yoga has an effect on the blood glucose parameters in diabetes. Hence, strategies to motivate participants to undergo 'lifestyle modification practices' including maximizing adherence to yoga should be the focus to experience any beneficial effects of yoga.

  • Adhering to a t'ai chi program to improve glucose control and quality of life for individuals with type 2 diabetes.

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    Abstract Title:

    Adhering to a t'ai chi program to improve glucose control and quality of life for individuals with type 2 diabetes.

    Abstract Source:

    J Altern Complement Med. 2009 Jun;15(6):627-32. PMID: 19500007

    Abstract Author(s):

    Rhayun Song, Sukhee Ahn, Beverly L Roberts, Eun Ok Lee, You Hern Ahn

    Article Affiliation:

    College of Nursing, Chungnam National University, Daegon 301747, Korea.

    Abstract:

    PURPOSE:This study was to examine the effects of adherence to a 6-month t'ai chi exercise program on glucose control, diabetic self-care activities, and quality of life among individuals with type 2 diabetes.

    METHOD:The data from a quasi-experimental study at multisite health-promotion centers in Korea with pretest and 3- and 6-month post-test measures were used. Ninety-nine (99) adults diagnosed with type 2 diabetes and HbA1c 6.0 or higher were included in the analysis. The t'ai chi intervention consisted of 19 movements from Yang and Sun styles provided twice a week for 6 months. Sixty-two (62) subjects completed both pretest and post-test measures. To achieve the desired outcomes, subjects needed to complete 80% of the sessions of the t'ai chi program, and 31 subjects who met this criteria were compared to those who did not (n = 31). Outcome measures included glucose control (fasting blood sugar, HbA1c), diabetic self-care activities, and quality of life (36-Item Short Form Health Survey, version 2).

    RESULTS:Using repeated measure analysis of variance for baseline, 3 months, and 6 months, the adherent group had greater decline in fasting glucose (interaction effect F = 5.60, df = 2, p<0.05) and HbA1c (interaction effect F = 4.15, df = 2, p<0.05) than the nonadherers. The adherent group performed significantly more diabetic self-care activities (interaction effect F = 5.13, df = 2, p<0.05), and had better quality of life in mental component summary, social functioning, mental health, and vitality as compared to the nonadherent group. The significant differences in quality of life remained after adjusting for self-care activities except for mental health, which was no longer significant.

    CONCLUSION:For those with type 2 diabetes, t'ai chi could be an alternative exercise intervention to increase glucose control, diabetic self-care activities, and quality of life. Whether t'ai chi can reduce or prevent diabetic complications requires further study.

  • An extract of Syzygium aromaticum represses genes encoding hepatic gluconeogenic enzymes.

    Abstract Title:

    An extract of Syzygium aromaticum represses genes encoding hepatic gluconeogenic enzymes.

    Abstract Source:

    J Ethnopharmacol. 2005 Jan 4;96(1-2):295-301. PMID: 15588682

    Abstract Author(s):

    Ratna Chakraborty Prasad, Birger Herzog, Braden Boone, Lauren Sims, Mary Waltner-Law

    Abstract:

    Insulin action is impaired in diabetic patients, which leads to increased hepatic glucose production. Plants and herbs have been used for medicinal purposes, including the treatment of diabetes, for centuries. Since dietary management is a starting point for the treatment of diabetes, it is important to recognize the effect of plant-based compounds on tissues that regulate glucose metabolism, such as the liver. In a recent study, several herbs and spices were found to increase glucose uptake into adipocytes, an insulin-like effect. Our data reveal that Syzygium aromaticum (L.) Merrill and Perry (Myrtaceae) (commonly referred to as clove) extract acts like insulin in hepatocytes and hepatoma cells by reducing phosphoenolpyruvate carboxykinase (PEPCK) and glucose 6-phosphatase (G6Pase) gene expression. Much like insulin, clove-mediated repression is reversed by PI3K inhibitors and N-acetylcysteine (NAC). A more global analysis of gene expression by DNA microarray analysis reveals that clove and insulin regulate the expression of many of the same genes in a similar manner. These results demonstrate that consumption of certain plant-based diets may have beneficial effects for the treatment of diabetes and indicate a potential role for compounds derived from clove as insulin-mimetic agents.

  • Anti-Inflammatory Effect of Exercise Mediated by Toll-Like Receptor Regulation in Innate Immune Cells - A Review.

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    Abstract Title:

    Anti-Inflammatory Effect of Exercise Mediated by Toll-Like Receptor Regulation in Innate Immune Cells - A Review.

    Abstract Source:

    Int Rev Immunol. 2019 Nov 4:1-14. Epub 2019 Nov 4. PMID: 31682154

    Abstract Author(s):

    Nicolas Collao, Isabel Rada, Marc Francaux, Louise Deldicque, Hermann Zbinden-Foncea

    Article Affiliation:

    Nicolas Collao

    Abstract:

    Over the last three decades, the combination of a sedentary lifestyle and excessive food intake has led to a significant increase in the prevalence of obesity. The latter favors a chronic low-grade inflammatory state and an over-activation of the innate immune system, which contribute to insulin resistance and type 2 diabetes. Physical exercise is a powerful preventive tool and treatment for several diseases as it induces metabolic and immune effects that provide health benefits. Exercise is known to reduce inflammation; however, the underlying mechanisms responsible are not fully elucidated. One proposed mechanism is a reduced expression and/or activation of pro-inflammatory toll-like receptors (TLRs) on innate immune cells after exercise, which could contribute to the protective effect of exercise against insulin resistance and the prevention of the development of metabolic diseases. The aim of the present study is therefore to review the current evidence about the anti-inflammatory effects of exercise and toll-like receptors regulation on immune cells in humans. Key PointsObesity leads to a low-grade chronic inflammatory state and an over-activation of the innate immune system that is directly involved in the develop metabolic syndrome.The anti-inflammatory effect of exercise has been previously suggested through the reduction of the expression and/or activation of pro-inflammatory toll-like receptors (TLRs) in innate immune cells, which represent one of the main inflammatory responses triggered by obesityThe underlying mechanisms in which toll-like receptors expression modulate the reduction of chronic inflammation are not fully elucidated.

  • Anti-inflammatory effects of vitamin D and resistance training in men with type 2 diabetes mellitus and vitamin D deficiency: a randomized, double-blinded, placebo-controlled clinical trial.

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    Abstract Title:

    Anti-inflammatory effects of vitamin D and resistance training in men with type 2 diabetes mellitus and vitamin D deficiency: a randomized, double-blinded, placebo-controlled clinical trial.

    Abstract Source:

    J Diabetes Metab Disord. 2019 Dec ;18(2):323-331. Epub 2019 Jun 24. PMID: 31890657

    Abstract Author(s):

    Ali Dadrass, Khalid Mohamadzadeh Salamat, Kamaladdin Hamidi, Kamal Azizbeigi

    Article Affiliation:

    Ali Dadrass

    Abstract:

    Objectives:The present study aimed to investigate the anti-inflammatory effects of vitamin D and resistance training in men with type 2 diabetes mellitus and vitamin D deficiency.

    Design:This study was a randomized, placebo-controlled, double-blinded clinical trial.: IRCT20190204042621N1.

    Participants:Forty-eight patients with type 2 diabetes aged 40-65 (from a total of 52 volunteers in Ardabil diabetes clinic) were randomly assigned to either the vitamin D supplementation with resistance training group (VD + RT: = 12), the resistance training group (RT: = 12), the vitamin D supplementation group (VD: = 12), or the control group (CON: = 12).

    Intervention:The subjects in VD group took vitamin D supplements at 50000 IU per 2 weeks for 3 months; the subjects in RT group exercised 3 times per week for 12 weeks; and the subjects in VD + RT group participated in both treatments. Subjects in CON group were asked to maintain normal daily life pattern for the duration of the study.

    Measurements:Serum Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α) and C-reactive protein (CRP) levels were determined at pre and post-test and the data were compared among the four groups and between two tests (4 × 2) using two-way ANOVA with repeated measures.

    Results:IL-6 decreased significantly ( = 0.001) in all groups (VD + RT = % -71.73, RT = % -65.85, VD = % -61.70). TNF-α decreased significantly ( = 0.001) in VD + RT (% -44.90) and RT (% -40) groups. CRP showed no significant change in any group ( > 0.05).

    Conclusion:Results demonstrated that vitamin D supplementation in addition to resistance training had positive effects on some inflammatory markers in T2D and vitamin D deficient men. Vitamin D supplementation was especially effective when it was complemented with exercise training.

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