Long-term administration of inulin-type fructans has no significant lipid-lowering effect in normolipidemic humans. Effects of High Performance Inulin Supplementation on Glycemic Control and Antioxidant Status in Women with Type 2 Diabetes Inulin supplementation prevents high fructose diet-induced hypertension in rats. Assessing the Effect of High Performance Inulin Supplementation via KLF5 mRNA Expression in Adults with Type 2 Diabetes: A Randomized Placebo Controlled Clinical Trail The fermentable fibre inulin increases postprandial serum short-chain fatty acids and reduces free-fatty acids and ghrelin in healthy subjects. Effects of high performance inulin supplementation on glycemic status and lipid profile in women with type 2 diabetes: a randomized, placebo-controlled clinical trial. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized trial. The effect of the daily intake of inulin on fasting lipid, insulin and glucose concentrations in middle-aged men and women. Effect of Butyrate and Inulin Supplementation on Glycemic Status, Lipid Profile and Glucagon-Like Peptide 1 Level in Patients with Type 2 Diabetes: A Randomized Double-Blind, Placebo-Controlled Trial. Replacement of glycaemic carbohydrates by inulin-type fructans from chicory (oligofructose, inulin) reduces the postprandial blood glucose and insulin response to foods: report of two double-blind, randomized, controlled trials Ascorbic acid supplementation improves skeletal muscle oxidative stress and insulin sensitivity in people with type 2 diabetes: Findings of a randomized controlled study. A Randomised Crossover Trial: The Effect of Inulin on Glucose Homeostasis in Subtypes of Prediabetes Fish oil supplemented for 9 months does not improve glycaemic control or insulin sensitivity in subjects with impaired glucose regulation: a parallel randomised controlled trial. A Combination of Prebiotic Inulin and Oligofructose Improve Some of Cardiovascular Disease Risk Factors in Women with Type 2 Diabetes: A Randomized Controlled Clinical Trial. Glycemic control in patients with type 2 diabetes mellitus switched from twice-daily immediate-release metformin to a once-daily extended-release formulation. The efficacy of omega-3 fatty acid supplementation on plasma homocysteine and malondialdehyde levels of type 2 diabetic patients. Effect of 6-week course of glucagon-like peptide 1 on glycaemic control, insulin sensitivity, and β-cell function in type 2 diabetes: a parallel-group study
Short-term studies have shown that the addition to diet of inulin-type fructans , a nondigestible carbohydrate , may have a plasma lipid-lowering effect in humans . Whether this beneficial effect persists during long-term administration has not been determined . The study was aim ed at determining whether a prolonged ( 6 months ) administration of inulin-type fructans to healthy subjects has a lipid-lowering action . In a double-blind , r and omized , placebo-controlled study , 17 healthy subjects were studied before and after 6 months of daily administration of placebo ( 8 subjects ) or 10 g of a mix of inulin and oligofructose ( 9 subjects ) . During this 6-month period , they consumed their usual diet and did not modify their everyday way of life . We measured plasma lipid concentrations ; cholesterol synthesis and hepatic lipogenesis ; and adipose tissue and circulating mononuclear cell messenger RNA concentrations of key regulatory genes of cholesterol metabolism . Compared with the administration of placebo , the administration of inulin-type fructans had no effect on plasma triacylglycerol concentrations and hepatic lipogenesis and induced only a nonsignificant trend for decreased plasma total and low-density lipoprotein cholesterol levels and increased high-density lipoprotein cholesterol concentration . Cholesterol synthesis was not significantly modified . Of all the messenger RNA concentrations measured , none was significantly modified by the administration of inulin-type fructans . In conclusion , contrary to what was observed in short-term studies , we observed no significant beneficial effect of a long-term ( 6-month ) administration of inulin-type fructans on plasma lipids in healthy human subjects Background The purpose of this study was to evaluate the effects of high performance inulin supplementation on blood glycemic control and antioxidant status in women with type 2 diabetes . Methods In a r and omized , triple-blind controlled trial , 49 females ( fiber intake < 30 g/day , 25<body mass index < 35 kg/m2 ) with type 2 diabetes were recruited from the Iran Diabetes Society and from endocrinology and metabolism clinics associated with the Tabriz University of Medical Science . The participants were divided into one of two groups in which the participants either received 10 g/day of inulin ( intervention , n=24 ) or maltodextrin ( control , n=25 ) for 2 months . Fasting blood sample s were obtained and both glycemic control and antioxidant status were determined at baseline and at the end of the study . Results At the end of the study period , there were significant decreases in fasting plasma glucose ( 8.47 % ) , glycosylated hemoglobin ( 10.43 % ) , and malondialdehyde ( 37.21 % ) levels and significant increases in total antioxidant capacity ( 18.82 % ) and superoxide dismutase activity ( 4.36 % ) in the inulin group when compared to the maltodextrin group ( P<0.05 ) . Changes in fasting insulin , homeostasis model assessment of insulin resistance , and catalase activity were not significant in the inulin group when compared with the maltodextrin group . Glutathione peroxidase activity remained unchanged in both groups . Conclusion Inulin supplementation may improve some glycemic and antioxidant indices and decrease malondialdehyde levels in women with type 2 diabetes . Further investigations are needed in order to confirm the positive effects that inulin may have on the glycemic and antioxidant indices of patients with type 2 diabetes BACKGROUND & AIMS The aim of this experiment was to evaluate the potential beneficial effect of supplementation with different inulin-type fructan fractions against common features of the metabolic syndrome in a rat model of this syndrome ( fructose-fed rat ) . METHODS Forty Wistar rats were r and omly divided into five groups and the animals received for 4 weeks either a semi-purified starch or fructose-based diet , or diets in which fructose was partially substituted with various fructans : 10 g/100 g of long-chain inulin or oligofructose , or an oligofructose-enriched inulin . After this period , blood pressure was measured and sample s of blood and tissues were collected for selected biochemical analyses . RESULTS As compared to the starch-fed group , the fructose-fed rats presented : hypertriglyceridemia , hypertension , increased susceptibility to heart peroxidation and renal damages . Long-chain inulin and oligofructose-enriched inulin supplementation prevented fructose induced elevated blood pressure , susceptibility to heart peroxidation and renal damages . All inulin-type fructans containing diets prevented fructose induced hypertriglyceridemia . CONCLUSIONS These results suggest that supplementation with inulin-type fructans is efficient against fructose induced hypertension and that effects are most pronounced for long-chain inulin and oligofructose-enriched inulin . We hypothesize that the anti-hypertensive effect of inulin could be explained by the reduction of the high fructose induced oxidative stress Purpose : The worldwide prevalence of metabolic disorders such as diabetes is increasing rapidly . Currently , the complications of diabetes are the major health concern . The aim of this study was to investigate the effect of high performance ( HP ) inulin supplementation on glucose homeostasis via KLF5 mRNA expression in adults with type 2 diabetes . Methods : In the present clinical trial conducted for a duration of 6 weeks , 46 volunteers diabetic patients referring to diabetes clinic in Tabriz , Iran , were r and omly assigned into intervention ( n= 23 , consuming 10 gr/d HP inulin ) and control groups ( n= 23 , consuming 10 gr/ d starch ) . We assessed glycemic and anthropometric indices , blood lipids and plasmatic level of miR-375 as well as KLF5 mRNA expression before and after the intervention . Results : Findings indicated that inulin supplementation significantly decreased fasting plasma glucose ( FPG ) in comparison to the placebo group ( P<0.001 ) . Also Intra-group and between group results showed that inulin supplementation result ed in significant decrease in KLF5 mRNA expression in peripheral blood mononuclear cells ( P BMC s ) ( Fold change : 0.61± 0.11 ; P-value= 0.001 ) and significant increase in plasmatic level of miR-375 ( Fold change : 3.75± 0.70 ; P-value=0.004 ) . Conclusion : Considering the improvements of FPG level in diabetic patients , it seems that HP inulin supplementation may be beneficial in controlling diabetes via the expression of some genes . However , further studies are needed to achieve concise conclusions It is thought that diets high in dietary fibre are associated with reduced risk for type 2 diabetes  , at least in part because the short-chain fatty acids ( SCFAs ) produced during the colonic fermentation of fibre beneficially influence circulating concentrations of free-fatty acids ( FFAs ) and gut hormones involved in the regulation of blood glucose and body mass . However , there is a paucity of data showing this sequence of events in humans . Thus , our objective was to determine the effect of the fermentable fibre inulin on postpr and ial glucose , insulin , SCFA , FFA , and gut hormone responses in healthy subjects . Overnight fasted healthy subjects ( n = 12 ) were studied for 6 h after consuming 400 mL drinks , containing 80 g high-fructose corn syrup ( 80HFCS ) , 56 g HFCS ( 56HFCS ) , or 56 g HFCS plus 24 g inulin ( Inulin ) , using a r and omized , single-blind , crossover design . A st and ard lunch was served 4 h after the test drink . Glucose and insulin responses after Inulin did not differ significantly from those after 80HFCS or 56HFCS . Serum acetate , propionate , and butyrate were significantly higher after Inulin than after HFCS drinks from 4 - 6 h. FFAs fell at a similar rate after all 3 test drinks , but were lower after Inulin than after 56HFCS at 4 h ( 0.40 + /- 0.06 vs. 0.51 + /- 0.06 mmol*L-1 ; p < 0.05 ) . Compared with 56HFCS , Inulin significantly increased plasma glucagon-like peptide-1 concentrations at 30 min , and reduced ghrelin at 4.5 h and 6 h. The results are consistent with the hypothesis that dietary fibre increases the production of colonic SCFAs , which may reduce type 2 diabetes risk by reducing postpr and ial FFAs and favorably affecting gut hormones , which regulate food intake BACKGROUND Type 2 diabetes mellitus , as a noncommunicable disease , is the main public health challenge in the 21st century . The prevalence of diabetes mellitus adjusted for the world population in Iran was 8 % until the year 2010.Lipid levels are considered as important parameters to be evaluated , as high serum lipid levels are often reported as a complication in patients with diabetes mellitus . It is cl aim ed that functional foods may improve complications of diabetes mellitus , so this study was design ed to evaluate the effects of high performance inulin on glycemic status and lipid profile of women with type 2 diabetes . METHODS The study was a r and omized controlled clinical trial . Forty-nine type 2 diabetic females ( fiber intake < 30g/d , 25 < BMI < 35 kg/m2 ) were divided into two groups . Patients in the intervention group ( n=24 ) received 10g/d inulin and patients in the control group ( n=25 ) received 10g/d maltodextrin for 8 weeks .  Glycemic status and lipid profile indices were measured pre and post intervention . Data were analyzed using SPSS software ( verision11.5 ) . Paired , unpaired t-test and ANCOVA were used to compare quantitative variables . RESULTS Supplementation with inulin caused a significant reduction in FBS ( 8.50 % ) , HbA1c ( 10.40 % ) , total cholesterol ( 12.90 % ) , triglyceride ( 23.60 % ) , LDL-c ( 35.30 % ) , LDL-c/HDL-c ratio ( 16.25 % ) and TC/HDL-c ratio ( 25.20 % ) and increased HDL-c ( 19.90 % ) . The changes for the control group parameters were not significant at the end of study . CONCLUSION Inulin may help to control diabetes and its complications via improving glycemic and lipid parameters BACKGROUND Pre clinical studies have shown that the combination of chromium picolinate and biotin significantly enhances glucose uptake in skeletal muscle cells and enhances glucose disposal . The present pilot study was conducted to determine if supplementation with chromium picolinate and biotin can improve glycemic control in patients with type 2 diabetes mellitus with suboptimal glycemic control despite use of oral antihyperglycemic agents . METHODS Forty-three subjects with impaired glycemic control ( 2-h glucose > 200 mg/dL ; glycated hemoglobin > or=7 % ) , despite treatments with oral antihyperglycemic agents  , were r and omized to receive 600 microg of chromium as chromium picolinate and biotin ( 2 mg/day ) ( Diachrome ( , Nutrition 21 , Inc. , Purchase , NY ) in addition to their pre study oral antihyperglycemic agent therapy . Measurements of glycemic control and blood lipids were taken at baseline and after 4 weeks . RESULTS After 4 weeks , there was a significantly greater reduction in the total area under the curve for glucose during the 2-h oral glucose tolerance test for the treatment group ( mean change -9.7 % ) compared with the placebo group ( mean change + 5.1 % , P < 0.03 ) . Significantly greater reductions were also seen in fructosamine ( P < 0.03 ) , triglycerides ( P < 0.02 ) , and triglycerides/ high-density lipoprotein cholesterol ratio ( P < 0.05 ) in the treatment group . No significant adverse events were attributed to chromium picolinate and biotin supplementation . CONCLUSIONS This pilot study demonstrates that supplementation with a combination of chromium picolinate and biotin in poorly controlled patients with diabetes receiving antidiabetic therapy improved glucose management and several lipid measurements .  Chromium picolinate/ biotin supplementation may represent an effective adjunctive nutritional therapy to people with poorly controlled diabetes with the potential for improving lipid metabolism The present study was carried out to examine the effect of the daily intake of 10 g inulin on fasting blood lipid , glucose and insulin levels in healthy middle-aged men and women with moderately raised total plasma cholesterol ( TC ) and triacylglycerol ( TAG ) levels .  This study was a double-blind r and omized placebo-controlled parallel study in which fifty-four middle-aged subjects received either inulin or placebo for a period of 8 weeks . Fasting blood sample s were collected before the supplementation period ( baseline sample s 1 and 2 , separated by 1 week ) and at weeks 4 and 8 , with a follow-up at week 12 . Compared with baseline values , insulin concentrations were significantly lower at 4 weeks ( P < 0.01 ) in the inulin group . There was a trend for TAG values , compared with baseline , to be lower in the inulin group at 8 weeks ( P < 0.08 ) returning to baseline concentrations at week 12 . On comparison of the inulin and placebo groups , the fasting TAG responses over the 8-week test period were shown to be significantly different ( P < 0.05 , repeated measures ANOVA ) , which was largely due to lower plasma TAG levels in the inulin group at week 8 . The percentage change in TAG levels in the inulin group during the 8-week study was shown to correlate with the initial TAG level of the subjects ( rs -0.499 , P = 0.004 ) . We therefore conclude that the daily addition of 10 g inulin to the diet significantly reduced fasting insulin concentrations during the 8-week test period and result ed in lower plasma TAG levels , particularly in subjects in whom fasting TAG levels were greater than 1.5 mmol/l . These data support findings from animal studies that fructans influence the formation and /or degradation of TAG-rich lipoprotein particles , and the insulin data are also consistent with recent studies showing attenuation of insulin levels in fructan-treated rats Studies on humans with diabetes mellitus showed that the crosstalk between the intestinal microbiota and the host has a key role in controlling the disease . The aim of this study was to evaluate the effects of sodium butyrate and high performance inulin supplementation simultaneously or singly on glycemic status , lipid profile , and glucagon-like peptide 1 level in adults with type 2 diabetes mellitus . Sixty patients were recruited for the study . The participants were r and omly allocated , using r and omized block procedure , to one of the four treatment groups ( A , B , C , or D ) . Group A received sodium butyrate capsules , group B received inulin supplement powder , group C was exposed to the concomitant use of inulin and sodium butyrate , and group D consumed placebo for 45 consecutive days . Markers of glycemia , lipid profile , and glucagon-like peptide 1 were measured pre- and post-intervention . Dietary supplementation in groups A , B , and C significantly reduced diastolic blood pressure in comparison with the placebo group ( p<0.05 ) . Also , intra-group statistical analysis showed that only treatment with sodium butyrate + inulin ( group C ) significantly reduced fasting blood sugar ( p=0.049 ) and waist to hip ratio ( p=0.020 ) . Waist circumference in groups B and C reduced significantly after the intervention ( p=0.007 and p=0.011 ; respectively ) . The post hoc Tukey tests showed significant increase in glucagon-like peptide 1 concentration in groups A and C in comparison with group D ( p<0.05 ) . The results suggest that inulin supplementation may be useful to diabetic patients and these effects could be increased with butyrate supplement Purpose Inulin-type fructans are recognized as prebiotic dietary fibres and classified as non-digestible carbohydrates that do not contribute to glycaemia . The aim of the present studies was to investigate the glycaemic response ( GR ) and insulinaemic response ( IR ) to foods in which sucrose was partially replaced by inulin or oligofructose from chicory . Methods In a double-blind , r and omized , controlled cross-over design , 40–42 healthy adults consumed a yogurt drink containing oligofructose or fruit jelly containing inulin and the respective full-sugar variants .  Capillary blood glucose and insulin were measured in fasted participants and at 15 , 30 , 45 , 60 , 90 , and 120 min after starting to drink/eat . For each test food , the incremental area under the curve ( iAUC ) for glucose and insulin was calculated and the GR and IR determined . Results Consumption of a yogurt drink with oligofructose which was 20 % reduced in sugars significantly lowered the glycaemic response compared to the full-sugar reference ( iAUC120min 31.9 and 37.3 mmol/L/min , respectively ; p < 0.05 ) . A fruit jelly made with inulin and containing 30 % less sugars than the full-sugar variant likewise result ed in a significantly reduced blood glucose response ( iAUC120min 53.7 and 63.7 mmol/L/min , respectively ; p < 0.05 ) . In both studies , the postpr and ial insulin response was lowered in parallel ( p < 0.05 ) . The reduction of postpr and ial glycaemia was positively correlated to the proportion of sugars replaced by inulin-type fructans ( p < 0.001 ) . Conclusions In conclusion , the studies confirmed that substitution of glycaemic sugars by inulin or oligofructose from chicory may be an effective strategy to reduce the postpr and ial blood glucose response to foods AIM /HYPOTHESIS Skeletal muscle insulin resistance and oxidative stress are characteristic metabolic disturbances in people with type 2 diabetes . Studies in insulin resistant rodents show an improvement in skeletal muscle insulin sensitivity and oxidative stress following antioxidant supplementation . We therefore investigated the potential ameliorative effects of antioxidant ascorbic acid ( AA ) supplementation on skeletal muscle insulin sensitivity and oxidative stress in people with type 2 diabetes . METHODS Participants with stable glucose control commenced a r and omized cross-over study involving four months of AA ( 2 × 500 mg/day ) or placebo supplementation . Insulin sensitivity was assessed using a hyperinsulinaemic , euglycaemic clamp coupled with infusion of 6,6-D2 glucose . Muscle biopsies were measured for AA concentration and oxidative stress markers that included basal measures ( 2',7'-dichlorofluorescin [ DCFH ] oxidation , ratio of reduced-to-oxidized glutathione [ GSH/GSSG ] and F2-Isoprostanes ) and insulin-stimulated measures ( DCFH oxidation ) . Antioxidant concentrations , citrate synthase activity and protein abundances of sodium-dependent vitamin C transporter 2 ( SVCT2 ) , total Akt and phosphorylated Akt ( ser473 ) were also measured in muscle sample s. RESULTS AA supplementation significantly increased insulin-mediated glucose disposal ( delta rate of glucose disappearance ; ∆Rd ) ( p=0.009 ) , peripheral insulin-sensitivity index ( p=0.046 ) , skeletal muscle AA concentration ( p=0.017 ) and muscle SVCT2 protein expression ( p=0.008 ) ; but significantly decreased skeletal muscle DCFH oxidation during hyperinsulinaemia ( p=0.007 ) when compared with  placebo . Total superoxide dismutase activity was also lower following AA supplementation when compared with placebo ( p=0.006 ) . Basal oxidative stress markers , citrate synthase activity , endogenous glucose production , HbA1C and muscle Akt expression were not significantly altered by AA supplementation . CONCLUSIONS /INTERPRETATION In summary , oral AA supplementation ameliorates skeletal muscle oxidative stress during hyperinsulinaemia and improves insulin-mediated glucose disposal in people with type 2 diabetes . Findings implicate AA supplementation as a potentially inexpensive , convenient , and effective adjunct therapy in the treatment of insulin resistance in people with type 2 diabetes Background : Fermentable carbohydrates ( FCHO ) have been shown to improve insulin sensitivity in normoglycaemic and insulin-resistant subjects . However , there are no data on subjects with prediabetes . We aim ed to investigate the effect of the FCHO inulin , on glucose homeostasis in subjects with prediabetes . Methods : In a double-blind and placebo-controlled crossover study , 40 volunteers with prediabetes were r and omly allocated to take 30 g/day of inulin or cellulose for 2 weeks in a crossover trial , following a 4-week dose-escalation run-in . Fasting insulin and glucose were measured for all subjects . Fifteen of the 40 subjects also underwent a meal tolerance test to assess insulin sensitivity , free fatty acids and glucagon-like peptide-1 concentrations . A sub analysis was carried out to examine any differences between the prediabetes subtypes . Results : Inulin was associated with a significant increase in ( 0 - 30 min)incremental AUC ( iAUC ) for insulin ( treatment : p < 0.04 ) and ( 0 - 60 min)iAUC for insulin ( treatment : p < 0.04 ) compared to control . There was a significant reduction in insulin resistance measured by the homeostatic model assessment in the isolated-impaired fasting glucose ( p < 0.05 ) but not in the isolated-impaired glucose tolerance groups ( p = 0.59 ) . Conclusion : The FCHO , inulin , may have unique metabolic effects that are of particular benefit to people at risk of diabetes , which warrant further investigation The effects of fish oil ( FO ) supplementation on glycaemic control are unclear , and positive effects may occur only when the phospholipid content of tissue membranes exceeds 14 % as n-3 PUFA . Subjects ( n 36 , thirty-three completed ) were paired based on metabolic parameters and allocated into a parallel double-blind r and omised trial with one of each pair offered daily either 6 g of FO ( 3·9 g n-3 PUFA ) or 6 g of maize oil ( MO ) for 9 months . Hyperinsulinaemic-euglycaemic-euaminoacidaemic ( HIEGEAA ) clamps ( with [ 6,6 2H2 glucose ] ) were performed at the start and end of the intervention . Endogenous glucose production ( EGP ) and whole-body protein turnover ( WBPT ) were each measured after an overnight fast . The primary outcome involved the effect of oil type on insulin sensitivity related to glycaemic control . The secondary outcome involved the effect of oil type on WBPT . Subjects on  FO ( n 16 ) had increased erythrocyte n-3 PUFA concentrations > 14 % , whereas subjects on MO ( n 17 ) had unaltered n-3 PUFA concentrations at 9 % . Type of oil had no effect on fasting EGP , insulin sensitivity or total glucose disposal during the HIEGEAA clamp . In contrast , under insulin-stimulated conditions , total protein disposal ( P=0·007 ) and endogenous WBPT ( P=0·001 ) were both increased with FO . In an associated pilot study ( n 4 , three completed ) , although n-3 PUFA in erythrocyte membranes increased to > 14 % with the FO supplement , the enrichment in muscle membranes remained lower ( 8 % ; P<0·001 ) . In conclusion , long-term supplementation with FO , at amounts near the safety limits set by regulatory authorities in Europe and the USA , did not alter glycaemic control but did have an impact on WBPT PURPOSE This trial was conducted to evaluate the effects of oligofructose-enriched inulin on some of cardiovascular disease risk factors in women with type 2 diabetes . METHODS 52 females ( 25 < BMI < 35 kg/m2 ) with type 2 diabetes were r and omly assigned to two groups . Participants received 10g/d oligofructose-enriched inulin ( n=27 ) or 10g/d placebo ( n=25 ) for 8 weeks . Fasting blood sample s were taken to measure metabolic profiles , malondialdehyd and antioxidant enzymes at baseline and after the 8 weeks intervention . Paired , unpaired sample t-test and analysis of covariance were used to comparison of quantitative variables . RESULTS After 8 weeks , in the oligofructose-enriched inulin group there was a significant increase in total antioxidant capacity ( 0.2 mmol/l , 20.0 % ) and a significant decrease in fasting plasma glucose ( 19.2 mg/dL , 9.4 % ) HbA1c ( 0.5 % , 8.4 % ) , total cholesterol ( TC ) ( 28.0 mg/dL , 14.1 % ) , low-density lipoprotein cholesterol ( LDL-c ) ( 22.0 mg/dL , 21.7 % ) , TC/HDL-c ratio ( 0.73 , 20.7 % ) , LDL-c/HDL-c ratio ( 0.55 , 27.5 % ) and malondialdehyd ( 1.7 nmol/ml , 39.7 % ) compared to the placebo group . Changes in concentrations of triglycerides , high-density lipoprotein cholesterol ( HDLc ) , superoxide dismutase , catalase and glutathione peroxidase were not significant in oligofructose-enriched inulin group compared to the placebo group . CONCLUSION Oligofructose-enriched inulin may improve glycemic indices , lipid profile , antioxidant status and malondialdehyd in women with type 2 diabetes BACKGROUND The extended-release formulation of metformin ( MXR ) prolongs drug absorption in the upper gastrointestinal tract and permits once-daily dosing in patients with type 2 diabetes mellitus . This newer formulation may enhance patient compliance with oral therapy and improve long-term control of diabetes compared with the conventional immediate-release formulation of metformin ( MIR ) . OBJECTIVE The goal of this study was to determine the effects on glycemic control of a switch to MXR therapy in patients with type 2 diabetes currently treated with MIR .  METHODS This was a multicenter , r and omized , double-blind , parallel-group study in patients with established type 2 diabetes . Eligible patients were to have a glycated hemoglobin ( HbA1c ) value < or = 8.5 % and mean fasting plasma glucose ( FPG ) concentrations < or = 200 mg/dL while receiving MIR 500 mg BID for at least 8 weeks . After a 2-week , single-blind lead-in period , patients were r and omly assigned to receive MXR 1000 or 1500 mg QD for 24 weeks or to continue MIR 500 mg BID for 24 weeks . The primary efficacy variable was change in HbA1c from baseline to week 12 . Other variables included change in FPG levels ; change in HbA1c ; distribution of HbA1c values ; mean daily blood glucose concentrations ( self-monitored ) ; levels of fructosamine , serum insulin , and lipids ; and body weight . RESULTS Two hundred seventeen patients were r and omized to treatment . The mean change from baseline in HbA1c values at weeks 12 and 24 were small and similar in the 3 treatment groups . At week 12 , the mean change from baseline in HbA1c was 0.15 % for MIR , 0.23 % for MXR 1000 mg , and 0.04 % for MXR 1500 mg . The corresponding mean changes at week 24 were 0.06 % , 0.25 % , and 0.14 % . CONCLUSIONS In this study , patients with type 2 diabetes who had been receiving twice-daily MIR  achieved comparable glycemic control when therapy was switched to once-daily MXR at the same or a greater total daily dose BACKGROUND AND AIMS Cardiovascular diseases are the major cause of mortality among diabetic patients . The concentration of malondialdehyde ( MDA ) and homocysteine is believed to play a role in cardiovascular diseases . Omega-3 fatty acid supplementation could be effective in some diabetes complications and in the control of the glycemic index . However , it may increase lipid peroxidation . The objective of this study was to determine the effect of omega-3 fatty acids on the concentration of homocysteine and MDA in diabetic patients . METHODS AND RESULTS A r and omized double-blind , placebo-controlled clinical trial was conducted on 81 patients with type 2 diabetes . The patients were r and omly assigned to either the treatment or control groups . Each subject received three capsules of omega-3 fatty acids or a placebo every day for a period of 2months . The two groups were similar in terms of body mass index and food intake . At the beginning of the study and after 2months of supplementation their levels of HbA(1)c , homocysteine , MDA , C-reactive protein ( CRP ) , total cholesterol , LDL-cholesterol and fasting blood sugar ( FBS ) were determined . Due to omega-3 fatty acid supplementation , homocysteine was changed significantly in both treatment and control groups up to -3.10mumol/L and 0.10mumol/L respectively , and HbA(1)c decreased by 0.75 % in the treatment group and increased by 0.26 % in the control group . However , the changes in fasting blood sugar ( FBS ) , malondialdehyde ( MDA ) , C-reactive protein ( CRP ) , total cholesterol and LDL-cholesterol levels were not significant . CONCLUSION The consumption of omega-3 fatty acid supplements ( 3g/day ) for 2months decreases the levels of homocysteine in diabetic patients with no change in FBS , MDA and CRP levels BACKGROUND Glucagon-like peptide 1 ( GLP-1 ) has been proposed as a treatment for type 2 diabetes . We have investigated the long-term effects of continuous administration of this peptide hormone in a 6-week pilot study . METHODS 20 patients with type 2 diabetes were alternately assigned continuous subcutaneous infusion of GLP-1 ( n=10 ) or saline ( n=10 ) for 6 weeks . Before ( week 0 ) and at weeks 1 and 6 , they underwent beta-cell function tests ( hyperglycaemic clamps ) , 8 h profiles of plasma glucose , insulin , C-peptide , glucagon , and free fatty acids , and appetite and side-effect ratings on 100 mm visual analogue scales ; at weeks 0 and 6 they also underwent dexascanning , measurement of insulin sensitivity ( hyperinsulinaemic euglycaemic clamps ) , haemoglobin A(1c ) , and fructosamine . The primary endpoints were haemoglobin A(1c ) concentration , 8-h profile of glucose concentration in plasma , and beta-cell function ( defined as the first-phase response to glucose and the maximum insulin secretory capacity of the cell ) . Analyses were per protocol . FINDINGS One patient assigned saline was excluded because no veins were accessible . In the remaining nine patients in that group , no significant changes were observed except an increase in fructosamine concentration ( p=0.0004 ) . In the GLP-1 group , fasting and 8 h mean plasma glucose decreased by 4.3 mmol/L and 5.5 mmol/L ( p<0.0001 ) . Haemoglobin A(1c ) decreased by 1.3 % ( p=0.003 ) and fructosamine fell to normal values ( p=0.0002 ) . Fasting and 8 h mean concentrations of free fatty acids decreased by 30 % and 23 % ( p=0.0005 and 0.01 , respectively ) . Gastric emptying was inhibited , bodyweight decreased by 1.9 kg , and appetite was reduced . Both insulin sensitivity and beta-cell function improved ( p=0.003 and p=0.003 , respectively ) . No important side-effects were seen . INTERPRETATION GLP-1 could be a new treatment for type 2 diabetes , though further investigation of the long-term effects of GLP-1 is needed
Moreover , subgroup analyses suggested that the effects of glycemic control were significantly influenced by the sex of the subjects and the type and the method of intake of ITF .
Conclusions Our analyses confirmed that these four main glycemic indicators were significantly reduced by ITF supplementation , particularly in the prediabetes and T2DM population .
Evidence supports that reasonable administration of ITF supplementation may have potential clinical value as an adjuvant therapy for prediabetes and T2DM management .
Background Currently , many clinical trials have shown that inulin-type fructans ( ITF ) supplementation is associated with glycemic control ; nevertheless , the results are inconclusive .
The aim of this meta- analysis of r and omized controlled trials was to assess the effects of ITF supplementation on glycemic control .