Effect of pharmaceutical care on clinical outcomes of outpatients with type 2 diabetes mellitus Ginseng Therapy in Non-Insulin-Dependent Diabetic Patients: Effects on psychophysical performance, glucose homeostasis, serum lipids, serum aminoterminalpropeptide concentration, and body weight Randomized controlled clinical trial of a combination therapy of vildagliptin plus an α-glucosidase inhibitor for patients with type II diabetes mellitus A randomized controlled clinical trial of vildagliptin plus metformin combination therapy in patients with type II diabetes mellitus Glycemic and lipid responses to glucomannan in Thais with type 2 diabetes mellitus. Therapeutic comparison of metformin and sulfonylurea, alone and in various combinations. A double-blind controlled study. Low dose chromium-polynicotinate or policosanol is effective in hypercholesterolemic children only in combination with glucomannan. Konjac Supplement Alleviated Hypercholesterolemia and Hyperglycemia in Type 2 Diabetic Subjects—A Randomized Double-Blind Trial Chinese herbal medicine for impaired glucose tolerance: a randomized placebo controlled trial Safety and Efficacy of Glucomannan for Weight Loss in Overweight and Moderately Obese Adults Impact of Periodic Follow-Up Testing Among Urban American Indian Women With Impaired Fasting Glucose
Background In the People ’s Republic of China , out patients have limited time with their physicians . Thus , compared to in patients , out patients have lower medication adherence and are less knowledgeable about their disease . Objective The objective of this study was to evaluate the effect of pharmaceutical care on clinical outcomes of out patients with type 2 diabetes mellitus ( T2DM ) . Patients and methods A r and omized , controlled , prospect i ve clinical trial was conducted recruiting a total of 240 T2DM out patients from Zhongda Hospital , Southeast University . The control group ( CG ) received only common care from medical staff , whereas the inter vention group ( IG ) received extra pharmaceutical care from clinical pharmacists . Biochemical data such as  blood pressure ( BP ) , fasting blood glucose ( FBG ) , glycosylated hemoglobin A1 ( HbA1c ) , and blood lipid  were collected before and after 6-month intervention . The primary end points in this study were FBG and HbA1c . Results After the intervention , most of the baseline clinical outcomes of the patients in IG significantly improved , while only body mass index , diastolic BP , low-density lipoprotein cholesterol , and total cholesterol ( TC ) improved significantly in patients in the CG . Compared to CG , in IG , there were significant improvements in FBG , HbA1c , TC , the target attainment rates of HbA1c , and BP . Conclusion Pharmaceutical care provided by clinical pharmacists could improve the control of diabetes of out patients , and clinical pharmacists could play an important role in diabetes management OBJECTIVE To investigate the effect of ginseng on newly diagnosed non-insulin-dependent diabetes mellitus ( NIDDM ) patients . RESEARCH DESIGN AND METHODS In this double-blind placebo-controlled study , 36 NIDDM patients were treated for 8 weeks with ginseng ( 100 or 200 mg ) or placebo . Efficacy was evaluated with psychophysical tests and measurements of glucose balance , serum lipids , aminoterminalpropeptide ( PIIINP ) concentration , and body weight . RESULTS Ginseng therapy elevated mood , improved psychophysical performance , and reduced fasting blood glucose ( FBG ) and body weight . The 200-mg dose of ginseng improved glycated hemoglobin , serum PIIINP , and physical activity . Placebo reduced body weight and altered the serum lipid profile but did not alter FBG . CONCLUSIONS Ginseng may be a useful therapeutic adjunct in the management of NIDDM The aim of this study was to assess the efficacy of a combination therapy of vildagliptin plus an α-glucosidase inhibitor for patients with type II diabetes mellitus . Type II diabetic patients exhibiting poor glycemic control following α-glucosidase inhibitor treatment for at least two months were selected and r and omly distributed into vildagliptin and placebo groups . The body weight , fasting blood glucose ( FBG ) , postpr and ial glucose ( PPG ) , glycated hemoglobin ( HBA1c ) and blood lipid levels and hepatorenal functions of the patients were determined before and 12 weeks after the trial . Following the trial , the FBG , PPG , HbA1c , cholesterol ( CHOL ) and triglyceride ( TG ) levels in the vildagliptin group were significantly decreased compared with the pretreatment levels ( P<0.05 ) , whereas only the PPG level in the placebo group decreased ( P<0.05 ) . The FBG , PPG and HbA1c levels in the vildagliptin group were markedly lower than those in the placebo group 12 weeks after the trial . A comparison of the body weights and hepatorenal functions before and after the trial or between groups did not show statistically significant differences . The combination therapy of vildagliptin plus an α-glucosidase inhibitor effectively reduced the FBG , PPG and HbA1c levels in patients without inducing weight gain or hepatorenal dysfunction . However , the therapy may have caused a reduction in the blood lipid levels The aim of the present study was to assess the efficacy and safety of vildagliptin plus metformin combination therapy in patients with type II diabetes mellitus . Type II diabetic patients with poor glycemic control following at least three months of metformin treatment were selected and r and omized into two groups . Vildagliptin or placebo was administered with metformin .  Body weight , fasting blood glucose ( FBG ) , postpr and ial glucose ( PPG ) , glycated hemoglobin ( HbA1c ) , blood lipid and hepatorenal function levels were analyzed in the patients prior to and 24-weeks after the trial . FBG , PPG and HbA1c levels of the patients in the vildagliptin group significantly decreased following the trial , whereas no statistically significant differences were observed in the various indicators of the placebo group prior to and following the trial . The FBG , PPG and HbA1c levels in the vildagliptin group were significantly lower compared with the placebo group 24-weeks after the trial . Comparisons of body weight , blood lipid and hepatorenal function between the groups prior to and following the trial exhibited no statistically significant differences . Therefore , vildagliptin plus metformin combination therapy effectively reduced FBG , PPG and HbA1c levels in patients with no risk of weight gain or hepatorenal dysfunction OBJECTIVE To evaluate the benefits of glucomannan supplement on glycemic and lipid controls in type 2 diabetic patients . MATERIAL AND METHOD A single-blind , placebo-controlled , crossover trial with two treatments separated by a 2-week washout period was performed in 10 men and 10 women with type 2 diabetes mellitus . Two separated protocol s of experiments were sequentially followed . Initially , purified glucomannan ( 1 g ) or placebo was ingested 30 min before 75-g glucose load to evaluate their effects on glucose absorption and insulin secretion in oral glucose tolerance test ( OGTT ) . Later , the glycemic and lipid changes after 4-week intervention with 3 g/day glucomannan comparing to the placebo were determined . The st and ard OGTT was performed before and after ending of each intervention . RESULTS Glucomannan taken before performing the OGTT can lower the rise of blood glucose and insulin from 1 to 2 hour in comparison with the placebo , though a statistically significance of insulin was not achieved . Long-term glucomannan supplement significantly reduced the 120-min glucose area under the curve of OGTT . Glucomannan also decreased the rise of low-density lipoprotein cholesterol ( LDL-C ) . Reductions of HOMA-insulin resistance index and body mass index were detected in glucomannan-treated group though the former was shown only in females . No within- and between-group differences of insulin , fructosamine , and other lipids were observed in glucomannan- nor placebo- treated groups . CONCLUSION In type 2 diabetes , pre-pr and ial glucomannan ingestion attenuated a rise of blood glucose without significantly affecting insulin levels . Long-term supplement of glucomannan to the regular diabetic regimen lessened post challenge glucose AUC and impeded the rise of LDL-C. Supplement of glucomannan may be beneficial to the glycemic and lipid controls in type 2 diabetes mellitus OBJECTIVE To assess and compare the therapeutic efficacy and safety of metformin ( M ) and sulfonylurea ( glyburide , G ) , alone and in various combinations , in patients with non-insulin-dependent diabetes mellitus ( NIDDM ) . RESEARCH DESIGN AND METHODS Of 165 patients ( fasting blood glucose [ FBG ] > or = 6.7 mmol/l ) initially treated with diet alone , 144 ( FBG still > or = 6.7 mmol/l ) were r and omized to double-blind , double-dummy controlled treatment with M , G , or primary combination therapy ( MG ) . The dose was titrated , with FBG < 6.7 mmol/l as target , using , at most , six dose levels . The first three dose levels comprised increasing single-drug therapy ( M or G ) or primary combination at increasing but low dosage ( MGL ) , and the second three levels were composed of various high-dose combinations , i.e. , add-on therapy ( M/G or G/M ) and primary combination escalated to high dosage ( MGH ) . Medication was maintained for 6 months after completed dose titration . RESULTS The FBG target was achieved in 9 % of patients after diet alone . Single-drug therapy  was insufficient in 36 % and MGL in 25 % ( NS ) of the r and omized patients . There was further improvement in glucose control by the high-dose combinations . Mean FBG + /- SE was reduced ( P = 0.001 ) from 9.1 + /- 0.4 to 7.0 + /- 0.2 mmol/l in those maintained on single-drug treatment or low-dose primary combination . Those treated with different high-dose combinations had a large mean FBG reduction , from 13.3 + /- 0.8 to 7.8 + /- 0.6 mmol/l . HbA1c levels showed corresponding reductions , and glycemic levels rose after drug discontinuation . Fasting C-peptide rose during treatment with G and MGL but not with M , while fasting insulin was not significantly changed . Meal-stimulated C-peptide and insulin levels were unchanged by M but increased by G and , to a lesser extent , by MGL . There were no significant insulin or C-peptide differences between the different high-dose combinations ( M/G , G/M , and MGH ) . Body weight did not change following treatment with M or combination but increased by 2.8 + /- 0.7 kg following G alone . Blood pressure was unchanged . Overall effects on plasma lipids were small , with no significant differences between groups . Drug safety was satisfactory , even if the reporting of ( usually modest ) adverse events was high ; the profile , but not the frequency , differed between groups . CONCLUSIONS Dose-effect titrated treatment with either metformin or glyburide promotes equal degrees of glycemic control . The former , but not the latter , is able to achieve this control without increasing body weight or hyperinsulinemia . Near-normal glycemia can be obtained by a combination of metformin and sulfonylurea , even in advanced NIDDM OBJECTIVE A low-fat , fiber-rich diet is the first step in the management for hypercholesterolemic children .  Glucomannan ( GM ) is a natural fiber that has been demonstrated to lower total and LDL-cholesterol . The use of high-dose chromium-polynicotinate ( CP ) and policosanol ( PC ) has also shown cholesterol-lowering benefits . We aim ed at investigating the effects of low-dose CP or PC and their GM combination in hypercholesterolemic children . METHODS A double-blind trial was conducted in 120 children ( 60 M , 60 F , 9 ± 4 years , median 9.6 years , range : 3 - 16 years ) r and omly assigned to 5 neutraceutical and 1 placebo ( only resistant starch ) 8-week treatment groups . Fasting blood glucose ( FBG ) , total cholesterol ( CholT ) , triglycerides ( TG ) , HDL and LDL cholesterol were considered . RESULTS GM combination of low-dose CP or PC  reduced CholT and LDL without changing HDL , TG and FBG . The highest post-treatment changes were seen after GM combination with CP ( CholT 85 ± 3 % and LDL 85 ± 5 % , of pretreatment ) which was significantly ( p < 0.01 ) less than with low-dose CP or PC and starch . When GM was associated with starch , there was no lipid lowering effect , which was an unexpected finding as compared to previous data with GM and no starch . No adverse effects were reported . CONCLUSION This is the first report to show the cholesterol-lowering efficacy  of GM combined treatment with low-dose CP or PC . Further studies are needed to investigate the best combinations and doses of nutraceutics to be added to the st and ard GM treatment . The potential negative association of GM and nutraceutics with starch is clearly shown Objectives : The present study was design ed to evaluate effects of konjac glucomannan ( KGM ) supplement ( 3.6 g/day ) for 28 days on blood lipid and glucose levels in hyperlipidemic type 2 diabetic patients and the possible mechanism for the reductions in blood lipid levels . Methods : Twenty-two diabetic subjects ( age 64.2 + 8.4 years , BMI 25.5 + 3.2 kg/m2 ) with elevated blood cholesterol levels ( fasting glucose between 6.7–14.4 mmol/L ) , but currently not taking lipid-lowering medication , were recruited to participate in a two 28-day period , r and omized , double-blind , crossover clinical trial . Fasting blood sample s drawn on the initial and final days of each period were determined for plasma lipids and glucose levels . Feces collected at the end of each experimental period were analyzed for neutral sterol and bile acid contents . Results : Compared with placebo , KGM effectively reduced plasma cholesterol ( 11.1 % , p = 0.0001 , adjusted α = 0.006 ) , LDL-cholesterol ( 20.7 % , p = 0.0004 , adjusted α = 0.006 ) , total/HDL cholesterol ratio ( 15.6 % , p = 0.0005 , adjusted α = 0.007 ) , ApoB ( 12.9 % , p = 0.0001 , adjusted α = 0.006 ) and fasting glucose ( 23.2 % , p = 0.002 , adjusted α = 0.008 ) . Plasma triglyceride , HDL-cholesterol , LDL/HDL cholesterol , postpr and ial glucose and body weight were not significant after adjustment by the Bonferroni-Hochberg procedure . Fecal neutral sterol and bile acid concentrations were increased by 18.0 % ( p = 0.004 ) and 75.4 % ( p < 0.001 ) , respectively , with KGM supplement . Conclusions : The KGM supplement improved blood lipid levels by enhancing fecal excretion of neutral sterol and bile acid and alleviated the elevated glucose levels in diabetic subjects . KGM could be an adjunct for the treatment of hyperlipidemic diabetic subjects Background Diabetes remains a major health problem worldwide . Low-risk low-cost alternatives to pharmaceutical interventions are needed where lifestyle modifications have failed . We conducted a double-blind r and omised placebo controlled trial to investigate the efficacy of a Chinese herbal formula , Jiangtang Xiaozhi , in treating impaired glucose control and insulin resistance in persons with prediabetes and controlled diabetes . Methods Seventy-one patients with prediabetes or ‘ controlled ’ diabetes were r and omised to receive 3 capsules of Jiangtang Xiaozhi ( n = 39 ) or placebo ( n = 32 ) three times daily for 16 weeks with a follow up eight weeks later ( week 24 ) . The primary outcome was change in glycaemic control as evidence d by fasting blood glucose ( FBG ) , post-pr and ial plasma glucose and glycosylated haemoglobin ( HbA1c ) . Other measures included change in fasting insulin , insulin resistance and sensitivity , lipids , C-reactive protein ( CRP ) , body mass index ( BMI ) , waist girth , blood pressure ( BP ) , health related quality of life ( HRQoL ) and safety . Analysis of covariance ( ANCOVA ) was used to model outcomes at 16 weeks , by treatment group corrected for baseline level of the outcome variable . Results In patients receiving Jiangtang Xiaozhi , FBG was not significantly different ( p = 0.73 ) compared to placebo after 16 weeks of treatment ( 6.3 ± 1.1 mmol/L vs 6.7 ± 1.3 mmol/L ) . There was a significant difference ( p = 0.04 ) in the mean levels of fasting insulin between the treatment group ( 11.6 ± 5.5 mmol/L ) and the placebo group ( 22.1 ± 25.9 mmol/L ) . Insulin resistance slightly decreased in the treatment group ( 1.58 ± 0.74 ) compared to that of the placebo group ( 2.43 ± 1.59 ) but this change did not reach statistical significance ( p = 0.06 ) . Patients taking Jiangtang Xiaozhi had a significant improvement in high-density lipoprotein ( HDL ) level compared to the placebo group at week 16 ( p = 0.03 ) . Mean levels of cholesterol , triglycerides , BMI , waist-girth , HRQoL , BP , CRP and insulin sensitivity were not significantly different between the two groups . The herbal medicine was well tolerated . Conclusions In the current study , the 16 week Jiangtang Xiaozhi treatment did not lower fasting blood glucose , but it improved serum  insulin and HDL cholesterol in a Western population with prediabetes or controlled diabetes . Our trial may have been underpowered . Dosage needs to be considered before commencing a longer adequately powered trial . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12612000128897;https://www.anzctr.org.au/Trial/ Registration /Trial Review Background . Few safe and effective dietary supplements are available to promote weight loss . We evaluated the safety and efficacy of glucomannan , a water-soluble fiber supplement , for achieving weight loss in overweight and moderately obese individuals consuming self-selected diets . Methods . Participants were r and omly assigned to take 1.33 grams of glucomannan or identically looking placebo capsules with 236.6 mL ( 8 ounces ) of water one hour before breakfast , lunch , and dinner for 8 weeks . The primary efficacy outcome was change in body weight after 8 weeks . Other efficacy outcomes were changes in body composition , hunger/fullness , and lipid and glucose concentrations . Safety outcomes included gastrointestinal symptoms/tolerance and serum liver enzymes and creatinine levels . Results . A total of 53 participants ( 18–65 years of age ; BMI 25–35 kg/m2 ) were enrolled and r and omized . The two groups did not differ with respect to baseline characteristics and compliance with the study supplement . At 8 weeks , there was no significant difference between the glucomannan and placebo groups in amount of weight loss ( −.40 ± .06 and −.43 ± .07 , resp . ) or other efficacy outcomes or in any of the safety outcomes . Conclusions . Glucomannan supplements administered over 8 weeks were well tolerated but did not promote weight loss or significantly alter body composition , hunger/fullness , or lipid and glucose parameters . This trial is registered with NCT00613600 Introduction Impaired fasting glucose ( IFG ) often progresses to type 2 diabetes . Given the severity and prevalence of this disease , primary prevention is important . Intensive lifestyle counseling interventions have delayed or prevented the onset of type 2 diabetes , but it is not known whether less intensive , more easily replicable efforts can also be effective . Methods In a lifestyle intervention study design ed to reduce risks for type 2 diabetes , 200 American Indian women without diabetes , aged 18 to 40 years , were recruited from an urban community without regard to weight or IFG and block-r and omized into intervention and control groups on the basis of fasting blood glucose ( FBG ) . Dietary and physical activity behaviors were reported , and clinical metabolic , fitness , and body composition measures were taken at baseline and at periodic follow-up through 18 months . American Indian facilitators used a group- discussion format during the first 6 months to deliver a culturally influenced educational intervention on healthy eating , physical activity , social support , and goal setting . We analyzed a subset of young American Indian women with IFG at baseline ( n = 42 ) , selected from both the intervention and control groups . Results Among the women with IFG , mean FBG significantly decreased from baseline to follow-up ( P < .001 ) and converted to normal ( < 5.6 mmol/L or < 100 mg/dL ) in 62.0 % of the 30 women who completed the 18-month follow-up , irrespective of participation in the group educational sessions . Other improved metabolic values included significant decreases in mean fasting blood total cholesterol and low-density lipoprotein cholesterol levels . The women reported significant overall mean decreases in intake of total energy , saturated fat , total fat , total sugar , sweetened beverages , proportion of sweet foods in the diet , and hours of TV watching . Conclusion Volunteers with IFG in this study benefited from learning their FBG values and reporting their dietary patterns ; they made dietary changes and improved their FBG and lipid profiles . If confirmed in larger sample s , these results support periodic dietary and body composition assessment , as well as glucose monitoring among women with IFG
The use of glucomannan did not appear to significantly alter any other study endpoints .
Pediatric patients , patients receiving dietary modification , and patients with impaired glucose metabolism did not benefit from glucomannan to the same degree .
Glucomannan appears to beneficially affect total cholesterol , LDL cholesterol , triglycerides , body weight , and FBG , but not HDL cholesterol or BP
BACKGROUND Several clinical trials have investigated the impact of glucomannan on plasma lipids , body weight , fasting blood glucose ( FBG ) , and blood pressure ( BP ) , but have yielded conflicting results and had only modest sample sizes .
OBJECTIVE The objective was to perform a meta- analysis of r and omized controlled trials of glucomannan to better characterize its impact on plasma lipids , FBG , body weight , and BP .