A randomized controlled clinical trial investigating the effect of DASH diet on insulin resistance, inflammation, and oxidative stress in gestational diabetes. DASH diet, insulin resistance, and serum hs-CRP in polycystic ovary syndrome: a randomized controlled clinical trial. Effect of alpha-lipoic acid on blood glucose, insulin resistance and glutathione peroxidase of type 2 diabetic patients. Effects of the Dietary Approaches to Stop Hypertension (DASH) Eating Plan on Cardiovascular Risks Among Type 2 Diabetic Patients Effect of Therapeutic Dose of Vitamin D on Serum Adiponectin and Glycemia in Vitamin D-Insufficient or Deficient Type 2 Diabetic Patients Favourable effects of the Dietary Approaches to Stop Hypertension diet on glucose tolerance and lipid profiles in gestational diabetes: a randomised clinical trial. Prudent diet and the risk of insulin resistance. Lowering Uric Acid With Allopurinol Improves Insulin Resistance and Systemic Inflammation in Asymptomatic Hyperuricemia Pre-teen insulin resistance predicts weight gain, impaired fasting glucose, and type 2 diabetes at age 18-19 y: a 10-y prospective study of black and white girls. The Association between Adherence to the Mediterranean Diet and Fasting Indices of Glucose Homoeostasis: The ATTICA Study The effect of ginger powder supplementation on insulin resistance and glycemic indices in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Impact of treatment with oral calcitriol on glucose indices in type 2 diabetes mellitus patients. Effects of high vs low glycemic index of dietary carbohydrate on cardiovascular disease risk factors and insulin sensitivity: the OmniCarb randomized clinical trial. Comparison of glycaemic control over 1 year with pioglitazone or gliclazide in patients with Type 2 diabetes. Population-based incidence rates and risk factors for type 2 diabetes in white individuals: the Bruneck study. Chromium Nicotinate Has No Effect on Insulin Sensitivity, Glycemic Control, and Lipid Profile in Subjects with Type 2 Diabetes
OBJECTIVE To our knowledge , no reports are available indicating the effects of the dietary approaches to stop hypertension ( DASH ) eating plan on insulin resistance , inflammation , and oxidative stress among pregnant women with gestational diabetes mellitus ( GDM ) . This study was design ed to investigate the effects of the DASH diet on insulin resistance , serum high-sensitivity C-reactive protein ( hs-CRP ) and biomarkers of oxidative stress among pregnant women with GDM . METHODS This r and omized controlled clinical trial was performed with 32 pregnant women diagnosed with GDM at 24 to 28 wk gestation . Participants were r and omly assigned to consume either the control ( n = 16 ) or DASH diet ( n = 16 ) for 4 wk . The DASH diet was rich in fruits , vegetables , whole grains , and low-fat dairy products and was low in saturated fats , total fats , cholesterol , refined grains , and sweets , with a total of 2400 mg/d of sodium . The control diet contained 40 % to 55 % of its energy as carbohydrates , 10 % to 20 % as proteins , and 25 % to 30 % as total fats . Fasting blood sample s were taken at baseline and after 4 wk of intervention to measure fasting plasma glucose ( FPG ) , serum insulin , and hs-CRP , homeostasis model of assessment -insulin resistance ( HOMA-IR ) , plasma total antioxidant capacity ( TAC ) , and total glutathione levels ( GSH ) . RESULTS Consumption of the DASH diet compared with the control diet result ed in decreased FPG ( -7.62 versus 3.68 mg/dL ; P = 0.02 ) , serum insulin levels ( -2.62 versus 4.32 μIU/mL , P = 0.03 ) , and HOMA-IR score ( -0.8 versus 1.1 ; P = 0.03 ) . Increased concentrations of plasma TAC ( 45.2 versus -159.2 mmol/L ; P < 0.0001 ) and GSH ( 108.1 versus -150.9 μmol/L ; P < 0.0001 ) also were seen in the DASH group compared with control group . We failed to find a significant difference in mean changes of serum hs-CRP levels between the two diets . Within-group comparisons revealed significant reductions in plasma TAC and GSH levels in the control diet , while a significant increase in these biomarkers in the DASH diet . CONCLUSION Consumption of the DASH diet in pregnant women with GDM had beneficial effects on FPG , serum insulin levels , HOMA-IR score , plasma TAC , and total GSH levels . The effects of this dietary pattern on pregnancy outcomes need to be investigated in future studies UNLABELLED This study was design ed to assess the effects of Dietary Approaches to Stop Hypertension ( DASH ) eating plan on insulin resistance and serum hs-CRP in overweight and obese women with PCOS . This r and omized controlled clinical trial was done on 48 women diagnosed with PCOS . Subjects were r and omly assigned to consume either the control ( n=24 ) or the DASH eating pattern ( n=24 ) for 8 weeks . The DASH diet consisted of 52 % carbohydrates , 18 % proteins , and 30 % total fats . It was design ed to be rich in fruits , vegetables , whole grains , and low-fat dairy products and low in saturated fats , cholesterol , refined grains , and sweets . Sodium content of the DASH diet was design ed to be less than 2 400 mg/day . The control diet was also design ed to contain 52 % carbohydrates , 18 % protein , and 30 % total fat . Fasting blood sample s were taken at baseline and after 8 weeks intervention to measure -insulin resistance and serum hs-CRP levels . -Adherence to the DASH eating pattern , compared to the -control diet , result ed in a significant reduction of serum insulin levels ( -1.88 vs. 2.89 μIU/ml , p=0.03 ) , HOMA-IR score ( -0.45 vs. 0.80 ; p=0.01 ) , and serum hs-CRP levels ( -763.29 vs. 665.95 ng/ml , p=0.009 ) . Additionally , a significant reduction in waist ( -5.2 vs. -2.1 cm ; p=0.003 ) and hip circumference ( -5.9 vs. -1 cm ; p<0.0001 ) was also seen in the DASH group compared with the control group . In conclusion , consumption of the DASH eating pattern for 8 weeks in overweight and obese women with PCOS result ed in the improvement of insulin resistance , serum hs-CRP levels , and abdominal fat accumulation . CLINICAL TRIAL REGISTRATION NUMBER www.i rct .ir : I RCT 201304235623N6 OBJECTIVE To examine the effects of alpha-lipoic acid ( ALA ) treatment over a period of 2 months on fasting blood glucose ( FBG ) , insulin resistance ( IR ) , and glutathione peroxidase ( GH-Px ) activity in type 2 diabetes ( T2DM ) patients . METHODS This study took place in Motahari Clinic , Shiraz , Iran , which is affiliated to Shiraz University of Medical Sciences from May to October 2006 . Type 2 DM patients ( n=57 ) were divided into 2 groups to receive either ALA ( 300 mg daily ) or placebo by systematic r and omization , and were followed-up for 8 weeks . After an overnight fasting and 2 hours after breakfast , patients ' blood sample s were drawn and tested for FBG , 2 hours  PPG , serum insulin level , and GH-Px activity .  RESULTS The result of the study showed a significant decrease in FBG and PPG levels , IR-Homeostasis Model Assessment ( IR-HOMA index ) and GH-Px level in the ALA group . The comparison of differences between FBG and IR at the beginning and at the end of study in the ALA treated group and the placebo group were also significant . CONCLUSION This study supports the use of ALA as an antioxidant in the care of diabetic patients OBJECTIVE To determine the effects of the Dietary Approaches to Stop Hypertension ( DASH ) eating pattern on cardiometabolic risks in type 2 diabetic patients . RESEARCH DESIGN AND METHODS A r and omized crossover clinical trial was undertaken in 31 type 2 diabetic patients . For 8 weeks , participants were r and omly assigned to a control diet or the DASH eating pattern . RESULTS After following the DASH eating pattern , body weight ( P = 0.007 ) and waist circumference ( P = 0.002 ) reduced significantly . Fasting blood glucose levels and A1C decreased after adoption of the DASH diet ( −29.4 ± 6.3 mg/dl ; P = 0.04 and −1.7 ± 0.1 % ; P = 0.04 , respectively ) . After the DASH diet , the mean change for HDL cholesterol levels was higher ( 4.3 ± 0.9 mg/dl ; P = 0.001 ) and LDL cholesterol was reduced ( −17.2 ± 3.5 mg/dl ; P = 0.02 ) . Additionally , DASH had beneficial effects on systolic ( −13.6 ± 3.5 vs. −3.1 ± 2.7 mmHg ; P = 0.02 ) and diastolic blood pressure ( −9.5 ± 2.6 vs. −0.7 ± 3.3 mmHg ; P = 0.04 ) . CONCLUSIONS Among diabetic patients , the DASH diet had beneficial effects on cardiometabolic risks Background : Lower vitamin D status has been reported in diabetic patients . Serum 25-hydroxyvitamin D and adiponectin were inversely associated with type 2 diabetes and insulin resistance . Vitamin D may involve in regulation of the adiponectin levels , which is directly related to insulin sensitivity . Objectives : The aim of this study was to investigate the effect of therapeutic dose of vitamin D on serum adiponectin and insulin resistance in vitamin D-insufficient or deficient type 2 diabetic patients . Material s and Methods : This double-blind , r and omized , clinical trial was conducted on 81 type 2 diabetic patients with vitamin D level of 10 - 30 ng/mL. Intervention was 50000 IU vitamin D or placebo once a week for 8 weeks . At the beginning and end of the study , blood sample s were collected after 12 hours of fasting and serum glucose , insulin , 25-hydroxyvitamin D , and adiponectin were measured . Insulin resistance was calculated by homeostasis model assessment ( HOMA-IR ) . Results : After 8-week intervention , serum 25-hydroxyvitamin D significantly increased and reached the normal levels in patients receiving vitamin D ( P < 0.001 ) and the levels of fasting serum glucose , insulin , and HOMA-IR were significantly decreased ( P = 0.04 , 0.02 and 0.007 , respectively ) . No significant changes were observed in these levels in the placebo group . Significant differences were observed in mean changes in the above-mentioned variables between the two groups ( P = 0.01 , 0.04 and 0.006 , respectively ) . No significant changes were found in serum adiponectin in the vitamin D and placebo groups ( P = 0.83 ) . Conclusions : Therapeutic dose of vitamin D can improve vitamin D status and glycemic indicators . But it seems that an 8-week intervention period was not sufficient to reveal the possible effects of vitamin D on serum adiponectin levels Although gestational diabetes mellitus ( GDM ) is associated with an increased risk of maternal and neonatal morbidity , there is no consensus as to the optimal approach of nutritional management in these patients . The present study was design ed to assess the effect of the Dietary Approaches to Stop Hypertension ( DASH ) eating plan on glucose tolerance and lipid profiles of pregnant women with GDM . The present r and omised controlled clinical trial was performed among thirty-four women diagnosed with GDM at 24 - 28 weeks of gestation . Subjects were r and omly assigned to consume either the control diet ( n 17 ) or the DASH eating pattern ( n 17 ) for 4 weeks . The control diet was design ed to contain 45 - 55 % carbohydrates , 15 - 20 % protein and 25 - 30 % total fat . The macronutrient composition of the DASH diet was similar to the control diet ; however , the DASH diet was rich in fruits , vegetables , whole grains and low-fat dairy products , and contained lower amounts of saturated fats , cholesterol and refined grains with a total of 2400 mg Na/d . Fasting blood sample s were taken at baseline and after 4 weeks of intervention to measure fasting plasma glucose , glycated Hb ( HbA1c ) and lipid profiles . Participants underwent a 3 h oral glucose tolerance tests and blood sample s were collected at 60 , 120 and 180 min to measure plasma glucose levels . Adherence to the DASH eating pattern , compared with the control diet , result ed in improved glucose tolerance such that plasma glucose levels reduced at 60 ( 21·86 v. 20·45 mmol/l , Pgroup = 0·02 ) , 120 ( 22·3 v. 0·2 mmol/l , Pgroup = 0·001 ) and 180 min ( 21·7 v. 0·22 mmol/l , Pgroup = 0·002 ) after the glucose load . Decreased HbA1c levels ( 20·2 v. 0·05 % , Pgroup = 0·001 ) was also seen in the DASH group compared with the control group . Mean changes for serum total ( 20·42 v. 0·31 mmol/l , Pgroup = 0·01 ) and LDL-cholesterol ( 20·47 v. 0·22 mmol/l , Pgroup = 0·005 ) , TAG ( 20·17 v. 0·34 mmol/l , Pgroup = 0·01 ) and total : HDL-cholesterol ratio ( 20·6 ( SD 0·9 ) v. 0·3 ( SD 0·8 ) , Pgroup = 0·008 ) were significantly different between the two diets . Additionally , consumption of the DASH diet favourably influenced systolic blood pressure ( 22·6 v. 1·7 mmHg , Pgroup = 0·001 ) . Mean changes of fasting plasma glucose ( 20·29 v. 0·15 mmol/l , Pgroup = 0·09 ) were nonsignificant comparing the DASH diet with the control diet . In conclusion , consumption of the DASH eating pattern for 4 weeks among pregnant women with GDM result ed in beneficial effects on glucose tolerance and lipid profiles compared with the control diet BACKGROUND AND AIM Diet is a potentially modifiable risk factor for diabetes .  Dietary patterns may exert greater effects on health than individual foods , nutrients or food groups . Data on associations between dietary patterns and the risk of insulin resistance and type  2 diabetes  are sparse . The aim of the study was to examine associations between dietary patterns and the risk of insulin resistance . METHODS AND RESULTS We performed a cross sectional study involving a group of 1018 men and women , sample d from 17 general practice lists in the South of Irel and , with a response rate of 69 % . Participants completed a detailed health and lifestyle question naire and provided fasting blood sample s for analysis of glucose , insulin and lipids . Dietary intake  was assessed using a food frequency question naire . The food frequency question naire was a modification of the UK arm of the European Prospect i ve Investigation into cancer , EPIC study , which was based on that used in the US Nurses ' Health Study . Dietary patterns were assessed by K cluster analysis . Insulin resistance was estimated on the basis of fasting glucose and insulin , using the glucose homeostasis model ( HOMA scores ) . Insulin resistance was defined as the upper quartile of the HOMA scores . Three dietary patterns were identified by cluster analysis ( traditional Irish diet , a prudent diet and an alcohol and convenience foods diet ) . Participants in clusters 1 ( traditional Irish diet ) and 3 ( high alcohol and convenience foods ) had a lower intake of more ' healthy ' food groups ( such as fruit , vegetables , low fat dairy products , poultry , fish and whole grain products ) and higher intake of foods richer in total and SFA content ( such as high fat dairy products , butter , meat and meat products ) . Cluster 2 ( prudent dietary pattern ) was characterized by a higher intake of food groups that are typically recommended in health promotion programs and a lower intake of meat ( read meat ) , meat products , sweets , high fat dairy and white bread ( white bread and unrefined cereal ) . The prudent diet had the lowest HOMA scores in analysis of covariance . The prevalence of insulin resistance in the prudent diet was lower than that in the traditional diet ( OR=0.53 ; 95%CI , 0.33 - 0.85 in fully adjusted analysis ) . CONCLUSION A prudent diet may be associated with enhanced insulin sensitivity and a lower risk of type 2 diabetes Background Hyperuricemia is an independent predictor of impaired fasting glucose and type 2 diabetes , but whether it has a causal role in insulin resistance remains controversial . Here we tested the hypothesis that lowering uric acid in hyperuricemic nondiabetic subjects might improve insulin resistance . Methods Subjects with asymptomatic hyperuricemia ( n = 73 ) were prospect ively placed on allopurinol ( n = 40 ) or control ( n = 33 ) for 3 months . An additional control group consisted of 48 normouricemic subjects .  Serum uric acid , fasting glucose , fasting insulin , HOMA-IR ( homeostatic model assessment of insulin resistance ) , and high-sensitivity C-reactive protein were measured at baseline and at 3 months . Results Allopurinol-treated subjects showed a reduction in serum uric acid in association with improvement in fasting blood glucose , fasting insulin , and HOMA-IR index , as well as a reduction in serum high-sensitivity C-reactive protein . The number of subjects with impaired fasting glucose significantly decreased in the allopurinol group at 3 months compared with baseline ( n = 8 [ 20 % ] vs n = 30 [ 75 % ] , 3 months vs baseline , P < 0.001 ) . In the hyperuricemic control group , only glucose decreased significantly and , in the normouricemic control , no end point changed . Conclusions Allopurinol lowers uric acid and improves insulin resistance and systemic inflammation in asymptomatic hyperuricemia . Larger clinical trials are recommended to determine if lowering uric acid can help prevent type 2 diabetes BACKGROUND Identifying early pre-teen predictors of  adolescent weight gain and the development of impaired fasting glucose ( IFG ) and type 2 diabetes ( T2DM ) at age 18 - 19 y could provide avenues for prevention . OBJECTIVE We evaluated possible pre-teen predictors for development of IFG , T2DM , and changes in body mass index at age 18 - 19 y in black and white girls . DESIGN In a prospect i ve cohort study , body habitus and fasting insulin and glucose were measured at ages 9 - 10 and 18 - 19 y , and multiple 3-d diet records were collected . Factors predicting 10-y change in body mass index and development of IFG and T2DM together were assessed . RESULTS In multivariate analyses , 10-y change in homeostatic model assessment of insulin resistance ( HOMA-IR ) and the age 9 - 10 y HOMA-IR x percentage of calories from fat interaction were positive predictors of 10-y changes in body mass index . At age 18 - 19 y , there were 5 incident cases of T2DM , 37 cases of IFG , and 597 noncases . Age 9 - 10 y IFG and HOMA-IR ( or insulin ) , 10-y change in HOMA-IR ( or insulin ) , and the age 9 - 10 y insulin x total caloric intake interaction predicted IFG and T2DM at age 18 - 19 y. CONCLUSIONS Pre-teen IFG , insulin resistance ( and insulin ) , and rapidly increasing insulin resistance during adolescence identifies girls who are at greater risk of future IFG and T2DM . In addition , insulin resistance , interacting with high-fat diets , identifies girls who are at risk of greater weight gain . These findings could open avenues to primary prevention of obesity , IFG , and T2DM in children Objective : We investigated the association between adherence to Mediterranean diet and fasting indices of glucose homoeostasis , in a Greek adult population . Methods : During 2001–2002 we r and omly enrolled 1514 men and 1528 women ( 18–89 years old ) without history of CVD , from the Attica area . Diabetes mellitus ( type 2 ) and impaired fasting glucose ( IFG ) were defined according to the established ADA criteria . Insulin resistance was evaluated by HOMA-IR .  Dietary habits  were assessed through a vali date d food frequency question  naire and a diet score  ( range 0–55 ) was developed ( higher values means greater adherence to the Mediterranean diet ) . Results : The overall prevalence of diabetes type 2 was 7.9 % in men and 6.0 % in women ( P = 0.05 ) . Mean diet score was 26.3 ± 6.8 in normoglycemic , 25.7 ± 6.4 in IFG and 22.2 ± 5.8 in diabetic subjects ( p < 0.001 ) . In normoglycemic subjects who were in the upper tertile of the diet score we observed 7 % lower glucose ( p < 0.05 ) , 5 % lower insulin ( p < 0.05 ) and 15 % lower HOMA-IR ( p < 0.01 ) levels compared to subjects in the lower tertile of the diet score . Additionally , in diabetic/IFG participants who where in the upper tertile of the diet score we observed 15 % lower glucose ( p < 0.05 ) , 15 % lower insulin ( p < 0.05 ) and 27 % lower HOMA-IR ( p < 0.01 ) levels compared to those in the lower tertile . However , multiple regression analysis , adjusted for age , sex , BMI , waist-to-hip ratio , physical activity , smoking status , and presence of hypertension and hypercholesterolemia , confirmed the previous associations in normoglycemic , but not in diabetic/IFG people . Conclusion : An inverse association was observed between adherence to Mediterranean diet  and indices of glucose homeostasis , only in normoglycemic people OBJECTIVE To identify the effect of some herbal products on insulin resistance . Regarding the scientific evidence s existing about ginger , this research was therefore carried out to identify the effect of ginger supplementation on insulin resistance and glycemic indices in diabetes mellitus . METHODS This is a r and omized , double-blind , placebo-controlled trial in which 88 participants affected by diabetes were r and omly assigned into ginger ( GG ) and placebo ( PG ) groups . The GG received 3 one-gram capsules containing ginger powder whereas the PG received 3 one-gram microcrystalline-containing capsules daily for 8 weeks . HbA1c , fructosamine , fasting blood sugar ( FBS ) , fasting insulin , homeostasis model assessment insulin resistance index ( HOMA-IR ) , β-cell function ( β% ) , insulin sensitivity ( S% ) and the quantitative insulin sensitivity check index ( QUICKI ) were assessed before and after the intervention . RESULTS FBS mean showed a decrease of 10.5 % ( p=0.003 ) in the GG whereas the mean had an increase of 21 % in the PG ( p=0.01 ) . Variation in HbA1c mean was in line with that of FBS . Statistical difference was found in the two groups before and after the intervention in terms of median of fasting insulin level , S% and HOMA-IR ( P<0.005 ) . Moreover QUICKI mean increased significantly in the two groups , the mean difference , however , was significantly higher in the GG . CONCLUSIONS The study demonstrated that daily consumption of 3 one-gram capsules of ginger powder for 8 weeks is useful for patients with type 2 diabetes due to FBS and HbA1c reduction and improvement of insulin resistance indices such as QUICKI index INTRODUCTION Type 2 diabetes is a major public health problem . Recent epidemiological evidence also points to a potential association of vitamin D insufficiency with adverse metabolic risks , including that for type 2 diabetes . SUBJECTS AND METHOD A double-blind r and omized placebo-controlled trial was carried out . Seventy subjects with type 2 diabetes , age 30 - 75 years old , were r and omly assigned in a double-blind fashion to two groups . One group received two capsules of calcitriol ( 0.25 μg 1,25-dihydroxy cholecalciferol per each capsule ) per day . The second group received placebo tablets . At the beginning , middle and the end of the 12 week supplementation trial , serum glucose , insulin , calcium and phosphorous , HbA1c and 25(OH ) vitamin D were measured . RESULTS There was no significant difference between two groups at baseline . At the end of the study , fasting plasma glucose increased in the control group ( p=0.038 ) , while it remained unchanged in calcitriol group . Level of insulin and HbA1c increased significantly in both groups ( p=0.013 and 0.0004 in treatment and control group ) . Regarding insulin resistance indices , there was a significant change in HOMA-IR and QUICKI in both groups ( p=0.023 and 0.002 in treatment and 0.001 and < 0.001 in control group respectively ) . Insulin secretion as assessed by HOMA-%β , remained relatively unchanged in the control group , while it increased significantly in the treatment group at the end of study ( p=0.009 ) . CONCLUSION Vitamin D supplementation attenuated the increase in glycemia , and increased insulin secretion , but had no effect on insulin resistance IMPORTANCE Foods that have similar carbohydrate content can differ in the amount they raise blood glucose . The effects of this property , called the glycemic index , on risk factors for cardiovascular disease and diabetes are not well understood . OBJECTIVE To determine the effect of glycemic index and amount of total dietary carbohydrate on risk factors for cardiovascular disease and diabetes . DESIGN , SETTING , AND PARTICIPANTS R and omized crossover-controlled feeding trial conducted in research units in academic medical centers , in which 163 overweight adults ( systolic blood pressure , 120 - 159 mm Hg ) were given 4 complete diets that contained all of their meals , snacks , and calorie-containing beverages , each for 5 weeks , and completed at least 2 study diets . The first participant was enrolled April 1 , 2008 ; the last participant finished December 22 , 2010 . For any pair of the 4 diets , there were 135 to 150 participants contributing at least 1 primary outcome measure . INTERVENTIONS ( 1 ) A high-glycemic index ( 65 % on the glucose scale ) , high-carbohydrate diet ( 58 % energy ) ; ( 2 ) a low-glycemic index ( 40 % ) , high-carbohydrate diet ; ( 3 ) a high-glycemic index , low-carbohydrate diet ( 40 % energy ) ; and ( 4 ) a low-glycemic index , low-carbohydrate diet . Each diet was based on a healthful DASH-type diet . MAIN OUTCOMES AND MEASURES The 5 primary outcomes were insulin sensitivity , determined from the areas under the curves of glucose and insulin levels during an oral glucose tolerance test ; levels of low-density lipoprotein ( LDL ) cholesterol , high-density lipoprotein ( HDL ) cholesterol , and triglycerides ; and systolic blood pressure . RESULTS At high dietary carbohydrate content , the low- compared with high-glycemic index level decreased insulin sensitivity from 8.9 to 7.1 units ( -20 % , P = .002 ) ; increased LDL cholesterol from 139 to 147 mg/dL ( 6 % , P ≤ .001 ) ; and did not affect levels of HDL cholesterol , triglycerides , or blood pressure . At low carbohydrate content , the low- compared with high-glycemic index level did not affect the outcomes except for decreasing triglycerides from 91 to 86 mg/dL ( -5 % , P = .02 ) . In the primary diet contrast , the low-glycemic index , low-carbohydrate diet , compared with the high-glycemic index , high-carbohydrate diet , did not affect insulin sensitivity , systolic blood pressure , LDL cholesterol , or HDL cholesterol but did lower triglycerides from 111 to 86 mg/dL ( -23 % , P ≤ .001 ) . CONCLUSIONS AND RELEVANCE In this 5-week controlled feeding study , diets with low glycemic index of dietary carbohydrate , compared with high glycemic index of dietary carbohydrate , did not result in improvements in insulin sensitivity , lipid levels , or systolic blood pressure . In the context of an overall DASH-type diet , using glycemic index to select specific foods may not improve cardiovascular risk factors or insulin resistance . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00608049 AIMS To compare long-term ( 1 year ) efficacy and safety of pioglitazone and gliclazide in patients with Type 2 diabetes . METHODS This was a double-blind , multicentre , comparative , parallel group trial in 283 patients with Type 2 diabetes , who were r and omized to receive 1-year treatment with pioglitazone 30 - 45 mg/day or gliclazide 80 - 320 mg/day . Drug dose was titrated on the basis of self-monitored blood glucose ( SMBG ) measurements and HbA1c values . The 1-year changes in HbA1c , fasting blood glucose ( FBG ) , insulin , HOMA-S ( HOmeostatic Model Assessment ) and SMBG were compared . In a subgroup of patients ( n = 10 ) , systemic glucose production and utilization were determined by a combination of isotopic ( deuterated glucose ) and clamp techniques . RESULTS In both groups , there were similar decreases in HbA1c  ( pioglitazone : -0.79 % ; gliclazide : -0.79 % ) and FBG  ( pioglitazone : -1.0 mmol/l ; gliclazide : -0.7 mmol/l ) , whereas the slope of the reduction of fasting blood glucose was different between groups ( P = 0.004 ) . Insulin levels as well as insulin resistance assessed using HOMA-S decreased significantly only after pioglitazone treatment ( -11.94 pmol/l and -1.03 , respectively , both P = 0.002 vs. baseline ) . A significantly greater reduction in systemic glucose production was observed in the pioglitazone group ( -2.48 micromol/kg/min , P = 0.042 ) than in the gliclazide group ( -1.02 micromol/kg/min ) . A few , mild adverse events occurred in both groups . CONCLUSIONS A comparable decrease in HbA1c and FBG was observed with pioglitazone and gliclazide . However , with pioglitazone there was a continuous decrease in FBG over 1 year , whereas gliclazide failed to maintain a similar trend . This favourable effect of pioglitazone was due to its insulin-sensitizing effect and ability to decrease systemic glucose production Incidence rates and risk factors for type 2 diabetes in low-risk population s are not well documented . We investigated these in white individuals who were aged 40 - 79 years and from the population of Bruneck , Italy . Of an age- and sex-stratified r and om sample of 1,000 individuals who were identified in 1990 , 919 underwent an oral glucose tolerance test ( OGTT ) and an assessment of physiological risk factors for diabetes , including insulin resistance ( homeostasis model assessment , HOMA-IR ) , and  postchallenge insulin response  ( Sluiter 's Index ) . Diabetes at baseline by fasting or 2-h OGTT plasma glucose ( World Health Organization criteria , n = 82 ) was excluded , leaving 837 individuals who were followed for 10 years .  Incident cases of diabetes were ascertained by confirmed diabetes treatment or a fasting glucose > or=7.0 mmol/l . At follow-up , 64 individuals had developed diabetes , corresponding to a population -st and ardized incidence rate of 7.6 per 1,000 person-years . Sex- and age-adjusted incidence rates were elevated 11-fold in individuals with impaired fasting glucose at baseline , 4-fold in those with impaired glucose tolerance , 3-fold in overweight individuals , 10-fold in obese individuals , and approximately 2-fold in individuals with dyslipidemia or hypertension . Incidence rates increased with increasing HOMA-IR and decreasing Sluiter 's Index . As compared with normal insulin sensitivity and normal insulin response , individuals with low insulin sensitivity and low insulin response had a sevenfold higher risk of diabetes . Baseline impaired fasting glucose , BMI , HOMA-IR , and Sluiter 's Index were the only independent predictors of incident diabetes in multivariate analyses . We conclude that approximately 1 % of European white individuals aged 40 - 79 years develop type 2 diabetes annually and that " subdiabetic " hyperglycemia , obesity , insulin resistance , and impaired insulin response to glucose are independent predictors of diabetes Objective : To investigate the effect of chromium nicotinate supplementation on insulin sensitivity , glycemic control , and lipid profile in subjects with type 2 diabetes . Material s and Methods : In a double-blind clinical trial , 56 overweight individuals with type 2 diabetes were r and omized into 3 groups : placebo ( NC0 ) , 50 μg ( NC50 ) , and 200 μg ( NC200 ) of chromium as chromium nicotinate .  Chromium status , sensitivity to insulin , glycemic control , and lipid profile were assessed at the beginning of the study and 45 days and 90 days after . Results : In the beginning , most subjects showed low concentrations of serum chromium ( 71.88 % ) , regular levels of urinary chromium ( 80.65 % ) , and insulin resistance ( 73.80 % ) . The serum chromium concentrations did not differ among the groups over time ( p = 0.2549 ) . The changes in serum chromium and urine concentrations did not relate to changes in fasting glucose ( p > 0.05 ) . At 90 days of intervention , there was no significant difference between groups in fasting glucose , glycosylated hemoglobin , homeostasis model assessment insulin resistance ( HOMA-IR ) , total cholesterol , and low-density lipoprotein ( LDL ) ; there was increase in homeostasis model assessment β-cell function ( HOMA-β ; p = 0.0349 ) and high-density lipoprotein ( HDL ; p = 0.0425 ) in the NC0 group and a reduction of triglycerides in the NC0 ( p = 0.0177 ) and NC50 ( p = 0.0336 ) groups . Conclusion : Supplementation at 50 and 200 μg of chromium as chromium nicotinate did not promote glycemic control , increase insulin sensitivity , or change the lipid profile of subjects with diabetes
The DASH dietary pattern may lead to an improvement in insulin sensitivity independent of weight loss .
The DASH diet may play an important role in glycemic control in long- term interventions .
OBJECTIVE Type 2 diabetes is a major public health problem .
The Dietary Approaches to Stop Hypertension ( DASH ) eating pattern may contribute to managing risk factors of type 2 diabetes .
The objective of this study was to conduct a systematic review and meta- analysis on r and omized controlled trials ( RCTs ) that examine the effects of DASH diet consumption on the indices of glycemic control such as fasting blood glucose ( FBG ) , serum fasting insulin level , and Homeostatic Model Assessment insulin resistance ( HOMA-IR ) .