Consumption of Synbiotic Bread Decreases Triacylglycerol and VLDL Levels While Increasing HDL Levels in Serum from Patients with Type-2 Diabetes The Consumption of Synbiotic Bread Containing Lactobacillus sporogenes and Inulin Affects Nitric Oxide and Malondialdehyde in Patients with Type 2 Diabetes Mellitus: Randomized, Double-Blind, Placebo-Controlled Trial Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Effectiveness of randomized control trial of mobile phone messages on control of fasting blood glucose in patients with type-2 diabetes mellitus in a Northern State of India Fasting blood glucose and risk of coronary heart disease, stroke, and all-cause mortality: a 17-year follow-up study of men born in 1913. Comparing the Effects of 8-Week Treatment With Fluoxetine and Imipramine on Fasting Blood Glucose of Patients With Major Depressive Disorder Effects of synbiotic food consumption on glycemic status and serum hs-CRP in pregnant women: a randomized controlled clinical trial Randomized controlled clinical trial of a combination therapy of vildagliptin plus an α-glucosidase inhibitor for patients with type II diabetes mellitus Association of fasting glucose levels with incident atherosclerotic cardiovascular disease: An 8‐year follow‐up study in a Chinese population SYNbiotics Easing Renal failure by improving Gut microbiologY (SYNERGY): a protocol of placebo-controlled randomised cross-over trial Effect of alpha-lipoic acid on blood glucose, insulin resistance and glutathione peroxidase of type 2 diabetic patients. A randomized controlled clinical trial of vildagliptin plus metformin combination therapy in patients with type II diabetes mellitus Diabetes, Fasting Glucose Levels, and Risk of Ischemic Stroke and Vascular Events Effect of pharmaceutical care on clinical outcomes of outpatients with type 2 diabetes mellitus Mushroom and dietary selenium intakes in relation to fasting glucose levels in a free-living Italian adult population: the Moli-sani Project. Synbiotic Food Consumption Reduces Levels of Triacylglycerols and VLDL, but not Cholesterol, LDL, or HDL in Plasma from Pregnant Women Effect of symbiotic supplementation on glycemic control, lipid profiles and microalbuminuria in patients with non-obese type 2 diabetes: a randomized, double-blind, clinical trial Therapeutic comparison of metformin and sulfonylurea, alone and in various combinations. A double-blind controlled study.
To our knowledge , no reports are available indicating the favorable effects of synbiotic bread consumption on blood lipid profiles among patients with type 2 diabetes mellitus ( T2DM ) . This study was conducted to evaluate the effects of the daily consumption of synbiotic bread on blood lipid profiles of patients with T2DM . This r and omized double-blinded controlled clinical trial was performed with 78 diabetic patients , aged 35–70 years . After a 2-week run-in period , subjects were r and omly assigned to consume either synbiotic ( n = 26 ) , probiotic ( n = 26 ) or control bread ( n = 26 ) for 8 weeks . The synbiotic bread contained viable and heat-resistant probiotic Lactobacillus sporogenes ( 1 × 108 CFU ) and 0.07 g inulin ( HPX ) as prebiotic per 1 g. The probiotic bread contained L. sporogenes ( 1 × 108 CFU ) per 1 g. Patients were asked to consume the synbiotic , probiotic and control breads three times a day in a 40 g package for a total of 120 g/day . Biochemical measurements including blood lipid profiles were conducted before and after 8 weeks of intervention . Consumption of the synbiotic bread , compared to the probiotic and control breads , led to a significant decrease in serum TAG ( P = 0.005 ) , VLDL-C ( P = 0.005 ) , TC/HDL-C ( P = 0.002 ) and a significant increase in serum HDL-C levels ( P = 0.01 ) . No significant effect of synbiotic bread consumption on FPG , TC , LDL-C and non-HDL-C levels was seen compared to the probiotic and control breads ( P > 0.05 ) . Trial registry code : http://www.i rct .ir I RCT 201311215623N13 Objectives : To our knowledge , no reports are available indicating the effects of synbiotic bread consumption on nitric oxide ( NO ) , biomarkers of oxidative stress , and liver enzymes among patients with type 2 diabetes mellitus ( T2DM ) . This study was performed to determine the effects of the daily consumption of synbiotic bread on NO , biomarkers of oxidative stress , and liver enzymes in patients with T2DM . Methods : This r and omized , double-blind , placebo-controlled trial was performed among 81 patients with diabetes , aged 35–70 years old . After a 2-week run-in period , patients were r and omly divided into 3 groups : group A ( n = 27 ) received synbiotic bread containing viable and the heat-resistant probiotic Lactobacillus sporogenes ( 1 × 108 CFU ) and 0.07 g inulin per 1 g , group B ( n = 27 ) received probiotic bread containing Lactobacillus sporogenes ( 1 × 108 CFU ) , and group C ( n = 27 ) received control bread for 8 weeks . Patients were asked to consume the synbiotic , probiotic , or control breads 3 times a day in 40 g packages for a total of 120 g/day . Fasting blood sample s were taken at baseline and after an 8-week intervention for quantificationof related markers . Results : After 8 weeks , the consumption of synbiotic bread compared to the probiotic and control breads result ed in a significant rise in plasma NO ( 40.6 ± 34.4 vs 18.5 ± 36.2 and −0.8 ± 24.5 µmol/L , respectively , p < 0.001 ) and a significant reduction in malondialdehyde ( MDA ) levels ( −0.7 ± 0.7 vs 0.6 ± 1.7 and 0.5 ± 1.5 µmol/L , respectively , p = 0.001 ) . We did not find any significant effect of the synbiotic bread consumption on plasma total antioxidant capacity ( TAC ) , plasma glutathione ( GSH ) , catalase , serum liver enzymes , calcium , iron , magnesium levels , and blood pressure compared to the probiotic and control breads . Conclusion : In conclusion , consumption of the synbiotic bread for 8 weeks among patients with T2DM had beneficial effects on plasma NO and MDA levels ; however , it did not affect plasma TAC , GSH , catalase levels , serum liver enzymes , calcium , iron , magnesium levels , and blood pressure BACKGROUND New diagnostic criteria for diabetes based on fasting blood glucose ( FBG ) level were approved by the American Diabetes Association . The impact of using FBG only has not been evaluated thoroughly . The fasting and the 2-hour glucose ( 2h-BG ) criteria were compared with regard to the prediction of mortality . METHODS Existing baseline data on glucose level at fasting and 2 hours after a 75-g oral glucose tolerance test from 10 prospect i ve European cohort studies including 15 388 men and 7126 women aged 30 to 89 years , with a median follow-up of 8.8 years , were analyzed . Hazards ratios for death from all causes , cardiovascular disease , coronary heart disease , and stroke were estimated . RESULTS Multivariate Cox regression analyses showed that the inclusion of FBG did not add significant information on the prediction of 2h-BG alone ( P>.10 for various causes ) , whereas the addition of 2h-BG to FBG criteria significantly improved the prediction ( P<.001 for all causes and P<.005 for cardiovascular disease ) . In a model including FBG and 2h-BG simultaneously , hazards ratios ( 95 % confidence intervals ) in subjects with diabetes on 2h-BG were 1.73 ( 1.45 - 2.06 ) for all causes , 1.40 ( 1.02 - 1.92 ) for cardiovascular disease , 1.56 ( 1.03 - 2.36 ) for coronary heart disease , and 1.29 ( 0.66 - 2.54 ) for stroke mortality , compared with the normal 2h-BG group . Compared with the normal FBG group , the corresponding hazards ratios in subjects with diabetes on FBG were 1.21 ( 1.01 - 1.44 ) , 1.20 ( 0.88 - 1.64 ) , 1.09 ( 0.71 - 1.67 ) , and 1.64 ( 0.88 - 3.07 ) , respectively . The largest number of excess deaths was observed in subjects who had impaired glucose tolerance but normal FBG levels . CONCLUSION The 2h-BG is a better predictor of deaths from all causes and cardiovascular disease than is FBG Limited availability of r and omized control trial warranted the conduct of a present study to demonstrate the effectiveness of mobile phone-based short message services ( SMSs ) on reduction in mean fasting blood glucose ( FBG ) in patients with type-2 diabetes mellitus . A total of 955 patients were recruited from primary and secondary health-care facilities and r and omized to intervention ( 479 ) and control ( 476 ) group . Messages were delivered to patients for 12 months tailoring to their recent FBG values . SMS included information to maintain the desired FBG levels and next due date for FBG assessment . Patients were statistically similar for their age , socioeconomic status , smoking , and alcohol use . After the intervention , an average FBG declined from 163.7 to 152.8 mg/dl ( P = 0.019 ) in intervention and from 150.5 to 149.2 mg/dl ( P = 0.859 ) in control group . Adjusted for the baseline FBG , the intervention was found to be significantly effective ( odds ratio : 1.7 ; 95 confidence interval : 1.2–2.6 ) This report concerns the relationship between baseline levels of fasting blood glucose ( FBG ) in non-diabetics and the subsequent 17-year incidence of coronary heart disease ( CHD ) , stroke and all-cause mortality .  In 1963 , 973 men aged 50 years were recruited from a general Swedish urban population for a prospect i ve study of risk factors for CHD . Eight hundred and fifty-five ( 88 % ) men agreed to participate and have been observed for 17 years . The 832 men who had no history of myocardial infa rct ion , stroke , diabetes mellitus or who had a fasting blood glucose below 7.0 mmol/l at baseline were selected for this analysis . CHD occurred in 106 men , 35 developed a stroke and 137 died during follow-up . When quintiles and deciles of the FBG distribution were considered , no trend of 17-year incidence of CHD , stroke or death was apparent . However , for men with an FBG above the 95th percentile ( greater than 5.7 mmol/l ) a non-significant trend towards increasing risk was indicated Abstract : This study was design ed to compare the effects of fluoxetine and imipramine on fasting blood glucose ( FBG ) in patients with major depressive disorder . Sixty nondiabetic patients with major depressive disorder ( based on Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition criteria ) entered this r and omized , double-blind study . Patients did not receive any medication affecting serum FBG levels for at least 2 weeks before the initiation of the study . Patients were assigned to receive 20 to 40 mg/d of fluoxetine or 75 to 200 mg/d of imipramine for 8 weeks . Pregnant women and patients with diabetes mellitus and a history of any major heart disease were excluded from this study . Additionally , none of the patients should have received electroconvulsive therapy within 6 months before the initiation of the antidepressants . FBG levels were measured at the initiation , as well as 4 and 8 weeks after starting antidepressants . Nineteen patients in the fluoxetine and 24 patients in the imipramine groups completed the study . In the fluoxetine group , FBG level was decreased from 88.5 mg/dL ( baseline ) to 85.0 mg/dL at week 4 ( P = 0.73 ) , and to 79.8 mg/dL at week 8 ( P < 0.001 ) . On the other h and , in the imipramine group , FBG level was increased from 86.96 mg/dL ( baseline ) to 89.71 mg/dL at week 4 ( P = 0.079 ) , and to 96.90 mg/dL at week 8 ( P < 0.001 ) . This 8-week study showed that FBG levels may decrease in depressive patients receiving fluoxetine and may increase in those patients treated with imipramine . Therefore , it is suggested to measure and monitor FBG before initiation and during treatment with fluoxetine and imipramine OBJECTIVE : The aim of this study was to determine the effects of synbiotic food consumption on glycemic status and serum high sensitivity C-reactive protein ( hs-CRP ) levels of Iranian pregnant women . DESIGN : This r and omized placebo-controlled clinical trial was performed among 52 pregnant women , primigravida , aged 18–35 year old , in their third trimester . After a 2-wk run-in period , subjects were r and omly assigned to consume either a synbiotic ( n=26 ) or control food ( n=26 ) for 9 weeks . The synbiotic food consisted of a probiotic Lactobacillus sporogenes ( 1 × 107 CFU ) , 0.04 g inulin as prebiotic with 0.38 g isomalt , 0.36 g sorbitol and 0.05 g stevia as sweetener per 1 g. Control food ( the same substance without probiotic bacteria and inulin ) was packed in identical 9-gram packages . Patients were asked to consume the synbiotic and control foods two times a day . Fasting blood sample s were taken at baseline and after a 9-wk intervention for quantification of related factors . RESULTS : Consumption of a synbiotic food did not show any significant change regarding the impact of insulin actions in the synbiotic group ; nonetheless , compared to the control food , it result ed in a significant decrease in serum insulin levels ( −0.26 vs. 6.34 µIU/mL , P=0.014 ) and HOMA-IR ( −0.13 vs. 1.13 , P=0.033 ) , a significant difference in HOMA-B ( 5.30 vs. 34.22 , P=0.040 ) and a significant rise in QUICKI score ( 0.002 vs. −0.02 , P=0.022 ) . CONCLUSIONS : Consumption of a synbiotic food for 9 weeks by pregnant women had beneficial effects on insulin actions compared to the control food , but did not affect FPG and serum hs-CRP concentrations 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 BACKGROUND Identification of the population at high risk of developing  atherosclerotic cardiovascular disease ( ASCVD ) is critical for its prevention . The aim of the present study was to evaluate the use of  fasting blood glucose ( FBG )  to predict ASCVD . METHODS In all , 18 610 participants , aged 35 - 74 years at enrollment , were included in this prospect i ve study . Baseline information was collected using a st and ardized question naire , physical examinations , and laboratory tests . During follow-up , disease status and vital information were up date d. Cox proportional hazards regression analysis was used to estimate associations , with normal FBG ( 70 - 99 mg/dL ) as the reference group . Anthropometric measurements , socioeconomic status , and conventional cardiovascular risk factors were included in the multivariate-adjusted model . RESULTS After 7.8 years follow-up ( 145 223 person-years ) , there were 519 cases of ASCVD . The multivariate-adjusted hazard ratios ( HR ) , with 95 % confidence intervals ( CI ) , for ASCVD in patients with low FBG ( < 70 mg/dL ) , impaired fasting glucose ( IFG ; 100 - 125 mg/dL ) , and diabetes ( ≥126 mg/dL , use of antidiabetic medication and /or self-report ) were 1.35 ( 0.84 , 2.15 ) , 1.02 ( 0.81 , 1.27 ) , and 1.68 ( 1.26 , 2.23 ) , respectively . Although IFG was associated with the development of diabetes ( multivariate-adjusted HR 3.67 ; 95 % CI 3.20 , 4.21 ) , it was only associated with incident ASCVD in the univariate model ( HR 1.52 ; 95 % CI 1.23 , 1.88 ) . The association of diabetes with coronary heart disease was more pronounced than that with stroke . Gender and residential differences were also identified . CONCLUSIONS In the present study , IFG was associated with the development of diabetes but not incident ASCVD . Prevention strategies to reduce the development of diabetes in people with IFG are critical to improve cardiovascular health Background Emerging evidence suggests modulating the microbiota in the large bowel of patients with chronic kidney disease ( CKD ) through pre- and /probiotic supplementation may inhibit the development of key nephrovascular toxins . To date , quality intervention trials investigating this novel treatment in CKD are lacking . The aim of SYNERGY is to assess the effectiveness of synbiotics ( co-administration of pre- and probiotics ) as a potential treatment targeting the synthesis of uremic toxins , specifically , indoxyl sulphate ( IS ) and p-cresyl sulphate ( PCS ) . Methods / design Thirty-seven patients with moderate to severe CKD ( Stage IV and V , pre-dialysis ) will be recruited to a double-blind , placebo-controlled , r and omised cross-over trial . Patients will be provided with synbiotic therapy or placebo for 6 weeks , with a 4 week washout before cross-over . The primary outcome is serum IS , total and free ( unbound ) concentrations , measured using ultra-performance liquid chromatography . Secondary outcomes include serum PCS , total and free ( unbound ) concentrations ; cardiovascular risk , measured by serum lipopolysaccharides , serum trimethylamine-N-oxide ( TMAO ) and inflammation and oxidative stress markers ; kidney damage , measured by 24 hour proteinuria and albuminuria , estimated glomerular filtration rate and renal tubule damage ( urinary kidney injury molecule-1 ) ; patients ’ self assessed quality of life ; and gastrointestinal symptoms . In addition , the effects on the community structure of the stool microbiota will be explored in a subset of patients to vali date the mechanistic rationale underpinning the synbiotic therapy . Discussion IS and PCS are two novel uremic toxins implicated in both cardiovascular disease ( CVD ) and progression of CKD . Preliminary studies indicate that synbiotic therapy maybe a promising strategy when considering a targeted , tolerable and cost-efficient therapy for lowering serum IS and PCS concentrations . This trial will provide high quality ‘ proof-of-concept ’ data to eluci date both the efficacy of synbiotic therapy for lowering the toxins and whether reductions in serum IS and PCS translate into clinical benefits . Considering the potential of pre- and probiotics to not only shift toxin levels , but to also impede CVD and CKD progression , SYNERGY will provide vital insight into the effectiveness of this innocuous nutritional therapy . Trial Registration Universal Trial Number : U1111 - 1142 - 4363 . Australian New Zeal and Clinical Trials Registry Number : ACTRN12613000493741 , date registered : 2nd May 2013 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 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 —There is insufficient r and omized trial data to support evidence -based recommendations for tight control of fasting blood glucose ( FBG ) among diabetic subjects in primary stroke prevention . We explored the relationship between FBG among diabetic subjects and risk of ischemic stroke in a multiethnic prospect i ve cohort . RESEARCH DESIGN AND METHODS —Medical and social data and FBG values were collected for 3,298 stroke-free community residents : mean age ± SD was 69 ±10 years ; 63 % were women , 21 % were white , 24 % were black , and 53 % were Hispanic ; and follow-up was 6.5 years .  Baseline FBG levels were categorized : 1 ) elevated FBG : history of diabetes and FBG ≥126 mg/dl ( 7.0 mmol/l ) ; 2 ) target FBG : history of diabetes and FBG < 126 mg/dl ( 7.0 mmol/l ) ; or 3 ) no diabetes/reference group . Cox models were used to calculate hazard ratios ( HRs ) and 95 % CI for ischemic stroke and vascular events . RESULTS —In the Northern Manhattan Study , 572 participants reported a history of diabetes and 59 % ( n = 338 ) had elevated FBG . Elevated FBG among diabetic subjects was associated with female sex ( P < 0.04 ) , Medicaid ( P = 0.01 ) , or no insurance ( P = 0.03 ) . We detected 190 ischemic strokes and 585 vascular events . Diabetic subjects with elevated FBG ( HR 2.7 [ 95 % CI 2.0–3.8 ] ) were at increased risk of stroke , but those with target FBG levels ( 1.2 [ 0.7–2.1 ] ) were not , even after adjustment . A similar relationship existed for vascular events : elevated FBG ( 2.0 [ 1.6–2.5 ] ) and target FBG ( 1.3 [ 0.9–1.8 ] . CONCLUSIONS —This prospect i ve cohort study provides evidence for the benefits of tighter glucose control for primary stroke prevention 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 AIM Mushrooms are known to be a major food source of selenium , a mineral associated with diabetes prevalence . This study aim ed to evaluate the relationship between mushroom and dietary selenium intakes  and blood glucose levels in a free-living adult Italian population . METHODS A total of 6879 men and 6891 women ( aged 53.1±11.0years ) with neither diabetes nor on special diets were analyzed from the population r and omly recruited for the Moli-sani study . The European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) food frequency question naire was used for dietary assessment . Fasting blood glucose ( FBG ) levels were measured from fasting serum sample s , and diabetes prevalence was determined according to American Diabetes Association diagnostic criteria . RESULTS In men , an increase of one ( 30-g ) portion/week in mushroom consumption was associated with a 0.43 - 0.55mmol/L increase in FBG at different levels of adjustment ( P<0.05 ) . In both men and women  , dietary selenium  was positively associated with blood glucose in both unadjusted and fully adjusted models ( P<0.05 for all ) . Both mushroom and dietary selenium  intakes were independently associated with blood glucose on multivariate analyses . In addition , high intakes of both were associated with higher diabetes prevalence in men and women ( OR>1 , P<0.05 ) . CONCLUSION The association of mushroom and selenium intakes  with FBG suggests that mushroom and selenium might each independently increase the risk of diabetes . However , prospect i ve studies are now necessary to confirm this hypothesis To our knowledge , no reports are available indicating the effects of synbiotic food consumption on blood lipid profiles and biomarkers of oxidative stress among pregnant women . This study was conducted to evaluate the effects of daily consumption of a synbiotic food on blood lipid profiles and biomarkers of oxidative stress in pregnant women . This r and omized , double-blind , controlled clinical trial was performed among 52 primigravida pregnant women , aged 18 to 35-year-old at their third trimester . After a 2-week run-in period , subjects were r and omly assigned to consume either a synbiotic ( n = 26 ) or control food ( n = 26 ) for 9 weeks . The synbiotic food consisted of a probiotic viable and heat-resistant Lactobacillus sporogenes ( 1 × 107 CFU ) and 0.04 g inulin (HPX)/g as the prebiotic . Patients were asked to consume the synbiotic and control foods two times a day . Biochemical measurements including blood lipid profiles , plasma total antioxidant capacity ( TAC ) and total glutathione ( GSH ) were conducted before and after 9 weeks of intervention . Consumption of a synbiotic food for 9 weeks result ed in a significant reduction in serum TAG ( P = 0.04 ) , VLDL ( P = 0.04 ) and a significant rise in plasma GSH levels ( P = 0.004 ) compared to the control food . No significant effects of the synbiotic food consumption on serum TC , LDL , HDL and plasma TAC levels ( P > 0.05 ) were observed . Trial registry code : http://www.i rct .ir . I RCT 201212105623N3 Background The prevalent raise of type 2 diabetes ( T2D ) around the globe , are creating higher risk for cardiovascular diseases ( CVDs ) and increasing strain on each country ’s health care budget in the world . Microalbuminuria has appeared as a key parameter in diabetic patients . Microalbuminuria is also related to increased cardiovascular morbidity in people who are non-obese diabetic . Some studies have suggested that consumption of symbiotic foods might help improve the metabolic profile , inflammatory factors and biomarkers of oxidative stress . The aim of trial was to determine the effect of symbiotic supplementation on glycemic control , lipid profiles and microalbuminuria in non-obese T2D . Methods In this r and omized , double-blind , clinical ly controlled trial , 70 patients with T2D ( 28 females , 42 males ) were r and omly divided into two groups ( n = 35 for each group ) . The symbiotic group ( SG ) consumed 500 mg/d of symbiotic supplementations containing probiotics ( Lactobacillus family , Bifidobacterium family , Streptococus thermophilus ) , Prebiotics ( Fructo oligosaccharide ) and B group vitamins ( 1 mg ) , lactose ( 0.5 mg ) , malt-dextrin , magnesium saturate and the placebo group ( PG ) consumed capsules filled with row starch and also B group vitamins ( 1 mg ) , lactose ( 0.5 mg ) , malt-dextrin , magnesium saturate for 9 weeks . Fasting blood glucose ( FBG ) , hemoglobin A1c ( HbA1c ) , blood lipid profiles , 24-h dietary recalls , and anthropometric measurements were measured at the baseline and at the end of trial . SPSS software , version 16 was used to test the data and the results were expressed as mean ± st and ard deviation . Paired sample s T-Test were used to compare continuous variables within groups . Comparison between different groups was performed through two independent sample s T-Test . In the absence of normal distribution , the comparison between the groups was made using non-parametric Wilcoxon on signed ranks and Mann – Whitney tests . P values < 0.05 was considered significant . Results Symbiotic supplementation decreased significantly , FBG ( P = 0.05 ) and HbA1c ( P < 0.01 ) . There were no significant differences in lipid profiles within and between the groups at the end of study ( P > 0.05 ) . Microalbuminuria ( P < 0.05 ) and HbA1c ( P < 0.05 ) are increased significantly in PG at the end of the study . Furthermore , the mean changes of microalbuminuria and HbA1c experienced significant between the two groups . There was significant reduction in urea between two groups from baseline ( P = 0.051 ) . No significant changes in baseline were shown in creatinine among the two groups or within either groups ( P > 0.05 ) . Conclusion The consumption of 500 mg/d symbiotic supplementation for 9 weeks could improve the HbA1c , BMI and Microalbuminuria in T2D . Although , No effect has been indicated on FBS , lipid profiles , urea and creatinine . Trial Registration The trial has been registered in the Iranian Registry of Clinical Trials I RCT 2015072223284N1 , identifier . Registered 21 May 2016 “ retrospectively registered ” 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
Conclusion This meta- analysis suggests that probiotic and synbiotic supplementation may be beneficial in  lowering FBG in adults with high baseline FBG ( ≥7 mmol/L ) and that multispecies probiotics may have more impact on FBG than single species
Purpose  High fasting blood glucose ( FBG ) can lead to chronic diseases such as diabetes mellitus , cardiovascular and kidney diseases .
Consuming probiotics or synbiotics may improve FBG .
A systematic review and meta- analysis of controlled trials was conducted to clarify the effect of probiotic and synbiotic consumption on FBG levels .