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Systematic Reviews Dec 2023To perform an evidence-based evaluation of the clinical efficacy of Taijiquan, Baduanjin, Yijinjing and Wuqinxi in interventions for type 2 diabetes. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To perform an evidence-based evaluation of the clinical efficacy of Taijiquan, Baduanjin, Yijinjing and Wuqinxi in interventions for type 2 diabetes.
DESIGN
A systematic review and network meta-analysis.
METHODS
The comprehensive search included Chinese and other language databases such as the MEDLINE (PubMed), Web of Science, Excerpta Medica Database (Embase), The Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, China Scientific Journal Database, VIP and China Biomedical Literature Database (CBM). Clinical randomized controlled trials of four traditional Chinese exercise therapies in the treatment of type 2 diabetes, including Taijiquan, Baduanjin, Yijinjing and Wuqinxi, were retrieved. The search time was conducted from the establishment of the database to 30 October 2022. Two researchers screened the documents that met the inclusion criteria, extracted data according to the preset table and evaluated the methodological quality of the included studies according to the quality evaluation tools recommended by the Cochrane System Reviewer Manual V.5.1. The R language, Stata and ADDIS statistical software programs were used to conduct statistics and analysis of intervention measures.
RESULTS
A total of 33 randomized controlled trials with 2609 patients were identified. All patients were from China. The results of the network meta-analysis showed that Taijiquan ranked the best for improving HbA1c, 2-h postprandial blood glucose (2hPG), low-density lipoprotein cholesterol (LDL-C) and insulin sensitivity index indicator levels; Yijinjing reduced fasting plasma glucose (FPG) and total cholesterol (TC) indicator levels for the best probability ranking; Baduanjin improved the triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) probability ranking the most. When the training period was less than 12 weeks, Baduanjin had better effects in improving 2hPG, TC, TG, HDL-C and LDL-C indicator levels. Taijiquan had better effects in reducing FPG levels. When the training period was 12 weeks, the effect of Yijinjing in improving FPG, HbAlc, TC and HDL-C levels was better than that in other traditional Chinese exercise, and Taijiquan had better effects in improving 2hPG, TG and LDL-C indicator levels. When the training period was longer than 12 weeks, Taijiquan had better effects in improving FPG, HbAlc, 2hPG and LDL-C indicator levels, and Baduanjin had better effects in improving TC, TG and HDL-C indicator levels.
CONCLUSION
The four traditional Chinese exercise therapies can improve blood glucose levels, blood lipid levels and insulin-related indicators of type 2 diabetes to varying degrees. Studies have shown that Taijiquan has a better targeted treatment effect on type 2 diabetes.
SYSTEMATIC REVIEW REGISTRATION
CRD42020214786.
PROTOCOL PUBLISHED
We published the protocol article "Network meta-analysis of four kinds of traditional Chinese exercise therapy in the treatment of type 2 diabetes: Protocol for a systematic review" in the BMJ Open magazine 2021, Issue 11, Volume 7.
Topics: Humans; Blood Glucose; Cholesterol, LDL; Diabetes Mellitus, Type 2; Exercise Therapy; Network Meta-Analysis; Randomized Controlled Trials as Topic; Systematic Reviews as Topic; Triglycerides
PubMed: 38093392
DOI: 10.1186/s13643-023-02384-1 -
Esophagus : Official Journal of the... Jul 2021Gastroesophageal reflux disease (GERD) is a commonly diagnosed gastrointestinal disorder, with a substantial impact on the quality of life. The underlying... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Gastroesophageal reflux disease (GERD) is a commonly diagnosed gastrointestinal disorder, with a substantial impact on the quality of life. The underlying pathophysiology of GERD is multifactorial and incompletely understood. Abnormal gastric electrical activity, measured using electrogastrography (EGG), may contribute. This study aimed to systematically review and meta-analyse the existing literature in which EGG was used in patients with GERD.
METHODS
Databases were systematically searched for studies using EGG in adults with GERD. The primary outcome was the percentage of recording time in the normogastric frequency range. Secondary outcomes were dominant frequency, dominant power, power ratio and prevalence of any EGG abnormality.
RESULTS
In total, 591 participants (427 patients with GERD; 164 healthy controls) from 13 studies were included. GERD patients spent 17.3% (SMD - 1.18, 95%CI: - 1.84, - 0.52) and 18.7% (SMD - 1.11, 95%CI: - 1.55, - 0.68) less of the preprandial and postprandial recording time in normogastric frequency ranges, respectively, compared to healthy controls. The dominant frequency, dominant power and power ratio were not significantly different to healthy controls in the preprandial and postprandial periods. The pooled prevalence of any EGG abnormality was significantly greater in patients with GERD than in healthy controls [46% (95%CI: 39-64%) vs. 10% (95%CI: 4-23%); p < 0.0001]. Correlations between GERD symptoms and EGG recordings were inconsistently studied. EGG techniques were heterogeneous.
CONCLUSIONS
Consistent abnormalities in gastric slow-wave activity, as measured by EGG, were identified in adults with GERD. Further investigation into these abnormalities using novel emerging electrophysiology techniques is desirable, to better define their contribution toward GERD pathophysiology.
Topics: Adult; Electromyography; Gastroesophageal Reflux; Humans; Postprandial Period; Quality of Life; Stomach
PubMed: 33594598
DOI: 10.1007/s10388-021-00820-6 -
Obesity (Silver Spring, Md.) Aug 2014To assess the effect of dietary pulses (beans, peas, chickpeas, lentils) on acute satiety and second meal intake, a systematic review and meta-analysis was conducted. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the effect of dietary pulses (beans, peas, chickpeas, lentils) on acute satiety and second meal intake, a systematic review and meta-analysis was conducted.
METHODS
MEDLINE, EMBASE, CINAHL, and the Cochrane Registry (through May 6, 2013) were searched for acute controlled trials examining the effect of dietary pulses on postprandial satiety or second meal intake compared with isocaloric controls. Two independent reviewers extracted data and assessed methodological quality and risk of bias. Data were pooled by generic inverse variance random effects models and expressed as ratio of means (RoMs) for satiety and mean differences (MDs) for second meal food intake, with 95% confidence intervals (95% CIs). Heterogeneity was assessed (Q statistic) and quantified (I(2) statistic). Protocol registration: clinicaltrials.gov identifier, NCT01605422.
RESULTS
Nine trials met the eligibility criteria. Dietary pulses produced a 31% greater satiety incremental area under the curve (IAUC) (RoM = 1.31, 95% CI: 1.09 to 1.58, P = 0.004; Phet = 0.96; I(2) = 0%) without affecting second meal intake (MD = -19.94, 95% CI: -75-35, P = 0.48; Phet = 0.01; I(2) = 63%). Our data are limited by the small sample sizes, narrow participant characteristics and significant unexplained heterogeneity among the available trials.
CONCLUSIONS
Pooled analyses show that dietary pulses contribute to acute satiety but not second meal intake.
Topics: Diet; Energy Intake; Fabaceae; Humans; Postprandial Period; Randomized Controlled Trials as Topic; Satiation
PubMed: 24820437
DOI: 10.1002/oby.20782 -
Polskie Archiwum Medycyny Wewnetrznej 2015Prandial insulin is a key component in insulin treatment of type 1 diabetes mellitus (T1DM) and in many patients with type 2 diabetes mellitus (T2DM). The evidence-based... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Prandial insulin is a key component in insulin treatment of type 1 diabetes mellitus (T1DM) and in many patients with type 2 diabetes mellitus (T2DM). The evidence-based data supporting the choice of an insulin preparation are still limited.
OBJECTIVES
We performed a systematic review to summarize and update the evidence on relative efficacy and safety of insulin aspart (IAsp) and regular human insulin (RHI) in both types of diabetes.
METHODS
Randomized controlled trials comparing IAsp with RHI in patients with either T1DM or T2DM and conducted until May 2013 were retrieved from a systematic search of MEDLINE, EMBASE, and Cochrane Library.
RESULTS
Of 16 relevant trials, 11 involved patients with T1DM and 5--with T2DM. In the T1DM population, IAsp, when compared with RHI, provided a greater reduction in hemoglobin A₁c (HbA₁c) levels (weighted mean difference [WMD], -0.11%; 95% confidence interval [CI], -0.16 to -0.05; WMD, -1.2 mmol/mol; 95% CI, -1.7 to -0.5), and improved postprandial glucose levels following breakfast (WMD, -1.40 mmol/l; 95% CI, -1.72 to -1.07), lunch (WMD, -1.01 mmol/l; 95% CI, -1.61 to -0.41), and dinner (WMD, -0.89 mmol/l; 95% CI, -1.19 to -0.59). The risk of nocturnal hypoglycemia was lower in T1DM patients receiving IAsp (relative risk, 0.76; 95% CI, 0.64-0.91), while no difference was observed for severe hypoglycemia. In T2DM patients, IAsp led to a greater reduction in HbA₁c levels (WMD, -0.22%; 95% CI, -0.39 to -0.05; -2.4 mmol/mol, -4.3 to -0.5) and postprandial blood glucose. The risk of overall hypoglycemia and severe adverse effects was comparable between the groups.
CONCLUSIONS
IAsp provides better glycemic control when compared with RHI in patients with T1DM and T2DM. Fewer T1DM patients treated with IAsp experienced nocturnal hypoglycemia, while both interventions showed a comparable risk of severe hypoglycemic events in both types of diabetes.
Topics: Blood Glucose; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Drug Therapy, Combination; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Insulin; Insulin Aspart; Postprandial Period; Randomized Controlled Trials as Topic
PubMed: 25644227
DOI: 10.20452/pamw.2705 -
Surgery For Obesity and Related... Aug 2016Due to the large number of Roux-en-Y gastric bypass surgeries performed over the last decade, reversal of the bypass to normal anatomy has been increasingly reported. (Review)
Review
BACKGROUND
Due to the large number of Roux-en-Y gastric bypass surgeries performed over the last decade, reversal of the bypass to normal anatomy has been increasingly reported.
SETTING
University affiliated Teaching Hospital, United States.
OBJECTIVES
The aim of this systematic review was to summarize the literature data regarding the indications, technical considerations, and outcomes of gastric bypass reversal.
METHODS
PubMed/MEDLINE search was conducted for articles reporting reversal of gastric bypass to normal anatomy. Patients' demographic characteristics, primary reason for reversal, reversal technique, and postreversal events were retrieved and categorized from each eligible paper.
RESULTS
Thirty-five articles encompassing a total of 100 patients were eligible. Malnutrition was the most common indication for reversal (12.3%), followed by severe dumping syndrome (9.4%), postprandial hypoglycemia (8.5%), and excessive weight loss (8.5%). Techniques for gastrogastrostomy were available in 42 patients, with the hand-sewn technique as the most common (67.4%) followed by the linear stapler (23.2%) and the end-to-end anastomosis stapler used in 3 patients (6.9%). The reversal technique was performed endoscopically and described in 3 studies (3 patients). Techniques for handling the Roux limb were described in 56 patients (56%); the limb was reconnected in 32 patients (57.2%) and resected in 24 patients (42.8%). Weight regain was the most prevalent postreversal event (28.8%), followed by severe gastroesophageal reflux diseases (10.2%) and persistent abdominal pain (6.8%). There was no reported mortality.
CONCLUSION
Gastric bypass reversal is indicated for excessive weight loss, dumping syndrome, and postprandial hypoglycemia. The procedure is well tolerated and feasible when performed laparoscopically and has no reported mortality.
Topics: Adult; Dumping Syndrome; Epidemiologic Methods; Feasibility Studies; Female; Gastric Bypass; Gastroesophageal Reflux; Gastroscopy; Gastrostomy; Humans; Hypoglycemia; Laparoscopy; Male; Malnutrition; Middle Aged; Postoperative Complications; Postprandial Period; Reoperation; Weight Loss; Young Adult
PubMed: 27260651
DOI: 10.1016/j.soard.2016.02.023 -
Nutrients May 2023Dietary fiber (DF) consumption has been associated with improved glycemic control in epidemiological and long-term interventional studies. However, its acute effects are... (Review)
Review
Dietary fiber (DF) consumption has been associated with improved glycemic control in epidemiological and long-term interventional studies. However, its acute effects are not yet clear. This systematic review aims to elucidate the postprandial effects of DF in starchy products on glycemia and insulinemia. An electronic search of databases was conducted, and forty-one records met the inclusion criteria and underwent a risk-of-bias assessment. It was shown that soluble DF does not clearly affect glycemia in individuals with normal weight, while resistant starch may be more effective in flattening glycemic responses. Concerning insulinemia, both soluble DF and resistant starch have mixed results, with either favorable or no effects. Data on insoluble DF and glucose metabolism are scarce. The same mixed results for glycemia can be seen in healthy volunteers with overweight/obesity, while resistant starch seems to improve insulinemic responses. Finally, more studies need to examine the acute effects of DF in starchy foods on glucose metabolism and insulin secretion in individuals facing glucose abnormalities. Additionally, more studies are needed to prove whether ingesting high-fiber carbohydrate-containing products per se can result in blunted glycemic and insulinemic responses and which DF type and amount are more effective.
Topics: Humans; Blood Glucose; Dietary Carbohydrates; Insulin; Resistant Starch; Cross-Over Studies; Glucose; Dietary Fiber; Postprandial Period; Glycemic Index
PubMed: 37242267
DOI: 10.3390/nu15102383 -
Frontiers in Nutrition 2021Millets (including sorghum) are known to be highly nutritious besides having a low carbon footprint and the ability to survive in high temperatures with minimal water....
Millets (including sorghum) are known to be highly nutritious besides having a low carbon footprint and the ability to survive in high temperatures with minimal water. Millets are widely recognised as having a low Glycaemic Index (GI) helping to manage diabetes. This systematic review and meta-analyzes across the different types of millets and different forms of processing/cooking collated all evidences. Of the 65 studies that were collected globally, 39 studies with 111 observations were used to analyze GI outcomes and 56 studies were used to analyze fasting, post-prandial glucose level, insulin index and HbA1c outcomes in a meta-analysis. It is evident from the descriptive statistics that the mean GI of millets is 52.7 ± 10.3, which is about 36% lower than in typical staples of milled rice (71.7 ± 14.4) and refined wheat (74.2 ± 14.9). The descriptive, meta and regression analyses revealed that Job's tears, fonio, foxtail, barnyard, and teff were the millets with low mean GI (<55) that are more effective (35-79%) in reducing dietary GI than the control samples. Millets with intermediate GI (55-69) are pearl millet, finger millet, kodo millet, little millet, and sorghum which have a 13-35% lower GI than the control with high GI (>69). A meta-analysis also showed that all millets had significantly ( < 0.01) lower GI than white rice, refined wheat, standard glucose or white wheat bread except little millet which had inconsistent data. Long term millet consumption lowered fasting and post-prandial blood glucose levels significantly ( < 0.01) by 12 and 15%, respectively, in diabetic subjects. There was a significant reduction in HbA1c level (from 6.65 ± 0.4 to 5.67 ± 0.4%) among pre-diabetic individuals ( < 0.01) who consumed millets for a long period. Minimally processed millets were 30% more effective in lowering GI of a meal compared to milled rice and refined wheat. In conclusion, millets can be beneficial in managing and reducing the risk of developing diabetes and could therefore be used to design appropriate meals for diabetic and pre-diabetic subjects as well as for non-diabetic people for a preventive approach.
PubMed: 34395493
DOI: 10.3389/fnut.2021.687428 -
Current Diabetes Reviews Nov 2008Postprandial lipemia has emerged as an independent risk factor for coronary artery disease. In this systematic review we examined the effect of the medications used for... (Review)
Review
Postprandial lipemia has emerged as an independent risk factor for coronary artery disease. In this systematic review we examined the effect of the medications used for the management of diabetes, obesity and dyslipidemia on postprandial lipemia. It should be mentioned that no standardization exists for a test meal and for the duration of observation postprandially to allow for direct comparisons between the published studies. Type 2 diabetes mellitus and insulin resistance are associated with enhanced postprandial lipemia. Insulin is effective in reducing both fasting and post prandial total triglyceride levels as well as triglycerides contained in the triglyceride-rich lipoprotein sub-fractions. Additionally, the newer rapid-acting insulin analogues seem to be more effective in the reduction of postprandial lipemia than the short-acting human insulins. Acarbose ameliorates postprandial lipemia and reduces the atherogenic chylomicron and very low density lipoprotein remnants. Metformin reduces both fasting and postprandial triglyceridemia, fasting and post-prandial free fatty acids and may increase the concentrations of the high density lipoprotein cholesterol. Sulfonylureas reduce fasting and postprandial triglyceride levels while data on the effect on high density lipoprotein levels are inconsistent. The effect of meglitinides on postprandial lipid metabolism is neutral. Rosiglitazone decreases fasting and postprandial free fatty acids but has no significant effect on fasting and postprandial triglycerides. Pioglitazone has additional beneficial effects on lipid metabolism because it reduces postprandial free fatty acids, fasting and postprandial triglycerides and increases high density lipoprotein cholesterol levels. Limited available data suggest that glucagon-like peptide-1 analogues and vildagliptin reduce postprandial lipemia through reduction of intestinally-derived triglycerides. No data exist on the effect of sitagliptin on postprandial lipemia. Orlistat improves postprandial lipemia by reducing the absorption of the dietary fat; no data exist on the effect of sibutramine and rimonabant on the metabolism of lipids in the postprandial state.
Topics: Acarbose; Anti-Obesity Agents; Chylomicrons; Clinical Trials as Topic; Diabetes Mellitus; Diabetes Mellitus, Type 2; Digestion; Humans; Hyperlipidemias; Hypoglycemic Agents; Lipase; Lipids; Obesity; Postprandial Period
PubMed: 18991602
DOI: 10.2174/157339908786241133 -
The Journal of Nutrition Nov 2019It is often assumed that lower postprandial glucose (PPG) and insulin (PPI) responses are induced by slower glucose influx from the gut (e.g., by delayed carbohydrate... (Meta-Analysis)
Meta-Analysis
BACKGROUND
It is often assumed that lower postprandial glucose (PPG) and insulin (PPI) responses are induced by slower glucose influx from the gut (e.g., by delayed carbohydrate digestion). However, changes in the rate of appearance of glucose in the peripheral circulation [rate of appearance of exogenous glucose (RaE)] may be accompanied by changes in endogenous glucose production (EGP) and the rate of disappearance of total glucose into tissues (RdT). The quantitative relationships between reductions in RaE and PPG/PPI levels are unclear.
OBJECTIVES
The objective was to perform a meta-analysis to quantify the effect of changes in RaE on changes in PPG and PPI levels (primary) and EGP and RdT (secondary).
METHODS
We systematically searched the Scopus, Medline, and Cochrane library databases through 10 January 2019 for randomized, controlled, carbohydrate-rich interventions that aimed to reduce RaE in humans, measured using dual or triple stable isotope methods. The 2-h net incremental AUCs for all variables were extracted or calculated. Relationships between RaE and outcomes were quantified by weighted regression analyses.
RESULTS
There were 12 articles, including 17 comparisons, that satisfied the inclusion criteria. The subjects were mainly men (60%), with age and BMI ranges of 18-40 y and 20.0-27.5 kg/m2, respectively. A 10% reduction in RaE was associated with reductions in PPG levels, PPI levels, and the RdT of 7% (95% CI: 2%, 12%; P = 0.010), 8% (95% CI: 2%, 13%; P = 0.012), and 11% (95% CI: 4%, 17%; P = 0.005), respectively, but was not significantly associated with a change in EGP (13%; 95% CI: -7%, 33%; P = 0.176). All fluxes together explained 70% and 26% of the variances in PPG and PPI levels, respectively.
CONCLUSIONS
In adults, reducing glucose RaE by diet is associated with significant reductions in PPG levels, PPI levels, and the rate of glucose disposal. This trial was registered in the PROSPERO database with identifier CRD42018084824.
Topics: Adult; Dietary Carbohydrates; Glucose; Humans; Insulin; Isotopes; Kinetics; Postprandial Period
PubMed: 31291451
DOI: 10.1093/jn/nxz150 -
Chinese Journal of Integrative Medicine Aug 2014To evaluate the efficacy and safety of "Three-Typed Syndrome Differentiation" (TTSD) in treating type 2 diabetes mellitus patients. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the efficacy and safety of "Three-Typed Syndrome Differentiation" (TTSD) in treating type 2 diabetes mellitus patients.
METHODS
A systematic review and meta-analysis was done based on the clinical diabetes treatment literature of the "TTSD". Overseas databases like the PubMed/MEDLINE, EMBASE, Cochrane Library and Cochrane Central Register of Controlled Clinical Trials, and China databases like China Biology Medicine Disc (CBM), Chinese national Knowledge Infrastructure (CNKI), Wanfang database, and VIP database, without limitation on language, were included with the time limitation from Jan 1982 to Dec 2012 by retrieval of relative original clinical research articles.
RESULTS
Nineteen articles where contains 1,840 diabetes patients were obtained, in which no adverse reactions were reported. Of these, 14 literatures involved the effect of fasting blood glucose (FBG), 10 involved that of postprandial 2-h blood glucose (P2hBG), and 19 involved the overall efficacy based on the national Chinese medicine (CM) diagnosis and treatment standard of diabetes. All the meta-analysis results prefer to the "TTSD" groups (CM+Western medicine Based on TTSD). The results show that, beside the efficacy of Western medicine, the concentrations of FBG and P2hBG in "TTSD" groups continue to drop with statistical significance. For "TTSD" groups, the FBG subsequently dropped 1.03 mmol/L, 95%CI [1.24,0.82] P <0.00001), the P2hBG subsequently dropped 1.09 mmol/L, 95% CI [1.61, 0.57] (P <0.0001), and the overall efficacies benefit 3.46 times those of Western medicine alone, 95% CI [2.67,4.48] (P <0.00001).
CONCLUSIONS
The CM by the diagnosis and treatment of type 2 diabetes based on TTSD might be safe and effective, and could better improve both blood glucose and the overall status of patients, including symptoms.
Topics: Blood Glucose; Diabetes Mellitus, Type 2; Fasting; Humans; Medicine, Chinese Traditional; Postprandial Period; Syndrome; Treatment Outcome
PubMed: 23918234
DOI: 10.1007/s11655-013-1462-2