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Results: 19

Exercise or exercise and diet for preventing type 2 diabetes mellitus

Type 2 diabetes is mainly characterised by a reduced ability of the hormone insulin to stimulate glucose uptake in body fat and muscles (insulin resistance) combined with insufficient insulin secretion that leads to increased blood glucose levels. It has been shown that weight reduction and an increase in daily energy expenditure decreases insulin resistance. There are some factors that are associated with an increased risk of type 2 diabetes: these are obesity, previous gestational diabetes, hypertension, family history of type 2 diabetes, dyslipidaemia and some ethnical groups are more at risk. Persons with "prediabetes" are also at high risk: they have abnormal blood glucose levels but not in the range of diabetes. Prediabetes often precedes the development of type 2 diabetes. We searched for trials that intended to prevent the development diabetes type 2 in the above mentioned at risk groups. We assessed the effects of increased physical activity alone or in combination with dietary interventions on diabetes incidence and other outcomes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus

Twenty‐one studies assessing interventions to improve adherence to treatment recommendations, not to diet or exercise, in people with type 2 diabetes in different settings (outpatients, community, hospitals, primary care) were included. There were many outcomes evaluated in these studies and a variety of adherence measurement instruments was used. Nurse led interventions, home aids, diabetes education and pharmacy led interventions showed a very small effect on some outcomes including metabolic control. No data on mortality or morbidity, nor on quality of life could be found.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Dietary advice for the prevention of type 2 diabetes mellitus in adults

Two trials randomised 358 participants to dietary advice and control treatment groups. The longest duration of dietary advice was six years, the only other trial lasted 12 months. Dietary advice appears to be effective in reducing the risk of diabetes by 33% compared to control group over six years. After 12 months, dietary advice appears to beneficially effect indicators of metabolic control. Data on mortality, morbidity, health‐related quality of life, adverse effects and costs were not reported.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Chinese herbal medicines for type 2 diabetes mellitus

We are still waiting for firm evidence on Chinese herbal medicines for treatment of non‐insulin‐dependent diabetes. Although the use of herbal medicines for treatment of diabetes has a long history especially in the East, current evidence cannot warrant to support the routine use in clinical practice. This systematic review evaluates the effects of various herbal preparations (including single herbs or mixtures of different herbs) for treating people with type 2 diabetes. The review shows that some herbal medicines lower blood sugar and relieving symptoms in patients with diabetes. However, the methodological quality of the clinical trials evaluating these herbs is generally poor. The analyses also indicate that trials with positive findings are more likely to be associated with exaggerated effects. However, the trials did not report significant adverse effects. In conclusion, herbal medicines should not be recommended for routine use in diabetic patients of type 2 diabetes until we get scientifically sound trials. Testing the herbs in larger, well‐designed trials is needed in order to establish the necessary evidence for their use.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Zinc supplementation for the prevention of type 2 diabetes mellitus

Currently no evidence to suggest the use of zinc for the primary prevention of type 2 diabetes. Diabetes mellitus is associated with long‐term complications, especially eye, kidney, nerve, heart and blood vessel disease. Type 2 diabetes is mainly characterised by a reduced ability of the hormone insulin to stimulate glucose uptake in body fat and muscles (insulin resistance) and affects most people suffering from diabetes. Type 2 diabetes may not cause symptoms for some time and may remain undetected for many years. Zinc, an important mineral, plays a relevant role in the synthesis and action of insulin. The human body does not produce zinc on its own, so it must be obtained from outside sources. The mineral zinc can be found in both animal and plant food sources, but the richest source of zinc comes from animal food sources.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Momordica charantia for type 2 diabetes mellitus

Mormordica charantia (bitter gourd or bitter melon) is a climbing perennial that is characterized by elongated, warty fruit‐like gourds or cucumbers and is native to the tropical belt. Although momordica charantia is commonly used in traditional medical practices, along with research suggesting its benefits for people with type 2 diabetes, the current evidence does not warrant using the plant in treating this disease. This review of trials found only four studies which had an overall low quality. Three trials showed no significant differences between momordica charantia and placebo or antidiabetic drugs (glibenclamide and metformin) in the blood sugar response. The duration of treatment ranged from four weeks to three months, and altogether 479 patients with type 2 diabetes mellitus participated. No trial investigated death from any cause, morbidity, health‐related quality of life or costs. Adverse effects were mostly moderate, including diarrhoea and abdominal pain. However, reporting of adverse effects was incomplete in the included studies. There are many varieties of preparations of momordica charantia, as well as variations in its use as a vegetable. Further studies are needed to assess the quality of the various momordica charantia preparations as well as to further evaluate its use in the diet of diabetic people.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Dietary advice for treatment of type 2 diabetes mellitus in adults

No high quality data on the efficacy of diet alone exists for treatment of type 2 diabetes mellitus. This systematic review assesses the effects of studies that examined dietary advice with or without the addition of exercise or behavioural approaches. Eighteen studies were included. No data were found on micro‐ or macrovascular diabetic complications, mortality or quality of life. It is difficult to draw reliable conclusions from the limited data that are presented in this review, however, the addition of exercise to dietary advice showed improvement of metabolic control after six‐ and twelve‐month follow‐up.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Long‐term non‐pharmacological weight loss interventions for adults with type 2 diabetes mellitus

Most persons with type 2 diabetes are overweight, and the health of these persons can be improved with weight loss. Weight loss is very difficult to achieve in the long‐term, however, particularly among persons with diabetes. This systematic review of diet, physical activity, and behavioral interventions for weight loss, revealed a decrease in weight of 1.7 kg at one year or more. These results were minimized by weight loss in the comparison group, however. No data were identified on quality of life or mortality.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Sweet potato for type 2 diabetes mellitus

Sweet potato (Ipomoea batatas) is a plant found in the tropical and subtropical belts and is one of the most nutritious tropical and subtropical vegetables. As well as being popular in cooking in countries in Asia‐Pacific, Africa and North America, sweet potato is also used in traditional medicine for the treatment of diabetes mellitus. We decided to investigate whether there is enough evidence from medical trials to show whether sweet potato works as a treatment for diabetes. This review of randomised controlled trials found only three studies (with a total of 140 participants) that evaluated the effects of sweet potato for type 2 diabetes mellitus compared with a fake medicine (placebo). All these trials were of very low quality. Two studies with 122 participants showed improved long‐term metabolic control of blood sugar levels as measured by glycosylated haemoglobin A1c (HbA1c) which was moderately lowered by 0.3% in participants who were given 4 g sweet potato tablets a day for three to five months. The duration of treatment ranged from six weeks to five months. No study investigated diabetic complications, death from any cause, health‐related quality of life, well‐being, functional outcomes or costs. Adverse effects were mostly mild, and included abdominal distension and pain. There are many varieties of sweet potatoes and sweet potato preparations. More trials are needed to assess the quality of the various sweet potato preparations as well as to evaluate further the use of different varieties of sweet potato in the diet of diabetic people.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Metformin monotherapy for type 2 diabetes mellitus

Our review confirm that tight glycaemia control with metformin monotherapy is one of the main therapeutic options for type 2 diabetes in patients with overweight or obesity, since it may prevent some events of macrovascular and microvascular complications, and mortality. With the exception of more benefit achieved in overweight and obese participants on metformin, there are not specific data across trials to perform subgroup analyses of patients with other cardiovascular risk factors, such as hyperlipidaemia, hypertension, impaired fibrinolysis, or older than 65, which could allow us to predict those who would benefit more from metformin monotherapy. There are not long term trials which compare more recent drugs, such as some sulphonylureas, thiazolidinediones, meglitinides, and alpha glucosidase inhibitors, with metformin for primary outcomes. Metformin produces strong beneficial changes in glycaemia control, and moderated in weight, lipids, insulinaemia and diastolic blood pressure. Sulphonylureas, alpha‐glucosidase inhibitors, thiazolidinediones, meglitinides, insulin, and diet fail to show more benefit for glycaemia control, body weight, or lipids, than metformin.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Whole grain foods for the prevention of type 2 diabetes mellitus

Food products derived from cereal grains as wheat, rice, corn, rye, oat, and barley constitute a major part of the daily diet in many countries. In refined‐grain products, the bran and germ of the grain, which contain the major amount of nutrients and dietary fibre, have been removed and only the starchy inner part of the grain (ca. 80% of the whole grain) is used. Whole grain foods contain either intact, flaked or broken grain kernels, coarsely ground kernels or flour that is made from whole grains (whole‐meal flour). In this review the effect of whole grain foods and cereal fibre (as a marker of whole‐grain food intake) on the prevention of type 2 diabetes mellitus (T2DM) was assessed using all available prospective cohort studies and randomised controlled trials. Only one randomised controlled trial was found which was of low methodological quality. This study investigated in 12 overweight persons during six weeks the effect of the consumption of refined grain foods versus that of whole grain foods on insulin sensitivity (risk factor for the development of T2DM). Intake of whole grain foods resulted in a slight improvement of insulin sensitivity, increased bowel movements and no adverse effects. No information was given about patient satisfaction, health related quality of life, total mortality and morbidity. In addition eleven prospective cohort studies were found. One study was conducted in Finland and the rest in the United States of America of which seven were done in health care workers. Some of the studies were of limited quality. They consistently showed that a high intake of whole grain foods or cereal fibre is associated with a lower risk of the development of T2DM. However, evidence for a protective effect coming from prospective cohort studies only has to be considered as weak as with this design no cause and effect relationship can be established. Well‐designed randomised controlled trials are needed to be able to draw definite conclusions about the preventive effects of whole grain consumption on development of T2DM.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Exercise for type 2 diabetes mellitus

Exercise, dietary changes and medications are frequently used in the management of type 2 diabetes. However, it is difficult to determine the independent effect of exercise from some trials because exercise has been combined with dietary modifications or medications, or compared with a control which includes another form of intervention. The review authors aimed to determine the effect of exercise on blood sugar control in type 2 diabetes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Reminder systems for women with previous gestational diabetes mellitus to increase uptake of testing for type 2 diabetes or impaired glucose tolerance

To assess the effects of reminder systems to increase uptake of testing for type 2 diabetes or impaired glucose tolerance in women with a history of gestational diabetes mellitus (GDM).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Self‐monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin

Self‐monitoring of blood glucose has been found to be effective as a tool in the self‐management of patients' glucose levels in people with type 1 diabetes and people with type 2 diabetes using insulin therapy. Patients can use the glucose values to adjust their insulin doses. It is hypothesized that patients with type 2 diabetes who are not using insulin might use the glucose values to adjust their diet and 'lifestyle'. However, there is no consensus on the effect of self‐monitoring of blood glucose for type 2 diabetes patients not using insulin. In this systematic review update six new randomised controlled trials were added to the six trials that had been included in the original review. For the comparison of the effect of self‐monitoring versus no self‐monitoring in patients with a diabetes duration of one year or more 2324 patients with a six months follow‐up and 493 patients with a 12 months follow‐up were available. Pooled results of studies including patients diagnosed with type 2 diabetes for at least one year show that self‐monitoring of blood glucose has a minimal effect in improving glucose control at six months, which disappears after 12 months follow‐up. The clinical benefit resulting from this effect is limited.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Type 2 diabetes: Does self-monitoring urine and blood glucose levels have benefits for people who do not inject insulin?

Regular self-monitoring of glucose levels has not been proven to have benefits for people with type 2 diabetes who do not inject insulin. It is not known whether self-monitoring can help prevent diabetes-related complications in this group of people.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 23, 2011

Type 2 diabetes: What advantages or disadvantages does saxagliptin/metformin (Komboglyze) have?

The fixed combination of the drugs saxagliptin and metformin (trade name Komboglyze) was approved in Germany in November 2011 for adults with type 2 diabetes who cannot lower their elevated blood sugar levels enough by making changes to their diet or doing exercise. The combination is an option for people who have not benefited enough from the conventional drug metformin on its own or who have already been taking saxagliptin and metformin as separate tablets. It can also be used together with insulin if insulin and metformin are not sufficient on their own.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 2, 2013

Premixed Insulin for Type 2 Diabetes: A Guide for Adults

The information in this guide comes from a government-funded review of research about premixed insulin. This guide compares the benefits, side effects, and costs of a newer type of premixed insulin with other kinds of insulin and pills for diabetes.

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: March 25, 2009

Medicines for Type 2 Diabetes: A Review of the Research for Adults

This summary covers the research on the benefits and possible side effects of medicines to lower or control your blood sugar. It will help you talk with your doctor or other health care professional to decide which medicines are best for you.

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: June 30, 2011

Very little evidence from randomised trials about optimal blood sugar (glucose) targets for pregnant women with type 1 or type 2 diabetes

Women who have either type 1 or type 2 diabetes before they become pregnant have an increased risk of pregnancy loss, high birthweight babies and perinatal deaths. The metabolic disruptions to the fetus caused by the mother's high blood sugars and insulin resistance can affect the development of organs, and cardiovascular malformations are the most common birth defects in infants born to diabetic mothers. Infants of diabetic mothers may also be at increased risk of developing obesity and type 2 diabetes. Management of diabetes in pregnancy therefore aims for tight control of glucose (glycaemic control) using careful combinations of diet, exercise, insulin or other anti‐diabetogenic drugs, clinical visits and monitoring.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

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