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Innovative health-promoting approaches of the era have verified phytoceutics as one of the prime therapeutic tools to alleviate numerous health-related ailments. The purpose of this paper is to probe the nutraceutic potential of ginger flowers and leaves against hyperglycemia.

The aqueous extracts of ginger flowers and leaves were observed on Sprague Dawley rats for 8 weeks. Two parallel studies were carried out based on dietary regimes: control and hyperglycemic diets. At the end of the experimental modus, the overnight fed rats were killed to determine the concentration of glucose and insulin in serum. The insulin resistance and insulin secretions were also calculated by formulae by considering fasting glucose and fasting insulin concentrations. Furthermore, the feed and drink intakes, body weight gain and hematological analysis were also carried out.

In streptozotocin-induced hyperglycemic rats, the ginger flowers extract depicted 5.62% reduction; however, ginger leaves extract reduced the glucose concentration up to 7.11% (p = 0.001). Similarly, ginger flowers extract uplifted the insulin concentration up to 3.07%, while, by ginger leaves extract, the insulin value increased to 4.11% (p = 0.002). For the insulin resistance, the ginger flower showed 5.32% decrease; however, the insulin resistance was reduced to 6.48% by ginger leaves (p = 0.014). Moreover, the insulin secretion increased to 18.9% by flower extract and 21.8% by ginger leave extract (p = 0.001). The feed intake and body weight gain increased momentously by the addition of ginger flowers and leaves; however, the drink intake and hematological analysis remained non-significant by the addition of ginger parts.

Conclusively, it was revealed that leaves have more hypoglycemic potential as compared to flowers.

The authors performed a systematic review and meta-analysis of all published randomized controlled trials with the aim to determine and quantify the anti-hyperglycemic effects of glutamine (Gln) in acute and chronic clinical settings.

The authors conducted a comprehensive search of all randomized clinical trials performed up to December 2018, to identify those investigating the impact of Gln supplementation on fasting blood sugar (FBS), insulin levels and homeostatic model assessment-insulin resistance (HOMA-IR) via ISI Web of Science, Cochrane library PubMed and SCOPUS databases. A meta-analysis of eligible studies was conducted using random effects model to estimate the pooled effect size. Fractional polynomial modeling was used to explore the dose–response relationships between Gln supplementation and diabetic indices.

The results of the present meta-analysis suggest that of Gln supplementation had a significant effect on FBS (weighted mean difference (WMD): –2.868 mg/dl, 95 per cent CI: –5.467, –0.269, p = 0.031). However, the authors failed to observe that Gln supplementation affected insulin levels (WMD: 1.06 units, 95 per cent CI: –1.13, 3.26, p = 0.34) and HOMA-IR (WMD: 0.001 units, 95 per cent CI: –2.031, 2.029, p = 0.999). Subgroup analyses showed that the highest decrease in FBS levels was observed when the duration of intervention was less than two weeks (WMD: –4.064 mg/dl, 95 per cent CI: –7.428, –0.700, p = 0.01) and when Gln was applied via infusion (WMD: –5.334 mg/dl, 95 per cent CI: –10.48, 0.17, p = 0.04).

The results from this meta-analysis show that Gln supplementation did not have a significant effect on insulin levels and HOMA-IR. However, it did significantly reduce the levels of FBS, obtaining a higher effect when the duration of the intervention period was less than two weeks.

Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. GDM is defined as glucose intolerance of variable severity with onset or first recognition during pregnancy. The purpose of this paper is to produce information on prevalence, screening and diagnosis, pathophysiology and dietary, medical and lifestyle management of GDM.

This literature review aimed to document and record the results of the most updated studies published dealing with dietary, medical and lifestyle factors in managing GDM.

The prevalence of GDM differs worldwide based on population characteristics, race/ethnicity and diagnostic criteria. The pathophysiology of GDM is multifactorial and it is likely that genetic and environmental factors are associated with the occurrence of GDM. Medical nutritional therapy remains the mainstay of GDM management and aerobic and resistance physical activities are helpful adjunctive therapy when euglycemia is not attained by the medical nutritional therapy alone. When diet and exercise fail to achieve glycemic control, pharmacological agents such as insulin therapy and oral hypoglycemic medications are prescribed. Plasma glucose measurement is an essential part of glycemic control during pregnancy, as well as glycemic control can be evaluated using indicators of glycemic control such as hemoglobin A1c (HbA1c), glycated albumin and fructosamine.

This review is a comprehensive review that illustrates the effect of healthy diet, medical therapy and lifestyle change on improving GDM condition.

This paper aims to determine the effect of black garlic (BG) on visceral fat, oxidative stress and insulin resistance (IR) compared with metformin and vitamin E in nonalcoholic fatty liver disease (NAFLD) rats.

A randomized post-test only design with control group was used in this study. Rats were given high-fat fructose diet enriched with 1.25% cholesterol and 0.5% cholic acid for eight weeks to induce NALFD condition. The administration of BG dose of 450 mg/200 gBW, 900 mg/200 gBW and 1350 mg/200 gBW with a comparative control of 45 mg/200 gBW of metformin and vitamin E of 9 IU/200 gBW were given for four weeks via oral gavage to reduce visceral fat, oxidative stress and improve IR. Statistical analyses were performed to examine differences between groups with one-way analysis of variance and nonparametrics test.

Rats given with three different doses of BG for four weeks did not reduce body weight from 244 ± 4.4 to 284 ± 4.6 g, 242 ± 2.5 to 272 ± 3.1 g and 240 ± 2.4 to 270 ± 3.6 g, respectively, but significantly reduced visceral fat (p = 0.001) on BG groups with 3.7 ± 1.3, 2.7 ± 0.7 and 1.8 ± 0.6 g, respectively. BG improved oxidative stress (p = 0.001) with malondialdehyde level 5.1 ± 0.2, 3.0 ± 0.06 and 2.3 ± 0.06 ng/mL, respectively, but did not better than vitamin E group 1 ± 0.03 ng/mL. Significant (p = 0.001) improvement on insulin resistance with homeostatic model assessment IR in BG groups were 5.3 ± 0.1, 4.4 ± 0.1 and 4 ± 0.1, respectively, but not as good as metformin group 3.7 ± 0.1.

Based on the experiment, there are several limitations including small sample size, performed on animal models in a relatively short time, did not examine organosulfurs compound (OSC) content of BG specifically and OSC affects metabolism in NAFLD remains unclear and will require further investigation.

BG is a functional food made from heated fresh garlic owing to the Maillard reaction and the organosulfur compounds as antioxidants. The higher the dose of BG, the greater the improvement in visceral fat, oxidative stress and IR in model NAFLD rats.

NAFLD is a liver disorder caused by excessive fat and energy intake, the treatment strategies among others through diet modification.

In model NAFLD rats, BG administration improved NALFD markers but did not better rather than the metformin and vitamin E result.

The epigallocatechin gallate (EGCG) effect in diabetes has been investigated in animal studies, but results of clinical trials are inconsistent. Thus, this study aims to evaluate the effects of EGCG supplementation in patients with type 2 diabetes mellitus (T2DM).

A total of 50 patients with T2DM were recruited in a double-blind, randomized, placebo-controlled trial. The eligible participants were randomly allocated to EGCG (n = 25) and placebo (n = 25) groups. The EGCG group received two capsules of EGCG (each capsule contained 150 mg; Shari Made®, Iran) and placebo group was administered two capsules of placebo (starch) for eight weeks. A three-day 24-h dietary recall and anthropometric and laboratory measurements were carried out at the beginning and the end of the study.

At the end of the trial, weight and body mass index (BMI) were decreased significantly in both groups, but the reduction was not statistically significant between the two groups. Fasting blood sugar decreased significantly in EGCG group. No significant between-group and within-group differences were found in insulin, homeostatic model assessment of insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index values. The high-sensitive C-reactive protein (hs-CRP) was significantly reduced in the EGCG group (4.13 ± 0.48-3.93 ± 0.50, p = 0.003) compared to baseline.

This study showed that consuming 300 mg/day of EGCG for eight weeks in patients with T2DM caused a significant decrease in fasting blood glucose, body weight, BMI and hs-CRP compared to baseline. Therefore, the EGCG supplementation may improve glycemic control, anthropometric and inflammation status in T2DM.

The purpose of this study was to investigate diabetes self-care behaviors, stigmatization and A1C as predictors of a negative perception of insulin treatment in insulin-treated type 2 diabetic patients.

A descriptive cross-sectional and relational design was used. The study was carried out in the Diabetes Training Centre and Endocrine and Metabolism Clinic of a university hospital in the southeast of Turkey between May and October 2017. The research sample consisted of 100 type 2 diabetic patients determined by using a convenience sampling method. An introductory information form for type 2 diabetic patients, the Insulin Treatment Appraisal Scale (ITAS), Diabetes Self-Care Activities Survey (DSCAS) and Barriers to Insulin Treatment Scale (BIT) were used to collect the research data. The data were analyzed using descriptive statistics, correlations and step wise multi-linear regression.

The number of daily insulin injections, training received about insulin and stigmatization was significant predictors of a negative perception of insulin treatment.

Strategies to decrease diabetic individuals' fear of stigmatization should be utilized to minimize their negative insulin treatment perception (giving diabetic individuals training about diabetes, planning public training to inform society and using mass media tools). Diabetes educators should know that diabetic individuals' perception of the severity of the illness could influence the daily number of injections applied and decrease the negative perception regarding insulin.

The purpose of this systematic review and meta-analysis was to investigate the efficacy of propolis on glycemic indices in type 2 diabetic patients.

Web of science (ISI), Embase, Scopus and PubMed were systematically searched to find randomized controlled trials (RCTs) assessing the effects of propolis intake on glycemic controls in type 2 diabetic patients, from inception up to September 1, 2020. A random-effects model was used to pool weighted mean difference (WMD). Meta-regression was performed to detect the potential sources of inter-study heterogeneity.

Seven trials were included in the meta-analysis. Compared to controls, propolis intake significantly improved serum fasting blood sugar (FBS) (WMD = −13.62 mg/dl, 95% CI = [−23.04, −4.20], P = 0.005, I2 = 58.5%) and hemoglobin A1C (HbA1c) (WMD = −0.52%, 95% CI = [−0.86, −0.18], P = 0.002, I2 = 64.0%). In contrast, receiving propolis did not change serum insulin (WMD = −1.46 (uIU/ml), 95% CI = [−2.94, 0.02], P = 0.05, I2 = 75.0%) and homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = −0.98 (%), 95% CI = [−2.00, 0.04], P = 0.06, I2 = 82.3%) compared to controls.

The present meta-analysis demonstrated that propolis intake significantly reduces serum FBS and HbA1c in diabetic patients but does not alter serum insulin and HOMA-IR. Further large-scale RCT’s are needed to approve these effects.

Many foods naturally contain dietary Cr, but lost during processing and cooking. Type 2 diabetes mellitus (T2DM) has been associated with poor glycemic control and low Cr status. The objectives of the current study were to evaluate the dietary Cr intake and its relationship with diabetes risk factors in moderately obese subjects with T2DM.

Thirty‐six subjects (age: 26–65 years) were recruited through local advertisements. Subjects were taking stable doses of oral antidiabetic medication(s) excluding concomitant insulin. Subjects had HbA1c ≥7 per cent, persistent impaired glucose control (2 hour glucose >200 mg dL⁻¹) and at least a one‐year history of T2DM. Demographic characteristics, blood pressure, body mass index (BMI), family and medical history were recorded. Three‐day dietary intakes were collected and evaluated for Cr and nutrient content using Nutritionist V software. Plasma glucose, circulating insulin and lipid profile were analyzed. Homeostatic model assessment insulin resistance (IR), beta cell function (BCF) and derived ratios were calculated. Morning void urinary chromium levels were also measured.

It was observed that mean dietary Cr intake of adults (30 mcg) was below the suggested recommended daily intake (RDI) of 120 mcg day⁻¹. These estimates correspond to approximately 16.4 μg Cr per 1000 Kcals. A significant correlation was observed between dietary Cr and fasting insulin (p<0.05), total‐C (p<0.05), LDL‐C (p<0.01), triglycerides (p<0.05), BCF (p<0.05), TG/HDL‐C ratio (p<0.01), HOMA BCF (p<0.05) and with atherogenic index in plasma (p<0.05).

In this study, the consumption of chromium is less than the RDI. Overall the results suggest that the US diets are inadequate in the essential metal chromium. Further studies are required to explore the relationship of Cr absorption with dietary Cr intake and risk factors in T2DM.

The ketogenic diet (KD) has gained popularity due to its ability to improve type 2 diabetes, weight loss, antioxidant and anti-inflammatory activity. However, long-term use of the KD might not be safe due to its adverse effects. This study examined the effects of the KD alone or in combination with Zamzam water (holy water for Muslims) on glucose homeostasis, lipid parameters and oxidant-antioxidant variables in rats.

Based on the diet given for ten weeks, three groups of adult male Wistar rats were made (12 rats/group): (1) rats which fed on a chow diet and ordinary water, (2) rats which fed on KD and ordinary water and (3) rats which were given KD along with Zamzam. Fasting blood glucose (FBG), serum insulin, insulin resistance (HOMA-IR), LDL cholesterol, HDL cholesterol, superoxide dismutase and malondialdehyde were compared by one-way ANOVA followed by post-hoc Tukey’s HSD test among groups.

Rats which fed on KD and Zamzam water had significantly reduced FBG and LDL cholesterol compared to the rats which fed on a chow diet and ordinary water (p-values 0.001), and KD and ordinary water (p-value 0.004 and 0.006, respectively). Serum insulin, insulin resistance, HDL cholesterol, superoxide dismutase and malondialdehyde did not differ significantly.

Consumption of KD along with Zamzam for ten weeks significantly reduces FBG and LDL cholesterol. KD alone does not decrease these parameters in ten weeks duration.

The purpose of this study was to investigate the effects of prickly pear (Opuntia ficus indica (OFI)) nopalitos on body weight, food consumption, arterial blood pressure, glucidic homeostasis, cholesterol metabolic pathway and tissues redox status in type 2 diabetic (T2D) rats fed a high-fat diet (HFD).

Rats were fed by a HFD containing 30 per cent sheep fat for 10 weeks, after which they were rendered diabetic by an injection of a low dose of streptozotocin (STZ) (35 mg/kg). The diabetic rats were then divided into two groups. The first group consumed the HFD supplemented with 5 per cent (g/100 g diet) of freeze-dried OFI nopalitos (HFD-OFI), and the second group received the HFD without supplementation (HFD).

OFI nopalitos treatment decreased significantly arterial diastolic (−20%; p = 0.0001) and systolic (−16%; p = 0.0001) pressures, glycemia (−14%; p = 0.03), insulinemia (−50%; p = 0.04), glycated hemoglobin (−49%; p = 0.003), homeostasis model assessment insulin resistance (−67%; p = 0.03), cholesterolemia (−31%; p = 0.003), very-low and low-density lipoprotein cholesterol (−38%; p = 0.002 and −63% p = 0.0002, respectively); thiobarbituric acid reactive substances and lipid hydroperoxide contents, respectively, in liver (−26% p = 0.02, −20% p = 0.02), adipose tissue (−30% p = 0.002, −25% p = 0.001), muscle (−29% p = 0.003, −25% p = 0.008) and kidney (lipid hydroperoxides only (−28%; p = 0.001) but increased high-density lipoprotein (HDL₂) cholesteryl esters (+61%; p = 0.0001), serum lecithin: cholesterol acyltransferase activity (+21%; p = 0.006) and antioxidant enzymes activities (superoxide dismutase, glutathione peroxidase and catalase) of some tissues (liver, adipose tissue, muscle and kidney).

Freeze-dried OFI nopalitos improves arterial blood pressure, glycemic control, metabolic pathway of cholesterol and redox status in T2D rats.