***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Nopal is a plant used in traditional Mexican medicine to treat diabetes . However , there is insufficient scientific evidence to demonstrate whether nopal can regulate postpr and ial glucose . The purpose for conducting this study was to evaluate the glycemic index , insulinemic index , glucose-dependent insulinotropic peptide ( GIP ) index , and the glucagon-like peptide 1 ( GLP-1 ) index , and the effect of nopal on patients with type 2 diabetes after consumption of a high-carbohydrate breakfast ( HCB ) or high-soy-protein breakfast ( HSPB ) on the postpr and ial response of glucose , insulin , GIP , GLP-1 , and antioxidant activity . In study 1 , the glycemic index , insulinemic index , GIP index , and GLP-1 index were calculated for seven healthy participants who consumed 50 g of available carbohydrates from glucose or dehydrated nopal . In study 2 , 14 patients with type 2 diabetes consumed nopal in HCB or HSPB with or without 300 g steamed nopal . The glycemic index of nopal was 32.5±4 , insulinemic index was 36.1±6 , GIP index was 6.5±3.0 , and GLP-1 index was 25.9±18 . For those patients with type 2 diabetes who consumed the HCB+nopal , there was significantly lower area under the curve for glucose ( 287±30 ) than for those who consumed the HCB only ( 443±49 ) , and lower incremental area under the curve for insulin ( 5,952±833 vs 7,313±1,090 ) , and those patients with type 2 diabetes who consumed the HSPB avoided postpr and ial blood glucose peaks . Consumption of the HSPB+nopal significantly reduced the postpr and ial peaks of GIP concentration at 30 and 45 minutes and increased the antioxidant activity after 2 hours measured by the 2,2-diphenyl-1-picrilhidracyl method . These findings suggest that nopal could reduce postpr and ial blood glucose , serum insulin , and plasma GIP peaks , as well as increase antioxidant activity in healthy people and patients with type 2 diabetes AIM OF THE STUDY The aim of this study was to evaluate the acute and chronic effects of OpunDia ( Opuntia ficus-indica ) in obese pre-diabetic men and women . MATERIAL S AND METHODS This double-blind placebo controlled study included participants ( age range of 20 - 50 years ) r and omly assigned to one of the two groups and given a 16-week supply of either the 200 mg OpunDia ( n=15 ) , or placebo ( n=14 ) . The acute phase of the study consisted of an oral glucose tolerance test ( OGTT ) with a 400 mg bolus of OpunDia given 30 min before orally ingesting a 75 g glucose drink . Baseline and post 16-week concentrations of glucose , insulin , hsCRP , adiponectin , proinsulin , Hb1Ac , cholesterol , and a comprehensive metabolic panel were collected along with body composition measured via densitometry ( BOD POD ) . A repeated measures ANOVA was conducted to determine any significant interactions between group and time . Follow-up analysis was performed to determine differences among groups at each time point . Paired t-tests were performed on all variables to determine if any within group differences existed across time . RESULTS There was a statistically significant decrease ( P<0.05 ) in the blood glucose concentrations at the 60 ( 205.92+/-36.90 and 188.84+/-38.43 mg/dL , respectively ) , 90 ( 184.55+/-33.67 and 169.74+/-35.16 mg/dL , respectively ) and 120 min ( 159.24+/-17.85 and 148.89+/-24.86 mg/dL , respectively ) time points with the pre-OGTT compared to the OpunDia bolus trial . There were no between-group differences found with the OGTT time points , area under the curve , blood chemistry variables ( insulin , hsCRP , adiponectin , proinsulin , Hb1Ac ) , diet analysis variables ( carbohydrates , fat , protein and total kcals ) , body composition variables ( fat mass , fat free mass , percent body fat and total body weight ) , or blood chemistry safety parameters ( comprehensive metabolic panel ) pre-to-post 16-week intervention . CONCLUSIONS This study shows the acute blood glucose lowering effects and the long-term safety of the proprietary product OpunDia , thus supporting the traditional use of Opuntia ficus-indica for blood glucose management BACKGROUND The severity of the alcohol hangover may be related to inflammation induced by impurities in the alcohol beverage and byproducts of alcohol metabolism . An extract of the Opuntia ficus indica ( OFI ) plant diminishes the inflammatory response to stressful stimuli . METHODS In this double-blind , placebo-controlled , crossover trial , 64 healthy , young adult volunteers were r and omly assigned to receive OFI ( 1600 IU ) and identical placebo , given 5 hours before alcohol consumption . During 4 hours , subjects consumed up to 1.75 g of alcohol per kilogram of body weight . Hangover severity ( 9 symptoms ) and overall well-being were assessed on a scale ( 0 - 6 ) , and blood and urine sample s were obtained the following morning . Two weeks later , the study protocol was repeated with OFI and placebo reversed . RESULTS Fifty-five subjects completed both the  OFI  and placebo arms of the study . Three of the 9 symptoms-nausea , dry mouth , and anorexia-were significantly reduced by OFI ( all P<.05 ) . Overall , the symptom index was reduced by 2.7 points on average ( 95 % confidence interval , -0.2 to 5.5 ; P = .07 ) , and the risk of a severe hangover ( > /=18 points ) was reduced by half ( odds ratio , 0.38 ; 95 % confidence interval , 0.16 - 0.88 ; P = .02 ) . C-reactive protein levels were strongly associated with hangover severity ; the mean symptom index was 4.1 ( 95 % confidence interval , 1.2 - 7.1 ; P = .007 ) higher in subjects with morning C-reactive protein levels greater than 1.0 mg/L. In addition , C-reactive protein levels were 40 % higher after subjects consumed placebo compared with OFI . CONCLUSIONS The symptoms of the alcohol hangover are largely due to the activation of inflammation . An extract of the OFI plant has a moderate effect on reducing hangover symptoms , apparently by inhibiting the production of inflammatory mediators Background Oral intake of a specific extract of Opuntia ficus-indica cladode and fruit skin ( OpunDia ™ ) ( OFI ) has been shown to increase serum insulin concentration while reducing blood glucose level for a given amount of glucose ingestion after an endurance exercise bout in healthy young volunteers . However , it is unknown whether OFI-induced insulin stimulation after exercise is of the same magnitude than the stimulation by other insulinogenic agents like leucine as well as whether OFI can interact with those agents . Therefore , the aims of the present study were : 1 ) to compare the degree of insulin stimulation by OFI with the effect of leucine administration ; 2 ) to determine whether OFI and leucine have an additive action on insulin stimulation post-exercise . Methods Eleven subjects participated in a r and omized double-blind cross-over study involving four experimental sessions . In each session the subjects successively underwent a 2-h oral glucose tolerance test ( OGTT ) after a 30-min cycling bout at ~70 % VO2max . At t0 and t60 during the OGTT , subjects ingested 75 g glucose and capsules containing either 1 ) a placebo ; 2 ) 1000 mg OFI ; 3 ) 3 g leucine ; 4 ) 1000 mg OFI + 3 g leucine . Blood sample s were collected before and at 30-min intervals during the OGTT for determination of blood glucose and serum insulin . Results Whereas no effect of leucine was measured , OFI reduced blood glucose at t90 by ~7 % and the area under the glucose curve by ~15 % and increased serum insulin concentration at t90 by ~35 % compared to placebo ( P<0.05 ) . From t60 to the end of the OGTT , serum insulin concentration was higher in OFI+leucine than in placebo which result ed in a higher area under the insulin curve ( + 40 % , P<0.05 ) . Conclusion Carbohydrate-induced insulin stimulation post-exercise can be further increased by the combination of OFI with leucine . OFI and leucine could be interesting ingredients to include together in recovery drinks to resynthesize muscle glycogen faster post-exercise . Still , it needs to be confirmed that such nutritional strategy effectively stimulates post-exercise muscle glycogen re synthesis The effect of a high insoluble-fiber ( IF ) diet containing 15 % cellulose in dry matter , high soluble-fiber ( SF ) diet containing 15 % pectin in dry matter , and low-fiber ( LF ) diet on glycemic control in 6 dogs with alloxan-induced insulin-dependent diabetes mellitus was evaluated . Each diet contained greater than 50 % digestible carbohydrate in dry matter . A crossover study was used with each dog r and omly assigned to a predetermined diet sequence . Each dog was fed each diet for 56 days . Caloric intake was adjusted weekly as needed to maintain each dog within 1.5 kg of its body weight measured prior to induction of diabetes mellitus . All dogs were given pork lente insulin and half of their daily caloric intake at 12-hour intervals . Mean ( + /- SEM ) daily caloric intake was significantly ( P less than 0.05 ) less when dogs consumed the IF diet vs the SF and LF diets ( 66 + /- 3 kcal/kg , 81 + /- 5 kcal/kg , and 79 + /- 4 kcal/kg , respectively ) . Serum alkaline phosphatase activity was significantly ( P less than 0.05 ) higher when dogs consumed the LF diet vs the IF and SF diets ( 182 + /- 37 IU/L , 131 + /- 24 IU/L , and 143 + /- 24 IU/L , respectively ) . Mean postpr and ial plasma glucose concentration measured every 2 hours for 24 hours , beginning at the time of the morning insulin injection , was significantly ( P less than 0.05 ) lower at most blood sampling times in dogs fed IF and SF diets , compared with dogs fed the LF diet . ( ABSTRACT TRUNCATED AT 250 WORDS BACKGROUND The effect of increasing the intake of dietary fiber on glycemic control in patients with type 2 diabetes mellitus is controversial . METHODS In a r and omized , crossover study , we assigned 13 patients with type 2 diabetes mellitus to follow two diets , each for six weeks : a diet containing moderate amounts of fiber ( total , 24 g ; 8 g of soluble fiber and 16 g of insoluble fiber ) , as recommended by the American Diabetes Association ( ADA ) , and a high-fiber diet ( total , 50 g ; 25 g of soluble fiber and 25 g of insoluble fiber ) , containing foods not fortified with fiber ( unfortified foods ) . Both diets , prepared in a research kitchen , had the same macronutrient and energy content . We compared the effects of the two diets on glycemic control and plasma lipid concentrations . RESULTS Compliance with the diets was excellent . During the sixth week , the high-fiber diet , as compared with the the sixth week of the ADA diet , mean daily prepr and ial plasma glucose concentrations were 13 mg per deciliter [ 0.7 mmol per liter ] lower ( 95 percent confidence interval , 1 to 24 mg per deciliter [ 0.1 to 1.3 mmol per liter ] ; P=0.04 ) and mean median difference , daily urinary glucose excretion 1.3 g ( 0.23 ; 95 percent confidence interval , 0.03 to 1.83 g ; P= 0.008 ) . The high-fiber diet also lowered the area under the curve for 24-hour plasma glucose and insulin concentrations , which were measured every two hours , by 10 percent ( P=0.02 ) and 12 percent ( P=0.05 ) , respectively . The high-fiber diet reduced plasma total cholesterol concentrations by 6.7 percent ( P=0.02 ) , triglyceride concentrations by 10.2 percent ( P=0.02 ) , and very-low-density lipoprotein cholesterol concentrations by 12.5 percent ( P=0.01 ) . CONCLUSIONS A 
    Output:
    
Following the PRISMA 2009 guidelines , six electronic data bases ( Food Science and Technology Abstract s ( EBSCO ) , Medline , Scopus , CINAHL , Web of Science and Cochrane ) were search ed for articles investigating the effect of Opuntia spp .
The findings of this review indicate variations in effects between cacti components and products .
Cladode and select Opuntia spp .
products predominately demonstrated significant reductions in serum glucose and insulin , indicating potential as a functional food c and i date .
Prickly Pear fruit was predominately reported to have no significant effects on glucose or insulin .
The quality of evidence appeared to vary based on the type of Opuntia spp .
Studies that used specifically the fruit or cladode had high risk of bias , whereas studies which used combined Opuntia spp .
products had a lower risk of bias .
Conclusion : Currently , there is a lack of evidence to support the recommendation of using Opuntia spp .
fruit products as an alternative or complementary therapy in the reduction of risk or management of Type 2 Diabetes Mellitus .