***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: Background The apolipoprotein A5 gene ( APOA5 ) -1131 T > C polymorphism is associated with mild hypertriglyceridemia in type 2 diabetic subjects , and interacts with dietary fat in the determination of triglyceride concentrations . We examined whether a substitution of whole grains and legumes for refined rice in a high carbohydrate diet ( about 65 % of energy derived from carbohydrate ) may modify the effect of this variant on changes in apolipoprotein A-V ( apoA-V ) and triglyceride concentrations . Methods We genotyped the APOA5 -1131 T > C in individuals with impaired fasting glucose ( IFG ) or newly diagnosed type 2 diabetes , who were r and omly assigned to either a group ingesting whole grain and legume meals daily or a control group for 12 weeks . Results After dietary intervention , we observed significant interactions between the APOA5 -1131 T > C polymorphism and carbohydrate sources ( whole grains and legumes versus refined rice ) in the determination of mean percent changes in triglyceride and apoA-V ( P interactions < 0.001 and = 0.038 , respectively ) . In the refined rice group ( n = 93 ) , the carriers of the risk C allele ( n = 50 ) showed a greater increase in the mean percent changes of triglyceride and apoA-V than noncarriers after adjusting for HOMA-IR ( P = 0.004 and 0.021 , respectively ) . The whole grain and legume group ( n = 92 ) , however , showed a decrease in fasting glucose , HOMA-IR , and triglyceride , and an increase in apoA-V , irrespective of genotype . Conclusions The data showed that the magnitude of the genetic effect of the APOA5 -1131C variant on triglyceride and apoA-V levels was modulated when substituting consumption of whole grains and legumes for refined rice as a carbohydrate source in IFG or diabetic subjects . Trial registration Clinical Trials.gov : NCT01784952 Background The heterogeneity statistic I2 , interpreted as the percentage of variability due to heterogeneity between studies rather than sampling error , depends on precision , that is , the size of the studies included . Methods Based on a real meta- analysis , we simulate artificially ' inflating ' the sample size under the r and om effects model . For a given inflation factor M = 1 , 2 , 3 , ... and for each trial i , we create a M-inflated trial by drawing a treatment effect estimate from the r and om effects model , using si2MathType@MTEF@5@5@+=feaagaart1ev2aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacPC6xNi = xH8viVGI8Gi = hEeeu0xXdbba9frFj0xb9qqpG0dXdb9aspeI8k8fiI+fsY = rqGqVepae9pg0db9vqaiVgFr0xfr = xfr = xc9adbaqaaeGaciGaaiaabeqaaeqabiWaaaGcbaGaem4Cam3aa0baaSqaaiabdMgaPbqaaiabikdaYaaaaaa@2FBE@/M as within-trial sampling variance . Results As precision increases , while estimates of the heterogeneity variance τ2 remain unchanged on average , estimates of I2 increase rapidly to nearly 100 % . A similar phenomenon is apparent in a sample of 157 meta-analyses . Conclusion When deciding whether or not to pool treatment estimates in a meta- analysis , the yard-stick should be the clinical relevance of any heterogeneity present . τ2 , rather than I2 , is the appropriate measure for this purpose Context Increased prevalence of type 2 diabetes mellitus and prediabetes worldwide is attributed in part to an unhealthy diet . Objective To evaluate whether 12 weeks of high monounsaturated fatty acid ( MUFA ) or fiber-rich weight-maintenance diet lowers hepatic fat and improves glucose tolerance in people with prediabetes . Design Subjects underwent a [ 6 , 6 - 2H2]-labeled 75-g oral glucose tolerance test to estimate hepatic insulin sensitivity and liver fat fraction ( LFF ) using magnetic resonance spectroscopy before and after intervention . Setting Mayo Clinic Clinical Research Trials Unit . Participants 43 subjects with prediabetes . Intervention Subjects were r and omized into three isocaloric weight-maintaining diets containing MUFA ( olive oil ) , extra fiber , and st and ard US food ( control-habitual diet ) . Outcome Measures LFF , glucose tolerance , and indices of insulin action and secretion . Results Body weight was maintained constant in all groups during the intervention . Glucose and hormonal concentrations were similar in all groups before , and unchanged after , 12 weeks of intervention . LFF was significantly lower after intervention in the MUFA group ( P < 0.0003 ) but remained unchanged in the fiber ( P = 0.25 ) and control groups ( P = 0.45 ) . After 12 weeks , LFF was significantly lower in the MUFA than in the control group ( P = 0.01 ) , but fiber and control groups did not differ ( P = 0.41 ) . Indices of insulin action and secretion were not significantly different between the MUFA and control groups after intervention ( P ≥ 0.11 ) , but within-group comparison showed higher hepatic ( P = 0.01 ) and total insulin sensitivity ( P < 0.04 ) with MUFA . Conclusions Twelve weeks of a MUFA diet decreases hepatic fat and improves both hepatic and total insulin sensitivity Realistic high-fiber and regular low-fiber diets were given for 8 wk each to noninsulin-dependent diabetes mellitus ( NIDDM ) patients whose diabetes was being controlled satisfactorily by diet alone . The purpose of the study was to evaluate the metabolic effects of dietary fiber without changing energy intake or proportions of protein , fat , and carbohydrates . The high-fiber diet induced lower fasting blood glucose levels ( p less than 0.01 ) and decreased the ratio of low-density lipoproteins to high-density lipoproteins ( p less than 0.025 ) ; no difference was found in HbA1c between the two diet periods . Continuous glucose monitoring also showed a difference in fasting glucose levels that remained after identical low-fiber test meals . The incremental glucose responses did not differ . The fasting and incremental postpr and ial levels of insulin , C-peptide , glucagon , and somatostatin did not change , whereas the mean triglyceride concentrations were lower after the high-fiber diet . The results suggest a beneficial effect of dietary fiber in the metabolic control of NIDDM Summary The effects of guar gum ( GG ) and microcrystalline cellulose ( MC ) on metabolic control and serum lipids were compared in a double-blind , cross-over trial in 18 poorly controlled Type 2 diabetic patients . There were two 12 week treatment periods separated by a 4 week wash-out period . A significant reduction in fasting BG was found after 6 weeks treatment with GG , but the initial level was regained after further 6 weeks , at the end of the treatment period . No statistically significant change in fasting BG was observed with MC .  Serum cholesterol was lowered by 10 % during GG treatment . Microcrystalline cellulose had no effect on serum lipids . The results suggest , that during 12 weeks supplementation with guar gum , the improvement in glycemic control was not sustained , but that it might reduce the risk of macrovascular disease in diabetic patients Improvement of insulin resistance and inflammation is a basic strategy in the management of type 2 diabetes . There is limited evidence that prebiotics improve insulin resistance and inflammation . However , the ameliorating effect of resistant dextrin , as a prebiotic , on insulin resistance and inflammation in patients with type 2 diabetes has not been investigated so far . Therefore , the present study aim ed to examine the effects of resistant dextrin on insulin resistance and inflammation in type 2 diabetic patients . In a r and omised controlled clinical trial , fifty-five women with type 2 diabetes were assigned to two groups : the intervention group ( n 30 ) and the control group ( n 25 ) . The intervention group received a daily supplement of 10 g resistant dextrin and the control group received a similar amount of maltodextrin as placebo for 8 weeks . Fasting plasma glucose ( FPG ) , HbA1c , insulin , high-sensitivity C-reactive protein ( hs-CRP ) , IL-6 , TNF-α , malondialdehyde ( MDA ) and serum endotoxin concentrations were measured before and after the intervention . Data were analysed using SPSS ( version 13 ) . Paired and unpaired t tests and ANCOVA were used to compare quantitative variables after the intervention . Patients supplemented with resistant dextrin exhibited a significant decrease in fasting insulin ( 20.1 pmol/l , 22.8 % ) , homeostasis model assessment of insulin resistance ( 1.3 , 24.9 % ) , quantitative insulin sensitivity check index ( 0.2 , 7.2 % ) , IL-6 ( 1.4 pg/ml , 28.4 % ) , TNF-α ( 5.4 pg/ml , 18.8 % ) , MDA ( 1.2 nmol/ml , 25.6 % ) and endotoxin ( 6.2 endotoxin units/ml , 17.8 % ) concentrations than those supplemented with maltodextrin ( P < 0.05 ) . Decreases in FPG ( 0.05 mmol/l , 0.6 % ) , HbA1c ( 0.5 % , 9.6 % ) and hs-CRP ( 2.7 ng/ml , 35.1 % ) concentrations in the resistant dextrin group were not significant when compared with the maltodextrin group . In conclusion , resistant dextrin supplementation can modulate inflammation and improve insulin resistance in women with type 2 diabetes BACKGROUND & AIMS The gut microbiota affects host lipid and glucose metabolism , satiety , and chronic low- grade inflammation to contribute to obesity and type 2 diabetes . Fermentation end products , in particular the short-chain fatty acid ( SCFA ) acetate , are believed to be involved in these processes . We investigated the long-term effects of supplementation with galacto-oligosaccharides ( GOS ) , an acetogenic fiber , on the composition of the human gut microbiota and human metabolism . METHODS We performed a double-blinded , placebo-controlled , parallel intervention study of 44 overweight or obese ( body mass index , 28 - 40 kg/m2 ) prediabetic men and women ( ages , 45 - 70 y ) from October 2014 through October 2015 in Maastricht , The Netherl and s. The participants were assigned r and omly to groups who ingested 15 g GOS or isocaloric placebo ( maltodextrin ) daily with their regular meals for 12 weeks . Before and after this period , we collected data on peripheral and adipose tissue insulin sensitivity , fecal microbiota composition , plasma and fecal SCFA , energy expenditure and substrate oxidation , body composition , and hormonal and inflammatory responses . The primary outcome was the effect of GOS on peripheral insulin sensitivity , measured by the hyperinsulinemic-euglycemic clamp method . RESULTS Supplementation of diets with GOS , but not placebo , increased the abundance of Bifidobacterium species in feces by 5-fold ( P = .009 ; q = 0.144 ) . Microbial richness or diversity in fecal sample s were not affected . We did not observe any differences in fecal or fasting plasma SCFA concentrations or in systemic concentrations of gut-derived hormones , incretins , lipopolysaccharide-binding protein , or other markers of inflammation . In addition , no significant alterations in peripheral and adipose tissue insulin sensitivity , body composition , and energy and substrate metabolism were found . CONCLUSIONS Twelve-week supplementation of GOS selectively increased fecal Bifidobacterium species abundance , but this did not produce significant changes in insulin sensitivity or related substrate and energy metabolism in overweight or obese prediabetic men and women . ClincialTrials.gov number , NCT02271776 Background Water-soluble dietary fibers intake may help control blood glucose and body weight . Objective The objective of the study was to determine whether soluble fiber supplementation from psyllium improves glycemic control indicators and body weight in type 2 diabetic patients . Method Forty type 2 diabetes patients , non-smoker , aged > 35 years were stratified to different strata according to sex , age , body mass index ( BMI ) and fasting blood sugar level ( FBS ) and r and omly assigned into two groups ; The intervention group which consists of 20 participants was on soluble fiber ( 10.5 g daily ) , and the control group which consist of 20 participants continued on their regular diet for eight weeks duration . Results 
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CONCLUSIONS Higher-fibre diets are an important component of diabetes management , result ing in improvements in measures of glycaemic control , blood lipids , body weight , and inflammation , as well as a reduction in premature mortality .
These benefits were not confined to any fibre type or to any type of diabetes and were apparent across the range of intakes , although greater improvements in glycaemic control were observed for those moving from low to moderate or high intakes .
Based on these findings , increasing daily fibre intake by 15 g or to 35 g might be a reasonable target that would be expected to reduce risk of premature mortality in adults with diabetes