***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: This study was a r and omized , double-blind placebo-controlled trial to assess the efficacy of 4 weeks of mulberry leaf aqueous extract ( MLAE ) supplementation ( 5 g/day ) for postpr and ial glycemic control in 36 subjects with impaired fasting glucose ( IFG ) tolerance . Postpr and ial responses in the glucose , insulin , and C-peptide levels were measured after a carbohydrate load both at baseline and after 4 weeks of MLAE supplementation . The postpr and ial glycemic response was attenuated in the MLAE group after the treatment period , particularly 30 and 60 min after loading ( P=.003 and 0.0325 for glucose , P=.0005 and .0350 for insulin , and P=.0151 and .0864 for C-peptide ) . Additionally , the incremental area under the curve for insulin was significantly lower in the MLAE group than in the placebo group ( P=.0207 ) . Four weeks of MLAE supplementation improved postpr and ial glycemic control in individuals with IFG tolerance BACKGROUND In type 2 diabetes , tight glycaemic control lowers the risk of diabetic complications , but it remains uncertain whether variability of glycaemia influences outcomes . We examined the association of glycated haemoglobin ( HbA1c ) variability with incident chronic kidney disease and cardiovascular disease in a prospect i ve cohort of 8439 Chinese patients with type 2 diabetes recruited from 1994 to 2007 . METHODS Intrapersonal mean and SD of serially measured HbA1c were calculated . Chronic kidney disease was defined as estimated glomerular filtration rate < 60 ml/min per 1.73 m² . Cardiovascular disease was defined as events of ischemic heart disease , heart failure , ischemic stroke or peripheral vascular disease . RESULTS Over a median follow-up period of 7.2 years , 19.7 and 10.0 % of patients developed chronic kidney disease and cardiovascular disease , respectively . Patients who progressed to chronic kidney disease had higher mean HbA1c ( 7.8 ± 1.3 % vs 7.4 ± 1.2 % , p < 0.001 ) and SD ( 1.0 ± 0.8 % vs 0.8 ± 0.6 % , p < 0.001 ) than nonprogressors . Similarly , patients who developed cardiovascular disease had higher mean HbA1c ( 7.7 ± 1.3 % vs 7.4 ± 1.2 % , p < 0.001 ) and SD ( 1.4 ± 1.1 % vs 1.1 ± 0.8 % , p < 0.001 ) than patients who did not develop cardiovascular disease . By using multivariate-adjusted Cox regression analysis , adjusted SD was associated with incident chronic kidney disease and cardiovascular disease with corresponding hazard ratios of 1.16 ( 95 % CI 1.11 - 1.22 ) , p < 0.001 ) and 1.27 ( 95 % CI 1.15 - 1.40 , p < 0.001 ) , independent of mean HbA1c and other confounding variables . CONCLUSIONS Long-term glycaemic variability expressed by SD of HbA1c predicted development of renal and cardiovascular complications Objective : We recently reported that eating glutinous brown rice ( GBR ) for 1 day improved the whole-day glucose profile and postpr and ial plasma glucose level compared with eating white rice ( WR ) or st and ard brown rice . However , it was unknown whether eating GBR could maintain improvement of glycemic control for a longer period . Therefore , we evaluated the effect of GBR intake for 8 weeks on glycemic control in out patients with diabetes mellitus . Methods : This was an open-label r and omized crossover study in out patients with type 2 diabetes . Among the 18 subjects registered in this study , 2 were excluded from analysis . After a 1-week observation period while eating WR twice a day , the patients were r and omly assigned to two groups . One group ate GBR as a staple food twice a day for 8 weeks and then switched to WR for the next 8 weeks , while the other group ate WR first and then switched to GBR . A mixed meal tolerance test was performed at baseline and after 8 and 16 weeks of dietary intervention to evaluate plasma glucose and serum C-peptide . Results : None of the subjects failed to complete the study because of disliking the taste of GBR . Hemoglobin A1c ( 7.5–7.2 % , P=0.014 ) and glycoalbumin ( 20.4–19.4 % , P=0.029 ) both decreased significantly when the patients were eating GBR . Additionally , the 30-min postpr and ial plasma glucose level ( 194–172 mg dl−1 , P=0.031 ) and the incremental area under the concentration vs time curve of serum C-peptide ( 31.3–22.1 ng min ml−1 , P=0.023 ) during the mixed meal tolerance test were also decreased significantly by intake of GBR . In contrast , there were no changes of glycemic control during the WR period . Conclusions : We confirmed that GBR was well tolerated for 8 weeks and improved glycemic control in patients with type 2 diabetes BACKGROUND Increasing evidence suggests an important role of carbohydrate quality in the development of type 2 diabetes . OBJECTIVE Our objective was to prospect ively examine the association between glycemic index , glycemic load , and dietary fiber and the risk of type 2 diabetes in a large cohort of young women . DESIGN In 1991 , 91249 women completed a semiquantitative food-frequency question naire that assessed dietary intake .  The women were followed for 8 y for the development of incident type 2 diabetes , and dietary information was up date d in 1995 . RESULTS We identified 741 incident cases of confirmed type 2 diabetes during 8 y ( 716 300 person-years ) of follow-up . After adjustment for age , body mass index , family history of diabetes , and other potential confounders , glycemic index was significantly associated with an increased risk of diabetes ( multivariate relative risks for quintiles 1 - 5 , respectively : 1 , 1.15 , 1.07 , 1.27 , and 1.59 ; 95 % CI : 1.21 , 2.10 ; P for trend = 0.001 ) . Conversely , cereal fiber intake was associated with a decreased risk of diabetes ( multivariate relative risks for quintiles 1 - 5 , respectively : 1 , 0.85 , 0.87 , 0.82 , and 0.64 ; 95 % CI : 0.48 , 0.86 ; P for trend = 0.004 ) . Glycemic load was not significantly associated with risk in the overall cohort ( multivariate relative risks for quintiles 1 - 5 , respectively : 1 , 1.31 , 1.20 , 1.14 , and 1.33 ; 95 % CI : 0.92 , 1.91 ; P for trend = 0.21 ) . CONCLUSIONS A diet high in rapidly absorbed carbohydrates and low in cereal fiber is associated with an increased risk of type 2 diabetes The glycaemic index ( GI ) concept was originally introduced to classify different sources of carbohydrate (CHO)-rich foods , usually having an energy content of > 80 % from CHO , to their effect on post-meal glycaemia . It was assumed to apply to foods that primarily deliver available CHO , causing hyperglycaemia . Low-GI foods were classified as being digested and absorbed slowly and high-GI foods as being rapidly digested and absorbed , result ing in different glycaemic responses . Low-GI foods were found to induce benefits on certain risk factors for CVD and diabetes . Accordingly it has been proposed that GI classification of foods and drinks could be useful to help consumers make ' healthy food choices ' within specific food groups . Classification of foods according to their impact on blood glucose responses requires a st and ardised way of measuring such responses . The present review discusses the most relevant method ological considerations and highlights specific recommendations regarding number of subjects , sex , subject status , inclusion and exclusion criteria , pre-test conditions , CHO test dose , blood sampling procedures , sampling times , test r and omisation and calculation of glycaemic response area under the curve . All together , these technical recommendations will help to implement or reinforce measurement of GI in laboratories and help to ensure quality of results . Since there is current international interest in alternative ways of expressing glycaemic responses to foods , some of these methods are discussed The aim of the study was to assess whether a simple substitution of carbohydrate in the conventionally recommended diet with protein and fat would result in a clinical ly meaningful reduction in postpr and ial hyperglycaemia in subjects with type 2 diabetes mellitus ( T2DM ) . In all , sixteen subjects with T2DM treated with metformin only , fourteen male , with a median age of 65 ( 43 - 70 ) years , HbA1c of 6·5 % ( 47 mmol/l ) ( 5·5 - 8·3 % ( 37 - 67 mmol/l ) ) and a BMI of 30 ( sd 4·4 ) kg/m2 participated in the r and omised , cross-over study . A carbohydrate-reduced high-protein ( CRHP ) diet was compared with an iso-energetic conventional diabetes ( CD ) diet . Macronutrient contents of the CRHP/CD diets consisted of 31/54 % energy from carbohydrate , 29/16 % energy from protein and 40/30 % energy from fat , respectively . Each diet was consumed on 2 consecutive days in a r and omised order . Postpr and ial glycaemia , pancreatic and gut hormones , as well as satiety , were evaluated at breakfast and lunch . Compared with the CD diet , the CRHP diet  reduced postpr and ial AUC of glucose by 14 % , insulin by 22 % and glucose-dependent insulinotropic polypeptide by 17 % ( all P<0·001 ) , respectively . Correspondingly , glucagon AUC increased by 33 % ( P<0·001 ) , cholecystokinin by 24 % ( P=0·004 ) and satiety scores by 7 % ( P=0·035 ) , respectively . A moderate reduction in carbohydrate with an increase in fat and protein in the diet , compared with an energy-matched CD diet , greatly reduced postpr and ial glucose excursions and result ed in increased satiety in patients with well-controlled T2DM Brown rice ( BR ) and white rice ( WR ) produce different glycaemic responses and their consumption may affect the dietary management of obesity . In the present study , the effects of BR and WR on abdominal fat distribution , metabolic parameters and endothelial function were evaluated in subjects with the metabolic syndrome in a r and omised cross-over fashion . In study 1 , acute postpr and ial metabolic parameters and flow- and nitroglycerine-mediated dilation ( FMD and NMD ) of the brachial artery were determined in male volunteers with or without the metabolic syndrome after ingestion of either BR or WR . The increases in glucose and insulin AUC were lower after ingestion of BR than after ingestion of WR ( P= 0·041 and P= 0·045 , respectively ) . FMD values were decreased 60 min after ingestion of WR ( P= 0·037 v. baseline ) , but the decrease was protected after ingestion of BR . In study 2 , a separate cohort of male volunteers ( n 27 ) with the metabolic syndrome was r and omised into two groups with different BR and WR consumption patterns . The values of weight-based parameters were decreased after consumption of BR for 8 weeks , but returned to baseline values after a WR consumption period . Insulin resistance and total cholesterol and LDL-cholesterol levels were reduced after consumption of BR . In conclusion , consumption of BR may be beneficial , partly owing to the lowering of glycaemic response , and may protect postpr and ial endothelial function in subjects with the metabolic syndrome . Long-term beneficial effects of BR  on metabolic parameters and endothelial function were also observed AIMS Reducing the intake of low molecular weight carbohydrates with artificial nutrition may lower glycaemic response in patients with diabetes . We evaluated effects of a diabetes-specific carbohydrate modified oral nutritional supplement ( ONS ) during 12 weeks administration in 40 elderly type 2 normal weight patients with diabetes with previous involuntary weight loss . METHODS Prospect i ve , r and omised , double-blind , controlled trial . Patients ingested 2 × 200 ml/day diabetes-specific or isocaloric st and ard ONS ( control ) in addition to their regular diet .  Parameters of glucose and lipid metabolism , functional and nutritional status were assessed at baseline , weeks 6 and 12 . RESULTS Postpr and ial glucose increment 
    Output:
    
There were no significant overall effects on fasting glucose and insulin .
In this small heterogeneous set of studies , an association was found between the magnitude of the acute postpr and ial responses and the change in fasting glucose , but no other outcomes .