***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: The study was carried out in 10 females with type 2 diabetes aged 32 - 60 yrs . All of them were receiving weight-maintaining diets composed of 12 per cent protein , 30 per cent fat and 58 per cent carbohydrate . The only difference among all study -diets was the types of complex carbohydrate used . High-glycemic diet ( HG ) or low glycemic diet ( LG ) consisted mainly of glutinous rice or mungbean noodles and the intermediate-glycemic diet ( DM ) was solely white rice . After the metabolic evaluation of the baseline diet ( BL ) , each subject was placed on DM and followed r and omly by HG and LG or vice versa for 4 weeks each . The diurnal plasma glucose levels tended to be lowest after LG . The integrated plasma glucose levels among all diets were not different . The integrated insulin levels after DM and LG did not differ but they were lower than HG and BL . Long-term ingestion of all test-diets spilt less urinary glucose than BL , the lowest was LG . HbA1 levels and nitrogen balance after all diets were better than BL , the best was LG . It was concluded that in addition to strict dietary control , ingestion of mungbean noodles ( a low glycemic diet ) without increasing fiber intake , can improve diabetic control and protein conservation in type 2 diabetes The influence of dietary carbohydrate types on insulin action and muscle substrates was investigated . Seven healthy young men ingested two isoenergetic diets with 46 - 47 % of energy as carbohydrates , 41 % as fat , and 13 - 14 % as protein , in which the carbohydrates either had a high glycemic index ( HGI ) or a low glycemic index ( LGI ) for 30 d , two times in a r and omized crossover design . A euglycemic hyperinsulinemic clamp procedure was performed at the end of each dietary period . Whole-body glucose uptake was similar with both diets at a low plasma insulin concentration ( 370 pmol/L ) but decreased ( P < 0.05 ) at a high insulin concentration ( 2.4 nmol/L ) with the LGI diet compared with the HGI diet . Higher plasma fatty acid concentrations during part of the day were found with the LGI diet compared with the HGI diet ( P < 0.05 ) . Initially , blood glucose and plasma insulin concentrations were lower ( P < 0.05 ) during part of the day with the LGI than with the HGI diet , but after 30 d of the diet this difference diminished . Muscle glycogen and triacylglycerol concentrations were increased ( P < 0.05 ) by 14 % and 22 % , respectively , with the HGI diet compared with the LGI diet , and muscle triacylglycerol concentrations did not correlate with insulin action . It is concluded that when ingesting a diet with an energy composition common in Western countries , switching the carbohydrates from high to low GI sources decreases insulin action on whole-body glucose disposal at a high but not at a physiologic plasma insulin concentration . Furthermore , adaptation in terms of carbohydrate digestion and /or absorption to a diet rich in LGI carbohydrates may take place over 4 wk Eight patients with noninsulin-dependent diabetes underwent two 2-wk study periods in r and om order during which they were provided with carbohydrate foods with either a high or low glycemic index ( GI ) . Over both high-GI and low-GI periods there were significant reductions in body weight , serum fructosamine , and cholesterol . Reductions in fasting blood glucose , HbA1c , and urinary c-peptide-to-creatinine ratio were significant only over the low-GI period despite a smaller mean weight loss . Reductions in triglyceride were significant only over the high-GI diet . Inclusion of low-GI foods into diets of patients with diabetes may be an additional measure that favorably influences carbohydrate metabolism without increasing insulin dem and BACKGROUND The optimal source and amount of dietary carbohydrate for managing type 2 diabetes ( T2DM ) are unknown . OBJECTIVE We aim ed to compare the effects of altering the glycemic index or the amount of carbohydrate on glycated hemoglobin ( HbA1c ) , plasma glucose , lipids , and C-reactive protein ( CRP ) in T2DM patients . DESIGN Subjects with T2DM managed by diet alone ( n=162 ) were r and omly assigned to receive high-carbohydrate , high-glycemic-index ( high-GI ) , high-carbohydrate , low-glycemic-index ( low-GI ) , or low-carbohydrate , high-monounsaturated-fat ( low-CHO ) diets for 1 y. RESULTS The high-GI , low-GI , and low-CHO diets contained , respectively , 47 % , 52 % , and 39 % of energy as carbohydrate and 31 % , 27 % , and 40 % of energy as fat ; they had GIs of 63 , 55 , and 59 , respectively . Body weight and HbA1c did not differ significantly between diets . Fasting glucose was higher ( P=0.041 ) , but 2-h postload glucose was lower ( P=0.010 ) after 12 mo of the low-GI diet . With the low-GI diet , overall mean triacylglycerol was 12 % higher and HDL cholesterol 4 % lower than with the low-CHO diet ( P<0.05 ) , but the difference in the ratio of total to HDL cholesterol disappeared by 6 mo ( time x diet interaction , P=0.044 ) . Overall mean CRP with the low-GI diet , 1.95 mg/L , was 30 % less than that with the high-GI diet , 2.75 mg/L ( P=0.0078 ) ; the concentration with the low-CHO diet , 2.35 mg/L , was intermediate . CONCLUSIONS In subjects with T2DM managed by diet alone with optimal glycemic control , long-term HbA1c was not affected by altering the GI or the amount of dietary carbohydrate . Differences in total : HDL cholesterol among diets had disappeared by 6 mo . However , because of sustained reductions in postpr and ial glucose and CRP , a low-GI diet may be preferred for the dietary management of T2DM The determine the effect of different foods on the blood glucose , 62 commonly eaten foods and sugars were fed individually to groups of 5 to 10 healthy fasting volunteers .  Blood glucose levels were measured over 2 h , and expressed as a percentage of the area under the glucose response curve when the same amount of carbohydrate was taken as glucose . The largest rises were seen with vegetables ( 70 + /- 5 % ) , followed by breakfast cereals ( 65 + /- 5 % ) , cereals and biscuits ( 60 + /- 3 % ) , fruit ( 50 + /- 5 % ) , dairy products ( 35 + /- 1 % ) , and dried legumes ( 31 + /- 3 % ) . A significant negative relationship was seen between fat ( p less than 0.01 ) and protein ( p less than 0.001 ) and postpr and ial glucose rise but not with fiber or sugar content OBJECTIVE To determine the long-term effect of low glycemic index dietary advice on metabolic control and quality of life in children with type 1 diabetes . RESEARCH DESIGN AND METHODS Children with type 1 diabetes ( n = 104 ) were recruited to a prospect i ve , stratified , r and omized , parallel study to examine the effects of a measured carbohydrate exchange ( CHOx ) diet versus a more flexible low-glycemic index ( GI ) dietary regimen on HbA(1c ) levels , incidence of hypo- and hyperglycemia , insulin dose , dietary intake , and measures of quality of life over 12 months . RESULTS At 12 months , children in the low-GI group had significantly better HbA(1c ) levels than those in the CHOx group ( 8.05 + /- 0.95 vs. 8.61 + /- 1.37 % , P = 0.05 ) . Rates of excessive hyperglycemia ( > 15 episodes per month ) were significantly lower in the low-GI group ( 35 vs. 66 % , P = 0.006 ) . There were no differences in insulin dose , hypoglycemic episodes , or dietary composition . The low-GI dietary regimen was associated with better quality of life for both children and parents . CONCLUSIONS Flexible dietary instruction based on the food pyramid with an emphasis of low-GI foods improves HbA(1c ) levels without increasing the risk of hypoglycemia and enhances the quality of life in children with diabetes OBJECTIVE To evaluate in type 1 diabetic patients 1 ) the long-term feasibility of a high-fiber ( HF ) diet composed exclusively of natural foodstuffs and 2 ) the efficacy of this diet in relation to blood glucose control and incidence of hypoglycemic episodes . RESEARCH DESIGN AND METHODS The study was r and omized with parallel groups . Participants were part of a larger multicenter study on the effects of acarbose on glucose control in diabetes .  A total of 63 type 1 diabetic patients , age 28 + /- 9 years , BMI 24 + /- 0.6 kg/m2 , after a 4-week run-in period on their habitual diet , were r and omized to either an HF ( n = 32 ) or a low-fiber ( LF ) diet ( n = 31 ) for 24 weeks . The two diets , composed exclusively of natural foodstuffs , were weight-maintaining and , aside from their fiber content , were similar for all nutrients . At the end of the run-in period and the dietary treatment , fasting blood sample s for the measurement of plasma cholesterol , HDL cholesterol , triglyceride , and HbA(1c ) were collected . A daily glycemic profile was performed on a day in which the participants had consumed a st and ard menu representative of their treatment diet ( HF or LF ) . RESULTS Of the 63 study subjects , 29 in the HF group ( 91 % ) and 25 in the LF group ( 81 % ) completed the study Compared with the LF diet , the HF diet after 24 weeks decreased both mean daily blood glucose concentrations ( P < 0.05 ) and number of hypoglycemic events ( P < 0.01 ) . When compliance to diet was taken into account , 83 % of the subjects on the HF diet and 88 % on the LF diet were compliant . In this subgroup , compared with the LF diet , the HF diet significantly reduced mean daily blood glucose concentrations ( P < 0.001 ) , HbA(1c ) ( P < 0.05 ) , and number of hypoglycemic events ( P < 0.01 ) . CONCLUSIONS In type 1 diabetic patients , an HF diet is feasible in the long term and , compared with an LF diet , improves glycemic control and reduces the number of hypoglycemic events Abstract Objective : To determine whether tight control of blood pressure prevents macrovascular and microvascular complications in patients with type 2 diabetes . Design : R and omised controlled trial comparing tight control of blood pressure aim ing at a blood pressure of < 150/85 mm Hg ( with the use of an angiotensin converting enzyme inhibitor captopril or a β blocker atenolol as main treatment ) with less tight control aim ing at a blood pressure of < 180/105 mm Hg . Setting : 20 hospital based clinics in Engl and , Scotl and , and Northern Irel and . Subjects : 1148 hypertensive patients with type 2 diabetes ( mean age 56 , mean blood pressure at entry 160/94 mm Hg ) ; 758 patients were allocated to tight control of blood pressure  and 390 patients to less tight control  with a median follow up of 8.4 years . Main outcome measures : Predefined clinical end points , fatal and non-fatal , related to diabetes , deaths related to diabetes , and all cause mortality . Surrogate measures of microvascular disease included urinary albumin excretion and retinal photography . Results : Mean blood pressure during follow up was significantly reduced in the group assigned tight blood pressure control ( 144/82 mm Hg ) compared with the group assigned to less tight control ( 154/87 mm Hg ) ( P<0.0001 ) . Reductions in risk in the group assigned to tight control compared with that assigned to less tight control were 24 % in diabetes related end points ( 95 % confidence interval 8 % to 38 % ) ( P=0.0046 ) , 32 % in deaths related to diabetes ( 6 % to 51 % ) ( P=0.019 ) , 44 % in strokes ( 11 % to 65 % ) ( P=0.013 ) , 
    Output:
    
AUTHORS ' CONCLUSIONS A low-GI diet can improve glycaemic control in diabetes without compromising hypoglycaemic events