human
***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 Green tea is one of the most popular beverages in the world . It is believed to have beneficial effects in the prevention and treatment of many diseases , one of which is type 2 diabetes . The aim of the study is to examine the effect of a decaffeinated green tea extract ( GTE ) providing a daily dose of 856 mg of epigallocatechin gallate ( EGCG ) on obese individuals with type 2 diabetes . MATERIAL S AND METHODS The clinical trial was a r and omized , double-blind , placebo-controlled clinical trial conducted from December 2007 through November 2008 . The subjects were r and omly assigned to either receive 1,500 mg of a decaffeinated GTE or placebo daily for 16 weeks . Sixty-eight of 80 subjects , ages 20 - 65 years with BMI > 25 kg/m2 and type 2 diabetes for more than one year , completed this study .  Homeostasis model assessment for insulin resistance ( HOMA-IR ) was used as the major outcome measurement . At baseline and after 16 weeks of treatment , anthropometric measurements , fasting glucose , hemoglobin A1C percent ( HbA1C ) , hormone peptides , and plasma lipoproteins were measured from both groups . RESULTS No statistically significant differences were detected between the decaffeinated GTE and placebo groups in any measured variable . A statistically significant within-group 0.4-percent reduction in HbA1C ( from 8.4 to 8.0 % ) was observed after GTE treatment compared to baseline . Within-group comparison also revealed that the GTE group had significant reductions in waist circumference ( WC ) , HOMA-IR index , and insulin level , and a significant increase in the level of ghrelin . Within-group comparison of those in the placebo group showed a significant increase in the level of ghrelin . CONCLUSIONS This study found no statistical difference in any measured variable between the decaffeinated GTE and placebo groups ; however , there were some statistically significant within-group changes detected . More research is required to determine whether a decaffeinated GTE st and ardized for EGCG content will provide any clinical benefits in obese individuals with type 2 diabetes . Clinical Trial Registration NO : NCT00567905 In vitro and in vivo animal studies have reported strong insulin-like or insulin-potentiating effects after cinnamon administration . Recently , a human intervention study showed that cinnamon supplementation ( 1 g/d ) strongly reduced fasting blood glucose concentration ( 30 % ) and improved the blood lipid profile in patients with type 2 diabetes . The objective of this study was to investigate the effects of cinnamon supplementation on insulin sensitivity and /or glucose tolerance and blood lipid profile in patients with type 2 diabetes . Therefore , a total of 25 postmenopausal patients with type 2 diabetes ( aged 62.9 + /- 1.5 y , BMI 30.4 + /- 0.9 kg/m2 ) participated in a 6-wk intervention during which they were supplemented with either cinnamon ( Cinnamomum cassia , 1.5 g/d ) or a placebo . Before and after 2 and 6 wk of supplementation , arterialized blood sample s were obtained and oral glucose tolerance tests were performed . Blood lipid profiles and multiple indices of whole-body insulin sensitivity were determined . There were no time x treatment interactions for whole-body insulin sensitivity or oral glucose tolerance . The blood lipid profile of fasting subjects did not change after cinnamon supplementation . We conclude that cinnamon supplementation ( 1.5 g/d ) does not improve whole-body insulin sensitivity or oral glucose tolerance and does not modulate blood lipid profile in postmenopausal patients with type 2 diabetes . More research on the proposed health benefits of cinnamon supplementation is warranted before health cl aims should be made Antioxidants are compounds physiologically produced or provided through the diet with a potential to inhibit the oxidation of important biological molecules , such as proteins , lipids , and DNA . The contemporary Greek diet is still strongly influenced by Mediterranean dietary traditions . The traditional Mediterranean diet ( MD ) is a plant-based diet with apparently beneficial health properties , to which a high antioxidant content may contribute . To explore this issue in detail , a data base of the content of > 200  Greek foods and recipes for a wide spectrum of antioxidant compounds and indices ( flavonoids , proanthocyannidins , other antioxidant microcomponents , and total antioxidant capacity ) was developed . The data base enabled the estimation of antioxidant intakes in Greece using the population -based European Prospect i ve Investigation into Cancer and Nutrition study , in which > 28,000 Greeks participate . The results of this work suggest that the contemporary MD in the Greek population is a rich source of a variety of antioxidants . These data can be used in studies about the relationship between antioxidant intake and chronic diseases in the Greek population Resveratrol is a naturally occurring polyphenolic compound . Numerous animal studies have been reported on its wide-ranging beneficial effects in the biological system including diabetes mellitus ( DM ) . We hypothesized , therefore , that oral supplementation of resveratrol would improve the glycemic control and the associated risk factors in patients with type 2 diabetes mellitus ( T2DM ) . The present clinical study was therefore carried out to test the hypothesis . Sixty-two patients with T2DM were enrolled from Government Headquarters Hospital , Ootacamund , India , in a prospect i ve , open-label , r and omized , controlled trial . Patients were r and omized into control and intervention groups . The control group received only oral hypoglycemic agents , whereas the intervention group received resveratrol ( 250 mg/d ) along with their oral hypoglycemic agents for a period of 3 months . Hemoglobin A(1c ) , lipid profile , urea nitrogen , creatinine , and protein were measured at the baseline and at the end of 3 months . The results reveal that supplementation of resveratrol for 3 months significantly improves the mean hemoglobin A(1c ) ( means ± SD , 9.99 ± 1.50 vs 9.65 ± 1.54 ; P < .05 ) , systolic blood pressure ( mean ± SD , 139.71 ± 16.10 vs 127.92 ± 15.37 ; P < .05 ) , total cholesterol ( mean ± SD , 4.70 ± 0.90 vs 4.33 ± 0.76 ; P < .05 ) , and total protein ( mean ± SD , 75.6 ± 4.6 vs 72.3 ± 6.2 ; P < .05 ) in T2DM . No significant changes in body weight and high-density lipoprotein and low-density lipoprotein cholesterols were observed . Oral supplementation of resveratrol is thus found to be effective in improving glycemic control and may possibly provide a potential adjuvant for the treatment and management of diabetes Diabetes is the most common cause of end-stage renal disease and an important risk factor for morbidity and mortality in dialysis patients . Glycemic control , utilizing serial measurement of glycosylated hemoglobin ( HbA1c ) , is generally recommended to limit end-organ damage , including cardiovascular morbidity and mortality . We , along with others , have previously suggested that HbA1c may not be a reliable measure of glycemic control in dialysis patients , and have therefore explored the use of serum fructosamine ( SF ) as an alternative marker . The objective of this study was to compare HbA1c levels with SF in monitoring glycemic control and associated morbidity ( infection and hospitalization ) in diabetic patients in a large urban hemodialysis ( HD ) center . We enrolled 100 diabetic HD patients and followed them up prospect ively for 3 years . Data on demographics , as well as biochemical and clinical data , including hospitalizations and infections , were recorded . The mean age was 63 years . In all 54 % were women and the majority were African Americans ( 72 % ) . As expected , HbA1c and albumin-corrected fructosamine ( AlbF ) levels were highly correlated and both were significantly associated with serum glucose . AlbF , however , was more highly correlated with mean glucose values when less than 150 mg/dl and was a more useful predictor of morbidity . By univariate logistic regression and by Poisson regression analysis , AlbF , but not HbA1c , was a significant predictor of hospitalization . Additionally , in patients dialyzed by arteriovenous ( AV ) access ( that is , excluding those dialyzed via vascular catheters ) , AlbF , but not HbA1c , was a significant predictor of infection . In conclusion , AlbF is as reliable a marker as HbA1c for glycemic control in diabetic patients on HD , and may be advantageous for patients with serum glucose in a desirable therapeutic range ( < 150 mg/dl ) . In addition , AlbF , but not HbA1c , is associated with morbidity ( hospitalizations and infections ) in diabetic patients on HD Aims /hypothesisThere is conflicting evidence regarding appropriate glycaemic targets for patients with type 2 diabetes . Here , we investigate the relationship between HbA1c and the risks of vascular complications and death in such patients . Methods Eleven thous and one hundred and forty patients were r and omised to intensive or st and ard glucose control in the Action in Diabetes and Vascular disease : Preterax and Diamicron Modified Release Controlled Evaluation ( ADVANCE ) trial . Glycaemic exposure was assessed as the mean of HbA1c measurements during follow-up and prior to the first event . Adjusted risks for each HbA1c decile were estimated using Cox models . Possible differences in the association between HbA1c and risks at different levels of HbA1c were explored using linear spline models . Results There was a non-linear relationship between mean HbA1c during follow-up and the risks of macrovascular events , microvascular events and death . Within the range of HbA1c studied ( 5.5–10.5 % ) , there was evidence of ‘ thresholds ’ , such that below HbA1c levels of 7.0 % for macrovascular events and death , and 6.5 % for microvascular events , there was no significant change in risks ( all p > 0.8 ) . Above these thresholds , the risks increased significantly : every 1 % higher HbA1c level was associated with a 38 % higher risk of a macrovascular event , a 40 % higher risk of a microvascular event and a 38 % higher risk of death ( all p < 0.0001 ) . Conclusions /interpretationIn patients with type 2 diabetes , HbA1c levels were associated with lower risks of macrovascular events and death down to a threshold of 7.0 % and microvascular events down to a threshold of 6.5 % . There was no evidence of lower risks below these levels but neither was there clear evidence of harm . Trial Registration : Clinical Trial.gov NCT00145925 Funding : Servier and the National Health and Medical Research Council of Australia ( project grant ID 211086 and programme grant IDs 358395 and 571281 Recent evidence suggests that tea from Camellia sinensis ( eg , green , oolong , and black tea ) may have a hypoglycemic effect . We evaluated the ability of an extract of green and black tea to improve glucose control over a 3-month period . A double-blind , placebo-controlled , r and omized multiple-dose ( 0 , 375 , or 750 mg per day for 3 months ) study in adults with type 2 diabetes mellitus not taking insulin was performed . The primary end point was change in glycosylated hemoglobin at 3 months . The 49 subjects who completed this study were predominantly white with an average age of 65 years and a median duration of diabetes of 6 years , and 80 % of them reported using hypoglycemic medication .  After 3 months , the mean changes in glycosylated hemoglobin were + 0.4 ( 95 % confidence interval , 0.2 - 0.6 ) , + 0.3 ( 0.1 - 0.5 ) , and + 0.5 ( 0.1 - 0.9 ) in the placebo , 375-mg , and 750-mg arms , respectively . The changes were not significantly different between study arms . We did not find a hypoglycemic effect of extract of green and black tea in adults with type 2 diabetes mellitus OBJECTIVE To assess the effect of dietary flavonoids on cardiovascular disease ( CVD ) risk in postmenopausal women with type 2 diabetes on established statin and hypoglycemic therapy . RESEARCH DESIGN AND METHODS Despite being medicated , patients with type 2 diabetes have elevated CVD risk , particularly postmenopausal women . Although dietary flavonoids have been shown to reduce CVD risk factors in healthy participants , no long-term trials have examined the additional benefits of flavonoids to CVD risk in medicated postmenopausal women with type 2 diabetes . We conducted a parallel- design , placebo-controlled trial with type 2 diabetic patients r and omized to consume 27 g/day ( split dose ) flavonoid-enriched chocolate ( containing 850 mg flavan-3-ols 
    Output:
    
agent
In conclusion , polyphenols can successfully reduce HbA1c in T2DM without any intervention at glycemia , and could contribute to the prevention of diabetes complications
***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 Green tea is one of the most popular beverages in the world . It is believed to have beneficial effects in the prevention and treatment of many diseases , one of which is type 2 diabetes . The aim of the study is to examine the effect of a decaffeinated green tea extract ( GTE ) providing a daily dose of 856 mg of epigallocatechin gallate ( EGCG ) on obese individuals with type 2 diabetes . MATERIAL S AND METHODS The clinical trial was a r and omized , double-blind , placebo-controlled clinical trial conducted from December 2007 through November 2008 . The subjects were r and omly assigned to either receive 1,500 mg of a decaffeinated GTE or placebo daily for 16 weeks . Sixty-eight of 80 subjects , ages 20 - 65 years with BMI > 25 kg/m2 and type 2 diabetes for more than one year , completed this study .  Homeostasis model assessment for insulin resistance ( HOMA-IR ) was used as the major outcome measurement . At baseline and after 16 weeks of treatment , anthropometric measurements , fasting glucose , hemoglobin A1C percent ( HbA1C ) , hormone peptides , and plasma lipoproteins were measured from both groups . RESULTS No statistically significant differences were detected between the decaffeinated GTE and placebo groups in any measured variable . A statistically significant within-group 0.4-percent reduction in HbA1C ( from 8.4 to 8.0 % ) was observed after GTE treatment compared to baseline . Within-group comparison also revealed that the GTE group had significant reductions in waist circumference ( WC ) , HOMA-IR index , and insulin level , and a significant increase in the level of ghrelin . Within-group comparison of those in the placebo group showed a significant increase in the level of ghrelin . CONCLUSIONS This study found no statistical difference in any measured variable between the decaffeinated GTE and placebo groups ; however , there were some statistically significant within-group changes detected . More research is required to determine whether a decaffeinated GTE st and ardized for EGCG content will provide any clinical benefits in obese individuals with type 2 diabetes . Clinical Trial Registration NO : NCT00567905 In vitro and in vivo animal studies have reported strong insulin-like or insulin-potentiating effects after cinnamon administration . Recently , a human intervention study showed that cinnamon supplementation ( 1 g/d ) strongly reduced fasting blood glucose concentration ( 30 % ) and improved the blood lipid profile in patients with type 2 diabetes . The objective of this study was to investigate the effects of cinnamon supplementation on insulin sensitivity and /or glucose tolerance and blood lipid profile in patients with type 2 diabetes . Therefore , a total of 25 postmenopausal patients with type 2 diabetes ( aged 62.9 + /- 1.5 y , BMI 30.4 + /- 0.9 kg/m2 ) participated in a 6-wk intervention during which they were supplemented with either cinnamon ( Cinnamomum cassia , 1.5 g/d ) or a placebo . Before and after 2 and 6 wk of supplementation , arterialized blood sample s were obtained and oral glucose tolerance tests were performed . Blood lipid profiles and multiple indices of whole-body insulin sensitivity were determined . There were no time x treatment interactions for whole-body insulin sensitivity or oral glucose tolerance . The blood lipid profile of fasting subjects did not change after cinnamon supplementation . We conclude that cinnamon supplementation ( 1.5 g/d ) does not improve whole-body insulin sensitivity or oral glucose tolerance and does not modulate blood lipid profile in postmenopausal patients with type 2 diabetes . More research on the proposed health benefits of cinnamon supplementation is warranted before health cl aims should be made Antioxidants are compounds physiologically produced or provided through the diet with a potential to inhibit the oxidation of important biological molecules , such as proteins , lipids , and DNA . The contemporary Greek diet is still strongly influenced by Mediterranean dietary traditions . The traditional Mediterranean diet ( MD ) is a plant-based diet with apparently beneficial health properties , to which a high antioxidant content may contribute . To explore this issue in detail , a data base of the content of > 200  Greek foods and recipes for a wide spectrum of antioxidant compounds and indices ( flavonoids , proanthocyannidins , other antioxidant microcomponents , and total antioxidant capacity ) was developed . The data base enabled the estimation of antioxidant intakes in Greece using the population -based European Prospect i ve Investigation into Cancer and Nutrition study , in which > 28,000 Greeks participate . The results of this work suggest that the contemporary MD in the Greek population is a rich source of a variety of antioxidants . These data can be used in studies about the relationship between antioxidant intake and chronic diseases in the Greek population Resveratrol is a naturally occurring polyphenolic compound . Numerous animal studies have been reported on its wide-ranging beneficial effects in the biological system including diabetes mellitus ( DM ) . We hypothesized , therefore , that oral supplementation of resveratrol would improve the glycemic control and the associated risk factors in patients with type 2 diabetes mellitus ( T2DM ) . The present clinical study was therefore carried out to test the hypothesis . Sixty-two patients with T2DM were enrolled from Government Headquarters Hospital , Ootacamund , India , in a prospect i ve , open-label , r and omized , controlled trial . Patients were r and omized into control and intervention groups . The control group received only oral hypoglycemic agents , whereas the intervention group received resveratrol ( 250 mg/d ) along with their oral hypoglycemic agents for a period of 3 months . Hemoglobin A(1c ) , lipid profile , urea nitrogen , creatinine , and protein were measured at the baseline and at the end of 3 months . The results reveal that supplementation of resveratrol for 3 months significantly improves the mean hemoglobin A(1c ) ( means ± SD , 9.99 ± 1.50 vs 9.65 ± 1.54 ; P < .05 ) , systolic blood pressure ( mean ± SD , 139.71 ± 16.10 vs 127.92 ± 15.37 ; P < .05 ) , total cholesterol ( mean ± SD , 4.70 ± 0.90 vs 4.33 ± 0.76 ; P < .05 ) , and total protein ( mean ± SD , 75.6 ± 4.6 vs 72.3 ± 6.2 ; P < .05 ) in T2DM . No significant changes in body weight and high-density lipoprotein and low-density lipoprotein cholesterols were observed . Oral supplementation of resveratrol is thus found to be effective in improving glycemic control and may possibly provide a potential adjuvant for the treatment and management of diabetes Diabetes is the most common cause of end-stage renal disease and an important risk factor for morbidity and mortality in dialysis patients . Glycemic control , utilizing serial measurement of glycosylated hemoglobin ( HbA1c ) , is generally recommended to limit end-organ damage , including cardiovascular morbidity and mortality . We , along with others , have previously suggested that HbA1c may not be a reliable measure of glycemic control in dialysis patients , and have therefore explored the use of serum fructosamine ( SF ) as an alternative marker . The objective of this study was to compare HbA1c levels with SF in monitoring glycemic control and associated morbidity ( infection and hospitalization ) in diabetic patients in a large urban hemodialysis ( HD ) center . We enrolled 100 diabetic HD patients and followed them up prospect ively for 3 years . Data on demographics , as well as biochemical and clinical data , including hospitalizations and infections , were recorded . The mean age was 63 years . In all 54 % were women and the majority were African Americans ( 72 % ) . As expected , HbA1c and albumin-corrected fructosamine ( AlbF ) levels were highly correlated and both were significantly associated with serum glucose . AlbF , however , was more highly correlated with mean glucose values when less than 150 mg/dl and was a more useful predictor of morbidity . By univariate logistic regression and by Poisson regression analysis , AlbF , but not HbA1c , was a significant predictor of hospitalization . Additionally , in patients dialyzed by arteriovenous ( AV ) access ( that is , excluding those dialyzed via vascular catheters ) , AlbF , but not HbA1c , was a significant predictor of infection . In conclusion , AlbF is as reliable a marker as HbA1c for glycemic control in diabetic patients on HD , and may be advantageous for patients with serum glucose in a desirable therapeutic range ( < 150 mg/dl ) . In addition , AlbF , but not HbA1c , is associated with morbidity ( hospitalizations and infections ) in diabetic patients on HD Aims /hypothesisThere is conflicting evidence regarding appropriate glycaemic targets for patients with type 2 diabetes . Here , we investigate the relationship between HbA1c and the risks of vascular complications and death in such patients . Methods Eleven thous and one hundred and forty patients were r and omised to intensive or st and ard glucose control in the Action in Diabetes and Vascular disease : Preterax and Diamicron Modified Release Controlled Evaluation ( ADVANCE ) trial . Glycaemic exposure was assessed as the mean of HbA1c measurements during follow-up and prior to the first event . Adjusted risks for each HbA1c decile were estimated using Cox models . Possible differences in the association between HbA1c and risks at different levels of HbA1c were explored using linear spline models . Results There was a non-linear relationship between mean HbA1c during follow-up and the risks of macrovascular events , microvascular events and death . Within the range of HbA1c studied ( 5.5–10.5 % ) , there was evidence of ‘ thresholds ’ , such that below HbA1c levels of 7.0 % for macrovascular events and death , and 6.5 % for microvascular events , there was no significant change in risks ( all p > 0.8 ) . Above these thresholds , the risks increased significantly : every 1 % higher HbA1c level was associated with a 38 % higher risk of a macrovascular event , a 40 % higher risk of a microvascular event and a 38 % higher risk of death ( all p < 0.0001 ) . Conclusions /interpretationIn patients with type 2 diabetes , HbA1c levels were associated with lower risks of macrovascular events and death down to a threshold of 7.0 % and microvascular events down to a threshold of 6.5 % . There was no evidence of lower risks below these levels but neither was there clear evidence of harm . Trial Registration : Clinical Trial.gov NCT00145925 Funding : Servier and the National Health and Medical Research Council of Australia ( project grant ID 211086 and programme grant IDs 358395 and 571281 Recent evidence suggests that tea from Camellia sinensis ( eg , green , oolong , and black tea ) may have a hypoglycemic effect . We evaluated the ability of an extract of green and black tea to improve glucose control over a 3-month period . A double-blind , placebo-controlled , r and omized multiple-dose ( 0 , 375 , or 750 mg per day for 3 months ) study in adults with type 2 diabetes mellitus not taking insulin was performed . The primary end point was change in glycosylated hemoglobin at 3 months . The 49 subjects who completed this study were predominantly white with an average age of 65 years and a median duration of diabetes of 6 years , and 80 % of them reported using hypoglycemic medication .  After 3 months , the mean changes in glycosylated hemoglobin were + 0.4 ( 95 % confidence interval , 0.2 - 0.6 ) , + 0.3 ( 0.1 - 0.5 ) , and + 0.5 ( 0.1 - 0.9 ) in the placebo , 375-mg , and 750-mg arms , respectively . The changes were not significantly different between study arms . We did not find a hypoglycemic effect of extract of green and black tea in adults with type 2 diabetes mellitus OBJECTIVE To assess the effect of dietary flavonoids on cardiovascular disease ( CVD ) risk in postmenopausal women with type 2 diabetes on established statin and hypoglycemic therapy . RESEARCH DESIGN AND METHODS Despite being medicated , patients with type 2 diabetes have elevated CVD risk , particularly postmenopausal women . Although dietary flavonoids have been shown to reduce CVD risk factors in healthy participants , no long-term trials have examined the additional benefits of flavonoids to CVD risk in medicated postmenopausal women with type 2 diabetes . We conducted a parallel- design , placebo-controlled trial with type 2 diabetic patients r and omized to consume 27 g/day ( split dose ) flavonoid-enriched chocolate ( containing 850 mg flavan-3-ols 
    Output:
    