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: Aims : To evaluate the effects of zinc with or without other antioxidants on blood glucose , lipid profile , and serum creatinine in adult diabetics on long-term follow-up . Material s and methods : Patients ( n = 96 ) were r and omly allocated to three groups : group A ( n = 29 ) was supplemented with oral zinc sulfate ( 22 mg/day ) and multivitamin/mineral ( zinc+MVM ) preparation ; group B ( n = 31 ) was given the same preparation without zinc ( MVM ) ; and group C ( n = 36 ) was given a matching placebo for a period of 4 months in a single-blinded study . Blood sample s were taken at baseline and after 4 months of supplementation to assess blood glucose ( fasting and postpr and ial ) and glycosylated hemoglobin ( HbA1C% ) and serum levels of zinc , creatinine , and lipids . Results : The zinc+MVM group had a mean change of fasting blood sugar −0.33 mmol/L ( st and ard error of the mean 0.21 mmol/L ) and was significant ( P = 0.05 ) when compared with the other two groups ( mean change in the MVM group + 0.19 ( 0.31 ) mmol/L and + 0.43 ( 0.23 ) mmol/L in the control group , respectively ) . The HbA1C% level reduced significantly , irrespective of the baseline level , in zinc+MVM-supplemented individuals . In the other two groups , the change of HbA1C% level was not significant . Serum lipid levels reduced significantly in the zinc+MVM and MVM groups . Conclusions : Zinc+MVM supplementation showed beneficial effects in the metabolic control of adult diabetics in addition to elevating their serum zinc level . Zinc supplementation  improved glycemic control measured by HbA1C% and fasting and postpr and ial glucose . Furthermore , zinc supplementation  lowered serum cholesterol and cholesterol/high-density lipoprotein ratio Objective : To determine the effects of combined zinc ( Zn ) and chromium ( Cr ) supplementation on oxidative stress and glucose homeostasis of people with type 2 diabetes . Design : Tunisian adult subjects with HbA1C > 7.5 % were supplemented for 6 months with 30 mg/d of Zn as Zn gluconate or 400 μg/d of Cr as Cr pidolate or combined Zn/Cr supplementation or placebo . The effects of supplementation on plasma zinc ( Zn ) , copper ( Cu ) , selenium ( Se ) , urinary Zn , Cr , plasma thiobarbituric acid reactive substances ( TBARS ) , Cu-Zn superoxide dismutase ( SOD ) and Se glutathione peroxidase ( GPx ) in red blood cells , blood lipids and lipoproteins , HbA1C and fasting glucose were measured at the beginning of the study and after six months . Results : At the beginning of the study , more than 30 % of the subjects may have been Zn deficient with plasma Zn values less than 10.7 μmol/L , whereas levels of plasma Cu , Se and antioxidant RBC enzyme activities were in the normal ranges . Following supplementation , there were significant decreases of plasma TBARS in the Cr ( 13.6 % ) , Zn ( 13.6 % ) and Zn/Cr ( 18.2 % ) groups with no significant changes in the placebo group . The value for the TBARS of the control healthy Tunisian subjects was 2.08 ± 0.04 μmol/L and that of the Tunisian subjects with diabetes was 3.32 ± 0.05 μmol/L. This difference of 1.24 μmol/L between the control group and the subjects with diabetes was reduced from 36 % to 50 % in the three supplemented groups . Supplementation did not modify significantly HbA1C nor glucose homeostasis . No adverse effects  of Zn supplementation were observed on Cu status , HDL cholesterol nor interactions in Zn or Cr . Conclusions : These data suggest the potential beneficial antioxidant effects of the individual and combined supplementation of Zn and Cr in people with type 2 DM . These results are particularly important in light of the deleterious consequences of oxidative stress in people with diabetes Non-insulin-dependent diabetes mellitus ( NIDDM ) may cause vulnerability to moderate zinc deficiency . In this study , short-term zinc supplementation ( 30 mg/d as amino acid chelate for 3 wk ) elevated plasma zinc and activities of 5'-nucleotidase , a zinc-dependant enzyme , in 20 postmenopausal women with NIDDM .  Placebo , given to 20 other women with NIDDM , had no effects on these indexes nor on any others taken in this study . Although zinc supplementation doubled the mean value for 5'-nucleotidase activity , values were still significantly lower than those of age-matched control subjects . Plasma insulin-like growth factor I concentrations increased with zinc treatment if starting concentrations were < 165 microg/L but were unchanged if they were > 165 microg/L. Lipoprotein oxidation in vitro , which has abnormal lag times and propagation rates for subjects with NIDDM and for moderately zinc-deficient rats , were unchanged by zinc supplementation . Possibly , this lack of effect occurred because the zinc treatment did not normalize zinc status . In conclusion , this study supports the contention that moderate zinc deficiency occurs frequently in subjects with NIDDM DESIGN Placebo for 3 months , followed by 30 mg/day zinc gluconate in identical capsules . SETTING Diabetic out patients clinic at the University Hospital , Grenoble . SUBJECTS Diabetic patients cared for type I diabetes mellitus . 22 patients began the study , 4 dropped out . 10 patients suffered of an early retinopathy , 8 patients had no retinopathy . INTERVENTIONS In this order : T0 biological measurements , 3 months placebo treatment , T1 biological measurements , 3 months zinc gluconate treatment , T2 biological measurements . Plasma Zn , Cu , Se , thiobarbituric acid reactants and antioxidant enzymes were measured [ plasma and red glutathione peroxidase ( Se-GPx ) , red cell superoxide dismutase ( Cu-Zn-SOD ) ] . RESULTS Lower plasma zinc level in the two groups . An increase in zinc level was observed and was more important in diabetic patients with no retinopathy ( P = 0.05 ) . The thiobarbituric acid reactants were above the reference values in all the patients , and were decreased at T2 ( P < 0.05 ) . Increase of GPx activity after zinc supplementation in patients with retinopathy . CONCLUSIONS Zinc deficiency in insulin-dependent diabetic patients is corrected by a zinc supplementation . Moreover this supplementation decreases lipid peroxidation . The effects of zinc are different in diabetic patients with or without retinopathy . The increase in Se-GPx activity observed in patients with retinopathy could be linked to the protective effect of zinc on the protein itself Objective : The present study design ed to assess the effect of Mg+Zn , vitamin C+E , and combination of these micronutrients on blood pressure in type 2 diabetic patients . Material s and Methods : In a r and omized , double-blind , placebo controlled clinical trial , 69 type 2 diabetic patients were r and omly divided into four groups , each group receiving one of the following daily supplement for three months ; group M : 200 mg Mg and 30 mg Zn ( n = 16 ) , group V : 200 mg vitamin C and 150 mg vitamin E ( n = 18 ) , group MV : minerals plus vitamins ( n = 17 ) , group P : placebo ( n = 18 ) . Blood pressure was measured at the beginning and at the end of the trial . Treatment effects were analyzed by general linear modeling . Results : Results indicate that after three months of supplementation  levels of systolic , diastolic and mean blood pressure decreased significantly in the MV group by 8 mmHg ( 122 ± 16 vs. 130 ± 19 mmHg ) , 6 mmHg ( 77 ± 9 vs. 83 ± 11 mmHg ) , and 7 mmHg ( 92 ± 9 vs. 99 ± 13 mmHg ) , respectively ( p < 0.05 ) . Also combination of vitamin and mineral supplementation had significantly effects in increasing serum potassium ( p < 0.05 ) and in decreasing serum malondialdehyde ( p < 0.05 ) . There was no significant change in the levels of these parameters in the other three groups . Conclusion : The results of the present study indicated that in type 2 diabetic patients  a combination of vitamins and minerals , rather than vitamin C and E or Mg and Zn , might decrease blood pressure Glycemic control and prevention of secondary complications are the most important goals of using pharmacologic treatment of diabetes mellitus ( DM ) . The inadequate responses to oral hypoglycemic agents may be attributed to inadequate postreceptor events even when insulin levels are quite sufficient , and associated with oxidative stress induced by long-term hyperglycemia . The administration of antioxidants such as melatonin and zinc may improve tissue responses to insulin and increase the efficacy of drugs , e.g. metformin , which act through this pathway . This project was design ed to evaluate the effects of melatonin and zinc on the lipid profile and renal function in type 2 DM patients poorly controlled with metformin .  A placebo-controlled , double-blind clinical trial was performed in which 46 type 2 diabetic patients were selected and allocated into three groups . These groups were treated with single daily oral doses of both 10 mg of melatonin and 50 mg of zinc acetate alone : 10 mg of melatonin and 50 mg of zinc acetate in addition to the regularly used metformin or placebo , given at bedtime for 90 days . Fasting lipid profiles and microalbuminuria ( MAU ) were measured before initiating the treatments ( zero time ) and after 30 and 90 days of treatment . Daily administration of melatonin and zinc improved the impaired lipid profile and decreased the level of MAU ; the addition of this treatment regimen in combination with metformin improved the tissue responses to this oral hypoglycemic agent . In conclusion , the combination of melatonin and zinc acetate , when used alone or in combination with metformin , improves DM-related complications such as the impaired lipid profile and MAU in type 2 DM patients Background and aim There is accumulating evidence that shows the metabolism of zinc and vitamin A are altered in diabetes mellitus type I ( DMTI ) , thus the present study was conducted to evaluate the effects of combination of zinc and vitamin A supplementation on serum fasting blood sugar ( FBS ) , insulin , apoprotein B and apoprotein A-I in patients with DMTI . Design Forty-eight , 7-year-old to 20-year-old patients with at least 2 years of DMTI history , without any metabolic condition or medicine intake with insulin treatment , participated in a r and omized double-blind clinical trial for 12 weeks . They were divided into zinc and vitamin A (VAZ)-supplemented ( 10 mg elemental zinc per day and one-half of a 25,000 IU vitamin A tablet every other day ) and /or placebo groups after matching for sex , age and DMTI duration . Nutrient intake was estimated using 24 h recall and was analyzed by food processor program . Serum apoproteins B and A-I , FBS and insulin levels were determined at the beginning and end of the trial . Results There was significant increase in apoprotein A-I ( P < 0.0001 ) and a significant decrease in apoprotein B ( P < 0.0001 ) and apoprotein B/apoprotein A-I ratio ( P < 0.0001 ) at the end of the study compared with baseline values in the VAZ group but apoprotein A-I had a significant increase ( P < 0.0001 ) and the apoprotein B/apoprotein A-I ratio had a significant decrease ( P = 0.02 ) at the end of study in the VAZ group compared with the control group Conclusion It seems that combined zinc and vitamin A supplementation can improve serum apoprotein A-I , apoprotein B and the apoprotein B/apoprotein A-I ratio in patients with DMTI OBJECTIVE The present study was design ed to assess the effect of magnesium plus zinc , vitamins C plus E , and a combination of these micronutrients on nephropathy indexes in type 2 diabetic patients . RESEARCH DESIGN AND METHODS In a r and omized , double-blind , placebo-controlled clinical trial , 69 type 2 diabetic patients were r and omly divided into four groups , each group receiving one of the following daily supplement for 3 months : group M ( n = 16 ) , 200 mg Mg and 30 mg Zn ; group V ( n = 18 ) , 200 mg vitamin C and 100 IU vitamin E ; group MV ( n = 17 ) , minerals plus vitamins ; and group P ( n 
    Output:
    
agent
Studies have also shown a significant reduction in systolic and diastolic blood pressures after Zinc supplementation .
This first comprehensive systematic review and meta- analysis on the effects of Zinc supplementation in patients with diabetes demonstrates that Zinc supplementation  has beneficial effects on glycaemic control and promotes healthy lipid parameters .
***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: Aims : To evaluate the effects of zinc with or without other antioxidants on blood glucose , lipid profile , and serum creatinine in adult diabetics on long-term follow-up . Material s and methods : Patients ( n = 96 ) were r and omly allocated to three groups : group A ( n = 29 ) was supplemented with oral zinc sulfate ( 22 mg/day ) and multivitamin/mineral ( zinc+MVM ) preparation ; group B ( n = 31 ) was given the same preparation without zinc ( MVM ) ; and group C ( n = 36 ) was given a matching placebo for a period of 4 months in a single-blinded study . Blood sample s were taken at baseline and after 4 months of supplementation to assess blood glucose ( fasting and postpr and ial ) and glycosylated hemoglobin ( HbA1C% ) and serum levels of zinc , creatinine , and lipids . Results : The zinc+MVM group had a mean change of fasting blood sugar −0.33 mmol/L ( st and ard error of the mean 0.21 mmol/L ) and was significant ( P = 0.05 ) when compared with the other two groups ( mean change in the MVM group + 0.19 ( 0.31 ) mmol/L and + 0.43 ( 0.23 ) mmol/L in the control group , respectively ) . The HbA1C% level reduced significantly , irrespective of the baseline level , in zinc+MVM-supplemented individuals . In the other two groups , the change of HbA1C% level was not significant . Serum lipid levels reduced significantly in the zinc+MVM and MVM groups . Conclusions : Zinc+MVM supplementation showed beneficial effects in the metabolic control of adult diabetics in addition to elevating their serum zinc level . Zinc supplementation  improved glycemic control measured by HbA1C% and fasting and postpr and ial glucose . Furthermore , zinc supplementation  lowered serum cholesterol and cholesterol/high-density lipoprotein ratio Objective : To determine the effects of combined zinc ( Zn ) and chromium ( Cr ) supplementation on oxidative stress and glucose homeostasis of people with type 2 diabetes . Design : Tunisian adult subjects with HbA1C > 7.5 % were supplemented for 6 months with 30 mg/d of Zn as Zn gluconate or 400 μg/d of Cr as Cr pidolate or combined Zn/Cr supplementation or placebo . The effects of supplementation on plasma zinc ( Zn ) , copper ( Cu ) , selenium ( Se ) , urinary Zn , Cr , plasma thiobarbituric acid reactive substances ( TBARS ) , Cu-Zn superoxide dismutase ( SOD ) and Se glutathione peroxidase ( GPx ) in red blood cells , blood lipids and lipoproteins , HbA1C and fasting glucose were measured at the beginning of the study and after six months . Results : At the beginning of the study , more than 30 % of the subjects may have been Zn deficient with plasma Zn values less than 10.7 μmol/L , whereas levels of plasma Cu , Se and antioxidant RBC enzyme activities were in the normal ranges . Following supplementation , there were significant decreases of plasma TBARS in the Cr ( 13.6 % ) , Zn ( 13.6 % ) and Zn/Cr ( 18.2 % ) groups with no significant changes in the placebo group . The value for the TBARS of the control healthy Tunisian subjects was 2.08 ± 0.04 μmol/L and that of the Tunisian subjects with diabetes was 3.32 ± 0.05 μmol/L. This difference of 1.24 μmol/L between the control group and the subjects with diabetes was reduced from 36 % to 50 % in the three supplemented groups . Supplementation did not modify significantly HbA1C nor glucose homeostasis . No adverse effects  of Zn supplementation were observed on Cu status , HDL cholesterol nor interactions in Zn or Cr . Conclusions : These data suggest the potential beneficial antioxidant effects of the individual and combined supplementation of Zn and Cr in people with type 2 DM . These results are particularly important in light of the deleterious consequences of oxidative stress in people with diabetes Non-insulin-dependent diabetes mellitus ( NIDDM ) may cause vulnerability to moderate zinc deficiency . In this study , short-term zinc supplementation ( 30 mg/d as amino acid chelate for 3 wk ) elevated plasma zinc and activities of 5'-nucleotidase , a zinc-dependant enzyme , in 20 postmenopausal women with NIDDM .  Placebo , given to 20 other women with NIDDM , had no effects on these indexes nor on any others taken in this study . Although zinc supplementation doubled the mean value for 5'-nucleotidase activity , values were still significantly lower than those of age-matched control subjects . Plasma insulin-like growth factor I concentrations increased with zinc treatment if starting concentrations were < 165 microg/L but were unchanged if they were > 165 microg/L. Lipoprotein oxidation in vitro , which has abnormal lag times and propagation rates for subjects with NIDDM and for moderately zinc-deficient rats , were unchanged by zinc supplementation . Possibly , this lack of effect occurred because the zinc treatment did not normalize zinc status . In conclusion , this study supports the contention that moderate zinc deficiency occurs frequently in subjects with NIDDM DESIGN Placebo for 3 months , followed by 30 mg/day zinc gluconate in identical capsules . SETTING Diabetic out patients clinic at the University Hospital , Grenoble . SUBJECTS Diabetic patients cared for type I diabetes mellitus . 22 patients began the study , 4 dropped out . 10 patients suffered of an early retinopathy , 8 patients had no retinopathy . INTERVENTIONS In this order : T0 biological measurements , 3 months placebo treatment , T1 biological measurements , 3 months zinc gluconate treatment , T2 biological measurements . Plasma Zn , Cu , Se , thiobarbituric acid reactants and antioxidant enzymes were measured [ plasma and red glutathione peroxidase ( Se-GPx ) , red cell superoxide dismutase ( Cu-Zn-SOD ) ] . RESULTS Lower plasma zinc level in the two groups . An increase in zinc level was observed and was more important in diabetic patients with no retinopathy ( P = 0.05 ) . The thiobarbituric acid reactants were above the reference values in all the patients , and were decreased at T2 ( P < 0.05 ) . Increase of GPx activity after zinc supplementation in patients with retinopathy . CONCLUSIONS Zinc deficiency in insulin-dependent diabetic patients is corrected by a zinc supplementation . Moreover this supplementation decreases lipid peroxidation . The effects of zinc are different in diabetic patients with or without retinopathy . The increase in Se-GPx activity observed in patients with retinopathy could be linked to the protective effect of zinc on the protein itself Objective : The present study design ed to assess the effect of Mg+Zn , vitamin C+E , and combination of these micronutrients on blood pressure in type 2 diabetic patients . Material s and Methods : In a r and omized , double-blind , placebo controlled clinical trial , 69 type 2 diabetic patients were r and omly divided into four groups , each group receiving one of the following daily supplement for three months ; group M : 200 mg Mg and 30 mg Zn ( n = 16 ) , group V : 200 mg vitamin C and 150 mg vitamin E ( n = 18 ) , group MV : minerals plus vitamins ( n = 17 ) , group P : placebo ( n = 18 ) . Blood pressure was measured at the beginning and at the end of the trial . Treatment effects were analyzed by general linear modeling . Results : Results indicate that after three months of supplementation  levels of systolic , diastolic and mean blood pressure decreased significantly in the MV group by 8 mmHg ( 122 ± 16 vs. 130 ± 19 mmHg ) , 6 mmHg ( 77 ± 9 vs. 83 ± 11 mmHg ) , and 7 mmHg ( 92 ± 9 vs. 99 ± 13 mmHg ) , respectively ( p < 0.05 ) . Also combination of vitamin and mineral supplementation had significantly effects in increasing serum potassium ( p < 0.05 ) and in decreasing serum malondialdehyde ( p < 0.05 ) . There was no significant change in the levels of these parameters in the other three groups . Conclusion : The results of the present study indicated that in type 2 diabetic patients  a combination of vitamins and minerals , rather than vitamin C and E or Mg and Zn , might decrease blood pressure Glycemic control and prevention of secondary complications are the most important goals of using pharmacologic treatment of diabetes mellitus ( DM ) . The inadequate responses to oral hypoglycemic agents may be attributed to inadequate postreceptor events even when insulin levels are quite sufficient , and associated with oxidative stress induced by long-term hyperglycemia . The administration of antioxidants such as melatonin and zinc may improve tissue responses to insulin and increase the efficacy of drugs , e.g. metformin , which act through this pathway . This project was design ed to evaluate the effects of melatonin and zinc on the lipid profile and renal function in type 2 DM patients poorly controlled with metformin .  A placebo-controlled , double-blind clinical trial was performed in which 46 type 2 diabetic patients were selected and allocated into three groups . These groups were treated with single daily oral doses of both 10 mg of melatonin and 50 mg of zinc acetate alone : 10 mg of melatonin and 50 mg of zinc acetate in addition to the regularly used metformin or placebo , given at bedtime for 90 days . Fasting lipid profiles and microalbuminuria ( MAU ) were measured before initiating the treatments ( zero time ) and after 30 and 90 days of treatment . Daily administration of melatonin and zinc improved the impaired lipid profile and decreased the level of MAU ; the addition of this treatment regimen in combination with metformin improved the tissue responses to this oral hypoglycemic agent . In conclusion , the combination of melatonin and zinc acetate , when used alone or in combination with metformin , improves DM-related complications such as the impaired lipid profile and MAU in type 2 DM patients Background and aim There is accumulating evidence that shows the metabolism of zinc and vitamin A are altered in diabetes mellitus type I ( DMTI ) , thus the present study was conducted to evaluate the effects of combination of zinc and vitamin A supplementation on serum fasting blood sugar ( FBS ) , insulin , apoprotein B and apoprotein A-I in patients with DMTI . Design Forty-eight , 7-year-old to 20-year-old patients with at least 2 years of DMTI history , without any metabolic condition or medicine intake with insulin treatment , participated in a r and omized double-blind clinical trial for 12 weeks . They were divided into zinc and vitamin A (VAZ)-supplemented ( 10 mg elemental zinc per day and one-half of a 25,000 IU vitamin A tablet every other day ) and /or placebo groups after matching for sex , age and DMTI duration . Nutrient intake was estimated using 24 h recall and was analyzed by food processor program . Serum apoproteins B and A-I , FBS and insulin levels were determined at the beginning and end of the trial . Results There was significant increase in apoprotein A-I ( P < 0.0001 ) and a significant decrease in apoprotein B ( P < 0.0001 ) and apoprotein B/apoprotein A-I ratio ( P < 0.0001 ) at the end of the study compared with baseline values in the VAZ group but apoprotein A-I had a significant increase ( P < 0.0001 ) and the apoprotein B/apoprotein A-I ratio had a significant decrease ( P = 0.02 ) at the end of study in the VAZ group compared with the control group Conclusion It seems that combined zinc and vitamin A supplementation can improve serum apoprotein A-I , apoprotein B and the apoprotein B/apoprotein A-I ratio in patients with DMTI OBJECTIVE The present study was design ed to assess the effect of magnesium plus zinc , vitamins C plus E , and a combination of these micronutrients on nephropathy indexes in type 2 diabetic patients . RESEARCH DESIGN AND METHODS In a r and omized , double-blind , placebo-controlled clinical trial , 69 type 2 diabetic patients were r and omly divided into four groups , each group receiving one of the following daily supplement for 3 months : group M ( n = 16 ) , 200 mg Mg and 30 mg Zn ; group V ( n = 18 ) , 200 mg vitamin C and 100 IU vitamin E ; group MV ( n = 17 ) , minerals plus vitamins ; and group P ( n 
    Output:
    