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: OBJECTIVE Hypomagnesemia occurs in 25–38 % of patients with type 2 diabetes . Several studies have suggested an association between magnesium ( Mg ) depletion and insulin resistance and /or reduction of insulin secretion in these cases . Our purpose was to evaluate if Mg supplementation ( as magnesium oxide [ MgO ] ) would improve metabolic control in patients with type 2 diabetes . RESEARCH DESIGN AND METHODS We studied 128 patients with type 2 diabetes ( 32 men , 96 women , aged 30–69 years ) , treated by diet or diet plus oral antidiabetic drugs , in the Bahia Federal University Hospital , Brazil . Patients at risk for hypomagnesemia or with reduced renal function were excluded . This study was a clinical r and omized double-blind placebo-controlled trial . Patients received either placebo , 20.7 mmol MgO , or 41.4 mmol MgO daily(elementary Mg ) for 30 days . Mg concentrations were measured in plasma , in mononuclear cells , and in 24-h urine sample s. Fasting blood glucose , HbA1 , and fructosamine were used as parameters of metabolic control . RESULTS Of the patients , 47.7 % had low plasma Mg , and 31.1 % had low intramononuclear Mg levels . Intracellular Mg in patients with diabetes was significantly lower than in the normal population ( 62 blood donors ; 1.4 ± 0.6 vs. 1.7 ± 0.6 μg/mg of total proteins ) . No correlation was found between plasma and intracellular Mg concentrations ( r = −0.179 ; P = 0.15 ) or between Mg concentrations and glycemic control ( r = −0.165 ; P = 0.12 ) . Intracellular Mg levels were lower in patients with peripheral neuropathy than in those without ( 1.2 ± 0.5 vs. 1.5 ± 0.6 μg/mg ) . Similar findings were observed in patients with coronary disease ( 1.0 ± 0.5 vs. 1.5 ± 0.6 μg/mg ) . In the placebo and in the 20.7 mmol Mg groups , neither a change in plasma and intracellular levels nor an improvement in glycemic control were observed . Replacement with 41.4 mmol Mg tended to increase plasma , cellular , and urine Mg and caused a significant fall ( 4.1 ± 0.8 to 3.8 ± 0.7 mmol/1 ) in fructosamine ( normal , 1.87–2.87 mmol/1 ) . CONCLUSIONS Mg depletion is common in poorly controlled patients with type 2 diabetes , especially in those with neuropathy or coronary disease . More prolonged use of Mg in doses that are higher than usual is needed toestablish its routine or selective administration in patients with type 2 diabetes to improve control or prevent chronic complications 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 BACKGROUND We investigated the potential effects of chromium supplementation on QTc interval duration in type 2 diabetic patients . METHODS Of 60 patients with type 2 diabetes mellitus , 30 were r and omly assigned to group A , and 30 to group B. Group A received 1000 microg of chromium picolinate ( CrPic ) daily for 3 months , followed by placebo in the next 3 months ; group B was treated with placebo for the first 3 months and CrPic in the next 3 months . At each visit , QT interval was measured on a  st and ard electrocardiogram  by averaging 3 consecutive beats in leads II and V4 and corrected for heart rate with Bazett formula . RESULTS Although baseline QTc interval was similar in both groups ( 422 + /- 34 milliseconds in group A vs 425 + /- 24 milliseconds in group B , P = .77 ) , QTc interval at 3 months was shorter in group A ( 406 + /- 35 milliseconds ) than in group B ( 431 + /- 26 milliseconds , P = .01 ) . In the following 3 months , QTc interval shortened in group B but not in group A , which result ed in a comparable QTc interval duration of both groups at the end of the study ( 414 + /- 28 milliseconds in group A vs 409 + /- 22 milliseconds in group B , P = .50 ) . Apart from body mass index ( 31.4 + /- 4.2 kg/m2 in patients with QTc shortening vs 28.7 + /- 4.2 kg/m2 in patients without QTc shortening , P = .03 ) , none of the clinical and laboratory variables predicted QTc interval shortening in our patient cohort . CONCLUSIONS Short-term chromium supplementation shortens QTc interval in patients with type 2 diabetes mellitus OBJECTIVE Phytoestrogen consumption has been shown to reduce risk factors for cardiovascular disease . Type 2 diabetes confers an adverse cardiovascular risk profile particularly in women after menopause . The aim of this study was to determine whether a dietary supplement with soy protein and isoflavones affected insulin resistance , glycemic control , and cardiovascular risk markers in postmenopausal women with type 2 diabetes . RESEARCH DESIGN AND METHODS A total of 32 postmenopausal women with diet-controlled type 2 diabetes completed a r and omized , double blind , cross-over trial of dietary supplementation with phytoestrogens ( soy protein 30 g/day , isoflavones 132 mg/day ) versus placebo ( cellulose 30 g/day ) for 12 weeks , separated by a 2-week washout period . RESULTS Compliance with the dietary supplementation was > 90 % for both treatment phases . When compared with the mean percentage change from baseline seen after 12 weeks of placebo , phytoestrogen supplementation demonstrated significantly lower mean values for fasting insulin ( mean + /- SD 8.09 + /- 21.9 % , P = 0.006 ) , insulin resistance ( 6.47 + /- 27.7 % , P = 0.003 ) , HbA(1c ) ( 0.64 + /- 3.19 % , P = 0.048 ) , total cholesterol ( 4.07 + /- 8.13 % , P = 0.004 ) , LDL cholesterol ( 7.09 + /- 12.7 % , P = 0.001 ) , cholesterol/HDL cholesterol ratio ( 3.89 + /- 11.7 % , P = 0.015 ) , and free thyroxine ( 2.50 + /- 8.47 % , P = 0.004 ) . No significant change occurred in HDL cholesterol , triglycerides , weight , blood pressure , creatinine , dehydroepi and rosterone sulfate , and rostenedione , and the hypothalamic-pituitary-ovarian axis hormones . CONCLUSIONS These results show that dietary supplementation with soy phytoestrogens favorably alters insulin resistance , glycemic control , and serum lipoproteins in postmenopausal women with type 2 diabetes , thereby improving their cardiovascular risk profile Alpha-lipoic acid ( ALA ) , a naturally occuring compound and a radical scavenger was shown to enhance glucose transport and utilization in different experimental and animal models . Clinical studies described an increase of insulin sensitivity after acute and short-term ( 10 d ) parenteral administration of ALA . The effects of a 4-week oral treatment with alpha-lipoic acid were evaluated in a placebo-controlled , multicenter pilot study to determine see whether oral treatment also improves insulin sensitivity . Seventy-four patients with type-2 diabetes were r and omized to either placebo ( n = 19 ) ; or active treatment in various doses of 600 mg once daily ( n = 19 ) , twice daily ( 1200 mg ; n = 18 ) , or thrice daily ( 1800 mg ; n = 18 ) alpha-lipoic acid . An isoglycemic glucose-clamp was done on days 0 ( pre ) and 29 ( post ) . In this explorative study , analysis was done according to the number of subjects showing an improvement of insulin sensitivity after treatment . Furthermore , the effects of active vs. placebo treatment on insulin sensitivity was compared . All four groups were comparable and had a similar degree of hyperglycemia and insulin sensitivity at baseline . When compared to placebo , significantly more subjects had an increase in insulin-stimulated glucose disposal ( MCR ) after ALA treatment in each group . As there was no dose effect seen in the three different alpha-lipoic acid groups , all subjects receiving ALA were combined in the " active " group and then compared to placebo . This revealed significantly different changes in MCR after treatment ( + 27 % vs. placebo ; p < .01 ) . This placebo-controlled explorative study confirms previous observations of an increase of insulin sensitivity in type-2 diabetes after acute and chronic intravenous administration of ALA . The results suggest that oral administration of alpha-lipoic acid can improve insulin sensitivity in patients with type-2 diabetes . The encouraging findings of this pilot trial need to be substantiated by further investigations We demonstrated similar plasma concentrations and urinary losses but lower erythrocyte magnesium concentrations ( 2.18 + /- 0.04 vs 1.86 + /- 0.03 mmol/L , P less than 0.01 ) in twelve aged ( 77.8 + /- 2.1 y ) vs 25 young ( 36.1 + /- 0.4 y ) , nonobese subjects . Subsequently , aged subjects were enrolled in a double-blind , r and omized , crossover study in which placebo ( for 4 wk ) and chronic magnesium administration ( CMA ) ( 4.5 g/d for 4 wk ) were provided . At the end of each treatment period an intravenous glucose tolerance test ( 0.33 g/kg body wt ) and a euglycemic glucose clamp with simultaneous [D-3H]glucose infusion and indirect calorimetry were performed . CMA vs placebo significantly increased erythrocyte magnesium concentration and improved insulin response and action . Net increase in erythrocyte magnesium significantly and positively correlated with the decrease in erythrocyte membrane microviscosity and with the net increase in both insulin secretion and action . In aged patients , correction of a low erythrocyte magnesium concentration may allow an improvement of glucose h and ling BACKGROUND Some studies have shown potential benefit of vitamin E on platelet function , but several clinical trials failed to show improved cardiovascular outcome with alpha-tocopherol supplementation . Gamma-tocopherol , a major dietary form of vitamin E , may have protective properties different from those of alpha-tocopherol . OBJECTIVE We compared the effects of supplementation with alpha-tocop 
    Output:
    
agent
The review of trials identifies positive effects of these nutrients on various outcome measures relating to insulin resistance and cardiovascular factors .
A majority of the trials found a positive effect of chromium on fasting plasma glucose .
Isoflavones were found to have a positive effect on insulin resistance and cardiovascular outcome measures , but only when combined with soy proteins .
Vitamin E is reported to reduce oxidative stress at levels of 200 mg day(-1 ) or more
***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: OBJECTIVE Hypomagnesemia occurs in 25–38 % of patients with type 2 diabetes . Several studies have suggested an association between magnesium ( Mg ) depletion and insulin resistance and /or reduction of insulin secretion in these cases . Our purpose was to evaluate if Mg supplementation ( as magnesium oxide [ MgO ] ) would improve metabolic control in patients with type 2 diabetes . RESEARCH DESIGN AND METHODS We studied 128 patients with type 2 diabetes ( 32 men , 96 women , aged 30–69 years ) , treated by diet or diet plus oral antidiabetic drugs , in the Bahia Federal University Hospital , Brazil . Patients at risk for hypomagnesemia or with reduced renal function were excluded . This study was a clinical r and omized double-blind placebo-controlled trial . Patients received either placebo , 20.7 mmol MgO , or 41.4 mmol MgO daily(elementary Mg ) for 30 days . Mg concentrations were measured in plasma , in mononuclear cells , and in 24-h urine sample s. Fasting blood glucose , HbA1 , and fructosamine were used as parameters of metabolic control . RESULTS Of the patients , 47.7 % had low plasma Mg , and 31.1 % had low intramononuclear Mg levels . Intracellular Mg in patients with diabetes was significantly lower than in the normal population ( 62 blood donors ; 1.4 ± 0.6 vs. 1.7 ± 0.6 μg/mg of total proteins ) . No correlation was found between plasma and intracellular Mg concentrations ( r = −0.179 ; P = 0.15 ) or between Mg concentrations and glycemic control ( r = −0.165 ; P = 0.12 ) . Intracellular Mg levels were lower in patients with peripheral neuropathy than in those without ( 1.2 ± 0.5 vs. 1.5 ± 0.6 μg/mg ) . Similar findings were observed in patients with coronary disease ( 1.0 ± 0.5 vs. 1.5 ± 0.6 μg/mg ) . In the placebo and in the 20.7 mmol Mg groups , neither a change in plasma and intracellular levels nor an improvement in glycemic control were observed . Replacement with 41.4 mmol Mg tended to increase plasma , cellular , and urine Mg and caused a significant fall ( 4.1 ± 0.8 to 3.8 ± 0.7 mmol/1 ) in fructosamine ( normal , 1.87–2.87 mmol/1 ) . CONCLUSIONS Mg depletion is common in poorly controlled patients with type 2 diabetes , especially in those with neuropathy or coronary disease . More prolonged use of Mg in doses that are higher than usual is needed toestablish its routine or selective administration in patients with type 2 diabetes to improve control or prevent chronic complications 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 BACKGROUND We investigated the potential effects of chromium supplementation on QTc interval duration in type 2 diabetic patients . METHODS Of 60 patients with type 2 diabetes mellitus , 30 were r and omly assigned to group A , and 30 to group B. Group A received 1000 microg of chromium picolinate ( CrPic ) daily for 3 months , followed by placebo in the next 3 months ; group B was treated with placebo for the first 3 months and CrPic in the next 3 months . At each visit , QT interval was measured on a  st and ard electrocardiogram  by averaging 3 consecutive beats in leads II and V4 and corrected for heart rate with Bazett formula . RESULTS Although baseline QTc interval was similar in both groups ( 422 + /- 34 milliseconds in group A vs 425 + /- 24 milliseconds in group B , P = .77 ) , QTc interval at 3 months was shorter in group A ( 406 + /- 35 milliseconds ) than in group B ( 431 + /- 26 milliseconds , P = .01 ) . In the following 3 months , QTc interval shortened in group B but not in group A , which result ed in a comparable QTc interval duration of both groups at the end of the study ( 414 + /- 28 milliseconds in group A vs 409 + /- 22 milliseconds in group B , P = .50 ) . Apart from body mass index ( 31.4 + /- 4.2 kg/m2 in patients with QTc shortening vs 28.7 + /- 4.2 kg/m2 in patients without QTc shortening , P = .03 ) , none of the clinical and laboratory variables predicted QTc interval shortening in our patient cohort . CONCLUSIONS Short-term chromium supplementation shortens QTc interval in patients with type 2 diabetes mellitus OBJECTIVE Phytoestrogen consumption has been shown to reduce risk factors for cardiovascular disease . Type 2 diabetes confers an adverse cardiovascular risk profile particularly in women after menopause . The aim of this study was to determine whether a dietary supplement with soy protein and isoflavones affected insulin resistance , glycemic control , and cardiovascular risk markers in postmenopausal women with type 2 diabetes . RESEARCH DESIGN AND METHODS A total of 32 postmenopausal women with diet-controlled type 2 diabetes completed a r and omized , double blind , cross-over trial of dietary supplementation with phytoestrogens ( soy protein 30 g/day , isoflavones 132 mg/day ) versus placebo ( cellulose 30 g/day ) for 12 weeks , separated by a 2-week washout period . RESULTS Compliance with the dietary supplementation was > 90 % for both treatment phases . When compared with the mean percentage change from baseline seen after 12 weeks of placebo , phytoestrogen supplementation demonstrated significantly lower mean values for fasting insulin ( mean + /- SD 8.09 + /- 21.9 % , P = 0.006 ) , insulin resistance ( 6.47 + /- 27.7 % , P = 0.003 ) , HbA(1c ) ( 0.64 + /- 3.19 % , P = 0.048 ) , total cholesterol ( 4.07 + /- 8.13 % , P = 0.004 ) , LDL cholesterol ( 7.09 + /- 12.7 % , P = 0.001 ) , cholesterol/HDL cholesterol ratio ( 3.89 + /- 11.7 % , P = 0.015 ) , and free thyroxine ( 2.50 + /- 8.47 % , P = 0.004 ) . No significant change occurred in HDL cholesterol , triglycerides , weight , blood pressure , creatinine , dehydroepi and rosterone sulfate , and rostenedione , and the hypothalamic-pituitary-ovarian axis hormones . CONCLUSIONS These results show that dietary supplementation with soy phytoestrogens favorably alters insulin resistance , glycemic control , and serum lipoproteins in postmenopausal women with type 2 diabetes , thereby improving their cardiovascular risk profile Alpha-lipoic acid ( ALA ) , a naturally occuring compound and a radical scavenger was shown to enhance glucose transport and utilization in different experimental and animal models . Clinical studies described an increase of insulin sensitivity after acute and short-term ( 10 d ) parenteral administration of ALA . The effects of a 4-week oral treatment with alpha-lipoic acid were evaluated in a placebo-controlled , multicenter pilot study to determine see whether oral treatment also improves insulin sensitivity . Seventy-four patients with type-2 diabetes were r and omized to either placebo ( n = 19 ) ; or active treatment in various doses of 600 mg once daily ( n = 19 ) , twice daily ( 1200 mg ; n = 18 ) , or thrice daily ( 1800 mg ; n = 18 ) alpha-lipoic acid . An isoglycemic glucose-clamp was done on days 0 ( pre ) and 29 ( post ) . In this explorative study , analysis was done according to the number of subjects showing an improvement of insulin sensitivity after treatment . Furthermore , the effects of active vs. placebo treatment on insulin sensitivity was compared . All four groups were comparable and had a similar degree of hyperglycemia and insulin sensitivity at baseline . When compared to placebo , significantly more subjects had an increase in insulin-stimulated glucose disposal ( MCR ) after ALA treatment in each group . As there was no dose effect seen in the three different alpha-lipoic acid groups , all subjects receiving ALA were combined in the " active " group and then compared to placebo . This revealed significantly different changes in MCR after treatment ( + 27 % vs. placebo ; p < .01 ) . This placebo-controlled explorative study confirms previous observations of an increase of insulin sensitivity in type-2 diabetes after acute and chronic intravenous administration of ALA . The results suggest that oral administration of alpha-lipoic acid can improve insulin sensitivity in patients with type-2 diabetes . The encouraging findings of this pilot trial need to be substantiated by further investigations We demonstrated similar plasma concentrations and urinary losses but lower erythrocyte magnesium concentrations ( 2.18 + /- 0.04 vs 1.86 + /- 0.03 mmol/L , P less than 0.01 ) in twelve aged ( 77.8 + /- 2.1 y ) vs 25 young ( 36.1 + /- 0.4 y ) , nonobese subjects . Subsequently , aged subjects were enrolled in a double-blind , r and omized , crossover study in which placebo ( for 4 wk ) and chronic magnesium administration ( CMA ) ( 4.5 g/d for 4 wk ) were provided . At the end of each treatment period an intravenous glucose tolerance test ( 0.33 g/kg body wt ) and a euglycemic glucose clamp with simultaneous [D-3H]glucose infusion and indirect calorimetry were performed . CMA vs placebo significantly increased erythrocyte magnesium concentration and improved insulin response and action . Net increase in erythrocyte magnesium significantly and positively correlated with the decrease in erythrocyte membrane microviscosity and with the net increase in both insulin secretion and action . In aged patients , correction of a low erythrocyte magnesium concentration may allow an improvement of glucose h and ling BACKGROUND Some studies have shown potential benefit of vitamin E on platelet function , but several clinical trials failed to show improved cardiovascular outcome with alpha-tocopherol supplementation . Gamma-tocopherol , a major dietary form of vitamin E , may have protective properties different from those of alpha-tocopherol . OBJECTIVE We compared the effects of supplementation with alpha-tocop 
    Output:
    