Effect of fenugreek (Trigonella foenum-graecum L.) intake on glycemia: A meta-analysis of clinical trials

10.1186/1475-2891-13-7Nutrition Journal131

Comparison of active treatments for impaired glucose regulation : a Salford Royal Foundation Trust and Hitachi collaboration (CATFISH): study protocol for a randomized controlled trial

BACKGROUND: Diabetes is highly prevalent and contributes to significant morbidity and mortality worldwide. Behaviour change interventions that target health and lifestyle factors associated with the onset of diabetes can delay progression to diabetes, but many approaches rely on intensive one-to-one contact by specialists. Health coaching is an approach based on motivational interviewing that can potentially deliver behaviour change interventions by non-specialists at a larger scale. This trial protocol describes a randomized controlled trial (CATFISH) that tests whether a web-enhanced telephone health coaching intervention (IGR3) is more acceptable and efficient than a telephone-only health coaching intervention (IGR2) for people with prediabetes (impaired glucose regulation). METHODS: CATFISH is a two-parallel group, single-centre individually randomized controlled trial. Eligible participants are patients aged ≥18 years with impaired glucose regulation (HbA1c concentration between 42 and 47 mmol/mol), have access to a telephone and home internet and have been referred to an existing telephone health coaching service at Salford Royal NHS Foundation Trust, Salford, UK. Participants who give written informed consent will be randomized remotely (via a clinical trials unit) to either the existing pathway (IGR2) or the new web-enhanced pathway (IGR3) for 9 months. The primary outcome measure is patient acceptability at 9 months, determined using the Client Satisfaction Questionnaire. Secondary outcome measures at 9 months are: cost of delivery of IGR2 and IGR3, mental health, quality of life, patient activation, self-management, weight (kg), HbA1c concentration, and body mass index. All outcome measures will be analyzed on an intention-to-treat basis. A qualitative process evaluation will explore the experiences of participants and providers with a focus on understanding usability of interventions, mechanisms of behaviour change, and impact of context on delivery and user acceptability. Qualitative data will be analyzed using Framework. DISCUSSION: The CATFISH trial will provide a pragmatic assessment of whether a web-based information technology platform can enhance acceptability of a telephone health coaching intervention for people with prediabetes. The data will prove critical in understanding the role of web applications to improve engagement with evidence-based approaches to preventing diabetes. TRIAL REGISTRATION: ISRCTN16534814 . Registered on 7 February 2016

Effect of kiwifruit on metabolic health in patients with cardiovascular risk factors: a systematic review and meta-analysis

Naeti Suksomboon,1 Nalinee Poolsup,2 Wei Lin1 1Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand; 2Department of Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, Thailand Background: Kiwifruit seems to have beneficial effect on metabolic health because it contains abundant phytochemicals and antioxidants. This study aimed to assess the effect of kiwifruit on metabolic health in participants with cardiovascular risk factors.Methods: Literature was searched from PubMed, CENTRAL, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Scopus, Proquest, Latin American and Caribbean Health Sciences Literature, International Clinical Trials Registry Platform, Australia New Zealand Clinical Trials Registry, https://clinicaltrials.gov/, China National Knowledge Infrastructure, Wanfang Standards Database, European Association for the Study of Diabetes, and American Diabetes Association conferences up to August 2018. Citing references were manually searched. Randomized controlled trials were selected if they evaluated the effect of kiwifruit in patients with cardiovascular risk factors and reported SBP, DBP, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glycated hemoglobin (A1C), fasting plasma glucose (FPG), homeostasis model assessment of insulin resistance (HOMA-IR), 2-hour postprandial glucose, or body weight (BW). Data extraction and study quality assessment were performed independently by two investigators. Any inconsistencies were resolved by a third investigator. Treatment effect was estimated with mean difference (MD). Effect estimates were pooled using inverse-variance weighted method. Heterogeneity was assessed by the I2 and Q statistic.Results: Five randomized controlled trials involving 489 participants met the inclusion criteria. These included hypercholesterolemia, hypertension, type 2 diabetes mellitus, and male smokers. There was no effect of kiwifruit on SBP (MD, –1.72 mmHg; 95% CI: –4.27 to 0.84); DBP (MD, –2.35 mmHg; 95% CI: –5.10 to 0.41); TC (MD, –0.14 mmol/L; 95% CI: –0.71 to 0.43); TG (MD, –0.23 mmol/L; 95% CI: –0.66 to 0.20); LDL-C (MD, –0.41 mmol/L; 95% CI: –0.99 to 0.18); HDL-C (MD, 0.15 mmol/L; 95% CI: –0.18 to 0.48); FPG (MD, –0.08 mmol/L; 95% CI: –0.37 to 0.21); HOMA-IR (MD, –0.29; 95% CI: –0.61 to 0.02), and BW (MD, –1.08 kg; 95% CI: –4.22 to 2.05).Conclusion: This meta-analysis suggested no effect of kiwifruit on metabolic health in patients with cardiovascular risk factors, although there seemed to be a trend of improvement after kiwifruit intervention. Keywords:  Actinidia, metabolic diseases, lipid, cholesterol, blood glucose, blood pressur

HLA‐B27‐associated acute anterior uveitis in the University Referral Centre in North Thailand: clinical presentation and visual prognosis

BACKGROUND: Acute anterior uveitis (AAU) is the most frequent type of uveitis encountered in the west. Although human leucocyte antigen (HLA)‐B27‐associated ankylosing spondylitis was reported in South East Asia, it is not known whether HLA‐B27‐associated ocular disease is prevalent in Thailand. METHODS: A prospective study of 100 unrelated blood donors and 121 consecutive patients with AAU was carried out. All people underwent HLA‐B27 typing and full ocular examination. Radiological examination of the sacroiliac joints was conducted in patients with low back pain or arthralgias. RESULTS: The prevalence of HLA‐B27 was 10% among the blood donors in contrast with 44% in the AAU group (p<0.001). The clinical characteristics of HLA‐B27‐associated AAU were similar to those published throughout the world (unilaterality in 74%, hypopyon in 31%, recurrent AAU in 64%). However, the increased intraocular pressure (IOP) was more common in the HLA‐B‐27‐negative group (p = 0.03) than in their HLA‐B27‐positive counterparts. At least 15% of the HLA B27‐positive group had radiological signs of ankylosing spondylitis. CONCLUSION: The prevalence of HLA‐B27 in the population without uveitis in Thailand is about 10% and clinical characteristics of HLA‐B27‐positive AAU are similar to those reported in the west. In contrast with earlier reports, HLA‐B27‐negative AAU in Thailand was associated with increased IOP and should be further studied