Search Results (477)

Background/Objectives: The determination of glycated haemoglobin (HbA1c) is a cornerstone of the diagnosis and management of diabetes mellitus, serving as a reliable biomarker for assessing long-term glycaemic control. While high-performance liquid chromatography (HPLC) is regarded as the gold standard for HbA1c measurement, its widespread adoption is limited by high costs, operational complexity, and resource requirements. Alternative methodologies, including immunoturbidimetric assays, have garnered interest as practical solutions. This study evaluates the analytical performance of an immunoturbidimetric method for HbA1c determination and its comparability with a validated HPLC method. Methods: The evaluation process was conducted in accordance with the Clinical and Laboratory Standards Institute (CLSI) guidelines. The results from 178 human sample leftovers, covering the medical decision range, were compared with those obtained using the HPLC-based Menarini ADAMS A1c HA-8180T system. The analytical performance regarding repeatability and within-laboratory imprecision was also assessed. The probability risk of misinterpreting the analytical results was also calculated. Results: The Passing–Bablok regression indicated a strong correlation between the two methods, with a slope of 1.00 (95% CI: 1.00 to 1.04). The Bland–Altman analysis confirmed minimal systematic differences, showing a mean bias of −0.07% for NGSP and −0.74 mmol/mol for IFCC, both falling within the predefined total allowable error (ATE) limits. Imprecision studies demonstrated excellent repeatability and intermediate precision, with coefficients of variation (CV) ranging from 0.68% to 2.4% across all levels. The risk assessment of diagnostic misinterpretation indicated minimal deviation from an ideal analytical system, in which the measurement uncertainty was regarded as zero. Conclusions: The findings establish the immunoturbidimetric method as a reliable and cost-effective alternative to HPLC for routine HbA1c determination. Its strong analytical performance, combined with operational efficiency, makes it a valuable tool for laboratories, particularly in resource-limited settings, enhancing access to high-quality diabetes monitoring. Full article

Gestational diabetes mellitus (GDM) is a complication that affects 20% of pregnancies worldwide. It is associated with adverse short- and long-term cardiometabolic outcomes for both mother and infant. Effective management of GDM involves lifestyle modifications, including medical nutrition therapy (MNT) and physical activity (PA), with the addition of insulin or metformin if glycaemic control remains inadequate. However, substantial gaps persist in the determination of optimal medical nutrition therapy (MNT) for women with GDM. Challenges in MNT include individual variation in glucose tolerance and changing maternal physiology and dietary requirements during pregnancy. Achieving optimal glycaemic control depends on careful macronutrient balance, particularly the distribution and quality of carbohydrate intake and sufficient protein and fat intake. Additionally, micronutrient deficiencies, such as inadequate vitamin D, calcium, and essential minerals, may exacerbate oxidative stress, inflammation, and glycaemic dysregulation, further impacting foetal growth and development. Cultural beliefs and dietary practices among pregnant women can also hinder adherence to recommended nutritional guidelines. Conditions like hyperemesis gravidarum (HG) affect ~1% to 2% of pregnant women can result in unintended energy and nutrient deficits. This special issue explores the current evidence and major barriers to optimising dietary therapy for women with GDM. It also identifies future research priorities to advance clinical practice, improve maternal and foetal outcomes, and address gaps in personalised nutrition interventions. Full article

Background: Dietary fibre plays a crucial role in metabolic regulation, inflammation, and microbiome composition. However, its impact on systemic and oral health, particularly in periodontitis, remains unclear. This study investigated the effects of high- and low-fibre diets on body composition, glycaemic control, inflammation, microbiome, and metabolome in a murine model of experimental periodontitis. Methods: Thirty-six male C57BL/6 mice were randomised to a high-fibre (40% fibre) or low-fibre (5% fibre) diet for eight weeks. Body weight, fat mass, lean mass, fasting blood glucose, serum inflammatory markers, alveolar bone loss, and root length were assessed. Oral and faecal microbiome composition was analysed using 16S rRNA sequencing. Metabolomic and short-chain fatty acid (SCFA) profiling was conducted using liquid chromatography–mass spectrometry (LC-MS). Results: Mice on the high-fibre diet exhibited significantly lower body weight (p < 0.0001), fat mass (p = 0.0007), and lean mass (p < 0.0001) compared to the low-fibre group. Fasting blood glucose levels were significantly lower in the high-fibre group (p = 0.0013). TNF-α and IFN-γ levels were significantly elevated in the low-fibre group (p < 0.0001), suggesting a heightened pro-inflammatory state. While alveolar bone loss and root length did not differ significantly, microbiome analysis revealed distinct bacterial compositions (PERMANOVA, p < 0.05), with fibre-fermenting taxa enriched in high-fibre-fed mice. Metabolomic analysis identified 19 significantly altered metabolites, indicating dietary adaptations. Conclusions: A high-fibre diet improves glycaemic control, reduces systemic inflammation, and alters microbial and metabolic profiles in experimental periodontitis. These findings highlight dietary fibre’s role in modulating metabolic and inflammatory pathways relevant to periodontal and systemic diseases. Full article

Randomised controlled trials involving healthy participants were conducted to investigate the impact of cooking and ingestion patterns on the physiological response and preloading effect of air-dried jujube (AJ). The participants’ postprandial glycaemic and insulinemic responses were tested after ingestion of cooked or uncooked air-dried jujube containing 50 g (as a sole food source) or 15 g (as a preload food prior to a rice meal) of available carbohydrates. Compared with the uncooked AJ, the cooked air-dried jujube (CAJ) induced a 34.5% higher glycaemic peak, 57.1% greater glycaemic variability, and a 159.1% larger negative area under the glycaemic response curve when ingested as the only food in a meal. When eaten as a preload prior to a rice meal, the CAJ reduced the postprandial glycaemic peak by 25.17%. The CAJ preload enhanced insulin production in the 15 min after preloading but did not increase the total amount of postprandial insulin secretion. The result suggests that when taken as preload, the loose matrix of cooked fruits may exhibit glycaemic benefits by eliciting early insulin production and may therefore be conducive to the blood glucose management of a carbohydrate-laden meal. Full article

Background/Objectives: International guidelines recommend that all children and adolescents with type 1 diabetes (T1D) receive education on the glycaemic impact of fat and protein from diagnosis. In addition, the insulin strategy should be adjusted to compensate for fat and protein excursions. Data from continuous glucose monitoring (CGM) can guide insulin adjustment. This study sought to determine whether the current practices of dietitians in Australia and New Zealand align with guidelines. Methods: An anonymous, online survey of paediatric T1D dietitians working in tertiary centres (n = 20; Australia, n = 14, New Zealand, n = 6) was undertaken from February to March 2023. The Australian and New Zealand Society for Paediatric Endocrinology and Diabetes (ANZSPED) disseminated the survey link. The questionnaire covered three content domains: demographic information about the clinic and practitioner, the health professionals’ education practices regarding fat and protein, and the use of CGM. Results: This pilot study had a 100% response rate, with a dietitian representative from all eligible centres responding on behalf of the diabetes team. Only 10% (n = 2) of respondents both (i) provided education on the glycaemic impact of fat and protein to all families at diagnosis and (ii) always provided insulin strategies to manage fat and protein where it impacted glycemia, as per guidelines. Barriers to education included a lack of procedure (47%, n = 7), consumer resources (40%, n = 6), and time (33%, n = 5). Reasons for not recommending strategies to manage fat and protein were perceptions that the family was overwhelmed (100%, n = 10) or not interested (60%, n = 6), and uncertainty of the best strategy (40%, n = 4). CGM was used by “almost all” respondents to educate and adjust the insulin strategy (90%, n = 18). Conclusions: Most dietitians surveyed were not consistently providing fat and protein education and management strategies to children with T1D in line with guidelines. CGM is a key tool routinely used by dietitians in nutrition education to help guide insulin adjustment. Dietitians need greater support through educational resources for families and training in evidence-based strategies to manage deglycation from dietary fat and protein to align with guidelines. Full article

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease often associated with metabolic disorders such as diabetes mellitus. Recent research suggests a link between systemic inflammation and insulin–glucose dysregulation in HS. This study investigates the relationship between insulin–glucose homeostasis, diabetes mellitus and the haptoglobin concentration in HS patients. Methods: We assessed 95 HS patients and 49 controls using validated fasting-based function tests, including the Structural Parameter Inference Approach (SPINA), Homeostasis Model Assessment (HOMA) and Quantitative Insulin Sensitivity Check Index (QUICKI). Results: The HS patients had a significantly higher fasting insulin concentration (97.2 vs. 69.0 pmol/L, p = 0.035), increased insulin resistance (HOMA-IR: 3.47 vs. 2.57, p = 0.016) and impaired insulin sensitivity (SPINA-GR: 1.34 vs. 1.76 mol/s, p = 0.017). In diabetes, the insulin sensitivity was more strongly reduced (SPINA-GR: 0.61 vs. 1.41 mol/s, p = 0.0057) and the insulin resistance increased (HOMA-IR: 7.3 vs. 3.2, p = 0.017). Higher haptoglobin concentrations were accompanied by worse glycaemic control, demonstrating a significantly elevated fasting glucose (5.77 vs. 5.11 mmol/L, p = 0.043) concentration and HbA1c (5.7% vs. 5.4%, p = 0.0081) fraction. Conclusions: Our findings suggest that chronic inflammation in HS contributes to metabolic dysregulation, worsening insulin resistance and glycaemic control, particularly in those with elevated haptoglobin or diabetes. Full article

With the prevalence of obesity and overweight increasing at an alarming rate, more and more researchers are focused on identifying effective weight loss strategies. The ketogenic diet (KD), used as a treatment in epilepsy management for over 100 years, is additionally gaining popularity as a weight loss method. Although its efficacy in weight loss is well documented, the areas where it may be beneficial to other dietary approaches need to be carefully examined. The objective of this paper is to identify the potential benefits of the KD over alternative dietary weight loss strategies based on a comprehensive literature review. It has been shown that the KD may be more bioenergetically efficient than other dietary strategies, inter alia owing to its effect on curtailing hunger, improving satiety and decreasing appetite (influence on hunger and satiety hormones and the sensation of hunger), inducing faster initial weight loss (associated with lower glycogen levels and reduced water retention), and controlling glycaemia and insulinemia (directly attributable to the low-carbohydrate nature of KD and indirectly to the other areas described). These effects are accompanied by improved insulin sensitivity, reduced inflammation (through ketone bodies and avoidance of pro-inflammatory sugars), reduced need for pharmacological obesity control (the diet’s mechanisms are similar to those of medication but without the side effects), and positive impacts on psychological factors and food addiction. Based on the authors’ review of the latest research, it is reasonable to conclude that, due to these many additional health benefits, the KD may be advantageous to other diet-based weight loss strategies. This important hypothesis deserves further exploration, which could be achieved by including outcome measures other than weight loss in future clinical trials, especially when comparing different diets of equal caloric value. Full article

Aim: Mobile health (mHealth) applications have been reported to be effective in improving glycaemic control and cardiometabolic health, but mainly as part of shorter-term intervention studies. The aim of this study is to examine the effect of the ongoing Defeat Diabetes mHealth low-carbohydrate diet (LCD) intervention on clinical markers and cardiometabolic risk after 6 months of intervention. Methods: Data were collected via primary care physicians as part of routine T2D monitoring. These included HbA1c (primary outcome), blood pressure, blood lipids, and markers of kidney and liver function. Anthropometrics, as well as changes in the prescription of diabetes, hypertension, and dyslipidaemia medication, were also recorded. Calculated variables, total cholesterol to HDL-c, triglyceride to HDL-c, and waist to height ratios, were analysed to examine changes in cardiometabolic risk profile. Three-day food records were used to assess dietary intake and intervention adherence. Univariate regression models examined changes from baseline to 6 months. Results: Ninety-four participants remained in the study out of the ninety-nine at baseline (mean age 59 ± 11 years, 55 females). After 6 months of intervention, there were significant reductions in HbA1c by −1.0% (95% CI: −1.3 to −0.6), as well as in the liver enzymes ALT (−9.3 U/L 95% CI −16.3 to −2.4) and GGT (−18.8 U/L 95% CI: −31.4 to −6.3) across the cohort. In addition, there was a significant reduction in cardiometabolic risk, as measured by the calculated variables and a decrease in waist circumference (−4.6 cm 95% CI: −8.9 to −0.2). Conclusions: People with T2D receiving LCD education and resources through the Defeat Diabetes mHealth app (version 3.3.8) improved their glycaemic control after 6 months of intervention. Cardiometabolic risk profile and liver function also showed significant improvement. These findings indicate that the use of an LCD digital app is a valuable adjunct in the management of T2D. Full article

Background and objectives: Type 2 diabetes mellitus (T2DM) affects brain white matter microstructure. While diffusion tensor imaging (DTI) has been used to study white matter abnormalities in T2DM, it lacks specificity for complex white matter tracts. Neurite orientation dispersion and density imaging (NODDI) offers a more specific approach to characterising white matter microstructures. This study aims to explore white matter alterations in T2DM using both DTI and NODDI and assess their association with disease duration and glycaemic control, as indicated by HbA1c levels. Methods and Materials: We analysed white matter microstructure in 48 tracts using data from the UK Biobank, involving 1023 T2DM participants (39% women, mean age 66) and 30,744 non-T2DM controls (53% women, mean age 64). Participants underwent 3.0T multiparametric brain imaging, including T1-weighted and diffusion imaging for DTI and NODDI. We performed region-of-interest analyses on fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), orientation dispersion index (ODI), intracellular volume fraction (ICVF), and isotropic water fraction (IsoVF) to assess white matter abnormalities. Results: We observed reduced FA and ICVF, and increased MD, AD, RD, ODI, and IsoVF in T2DM participants compared to controls (p < 0.05). These changes were associated with longer disease duration and higher HbA1c levels (0 < r ≤ 0.2, p < 0.05). NODDI identified microstructural changes in white matter that were proxies for reduced neurite density and disrupted fibre orientation, correlating with disease progression and poor glucose control. In conclusion, NODDI contributed to DTI in capturing white matter differences in participants with type 2 diabetes, suggesting the feasibility of NODDI in detecting white matter alterations in type 2 diabetes. Type 2 diabetes can cause white matter microstructural abnormalities that have associations with glucose control. Conclusions: The NODDI diffusion model allows the characterisation of white matter neuroaxonal pathology in type 2 diabetes, giving biophysical information for understanding the impact of type 2 diabetes on brain microstructure. Future research should focus on the longitudinal tracking of these microstructural changes to better understand their potential as early biomarkers for cognitive decline in T2DM. Full article

Inflammation is associated with the pathophysiology of type 2 diabetes and COVID-19. Phytochemicals have the potential to modulate inflammation, expression of SARS-CoV-2 viral entry receptors (angiotensin-converting enzyme 2 (ACE2) and transmembrane protease, serine 2 (TMPRSS2)) and glucose transport in the gut. This study assessed the impact of phytochemicals on these processes. We screened 12 phytochemicals alongside 10 pharmaceuticals and three plant extracts, selected for known or hypothesised effects on the SARS-CoV-2 receptors and COVID-19 risk, for their effects on the expression of ACE2 or TMPRSS2 in differentiated Caco-2/TC7 human intestinal epithelial cells. Genistein, apigenin, artemisinin and sulforaphane were the most promising ones, as assessed by the downregulation of TMPRSS2, and thus they were used in subsequent experiments. The cells were then co-stimulated with pro-inflammatory cytokines interleukin-1 beta (IL-1β) and tumour necrosis factor-alpha (TNF-α) for ≤168 h to induce inflammation, which are known to induce multiple pathways, including the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway. Target gene expression (ACE2, TMPRSS2, SGLT1 (sodium-dependent glucose transporter 1) and GLUT2 (glucose transporter 2)) was measured by droplet digital PCR, while interleukin-1 (IL-6), interleukin-1 (IL-8) and ACE2 proteins were assessed using ELISA in both normal and inflamed cells. IL-1β and TNF-α treatment upregulated ACE2, TMPRSS2 and SGLT1 gene expression. ACE2 increased with the duration of cytokine exposure, coupled with a significant decrease in IL-8, SGLT1 and TMPRSS2 over time. Pearson correlation analysis revealed that the increase in ACE2 was strongly associated with a decrease in IL-8 (r = −0.77, p < 0.01). The regulation of SGLT1 gene expression followed the same pattern as TMPRSS2, implying a common mechanism. Although none of the phytochemicals decreased inflammation-induced IL-8 secretion, genistein normalised inflammation-induced increases in SGLT1 and TMPRSS2. The association between TMPRSS2 and SGLT1 gene expression, which is particularly evident in inflammatory conditions, suggests a common regulatory pathway. Genistein downregulated the inflammation-induced increase in SGLT1 and TMPRSS2, which may help lower the postprandial glycaemic response and COVID-19 risk or severity in healthy individuals and those with metabolic disorders. Full article

Background/Objectives: Working with young adults with T1D in outpatients clinic entails achieving a delicate balance between maintaining trust and improving diabetes management. By looking at the interactions between healthcare professionals and young adults with T1D as narrative emplotment, this article seeks to investigate how illness narratives are part of and actively worked on in consultations. Methods: Based on ethnographic observations of fourteen consultations with young adults 18–23 years of age, three narrative strategies to promote better diabetes management among the young adults were identified: (1) replacing sub-optimal practice with technology, (2) encouraging enhanced autonomy, and (3) setting realistic standards for diabetes care. Each strategy works to create a meaningful explanation for experienced challenges, formingas a basis for improved diabetes self-management. Results: Consultations were found to create a space where the meaning of living with an illness can be discussed between the healthcare professionals and the patients. Conclusions: Looking at how this meaning is negotiated in the consultations is an important aspect of understanding how daily diabetes management is made practicable, especially when working with young adults who are constituting their identities and often live with sub-optimal glycaemic control. Full article

Background/Objectives: The interest in creating new products to decrease the risk of developing non-communicable chronic diseases such as type 2 diabetes (T2D) is increasing. These products include traditional food sources used as part of diverse cultures around the world, such as dragon fruit. The aim of this study was to investigate the effects of a frozen red dragon fruit (FRDF) beverage on blood pressure, glycaemic response (GR) and insulinaemic response (IR), lipid profile (LP), total antioxidant status (TAS), and C-reactive protein (CRP) levels in healthy subjects and individuals at risk of T2D. Methods: A parallel design trial (UREC registration number 211527; ClinicalTrials.gov registration number NCT05199636/19 January 2022) lasting four weeks and involving three testing sessions was conducted; participants were randomly assigned to one of two treatments (following general health guidance or consuming FRDF beverage). Systolic and diastolic blood pressures were taken; venous blood samples were collected to determine the LP and CRP levels; and capillary blood samples were taken before and after consuming a standard glucose drink to evaluate GR and IR at 15 min intervals (first hour) and 30 min intervals (second hour). Results: Eighteen participants completed this study, nine healthy (28.44 ± 5.20 years) and nine at risk (31.78 ± 12.11 years). The daily consumption of an FRDF-based beverage for four weeks by individuals at risk of T2D resulted in a reduction in blood pressure and IR–incremental area under the curve. The LP showed a downward trend, and a significant difference between treatments (p = 0.009) was found for CRP levels. Conclusions: Beverages based on FRDF may have the potential to decrease the risk of T2D. Full article

Background: Metabolic syndrome (MetS) is a syndrome that comprises central obesity, increased serum triglyceride (TG) levels, decreased serum HDL cholesterol (HDL) levels, raised blood pressure (BP), and impaired glucose regulation, including prediabetic and diabetic glycaemic levels. Recently, the association with endometrial cancer (EC) has been described but it is unclear if the risk associated with MetS is higher than the individual effect of obesity alone. This study investigates the association between MetS components and differing MetS definitions on EC risk and compares the risk of MetS with the risk posed by obesity alone. It also analyses how MetS affects the risk of EC development in the pre- and post-menopausal subgroups. Methods: A prospective cohort study was undertaken using data from the UK biobank. Multivariable Cox proportional risk models with the time to diagnosis (years) were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of MetS and its components on the risk of EC. A subgroup analysis was also undertaken for pre- and post-menopausal participants. Kaplan–Meier (KM) was undertaken to assess the difference in the risk of EC development in differing BMI classes, and in pre- and post-menopausal subgroups. Results: A total of 177,005 females from the UK biobank were included in this study. Of those participants who developed EC (n = 1454), waist circumference > 80 cm, BMI > 30 kg/m², hypertension > 130/80 mmHg, hyperlipidaemia and diabetes (HbA1C > 48 mmol/L were significant predictors of EC development, with waist circumference being the strongest predictor (HR = 2.21; 95% CI: 1.98–2.47, p < 0.001). Comparing the pre- and post-menopausal subgroup, hypertriglyceridaemia and diabetes were the strongest predictors of EC in the pre-menopausal subgroup (HR = 1.53; 95% CI: 1.18–1.99 and HR = 1.51; 95% CI: 1.08–2.12, p < 0.05, respectively). Raised waist circumference was not a significant independent predictor in the pre-menopausal subgroup. A KM curve analysis showed a clear distinction between those with and without MetS in the pre-menopausal group, suggesting a benefit of testing for MetS components in pre-menopausal women with obesity. Conclusions: Components of MetS, both independently and in combination, significantly increase the risk of EC. Screening those with obesity for MetS in their pre-menopausal years may help to identify those at the highest risk. Full article

Carbohydrate intake (CI) has the largest impact on the short-term glycaemia of all nutrients, yet optimal CI management in gestational diabetes remains unclear. Objective: To examine CI behaviours in individuals with recently diagnosed gestational diabetes and their association with self-monitored blood glucose. Methods: Data from 97 individuals were collected using food and blood glucose diaries. CI (including amounts, types, and timing) was manually assessed using 15 g servings over 5–8 days, while a 3-day computerised analysis examined a broader intake of macro- and micronutrients. Results: Elevated fasting glycaemia (EFG) was associated with lower total CI (Mdn 10.8 vs. 12.5 servings/day, p = 0.006), missed meals (Mdn 1.4 vs. 0.0/week, p = 0.007), missed snacks (Mdn 10.5 vs. 7.5/week, p = 0.038), low-carbohydrate meals (<30 g; Mdn 4.3 vs. 2.0/week, p = 0.004), and a higher proportion of energy intake from fat (Mdn 35% vs. 33%, p = 0.047), as compared with in-target fasting glycaemia. In contrast, elevated postprandial glycaemia (EPG) was not significantly associated with total CI, low-carbohydrate meals (<30 g), low-carbohydrate snacks (<15 g), or high-carbohydrate loads (>50 g). EPG was instead associated with high-glycaemic index meals (Mdn 1.6 vs. 0.9 lunch meals/week, p = 0.026; Mdn 0.9 vs. 0.0 dinner meals/week, p = 0.023); and a lower intake of energy (Mdn 7650 kJ vs. 9070 kJ/day, p = 0.031), protein (Mdn 91 g vs. 109 g/day, p = 0.015), fat (Mdn 61 g vs. 84 g/day, p = 0.003), and multiple micronutrients (p <0.05), as compared with in-target postprandial glycaemia. Conclusions: CI profiles differed for individuals with EFG, as compared with EPG, emphasising the need for dietary guidelines tailored for gestational diabetes subtypes. Further interventional studies are needed to explore these findings, particularly the associations between EFG and low CI behaviours. Full article

Background: Type 2 Diabetes (T2D) is increasingly becoming a critical healthcare priority globally. Medical interventions are primary strategies for managing diabetes, but more recently, diet/nutrition therapy, including the use of functional food products such as cinnamon and/or cinnamon products, has garnered considerable attention. The focus of this systematic review and meta-analysis is to examine whether cinnamon improves blood glucose parameters, body mass index, and inflammatory markers in people with T2DM. Method: PRISMA and PICOS frameworks were used for the review. EBSCOhost was used to search for relevant literature in health science research databases, while EMBASE and reference lists were used to access other relevant articles. Results: For systematic review and meta-analysis, 14 and 12 studies, respectively, were included (five from Iran, two each from the USA and India, and one each from the UK, China, Germany, Portugal, and Iraq). All participants had T2DM with ages ranging from ≥30–65 years. The effect of cinnamon on glycaemic control and other parameters did not follow a regular pattern. Effect on HbA1c (nine studies and 605 participants; MD of −0.07 (95% CI, −0.13, −0.01, p = 0.02), postprandial blood glucose (PBG) and BMI showed significant (p < 0.05) reductions. However, cinnamon exhibited no significant (p > 0.05) impact on FBG (MD of −1.73 (95% CI, −3.98, 0.52, p = 0.13), CRP, TNF-α, and IL-6 in people with T2D; neither did the sensitivity test reveal any change in relation to these parameters. Conclusions: Cinnamon or cinnamon extracts/products are significantly effective in diabetes management through reduction in HbA1c, PBG, and BMI. Full article