Summary: In adults with abdominal obesity and at least one additional feature of metabolic syndrome (n=23), an 8-week isoenergetic diet enriched with wheat aleurone high in fermentable fiber and bioactive compounds demonstrated significant increase in postprandial butyrate concentrations with inverse correlation to oxidative stress markers (8-isoprostane) compared to a calorie-matched diet based on refined wheat products, with no significant differences observed for other short-chain fatty acids. PICO Description Population Twenty-three adults with abdominal obesity and at least one additional feature of the metabolic syndrome (elevated cardio-metabolic risk). Intervention An 8-week isoenergetic diet enriched with wheat aleurone—a bran fraction high in…
Author: FWA
Summary: In children and adolescents (n=179) with overweight or obesity enrolled in a healthy lifestyle programme in New Zealand, exposure to healthier neighbourhood food and physical activity environments as measured by the Healthy Environments Index for Children (HEIC) demonstrated modest improvements in certain dietary behaviours including increased water intake and reduced sweet drink intake at 24 months compared to lower exposure or low HEIC scores in rural or less supportive environments, with no consistent improvements in broader health outcomes and need for further validation. PICO Description Population Children and adolescents (n=179) in Taranaki, New Zealand, identified as having overweight or…
Clinical Context Managing postprandial glucose after high-fat, high-protein meals remains one of the most challenging aspects of type 1 diabetes (T1D) management. While standard insulin dosing focuses on carbohydrate counting, meals rich in fat and protein cause delayed and prolonged glucose elevations that simple pre-meal boluses cannot adequately cover. A pizza dinner, for example, may cause glucose to rise 4-6 hours after eating, long after rapid-acting insulin has peaked and waned. Extended (or “dual-wave” or “combo”) boluses address this by delivering insulin over several hours rather than all at once. However, calculating the appropriate dose for the extended portion remains…
Clinical Context Current automated insulin delivery (AID) systems—often called “artificial pancreas” technology—have dramatically improved glycemic control in type 1 diabetes, but they still require user input: patients must count carbohydrates and announce meals to trigger meal-time insulin boluses. This reliance on carbohydrate counting remains a significant burden. Carb counting is imprecise (studies show 50% estimation errors are common), and missed or late meal announcements result in postprandial hyperglycemia. The holy grail of diabetes technology is a “fully closed-loop” system that requires no user input—a truly automated pancreas that detects meals from glucose excursions and responds appropriately. However, insulin’s slow pharmacokinetics…
Summary: In adults with type 1 diabetes requiring insulin therapy, a fully closed-loop system combining automated insulin and pramlintide delivery without carbohydrate counting or meal announcements demonstrated maintained time in range (~79%) comparable to standard hybrid closed-loop control compared to standard hybrid closed-loop management with carbohydrate counting and meal boluses, with need for larger, longer investigations to confirm clinical benefits and safety. PICO Description Population Adults with type 1 diabetes requiring insulin therapy, participating in a pilot outpatient assessment. Intervention Fully closed-loop system combining automated insulin and pramlintide delivery without carbohydrate counting or meal announcements. Comparison Standard hybrid closed-loop management…
Clinical Context Postprandial hyperglycemia—the spike in blood glucose that follows meals—is increasingly recognized as an independent cardiovascular risk factor and a driver of glycemic variability. Even in individuals without diabetes, repeated glucose spikes promote oxidative stress, endothelial dysfunction, and inflammation. For people with diabetes or prediabetes, controlling these postprandial excursions is often more challenging than managing fasting glucose. While medication and macronutrient composition have traditionally dominated diabetes nutrition counseling, emerging research highlights that the order in which foods are consumed within a meal significantly impacts glucose response. The concept is intuitive: when vegetables and protein are consumed first, they reach…
Summary: In adult patients with diabetic foot ulcers requiring wound closure, application of polylactic acid (PLA) dermal matrix dressings demonstrated faster wound closure, improved patient quality of life, and reduced overall healthcare costs compared to collagen-based dressings as standard wound care, with no significant increase in adverse events and economic dominance as the cost-utility strategy. PICO Description Population Adult patients with diabetic foot ulcers requiring wound closure. Intervention Application of polylactic acid (PLA) dermal matrix dressings for wound management. Comparison Use of collagen-based dressings as standard wound care for diabetic foot ulcers. Outcome PLA dressings resulted in faster wound closure,…
Summary: In pregnant women diagnosed with gestational diabetes mellitus from both culturally and linguistically diverse (CALD) and non-CALD backgrounds, a low-intensity individualized dietary intervention designed to be feasible across cultural groups demonstrated similar acceptability and feasibility with comparable behavioral and dietary responses between groups compared to standard antenatal care not specifically adapted for cultural diversity, with need for more culturally nuanced research to optimize inclusivity and effectiveness. PICO Description Population Pregnant women diagnosed with gestational diabetes mellitus from both culturally and linguistically diverse (CALD) and non-CALD backgrounds. Intervention Low-intensity individualized dietary intervention designed to be feasible and acceptable across cultural…
Summary: In children diagnosed with type 1 diabetes mellitus requiring prandial insulin therapy, advanced insulin dose calculation algorithms designed to account for protein and fat content demonstrated significantly improved postprandial glycemic control with increased time in range and time in tight range compared to standard insulin dosing based on carbohydrate counting method alone, with some increase in hypoglycemic events observed. PICO Description Population Children diagnosed with type 1 diabetes mellitus requiring prandial insulin therapy. Intervention Two different advanced insulin dose calculation algorithms designed to account for protein and fat content to optimize postprandial glycemia. Comparison Standard insulin dosing based on…
Summary: In middle-aged women diagnosed with prediabetes, vitamin D supplementation according to the study protocol demonstrated significantly improved insulin secretion compared to placebo control group without vitamin D supplementation, with no significant effects on fasting blood sugar, lipid profiles, anthropometric indices, or body composition. PICO Description Population Middle-aged women diagnosed with prediabetes. Intervention Vitamin D supplementation according to the study protocol. Comparison Placebo control group without vitamin D supplementation. Outcome Vitamin D supplementation significantly improved insulin secretion but did not significantly affect fasting blood sugar, lipid profiles, anthropometric indices, or body composition. Clinical Context Vitamin D deficiency affects an estimated…