Increasing dietary fiber intake for type 2 diabetes mellitus management: A systematic review

BACKGROUND Type 2 diabetes is a chronic,non-communicable disease with a substantial global impact,affecting a significant number of individuals.Its etiology is closely tied to imbalanced dietary practices and sedentary lifestyles.Conversely,increasing die-tary fiber(DF)intake has consistently demonstrated health benefits in numerous studies,including improvements in glycemic control and weight management.AIM To investigate the efficacy of DF interventions in the management of type 2 diabetes mellitus(T2DM).METHODS A systematic literature review was conducted to explore the association between DF intake and the management of T2DM.Following the inclusion and exclusion criteria,a total of 26 studies were included in this review.RESULTS The main strategies implied to increased DF intake were:High DF diet plus acarbose(2 studies);DF supplements(14 studies);and high DF diets(10 studies).Overall,most studies indicated that increased DF intake resulted in im-provements in glycemic control and weight management in T2DM patients.CONCLUSION DF represents a valuable strategy in the treatment of type 2 diabetes,improving health outcomes.DF intake offers the potential to improve quality of life and reduce complications and mortality associated with diabetes.Likewise,through supplements or enriched foods,DF contributes significantly to the control of several markers such as HbA1c,blood glucose,triglycerides,low-density lipoprotein,and body weight.

Role of the phase angle in the prognosis of the cirrhotic patient:15 years of follow-up

BACKGROUND In 2019,cirrhosis accounted for 2.4%of global deaths.The projection for 2030 is an increase in this index.In recent years,hospitalization costs have escalated by 36%for compensated cirrhosis and 24%for decompensated cirrhosis.Therefore,it is necessary to identify a tool capable of predicting the mortality of these patients according to their clinical condition and consequently extending their survival time.Different studies have shown that the phase angle(PA)can be a feasible method in clinical practice,with the potential to guide assertive patient management in the therapeutic of chronic liver disease.AIM To evaluate the prognostic role of PA in cirrhotic patients over a 15-year followup period.METHODS Retrospective cohort study with 129 cirrhotic patients of both sexes over 18 years old.Diagnosis of cirrhosis by liver biopsy.The first year of data collection was 2007,and data regarding outcomes was collected in 2023.Data were gathered from medical records,such as esophageal varices(EV),EV bleeding,ascites,spontaneous bacterial peritonitis(SBP),encephalopathy,laboratory findings and PA.The cut-off value for the PA was 5.4°,a value described in 2012 by Fernandes et al for 129 patients evaluated in this study and the cut-off points for the Brazilian population presented in percentiles(P),as described by Mattiello et al.The mortality was assessed using the PA percentile through Kaplan-Meier curves and multivariate binary logistic regression models.RESULTS Patients were divided into two groups according to the PA 5.4th(PA>5.4°,n=40;PA≤5.4°,n=89)PA percentile(<P50,n=56;≥P50 n=73).The percentile classification was more accurate in identifying long-term deaths than the 5.4ºPA.Patients with<P50 had a higher number of relevant complications such as ascites,SBP,liver encephalopathy and HCC.PA is strongly correlated with serum albumin(P<0.001),International Normalized Ratio(P=0.01),total bilirubin(P=0.02)and direct bilirubin(P=0.003).PA is correlated with survival time(P<0.001)and length of stay(P=0.02).Logistic regression analysis shows that an increase of 1°in PA enlarges the cirrhotic patient's chance of survival by 17.7%.CONCLUSION PA is a good predictor of morbidity and mortality for cirrhotic patients.The PA by percentile showed greater sensitivity in predicting mortality compared to the cut-off point of 5.4º.