Table 1.
Variables | Finding 1 | Level of Evidence 2 | Reference |
---|---|---|---|
Epidemiological Evidence | |||
Fasting blood glucose | ↓ | + | [11] |
Plasma insulin | ↓ | + | |
HOMA-IR | ↓ | + | [11,12] |
HOMA-B | ↓ | + | [11] |
HbA1c | ↓ | + | |
OGTT | ↓ | + | |
Diabetes incidence | ↓/↔ | + | [13,14] |
Diabetes prevalence | ↓/↔ | + | [13,15,16,17] |
CVD incidence in participants with T2D | ↓ | + | [18] |
Diabetes mortality | ↓ | ++ | [19] |
Clinical Trial Evidence | |||
Acute Trial Evidence | |||
In participants free of T2D: | |||
Postprandial glycemia | ↓ | ++ | [20,21,22,23,24,25,26] |
Postprandial insulinemia | ↓/↔ | + | [21,27,28] |
In participants with T2D: | |||
Postprandial glycemia | ↓ | + | [21,23,29,30] |
Postprandial insulinemia | ↓/↔ | + | [21,29] |
Glucose metabolic clearance rate | ↑ | + | [29] |
Longer-term Trial Evidence | |||
In participants free of T2D at baseline: | |||
Diabetes incidence | ↓/↔ | + | [31,32,33] |
In participants with T2D at baseline: | |||
Fasting glucose | ↓ | + | [30,34,35,36,37,38,39] |
Fasting insulin | ↔ | + | |
HbA1c | ↓ | + | |
HOMA-IR | ↔ | + | |
In participants with/without T2D at baseline: | |||
Fasting glucose | ↔ | + | [40] |
Fasting insulin | ↓ | + | |
HbA1c | ↔ | + | |
HOMA-IR | ↓ | + |
Abbreviations: CVD, cardiovascular disease; HbA1c, glycated hemoglobin; HOMA, homoeostasis model assessment; IR, insulin resistance; OGTT, oral glucose tolerance test; T2D, type 2 diabetes mellitus. 1 Findings are based on the authors’ review, and assessment of the noted literature, and hence could present some subjectivity. In general: ↓, majority of evidence indicated a decrease; ↑, majority of evidence indicated an increase; ↔, majority of evidence indicated no change observed; ↓/↔, majority of evidence was split between showing a decrease or no effect on the outcome. Where “majority of evidence” refers to the entirety of the evidence, if a relevant systematic review and meta-analysis was conducted these findings were used as the basis of this determination. 2 Level of Evidence is based on the authors’ review and assessment and, hence, could present with some subjectivity. In general: +, limited and/or inconsistent evidence from few studies in the denoted type of study design; ++, consistent evidence in several studies in the denoted type of study design.