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The aim of the present study was to evaluate the effect of three different combinations of hormone replacement therapy (HRT) on insulin secretion, peripheral insulin sensitivity, serum lipid levels and parameters of oxidative stress. Seven type II diabetic women of mean age 55.4 +/- 4.7 years, who had been menopausal for an average of 5 years, were enrolled in the study. Phases of insulin secretion--first (FPIS) and second (SPIS)--and the area under the curve (AUC) for insulin secretion were studied during an intravenous glucose tolerance test (IVGTT). Insulin sensitivity was determined using the manual euglycemic-hyperinsulinemic clamp technique. Three different HRT combinations were applied consecutively for 3-month periods: estradiol valerate plus cyproterone acetate (Climen); transdermal 17 beta-estradiol (System TTS 50) plus dydrogesterone (Duphaston) 10 mg daily for 10 days a month; oral 17 beta-estradiol plus dydrogesterone (Femoston) for 14 days a month. A group of nine women with normal glucose tolerance (according to World Health Organization criteria during a 75-g oral glucose tolerance test (OGTT)), of mean age 50.1 +/- 8.2 years and mean body mass index 24.60 +/- 2.01 kg/m2, were also studied, and served as a control group. Insulin secretion improved significantly after Climen: FPIS increased by 16% and SPIS by 44%. Insulin sensitivity increased by 50% after Systen TTS 50 + Duphaston; fasting hyperinsulinemia was normalized and total antioxidant capacity of the serum (TAOCS) was significantly raised (p < 0.01). Femoston led to an increase in insulin sensitivity (by 23%) and in TAOCS (p < 0.05), while fasting hyperinsulinemia remained unchanged. HRT should be prescribed in type II diabetic postmenopausal women because of its favorable effect on existing pathophysiological defects. Cyproterone acetate should be preferred in cases with a predominant beta-cell insulin secretion defect, while dydrogesterone in combination with a transdermal estrogen should be recommended in cases with leading insulin resistance.

Background: The frequency of family meals has been suggested as a protective factor against obesity among children.Objective: This study aimed to investigate the cross-sectional and longitudinal associations between family meals frequency and children's overweight/obesity in families at high risk of type 2 diabetes (T2D) across six European countries.Methods: 989 parent-child dyads (52% girls and 72% mothers) were included. Participants completed validated measures to assess the frequency of family meals and anthropometrics. Multivariable regression models were applied to examine the

Abbreviation: (HbA1c) hemoglobin A1c, (SD) standard deviation, (SMBG) self-monitoring of blood glucose Keywords: HbA1c, self-monitoring, SMBG, type 2 diabetes Corresponding Author: Christopher Parkin, M.S., CGParkin Communications, Inc., 219 Red Rock Road, Boulder City, NV 89005; email address chris@cgparkin.org St ructured self-monitoring of blood glucose (SMBG) is an approach to diabetes management in which blood glucose data are generated according to a defined testing regimen, interpreted, and then used to make changes in therapy. 1Findings from recent studies have demonstrated that appropriate use of structured SMBG improves glycemic control, facilitates therapy intensification, and promotes desired behavioral changes, leading to improved clinical outcomes. 2-9We have reported findings from a 3-month, noncontrolled, interventional study that used a modified version of the Structured Testing Program study intervention, demonstrating that this approach can be effectively adapted for use in general medical practice to improve hemoglobin A1c (HbA1c) levels.10 At study end, participants showed significant reductions in mean [standard deviation (SD)] HbA1c levels compared to baseline from 9.2% (1.6%) to 8.0% (1.4%), p < .001). Improvements in average blood glucose, body mass index, lipids, and blood pressure were also highly significant (p < .001). To further determine the efficacy of the intervention, we analyzed 6-month follow-up data from participants enrolled in our prior study and assessed changes in their glycemic control compared with that of participants who did not use structured SMBG.In our 6-month retrospectively controlled study, 526 diabetes patients (99 type 1, 423 type 2) were asked to generate a blood glucose profile before their 3-month and 6-month clinic visits, using a paper-based tool (ACCU-CHEK ® 360° View Blood Glucose Analysis System, Roche Diagnostics, Mannheim, Germany). Measurements were taken before and 2 h after main meals and before bedtime on three consecutive days. End points included change from baseline in HbA1c and other parameters of diabetes complications. Data were also obtained from an additional 122 patients (control subjects) who did not use structured SMBG during the same time period. Baseline HbA1c values for the active and control groups were 9.5 (1.6%) and 9.1 (1.1%), respectively.At 6 months, paired HbA1c values were obtained for 281 active and 122 control group participants. Active group participants showed significantly greater reductions in mean (SD) HbA1c levels at 6 months compared with control group patients: -1.9% (2.0) vs -0.3% (0.1); p < .0001. The percentage of participants who reported at least one severe hypoglycemic event was significantly greater in the control group than in the active group: 34.4% (n = 42) vs 3.9% (n = 21).

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