Studies examining the effects of consumption of diets low in advanced glycation end products (AGEs) on cardiometabolic parameters are conflicting. Hence, we performed a meta-analysis to determine the effect of low AGE diets in reducing cardiometabolic risk factors. Seventeen randomised controlled trials comprising 560 participants were included. Meta-analyses using random effects models were used to analyse the data. Low AGE diets decreased insulin resistance (mean difference [MD] −1.3, 95% CI −2.3, −0.2), total cholesterol (MD −8.5 mg/dl, 95% CI −9.5, −7.4) and low-density lipoprotein (MD −2.4 mg/dl, 95% CI −3.4, −1.3). There were no changes in weight, fasting glucose, 2-h glucose and insulin, haemoglobin A1c, high-density lipoprotein or blood pressure. In a subgroup of patients with type 2 diabetes, a decrease in fasting insulin (MD −7 µU/ml, 95% CI −11.5, −2.5) was observed. Tumour necrosis factor α, vascular cell adhesion molecule-1, 8-isoprostane, leptin, circulating AGEs and receptor for AGEs were reduced after consumption of low AGE diets with increased adiponectin and sirtuin-1. Our findings suggest that diets low in AGEs may be an effective strategy for improving cardiometabolic profiles in individuals with and without type 2 diabetes.
Time in range is a key glycemic metric, and comparisons of management technologies for this outcome are critical to guide device selection.
PURPOSEWe conducted a systematic review and network meta-analysis to compare and rank technologies for time in glycemic ranges.
<b>Background: </b>Time-in-range
is a key glycaemic metric, and comparisons of management technologies for this
outcome are critical to guide device selection.
<p><b> </b></p>
<p><b>Purpose: </b>We
conducted a systematic review and network meta-analysis to compare and rank
technologies for time in glycaemic ranges.</p>
<p> </p>
<p><b>Data sources: </b>We searched All Evidenced Based Medicine Reviews, CINAHL,
EMBASE, MEDLINE, MEDLINE In-Process and other non-indexed citations, PROSPERO,
PsycINFO, PubMed, and Web of Science until 24 April, 2019.</p>
<p> </p>
<p><b>Study selection: </b>We included randomised controlled trials <u>></u>2
weeks duration comparing technologies for management of type 1 diabetes in
adults (<u>></u>18 years of age), excluding pregnant women. </p>
<p> </p>
<p><b>Data extraction: </b>Data were extracted using a predefined template. Outcomes
were percent time with sensor glucose levels 3.9–10.0mmol/l (70–180mg/dL),
>10.0mmol/L (180mg/dL), and <3.9mmol/L (70mg/dL). </p>
<p><b> </b></p>
<p><b>Data synthesis: </b>We identified 16,772 publications, of which 14 eligible
studies compared eight technologies comprising 1,043 participants. Closed loop
systems lead to greater percent time-in-range than any other management
strategy and was 17.85 (95% predictive interval [PrI] 7.56–28.14) higher than
usual care of multiple daily injections with capillary glucose testing. Closed
loop systems ranked best for percent time-in-range or above range utilising
surface under the cumulative ranking curve (SUCRA–98.5 and 93.5 respectively).
Closed loop systems also ranked highly for time below range (SUCRA–62.2). </p>
<p><b> </b></p>
<p><b>Limitations: </b>Overall risk of bias ratings were moderate for all
outcomes. Certainty of evidence was very low.</p>
<p><b> </b></p>
<p><b>Conclusions: </b>In the first integrated comparison of multiple management
strategies considering time-in-range, we found that the efficacy of closed loop
systems appeared better than all other approaches. </p>
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