OBJECTIVETo evaluate the effects of qualitative dietary changes and the interaction with aerobic exercise training on liver fat content independent of weight loss in patients with type 2 diabetes.RESEARCH DESIGN AND METHODSWith use of a factorial 2 × 2 randomized parallel-group design, 37 men and 8 women, aged 35–70 years, with type 2 diabetes in satisfactory blood glucose control on diet or diet plus metformin treatment were assigned to one of the following groups for an 8-week period: 1) high-carbohydrate/high-fiber/low–glycemic index diet (CHO/fiber group), 2) high-MUFA diet (MUFA group), 3) high-carbohydrate/high-fiber/low–glycemic index diet plus physical activity program (CHO/fiber+Ex group), and 4) high-MUFA diet plus physical activity program (MUFA+Ex group). Before and after intervention, hepatic fat content was measured by 1H NMR.RESULTSDietary compliance was optimal and body weight remained stable in all groups. Liver fat content decreased more in MUFA (−29%) and MUFA+Ex (−25%) groups than in CHO/fiber (−4%) and CHO/fiber+Ex groups (−6%). Two-way repeated-measures ANOVA, including baseline values as covariate, showed a significant effect on liver fat content for diet (P = 0.006), with no effects for exercise training (P = 0.789) or diet-exercise interaction (P = 0.712).CONCLUSIONSAn isocaloric diet enriched in MUFA compared with a diet higher in carbohydrate and fiber was associated with a clinically relevant reduction of hepatic fat content in type 2 diabetic patients independent of an aerobic training program and should be considered for the nutritional management of hepatic steatosis in people with type 2 diabetes.

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RESEARCH DESIGN -A multicenter study was performed in 70 diabetic patients. A microdialysis fiber was inserted subcutaneously into the periumbelical region and perfused with a buffer solution. Glucose concentrations in the dialysate were then measured every 3 min by the glucose sensor over a 24-h period, during which nine venous blood samples were also collected throughout the day.RESULTS -Both the insertion of the fiber and the wearing of the device were well tolerated by the patients. Subcutaneous glucose levels were well correlated with venous glucose measurements (r ϭ 0.9, P Ͻ 0.001) over a wide range (40 -400 mg/dl) for up to 24 h, with a single-point calibration. An analysis of 381 data pairs showed a linear relationship between the GlucoDay and serial venous blood glucose levels, and 97% of the data fell in the A and B regions of the error grid analysis. Percentage bias between the GlucoDay and the blood venous levels was Ϫ2.0% in the hypoglycemic range (Ͻ70 mg/dl), 6.9% in the euglycemic range (70 -180 mg/dl), and 11.2% in the hyperglycemic range (Ͼ180 mg/dl).CONCLUSIONS -The GlucoDay system demonstrated high reliability and reported values that closely agreed with venous blood glucose measurements. The system was well tolerated and thus constitutes a relatively easy method to monitor glucose excursions in diabetic patients. Diabetes Care 25:347-352, 2002T he benefits of strict metabolic control on microvascular complications of both type 1 and type 2 diabetes have been well established (1,2). In the last decade, self-monitoring of blood glucose levels has been the only available measure for diabetic patients to achieve a good metabolic control; however, glucose fluctuations during the day are often missed with this technique (3), and only continuous glucose measurements over prolonged periods can ensure optimal blood glucose management. Recently, minimally invasive techniques have been proposed for continuous monitoring of subcutaneous glucose in both normal and diabetic patients. Microdialysis of subcutaneous adipose tissue has been shown to identify glucose variations in vivo that closely mimic blood glucose patterns observed in patients on intensified insulin therapy. A monitoring system that provides automatic and frequent determinations would therefore identify the glycemic excursions and typical glucose trends in diabetic patients in a manner that is not possible even with frequent blood glucose meter readings. The ability to detect such fluctuations during the day, and particularly during the night, would enable appropriate changes in diabetes management in order to achieve the goal of optimal metabolic control in diabetic patients.We documented the efficacy of a new glucose sensor and its accuracy in monitoring glucose levels in type 1 and type 2 diabetic patients recruited in a multicenter study. The GlucoDay is composed of a subcutaneous microdialysis probe connected to a portable unit. The system takes a glucose measurement every second and stores an average value every 3 min, for a total of ...

Diets naturally rich in polyphenols positively influence fasting and postprandial TRLs and reduce oxidative stress. Marine LCn3s reduce TRLs of exogenous origin. Through their effects on postprandial lipemia and oxidative stress, polyphenols may favorably affect cardiovascular disease risk.

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