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      Protective effect of tartary buckwheat on renal function in type 2 diabetics: a randomized controlled trial

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          Abstract

          Tartary buckwheat (TB) has been reported to be associated with a decreased risk of type 2 diabetes mellitus (T2DM), and T2DM has had a major impact on the development of diabetic kidney disease (DKD). Thus, the hypothesis that a daily intake of TB will improve DKD risk factors, including urinary albumin to creatinine ratio (UACR), urea nitrogen (UN), serum creatinine, and uric acid was tested. In a parallel, randomized, open-label controlled trial, 104 T2DM patients were randomly assigned to a diet control group (systematic diet plans and intensive nutritional education) or a TB intervention group (daily replacement of a portion of staple foods with TB foods). Blood samples and dietary information were collected at baseline and the end of the 4-week study. The primary outcomes were that TB significantly decreased the rela tive changes in UACR (2.43–2.35, logarithmic transformed mg/g creatinine) and UN (5.12–4.91 mmol/L) in the TB intervention group vs the diet control group at 4 weeks ( P<0.05), without obvious effect on blood glucose during the 4-week study. In addition, subgroup analyses based on different DKD stages also showed a significant reduction in UACR and UN for the T2DM patients with normoalbuminuria and microalbuminuria ( P<0.05). These results support the hypothesis that TB as a replacement of staple food probably alleviates renal dysfunction in T2DM patients.

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          Most cited references 18

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          Comparative evaluation of quercetin, isoquercetin and rutin as inhibitors of alpha-glucosidase.

           J. Bian,  F Shan,  F Zhou (2009)
          Three flavonoids from tartary buckwheat bran, namely, quercetin (Que), isoquercetin (Iso) and rutin (Rut), have been evaluated as alpha-glucosidase inhibitors by fluorescence spectroscopy and enzymatic kinetics and have also been compared with the market diabetes healer, acarbose. The results indicated that Que, Iso and Rut could bind alpha-glucosidase to form a new complex, which exhibited a strong static fluorescence quenching via nonradiation energy transfer, and an obvious blue shift of maximum fluorescence. The sequence of binding constants (K(A)) was Que > Iso > Rut, and the number of binding sites was one for all of the three cases. The thermodynamic parameters were obtained by calculations based on data of binding constants. They revealed that the main driving force of the above-mentioned interaction was hydrophobic. Enzymatic kinetics measurements showed that all of the three compounds were effective inhibitors against alpha-glucosidase. Inhibitory modes all belonged to a mixed type of noncompetitive and anticompetitive. The sequence of affinity (1/K(i)) was in accordance with the results of binding constants (K(A)). The concentrations which gave 50% inhibition (IC(50)) were 0.017 mmol*L(-1), 0.185 mmol*L(-1) and 0.196 mmol*L(-1), compared with acarbose's IC(50) (0.091 mmol*L(-1)); the dose of acarbose was almost five times of that of Que and half of that of Iso and Rut. Our results explained why the inhibition on alpha-glucosidase of tartary buckwheat bran extractive substance (mainly Rut) was much weaker than that of its hydrolysis product (a mixture of Que, Iso and Rut). This work would be significant for the development of more powerful antidiabetes drugs and efficacious utilization of tartary buckwheat, which has been proved as an acknowledged food in the diet of diabetic patients.
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            The evidence for medical nutrition therapy for type 1 and type 2 diabetes in adults.

            This article reviews the evidence and nutrition practice recommendations from the American Dietetic Association's nutrition practice guidelines for type 1 and type 2 diabetes in adults. The research literature was reviewed to answer nutrition practice questions and resulted in 29 recommendations. Here, we present the recommendations and provide a comprehensive and systematic review of the evidence associated with their development. Major nutrition therapy factors reviewed are carbohydrate (intake, sucrose, non-nutritive sweeteners, glycemic index, and fiber), protein intake, cardiovascular disease, and weight management. Contributing factors to nutrition therapy reviewed are physical activity and glucose monitoring. Based on individualized nutrition therapy client/patient goals and lifestyle changes the client/patient is willing and able to make, registered dietitians can select appropriate interventions based on key recommendations that include consistency in day-to-day carbohydrate intake, adjusting insulin doses to match carbohydrate intake, substitution of sucrose-containing foods, usual protein intake, cardioprotective nutrition interventions, weight management strategies, regular physical activity, and use of self-monitored blood glucose data. The evidence is strong that medical nutrition therapy provided by registered dietitians is an effective and essential therapy in the management of diabetes. Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
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              Substituting white rice with brown rice for 16 weeks does not substantially affect metabolic risk factors in middle-aged Chinese men and women with diabetes or a high risk for diabetes.

              Epidemiologic studies have suggested that higher consumption of white rice (WR) is associated with increased risk for type 2 diabetes mellitus. However, it is unclear whether substituting brown rice (BR) for WR can improve metabolic risk factors. A total of 202 middle-aged adults with diabetes or a high risk for diabetes were randomly assigned to a WR (n = 101) or BR group (n = 101) and consumed the rice ad libitum for 16 wk. Metabolic risk markers, including BMI, waist circumference, blood pressure, glycated hemoglobin, and serum lipid, glucose, and insulin concentrations were measured before and after the intervention. Over the course of the intervention, no between-group differences were found for any markers except the serum LDL cholesterol concentration, which decreased more in the WR group compared to the BR group (P = 0.02). However, this effect was observed only among participants with diabetes (n = 47). The reversion rate of reduced serum HDL cholesterol was marginally higher in the BR group (14.9%) than in the WR group (6.9%) (P = 0.07). Among participants with diabetes, a greater reduction in diastolic blood pressure was observed in the BR group compared to the WR group (P = 0.02). Our study suggests that incorporating BR into the daily diet for 16 wk did not substantially improve metabolic risk factors. Further studies with larger sample sizes, longer durations of follow-up, and different varieties of rice are needed to carefully examine the role of BR in the prevention and management of diabetes.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                1176-6336
                1178-203X
                2016
                18 November 2016
                : 12
                : 1721-1727
                Affiliations
                [1 ]Institute of Food and Nutrition Development, Ministry of Agriculture
                [2 ]College of Food Science and Nutritional Engineering, China Agricultural University
                [3 ]Department of Nutrition, Pinggu Hospital of Traditional Chinese Medicine, Pinggu
                [4 ]Department of Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
                Author notes
                Correspondence: Yanping Liu, Peking Union Medical College Hospital (East), Number 1 Shuaifuyuan Wangfujing, Dongcheng, Beijing 100730, China, Tel/fax +86 10 6915 9081, Email liuyp1227@ 123456vip.sina.com
                Article
                tcrm-12-1721
                10.2147/TCRM.S123008
                5125721
                © 2016 Qiu et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Categories
                Original Research

                Medicine

                tartary buckwheat, dietary intervention, type 2 diabetes mellitus, renal function

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