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Dietary Restriction of Advanced Glycation End-Products (AGEs) in Patients with Diabetes: A Systematic Review of Randomized Controlled Trials.

International journal of molecular sciences
October 23, 2024
Paraskevi Detopoulou et al. (10 authors)
Journal ArticleSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to review randomized controlled trials on low-dietary AGE interventions in diabetic patients to assess effects on inflammation, glucose, and lipid outcomes.

Results Summary

A low-dietary AGE pattern reduced circulating AGEs and showed consistent benefits for oxidative stress and inflammation, but effects on glycemic and lipid parameters were inconsistent and modest.

Population

Patients with diabetes, age > 18 years

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (14)
InterventionDirectionEndpointPopulationDosageImpactClaim #
low-dietary AGE (L-dAGEs) interventions
decrease
circulating AGEs
patients with diabetes
3/3 studies
A reduction in circulating AGEs was documented
#1
low-dietary AGE (L-dAGEs) diet
no change
glycemic parameters
patients with diabetes
-
No particular differences were documented
#2
low-dietary AGE (L-dAGEs) diet
decrease
glucose levels
patients with diabetes
one out of six studies (1/6)
Reductions in glucose levels were observed
#3
low-dietary AGE (L-dAGEs) diet
no change
HbA1c
patients with diabetes
0/6
HbA1c did not change
#4
low-dietary AGE (L-dAGEs) diet
no change
HOMA
patients with diabetes
0/3
HOMA did not change
#5
low-dietary AGE (L-dAGEs) diet
neutral
lipid profile
patients with diabetes
one out of four studies (1/4)
Lipid profile changed
#6
low-dietary AGE (L-dAGEs) diet
decrease
oxidative stress
patients with diabetes
3/3 studies
beneficial effects
#7
low-dietary AGE (L-dAGEs) diet
decrease
inflammatory markers
patients with diabetes
4/4 studies
beneficial effects
#8
low-dietary AGE (L-dAGEs) diet
increase
adiponectin
patients with diabetes
-
adiponectin increases
#9
low-dietary AGE (L-dAGEs) pattern
decrease
AGEs accumulation
patients with diabetes
-
may minimize AGEs accumulation
#10
low-dietary AGE (L-dAGEs) pattern
decrease
oxidative stress
patients with diabetes
-
have beneficial effects
#11
low-dietary AGE (L-dAGEs) pattern
decrease
inflammation indices
patients with diabetes
-
have beneficial effects
#12
low-dietary AGE (L-dAGEs) pattern
neutral
glycemic parameters
patients with diabetes
-
effects are inconsistent and modest
#13
low-dietary AGE (L-dAGEs) pattern
neutral
lipemic parameters
patients with diabetes
-
effects are inconsistent and modest
#14
Abstract

Advanced Glycation End Products (AGEs) are formed through non-enzymatic reactions between reducing sugars and proteins, nucleic acids or lipids (for example through hyperoxidation). In diabetes, elevated glucose levels provide more substrate for AGEs formation. AGEs can also be ingested through the diet from foods cooked at high temperatures, or containing much sugar. The present work aimed to review all published randomized controlled trials (RCT) on low-dietary AGE (L-dAGEs) interventions in patients with diabetes. Pubmed, Scopus and Cochrane databases were searched (until 29 February 2024) with appropriate keywords (inclusion criteria: RCT, patients with diabetes, age > 18 years, outcomes related to inflammation, glucose, and lipids; exclusion criteria: non-RCTs, case-series, case reports and Letter to the Editor, or animal studies). The present review was registered to the Open Science Framework (OSF). From 7091 studies, seven were ultimately included. Bias was assessed with the updated Cochrane Risk of Bias tool. A reduction in circulating AGEs was documented in 3/3 studies. No particular differences were documented in glycemic parameters after a L-dAGEs diet. Reductions in glucose levels were observed in one out of six studies (1/6), while HbA1c and HOMA did not change in any study (0/6 and 0/3, correspondingly). Lipid profile also changed in one out of four studies (1/4). More consistent results were observed for oxidative stress (beneficial effects in 3/3 studies) and inflammatory markers (beneficial effects in 4/4 studies). Other athero-protective effects, such as adiponectin increases, were reported. Limitations included the small sample size and the fact that dietary and physical activity habits were not considered in most studies. In conclusion, a L-dAGEs pattern may minimize AGEs accumulation and have beneficial effects on oxidative stress and inflammation indices, while its effects on glycemic and lipemic parameters are inconsistent and modest in patients with diabetes.

Medical Subject Headings (MeSH)
HumansBlood GlucoseDiabetes MellitusDietGlycation End Products, AdvancedRandomized Controlled Trials as Topic
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality75/10
Research Impact Scores
APT Score0.05
Weight Score2.34
Normalized Score0.61
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