Volume 33, Issue 6 (September 2022)
Studies in Medical Sciences 2022, 33(6): 426-440 |
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Research code: IR.UMA.REC.1401.033
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Ghiyami S H, Afroundeh R, Pourvaghar M J, Sadeghi A, Katebi L. THE EFFECT OF 8 WEEKS COMBINED TRAINING ALONG WITH THE USE OF MULBERRY LEAF EXTRACT ON SERUM LEVELS OF FETUIN A AND FETUIN B LEVELS IN ELDERLY MEN WITH TYPE DIABETES 2. Studies in Medical Sciences 2022; 33 (6) :426-440
URL: http://umj.umsu.ac.ir/article-1-5855-en.html
URL: http://umj.umsu.ac.ir/article-1-5855-en.html
Associate Professor of Sports Physiology, Faculty of Educational Sciences and Psychology, Mohaghegh Ardabili University, Ardabil, Iran , afroundeh@uma.ac.ir
Abstract: (696 Views)
Background & Aims: Fetuin-A and Fetuin B have effective role in age-related metabolic disorders such as type 2 diabetes. This study aimed to determine the effect of 8 weeks combined training along with consumption of Mulberry Leaf Extract on serum Fetuin-A and Fetuin B levels in elderly men with type 2 diabetes
Materials & Methods: In this case-control study, 40 elderly people with diabetes were randomly divided into five groups of: control (n = 8), placebo (n = 8), extract (n= 8), training (n=8), and extract + training (n = 8). Training was done for eight weeks and three sessions of 90 minutes each. 3000 ml of Mulberry Leaf Extract per day was prescribed along with three main meals. Fetuin A and Fetuin B levels were measured before the intervention and 48 hours after the last training session. Data were analyzed using SPSS version 23 statistical software at a significance level of P<0.05 and using paired t-test and analysis of covariance.
Results: In the training, extract, and training+extract groups, a significant decrease in fetuin-A and fetuin B levels was observed (P<0.05). The extract + training group shows a larger decrease in Fetuin A (6.02%) and Fetoin B (5.09%) compared to the pre-test. Between groups analyses showed significant differences in the levels of Fetuin (P=0.002) and Fetuin B (P=0.001), and these changes were greater in the extract + training group than them in the training and extract groups.
Conclusion: The results of this research showed that prescribing a combined exercise program along with the consumption of Mulberry Leaf Extract in diabetic elderly can possibly have a positive effect on Fetoin A, Fetoin B levels.
Materials & Methods: In this case-control study, 40 elderly people with diabetes were randomly divided into five groups of: control (n = 8), placebo (n = 8), extract (n= 8), training (n=8), and extract + training (n = 8). Training was done for eight weeks and three sessions of 90 minutes each. 3000 ml of Mulberry Leaf Extract per day was prescribed along with three main meals. Fetuin A and Fetuin B levels were measured before the intervention and 48 hours after the last training session. Data were analyzed using SPSS version 23 statistical software at a significance level of P<0.05 and using paired t-test and analysis of covariance.
Results: In the training, extract, and training+extract groups, a significant decrease in fetuin-A and fetuin B levels was observed (P<0.05). The extract + training group shows a larger decrease in Fetuin A (6.02%) and Fetoin B (5.09%) compared to the pre-test. Between groups analyses showed significant differences in the levels of Fetuin (P=0.002) and Fetuin B (P=0.001), and these changes were greater in the extract + training group than them in the training and extract groups.
Conclusion: The results of this research showed that prescribing a combined exercise program along with the consumption of Mulberry Leaf Extract in diabetic elderly can possibly have a positive effect on Fetoin A, Fetoin B levels.
References
1. Paudel G, Vandelanotte C, Dahal PK, Biswas T, Yadav UN, Sugishita T, et al. Self-care behaviours among people with type 2 diabetes mellitus in South Asia: A systematic review and meta-analysis. J Glob Health 2022;12:0405 [DOI:10.7189/jogh.12.04056] [PMID] [PMCID]
2. 2 Chentli F, Azzoug S, Mahgoun S. Diabetes mellitus in elderly. Indian J Endocrinol Metab 2015;19(6):744-52. [DOI:10.4103/2230-8210.167553] [PMID] [PMCID]
3. Chang AM, Halter JB. Aging and insulin secretion. Am J Physiol Endocrinol Metab 2003;284(1): 7-12. [DOI:10.1152/ajpendo.00366.2002] [PMID]
4. Tougaard NH, Møller AL, Rønn PF, Hansen TW, Genovese F, Karsdal MA, et al. Endotrophin as a marker of complications in a type 2 diabetes cohort. Diabetes Care 2022;45(11):2746-8. [DOI:10.2337/dc22-0852] [PMID]
5. Pranata S, Wu S-FV, Chu C-H, Nugroho KH. Precision health care strategies for older adults with diabetes in Indonesia: a Delphi consensus study. Med J Indones 2021;30(3):221-7. [DOI:10.13181/mji.oa.215525]
6. Kagansky N, Levy S, Rimon E, Cojocaru L, Fridman A, Ozer Z, et al. Hypoglycemia as a predictor of mortality in hospitalized elderly patients. Arch Intern Med 2003;163(15):1825-9. [DOI:10.1001/archinte.163.15.1825] [PMID]
7. Park SW, Goodpaster BH, Lee JS, Kuller LH, Boudreau R, de Rekeneire N, et al. Excessive loss of skeletal muscle mass in older adults with type 2 diabetes. Diabetes Care 2009;32(11):1993-7. [DOI:10.2337/dc09-0264] [PMID] [PMCID]
8. Marwick TH, Hordern MD, Miller T, Chyun DA, Bertoni AG, Blumenthal RS, et al. Exercise training for type 2 diabetes mellitus: impact on cardiovascular risk: a scientific statement from the American Heart Association. Circulation 2009;119(25): 44-62 [DOI:10.1161/CIRCULATIONAHA.109.192521] [PMID]
9. Nordlie RC, Foster JD, Lange AJ. Regulation of glucose production by the liver. Annu Rev Nutr 1999;19(1):379-406. [DOI:10.1146/annurev.nutr.19.1.379] [PMID]
10. Petersen KF, Dufour S, Befroy D, Lehrke M, Hendler RE, Shulman GI. Reversal of nonalcoholic hepatic steatosis, hepatic insulin resistance, and hyperglycemia by moderate weight reduction in patients with type 2 diabetes. Diabetes 2005;54(3):603-8. [DOI:10.2337/diabetes.54.3.603] [PMID] [PMCID]
11. Leibiger IB, Berggren P-O. Sirt1: a metabolic master switch that modulates lifespan. Nat Med 2006;12(1):34-66. [DOI:10.1038/nm0106-34] [PMID]
12. Alcendor RR, Gao S, Zhai P, Zablocki D, Holle E, Yu X, et al. Sirt1 regulates aging and resistance to oxidative stress in the heart. Circ Res 2007;100(10):12-21. [DOI:10.1161/01.RES.0000267723.65696.4a] [PMID]
13. Haigis MC, Sinclair DA. Mammalian sirtuins: biological insights and disease relevance. Annu Rev Pathol 2010;5(1):253-95. [DOI:10.1146/annurev.pathol.4.110807.092250] [PMID] [PMCID]
14. Silva JP, Wahlestedt C. Role of Sirtuin 1 in metabolic regulation. Drug Discov Today.2010;15(17-18):781-91 [DOI:10.1016/j.drudis.2010.07.001] [PMID]
15. Vizvari E., Farzanegi P, Abbas Zade Sourati H,. Effect of vigorous aerobic exercise on serum levels of SIRT1, FGF21 and fetuin A in women with type II diabetes. Med Lab J 2018;12(2):1-6. (Persian) [DOI:10.29252/mlj.12.2.1]
16. Mathews ST, Rakhade S, Zhou X, Parker GC, Coscina DV, Grunberger G. Fetuin-null mice are protected against obesity and insulin resistance associated with aging. Biochem Biophys Res Commun 2006;350(2):37-43. [DOI:10.1016/j.bbrc.2006.09.071] [PMID]
17. Jung TW, Youn B-S, Choi HY, Lee SY, Hong HC, Yang SJ, et al. Salsalate and adiponectin ameliorate hepatic steatosis by inhibition of the hepatokine fetuin-A. Biochem Pharmacol 2013;86(7):960-9. [DOI:10.1016/j.bcp.2013.07.034] [PMID]
18. Mori K, Emoto M, Yokoyama H, Araki T, Teramura M, Koyama H, et al. Association of serum fetuin-A with insulin resistance in type 2 diabetic and nondiabetic subjects. Diabetes Care 2006;29(2):468. [DOI:10.2337/diacare.29.02.06.dc05-1484] [PMID]
19. Denecke B, Gräber S, Schäfer C, Heiss A, Wöltje M, Jahnen-Dechent W. Tissue distribution and activity testing suggest a similar but not identical function of fetuin-B and fetuin-A. Biochem J 2003;376(Pt 1):35-45. [DOI:10.1042/bj20030676] [PMID] [PMCID]
20. Qu H, Qiu Y, Wang Y, Liao Y, Zheng Y, Zheng H. Plasma fetuin-B concentrations are associated with insulin resistance and first-phase glucose-stimulated insulin secretion in individuals with different degrees of glucose tolerance. Diabetes Metab 2018;44(6):488-92. [DOI:10.1016/j.diabet.2018.02.003] [PMID]
21. Meex RC, Hoy AJ, Morris A, Brown RD, Lo JCY, Burke M, et al. Fetuin B is a secreted hepatocyte factor linking steatosis to impaired glucose metabolism. Cell Metab 2015;22(6):1078-89. [DOI:10.1016/j.cmet.2015.09.023] [PMID]
22. Peter A, Kovarova M, Staiger H, Machann J, Schick F, Königsrainer A, et al. The hepatokines fetuin-A and fetuin-B are upregulated in the state of hepatic steatosis and may differently impact on glucose homeostasis in humans. Am J Physiol Endocrinol Metab 2018;314(3): 266-73. [DOI:10.1152/ajpendo.00262.2017] [PMID]
23. Zhu J, Wan X, Wang Y, Zhu K, Li C, Yu C, et al. Serum fetuin B level increased in subjects of nonalcoholic fatty liver disease: a case-control study. Endocrine 2017;56(1):208-11. [DOI:10.1007/s12020-016-1112-5] [PMID]
24. Peron EP, Ogbonna KC, Donohoe KL. Antidiabetic medications and polypharmacy. Clin Geriatr Med 2015;31(1):17-27 [DOI:10.1016/j.cger.2014.08.017] [PMID] [PMCID]
25. Cao H, Polansky MM, Anderson RA. Cinnamon extract and polyphenols affect the expression of tristetraprolin, insulin receptor, and glucose transporter 4 in mouse 3T3-L1 adipocytes. Arch Biochem Biophys 2007;459(2):214-22. [DOI:10.1016/j.abb.2006.12.034] [PMID]
26. Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, et al. Physical activity/exercise and diabetes: A position statement of the American diabetes association. Diabetes Care 2016;39(11):2065-79. [DOI:10.2337/dc16-1728] [PMID] [PMCID]
27. Herbal therapeutics then and now. In: Pharmacodynamic Basis of Herbal Medicine. CRC Press; 2010. 53-78. [DOI:10.1201/9781420041781-6]
28. Thondre PS, Lightowler H, Ahlstrom L, Gallagher A. Correction to: Mulberry leaf extract improves glycaemic response and insulaemic response to sucrose in healthy subjects: results of a randomized, double blind, placebo‑controlled study. Nutr Metab 2021;18(1):52.
https://doi.org/10.1186/s12986-021-00571-2 [DOI:10.1186/s12986-021-00577-w] [PMID] [PMCID]
29. Umpierre D, Ribeiro PAB, Schaan BD, Ribeiro JP. Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review with meta-regression analysis. Diabetologia 2013;56(2):242-51. [DOI:10.1007/s00125-012-2774-z] [PMID]
30. Oliveira C, Simões M, Carvalho J, Ribeiro J. Combined exercise for people with type 2 diabetes mellitus: a systematic review. Diabetes Res Clin Pract 2012;98(2):187-98. [DOI:10.1016/j.diabres.2012.08.004] [PMID]
31. Loimaala A, Groundstroem K, Rinne M, Nenonen A, Huhtala H, Parkkari J, et al. Effect of long-term endurance and strength training on metabolic control and arterial elasticity in patients with type 2 diabetes mellitus. Am J Cardiol 2009;103(7):972-977. [DOI:10.1016/j.amjcard.2008.12.026] [PMID]
32. Maiorana A, O'Driscoll G, Goodman C, Taylor R, Green D. Combined aerobic and resistance exercise improves glycemic control and fitness in type 2 diabetes. Diabetes Res Clin Pract 2002;56(2):115-23. [DOI:10.1016/S0168-8227(01)00368-0] [PMID]
33. Larose J, Sigal RJ, Boulé NG, Wells GA, Prud'homme D, Fortier MS, et al. Effect of exercise training on physical fitness in type II diabetes mellitus. Med Sci Sports Exerc 2010;42(8): 39-47. [DOI:10.1249/MSS.0b013e3181d322dd] [PMID]
34. Schultes B, Frick J, Ernst B, Stefan N, Fritsche A. The effect of 6-weeks of aerobic exercise training on serum fetuin-A levels in non-diabetic obese women. Exp Clin Endocrinol Diabetes 2010;118(10):754-6. [DOI:10.1055/s-0030-1253418] [PMID]
35. Keihanian A, Arazi H, Kargarfard M. Effects of aerobic versus resistance training on serum fetuin-A, fetuin-B, and fibroblast growth factor-21 levels in male diabetic patients. Physiol Int 2019;106(1):70-80. [DOI:10.1556/2060.106.2019.01] [PMID]
36. Tond SB, Arak University of Medical Sciences, Iran, Fallah S, Salemi Z, Seifi M, Iran University of Medical Sciences, Iran, et al. Influence of mulberry leaf extract on serum adiponectin, visfatin and lipid profile levels in type 2 diabetic rats. Braz Arch Biol Technol 2016;59(0).16-59. [DOI:10.1590/1678-4324-2016160297]
37. Naowaboot J, Pannangpetch P, Kukongviriyapan V, Kukongviriyapan U, Nakmareong S, Itharat A.Mulberry leaf extract restores arterial pressure in streptozotocin-induced chronic diabetic rats. Nutr Res 2009;29(8):2-8. [DOI:10.1016/j.nutres.2009.06.002] [PMID]
38. Oh K-S, Ryu SY, Lee S, Seo HW, Oh BK, Kim YS, et al. Melanin-concentrating hormone-1 receptor antagonism and anti-obesity effects of ethanolic extract from Morus alba leaves in diet-induced obese mice. J Ethnopharmacol 2009;122(2):216-20. [DOI:10.1016/j.jep.2009.01.020] [PMID]
39. Kim D-S, Kang YM, Jin WY, Sung Y-Y, Choi G, Kim HK. Antioxidant activities and polyphenol content of Morus alba leaf extracts collected from varying regions. Biomed Rep 2014;2(5):75-80. [DOI:10.3892/br.2014.294] [PMID] [PMCID]
40. Park JM, Bong HY, Jeong HI, Kim YK, Kim JY, Kwon O. Postprandial hypoglycemic effect of mulberry leaf in Goto-Kakizaki rats and counterpart control Wistar rats. Nutr Res Pract 2009 Winter;3(4):272-8. [DOI:10.4162/nrp.2009.3.4.272] [PMID] [PMCID]
41. Hsu L-S, Ho H-H, Lin M-C, Chyau C-C, Peng J-S, Wang C-J. Mulberry water extracts (MWEs) ameliorated carbon tetrachloride-induced liver damages in rat. Food Chem Toxicol 2012;50(9):3086-93. [DOI:10.1016/j.fct.2012.05.055] [PMID]
42. Riche DM, Riche KD, East HE, Barrett EK, May WL. Impact of mulberry leaf extract on type 2 diabetes (Mul-DM): A randomized, placebo-controlled pilot study. Complement Ther Med 2017;32:105-8. [DOI:10.1016/j.ctim.2017.04.006] [PMID]
43. Jeszka-Skowron M, Flaczyk E, Jeszka J, Krejpcio Z, Król E, Buchowski MS. Mulberry leaf extract intake reduces hyperglycaemia in streptozotocin (STZ)-induced diabetic rats fed high-fat diet. J Funct Foods 2014;8:9-17. [DOI:10.1016/j.jff.2014.02.018]
44. Derdemezis CS, Kiortsis DN, Tsimihodimos V, Petraki MP, Vezyraki P, Elisaf MS, et al. Effect of plant polyphenols on adipokine secretion from human SGBS adipocytes. Biochem Res Int 2011;2011:285618. [DOI:10.1155/2011/285618] [PMID] [PMCID]
45. Asai A, Nakagawa K, Higuchi O, Kimura T, Kojima Y, Kariya J, et al. Effect of mulberry leaf extract with enriched 1-deoxynojirimycin content on postprandial glycemic control in subjects with impaired glucose metabolism: Mulberry DNJ and postprandial glycemia. J Diabetes Investig 2011;2(4):18-23 [DOI:10.1111/j.2040-1124.2011.00101.x] [PMID] [PMCID]
46. Uchiyama H, Komatsu K-I, Nakata A, Sato K, Mihara Y, Takaguri A, et al. Global liver gene expression analysis on a Murine hepatic steatosis model treated with mulberry (Morus alba L.) leaf powder. Anticancer Res 2018;38(7):5-11. [DOI:10.21873/anticanres.12729] [PMID]
47. Ferriolli E, Pessanha FPAS, Marchesi JCLS. Diabetes and exercise in the elderly. Med Sport Sci 2014;60: 2-9. [DOI:10.1159/000357342] [PMID]
48. Snowling NJ, Hopkins WG. Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: A meta-analysis. Diabetes Care 2007;30(4):e26-e26. [DOI:10.2337/dc06-2626]
49. Umpierre D, Ribeiro PAB, Kramer CK, Leitão CB, Zucatti ATN, Azevedo MJ, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis: A systematic review and meta-analysis. JAMA 2011;305(17):1790-9. [DOI:10.1001/jama.2011.576] [PMID]
50. Boule NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials. Scand J Med Sci Sports 2002;12(1):60-71. [DOI:10.1034/j.1600-0838.2002.120111_3.x]
51. Touvra A-M, Volaklis KA, Spassis AT, Zois CE, Douda HD, Kotsa K, et al. Combined strength and aerobic training increases transforming growth factor-β1 in patients with type 2 diabetes. Hormones(Athens) 2011;10(2): 25-30. [DOI:10.14310/horm.2002.1302] [PMID]
52. Shenoy S, Guglani R, Sandhu JS. Effectiveness of an aerobic walking program using heart rate monitor and pedometer on the parameters of diabetes control in Asian Indians with type 2 diabetes. Prim Care Diabetes 2010;4(1):41-5. [DOI:10.1016/j.pcd.2009.10.004] [PMID]
53. Seyedizadeh SH, Cheragh-Birjandi S, Hamedi Nia MR. The effects of combined exercise training (resistance-aerobic) on serum kinesin and physical function in type 2 diabetes patients with diabetic peripheral neuropathy (randomized controlled trials). J Diabetes Res 2020;2020:6978128. (Persian) [DOI:10.1155/2020/6978128] [PMID] [PMCID]
54. Aliniya N, Elmieh A, Fadaei Chafy MR,. Interaction effect of combined exercise and supplementation with portulaca oleracea on liver enzymes in obese postmenopausal women with Non-Alcoholic Fatty Liver Disease. Med Res 2020;10(1):68-79. (Persian) [DOI:10.32598/cmja.10.1.960.1]
55. Takalooei F, Shahrbanian S, Anthony C,Hackney, Regulation of Metabolic Homeostasis by Reducing Selected Hepato-adipokines in Response to Three Types of Resistance Training in Men with Obesity. J Basic Res Med Sci 2022;9(1):50-61. [Google Scholar]
56. Blumenthal JB, Gitterman A, Ryan AS, Prior SJ. Effects of exercise training and weight loss on plasma fetuin-A levels and insulin sensitivity in overweight older men. J Diabetes Res 2017;2017:1-7. [DOI:10.1155/2017/1492581] [PMID] [PMCID]
57. Malin SK, del Rincon JP, Huang H, Kirwan JP. Exercise-induced lowering of fetuin-A may increase hepatic insulin sensitivity. Med Sci Sports Exerc 2014;46(11):85-90. [DOI:10.1249/MSS.0000000000000338] [PMID] [PMCID]
58. Vizvari E, Farzanegi P, Abbas Zade H. Effect of moderate aerobic exercise on serum levels of FGF21 and fetuin A in women with type 2 diabetes. Med Lab J 2020;14(6):17-22. [DOI:10.52547/mlj.14.6.17]
59. Samadi A, Abbassi Daloii A, Barari A, Saeidi A. The effect of twelve weeks of combined training with and without canagliflozin consumption on fetuin A and fetuin B in type 2 diabetic men. J Basic Res Med Sci 2020;7(4):20-30. (Persian) [Google Scholar]
60. El-Ashmawy HM, Ahmed AM. Serum fetuin-B level is an independent marker for nonalcoholic fatty liver disease in patients with type 2 diabetes. Eur J Gastroenterol Hepatol 2019;31(7):59-64. [DOI:10.1097/MEG.0000000000001354] [PMID]
61. Sun Q, Cornelis MC, Manson JE, Hu FB. Plasma levels of fetuin-A and hepatic enzymes and risk of type 2 diabetes in women in the U.S. Diabetes 2013;62(1):49-55. [DOI:10.2337/db12-0372] [PMID] [PMCID]
62. Malin SK, Mulya A, Fealy CE, Haus JM, Pagadala MR, Scelsi AR, et al. Fetuin-A is linked to improved glucose tolerance after short-term exercise training in nonalcoholic fatty liver disease. J Appl Physiol 2013;115(7):88-94. [DOI:10.1152/japplphysiol.00237.2013] [PMID] [PMCID]
63. Lee S, Norheim F, Gulseth HL, Langleite TM, Kolnes KJ, Tangen DS, et al. Interaction between plasma fetuin-A and free fatty acids predicts changes in insulin sensitivity in response to long-term exercise. Physiol Rep 2017;5(5):e13183. [DOI:10.14814/phy2.13183] [PMID] [PMCID]
64. Cox JH, Cortright RN, Dohm GL, Houmard JA. Effect of aging on response to exercise training in humans: skeletal muscle GLUT-4 and insulin sensitivity. J Appl Physiol 1999;86(6):2019-25. [DOI:10.1152/jappl.1999.86.6.2019] [PMID]
65. Hovanec N, Sawant A, Overend TJ, Petrella RJ, Vandervoort AA. Resistance training and older adults with type 2 diabetes mellitus: strength of the evidence. J Aging Res 2012;2012:284635. [DOI:10.1155/2012/284635] [PMID] [PMCID]
66. DeFronzo RA, Jacot E, Jequier E, Maeder E, Wahren J, Felber JP. The effect of insulin on the disposal of intravenous glucose. Results from indirect calorimetry and hepatic and femoral venous catheterization. Diabetes 1981;30(12):1000-7. [DOI:10.2337/diab.30.12.1000] [PMID]
67. Ruderman N, Devlin J, Schneider S, editors. Handbook of exercise in diabetes. 2nd ed. Alexandria, VA: American Diabetes Association; 2001. [PMCID]
68. Ramírez-Vélez R, García-Hermoso A, Hackney AC, Izquierdo M. Effects of exercise training on Fetuin-a in obese, type 2 diabetes and cardiovascular disease in adults and elderly: a systematic review and Meta-analysis. Lipids Health Dis 2019;18(1):23. [DOI:10.1186/s12944-019-0962-2] [PMID] [PMCID]
69. Chung HI, Kim J, Kim JY, Kwon O. Acute intake of mulberry leaf aqueous extract affects postprandial glucose response after maltose loading: Randomized double-blind placebo-controlled pilot study. J Funct Foods 2013;5(3):1502-6. [DOI:10.1016/j.jff.2013.04.015]
70. Mudra M, Ercan-Fang N, Zhong L, Furne J, Levitt M. Influence of mulberry leaf extract on the blood glucose and breath hydrogen response to ingestion of 75 g sucrose by type 2 diabetic and control subjects. Diabetes Care 2007;30(5):1272-4. [DOI:10.2337/dc06-2120] [PMID]
71. Mohammadi J, Naik PR. Evaluation of hypoglycemic effect of Morus alba in an animal model. Indian J Pharmacol 2008;40(1):15-8. (Persian) [DOI:10.4103/0253-7613.40483] [PMID] [PMCID]
72. Kilpatrick ES. Haemoglobin A1c in the diagnosis and monitoring of diabetes mellitus. J Clin Pathol 2008;61(9):977-82. [DOI:10.1136/jcp.2007.054304] [PMID]
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