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Effect of Pistachio Intake on Insulin Resistance and Type 2 Diabetes Mellitus

Not Applicable
Completed
Conditions
Type 2 Diabetes Mellitus
Interventions
Dietary Supplement: Pistachios
Other: control diet
Registration Number
NCT01441921
Lead Sponsor
Institut Investigacio Sanitaria Pere Virgili
Brief Summary

Hypothesis: Chronic intake of pistachios improves glucose metabolism and insulin resistance status thus contributing to decrease the risk of type 2 diabetes mellitus and its associated abnormalities.

Detailed Description

In free-living overweight or obese adult with impaired fasting glucose or impaired glucose tolerance we will compare the effects of a pistachio-rich diet or a Mediterranean Diet on:

* Fasting glucose levels, hemoglobin A1c, insulin, C peptide, HOMA IR, advanced glycation end products and soluble receptor of advanced glycation-end products.

* Peripheral haemostatic parameters.

* Plasma inflammatory markers.

* Lymphocyte expression of toll-like receptors, C peptide, resistin and interleukin-6 in peripheral leukocytes.

* Lymphocyte glucose transport and expression of glucose transporter 4 in peripheral blood leukocytes.

* Platelet function including platelet number, mean platelet volume, platelet factor 4 levels and urinary 11-dehydro-thromboxane B2.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
50
Inclusion Criteria
  • BMI less than 35 kg/m2.
  • Fasting plasma glucose levels between 100 and 125 mg/dl or
  • Oral glucose tolerance test of 140 to 199 mg/dl.
Exclusion Criteria
  • Diabetes mellitus.
  • Alcohol, tobacco, or drug abuse.
  • Significant liver, kidney, thyroid, or other endocrine diseases.
  • Frequent consumption of nuts or known history of allergy to them.
  • Use of plant sterol, oral antidiabetic drugs, supplemental use of phyllium, fish oil supplements and multivitamins, vitamin E or other antioxidant supplements.
  • Bad dentures, implying difficulty to chew pistachios.
  • Being pregnant or wishing to become a pregnant 6 months before or during the study, lactating 6wk before or during the study.
  • Following vegetarian or weight loss diets.
  • Other medical or social conditions that difficult the compliance to the intervention.

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Pistachio dietPistachiosDiet supplemented with 2 ounces of pistachio (35% fat, 50% carbohydrates adn 15% protein)
Control dietcontrol dietLow-fat normocaloric diet (30% fat, 55% carbohydrates, 15% proteins)
Primary Outcome Measures
NameTimeMethod
Changes from baseline in circulating levels of glucose and insulin according to the intervention armParticipants will be followed for 9 months. Measurements will be done before and after 4 months of the first and second intervention arm

Measurement of circulating glucose and insulin levels and cellular glucose uptake

Secondary Outcome Measures
NameTimeMethod
Changes from baseline in HL and LDL size according to the intervention armParticipants will be followed for 9 months. Measurements will be done before and after 4 months of the first and second intervention arm

Plasmi lipoprotein size will be measured by polycacrylamide gradient gel electrophoresis

Changes in advanced glycation end products according to the intervention armParticipants will be followed for 9 months. Measurements will be done before and after 4 months of the first and second intervention arm

Advanced glycation end products and soluble receptor of advanced glycation-end produtcs will be measured

Changes from baseline in gene expression in the peripheral cells according to the intervention armParticipants will be followed for 9 months. Measurements will be done before and after 4 months of the first and second intervention arm

RNA from peripheral leukocytes will be isolated for the subsequent measurements of changes in gene expression of toll-like receptors, GLUT-4, C-peptide, resistin adn IL-6, and genes involved in telomere maintenance and oxidation

Changes from baseline in inflammatory, oxidative and metabolic risk markers related to glucose/insulin metabolism according to the intervention armParticipants will be followed for 9 months. Measurements will be done before and after 4 months of the first and second intervention arm

Cpeptide, resistin, IL-6, IL-18, Ghrelin, leptin, adiponectin, GLP-1 and oxidized LDL will be measured.

Changes from baseline in platelet function according to the intervention armParticipants will be followed for 9 months. Measurements will be done before and after 4 months of the first and second intervention arm

Platelet number, mean platelet volume and platelet factor 4 in blood, and urinary levels of 11-dehydro-thromboxane B2 will be assessed.

Changes from baseline in haemostatic parameters according to the intervention armParticipants will be followed for 9 months. Measurements will be done before and after 4 months of the first and second intervention arm

Tissue factor, fibrinogen, PAI-1, vWF will be measured.

Changes from baseline in cellular glucose uptake according to the intervention armParticipants will be followed for 9 months. Measurements will be done before and after 4 months of the first and second intervention arm

Glucose uptake and GLUT4 protein levels will be assessed in peripheral leukocytes

Changes from baseline in telomeric length of leukocytes (LTL)Participants will be followed for 9 months. Measurements will be done before and after 4 months of the first intervention arm. Measurements will be not analysed after the second period due to expected carry-over effect.

Telomere lenght will be evaluated as a biomarker of biological age and general health status. Telomere attrition may play an important role in the pathogenesis and severity of type 2 diabetes (T2D) increasing the probability of beta-cell senescence, leading to reduced cell mass and decreased insulin secretion.

Trial Locations

Locations (1)

Human Nutrition Unit, Faculty of Medicine, Rovira i Virgili University

🇪🇸

Reus, Tarragona, Spain

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