Search Results (472)

The consumption of ultra-processed foods (UPFs) in adolescence is high due to their widespread availability and accessibility and has been linked to increased cardiometabolic risk. In the Autonomous City of Melilla, an environment with particular cultural and religious characteristics, it is relevant to analyze the relationship of UPFs with metabolic markers of type 2 diabetes mellitus. This is a cross-sectional pilot study on 31 Muslim adolescents aged 15 to 17 years. The NOVA food classification was used to identify UPFs. The final sample comprised Muslim adolescents because written consent for venous blood sampling was obtained only from Muslim families/legal guardians. Separate multiple linear regression models adjusted for sex were fitted to examine the associations between UPF intake (%E/day) and each cardiometabolic and inflammatory marker. Higher UPF intake was positively associated with BMI, body fat percentage, waist circumference, waist-to-height indicator (ICA), and fasting glucose after controlling for the false discovery rate (q < 0.05). Regarding the inflammatory component, Muslim girls had elevated levels of IL-7, IL-10, and IL-13, and Muslim boys had higher levels of MIP-1β. In addition, IL-8 correlated positively with waist circumference, BMI, and the HDL/LDL ratio, while MCP-1 was negatively associated with Apo A1, total cholesterol, and HDL. In this exploratory pilot study, higher intake of UPF appears to be associated with greater central adiposity and higher fasting glucose; these hypothesis-generating findings warrant confirmation in larger, representative samples and may inform culturally adapted nutritional screening in Melilla. Full article

Background/Objectives: In all types of diabetes, elevated blood glucose levels cause pathological changes in skeletal muscle, primarily due to oxidative stress, mitochondrial dysfunction, and excessive production of reactive oxygen species (ROS). Regular exercise can help mitigate these effects; however, the underlying mechanisms, particularly those involving the mitochondrial permeability transition pore (mPTP), remain incompletely understood. This study aimed to explore the effects of aerobic exercise training (AET) on oxidative stress and the expression of mPTP components in the skeletal muscle of streptozotocin-induced diabetic rats. Methods: Male Wistar rats were randomly divided into three groups: Healthy Sedentary (H-SED), Diabetic Sedentary (D-SED), and Diabetic Exercise-trained (D-EXER); n = 6 per group. The D-EXER group performed AET (0° slope) 5 days/week for 8 weeks. After the intervention period, body weight and fasting blood glucose (FBG) levels were measured, and soleus muscles were collected and analyzed for oxidative stress biomarkers, Western blotting, and gene expression using qRT-PCR. Results: Following an 8-week intervention, AET reduced FBG concentrations. Accordingly, in the soleus muscles of the D-EXER group, ROS levels decreased, and redox balance was improved compared to the D-SED group. Exercise training reduced CypD and Casp9 mRNA expression and increased Bcl-2 mRNA expression, whereas Ant1 mRNA expression was only slightly altered. CypD protein expression was decreased in exercised diabetic rats, while VDAC1 protein and mRNA levels remained unchanged. In the D-EXER group, there were significant inverse correlations between CypD and Casp9 mRNA expression levels and glutathione redox state. Conclusions: The current study suggests that 8 weeks of AET, in addition to reducing hyperglycemia, may favorably influence oxidative balance and the expression of mPTP-related molecular components in diabetic skeletal muscle. Full article

Chronic pain and sleep disturbances are frequently associated and profoundly affect the quality of life, creating intertwined physical, emotional, and social challenges. This narrative review synthesizes current evidence on the molecular mechanisms and pharmacological influences underlying this bidirectional relationship. Elevated pro-inflammatory cytokines (IL-1β, IL-6, IL-10, TNF-α), neurodegenerative markers (tau, β-amyloid 42), metabolic hormones, and fasting glucose have been consistently associated with both objective and subjective sleep impairments in chronic pain conditions. Pharmacological agents such as melatonin and opioids exhibit heterogeneous effects on neurophysiological pathways, reflecting differences in mechanisms of action and their modulation of biological processes. Rather than offering therapeutic recommendations, this review aims to clarify how these mediators and drugs shape the complex interplay between pain and sleep. Overall, the evidence suggests that persistent dysregulation of inflammatory, neurodegenerative, and metabolic pathways may drive the reciprocal and detrimental interaction between chronic pain and sleep disturbances, highlighting opportunities for targeted research and integrated clinical strategies. Full article

Dietary pattern characterized by low intake of vegetables and fruits and high consumption of fat, soft drink and desserts are associated with an increased risk of chronic diseases. To investigate the effects of folate status and fructose intake on adenine-induced chronic kidney disease (CKD), seven-week-old C57BL/6 mice were divided into six groups and fed either a control diet (Ctrl), a 26% (w/w) high-fructose diet (Hfru), Ctrl plus 0.15% adenine (Ctrl+ade), Hfru+ade, Hfru with folate deficiency plus adenine (Hfru−f+ade), or Hfru with tenfold folate supplementation plus adenine (Hfru+f10+ade). After 10 weeks on the assigned diets, adenine was administrated to the +ade groups for 7 weeks. The results showed that all adenine-treated mice exhibited increased fasting blood glucose, urinary glucose, and elevated renal expression of collagen 1a1 (Col1a1), fibronectin (Fn1), and smooth muscle α-actin (Acta2). Compared with Ctrl mice, Hfru-fed mice showed significantly higher serum creatinine, increased urinary protein, and reduced creatinine clearance. Adenine induced kidney injury in all +ade groups, with the most severe damage observed in Hfru−f+ade mice, as indicated by elevated blood urine nitrogen (BUN), urinary protein, neutrophil gelatinase-associated lipocalin (NGAL), and renal fibrosis. In contrast, Hfru+f10+ade mice showed the lowest levels of these renal injury markers. The Hfru+ade diets increased renal Hif1α and iNos gene expression, which was further exacerbated by folate deficiency. Secretion of the anti-inflammatory cytokine interleukin (IL-10) by splenocytes was significantly reduced under folate-deficient conditions. Renal IL-10 levels were suppressed in all +ade groups but were significantly increased by folate supplementation. Renal IL-10 levels were negatively correlated with the inflammatory chemokine monocyte chemoattractant protein (MCP-1) and transforming growth factor (TGF)-β, whereas renal MCP-1 levels showed positive correlations with TGF-β and IL-6. Overall, these findings suggest that high fructose consumption in the absence of adequate folate intake may be of concern for CKD progression. Full article

Allostatic load is a physiological measure of chronic stress, and stress is implicated in disrupting appetite regulation. Individuals with obesity and type 2 diabetes have higher allostatic load compared to lean counterparts. However, whether allostatic load differs across prediabetes phenotypes and relates to appetite is unknown. Purpose: Test whether prediabetes phenotypes differ in allostatic load in relation to altered appetite regulation. Methods: Individuals with obesity were recruited, and prediabetes was determined using American Diabetes Association (ADA) criteria (75 g OGTT) for this cross-sectional study. After an overnight fast, appetite hormones (ghrelin and PYY), insulin, and glucose were measured every 30 min up to 120 min of the OGTT. Perception of hunger and fullness as well as desire for sweet and fatty foods were assessed using a visual analog scale. Allostatic load was calculated from physiologic markers. Aerobic fitness (VO₂max), body composition (DXA), clinical labs, and quality-of-life questionnaires were also collected. Results: Participants with impaired fasting glucose (IFG) + impaired glucose tolerance (IGT) had a higher allostatic load, obesity, and insulin resistance compared with IFG or IGT (all p < 0.05), independent of fitness. IFG + IGT also had lower fasting ghrelin (p < 0.05) and no difference in fasting PYY. Hunger, fullness, and sweet ratings were comparable across groups, but fatty food ratings tended to be higher in IFG + IGT than NGT. Conclusions: Allostatic load was associated with altered fasting ghrelin levels in individuals with IFG + IGT, along with elevated body weight and insulin resistance. These findings suggest stress is a potential mechanism underlying appetite dysregulation in different forms of prediabetes. Full article

Background and Objectives: Early detection of chronic diseases is essential for improving health outcomes and reducing long-term complications. In Poland, the POZ PLUS pilot programme introduced the Health Check-up (Bilans Zdrowia, BZ) tool, a structured preventive assessment designed to support early identification of chronic conditions in primary care. This study aimed to assess the association between participation in the Health Check-up and the detection (diagnostic yield) of hypertension, type 2 diabetes, lipid metabolism disorders, elevated fasting blood glucose, hypothyroidism, and non-toxic goiter by comparing outcomes in an intervention group and a control group. Materials and Methods: A non-randomised comparative study was conducted using routine clinical data from Health Check-ups performed within the POZ PLUS pilot. Detection rates were compared with those obtained in standard primary care practice during the same period. The study group consisted of 865 adults who met the inclusion criteria and underwent the BZ procedure, while the control group comprised 3199 patients with comparable eligibility who received usual care. Data analysis was performed using R and RStudio. Results: Hypertension detection was similar in both groups: 4.6% (95% CI: 3.3–6.3%) in the intervention group versus 4.5% (95% CI: 3.8–5.3%) in the control group (p = 0.9505). No significant difference was observed in type 2 diabetes detection: 0.7% (95% CI: 0.3–1.5%) versus 0.4% (95% CI: 0.2–0.7%) (p = 0.4134). In contrast, detection rates were significantly higher in the Health Check-up group for lipid metabolism disorders (10.3% vs. 2.6%; p < 0.001), abnormal fasting glucose (2.9% vs. 1.8%; p = 0.0465), and thyroid diseases, including hypothyroidism and non-toxic goiter (4.3% vs. 2.3%; p = 0.0016). Conclusions: The Health Check-up tool was associated with higher detection rates of lipid disorders, impaired fasting glucose, and thyroid diseases compared with usual care, suggesting increased diagnostic yield under a structured preventive assessment pathway. Further research should evaluate downstream clinical outcomes and cost-effectiveness. Given the non-randomised design and differential diagnostic intensity between groups, these findings should be interpreted as associations with diagnostic yield rather than causal effects on disease incidence or clinical outcomes. Full article

Background: Early prediction of gestational diabetes mellitus (GDM) remains a major clinical challenge, and the current oral glucose tolerance test (OGTT) is time-consuming and inconvenient for clinical routine. This study aimed to develop a novel predictive model for postprandial hyperglycemia GDM (pp-GDM) and postprandial glucose elevation using fasting serological and metabolic profiles. Method: We used High-Performance Liquid Chromatography-Mass Spectrometry (HPLC-MS) to analyze fasting plasma amino acid profiles at 24–28 weeks of gestation for 60 pp-GDM patients and 120 controls. Binary logistic regression model was constructed to identify potential biomarkers for pp-GDM prediction. Results: By incorporating amino acid indicators such as isoleucine, phenylalanine, threonine, and aspartate into the predictive model alongside traditional predictors (including BMI at sampling, fasting insulin, glycated hemoglobin, and uric acid), the overall predictive performance was significantly improved from 78.2% to 91.1%. A clinically practical nomogram for risk assessment was subsequently developed. Conclusions: This fasting metabolite-based model provides a reliable tool for early prediction of pp-GDM and postprandial hyperglycemia, which may reduce the need for OGTT and facilitate timely clinical decision making. Full article

Background and Objectives: Dichrostachys glomerata and Cissus quadrangularis, two species traditionally used in Cameroon, are recognized for their weight-reducing potential. This study examined the effects of standardized extracts of these botanicals on glucagon-like peptide-1 (GLP-1), dipeptidyl peptidase-4 (DPP-4), and key metabolic outcomes in individuals with excess body weight. Materials and Methods: In this 16-week, randomized, double-blind, placebo-controlled trial, 248 adults (126 women and 122 men; mean age 41.3 ± 0.3 years; BMI 25–34.9 kg/m²) were assigned to receive 400 mg D. glomerata extract (DGE), 300 mg C. quadrangularis extract (CQE), semaglutide (dose-escalated from 3 mg to 14 mg), or placebo, administered once daily. These are all standard clinical regimens. Primary assessments included changes in GLP-1 levels and DPP-4 activity. Secondary evaluations included body composition, caloric intake, satiety response, fasting glucose levels, and lipid profiles. Results: Participants receiving DGE or CQE displayed notable elevations in circulating GLP-1 (+38.6 pg/mL and +42.2 pg/mL, respectively; p < 0.01) and significant reductions in DPP-4 activity (−15.3% and −17.8%; p < 0.01) compared with placebo. Both extracts produced substantial improvements in body weight (−5.2% and −5.8%), body fat (−10.3% and −10.9%), energy intake (−16.2% and −17.5%), and satiety (+25.6% and +27.4%) (p < 0.01). Significant changes in fasting glucose and serum lipid levels were also observed (p < 0.05). These responses are comparable to those of semaglutide. Moreover, GLP-1 increments showed strong negative correlations with body fat percentage (r = −0.91 to −0.92; p < 0.001) and DPP-4 activity (r = −0.97 to −0.98; p < 0.001). Conclusions: Supplementation with D. glomerata and C. quadrangularis extracts enhanced GLP-1 secretion and reduced DPP-4 activity, yielding significant benefits for body composition and metabolic parameters. These findings indicate that both botanicals are promising natural agents for managing obesity through incretin-based mechanisms. Full article

Introduction: Immune dysfunction plays a significant role in Metabolic syndrome, contributing to both insulin resistance and chronic low-grade inflammation. This immune dysfunction is characterized by overproduction of inflammatory cytokines among which of primary importance are tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and (MCP-1), whereas others such as interferon gamma (IFN-γ), IL-17A, and the anti-inflammatory IL-10 appear to be of secondary importance. Cytokines also play a significant role in Post-COVID disorders contributing to prolonged immune dysregulation and persistent subclinical inflammation. However, their role in the newly emerging metabolic disorders following infection remains poorly defined. Methods and materials: In the current study 78 patients (26 men and 52 women) were included, divided into two groups—group 1 (individuals with newly diagnosed carbohydrate disorders after proven COVID-19 or Post-COVID group; n = 35) and group 2 (COVID-19 negative persons with Metabolic Syndrome; n = 33). They were further divided into several subgroups according to type of metabolic disorder present. Standard biochemical, hormonal and immunological parameters were measured using ELISA and ECLIA methods, as well as some indices for assessment of insulin resistance were calculated using the corresponding formula. Results: Patients from both groups demonstrate similar metabolic parameters including BMI and unadjusted lipid and uric acid levels (p > 0.05). After adjustment for age, sex, and BMI revealed significant differences, Post-COVID status independently predicted higher fasting glucose, HbA1c, total cholesterol, LDL-cholesterol, triglycerides, uric acid, and insulin-resistance indices, indicating substantially impaired glycemic and metabolic control beyond traditional risk factors. Furthermore, the Post-COVID cohort demonstrated marked cytokine dysregulation, with significantly elevated levels of TNF-α, IFN-γ, IL-17A, and IL-10 after adjustment. Conclusions: The observed changes in both metabolic and immune parameters studied among the two groups show many similarities, but some significant differences have also been identified. Together, these findings indicate that Post-COVID metabolic dysfunction is characterized by inflammation-driven dyslipidemia, heightened oxidative stress, and persistent immune activation, distinguishing it from classical Metabolic syndrome. Full article

Decreased skeletal muscle mass and function are a serious complication of long-term diabetes, often leading to numerous adverse outcomes. The primary pathological features of diabetic sarcopenia include muscle fiber atrophy and interstitial fibrosis. Although resistance exercise (RE) has been reported to mitigate skeletal muscle atrophy in type 2 diabetes mellitus (T2DM), the underlying mechanisms remain unclear. Fibroblast growth factor 21 (FGF21), an exercise-induced cytokine, has been shown to protect against skeletal muscle atrophy at elevated levels. In this study, a T2DM mouse model was established through 12 weeks of high-fat diet feeding and intraperitoneal injection of streptozotocin (STZ) to investigate the effect and mechanism of RE on skeletal muscle atrophy in T2DM mice. Our results demonstrated that 8 weeks of RE significantly decreased body weight, fat mass, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), and serum insulin levels in T2DM mice. RE also improved lean mass, glucose tolerance (IPGTT), and insulin tolerance (ITT). Additionally, RE increased skeletal muscle mass cross-sectional area (CSA) while attenuating fibrosis and inflammatory responses in skeletal muscle. Notably, RE upregulated FGF21 expression and activated the PI3K/Akt signaling pathway in diabetic skeletal muscle. RE promoted the phosphorylation of mTOR, 4EBP1, and p70S6K while suppressing the expression of the atrophy-related E3 ubiquitin ligases MuRF1 and MAFbx/Atrogin-1. Furthermore, RE inhibited lipid synthesis and enhanced both lipid oxidation and glucose utilization in skeletal muscle of T2DM mice. RE also improved mitochondrial biogenesis and dynamics in skeletal muscle of T2DM mice. In summary, 8 weeks of RE alleviated skeletal muscle atrophy in T2DM mice via activation of the FGF21/PI3K/Akt signaling pathway, which enhanced protein synthesis, improved glycolipid metabolism and mitochondrial quality control, and attenuated fibrosis and inflammation. Full article

Background and Objectives: Cardiometabolic diseases are rising in Latin America, yet rural Amazonian populations remain understudied. We aimed to characterize the prevalence and factors associated with a simple composite cardiometabolic risk in rural Amazonian adults. Materials and Methods: We conducted an analytical cross-sectional study during community screenings in San Martín, Peru, in 2025, enrolling adults aged ≥ 18 years. The outcome was present when ≥2 biological/anthropometric alterations were identified at the same visit (hypertension, dyslipidemia, hyperglycemia, hyperuricemia, general obesity, abdominal obesity, or elevated waist-to-hip ratio). Behaviors included current tobacco use, alcohol risk (AUDIT), and physical activity (IPAQ). We summarized variables (univariate), compared groups (bivariate: chi-square; Fisher for alcohol), and fitted modified Poisson regression with robust errors to estimate prevalence ratios (PRs); variables with p ≤ 0.20 in bivariate analysis entered multivariable models. Results: We enrolled 205 adults; 70.2% met the composite outcome. In multivariable models, abdominal obesity (adjusted PR [aPR] 1.70; 95% CI 1.40–2.10), hyperglycemia (1.65; 1.25–2.17), hyperuricemia (1.38; 1.19–1.61), dyslipidemia (1.25; 1.07–1.46), and general obesity (1.21; 1.04–1.40) were independently associated with cardiometabolic risk. Hypertension (1.06; 0.88–1.29) and elevated waist-to-hip ratio (1.20; 0.88–1.63) were not. Physical activity differed crudely but showed no independent association; tobacco and alcohol were not associated. Conclusions: In this rural Amazonian population, we observed a high prevalence of composite cardiometabolic risk and found that central adiposity and metabolic derangements, not blood pressure or self-reported behaviors, were the main correlates. Simple measures such as waist circumference, fasting glucose or HbA1c, a basic lipid panel, and serum urate may help flag adults at higher cardiometabolic risk in similar low-resource primary-care settings, but prospective studies are needed to evaluate their predictive value and screening performance. Full article

Cytochrome P450, family 7, subfamily b, polypeptide 1 (CYP7B1) is a widely expressed enzyme involved in the hydroxylation of sterols. Generated by transposon technology in zygotes, male rats lacking Cyp7b1 expression in homozygosis showed an absence of Cyp7b1 mRNA expression in the liver, small intestine, adipose tissue, and muscle. Elevated levels of 25-hydroxycholesterol were found in the liver of mutant rats. After overnight fasting, plasma triglyceride (TG) levels were increased in the homozygous rats. In agreement with this, increased hepatic secretion of very-low-density lipoprotein-TG (VLDL) in fasting rats treated with tyloxapol and decreased low-density receptor protein (LDLr) on the hepatocyte plasma membranes were observed. The decrease in LDLr was not due to decreased mRNA expression but to increased expressions of its proteases (Psck9 and Mylip). RNA sequencing identified Fasn, Igfbp2, and Pcsk9 as targets of the Cyp7b1 absence. However, the hepatic protein contents of IGFBP2 were increased in Cyp7b1-deficient rats, accompanied by a normal glucose tolerance test. HepG2 cells lacking CYP7B1 showed increased expressions of FASN and IGFBP2. These results suggest a role of CYP7B1 in the control of hepatic IGFBP2 and VLDL-TG secretion as a prediabetes sign exerted through 25-hydroxycholesterol and transcriptional or translational mechanisms depending on the species. Full article

Background/Objectives: Cognitive decline in older people is greatly affected by various risk factors, especially imbalances in trace elements. This study aimed to examine the relationships between serum levels of selenium, zinc, and copper and cognitive impairment. This study included 854 participants aged 63 to 85 years. Methods: We conducted clinical assessments of metabolic disorders and measured serum levels of selenium, zinc, and copper. Cognitive impairment was evaluated using the Mini-Cog test. Results: The primary analysis identified significant differences (all p < 0.05) in age, body mass index, waist circumference, various metabolic parameters (such as fasting plasma glucose, glycated hemoglobin, and plasma triglyceride levels) and some cardiometabolic indices between the groups with and without cognitive impairment. Further assessments using multiple logistic regression and receiver operating characteristic analysis showed an association between increased serum selenium and zinc levels and a protective effect against cognitive impairment. In contrast, elevated serum copper levels were identified as a risk factor for cognitive impairment. This analysis also demonstrated high sensitivity and specificity, along with established cut-off levels for all of the trace elements studied. Conclusions: The Mini-Cog test is an effective cognitive screening test for the older population. Our findings establish a significant association between the balanced status of key antioxidant trace elements and cognitive health. Specifically, adequate serum selenium and zinc levels are associated with enhanced cognitive performance, while elevated copper may indicate a pro-oxidant state detrimental to cognitive function. Consequently, these three elements offer promise as practical, accessible biomarkers for the early identification and risk stratification of individuals susceptible to cognitive impairment. Future research should prioritize clinical trials focused on targeted nutritional strategies—specifically optimizing dietary intake and/or supplementation of selenium and zinc while carefully managing copper balance—as a viable primary prevention approach to reduce the global burden of cognitive decline. Full article

Objectives: This study investigated the potential beneficial effects of a probiotic candidate, Clostridium cochlearium 2316, in modulating physiological and metabolic markers in mice with high-fat diet-induced obesity (DIO). Methods: C57BL/6 DIO mice were assigned to three groups (ad libitum): standard low-fat control (LF, 10% fat), high-fat diet (HF, 60% fat), and high-fat diet supplemented with approximately one billion CFU/day of CC2316 via daily oral gavage for 16 weeks. Results: After 16 weeks, the CC group exhibited 17.3% lower body weight gain (p < 0.001) and significant fat mass decrease (p < 0.0001) compared to HF mice. Serum biochemistry showed that CC2316 supplementation resulted in a 27.7% reduction in fasting blood glucose (p < 0.05), a 58.4% reduction in fasting insulin (p < 0.01), and an 89.4% improvement in HOMA-IR score (p < 0.05). Furthermore, serum total cholesterol level decreased dramatically by 40.2% in the CC group (p < 0.001). Despite a higher caloric absorption rate (p < 0.001), CC mice demonstrated a significant beneficial shift in energy expenditure, characterized by an increased basal metabolic rate (p < 0.05), higher energy expenditure (p < 0.05), and an elevated respiratory quotient (RER) (p < 0.05), alongside increased physical activity (p < 0.05). Conclusions: This investigation strongly suggests that CC2316 supplementation mitigates the adverse effects of HFD-induced obesity by modulating whole-body energy metabolism, positioning it as a potential aid to lower risk factors associated with metabolic syndrome. The precise mechanisms linking the gut microbiome to altered energy substrate utilization are discussed and suggested for further investigation. Full article

Probiotics have been studied for their potential to treat chronic diseases. This study examined the use of Lacticaseibacillus rhamnosus BST.L-601 as an anti-diabetic symbiotic with sweet potato for fermentation. The medium supplemented with sweet potato showed increased productivity and enhanced storability. The anti-diabetic effect of fermented BST.L-601 was evaluated using the C2C12 myotube and a type 2 diabetes mellitus (T2DM)-induced db/db (Lepr^db/Lepr^db) mouse model. Treatment with heat-killed BST.L-601 increased glucose uptake by 125% and α-glucosidase inhibition in a dose-dependent manner without cytotoxicity for myotubes. 8 weeks of oral administration of BST.L-601 led to anti-diabetic activities in various biomarkers in the mouse model, including lowered fasting blood glucose by 88% and elevated mRNA expression of glucose metabolism-related factors IRS-1 (510%) and GLUT4 (181%) from skeletal muscle. Moreover, the improvement of induced T2DM in mice was supported by blood serum analysis. Immunohistochemistry showed increased insulin and decreased glucagon secreted from β and α cells in the pancreas islet. Microbiota analysis demonstrated elevated microbiome diversity in mice treated with BST.L-601. Furthermore, the safety and probiotic properties of the strain were confirmed. These results suggest that BST.L-601 fermented with sweet potato could be a functional symbiotic used to improve diabetes, particularly T2DM. Full article