Chronic Ingestion of Flavan-3-ols and Isoflavones Improves Insulin Sensitivity and Lipoprotein Status and Attenuates Estimated 10-Year CVD Risk in Medicated Postmenopausal Women With Type 2 Diabetes
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OBJECTIVE: To assess the effect of dietary flavonoids on cardiovascular disease (CVD) risk in postmenopausal women with type 2 diabetes on established statin and hypoglycemic therapy. RESEARCH DESIGN AND METHODS: Despite being medicated, patients with type 2 diabetes have elevated CVD risk, particularly postmenopausal women. Although dietary flavonoids have been shown to reduce CVD risk factors in healthy participants, no long-term trials have examined the additional benefits of flavonoids to CVD risk in medicated postmenopausal women with type 2 diabetes. We conducted a parallel-design, placebo-controlled trial with type 2 diabetic patients randomized to consume 27 g/day (split dose) flavonoid-enriched chocolate (containing 850 mg flavan-3-ols [90 mg epicatechin] and 100 mg isoflavones [aglycone equivalents)]/day) or matched placebo for 1 year. RESULTS: Ninety-three patients completed the trial, and adherence was high (flavonoid 91.3%; placebo 91.6%). Compared with the placebo group, the combined flavonoid intervention resulted in a significant reduction in estimated peripheral insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR] −0.3 ± 0.2; P = 0.004) and improvement in insulin sensitivity (quantitative insulin sensitivity index [QUICKI] 0.003 ± 0.00; P = 0.04) as a result of a significant decrease in insulin levels (−0.8 ± 0.5 mU/L; P = 0.02). Significant reductions in total cholesterol:HDL-cholesterol (HDL-C) ratio (−0.2 ± 0.1; P = 0.01) and LDL-cholesterol (LDL-C) (−0.1 ± 0.1 mmol/L; P = 0.04) were also observed. Estimated 10-year total coronary heart disease risk (derived from UK Prospective Diabetes Study algorithm) was attenuated after flavonoid intervention (flavonoid +0.1 ± 0.3 vs. placebo 1.1 ± 0.3; P = 0.02). No effect on blood pressure, HbA1c, or glucose was observed. CONCLUSIONS: One-year intervention with flavan-3-ols and isoflavones improved biomarkers of CVD risk, highlighting the additional benefit of flavonoids to standard drug therapy in managing CVD risk in postmenopausal type 2 diabetic patients.
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Flavonoids have been reported to provide additional benefits to established hypoglycemic therapy in postmenopausal women with type 2 diabetes.
“Interestingly, flavonoids have been reported recently to exert additional benefits to established hypoglycemic therapy in postmenopausal type 2 diabetic patients.26”
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Self-citation
- Authors
- Curtis, P. J., Sampson, M., Potter, J., Dhatariya, K., Kroon, P. A., & Cassidy, A.
- Affiliations
- University of East Anglia (GB)
- Norfolk and Norwich University Hospital (GB)
- Quadram Institute (GB)
- Corresponding author
- Cassidy, Aedín
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2012-01-16
- Volume
- 35
- Issue
- 2
- Pages
- 226-232
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3263874
- OpenAlex
- W2100144002
- Cited by
- 200
- References
- 39
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 10 · 2023: 14 · 2022: 19 · 2021: 11 · 2020: 15 · 2019: 12 · 2018: 21 · 2017: 15 · 2016: 21 · 2015: 17 · 2014: 9 · 2013: 14 · 2012: 8
- FWCI
- 10.64
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Funders
- Diabetes UK (06/0003397)
- Biotechnology and Biological Sciences Research Council (BBS/E/F/00043039, BBS/E/F/00044434)
- Topics
- Health Sciences › Medicine › Biochemistry › Phytochemicals and Antioxidant Activities
- Health Sciences › Medicine › Pathology and Forensic Medicine › Phytoestrogen effects and research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- flavan-3-ols, isoflavones, dietary flavonoids, type 2 diabetes, postmenopausal women, insulin sensitivity, insulin resistance, lipoprotein profile, cardiovascular risk, epicatechin, statin therapy, hypoglycemic therapy, coronary heart disease risk, HOMA-IR, QUICKI
- MeSH terms
- Aged, Cardiovascular Diseases, Cholesterol, Diabetes Mellitus, Type 2, Female, Flavonoids, Humans, Insulin Resistance, Isoflavones, Lipoproteins, Cholesterol, HDL, Cholesterol, LDL, Middle Aged, Postmenopause
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