الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Diabetes Mellitus is a chronic disease with many dramatic complications on the long term. Type II is more common than type I and is now diagnosed in all age groups including youth and children. Controlling the blood sugar level along with controlling the lipid profile have a very important role in preventing and decreasing the long term complications.
Inflammation plays a major role in the pathogenesis and complications of diabetes.
Expanding concern in diabetes was raised lately because it has been associated with cardiovascular, cerebrovascular, retinal and renal complications and also with highmortality rate. Dietary management of diabetes along with life style modification hasa very important rolein alleviating and postponing complications of diabetes and in controlling blood sugar level and overall wellbeing of diabetic patients. In conclusion, novel strategies as probiotic intakehave been used nowadays to control diabetes and decrease the dependence on drugs and other chemicals such as statins to control blood sugar level, cholesterol and TGs levels.
The general objective of this study was to evaluate the effect of probiotic intake on the glycemic control, blood lipid profile and inflammatory markers among type 2 diabetic patients.. The specific objectives of the study were to design and implement dietary intervention programme using yeast and yogurt for diabetic patients for four months, determine the effect ofdietary intervention programme using yeast and yogurt fasting blood glucose level,two hours post prandial blood glucose level,total cholesterol and triglyceride serum level, HDL& LDL Cholesterol level,CRP level,IL-6 level, TNF-α level and Glycosylated haemoglobin level.
The study was conducted on 100 diabetic patients the duration of the study was 4 months. The studied patients were subjected to full history taking (medical and dietary) using pre-designed questionnaire Also anthropometric assessment and laboratory investigations were used prior to the nutritional intervention. Afterwards they were divided into 4 groups each of 25 patients, they were all instructed to eat well balanced diet according to individually-calculated energy requirementsand the second group received 2 cups of Probiotic yogurt daily, the third group received one teaspoonful yeast daily and the fourth group received both yogurt and yeast. Then the effect of the intervention on anthropometric measurments,laboratory parameterswere evaluated after 2months of theintervention and at the end of the study.
The results of this study showed that :
1. Theintake of probiotics on daily basis has a very important role in decreasing body weight, BMI, waist circumference, hip circumference, body fat percentage and water percentage mainly with Probiotic yogurt intake either alone or combined with the intake of yeast.
2. The daily intake of probiotic either in the form of Probiotic yogurt alone, yeast alone or combination of both of them showeda significant decrease of fasting blood sugar level,2 h PP blood sugar level and HbA1c level.
3. Thedaily intake of probiotic either in the form of Probiotic yogurt alone, yeast alone or combination of both of them showeda significant decrease of the three parameters of inflammatory markers studied. There was significant reduction inhs-CRP, IL-6 and TNF- α.
4. Either calorie restriction alone or combined with daily intake of probiotic either in the form of Probiotic yogurt alone, yeast alone or combination of both of them showeda significant decrease ofblood cholesterol level with no difference between the four groups. Daily intake of probiotic either in the form of Probiotic yogurt alone, yeast alone or combination of both of them had a significant effect on both increasing HDL cholesterol level and decreasing LDL cholesterol level.On the other hand there was significant reduction in TG level only with the daily intake of Probiotic yogurt alone or combined with yeast with no chage when yeast was taken alone.
from this study it could be concluded that:
1. Life style modification is a backbone in controlling diabetes mellitus .
2. It is important for diabetic patients to follow a balanced diet along with practicing excercises for half an hour five times per week.
3. The daily probiotic intakehas a promising role in the management of the hyperglycemic state.
4. The daily probiotic intake has a significant role in controlling inflammation in type 2 diabetic patientsmainly probiotic yogurt alone or in combination with yeast intake.
5. The daily probiotic yogurt intake has a role incontrolling the fasting blood glucose level and, 2hours post prandialblood glucose level and glycosylated hemoglobin level.
6. There was alsoobvious change on the parameters of the lipid profile mainly total cholesterol, Triglycerideand High density lipoprotein levelsof diabetic patients with the intake of probiotics.
The most important recommendations from this study:
1. Life style modifications in the form of energy restriction along with increasing the level of physical activity is very important fortype 2 diabetic patients.
2. The routine intake of medicationsto control blood glucose levels, lipid profile and weightcould be combined with dietary modifications which may decrease the dose and number of drugs used.
3. It is advisable to take probiotics either Probiotic yogurt alone, or a combination of both yeast and yogurt has as it has a promising role in lowering blood glucose levels in diabetic patients.
4. It is advisable to take probiotics eitherProbiotic yogurt alone, or a combination of both as it has a promising role in controlling inflammation in diabetic patients.
5. It is not advisable for type 2 diabetic patients to take yeast alone as a source of probiotics as it leads to weight gain
6. More studies are needed to investigate the effect ofother types of probiotics on the diabetic and lipid profiles.
7. Further studies are needed to evaluate the effect of long term use of different strains of probiotics on the control of diabetic ,inflammatory and lipid profile of type 2 diabetic patients.
8. Further studies are needed to evaluate the effect of use of different strains of probiotics on the control of diabetic ,inflammatory and lipid profile of prediabetic patients.