{ "document_id": "fresh-bethgelab-298331", "source_sha256": "b7eff773bb1f99e0ec70566688feff4ba5a0189784a14a115bf01994215833e7", "kind": "ku", "status": "generated", "result": { "schema_version": "1.0", "title": "A six-month periodic fasting reduces microalbuminuria and improves metabolic control in patients with type 2 diabetes and diabetic nephropathy: a randomized controlled study", "abstract_sha256": "", "mode": "sequential", "model": "base", "config": { "mode": "sequential", "chunk_words": 1000, "context_words": 0, "previous_units": 10, "canonicalize": false, "minhash_permutations": 16, "canonicalization_max_tokens": 4096, "parse_retries": 0 }, "knowledge_units": [ { "chunk_index": 0, "context_summary": "A randomized controlled study evaluated the impact of a six-month fasting-mimicking diet on metabolic markers and albuminuria in patients with type 2 diabetes and diabetic nephropathy. The intervention group showed significant improvements in microalbuminuria and insulin resistance compared to a Mediterranean diet control group. These benefits were partially sustained at follow-up, while markers for DNA damage and dicarbonyl detoxification remained unchanged.", "entities": [ { "name": "Fasting-mimicking diet (FMD)", "entity_id": "fasting_mimicking_diet_fmd", "entity_type": "method", "aliases": [], "attributes": { "duration": "six months", "structure": "five-day diet intervention followed by refeeding, repeated for six cycles" }, "relationships": [ { "predicate": "reduces", "target": "microalbuminuria", "attributes": { "magnitude": "-30.3mg/g", "p_value": "<=0.05" }, "target_id": null }, { "predicate": "reduces", "target": "HOMA-IR", "attributes": { "magnitude": "-3.8", "p_value": "<=0.05" }, "target_id": null }, { "predicate": "reduces", "target": "suPAR", "attributes": { "magnitude": "-156.6pg/ml", "p_value": "<=0.05" }, "target_id": null }, { "predicate": "no_effect_on", "target": "markers of dicarbonyl detoxification", "attributes": {}, "target_id": null }, { "predicate": "no_effect_on", "target": "DNA-damage/repair markers", "attributes": {}, "target_id": null } ] }, { "name": "Mediterranean diet", "entity_id": "mediterranean_diet", "entity_type": "method", "aliases": [], "attributes": { "role": "control group intervention" }, "relationships": [] }, { "name": "Type 2 diabetes patients with diabetic nephropathy", "entity_id": "type_2_diabetes_patients_with_diabetic_nephropathy", "entity_type": "other", "aliases": [], "attributes": { "sample_size": 40, "baseline_hba1c": "7.8±0.2% [62.1±2.3 mmol/mol]", "inclusion_criterion": "increased albumin-to-creatinine ratio (ACR)", "model_entity_type": "population" }, "relationships": [ { "predicate": "randomized_to", "target": "Fasting-mimicking diet (FMD)", "attributes": { "n": 21 }, "target_id": null }, { "predicate": "randomized_to", "target": "Mediterranean diet", "attributes": { "n": 19 }, "target_id": null } ] }, { "name": "Albumin-to-creatinine ratio (ACR)", "entity_id": "albumin_to_creatinine_ratio_acr", "entity_type": "measurement", "aliases": [], "attributes": { "role": "primary endpoint" }, "relationships": [ { "predicate": "measured_in", "target": "Type 2 diabetes patients with diabetic nephropathy", "attributes": {}, "target_id": null } ] }, { "name": "HOMA-IR", "entity_id": "homa_ir", "entity_type": "measurement", "aliases": [], "attributes": { "role": "secondary endpoint" }, "relationships": [ { "predicate": "reduction_sustained_at_followup", "target": "1.9", "attributes": { "p_value": "<=0.05" }, "target_id": null } ] }, { "name": "suPAR", "entity_id": "supar", "entity_type": "measurement", "aliases": [], "attributes": { "role": "secondary endpoint", "biological_marker": "senescence" }, "relationships": [] }, { "name": "University Hospital of Heidelberg", "entity_id": "university_hospital_of_heidelberg", "entity_type": "organization", "aliases": [], "attributes": { "location": "Heidelberg" }, "relationships": [ { "predicate": "hosted_study", "target": "Randomized controlled study on FMD", "attributes": {}, "target_id": null } ] }, { "name": "Randomized controlled study on FMD", "entity_id": "randomized_controlled_study_on_fmd", "entity_type": "event", "aliases": [], "attributes": { "registration_id": "DRKS00014287", "ethics_approval": "S-682/2016", "design": "open randomized controlled study" }, "relationships": [ { "predicate": "conducted_by", "target": "Alba Sulaj, Stefan Kopf, and colleagues", "attributes": {}, "target_id": null } ] } ], "source": { "chunk_index": 0, "start_word": 0, "end_word": 995, "word_count": 995, "sha256": "774d4d1f3bd8c4b93cef6c482e941d8ff21d509d4580a2017016ad70414abe37", "sentence_minhash": [ 6510041791773535, 7605519510423274, 12309405932600981, 61919449716151556, 31941388625203915, 62667647458868521, 23718652799488495, 83575544965282909, 130591936822558120, 2607707833378508, 6226213327830117, 95656761971753031, 21933493368060407, 906306679132868, 73860429008392155, 658790404649858 ] }, "extraction_warnings": [ "normalized unsupported entity type 'population' for 'Type 2 diabetes patients with diabetic nephropathy'" ] }, { "chunk_index": 1, "context_summary": "The study used a stratified random sampling method, based on Body Mass Index (BMI) and HbA1c levels, to assign patients to either a fasting-like diet (FMD) or a control group that followed a Mediterranean diet (M-diet). The FMD involved specific restrictions on calorie and macronutrient intake for five days of the month, while the M-diet involved a normal calorie intake. 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While FMD induced greater weight loss, body composition changes were not significantly different between groups, and most metabolic improvements were not sustained at follow-up. 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"predicate": "difference_of_change_microalbuminuria_3_cycles", "target": "-23.7mg/g", "attributes": { "p_value": "<=0.05" }, "target_id": null }, { "predicate": "difference_of_change_macroalbuminuria_3_cycles", "target": "-176.2mg/g", "attributes": { "p_value": "0.47" }, "target_id": null } ] }, { "name": "HOMA-IR", "entity_id": "homa_ir", "entity_type": "measurement", "aliases": [], "attributes": {}, "relationships": [ { "predicate": "sustained_reduction_at_follow_up", "target": "-1.9", "attributes": { "p_value": "<=0.05" }, "target_id": null } ] }, { "name": "Body composition", "entity_id": "body_composition", "entity_type": "measurement", "aliases": [], "attributes": {}, "relationships": [ { "predicate": "no_significant_change_between_groups", "target": "fat and fat-free mass", "attributes": { "condition": "adjusted for weight loss" }, "target_id": null } ] }, { "name": "Plasma MG-H1", "entity_id": "plasma_mg_h1", "entity_type": "measurement", "aliases": [], "attributes": {}, 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Blood ketones increased significantly in the FMD group, and the diet reduced albuminuria specifically in patients with microalbuminuria, an effect comparable to SGLT-2 inhibitors but absent in those with macroalbuminuria. 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