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Menichetti G, Ravandi B, Mozaffarian D, Barabási AL. Machine learning prediction of the degree of food processing. Nat Commun 2023; 14:2312. [PMID: 37085506 PMCID: PMC10121643 DOI: 10.1038/s41467-023-37457-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 03/16/2023] [Indexed: 04/23/2023] Open
Abstract
Despite the accumulating evidence that increased consumption of ultra-processed food has adverse health implications, it remains difficult to decide what constitutes processed food. Indeed, the current processing-based classification of food has limited coverage and does not differentiate between degrees of processing, hindering consumer choices and slowing research on the health implications of processed food. Here we introduce a machine learning algorithm that accurately predicts the degree of processing for any food, indicating that over 73% of the US food supply is ultra-processed. We show that the increased reliance of an individual's diet on ultra-processed food correlates with higher risk of metabolic syndrome, diabetes, angina, elevated blood pressure and biological age, and reduces the bio-availability of vitamins. Finally, we find that replacing foods with less processed alternatives can significantly reduce the health implications of ultra-processed food, suggesting that access to information on the degree of processing, currently unavailable to consumers, could improve population health.
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Affiliation(s)
- Giulia Menichetti
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Network Science Institute and Department of Physics, Northeastern University, Boston, MA, USA
| | - Babak Ravandi
- Network Science Institute and Department of Physics, Northeastern University, Boston, MA, USA
| | - Dariush Mozaffarian
- Tufts Friedman School of Nutrition Science and Policy, Boston, MA, USA
- Tufts School of Medicine and Medical Center, Boston, MA, USA
| | - Albert-László Barabási
- Network Science Institute and Department of Physics, Northeastern University, Boston, MA, USA.
- Department of Network and Data Science, Central European University, Budapest, Hungary.
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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52
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Schwab U, Lankinen M, Uusitupa M, Laakso M. Lifestyle Intervention Guided by Group and Internet-Based Counseling in the T2D-GENE Trial Supports Its Applicability and Feasibility. Nutrients 2023; 15:nu15071787. [PMID: 37049626 PMCID: PMC10097002 DOI: 10.3390/nu15071787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/24/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
Type 2 diabetes (T2D) can be prevented or postponed by lifestyle modifications as shown by previous intervention studies. In most of these studies, participants have received resource-demanding individual counseling. In the 3-year T2D-GENE trial with lifestyle intervention, we investigated whether a less resource-demanding form of group and internet-based counseling is feasible and effective in preventing T2D in people with an increased risk for T2D. Altogether, 628 middle-aged to elderly men either with a high number or low number of T2D risk alleles were recruited. Five to seven group sessions were organized during the intervention, in addition to information and activities delivered via the web portal, and weekly monitoring of body weight and physical activity. Four-day food records with personal feedback were documented five times during the study. Of the 549 participants completing the study, over 90% participated in the group sessions and kept the food records. The four self-feedback tasks delivered during the second and the third years of the study were completed by 80-89% of the participants. In conclusion, a group and web portal-based lifestyle intervention is applicable for middle-aged to elderly men as a lifestyle modification aiming to prevent T2D.
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Affiliation(s)
- Ursula Schwab
- Department of Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70211 Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland
| | - Maria Lankinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland
| | - Markku Laakso
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio and Kuopio University Hospital, 70211 Kuopio, Finland
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Bose C, Kinge AD, Sultana J, Biswas AK, Bhattacharya K, Syamal AK. Impact of a lifestyle intervention program on cardio-metabolic parameters among obese adults: A comparative population-based study in West Bengal, India. J Med Life 2023; 16:559-570. [PMID: 37305820 PMCID: PMC10251381 DOI: 10.25122/jml-2022-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/26/2022] [Indexed: 06/13/2023] Open
Abstract
The obesity epidemic is not only limited to high-income or urbanized societies, but has also become prevalent among rural communities, even in India. Approaches to modifiable behaviors, like unhealthy dietary habits or a sedentary lifestyle, could bring positive results among obese populations. This research aimed to assess the effectiveness of lifestyle intervention programs to prevent obesity and cardio-metabolic risks among Bengali obese adults (Body Mass Index of 25-30kg/m2). The population was selected from rural and urban communities of Hooghly district in west Bengal, India and included 121 participants (20-50 years), divided into four groups (rural male, rural female, urban male, and urban female) who underwent a 12-month intervention program. Anthropometric parameters, systolic and diastolic blood pressure, biochemical parameters (fasting blood glucose, fasting plasma insulin, Homeostatic Model Assessment for Insulin Resistance [HOMA-IR] and lipid profile), dietary habits, and physical activity profiles were assessed before the study (baseline), after 12 months of intervention (post-intervention), and after 24 months (follow-up), among all groups, to evaluate changes in data within and between the groups (rural vs. urban). The results showed a significant decline in anthropometric parameters and fasting blood glucose levels among all intervention groups, HOMA-IR in rural females, and serum triglyceride levels in urban groups. A significant improvement was noted regarding dietary habits and physical activity, even during follow-up. The impact of the intervention program did not show any rural-urban difference. The lifestyle intervention program was effective in reducing obesity and related health risks and promoting a healthy lifestyle among the target population.
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Affiliation(s)
- Chaitali Bose
- Post-Graduate Department of Physiology, Hooghly Mohsin College, University of Burdwan, Hooghly, West-Bengal, India
| | - Amol Dilip Kinge
- Department of Community Medicine, Government Medical College, Nandurbar, Maharastra, India
| | - Julekha Sultana
- Department of Community Medicine, Government Medical College, Nandurbar, Maharastra, India
| | - Ajoy Kumar Biswas
- Department of Medicine, G.D Hospital and Diabetes Institute Kolkata, Kolkata, West-Bengal, India
| | - Koushik Bhattacharya
- Department of Physiotherapy, School of Allied Health Sciences, Swami Vivekananda University, Barrackpore, West-Bengal, India
| | - Alak Kumar Syamal
- Post-Graduate Department of Physiology, Hooghly Mohsin College, University of Burdwan, Hooghly, West-Bengal, India
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Salama II, Sami SM, Salama SI, Abdel-Latif GA, Aboulghate A, Raslan HM, Mohsen A, Rasmy H, Ibrahim MH, Ganem MMF, Abdelmohsen AM, El-Etreby LA, Ibrahim NA, Fouad WA, El-Deeb SE. Impact of lifestyle modification on glycemic control and cognitive function among Type II diabetes mellitus patients. Future Sci OA 2023; 9:FSO835. [PMID: 37006227 PMCID: PMC10051212 DOI: 10.2144/fsoa-2022-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/15/2023] [Indexed: 03/11/2023] Open
Abstract
Aim: Assessing impact of lifestyle modification on Type 2 diabetes mellitus (T2DM) glycemic control and cognitive function. Subjects & methods: Prospective study was conducted on T2DM patients (92 patients as interventional group and 92 patients conventional therapy). Results: After 6 months, significant improvements of HbA1c, oxidant and antioxidant, lipid profile, and cognitive function among only the interventional group (p < 0.05). Using logistic analysis, conventional therapy, DM duration >10 years, lower education, HbA1c baseline >7 were significant predictive risks for uncontrolled DM (AOR 4.2, 2.9, 2.7 and 2.2, respectively). While, conventional therapy, baseline mild cognitive impairment (MCI) and females were significant risks for MCI (AOR 11.5, 10.8 and 4.8, respectively). Conclusion: Lifestyle modification is a very important for glycemic control and cognitive function. Clinical Trial Registration: NCT04891887 ( ClinicalTrials.gov )
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Affiliation(s)
- Iman I Salama
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Samia M Sami
- Child Health Department, National Research Center, Cairo, 12622, Egypt
| | - Somaia I Salama
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Ghada A Abdel-Latif
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Ahmed Aboulghate
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Hala M Raslan
- Internal Medicine Department, National Research Center, Cairo, 12622, Egypt
| | - Amira Mohsen
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Hanaa Rasmy
- Clinical & Chemical Pathology Department, Centre of Excellence, National Research Centre, Cairo, 12622, Egypt
| | - Mona Hamed Ibrahim
- Clinical & Chemical Pathology Department, Centre of Excellence, National Research Centre, Cairo, 12622, Egypt
| | - Mona MF Ganem
- Internal Medicine Department, National Research Center, Cairo, 12622, Egypt
| | - Aida M Abdelmohsen
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Lobna A El-Etreby
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Nihad A Ibrahim
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Walaa A Fouad
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
| | - Sherif E El-Deeb
- Community Medicine Research Department, National Research Center, Cairo, 12622, Egypt
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Wangler J, Jansky M. Attitudes and experiences of registered diabetes specialists in using health apps for managing type 2 diabetes: results from a mixed-methods study in Germany 2021/2022. Arch Public Health 2023; 81:36. [PMID: 36882859 PMCID: PMC9990333 DOI: 10.1186/s13690-023-01051-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/28/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Hardly any area of application for health apps is seen to be as promising as health and lifestyle support in type 2 diabetes mellitus. Research has emphasised the benefits of such mHealth apps for disease prevention, monitoring, and management, but there is still a lack of empirical data on the role that health apps play in actual type 2 diabetes care. The aim of the present study was to gain an overview of the attitudes and experiences of physicians specialising in diabetes with regard to the benefits of health apps for type 2 diabetes prevention and management. METHODS An online survey was conducted amongst all 1746 physicians at practices specialised in diabetes in Germany between September 2021 and April 2022. A total of 538 (31%) of the physicians contacted participated in the survey. In addition, qualitative interviews were conducted with 16 randomly selected resident diabetes specialists. None of the interviewees took part in the quantitative survey. RESULTS Resident diabetes specialists saw a clear benefit in type 2 diabetes-related health apps, primarily citing improvements in empowerment (73%), motivation (75%), and compliance (71%). Respondents rated self-monitoring for risk factors (88%), lifestyle-supporting (86%), and everyday routine features (82%) as especially beneficial. Physicians mainly in urban practice environments were open to apps and their use in patient care despite their potential benefit. Respondents expressed reservations and doubts on app user-friendliness in some patient groups (66%), privacy in existing apps (57%), and the legal conditions of using apps in patient care (80%). Of those surveyed, 39% felt capable of advising patients on diabetes-related apps. Most of the physicians that had already used apps in patient care saw positive effects in increased compliance (74%), earlier detection of or reduction in complications (60%), weight reduction (48%), and decreased HbA1c levels (37%). CONCLUSIONS Resident diabetes specialists saw a real-life benefit with added value from health apps for managing type 2 diabetes. Despite the favourable role that health apps may play in disease prevention and management, many physicians expressed reservations regarding usability, transparency, security, and privacy in such apps. These concerns should be addressed more intensively towards bringing about ideal conditions for integrating health apps successfully in diabetes care. This includes uniform standards governing quality, privacy, and legal conditions as binding as possible with regard to apps and their use in a clinical setting.
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Affiliation(s)
- Julian Wangler
- Center for General Medicine and Geriatrics, University Medical Center of the Johannes Gutenberg University Mainz, Am Pulverturm 13, 55131, Mainz, Germany.
| | - Michael Jansky
- Center for General Medicine and Geriatrics, University Medical Center of the Johannes Gutenberg University Mainz, Am Pulverturm 13, 55131, Mainz, Germany
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Kamarli Altun H, Özyildirim C, Koç Ş, Aksoy HN, Sağir B, Bozkurt MS, Karasu H. The factors associated with orthorexia nervosa in type 2 diabetes and their effect on diabetes self-management scores. Eat Weight Disord 2023; 28:22. [PMID: 36809582 PMCID: PMC9944002 DOI: 10.1007/s40519-023-01552-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 02/10/2023] [Indexed: 02/23/2023] Open
Abstract
PURPOSE This study aimed to determine the factors affecting the ORTO-R scores in individuals with T2DM and to investigate their effect on diabetes self-management. METHODS The study included 373 individuals with type 2 diabetes between the ages of 18-65 who applied to Akdeniz University Hospital Endocrinology and Metabolic Diseases Polyclinic between January and May 2022. A questionnaire including sociodemographic data, information about diabetes, and nutritional habits, and the ORTO-R and Type 2 Diabetes Self-Management Scales were used to collect data. Linear regression analysis was performed to determine the factors affecting ORTO-R. RESULTS The linear regression analysis showed that age, gender, education level, and duration of diabetes affected ORTO-R scores in patients with type 2 diabetes. Body mass index, comorbidities (cardiovascular diseases, kidney diseases and hypertension), diabetes-related complications, diabetes treatment method and dieting had no significant contribution to the model (p > 0.05). We also found that education level, comorbidities, diabetes-related complications, diabetes treatment method, dieting, and BMI can affect diabetes self-management. CONCLUSION It should be kept in mind that type 2 diabetes are at risk of orthorexia nervosa (ON) in terms of various aspects such as age, gender, education level and duration of diabetes. Since the factors affecting the risk of ON and the factors affecting diabetes self-management are intertwined, orthorexic tendencies should be kept under control while trying to increase self-management in these patients. In this respect, developing individual recommendations according to the psychosocial characteristics of patients may be an effective approach. LEVEL OF EVIDENCE Level V, cross-sectional study.
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Affiliation(s)
- Hülya Kamarli Altun
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Caner Özyildirim
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye.
| | - Şeyma Koç
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Hatice Nur Aksoy
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Beyza Sağir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Merve Sefa Bozkurt
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Hakan Karasu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
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Whiteley C, Benton F, Matwiejczyk L, Luscombe-Marsh N. Determining Dietary Patterns to Recommend for Type 2 Diabetes: An Umbrella Review. Nutrients 2023; 15:nu15040861. [PMID: 36839218 PMCID: PMC9958769 DOI: 10.3390/nu15040861] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Some specific dietary patterns improve glycaemic levels and cardiovascular risk factors better than others. We aimed to identify the most effective dietary patterns using a food-focused approach to improve blood glucose management (primary outcome) and cardiovascular risk factors (secondary outcome) in people with type 2 diabetes. An umbrella review was conducted comparing dietary patterns for the management of these outcomes. Studies published between 2012 and 2022 were identified using PubMed Central, ProQuest, Web of Science, and the Cochrane Database of Systematic Reviews. Thirty systematic reviews met the inclusion criteria. Twenty-two of thirty reviews quantitated (via meta-analyses of over 212 randomised control trials) the effect size of different dietary patterns. Twelve reviews found Low-carbohydrate (LC), Mediterranean (M), Plant-based (PB), and/or Low-glycaemic Index (LGI) diets reduced HbA1c moderately more than control diets (typically a high-carbohydrate, low-fat diet) (i.e., LC: -0.1 to -0.5%; M: -0.3 to -0.5%; PB: -0.2 to -0.4%; LGI -0.2 to -0.5%; all p-value < 0.01). We conclude that Low-carbohydrate, Mediterranean, Plant-based, and Low-glycaemic Index dietary patterns are all clinically effective for people with type 2 diabetes as alternatives to high-carbohydrate, low-fat diets typically used for managing glycaemic levels and CVD risk. However, quality evidence about the sustainability of effects and safety remains limited, warranting future research.
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Affiliation(s)
- Cathryn Whiteley
- Research and Program Development, Diabetes SA, Hilton, SA 5033, Australia
| | - Fiona Benton
- Research and Program Development, Diabetes SA, Hilton, SA 5033, Australia
| | - Louisa Matwiejczyk
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia
| | - Natalie Luscombe-Marsh
- Research and Program Development, Diabetes SA, Hilton, SA 5033, Australia
- Correspondence: ; Tel.: +61-08-8354-5803
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Joshua SR, Shin S, Lee JH, Kim SK. Health to Eat: A Smart Plate with Food Recognition, Classification, and Weight Measurement for Type-2 Diabetic Mellitus Patients' Nutrition Control. SENSORS (BASEL, SWITZERLAND) 2023; 23:1656. [PMID: 36772693 PMCID: PMC9920985 DOI: 10.3390/s23031656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
The management of type 2 diabetes mellitus (T2DM) is generally not only focused on pharmacological therapy. Medical nutrition therapy is often forgotten by patients for several reasons, such as difficulty determining the right nutritional pattern for themselves, regulating their daily nutritional patterns, or even not heeding nutritional diet recommendations given by doctors. Management of nutritional therapy is one of the important efforts that can be made by diabetic patients to prevent an increase in the complexity of the disease. Setting a diet with proper nutrition will help patients manage a healthy diet. The development of Smart Plate Health to Eat is a technological innovation that helps patients and users know the type of food, weight, and nutrients contained in certain foods. This study involved 50 types of food with a total of 30,800 foods using the YOLOv5s algorithm, where the identification, measurement of weight, and nutrition of food were investigated using a Chenbo load cell weight sensor (1 kg), an HX711 weight weighing A/D module pressure sensor, and an IMX219-160 camera module (waveshare). The results of this study showed good identification accuracy in the analysis of four types of food: rice (58%), braised quail eggs in soy sauce (60%), spicy beef soup (62%), and dried radish (31%), with accuracy for weight and nutrition (100%).
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Affiliation(s)
- Salaki Reynaldo Joshua
- Department of Electronics, Information and Communication Engineering, Kangwon National University, Samcheok-si 25913, Republic of Korea
| | - Seungheon Shin
- Department of Computer Engineering, Kangwon National University, Samcheok-si 25913, Republic of Korea
| | - Je-Hoon Lee
- Department of Electronics, Information and Communication Engineering, Kangwon National University, Samcheok-si 25913, Republic of Korea
| | - Seong Kun Kim
- Department of Liberal Studies, Kangwon National University, Samcheok-si 25913, Republic of Korea
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Zamora-Ros R, Cayssials V, Clèries R, Torrents M, Byrnes G, Weiderpass E, Sandström M, Almquist M, Boutron-Ruault MC, Tjønneland A, Kyrø C, Katzke VA, Le Cornet C, Masala G, Krogh V, Iannuzzo G, Tumino R, Milani L, Skeie G, Ubago-Guisado E, Amiano P, Chirlaque MD, Ardanaz E, Janzi S, Eriksson L, Freisling H, Heath AK, Rinaldi S, Agudo A. Sweetened beverages are associated with a higher risk of differentiated thyroid cancer in the EPIC cohort: a dietary pattern approach. Eur J Nutr 2023; 62:105-114. [PMID: 35907037 DOI: 10.1007/s00394-022-02953-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 07/05/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Dietary pattern analysis has gained particular interest, because it reflects the complexity of dietary intake. The aim of this study was to explore the associations between a posteriori dietary patterns, derived using a data-driven approach, and the risk of differentiated thyroid cancer (TC) in Europe. METHODS This investigation included 450,064 adults from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Dietary intake was assessed using validated country-specific dietary questionnaires. A posteriori dietary patterns were computed using principal component analyses. Cox regression was used to calculate multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS After a mean follow-up time of 14 years, 712 first differentiated TCs were diagnosed. In the fully adjusted model, a dietary pattern characterized by alcohol consumption (basically beer and wine) was negatively associated with differentiated TC risk (HRQ4vs.Q1 = 0.75; 95% CI:0.60-0.94, P-trend = 0.005), while a dietary pattern rich in sweetened beverages was positively associated with differentiated TC risk (HRQ4vs.Q1 = 1.26; 95% CI:0.99-1.61; P-trend = 0.07). The remaining 8 dietary patterns were not related to differentiated TC risk. The intake of sweetened beverages was positively associated with differentiated TC risk (HR100mL/d = 1.05; 95% CI:1.00-1.11), especially with papillary TC risk (HR100mL/d = 1.07; 95% CI:1.01-1.13). Similar results were observed with sugary and artificially sweetened beverages. CONCLUSIONS The investigation of dietary patterns detected that the consumption of sweetened beverages was associated with a higher risk of differentiated thyroid cancer. Our results are in line with the general dietary recommendations of reducing the consumption of sweetened beverages.
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Affiliation(s)
- Raul Zamora-Ros
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat (Barcelona) , Av Gran Via 199-203, 08908, Barcelona, Spain.
| | - Valerie Cayssials
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat (Barcelona) , Av Gran Via 199-203, 08908, Barcelona, Spain
- Department of Veterinary Public Health, Faculty of Veterinary, University of the Republic, Montevideo, Uruguay
- Department of Quantitative Methods, Faculty of Medicine, University of the Republic, Montevideo, Uruguay
| | - Ramon Clèries
- Pla Director d'Oncologia, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat (Barcelona),, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Maria Torrents
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat (Barcelona) , Av Gran Via 199-203, 08908, Barcelona, Spain
| | - Graham Byrnes
- International Agency for Research On Cancer (IARC-WHO), Lyon, France
| | | | - Maria Sandström
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Martin Almquist
- Department of Surgery, Skåne University Hospital Malmö, Lund University, Lund, Sweden
| | - Marie-Christine Boutron-Ruault
- Centre for Research in Epidemiology and Population Health (CESP), Université Paris-Saclay, Université Paris-Sud, INSERM U1018, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Charlotte Le Cornet
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Giovanna Masala
- Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Gabriella Iannuzzo
- Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Naples, Italy
| | - Rosario Tumino
- AIRE - ONLUS, Hyblean Association for Epidemiological Research, Ragusa, Italy
| | - Lorenzo Milani
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Guri Skeie
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Esther Ubago-Guisado
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Pilar Amiano
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Sub Directorate for Public Health and Addictions of Gipuzkoa, Ministry of Health of the Basque Government, Biodonostia Health Research Institute, San Sebastian, Spain
| | - María-Dolores Chirlaque
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, IMIB-Arrixaca, Murcia Regional Health Council, Murcia University, Murcia, Spain
| | - Eva Ardanaz
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Suzanne Janzi
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Malmö, Sweden
| | | | - Heinz Freisling
- International Agency for Research On Cancer (IARC-WHO), Lyon, France
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Sabina Rinaldi
- International Agency for Research On Cancer (IARC-WHO), Lyon, France
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat (Barcelona) , Av Gran Via 199-203, 08908, Barcelona, Spain
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Zaleha MI, Noor Hassim I, Azmi MT, Hasni JM, Rosnah I, Nor Ashikin MNK, Nafza MN, Nurul Hafza AR, Najihah ZA, Khairul Hazdi Y. Pattern of macronutrients intake among type-2 diabetes mellitus (T2DM) patients in Malaysia. BMC Nutr 2023; 9:21. [PMID: 36717873 PMCID: PMC9885606 DOI: 10.1186/s40795-022-00648-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 12/09/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The incidence of type 2 diabetes mellitus (T2DM) is rising rapidly in Malaysia. Modifying dietary intake is key to both the prevention and treatment of T2DM. This study aims to investigate the pattern of macronutrient intake among T2DM patients in Malaysia. METHODS This study was carried out on adults aged between 35 and 70 years, residing in urban and rural Malaysian communities. A series of standardised questionnaires was used to assess the sociodemographic information, dietary intake and physical activity level of 15,353 respondents who provided informed consent to participate in this study. Blood sampling (finger prick test) and physical examination were performed to obtain blood glucose and anthropometric data, respectively. The Chi-square test was used to assess differences in the trends of macronutrient intake among T2DM patients. RESULTS The total number of participants diagnosed with T2DM in this study was 2254. Of these, 453 (20.1%) were newly diagnosed, 1156 (51.3%) were diagnosed for ≤5 years and 645 (28.6%) were diagnosed for > 5 years. Male patients show that there were significant differences among the three groups of T2DM according to the following variables: age, BMI, residency, participant comorbidity of hypertension, family history of T2DM and hypertension, and active smoker. Meanwhile, female patients show significant differences among the three groups of T2DM according to the following variables: age, BMI, marital status, education level, residency, participant comorbidity of hypertension and family history of T2DM. Most of the male patients consumed appropriate proportions of carbohydrate (458, 60.7%) and protein (618, 81.9%). However, female patients did not show any significant differences of the macronutrients intake among the three groups of T2DM patients. CONCLUSIONS The pattern of dietary intake among T2DM patients in this study showed consumption of carbohydrate and protein within the range of Malaysian RNI, coupled with high fat intake. Compliance with the Recommended Nutrient Intake (RNI) was satisfactory for both carbohydrate and protein but not for fat. The pattern indicated a preference for fat rather than protein when carbohydrate intake was restricted.
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Affiliation(s)
- Md Isa Zaleha
- grid.240541.60000 0004 0627 933XDepartment of Community Health, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras Malaysia
| | - Ismail Noor Hassim
- grid.240541.60000 0004 0627 933XDepartment of Community Health, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras Malaysia
| | - Mohd Tamil Azmi
- grid.240541.60000 0004 0627 933XDepartment of Community Health, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras Malaysia
| | - Jaafar Mohd Hasni
- grid.240541.60000 0004 0627 933XDepartment of Community Health, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras Malaysia
| | - Ismail Rosnah
- grid.240541.60000 0004 0627 933XDepartment of Community Health, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras Malaysia
| | - Mohamed Noor Khan Nor Ashikin
- grid.412259.90000 0001 2161 1343Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, Sungai Buloh, Selangor Malaysia
| | - Mat Nasir Nafza
- grid.412259.90000 0001 2161 1343Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, Sungai Buloh, Selangor Malaysia
| | - Ab Razak Nurul Hafza
- grid.240541.60000 0004 0627 933XDepartment of Community Health, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras Malaysia
| | - Zainol Abidin Najihah
- grid.240541.60000 0004 0627 933XDepartment of Community Health, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras Malaysia ,grid.444504.50000 0004 1772 3483Department of Diagnostic & Allied Health Science, Faculty of Health and Life Sciences, Management & Science University, Shah Alam, Selangor Malaysia
| | - Yusof Khairul Hazdi
- grid.240541.60000 0004 0627 933XDepartment of Community Health, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras Malaysia
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Chimonyo VGP, Govender L, Nyathi M, Scheelbeek PFD, Choruma DJ, Mustafa M, Massawe F, Slotow R, Modi AT, Mabhaudhi T. Can cereal-legume intercrop systems contribute to household nutrition in semi-arid environments: A systematic review and meta-analysis. Front Nutr 2023; 10:1060246. [PMID: 36793925 PMCID: PMC9923432 DOI: 10.3389/fnut.2023.1060246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/10/2023] [Indexed: 01/27/2023] Open
Abstract
Introduction Intercropping cereals with legumes can intensify rainfed cereal monocropping for improved household food and nutritional security. However, there is scant literature confirming the associated nutritional benefits. Methodology A systematic review and meta-analysis of nutritional water productivity (NWP) and nutrient contribution (NC) of selected cereal-legume intercrop systems was conducted through literature searches in Scopus, Web of Science and ScienceDirect databases. After the assessment, only nine articles written in English that were field experiments comprising grain cereal and legume intercrop systems were retained. Using the R statistical software (version 3.6.0), paired t-tests were used to determine if differences existed between the intercrop system and the corresponding cereal monocrop for yield (Y), water productivity (WP), NC, and NWP. Results The intercropped cereal or legume yield was 10 to 35% lower than that for the corresponding monocrop system. In most instances, intercropping cereals with legumes improved NY, NWP, and NC due to their added nutrients. Substantial improvements were observed for calcium (Ca), where NY, NWP, and NC improved by 658, 82, and 256%, respectively. Discussion Results showed that cereal-legume intercrop systems could improve nutrient yield in water-limited environments. Promoting cereal- legume intercrops that feature nutrient-dense legume component crops could contribute toward addressing the SDGs of Zero Hunger (SDG 3), Good Health and Well-3 (SDG 2) and Responsible consumption and production (SDG 12).
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Affiliation(s)
- Vimbayi Grace Petrova Chimonyo
- Centre for Transformative Agricultural and Food Systems (CTAFS), School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
- International Maize and Wheat Improvement Center (CIMMYT)-Zimbabwe, Harare, Zimbabwe
| | - Laurencia Govender
- Centre for Transformative Agricultural and Food Systems (CTAFS), Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Melvin Nyathi
- Agricultural Research Council, Vegetables and Ornamental Plants (ARC-VOP), Pretoria, South Africa
| | - Pauline Franka Denise Scheelbeek
- Centre for Transformative Agricultural and Food Systems (CTAFS), School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dennis Junior Choruma
- Centre for Transformative Agricultural and Food Systems (CTAFS), School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Maysoun Mustafa
- Future Food Beacon Malaysia, School of Biosciences, University of Nottingham Malaysia, Semenyih, Selangor, Malaysia
| | - Festo Massawe
- Centre for Transformative Agricultural and Food Systems (CTAFS), School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
- Future Food Beacon Malaysia, School of Biosciences, University of Nottingham Malaysia, Semenyih, Selangor, Malaysia
| | - Rob Slotow
- Centre for Transformative Agricultural and Food Systems (CTAFS), School of Life Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Albert Thembinkosi Modi
- Centre for Transformative Agricultural and Food Systems (CTAFS), School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Tafadzwanashe Mabhaudhi
- Centre for Transformative Agricultural and Food Systems (CTAFS), School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
- Future Food Beacon Malaysia, School of Biosciences, University of Nottingham Malaysia, Semenyih, Selangor, Malaysia
- International Water Management Institute (IWMI), Pretoria, South Africa
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Meng Y, Meng Q, Li C, Wang M, Li S, Ying J, Zheng H, Bai S, Xue Y, Shen Q. A comparison between partially peeled hulless barley and whole grain hulless barley: beneficial effects on the regulation of serum glucose and the gut microbiota in high-fat diet-induced obese mice. Food Funct 2023; 14:886-898. [PMID: 36537611 DOI: 10.1039/d2fo02098j] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Though the hypoglycemic effect of whole grain hulless barley (Hordeum vulgare L.) has been documented, whether glucose metabolism would be improved by hulless barley with moderate peeling is still unclear. The purpose of this study was to compare the differences in glucose metabolism and gut microbiota between partially (10%) peeled hulless barley (PHB) and whole grain hulless barley (WHB) intervention in obese mice induced by a high-fat diet. The results showed that both PHB and WHB interventions significantly improved the impaired glucose tolerance, fat accumulation in fat and liver tissues, and the impaired intestinal barrier in mice. The dysbiosis of gut microbiota was improved and the relative abundance of some beneficial bacteria such as genera Lactobacillus, Bifidobacterium, Ileibacterium, and norank_f__Mutibaculaceae was increased by both, PHB and WHB, interventions. Spearman correlation analysis revealed that the abundance of Bifidobacterium was negatively correlated with the area under the blood glucose curve. In conclusion, our results provide evidence that hulless barley improved the gut microbiota and impaired glucose tolerance in mice, and also showed that there was little loss of hypoglycemic effect even when hulless barley was moderately peeled.
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Affiliation(s)
- Yantong Meng
- National Engineering and Technology Research Center for Fruits and Vegetables, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, P.R. China.
| | - Qingjia Meng
- COFCO Nutrition and Health Research Institute Co., Ltd, Beijing, 100020, P.R. China.
| | - Chang Li
- National Engineering and Technology Research Center for Fruits and Vegetables, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, P.R. China.
| | - Mengqian Wang
- COFCO Nutrition and Health Research Institute Co., Ltd, Beijing, 100020, P.R. China.
| | - Siqi Li
- National Engineering and Technology Research Center for Fruits and Vegetables, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, P.R. China.
| | - Jian Ying
- COFCO Nutrition and Health Research Institute Co., Ltd, Beijing, 100020, P.R. China.
| | - Hao Zheng
- National Engineering and Technology Research Center for Fruits and Vegetables, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, P.R. China.
| | - Shuqun Bai
- COFCO Nutrition and Health Research Institute Co., Ltd, Beijing, 100020, P.R. China.
| | - Yong Xue
- National Engineering and Technology Research Center for Fruits and Vegetables, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, P.R. China. .,National Center of Technology Innovation (Deep Processing of Highland Barley) in Food Industry, China Agricultural University, No. 17 Qinghua East Road, Haidian District, Beijing, 100083, P.R. China.,Key Laboratory of Plant Protein and Grain Processing, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
| | - Qun Shen
- National Engineering and Technology Research Center for Fruits and Vegetables, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, P.R. China. .,National Center of Technology Innovation (Deep Processing of Highland Barley) in Food Industry, China Agricultural University, No. 17 Qinghua East Road, Haidian District, Beijing, 100083, P.R. China.,Key Laboratory of Plant Protein and Grain Processing, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
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Development of a Semi-Quantitative Food Frequency Questionnaire to Estimate Macronutrient Intake among Type 2 Diabetes Mellitus Patients in Malaysia. Nutrients 2023; 15:nu15030506. [PMID: 36771212 PMCID: PMC9921655 DOI: 10.3390/nu15030506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/21/2023] Open
Abstract
The Food Frequency Questionnaire (FFQ) is one of the most frequently used instruments in epidemiological studies for evaluating dietary intake. Because of the variety of dietary habits within different populations, an FFQ must be tailored to the specific group. To date, no specific FFQ has been developed for type 2 diabetes mellitus (T2DM) patients in Malaysia. In this study, we developed a semi-quantitative FFQ to estimate macronutrient intake among T2DM patients. The development of the FFQ was based on the data acquired from 150 respondents with T2DM from the southern part of Peninsular Malaysia who completed the three-day 24-h dietary recalls. The respondents were selected by convenience sampling. The mean intake from each food item and the proportions of macronutrients were calculated. The approach from a previous study was used to compile a list of foods items with a cumulative 90% macronutrient contribution that is significant for the nutrient of interest. In conclusion, we have successfully developed a new semi-quantitative FFQ with a total of 79 food items and nine food groups. The frequencies of the FFQ were divided into nine categories and this FFQ represents the usual food intake of T2DM patients in Malaysia. However, this tool has yet to be validated in patients with T2DM in Malaysia.
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Yeung SMH, Oosterwijk MM, Poelstra M, Gant CM, Rotmans JI, Hoorn EJ, Vogt L, Navis G, Bakker SJL, de Borst MH, Laverman GD. Low Urinary Potassium Excretion Is Associated with Higher Risk of All-Cause Mortality in Patients with Type 2 Diabetes: Results of the Dutch Diabetes and Lifestyle Cohort Twente (DIALECT). J Nutr 2023; 152:2856-2864. [PMID: 36130237 DOI: 10.1093/jn/nxac215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/21/2022] [Accepted: 09/09/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Low 24-h urinary potassium excretion, reflecting low potassium intake, is associated with premature mortality in the general population. OBJECTIVES To determine whether urinary potassium excretion is associated with all-cause mortality in patients with type 2 diabetes. METHODS We performed a prospective cohort study in 654 patients with type 2 diabetes in the Diabetes and Lifestyle Cohort Twente (DIALECT). Sex-specific tertiles of 24-h urinary potassium excretion were analyzed in a multivariable Cox regression model with all-cause mortality. The outpatient program of the hospital uses a continuous surveillance system by the municipal registry of death to ensure up-to-date information on the patient's status (alive or deceased). FFQs were used to study associations between urinary potassium excretion and food products. RESULTS Urinary potassium excretion at baseline was 84 ± 25 mmol/d in males and 65 ± 22 mmol/d in females, corresponding to estimated potassium intakes of 4250 ± 1270 mg/d and 3300 ± 875 mg/d. During a median follow-up of 5.2 (IQR: 2.7-7.9] y, 96 participants died. In a fully adjusted model, patients in the lowest sex-specific tertile had a higher risk of all-cause mortality, compared with patients in the highest sex-specific tertile (HR: 2.09; 95% CI: 1.06, 4.10; P = 0.03). Patients in the lowest sex-specific tertile consumed fewer fruits and vegetables, dairy, coffee, and potato products compared with patients in the highest sex-specific tertile (all P < 0.05). CONCLUSIONS Low potassium intake is associated with a higher risk of all-cause mortality in Dutch patients with type 2 diabetes. Intervention studies are needed to determine whether potassium supplementation improves longevity in patients with type 2 diabetes. This trial was registered in the Dutch Trial Register as NTR trial code 5855.
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Affiliation(s)
- Stanley M H Yeung
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Milou M Oosterwijk
- Department of Internal Medicine/Nephrology, Ziekenhuisgroep Twente Hospital, Almelo and Hengelo, The Netherlands
| | - Monique Poelstra
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Christina M Gant
- Department of Internal Medicine, Meander Medical Center, Amersfoort, The Netherlands
| | - Joris I Rotmans
- Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Ewout J Hoorn
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Liffert Vogt
- Department of Internal Medicine, Section of Nephrology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Gerjan Navis
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Martin H de Borst
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gozewijn D Laverman
- Department of Internal Medicine/Nephrology, Ziekenhuisgroep Twente Hospital, Almelo and Hengelo, The Netherlands
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Sobotka O, Ticha M, Kubickova M, Adamek P, Polakova L, Mezera V, Sobotka L. Should Carbohydrate Intake Be More Liberal during Oral and Enteral Nutrition in Type 2 Diabetic Patients? Nutrients 2023; 15:nu15020439. [PMID: 36678311 PMCID: PMC9863670 DOI: 10.3390/nu15020439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
Carbohydrate (CHO) intake in oral and enteral nutrition is regularly reduced in nutritional support of older patients due to the high prevalence of diabetes (usually type 2-T2DM) in this age group. However, CHO shortage can lead to the lack of building blocks necessary for tissue regeneration and other anabolic processes. Moreover, low CHO intake decreases CHO oxidation and can increase insulin resistance. The aim of our current study was to determine the extent to which an increased intake of a rapidly digestible carbohydrate-maltodextrin-affects blood glucose levels monitored continuously for one week in patients with and without T2DM. Twenty-one patients (14 T2DM and seven without diabetes) were studied for two weeks. During the first week, patients with T2DM received standard diabetic nutrition (250 g CHO per day) and patients without diabetes received a standard diet (350 g of CHO per day). During the second week, the daily CHO intake was increased to 400 in T2DM and 500 g in nondiabetic patients by addition of 150 g maltodextrin divided into three equal doses of 50 g and given immediately after the main meal. Plasma glucose level was monitored continually with the help of a subcutaneous sensor during both weeks. The increased CHO intake led to transient postprandial increase of glucose levels in T2DM patients. This rise was more manifest during the first three days of CHO intake, and then the postprandial peak hyperglycemia was blunted. During the night's fasting period, the glucose levels were not influenced by maltodextrin. Supplementation of additional CHO did not influence the percentual range of high glucose level and decreased a risk of hypoglycaemia. No change in T2DM treatment was indicated. The results confirm our assumption that increased CHO intake as an alternative to CHO restriction in type 2 diabetic patients during oral and enteral nutritional support is safe.
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Affiliation(s)
- Ondrej Sobotka
- 3rd Department of Medicine, Metabolic Care and Gerontology, Medical Faculty, Charles University, 50005 Hradec Kralove, Czech Republic
| | - Marie Ticha
- 3rd Department of Medicine, Metabolic Care and Gerontology, Medical Faculty, Charles University, 50005 Hradec Kralove, Czech Republic
| | - Marketa Kubickova
- 3rd Department of Medicine, Metabolic Care and Gerontology, Medical Faculty, Charles University, 50005 Hradec Kralove, Czech Republic
| | - Petr Adamek
- Levit’s Aftercare Centre, 50801 Horice, Czech Republic
| | | | - Vojtech Mezera
- 3rd Department of Medicine, Metabolic Care and Gerontology, Medical Faculty, Charles University, 50005 Hradec Kralove, Czech Republic
- Geriatric Center, Pardubice Hospital, 53203 Pardubice, Czech Republic
| | - Lubos Sobotka
- 3rd Department of Medicine, Metabolic Care and Gerontology, Medical Faculty, Charles University, 50005 Hradec Kralove, Czech Republic
- Correspondence:
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66
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Li Y, Pei H, Zhou C, Lou Y. Dietary cholesterol consumption and incidence of type 2 diabetes mellitus: A dose-response meta-analysis of prospective cohort studies. Nutr Metab Cardiovasc Dis 2023; 33:2-10. [PMID: 36411220 DOI: 10.1016/j.numecd.2022.07.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIM The purpose of this meta-analysis was to evaluate the dose-response relationship between dietary cholesterol (DC) consumption and the incidence of type 2 diabetes mellitus (T2DM). METHODS AND RESULTS Prospective studies with the endpoint of T2DM were included. The Random-effect model weighted by inverse variance was used. Meta-regression and subgroup analyses were conducted to explore the potential sources of heterogeneity by specified study characteristics. Restricted cubic splines regression models were used to estimate the dose-response relationship. 11 prospective studies comprising of 355 230 subjects were included. Compared to lowest DC consumption, highest DC consumption was associated with an increased risk of T2DM (RR 1.15, 95% CI 1.03 to 1.28, P = 0.012; chi-squared = 31.41, I-squared 58.6%, P heterogeneity = 0.003). Subgroup analyses have shown that this positive association was more evident in western countries than in eastern countries (RR 1.19, 95% CI 1.06 to 1.36 VS 1.34, 95% CI 0.84 to 1.29; P subgroup difference = 0.02). For 100 mg/d increment in DC intake, the pooled RR was 1.05, (95% CI 1.04 to 1.07, Plinearity = 0.000, Pnonlinearity = 0.02), 1.06 (95% CI 1.04 to 1.07, Plinearity=0.000), and 1.01 (95% CI 0.98 to 1.05, Plinearity = 0.525) for the incidence of T2DM, in western and eastern countries, respectively. CONCLUSIONS Our study suggests that there is a positive dose-response association between DC consumption and the incidence of T2DM, especially in western countries. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020216318.
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Affiliation(s)
- Yuehua Li
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Hanjun Pei
- Department of Cardiology, The First Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia, China
| | - Chenghui Zhou
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Ying Lou
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
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Affiliation(s)
- Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Munich-Neuherberg, Germany
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He J, Chen F, Wan S, Luo Y, Luo J, He S, Zhou D, An P, Zeng P. Association of Serum Antioxidant Minerals and Type 2 Diabetes Mellitus in Chinese Urban Residents. Antioxidants (Basel) 2022; 12:62. [PMID: 36670924 PMCID: PMC9854585 DOI: 10.3390/antiox12010062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/09/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022] Open
Abstract
Antioxidant minerals including zinc, copper and selenium play critical roles in the maintenance of the redox balance in the body. However, their influences on type 2 diabetes mellitus (T2DM) are still inconclusive in Chinese populations. To elucidate the relationship between antioxidant minerals and T2DM, serum zinc, copper and selenium concentrations were measured in 1443 Chinese urban residents using a 1:2 matched case-control study. Conditional logistic regression models (CLR) were used to obtain the odds ratios (ORs) and 95% confidence intervals (CIs), and restricted cubic splines (RCS) were used to examine their dose−response associations. Serum zinc (OR = 0.52 [0.35, 0.77]) and copper concentrations (OR = 0.25 [0.17, 0.37]) were negatively associated with T2DM in a fully adjusted model. An L-shaped zinc-T2DM association (Poverall association = 0.003, and Pnonlinearity = 0.005) and a negative linear copper-T2DM association (Poverall association < 0.0001, and Pnonlinearity = 0.395) were observed. No association was found between serum selenium and T2DM in fully adjusted CLR or RCS models. In addition, joint associations with T2DM were identified between serum zinc and copper and between serum selenium and copper. In conclusion, our study emphasizes the importance of an adequate intake of antioxidant minerals for T2DM prevention in the Chinese population.
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Affiliation(s)
- Jingjing He
- Department of Nutrition and Health, China Agricultural University, Beijing 100193, China
| | - Fangyan Chen
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing 100730, China
| | - Sitong Wan
- Department of Nutrition and Health, China Agricultural University, Beijing 100193, China
| | - Yongting Luo
- Department of Nutrition and Health, China Agricultural University, Beijing 100193, China
| | - Junjie Luo
- Department of Nutrition and Health, China Agricultural University, Beijing 100193, China
| | - Shuli He
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Daizhan Zhou
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Peng An
- Department of Nutrition and Health, China Agricultural University, Beijing 100193, China
| | - Ping Zeng
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing 100730, China
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Despite similar clinical features metabolomics reveals distinct signatures in insulin resistant and progressively obese minipigs. J Physiol Biochem 2022. [DOI: 10.1007/s13105-022-00940-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Liang S, Mijatovic J, Li A, Koemel N, Nasir R, Toniutti C, Bell-Anderson K, Skilton M, O’Leary F. Dietary Patterns and Non-Communicable Disease Biomarkers: A Network Meta-Analysis and Nutritional Geometry Approach. Nutrients 2022; 15:76. [PMID: 36615733 PMCID: PMC9824098 DOI: 10.3390/nu15010076] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/17/2022] [Accepted: 12/18/2022] [Indexed: 12/28/2022] Open
Abstract
Quantitative rankings of multiple dietary patterns for their effects on non-communicable disease (NCD) biomarkers is lacking and would inform primary prevention strategies. Accordingly, a network meta-analysis (NMA) was conducted to compare and rank the effects of different dietary patterns on NCD biomarkers, and associations of dietary patterns’ underlying macronutrient composition with NCD biomarkers were determined by a nutritional geometry approach. Randomised controlled trials (RCTs) were eligible for inclusion if they enrolled healthy participants, employed food-based dietary pattern interventions without energy restriction, and reported NCD biomarker outcomes. NCD biomarkers were included as an outcome if ≥10 trials were available. A systematic search of five electronic databases identified 4008 records. Sixty-eight articles from 59 RCTs reporting lipids, glycemic, and inflammatory biomarkers were included for quantitative syntheses. Risk-of-bias was predominantly categorized as low or having some concerns, and confidence-of-evidence low. Relative to western habitual diet, the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), dietary guidelines-based, plant-based, and low-fat diets reduced low-density lipoprotein cholesterol (mean difference range: −0.29 to −0.17 mmol/L), total cholesterol (−0.36 to −0.24 mmol/L), and apolipoprotein B (−0.11 to −0.07 g/L) (all p < 0.05); the Paleo, plant-based and dietary guidelines-based diets reduced homeostasis model assessment of insulin resistance (−0.95 to −0.35, all p < 0.05). No dietary pattern ranked consistently highest. The Paleo diet received the highest all-outcomes-combined average Surface Under the Cumulative Ranking Curve value (67%), followed by DASH (62%) and Mediterranean diets (57%), whereas western habitual diet was lowest (36%). Our findings were independent of macronutrient composition, highlighting the significance of dietary pattern-level analysis.
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Affiliation(s)
- Shuang Liang
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Jovana Mijatovic
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Ang Li
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Nicholas Koemel
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Reeja Nasir
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Clémence Toniutti
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Kim Bell-Anderson
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- Faculty of Science, The University of Sydney, Sydney, NSW 2006, Australia
| | - Michael Skilton
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Sydney, NSW 2050, Australia
| | - Fiona O’Leary
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
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Yang S, Liu C, Ye Z, Zhou C, Liu M, Zhang Y, Wu Q, Zhang Z, He P, Zhang Y, Li H, Qin X. Variety and Quantity of Dietary-Insoluble Fiber Intake From Different Sources and Risk of New-Onset Diabetes. J Clin Endocrinol Metab 2022; 108:175-183. [PMID: 36074905 PMCID: PMC10091492 DOI: 10.1210/clinem/dgac526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/24/2022] [Indexed: 02/03/2023]
Abstract
CONTEXT The relationship between the variety and quantity of different sources of dietary-insoluble fiber intake and diabetes remain uncertain. OBJECTIVE We aimed to investigate the associations between the variety and quantity of insoluble fiber intake from 6 major food sources and new-onset diabetes, using data from the China Health and Nutrition Survey (CHNS). METHODS A total of 16 272 participants without diabetes at baseline from CHNS were included. Dietary intake was measured by 3 consecutive 24-hour dietary recalls combined with a household food inventory. Energy-adjusted dietary intake was used in analyses. The variety score of insoluble-fiber sources was defined as the number of specific-sourced insoluble fiber consumed at the appropriate level, accounting for both types and quantity of insoluble fiber. Participants with self-reported physician-diagnosed diabetes, or fasting glucose greater than or equal to 7.0 mmol/L or glycated hemoglobin A1c greater than or equal to 6.5% during follow-up were defined as having new-onset diabetes. RESULTS During a median follow-up of 9.0 years, 1101 participants developed new-onset diabetes. There were U-shaped associations for energy-adjusted dietary intake of total insoluble fiber, and energy-adjusted insoluble fiber derived from refined and whole grains; and L-shaped associations for energy-adjusted insoluble fiber derived from vegetables, legumes, fruits, and tubers with new-onset diabetes (all P for nonlinearity < .001). Moreover, a higher variety score of insoluble fiber sources was significantly associated with a lower risk of new-onset diabetes (per 1-score increment, hazard ratio, 0.61; 95% CI, 0.58-0.65). CONCLUSION There was an inverse association between the variety of insoluble fiber with appropriate quantity from different food sources and new-onset diabetes.
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Affiliation(s)
- Sisi Yang
- Division of Nephrology, Nanfang Hospital Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Chengzhang Liu
- Division of Nephrology, Nanfang Hospital Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Qimeng Wu
- Division of Nephrology, Nanfang Hospital Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Huan Li
- Division of Nephrology, Nanfang Hospital Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
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Li Q, Luo K, Su Z, Huang F, Wu Y, Zhou F, Li Y, Peng X, Li J, Ren B. Dental calculus: A repository of bioinformation indicating diseases and human evolution. Front Cell Infect Microbiol 2022; 12:1035324. [PMID: 36579339 PMCID: PMC9791188 DOI: 10.3389/fcimb.2022.1035324] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/11/2022] [Indexed: 12/14/2022] Open
Abstract
Dental calculus has long been considered as a vital contributing factor of periodontal diseases. Our review focuses on the role of dental calculus as a repository and discusses the bioinformation recently reported to be concealed in dental calculus from three perspectives: time-varying oral condition, systemic diseases, and anthropology at various times. Molecular information representing an individual's contemporary oral health status could be detected in dental calculus. Additionally, pathogenic factors of systemic diseases were found in dental calculus, including bacteria, viruses and toxic heavy metals. Thus, dental calculus has been proposed to play a role as biological data storage for detection of molecular markers of latent health concerns. Through the study of environmental debris in dental calculus, an overview of an individual's historical dietary habits and information about the environment, individual behaviors and social culture changes can be unveiled. This review summarizes a new role of dental calculus as a repository of bioinformation, with potential use in the prediction of oral diseases, systemic diseases, and even anthropology.
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Affiliation(s)
- Qinyang Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Kaihua Luo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhifei Su
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fangting Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yajie Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fangjie Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuqing Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xian Peng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiyao Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,*Correspondence: Jiyao Li, ; Biao Ren,
| | - Biao Ren
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,*Correspondence: Jiyao Li, ; Biao Ren,
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Rigby RR, Williams LT, Mitchell LJ, Ball L, Hamilton K. Understanding dietary behaviour change after a diagnosis of diabetes: A qualitative investigation of adults with type 2 diabetes. PLoS One 2022; 17:e0278984. [PMID: 36508418 PMCID: PMC9744287 DOI: 10.1371/journal.pone.0278984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
Type 2 diabetes (T2D) is a major public health concern. Optimal management of T2D often requires individuals to make substantial changes to their dietary intake. This research employed a qualitative methodology to examine decision making processes underpinning dietary behaviour change. Semi-structured telephone interviews were conducted on a purposive sample of 21 Australian adults who had recently consulted a dietitian after being diagnosed with T2D. Data were analysed using theoretical thematic analysis and themes were matched deductively with constructs that underpin motivational, volitional, and implicit processes which exist in common models of behaviour change. Influences on motivation, such as a desire to improve health status and making use of valuable support networks featured in participant narratives. Volitional influences included knowing their limits, dealing with falling off the wagon, and learning how their body responds to food. The themes unlearning habits and limit the availability were identified as underpinning implicit influences on dietary change. Individual differences and emotions were constructs additional to the model that influenced dietary change. These findings contribute to a richer understanding of the subjective experiences of adults with T2D regarding dietary change and highlight the multiple processes that guide their decision making in this context.
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Affiliation(s)
- Roshan R. Rigby
- School of Health Sciences and Social Work, Griffith University, Southport, Gold Coast, QLD, Australia
- Menzies Health Institute Queensland, Southport, Gold Coast, QLD, Australia
- * E-mail:
| | - Lauren T. Williams
- School of Health Sciences and Social Work, Griffith University, Southport, Gold Coast, QLD, Australia
- Menzies Health Institute Queensland, Southport, Gold Coast, QLD, Australia
| | - Lana J. Mitchell
- School of Health Sciences and Social Work, Griffith University, Southport, Gold Coast, QLD, Australia
- Menzies Health Institute Queensland, Southport, Gold Coast, QLD, Australia
| | - Lauren Ball
- School of Health Sciences and Social Work, Griffith University, Southport, Gold Coast, QLD, Australia
- Menzies Health Institute Queensland, Southport, Gold Coast, QLD, Australia
| | - Kyra Hamilton
- Menzies Health Institute Queensland, Southport, Gold Coast, QLD, Australia
- School of Applied Psychology, Griffith University, Mt Gravatt, QLD, Australia
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Zee B, Lee J, Lai M, Chee P, Rafferty J, Thomas R, Owens D. Digital solution for detection of undiagnosed diabetes using machine learning-based retinal image analysis. BMJ Open Diabetes Res Care 2022; 10:10/6/e002914. [PMID: 36549873 PMCID: PMC9809219 DOI: 10.1136/bmjdrc-2022-002914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/12/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Undiagnosed diabetes is a global health issue. Previous studies have estimated that about 24.1%-75.1% of all diabetes cases are undiagnosed, leading to more diabetic complications and inducing huge healthcare costs. Many current methods for diabetes diagnosis rely on metabolic indices and are subject to considerable variability. In contrast, a digital approach based on retinal image represents a stable marker of overall glycemic status. RESEARCH DESIGN AND METHODS Our study involves 2221 subjects for developing a classification model, with 945 subjects with diabetes and 1276 controls. The training data included 70% and the testing data 30% of the subjects. All subjects had their retinal images taken using a non-mydriatic fundus camera. Two separate data sets were used for external validation. The Hong Kong testing data contain 734 controls without diabetes and 660 subjects with diabetes, and the UK testing data have 1682 subjects with diabetes. RESULTS The 10-fold cross-validation using the support vector machine approach has a sensitivity of 92% and a specificity of 96.2%. The separate testing data from Hong Kong provided a sensitivity of 99.5% and a specificity of 91.1%. For the UK testing data, the sensitivity is 98.0%. The accuracy of the Caucasian retinal images is comparable with that of the Asian data. It implies that the digital method can be applied globally. Those with diabetes complications in both Hong Kong and UK data have a higher probability of risk of diabetes compared with diabetes subjects without complications. CONCLUSIONS A digital machine learning-based method to estimate the risk of diabetes based on retinal images has been developed and validated using both Asian and Caucasian data. Retinal image analysis is a fast, convenient, and non-invasive technique for community health applications. In addition, it is an ideal solution for undiagnosed diabetes prescreening.
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Affiliation(s)
- Benny Zee
- Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
- Clinical Trials and Biostatistics Lab, CUHK Shenzhen Research Institute, Shenzhen, People's Republic of China
| | - Jack Lee
- Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Maria Lai
- Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Peter Chee
- St. John Hospital, Hospital Authority of Hong Kong, Hong Kong, People's Republic of China
| | - James Rafferty
- Centre for Biomathematics, Swansea University, Swansea, Wales, UK
| | - Rebecca Thomas
- Biomedical Science, Swansea University, Swansea, Wales, UK
| | - David Owens
- Biomedical Science, Swansea University, Swansea, Wales, UK
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Yi J, Zhao T, Zhang Y, Tan Y, Han X, Tang Y, Chen G. Isolated compounds from Dracaena angustifolia Roxb and acarbose synergistically/additively inhibit α-glucosidase and α-amylase: an in vitro study. BMC Complement Med Ther 2022; 22:177. [PMID: 35780093 PMCID: PMC9250238 DOI: 10.1186/s12906-022-03649-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/13/2022] [Indexed: 11/12/2022] Open
Abstract
Background As a traditional herbal medicine, Dracaena angustifolia Roxb has been used as an anti-inflammatory agent by the Li people in Hainan, China. In preliminary phytochemical studies conducted in our lab, its fractions were found to inhibit α-glucosidase in vitro, indicating a potential for alleviating glucose dysregulation. Methods Through in vitro enzymatic assays, the abilities of the separated components to affect α-glucosidase and α-amylase were evaluated. By establishing concentration gradients and generating Lineweaver–Burk plots, the corresponding inhibition modes together with kinetic parameters were assessed. Following the evaluation of the outcomes of their combination with acarbose, computational docking and molecular dynamic simulations were carried out to analyse the interaction mechanisms and perform virtual screening against human enzymes. Results Compared with acarbose, 7 compounds, including flavonoid derivatives, amides and aromatic derivatives, with higher α-glucosidase inhibitory efficiencies were confirmed. It was found that those competitive/mixed candidates and acarbose interacted synergistically or additively on α-glucosidase. Moreover, 3 of them were able to inhibit α-amylase in mixed mode, and additive effects were observed in combination with acarbose. Through in silico docking, it was found that the active site residues as well as adjacent residues were involved in α-glucosidase and α-amylase binding, which were mainly achieved through hydrogen bonding. Among those dual-function flavonoids, Compound 9 was predicted to be a considerable inhibitor of human enzymes, as the formation of ligand–enzyme complexes was mediated by the residues responsible for substrate recognition and catalysis, the stabilities of which were reiterated by molecular dynamics simulations. Conclusion Despite their mild effects on α-amylase, considerable α-glucosidase inhibitory efficiencies and potential synergy with acarbose were exhibited by these natural candidates. Furthermore, a stable ligand, human α-glucosidase, was predicted by the performed simulations, which provided useful information for the application of Dracaena angustifolia Roxb in diabetes treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03649-3.
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76
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Forouhi NG. Nutrition and Type 2 Diabetes: Computational Optimization Modeling to Expand the Evidence Base for South Asians. Diabetes Care 2022; 45:2811-2813. [PMID: 36455116 DOI: 10.2337/dci22-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Damián-Medina K, Milenkovic D, Salinas-Moreno Y, Corral-Jara KF, Figueroa-Yáñez L, Marino-Marmolejo E, Lugo-Cervantes E. Anthocyanin-rich extract from black beans exerts anti-diabetic effects in rats through a multi-genomic mode of action in adipose tissue. Front Nutr 2022; 9. [DOI: https:/doi.org/10.3389/fnut.2022.1019259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024] Open
Abstract
Black beans (BB) are an important source of a range of plant bioactive compounds including polyphenols, particularly anthocyanins. Several studies support that consumption of BB is associated with health benefits, including prevention of type 2 diabetes mellitus (T2DM). However, molecular mechanisms underlying the potential health properties of BB on adipose tissue (AT) are still largely unknown. The purpose of this study was to investigate multi-genomic effects of BB intake and identify regulatory networks potentially mediating T2DM on AT. Male Wistar diabetic rats consumed an anthocyanin-rich black bean extract for 5 weeks. Global gene expression from AT, protein coding and non-coding RNA profiles were determined using RNAseq. Biological function analyses were performed using a variety of bioinformatic tools. The evaluation of global gene expression profiles exhibited significant change following BB consumption with 406 significantly differentially expressed genes, 33 miRNA and 39 lncRNA and 3 snRNA. Functional analyses indicated that these genes play an important role in regulation of PI3K signaling, NIN/NF-kB signaling, insulin secretion, and endoplasmic reticulum (ER) organization. Interestingly, transcription factors such as GATA2, or POU2AF1 demonstrated to modulate their activity by BB extract by direct interaction with polyphenol metabolites, or by interactions with cell signaling proteins, like PKB, AKT or PI3K, that could control transcription factor activity and as a result impact on adipogenesis regulation. Therefore, the constant consumption of an anthocyanin-rich black bean extract may have anti-diabetic protective effects by modulating gene expression, resulting in a promising alternative for T2DM patients.
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Damián-Medina K, Milenkovic D, Salinas-Moreno Y, Corral-Jara KF, Figueroa-Yáñez L, Marino-Marmolejo E, Lugo-Cervantes E. Anthocyanin-rich extract from black beans exerts anti-diabetic effects in rats through a multi-genomic mode of action in adipose tissue. Front Nutr 2022; 9:1019259. [PMID: 36451736 PMCID: PMC9702351 DOI: 10.3389/fnut.2022.1019259] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 10/17/2022] [Indexed: 11/19/2023] Open
Abstract
Black beans (BB) are an important source of a range of plant bioactive compounds including polyphenols, particularly anthocyanins. Several studies support that consumption of BB is associated with health benefits, including prevention of type 2 diabetes mellitus (T2DM). However, molecular mechanisms underlying the potential health properties of BB on adipose tissue (AT) are still largely unknown. The purpose of this study was to investigate multi-genomic effects of BB intake and identify regulatory networks potentially mediating T2DM on AT. Male Wistar diabetic rats consumed an anthocyanin-rich black bean extract for 5 weeks. Global gene expression from AT, protein coding and non-coding RNA profiles were determined using RNAseq. Biological function analyses were performed using a variety of bioinformatic tools. The evaluation of global gene expression profiles exhibited significant change following BB consumption with 406 significantly differentially expressed genes, 33 miRNA and 39 lncRNA and 3 snRNA. Functional analyses indicated that these genes play an important role in regulation of PI3K signaling, NIN/NF-kB signaling, insulin secretion, and endoplasmic reticulum (ER) organization. Interestingly, transcription factors such as GATA2, or POU2AF1 demonstrated to modulate their activity by BB extract by direct interaction with polyphenol metabolites, or by interactions with cell signaling proteins, like PKB, AKT or PI3K, that could control transcription factor activity and as a result impact on adipogenesis regulation. Therefore, the constant consumption of an anthocyanin-rich black bean extract may have anti-diabetic protective effects by modulating gene expression, resulting in a promising alternative for T2DM patients.
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Affiliation(s)
- Karla Damián-Medina
- Food Technology Unit, Center for Research and Assistance in Technology and Design of the State of Jalisco, A.C. (CIATEJ), Guadalajara, Jalisco, Mexico
| | - Dragan Milenkovic
- Department of Nutrition, University of California, Davis, Davis, CA, United States
| | - Yolanda Salinas-Moreno
- National Institute of Forestry, Agriculture and Livestock Research (INIFAP), Guadalajara, Jalisco, Mexico
| | | | - Luis Figueroa-Yáñez
- Industrial Biotechnology Unit, Center for Research and Assistance in Technology and Design of the State of Jalisco, A.C. (CIATEJ), Guadalajara, Jalisco, Mexico
| | - Erika Marino-Marmolejo
- Medical and Pharmaceutical Biotechnology Unit, Center for Research and Assistance in Technology and Design of the State of Jalisco, A.C. (CIATEJ), Guadalajara, Jalisco, Mexico
| | - Eugenia Lugo-Cervantes
- Food Technology Unit, Center for Research and Assistance in Technology and Design of the State of Jalisco, A.C. (CIATEJ), Guadalajara, Jalisco, Mexico
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79
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Xie W, Yu W, Chen S, Ma Z, Yang T, Song Z. Low aspartate aminotransferase/alanine aminotransferase (DeRitis) ratio assists in predicting diabetes in Chinese population. Front Public Health 2022; 10:1049804. [PMID: 36408044 PMCID: PMC9666731 DOI: 10.3389/fpubh.2022.1049804] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Background Few studies discussed the predictive ability of aspartate aminotransferase/alanine aminotransferase (AST/ALT, DeRitis) ratio for diabetes risk. The aim of this study was to characterize the role of AST/ALT ratio in the prediction of Chinese diabetes. Methods This retrospective cohort study analyzed a Chinese population comprising 87,883 participants without diabetes at baseline between 2010 and 2016. Cox proportional hazards regression was used to identify independent risk factors. Restricted cubic spline (RCS) was performed to investigate the non-linear correlation between AST/ALT ratio and diabetes risk. Results During a median follow-up period of 3.01 years, 1,877 participants developed diabetes. Comparing the baseline characteristics, diabetes group exhibited lower AST/ALT ratio. The Kaplan-Meier curve showed that participants with low AST/ALT ratio had higher cumulative incidence, and Cox regression also demonstrated that the lower AST/ALT ratio, the higher diabetes risk (HR: 0.56, 95% CI: 0.37-0.85, P = 0.006). The RCS model revealed a non-linear correlation between AST/ALT ratio and diabetes risk. In the condition of AST/ALT ratio ≤1.18, diabetes risk increased as it decreased (HR: 0.42, 95% CI: 0.19-0.91, P = 0.028). In contrast, AST/ALT ratio did not independently affect diabetes when beyond 1.18. Conclusion AST/ALT ratio is a valuable predictor of diabetes. Diabetes risk increases rapidly in the condition of AST/ALT ratio ≤1.18.
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Affiliation(s)
- Wangcheng Xie
- Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Weidi Yu
- Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shanshan Chen
- College of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Zhilong Ma
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Tingsong Yang
- Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhenshun Song
- Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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Wu JH, Trieu K, Coyle D, Huang L, Wijesuriya N, Nallaiah K, Lung T, Di Tanna GL, Zheng M, Mozaffarian D, MacMillan F, Simmons D, Wu T, Twigg S, Gauld A, Constantino M, McGill M, Wong J, Neal B. Testing the Feasibility and Dietary Impact of a "Produce Prescription" Program for Adults with Undermanaged Type 2 Diabetes and Food Insecurity in Australia. J Nutr 2022; 152:2409-2418. [PMID: 36774107 DOI: 10.1093/jn/nxac152] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/06/2022] [Accepted: 07/06/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND There is growing interest in Food is Medicine programs that incorporate food-based interventions into health care for patients with diet-related conditions. OBJECTIVES We aimed to test the feasibility of a "produce prescription" program and its impact on diet quality for people with type 2 diabetes (T2D) experiencing food insecurity in Australia. METHODS We conducted a pre-post intervention study in n = 50 adults experiencing food insecurity with T2D and glycated hemoglobin (HbA1c) ≥8%. Once enrolled, participants received healthy food boxes weekly free of charge, with the contents sufficient to create 2 meals/d, 5 d/wk for the entire household, over 12 wk. Participants were also provided with tailored recipes and behavioral change support. The primary outcome was change in diet quality assessed by 24-h diet recalls. Secondary outcomes included differences in cardiovascular disease risk factors; blood micronutrients; and feasibility indicators. Differences in the baseline and 12-wk mean primary and secondary outcomes were assessed by paired t tests. RESULTS Participants were older adults with mean ± SD age 63 ± 9 y (range: 40-87 y), HbA1c 9.8% ± 1.5%, and 46% were female. Overall, 92% completed the final study follow-up for the primary outcome. Compared with baseline, diet quality improved at week 12, with an increase in the mean overall diet quality (Alternate Healthy Eating Index score) of 12.9 (95% CI: 8.7, 17.1; P < 0.001), driven by significant improvements in vegetables, fruits, whole grains, red/processed meat, trans fat, sodium, and alcohol consumption. Blood lipids also improved (total:HDL cholesterol: -0.48; 95% CI: -0.72, -0.24; P < 0.001), and there was significant weight loss (-1.74 kg; 95% CI: -2.80, -0.68 kg, P = 0.002), but no changes in other clinical outcomes. Participants reported high levels of satisfaction with the program. CONCLUSIONS These findings provide strong support for an adequately powered randomized trial to assess effects of produce prescription as an innovative approach to improve clinical management among individuals with T2D experiencing food insecurity. This trial was registered at https://anzctr.org.au/ as ACTRN12621000404820.
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Affiliation(s)
- Jason Hy Wu
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
| | - Kathy Trieu
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Daisy Coyle
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Liping Huang
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Nirupama Wijesuriya
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Kellie Nallaiah
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas Lung
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Gian L Di Tanna
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Freya MacMillan
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia; Diabetes, Obesity and Metabolism Translational Research Unit (DOMTRU), School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia; Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - David Simmons
- Diabetes, Obesity and Metabolism Translational Research Unit (DOMTRU), School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia; Macarthur Diabetes Service, Camden and Campbelltown Hospital, Campbelltown, New South Wales, Australia
| | - Ted Wu
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Royal Prince Alfred Clinic, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Stephen Twigg
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Royal Prince Alfred Clinic, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Amanda Gauld
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Royal Prince Alfred Clinic, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Maria Constantino
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Royal Prince Alfred Clinic, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Margaret McGill
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Royal Prince Alfred Clinic, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jencia Wong
- Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Royal Prince Alfred Clinic, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Bruce Neal
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia; Imperial College London, School of Public Health, London, United Kingdom
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81
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Zhang Y, Zhou XA, Liu C, Shen Q, Wu Y. Vitamin B6 Inhibits High Glucose-Induced Islet β Cell Apoptosis by Upregulating Autophagy. Metabolites 2022; 12:1048. [PMID: 36355132 PMCID: PMC9695582 DOI: 10.3390/metabo12111048] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 07/27/2023] Open
Abstract
Vitamin B6 may alleviate diabetes by regulating insulin secretion and increasing insulin sensitivity, but its mechanism remains to be explored. In this study, vitamin B6-mediated autophagy and high glucose-induced apoptosis were tested to investigate the mechanism by which vitamin B6 regulates insulin release. The results showed that 20 mM glucose increased the apoptosis rate from 10.39% to 22.44%. Vitamin B6 reduced the apoptosis rate of RIN-m5F cells from 22.44% to 11.31%. Our data also showed that the vitamin B6 content in processed eggs was decreased and that the hydrothermal process did not affect the bioactivity of vitamin B6. Vitamin B6 increased the number of autophagosomes and the ratio of autophagosome marker protein microtubule associated protein 1 light chain 3 beta to microtubule associated protein 1 light chain 3 alpha (LC3-II/LC3-I). It also decreased the amount of sequetosome 1 (SQSTM1/p62) and inhibited the phosphorylation of p70 ribosomal protein S6 kinase (p70S6K) under normal and high glucose stress. Another study showed that vitamin B6 inhibited the apoptosis rate, whereas the autophagy inhibitor 3-methyladenine (3-MA) blocked the protective effect of vitamin B6 against apoptosis induced by high glucose. The hydrothermal process decreased the vitamin B6 content in eggs but had no effect on the cytoprotective function of vitamin B6 in RIN-m5f cells. In conclusion, we demonstrated that vitamin B6-mediated autophagy protected RIN-m5f cells from high glucose-induced apoptosis might via the mTOR-dependent pathway. Our data also suggest that low temperatures and short-term hydrothermal processes are beneficial for dietary eggs.
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Affiliation(s)
- Yu Zhang
- Key Laboratory for Food Science and Biotechnology of Hunan Province, College of Food Science and Technology, Hunan Agricultural University, Changsha 410128, China
- Horticulture and Landscape College, Hunan Agricultural University, Changsha 410128, China
| | - Xi-an Zhou
- Key Laboratory for Food Science and Biotechnology of Hunan Province, College of Food Science and Technology, Hunan Agricultural University, Changsha 410128, China
- Horticulture and Landscape College, Hunan Agricultural University, Changsha 410128, China
| | - Chuxin Liu
- Key Laboratory for Food Science and Biotechnology of Hunan Province, College of Food Science and Technology, Hunan Agricultural University, Changsha 410128, China
- Horticulture and Landscape College, Hunan Agricultural University, Changsha 410128, China
| | - Qingwu Shen
- Key Laboratory for Food Science and Biotechnology of Hunan Province, College of Food Science and Technology, Hunan Agricultural University, Changsha 410128, China
- Horticulture and Landscape College, Hunan Agricultural University, Changsha 410128, China
| | - Yanyang Wu
- Key Laboratory for Food Science and Biotechnology of Hunan Province, College of Food Science and Technology, Hunan Agricultural University, Changsha 410128, China
- Horticulture and Landscape College, Hunan Agricultural University, Changsha 410128, China
- Hunan Co-Innovation Center for Utilization of Botanical Functional Ingredients, Changsha 410128, China
- State Key Laboratory of Subhealth Intervention Technology, Changsha 410128, China
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82
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A. B. Attanayake HMD, Barnett A, Burton NW, Brown WJ, Cramb SM. Diabetes and physical activity: A prospective cohort study. PLoS One 2022; 17:e0276761. [PMID: 36288344 PMCID: PMC9604951 DOI: 10.1371/journal.pone.0276761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 10/12/2022] [Indexed: 01/24/2023] Open
Abstract
Diabetes is on the rise as the worldwide population ages. While physical activity can help protect against diabetes, ageing is commonly associated with reduced physical activity. This study aimed to examine if physical activity differs by diabetes status in mid-aged adults, how this association changes over time, and whether physical activity-related sociodemographic factors and health indicators differ in those with and without diabetes. Data came from four waves of the How Areas in Brisbane Influence HealTh and AcTivity (HABITAT), a longitudinal study of mid-age adults living in Brisbane, Australia. Random effects/Expectation-maximisation (RE-EM) regression trees were used to identify factors affecting physical activity among those with and without diabetes, both separately and combined. At study entry, those with diabetes had a higher median age of 58 years (95% CI: 57-60) and a lower median physical activity of 699 MET.min/week (95% CI: 599-799) than people without diabetes (53 years (95% CI: 53-53) and 849 MET.min/week (95% CI: 799-899)). However, the strongest factors influencing physical activity were BMI and gender, not diabetes status. It is vital to promote physical activity among adults, in particular among those with high BMI and women, as well as those with and at high risk of diseases like diabetes.
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Affiliation(s)
| | - Adrian Barnett
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Centre for Health Services Innovation & Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Nicola W. Burton
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
- Menzies Health Institute Queensland, Griffth University, Brisbane, Queensland, Australia
| | - Wendy J. Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Susanna M. Cramb
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Centre for Health Services Innovation & Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
- Centre for Data Science, Queensland University of Technology, Brisbane, Queensland, Australia
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83
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Dietary Management Tools Improve the Dietary Skills of Patients with T2DM in Communities. Nutrients 2022; 14:nu14214453. [PMID: 36364716 PMCID: PMC9654010 DOI: 10.3390/nu14214453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Dietary management is of paramount importance in the prevention and control of type 2 diabetes mellitus (T2DM). This one-year cluster-randomized controlled trial aims to evaluate the effect of dietary management tools on the dietary skills of patients with T2DM. Twenty-two communities were randomly assigned to an intervention group and a control group, and participants in the intervention group received a food guiding booklet (G) and a dinner set (D). The frequency of dietary management tools usage was collected at baseline and every three months, and different use patterns were identified by a group-based trajectory model. A self-compiled diabetic dietary skills scale and blood glucose were collected at baseline, 3, and 12 months, and a using generalized linear mixed model (GLMM) to explore the influence factors of dietary skills and blood glucose. The finding revealed four dietary tool-usage patterns among the participants: Insist using G/D, Give up gradually G/D, Give up after use G, and Never use G/D. GLMM indicated that dietary skills were higher over time (p < 0.05), and in participants using the guiding booklet (p < 0.001) or dinner set (p < 0.001), or with higher education (p < 0.001). Additionally, blood glucose were lower among participants with higher dietary skills (p = 0.003), higher educational level (p = 0.046), and a 3000−5000 monthly income (p = 0.026). These findings support using food management tools like the guiding booklet and dinner set as a useful strategy in primary health care centers for individuals with T2DM to increase their dietary skills and blood glucose control.
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84
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Baral J, Karki KB, Thapa P, Timalsina A, Bhandari R, Bhandari R, Kharel B, Adhikari N. Adherence to Dietary Recommendation and Its Associated Factors among People with Type 2 Diabetes: A Cross-Sectional Study in Nepal. J Diabetes Res 2022; 2022:6136059. [PMID: 36313817 PMCID: PMC9616656 DOI: 10.1155/2022/6136059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/27/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Intensive lifestyle modification including a healthy diet changes the diagnostic status of patient from prediabetes to nondiabetes. In type 2 diabetes, improper eating habits increase insulin resistance. This study is aimed at assessing adherence to the dietary recommendation and its associated factors among people with type 2 diabetes. Methods A cross-sectional descriptive study was conducted among systematically sampled type 2 diabetic patients using interview on Gandaki Medical College Teaching Hospital and Diabetes, Thyroid, and Endocrinology Care Center, Pokhara. The Perceived Dietary Adherence Questionnaire was used to assess dietary adherence. Data was entered in EpiData version 3.1 and analyzed on SPSS version 20. Logistic regression with adjusted odds ratio and the corresponding 95% confidence intervals were used to find out significance of association. Results Among 204 participants, only 15.7% of the participants had good dietary adherence. The mean age and standard deviation were 53.03 ± 11.90 years. Factors such as participants living in single family (AOR 2.7, 95% CI 1.0-7.4), participants who could afford recommended diet (AOR 2.9, 95% CI 1.0-8.3), participants having self-control on food (AOR 4.1, 95% CI 1.2-14.1), participants who were engaged in moderate to heavy physical activities (AOR 3.3, 95% CI 1.2-9.2), and participants who had adherence to medication (AOR 3.5, 95% CI 1.2-10.1) were significantly associated with adherence to dietary recommendation. Conclusions Adherence to dietary recommendation among people with type 2 diabetes was low. Factors such as family type, affordability of recommended diet, self-control on food, physical activity, and medication adherence were significantly associated with adherence to dietary recommendations among people with type 2 diabetes. These factors should be considered by nutrition counselors and clinical decision-makers in patient counseling regarding dietary adherence.
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Affiliation(s)
- Jijeebisha Baral
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Khem Bahadur Karki
- Department of Community Medicine, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Pratibha Thapa
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Ashish Timalsina
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Rama Bhandari
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Rabindra Bhandari
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Bijaya Kharel
- Department of ENT, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Nabin Adhikari
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
- Dhulikhel Hospital, Research and Development Department, Dhulikhel, Kavrepalanchok, Nepal
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85
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Joshi S, Verma R, Lathia T, Selvan C, Tanna S, Saraf A, Tiwaskar M, Modi A, Kalra S, K V, Chitale M, Malde F, Abdul Khader M, Singal AK. Changes in HbA1c and weight in people with Type 2 Diabetes after continuous glucose monitoring based Diabefly-Pro digital therapeutics program: Analysis of real-world data (Preprint). JMIR Diabetes 2022; 8:e43292. [PMID: 37133922 DOI: 10.2196/43292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/31/2023] [Accepted: 03/07/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Digital therapeutic platforms facilitate health care through patient-centered strategies based on multidisciplinary teams and shared decision-making. Such platforms can be used for developing a dynamic model of diabetes care delivery, which can help in improving glycemic control by promoting long-term behavior changes in people with diabetes. OBJECTIVE This study aims to evaluate the real-world effectiveness of the Fitterfly Diabetes CGM digital therapeutics program for improving glycemic control in people with type 2 diabetes mellitus (T2DM) after the completion of 90 days in the program. METHODS We analyzed deidentified data of 109 participants in the Fitterfly Diabetes CGM program. This program was delivered through the Fitterfly mobile app coupled with continuous glucose monitoring (CGM) technology. This program consists of 3 phases: the first phase is observation, wherein the patient's CGM readings are observed for 7 days (week 1); the second phase is the intervention; and the third phase aims at sustaining the lifestyle modification introduced during the second phase. The primary outcome of our study was the change in the participants' hemoglobin A1c (HbA1c) levels after program completion. We also evaluated the changes in participant weight and BMI after the program, changes in the CGM metrics in the initial 2 weeks of the program, and the effects of participant engagement in the program on improving their clinical outcomes. RESULTS At the end of the 90 days of the program, the mean HbA1c levels, weight, and BMI of the participants were significantly reduced by 1.2% (SD 1.6%), 2.05 (SD 2.84) kg, and 0.74 (SD 1.02) kg/m2 from baseline values of 8.4% (SD 1.7%), 74.45 (SD 14.96) kg, and 27.44 (SD 4.69) kg/m2 in week 1, respectively (P<.001). The average blood glucose levels and time above range values showed a significant mean reduction by 16.44 (SD 32.05) mg/dL and 8.7% (SD 17.1%) in week 2 from week 1 baseline values of 152.90 (SD 51.63) mg/dL and 36.7% (SD 28.4%), respectively (P<.001 for both). Time in range values significantly improved by 7.1% (SD 16.7%) from a baseline value of 57.5% (SD 25%) in week 1 (P<.001). Of all the participants, 46.9% (50/109) showed HbA1c reduction ≥1% and 38.5% (42/109) showed weight loss ≥4%. The average number of times the mobile app was opened by each participant during the program was 108.80 (SD 127.91) times. CONCLUSIONS Our study shows that participants in the Fitterfly Diabetes CGM program showed a significant improvement in their glycemic control and reduction in weight and BMI. They also showed a high level of engagement with the program. Weight reduction was significantly associated with higher participant engagement with the program. Thus, this digital therapeutic program can be considered as an effective tool for improving glycemic control in people with T2DM.
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Affiliation(s)
- Shilpa Joshi
- Department of Metabolic Nutrition, Fitterfly HealthTech Pvt Ltd, Navi Mumbai, India
| | - Ritika Verma
- Department of Scientific writing and Research, Fitterfly HealthTech Pvt Ltd, Navi Mumbai, India
| | - Tejal Lathia
- Department of Endocrinology and Diabetology, Apollo Hospitals, Navi Mumbai, India
| | - Chitra Selvan
- Department of Endocrinology and Diabetology, MS Ramaiah Memorial Hospital, Bangalore, India
| | - Snehal Tanna
- Department of Internal Medicine, Jupiter Hospital, Thane, India
| | - Amit Saraf
- Department of Internal Medicine, Jupiter Hospital, Thane, India
| | - Mangesh Tiwaskar
- Department of Diabetology, Shilpa Medical Research Center, Mumbai, India
| | - Alok Modi
- Department of General Medicine, Kevalya Hospital, Thane, India
| | - Sanjay Kalra
- Department of Endocrinology and Diabetology, Bharti Research Institute of Diabetes and Endocrinology, Haryana, India
| | - Vasudevarao K
- Department of Endocrinology and Diabetology, Hridayam Diabetes World, Thane, India
| | - Manoj Chitale
- Department of General Medicine, Shree Clinic, Nashik, India
| | - Forum Malde
- Department of Metabolic Nutrition, Fitterfly HealthTech Pvt Ltd, Navi Mumbai, India
| | - Mohammed Abdul Khader
- Department of Scientific writing and Research, Fitterfly HealthTech Pvt Ltd, Navi Mumbai, India
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Proportion and risk factors of diabetic retinopathy by stage in less-developed rural areas of Hunan province of China: A multi-site cross-sectional study. BMC Public Health 2022; 22:1871. [PMID: 36207704 PMCID: PMC9541011 DOI: 10.1186/s12889-022-14232-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/17/2022] [Accepted: 09/20/2022] [Indexed: 11/20/2022] Open
Abstract
Aims To investigate the proportion and risk factors of diabetic retinopathy (DR) by stages in less-developed rural areas in Hunan Province of China. Background DR is common among people with diabetes but not well recognized in less-developed rural areas. There is insufficient evidence on the risk factors of DR by stages, making it challenging to develop targeted prevention and intervention programs for DR in primary care settings. Methods A multi-site cross-sectional survey was conducted among people with type 2 diabetes mellitus (T2DM) from four less-developed counties in Hunan Province of China. All participants underwent the screening of DR via digital fundus photography and completed self-reported questionnaires on their socio-demographic and clinical characteristics, diabetes self-efficacy, diabetes self-care behaviors, social support, family function, and health service accessibility. The multinomial logistic regression models were employed to explore the risk factors of DR by stage, which were selected based on the socio-ecological model, literature, and clinical experience. Results A total of 196 participants were included in this study with an average age of 57.43 ± 10.26. 59.6% (117/196) of the participants were identified as DR, including 37.2% (73/196) non-proliferative DR and 22.4% (44/196) proliferative DR. Compared to the non-DR group, the risk factors of non-proliferative DR and proliferative DR were diabetes duration (OR: 1.10, 95 CI%: 1.04–1.17; OR: 1.14, 95 CI% 1.06–1.22) and self-monitoring of blood glucose (OR: 1.09, 95 CI% 1.01–1.17; OR: 1.11, 95 CI%: 1.02–1.20); the protective factors of non-proliferative DR was accessible complication prevention and management education (OR: 0.37, 95 CI% 0.14–0.94) while the protective factors of proliferative DR were physical activities (OR: 0.89, 95 CI%: 0.80–0.98). Compared to the non-proliferative DR group, the protective factors of proliferative DR were physical activities (OR: 0.89, 95 CI% 0.02–0.89) and family function (OR: 0.84, 95 CI%: 0.04–0.84). Conclusion DR was prevalent among people with T2DM in less-developed rural areas, indicating the need of strengthening DR screening. Risk factors of DR varied by stage while sharing some common factors. Future DR prevention and intervention programs may benefit from improving these factors to reduce the risk of DR by stage.
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Landgraf R, Aberle J, Birkenfeld AL, Gallwitz B, Kellerer M, Klein HH, Müller-Wieland D, Nauck MA, Wiesner T, Siegel E. Therapie des Typ-2-Diabetes. DIABETOL STOFFWECHS 2022. [DOI: 10.1055/a-1789-5650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - Jens Aberle
- Sektion Endokrinologie und Diabetologie, Universitäres Adipositas-Zentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Deutschland
| | | | - Baptist Gallwitz
- Medizinische Klinik IV, Diabetologie, Endokrinologie, Nephrologie, Universitätsklinikum Tübingen, Deutschland
| | - Monika Kellerer
- Zentrum für Innere Medizin I, Marienhospital Stuttgart, Deutschland
| | - Harald H. Klein
- MVZ für Diagnostik und Therapie Bochum, Bergstraße 26, 44791 Bochum, Deutschland
| | - Dirk Müller-Wieland
- Medizinische Klinik I, Universitätsklinikum RWTH Aachen, Aachen, Deutschland
| | - Michael A. Nauck
- Sektion Diabetologie, Endokrinologie, Stoffwechsel, Med. Klinik I, St.-Josef-Hospital, Ruhr-Universität, Bochum, Deutschland
| | | | - Erhard Siegel
- Abteilung für Innere Medizin – Gastroenterologie, Diabetologie/Endokrinologie und Ernährungsmedizin, St. Josefkrankenhaus Heidelberg GmbH, Heidelberg, Deutschland
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Tapp RJ, Owen CG, Barman SA, Strachan DP, Welikala RA, Foster PJ, Whincup PH, Rudnicka AR. Retinal microvascular associations with cardiometabolic risk factors differ by diabetes status: results from the UK Biobank. Diabetologia 2022; 65:1652-1663. [PMID: 35852586 PMCID: PMC9477904 DOI: 10.1007/s00125-022-05745-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 03/25/2022] [Indexed: 12/30/2022]
Abstract
AIMS/HYPOTHESIS The aim of the study was to examine the association of retinal vessel morphometry with BP, body composition and biochemistry, and to determine whether these associations differ by diabetes status. METHODS The UK Biobank ocular assessment included 68,550 participants aged 40-70 years who underwent non-mydriatic retinal photography, BP and body composition measurements, and haematological analysis. A fully automated image analysis program provided measurements of retinal vessel diameter and tortuosity. The associations between retinal vessel morphology and cardiometabolic risk factors by diabetes status were examined using multilevel linear regression, to provide absolute differences in vessel diameter and percentage differences in tortuosity (allowing for within-person clustering). RESULTS A total of 50,233 participants (a reduction from 68,550) were included in these analyses. Overall, those with diabetes had significantly more tortuous venules and wider arteriolar diameters compared with those without. Associations between venular tortuosity and cardiometabolic risk factors differed according to diabetes status (p interaction <0.01) for total fat mass index, HbA1c, C-reactive protein, white cell count and granulocyte count. For example, a unit rise in white cell count was associated with a 0.18% increase (95% CI 0.05, 0.32%) in venular tortuosity for those without diabetes and a 1.48% increase (95% CI 0.90, 2.07%) among those with diabetes. For arteriolar diameter, significant interactions were evident for systolic BP, diastolic BP, mean arterial pressure (MAP) and LDL-cholesterol. For example, a 10 mmHg rise in systolic BP was associated with a -0.92 μm difference (95% CI -0.96 to -0.88 μm) in arteriolar diameter for those without diabetes, and a -0.58 μm difference (95% CI -0.76 to -0.41 μm) among those with diabetes. No interactions were observed for arteriolar tortuosity or venular diameters. CONCLUSIONS/INTERPRETATION We provide clear evidence of the modifying effect of diabetes on cardiometabolic risk factor associations with retinal microvascular architecture. These observations suggest the occurrence of preclinical disease processes, and may be a sign of impaired autoregulation due to hyperglycaemia, which has been suggested to play a pivotal role in the development of diabetes-related microvascular complications. DATA AVAILABILITY The data supporting the results reported here are available through the UK Biobank ( https://www.ukbiobank.ac.uk/enable-your-research/apply-for-access ).
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Affiliation(s)
- Robyn J Tapp
- Population Health Research Institute, St George's, University of London, London, UK.
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, UK.
| | - Christopher G Owen
- Population Health Research Institute, St George's, University of London, London, UK
| | - Sarah A Barman
- Faculty of Science, Engineering and Computing, Kingston University, Kingston upon Thames, Surrey, UK
| | - David P Strachan
- Population Health Research Institute, St George's, University of London, London, UK
| | - Roshan A Welikala
- Faculty of Science, Engineering and Computing, Kingston University, Kingston upon Thames, Surrey, UK
| | - Paul J Foster
- Integrative Epidemiology Research Group, UCL Institute of Ophthalmology, London, UK
- NIHR Biomedical Research Centre at Moorfields Eye Hospital, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, London, UK
| | - Alicja R Rudnicka
- Population Health Research Institute, St George's, University of London, London, UK.
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Xu Z, Zhang H, Wu C, Zheng Y, Jiang J. Effect of metformin on adverse outcomes in T2DM patients: Systemic review and meta-analysis of observational studies. Front Cardiovasc Med 2022; 9:944902. [PMID: 36211585 PMCID: PMC9539433 DOI: 10.3389/fcvm.2022.944902] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/08/2022] [Indexed: 11/15/2022] Open
Abstract
Background The cardiovascular protection effect of metformin on patients with type 2 diabetes mellitus (T2DM) remains inconclusive. This systemic review and meta-analysis were to estimate the effect of metformin on mortality and cardiovascular events among patients with T2DM. Methods A search of the Pubmed and EMBASE databases up to December 2021 was performed. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled by a random-effects model with an inverse variance method. Results A total of 39 studies involving 2473009 T2DM patients were adopted. Compared to non-metformin therapy, the use of metformin was not significantly associated with a reduced risk of major adverse cardiovascular event (MACE) (HR = 1.06, 95%CI 0.91–1.22; I2 = 82%), hospitalization (HR = 0.85, 95%CI 0.64–1.13; I2 = 98%), heart failure (HR = 0.86, 95%CI 0.60–1.25; I2 = 99%), stroke (HR = 1.16, 95%CI 0.88–1.53; I2 = 84%), and risk of AMI (HR = 0.88, 95%CI 0.69–1.14; I2 = 88%) in T2DM patients. Metformin was also not associated with significantly lowered risk of MACE compared to dipeptidyl peptidase-4 inhibitor (DPP-4i) in T2DM patients (HR = 0.95, 95%CI 0.73–1.23; I2 = 84%). Conclusions The effect of metformin on some cardiovascular outcomes was not significantly better than the non-metformin therapy or DPP-4i in T2DM patients based on observational studies.
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Affiliation(s)
- Zhicheng Xu
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- *Correspondence: Zhicheng Xu
| | - Haidong Zhang
- Department of Nephrology, Peking University Third Hospital, Bejing, China
- Haidong Zhang
| | - Chenghui Wu
- School of Medicine, Sun Yat-sen University, Shenzhen, China
| | - Yuxiang Zheng
- Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingzhou Jiang
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Jingzhou Jiang
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O'Shea ME, Sheehan Gilroy B, Greaney AM, MacDonald A. Moving through adulthood: The lived experience of Irish adults with PKU. Front Psychol 2022; 13:983154. [PMID: 36176784 PMCID: PMC9513515 DOI: 10.3389/fpsyg.2022.983154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThis paper represents a portion of the findings from one of the first research studies eliciting the lived experience of adults with an early diagnosis of Phenylketonuria (PKU) living in Ireland. Ireland has one of the highest prevalence rates of PKU in Europe, however, little is known about the experience of Irish adults with PKU. Furthermore, Ireland is one of the first countries in the world to introduce neonatal screening followed by the introduction of long-term dietary therapy over 50 years ago. This study presents the first comprehensive assessment of the lived experience of Irish adults with PKU on long term dietary therapy.MethodsNarrative data was collected from eleven self-selected participants, using semi-structured interviews. The interviews were divided into five sections focused on eliciting a holistic understanding of the lived experience of adults with PKU living in Ireland. Thematic analysis was guided by Colaizzi's Framework (1978) in conjunction with NVivo qualitative data analysis software.FindingsFindings from the original research encompassed a broad understanding of the lived experience of adults with PKU living in Ireland, including factors influencing dietary therapy and managing PHE blood levels. The themes being discussed within this article are those which appear to be least represented within current literature: living with PKU, including reproductive health, the importance of self-management and establishing routine, support networks in adulthood and concerns regarding aging with PKU.ConclusionIt was evident from the findings that a diagnosis of PKU can influence how adults with PKU may experience aging and their own mortality. These findings offer new insight into the vulnerability attached to the experience of aging with PKU and may be beneficial to advocacy groups and for future development of policy and practice.
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Affiliation(s)
- Mary-Ellen O'Shea
- School of Health and Social Sciences, Munster Technological University, Kerry, Ireland
- *Correspondence: Mary-Ellen O'Shea
| | | | - Anna-Marie Greaney
- School of Health and Social Sciences, Munster Technological University, Kerry, Ireland
| | - Anita MacDonald
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
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Wangler J, Jansky M. Bedeutung und Einsatzpotenziale von Gesundheits-Apps in der diabetologischen Versorgung – Ergebnisse einer Befragungsstudie. DIABETOL STOFFWECHS 2022. [DOI: 10.1055/a-1859-6400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Zusammenfassung
Hintergrund Mit Blick auf Diabetes mellitus Typ 2 als lebensstilinduzierte Erkrankung wird ein großer potenzieller Nutzen in Gesundheits-Apps gesehen, die gesundheitsunterstützend bei Prävention und Monitoring oder auch der Therapie helfen sollen. Das Ziel der Studie ist es, den Anwendungshorizont, die Akzeptanz und Einstellungen sowie Erfahrungen von Ärzt*innen aus diabetologischen Schwerpunktpraxen hinsichtlich des Nutzungspotenzials von Gesundheits-Apps für Diagnostik, Therapie und Prävention bei Diabetes mellitus Typ 2 explorativ zu beleuchten.
Methodik Aufbauend auf mehreren Vorstudien wurden mittels schriftlicher Befragung zwischen März und Mai 2021 insgesamt 291 Ärzt*innen diabetologischer Schwerpunktpraxen in Rheinland-Pfalz, Hessen, Thüringen und dem Saarland anonymisiert befragt. Die Rücklaufquote beträgt 30% (N=88). Neben der deskriptiven Analyse wurde ein t-Test bei unabhängigen Stichproben durchgeführt.
Ergebnisse Die Befragten verbinden mit dem Einsatz von Apps eine wirksame Stärkung von Empowerment, Motivation und Compliance, aber auch durch Erinnerungs- und lebensstilunterstützenden Funktionen eine mögliche Effektivierung der Prävention und des Erkrankungsmanagements von Typ-2-Diabetes-Patient*innen. Gerade jüngere Ärzt*innen in städtischen Praxisumgebungen begegnen Gesundheits-Apps mit positiver Einstellung und greifen im Praxisalltag auf solche Tools zurück. Skepsis besteht auf Seiten der Befragten u.a. in Bezug auf die Anwendungsfreundlichkeit und Datensicherheit bestehender Apps sowie hinsichtlich rechtlicher Fragestellungen. Eine Mehrheit räumt ein, keinen ausreichenden Überblick über diabetologische Apps zu besitzen und traut sich eine Beratung von Patient*innen nur bedingt zu. Diejenigen Ärzt*innen, bei denen Apps schon in der Versorgung Einzug fanden, beobachten in großer Mehrzahl positive Effekte bei der Steigerung der Compliance, im schnelleren Aufdecken bzw. Verringern von Komplikationen, bei der Gewichtsreduktion sowie bei der Abnahme des HbA1c-Werts.
Diskussion Trotz der positiver Effekte, die Gesundheits-Apps für Prävention und Therapie haben können, bestehen bei vielen diabetologischen Ärzt*innen Vorbehalte hinsichtlich der Überschaubarkeit, Transparenz und Sicherheit von Apps. Diese Bedenken sollten verstärkt adressiert werden, um die richtigen Voraussetzungen für eine erfolgreiche Integration von Gesundheits-Apps in die diabetologische Versorgung zu schaffen (u.a. verbindliche Datenschutz- und Qualitätsstandards, klare Rechtslage in Bezug auf die Anwendung von Apps, Schulungen, Tools zur Übersicht und Einordnung).
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Affiliation(s)
- Julian Wangler
- Zentrum für Allgemeinmedizin und Geriatrie, Universitätsmedizin Mainz, Mainz, Germany
| | - Michael Jansky
- Zentrum für Allgemeinmedizin und Geriatrie, Universitätsmedizin Mainz, Mainz, Germany
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Dharmalingam M, Das R, Jain S, Gupta S, Gupta M, Kudrigikar V, Bachani D, Mehta S, Joglekar S. Impact of Partial Meal Replacement on Glycemic Levels and Body Weight in Indian Patients with Type 2 Diabetes (PRIDE): A Randomized Controlled Study. Diabetes Ther 2022; 13:1599-1619. [PMID: 35834107 PMCID: PMC9281377 DOI: 10.1007/s13300-022-01294-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/21/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Partial meal replacement (PMR) offers potential glycemic and weight control benefits in type 2 diabetes mellitus (T2DM) patients. We evaluated the clinical impact of PMR (diabetes-specific nutritional supplement [DSNS]) in overweight/obese Indian patients with T2DM. METHODS PRIDE, a 12-week, phase IV, open-label, multicenter study randomized (1:1) newly diagnosed T2DM patients (≤ 1 year) to either DSNS plus standard of care (SOC; diabetes treatment with dietary counseling) group (PMR) or SOC alone group (SOC). The primary endpoint was mean change in glycated hemoglobin (HbA1c) from baseline to week 12. Secondary endpoints were changes in glucose profiles, body weight, waist circumference, lipid profile, and factors impacting quality-of-life (QoL) at week 6 and 12 from baseline. Safety was assessed throughout the study. RESULTS Of the 176 patients enrolled, 171 (n = 85 in PMR group; n = 86 in SOC group) were included in the modified intent-to-treat population. The mean reduction in HbA1c at week 12 from baseline in PMR group was significant compared to the SOC group (- 0.59 vs. - 0.21%, p = 0.002). At week 12, the PMR group showed significant reduction in mean body weight (- 2.19 vs. - 0.22 kg; p = 0.001) and waist circumference (- 2.34 vs. - 0.48 cm; p = 0.001) compared to SOC group. Mean fasting plasma glucose and post-prandial glucose significantly reduced from baseline at week 6 and 12 in each group (p < 0.05). No significant change was observed in lipid profile. QoL parameters (treatment adherence, general well-being, and energy fulfilment) in the PMR were significantly better than SOC group (p < 0.05). Patients were satisfied with the taste of DSNS. No serious adverse events were reported. CONCLUSIONS DSNS is an encouraging option for PMR strategy, as it significantly improved HbA1c, body weight, waist circumference, and overall well-being among overweight/obese Indian T2DM patients. TRIAL IDENTIFICATION NO CTRI/2019/10/021595.
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Affiliation(s)
- Mala Dharmalingam
- Endocrinology and Diabetes Research Center and Laboratory, Bangalore, 560003, India
| | - Rupam Das
- Downtown Hospital, Guwahati, 781006, India
| | - Sandeep Jain
- Marudhar Hospital, Jaipur, Rajasthan, 302012, India
| | - Sachin Gupta
- Shubham Multispeciality Hospital, Amraiwadi, Ahmedabad, 380026, India
| | - Manoj Gupta
- Health Point Hospital, Kolkata, 700025, India
| | - Vinay Kudrigikar
- India Medical Affairs, Sun Pharma Laboratories Ltd., Sun House, Plot No. 201 8/1, Western Express Highway, Goregaon (E), Mumbai, Maharashtra, 400063, India.
| | - Deepak Bachani
- India Medical Affairs, Sun Pharma Laboratories Ltd., Sun House, Plot No. 201 8/1, Western Express Highway, Goregaon (E), Mumbai, Maharashtra, 400063, India
| | - Suyog Mehta
- India Medical Affairs, Sun Pharma Laboratories Ltd., Sun House, Plot No. 201 8/1, Western Express Highway, Goregaon (E), Mumbai, Maharashtra, 400063, India
| | - Sadhna Joglekar
- India Medical Affairs, Sun Pharma Laboratories Ltd., Sun House, Plot No. 201 8/1, Western Express Highway, Goregaon (E), Mumbai, Maharashtra, 400063, India
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Newson L, Parody FH. Investigating the experiences of low-carbohydrate diets for people living with Type 2 Diabetes: A thematic analysis. PLoS One 2022; 17:e0273422. [PMID: 35994442 PMCID: PMC9394793 DOI: 10.1371/journal.pone.0273422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/09/2022] [Indexed: 11/18/2022] Open
Abstract
Low-Carbohydrate Diets (LCDs) are becoming increasingly popular to manage Type 2 diabetes mellitus (T2DM). However, there is a need to identify people with T2DM’s understanding of LCDs, their reasons for engaging in such a diet, how they sustain it and any challenges they face. This study aimed to assess the experience of adhering to a LCD within a sample of individuals with T2DM. Ten participants with T2DM were recruited using a self-selecting sampling method from an online diabetes community that promotes LCDs. Participants completed one-to-one digitally recorded semi-structured interviews, which were later transcribed verbatim and data subjected to Thematic Analysis. Five core themes and twelve subthemes were developed during the analysis: (1) Lack of professional guidance; (2) Fear of complications & long-term medication use; (3) Dietary control as motivation; (4) Positive health outcomes; and (5) Social support. The findings are discussed with reference to a psychological model of behaviour, COM-B. Participants reported gaining knowledge and skills to increase their Capability to engage in LCDs, Motivation to manage diabetes outcomes influenced adherence. However, challenges were reported with the Opportunity to engage in behaviour, mainly influenced by social support. Health professionals and significant others may benefit from resources to help build knowledge and understanding and assist with maintaining a LCD long-term.
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Affiliation(s)
- Lisa Newson
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
- * E-mail:
| | - Francesca Helen Parody
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
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Habte ML, Beyene EA, Feyisa TO, Admasu FT, Tilahun A, Diribsa GC. Nutritional Values of Teff ( Eragrostis tef) in Diabetic Patients: Narrative Review. Diabetes Metab Syndr Obes 2022; 15:2599-2606. [PMID: 36035517 PMCID: PMC9416382 DOI: 10.2147/dmso.s366958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/16/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Teff (Eragrostis tef) is an indigenous crop in Ethiopia and exists in white, red, and mixed varieties. Several types of research confirmed that teff is rich in many essential amino acids, slowly digesting carbohydrates, essential fatty acids, minerals, vitamins, fibers, and other components. Since teff has a low glycemic index, is enriched in essential amino acids and fatty acids, and contains nutritionally balanced minerals, vitamins, and their precursors, it could be a promising food for the prevention and management of diabetes. People with diabetes mellitus are recommended to feed on a diet having a low glycemic index and enriched in essential nutrients. Objective This review aimed to summarize the nutritional composition of teff (Eragrostis tef) and its value in diabetic patients. Methodology We searched Web of Science, PubMed, Medline, Embase, and Google Scholar for studies on the nutritional composition of teff and its value for diabetic patients published in English since 2010. Conclusion According to available data, teff is a nutritionally valuable food type for diabetic patients.
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Affiliation(s)
- Mezgebu Legesse Habte
- Department of Medical Biochemistry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Etsegenet Assefa Beyene
- Department of Biochemistry, College of Health and Medical Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Teka Obsa Feyisa
- Department of Medical Biochemistry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fitalew Tadele Admasu
- Department Medical Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Anmut Tilahun
- Department Medical Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getahun Chala Diribsa
- Department of Medical Physiology, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Ralph AF, Brennan L, Byrne S, Caldwell B, Farmer J, Hart LM, Heruc GA, Maguire S, Piya MK, Quin J, Trobe SK, Wallis A, Williams-Tchen AJ, Hay P. Management of eating disorders for people with higher weight: clinical practice guideline. J Eat Disord 2022; 10:121. [PMID: 35978344 PMCID: PMC9386978 DOI: 10.1186/s40337-022-00622-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The prevalence of eating disorders is high in people with higher weight. However, despite this, eating disorders experienced by people with higher weight have been consistently under-recognised and under-treated, and there is little to guide clinicians in the management of eating disorders in this population. AIM The aim of this guideline is to synthesise the current best practice approaches to the management of eating disorders in people with higher weight and make evidence-based clinical practice recommendations. METHODS The National Eating Disorders Collaboration Steering Committee auspiced a Development Group for a Clinical Practice Guideline for the treatment of eating disorders for people with higher weight. The Development Group followed the 'Guidelines for Guidelines' process outlined by the National Health and Medical Research Council and aim to meet their Standards to be: 1. relevant and useful for decision making; 2. transparent; 3. overseen by a guideline development group; 4. identifying and managing conflicts of interest; 5. focused on health and related outcomes; 6. evidence informed; 7. making actionable recommendations; 8. up-to-date; and, 9. accessible. The development group included people with clinical and/or academic expertise and/or lived experience. The guideline has undergone extensive peer review and consultation over an 18-month period involving reviews by key stakeholders, including experts and organisations with clinical academic and/or lived experience. RECOMMENDATIONS Twenty-one clinical recommendations are made and graded according to the National Health and Medical Research Council evidence levels. Strong recommendations were supported for psychological treatment as a first-line treatment approach adults (with bulimia nervosa or binge-eating disorder), adolescents and children. Clinical considerations such as weight stigma, interprofessional collaborative practice and cultural considerations are also discussed. CONCLUSIONS This guideline will fill an important gap in the need to better understand and care for people experiencing eating disorders who also have higher weight. This guideline acknowledges deficits in knowledge and consequently the reliance on consensus and lower levels of evidence for many recommendations, and the need for research particularly evaluating weight-neutral and other more recent approaches in this field.
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Affiliation(s)
| | - Leah Brennan
- School of Psychology and Public Health, La Trobe University, Wodonga, Australia
| | - Sue Byrne
- Department of Psychology, University of Western Australia, Perth, Australia
| | | | - Jo Farmer
- Lived Experience Advocate, Melbourne, Australia
| | - Laura M. Hart
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Gabriella A. Heruc
- Eating Disorders and Nutrition Research Group (ENRG), School of Medicine, Western Sydney University, Sydney, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia
- Sydney Local Health District, NSW Health, Sydney, Australia
| | - Milan K. Piya
- School of Medicine, Western Sydney University, Macarthur Clinical School, Sydney, Australia
- Camden and Campbelltown Hospitals, Sydney, Australia
| | - Julia Quin
- Lived Experience Advocate, Melbourne, Australia
| | - Sarah K. Trobe
- National Eating Disorders Collaboration, Sydney, Australia
| | - Andrew Wallis
- Sydney Children’s Hospitals Network, The Children’s Hospital Westmead, Sydney, Australia
| | | | - Phillipa Hay
- Eating Disorders and Body Image (EDBI), Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- South Western Sydney Local Health District, Sydney, Australia
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Selman A, Burns S, Reddy AP, Culberson J, Reddy PH. The Role of Obesity and Diabetes in Dementia. Int J Mol Sci 2022; 23:ijms23169267. [PMID: 36012526 PMCID: PMC9408882 DOI: 10.3390/ijms23169267] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 12/06/2022] Open
Abstract
Chronic conditions such as obesity, diabetes, and dementia are increasing in the United States (US) population. Knowledge of these chronic conditions, preventative measures, and proper management tactics is important and critical to preventing disease. The overlap between obesity, diabetes, and dementia is becoming further elucidated. These conditions share a similar origin through the components of increasing age, gender, genetic and epigenetic predispositions, depression, and a high-fat Western diet (WD) that all contribute to the inflammatory state associated with the development of obesity, diabetes, and dementia. This inflammatory state leads to the dysregulation of food intake and insulin resistance. Obesity is often the cornerstone that leads to the development of diabetes and, subsequently, in the case of type 2 diabetes mellitus (T2DM), progression to “type 3 diabetes mellitus (T3DM)”. Obesity and depression are closely associated with diabetes. However, dementia can be avoided with lifestyle modifications, by switching to a plant-based diet (e.g., a Mediterranean diet (MD)), and increasing physical activity. Diet and exercise are not the only treatment options. There are several surgical and pharmacological interventions available for prevention. Current and future research within each of these fields is warranted and offers the chance for new treatment options and a better understanding of the pathogenesis of each condition.
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Affiliation(s)
- Ashley Selman
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Scott Burns
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Arubala P. Reddy
- Nutritional Sciences Department, College Human Sciences, Texas Tech University, Lubbock, TX 79409, USA
| | - John Culberson
- Department of Family Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P. Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Nutritional Sciences Department, College Human Sciences, Texas Tech University, Lubbock, TX 79409, USA
- Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Correspondence: ; Tel.: +1-806-743-3194
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Kupai K, Várkonyi T, Török S, Gáti V, Czimmerer Z, Puskás LG, Szebeni GJ. Recent Progress in the Diagnosis and Management of Type 2 Diabetes Mellitus in the Era of COVID-19 and Single Cell Multi-Omics Technologies. Life (Basel) 2022; 12:1205. [PMID: 36013384 PMCID: PMC9409806 DOI: 10.3390/life12081205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/29/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is one of the world's leading causes of death and life-threatening conditions. Therefore, we review the complex vicious circle of causes responsible for T2DM and risk factors such as the western diet, obesity, genetic predisposition, environmental factors, and SARS-CoV-2 infection. The prevalence and economic burden of T2DM on societal and healthcare systems are dissected. Recent progress on the diagnosis and clinical management of T2DM, including both non-pharmacological and latest pharmacological treatment regimens, are summarized. The treatment of T2DM is becoming more complex as new medications are approved. This review is focused on the non-insulin treatments of T2DM to reach optimal therapy beyond glycemic management. We review experimental and clinical findings of SARS-CoV-2 risks that are attributable to T2DM patients. Finally, we shed light on the recent single-cell-based technologies and multi-omics approaches that have reached breakthroughs in the understanding of the pathomechanism of T2DM.
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Affiliation(s)
- Krisztina Kupai
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Közép fasor 52, 6726 Szeged, Hungary
- Department of Internal Medicine, University of Szeged, Korányi fasor 8, 6720 Szeged, Hungary
| | - Tamás Várkonyi
- Department of Internal Medicine, University of Szeged, Korányi fasor 8, 6720 Szeged, Hungary
| | - Szilvia Török
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Közép fasor 52, 6726 Szeged, Hungary
| | - Viktória Gáti
- Laboratory of Functional Genomics, Biological Research Centre, Temesvári krt. 62, 6726 Szeged, Hungary
| | - Zsolt Czimmerer
- Laboratory of Functional Genomics, Biological Research Centre, Temesvári krt. 62, 6726 Szeged, Hungary
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Life Science Building, Egyetem tér 1, 4032 Debrecen, Hungary
| | - László G. Puskás
- Laboratory of Functional Genomics, Biological Research Centre, Temesvári krt. 62, 6726 Szeged, Hungary
- Avidin Ltd., Alsó kikötő sor 11/D, 6726 Szeged, Hungary
| | - Gábor J. Szebeni
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Közép fasor 52, 6726 Szeged, Hungary
- Laboratory of Functional Genomics, Biological Research Centre, Temesvári krt. 62, 6726 Szeged, Hungary
- CS-Smartlab Devices Ltd., Ady E. u. 14, 7761 Kozármisleny, Hungary
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98
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Precision Medicine for Chronic Diseases: Focus on Lifestyle Changes. J Pers Med 2022; 12:jpm12081291. [PMID: 36013240 PMCID: PMC9409984 DOI: 10.3390/jpm12081291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022] Open
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99
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Landgraf R, Aberle J, Birkenfeld AL, Gallwitz B, Kellerer M, Klein H, Müller-Wieland D, Nauck MA, Wiesner T, Siegel E. Therapy of Type 2 Diabetes. Exp Clin Endocrinol Diabetes 2022; 130:S80-S112. [PMID: 35839797 DOI: 10.1055/a-1624-3449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Jens Aberle
- Division of Endocrinology and Diabetology, University Obesity Centre Hamburg, University Hospital Hamburg-Eppendorf, Germany
| | | | - Baptist Gallwitz
- Department of Internal Medicine IV, Diabetology, Endocrinology, Nephrology, University Hospital Tübingen, Germany
| | - Monika Kellerer
- Department of Internal Medicine I, Marienhospital, Stuttgart, Germany
| | - Harald Klein
- Department of Internal Medicine I, University Hospital Bergmannsheil, Bochum, Germany
| | - Dirk Müller-Wieland
- Department of Internal Medicine I, University Hospital RWTH, Aachen, Germany
| | - Michael A Nauck
- Diabetes Centre Bochum-Hattingen, St.-Josef-Hospital, Ruhr-University, Bochum, Germany
| | | | - Erhard Siegel
- Department of Internal Medicine - Gastroenterology, Diabetology/Endocrinology and Nutritional Medicine, St. Josefkrankenhaus Heidelberg GmbH, Heidelberg, Germany
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100
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Oxidative Stress in Type 2 Diabetes: The Case for Future Pediatric Redoxomics Studies. Antioxidants (Basel) 2022; 11:antiox11071336. [PMID: 35883827 PMCID: PMC9312244 DOI: 10.3390/antiox11071336] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 01/27/2023] Open
Abstract
Considerable evidence supports the role of oxidative stress in adult type 2 diabetes (T2D). Due to increasing rates of pediatric obesity, lack of physical activity, and consumption of excess food calories, it is projected that the number of children living with insulin resistance, prediabetes, and T2D will markedly increase with enormous worldwide economic costs. Understanding the factors contributing to oxidative stress and T2D risk may help develop optimal early intervention strategies. Evidence suggests that oxidative stress, triggered by excess dietary fat consumption, causes excess mitochondrial hydrogen peroxide emission in skeletal muscle, alters redox status, and promotes insulin resistance leading to T2D. The pathophysiological events arising from excess calorie-induced mitochondrial reactive oxygen species production are complex and not yet investigated in children. Systems medicine is an integrative approach leveraging conventional medical information and environmental factors with data obtained from “omics” technologies such as genomics, proteomics, and metabolomics. In adults with T2D, systems medicine shows promise in risk assessment and predicting drug response. Redoxomics is a branch of systems medicine focusing on “omics” data related to redox status. Systems medicine with a complementary emphasis on redoxomics can potentially optimize future healthcare strategies for adults and children with T2D.
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