1
|
Chang S, Liu H. Effects of combined resistance training and Tai Chi on oxidative stress, blood glucose and lipid metabolism and quality of life in elderly patients with type 2 diabetes mellitus. Res Sports Med 2024; 32:871-884. [PMID: 38715371 DOI: 10.1080/15438627.2024.2349521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 04/16/2024] [Indexed: 08/06/2024]
Abstract
This study examined the effects of resistance training (RT), Tai Chi (TC) and combination intervention (RT & TC) on the oxidative stress, blood glucose and lipid metabolism and quality of life of elderly patients with type 2 diabetes mellitus (T2DM). Ninety-four elderly patients with T2DM were randomly divided into an RT group (RTG, n = 23), TC group (TCG, n = 24), combination intervention group (CIG, n = 24) and control group (CG, n = 23). All participants were given nutrition and medication. On this basis, RTG, TCG and CIG were administered for 24 weeks (3 times/week, 40 minutes/time). Observation indicators were malondialdehyde (MDA), superoxide dismutase (SOD), 8-hydroxy-2 deoxyguanosine (8-OHdG), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), haemoglobin A1c (HbA1c) and diabetes specific quality of life (DSQL). RT, TC and joint intervention can reduce the oxidative stress damage on elderly patients with T2DM to different degrees, control the levels of blood sugar and blood lipid and improve the quality of life. Compared with single intervention, combination intervention can further reduce the level of oxidative stress but has no additional benefits on blood glucose and lipid control and quality of life.
Collapse
Affiliation(s)
- Shuwan Chang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
- Department of Sports Human Science, Sichuan Sports College, Chengdu, China
| | - Heng Liu
- College of Physical Education, Chongqing University, Chongqing, China
| |
Collapse
|
2
|
McMullen B, Duncanson K, Collins C, MacDonald-Wicks L. A systematic review of the mechanisms influencing engagement in diabetes prevention programmes for people with pre-diabetes. Diabet Med 2024; 41:e15323. [PMID: 38829966 DOI: 10.1111/dme.15323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/02/2024] [Accepted: 03/20/2024] [Indexed: 06/05/2024]
Abstract
AIMS To identify barriers and enablers that influence engagement in and acceptability of diabetes prevention programmes for people with pre-diabetes. The results will provide insights for developing strategies and recommendations to improve design and delivery of diabetes prevention programmes with enhanced engagement and acceptability for people with pre-diabetes. METHODS This review used a critical realist approach to examine context and mechanisms of diabetes prevention programmes. Medline, Embase, PsycInfo, Cinahl, Web of Science, Scopus and Pre-Medline were searched for English language studies published between 2000 and 2023. A quality assessment was conducted using Joanna Briggs Institute critical appraisal tools. RESULTS A total of 90 papers met inclusion criteria. The included studies used a variety of quantitative and qualitative methodologies. Data extracted focused on barriers and enablers to engagement in and acceptability of diabetes prevention programmes, with seven key mechanisms identified. These included financial, environmental, personal, healthcare, social and cultural, demographic and programme mechanisms. Findings highlighted diverse factors that influenced engagement in preventive programmes and the importance of considering these factors when planning, developing and implementing future diabetes prevention programmes. CONCLUSIONS Mechanisms identified in this review can inform design and development of diabetes prevention programmes for people with pre-diabetes and provide guidance for healthcare professionals and policymakers. This will facilitate increased participation and engagement in preventive programmes, potentially reducing progression and/or incidence of pre-diabetes to type 2 diabetes and improving health outcomes.
Collapse
Affiliation(s)
- Britney McMullen
- Mid North Coast Local Health District, University of Newcastle, Coffs Harbour, Australia
| | - Kerith Duncanson
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Clare Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Lesley MacDonald-Wicks
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| |
Collapse
|
3
|
Luo H, Zhang J, Li X, Li T, Shen W. Eldecalcitol for sarcopenia prevention in adults with prediabetes. THE LANCET. HEALTHY LONGEVITY 2024; 5:e389. [PMID: 38824954 DOI: 10.1016/s2666-7568(24)00091-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/08/2024] [Indexed: 06/04/2024] Open
Affiliation(s)
- Honglian Luo
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Jiafeng Zhang
- Department of Laboratory Medicine, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Xianhua Li
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tuo Li
- Department of Endocrinology, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Wei Shen
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
| |
Collapse
|
4
|
Sabatini S, Nolan JJ, O'Donoghue G, Kennedy A, Petrie J, Walker M, O'Gorman DJ, Gastaldelli A. Baseline phenotypes with preserved β-cell function and high insulin concentrations have the best improvements in glucose tolerance after weight loss: results from the prospective DEXLIFE and EGIR-RISC studies. Metabolism 2024; 155:155910. [PMID: 38599278 DOI: 10.1016/j.metabol.2024.155910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/04/2024] [Accepted: 04/04/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Weight loss and lifestyle intervention improve glucose tolerance delaying the onset of type 2 diabetes (T2D), but individual responses are highly variable. Determining the predictive factors linked to the beneficial effects of weight loss on glucose tolerance could provide tools for individualized prevention plans. Thus, the aim was to investigate the relationship between pre-intervention values of insulin sensitivity and secretion and the improvement in glucose metabolism after weight loss. METHODS In the DEXLIFE cohort (373 individuals at high risk of T2D, assigned 3:1 to a 12-week lifestyle intervention or a control arm, Trial Registration: ISRCTN66987085), K-means clustering and logistic regression analysis were performed based on pre-intervention indices of insulin sensitivity, insulin secretion (AUC-I), and glucose-stimulated insulin response (ratio of incremental areas of insulin and glucose, iAUC I/G). The response to the intervention was evaluated in terms of reduction of OGTT-glucose concentration. Clusters' validation was done in the prospective EGIR-RISC cohort (n = 1538). RESULTS Four replicable clusters with different glycemic and metabolomic profiles were identified. Individuals had similar weight loss, but improvement in glycemic profile and β-cell function was different among clusters, highly depending on pre-intervention insulin response to OGTT. Pre-intervention high insulin response was associated with the best improvement in AUC-G, while clusters with low AUC-I and iAUC I/G showed no beneficial effect of weight loss on glucose control, as also confirmed by the logistic regression model. CONCLUSIONS Individuals with preserved β-cell function and high insulin concentrations at baseline have the best improvement in glucose tolerance after weight loss.
Collapse
Affiliation(s)
- Silvia Sabatini
- Institute of Clinical Physiology, National Research Council, CNR, Pisa, Italy
| | - John J Nolan
- Department of Clinical Medicine, Trinity College Dublin, Ireland
| | - Grainne O'Donoghue
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Aileen Kennedy
- School of Biological, Health and Sports Sciences, Technological University Dublin, Dublin, Ireland
| | - John Petrie
- School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Mark Walker
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Donal J O'Gorman
- School of Health and Human Performance, Dublin City University, Glasnevin, Dublin, Ireland
| | - Amalia Gastaldelli
- Institute of Clinical Physiology, National Research Council, CNR, Pisa, Italy.; Diabetes Division, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| |
Collapse
|
5
|
Chakkalakal RJ, Galaviz KI, Thirunavukkarasu S, Shah MK, Narayan KMV. Test and Treat for Prediabetes: A Review of the Health Effects of Prediabetes and the Role of Screening and Prevention. Annu Rev Public Health 2024; 45:151-167. [PMID: 38109519 DOI: 10.1146/annurev-publhealth-060222-023417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
The term prediabetes describes blood glucose levels above the normal range but below the threshold to diagnose type 2 diabetes. Several population health initiatives encourage a test and treat approach for prediabetes. In this approach, screening and identification of individuals with prediabetes should be followed by prompt referral to structured lifestyle modification programs or pharmacologic interventions that have been shown to prevent or delay the progression to type 2 diabetes in clinical trials. Here we provide a critical review of evidence for this test and treat approach by examining health outcomes associated with prediabetes and the availability and effectiveness of lifestyle modification approaches that target prediabetes. We also describe current limitations to the reach and uptake of evidence-based treatment options for prediabetes. Finally, we highlight lessons learned from identifying and labeling other preconditions to consider challenges and opportunities that may arise with increasing awareness of prediabetes as part of routine preventive care.
Collapse
Affiliation(s)
- Rosette J Chakkalakal
- Department of Medicine, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA;
- Department of Family and Preventive Medicine, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, Georgia, USA
| | - Karla I Galaviz
- Indiana University School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, USA
| | - Sathish Thirunavukkarasu
- Department of Family and Preventive Medicine, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, Georgia, USA
| | - Megha K Shah
- Department of Family and Preventive Medicine, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, Georgia, USA
| | - K M Venkat Narayan
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, Georgia, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
6
|
Thirunavukkarasu S. Utilizing 1-hour post-load glucose for identifying individuals with isolated impaired fasting glucose. Diabetes Res Clin Pract 2024; 210:111633. [PMID: 38513986 DOI: 10.1016/j.diabres.2024.111633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Sathish Thirunavukkarasu
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA.
| |
Collapse
|
7
|
Han CY, Lim SL, Ong KW, Johal J, Gulyani A. Behavioral Lifestyle Intervention Program Using Mobile Application Improves Diet Quality in Adults With Prediabetes (D'LITE Study): A Randomized Controlled Trial. J Acad Nutr Diet 2024; 124:358-371. [PMID: 37820787 DOI: 10.1016/j.jand.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 09/29/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Mobile health applications (mHealth apps) are increasingly being used in weight loss interventions. However, evidence on the effects of such interventions on diet quality and their correlation with weight loss is lacking. OBJECTIVE The objective of this study was to examine whether changes in the diet quality of adults with prediabetes followed the use of an mHealth-enabled lifestyle intervention, compared with those who did not, and whether these changes correlated with weight loss. DESIGN A secondary analysis of a 6-month randomized controlled trial Diabetes Lifestyle Intervention using Technology Empowerment (D'LITE) was conducted, with participants recruited from October 2017 to September 2019. PARTICIPANTS/SETTING Community-dwelling adults (n = 148) in Singapore diagnosed with prediabetes and body mass index (BMI) ≥23 were included in this study. INTERVENTION Participants were randomized to receive either a 6-month mHealth-enabled lifestyle intervention program (diet and physical activity) or standard care dietary advice. MAIN OUTCOME MEASURES Dietary data were collected in the form of 2-day food records at baseline, 3, and 6 months. Changes in Alternate Healthy Eating Index-2010 (AHEI-2010) scores and food groups (servings/day), calculated from the dietary data, and correlation between changes in AHEI-2010 and weight loss at 3 and 6 months, were examined. STATISTICAL ANALYSES Between-group comparisons of continuous variables and within-participants variation were performed using longitudinal mixed-effect models, intention-to-treat principles. The models included treatment groups, time (baseline, 3 months, and 6 months), and covariates (age, sex, and BMI), as well as the group × time interactions, as fixed variables and within-participant variation in outcome values as random variable. The random intercept for participants accounted for the dependence of repeated measures. A likelihood ratio test was also conducted to test random effect variance. Spearman correlation test was used to examine correlation between changes in AHEI-2010 scores and weight loss. RESULTS There was a significant improvement in overall diet quality as ascertained by the AHEI-2010, by 6.2 points (95% confidence interval [CI], 3.8-8.7; P < 0.001) in the intervention group as compared with the control. The participants in the intervention group had a significantly greater reduction in intake of sugar-sweetened beverages (SSB) by 0.5 servings/day (95% CI, -0.8, -0.2; P < 0.001) and sodium by 726 mg/day (95% CI, -983, -468; P < .001), compared with those receiving standard care. At 3 and 6 months, a significant decrease in SSB (0.8 servings/day; 0.7 servings/day, respectively) and sodium (297 mg/day; 296 mg/day, respectively) intakes were reported compared with baseline intakes. Small positive correlations (r = 0.2; P < 0.05) were observed between changes in AHEI-2010 scores from baseline and percentage weight loss at 3 and 6 months. CONCLUSION For adults with prediabetes in Singapore, diet quality can be improved with an mHealth-enabled lifestyle intervention program. A small positive correlation exists between AHEI-2010 scores and weight loss.
Collapse
Affiliation(s)
- Chad Yixian Han
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia; NOVI Health, Singapore.
| | - Su Lin Lim
- Dietetics Department, National University Hospital, National University Health System, Singapore
| | - Kai Wen Ong
- Dietetics Department, National University Hospital, National University Health System, Singapore
| | - Jolyn Johal
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia
| | - Aarti Gulyani
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia
| |
Collapse
|
8
|
Thirunavukkarasu S, Taylor R, Khunti K, Tapp RJ, Raben A, Zhu R, Kapoor N, Narayan KMV, Ali MK, Shaw JE. Low-calorie diets for people with isolated impaired fasting glucose. COMMUNICATIONS MEDICINE 2024; 4:35. [PMID: 38429400 PMCID: PMC10907622 DOI: 10.1038/s43856-024-00466-2] [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: 11/04/2023] [Accepted: 02/22/2024] [Indexed: 03/03/2024] Open
Abstract
Thirunavukkarasu et al. discuss how standard lifestyle interventions prove ineffective in preventing type 2 diabetes in individuals with isolated impaired fasting glucose, a highly prevalent prediabetes phenotype globally. They propose low-calorie diets as a promising strategy for diabetes prevention in this high-risk population.
Collapse
Affiliation(s)
- Sathish Thirunavukkarasu
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA.
| | - Roy Taylor
- Translational and Clinical Research Institute, Magnetic Resonance Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Robyn J Tapp
- Centre for Intelligent Health Care, Coventry University, Coventry, UK
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Ruixin Zhu
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
| | - K M Venkat Narayan
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA
| | - Mohammed K Ali
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| |
Collapse
|
9
|
Qiu S, Cai X, Zhou X, Xu J, Sun Z, Guo H, Wu T. Muscle Quality in Relation to Prediabetes Phenotypes: A Population-Based Study With Mediation Analysis. J Clin Endocrinol Metab 2024; 109:e1151-e1158. [PMID: 37878955 DOI: 10.1210/clinem/dgad630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/05/2023] [Accepted: 10/20/2023] [Indexed: 10/27/2023]
Abstract
CONTEXT Prediabetes is associated with an increased risk of physical disability, yet no studies have assessed the extent to which muscle quality, a measure reflecting muscle functionality, was altered in prediabetes and its specific phenotype. OBJECTIVE We evaluated their associations in a general US population with mediation analysis. METHODS This was a cross-sectional study based on the National Health and Nutrition Examination Survey 2011-2014. Participants with prediabetes were stratified as having an isolated defect (impaired fasting glucose [IFG], impaired glucose tolerance [IGT], or impaired hemoglobin A1c [IA1c]), 2 defects (IFG + IGT, IFG + IA1c, or IGT + IA1c), or all defects (IFG + IGT + IA1c). Muscle quality was calculated as dominant grip strength divided by dominant arm muscle mass measured by dual-energy X-ray absorptiometry. RESULTS We included 2351 participants (938 with prediabetes and 1413 with normoglycemia). Despite higher grip strength and larger arm muscle mass, arm muscle quality was lower in prediabetes and all prediabetes phenotypes (except for IGT) than normoglycemia (all P < .04), and was unrelated to prediabetes awareness. Arm muscle quality was decreased and the odds of low arm muscle quality was increased in prediabetes with increasing numbers of glucometabolic defects (both P < .001), with insulin resistance being the predominant mediator. HbA1c-defined prediabetes (IA1c) had lower arm muscle quality and higher odds of low arm muscle quality than blood glucose-defined prediabetes (IFG, IGT, or IFG + IGT). CONCLUSION Muscle quality was impaired in prediabetes and its specific phenotype. Relative to blood glucose, elevated HbA1c might be a better predictor of reduced muscle quality.
Collapse
Affiliation(s)
- Shanhu Qiu
- Department of General Practice, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing 210009, China
- Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing 210009, China
| | - Xue Cai
- Department of Nursing Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Xiaoying Zhou
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing 210009, China
| | - Jinshui Xu
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210000, China
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing 210009, China
| | - Haijian Guo
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210000, China
| | - Tongzhi Wu
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide 5000, Australia
| |
Collapse
|
10
|
Wang G, Chen Y, Liu X, Ma S, Jiang M. Global research trends in prediabetes over the past decade: Bibliometric and visualized analysis. Medicine (Baltimore) 2024; 103:e36857. [PMID: 38241546 PMCID: PMC10798732 DOI: 10.1097/md.0000000000036857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/13/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECT This study aimed to investigate global research advances and hot trends in prediabetes in the last decade based on a bibliometric analysis of publications. Publications from 2013 to 2022 were retrieved from the Web of Science Core Collection database through a topic search. With the use of CiteSpace, VOS viewer, and Bibliometrix R software packages, the number of publications, production categories, countries/regions, institutions, authors, journals, references, and keywords were comprehensively analyzed to sort out the hot spots and directions of prediabetes and predict the future research directions. A total of 13,223 papers were recruited for this study by the end of March 3, 2023. A generally increasing trend was observed in the number of annual publications. PLOS ONE (journal), USA (national), and the University of Copenhagen (institutional) published the most papers in this research area. The top 3 contributor authors were Tuomilehto Jaakko, Rathmann Wolfgang, and Peters Annette. "Intestinal microbiota" (2020-2022) was the most populated keyword in terms of intensity, and "biomarkers," "gut microbiota," and "metabolomics" were the most populated keywords in the last 3 years. "Prediabetes: a high-risk state for diabetes development-2012" was the strongest burst reference. This study summarized the research hotspots and trends in prediabetes research in the last decade. Frontier research can be found in the journal Diabetes Care and Journal of Clinical Endocrinology Metabolism. Prediabetes research focuses on preventing risk factors to reduce the prevalence of prediabetes, and current research hotspots focus on gut microbes and metabolism-related biomarkers.
Collapse
Affiliation(s)
- Guoyu Wang
- Department of Traditional Chinese Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yafei Chen
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinxin Liu
- Department of Traditional Chinese Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Siyi Ma
- Department of Traditional Chinese Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Min Jiang
- Department of Traditional Chinese Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
11
|
Hu Y, Han Y, Liu Y, Cui Y, Ni Z, Wei L, Cao C, Hu H, He Y. A nomogram model for predicting 5-year risk of prediabetes in Chinese adults. Sci Rep 2023; 13:22523. [PMID: 38110661 PMCID: PMC10728122 DOI: 10.1038/s41598-023-50122-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/15/2023] [Indexed: 12/20/2023] Open
Abstract
Early identification is crucial to effectively intervene in individuals at high risk of developing pre-diabetes. This study aimed to create a personalized nomogram to determine the 5-year risk of pre-diabetes among Chinese adults. This retrospective cohort study included 184,188 participants without prediabetes at baseline. Training cohorts (92,177) and validation cohorts (92,011) were randomly assigned (92,011). We compared five prediction models on the training cohorts: full cox proportional hazards model, stepwise cox proportional hazards model, multivariable fractional polynomials (MFP), machine learning, and least absolute shrinkage and selection operator (LASSO) models. At the same time, we validated the above five models on the validation set. And we chose the LASSO model as the final risk prediction model for prediabetes. We presented the model with a nomogram. The model's performance was evaluated in terms of its discriminative ability, clinical utility, and calibration using the area under the receiver operating characteristic (ROC) curve, decision curve analysis, and calibration analysis on the training cohorts. Simultaneously, we also evaluated the above nomogram on the validation set. The 5-year incidence of prediabetes was 10.70% and 10.69% in the training and validation cohort, respectively. We developed a simple nomogram that predicted the risk of prediabetes by using the parameters of age, body mass index (BMI), fasting plasma glucose (FBG), triglycerides (TG), systolic blood pressure (SBP), and serum creatinine (Scr). The nomogram's area under the receiver operating characteristic curve (AUC) was 0.7341 (95% CI 0.7290-0.7392) for the training cohort and 0.7336 (95% CI 0.7285-0.7387) for the validation cohort, indicating good discriminative ability. The calibration curve showed a perfect fit between the predicted prediabetes risk and the observed prediabetes risk. An analysis of the decision curve presented the clinical application of the nomogram, with alternative threshold probability spectrums being presented as well. A personalized prediabetes prediction nomogram was developed and validated among Chinese adults, identifying high-risk individuals. Doctors and others can easily and efficiently use our prediabetes prediction model when assessing prediabetes risk.
Collapse
Affiliation(s)
- Yanhua Hu
- College of Information Science and Engineering, Liuzhou Institute of Technology, Liuzhou, 545616, Guangxi Zhuang Autonomous Region, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China
- Department of Emergency, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China
| | - Yufei Liu
- Department of Neurosurgery, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China
- Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China
| | - Yanan Cui
- College of Information Science and Engineering, Liuzhou Institute of Technology, Liuzhou, 545616, Guangxi Zhuang Autonomous Region, China
| | - Zhiping Ni
- College of Information Science and Engineering, Liuzhou Institute of Technology, Liuzhou, 545616, Guangxi Zhuang Autonomous Region, China
| | - Ling Wei
- College of Information Science and Engineering, Liuzhou Institute of Technology, Liuzhou, 545616, Guangxi Zhuang Autonomous Region, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong Province, China.
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People's Hospital, No. 3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong Province, China.
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China.
| | - Yongcheng He
- Department of Nephrology, Shenzhen Hengsheng Hospital, No. 20 Yintian Road, Baoan District, Shenzhen, 518000, Guangdong Province, China.
- Department of Nephrology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China.
| |
Collapse
|
12
|
Wang Y, Jiang Y, Li J, Lin X, Luo Y, Tan S, Yang H, Gao Z, Cui X, Yin P, Kong D, Gao Y, Cheng Y, Zhang L, Tang P, Lyu H. Effect of denosumab on glucose metabolism in postmenopausal osteoporotic women with prediabetes: a study protocol for a 12-month multicenter, open-label, randomized controlled trial. Trials 2023; 24:812. [PMID: 38111052 PMCID: PMC10726555 DOI: 10.1186/s13063-023-07769-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/03/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Participants with prediabetes are at a high risk of developing type 2 diabetes (T2D). Recent studies have suggested that blocking the receptor activator of nuclear factor-κB ligand (RANKL) may improve glucose metabolism and delay the development of T2D. However, the effect of denosumab, a fully human monoclonal antibody that inhibits RANKL, on glycemic parameters in the prediabetes population is uncertain. We aim to examine the effect of denosumab on glucose metabolism in postmenopausal women with osteoporosis and prediabetes. METHODS This is a 12-month multicenter, open-label, randomized controlled trial involving postmenopausal women who have been diagnosed with both osteoporosis and prediabetes. Osteoporosis is defined by the World Health Organization (WHO) as a bone mineral density T score of ≤ - 2.5, as measured by dual-energy X-ray absorptiometry (DXA). Prediabetes is defined as (i) a fasting plasma glucose level of 100-125 mg/dL, (ii) a 2-hour plasma glucose level of 140-199 mg/dL, or (iii) a glycosylated hemoglobin A1c (HbA1c) level of 5.7-6.4%. A total of 346 eligible subjects will be randomly assigned in a 1:1 ratio to receive either subcutaneous denosumab 60 mg every 6 months or oral alendronate 70 mg every week for 12 months. The primary outcome is the change in HbA1c levels from baseline to 12 months. Secondary outcomes include changes in fasting and 2-hour blood glucose levels, serum insulin levels, C-peptide levels, and insulin sensitivity from baseline to 12 months, and the incidence of T2D at the end of the study. Follow-up visits will be scheduled at 3, 6, 9, and 12 months. DISCUSSION This study aims to provide evidence on the efficacy of denosumab on glucose metabolism in postmenopausal women with osteoporosis and prediabetes. The results derived from this clinical trial may provide insight into the potential of denosumab in preventing T2D in high-risk populations. TRIAL REGISTRATION This study had been registered in the Chinese Clinical Trials Registry. REGISTRATION NUMBER ChiCTR2300070789 on April 23, 2023. https://www.chictr.org.cn .
Collapse
Affiliation(s)
- Yilin Wang
- Medical School of Chinese PLA, Beijing, 100853, China
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Yu Jiang
- Medical School of Chinese PLA, Beijing, 100853, China
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Jia Li
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, 100853, China
| | - Xisheng Lin
- Medical School of Chinese PLA, Beijing, 100853, China
- Department of Rehabilitation, the Second Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Yan Luo
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, 100853, China
| | - Shuhuai Tan
- Medical School of Chinese PLA, Beijing, 100853, China
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Haohan Yang
- Medical School of Chinese PLA, Beijing, 100853, China
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Zefu Gao
- Medical School of Chinese PLA, Beijing, 100853, China
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Xiang Cui
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, 100853, China
| | - Pengbin Yin
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, 100853, China
| | - Dan Kong
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Yuan Gao
- Department of Nursing, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Yu Cheng
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Licheng Zhang
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, 100853, China
| | - Peifu Tang
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China.
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, 100853, China.
| | - Houchen Lyu
- Department of Orthopedics, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China.
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, 100853, China.
| |
Collapse
|
13
|
Yu Y, Xu X, Tan D, Yin Y, Yang X, Yu R. A study on the use of acupoint catgut embedding in the treatment of pre-diabetes: a meta-analysis and data mining approach. Front Public Health 2023; 11:1282720. [PMID: 38131018 PMCID: PMC10733528 DOI: 10.3389/fpubh.2023.1282720] [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: 09/09/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Objective The efficacy of acupoint catgut embedding (ACE) for the treatment of pre-diabetes remains controversial. Therefore, this study investigated the clinical efficacy and acupoint selection in ACE for the treatment of pre-diabetes. Methods Eight common databases were searched for relevant literature on ACE for pre-diabetes. Meta-analysis was used to evaluate its efficacy and safety, and data mining was used to explore the protocol for acupoint selection. Results The meta-analysis revealed that compared with conventional treatment alone, conventional treatment combined with ACE reduced the levels of glycated hemoglobin A1c [mean difference (MD) -0.45, 95% confidence interval (CI) -0.67 to -0.24%, p < 0.001], fasting blood glucose (MD -0.61 mmol/L, 95% CI -0.87 to -0.36 mmol/L, p < 0.001), 2-h postprandial glucose (MD -0.77 mmol/L, 95% CI -0.98 to -0.55 mmol/L, p < 0.001), total cholesterol (MD -0.37 mmol/L, 95% CI -0.74 to 0.00 mmol/L, p = 0.049), triglyceride (MD -0.49 mmol/L, 95% CI -0.77 to -0.20 mmol/L, p < 0.001) and low-density lipoprotein cholesterol (MD -0.23 mmol/L, 95% CI -0.33 to -0.12 mmol/L, p < 0.001), and increased high-density lipoprotein cholesterol levels (MD 0.16 mmol/L, 95% CI 0.05 to 0.27 mmol/L, p = 0.004), whereas changes in the body mass index and the adverse event rates were comparable between groups. Data mining revealed that Pishu (BL20), Weiwanxiashu (EX-B3), Zusanli (ST36), Shenshu (BL23), Sanyinjiao (SP6), Weishu (BL21), and Taixi (KI3) were the core acupoints used in ACE for pre-diabetes. Conclusion ACE can effectively improve blood glucose and lipid levels in pre-diabetes patients and has a good safety profile. ACE consisting of Pishu (BL20), Weiwanxiashu (EX-B3), Zusanli (ST36), Shenshu (BL23), Sanyinjiao (SP6), Weishu (BL21), and Taixi (KI3), is a promising complementary strategy for the treatment of pre-diabetes.
Collapse
Affiliation(s)
- Yunfeng Yu
- Endocrinology Department, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xuan Xu
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Danni Tan
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Yuman Yin
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xinyu Yang
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Rong Yu
- Endocrinology Department, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| |
Collapse
|
14
|
Thirunavukkarasu S. Comment on Rooney et al. Global Prevalence of Prediabetes. Diabetes Care 2023;46:1388-1394. Diabetes Care 2023; 46:e219. [PMID: 38011527 DOI: 10.2337/dc23-1539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Affiliation(s)
- Sathish Thirunavukkarasu
- Department of Family and Preventive Medicine, School of Medicine, and Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA
| |
Collapse
|
15
|
Sathish T, Khunti K, Narayan KV, Mohan V, Davies MJ, Yates T, Oldenburg B, Thankappan KR, Tapp RJ, Bajpai R, Anjana RM, Weber MB, Ali MK, Shaw JE. Effect of Conventional Lifestyle Interventions on Type 2 Diabetes Incidence by Glucose-Defined Prediabetes Phenotype: An Individual Participant Data Meta-analysis of Randomized Controlled Trials. Diabetes Care 2023; 46:1903-1907. [PMID: 37650824 PMCID: PMC10620543 DOI: 10.2337/dc23-0696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/11/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE To examine whether the effect of conventional lifestyle interventions on type 2 diabetes incidence differs by glucose-defined prediabetes phenotype. RESEARCH DESIGN AND METHODS We searched multiple databases until 1 April 2023 for randomized controlled trials that recruited people with isolated impaired fasting glucose (i-IFG), isolated impaired glucose tolerance (i-IGT), and impaired fasting glucose plus impaired glucose tolerance (IFG+IGT). Individual participant data were pooled from relevant trials and analyzed through random-effects models with use of the within-trial interactions approach. RESULTS Four trials with 2,794 participants (mean age 53.0 years, 60.7% men) were included: 1,240 (44.4%), 796 (28.5%), and 758 (27.1%) had i-IFG, i-IGT, and IFG+IGT, respectively. After a median of 2.5 years, the pooled hazard ratio for diabetes incidence in i-IFG was 0.97 (95% CI 0.66, 1.44), i-IGT 0.65 (0.44, 0.96), and IFG+IGT 0.51 (0.38, 0.68; Pinteraction = 0.01). CONCLUSIONS Conventional lifestyle interventions reduced diabetes incidence in people with IGT (with or without IFG) but not in those with i-IFG.
Collapse
Affiliation(s)
- Thirunavukkarasu Sathish
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, U.K
| | - K.M. Venkat Narayan
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Melanie J. Davies
- Diabetes Research Centre, University of Leicester, Leicester, U.K
- NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, U.K
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, U.K
- NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, U.K
| | - Brian Oldenburg
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Kavumpurathu R. Thankappan
- Department of Public Health, Amrita Institute of Medical Sciences & Research Center, Kochi, Kerala, India
| | - Robyn J. Tapp
- Research Institute for Health and Wellbeing, Coventry University, Coventry, U.K
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Ram Bajpai
- School of Medicine, Keele University, Staffordshire, U.K
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Mary B. Weber
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Mohammed K. Ali
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jonathan E. Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| |
Collapse
|
16
|
Qiu S, Cai X, Sun Z, Wu T. Comment on 'Prediabetes is an independent risk factor for sarcopenia in older men, but not in older women: the Bunkyo Health Study' by Kaga et al. J Cachexia Sarcopenia Muscle 2023; 14:2452-2453. [PMID: 37435695 PMCID: PMC10570061 DOI: 10.1002/jcsm.13293] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Affiliation(s)
- Shanhu Qiu
- Department of General Practice, School of Medicine, Institute of Diabetes, Zhongda HospitalSoutheast UniversityNanjingChina
- Research and Education Centre of General Practice, Zhongda HospitalSoutheast UniversityNanjingChina
| | - Xue Cai
- Department of Nursing Management, School of Medicine, Zhongda HospitalSoutheast UniversityNanjingChina
| | - Zilin Sun
- Department of Endocrinology, School of Medicine, Institute of Diabetes, Zhongda HospitalSoutheast UniversityNanjingChina
| | - Tongzhi Wu
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good HealthThe University of AdelaideAdelaideAustralia
| |
Collapse
|
17
|
Sathish T. Precision prevention of type 2 diabetes: An approach to revitalize current lifestyle interventions. Diabetes Res Clin Pract 2023; 200:110722. [PMID: 37207945 PMCID: PMC10427778 DOI: 10.1016/j.diabres.2023.110722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/21/2023]
Affiliation(s)
- Thirunavukkarasu Sathish
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA.
| |
Collapse
|
18
|
Akhtari FS, Lloyd D, Burkholder A, Tong X, House JS, Lee EY, Buse J, Schurman SH, Fargo DC, Schmitt CP, Hall J, Motsinger-Reif AA. Questionnaire-Based Polyexposure Assessment Outperforms Polygenic Scores for Classification of Type 2 Diabetes in a Multiancestry Cohort. Diabetes Care 2023; 46:929-937. [PMID: 36383734 PMCID: PMC10154656 DOI: 10.2337/dc22-0295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 10/23/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Environmental exposures may have greater predictive power for type 2 diabetes than polygenic scores (PGS). Studies examining environmental risk factors, however, have included only individuals with European ancestry, limiting the applicability of results. We conducted an exposome-wide association study in the multiancestry Personalized Environment and Genes Study to assess the effects of environmental factors on type 2 diabetes. RESEARCH DESIGN AND METHODS Using logistic regression for single-exposure analysis, we identified exposures associated with type 2 diabetes, adjusting for age, BMI, household income, and self-reported sex and race. To compare cumulative genetic and environmental effects, we computed an overall clinical score (OCS) as a weighted sum of BMI and prediabetes, hypertension, and high cholesterol status and a polyexposure score (PXS) as a weighted sum of 13 environmental variables. Using UK Biobank data, we developed a multiancestry PGS and calculated it for participants. RESULTS We found 76 significant associations with type 2 diabetes, including novel associations of asbestos and coal dust exposure. OCS, PXS, and PGS were significantly associated with type 2 diabetes. PXS had moderate power to determine associations, with larger effect size and greater power and reclassification improvement than PGS. For all scores, the results differed by race. CONCLUSIONS Our findings in a multiancestry cohort elucidate how type 2 diabetes odds can be attributed to clinical, genetic, and environmental factors and emphasize the need for exposome data in disease-risk association studies. Race-based differences in predictive scores highlight the need for genetic and exposome-wide studies in diverse populations.
Collapse
Affiliation(s)
- Farida S. Akhtari
- Biostatistics & Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, NC
- Clinical Research Branch, National Institute of Environmental Health Sciences, Durham, NC
| | - Dillon Lloyd
- Biostatistics & Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, NC
| | - Adam Burkholder
- Office of the Director, National Institute of Environmental Health Sciences, Durham, NC
| | - Xiaoran Tong
- Biostatistics & Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, NC
| | - John S. House
- Biostatistics & Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, NC
| | - Eunice Y. Lee
- Biostatistics & Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, NC
| | - John Buse
- Department of Medicine, University of North Carolina, Chapel Hill, NC
| | - Shepherd H. Schurman
- Clinical Research Branch, National Institute of Environmental Health Sciences, Durham, NC
| | - David C. Fargo
- Office of the Director, National Institute of Environmental Health Sciences, Durham, NC
| | - Charles P. Schmitt
- Office of Data Science, National Institute of Environmental Health Science, Durham, NC
| | - Janet Hall
- Clinical Research Branch, National Institute of Environmental Health Sciences, Durham, NC
| | - Alison A. Motsinger-Reif
- Biostatistics & Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, NC
| |
Collapse
|
19
|
Golovaty I, Ritchie ND, Tuomilehto J, Mohan V, Ali MK, Gregg EW, Bergman M, Moin T. Two decades of diabetes prevention efforts: A call to innovate and revitalize our approach to lifestyle change. Diabetes Res Clin Pract 2023; 198:110195. [PMID: 36470316 PMCID: PMC10079599 DOI: 10.1016/j.diabres.2022.110195] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/07/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
The impact of global diabetes prevention efforts has been modest despite the promise of landmark diabetes prevention trials nearly twenty years ago. While national and regional initiatives show potential, challenges remain to adapt large-scale strategies in the real-world that fits individuals and their communities. Additionally, the sedentary lifestyle changes during the COVID-19 pandemic and guidelines that now call for earlier screening (e.g., US Preventative Task Force) will increase the pool of eligible adults worldwide. Thus, a more adaptable, person-centered approach that expands the current toolkit is urgently needed to innovate and revitalize our approach to diabetes prevention. This review identifies key priorities to optimize the population-level delivery of diabetes prevention based on a consensus-based evaluation of the current evidence among experts in global translational programs; key priorities identified include (1) participant eligibility, (2) intervention intensity, (3) delivery components, (4) behavioral economics, (5) technology, and (6) the role of pharmacotherapy. We offer a conceptual framework for a broader, person-centered approach to better address an individual's risk, readiness, barriers, and digital competency.
Collapse
Affiliation(s)
- Ilya Golovaty
- Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA; General Medicine Service, VA Puget Sound Health Care System, Seattle, WA, USA.
| | - Natalie D Ritchie
- Office of Research, Denver Health and Hospital Authority, Denver, CO. Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. University of Colorado College of Nursing, Aurora, CO, USA
| | - Jaakko Tuomilehto
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland; Saudi Diabetes Research Group, King Abdulaziz University Jeddah, Saudi Arabia; Department of International Health, National School of Public Health, Instituto de Salud Carlos III. Madrid, Spain
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation & Chairman, Dr. Mohan's Diabetes Specialties Centre, Chennai, India
| | - Mohammed K Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Edward W Gregg
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Michael Bergman
- Division of Endocrinology and Metabolism, Department of Medicine and of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Tannaz Moin
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA; VA Greater Los Angeles Health System and HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Los Angeles, CA, USA
| |
Collapse
|
20
|
Personalized lifestyle change approaches for preventing type 2 diabetes in people with prediabetes. Int J Diabetes Dev Ctries 2023. [DOI: 10.1007/s13410-023-01189-1] [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: 03/12/2023] Open
|
21
|
Zhang X, Yue Y, Liu S, Cong X, Wang W, Li J. Relationship between BMI and risk of impaired glucose tolerance and impaired fasting glucose in Chinese adults: a prospective study. BMC Public Health 2023; 23:14. [PMID: 36597050 PMCID: PMC9811686 DOI: 10.1186/s12889-022-14912-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 12/20/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Current studies in most Western countries have largely focused on body mass index (BMI) as an important risk factor for impaired glucose tolerance (IGT) and impaired fasting glucose (IFG), which have different pathophysiological bases. In people with obesity, the prevalence of IGT is higher and the prevalence of IFG is lower. The prevalence of IGT in the Asian population is higher than that in the white population, and the obesity rate in China is still increasing. However, few cohort studies explore the relationship between BMI and the incidence of IGT and IFG in China. We aimed to explore the relationship between BMI and the risk of IGT and IFG in Chinese adults and analyze the differences between them. METHODS The baseline data were obtained from the 2010 China Chronic Disease and Risk Factor Surveillance, of which 20 surveillance sites were followed up from 2016 to 2017. Finally, in this study, a total of 5,578 studies were grouped into BMI categories of underweight (BMI < 18.5 kg/m2), normal weight (18.5-23.9 kg/m2), overweight (24.0-27.9 kg/m2), and obesity (≥ 28.0 kg/m2). We used the unconditional logistic regression model to analyze the relationship between BMI and the risk of IGT and IFG. RESULTS During an average follow-up of 6.4 years, 562 developed IGT and 257 developed IFG. After age, gender, urban and rural areas, physical activity, family history of diabetes, hypertension, abdominal obesity, dyslipidemia, and other factors were adjusted, overweight increased the risk of IGT by 35% [odds ratio (OR) 1.35, 95% confidence interval (CI) 1.08-1.70], and obesity increased the risk of IGT by 77% (OR 1.77, 95% CI 1.27-1.47). After the factors consistent with the above were adjusted, only obesity increased the risk of IFG by 122% (OR 2.22, 95% CI 1.39-3.54). CONCLUSIONS In China, obesity is an important risk factor for IGT and IFG, and the risk of IGT increases during the overweight stage.
Collapse
Affiliation(s)
- Xin Zhang
- grid.508400.9National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Diseases Control and Prevention, Beijing, 100050 China
| | - Yankun Yue
- grid.24696.3f0000 0004 0369 153XFu Xing Hospital, Capital Medical University, Beijing, 100045 China
| | - Shaobo Liu
- grid.508400.9National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Diseases Control and Prevention, Beijing, 100050 China
| | - Xiangfeng Cong
- grid.508400.9National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Diseases Control and Prevention, Beijing, 100050 China
| | - Wenjuan Wang
- grid.508400.9National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Diseases Control and Prevention, Beijing, 100050 China
| | - Jianhong Li
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Diseases Control and Prevention, Beijing, 100050, China.
| |
Collapse
|
22
|
Shahabi N, Hosseini Z, Aghamolaei T, Ghanbarnejad A, Behzad A. Application of Pender's health promotion model for type 2 diabetes treatment adherence: protocol for a mixed methods study in southern Iran. Trials 2022; 23:1056. [PMID: 36578044 PMCID: PMC9795658 DOI: 10.1186/s13063-022-07027-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) mellitus treatment as a chronic disease requires adequate adherence to treatment including controlling blood glucose levels and lifestyle management. The aim of this study is to investigate the factors affecting of adherence to T2D treatment from the perspective of patients and design an intervention program based on Pender's health promotion model (HPM) to increase T2D treatment adherence in Bandar Abbas, a city located in the south of Iran. METHODS This mixed method study will consist of qualitative stage, questionnaire design and a randomized, open-label, parallel-group interventional study based on HPM in southern Iran. Sampling for qualitative stage will continue until reaching the saturation. In the intervention stage, participants will be 166 T2D patients referring to the Bandar Abbas Diabetes Clinic will be randomized into intervention and control groups (allocation 1:1). After identifying the factors affecting adherence to treatment in T2D patients by qualitative study and literature review, a questionnaire based on HPM will be designed. In the next stage, 10 sessions of intervention for the intervention group will be designed. To evaluate the effect of the intervention, intervention and control groups will be tested for hemoglobin A1c (HbA1c) before and 3 months after the intervention. DISCUSSION This designed study is a program for improving treatment adherence in T2D based on the HPM model and contributes to a better understanding of effective factors in adherence to treatment in T2D patients. The results of this project can be used for macro-diabetic planning. TRIAL REGISTRATION This study is registered on the Iranian Registry of Clinical Trials (IRCT20211228053558N1: https://www.irct.ir/trial/61741 ) and first release date of 17th March 2022.
Collapse
Affiliation(s)
- Nahid Shahabi
- grid.412237.10000 0004 0385 452XStudent Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Hosseini
- grid.412237.10000 0004 0385 452XSocial Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- grid.412237.10000 0004 0385 452XCardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Amin Ghanbarnejad
- grid.412237.10000 0004 0385 452XSocial Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ahmad Behzad
- grid.412237.10000 0004 0385 452XSocial Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| |
Collapse
|
23
|
Liu W, Ma R, Lu S, Wen Y, Li H, Wang J, Sun B. Acid-Resistant Mesoporous Metal-Organic Frameworks as Carriers for Targeted Hypoglycemic Peptide Delivery: Peptide Encapsulation, Release, and Bioactivity. ACS APPLIED MATERIALS & INTERFACES 2022; 14:55447-55457. [PMID: 36478454 DOI: 10.1021/acsami.2c18452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Oral administration of bioactive peptides with α-glucosidase inhibitory activities is a promising strategy for diabetes mellitus. The wheat germ peptide Leu-Asp-Leu-Gln-Arg (LDLQR) has been previously proven to inhibit the activity of α-glucosidase efficiently. However, it is still difficult to transport the peptide to the intestine completely due to the harsh condition of the stomach. Herein, an acid-resistant zirconium-based metal-organic framework, NU-1000, was used to immobilize LDLQR with a high encapsulation capacity (92.72%) and encapsulation efficiency (44.08%) in only 10 min. The in vitro release results showed that the acid-stable NU-1000 not only effectively protected LDLQR from degradation in the presence of stomach acid and pepsin effectively but also ensured the release of encapsulated LDLQR under simulated intestinal conditions. Furthermore, LDLQR@NU-1000 could slow down the elevated blood sugar caused by maltose in mice and the area under blood sugar curve decreased by almost 20% when compared with the control group. The inflammatory factor (IL-1β, IL-6) in vivo and cell growth in vitro were almost the same between NU-1000 treatment and normal control groups. This study indicates NU-1000 is a promising vehicle for targeted peptide-based bioactive delivery to the small intestine.
Collapse
Affiliation(s)
- Weiwei Liu
- China-Canada Joint Laboratory of Food Nutrition and Health (Beijing), School of Food and Health, Beijing Technology and Business University (BTBU), 11 Fucheng Road, Beijing100048, China
| | - Ruolan Ma
- China-Canada Joint Laboratory of Food Nutrition and Health (Beijing), School of Food and Health, Beijing Technology and Business University (BTBU), 11 Fucheng Road, Beijing100048, China
| | - Shiyi Lu
- China-Canada Joint Laboratory of Food Nutrition and Health (Beijing), School of Food and Health, Beijing Technology and Business University (BTBU), 11 Fucheng Road, Beijing100048, China
| | - Yangyang Wen
- College of Chemistry and Materials Engineering, Beijing Technology and Business University (BTBU), Beijing100048, China
| | - Hongyan Li
- China-Canada Joint Laboratory of Food Nutrition and Health (Beijing), School of Food and Health, Beijing Technology and Business University (BTBU), 11 Fucheng Road, Beijing100048, China
| | - Jing Wang
- China-Canada Joint Laboratory of Food Nutrition and Health (Beijing), School of Food and Health, Beijing Technology and Business University (BTBU), 11 Fucheng Road, Beijing100048, China
| | - Baoguo Sun
- China-Canada Joint Laboratory of Food Nutrition and Health (Beijing), School of Food and Health, Beijing Technology and Business University (BTBU), 11 Fucheng Road, Beijing100048, China
| |
Collapse
|
24
|
Circulating microRNAs from early childhood and adolescence are associated with pre-diabetes at 18 years of age in women from the PMNS cohort. J Dev Orig Health Dis 2022; 13:806-811. [PMID: 35450554 DOI: 10.1017/s2040174422000137] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
With type 2 diabetes presenting at younger ages, there is a growing need to identify biomarkers of future glucose intolerance. A high (20%) prevalence of glucose intolerance at 18 years was seen in women from the Pune Maternal Nutrition Study (PMNS) birth cohort. We investigated the potential of circulating microRNAs in risk stratification for future pre-diabetes in these women. Here, we provide preliminary longitudinal analyses of circulating microRNAs in normal glucose tolerant (NGT@18y, N = 10) and glucose intolerant (N = 8) women (ADA criteria) at 6, 12 and 17 years of their age using discovery analysis (OpenArray™ platform). Machine-learning workflows involving Lasso with bootstrapping/leave-one-out cross-validation identified microRNAs associated with glucose intolerance at 18 years of age. Several microRNAs, including miR-212-3p, miR-30e-3p and miR-638, stratified glucose-intolerant women from NGT at childhood. Our results suggest that circulating microRNAs, longitudinally assessed over 17 years of life, are dynamic biomarkers associated with and predictive of pre-diabetes at 18 years of age. Validation of these findings in males and remaining participants from the PMNS birth cohort will provide a unique opportunity to study novel epigenetic mechanisms in the life-course progression of glucose intolerance and enhance current clinical risk prediction of pre-diabetes and progression to type 2 diabetes.
Collapse
|
25
|
Zhu R, Jalo E, Silvestre MP, Poppitt SD, Handjieva-Darlenska T, Handjiev S, Huttunen-Lenz M, Mackintosh K, Stratton G, Navas-Carretero S, Pietiläinen KH, Simpson E, Macdonald IA, Muirhead R, Brand-Miller J, Fogelholm M, Færch K, Martinez JA, Westerterp-Plantenga MS, Adam TC, Raben A. Does the Effect of a 3-Year Lifestyle Intervention on Body Weight and Cardiometabolic Health Differ by Prediabetes Metabolic Phenotype? A Post Hoc Analysis of the PREVIEW Study. Diabetes Care 2022; 45:2698-2708. [PMID: 35696263 DOI: 10.2337/dc22-0549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/25/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine whether the effect of a 3-year lifestyle intervention on body weight and cardiometabolic risk factors differs by prediabetes metabolic phenotype. RESEARCH DESIGN AND METHODS This post hoc analysis of the multicenter, randomized trial, PREVention of diabetes through lifestyle interventions and population studies In Europe and around the World (PREVIEW), included 1,510 participants with prediabetes (BMI ≥25 kg ⋅ m-2; defined using oral glucose tolerance tests). Of these, 58% had isolated impaired fasting glucose (iIFG), 6% had isolated impaired glucose tolerance (iIGT), and 36% had IFG+IGT; 73% had normal hemoglobin A1c (HbA1c; <39 mmol ⋅ mol-1) and 25% had intermediate HbA1c (39-47 mmol ⋅ mol-1). Participants underwent an 8-week diet-induced rapid weight loss, followed by a 148-week lifestyle-based weight maintenance intervention. Linear mixed models adjusted for intervention arm and other confounders were used. RESULTS In the available-case and complete-case analyses, participants with IFG+IGT had greater sustained weight loss after lifestyle intervention (adjusted mean at 156 weeks -3.5% [95% CI, -4.7%, -2.3%]) than those with iIFG (mean -2.5% [-3.6%, -1.3%]) relative to baseline (P = 0.011). Participants with IFG+IGT and iIFG had similar cardiometabolic benefits from the lifestyle intervention. The differences in cardiometabolic benefits between those with iIGT and IFG+IGT were minor or inconsistent in different analyses. Participants with normal versus intermediate HbA1c had similar weight loss over 3 years and minor differences in cardiometabolic benefits during weight loss, whereas those with normal HbA1c had greater improvements in fasting glucose, 2-h glucose (adjusted between-group difference at 156 weeks -0.54 mmol ⋅ L-1 [95% CI -0.70, -0.39], P < 0.001), and triglycerides (difference -0.07 mmol ⋅ L-1 [-0.11, -0.03], P < 0.001) during the lifestyle intervention. CONCLUSIONS Individuals with iIFG and IFG+IGT had similar improvements in cardiometabolic health from a lifestyle intervention. Those with normal HbA1c had greater improvements than those with intermediate HbA1c.
Collapse
Affiliation(s)
- Ruixin Zhu
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Marta P Silvestre
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Center for Health Technology and Services Research (CINTESIS), NOVA Medical School (NMS), Universidade Nova de Lisboa, Lisboa, Portugal
| | - Sally D Poppitt
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | | | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Maija Huttunen-Lenz
- Institute for Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Kelly Mackintosh
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, U.K
| | - Gareth Stratton
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, U.K
| | - Santiago Navas-Carretero
- Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA) Instituto for Health Research, Pamplona, Spain
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Abdominal Center, Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Elizabeth Simpson
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, Medical Research Council (MRC)/Alzheimer's Research UK (ARUK) Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, U.K
| | - Ian A Macdonald
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, Medical Research Council (MRC)/Alzheimer's Research UK (ARUK) Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, U.K
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Kristine Færch
- Clinical Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Alfredo Martinez
- Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain.,Department of Nutrition and Physiology, University of Navarra, Pamplona, Spain.,Precision Nutrition and Cardiometabolic Health Program, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) Universidad Autónoma de Madrid (UAM) + Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Margriet S Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Tanja C Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Clinical Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark
| |
Collapse
|
26
|
Carrasco-Zanini J, Pietzner M, Lindbohm JV, Wheeler E, Oerton E, Kerrison N, Simpson M, Westacott M, Drolet D, Kivimaki M, Ostroff R, Williams SA, Wareham NJ, Langenberg C. Proteomic signatures for identification of impaired glucose tolerance. Nat Med 2022; 28:2293-2300. [PMID: 36357677 PMCID: PMC7614638 DOI: 10.1038/s41591-022-02055-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 09/27/2022] [Indexed: 11/12/2022]
Abstract
The implementation of recommendations for type 2 diabetes (T2D) screening and diagnosis focuses on the measurement of glycated hemoglobin (HbA1c) and fasting glucose. This approach leaves a large number of individuals with isolated impaired glucose tolerance (iIGT), who are only detectable through oral glucose tolerance tests (OGTTs), at risk of diabetes and its severe complications. We applied machine learning to the proteomic profiles of a single fasted sample from 11,546 participants of the Fenland study to test discrimination of iIGT defined using the gold-standard OGTTs. We observed significantly improved discriminative performance by adding only three proteins (RTN4R, CBPM and GHR) to the best clinical model (AUROC = 0.80 (95% confidence interval: 0.79-0.86), P = 0.004), which we validated in an external cohort. Increased plasma levels of these candidate proteins were associated with an increased risk for future T2D in an independent cohort and were also increased in individuals genetically susceptible to impaired glucose homeostasis and T2D. Assessment of a limited number of proteins can identify individuals likely to be missed by current diagnostic strategies and at high risk of T2D and its complications.
Collapse
Affiliation(s)
- Julia Carrasco-Zanini
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Maik Pietzner
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Joni V Lindbohm
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
- The Klarman Cell Observatory, Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Eleanor Wheeler
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Erin Oerton
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Nicola Kerrison
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | | | | | | - Mika Kivimaki
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | | | - Nicholas J Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Claudia Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK.
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Precision Healthcare University Research Institute, Queen Mary University of London, London, UK.
| |
Collapse
|
27
|
Asgari S, Masrouri S, Khalili D, Azizi F, Hadaegh F. Differences in the impact of impaired glucose status on clinical outcomes in younger and older adults: Over a decade of follow-up in the Tehran lipid and glucose study. Front Cardiovasc Med 2022; 9:1018403. [PMID: 36386371 PMCID: PMC9662168 DOI: 10.3389/fcvm.2022.1018403] [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: 08/13/2022] [Accepted: 09/28/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Studies found that the impact of dysglycemia on microvascular, macrovascular events and mortality outcomes were different between the younger vs. older population. We aimed to investigate the age-specific association of prediabetes with clinical outcomes including type 2 diabetes (T2DM), hypertension, chronic kidney disease (CKD), cardiovascular disease (CVD), and mortality. Materials and methods A total of 5,970 Iranians (3,829 women) aged ≥30 years, without T2DM, were included. The age-specific (<60 and ≥60 years; minimum p-value for interaction = 0.001) multivariable-adjusted Cox regression was done to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the impaired glucose status including impaired fasting glucose (IFG) vs. normal fasting glucose (NFG), impaired glucose tolerance (IGT) vs. normal glucose tolerance (NGT), and IFG&IGT vs. NFG/NGT with each outcome. Results Among individuals aged ≥60 years, the prevalence of impaired glucose status (IFG, IGT, or both) was about 2 times higher compared to those aged <60. Age-specific association between prediabetes and incident hypertension was found for those aged <60 years; [HR (95% CI); IFG: 1.38 (1.16–1.65), IGT: 1.51 (1.26–1.81), and IFG&IGT: 1.62 (1.21–2.12)]. For CVD, in all impaired glycemic states, those aged <60 were at higher significant risk [IFG: 1.39 (1.09–1.77), IGT: 1.53 (1.19–1.97), and IFG&IGT: 1.60 (1.14–2.25)]. Stratified analyses showed similar associations for IFG and IGT with non-CV mortality 1.71 (1.04–2.80) and 2.12 (1.30–3.46), respectively, and for all-cause mortality among those aged <60 years [IFG: 1.63 (1.08–2.45) and IGT: 1.82 (1.20–2.76)]. In both age groups, all glycemic status groups were significantly associated with T2DM but not with CKD and CV mortality. Conclusions The high prevalence of prediabetes particularly among the elderly population, limited resources, and the observed significant age differences in the impact of prediabetes states on different clinical outcomes calls for multicomponent intervention strategies by policy health makers, including lifestyle and possible pharmacological therapy, with the priority for the young Iranian population.
Collapse
Affiliation(s)
- Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soroush Masrouri
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Correspondence: Farzad Hadaegh
| |
Collapse
|
28
|
Kodapally B, Vilane Z, Nsamba J, Joseph A, Mathews E, Thankappan KR. The suitability, acceptability, and feasibility of a culturally contextualized low-calorie diet among women at high risk for diabetes mellitus in Kerala: a mixed-methods study. Int J Diabetes Dev Ctries 2022; 43:1-16. [PMID: 36245572 PMCID: PMC9552705 DOI: 10.1007/s13410-022-01134-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/21/2022] [Indexed: 11/01/2022] Open
Abstract
Background Nutritional therapy has been conventionally recommended for people with prediabetes as a method to delay or halt progression to type 2 diabetes mellitus (T2DM). The extensive diversity in food culture and habits in India pose a challenge in devising a uniform low-calorie diet plan. Though there are a number of studies related to different diet therapies, there exists limited evidence on culturally contextualized low-calorie diet plans and their process in India. The objective of the study is to test the suitability, acceptability, and feasibility of a culturally contextualized low-calorie diet among women with high risk for T2DM in Kerala. Method We employed a four-stage equal-status sequential design for this study. Firstly, in-depth interviews (n = 10) were conducted to understand the modifiable and non-modifiable components of the usual diet for diabetes prevention. Secondly, we developed a low-calorie diet plan (1500 kcal per day) based on the local preferences and availability. Thirdly, we piloted the diet plan among 18 individuals in the community to know its acceptability. Fourthly, in-depth interviews were done (n = 4) among pilot participants to understand the feasibility of pursuing it through facilitators and barriers to implementing the diet plan. Results Low-calorie diet plan was suitable for this setting as the burden of diabetes is very high and the diet plan had dietary components similar to the usual diet. Though participants had an intrinsic motivation to follow a healthy lifestyle, several systemic challenges such as the high cost of healthy foods options (fruits and vegetables), rice addiction, and food preferences driven by peer pressure act as hurdles. Conclusion Apart from culturally contextualizing the low-calorie diet, it is important that complementary strategic measures such as reorientation of the public distribution system and subsidizing fruit and vegetable production and cost are required for the suitability, acceptability, and feasibility of implementation. Supplementary Information The online version contains supplementary material available at 10.1007/s13410-022-01134-8.
Collapse
Affiliation(s)
- Bhagiaswari Kodapally
- Department of Public Health & Community Medicine, Central University of Kerala, Kasaragod, India
| | - Zinto Vilane
- Department of Public Health & Community Medicine, Central University of Kerala, Kasaragod, India
| | - Jonathan Nsamba
- Department of Public Health & Community Medicine, Central University of Kerala, Kasaragod, India
| | - Anjaly Joseph
- Department of Public Health & Community Medicine, Central University of Kerala, Kasaragod, India
| | - Elezebeth Mathews
- Department of Public Health & Community Medicine, Central University of Kerala, Kasaragod, India
| | | |
Collapse
|
29
|
Sevilla-Gonzalez MDR, Manning AK, Westerman KE, Aguilar-Salinas CA, Deik A, Clish CB. Metabolomic markers of glucose regulation after a lifestyle intervention in prediabetes. BMJ Open Diabetes Res Care 2022; 10:10/5/e003010. [PMID: 36253014 PMCID: PMC9577902 DOI: 10.1136/bmjdrc-2022-003010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/16/2022] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Disentangling the specific factors that regulate glycemia from prediabetes to normoglycemia could improve type 2 diabetes prevention strategies. Metabolomics provides substantial insights into the biological understanding of environmental factors such as diet. This study aimed to identify metabolomic markers of regression to normoglycemia in the context of a lifestyle intervention (LSI) in individuals with prediabetes. RESEARCH DESIGN AND METHODS We conducted a single-arm intervention study with 24 weeks of follow-up. Eligible study participants had at least one prediabetes criteria according to the American Diabetes Association guidelines, and body mass index between 25 and 45 kg/m2. LSI refers to a hypocaloric diet and >150 min of physical activity per week. Regression to normoglycemia (RNGR) was defined as achieving hemoglobin A1c (HbA1c) <5.5% in the final visit. Baseline and postintervention plasma metabolomic profiles were measured using liquid chromatography-tandem mass spectrometry. To select metabolites associated with RNGR, we conducted the least absolute shrinkage and selection operator-penalized regressions. RESULTS The final sample was composed of 82 study participants. Changes in three metabolites were significantly associated with regression to normoglycemia; N-acetyl-D-galactosamine (OR=0.54; 95% CI 0.32 to 0.82), putrescine (OR=0.90, 95% CI 0.81 to 0.98), and 7-methylguanine (OR=1.06; 95% CI 1.02 to 1.17), independent of HbA1c and weight loss. In addition, metabolomic perturbations due to LSI displayed enrichment of taurine and hypotaurine metabolism pathway (p=0.03) compatible with biomarkers of protein consumption, lower red meat and animal fats and higher seafood and vegetables. CONCLUSIONS Evidence from this study suggests that specific metabolomic markers have an influence on glucose regulation in individuals with prediabetes after 24 weeks of LSI independently of other treatment effects such as weight loss.
Collapse
Affiliation(s)
- Magdalena Del Rocio Sevilla-Gonzalez
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Metabolism Program, The Broad Insitute of MIT and Harvard, Cambridge, MA, USA
- Unidad de Investigacion en Enfermedades Metabólicas, Insituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México City, Mexico
| | - Alisa K Manning
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Metabolism Program, The Broad Insitute of MIT and Harvard, Cambridge, MA, USA
| | - Kenneth E Westerman
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Metabolism Program, The Broad Insitute of MIT and Harvard, Cambridge, MA, USA
| | - Carlos Alberto Aguilar-Salinas
- Unidad de Investigacion en Enfermedades Metabólicas, Insituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México City, Mexico
| | - Amy Deik
- Metabolomics Platform, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Clary B Clish
- Metabolomics Platform, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| |
Collapse
|
30
|
Sathish T, Shaw JE. We Need Lifestyle Modification Trials for the Reversal of Impaired Fasting Glucose. Am J Prev Med 2022; 63:664-665. [PMID: 36137669 DOI: 10.1016/j.amepre.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 04/08/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Thirunavukkarasu Sathish
- Department of Global Health, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | | |
Collapse
|
31
|
Hepatic Steatosis Index and the Risk of Type 2 Diabetes Mellitus in China: Insights from a General Population-Based Cohort Study. DISEASE MARKERS 2022; 2022:3150380. [PMID: 35968500 PMCID: PMC9365599 DOI: 10.1155/2022/3150380] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022]
Abstract
Purpose In the Chinese population, we looked at the relationship between the hepatic steatosis index (HSI) and the risk of type 2 diabetes mellitus (T2DM). Methods To evaluate the association between HSI and the risk of T2DM, Cox regression models were employed. Hazard ratios (HR) and 95 percent confidence intervals (CI) were computed. A stratified analysis with interaction testing was also carried out. Additionally, we evaluated the incremental predictive value of the HSI over the established risk factors using the C-statistic, the IDI, and the NRI. Results During a median follow-up period of 2.97 years, 433 (1.97%) participants developed new-onset T2DM. The smoothing curve fit plot showed a positive correlation between HSI and the risk of T2DM. After adjusting for all noncollinear variables, the risk of T2DM increased by 62% for every 1 standard deviation (SD) increase in HSI. Subgroup analysis indicated that higher HSI levels were associated with a higher risk of T2DM in those aged < 40 years. The addition of HSI enhanced the reclassification and discrimination of established risk factors, with an IDI of 0.027 and an NRI of 0.348 (both P < 0.001). Conclusion Our findings suggest that an elevated HSI is substantially associated with a greater risk of T2DM in the Chinese population. HSI has the potential to be an available and supplementary monitoring method for the management of T2DM risk stratification in the Chinese population.
Collapse
|
32
|
Rocca-Nación J, Calderon M. Cardiovascular risk, fatty liver disease, glucose and insulin curve among prediabetes phenotypes in Peruvian population. AMERICAN JOURNAL OF MEDICINE OPEN 2022; 7:100007. [PMID: 39035828 PMCID: PMC11256264 DOI: 10.1016/j.ajmo.2022.100007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/15/2022] [Accepted: 01/22/2022] [Indexed: 07/23/2024]
Abstract
Aims To describe the cardiovascular risks, fatty liver disease, and glucose and insulin curve among prediabetes phenotypes (PPh) in Peruvian population. Methods A study was carried out using a secondary database of a series of patients with identified risk factors for diabetes mellitus type 2 in one clinic in Lima, Peru. Patients were divided according with the OGTT in impaired glucose 2h or IGT(Pph1), impaired fasting glucose or IFG(Pph3) or both(Pph2). Results 259 patients were identified for analysis, 149 of whom had normal OGTT, 94 had prediabetes (36.3%), and 16 diabetes (6.2%). We found that 37(39.4%), 37(39.4%) and 20(21.2%) presented Pph1, Pph-2 and Pph-3 respectively. Most of the cardiovascular risks and hepatic function comparison showed no difference in our study sample groups. However, we found that Pph2 showed significantly higher abnormalities in HDL-c, triglycerides, hepatic steatosis, and HOMA-IR compared with normal OGTT group (p < 0.05). Interestingly, this difference was not seen with the other phenotypes. Also, hepatic steatosis was higher in Pph2 compared to Pph3 (p < 0.05). HOMA-IR was high in Phenotype 2 compared with Phenotype 1. Regarding hepatic steatosis, this was high in all prediabetes phenotypes, however we found this to be of statistical significance in Pph2 compared to Pph3 (p < 0.01). Conclusions In general, prediabetes phenotypes show a similar association with cardiovascular risk factors and hepatic steatosis, however, Pph2 show more differences in specific comparisons. We believe that this study is a starting point for further investigation to understand prediabetes in Peruvian population and be able to improve disease risk stratification.
Collapse
Affiliation(s)
- Jesus Rocca-Nación
- Endocrinology Department, Ricardo Palma Clinic, Av. Javier Prado Este 1066, San Isidro, Lima, Peru
| | - Maria Calderon
- Newcastle Upon Tyne Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, NE14LP, United Kingdom
- HAMPI: Consultores en Salud, Lima, Peru
| |
Collapse
|
33
|
Abu-Zaiton A, Alsohaili S, Aljamal A, Algaramseh A, Habash M, Abu-Zaitoo Y, Abu-Samak M. Physiological and Biochemical Changes in Diabetic Rats Treated with Combined Extracts of Artemisia herba-alba and Anabasis syriaca. INT J PHARMACOL 2022. [DOI: 10.3923/ijp.2022.1084.1092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
34
|
Coppell KJ, Abel S, Whitehead LC, Tangiora A, Spedding T, Tipene-Leach D. A diagnosis of prediabetes when combined with lifestyle advice and support is considered helpful rather than a negative label by a demographically diverse group: A qualitative study. Prim Care Diabetes 2022; 16:301-306. [PMID: 34953750 DOI: 10.1016/j.pcd.2021.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/16/2021] [Accepted: 10/02/2021] [Indexed: 12/14/2022]
Abstract
AIMS The aim of this study was to explore the experience and perceptions of a diagnosis of prediabetes among a demographically diverse sample of New Zealanders who had, and had not, regressed to normoglycaemia following participation in a primary care nurse-delivered intervention for 6 months. The sample included Indigenous Māori who have high rates of diabetes and associated co-morbidities. METHODS A purposefully selected sample of 58 people with prediabetes and BMI >25 kg/m2, stratified by male/female, Māori/non-Māori, and those who had/had not regressed to normoglycaemia, after completing 6-months of a prediabetes intervention were interviewed. Interviews were audio-recorded and transcribed. Data were analysed by thematic analysis. RESULTS Most participants recalled being shocked when told they had prediabetes, but they did not perceive the diagnosis to be a label in a negative sense, and some, described the diagnosis as helpful. Participants appreciated knowing that prediabetes could be reversed, and the opportunity to be able to take supported action and make lifestyle changes through the nurse-delivered prediabetes lifestyle intervention. Participants' clear preference was to take control and make dietary changes, not to take Metformin. CONCLUSIONS Prediabetes was not considered a negative label, but an opportunity, when coupled with a primary care nurse-delivered dietary intervention.
Collapse
Affiliation(s)
- Kirsten J Coppell
- Department of Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | - Sally Abel
- Kaupapa Consulting Ltd., 52 Vigor Brown St, Napier 4110, New Zealand
| | - Lisa C Whitehead
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia
| | | | - Terrie Spedding
- Health Hawke's Bay, 100 McLeod Street, Hastings 4120, New Zealand
| | - David Tipene-Leach
- Eastern Institute of Technology, 501 Gloucester Street, Taradale, Napier 4112, Hawke's Bay, New Zealand
| |
Collapse
|
35
|
Wang M, Zhang Z, Huo Q, Wang M, Sun Y, Liu H, Chang J, He B, Liang Y. Targeted Polymeric Nanoparticles Based on Mangiferin for Enhanced Protection of Pancreatic β-Cells and Type 1 Diabetes Mellitus Efficacy. ACS APPLIED MATERIALS & INTERFACES 2022; 14:11092-11103. [PMID: 35199981 DOI: 10.1021/acsami.1c22964] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Mangiferin (MGF) is found in many natural plants, such as Rhizoma Anemarrhenae, and has anti-diabetes effects. However, its clinical applications and development are limited by poor solubility and low-concentration enrichment in pancreatic islets. In this paper, targeted polymeric nanoparticles were constructed for MGF delivery with the desired drug loading content (6.86 ± 0.60%), excellent blood circulation, and missile-like delivery to the pancreas. Briefly, Glucagon-like peptide 1 (GLP-1) as an active targeting agent to the pancreas was immobilized on the block copolymer polyethyleneglycol-polycaprolactone (PEG-PCL) to obtain final GLP-1-PEG-PCL amphiphiles. Spherical MGF-loaded polymeric nanoparticles were acquired from the self-assembly of the targeted GDPP nanoparticles and MGF with a homogeneous size of 158.9 ± 1.7 nm and a negative potential for a good steady state in circulation. In this drug vehicle, GLP-1 acts as the missile vanguard via the GLP-1 receptor on the surface of the pancreas for improving the accumulation and efficiency of MGF in the pancreas, the hypoglycemic effect of MGF, and the restorative effect on pancreatic islets, which were investigated. As compared to free MGF, MGF/GDPP nanoparticles appeared to be more concentrated in the pancreas, with better blood glucose and glucose tolerance, enhanced insulin levels, increased β-cell proliferation, reduced β-cell apoptosis, and islet repair in vivo. This targeted drug delivery system provided a novel strategy and hope for enhancing MGF delivery and anti-diabetes efficacy.
Collapse
Affiliation(s)
- Mengdi Wang
- Department of Pharmaceutics, School of Pharmacy, Qingdao University, Qingdao 266073, China
| | - Zhuoran Zhang
- Department of Dentistry, Qingdao Special Service Sanatorium of PLA Navy, Qingdao 266021, China
| | - Qingqing Huo
- Department of Pharmaceutics, School of Pharmacy, Qingdao University, Qingdao 266073, China
| | - Maolong Wang
- Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Yong Sun
- Department of Pharmaceutics, School of Pharmacy, Qingdao University, Qingdao 266073, China
| | - Hongling Liu
- Department of Pharmacy, Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Jing Chang
- College of Marine Life Science, Ocean University of China, Qingdao 266003, China
| | - Bin He
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Yan Liang
- Department of Pharmaceutics, School of Pharmacy, Qingdao University, Qingdao 266073, China
| |
Collapse
|
36
|
Mathews E, Sathish T, Joseph A, Kodapally B, Thulaseedharan JV, Narayan KMV, Oldenburg B, Thankappan KR. Effectiveness and implementation of a lifestyle modification intervention for women with isolated impaired fasting glucose: Study protocol for a hybrid type 2 study in Kerala, India. Wellcome Open Res 2022; 7:62. [PMID: 36865369 PMCID: PMC9971662 DOI: 10.12688/wellcomeopenres.17631.1] [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] [Accepted: 02/01/2022] [Indexed: 01/21/2023] Open
Abstract
Background: Isolated impaired fasting glucose (i-IFG) constitutes a major group in the prediabetic spectrum among Indians, and thus it is imperative to identify effective diabetes prevention strategies. This study aims to evaluate the effects of an intensive community-based lifestyle modification program on regression to normoglycemia among women with i-IFG, compared to a control group at 24 months. The study also aims to evaluate the implementation of the intervention, via both process and implementation outcomes. Methods: We will use a hybrid design (Effectiveness-implementation hybrid type 2 trial) to test the effectiveness and implementation of the lifestyle modification intervention. Effectiveness is evaluated using a randomized controlled trial among 950 overweight or obese women, aged 30 to 60 years, with i-IFG on an oral glucose tolerance test in the Indian state of Kerala. The intervention involves an intensive lifestyle modification program through group and individually mentored sessions using behavioural determinants and behavioural change techniques. The intervention group will receive the intervention for a period of 12 months and the control group will receive general health advice through a health education booklet. Data on behavioural, clinical, and biochemical measures will be collected using standard methods at 12 and 24 months. The primary outcome will be regression to normoglycemia at 24 months, as defined by the American Diabetes Association criteria. Discussion: This study will provide the first evidence on the effects of lifestyle interventions on regression to normoglycemia in people with i-IFG among Indians. CTRI registration: CTRI/2021/07/035289 (30/07/2021).
Collapse
Affiliation(s)
- Elezebeth Mathews
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, 671320, India,
| | | | - Anjaly Joseph
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, 671320, India
| | - Bhagieshwari Kodapally
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, 671320, India
| | - Jissa Vinoda Thulaseedharan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 675011, India
| | - KM Venkat Narayan
- Emory Global Diabetes Research Center, Emory University, Atlanta, Georgia, GA 30322, USA
| | - Brian Oldenburg
- Baker Heart and Diabetes Institute, Baker Heart and Diabetes Institute, Melbourne, Victoria, Victoria 3004, Australia
| | | |
Collapse
|
37
|
Han YM, Yang H, Huang QL, Sun ZJ, Li ML, Zhang JB, Deng KJ, Chen S, Lin H. Risk prediction of diabetes and pre-diabetes based on physical examination data. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2022; 19:3597-3608. [PMID: 35341266 DOI: 10.3934/mbe.2022166] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Diabetes is a metabolic disorder caused by insufficient insulin secretion and insulin secretion disorders. From health to diabetes, there are generally three stages: health, pre-diabetes and type 2 diabetes. Early diagnosis of diabetes is the most effective way to prevent and control diabetes and its complications. In this work, we collected the physical examination data from Beijing Physical Examination Center from January 2006 to December 2017, and divided the population into three groups according to the WHO (1999) Diabetes Diagnostic Standards: normal fasting plasma glucose (NFG) (FPG < 6.1 mmol/L), mildly impaired fasting plasma glucose (IFG) (6.1 mmol/L ≤ FPG < 7.0 mmol/L) and type 2 diabetes (T2DM) (FPG > 7.0 mmol/L). Finally, we obtained1,221,598 NFG samples, 285,965 IFG samples and 387,076 T2DM samples, with a total of 15 physical examination indexes. Furthermore, taking eXtreme Gradient Boosting (XGBoost), random forest (RF), Logistic Regression (LR), and Fully connected neural network (FCN) as classifiers, four models were constructed to distinguish NFG, IFG and T2DM. The comparison results show that XGBoost has the best performance, with AUC (macro) of 0.7874 and AUC (micro) of 0.8633. In addition, based on the XGBoost classifier, three binary classification models were also established to discriminate NFG from IFG, NFG from T2DM, IFG from T2DM. On the independent dataset, the AUCs were 0.7808, 0.8687, 0.7067, respectively. Finally, we analyzed the importance of the features and identified the risk factors associated with diabetes.
Collapse
Affiliation(s)
- Yu-Mei Han
- Beijing Physical Examination Center, Beijing, China
| | - Hui Yang
- School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Qin-Lai Huang
- School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Zi-Jie Sun
- School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | | | | | - Ke-Jun Deng
- School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Shuo Chen
- Beijing Physical Examination Center, Beijing, China
| | - Hao Lin
- School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu 610054, China
| |
Collapse
|
38
|
Hafiz MS, Campbell MD, Orsi NM, Mappa G, Orfila C, Boesch C. Impact of food processing on postprandial glycaemic and appetite responses in healthy adults: a randomized, controlled trial. Food Funct 2022; 13:1280-1290. [PMID: 35024710 DOI: 10.1039/d1fo02304g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Chickpeas are among the lowest glycaemic index carbohydrate foods eliciting protracted digestion and enhanced satiety responses. In vitro studies suggest that mechanical processing of chickpeas significantly increases starch digestion. However, there is little evidence regarding the impact of processing on postprandial glycaemic response in response to chickpea intake in vivo. Therefore, the aim of this study was to determine the effect of mechanical processing on postprandial interstitial glycaemic and satiety responses in humans. In a randomised crossover design, thirteen normoglycaemic adults attended 4 separate laboratory visits following an overnight fast. On each occasion, one of four test meals, matched for available carbohydrate content and consisting of different physical forms of chickpeas (whole, puree, and pasta) or control (mashed potato), was administered followed by a subsequent standardised lunch meal. Continuous glucose monitoring captured interstitial glucose responses, accompanied by periodic venous blood samples for retrospective analysis of C-peptide, glucagon like peptide-1 (GLP-1), ghrelin, leptin, resistin, and cortisol. Subjective appetite responses were measured by Visual Analogue Scale (VAS). Postprandial glycaemic responses were comparable between chickpea treatments albeit significantly lower than the control (p < 0.001). Similarly, all chickpea treatments elicited significantly lower C-peptide and GLP-1 responses compared to the control (p < 0.05), accompanied by enhanced subjective satiety responses (p < 0.05), whilst no significant differences in satiety hormones were detected among different intervention groups (p > 0.05). Chickpea consumption elicits low postprandial glycaemic responses and enhanced subjective satiety responses irrespective of processing methods.
Collapse
Affiliation(s)
- Maryam S Hafiz
- School of Food Science and Nutrition, University of Leeds, Leeds, UK. .,Faculty of Applied Medical Sciences, Department of Clinical Nutrition, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - Matthew D Campbell
- School of Nursing and Health Sciences, Faculty of Health Sciences and Wellbeing, University of Sunderland, UK.,Wellcome-MRC Institute of Metabolic Science, University of Cambridge, UK.,Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, UK
| | - Nicolas M Orsi
- Leeds Institute of Cancer & Pathology, St James's University Hospital, Leeds, UK
| | - Georgia Mappa
- Leeds Institute of Cancer & Pathology, St James's University Hospital, Leeds, UK
| | - Caroline Orfila
- School of Food Science and Nutrition, University of Leeds, Leeds, UK.
| | - Christine Boesch
- School of Food Science and Nutrition, University of Leeds, Leeds, UK.
| |
Collapse
|
39
|
|
40
|
Sathish T. Lifestyle-based precision medicine for reducing diabetes incidence in people with prediabetes. Prim Care Diabetes 2022; 16:215. [PMID: 34974996 DOI: 10.1016/j.pcd.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/09/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022]
|
41
|
Xu Y, Zheng S, Jiang S, Chen J, Zhu X, Zhang Y. The effect of Chinese herbal formulas combined with metformin on modulating the gut microbiota in the amelioration of type 2 diabetes mellitus: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2022; 13:927959. [PMID: 36187136 PMCID: PMC9521410 DOI: 10.3389/fendo.2022.927959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/15/2022] [Indexed: 12/02/2022] Open
Abstract
UNLABELLED To assess and analyse the effectiveness and safety of combined Chinese herbal formula (CHF) and metformin treatment in the modulation of the gut microbiota in the amelioration of type 2 diabetes mellitus(T2DM), all publications addressing the effect of this combination treatment on the quantitative alterations in the gut microbiota and glucose parameters were collected. Rob tool in the Cochrane handbook was performed to evaluate the methodological quality of all included studies. Relevant information and statistics were abstracted and synthesized in Review Manager 5.4 to evaluate the efficacy of combination treatment. Sensitivity analyses and subgroup analyses were used to analyse the sources of heterogeneity. Publication bias analyses were performed by Stata software to assess the robustness and quality of the outcomes. As a result, a total of 12 eligible RCTs with 1307 T2DM participants from 7 electronic databases were included. Combined CHF with metformin treatment showed better efficacies than metformin monotherapy in regulating the structure of the gut microbiota, characterized by increased Bifidobacterium, Lactobacillus and Bacteroidetes and decreased Enterobacteriaceae, Enterococcus, and Saccharomyces along with better decreases in glycated haemoglobin, fasting plasma glucose, 2-hour postprandial blood glucose, fasting insulin and homeostasis model assessment of insulin resistance. Subgroup analyses further analysed the effect of metformin doses and CHF classifications on controlling hyperglycaemia and altering the gut microbiota. In conclusion, our meta-analysis suggested that combined CHF with metformin treatment is promising for the modulation of the gut microbiota along with ameliorating hyperglycemia in T2DM patients. Importantly, more well-designed RCTs are needed to validate the outcomes and verify the treatment value for clinical purposes. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021291524, identifier CRD42021291524.
Collapse
|
42
|
Wanger L, Gar C, Rippl M, Kern-Matschilles S, Potzel A, Haschka S, Seissler J, Hesse N, Lechner A. Function outperforms morphology in the assessment of muscular contribution to insulin sensitivity in premenopausal women. Diab Vasc Dis Res 2022; 19:14791641211070281. [PMID: 35358403 PMCID: PMC8977731 DOI: 10.1177/14791641211070281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Skeletal muscle contributes significantly to insulin sensitivity in humans. However, which non-invasive measurement best reflects this contribution remains unknown. Consequently, this paper compares morphologic and functional measurements. RESEARCH METHODS AND DESIGN We conducted a cross-sectional analysis of 144 premenopausal women enrolled in the "Prediction, Prevention, and Sub-classification of Type 2 Diabetes" (PPSDiab) cohort study. For the analysis, we quantified insulin sensitivity by oral glucose tolerance testing and, in a subgroup of 30 women, euglycemic clamp. To assess skeletal muscle, we measured volume by magnetic resonance imaging, intramyocellular lipid content by magnetic resonance spectroscopy, and physical fitness by cardiopulmonary exercise testing. RESULTS The mean age of the cohort was 35.7 ± 4.1 years and 94 participants (65%) had a history of gestational diabetes mellitus. Of the morphologic and functional muscle parameters, the maximum workload achieved during cardiopulmonary exercise testing associated most closely with insulin sensitivity (standardized beta = 0.39; p < .001). Peak oxygen uptake also demonstrated significant associations, whereas muscle volume and intramyocellular lipid content displayed none. CONCLUSION Functional measurements provided a better assessment of the muscular contribution to insulin sensitivity than morphologic measurements in premenopausal women. In particular, exercise testing rendered an easy and cost-effective method applicable in clinical settings and other human studies.
Collapse
Affiliation(s)
- Lorena Wanger
- Diabetes Research Group, Medizinische Klinik und Poliklinik
IV, LMU Klinikum, München, Germany
| | - Christina Gar
- Klinik und Poliklinik für Radiologie,
LMU Klinikum, München, Germany
- Clinical Cooperation Group Type 2
Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research
(DZD), Neuherberg, Germany
| | - Michaela Rippl
- Diabetes Research Group, Medizinische Klinik und Poliklinik
IV, LMU Klinikum, München, Germany
| | - Stefanie Kern-Matschilles
- Klinik und Poliklinik für Radiologie,
LMU Klinikum, München, Germany
- Clinical Cooperation Group Type 2
Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research
(DZD), Neuherberg, Germany
| | - Anne Potzel
- Klinik und Poliklinik für Radiologie,
LMU Klinikum, München, Germany
- Clinical Cooperation Group Type 2
Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research
(DZD), Neuherberg, Germany
| | - Stefanie Haschka
- Klinik und Poliklinik für Radiologie,
LMU Klinikum, München, Germany
- Clinical Cooperation Group Type 2
Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research
(DZD), Neuherberg, Germany
| | - Jochen Seissler
- Klinik und Poliklinik für Radiologie,
LMU Klinikum, München, Germany
- Clinical Cooperation Group Type 2
Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research
(DZD), Neuherberg, Germany
| | - Nina Hesse
- Diabetes Research Group, Medizinische Klinik und Poliklinik
IV, LMU Klinikum, München, Germany
| | - Andreas Lechner
- Klinik und Poliklinik für Radiologie,
LMU Klinikum, München, Germany
- Clinical Cooperation Group Type 2
Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research
(DZD), Neuherberg, Germany
| |
Collapse
|
43
|
Sathish T, Tapp RJ, Shaw JE. Do lifestyle interventions reduce diabetes incidence in people with isolated impaired fasting glucose? Diabetes Obes Metab 2021; 23:2827-2828. [PMID: 34432366 DOI: 10.1111/dom.14529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 01/24/2023]
Affiliation(s)
| | - Robyn J Tapp
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| |
Collapse
|
44
|
Navas-Carretero S, San-Cristobal R, Siig Vestentoft P, Brand-Miller JC, Jalo E, Westerterp-Plantenga M, Simpson EJ, Handjieva-Darlenska T, Stratton G, Huttunen-Lenz M, Lam T, Muirhead R, Poppitt S, Pietiläinen KH, Adam T, Taylor MA, Handjiev S, McNarry MA, Hansen S, Brodie S, Silvestre MP, Macdonald IA, Boyadjieva N, Mackintosh KA, Schlicht W, Liu A, Larsen TM, Fogelholm M, Raben A, Martinez JA. Appraisal of Triglyceride-Related Markers as Early Predictors of Metabolic Outcomes in the PREVIEW Lifestyle Intervention: A Controlled Post-hoc Trial. Front Nutr 2021; 8:733697. [PMID: 34790686 PMCID: PMC8592084 DOI: 10.3389/fnut.2021.733697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/24/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Individuals with pre-diabetes are commonly overweight and benefit from dietary and physical activity strategies aimed at decreasing body weight and hyperglycemia. Early insulin resistance can be estimated via the triglyceride glucose index {TyG = Ln [TG (mg/dl) × fasting plasma glucose (FPG) (mg/dl)/2]} and the hypertriglyceridemic-high waist phenotype (TyG-waist), based on TyG x waist circumference (WC) measurements. Both indices may be useful for implementing personalized metabolic management. In this secondary analysis of a randomized controlled trial (RCT), we aimed to determine whether the differences in baseline TyG values and TyG-waist phenotype predicted individual responses to type-2 diabetes (T2D) prevention programs. Methods: The present post-hoc analyses were conducted within the Prevention of Diabetes through Lifestyle intervention and population studies in Europe and around the world (PREVIEW) study completers (n = 899), a multi-center RCT conducted in eight countries (NCT01777893). The study aimed to reduce the incidence of T2D in a population with pre-diabetes during a 3-year randomized intervention with two sequential phases. The first phase was a 2-month weight loss intervention to achieve ≥8% weight loss. The second phase was a 34-month weight loss maintenance intervention with two diets providing different amounts of protein and different glycemic indices, and two physical activity programs with different exercise intensities in a 2 x 2 factorial design. On investigation days, we assessed anthropometrics, glucose/lipid metabolism markers, and diet and exercise questionnaires under standardized procedures. Results: Diabetes-related markers improved during all four lifestyle interventions. Higher baseline TyG index (p < 0.001) was associated with greater reductions in body weight, fasting glucose, and triglyceride (TG), while a high TyG-waist phenotype predicted better TG responses, particularly in those randomized to physical activity (PA) of moderate intensity. Conclusions: Two novel indices of insulin resistance (TyG and TyG-waist) may allow for a more personalized approach to avoiding progression to T2D. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT01777893 reference, identifier: NCT01777893.
Collapse
Affiliation(s)
- Santiago Navas-Carretero
- Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red (CIBER) obn, Instituto de Salud Carlos III, Madrid, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | | | - Pia Siig Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jennie C Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Margriet Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Elizabeth J Simpson
- Division of Physiology, Pharmacology and Neuroscience, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom
| | | | - Gareth Stratton
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea, United Kingdom
| | - Maija Huttunen-Lenz
- Institute of Nursing Science, University of Education, Schwäbisch Gmünd, Germany
| | - Tony Lam
- NetUnion Sarl, Lausanne, Switzerland
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Sally Poppitt
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Diabetes and Obesity Research Program, University of Helsinki and Endocrinology, Helsinki, Finland.,Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tanja Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Moira A Taylor
- Division of Physiology, Pharmacology and Neuroscience, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom
| | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Melitta A McNarry
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea, United Kingdom
| | - Sylvia Hansen
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany
| | - Shannon Brodie
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Marta P Silvestre
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Center for Health Technology Services Research (CINTESIS), NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Ian A Macdonald
- Division of Physiology, Pharmacology and Neuroscience, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom
| | - Nadka Boyadjieva
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Kelly A Mackintosh
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea, United Kingdom
| | - Wolfgang Schlicht
- Exercise and Health Sciences, University of Stuttgart, Nobelstraße, Germany
| | - Amy Liu
- Human Nutrition Unit, Department of Medicine, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Thomas M Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | - J Alfredo Martinez
- Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red (CIBER) obn, Instituto de Salud Carlos III, Madrid, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| |
Collapse
|
45
|
Gong Q, Zhang P, Wang J, Gregg EW, Cheng YJ, Li G, Bennett PH. Efficacy of lifestyle intervention in adults with impaired glucose tolerance with and without impaired fasting plasma glucose: A post hoc analysis of Da Qing Diabetes Prevention Outcome Study. Diabetes Obes Metab 2021; 23:2385-2394. [PMID: 34212465 PMCID: PMC8429240 DOI: 10.1111/dom.14481] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/04/2021] [Accepted: 06/27/2021] [Indexed: 12/28/2022]
Abstract
AIMS The extent that pre-diabetic fasting plasma glucose (FPG) levels influence the effectiveness of lifestyle interventions in preventing type 2 diabetes (T2DM) is uncertain. We aimed to determine if the outcome of lifestyle intervention in people with impaired glucose tolerance (IGT) differs in those with normal or impaired FPG levels. MATERIALS AND METHODS Data were used from the Da Qing Diabetes Prevention Outcome Study, which was a 30-year follow-up of a 6-year randomized trial of lifestyle intervention in 576 people with IGT. We then conducted a post-hoc analysis to compare the efficacy of intervention to reduce the incidence of T2DM and its complications in those with baseline FPG <100 mg/dL and FPG ≥100 mg/dL. RESULTS Lifestyle intervention reduced the cumulative incidence of T2DM by 37%-46% in those with baseline FPG <100 mg/dL and by 47%-51% in those with FPG ≥100 mg/dL. The FPG <100 mg/dL group had a lower cumulative incidence of diabetes and 6.41 years median delay in its onset compared with 2.21 years delay in the FPG ≥100 mg/dL group. In those with FPG <100 mg/dL intervention was associated with at least as great a reduction in cardiovascular disease and all-cause mortality as in the FPG ≥100 mg/dL group. CONCLUSIONS Lifestyle intervention reduced the incidence of T2DM in people with IGT regardless of baseline FPG levels, and in those with FPG <100 mg/dL led to a substantial delay in its onset. All persons with IGT, with normal or impaired FPG levels, may benefit from lifestyle intervention to delay its onset and mitigate the incidence of T2DM.
Collapse
Affiliation(s)
- Qiuhong Gong
- Endocrinology and Cardiovascular Disease Center, National Center of Cardiology &Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ping Zhang
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Edward W. Gregg
- Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
| | - Yiling J. Cheng
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Guangwei Li
- Endocrinology and Cardiovascular Disease Center, National Center of Cardiology &Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- China–Japan Friendship Hospital, Beijing, China
| | - Peter H. Bennett
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | | |
Collapse
|
46
|
Gong W, Yang S, Zhang F, Tian F, Chen J, Yin Z, Ding S, Yang W, Luo R. A dual-quenched ECL immunosensor for ultrasensitive detection of retinol binding protein 4 based on luminol@AuPt/ZIF-67 and MnO 2@CNTs. J Nanobiotechnology 2021; 19:272. [PMID: 34496877 PMCID: PMC8425071 DOI: 10.1186/s12951-021-01020-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/30/2021] [Indexed: 11/14/2022] Open
Abstract
Background Retinol binding protein 4 (RBP4) has been regarded as an important serological biomarker for type 2 diabetes mellitus (T2DM). Hence, the construction of a highly sensitive detection method for RBP4 is the key to early prevention and multidisciplinary intervention of T2DM. In this work, a dual-quenched electrochemiluminescence (ECL) immunosensor has been fabricated for ultrasensitive detection of RBP4 by combining zeolitic imidazolate framework-67/AuPt-supported luminol (luminol@AuPt/ZIF-67) with MnO2 nanosheets-grown on carbon nanotubes (MnO2@CNTs). Results AuPt/ZIF-67 hybrids with high-efficiency peroxidase-like activity could provide multipoint binding sites for luminol and antibodies and significantly boost the amplified initial signal of the ECL immunosensor. Upon glutathione/H2O2 coreactants system, MnO2@CNTs composites could quench the initial signal by inhibiting mimic peroxidase activity of luminol@AuPt/ZIF-67. Moreover, the absorption spectrum of the MnO2@CNTs composites completely overlaps with the emission spectrum of luminol, which can further reduce initial signal by ECL resonance energy transfer (ECL-RET). Conclusions Benefiting from the above-mentioned properties, the designed immunoassay sensitivity exhibited excellent sensitivity and relative stability for RBP4 detection range from 0.0001 to 100 ng mL−1 with a low detection limit of 43 fg mL−1. Therefore, our ECL immunosensor provides an alternative assaying strategy for early diagnosis of T2DM. Graphic abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12951-021-01020-1.
Collapse
Affiliation(s)
- Wei Gong
- Medical Examination Centre, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.,Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Suqing Yang
- Chongqing Testing & Lnspection Center for Medical Devices, Chongqing, 400016, China
| | - Fen Zhang
- Medical Examination Centre, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.,Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Fengshun Tian
- Medical Examination Centre, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.,Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Junman Chen
- Key Laboratory of Clinical Laboratory Diagnostics (Ministry of Education), College of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, China
| | - Zhigang Yin
- Key Laboratory of Clinical Laboratory Diagnostics (Ministry of Education), College of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, China
| | - Shijia Ding
- Key Laboratory of Clinical Laboratory Diagnostics (Ministry of Education), College of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, China
| | - Wei Yang
- Key Laboratory of Clinical Laboratory Diagnostics (Ministry of Education), College of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, China.
| | - Rong Luo
- Medical Examination Centre, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. .,Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
| |
Collapse
|
47
|
Guerra JVS, Dias MMG, Brilhante AJVC, Terra MF, García-Arévalo M, Figueira ACM. Multifactorial Basis and Therapeutic Strategies in Metabolism-Related Diseases. Nutrients 2021; 13:nu13082830. [PMID: 34444990 PMCID: PMC8398524 DOI: 10.3390/nu13082830] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 12/11/2022] Open
Abstract
Throughout the 20th and 21st centuries, the incidence of non-communicable diseases (NCDs), also known as chronic diseases, has been increasing worldwide. Changes in dietary and physical activity patterns, along with genetic conditions, are the main factors that modulate the metabolism of individuals, leading to the development of NCDs. Obesity, diabetes, metabolic associated fatty liver disease (MAFLD), and cardiovascular diseases (CVDs) are classified in this group of chronic diseases. Therefore, understanding the underlying molecular mechanisms of these diseases leads us to develop more accurate and effective treatments to reduce or mitigate their prevalence in the population. Given the global relevance of NCDs and ongoing research progress, this article reviews the current understanding about NCDs and their related risk factors, with a focus on obesity, diabetes, MAFLD, and CVDs, summarizing the knowledge about their pathophysiology and highlighting the currently available and emerging therapeutic strategies, especially pharmacological interventions. All of these diseases play an important role in the contamination by the SARS-CoV-2 virus, as well as in the progression and severity of the symptoms of the coronavirus disease 2019 (COVID-19). Therefore, we briefly explore the relationship between NCDs and COVID-19.
Collapse
Affiliation(s)
- João V. S. Guerra
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Graduate Program in Pharmaceutical Sciences, Faculty Pharmaceutical Sciences, University of Campinas, Campinas 13083-970, Brazil
| | - Marieli M. G. Dias
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Graduate Program in Functional and Molecular Biology, Institute of Biology, State University of Campinas (Unicamp), Campinas 13083-970, Brazil;
| | - Anna J. V. C. Brilhante
- Graduate Program in Functional and Molecular Biology, Institute of Biology, State University of Campinas (Unicamp), Campinas 13083-970, Brazil;
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biorenewables National Laboratory (LNBR), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil
| | - Maiara F. Terra
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Graduate Program in Functional and Molecular Biology, Institute of Biology, State University of Campinas (Unicamp), Campinas 13083-970, Brazil;
| | - Marta García-Arévalo
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Correspondence: or (M.G.-A.); (A.C.M.F.)
| | - Ana Carolina M. Figueira
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Correspondence: or (M.G.-A.); (A.C.M.F.)
| |
Collapse
|
48
|
Hung HC, Wu HT, Lin CH, Chou HW, Ou HY, Chang CJ. Associations between GDF15 levels and pre-diabetes in non-obese subjects. J Investig Med 2021; 70:79-84. [PMID: 34376526 DOI: 10.1136/jim-2021-001805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 12/24/2022]
Abstract
Growth differentiation factor 15 (GDF15) is a stress-response cytokine which belongs to the transforming growth factor β superfamily. Although GDF15 was initially found to have a role in metabolic diseases, the association between GDF15 and dysglycemic status remains inconclusive. Thus, the aim of this study was to examine the relationships between GDF15 and different glycemic statuses in non-obese subjects. We enrolled 502 non-obese subjects, among individuals who had normal glucose tolerance (NGT; n=125), isolated impaired fasting glucose (IFG; n=116), isolated impaired glucose tolerance (IGT; n=106), IFG plus IGT (n=27), and newly diagnosed diabetes (NDD; n=128). A multivariate linear regression analysis of GDF15 levels was used to find independent predictors. The median (IQR) GDF15 levels were 1641.0 (1187.0-1985.5) pg/mL, 1656.1 (1226.8-2379.7) pg/mL, 1487.8 (1145.9-1987.2) pg/mL, 1722.2 (1172.9-1939.0) pg/mL, and 2204.5 (1767.4-2919.1) pg/mL in NGT, IFG, IGT, IFG plus IGT, and NDD groups, respectively. The NDD group had significantly higher GDF15 levels than those with NGT, IFG, IGT, and IFG plus IGT. The IFG group had a significantly higher GDF15 value than the NGT group. In multivariate linear regression analysis, IFG (beta=0.145, 95% CI 192.487 to 740.937, p=0.001), NDD (beta=0.227, 95% CI 390.459 to 888.145, p<0.001), and high-sensitivity C reactive protein (beta=0.105, 95% CI 3.276 to 27.768, p=0.013) were independently associated with GDF15 levels. Non-obese subjects with isolated IFG and NDD had significantly higher GDF15 levels than those with NGT. In addition, A1C was independently associated with GDF15 levels. IFG and NDD, but not isolated IGT or IFG plus IGT, were positively associated with GDF15 levels.
Collapse
Affiliation(s)
- Hao-Chang Hung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Hung-Tsung Wu
- Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Han Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Hsuan-Wen Chou
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Horng-Yih Ou
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Jen Chang
- Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan
| |
Collapse
|
49
|
Lonardo A, Mantovani A. Clearing hepatitis C virus with direct antiviral agents reduces cardiovascular events in patients with prediabetes. Commentary to Sasso and colleagues. Nutr Metab Cardiovasc Dis 2021; 31:2354-2357. [PMID: 34154889 DOI: 10.1016/j.numecd.2021.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 02/07/2023]
Abstract
Liver health is a key determinant of cardiovascular risk (CVR). Hepatic fibrosis is the shared common result of chronic hepatitis, irrespective of aetiology. Fibrosis profoundly distorts liver tissue architecture and perturbs hepatic physiology, dictates the course of chronic liver disease and is increasingly recognized as a CVR factor. The relative weights of pre-diabetes and hepatic fibrosis as risk factors for major adverse cardiac events (MACE) in patients with HCV remain an open issue. Sasso and Colleagues answered this research question by treating approximately half of 770 HCV positive pre-diabetic patients with direct antiviral agents (DAAs), while the rest served as historical controls. Data have shown that achieving HCV clearance with DAAs was associated with a 60% reduced risk of MACE, thereby implying that this antiviral strategy is recommended in HCV positive pre-diabetic patients, regardless of the severity of liver disease and concurrent CVR factors. This study paves the way for additional studies addressing the molecular patho-mechanisms and changes in the clinical spectrum involved in cardio-metabolic protection following HCV eradication in patients with pre-diabetes.
Collapse
Affiliation(s)
- Amedeo Lonardo
- Metabolic Syndrome Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria, Modena, Italy.
| | - Alessandro Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
| |
Collapse
|
50
|
Verma AK, Goyal Y, Bhatt D, Dev K, Alsahli MA, Rahmani AH, Almatroudi A. A Compendium of Perspectives on Diabetes: A Challenge for Sustainable Health in the Modern Era. Diabetes Metab Syndr Obes 2021; 14:2775-2787. [PMID: 34168477 PMCID: PMC8216699 DOI: 10.2147/dmso.s304751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/23/2021] [Indexed: 12/13/2022] Open
Abstract
Diabetes is a chronic illness. Hyperglycemia is the characteristic of this disorder. Diabetes is a global crisis which affects the economy and health of all nations. Over the last decades, the number of individuals living with diabetes has significantly increased worldwide. Asia is a key epicenter of the emerging diabetes epidemic, with China and India the two nations having the highest number of diabetic people. Economic development, modernization, unhealthy diet, population aging, and sedentary lifestyles are the major factors responsible for the increasing diabetes epidemic. Diabetes is associated with several complications, and cardiovascular disease is the most important cause of morbidity and mortality among people with diabetes. These life-threatening problems can be prevented or delayed by proper management of diabetes. Lifestyle modification is an important factor to decrease the diabetes risk. The frequency of diabetic complications will rise if there is a lack of cost-effective and sustainable interventions. Hence, prevention of diabetes and its complications such as diabetic retinopathy and cardiovascular disease should be a crucial part of all future health-related public policies among all nations. This review summarizes current epidemiological aspects of diabetes in the world along with its complications, preventive measures, and treatment.
Collapse
Affiliation(s)
- Amit K Verma
- Department of Biotechnology, Jamia Millia Islamia, New Delhi, India
| | - Yamini Goyal
- Department of Biotechnology, Jamia Millia Islamia, New Delhi, India
| | - Deepti Bhatt
- Department of Biotechnology, Jamia Millia Islamia, New Delhi, India
| | - Kapil Dev
- Department of Biotechnology, Jamia Millia Islamia, New Delhi, India
| | - Mohammed A Alsahli
- Department of Medical Laboratories, College of Applied Medical Science, Qassim University, Buraidah, 52571, Saudi Arabia
| | - Arshad Husain Rahmani
- Department of Medical Laboratories, College of Applied Medical Science, Qassim University, Buraidah, 52571, Saudi Arabia
| | - Ahmad Almatroudi
- Department of Medical Laboratories, College of Applied Medical Science, Qassim University, Buraidah, 52571, Saudi Arabia
| |
Collapse
|