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Hwang J, Kim H, Kwon O. Dietary patterns and the risk of diabetes in Korean adults: A cross-sectional and prospective cohort study. Nutrition 2024; 125:112491. [PMID: 38865772 DOI: 10.1016/j.nut.2024.112491] [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: 01/07/2024] [Revised: 04/12/2024] [Accepted: 05/01/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE The aim of this study was to identify dietary patterns associated with diabetes in Korean adults and to investigate their association with diabetes risk in both a cross-sectional and prospective study. METHODS Predefined food groups collected by the Korea National Health and Nutrition Examination Survey (KNHANES 2015-2018, n = 19 721) were entered in a reduced rank regression (RRR) model, followed by stepwise linear regression analyses to identify the most predictive dietary patterns. We evaluated the construct validity of dietary patterns in two independent samples from KNHANES 2019 to 2021 (n = 14 223) and the Health Examinees (HEXA) cohort study (n = 30 013). Associations between dietary patterns and diabetes risk were examined using multivariable regression and multivariable-adjusted Cox proportional hazard models, respectively. RESULTS A dietary pattern was identified with high positive loadings for refined white rice, kimchi and salted vegetables, wheat flour and bread, and seasonings, and high negative loadings for whole grains, legumes with tofu and soymilk, poultry, eggs, and plant oils. The higher pattern scores were significantly associated with diabetes risk in KNHANES 2015 to 2018 (male: odds ratio [OR]: 1.59; 95% confidence interval [CI]: 1.35, 1.88; female: OR: 1.37; 95% CI: 1.18, 1.52), KNHANES 2019 to 2021 (male: OR: 1.47; 95% CI: 1.01, 1.69; female: OR: 1.37; 95% CI: 1.18, 1.54), and HEXA study (male: hazard ratio [HR]: 1.10; 95% CI: 1.01, 1.34; female: HR: 1.24; 95% CI: 1.02, 1.52). CONCLUSIONS Dietary patterns derived by RRR followed by stepwise linear regression analyses were associated with increased risks of diabetes among Korean adults.
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Affiliation(s)
- Jiyoung Hwang
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea; Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
| | - Hyesook Kim
- Department of Food and Nutrition, Wonkwang University, Jeonbuk, Republic of Korea
| | - Oran Kwon
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea; Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea.
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Jayedi A, Soltani S, Emadi A, Najafi A, Zargar MS. Efficacy of lifestyle weight loss interventions on regression to normoglycemia and progression to type 2 diabetes in individuals with prediabetes: a systematic review and pairwise and dose-response meta-analyses. Am J Clin Nutr 2024:S0002-9165(24)00729-9. [PMID: 39222689 DOI: 10.1016/j.ajcnut.2024.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 08/21/2024] [Accepted: 08/29/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Current recommendations for weight loss in individuals with prediabetes come from individual trials and are derived from older data. OBJECTIVE To elucidate the dose-dependent impacts of weight loss on participants with prediabetes to determine the optimal magnitude of weight loss required for the implementation of the most effective diabetes prevention program. METHODS We searched PubMed, Scopus, CENTRAL, CINAHL, and grey literature sources to September 2023 for randomized trials ≥6 months that evaluated the efficacy of a lifestyle weight loss intervention on participants with prediabetes. We conducted random-effects pairwise meta-analyses to calculate relative and absolute effects. We performed one-stage weighted mixed-effects meta-analysis to elucidate the dose-response curves. RESULTS 44 randomized trials with 14,742 participants with prediabetes (intervention duration range: 6 to 72 months [median=24 months], average weight loss range: 1% to 9%) were included. Lifestyle weight loss interventions increased regression to normoglycemia by 11 per 100 participants (95%CI: 8 more, 17 more; risk ratio: 1.51, 95%CI: 1.27, 1.80; n=20 trials, GRADE=moderate), and reduced progression to type 2 diabetes by 8 per 100 participants (95%CI: 11 fewer, 6 fewer; risk ratio: 0.59, 95%CI: 0.51, 0.67; n=37, GRADE=moderate). There were no significant or credible differences among subgroups categorized by the type and duration of intervention. Dose-response meta-analyses indicated that the risk of regression to normoglycemia increased and the risk of progression to type 2 diabetes declined in a linear pattern within the range of weight loss from 1% to 9%. CONCLUSIONS Over a median duration of 24 months, with weight loss ranging from 1% to 9%, the relationship between weight loss and the progression to type 2 diabetes, as well as the regression to normoglycemia, follows a linear pattern. Any form of lifestyle weight loss interventions including diet, exercise, or a combination of both, can have beneficial impacts on participants with prediabetes. PROTOCOL REGISTRATION PROSPERO (CRD42023465322).
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Affiliation(s)
- Ahmad Jayedi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom; Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Non-Communicable Disease Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Emadi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
| | - Ali Najafi
- Department of Gastroenterology, Imam Hossein Center For Education, Research and Treatment, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahdieh-Sadat Zargar
- Clinical Research Development Unit, Kowsar Educational, Research and Therapeutic Hospital, Semnan University of Medical Sciences, Semnan, Iran
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Cabré JJ, Barrio F, Vizcaíno J, Martínez A, Mur T, Sagarra R, Dalmau S. Results of the implementation of the DP-TRANSFERS project in Catalonia: a translational method to improve diabetes screening and prevention in primary care. Rev Clin Esp 2024:S2254-8874(24)00112-7. [PMID: 39216807 DOI: 10.1016/j.rceng.2024.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 06/25/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION DP-TRANSFERS is a translational lifestyle intervention project, which follows a previous protocol described in the DE-PLAN-CAT study. OBJECTIVE Analyze the feasibility of reproducing the intensive intervention and estimating the effect of translation in real conditions of clinical practice in primary care. METHODOLOGY Implementation of the face-to-face group intervention adjusted to 2 years. After screening, the intervention consisted of a basic module and a continuity module. Stratifying by clusters (health centers), a representative sample (centers, professionals and participants) was evaluated (FINDRISC > 11 and/or prediabetes) from 2016 to 2020. The effect of the intervention on the incidence of diabetes was analyzed. RESULTS The intervention, feasible in 95 of 123 centers, involved 343 of 647 professionals. Of 2,381 subjects screened, 1,713 participated in the basic module, with 1,186 participants completing the first year and 776 completing the second. 121 participants (7.06%) were diagnosed with diabetes: 77 (4.49%) during the first year; 44 (2.57%) during the second. The bivariate analysis showed that those subjects in whom diabetes affected differed in: previous glycemic status, A1c, HDL-cholesterol, FINDRISC score and adherence to the Mediterranean diet, and in the differences between the beginning and end of the study of: body weight, BMI and abdominal circumference. CONCLUSIONS The intensive intervention substantially reduced (23.6%) the incidence of diabetes compared to that previously estimated in standardized intervention. The following acted as protective factors: a better glycemic status, lower baseline risk, elevated HDL-cholesterol, or achieving a reduction in weight or abdominal circumference during the study.
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Affiliation(s)
- J J Cabré
- Instituto de Investigación en Atención Primaria IDIAP Jordi Gol, Institut Català de la Salut, División de Atención Primaria, Reus-Barcelona, Spain; CAP Sant Pere de Reus, Institut Català de la Salut, División de Atención Primaria, Reus, Tarragona, Spain.
| | - F Barrio
- Instituto de Investigación en Atención Primaria IDIAP Jordi Gol, Institut Català de la Salut, División de Atención Primaria, Reus-Barcelona, Spain; CAP Sant Pere de Reus, Institut Català de la Salut, División de Atención Primaria, Reus, Tarragona, Spain
| | - J Vizcaíno
- Instituto de Investigación en Atención Primaria IDIAP Jordi Gol, Institut Català de la Salut, División de Atención Primaria, Reus-Barcelona, Spain; CAP Salou, Institut Català de la Salut, División de Atención Primaria, Salou, Tarragona, Spain
| | - A Martínez
- CAP El Carmel, Institut Català de la Salut, División de Atención Primaria, Barcelona, Spain
| | - T Mur
- CAP Rubí, Atención Primaria Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - R Sagarra
- Instituto de Investigación en Atención Primaria IDIAP Jordi Gol, Institut Català de la Salut, División de Atención Primaria, Reus-Barcelona, Spain
| | - S Dalmau
- Instituto de Investigación en Atención Primaria IDIAP Jordi Gol, Institut Català de la Salut, División de Atención Primaria, Reus-Barcelona, Spain
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Kourpas E, Makrilakis K, Dafoulas G, Iotova V, Tsochev K, Dimova R, Cardon G, González-Gil EM, Moreno L, Kivelä J, Lindström J, Rurik I, Antal E, Timpel P, Schwartz P, Mavrogianni C, Manios Y, Liatis S. Factors affecting continuous participation in follow-up evaluations during a lifestyle intervention programme for type 2 diabetes prevention: The Feel4Diabetes-study. Diabet Med 2024; 41:e15368. [PMID: 38837852 DOI: 10.1111/dme.15368] [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: 01/05/2024] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 06/07/2024]
Abstract
AIMS Community- and school-based lifestyle interventions are an efficient method of preventing type 2 diabetes in vulnerable populations. Many participants, however, fail to complete the necessary follow-ups. We investigated factors affecting the continuous participation in follow-up evaluations during the Feel4Diabetes-study, a multilevel intervention programme implemented across Europe. METHODS Socioeconomic, sociodemographic and clinical factors were assessed for 2702 participants within six participating countries: Bulgaria and Hungary (low-to-middle-income countries, LMIC), Belgium and Finland (high-income countries, HIC) and Greece and Spain (high-income countries under austerity measures, HICAM). RESULTS Statistically significant differences were detected with respect to sex, control group, education level, employment status, BMI and blood pressure measurements (systolic and diastolic blood pressure). Post hoc analysis revealed significant differences within socioeconomic regions. Higher levels of education were associated with significantly lower attrition in HIC (p < 0.05) and HICAM (p < 0.001), higher employment status was associated with lower attrition in HICAM (p < 0.001) and being female was associated with lower attrition in LMIC (p < 0.001). Surprisingly, the intervention group exhibited higher-than-expected attrition in HIC (p < 0.001) and HICAM (p = 0.003), and lower attrition in LMIC (p = 0.007). When tested together in the same multivariable predictive model, all sociodemographic and socioeconomic variables along with higher BMI retained their statistical significance, while systolic and diastolic blood pressure failed to remain significant. CONCLUSIONS Key socioeconomic and sociodemographic factors along with BMI play a significant role in determining continuous participation in follow-up evaluations during school- and community-based intervention programmes.
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Affiliation(s)
- Elias Kourpas
- Department of Business Administration, Gies College of Business, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Diabetes Centre, Laiko General Hospital, Athens, Greece
| | - George Dafoulas
- Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Kaloyan Tsochev
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Roumyana Dimova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Esther M González-Gil
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Moreno
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Jemina Kivelä
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Lindström
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Patrick Timpel
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Peter Schwartz
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Stavros Liatis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Diabetes Centre, Laiko General Hospital, Athens, Greece
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Zarei I, Eloranta AM, Klåvus A, Väistö J, Lehtonen M, Mikkonen S, Koistinen VM, Sallinen T, Haapala EA, Lintu N, Soininen S, Haikonen R, Atalay M, Schwab U, Auriola S, Kolehmainen M, Hanhineva K, Lakka TA. Eight-year diet and physical activity intervention affects serum metabolites during childhood and adolescence: A nonrandomized controlled trial. iScience 2024; 27:110295. [PMID: 39055945 PMCID: PMC11269805 DOI: 10.1016/j.isci.2024.110295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/16/2024] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
Long-term lifestyle interventions in childhood and adolescence can significantly improve cardiometabolic health, but the underlying molecular mechanisms remain poorly understood. To address this knowledge gap, we conducted an 8-year diet and physical activity intervention in a general population of children. The research revealed that the intervention influenced 80 serum metabolites over two years, with 17 metabolites continuing to be affected after eight years. The intervention primarily impacted fatty amides, including palmitic amide, linoleamide, oleamide, and others, as well as unsaturated fatty acids, acylcarnitines, phospholipids, sterols, gut microbiota-derived metabolites, amino acids, and purine metabolites. Particularly noteworthy were the pronounced changes in serum fatty amides. These serum metabolite alterations could represent molecular mechanisms responsible for the observed benefits of long-term lifestyle interventions on cardiometabolic and overall health since childhood. Understanding these metabolic changes may provide valuable insights into the prevention of cardiometabolic and other non-communicable diseases since childhood.
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Affiliation(s)
- Iman Zarei
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Aino-Maija Eloranta
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Anton Klåvus
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Juuso Väistö
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Marko Lehtonen
- School of Pharmacy, Faculty of Health Science, University of Eastern Finland, Kuopio, Finland
- LC-MS Metabolomics Center, Biocenter Kuopio, Kuopio, Finland
| | - Santtu Mikkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Ville M. Koistinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Food Chemistry and Food Development Unit, Department of Biochemistry, University of Turku, Turku, Finland
| | - Taisa Sallinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Eero A. Haapala
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Niina Lintu
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Sonja Soininen
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Physician and Nursing Services, Health and Social Services Centre, Wellbeing Services County of North Savo, Varkaus, Finland
| | - Retu Haikonen
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Mustafa Atalay
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Seppo Auriola
- School of Pharmacy, Faculty of Health Science, University of Eastern Finland, Kuopio, Finland
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kati Hanhineva
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Food Chemistry and Food Development Unit, Department of Biochemistry, University of Turku, Turku, Finland
| | - Timo A. Lakka
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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Abudigin WI, Bajaber A, Subash-Babu P. Impact of various dietary lipids on amelioration of biomarkers linked to metabolic syndrome in both healthy and diabetic Wistar rats. BMC Nutr 2024; 10:75. [PMID: 38755663 PMCID: PMC11097575 DOI: 10.1186/s40795-024-00881-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The present study was designed to investigate the influence of different dietary lipids (sheep's fat, olive oil, coconut oil, and corn oil) on specific biomarkers associated with metabolic syndrome in both healthy and diabetic rats. METHODS The study designed for 45 days, utilized a male diabetic wistar rat (body weight, 180-220 g) model induced by streptozotocin (45 mg/kg bw). The rats were divided into two sections: five non-diabetic and five diabetic groups, each containing six rats. The first group in each section serving as the control, received a standard diet. Both non-diabetic or diabetic groups, were provided with a standard diet enriched with 15% sheep fat, 15% coconut oil, 15% olive oil, and 15% corn oil, respectively for a duration of 45 days. RESULTS Post-supplementation, both healthy and diabetic control rats exhibited a higher food intake compared to rats supplemented with lipid diet; notably food intake was higher in diabetic control than healthy control. However, rats fed with coconut oil, olive oil and sheep fat showed weight gain at the end of the experiment, in both healthy and diabetic groups. Coconut oil supplementation significantly (p ≤ 0.05) increased HDL-C and total cholesterol level in diabetic groups compared to healthy group, it was confirmed by an increased PPAR-α and ABCA-1 protein level. Olive oil significantly decreased triglyceride, total cholesterol, and LDL-C levels in diabetic rats when compared to sheep fat or coconut oil. Corn oil significantly decreased fasting glucose, total cholesterol and LDL-C levels compared to all other groups. Corn and olive oil supplemented normal groups, found with significant increase in hepatic glucose-lipid oxidative metabolism associated protein, like FGF-21, MSH, ABCA-1, PPAR-γ and decreased lipogenesis proteins like, SREBP and PPAR-α levels. In contrast, sheep grease and coconut oil increased SREBP and PPAR-α expression in both normal and diabetic groups. Most notably, normal and diabetic groups pretreated with sheep grease resulted in increased inflammatory (MCP-1, IL-1β, TLR-4, TNF-α), and oxidative stress markers (LPO, GSH, GPx, SOD and CAT) linked with metabolic complications. CONCLUSION The combination or alternative use of olive oil and corn oil in daily diet may play a significant role in preventing proinflammatory condition associated with insulin resistance and cardiovascular diseases.
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Affiliation(s)
- Weaam I Abudigin
- Department of Food Science and Nutrition, College of Food & Agriculture Sciences, King Saud University, P.O. Box 22452, Riyadh, 11459, Saudi Arabia.
| | - Adnan Bajaber
- Department of Food Science and Nutrition, College of Food & Agriculture Sciences, King Saud University, P.O. Box 22452, Riyadh, 11459, Saudi Arabia
| | - Pandurangan Subash-Babu
- Department of Food Science and Nutrition, College of Food & Agriculture Sciences, King Saud University, P.O. Box 22452, Riyadh, 11459, Saudi Arabia
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Albalawi HFA. The Role of Tele-Exercise for People with Type 2 Diabetes: A Scoping Review. Healthcare (Basel) 2024; 12:917. [PMID: 38727474 PMCID: PMC11083061 DOI: 10.3390/healthcare12090917] [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: 03/27/2024] [Revised: 04/25/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Supervised exercise interventions tend to be more effective than unsupervised exercises or physical activity advice alone. However, people with type 2 diabetes may find it difficult to attend supervised exercise interventions due to several obstacles. Tele-exercise, or utilizing technology to deliver home-based exercise, might be a solution. OBJECTIVE This scoping review aimed to explore clinical trials investigating the impact of tele-exercise interventions in individuals with type 2 diabetes Methods: Four electronic databases were searched for the period up to January 2024 for clinical trials investigating the impact of tele-exercise on health-related outcomes in adults with type 2 diabetes. RESULTS Seven trials involving 460 individuals with type 2 diabetes met the inclusion criteria. In these trials, combined aerobic and resistance exercise programs were the main types delivered remotely. To deliver such programs, both synchronous (n = 4) and asynchronous (n = 3) delivery modes were adopted. Regardless of the delivery mode, all tele-exercise interventions led to improvements in various factors related to type 2 diabetes and its complications, including glycemic control, blood lipids, body composition, functional capacity, muscle strength, and quality of life. The improvements were also found to be as effective as those of supervised exercise. CONCLUSIONS Tele-exercise interventions seem to be feasible and as effective as supervised exercise interventions in terms of improving glycemic control, blood lipids, functional capacity, muscle strength, body composition, and quality of life for people with type 2 diabetes.
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Affiliation(s)
- Hani Fahad A Albalawi
- Department of Health Rehabilitation Sciences, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia
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Guion M, Mandereau-Bruno L, Goria S, Cosson E, Fosse-Edorh S. Eleven-year trends in socioeconomic inequalities in the prevalence and incidence of pharmacologically treated type 2 diabetes in France, 2010-2020. DIABETES & METABOLISM 2024; 50:101509. [PMID: 38216030 DOI: 10.1016/j.diabet.2024.101509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/20/2023] [Accepted: 12/29/2023] [Indexed: 01/14/2024]
Abstract
AIM This study aimed to describe the association between socioeconomic inequalities and the prevalence and incidence of pharmacologically-treated type 2 diabetes in European France over the 2010-2020 period. METHODS Diabetes cases were identified using a validated algorithm from the French National Health Data System. Analysis was restricted to adults aged 45 years and older to focus on type 2 diabetes. Socioeconomic inequalities were measured for all years in European France using the French deprivation index (FDep, 2015 version), which is an area-based deprivation indicator using population-weighted quintiles (Q1 corresponds to the least deprived municipalities). The relative risks of diabetes prevalence and incidence associated with FDep quintiles (Q1 as the reference) were estimated by sex using a log-linear Poisson model adjusted for year, age and French department. The study population was the French health consumers aged 45 years and over (from 24,228,526 in 2010 to 29,772,928 in 2020). RESULTS A positive gradient was observed in the relative risks of type 2 diabetes prevalence and incidence by FDep quintiles over the study period. The strength of the estimated associations increased over the last decade for prevalence among men and women and for incidence among men in the two most deprived quintiles. CONCLUSION Thus, type 2 diabetes prevention should include a proportionate universalism approach, proposing actions of greater intensity in the most deprived areas.
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Affiliation(s)
- Marie Guion
- Department of Non-Communicable Diseases and Trauma, Santé Publique France, Saint-Maurice, France; Recherche en Epidémiologie Nutritionnelle (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Bobigny, France.
| | | | - Sarah Goria
- Data science division, Santé Publique France, Saint-Maurice, France
| | - Emmanuel Cosson
- Recherche en Epidémiologie Nutritionnelle (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Bobigny, France; Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, University of Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, AP-HP, Bobigny, France
| | - Sandrine Fosse-Edorh
- Department of Non-Communicable Diseases and Trauma, Santé Publique France, Saint-Maurice, France
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Manninen S, Tilles-Tirkkonen T, Aittola K, Männikkö R, Karhunen L, Kolehmainen M, Schwab U, Lindström J, Lakka T, Pihlajamäki J. Associations of Lifestyle Patterns with Glucose and Lipid Metabolism in Finnish Adults at Increased Risk of Type 2 Diabetes. Mol Nutr Food Res 2024; 68:e2300338. [PMID: 38308150 DOI: 10.1002/mnfr.202300338] [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: 05/24/2023] [Revised: 10/18/2023] [Indexed: 02/04/2024]
Abstract
SCOPE Various lifestyle and sociodemographic factors have been associated with risk factors for type 2 diabetes (T2D). However, their combined associations with T2D risk factors have been studied much less. MATERIALS AND RESULTS This study investigates cross-sectional associations of lifestyle patterns with T2D risk factors among 2925 adults at increased risk participating in the Stop Diabetes study. Lifestyle patterns are determined using principal component analysis (PCA) with several lifestyle and sociodemographic factors. The associations of lifestyle patterns with measures of glucose and lipid metabolism and serum metabolites analyzed by nuclear magnetic resonance (NMR) spectroscopy are studied using linear regression analysis. "Healthy eating" pattern is associated with better glucose and insulin metabolism, more favorable lipoprotein and fatty acid profiles and lower serum concentrations of metabolites related to inflammation, insulin resistance, and T2D. "High socioeconomic status and low physical activity" pattern is associated with increased serum concentrations of branched-chain amino acids, as are "Meat and poultry" and "Sleeping hours" patterns. "Snacks" pattern is associated with lower serum concentrations of ketone bodies. CONCLUSIONS Our results show, in large scale primary care setting, that healthy eating is associated with better glucose and lipid metabolism and reveal novel associations of lifestyle patterns with metabolites related to glucose metabolism.
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Affiliation(s)
- Suvi Manninen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
| | - Tanja Tilles-Tirkkonen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
| | - Kirsikka Aittola
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
| | - Reija Männikkö
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
| | - Leila Karhunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, KYS, 70029, Finland
| | - Jaana Lindström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, 00271, Finland
| | - Timo Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, 70211, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, KYS, 70029, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, 70100, Finland
| | - Jussi Pihlajamäki
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, KYS, 70029, Finland
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10
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Fan Y, Li Z, Shi J, Liu S, Li L, Ding L, Zhao J, Pan Y, Lei H, He T, Li W, Li X, Mi Y, Ma L. The association between prepregnancy dietary fatty acids and risk of gestational diabetes mellitus: A prospective cohort study. Clin Nutr 2024; 43:484-493. [PMID: 38194788 DOI: 10.1016/j.clnu.2023.12.022] [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: 08/04/2023] [Revised: 12/12/2023] [Accepted: 12/29/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND & AIMS Epidemiologic studies have examined the association between dietary fatty acids and type 2 diabetes risk in general populations. Evidence regarding their associations with gestational diabetes mellitus (GDM) risk remains limited. This study aimed to evaluate prepregnancy fatty acids intake in relation to GDM risk. METHODS 3,725 pregnant women from the Xi'an Birth Cohort Study who were free of previous GDM or pre-existing chronic diseases were included. Dietary intake of total fat and individual fatty acids (including saturated fatty acids [SFA], monounsaturated fatty acids [MUFA], polyunsaturated fatty acids [PUFA], and trans fatty acids) during the year preceding pregnancy was assessed by a validated food-frequency questionnaire before 16 weeks of gestation. GDM was confirmed based on the 75-g oral glucose tolerance test. Log-binomial or modified Poisson regression models were applied to estimate the relative risks (RRs) and 95 % confidence intervals (95%CIs) of GDM for fatty acids intake. Generalized linear regression was adopted for blood glucose levels with fatty acids intake. RESULTS 644 (17.3 %) incident GDM cases were confirmed in our study. Participants in the highest intake of total fat substituting for carbohydrates had a 33 % reduced risk of GDM than those in the lowest intake (RR:0.67; 95%CI:0.55,0.81). For individual fatty acids, only PUFA intake was associated with a lower risk of GDM, with RR comparing extreme tertiles of 0.61 (95%CI:0.49,0.76). Each 2 % increase in energy from total fat and PUFA replacing carbohydrates decreased the risk of GDM by 6 % (95%CI:3 %,9 %) and 15 % (95%CI:9 %,21 %), respectively. Similar inverse associations with intake of total fat and PUFA were observed for blood glucose levels. Further analyses of SFA substitution showed that replacement of 2 % energy from SFA with PUFA and MUFA was associated with 26 % (RR:0.74; 95%CI:0.62,0.88) and 30 % (RR:0.70; 95%CI:0.50, 0.98) decreased risk of GDM, respectively. CONCLUSIONS Greater intake of total fat and PUFA before pregnancy was associated with lower risk of GDM when replacing carbohydrates. Substitution SFA with PUFA and MUFA was also inversely associated with GDM risk. These findings support the important role of optimal dietary fatty acids composition in the prevention of GDM.
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Affiliation(s)
- Yahui Fan
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Zhaofang Li
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Jia Shi
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Sijiao Liu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Lintian Li
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Lu Ding
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Jinping Zhao
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Yunjin Pan
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Haoyuan Lei
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Tongqiang He
- Department of Obstetrics, Northwest Women's and Children's Hospital, Xi'an 710061, China
| | - Weiling Li
- Department of Obstetrics, Xi'an Gaoxin Hospital, Xi'an 710061, China
| | - Xuelan Li
- Department of Obstetrics, The First Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
| | - Yang Mi
- Department of Obstetrics, Northwest Women's and Children's Hospital, Xi'an 710061, China.
| | - Le Ma
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an 710061, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education of China, Xi'an 710061, China.
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11
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Tang L, Lebreton E, Vambergue A, Fosse-Edorh S, Olié V, Barry Y, Weill A, Cosson E, Regnault N. Cross-sectional study examining factors impacting on uptake of postpartum type 2 diabetes screening among women diagnosed with hyperglycaemia in pregnancy. Diabetes Res Clin Pract 2024; 208:111116. [PMID: 38266823 DOI: 10.1016/j.diabres.2024.111116] [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: 10/12/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 01/26/2024]
Abstract
AIMS Early postpartum glucose screening of women with hyperglycaemia in pregnancy (HIP) can identify women who have the highest risk of developing impaired glucose tolerance and T2DM. This study examines the association between demographics, events during pregnancy, socioeconomic status and postpartum T2DM screening. METHODS Using the French National Health Data System, this cross-sectional study included all deliveries where the mother had HIP in France in 2015, (n = 76,862). The odds ratio (OR) for attending postpartum screening was calculated via multi-level logistic regression. RESULTS T2DM screening uptake at six months postpartum was 42·9% [95 % Confidence Interval: 42·6-43·3]. Several characteristics were associated with lower uptake: living in the most deprived area(OR = 0·78[0·74-0·83]); being < 25 years-old (reference age group 25-29;≤17: 0.53 [0·31-0·90];18-24: 0.73[0·69-0·78]); smoking (0·65[0·62-0·68]); obesity (0·93[0·89-0·97]); caesarean delivery (0·95[0·92-0·99]). Factors associated with higher uptake included primiparity (1·30[1·26-1·34]); having followed the French recommendations for HIP screening (1·24[1·20-1·28]); insulin prescription (1·75[1·69-1·81]) and pre-eclampsia (1·30[1·19-1·42]). p < 0.01 is justified due to sample size. CONCLUSION Improving identification of factors affecting postpartum T2DM screening uptake, such as demographics, socioeconomic context and events during pregnancy, may lead to development of target interventions to aide adherence to screening regime and thereby diagnosis of women with prediabetes or diabetes, for whom secondary and tertiary prevention is crucial.
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Affiliation(s)
- Luveon Tang
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France.
| | - Elodie Lebreton
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
| | - Anne Vambergue
- Endocrinology, Diabetology, Metabolism and Nutrition Department, Lille University Hospital, European Genomics Institute for Diabetes, University of Lille, France
| | - Sandrine Fosse-Edorh
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
| | - Valérie Olié
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
| | - Yaya Barry
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
| | - Alain Weill
- EPI-PHARE Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France; Paris 13 University, Sorbonne Paris Cité, AP-HP, Avicenne Hospital, Department of Endocrinology, CRNH-IdF, CINFO, Bobigny, France
| | - Emmanuel Cosson
- Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRA, France
| | - Nolwenn Regnault
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
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12
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Sanchez-Carro Y, de la Torre-Luque A, Vassou C, Lopez-Garcia P, Georgousopoulou E, Pitsavos C, Ayuso-Mateos JL, Panagiotakos D. Effects of elevated emotional symptoms on metabolic disease development: a 10-year follow-up study. Front Psychiatry 2023; 14:1148643. [PMID: 38111613 PMCID: PMC10725934 DOI: 10.3389/fpsyt.2023.1148643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 11/07/2023] [Indexed: 12/20/2023] Open
Abstract
Background In recent decades, the relationship between emotional disorders (i.e., depression and anxiety) and alterations in physiological functions (i.e., inflammation or metabolism) have been well supported. However, studies on a symptom-based approach have provided mixed results. Our study aims to gain insight into how subclinical statuses, featured by elevated depressive and/or anxious symptoms, may influence immunometabolic alterations in the concurrent relationship; and the development of metabolic diseases at 10-year follow-up: diabetes, hypertension and hypercholesterolemia. Methods Data from 758 Greek adults [394 men (aged 41 ± 10 years) and 364 women (aged 37 ± 12 years)] were used. Four groups were created according to the levels of depressive and anxiety symptoms: (1) control group (CG), (2) depressive group (DG), (3) anxiety group (AG) and (4) depressive and anxiety group (DAG). Multi-indicator multi-causes (MIMIC) modeling was used to estimate metabolic function and inflammatory response scores, on a wide selection of blood biomarkers. Finally, a binary logistic regression was carried out to study the influence of symptoms on the development of the aforementioned metabolic diseases on a 10-year follow-up. Results Group membership was not associated with metabolic function score. Conversely, DAG membership was related with higher inflammatory response score (B = 0.20, CI95 = 0.01, 0.40), with respect to the CG (p < 0.05). Both age and sex were significant variables in the calculation of both scores. Regarding disease at 10-year follow-up effect, risk of developing diabetes, hypertension and hypercholesterolemia was associated with age and socioeconomic status. Moreover, DG membership was significant for diabetes risk (OR = 2.08, CI95 = 1.00, 4.22) and DAG for hypercholesterolemia (OR = 1.68, CI95 = 1.16, 2.43). Limitations Data on anti-inflammatory drugs and psychopharmacological medication were not collected in this study. Conclusions Elevated symptoms of depression and anxiety accounts for inflammatory alterations at concurrent relationship and a higher risk of 10-year follow-up metabolic diseases.
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Affiliation(s)
- Yolanda Sanchez-Carro
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Center for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - Alejandro de la Torre-Luque
- Center for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid, Spain
| | - Christina Vassou
- School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Pilar Lopez-Garcia
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Center for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | | | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Center for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
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Wnuk K, Świtalski J, Tatara T, Miazga W, Jopek S, Augustynowicz A, Religioni U, Gujski M. Workplace Interventions for Type 2 Diabetes Mellitus Prevention-an Umbrella Review. Curr Diab Rep 2023; 23:293-304. [PMID: 37728724 PMCID: PMC10520112 DOI: 10.1007/s11892-023-01521-3] [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] [Accepted: 07/27/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE OF REVIEW Type 2 diabetes mellitus (T2DM) is a chronic disease that may lead to severe complications. The main methods of preventing or delaying the onset of T2DM include lifestyle changes. The purpose of this study is to identify and evaluate the effectiveness of workplace interventions aimed at preventing type 2 diabetes. An umbrella review was conducted in accordance with the Cochrane Collaboration guidelines. Searches were performed in Medline (via PubMed), Embase (via OVID), and Cochrane Library databases. The quality assessment of the included studies was performed using the AMSTAR2 tool. RECENT FINDINGS The final analysis included 7 studies. The majority (4 of 7) of the studies included in the review focused on workplace interventions based on the guidelines of the US Diabetes Prevention Program (DPP) or other similar programs. The method of decreasing the risk of type 2 diabetes among employees are programs consisting of multiple approaches aimed at improving parameters associated with diabetes, i.e., body weight, and therefore BMI, reduction, and reducing blood glucose levels, as well as HbA1c levels through educational approach and lifestyle changes. The results of those studies point to multicomponent interventions as more effective than single-component interventions. An effective workplace intervention aimed to reduce the risk of type 2 diabetes among employees is a multicomponent program consisting of elements such as educational activities, interventions targeting dietary changes and increased physical activity.
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Affiliation(s)
- Katarzyna Wnuk
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-826 Warsaw, Poland
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00-032 Warsaw, Poland
| | - Jakub Świtalski
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00-032 Warsaw, Poland
- Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, 01-445 Warsaw, Poland
| | - Tomasz Tatara
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00-032 Warsaw, Poland
- Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Wojciech Miazga
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-826 Warsaw, Poland
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00-032 Warsaw, Poland
| | - Sylwia Jopek
- Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, 01-445 Warsaw, Poland
| | - Anna Augustynowicz
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-826 Warsaw, Poland
- Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, 01-445 Warsaw, Poland
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-826 Warsaw, Poland
| | - Mariusz Gujski
- Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
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Wagner JA, Bermúdez-Millán A, Buckley TE, Buxton OM, Feinn RS, Kong S, Kuoch T, Scully MF. Community-based diabetes prevention randomized controlled trial in refugees with depression: effects on metabolic outcomes and depression. Sci Rep 2023; 13:8718. [PMID: 37253820 DOI: 10.1038/s41598-023-35738-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/23/2023] [Indexed: 06/01/2023] Open
Abstract
Depression and antidepressant medications increase risk for type 2 diabetes. Cambodian-Americans have exceedingly high rates of both depression and diabetes. This paper reports outcomes of a diabetes prevention trial for Cambodian-Americans with depression. Primary outcomes were HbA1c, insulin resistance and depressive symptoms. Participants were aged 35-75, Khmer speaking, at risk for diabetes, and met study criteria for likely depression by either (a) antidepressant medication and/or (b) prolonged elevated depressive symptoms. Participants were randomized to one of three community health worker (CHW) interventions: (1) lifestyle intervention called Eat, Walk, Sleep (EWS), (2) EWS plus medication therapy management sessions with a pharmacist/CHW team to resolve drug therapy problems (EWS + MTM), or, (3) social services (SS; control). Assessments were at baseline, post-treatment (12 months), and follow-up (15 months). The n = 188 participants were 78% female, average age of 55 years, half had a household income < $20,000, and modal educational attainment was 7.0 years. Compared to the other arms, EWS + MTM showed a significant decrease in HbA1c and a trend for reduced inflammation and stress hormones. Depressive symptoms improved for EWS and EWS + MTM relative to SS. There was no change in insulin resistance. Cardiometabolic and mental health can be improved in tandem among immigrant and refugee groups.
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Affiliation(s)
- Julie A Wagner
- University of Connecticut Schools of Medicine and Dental Medicine, UConn Health, 263 Farmington Ave., Farmington, CT, 06030, USA.
| | | | | | | | | | - Sengly Kong
- Khmer Health Advocates, West Hartford, CT, USA
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Salmela J, Konttinen H, Lappalainen R, Muotka J, Antikainen A, Lindström J, Tuomilehto J, Uusitupa M, Karhunen L. Eating behavior dimensions and 9-year weight loss maintenance: a sub-study of the Finnish Diabetes prevention study. Int J Obes (Lond) 2023:10.1038/s41366-023-01300-w. [PMID: 37149709 DOI: 10.1038/s41366-023-01300-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 03/03/2023] [Accepted: 03/17/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Behavioral processes through which lifestyle interventions influence risk factors for type 2 diabetes (T2DM), e.g., body weight, are not well-understood. We examined whether changes in psychological dimensions of eating behavior during the first year of lifestyle intervention would mediate the effects of intervention on body weight during a 9-year period. METHODS Middle-aged participants (38 men, 60 women) with overweight and impaired glucose tolerance (IGT) were randomized to an intensive, individualized lifestyle intervention group (n = 51) or a control group (n = 47). At baseline and annually thereafter until nine years body weight was measured and the Three Factor Eating Questionnaire assessing cognitive restraint of eating with flexible and rigid components, disinhibition and susceptibility to hunger was completed. This was a sub-study of the Finnish Diabetes Prevention Study, conducted in Kuopio research center. RESULTS During the first year of the intervention total cognitive (4.6 vs. 1.7 scores; p < 0.001), flexible (1.7 vs. 0.9; p = 0.018) and rigid (1.6 vs. 0.5; p = 0.001) restraint of eating increased, and body weight decreased (-5.2 vs. -1.2 kg; p < 0.001) more in the intervention group compared with the control group. The difference between the groups remained significant up to nine years regarding total (2.6 vs. 0.1 scores; p = 0.002) and rigid restraint (1.0 vs. 0.4; p = 0.004), and weight loss (-3.0 vs. 0.1 kg; p = 0.046). The first-year increases in total, flexible and rigid restraint statistically mediated the impact of intervention on weight loss during the 9-year study period. CONCLUSIONS Lifestyle intervention with intensive and individually tailored, professional counselling had long-lasting effects on cognitive restraint of eating and body weight in middle-aged participants with overweight and IGT. The mediation analyses suggest that early phase increase in cognitive restraint could have a role in long-term weight loss maintenance. This is important because long-term weight loss maintenance has various health benefits, including reduced risk of T2DM.
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Affiliation(s)
- Jutta Salmela
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Hanna Konttinen
- Social Psychology, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Joona Muotka
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Anne Antikainen
- Endocrinology and Clinical Nutrition, Kuopio University Hospital, Wellbeing Services County of North Savo, Kuopio, Finland
| | - Jaana Lindström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaakko Tuomilehto
- Department of Public Health and Welfare, 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
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Leila Karhunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
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Type 2 Diabetes Prevention Programs-From Proof-of-Concept Trials to National Intervention and Beyond. J Clin Med 2023; 12:jcm12051876. [PMID: 36902668 PMCID: PMC10003211 DOI: 10.3390/jcm12051876] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
The prevention of type 2 diabetes (T2D) in high-risk people with lifestyle interventions has been demonstrated by several randomized controlled trials. The intervention effect has sustained up to 20 years in post-trial monitoring of T2D incidence. In 2000, Finland launched the national T2D prevention plan. For screening for high T2D risk, the non-laboratory Finnish Diabetes Risk Score was developed and widely used, also in other countries. The incidence of drug-treated T2D has decreased steadily since 2010. The US congress authorized public funding for a national diabetes prevention program (NDPP) in 2010. It was built around a 16-visit program that relies on referral from primary care and self-referral of persons with either prediabetes or by a diabetes risk test. The program uses a train-the-trainer program. In 2015 the program started the inclusion of online programs. There has been limited implementation of nationwide T2D prevention programs in other countries. Despite the convincing results from RCTs in China and India, no translation to the national level was introduced there. T2D prevention efforts in low-and middle-income countries are still limited, but results have been promising. Barriers to efficient interventions are greater in these countries than in high-income countries, where many barriers also exist. Health disparities by socioeconomic status exist for T2D and its risk factors and form a challenge for preventive interventions. It seems that a stronger commitment to T2D prevention is needed, such as the successful WHO Framework Convention on Tobacco Control, which legally binds the countries to act.
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Doan L, Nguyen HT, Nguyen TTP, Phan TTL, Huy LD, Nguyen TTH, Doan TP. ModAsian FINDRISC as a Screening Tool for People with Undiagnosed Type 2 Diabetes Mellitus in Vietnam: A Community-Based Cross-Sectional Study. J Multidiscip Healthc 2023; 16:439-449. [PMID: 36814807 PMCID: PMC9940497 DOI: 10.2147/jmdh.s398455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/02/2023] [Indexed: 02/18/2023] Open
Abstract
Purpose Our study aims to evaluate the risk of developing type 2 diabetes mellitus in the next 10 years using ModAsian FINDRISC and additionally explore associated factors among the Vietnam population. Participants and Methods A cross-sectional study was conducted on 2258 participants aged 25 years old or above in Thua Thien Hue Province, Vietnam. The sample size is calculated based on the estimated sensitivity, and participants were randomly selected from different geographical and socio-economic areas. All participants were thoroughly medically examined, taking blood lipid profile and fasting blood glucose, taking blood pressure, anthropometric indexes, 12-lead electrocardiogram, and behavioral factors were investigated using the Vietnamese version of the WHO STEPS toolkit. The risk of developing T2DM was made based on the ModAsian FINDRISC. Results The incidence of developing type 2 diabetes mellitus among the study population was 4.21%. The group with a high or very high risk of developing type 2 diabetes mellitus in the next 10 years accounted for 2.52%. Body mass index (AUC = 0.840, 95% CI: 0.792-0.888), waist circumference (AUC = 0.824, 95% CI: 0.777-0.871), family history of diabetes mellitus (AUC = 0.751, 95% CI = 0.668-0.833), and history of antihypertensive medication use regularly (AUC = 0.708, 95% CI: 0.632-0.784) are the most associated factors of the ModAsian FINDRISC. Residential location (OR = 5.62, 95% CI: 1.91-16.54) and occupational status (OR = 0.35, 95% CI: 0.20-0.62) were significant factors associated with a high and very high risk of developing type 2 diabetes mellitus in the next 10 year. Conclusion Screening for the risk of type 2 diabetes mellitus and implementing intervention programs focusing on controlling weight, waist circumference, and blood pressure are essential for reducing type 2 diabetes mellitus incidence and burden in Vietnam.
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Affiliation(s)
- Long Doan
- Internal Medicine Department, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam
| | - Huong T Nguyen
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam
| | - Thao T P Nguyen
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam
| | - Thi Thuy Linh Phan
- Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam
| | - Le Duc Huy
- Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam
| | - Thi Thuy Hang Nguyen
- Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam
| | - Thuoc Phuoc Doan
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, Vietnam,Correspondence: Thuoc Phuoc Doan, Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Thua Thien Hue, 53000, Vietnam, Tel +84 914932577, Email
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18
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Ghannam N, Alahmed S, Aldahash R, Aljohani N, Alshammary A, Amir A, Kamal A, Khader S, Salah M, Shalabi H, Abdallah A, Elboghdady A. Addressing the Continuum of Dysglycaemia and Vascular Complications in Prediabetes and Type 2 Diabetes: Need for Early and Intensive Treatment. Diabetes Metab Syndr Obes 2023; 16:105-115. [PMID: 36760588 PMCID: PMC9844108 DOI: 10.2147/dmso.s396621] [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: 11/08/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
The onset of type 2 diabetes increases the risk of vascular complications and death. We know now that that this risk begins long before the diabetes diagnosis. Prediabetes and type 2 diabetes are not separate entities in practice and exist within a continuum of dysglycaemia and vascular risk that increases in severity over time. This excess risk requires early intervention with lifestyle therapy supported with pharmacologic antidiabetic therapy, intensified promptly where necessary throughout the duration of the diabetes continuum. Metformin is an evidence-based treatment for preventing prediabetes and improves cardiovascular outcomes in people with type 2 diabetes from diagnosis onwards. Newer agents (SGLT2 inhibitors and GLP-1 agonists) are appropriate for people presenting with type 2 diabetes and significant cardiovascular comorbidity. Additional therapies should be used without delay to achieve patients' individualised HbA1c goals and to minimise cardiovascular risk.
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Affiliation(s)
- Nadia Ghannam
- Ghannam Clinic, Jeddah, Saudi Arabia
- Correspondence: Nadia Ghannam, Ghannam Clinic, King Abdulaziz Road, Jeddah, 21411, Saudi Arabia, Email
| | | | - Raed Aldahash
- Ministry of National Guard (Health Affairs) and King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Afaf Alshammary
- Ministry of National Guard (Health Affairs), King Abdulaziz Medical City, Riyadh and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ashraf Amir
- Family Medicine International Medical Center, Jeddah, Saudi Arabia
| | | | - Said Khader
- Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Mohammed Salah
- Cairo University, Cairo, Egypt and GNP Hospital, Jeddah, Saudi Arabia
| | - Hani Shalabi
- University of Jeddah, Jeddah, Saudi Arabia
- Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
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19
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Silica-Based Nanomaterials for Diabetes Mellitus Treatment. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 10:bioengineering10010040. [PMID: 36671612 PMCID: PMC9855068 DOI: 10.3390/bioengineering10010040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/15/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022]
Abstract
Diabetes mellitus, a chronic metabolic disease with an alarming global prevalence, is associated with several serious health threats, including cardiovascular diseases. Current diabetes treatments have several limitations and disadvantages, creating the need for new effective formulations to combat this disease and its associated complications. This motivated the development of therapeutic strategies to overcome some of these limitations, such as low therapeutic drug bioavailability or poor compliance of patients with current therapeutic methodologies. Taking advantage of silica nanoparticle characteristics such as tuneable particle and pore size, surface chemistry and biocompatibility, silica-based nanocarriers have been developed with the potential to treat diabetes and regulate blood glucose concentration. This review discusses the main topics in the field, such as oral administration of insulin, glucose-responsive devices and innovative administration routes.
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20
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Buysschaert M, Bergman M, Valensi P. 1-h post-load plasma glucose for detecting early stages of prediabetes. DIABETES & METABOLISM 2022; 48:101395. [PMID: 36184047 DOI: 10.1016/j.diabet.2022.101395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
Prediabetes is a very prevalent condition associated with an increased risk of developing diabetes and/or other chronic complications, in particular cardiovascular disorders. Early detection is therefore mandatory since therapeutic interventions may limit the development of these complications. Diagnosis of prediabetes is currently based on glycemic criteria (fasting plasma glucose (PG), and/or glycemia at 120 min during a 75 g oral glucose tolerance test (OGTT) and/or glycated hemoglobin (HbA1c). Accumulating longitudinal evidence suggests that a 1-hour PG ≥155 mg/dl (8.6 mmol/l) during the OGTT is an earlier marker of prediabetes than fasting PG, 2-h post-load PG, or HbA1c. There is substantial evidence demonstrating that the 1-h post-load PG is a more sensitive predictor of type 2 diabetes, cardiovascular disease, microangiopathy and mortality compared with conventional glucose criteria. The aim of this review is to highlight the paramount importance of detecting prediabetes early in its pathophysiological course. Accordingly, as recommended by an international panel in a recent petition, 1-h post-load PG could replace current criteria for diagnosing early stages of "prediabetes" before prediabetes evolves as conventionally defined.
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Affiliation(s)
- M Buysschaert
- Service d'Endocrinologie et Nutrition, Cliniques universitaires UCLouvain Saint-Luc, B-1200 Brussels, Belgium.
| | - M Bergman
- NYU Grossman School of Medicine, Division of Endocrinology, Diabetes and Metabolism, New York, NY, USA
| | - P Valensi
- Unit of Endocrinology-Diabetology-Nutrition. Jean Verdier Hospital, APHP, Paris 13 University, Sorbonne Paris Cité, CINFO, CRNH-IdF. Bondy, France
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21
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Strauss M, Lavie CJ, Lippi G, Brzęk A, Vollenberg R, Sanchis-Gomar F, Leischik R. A systematic review of prevalence of metabolic syndrome in occupational groups - Does occupation matter in the global epidemic of metabolic syndrome? Prog Cardiovasc Dis 2022; 75:69-77. [PMID: 36162483 DOI: 10.1016/j.pcad.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 12/14/2022]
Abstract
Many occupations can influence the development of metabolic syndrome (MetS). This systematic review aims to evaluate studies on MetS prevalence in different occupational groups from different countries. An integrative review of the literature was conducted within the PubMed and Web of Science databases between January 2005 and February 2022. Only studies with over 3000 subjects that presented data about the prevalence of MetS in different occupational groups were included. The classification of occupational groups was based on the statistical category of economic activities in the European Community (EC). Of a total of 1942 screened records, ten studies were included, showing that MetS is a common health (main) risk factor in all occupational groups. However, the prevalence of MetS varies between nationalities, between and within occupational groups, and between genders. The reasons for this variation appear complex and supported by several causal explanations. The prevalence of MetS was highest among women in a group of Korean skilled agricultural, forestry, and fishery workers (Prevalence: 39.2%). Similarly, among men, the highest prevalence was found in Korean equipment, machine operating, and assembling workers (Prevalence: 35.4%). Male information and communication technology professionals from the Netherlands (Prevalence: 6.2%) and Spanish female catering and hospitality, personal, and security service workers (Prevalence: 5.9%) had the lowest rates of MetS. Overall, the results indicated that valid data on this topic are insufficient, and more randomized controlled trials are needed. Moreover, the different definitions of MetS complicate the accurate comparison between studies, paving the way to achieving consensus on a universal definition of MetS.
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Affiliation(s)
- Markus Strauss
- Department of Cardiology I- Coronary and Periphal Vascular Disease, Heart Failure Medicine, University Hospital Muenster, Cardiol, 48149 Muenster, Germany; Department of Cardiology, Faculty of Health, School of Medicine, University Witten/Herdecke, 58455 Witten, Germany.
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School - The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Giuseppe Lippi
- Section of Clinical Biochemistry and School of Medicine, University of Verona, Verona, Italy
| | - Anna Brzęk
- Department of Physiotherapy, Chair of Physiotherapy, Faculty of Health Sciences, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | - Richard Vollenberg
- Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Muenster, 48149 Muenster, Germany
| | - Fabian Sanchis-Gomar
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA.
| | - Roman Leischik
- Department of Cardiology, Faculty of Health, School of Medicine, University Witten/Herdecke, 58455 Witten, Germany
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22
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Khalangot MD, Gurianov VG, Zakharchenko TF, Pysarenko YM, Kravchenko VI. Metabolic and Anthropometric Parameters of Persons at Risk of Developing Type 2 Diabetes Mellitus Before and After 3 Months of Consuming Insoluble Dietary Fiber. Nutr Metab Insights 2022; 15:11786388221125181. [PMID: 36172505 PMCID: PMC9510971 DOI: 10.1177/11786388221125181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Observational studies have shown that insoluble fiber (IF) can be effective
in preventing type 2 diabetes (T2D), but there is a lack of experimental
data on the effect of short-term consumption of IF on metabolic parameters.
We tried to investigate whether there was an improvement in glycemia and
body composition in individuals at risk for T2D after 3 months of IF
consumption. Methods: This “Type 2 Diabetes Mellitus Prevention Ukraine (T2DPUA)” study describes
participants with impaired fasting glucose (IFG) as determined by ADA
criteria. The study involved 30 people, including 21 women (70%). Daily,
15 g of IF derived from wheat was used. T2DPUA did not have a placebo group
and the intervention lasted 3 months. Evaluation of fasting plasma glucose
(FPG) and 2h plasma glucose (2hPG), glycated hemoglobin (HbA1c), total
cholesterol, HDL-cholesterol, triacylglycerols, uric acid, and γ-glutamyl
transferase was performed. The baseline and 3-monthly anthropometric
examinations included measurements of weight, waist and hip circumference.
Fat mass was assessed by bioelectrical impedance analysis. Paired samples
t-test or Wilcoxon test were used. Result: A decrease of FPG (P = .042), HbA1c
(P < .001), 2hPG (P = .005), weight
(P < .001), body mass index
(P < .001), the proportion of body fat
(P = .006), and the absolute amount of fat
(P < .001), increases in systolic
(P < .001) and diastolic (P = .008)
blood pressure was shown. The number of people with hypertension did not
change. The absolute amount of body fat decreased by almost 5% and tolerance
to the standard glucose load improved by 15%. The dynamics of other
metabolic parameters were not revealed. Conclusion and Recommendation: Data about improvement of glycemia and body composition over a short period
of using IF by individuals with IFG are new and deserve larger studies.
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Affiliation(s)
- Mykola D Khalangot
- Endocrinology Department, Shupyk National Healthcare University, Kyiv, Ukraine.,Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - Vitaly G Gurianov
- Medical and Biological Physics and Informatics Department, Bogomolets National Medical University, Kyiv, Ukraine
| | - Tamara F Zakharchenko
- Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | | | - Victor I Kravchenko
- Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
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Identifying Glucose Metabolism Status in Nondiabetic Japanese Adults Using Machine Learning Model with Simple Questionnaire. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:1026121. [PMID: 36118835 PMCID: PMC9481387 DOI: 10.1155/2022/1026121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/01/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022]
Abstract
We aimed to identify the glucose metabolism statuses of nondiabetic Japanese adults using a machine learning model with a questionnaire. In this cross-sectional study, Japanese adults (aged 20–64 years) from Tokyo and surrounding areas were recruited. Participants underwent an oral glucose tolerance test (OGTT) and completed a questionnaire regarding lifestyle and physical characteristics. They were classified into four glycometabolic categories based on the OGTT results: category 1: best glucose metabolism, category 2: low insulin sensitivity, category 3: low insulin secretion, and category 4: combined characteristics of categories 2 and 3. A total of 977 individuals were included; the ratios of participants in categories 1, 2, 3, and 4 were 46%, 21%, 14%, and 19%, respectively. Machine learning models (decision tree, support vector machine, random forest, and XGBoost) were developed for identifying the glycometabolic category using questionnaire responses. Then, the top 10 most important variables in the random forest model were selected, and another random forest model was developed using these variables. Its areas under the receiver operating characteristic curve (AUCs) to classify category 1 and the others, category 2 and the others, category 3 and the others, and category 4 and the others were 0.68 (95% confidence intervals: 0.62–0.75), 0.66 (0.58–0.73), 0.61 (0.51–0.70), and 0.70 (0.62–0.77). For external validation of the model, the same dataset of 452 Japanese adults in Hokkaido was obtained. The AUCs to classify categories 1, 2, 3, and 4 and the others were 0.66 (0.61–0.71), 0.57 (0.51–0.62), 0.60 (0.50–0.69), and 0.64 (0.57–0.71). In conclusion, our model could identify the glucose metabolism status using only 10 factors of lifestyle and physical characteristics. This model may help the larger general population without diabetes to understand their glucose metabolism status and encourage lifestyle improvement to prevent diabetes.
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Jalleh RJ, Xie C, Deane AM, Plummer MP, Jones KL, Horowitz M, Kar P. One-hour plasma glucose level after a 75 g oral glucose load and its relationship to gastric emptying in survivors of critical illness and stress hyperglycaemia. CRIT CARE RESUSC 2022; 24:268-271. [PMID: 38046216 PMCID: PMC10692590 DOI: 10.51893/2022.3.oa6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: A 1-hour plasma glucose level ≥ 8.6 mmol/L in a 75 g oral glucose tolerance test has been strongly associated with increased morbidity and mortality in outpatients without diabetes. Our primary aim was to evaluate the 1-hour plasma glucose level in a 75 g glucose tolerance test in survivors of critical illness with stress hyperglycaemia at 3 months after intensive care unit (ICU) discharge, with the secondary aims to evaluate the 2-hour plasma glucose level, glycated haemoglobin (HbA1c), and gastric emptying. Design:Post hoc analysis of a single-centre, prospective cohort study. Setting: Single-centre, tertiary referral, mixed medical-surgical ICU. Participants: Consecutively admitted patients aged ≥ 18 years who developed stress hyperglycaemia and survived to hospital discharge were eligible. Interventions: Participants returned at 3 months after ICU discharge and underwent a 75 g oral glucose tolerance test. Main outcome measures: One- and 2-hour post load plasma glucose level, HbA1c, and assessment of gastric emptying via an isotope breath test. Results: Thirty-five patients (12 females; mean age, 58.5 years [SD, 10.5]; mean HbA1c, 37.4 mmol/mol [SD, 7.0]) attended the followup. In 32/35 patients (91%) the 1-hour post load plasma glucose level was ≥ 8.6 mmol/L. There was a positive correlation between the plasma glucose level at 1 hour (r2 = 0.21; P = 0.006), but no correlation between the 2-hour glucose level (r2 = 0.006; P = 0.63) and gastric emptying. Conclusion: Glucose intolerance, when defined as 1-hour glucose level ≥ 8.6 mmol/L following a 75 g oral glucose load, persists at 3 months in most survivors of stress hyperglycaemia and is dependent on the rate of gastric emptying. Longitudinal studies to characterise mechanisms underlying dysglycaemia and progression to diabetes in individuals with stress hyperglycaemia are indicated.
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Affiliation(s)
- Ryan J. Jalleh
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, SA, Australia
| | - Cong Xie
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, SA, Australia
| | - Adam M. Deane
- Intensive Care Unit, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Mark P. Plummer
- Intensive Care Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Karen L. Jones
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, SA, Australia
| | - Michael Horowitz
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, SA, Australia
| | - Palash Kar
- Intensive Care Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
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Giosuè A, Calabrese I, Riccardi G, Vaccaro O, Vitale M. Consumption of different animal-based foods and risk of type 2 diabetes: An umbrella review of meta-analyses of prospective studies. Diabetes Res Clin Pract 2022; 191:110071. [PMID: 36067917 DOI: 10.1016/j.diabres.2022.110071] [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: 06/21/2022] [Revised: 07/29/2022] [Accepted: 08/31/2022] [Indexed: 12/27/2022]
Abstract
We performed an umbrella review of dose-response meta-analyses of prospective studies reporting the incidence of type 2 diabetes associated with the consumption of animal-based foods. A systematic search was conducted in PubMed, Web of Science, Scopus, and Embase according to PRISMA. Thirteen meta-analyses are included in the study providing 175 summary risk ratio estimates. The consumption of 100 g/day of total or red meat, or 50 g/day of processed meat, were associated with an increased risk; RR and 95 % CI were respectively 1.20, 1.13-1.27; 1.22, 1.14-1.30 and 1.30, 1.22-1.39. White meat (50 g/day) was associated with an increased risk, but of lesser magnitude (RR 1.04, 95 % CI 1.00-1.08). A risk reduction was reported for 200 g/day of total dairy (RR 0.95, 95 % CI 0.92-0.98) or low-fat dairy (RR 0.96, 95 % CI 0.92-1.00) or milk (RR 0.90, 95 % CI 0.83-0.98), or 100 g/day of yogurt (RR 0.94, 95 % CI 0.90-0.98). No association with diabetes risk was reported for fish or eggs. In conclusions animal-based foods have a different association with diabetes risk. To reduce diabetes risk the consumption of red and processed meat should be restricted; a moderate consumption of dairy foods, milk and yogurt, can be encouraged; moderate amounts of fish and eggs are allowed.
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Affiliation(s)
- Annalisa Giosuè
- Dept. of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - Ilaria Calabrese
- Dept. of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - Gabriele Riccardi
- Dept. of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - Olga Vaccaro
- Dept. of Pharmacy, Federico II University, Naples, Italy.
| | - Marilena Vitale
- Dept. of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
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Seidel-Jacobs E, Kohl F, Tamayo M, Rosenbauer J, Schulze MB, Kuss O, Rathmann W. Impact of applying a diabetes risk score in primary care on change in physical activity: a pragmatic cluster randomised trial. Acta Diabetol 2022; 59:1031-1040. [PMID: 35551495 PMCID: PMC9098381 DOI: 10.1007/s00592-022-01895-y] [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: 03/10/2022] [Accepted: 04/15/2022] [Indexed: 11/29/2022]
Abstract
AIM There is little evidence of the impact of diabetes risk scores on individual diabetes risk factors, motivation for behaviour changes and mental health. The aim of this study was to investigate the effect of applying a noninvasive diabetes risk score in primary care as component of routine health checks on physical activity and secondary outcomes. METHODS Cluster randomised trial, in which primary care physicians (PCPs), randomised (1:1) by minimisation, enrolled participants with statutory health insurance without known diabetes, ≥ 35 years of age with a body mass index ≥ 27.0 kg/m2. The German Diabetes Risk Score was applied as add-on to the standard routine health check, conducted in the controls. Primary outcome was the difference in participants' physical activity (International Physical Activity Questionnaire) after 12 months. Secondary outcomes included body mass index, perceived health, anxiety, depression, and motivation for lifestyle change. Analysis was by intention-to-treat principle using mixed models. RESULTS 36 PCPs were randomised; remaining 30 PCPs (intervention: n = 16; control: n = 14) recruited 315 participants (intervention: n = 153; controls: n = 162). A slight increase in physical activity was observed in the intervention group with an adjusted mean change of 388 (95% confidence interval: - 235; 1011) metabolic equivalents minutes per week. There were no relevant changes in secondary outcomes. CONCLUSIONS The application of a noninvasive diabetes risk score alone is not effective in promoting physical activity in primary care. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (NCT03234322, registration date: July 31, 2017).
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Affiliation(s)
- Esther Seidel-Jacobs
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), 85764 Munich-Neuherberg, Germany
| | - Fiona Kohl
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Miguel Tamayo
- The Association of Statutory Health Insurance Physicians North Rhine, 40474 Düsseldorf, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), 85764 Munich-Neuherberg, Germany
| | - Matthias B. Schulze
- German Center for Diabetes Research (DZD), 85764 Munich-Neuherberg, Germany
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Oliver Kuss
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), 85764 Munich-Neuherberg, Germany
- Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), 85764 Munich-Neuherberg, Germany
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27
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Yan Y, Sun Y, Wang X, Zhu L, Chen Y, Liu Z. Acupuncture for Impaired Glucose Tolerance in People With Obesity: A Protocol for a Multicenter Randomized Controlled Trial. Front Med (Lausanne) 2022; 9:932102. [PMID: 35903320 PMCID: PMC9322107 DOI: 10.3389/fmed.2022.932102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/03/2022] [Indexed: 12/02/2022] Open
Abstract
Background Impaired glucose tolerance (IGT) is associated with being overweight/obesity and is a powerful risk factor for the disease of diabetes. In addition to lifestyle intervention that shows limited clinical application, acupuncture treatment has been a feasible treatment method for IGT in clinical practice. However, the effectiveness of acupuncture treatment has not been proved in evidence-based practice. Therefore, we design a multicenter randomized controlled trial to evaluate the efficacy and safety of acupuncture treatment for IGT in people with overweight/obesity. Methods The trial will be conducted at hospitals in three different sites in China. A total of 196 participants will be recruited and randomly assigned at a ratio of 1:1 to either to the acupuncture group or the sham acupuncture (SA) group. Both groups will receive 30 sessions of treatment for 12 consecutive weeks and will be provided with lifestyle intervention and a 24-week follow-up. The primary outcome will be change in the baseline value of 2-h blood glucose (2hPG) on the 12th week. Additionally, the expectancy of acupuncture, blinding, and safety will also be assessed. All statistical analyses will be performed by two-sided test, and a p-value of less than 0.05 will be considered statically significant. Discussion This study aims to provide quantitative clinical evidence of acupuncture effectiveness and safety in treating IGT in people who are overweight/obese. Clinical Trial Registration [www.ClinicalTrials.gov], identifier [NCT05347030].
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Affiliation(s)
- Yan Yan
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuanjie Sun
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinlu Wang
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lili Zhu
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Chen
- New Zealand College of Chinese Medicine, Auckland, New Zealand
| | - Zhishun Liu
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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28
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Dubé L, Spahis S, Lachaîne K, Lemieux A, Monhem H, Poulin SM, Randoll C, Travaillaud E, Ould-Chikh NEH, Marcil V, Delvin E, Levy E. Specialized Pro-Resolving Mediators Derived from N-3 Polyunsaturated Fatty Acids: Role in Metabolic Syndrome and Related Complications. Antioxid Redox Signal 2022; 37:54-83. [PMID: 35072542 DOI: 10.1089/ars.2021.0156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Significance: Metabolic syndrome (MetS) prevalence continues to grow and represents a serious public health issue worldwide. This multifactorial condition carries the risk of hastening the development of type 2 diabetes (T2D), non-alcoholic fatty liver disease (NAFLD), and cardiovascular diseases (CVD). Another troubling aspect of MetS is the requirement of poly-pharmacological therapy not devoid of side effects. Therefore, there is an urgent need for prospecting alternative nutraceuticals as effective therapeutic agents for MetS. Recent Advances: Currently, there is an increased interest in understanding the regulation of metabolic derangements by specialized pro-resolving lipid mediators (SPMs), especially those derived from the long chain n-3 polyunsaturated fatty acids. Critical Issues: The SPMs are recognized as efficient modulators that are capable of inhibiting the production of pro-inflammatory cytokines, blocking neutrophil activation/recruitment, and inducing non-phlogistic (anti-inflammatory) activation of macrophage engulfment and removal of apoptotic inflammatory cells and debris. The aim of the present review is precisely to first underline key concepts relative to SPM functions before focusing on their status and actions on MetS components (e.g., obesity, glucose dysmetabolism, hyperlipidemia, hypertension) and complications such as T2D, NAFLD, and CVD. Future Directions: Valuable data from preclinical and clinical investigations have emphasized the SPM functions and influence on oxidative stress- and inflammation-related MetS. Despite these promising findings obtained without compromising host defense, additional efforts are needed to evaluate their potential therapeutic applications and further develop practical tools to monitor their bioavailability to cope with cardiometabolic disorders. Antioxid. Redox Signal. 37, 54-83.
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Affiliation(s)
- Laurent Dubé
- Research Centre, Sainte-Justine Hospital, Université de Montréal, Montreal, Canada.,Department of Nutrition, Université de Montréal, Montreal, Canada
| | - Schohraya Spahis
- Research Centre, Sainte-Justine Hospital, Université de Montréal, Montreal, Canada.,Department of Nutrition, Université de Montréal, Montreal, Canada.,Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada
| | - Karelle Lachaîne
- Department of Nutrition, Université de Montréal, Montreal, Canada
| | | | - Hanine Monhem
- Department of Nutrition, Université de Montréal, Montreal, Canada
| | | | - Carolane Randoll
- Department of Nutrition, Université de Montréal, Montreal, Canada
| | - Eva Travaillaud
- Department of Nutrition, Université de Montréal, Montreal, Canada
| | | | - Valérie Marcil
- Research Centre, Sainte-Justine Hospital, Université de Montréal, Montreal, Canada.,Department of Nutrition, Université de Montréal, Montreal, Canada.,Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada
| | - Edgard Delvin
- Research Centre, Sainte-Justine Hospital, Université de Montréal, Montreal, Canada.,Department of Biochemistry, Université de Montréal, Montreal, Canada
| | - Emile Levy
- Research Centre, Sainte-Justine Hospital, Université de Montréal, Montreal, Canada.,Department of Nutrition, Université de Montréal, Montreal, Canada.,Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada.,Department of Pediatrics, Gastroenterology & Hepatology Unit, Université de Montréal, Montreal, Canada
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The effects of an 8-year individualised lifestyle intervention on food consumption and nutrient intake from childhood to adolescence: the PANIC Study. J Nutr Sci 2022; 11:e40. [PMID: 35720174 PMCID: PMC9171599 DOI: 10.1017/jns.2022.13] [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: 11/05/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/15/2022] Open
Abstract
We aimed to investigate the effects of a long-term, individualised, family-based lifestyle intervention on food consumption and nutrient intake from childhood to adolescence. We conducted an 8-year diet and physical activity intervention study in a population sample of children aged 7–9 years at baseline in 2007–2009. We allocated the participants to the intervention group (n 306) and the control group (n 198). We assessed diet by 4-d food records at baseline, 2-year follow-up and 8-year follow-up. We analysed the data using linear mixed-effects models adjusted for age at baseline and sex. The consumption of vegetables and vegetable oil-based spreads (fat ≥60 %) increased in the intervention group but did not change in the control group (P < 0⋅001 for time×group interaction). The consumption of fruits and berries increased in the intervention group but decreased in the control group (P = 0⋅036). The consumption of high-fat cheese (P = 0⋅029), butter-based spreads (P = 0⋅001) and salty snacks (P = 0⋅028) increased less, and the consumption of low-fat cheese (P = 0⋅004) increased more in the intervention group than in the control group. Saturated fat intake (P = 0⋅001) increased less, and the intakes of dietary fibre (P = 0⋅003), vitamin D (P = 0⋅042) and vitamin E (P = 0⋅027) increased more in the intervention group than in the control group. The intakes of vitamin C (P < 0⋅001) and folate (P = 0⋅001) increased in the intervention group but decreased in the control group. To conclude, individualised, family-based lifestyle intervention altered food choices towards more recommended diet and resulted in enhanced diet quality from childhood to adolescence.
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Paul P, Kaul R, Abdellatif B, Arabi M, Upadhyay R, Saliba R, Sebah M, Chaari A. The Promising Role of Microbiome Therapy on Biomarkers of Inflammation and Oxidative Stress in Type 2 Diabetes: A Systematic and Narrative Review. Front Nutr 2022; 9:906243. [PMID: 35711547 PMCID: PMC9197462 DOI: 10.3389/fnut.2022.906243] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 04/08/2022] [Indexed: 12/12/2022] Open
Abstract
Background One in 10 adults suffer from type 2 diabetes (T2D). The role of the gut microbiome, its homeostasis, and dysbiosis has been investigated with success in the pathogenesis as well as treatment of T2D. There is an increasing volume of literature reporting interventions of pro-, pre-, and synbiotics on T2D patients. Methods Studies investigating the effect of pro-, pre-, and synbiotics on biomarkers of inflammation and oxidative stress in T2D populations were extracted from databases such as PubMed, Scopus, Web of Science, Embase, and Cochrane from inception to January 2022. Results From an initial screening of 5,984 hits, 47 clinical studies were included. Both statistically significant and non-significant results have been compiled, analyzed, and discussed. We have found various promising pro-, pre-, and synbiotic formulations. Of these, multistrain/multispecies probiotics are found to be more effective than monostrain interventions. Additionally, our findings show resistant dextrin to be the most promising prebiotic, followed closely by inulin and oligosaccharides. Finally, we report that synbiotics have shown excellent effect on markers of oxidative stress and antioxidant enzymes. We further discuss the role of metabolites in the resulting effects in biomarkers and ultimately pathogenesis of T2D, bring attention toward the ability of such nutraceuticals to have significant role in COVID-19 therapy, and finally discuss few ongoing clinical trials and prospects. Conclusion Current literature of pro-, pre- and synbiotic administration for T2D therapy is promising and shows many significant results with respect to most markers of inflammation and oxidative stress.
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Affiliation(s)
- Pradipta Paul
- Division of Medical Education, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Ridhima Kaul
- Division of Medical Education, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Basma Abdellatif
- Division of Medical Education, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Maryam Arabi
- Division of Premedical Education, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Rohit Upadhyay
- Department of Medicine—Nephrology and Hypertension, Tulane University, School of Medicine, New Orleans, LA, United States
| | - Reya Saliba
- Distributed eLibrary, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Majda Sebah
- Division of Premedical Education, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Ali Chaari
- Division of Premedical Education, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
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31
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van Acht MR, van den Reek JMPA, de Jong EMGJ, Seyger MMB. The Effect of Lifestyle Changes on Disease Severity and Quality of Life in Patients with Plaque Psoriasis: A Narrative Review. PSORIASIS (AUCKLAND, N.Z.) 2022; 12:35-51. [PMID: 35433402 PMCID: PMC9007593 DOI: 10.2147/ptt.s294189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/31/2022] [Indexed: 01/24/2023]
Abstract
Objective To evaluate the effect of lifestyle changes on the severity of psoriasis and the quality of life in patients with psoriasis. Methods For this narrative review, PubMed, Embase and ClinicalTrials.gov were searched for lifestyle intervention studies with an intervention duration of at least 12 weeks. Results Thirty-four intervention studies were included. Most studies performed interventions in the diet of patients with psoriasis (n=9), or added supplements to the diet (n=18). Three studies comprised relaxation techniques and four studies combined relaxation or stress-reducing techniques with an educational program or exercise. No interventional studies were carried out regarding smoking, alcohol and sleep. Especially dietary and relaxation interventions showed promising results with respect to psoriasis severity and dermatology-related QoL, respectively. Regarding dietary supplements, the three largest studies investigating fish oil or vitamin D did not show significant effects. Conclusion There is some evidence that dietary and relaxation interventions could be promising with respect to psoriasis severity and dermatology-related QoL, respectively. Furthermore, our review identified important gaps in psoriasis lifestyle research regarding study design and reporting of outcomes.
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Affiliation(s)
- Maartje R van Acht
- Department of Dermatology, Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands
| | - Juul M P A van den Reek
- Department of Dermatology, Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands
| | - Elke M G J de Jong
- Department of Dermatology, Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands
| | - Marieke M B Seyger
- Department of Dermatology, Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands
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Höld E, Grüblbauer J, Wiesholzer M, Wewerka-Kreimel D, Stieger S, Kuschei W, Kisser P, Gützer E, Hemetek U, Ebner-Zarl A, Pripfl J. Improving glycemic control in patients with type 2 diabetes mellitus through a peer support instant messaging service intervention (DiabPeerS): study protocol for a randomized controlled trial. Trials 2022; 23:308. [PMID: 35422003 PMCID: PMC9009500 DOI: 10.1186/s13063-022-06202-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/26/2022] [Indexed: 12/15/2022] Open
Abstract
Background Diabetes mellitus is one of the four priority non-communicable diseases worldwide. It can lead to serious long-term complications and produces significant costs. Due to the chronicle character of the disease, it requires continuous medical treatment and good therapy adherence of those suffering. Therefore, diabetes self-management education (DSME) (and support DSMES) plays a significant role to increase patient’s self-management capacity and improve diabetes therapy. Research indicates that these outcomes might be difficult to maintain. Consequently, effective strategies to preserve the positive effects of DSMES are needed. Preliminary results show that peer support, which means support from a person who has experiential knowledge of a specific behavior or stressor and similar characteristics as the target population, is associated with better outcomes in terms of HbA1c, cardiovascular disease risk factors or self-efficacy at a lower cost compared to standard therapy. Peer-supported instant messaging services (IMS) approaches have significant potential for diabetes management because support can be provided easily and prompt, is inexpensive, and needs less effort to attend compared to standard therapy. The major objective of the study is to analyze the impact of a peer-supported IMS intervention in addition to a standard diabetes therapy on the glycemic control of type 2 diabetic patients. Methods A total of 205 participants with type 2 diabetes mellitus will be included and randomly assigned to an intervention or control group. Both groups will receive standard therapy, but the intervention group will participate in the peer-supported IMS intervention, additionally. The duration of the intervention will last for 7 months, followed by a follow-up of 7 months. Biochemical, behavioral, and psychosocial parameters will be measured before, in the middle, and after the intervention as well as after the follow-up. Discussion Type 2 diabetes mellitus and other non-communicable diseases put healthcare systems worldwide to the test. Peer-supported IMS interventions in addition to standard therapy might be part of new and cost-effective approaches to support patients independent from time and place. Trial registration ClinicalTrials.govNCT04797429. Registered on 15 March 2021.
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Affiliation(s)
- Elisabeth Höld
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria.
| | - Johanna Grüblbauer
- Institute of Creative\Media/Technologies, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Martin Wiesholzer
- Department of Internal Medicine I, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - Daniela Wewerka-Kreimel
- Bachelor Degree Program Dietetics, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Stefan Stieger
- Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | - Werner Kuschei
- Department of Internal Medicine I, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - Philip Kisser
- Fachbereich Versorgungsmanagement 3, Austrian Health Insurance Fund, St. Pölten, Austria
| | - Elisabeth Gützer
- Fachbereich Versorgungsmanagement 3, Austrian Health Insurance Fund, St. Pölten, Austria
| | - Ursula Hemetek
- Bachelor Degree Program Dietetics, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Astrid Ebner-Zarl
- Institute of Creative\Media/Technologies, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Jürgen Pripfl
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria.,Christian Doppler Forschungsgesellschaft, Vienna, Austria
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Peng X, Li J, Zhao H, Lai J, Lin J, Tang S. Lifestyle as well as metabolic syndrome and non-alcoholic fatty liver disease: an umbrella review of evidence from observational studies and randomized controlled trials. BMC Endocr Disord 2022; 22:95. [PMID: 35399069 PMCID: PMC8996397 DOI: 10.1186/s12902-022-01015-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND & AIMS Recent epidemiological studies have indicated that NAFLD is pathologically associated with a sedentary lifestyle, unhealthy dietary habits and metabolic syndrome. An umbrella review of meta-analyses was performed to summarize the quality of evidence regarding the epidemiologic associations between lifestyle, metabolic syndrome, and non-alcoholic fatty liver disease (NAFLD) in regards to risk and treatment. METHODS We searched PubMed, Web of Science and Embase Database from inception until June 1, 2021. Meta-analyses of observational studies and randomized controlled trials (RCTs) examining the associations of lifestyle as well as metabolic syndrome with NAFLD risk or treatment were screened. We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their P values, 95% prediction intervals, heterogeneity, and small-study effects. For meta-analyses of RCTs, outcomes with a random-effect P < 0.005 and a high-GRADE assessment were classified as strong evidence. RESULTS A total of 37 publications were included in this review: twenty-two publications reporting 41 meta-analyses of observational studies (37 unique outcomes) and 15 publications reporting 81 meta-analyses of RCTs (63 unique outcomes) met the inclusion criteria. Methodological quality was high for 97% of the included meta-analyses. Quality of evidence was rated high only for the association of sugar-sweetened soda consumption with increased NAFLD risk in meta-analyses of observational studies. Only 3 therapeutic interventions (green tea improving ALT, TG, TC and LDL, omega-3 PUFAs improving HOMR-IR and plasma glucose, and exercise improving RT and ALT) from meta -analyses of RCTs with suggestive (change to high/low/etc) levels of evidence were identified. CONCLUSION Despite many meta-analyses exploring the associations of lifestyle as well as metabolic syndrome with the risk or treatment of NAFLD, robust clinical RCTs are needed to further investigate the associations between lifestyle modifications and incidence of NAFLD or therapeutic effects on disease progression.
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Affiliation(s)
- Xiaojuan Peng
- Department of Endocrinology, Liuzhou People's Hospital, Liuzhou, Guangxi, 545006, PR China
| | - Juan Li
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, 510630, PR China
- Department of Infectious Disease, The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121001, PR China
| | - Hailiang Zhao
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, 510630, PR China
| | - Junlong Lai
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, 510630, PR China
| | - Junqin Lin
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, 510630, PR China
| | - Shaohui Tang
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, 510630, PR China.
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Vandenberghe D. Simulating lifestyle and medical interventions to prevent type-2 diabetes: an economic evaluation for Belgium. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:237-248. [PMID: 34390431 DOI: 10.1007/s10198-021-01362-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 07/29/2021] [Indexed: 06/13/2023]
Abstract
By 2040, over half a billion people globally are expected to have diabetes. This disease implies a loss in life quality and comes with a significant financial impact. To avoid prevalence increases in the main category of diabetes-type-2 diabetes (T-2D)-, preventive action among high-risk groups is necessary. Lifestyle and medical interventions with metformin among prediabetic individuals show strong potential to decrease or delay T-2D. The aim of this paper is to evaluate the cost-effectiveness and budget impact of a nation-wide implementation of these interventions, between 2020 and 2040, in Belgium. This is done through a dynamic, non-homogeneous, semi-Markov model which simulates prevalence and costs of a type of prediabetes (impaired glucose tolerance or IGT) and T-2D in Belgium. High-risk individuals are first screened; individuals with IGT then enroll in a lifestyle or metformin program. Compared to no intervention, both programs are very cost effective from the perspective of the health care system and cost-saving from a broader societal perspective. Both interventions require an initial, affordable government investment and later yield government savings. The lifestyle program is a cost-effective alternative to the metformin intervention and may yield additional benefits through, for example, improvements in mental health.
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Affiliation(s)
- Désirée Vandenberghe
- Department of Economics, Faculty of Economics and Business Administration, Ghent University, Tweekerkenstraat 2, 9000, Ghent, Belgium.
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Pizarro Â, Martins M, Simões J. Exploring the Policies Applied to Pharmaceutical Care Practice for Type 2 Diabetes over the Last Decade in European Community Pharmacies. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2021. [DOI: 10.1159/000519498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In the last decade (2010–2020), more than half of European countries have improved their health policies within the primary care for type 2 diabetes mellitus. Community pharmacies have been and could continue to be essential actors in this evolution of fighting the disease by providing a set of pharmacotherapeutic follow-up services for the person with diabetes. These services, designated by the Pharmaceutical Group of the European Union as “diabetes management” and “glucose measurement”, have aimed to optimize adherence to therapy and improve health outcomes. However, to follow the European guidelines of Good Pharmacy Practice, providing these services implies having a normative framework or a legal basis. Thus, this study sought to analyze the normative and regulatory framework on which community pharmacies in 28 European countries were based on providing this health care over the last decade.
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Franch-Nadal J, Fornos JA, Melogno Klinkas M, Rodríguez de Miguel M, Rodríguez-Fortúnez P, Lizán L, de Paz HD, Lería Gelabert M. Management of prediabetes from the perspective of Spanish physicians and community pharmacists: Detecta2 study. ENDOCRINOL DIAB NUTR 2021; 68:708-715. [PMID: 34924159 DOI: 10.1016/j.endien.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/22/2020] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Prediabetes is a high-risk state for diabetes. The study aims to describe routine clinical practice and the views of physicians and pharmacists on prediabetes management. MATERIALS AND METHODS An observational, descriptive, cross-sectional study was conducted using a structured questionnaire. RESULTS A total of 410 physicians and 393 pharmacists completed the questionnaire. Self-adherence to clinical practice guidelines (CPGs) was reported by 51.5% and 23.2% of physicians and pharmacists, respectively. Less than 60% of participants defined prediabetes according to main CPG. Regarding the use of screening strategies to detect prediabetes (physicians: 96%; pharmacists: 42.1%), reports indicate the opportunistic strategy is widely employed (≥75%) whereas systematic screening is unusual (<20%). Changes in lifestyle were deemed essential by almost all participants (≥95%), but in clinical practice only 58.3% of healthcare centers and 28.0% of pharmacies were found to provide awareness-raising/instruction. The role of pharmacists in the prevention of prediabetes/diabetes was judged useful by most participants. CONCLUSIONS Use of CPG, systematic prediabetes screening strategies, and specific strategies for patient education are scarce. The support of community pharmacists in prediabetes management was well valued. Therefore, it is crucial that the lines of action followed by both physicians and pharmacists align with each other and with the CPG.
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Affiliation(s)
- Josep Franch-Nadal
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain; CAP Drassanes Raval-Sud, Barcelona, Spain
| | | | | | | | | | - Luis Lizán
- Outcomes'10, S.L., Castellón de la Plana, Spain; Medicine Department, Jaume I University, Castellón de la Plana, Spain
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Exploring the provision and motives behind the adoption of health-promotion programmes in professional football clubs across four European countries. PLoS One 2021; 16:e0259458. [PMID: 34797842 PMCID: PMC8604315 DOI: 10.1371/journal.pone.0259458] [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: 05/20/2021] [Accepted: 10/19/2021] [Indexed: 11/19/2022] Open
Abstract
This study mapped existing health-promotion provisions targeting adults in professional football clubs across England, the Netherlands, Norway, and Portugal, and explored motives behind the clubs’ adoption of the European Fans in Training (EuroFIT) programme. We surveyed top-tier football clubs in the four countries and interviewed representatives from football clubs and the clubs’ charitable foundation who delivered EuroFIT. The findings showed large between-country differences, with football clubs in England reporting far greater healthy lifestyle provision than other countries. Relatively few health-promotion programmes targeted adults, particularly in the Netherlands, Portugal, and Norway. Club representatives reported that the motives for adopting the EuroFIT programme often involved adhering to both the social objectives of the football club or club’s foundation and business-related objectives. They viewed the scientific evidence and evaluation underpinning EuroFIT as helpful in demonstrating the value and potential future impact of both the programme and the clubs’ wider corporate social responsibility provision.
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Li Y, Shen H, Li Y, Bi M, Bi Y, Che X, Tian S, Liu Y. Sex-Specific Differences in the Associations Between Omega-6 Polyunsaturated Fatty Acids and Type 2 Diabetes in Chinese People. Front Nutr 2021; 8:739850. [PMID: 34746208 PMCID: PMC8568790 DOI: 10.3389/fnut.2021.739850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/27/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Some evidence indicates a potential beneficial effect of omega-6 polyunsaturated fatty acids (n-6 PUFAs) on type 2 diabetes mellitus (T2DM); however, the findings to date remains inconclusive and little is known about whether sex modifies these associations. Therefore, this study aimed to investigate potential sex-specific differences in this associations among Chinese adults. Methods: We conducted a cross-sectional study in an area of Dalian city, China; Chinese men and women who attended the Department of Clinical Nutrition and Metabolism between January and December 2020 were invited to participate in this study. All participants were assessed for basic demographic characteristics, fasting blood glucose, HbA1c, and other serum biomarkers and serum phospholipid FAs. Results: In total, 575 Chinese adult participants (270 men and 305 women) were included in the analysis. Hypertension and dyslipidaemia were more common among men than women, but there were no significant differences between the sexes in fatty acid composition, except for eicosadienoic acid (EA; 20:2n-6) and total monounsaturated fatty acids (MUFA). The age-adjusted OR for having T2DM in the highest quartile of arachidonic acid (20:4n-6) level was 0.47 (95% CI, 0.22, 0.98) in men, and this association remained consistently significant in the fully adjusted multivariate models. In contrast, no significant associations between n-6 PUFAs and T2DM risk were observed in women, regardless of model adjustment. Conclusions: In conclusion, these results demonstrate a notable sex-specific differences in the associations between n-6 PUFAs and T2DM. Higher n-6 PUFA status may be protective against the risk of T2DM in men.
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Affiliation(s)
- Yingying Li
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Hui Shen
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yike Li
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Mei Bi
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yanhong Bi
- Department of Research, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Xiaoyu Che
- Department of Research, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Simiao Tian
- Department of Research, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yazhuo Liu
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
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Health Behavior Trajectories in High Cardiovascular Risk Populations: Secondary Analysis of a Clinical Trial. J Cardiovasc Nurs 2021; 36:E80-E90. [PMID: 34495915 DOI: 10.1097/jcn.0000000000000850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The application of latent class growth analysis (LCGA) has been limited in behavioral studies on high-cardiovascular-risk populations. AIM The current study aimed to identify distinct health behavior trajectories in high-cardiovascular-risk populations using LCGA. We also examined the baseline individual characteristics associated with different health behavior trajectories and determined which trajectory is associated with improved cardiovascular risk outcomes at 52 weeks. METHODS This secondary analysis of a clinical trial included 200 patients admitted to primary care clinics. Latent class growth analysis was conducted to identify the trajectories of physical activity and dietary intake; these were measured at 4 different time points during a 52-week study period. Analysis of variance/χ2 test was used to assess the associations between baseline individual characteristics and trajectories, and logistic regression analysis was used to identify associations between trajectories and cardiovascular risk outcomes at 52 weeks. RESULTS Three trajectories were identified for physical activity (low-, moderate-, and high-stable). Risk perception, patient activation, and depressive symptoms predicted the trajectories. High-stable trajectory for physical activity was associated with better cardiovascular risk outcomes at the 52-week follow-up. Two trajectories (low-stable and high-decreasing) were identified for percent energy from fat, but the factors that can predict trajectories were limited. CONCLUSIONS Interventions are needed to target patients who begin with a lower physical activity level, with the goal of enhanced cardiovascular health. The predictors identified in the study may facilitate earlier and more tailored interventions.
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Cosson E, Bentounes SA, Nachtergaele C, Berkane N, Pinto S, Sal M, Bihan H, Tatulashvili S, Portal JJ, Carbillon L, Vicaut E. Prognosis Associated with Sub-Types of Hyperglycaemia in Pregnancy. J Clin Med 2021; 10:3904. [PMID: 34501352 PMCID: PMC8432067 DOI: 10.3390/jcm10173904] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 11/28/2022] Open
Abstract
We aimed to compare pregnancy outcomes in 4665 women according to the following types of hyperglycaemia in pregnancy sub-types: (i) normoglycaemia, (ii) gestational diabetes mellitus (GDM), (iii) diabetes in pregnancy (DIP), (iv) early-diagnosed (i.e., <22 weeks of gestation) GDM (eGDM), and (v) early-diagnosed DIP (eDIP). The prevalence of normoglycaemia, eGDM, eDIP, GDM, and DIP was 76.4%, 10.8%, 0.6%, 11.7%, and 0.6%, respectively. With regard to pregnancy outcomes, gestational weight gain (11.5 ± 5.5, 9.0 ± 5.4, 8.3 ± 4.7, 10.4 ± 5.3, and 10.1 ± 5.0 kg, p < 0.0001) and insulin requirement (none, 46.0%, 88.5%, 25.5%, and 51.7%; p < 0.001) differed according to the glycaemic sub-types. eGDM and eDIP were associated with higher rates of infant malformation. After adjustment for confounders, with normoglycaemia as the reference, only GDM was associated with large-for-gestational-age infant (odds ratio 1.34 (95% interval confidence 1.01-1.78) and only DIP was associated with hypertensive disorders (OR 3.48 (1.26-9.57)). To conclude, early-diagnosed hyperglycaemia was associated with an increased risk of malformation, suggesting that it was sometimes present at conception. Women with GDM, but not those with eGDM, had an increased risk of having a large-for-gestational-age infant, possibly because those with eGDM were treated early and therefore had less gestational weight gain. Women with DIP might benefit from specific surveillance for hypertensive disorders.
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Affiliation(s)
- Emmanuel Cosson
- AP-HP, Avicenne Hospital, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, 93000 Bobigny, France; (N.B.); (M.S.); (H.B.); (S.T.)
- Nutritional Epidemiology Research Unit, UMR U557 INSERM/U11125 INRAE/CNAM, Paris 13 University, Sorbonne Paris Cité, 93000 Bobigny, France
| | - Sid Ahmed Bentounes
- AP-HP, Clinical Research Unit St-Louis-Lariboisière, Denis Diderot University, 75010 Paris, France; (S.A.B.); (C.N.); (J.-J.P.); (E.V.)
| | - Charlotte Nachtergaele
- AP-HP, Clinical Research Unit St-Louis-Lariboisière, Denis Diderot University, 75010 Paris, France; (S.A.B.); (C.N.); (J.-J.P.); (E.V.)
| | - Narimane Berkane
- AP-HP, Avicenne Hospital, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, 93000 Bobigny, France; (N.B.); (M.S.); (H.B.); (S.T.)
| | - Sara Pinto
- AP-HP, Jean Verdier Hospital, Unit of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, 93143 Bondy, France;
| | - Meriem Sal
- AP-HP, Avicenne Hospital, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, 93000 Bobigny, France; (N.B.); (M.S.); (H.B.); (S.T.)
| | - Hélène Bihan
- AP-HP, Avicenne Hospital, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, 93000 Bobigny, France; (N.B.); (M.S.); (H.B.); (S.T.)
| | - Sopio Tatulashvili
- AP-HP, Avicenne Hospital, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, 93000 Bobigny, France; (N.B.); (M.S.); (H.B.); (S.T.)
| | - Jean-Jacques Portal
- AP-HP, Clinical Research Unit St-Louis-Lariboisière, Denis Diderot University, 75010 Paris, France; (S.A.B.); (C.N.); (J.-J.P.); (E.V.)
| | - Lionel Carbillon
- AP-HP, Jean Verdier Hospital, Department of Obstetrics and Gynecology, Paris 13 University, Sorbonne Paris Cité, 93143 Bondy, France;
| | - Eric Vicaut
- AP-HP, Clinical Research Unit St-Louis-Lariboisière, Denis Diderot University, 75010 Paris, France; (S.A.B.); (C.N.); (J.-J.P.); (E.V.)
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Magriplis E, Panagiotakos D, Papakonstantinou E, Mitsopoulou AV, Karageorgou D, Dimakopoulos I, Bakogianni I, Chourdakis M, Micha R, Michas G, Ntouroupi T, Tsaniklidou SM, Argyri K, Dimitriadis G, Zampelas A. Prevalence of type 2 diabetes mellitus in a representative sample of Greek adults and its association with modifiable risk factors: results from the Hellenic National Nutrition and Health Survey. Public Health 2021; 197:75-82. [PMID: 33478772 DOI: 10.1016/j.puhe.2020.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/31/2020] [Accepted: 10/03/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Diabetes mellitus is a disease associated with many complications leading to premature death. The aim of this study was to estimate prevalence of type 2 diabetes (T2D), and the proportion of the population unaware of the condition, in association with modifiable risk factors. STUDY DESIGN Data from the Hellenic National Nutrition and Health Survey were used (n = 3773 adults, 40.8% men) and were obtained by trained personnel. METHODS Diabetes mellitus disease status was categorized as per the International Classification of Diseases codes (10th version). A subsample from the two main metropolitan areas was used to assess T2D and impaired fasting glucose (IFG) (n = 990; 38.2% men) from plasma analysis. RESULTS The prevalence of T2D in the population was 5.2% in total, reaching 13.7% in adults aged >60 years (no sex differences). IFG was observed in 27.3% of adults in the two metropolitan areas, and 40% were unaware of having T2D in this subsample. The likelihood of having T2D significantly increased with age and body weight, whereas it decreased with higher educational level and physical activity (P for all <0.001). CONCLUSION The high T2D prevalence in adults, especially among the older age-groups, suggests a major public health problem in Greece.
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Affiliation(s)
- E Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece
| | - D Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education Harokopio University, Eleftheriou Venizelou 70, 176 76, Athens, Greece
| | - E Papakonstantinou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece
| | - A-V Mitsopoulou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece
| | - D Karageorgou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece
| | - I Dimakopoulos
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece
| | - I Bakogianni
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece
| | - M Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54 124, Thessaloniki, Greece
| | - R Micha
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece
| | - G Michas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece
| | - T Ntouroupi
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece
| | - S-M Tsaniklidou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece
| | - K Argyri
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece
| | - G Dimitriadis
- 2nd Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens, "Attikon" University Hospital, Haidari, Greece
| | - A Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece.
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Obafemi TO, Jaiyesimi KF, Olomola AA, Olasehinde OR, Olaoye OA, Adewumi FD, Afolabi BA, Adewale OB, Akintayo CO, Ojo OA. Combined effect of metformin and gallic acid on inflammation, antioxidant status, endoplasmic reticulum (ER) stress and glucose metabolism in fructose-fed streptozotocin-induced diabetic rats. Toxicol Rep 2021; 8:1419-1427. [PMID: 34345595 PMCID: PMC8319514 DOI: 10.1016/j.toxrep.2021.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 06/11/2021] [Accepted: 07/15/2021] [Indexed: 12/19/2022] Open
Abstract
Metformin, gallic acid and a combination of both improved glucose metabolism and antioxidant status in diabetic rats. Metformin, gallic acid and a combination of both lowered levels of IL-6 and TNF-α in liver and pancreas of diabetic rats. Metformin, gallic acid and a combination of both decreased the expression of ATF4 in liver and pancreas of diabetic rats. Metformin/GA combination appeared more effective than metformin only and gallic acid only.
Over time, diabetes patients usually need combination therapy involving two or more agents, including phytonutrients to attain therapeutic targets. The purpose of this research is to elucidate the combined effect of metformin and gallic acid (GA) on glucose metabolism, inflammation as well as oxidative and endoplasmic reticulum (ER) stresses in fructose-fed diabetic rats. Thirty-five rats of Wistar strain were arbitrarily distributed into five groups, each containing seven animals as follows: normal control, diabetic control, groups administered 100 mg/kg bw metformin only, 50 mg/kg bw gallic acid only and a combination of both. Experimental animals were made diabetic by single injection of 40 mg/kg streptozotocin (intraperitoneally) subsequent to 14 days administration of 10 % fructose prior. Treatment of rats continued for 21 days following diabetes confirmation. Glucose and insulin levels as well as lipid profile were evaluated in the serum, while activities of catalase and superoxide dismutase were estimated in both liver and pancreas. In addition, levels of malondialdehyde, interleukin-6 and tumor necrosis factor-alpha, as well as expression of activating transcription factor-4 were evaluated in liver and pancreas of diabetic rats. Activities of glucose-6-phosphatase and glucokinase were also determined in liver of diabetic animals. Metformin only, GA only and combination of metformin and GA significantly improved antioxidant status and glucose homeostasis while inflammation and endoplasmic reticulum stress were significantly ameliorated in diabetic rats. Metformin/GA combination appeared to improve glucose metabolism by increasing insulin level and ameliorating the dysregulated activities of glucose metabolizing enzymes and ER stress better than either metformin only or GA only. It could be concluded that coadministration of metformin/GA produced a combined effect in ameliorating diabetes in Wistar rats and could be considered in treatment of diabetes.
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Affiliation(s)
- Tajudeen O Obafemi
- Department of Biochemistry, Afe Babalola University, PMB 5454, Ado-Ekiti, Nigeria
| | - Kikelomo F Jaiyesimi
- Department of Biochemistry, Afe Babalola University, PMB 5454, Ado-Ekiti, Nigeria
| | - Adenike A Olomola
- Department of Biochemistry, Afe Babalola University, PMB 5454, Ado-Ekiti, Nigeria
| | - Oluwaseun R Olasehinde
- Medical Biochemistry Unit, College of Health Sciences, Afe Babalola University, PMB 5454, Ado-Ekiti, Nigeria
| | - Oyindamola A Olaoye
- Department of Biochemistry, Afe Babalola University, PMB 5454, Ado-Ekiti, Nigeria
| | - Funmilayo D Adewumi
- Industrial Chemistry Programme, Department of Chemical Sciences, Afe Babalola University, PMB 5454, Ado-Ekiti, Nigeria
| | | | - Olusola B Adewale
- Department of Biochemistry, Afe Babalola University, PMB 5454, Ado-Ekiti, Nigeria
| | | | - Oluwafemi A Ojo
- Department of Biochemistry, Landmark University, PMB 1001, Omu-aran, Nigeria
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Fuentes-Merlos Á, Orozco-Beltrán D, Quesada Rico JA, Reina R. Quality-of-Life Determinants in People with Diabetes Mellitus in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136929. [PMID: 34203455 PMCID: PMC8297329 DOI: 10.3390/ijerph18136929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 01/22/2023]
Abstract
This study aims to analyze self-perceived health and lifestyles in the European Union Member States Iceland, Norway, and the United Kingdom, examining associations with diabetes prevalence; and to identify the demographic, economic and health variables associated with diabetes in this population. We performed a cross-sectional study of 312,172 people aged 15 years and over (150,656 men and 161,516 women), using data collected from the European Health Interview Survey (EHIS). The EHIS includes questions on the health status and health determinants of the adult population, as well as health care use and accessibility. To estimate the magnitudes of the associations with diabetes prevalence, we fitted multivariate logistic models. The EHIS data revealed a prevalence of diabetes in Europe of 6.5% (n = 17,029). Diabetes was associated with being physically inactive (OR 1.14; 95% CI 1.02–1.28), obese (OR 2.75; 95% CI 2.60–2.90), male (OR 1.46; 95% CI 1.40–1.53) and 65–74 years old (OR 3.47; 95% CI 3.09–3.89); and having long-standing health problems (OR 7.39; 95% CI, 6.85–7.97). These results were consistent in the bivariate and multivariate analyses, with an area under the receiver operating characteristic curve of 0.87 (95% CI 0.87–0.88). In a large European health survey, diabetes was clearly associated with a poorer perceived quality of life, physical inactivity, obesity, and other comorbidities, as well as non-modifiable factors such as older age and male sex.
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Affiliation(s)
- Álvaro Fuentes-Merlos
- Department of Primary Health Care, San Juan de Alicante University Hospital, 03550 San Juan de Alicante, Spain;
| | - Domingo Orozco-Beltrán
- Department of Clinical Medicine, Miguel Hernández University, 03550 San Juan de Alicante, Spain;
| | - Jose A. Quesada Rico
- Department of Clinical Medicine, Miguel Hernández University, 03550 San Juan de Alicante, Spain;
- Correspondence: ; Tel.: +34-965-919-449
| | - Raul Reina
- Department of Sport Sciences, Sport Research Centre, Miguel Hernández University, 03202 Elche, Spain;
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Fründt T, Schröder N, Hölzemer A, Pinnschmidt H, de Heer J, Behrends BC, Renne T, Lautenbach A, Lohse AW, Schrader J. Prevalence and risk factors of undiagnosed diabetes mellitus among gastroenterological patients: a HbA1c-based single center experience. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2021; 60:1306-1313. [PMID: 34157754 DOI: 10.1055/a-1482-8840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Diabetes mellitus is a major risk factor for microvascular disease, leading to chronic kidney injury or cardiovascular disease, but there is a tremendous proportion of patients worldwide who suffer from undiagnosed diabetes. Until now, little is known about the prevalence of undiagnosed diabetes in gastroenterology inpatients. OBJECTIVE To improve detection of undiagnosed diabetes, a routine screening procedure for gastroenterology inpatients, based on hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) measurement, was established. METHODS We conducted a retrospective analysis of the implemented diabetes screening. Diabetes mellitus was diagnosed according to the guideline of the German Diabetes Association in patients with an HbA1c of ≥6.5% anld/or fasting plasma glucose (FPG) ≥126 mg/dL. Univariate and multivariate analyses were performed to identify independent risk factors for undiagnosed diabetes. RESULTS Within a 3-month period, 606 patients were eligible for a diabetes screening. Pre-existing diabetes was documented in 120 patients (19.8 %), undiagnosed diabetes was found in 24 (3.9%), and 162 patients (26.7%) met the definition for prediabetes. Steroid medication use, age, and liver cirrhosis due to primary sclerosing cholangitis (PSC) were identified as risk factors for undiagnosed diabetes. CONCLUSION The prevalence of undiagnosed diabetes in gastroenterology inpatients is markedly elevated in comparison to the general population, and a substantial number of inpatients are in a prediabetic status, underlining the need for diabetes screening. In addition to previously described risk factors of patient age and steroid medication use, we identified PSC-related liver cirrhosis (but not liver cirrhosis due to another etiology) as an independent risk factor for undiagnosed diabetes.
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Affiliation(s)
- Thorben Fründt
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Niko Schröder
- Department of Internal Medicine, Gastroenterology, Hepatology, Endoscopy and Diabetology, Osnabrück, Germany
| | - Angelique Hölzemer
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans Pinnschmidt
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jocelyn de Heer
- Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Berit C Behrends
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Renne
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Lautenbach
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ansgar W Lohse
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jörg Schrader
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Migrant Middle Eastern women with gestational diabetes seven years after delivery - positive long-term development of beliefs about health and illness shown in follow-up interviews. Prim Health Care Res Dev 2021; 22:e21. [PMID: 34034848 PMCID: PMC8165453 DOI: 10.1017/s1463423621000232] [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] [Indexed: 11/06/2022] Open
Abstract
AIM No previous studies have been found focusing on the long-term development of beliefs about health, illness and healthcare in migrant women with gestational diabetes mellitus (GDM). The aim of this study was to explore this and the influence on health-related behaviour (i.e. self-care and care seeking) in migrant women from the Middle East living in Sweden seven years after delivery. BACKGROUND GDM is increasing, particularly in migrant women. The risk of adverse outcomes of GDM for health can be improved by interventions reducing blood glucose and lifestyle modifications which medicalise the woman's pregnancy due to intensive follow-up and demanding self-care. The reactions might have an enduring impact on the women's long-term psychological and physical health and adoption of preventive health behaviours. METHOD Qualitative exploratory study. Semi-structured follow-up interviews 7 years after delivery with women previously interviewed in gestational weeks 34-38 and 3 and 14 months after delivery. Data analysed with qualitative content analysis. FINDINGS Health meant freedom from illness, feeling well and living long to be able to care for the children. The present situation was described either positively, changing to a healthier lifestyle, or negatively, with worries about being affected by type 2 diabetes. Beliefs changed among the majority of women, leading to a healthier lifestyle, and they looked positively back at the time when diagnosed and their reactions to it. With few exceptions, they were confident of being aware of future health risks and felt responsible for their own and their children's health/lifestyle. None except those diagnosed with type 2 diabetes had been in contact with healthcare since the last follow-up a year after delivery. Yet, they still would like and need a healthcare model delivering more information, particularly on developing a healthy lifestyle for children, and with regular check-ups also after the first year after delivery.
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Franch-Nadal J, Fornos JA, Melogno Klinkas M, Rodríguez de Miguel M, Rodríguez-Fortúnez P, Lizán L, de Paz HD, Lería Gelabert M. Management of prediabetes from the perspective of Spanish physicians and community pharmacists: Detecta2 study. ENDOCRINOL DIAB NUTR 2021; 68:S2530-0164(21)00103-8. [PMID: 34016564 DOI: 10.1016/j.endinu.2020.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Prediabetes is a high-risk state for diabetes. The study aims to describe routine clinical practice and the views of physicians and pharmacists on prediabetes management. MATERIALS AND METHODS An observational, descriptive, cross-sectional study was conducted using a structured questionnaire. RESULTS A total of 410 physicians and 393 pharmacists completed the questionnaire. Self-adherence to clinical practice guidelines (CPGs) was reported by 51.5% and 23.2% of physicians and pharmacists, respectively. Less than 60% of participants defined prediabetes according to main CPG. Regarding the use of screening strategies to detect prediabetes (physicians: 96%; pharmacists: 42.1%), reports indicate the opportunistic strategy is widely employed (≥75%) whereas systematic screening is unusual (<20%). Changes in lifestyle were deemed essential by almost all participants (≥95%), but in clinical practice only 58.3% of healthcare centers and 28.0% of pharmacies were found to provide awareness-raising/instruction. The role of pharmacists in the prevention of prediabetes/diabetes was judged useful by most participants. CONCLUSIONS Use of CPG, systematic prediabetes screening strategies, and specific strategies for patient education are scarce. The support of community pharmacists in prediabetes management was well valued. Therefore, it is crucial that the lines of action followed by both physicians and pharmacists align with each other and with the CPG.
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Affiliation(s)
- Josep Franch-Nadal
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain; CAP Drassanes Raval-Sud, Barcelona, Spain
| | | | | | | | | | - Luis Lizán
- Outcomes'10, S.L., Castellón de la Plana, Spain; Medicine Department, Jaume I University, Castellón de la Plana, Spain
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Wagner J, Bermudez-Millan A, Buckley T, Buxton OM, Feinn R, Kong S, Kuoch T, Nahmod NG, Scully M. A randomized trial to decrease risk for diabetes among Cambodian Americans with depression: Intervention development, baseline characteristics and process outcomes. Contemp Clin Trials 2021; 106:106427. [PMID: 33957272 PMCID: PMC8312406 DOI: 10.1016/j.cct.2021.106427] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/26/2021] [Accepted: 05/01/2021] [Indexed: 11/29/2022]
Abstract
Background: Depression and antidepressant medications are associated with increased risk for type 2 diabetes. It is not known if diabetes can be prevented in the setting of depression. Cambodian Americans have high rates of both depression and diabetes. This paper reports intervention development, experimental design, baseline characteristics, and process outcomes of diabetes prevention interventions for Cambodian Americans with depression, “Diabetes Risk Reduction through Eat, Walk, Sleep and Medication Therapy Management” (DREAM). Methods: Participants were aged 35–75, Khmer speaking, at high risk for developing diabetes, and met criteria for likely depression by either a) antidepressant medication and/or b) elevated depressive symptoms at two time-points during a study eligibility period. Treatment arms were: 1) community health educator (CHE) delivered lifestyle intervention called Eat, Walk, Sleep (EWS), 2) EWS plus pharmacist/CHE-delivered medication therapy management (EWS + MTM), and, 3) social services (SS; control). Results: 188 participants were randomized. Treatment fidelity was high (98% checklist adherence) and on a scale from 0 to 3, participants reported high EWS treatment satisfaction (M = 2.9, SD = 0.2), group cohesion (M = 2.9, SD = 0.3), and therapeutic alliance to CHEs (M = 2.9, SD = 0.2) and to pharmacists (2.9, SD = 0.3). Attendance was challenging but highly successful; in EWS, 99% attended ≥ one session and 86% completed ≥ 24 sessions, M = 27.3 (SD = 3.7) sessions. Of those randomized to EWS + MTM, 98% attended at least one MTM session and 77%) completed ≥ 4 sessions. Retention was high, 95% at 12-month and 96% at 15-month assessments. Conclusions: The interventions were successfully implemented. Lessons learned and suggestions for future trials are offered. ClinicalTrials.gov identifier: NCT02502929
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Affiliation(s)
- Julie Wagner
- UConn Schools of Medicine and Dental Medicine, USA.
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Rezki A, Fysekidis M, Chiheb S, Vicaut E, Cosson E, Valensi P. Acute and long-term effects of saxagliptin on post-prandial glycemic response in obese patients with impaired glucose tolerance. Nutr Metab Cardiovasc Dis 2021; 31:1257-1266. [PMID: 33618922 DOI: 10.1016/j.numecd.2020.12.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 11/25/2020] [Accepted: 12/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Dipeptidyl-peptidase inhibitors might be useful in type 2 diabetes prevention. ACCES (ACute and Chronic Effects of Saxagliptin) was a randomized, placebo-controlled, double-blind, controlled phase 2, pilot study aiming to examine in obese patients with impaired glucose tolerance (IGT) the acute effects and the effects after 12 weeks of treatment by saxagliptin on glucose levels at fasting and postprandially after a standard breakfast, and on glucose tolerance. METHODS AND RESULTS We included 24 obese patients with IGT. Patients were randomized to receive saxagliptin 5 mg or placebo in the morning. The treatment was taken on Visit 1 before breakfast, then continued for 12 weeks. Biochemical measurements were performed before, one, two and three hours after a standard breakfast including 75 g of carbohydrates, during Visit 1 and Visit 2 (12 weeks). Glucose variability (GV) was evaluated at Visit 1 from 24-h continuous glucose monitoring including the breakfast. A second OGTT was performed at Visit 3 (3-5 days after Visit 2). Compared with placebo-treated patients, saxagliptin-treated patients had lower 1 h and 2 h post-meal plasma glucose levels at Visit 1 and similar changes at Visit 2 (p < 0.01 to p < 0.004), with lower GV indexes after breakfast at Visit 1. At Visit 3, all patients but one in saxagliptin group and only 4 patients in placebo group turned to normal glucose tolerance. Lower glucose response to breakfast at Visit 1 was predictive of recovery of glucose tolerance. CONCLUSION Saxagliptin has metabolically beneficial effects in glucose-intolerant obese patients by significantly lowering postprandial blood glucose levels. CLINICAL TRIAL REGISTRATION NUMBER NCT01521312: https://clinicaltrials.gov/ct2/show/NCT01521312.
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Affiliation(s)
- Amel Rezki
- Department of Endocrinology, Diabetology, Nutrition, Jean Verdier Hospital, AP-HP, CRNH-IdF, CINFO, Paris Nord University, Sorbonne Paris Cité, Bondy, France; Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Marinos Fysekidis
- Department of Endocrinology, Diabetology, Nutrition, Jean Verdier Hospital, AP-HP, CRNH-IdF, CINFO, Paris Nord University, Sorbonne Paris Cité, Bondy, France; Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Sabrina Chiheb
- Department of Endocrinology, Diabetology, Nutrition, Jean Verdier Hospital, AP-HP, CRNH-IdF, CINFO, Paris Nord University, Sorbonne Paris Cité, Bondy, France
| | - Eric Vicaut
- Clinical Research Unit, Lariboisière-St Louis, Fernand Widal Hospital, APHP, Paris, France
| | - Emmanuel Cosson
- Department of Endocrinology, Diabetology, Nutrition, Jean Verdier Hospital, AP-HP, CRNH-IdF, CINFO, Paris Nord University, Sorbonne Paris Cité, Bondy, France; Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Paul Valensi
- Department of Endocrinology, Diabetology, Nutrition, Jean Verdier Hospital, AP-HP, CRNH-IdF, CINFO, Paris Nord University, Sorbonne Paris Cité, Bondy, France.
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Tatulashvili S, Gusto G, Cosson E, Balkau B, Gourdy P, Bonnet F, Bihan H, Fagherazzi G. Gonadal hormonal factors before menopause and incident type 2 diabetes in women: A 22-year follow-up of 83 799 women from the E3N cohort study. J Diabetes 2021; 13:330-338. [PMID: 33145935 DOI: 10.1111/1753-0407.13129] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/12/2020] [Accepted: 11/01/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In many populations the incidence of type 2 diabetes is higher in men than in women. This may be explained by exposure to female gonadal hormones, but so far, there is no consensus on their role over the life course in type 2 diabetes etiology. METHODS Data are from 83 799 French women from the E3N (Etude Épidémiologique de Femmes de la Mutuelle Générale de l'Education Nationale) cohort study, followed for 22 years. Multivariable Cox models including classical risk factors were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) between gonadal hormonal factors and incident type 2 diabetes. RESULTS Older age at menarche, more menstrual cycles, older age at menopause, longer duration of exposure to gonadal hormones and breastfeeding were inversely associated with incident type 2 diabetes cases (n = 4806). While a longer duration of menstrual cycles (HR = 1.23 [95% CI: 1.07-1.41] comparing ≥32 vs ≤24 days) and use of contraceptive pills (HR = 1.33 [1.25-1.42]) were associated with a greater risk of type 2 diabetes. CONCLUSIONS In women, a longer exposure to endogenous gonadal hormones with a later menopause as well as breastfeeding were associated with a lower risk of developing type 2 diabetes, independently of classical diabetes risk factors. In contrast, the use of contraceptive agents was associated with incident diabetes, but the influence of each type of contraception and of exposure duration remain to be investigated.
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Affiliation(s)
- Sopio Tatulashvili
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, Bobigny, France
| | - Gaelle Gusto
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) "Health Across Generations" Team, Université Paris-Saclay, Gustave Roussy, Espace Maurice Tubiana, Villejuif, France
| | - Emmanuel Cosson
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, Bobigny, France
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Paris Nord, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Beverley Balkau
- Clinical Epidemiology, Université Paris-Saclay, UVSQ, Inserm u1018, CESP, Villejuif, France
| | - Pierre Gourdy
- Diabetology Department, CHU Toulouse, Institute of Metabolic and Cardiovascular Diseases (I2MC, UMR1048 Inserm/UPS), University of Toulouse, Toulouse, France
| | - Fabrice Bonnet
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) "Health Across Generations" Team, Université Paris-Saclay, Gustave Roussy, Espace Maurice Tubiana, Villejuif, France
- Department of Endocrinology, Diabetology and Nutrition, CHU Rennes, Université de Rennes 1, Rennes, France
| | - Hélène Bihan
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, Bobigny, France
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Paris Nord, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Guy Fagherazzi
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) "Health Across Generations" Team, Université Paris-Saclay, Gustave Roussy, Espace Maurice Tubiana, Villejuif, France
- Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
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Miranda-Lora AL, Vilchis-Gil J, Juárez-Comboni DB, Cruz M, Klünder-Klünder M. A Genetic Risk Score Improves the Prediction of Type 2 Diabetes Mellitus in Mexican Youths but Has Lower Predictive Utility Compared With Non-Genetic Factors. Front Endocrinol (Lausanne) 2021; 12:647864. [PMID: 33776940 PMCID: PMC7994893 DOI: 10.3389/fendo.2021.647864] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/18/2021] [Indexed: 01/07/2023] Open
Abstract
Background Type 2 diabetes (T2D) is a multifactorial disease caused by a complex interplay between environmental risk factors and genetic predisposition. To date, a total of 10 single nucleotide polymorphism (SNPs) have been associated with pediatric-onset T2D in Mexicans, with a small individual effect size. A genetic risk score (GRS) that combines these SNPs could serve as a predictor of the risk for pediatric-onset T2D. Objective To assess the clinical utility of a GRS that combines 10 SNPs to improve risk prediction of pediatric-onset T2D in Mexicans. Methods This case-control study included 97 individuals with pediatric-onset T2D and 84 controls below 18 years old without T2D. Information regarding family history of T2D, demographics, perinatal risk factors, anthropometric measurements, biochemical variables, lifestyle, and fitness scores were then obtained. Moreover, 10 single nucleotide polymorphisms (SNPs) previously associated with pediatric-onset T2D in Mexicans were genotyped. The GRS was calculated by summing the 10 risk alleles. Pediatric-onset T2D risk variance was assessed using multivariable logistic regression models and the area under the receiver operating characteristic curve (AUC). Results The body mass index Z-score (Z-BMI) [odds ratio (OR) = 1.7; p = 0.009] and maternal history of T2D (OR = 7.1; p < 0.001) were found to be independently associated with pediatric-onset T2D. No association with other clinical risk factors was observed. The GRS also showed a significant association with pediatric-onset T2D (OR = 1.3 per risk allele; p = 0.006). The GRS, clinical risk factors, and GRS plus clinical risk factors had an AUC of 0.66 (95% CI 0.56-0.75), 0.72 (95% CI 0.62-0.81), and 0.78 (95% CI 0.70-0.87), respectively (p < 0.01). Conclusion The GRS based on 10 SNPs was associated with pediatric-onset T2D in Mexicans and improved its prediction with modest significance. However, clinical factors, such the Z-BMI and family history of T2D, continue to have the highest predictive utility in this population.
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Affiliation(s)
- América Liliana Miranda-Lora
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Jenny Vilchis-Gil
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | - Miguel Cruz
- Medical Research Unit in Biochemistry, Hospital de Especialidades Centro Médico Nacional SXXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Research Subdirectorate, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
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