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Bahadoran Z, Mirmiran P, Azizi F. Usual intake of dairy products and the chance of pre-diabetes regression to normal glycemia or progression to type 2 diabetes: a 9-year follow-up. Nutr Diabetes 2024; 14:15. [PMID: 38594262 PMCID: PMC11004158 DOI: 10.1038/s41387-024-00257-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 03/16/2023] [Accepted: 01/09/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND We assessed the possible effect of usual dairy consumption on pre-diabetes (Pre-DM) remission or progression to type 2 diabetes (T2D). METHODS Pre-DM adults (n = 334, mean age of 49.4 years, and 51.5% men) were assessed for dairy intakes (2006-2008) and followed up to 9 years for incidence of T2D or normal glycemia (NG). All biochemical measurements were done at baseline and all subsequent examinations with 3-y follow-up intervals. Multinomial regression models with adjustment of confounding variables were used to estimate odds ratios (OR) and 95% confidence intervals (CIs) of incident T2D and NG for each serving/d dairy consumption. RESULTS The odds of NG was significantly elevated by 69% (OR = 1.69, 95% CI = 1.00-2.86, P = 0.05) per 200 g/d increased high-fat dairy intake, while the amount of total dairy or low-fat dairy was not related to the outcomes. Higher intakes of yogurt were more likely to be associated with an increased odds of NG (OR = 1.82, 95% CI = 1.20-2.74, P = 0.01). Usual intakes of milk, cheese, or cream-butter were not associated to Pre-DM remission or progression to T2D. CONCLUSION Regular dairy consumption may increase the chance of Pre-DM regression to NG.
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Affiliation(s)
- Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Dixon SB, Wang F, Lu L, Wilson CL, Green DM, Merchant TE, Srivastava DK, Delaney A, Howell RM, Jefferies JL, Robison LL, Ness KK, Hudson MM, Chemaitilly W, Armstrong GT. Prediabetes and Associated Risk of Cardiovascular Events and Chronic Kidney Disease Among Adult Survivors of Childhood Cancer in the St Jude Lifetime Cohort. J Clin Oncol 2024; 42:1031-1043. [PMID: 38091552 PMCID: PMC10950176 DOI: 10.1200/jco.23.01005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/24/2023] [Accepted: 09/25/2023] [Indexed: 12/28/2023] Open
Abstract
PURPOSE Little is known about the prevalence of prediabetes and associated risk of cardiovascular events and chronic kidney disease (CKD) with this reversable condition in survivors. METHODS Prevalence of prediabetes (fasting plasma glucose 100-125 mg/dL or hemoglobin A1c 5.7%-6.4%) and diabetes was clinically assessed in 3,529 adults ≥5 years from childhood cancer diagnosis and 448 controls stratified by age. Cox proportional hazards regression estimated progression from prediabetes to diabetes, and risk of future cardiac events, stroke, CKD, and death. RESULTS Among survivors, median age 30 years (IQR, 18-65), and the prevalence of prediabetes was 29.2% (95% CI, 27.7 to 30.7) versus 18.1% (14.5 to 21.6) in controls and of diabetes was 6.5% (5.7 to 7.3) versus 4.7% (2.7 to 6.6). By age 40-49 years, more than half of the survivors had prediabetes (45.5%) or diabetes (14.0%). Among 695 survivors with prediabetes and longitudinal follow-up, 68 (10%; median follow-up, 5.1 years) progressed to diabetes. After adjustment for demographic factors and body composition, risk of progression was associated with radiation exposure to the pancreatic tail ≥10 Gy (hazard ratio [HR], 2.7 [95% CI, 1.1 to 6.8]) and total-body irradiation (4.4 [1.5 to 13.1]). Compared with survivors with normal glucose control, adjusting for relevant treatment exposures, those with prediabetes were at increased risk of future myocardial infarction (HR, 2.4 [95% CI, 1.2 to 4.8]) and CKD (2.9 [1.04 to 8.15]), while those with diabetes were also at increased risk of future cardiomyopathy (3.8 [1.4 to 10.5]) or stroke (3.4 [1.3 to 8.9]). CONCLUSION Prediabetes is highly prevalent in adult survivors of childhood cancer and independently associated with an increased risk of future cardiovascular and kidney complications. Prediabetes, a modifiable risk factor among childhood cancer survivors, represents a new target for intervention that may prevent subsequent morbidity and mortality.
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Affiliation(s)
- Stephanie B. Dixon
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Fang Wang
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Lu Lu
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Carmen L. Wilson
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Daniel M. Green
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Thomas E. Merchant
- Department of Radiation Oncology, St Jude Children's Research Hospital, Memphis, TN
| | | | - Angela Delaney
- Department of Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - Rebecca M. Howell
- Department of Radiation Physics, Division of Radiation Oncology, The University of Texas at MD Anderson Cancer Center, Houston, TX
| | - John L. Jefferies
- The Cardiac Institute, University of Tennessee Health Science Center, Memphis, TN
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Melissa M. Hudson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Wassim Chemaitilly
- Division of Pediatric Endocrinology, Diabetes and Metabolism, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Gregory T. Armstrong
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
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Jalali M, Bahadoran Z, Mirmiran P, Azizi F, Hosseinpanah F. Severity of adipose tissue dysfunction is associated with progression of pre-diabetes to type 2 diabetes: the Tehran Lipid and Glucose Study. BMC Public Health 2024; 24:121. [PMID: 38191327 PMCID: PMC10775602 DOI: 10.1186/s12889-023-17381-1] [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: 07/02/2023] [Accepted: 11/30/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND The association of prediabetes (Pre-DM) regression and progression with visceral adiposity index (VAI) and adipose tissue dysfunction (ATD) remains to be investigated. METHODS The present cohort study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) on 1458 Pre-DM cases (aged ≥ 21 years) who were followed for nine years. VAI was estimated based on waist circumference, body mass index, triglycerides, and high-density lipoprotein cholesterol. ATD status (i.e., absent, mild-moderate, and severe) was defined based on the age-stratified cutoff values of VAI. Multinomial logistic regression models with adjustment of potential confounders were used to estimate the chance of Pre-DM regression to normoglycemia or progression to T2D across ATD status. RESULTS During the study follow-up, 39.0% of the participants developed T2D, and 37.7% returned to normoglycemia. Compared to mild-moderate ATD, Pre-DM subjects with severe ATD had a higher risk of developing T2D by 45% (OR = 1.45, 95% CI = 11.08-1.93). Severe ATD was also associated with a decreased chance of returning to normoglycemia by 26% (OR = 0.74, 95% CI = 0.55-0.99). Participants with severe ATD had significantly higher fasting (overall mean = 111, 95% CI = 109-112 vs. 106, 95% CI = 105-108 mg/dL) and 2h-serum glucose (overall mean = 165, 95% CI = 161-168 vs. 153, 95% CI = 149-156 mg/dL) concentrations over time. CONCLUSION Severe ATD was associated with an elevated risk of developing T2D and longitudinal poor-glycemic controls in Pre-DM subjects. ATD may be a simple and useful index for detecting subjects at a higher risk of Pre-DM progression to T2D, allowing for timely intervention strategies.
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Affiliation(s)
- Mohammad Jalali
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 23, A'rabi St, Yeman Av, Velenjak, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 23, A'rabi St, Yeman Av, Velenjak, Tehran, Iran.
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 23, A'rabi St, Yeman Av, Velenjak, Tehran, Iran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Liu Y, Wang Q, Wu K, Sun Z, Tang Z, Li X, Zhang B. Anthocyanins' effects on diabetes mellitus and islet transplantation. Crit Rev Food Sci Nutr 2023; 63:12102-12125. [PMID: 35822311 DOI: 10.1080/10408398.2022.2098464] [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] [Indexed: 11/03/2022]
Abstract
The incidence of diabetes mellitus is dramatically increasing every year, causing a huge global burden. Moreover, existing anti-diabetic drugs inevitably bring adverse reactions, and the application of islet transplantation is often limited by the damage caused by oxidative stress after transplantation. Thus, new approaches are needed to combat the growing burden of diabetes mellitus. Anthocyanins are of great nutritional interest and have been documented that have beneficial effects on chronic diseases, including diabetes mellitus. Here, we describe the health effects of anthocyanins on diabetes mellitus and islet transplantation. Epidemiological studies demonstrated that moderate intake of anthocyanins leading to a reduction in risk of diabetes mellitus. Numerous experiments both animal and clinical studies also showed positive effects of anthocyanins on prevention and treatment of diabetes and diabetic complications. These effects of anthocyanins may be related to mechanisms of improving glucose and lipid metabolism and insulin resistance, antioxidant, and anti-inflammatory activities. In addition, damage and function of pancreatic islets after transplantation are also improved by anthocyanins. These findings suggest that daily intake of anthocyanins may not only improve nutritional metabolism in healthy individuals to prevent from diabetes, but also as a supplementary treatment of diabetes mellitus and islet transplantation. Thus, more evidence is needed to better understand the potential health benefits of anthocyanins.
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Affiliation(s)
- Yang Liu
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Qianwen Wang
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Kangze Wu
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhouyi Sun
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Zhe Tang
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Xian Li
- Zhejiang Provincial Key Laboratory of Horticultural Plant Integrative Biology, Zhejiang University, Hangzhou, China
- The State Agriculture Ministry Laboratory of Horticultural Plant Growth, Development and Quality Improvement, Zhejiang University, Hangzhou, China
| | - Bo Zhang
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Ha KH, Kim DJ, Han SJ. Associations of updated cardiovascular health metrics, including sleep health, with incident diabetes and cardiovascular events in older adults with prediabetes: A nationwide population-based cohort study. Diabetes Res Clin Pract 2023; 203:110820. [PMID: 37422164 DOI: 10.1016/j.diabres.2023.110820] [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: 04/25/2023] [Revised: 06/07/2023] [Accepted: 07/06/2023] [Indexed: 07/10/2023]
Abstract
AIMS To investigate the association of updated cardiovascular health (CVH) metrics, including sleep health, with the risk of diabetes and major adverse cardiovascular events (MACE) in older adults with prediabetes. METHODS A total of 7,948 older adults with prediabetes aged ≥ 65 years were included in this study. CVH was assessed using seven baseline metrics according to the modified American Heart Association recommendations. RESULTS During a median follow-up time of 11.9 years, 2,405 (30.3%) cases of diabetes and 2,039 (25.6%) MACE were recorded. Compared with the poor composite CVH metrics group, the multivariable-adjusted hazard ratios (HRs) in the intermediate and ideal composite CVH metrics groups were respectively 0.87 (95% confidence intervals [CI] = 0.78-0.96) and 0.72 (95% CI = 0.65-0.79) for diabetes events and 0.99 (95% CI = 0.88-1.11) and 0.88 (95% CI = 0.79-0.97) for MACE. The ideal composite CVH metrics group had a lower risk of diabetes and MACE in older adults aged 65-74 years, but not in those aged ≥ 75 years. CONCLUSIONS Ideal composite CVH metrics in older adults with prediabetes were associated with a lower risk of diabetes and MACE.
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Affiliation(s)
- Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Seung Jin Han
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
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Bahadoran Z, Mirmiran P, Shabani M, Azizi F. Higher daily physical activity levels may facilitate pre-diabetes regression to normoglycemia: A longitudinal study among an Iranian population. Prev Med Rep 2023; 34:102233. [PMID: 37288139 PMCID: PMC10241965 DOI: 10.1016/j.pmedr.2023.102233] [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: 12/19/2022] [Revised: 04/04/2023] [Accepted: 05/07/2023] [Indexed: 06/09/2023] Open
Abstract
The possible association of habitual physical activity (PA) and the risk of pre-diabetes (Pre-DM) progression to type 2 diabetes (T2D) or the chance of returning to normoglycemia was investigated. This cohort study included 1167 Pre-DM individuals (mean age of 53.5 years, and 45.3% men) who participated in the third phase of the Tehran Lipid and Glucose Study (2006-2008) and followed up to a median of 9 years. PA, including leisure time and job activities, was measured using a reliable and validated Iranian version of the Modifiable Activity Questionnaire and reported as metabolic equivalent (MET)-minutes per week. The odds ratios (ORs) and 95% confidence intervals (CIs) of incident T2D and returning to normoglycemia were estimated in relation to PA levels (i.e., per every 500 MET-minutes/week, or across categories of PA levels < 600 as a reference, 600-1500 and > 1500 MET-minutes/week). During the study follow-up, 39.0 % progressed to T2D, and 37.8% returned to normoglycemia. Compared to subjects with a PA < 600 MET-minutes/week, the chance of regression to normoglycemia increased by 58% [OR = 1.58, 95% CI = 1.03-2.40 ∼ relative risk (RR) = 1.32, 95% CI = 1.02-1.63] among the participants who had a PA > 1500 MET-minutes/week. We further noted that each 500 MET-min/week activity corresponded to an elevated chance of returning to normoglycemia by 5% (OR = 1.05, 95% CI = 1.01-1.11). The study's findings provided evidence that higher daily PA levels may facilitate Pre-DM regression to normoglycemia. The beneficial effect of PA in Pre-DM subjects needs to exceed the recommended levels (i.e., 600 MET-minutes/week).
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Affiliation(s)
- Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Shabani
- Department of General Science, Hashtgerd Branch, Islamic Azad University, Alborz, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gardner MP, Wang J, Hazlehurst JM, Sainsbury C, Blissett J, Nirantharakumar K, Thomas N, Bellary S. Risk of progression from pre-diabetes to type 2 diabetes in a large UK adult cohort. Diabet Med 2023; 40:e14996. [PMID: 36308066 PMCID: PMC10099224 DOI: 10.1111/dme.14996] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 10/05/2022] [Accepted: 10/25/2022] [Indexed: 11/28/2022]
Abstract
AIMS People with pre-diabetes are at high risk of progressing to type 2 diabetes. This progression is not well characterised by ethnicity, deprivation and age, which we describe in a large cohort of individuals with pre-diabetes. METHODS A retrospective cohort study with The Health Improvement Network (THIN) database was conducted. Patients aged 18 years and over and diagnosed with pre-diabetes [HbA1c 42 mmol/mol (6.0%) to 48 mmol/mol (6.5%) were included]. Cox proportional hazards regression was used to calculate adjusted hazard rate ratios (aHR) for the risk of progression from pre-diabetes to type 2 diabetes for each of the exposure categories [ethnicity, deprivation (Townsend), age and body mass index (BMI)] separately. RESULTS Of the baseline population with pre-diabetes (n = 397,853), South Asian (aHR 1.31; 95% CI 1.26-1.37) or Mixed-Race individuals (aHR 1.22; 95% CI 1.11-1.33) had an increased risk of progression to type 2 diabetes compared with those of white European ethnicity. Likewise, deprivation (aHR 1.17; 95% CI 1.14-1.20; most vs. least deprived) was associated with an increased risk of progression. Both younger (aHR 0.63; 95% CI 0.58-0.69; 18 to <30 years) and older individuals (aHR 0.85; 95% CI 0.84-0.87; ≥65 years) had a slower risk of progression from pre-diabetes to type 2 diabetes, than middle-aged (40 to <65 years) individuals. CONCLUSIONS South Asian or Mixed-Race individuals and people with social deprivation had an increased risk of progression from pre-diabetes to type 2 diabetes. Clinicians need to recognise the differing risk across their patient populations to implement appropriate prevention strategies.
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Affiliation(s)
- Michael P. Gardner
- Institute for Applied Health ResearchUniversity of BirminghamBirminghamUK
| | - Jingya Wang
- Institute for Applied Health ResearchUniversity of BirminghamBirminghamUK
| | | | - Chris Sainsbury
- Institute for Applied Health ResearchUniversity of BirminghamBirminghamUK
| | | | | | - Neil Thomas
- Institute for Applied Health ResearchUniversity of BirminghamBirminghamUK
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Nicolaisen SK, Thomsen RW, Lau CJ, Sørensen HT, Pedersen L. Development of a 5-year risk prediction model for type 2 diabetes in individuals with incident HbA1c-defined pre-diabetes in Denmark. BMJ Open Diabetes Res Care 2022; 10:10/5/e002946. [PMID: 36113888 PMCID: PMC9486231 DOI: 10.1136/bmjdrc-2022-002946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Pre-diabetes increases the risk of type 2 diabetes, but data are sparse on predictors in a population-based clinical setting. We aimed to develop and validate prediction models for 5-year risks of progressing to type 2 diabetes among individuals with incident HbA1c-defined pre-diabetes. RESEARCH DESIGN AND METHODS In this population-based cohort study, we used data from the Danish National Health Survey (DNHS; n=486 495), linked to healthcare registries and nationwide laboratory data in 2012-2018. We included individuals with a first HbA1c value of 42-47 mmol/mol (6.0%-6.4%), without prior indications of diabetes. To estimate individual 5-year cumulative incidences of type 2 diabetes (HbA1c ≥48 mmol/mol (6.5%)), Fine-Gray survival models were fitted in random 80% development samples and validated in 20% validation samples. Potential predictors were HbA1c, demographics, prescriptions, comorbidities, socioeconomic factors, and self-rated lifestyle. RESULTS Among 335 297 (68.9%) participants in DNHS with HbA1c measurements, 26 007 had pre-diabetes and were included in the study. Median HbA1c was 43.0 mmol/mol (IQR 42.0-44.0 mmol/mol, 6.1% (IQR 6.0%-6.2%)), median age was 69.6 years (IQR 61.0-77.1 years), and 51.9% were women. During a median follow-up of 2.7 years, 11.8% progressed to type 2 diabetes and 10.1% died. The final prediction model included HbA1c, age, sex, body mass index (BMI), any antihypertensive drug use, pancreatic disease, cancer, self-reported diet, doctor's advice to lose weight or change dietary habits, having someone to talk to, and self-rated health. In the validation sample, the 5-year area under the curve was 72.7 (95% CI 71.2 to 74.3), and the model was well calibrated. CONCLUSIONS In addition to well-known pre-diabetes predictors such as age, sex, and BMI, we found that measures of self-rated lifestyle, health, and social support are important and modifiable predictors for diabetes. Our model had an acceptable discriminative ability and was well calibrated.
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Affiliation(s)
- Sia K Nicolaisen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Reimar W Thomsen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Cathrine J Lau
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region of Denmark, Denmark
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Lars Pedersen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
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Djelić N, Borozan S, Dimitrijević-Srećković V, Pajović N, Mirilović M, Stopper H, Stanimirović Z. Oxidative Stress and DNA Damage in Peripheral Blood Mononuclear Cells from Normal, Obese, Prediabetic and Diabetic Persons Exposed to Thyroid Hormone In Vitro. Int J Mol Sci 2022; 23:ijms23169072. [PMID: 36012352 PMCID: PMC9409385 DOI: 10.3390/ijms23169072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/08/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022] Open
Abstract
Diabetes, a chronic group of medical disorders characterized byhyperglycemia, has become a global pandemic. Some hormones may influence the course and outcome of diabetes, especially if they potentiate the formation of reactive oxygen species (ROS). There is a close relationship between thyroid disorders and diabetes. The main objective of this investigation was to find out whether peripheral blood mononuclear cells (PBMCs) are more prone to DNA damage by triiodothyronine (T3) (0.1, 1 and 10 μM) at various stages of progression through diabetes (obese, prediabetics, and type 2 diabetes mellitus—T2DM persons). In addition, some biochemical parameters of oxidative stress (catalase-CAT, thiobarbituric acid reactive substances—TBARS) and lactate dehydrogenase (LDH) were evaluated. PBMCs from prediabetic and diabetic patients exhibited increased sensitivity for T3 regarding elevated level of DNA damage, inhibition of catalase, and increase of TBARS and LDH. PBMCs from obese patients reacted in the same manner, except for DNA damage. The results of this study should contribute to a better understanding of the role of thyroid hormones in the progression of T2DM.
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Affiliation(s)
- Ninoslav Djelić
- Department of Biology, Faculty of Veterinary Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Correspondence:
| | - Sunčica Borozan
- Department of Chemistry, Faculty of Veterinary Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | | | - Nevena Pajović
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Milorad Mirilović
- Department of Economics and Statistics, Faculty of Veterinary Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Helga Stopper
- Institute of Pharmacology and Toxicology, University of Würzburg, 97070 Würzburg, Germany
| | - Zoran Stanimirović
- Department of Biology, Faculty of Veterinary Medicine, University of Belgrade, 11000 Belgrade, Serbia
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Huang C, Ren C, Xuan X, Luo Y, Peng C. Nonlinear association between changes in fasting plasma glucose and the incidence of diabetes in a nondiabetic Chinese cohort. BMC Endocr Disord 2022; 22:191. [PMID: 35897092 PMCID: PMC9327176 DOI: 10.1186/s12902-022-01094-4] [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: 11/29/2021] [Accepted: 07/06/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Limited data show that changes in fasting plasma glucose (FPG changes) are related to the incidence of type 2 diabetes (T2D). We aimed to correlate FPG changes with incident diabetes and evaluate FPG changes as a marker to screen participants at high risk of T2D in China. METHODS A total of 116,816 individuals were followed during a median follow-up of 3.10 years by secondary analysis in a nondiabetic Chinese cohort. The turning points were derived from a receiver operating characteristic curve. Hazard ratios (HRs) were evaluated by Cox proportional hazards models. RESULTS A total of 2669 cases of T2D were identified (788 women and 1881 men). The age-standardized incidence of diabetes was 12.87 per 1000 person-years (women: 11.04; men: 14.69). A nonlinear relationship between FPG changes and incident diabetes is shown by the fitting curves. The curves were categorized into three stages by two turning points (-0.04 and 1.25 mmol/L) and conformed to the hook-like pattern: an initial decrease (stage-1), then a transient sharp elevation (stage-2), followed by a slow increase (stage-3). HRs per SD of FPG changes on incident diabetes varied with stage: stage-1: 0.16 (0.12, 0.23), stage-2: 0.20 (0.15, 0.28) and stage-3: 0.22 (0.16, 0.31). Compared with stage-1, the HR in stage-3 was significantly higher at 28.05 (23.99, 32.79), while the increase in stage-2 was slight at 2.16 (1.79, 2.61), and the HR in stage-3 rose to 30.09 (25.02, 36.19). CONCLUSIONS FPG changes had a strong correlation with the incidence of T2D and was a steady indicator that was used to distinguish the participants at high risk of diabetes.
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Affiliation(s)
- Chenghu Huang
- Department of Endocrinology, Bishan Hospital of Chongqing, Bishan Hospital of Chongqing Medical University, Bishan, Chongqing, 402760, China
| | - Chenhong Ren
- Taihe Hospital, Postgraduate Training Basement of Jinzhou Medical University, Hubei University of Medical, Shiyan, 442400, China
| | - Xiuping Xuan
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Yi Luo
- Department of Endocrinology, Bishan Hospital of Chongqing, Bishan Hospital of Chongqing Medical University, Bishan, Chongqing, 402760, China
| | - Caibi Peng
- Department of Endocrinology, Bishan Hospital of Chongqing, Bishan Hospital of Chongqing Medical University, Bishan, Chongqing, 402760, China.
- Bishan Maternity and Child Hospital of Chongqing, Bishan, Chongqing, 402760, China.
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11
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Wang X, Lin Y, Xiong Y, Zhang S, He Y, He Y, Zhang Z, Plasek JM, Zhou L, Bates DW, Tang C. Using an optimized generative model to infer the progression of complications in type 2 diabetes patients. BMC Med Inform Decis Mak 2022; 22:174. [PMID: 35778708 PMCID: PMC9250218 DOI: 10.1186/s12911-022-01915-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/22/2022] [Indexed: 02/08/2023] Open
Abstract
Background People live a long time in pre-diabetes/early diabetes without a formal diagnosis or management. Heterogeneity of progression coupled with deficiencies in electronic health records related to incomplete data, discrete events, and irregular event intervals make identification of pre-diabetes and critical points of diabetes progression challenging. Methods We utilized longitudinal electronic health records of 9298 patients with type 2 diabetes or prediabetes from 2005 to 2016 from a large regional healthcare delivery network in China. We optimized a generative Markov-Bayesian-based model to generate 5000 synthetic illness trajectories. The synthetic data were manually reviewed by endocrinologists. Results We build an optimized generative progression model for type 2 diabetes using anchor information to reduce the number of parameters learning in the third layer of the model from \documentclass[12pt]{minimal}
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\begin{document}$$N$$\end{document}N is the number of clinical findings, \documentclass[12pt]{minimal}
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\begin{document}$$C$$\end{document}C is the number of anchors. Based on this model, we infer the relationships between progression stages, the onset of complication categories, and the associated diagnoses during the whole progression of type 2 diabetes using electronic health records. Discussion Our findings indicate that 55.3% of single complications and 31.8% of complication patterns could be predicted early and managed appropriately to potentially delay (as it is a progressive disease) or prevented (by lifestyle modifications that keep patient from developing/triggering diabetes in the first place). Conclusions The full type 2 diabetes patient trajectories generated by the chronic disease progression model can counter a lack of real-world evidence of desired longitudinal timeframe while facilitating population health management.
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Affiliation(s)
- Xiaoxia Wang
- Shanghai Key Laboratory of Data Science, School of Computer Science, Fudan University, Shanghai, 200438, China.,College of Computer Science and Engineering, Northwest Normal University, Gansu, 730070, China
| | - Yifei Lin
- West China Hospital of Sichuan University, Sichuan, 610041, China
| | - Yun Xiong
- Shanghai Key Laboratory of Data Science, School of Computer Science, Fudan University, Shanghai, 200438, China
| | - Suhua Zhang
- Department of Kidney Disease, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Jiangsu, 215021, China
| | - Yanming He
- Department of Endocrinology, Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
| | - Yuqing He
- Institute for Data Industry, School of Economics, Fudan University, Shanghai, 200433, China
| | - Zhikun Zhang
- Shanghai Key Laboratory of Data Science, School of Computer Science, Fudan University, Shanghai, 200438, China.,Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Joseph M Plasek
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Li Zhou
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - David W Bates
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.,Clinical and Quality Analysis, Mass General Brigham, Boston, MA, 02145, USA
| | - Chunlei Tang
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA. .,Clinical and Quality Analysis, Mass General Brigham, Boston, MA, 02145, USA. .,Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA, 02120, USA.
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12
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Koyama AK, Bullard KM, Pavkov ME, Park J, Mardon R, Zhang P. Progression to Diabetes Among Older Adults With Hemoglobin A1c-Defined Prediabetes in the US. JAMA Netw Open 2022; 5:e228158. [PMID: 35442457 PMCID: PMC9021905 DOI: 10.1001/jamanetworkopen.2022.8158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This cohort study estimates the progression to diabetes among older adults with hemoglobin A1c–defined prediabetes in clinical settings in the US.
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Affiliation(s)
- Alain K. Koyama
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kai McKeever Bullard
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meda E. Pavkov
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joohyun Park
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Ping Zhang
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
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13
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Hu XY, Chang Y, Xu ZZ, Wang Y, Dai MM, Yu KK, Sun CB, Dong MX, Zhang JX, Xu N, Liu WS, Chen ZA. Rubusoside Reduces Blood Glucose and Inhibits Oxidative Stress by Activating the AMPK Signaling Pathway in Type 2 Diabetes Mellitus Mice. Nat Prod Commun 2022. [DOI: 10.1177/1934578x211069230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The current study aimed at investigating the therapeutic effects of rubusoside on type 2 diabetes mellitus (T2DM) mice models as an alternative hypoglycemic candidate drug. T2DM mice models were established with a combination of streptozotocin (STZ) intraperitoneal injection and high-fat diet. After 10 weeks of rubusoside intragastric administration (100, 200 mg/kg/day) to the mice, the body weight, fasting blood glucose, glucose tolerance, and blood lipids were measured. The liver protein expression levels of p-AMPK, GLUT2, GLUT4 and total antioxidant capacity were also investigated. After 10 weeks of rubusoside administration, the levels of blood glucose and lipids were decreased in T2DM mice. Compared with the model group, rubusoside administration significantly decreased the liver mass-to-body weight ratio, upregulated p-AMPK and GLUT4, and downregulated GLUT2 expression levels in the liver. Activities of superoxide dismutase (SOD), catalase (CAT), and gluathione peroxidase (GSH-Px) were increased, and the concentration of malondialdehyde (MDA) was decreased to reduce oxidative stress in the liver. Liver hematoxylin and eosin (H&E) pathological analysis also showed that rubusoside had a protective effect on T2DM mice liver. These results demonstrate that rubusoside could be used as an anti-diabetic candidate drug, and that its hypoglycemic mechanism might be related to the activation of adenosine 5′-monophosphate (AMP)-activated protein kinase (AMPK) to modulate the expression of GLUT2 and GLUT4. Finally, rubusoside could also increase total antioxidant capacity to protect the liver from oxidative stress.
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Affiliation(s)
- Xi-yu Hu
- College of Medical, Yanbian University, Yanji, PR China
| | | | - Zheng-zhe Xu
- Affiliated Hospital of Yanbian University, Yanji Jilin 133002, China
| | - Yan Wang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
| | - Min-min Dai
- College of Medical, Yanbian University, Yanji, PR China
| | - Kai-kai Yu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
| | - Cheng-biao Sun
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
| | - Ming-xin Dong
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
| | - Jian-xu Zhang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
| | - Na Xu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
- Jilin Medical College, Jilin, China
| | - Wen-sen Liu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
| | - Zheng-ai Chen
- College of Medical, Yanbian University, Yanji, PR China
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14
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Aljehani F, Alsulaiman A, Alqarni A, Almutairi F, Samkari M. Survey of Primary Care Physicians' Screening and Treatment Practices for Prediabetes in Saudi Arabia. Cureus 2022; 14:e21475. [PMID: 35106257 PMCID: PMC8786395 DOI: 10.7759/cureus.21475] [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] [Accepted: 01/21/2022] [Indexed: 11/05/2022] Open
Abstract
Background Prediabetes is defined as a condition in which glucose levels do not fulfill the criteria for type 2 diabetes mellitus (T2DM), indicating that the patient is at an increased risk of developing T2DM. The risk of developing T2DM can be decreased by adequately managing prediabetes. This study aimed to assess screening and therapeutic approaches to prediabetes among primary care physicians in Saudi Arabia because there is little contemporary data available on this topic. Methodology A cross-sectional study was performed among primary care physicians in Saudi Arabia. The participants completed a validated online survey questionnaire via Google Forms. Data collected included participants' demographic information, knowledge of T2DM risk factors, and opinions and beliefs on prediabetes management. Results In total, 155 primary care physicians responded to the questionnaire; 51% were male, 18.7% worked in Riyadh City, and 81.3% specialized in family medicine. Most study respondents (71.9%) were residents, and 64.5% worked for the Ministry of Health. Overall, 93.5% of the respondents had completed part of their postgraduate training in Saudi Arabia. Moreover, 27.7% of the respondents were aware of all nine risk factors associated with T2DM. The correct fasting glucose and hemoglobin A1c ranges for the diagnosis of prediabetes were identified by 50% and 43.6% of participants, respectively. Most respondents believed lifestyle modification and metformin to be the most effective management approaches to prediabetes, whereas lack of motivation toward lifestyle changes was deemed to be a major barrier. Conclusions We found significant gaps in primary care physicians' knowledge regarding prediabetes in Saudi Arabia, contributing to underscreening of the condition and undertreatment. Identifying these gaps is essential for focussing educational endeavors toward primary care physicians.
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Affiliation(s)
- Faisal Aljehani
- College of Medicine, Department of Internal Medicine, University of Jeddah, Jeddah, SAU
| | - Abdullah Alsulaiman
- College of Medicine, Department of Internal Medicine, University of Jeddah, Jeddah, SAU
| | - Abdulrahim Alqarni
- College of Medicine, Department of Internal Medicine, University of Jeddah, Jeddah, SAU
| | - Fahad Almutairi
- College of Medicine, Department of Internal Medicine, University of Jeddah, Jeddah, SAU
| | - May Samkari
- Health Program and Chronic Disease Adminstration, Public Health Administration at Saudi Ministry of Health, Jeddah, SAU
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15
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Lee JH, Chon S, Cha SA, Lim SY, Kim KR, Yun JS, Rhee SY, Yoon KH, Ahn YB, Woo JT, Ko SH. Impaired fasting glucose levels in overweight or obese subjects for screening of type 2 diabetes in Korea. Korean J Intern Med 2021; 36:382-391. [PMID: 32114752 PMCID: PMC7969057 DOI: 10.3904/kjim.2019.171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/05/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND/AIMS We examined the concordance rate among fasting plasma glucose (FPG), 2-hour post-challenge glucose (2hr PG), and hemoglobin A1c (HbA1c) in the diagnosis of diabetes in a population with a high-risk for type 2 diabetes mellitus (T2DM) in Korea. METHODS Among the participants from the Korean Diabetes Prevention Study, individuals with FPG ≥ 100 mg/dL, body mass index (BMI) ≥ 23.0 kg/m2, and no previous history of T2DM were consecutively enrolled after a 75 g glucose tolerance test. We analyzed the differences in the clinical characteristics in subjects with stage 1 (FPG, 100 to 109 mg/dL) and stage 2 (FPG, 110 to 125 mg/dL) impaired fasting glucose (IFG). RESULTS Of 1,637 participants, 27.2% had T2DM and 59.3% had IFG and/or impaired glucose tolerance (IGT). The mean age was 55.0 ± 8.1 years and the mean BMI was 26.3 ± 2.7 kg/m2. Based on FPG criteria, 515 (31.4%) and 352 (21.5%) subjects were classified as having stage 1 and stage 2 IFG, respectively. The 19.0% of stage 1 and 43.5% of stage 2 subjects showed 2hr PG levels in the diabetic range. Even for those in the normal FPG range, 63 (9.5%) participants showed a 2hr PG level of ≥ 200 mg/dL. Of 446 subjects with newly-diagnosed diabetes, 340 (76.2%) showed FPG levels < 126 mg/dL. CONCLUSION The oral glucose tolerance test should be actively considered for Korean adults who are overweight or obese with the IFG range (FPG, 100 to 125 mg/ dL) to allow for early detection of diabetes and prompt intervention.
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Affiliation(s)
- Jin-Hee Lee
- Catholic Institute of Smart Healthcare Center, Institute of Biomedical Industry, The Catholic University of Korea, Seoul, Korea
| | - Suk Chon
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Seon-Ah Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea
| | - Sun-Young Lim
- Catholic Institute of Smart Healthcare Center, Institute of Biomedical Industry, The Catholic University of Korea, Seoul, Korea
| | - Kook-Rye Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea
| | - Jae-Seung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kun-Ho Yoon
- Catholic Institute of Smart Healthcare Center, Institute of Biomedical Industry, The Catholic University of Korea, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yu-Bae Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea
| | - Jeong-Taek Woo
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea
- Correspondence to Seung-Hyun Ko, M.D. Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon 16247, Korea Tel: +82-31-881-8900 Fax: +82-31-253-8898 E-mail:
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16
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McKenzie AL, Athinarayanan SJ, McCue JJ, Adams RN, Keyes M, McCarter JP, Volek JS, Phinney SD, Hallberg SJ. Type 2 Diabetes Prevention Focused on Normalization of Glycemia: A Two-Year Pilot Study. Nutrients 2021; 13:749. [PMID: 33652715 PMCID: PMC7996820 DOI: 10.3390/nu13030749] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/09/2021] [Accepted: 02/19/2021] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study is to assess the effects of an alternative approach to type 2 diabetes prevention. Ninety-six patients with prediabetes (age 52 (10) years; 80% female; BMI 39.2 (7.1) kg/m2) received a continuous remote care intervention focused on reducing hyperglycemia through carbohydrate restricted nutrition therapy for two years in a single arm, prospective, longitudinal pilot study. Two-year retention was 75% (72 of 96 participants). Fifty-one percent of participants (49 of 96) met carbohydrate restriction goals as assessed by blood beta-hydroxybutyrate concentrations for more than one-third of reported measurements. Estimated cumulative incidence of normoglycemia (HbA1c <5.7% without medication) and type 2 diabetes (HbA1c ≥6.5% or <6.5% with medication other than metformin) at two years were 52.3% and 3%, respectively. Prevalence of metabolic syndrome, class II or greater obesity, and suspected hepatic steatosis significantly decreased at two years. These results demonstrate the potential utility of an alternate approach to type 2 diabetes prevention, carbohydrate restricted nutrition therapy delivered through a continuous remote care model, for normalization of glycemia and improvement in related comorbidities.
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Affiliation(s)
- Amy L McKenzie
- Virta Health, San Francisco, CA 94105, USA; (S.J.A.); (R.N.A.); (J.S.V.); (S.D.P.); (S.J.H.)
| | | | - Jackson J McCue
- University of Washington School of Medicine Wyoming WWAMI, Laramie, WY 82071, USA;
| | - Rebecca N Adams
- Virta Health, San Francisco, CA 94105, USA; (S.J.A.); (R.N.A.); (J.S.V.); (S.D.P.); (S.J.H.)
| | - Monica Keyes
- Department of Bariatric and Medical Weight Loss, Indiana University Health-Arnett, Lafayette, IN 47905, USA;
| | - James P McCarter
- Department of Genetics, Washington University School of Medicine, St. Louis, MO 63110, USA;
- Abbott Diabetes Care, Inc., Alameda, CA 94502, USA
| | - Jeff S Volek
- Virta Health, San Francisco, CA 94105, USA; (S.J.A.); (R.N.A.); (J.S.V.); (S.D.P.); (S.J.H.)
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA
| | - Stephen D Phinney
- Virta Health, San Francisco, CA 94105, USA; (S.J.A.); (R.N.A.); (J.S.V.); (S.D.P.); (S.J.H.)
| | - Sarah J Hallberg
- Virta Health, San Francisco, CA 94105, USA; (S.J.A.); (R.N.A.); (J.S.V.); (S.D.P.); (S.J.H.)
- Department of Bariatric and Medical Weight Loss, Indiana University Health-Arnett, Lafayette, IN 47905, USA;
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Abstract
Type 2 diabetes mellitus (T2DM) is associated with a two- to four-fold increased risk of developing cardiovascular disease (CVD) and microvascular complications, which may already be present before diagnosis. It is, therefore, important to detect people with an increased risk of T2DM at an early stage. In order to identify individuals with so-called 'pre-diabetes', comprising impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), current guidelines have developed definitions based on fasting plasma glucose, two-hour glucose concentrations and haemoglobin A1c. Subjects with pre-diabetes are at an increased risk of developing T2DM and CVD. This elevated risk seems similar according to the different criteria used to define pre-diabetes. The risk of progression to T2DM or CVD does, however, depend on other risk factors such as sex, body mass index and ethnicity. Based on the risk factors to develop T2DM, many risk assessment models have been developed to identify those at highest risk. These models perform well to identify those at risk and could be used to initiate preventive interventions. Many studies have shown that lifestyle modification and metformin are effective in preventing the development of T2DM, although lifestyle modification seems to have a more sustainable effect. In addition, lifestyle modification seems more effective in those with IGT than those with IFG. In this review, we will describe the different definitions used to define pre-diabetes, progression from pre-diabetes to T2DM or other vascular complications, risk factors associated with progressions and the management of progression to T2DM, ending with clinical recommendations.
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Affiliation(s)
- Jwj Beulens
- Department of Epidemiology and Biostatistics, Amsterdam UMC - Location VU, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - F Rutters
- Department of Epidemiology and Biostatistics, Amsterdam UMC - Location VU, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - L Rydén
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - O Schnell
- Forschergruppe Diabetes eV, Muenchen-Neuherberg, Germany
| | - L Mellbin
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - H E Hart
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Leidsche Rijn Julius Health Centers, Utrecht, The Netherlands
| | - R C Vos
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Leiden University Medical Center, Department of Public Health and Primary Care, LUMC-Campus The Hague, The Netherlands
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18
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Diet and Oral Health Coaching Methods and Models for the Independent Elderly. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10114021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Health-related behavior based on diet is an important determinant of oral health in independent elderly. Aging impairs senses, mastication, oral status, and function, causing nutritional needs and diet insufficiencies that contribute to a vicious circle of impairment. But the present needs of independent older adults suggest that health research and oral health care should shift from disease management and therapy to integral customized and personal treatment plans, including lifestyle, psychological, nutritional, and oral health coaching approaches. In this paper health coaching approaches in medical and dental settings are valued as to their effectiveness for older adults. Furthermore, coaching approaches for seniors are discussed and coaching models for better senior patient-dentist cooperation on the diet issue are suggested. Diet and oral health coaching is proven to be a modern senior patient-centered approach that needs to be incorporated at all relevant settings. It should aim to empower older adults in co-management of their oral diseases or bad diet habits affecting their oral health. This can be carried out through an incorporated educational plan for dentists either at the postgraduate or professional level since advantages seem to enhance the quality of life of the independent elderly.
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Sirdah MM, Reading NS. Genetic predisposition in type 2 diabetes: A promising approach toward a personalized management of diabetes. Clin Genet 2020; 98:525-547. [PMID: 32385895 DOI: 10.1111/cge.13772] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 05/04/2020] [Accepted: 05/04/2020] [Indexed: 02/06/2023]
Abstract
Diabetes mellitus, also known simply as diabetes, has been described as a chronic and complex endocrine metabolic disorder that is a leading cause of death across the globe. It is considered a key public health problem worldwide and one of four important non-communicable diseases prioritized for intervention through world health campaigns by various international foundations. Among its four categories, Type 2 diabetes (T2D) is the commonest form of diabetes accounting for over 90% of worldwide cases. Unlike monogenic inherited disorders that are passed on in a simple pattern, T2D is a multifactorial disease with a complex etiology, where a mixture of genetic and environmental factors are strong candidates for the development of the clinical condition and pathology. The genetic factors are believed to be key predisposing determinants in individual susceptibility to T2D. Therefore, identifying the predisposing genetic variants could be a crucial step in T2D management as it may ameliorate the clinical condition and preclude complications. Through an understanding the unique genetic and environmental factors that influence the development of this chronic disease individuals can benefit from personalized approaches to treatment. We searched the literature published in three electronic databases: PubMed, Scopus and ISI Web of Science for the current status of T2D and its associated genetic risk variants and discus promising approaches toward a personalized management of this chronic, non-communicable disorder.
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Affiliation(s)
- Mahmoud M Sirdah
- Division of Hematology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.,Biology Department, Al Azhar University-Gaza, Gaza, Palestine
| | - N Scott Reading
- Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, Utah, USA.,Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
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20
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Gamston CE, Kirby AN, Hansen RA, Redden DT, Whitley HP, Hanson C, Lloyd KB. Comparison of 3 risk factor-based screening tools for the identification of prediabetes. J Am Pharm Assoc (2003) 2020; 60:481-484. [PMID: 31889653 PMCID: PMC7269817 DOI: 10.1016/j.japh.2019.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 11/01/2019] [Accepted: 11/12/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare risk factor-based screening tools for identifying prediabetes. METHODS Participants in an employer-based wellness program were tested for glycosylated hemoglobin (A1C) at a regularly scheduled appointment, and prediabetes risk factor information was collected. The likelihood of having prediabetes and the need for laboratory testing were determined based on 3 risk factor-based screening tools: the Prediabetes Screening Test (PST), Prediabetes Risk Test (PRT), and 2016 American Diabetes Association guidelines (ADA2016). The results from the screening tools were compared with those of the A1C test. The predictive ability of the PST, PRT, and ADA2016 were compared using logistic regression. Results were validated with data from a secondary population. RESULTS Of the 3 risk factor-based tools examined, the PRT demonstrated the best combination of sensitivity and specificity for identifying prediabetes. From July 2016 to March 2017, 740 beneficiaries of an employer-sponsored wellness program had their A1C tested and provided risk factor information. The population prevalence of prediabetes was 9.3%. Analysis of a second independent population with a prediabetes prevalence of more than 50% of confirmed PRT's superiority despite differences in the calculated sensitivity and specificity for each population. CONCLUSION Because PRT predicts prediabetes better than PST or ADA2016, it should be used preferentially.
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21
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Barry E, Finnikin S. A borderline HBA 1c result. BMJ 2019; 365:l1361. [PMID: 30975710 DOI: 10.1136/bmj.l1361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Eleanor Barry
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Ramaswamy G, Chinnakali P, Selvaraju S, Nair D, Thekkur P, Selvaraj K, Shivashankar R, Singh AR, Vrushabhendra HN. High prevalence of prediabetes among the family members of individuals with diabetes. Findings from targeted screening program from south India. Diabetes Metab Syndr 2019; 13:866-872. [PMID: 30641823 DOI: 10.1016/j.dsx.2018.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 12/07/2018] [Indexed: 11/29/2022]
Abstract
AIM We aimed to screen for prediabetes, diabetes and other cardiovascular risk factors among family members of people with diabetes registered for care in a primary health centre in South India. METHODS During 2017-2018, we screened eligible family members of individuals with diabetes at their homes. We measured fasting capillary blood glucose (FCBG); for those with FCBG≥126 mg/dl, we confirmed the diagnosis of diabetes with fasting plasma glucose (FPG). We defined prediabetes as FCBG between 100 and 125 mg/dl; diabetes as both FCBG and FPG ≥126 mg/dl. We assessed non-communicable disease risk factors using WHO STEPS questionnaire. RESULTS Of total 884 participants, 873 (99%) underwent screening; 280 (32%) had prediabetes, and 19 (2.2%) were confirmed with diabetes. Of newly diagnosed, 17 (90%) were initiated on treatment. Of 873 participants, 180 (20.6%) were newly diagnosed with hypertension. Of the total, 7.3%, 5.2% and 16% reported tobacco use, alcohol use and high salt intake respectively. Nearly half (48%) had overweight. CONCLUSION Though the yield for diabetes is modest (3%), the house to house approach was able to screen 99% of eligible population. High prevalence of prediabetes and undiagnosed hypertension emphasize the need for screening and life style modifications.
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Affiliation(s)
- Gomathi Ramaswamy
- M.D. Community Medicine, Assistant Professor, Department of Community Medicine, Sri Venkateshwaraa Medical College Hospital and Research Center (SVMCH&RC), (Current Position: Research Officer, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, Puducherry, India.
| | - Palanivel Chinnakali
- M.D. Community Medicine, Associate Professor, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Sriram Selvaraju
- MPH, Scientist C, National Institute for Research in Tuberculosis, Chennai, India.
| | - Divya Nair
- M.D. Community Medicine, Program Officer, The INCLEN Trust International, New Delhi, India.
| | - Pruthu Thekkur
- M.D. Community Medicine, Monitoring and Evaluation Officer, The Union, South East Asia Office, New Delhi, India.
| | - Kalaiselvi Selvaraj
- M.D. Community Medicine, Assistant Professor, Department of Community Medicine, Pondicherry Institute of Medical Sciences (PIMS), Puducherry, India.
| | - Roopa Shivashankar
- M.D. Community Medicine, Centre for Chronic Disease Control, New Delhi, India.
| | - Akash Ranjan Singh
- M.D. Community Medicine, Senior Resident, Department of Community Medicine, All India Institute of Medical Sciences, Bhopal, India.
| | - Halevoor Nanjundappa Vrushabhendra
- M.D. Community Medicine, Assistant Professor, Department of Community Medicine, Sri Venkateshwaraa Medical College Hospital and Research Center (SVMCH&RC), (Current Position: Research Officer, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, Puducherry, India.
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23
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Wang QY, Tong AH, Pan YY, Zhang XD, Ding WY, Xiong W. The effect of cassia seed extract on the regulation of the LKB1-AMPK-GLUT4 signaling pathway in the skeletal muscle of diabetic rats to improve the insulin sensitivity of the skeletal muscle. Diabetol Metab Syndr 2019; 11:108. [PMID: 31890042 PMCID: PMC6924081 DOI: 10.1186/s13098-019-0504-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 12/09/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This study aimed to observe the hypoglycemic effect of cassia seed extract in rats with type-2 diabetes mellitus and its effect on reducing insulin resistance in the skeletal muscle. METHODS 50 rats were randomly divided into the normal, model, high-dose, middle-dose, and low-dose groups of cassia seed extract (n = 10 each). A high-fat diet combined with streptozotocin administration was adopted to build type 2 diabetes models. The cassia seed extract groups were fed different concentrations cassia seed extract while the normal and model groups were fed the same volume of normal saline. The weight, FINS, GIR, insulin tolerance, blood glucose and blood lipid level, oxidative stress indices and expressions related to the LKB1-AMPK-GLUT4 pathway were detected and compared between the two groups. RESULTS Compared with the normal group, the model group showed lower weight, glucose infusion rate and expressions related to LKB1-AMPK-GLUT4 pathway and higher FINS, insulin tolerance, blood glucose and blood lipid level and oxidative stress indices (all P < 0.05). Compared with the model group, higher weight, glucose infusion rate and expressions related to LKB1-AMPK-GLUT4 pathway and lower FINS, insulin tolerance, blood glucose and blood lipid level and oxidative stress indices were observed in all groups that were administered cassia see extract (all P < 0.05). CONCLUSION Cassia seed extract could noticeably improve the insulin resistance of diabetic rats and enhance the insulin sensitivity of their skeletal muscles. Its mechanism may be related to damage repair of the LKB1-AMPK-GLUT4 signaling pathway and oxidative stress in the skeletal muscle.
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Affiliation(s)
- Qiu-Ying Wang
- Endocrine Department, Heze Traditional Chinese Medicine Hospital, Heze, Shandong China
| | - Ai-Hua Tong
- Endocrinology Department, Linyi Central Hospital, Linyi, Shandong China
| | - Ying-Ying Pan
- Renal Rheumatism Immune Intervention Department, The People’s Hospital of Zhangqiu District, Jinan, Shandong China
| | - Xian-Dang Zhang
- Endocrine Department, Shandong Institute of Endocrine & Metabolic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, No. 18877, Jingshi Road, Lixia District, Jinan, 250062 China
| | - Wen-Yu Ding
- Endocrine Department, Shandong Institute of Endocrine & Metabolic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, No. 18877, Jingshi Road, Lixia District, Jinan, 250062 China
| | - Wen Xiong
- Endocrine Department, Shandong Institute of Endocrine & Metabolic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, No. 18877, Jingshi Road, Lixia District, Jinan, 250062 China
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24
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Sharma A, Kandlakunta H, Nagpal SJS, Ziding F, Hoos W, Petersen GM, Chari ST. Model to Determine Risk of Pancreatic Cancer in Patients With New-Onset Diabetes. Gastroenterology 2018; 155:730-739.e3. [PMID: 29775599 PMCID: PMC6120785 DOI: 10.1053/j.gastro.2018.05.023] [Citation(s) in RCA: 185] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/03/2018] [Accepted: 05/09/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND & AIMS Of patients with new-onset diabetes (NOD; based on glycemic status) older than 50 years, approximately 1% are diagnosed with pancreatic cancer (PC) within 3 years. We aimed to develop and validate a model to determine risk of PC in patients with NOD. METHODS We retrospectively collected data from 4 independent and nonoverlapping cohorts of patients (N = 1,561) with NOD (based on glycemic status; data collected at date of diagnosis and 12 months previously) in the Rochester Epidemiology Project from January 1, 2000 through December 31, 2015 to create our model. The model weighed scores for 3 factors identified in the discovery cohort to be most strongly associated with PC (64 patients with PC and 192 with type 2 diabetes): change in weight, change in blood glucose, and age at onset of diabetes. We called our model Enriching New-Onset Diabetes for Pancreatic Cancer (ENDPAC). We validated the locked-down model and cutoff score in an independent population-based cohort of 1,096 patients with diabetes; of these, 9 patients (82%) had PC within 3 years of meeting the criteria for NOD. RESULTS In the discovery cohort, the END-PAC model identified patients who developed PC within 3 years of diabetes onset (area under receiver operating characteristic curve 0.87); a score of at least 3 identified patients who developed PC with 80% sensitivity and specificity. In the validation cohort, a score of at least 3 identified 7 of 9 patients with PC (78%) with 85% specificity; the prevalence of PC in patients with a score of at least 3 (3.6%) was 4.4-fold greater than in patients with NOD. A high END-PAC score in patients who did not have PC (false positives) was often due to such factors as recent steroid use or different malignancy. An ENDPAC score no higher than 0 (in 49% of patients) meant that patients had an extremely low risk for PC. An END-PAC score of at least 3 identified 75% of patients in the discovery cohort more than 6 months before a diagnosis of PC. CONCLUSIONS Based on change in weight, change in blood glucose, and age at onset of diabetes, we developed and validated a model to determine risk of PC in patients with NOD based on glycemic status (END-PAC model). An independent prospective study is needed to further validate this model, which could contribute to early detection of PC.
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Affiliation(s)
- Ayush Sharma
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | | | | | - Feng Ziding
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - William Hoos
- Pancreatic Cancer Action Network, Manhattan Beach, CA
| | | | - Suresh T. Chari
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
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25
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DeJesus RS, Clark MM, Finney Rutten LJ, Jacobson RM, Croghan IT, Wilson PM, Jacobson DJ, Link SM, Fan C, St Sauver JL. Impact of a 12-week wellness coaching on self-care behaviors among primary care adult patients with prediabetes. Prev Med Rep 2018; 10:100-105. [PMID: 29850394 PMCID: PMC5966585 DOI: 10.1016/j.pmedr.2018.02.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 01/13/2018] [Accepted: 02/18/2018] [Indexed: 12/25/2022] Open
Abstract
This single arm prospective study assessed the impact of individualized wellness coaching intervention for primary care patients with prediabetes on self-reported changes in physical activity level and food choices. Five hundred sixty adult patients 18 years and older with prediabetes, seen in primary care clinic, were invited to participate in 12 weeks wellness coaching sessions delivered by certified coaches. Responses from questionnaires at baseline, 6 and 12 weeks were analyzed. Of 168 consented patients, 99 completed at least one coaching session; majority was elderly, female, overweight or obese. At baseline, 50% had <60 min aerobic exercise/week. At 6 and 12 weeks, average aerobic exercise time significantly increased from 117 min to 166 and 199 min respectively. Effect was sustained at 24 weeks. Success in making healthy eating choices also statistically improved from baseline. Significant effects on both activity level and eating behavior persisted even after adjusting for age, sex and baseline glucose/A1c values. Secondary outcomes of self-efficacy and quality of life likewise showed significant improvement. Results suggest that integration of wellness coaching in primary care practice among individuals at high risk for diabetes is feasible and may be useful as part of diabetes prevention management strategies in target populations. Future randomized clinical trials are needed to further explore this issue. Wellness coaching alone as an effective preventive strategy in patients with prediabetes is proposed. It can be incorporated in primary care practice. A 12 weeks session resulted in improved physical activity and healthy eating behavior. Self-efficacy and quality of life were also increased with coaching. Significant changes were seen in 6 weeks with sustained effect up to 24 weeks.
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Affiliation(s)
- Ramona S DeJesus
- Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.,Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Lila J Finney Rutten
- Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.,Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Robert M Jacobson
- Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.,Division of Community Pediatrics and Adolescent Medicine, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Ivana T Croghan
- Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.,Nicotine Research Program, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Patrick M Wilson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Debra J Jacobson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Sara M Link
- Dan Abrahams Healthy Living Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Chun Fan
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Jennifer L St Sauver
- Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.,Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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Strauss SM, McCarthy M. Arthritis-Related Limitations Predict Insufficient Physical Activity in Adults With Prediabetes Identified in the NHANES 2011-2014. DIABETES EDUCATOR 2017; 43:163-170. [PMID: 28169593 DOI: 10.1177/0145721717691849] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Purpose The purpose of the study was to determine the extent to which arthritis-related limitations are salient in predicting less than the recommended amount of time for adults with prediabetes to spend on moderate or vigorous physical activity. Methods Data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) in the United States were used to identify the predictors of insufficient physical activity in a large sample of adults with prediabetes 20 years of age and older (n = 2536). Results When extrapolated to more than 45 million adults in the United States at least 20 years of age with prediabetes, 42.7% had insufficient physical activity. Having arthritis-related functional limitations was a significant predictor of insufficient physical activity, even after accounting for the statistically significant contributions of female sex, older age, lower education level, higher body mass index, and depression. Conclusion When educating and counseling adults with prediabetes, diabetes educators should assess for arthritis-related functional limitations when examining factors that may affect prediabetes progression. Recommendations for physical activity for those with mobility and other limitations need to be individualized within a tailored exercise program to accommodate their specific limitations.
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Affiliation(s)
- Shiela M Strauss
- New York University Rory Meyers College of Nursing, New York, NY, USA (Dr Strauss, Dr McCarthy)
| | - Margaret McCarthy
- New York University Rory Meyers College of Nursing, New York, NY, USA (Dr Strauss, Dr McCarthy)
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