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Al-Onaizi M, Braysh K, Alkafeef SS, Altarrah D, Dannoon S, Alasousi D, Adel H, Al-Ajmi M, Kandari A, Najem R, Nizam R, Williams MR, John S, Thanaraj TA, Ahmad R, Al-Hussaini H, Al-Mulla F, Alzaid F. Glucose intolerance induces anxiety-like behaviors independent of obesity and insulin resistance in a novel model of nutritional metabolic stress. Nutr Neurosci 2024; 27:1143-1161. [PMID: 38319634 DOI: 10.1080/1028415x.2024.2310419] [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: 02/07/2024]
Abstract
OBJECTIVES Type 2 diabetes (T2D) is a metabolic disease of major public health concern. It impacts peripheral tissues and the central nervous system, leading to systemic dysmetabolism and neurocognitive impairments, including memory deficits, anxiety, and depression. The metabolic determinants of these neurocognitive impairments remain unidentified. Here, we sought to address this question by developing a proprietary (P-) high-fat diet (HFD), in which glucose intolerance precedes weight gain and insulin resistance. METHODS The P-HFD model was nutritionally characterized, and tested in vivo in mice that underwent behavioral and metabolic testing. The diet was benchmarked against reference models. . RESULTS P-HFD has 42% kcal from fat, high monounsaturated/polyunsaturated fatty acid ratio, and 10% (w/v) sucrose in drinking water. When administered, from the early stages of glucose intolerance alone, animals exhibit anxiety-like behavior, without depression nor recognition memory deficits. Long-term P-HFD feeding leads to weight gain, brain glucose hypometabolism as well as impaired recognition memory. Using an established genetic model of T2D (db/db) and of diet-induced obesity (60% kcal from fat) we show that additional insulin resistance and obesity are associated with depressive-like behaviors and recognition memory deficits. DISCUSSION Our findings demonstrate that glucose intolerance alone can elicit anxiety-like behavior. Through this study, we also provide a novel nutritional model (P-HFD) to characterize the discrete effects of glucose intolerance on cognition, behavior, and the physiology of metabolic disease.
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Affiliation(s)
- Mohammed Al-Onaizi
- Faculty of Medicine, Department of Anatomy, Kuwait University, Kuwait City, Kuwait
- Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Kawthar Braysh
- Faculty of Medicine, Department of Anatomy, Kuwait University, Kuwait City, Kuwait
| | - Selma S Alkafeef
- Faculty of Medicine, Department of Biochemistry, Kuwait University, Kuwait City, Kuwait
| | - Dana Altarrah
- Faculty of Public Health, Department of Social and Behavioral Science, Kuwait University, Kuwait City, Kuwait
| | - Shorouk Dannoon
- Faculty of Medicine, Department of Nuclear Medicine, Kuwait University, Kuwait City, Kuwait
| | - Dalal Alasousi
- Faculty of Science, Department of Biochemistry, Kuwait University, Kuwait City, Kuwait
| | - Hawraa Adel
- Faculty of Medicine, Department of Anatomy, Kuwait University, Kuwait City, Kuwait
| | - Mariam Al-Ajmi
- Faculty of Science, Department of Biochemistry, Kuwait University, Kuwait City, Kuwait
| | - Anwar Kandari
- Dasman Diabetes Institute, Kuwait City, Kuwait
- Ministry of Health, Kuwait City, Kuwait
| | - Rawan Najem
- Dasman Diabetes Institute, Kuwait City, Kuwait
| | | | | | - Sumi John
- Dasman Diabetes Institute, Kuwait City, Kuwait
| | | | | | - Heba Al-Hussaini
- Faculty of Medicine, Department of Anatomy, Kuwait University, Kuwait City, Kuwait
| | | | - Fawaz Alzaid
- Dasman Diabetes Institute, Kuwait City, Kuwait
- INSERM UMR-S1151, CNRS UMR-S8253, Université Paris Cité, Institut Necker Enfants Malades, Paris, France
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Salinero-Fort M, Mostaza-Prieto JM, Lahoz-Rallo C, Cárdenas-Valladolid J, Iriarte-Campo V, Estirado-Decabo E, Garcia-Iglesias F, Gonzalez-Alegre T, Fernandez-Puntero B, Cornejo-Del Rio VM, Sanchez-Arroyo V, Sabín-Rodríguez C, López-López S, Gómez-Campelo P, Taulero-Escalera B, Rodriguez-Artalejo F, San Andrés-Rebollo FJ, De Burgos-Lunar C. External validation of three diabetes prediction scores in a Spanish cohort: does adding high risk for depression improve the validation of the FINDRISC score (FINDRISC-MOOD)? BMJ Open 2024; 14:e083121. [PMID: 38844393 PMCID: PMC11163630 DOI: 10.1136/bmjopen-2023-083121] [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: 12/14/2023] [Accepted: 05/17/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES To evaluate the external validity of the FINDRISC, DESIR and ADA risk scores for the prediction of diabetes in a Spanish population aged >45 years and to test the possible improvement of FINDRISC by adding a new variable of high risk of depression when Patient Health Questionnaire-9 (PHQ-9) questionnaire score ≥10 (FINDRISC-MOOD). DESIGN Prospective population-based cohort study. SETTING 10 primary healthcare centres in the north of the city of Madrid (Spain). PARTICIPANTS A total of 1242 participants without a history of diabetes and with 2-hour oral glucose tolerance test (OGTT) plasma glucose <200 mg/dL (<11.1 mmol/L) were followed up for 7.3 years (median) using their electronic health records (EHRs) and telephone contact. PRIMARY AND SECONDARY OUTCOME MEASURES Diabetes risk scores (FINDRISC, DESIR, ADA), PHQ-9 questionnaire and 2-hour-OGTT were measured at baseline. Incident diabetes was defined as treatment for diabetes, fasting plasma glucose ≥126 mg/dL (≥7.0 mmol/L), new EHR diagnosis or self-reported diagnosis. External validation was performed according to optimal cut-off, sensitivity, specificity and Youden Index. Comparison between diabetes risk scores, including FINDRISC-MOOD (original FINDRISC score plus five points if PHQ-9 ≥10), was measured by area under the receiver operating characteristic curve (AUROC). RESULTS During follow-up, 104 (8.4%; 95% CI, 6.8 to 9.9) participants developed diabetes and 185 had a PHQ-9 score ≥10. The AUROC values were 0.70 (95% CI, 0.67 to 0.72) for FINDRISC-MOOD and 0.68 (95% CI, 0.65 to 0.71) for the original FINDRISC. The AUROCs for DESIR and ADA were 0.66 (95% CI, 0.63 to 0.68) and 0.66 (95% CI, 0.63 to 0.69), respectively. There were no significant differences in AUROC between FINDRISC-MOOD and the other scores. CONCLUSIONS The results of FINDRISC-MOOD were like those of the other risk scores and do not allow it to be recommended for clinical use.
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Affiliation(s)
- Miguel Salinero-Fort
- FIIBAP, Madrid, Spain
- Frailty, patterns of multimorbidity and mortality in the community-dwelling elderly population, IdiPAZ, Madrid, Spain
| | | | | | - Juan Cárdenas-Valladolid
- Gerencia Asistencial de Atención Primaria, Comunidad de Madrid Servicio Madrileno de Salud, Madrid, Spain
- Enfermería, Universidad Alfonso X El Sabio, Villanueva de la Canada, Spain
| | | | | | | | | | | | | | | | | | | | - Paloma Gómez-Campelo
- Fundación de Investigación, La Paz University Hospital Health Research Institute, Madrid, Spain
| | - Belen Taulero-Escalera
- Foundation for Research and Biomedical Innovation of Primary Care of the Community of Madrid (FIIBAP), Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autonoma de Madrid, Madrid, Spain
- CIBERESP, Madrid, Spain
- IMDEA-Food, CEI UAM+CSIC, Madrid, Spain
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Liu J, Yao C, Wang Y, Zhao J, Luo H. Non-drug interventions of traditional Chinese medicine in preventing type 2 diabetes: a review. Chin Med 2023; 18:151. [PMID: 37964315 PMCID: PMC10644617 DOI: 10.1186/s13020-023-00854-1] [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: 07/12/2023] [Accepted: 10/23/2023] [Indexed: 11/16/2023] Open
Abstract
Traditional Chinese medicine (TCM) is increasingly used to manage type 2 diabetes and its nonpharmacological interventions are showing potential for preventing type 2 diabetes. This study mainly reviews relevant research. The most mentioned non-drug treatments for preventing type 2 diabetes in TCM are healthy diet, physical activity, emotional therapy, and acupuncture. In most studies, blood glucose status in patients with prediabetes and type 2 diabetes was significantly improved after TCM non-drug interventions, and there was no significant difference between the adverse effect of TCM and control groups or other intervention groups, while the methodological quality of the clinical trials involving TCM generally kept a low level. The effectiveness of TCM in preventing type 2 diabetes has yet to be validated in large randomized controlled trials and the underlying mechanism also needs further exploration.
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Affiliation(s)
- Jingying Liu
- Macau Centre for Research and Development in Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, 999078, People's Republic of China
| | - Chun Yao
- Guangxi University of Chinese Medicine, Nanning, 530001, People's Republic of China
| | - Yitao Wang
- Macau Centre for Research and Development in Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, 999078, People's Republic of China
| | - Jinmin Zhao
- College of Pharmacy, Guangxi Medical University, Nanning, 530021, People's Republic of China.
| | - Hua Luo
- Macau Centre for Research and Development in Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, 999078, People's Republic of China.
- College of Pharmacy, Guangxi Medical University, Nanning, 530021, People's Republic of China.
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Arnardóttir E, Sigurðardóttir ÁK, Graue M, Kolltveit BCH, Skinner T. Can Waist-to-Height Ratio and Health Literacy Be Used in Primary Care for Prioritizing Further Assessment of People at T2DM Risk? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6606. [PMID: 37623189 PMCID: PMC10454465 DOI: 10.3390/ijerph20166606] [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: 06/16/2023] [Revised: 08/09/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND To identify people at risk of type 2 diabetes. Primary health care needs efficient and noninvasive screening tools to detect individuals in need of follow-up to promote health and well-being. Previous research has shown people with lower levels of health literacy and/or well-being scores are vulnerable but may benefit from intervention and follow-up care. AIMS This cross-sectional study, aimed to identify people at risk for type 2 diabetes by comparing the Finnish Diabetes Risk instrument with the waist-to-height ratio. Further, the difference was examined in health literacy and well-being scale scores in the countryside versus town areas, respectively. RESULTS In total, 220, aged 18-75 years, participated. Thereof, 13.2% displayed biomarkers at prediabetes level of HbA1c (39-47 mmol/mol); none had undiagnosed diabetes. Of the participants, 73% were overweight or obese. Waist-to-height ratio demonstrated 93.1% of the prediabetes group at moderate to high health risk and 64.4% of the normal group, with an area under the curve of 0.759, sensitivity of 93.3%, and specificity of 63.1%. Residency did not influence prediabetes prevalence, health literacy, or well-being. CONCLUSION Waist-to-height ratio and the Finnish Diabetes Risk instrument may be suitable for identifying who need further tests and follow-up care for health promotion in primary care.
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Affiliation(s)
- Elín Arnardóttir
- School of Health, Business and Natural Sciences, University of Akureyri, 600 Akureyri, Iceland
- Health Care Institution of North Iceland, 580 Siglufjordur, Iceland
| | - Árún K. Sigurðardóttir
- School of Health, Business and Natural Sciences, University of Akureyri, 600 Akureyri, Iceland
- Akureyri Hospital, 600 Akureyri, Iceland
| | - Marit Graue
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, 5063 Bergen, Norway
| | | | - Timothy Skinner
- Institute of Psychology, University of Copenhagen, 1017 Copenhagen K, Denmark
- Australian Centre for Behavioral Research in Diabetes, Melbourne, VIC 3053, Australia
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