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Cao Y, Shrestha A, Janiczak A, Li X, Lu Y, Haregu T. Lifestyle Intervention in Reducing Insulin Resistance and Preventing type 2 Diabetes in Asia Pacific Region: A Systematic Review and Meta-Analysis. Curr Diab Rep 2024; 24:207-215. [PMID: 39083158 PMCID: PMC11303493 DOI: 10.1007/s11892-024-01548-0] [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] [Accepted: 07/14/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE OF REVIEW To update the evidence of lifestyle interventions for the prevention of type 2 diabetes mellites (T2DM) in adults, particularly in the Asia Pacific region. The key questions to ask are: 1) How effective are lifestyle interventions in preventing T2DM among at-risk adults in the Asia Pacific Region? 2)What are the key characteristics of the implementation of lifestyle interventions for diabetes prevention? RECENT FINDINGS Lifestyle interventions for the prevention of T2DM have been suggested to be effective. There is evidence of ethnic differences in some glycaemic and anthropometric outcomes. The meta-analysis suggested a significant result in reducing waist circumference (standardised mean difference - 019, 95%CI ( -0.31, -0.06)), and no significant effects in other outcomes. However, the implementation outcomes suggested lifestyle intervention might be a cost-effective and sustainable approach in T2DM particularly in countries in the Asia Pacific Region. The focus of lifestyle intervention in the Asia Pacific Region should not only lie in the effectiveness of the trial but a thorough evaluation of the implementation outcomes, as well as cultural adaptations, with the support of all stakeholders through all stages of the implementation.
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Affiliation(s)
- Yingting Cao
- School of Allied Health, Human Services and Sport, La Trobe University, Plenty Road, Kingsbury Dr, Bundoora, VIC 3086, Australia.
- Non-communicable and implementation science lab, Baker Heart and Diabetes Institute, Alice Springs, Australia.
| | - Abha Shrestha
- Non-communicable and implementation science lab, Baker Heart and Diabetes Institute, Alice Springs, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Amy Janiczak
- School of Allied Health, Human Services and Sport, La Trobe University, Plenty Road, Kingsbury Dr, Bundoora, VIC 3086, Australia
| | - Xia Li
- Statistics Consultancy Platform, La Trobe University, Melbourne, Australia
| | - Yang Lu
- Non-communicable and implementation science lab, Baker Heart and Diabetes Institute, Alice Springs, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- School of Sociology and Population Studies, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Tilahun Haregu
- Non-communicable and implementation science lab, Baker Heart and Diabetes Institute, Alice Springs, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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Carrasco-Zanini J, Pietzner M, Wheeler E, Kerrison ND, Langenberg C, Wareham NJ. Multi-omic prediction of incident type 2 diabetes. Diabetologia 2024; 67:102-112. [PMID: 37889320 PMCID: PMC10709231 DOI: 10.1007/s00125-023-06027-x] [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: 06/07/2023] [Accepted: 08/30/2023] [Indexed: 10/28/2023]
Abstract
AIMS/HYPOTHESIS The identification of people who are at high risk of developing type 2 diabetes is a key part of population-level prevention strategies. Previous studies have evaluated the predictive utility of omics measurements, such as metabolites, proteins or polygenic scores, but have considered these separately. The improvement that combined omics biomarkers can provide over and above current clinical standard models is unclear. The aim of this study was to test the predictive performance of genome, proteome, metabolome and clinical biomarkers when added to established clinical prediction models for type 2 diabetes. METHODS We developed sparse interpretable prediction models in a prospective, nested type 2 diabetes case-cohort study (N=1105, incident type 2 diabetes cases=375) with 10,792 person-years of follow-up, selecting from 5759 features across the genome, proteome, metabolome and clinical biomarkers using least absolute shrinkage and selection operator (LASSO) regression. We compared the predictive performance of omics-derived predictors with a clinical model including the variables from the Cambridge Diabetes Risk Score and HbA1c. RESULTS Among single omics prediction models that did not include clinical risk factors, the top ten proteins alone achieved the highest performance (concordance index [C index]=0.82 [95% CI 0.75, 0.88]), suggesting the proteome as the most informative single omic layer in the absence of clinical information. However, the largest improvement in prediction of type 2 diabetes incidence over and above the clinical model was achieved by the top ten features across several omic layers (C index=0.87 [95% CI 0.82, 0.92], Δ C index=0.05, p=0.045). This improvement by the top ten omic features was also evident in individuals with HbA1c <42 mmol/mol (6.0%), the threshold for prediabetes (C index=0.84 [95% CI 0.77, 0.90], Δ C index=0.07, p=0.03), the group in whom prediction would be most useful since they are not targeted for preventative interventions by current clinical guidelines. In this subgroup, the type 2 diabetes polygenic risk score was the major contributor to the improvement in prediction, and achieved a comparable improvement in performance when added onto the clinical model alone (C index=0.83 [95% CI 0.75, 0.90], Δ C index=0.06, p=0.002). However, compared with those with prediabetes, individuals at high polygenic risk in this group had only around half the absolute risk for type 2 diabetes over a 20 year period. CONCLUSIONS/INTERPRETATION Omic approaches provided marginal improvements in prediction of incident type 2 diabetes. However, while a polygenic risk score does improve prediction in people with an HbA1c in the normoglycaemic range, the group in whom prediction would be most useful, even individuals with a high polygenic burden in that subgroup had a low absolute type 2 diabetes risk. This suggests a limited feasibility of implementing targeted population-based genetic screening for preventative interventions.
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Affiliation(s)
- Julia Carrasco-Zanini
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Institute of Metabolic Science, Cambridge, UK
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
- Precision Healthcare University Research Institute, Queen Mary University of London, London, UK
| | - Maik Pietzner
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Institute of Metabolic Science, Cambridge, UK
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
- Precision Healthcare University Research Institute, Queen Mary University of London, London, UK
| | - Eleanor Wheeler
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Institute of Metabolic Science, Cambridge, UK
| | - Nicola D Kerrison
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Institute of Metabolic Science, Cambridge, UK
| | - Claudia Langenberg
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Institute of Metabolic Science, Cambridge, UK.
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Precision Healthcare University Research Institute, Queen Mary University of London, London, UK.
| | - Nicholas J Wareham
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Institute of Metabolic Science, Cambridge, UK.
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Wang X, Tian B, Zhang S, Zhang J, Yang W, Li J, Wang W, Wang Y, Zhang W. Diabetes knowledge predicts HbA1c levels of people with type 2 diabetes mellitus in rural China: a ten-month follow-up study. Sci Rep 2023; 13:18248. [PMID: 37880376 PMCID: PMC10600128 DOI: 10.1038/s41598-023-45312-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 10/18/2023] [Indexed: 10/27/2023] Open
Abstract
Improving diabetes self-management (DSM) is facing real-world challenges among people with type 2 diabetes mellitus (T2DM) who have a low education level in resource-limited areas. This study aimed to investigate whether diabetes knowledge could predict glycemic levels in people with T2DM in rural China. This analytical cross-sectional study recruited 321 people with T2DM from eight villages by purposive sampling at baseline. After 10 months, 206 patients completed the follow-up survey and HbA1c tests, with a response rate of 64.17% (206/321). Multiple regression analysis was employed to explore the correlation between diabetes knowledge and HbA1c levels. The patient's diabetes knowledge was significantly negatively correlated with HbA1c levels before and after controlling for covariates in both hierarchical multiple regression and multiple logistic regression (p < 0.01). In addition, other influencing factors, including sex, age, marital status, employment status, income, and HbA1c levels at baseline, were also identified. Diabetes knowledge could predict HbA1c levels significantly among patients with low education levels in rural China. Therefore, interventions on improving diabetes knowledge need to be strengthened for patients in rural China so that they can improve their health outcomes and reduce the disease burden.
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Affiliation(s)
- Xiaoying Wang
- School of Social Development and Public Policy, Center for Behavioral Health, Beijing Normal University, Beijing, China
| | - Bo Tian
- School of Social Development and Public Policy, Center for Behavioral Health, Beijing Normal University, Beijing, China
| | - Shengfa Zhang
- National Population Heath Data Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinsui Zhang
- School of Public Health, Fudan University, Shanghai, China
| | - Weiping Yang
- Yancheng Dafeng People's Hospital, Yancheng, Jiangsu Province, China
| | - Jina Li
- School of Social Development and Public Policy, Center for Behavioral Health, Beijing Normal University, Beijing, China
| | - Weiwei Wang
- School of Sociology and Population Studies, Renmin University of China, Beijing, China
| | - Yuchen Wang
- North China Electric Power University, Beijing, China
| | - Weijun Zhang
- School of Social Development and Public Policy, Center for Behavioral Health, Beijing Normal University, Beijing, China.
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Bodhini D, Morton RW, Santhakumar V, Nakabuye M, Pomares-Millan H, Clemmensen C, Fitzpatrick SL, Guasch-Ferre M, Pankow JS, Ried-Larsen M, Franks PW, Tobias DK, Merino J, Mohan V, Loos RJF. Impact of individual and environmental factors on dietary or lifestyle interventions to prevent type 2 diabetes development: a systematic review. COMMUNICATIONS MEDICINE 2023; 3:133. [PMID: 37794109 PMCID: PMC10551013 DOI: 10.1038/s43856-023-00363-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND The variability in the effectiveness of type 2 diabetes (T2D) preventive interventions highlights the potential to identify the factors that determine treatment responses and those that would benefit the most from a given intervention. We conducted a systematic review to synthesize the evidence to support whether sociodemographic, clinical, behavioral, and molecular factors modify the efficacy of dietary or lifestyle interventions to prevent T2D. METHODS We searched MEDLINE, Embase, and Cochrane databases for studies reporting on the effect of a lifestyle, dietary pattern, or dietary supplement interventions on the incidence of T2D and reporting the results stratified by any effect modifier. We extracted relevant statistical findings and qualitatively synthesized the evidence for each modifier based on the direction of findings reported in available studies. We used the Diabetes Canada Clinical Practice Scale to assess the certainty of the evidence for a given effect modifier. RESULTS The 81 publications that met our criteria for inclusion are from 33 unique trials. The evidence is low to very low to attribute variability in intervention effectiveness to individual characteristics such as age, sex, BMI, race/ethnicity, socioeconomic status, baseline behavioral factors, or genetic predisposition. CONCLUSIONS We report evidence, albeit low certainty, that those with poorer health status, particularly those with prediabetes at baseline, tend to benefit more from T2D prevention strategies compared to healthier counterparts. Our synthesis highlights the need for purposefully designed clinical trials to inform whether individual factors influence the success of T2D prevention strategies.
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Affiliation(s)
| | - Robert W Morton
- Department of Pathology & Molecular Medicine, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
- Department of Translational Medicine, Medical Science, Novo Nordisk Foundation, Tuborg Havnevej 19, 2900, Hellerup, Denmark
| | - Vanessa Santhakumar
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Mariam Nakabuye
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hugo Pomares-Millan
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Skåne University Hospital Malmö, Malmö, Sweden
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Christoffer Clemmensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stephanie L Fitzpatrick
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Marta Guasch-Ferre
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - James S Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Mathias Ried-Larsen
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
- Institute for Sports and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Paul W Franks
- Department of Translational Medicine, Medical Science, Novo Nordisk Foundation, Tuborg Havnevej 19, 2900, Hellerup, Denmark
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Lund University Diabetes Centre, Department of Clinical Sciences, Lund University, Malmo, Sweden
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Deirdre K Tobias
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jordi Merino
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Diabetes Unit, Endocrine Division, Massachusetts General Hospital, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation, Chennai, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Ruth J F Loos
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Wang Z, Shi Q, Zeng Y, Li Y. Experiences and perceptions of self-management in people with prediabetes: A qualitative meta-synthesis. J Clin Nurs 2023; 32:5886-5903. [PMID: 37016501 DOI: 10.1111/jocn.16713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/13/2022] [Accepted: 03/20/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Diabetes has become a global public health problem. Strengthening the self-management ability of people with prediabetes plays an important role in preventing the occurrence and development of type 2 diabetes. The aim of this study is to synthesise the self-management experiences and perceptions of people with prediabetes, which can contribute to the development of self-management programs. METHODS This review adheres to the ENTREQ Guide. Evidence-based medicine database (JBI and Cochrane) and original literature database (PubMed, Medline, EMbase, Web of Science, Wanfang, CNKI and VIP) were searched up to 31 May 2022. Both Chinese and English literature of qualitative research on self-management experiences and perceptions of prediabetic patients were included. The quality of the included studies was evaluated, and the data were synthesised and analysed by thematic synthesis method. RESULTS A total of 23 primary studies containing 504 participants were included. After repeated reading and coding of the literature, three analytical themes were finally identified: coping with role management, success and failure in medical management, seeking and perceiving support. CONCLUSION Role management for people with prediabetes needs more attention. Healthcare providers should identify problems from patients' self-management experiences and improve professional skills to assist program modifications. Integrating the self-management program into community activities under the guidance of medical staff and inviting family members and peers to participate can increase involvement and improve the self-management ability. RELEVANCE TO CLINICAL PRACTICE These findings describe the different stages and issues in the self-management process of prediabetic patients. The practice of prediabetes self-management should incorporate the psychosocial, physical, and financial issues of the patients. As the main provider of health services, nurses should make patients aware of the susceptibility and severity of prediabetes and help them improve their self-management skills. NO PATIENT OR PUBLIC CONTRIBUTION This is a meta-synthesis without direct participation of patients.
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Affiliation(s)
- Zixin Wang
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qifang Shi
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yue Zeng
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yuzhe Li
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Bodhini D, Morton RW, Santhakumar V, Nakabuye M, Pomares-Millan H, Clemmensen C, Fitzpatrick SL, Guasch-Ferre M, Pankow JS, Ried-Larsen M, Franks PW, Tobias DK, Merino J, Mohan V, Loos RJF. Role of sociodemographic, clinical, behavioral, and molecular factors in precision prevention of type 2 diabetes: a systematic review. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.03.23289433. [PMID: 37205385 PMCID: PMC10187453 DOI: 10.1101/2023.05.03.23289433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The variability in the effectiveness of type 2 diabetes (T2D) preventive interventions highlights the potential to identify the factors that determine treatment responses and those that would benefit the most from a given intervention. We conducted a systematic review to synthesize the evidence to support whether sociodemographic, clinical, behavioral, and molecular characteristics modify the efficacy of dietary or lifestyle interventions to prevent T2D. Among the 80 publications that met our criteria for inclusion, the evidence was low to very low to attribute variability in intervention effectiveness to individual characteristics such as age, sex, BMI, race/ethnicity, socioeconomic status, baseline behavioral factors, or genetic predisposition. We found evidence, albeit low certainty, to support conclusions that those with poorer health status, particularly those with prediabetes at baseline, tend to benefit more from T2D prevention strategies compared to healthier counterparts. Our synthesis highlights the need for purposefully designed clinical trials to inform whether individual factors influence the success of T2D prevention strategies.
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Wang C, Zhang X, Li C, Li N, Jia X, Zhao H. Construction and Validation of a Model for Predicting Impaired Fasting Glucose Based on More Than 4000 General Population. Int J Gen Med 2023; 16:1415-1428. [PMID: 37155467 PMCID: PMC10122862 DOI: 10.2147/ijgm.s409426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023] Open
Abstract
Purpose Impaired fasting glucose (IFG) is associated with an increased risk of multiple diseases. Therefore, the early identification and intervention of IFG are particularly significant. Our study aims to construct and validate a clinical and laboratory-based nomogram (CLN) model for predicting IFG risk. Patients and Methods This cross-sectional study collected information on health check-up subjects. Risk predictors were screened mainly by the LASSO regression analysis and were applied to construct the CLN model. Furthermore, we showed examples of applications. Then, the accuracy of the CLN model was evaluated by the receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC) values, and the calibration curve of the CLN model in the training set and validation set, respectively. The decision curve analysis (DCA) was used to estimate the level of clinical benefit. Furthermore, the performance of the CLN model was evaluated in the independent validation dataset. Results In the model development dataset, 2340 subjects were randomly assigned to the training set (N = 1638) and validation set (N = 702). Six predictors significantly associated with IFG were screened and used in the construction of the CLN model, a subject was randomly selected, and the risk of developing IFG was predicted to be 83.6% by using the CLN model. The AUC values of the CLN model were 0.783 in the training set and 0.789 in the validation set. The calibration curve demonstrated good concordance. DCA showed that the CLN model has good clinical application. We further performed independent validation (N = 1875), showed an AUC of 0.801, with the good agreement and clinical diagnostic value. Conclusion We developed and validated the CLN model that could predict the risk of IFG in the general population. It not only facilitates the diagnosis and treatment of IFG but also helps to reduce the medical and economic burdens of IFG-related diseases.
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Affiliation(s)
- Cuicui Wang
- Department of Health Examination Center, The Second Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Xu Zhang
- Department of Respiratory Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Chenwei Li
- Department of Respiratory Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Na Li
- Department of General Practice, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an, People’s Republic of China
| | - Xueni Jia
- Department of Health Examination Center, The Second Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Hui Zhao
- Department of Health Examination Center, The Second Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
- Correspondence: Hui Zhao, Department of Health Examination Center, The Second Affiliated Hospital of Dalian Medical University, No. 467 Zhongshan Road, Shahekou District, Dalian, 116023, People’s Republic of China, Tel +86-17709875689, Email
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Pramono A, Fitranti DY, Nugroho KH, Sobirin MA, Syauqy A. The Association between Unhealthy Food Consumption and Impaired Glucose Metabolism among Adults with Overweight or Obesity: A Cross-Sectional Analysis of the Indonesian Population. J Obes 2023; 2023:2885769. [PMID: 37006782 PMCID: PMC10060072 DOI: 10.1155/2023/2885769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND It has been shown that dietary patterns are associated with glucose control. However, the association between the types of food consumed and blood glucose in overweight or obese individuals is still unclear. The present study aimed to determine the association between unhealthy food consumption and impaired glucose metabolism in adults with overweight or obesity. METHODS The analysis presented in this study was based on the data from a population-based, cross-sectional, nationally representative survey (Indonesian Basic Health Research 2018/RISKESDAS 2018). The body mass index (BMI) was calculated as weight (kg)/height squared (m2) and was determined based on the World Health Organization (WHO) criteria for the Asian population. A validated questionnaire and food card were used to assess the diet. Fasting plasma glucose and 2-hpost-prandial glucose were employed to determine blood glucose markers. RESULTS In total, 8752 adults with overweight or obesity were included in this analysis. We found that consumption of sweet, grilled, and processed foods was associated with impaired fasting plasma glucose (IFG) before and after adjustment (p < 0.05). Consumption of high-fat foods was also associated with impaired glucose tolerance (IGT) for all models tested (p < 0.05). Furthermore, all models showed a link between processed food consumption and combined glucose intolerance (CGI) (p ≤ 0.001). CONCLUSIONS Differential food group consumption was associated with IFG, IGT, and CGI in Indonesian adults who were overweight or obese.
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Affiliation(s)
- Adriyan Pramono
- Department of Nutrition, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
- Center of Nutrition Research (Cenure), Diponegoro University, Tembalang, Semarang 50275, Indonesia
| | - Deny Y. Fitranti
- Department of Nutrition, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
- Center of Nutrition Research (Cenure), Diponegoro University, Tembalang, Semarang 50275, Indonesia
| | - K. Heri Nugroho
- Department of Internal Medicine, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
| | - M. Ali Sobirin
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
| | - Ahmad Syauqy
- Department of Nutrition, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
- Center of Nutrition Research (Cenure), Diponegoro University, Tembalang, Semarang 50275, Indonesia
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Hao J, Yao Q, Lin Y, Sun Y, Zhang B, Hu M, Zhang J, Zhao N, Pei J, Liu Z, Zhu C. Cost-effectiveness of two screening strategies based on Chinese diabetes risk score for pre-diabetes in China. Front Public Health 2022; 10:1018084. [PMID: 36530668 PMCID: PMC9747942 DOI: 10.3389/fpubh.2022.1018084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Objective Studies have shown that screening for pre-diabetes mellitus (pre-DM) is essential to prevent type 2 diabetes mellitus (T2DM). This study evaluates the cost-effectiveness of two screening strategies that apply the Chinese Diabetes Risk Score (CDRS) to screen for pre-DM in China. Methods A Markov microsimulation model was conducted from a social perspective, and the input parameters were obtained from published literature or publicly available data. Two screening strategies for pre-DM based on CDRS were built and compared with the control group to determine the cost-effective strategy. The screening strategy of the control group was screening for pre-DM by fasting plasma glucose (FPG) test in adults undergoing annual health examination and no screening in adults without an annual health examination (status quo). Two screening strategies were strategy 1: screening for pre-DM using CDRS in all adults (including with or without an annual health examination); and strategy 2: supplemental self-screening for pre-DM using CDRS in adults without an annual health examination, based on the status quo. We focus on the cumulative prevalence of T2DM and the incremental cost-effectiveness ratio which signifies the cost per case of T2DM prevented. We also evaluated the cost-effectiveness from the health system perspective. One-way and probabilistic sensitivity analyses were conducted to verify the robustness of the results. Results The costs a case of T2DM prevented for strategy 1 compared with the control group and strategy 2 were $299.67 (95% CI 298.88, 300.46) and $385.89 (95% CI 381.58, 390.20), respectively. In addition, compared with the control group, the cost of strategy 2 to prevent a case of T2DM was $272.23 (95% CI 271.50, 272.96). Conclusions Screening for pre-DM using CDRS in all adults was the most cost-effective health policy. We suggest that medical institutions replace FPG with CDRS for pre-DM screening; at the same time, self-screening for pre-DM using CDRS is widely promoted among adults without an annual health examination. There were still some disputes about how CDRS is included in the health examination projects, so strategy 2 should be considered as an alternative screening strategy. Findings provide a reference for the application of the CDRS in pre-DM screening and contribute to T2DM prevention.
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Affiliation(s)
- Jingjing Hao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Qiang Yao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yidie Lin
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yue Sun
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Baiyang Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Meijing Hu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jing Zhang
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, China
| | - Ningxuan Zhao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jiao Pei
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zhonghua Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China,*Correspondence: Zhonghua Liu
| | - Cairong Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China,Cairong Zhu
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10
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Carrasco-Zanini J, Pietzner M, Lindbohm JV, Wheeler E, Oerton E, Kerrison N, Simpson M, Westacott M, Drolet D, Kivimaki M, Ostroff R, Williams SA, Wareham NJ, Langenberg C. Proteomic signatures for identification of impaired glucose tolerance. Nat Med 2022; 28:2293-2300. [PMID: 36357677 PMCID: PMC7614638 DOI: 10.1038/s41591-022-02055-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 09/27/2022] [Indexed: 11/12/2022]
Abstract
The implementation of recommendations for type 2 diabetes (T2D) screening and diagnosis focuses on the measurement of glycated hemoglobin (HbA1c) and fasting glucose. This approach leaves a large number of individuals with isolated impaired glucose tolerance (iIGT), who are only detectable through oral glucose tolerance tests (OGTTs), at risk of diabetes and its severe complications. We applied machine learning to the proteomic profiles of a single fasted sample from 11,546 participants of the Fenland study to test discrimination of iIGT defined using the gold-standard OGTTs. We observed significantly improved discriminative performance by adding only three proteins (RTN4R, CBPM and GHR) to the best clinical model (AUROC = 0.80 (95% confidence interval: 0.79-0.86), P = 0.004), which we validated in an external cohort. Increased plasma levels of these candidate proteins were associated with an increased risk for future T2D in an independent cohort and were also increased in individuals genetically susceptible to impaired glucose homeostasis and T2D. Assessment of a limited number of proteins can identify individuals likely to be missed by current diagnostic strategies and at high risk of T2D and its complications.
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Affiliation(s)
- Julia Carrasco-Zanini
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Maik Pietzner
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Joni V Lindbohm
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
- The Klarman Cell Observatory, Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Eleanor Wheeler
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Erin Oerton
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Nicola Kerrison
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | | | | | | - Mika Kivimaki
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | | | - Nicholas J Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Claudia Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK.
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Precision Healthcare University Research Institute, Queen Mary University of London, London, UK.
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11
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Zhu W. Exercise is medicine for type 2 diabetes: An interview with Dr. Sheri R. Colberg. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:179-183. [PMID: 35066215 PMCID: PMC9068737 DOI: 10.1016/j.jshs.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/14/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Weimo Zhu
- Shanghai University of Sport, Shanghai 200438, China; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
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12
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Sathish T, Tapp RJ, Shaw JE. Do lifestyle interventions reduce diabetes incidence in people with isolated impaired fasting glucose? Diabetes Obes Metab 2021; 23:2827-2828. [PMID: 34432366 DOI: 10.1111/dom.14529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 01/24/2023]
Affiliation(s)
| | - Robyn J Tapp
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
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