The association of specific types of vegetables consumption with 10-year type II diabetes risk: Findings from the ATTICA cohort study

Effects and mechanisms of anti-diabetic dietary natural products: an updated review

Diabetes is a global public health issue, characterized by an abnormal level of blood glucose. It can be classified into type 1, type 2, gestational, and other rare diabetes. Recent studies have reported that many dietary natural products exhibit anti-diabetic activity. In this narrative review, the effects and underlying mechanisms of dietary natural products on diabetes are summarized based on the results from epidemiological, experimental, and clinical studies. Some fruits (e.g., grape, blueberry, and cherry), vegetables (e.g., bitter melon and Lycium barbarum leaves), grains (e.g., oat, rye, and brown rice), legumes (e.g., soybean and black bean), spices (e.g., cinnamon and turmeric) and medicinal herbs (e.g., Aloe vera leaf and Nigella sativa), and vitamin C and carotenoids could play important roles in the prevention and management of diabetes. Their underlying mechanisms include exerting antioxidant, anti-inflammatory, and anti-glycation effects, inhibiting carbohydrate-hydrolyzing enzymes, enhancing insulin action, alleviating insulin resistance, modulating the gut microbiota, and so on. This review can provide people with a comprehensive knowledge of anti-diabetic dietary natural products, and support their further development into functional food to prevent and manage diabetes.

Cardiometabolic Care: Assessing Patients with Diabetes Mellitus with No Overt Cardiovascular Disease in the Light of Heart Failure Development Risk

The mechanisms leading to the development of heart failure (HF) in diabetes mellitus (DM) patients are multifactorial. Assessing the risk of HF development in patients with DM is valuable not only for the identification of a high-risk subgroup, but also equally important for defining low-risk subpopulations. Nowadays, DM and HF have been recognized as sharing similar metabolic pathways. Moreover, the clinical manifestation of HF can be independent of LVEF classification. Consequently, approaching HF should be through structural, hemodynamic and functional evaluation. Thus, both imaging parameters and biomarkers are important tools for the recognition of diabetic patients at risk of HF manifestation and HF phenotypes, and arrhythmogenic risk, and eventually for prognosis, aiming to improve patients' outcomes utilizing drugs and non-pharmaceutical cardioprotective tools such as diet modification.

Additive effects of obesity and vitamin D insufficiency on all-cause and cause-specific mortality

Obesity and vitamin D deficiency are both considered risk factors for mortality, but the potential additive effects of vitamin D status and obesity on mortality has not been well-studied. We aimed to examine the possible additive effects of obesity and vitamin D status on all-cause and cause-specific mortality. The data from the NHANES III (1988–1994) and NHANES 2001–2014 surveys were used, and multivariate Cox regression models were performed to assess the additive effects of vitamin D status and overweight/obesity/abdominal obesity on the all-cause, cardiovascular and cancer mortality, by stratifying Cox Hazard Ratios (HRs) across different categories of vitamin D status and body mass index (BMI) and waist circumference (WC) categories. The models were adjusted for age, race/ethnicity, gender, educational level, family income to poverty ratio, leisure-time physical activity, smoking, and drinking. Across all BMI/WC categories, there was an additive effect of the vitamin D both insufficiency and deficiency on all mortality rates, with deficiency having much stronger effect than insufficiency. Interestingly, the effect of vitamin D deficiency overcame the effect of obesity on all mortality rates. The highest HRs for overall and cardiovascular mortality were observed among vitamin D deficient obese/abdominally obese subjects, while for cancer mortality among vitamin D deficient normal weight/non-abdominally obese subjects. In stratified analyses, regarding all-cause mortality, there was an additive effect of the vitamin D both insufficiency and deficiency in all BMI/WC categories. Regarding cardiovascular mortality, there was an additive effect of vitamin D deficiency in all BMI/WC categories, but the additive effect of vitamin D insufficiency reached significance only in normal weight subjects. Regarding cancer mortality, the effect did not reach significance among obese subjects for vitamin D deficiency, while for insufficiency, significance was reached only among non-abdominally obese subjects. Interestingly, vitamin D surplus was associated with increased risk for cancer mortality in obese subjects, but there was an inadequate number of subjects in this category to make proper judgment. In conclusion, vitamin D insufficiency and deficiency gradually increase risk for mortality across all BMI/WC categories. In our analyses, vitamin D deficiency overcame the effect of obesity on mortality rates.