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Frank GKW, Scolnick B. Therapeutic ketogenic diet as treatment for anorexia nervosa. Front Nutr 2024; 11:1392135. [PMID: 39296512 PMCID: PMC11409850 DOI: 10.3389/fnut.2024.1392135] [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: 02/27/2024] [Accepted: 08/13/2024] [Indexed: 09/21/2024] Open
Abstract
Anorexia nervosa (AN) is a severe psychiatric disorder. However, we lack neurobiological models and interventions to explain and treat the core characteristics of food restriction, feeling fat, and body size overestimation. Research has made progress in understanding brain function involved in the pathophysiology of AN, but translating those results into biological therapies has been challenging. Studies have suggested that metabolic factors could contribute to developing and maintaining AN pathophysiology. Here, we describe a neurobiological model for why using a therapeutic ketogenic diet could address key alterations in brain function in AN and prevent the desire for weight loss and associated eating disorder-specific symptoms. This translational model is based on animal studies and human data and integrates behavioral traits, brain neural energy metabolism, and neurotransmitter function. Pilot data indicate that the intervention can dramatically reduce eating and body-related fears, although larger studies across illness stages still need to be conducted.
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Affiliation(s)
- Guido K W Frank
- Department of Psychiatry, San Diego School of Medicine, University of California, San Diego, San Diego, CA, United States
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Vasdeki D, Tsamos G, Athanasiadou KI, Michou V, Botsarakos E, Doumas M, Kotsa K, Koufakis T. Above the Clouds with Diabetes: From Pathophysiological Considerations to Practical Recommendations for Safe Flights. High Alt Med Biol 2024. [PMID: 39093868 DOI: 10.1089/ham.2024.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Abstract
Vasdeki, Dimitra, Georgios Tsamos, Kleoniki I. Athanasiadou, Vasiliki Michou, Evangelos Botsarakos, Michael Doumas, Kalliopi Kotsa, and Theocharis Koufakis. Above the clouds with diabetes: From pathophysiological considerations to practical recommendations for safe flights. High Alt Med Biol. 00:00-00, 2024. Background: The prevalence of diabetes mellitus has been following an increasing trend in the last decades, leading to a growing number of travelers with diabetes seeking pretravel advice from medical professionals. Methods: This narrative review summarizes the existing evidence on the intriguing association between diabetes and air travel, analyzes safety and certification protocols, and provides practical recommendations for the management of diabetes during flights. Results: During air travel, individuals with diabetes face challenges arising from inappropriate dietary options, restricted access to medications and healthcare services, disruption of medication dosing intervals, and exposure to hypobaric conditions in the airplane cabin. In addition, people with diabetes, especially those treated with insulin, have traditionally been considered ineligible to become professional pilots. However, this approach gradually changes and numerous countries are now implementing strict protocols to determine the eligibility of pilots with diabetes to operate flights. Conclusions: Given the increasing use of technology and new drugs in daily clinical practice, there is a need for further research in the field to shed light on existing knowledge gaps and ensure safe flights for people with diabetes.
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Affiliation(s)
- Dimitra Vasdeki
- Division of Endocrinology and Metabolism and Diabetes Centre, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Georgios Tsamos
- Division of Endocrinology and Metabolism and Diabetes Centre, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Kleoniki I Athanasiadou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki Michou
- Sports Medicine Laboratory, School of Physical Education & Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Michael Doumas
- Second Propedeutic Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kalliopi Kotsa
- Division of Endocrinology and Metabolism and Diabetes Centre, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Theocharis Koufakis
- Second Propedeutic Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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3
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Yuan S, Chen Y, Xie L. Association between glucose levels at admission and outcomes of pneumonia: a systematic review and meta-analysis. BMC Pulm Med 2024; 24:369. [PMID: 39080623 PMCID: PMC11290157 DOI: 10.1186/s12890-024-03126-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 06/24/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Elevated blood glucose at hospital admission is frequently observed and has been associated with adverse outcomes in various patient populations. This meta-analysis sought to consolidate existing evidence to assess the association between elevated blood glucose at admission and clinical outcomes amongst pneumonia patients. METHODS We searched PubMed, Medline, Cochrane library, Web of Science (WoS), and Scopus databases for studies, published up to 31 August 2023, and reporting on the clinical outcomes and the blood glucose levels at admission. Data were extracted by two independent reviewers. Random-effects meta-analyses were used to pool odds ratios (ORs) with 95% confidence intervals (CI) for dichotomous outcomes and weighted mean differences (WMDs) for continuous outcomes. RESULTS A total of 23 studies with 34,000 participants were included. Elevated blood glucose at admission was significantly associated with increased short-term (pooled OR: 2.67; 95%CI: 1.73-4.12) and long-term mortality (pooled OR: 1.70; 95%CI: 1.20-2.42). Patients with raised glucose levels were more likely to require ICU admission (pooled OR: 1.86; 95%CI: 1.31-2.64). Trends also suggested increased risks for hospital readmission and mechanical ventilation, though these were not statistically significant. Elevated blood glucose was linked with approximately 0.72 days longer duration of hospital stay. CONCLUSION Elevated blood glucose level at the time of hospital admission is associated with several adverse clinical outcomes, especially mortality, in patients with pneumonia. These findings underscore the importance of recognizing hyperglycemia as significant prognostic marker in pneumonia patients. Further research is needed to determine whether targeted interventions to control glucose levels can improve these outcomes.
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Affiliation(s)
- Siqi Yuan
- Intensive Care Unit, The First People's Hospital of Linping District, 369 Yingbin Road, Nanyuan Street, Linping District, Hangzhou City, Zhejiang Province, 311199, China
| | - Yixia Chen
- Intensive Care Unit, The First People's Hospital of Linping District, 369 Yingbin Road, Nanyuan Street, Linping District, Hangzhou City, Zhejiang Province, 311199, China
| | - Ling Xie
- Intensive Care Unit, The First People's Hospital of Linping District, 369 Yingbin Road, Nanyuan Street, Linping District, Hangzhou City, Zhejiang Province, 311199, China.
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Tabowei G, Dadzie SK, Ahmed S, Lohana M, Shahzad M, Zehra SN, Zubair M, Khan A. Comparison of the Clinical Manifestations of Acute Coronary Syndrome Between Diabetic and Non-diabetic Patients: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e64311. [PMID: 39130937 PMCID: PMC11316346 DOI: 10.7759/cureus.64311] [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] [Accepted: 07/09/2024] [Indexed: 08/13/2024] Open
Abstract
The presentation of acute coronary syndrome (ACS) in patients with type 2 diabetes mellitus (T2DM) may differ from that of non-diabetic patients, potentially leading to delayed diagnosis and treatment. This meta-analysis aimed to compare the clinical presentation of ACS between diabetic and non-diabetic patients. A systematic search of PubMed, Excerpta Medica database (EMBASE), and Web of Science databases was conducted for observational studies published from January 2010 onwards. Studies comparing ACS symptoms between diabetic and non-diabetic patients were included. The odds ratio (OR) with 95% confidence intervals (CI) was calculated using a random-effects model. Eight studies with a total of 29,503 patients (23.03% diabetic) were included. Diabetic patients were significantly less likely to present with chest pain compared to non-diabetic patients (OR: 0.43, 95% CI: 0.30 to 0.63, p<0.001). Anxiety (OR: 2.20, 95% CI: 1.17-4.14), shortness of breath (OR: 1.49, 95% CI: 1.11-2.01), and neck pain (OR: 1.62, 95% CI: 1.03-2.54) were significantly more common in diabetic patients. Sweating/cold sweat was less common in diabetics (OR: 0.60, 95% CI: 0.34-1.07), though not statistically significant. Other symptoms showed minimal differences between groups. High heterogeneity was observed across studies for most symptoms. This meta-analysis demonstrates that diabetic patients with ACS are less likely to experience typical chest pain and more likely to present with atypical symptoms such as anxiety, shortness of breath, and neck pain. These findings emphasize the need for healthcare providers to maintain high vigilance for atypical ACS presentations in diabetic patients. Tailored diagnostic approaches, modified triage protocols, and enhanced patient education are crucial to improving the timely diagnosis and treatment of ACS in this high-risk population.
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Affiliation(s)
- Godfrey Tabowei
- Internal Medicine, Texas Tech University Health Sciences Center, Odessa, USA
| | - Samuel K Dadzie
- Internal Medicine, Piedmont Athens Regional Medical Center, Athens, USA
| | - Saeed Ahmed
- Cardiology, Mohtarma Benazir Bhutto Shaheed Medical College, Mirpur, PAK
| | - Muskan Lohana
- Medicine, Liaquat University of Medical and Health Sciences, Hyderabad, PAK
| | | | | | | | - Areeba Khan
- Critical Care Medicine, United Medical and Dental College, Karachi, PAK
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MR Z, SN G, RR M, AA M, NL V, UG G, SM M, TF A. Characterization of Rhodiola heterodonta (Crassulaceae): Phytocomposition, Antioxidant and Antihyperglycemic Activities. Prev Nutr Food Sci 2024; 29:135-145. [PMID: 38974598 PMCID: PMC11223926 DOI: 10.3746/pnf.2024.29.2.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/29/2024] [Accepted: 05/21/2024] [Indexed: 07/09/2024] Open
Abstract
Plant extracts have been widely used in traditional medicine to prevent diabetes. The present study aimed to examine the antihyperglycemic properties of an ethanolic extract from Rhodiola heterodonta roots. In vitro evaluation revealed that treatment with the R. heterodonta extract resulted in significant reactive oxygen species inhibition, glucose binding, glucose transporter activation, and suppression of α-amylase and α-glucosidase. Moreover, the treatment with 100 mg/kg of R. heterodonta extract dramatically decreased glucose levels in glucose-, alloxan-, or adrenaline-induced diabetic rats. The information gathered in this study bridges the knowledge gap between traditional healers in Uzbekistan who utilize R. heterodonta and its potential for future medication development.
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Affiliation(s)
- Zaripova MR
- Institute of Bioorganic Chemistry, Academy of Science of Uzbekistan, Tashkent 100125, Uzbekistan
| | - Gayibova SN
- Institute of Bioorganic Chemistry, Academy of Science of Uzbekistan, Tashkent 100125, Uzbekistan
| | - Makhmudov RR
- Institute of Bioorganic Chemistry, Academy of Science of Uzbekistan, Tashkent 100125, Uzbekistan
| | - Mamadrahimov AA
- Institute of Bioorganic Chemistry, Academy of Science of Uzbekistan, Tashkent 100125, Uzbekistan
| | - Vypova NL
- Institute of Bioorganic Chemistry, Academy of Science of Uzbekistan, Tashkent 100125, Uzbekistan
| | - Gayibov UG
- Institute of Bioorganic Chemistry, Academy of Science of Uzbekistan, Tashkent 100125, Uzbekistan
| | - Miralimova SM
- Institute of Microbiology, Academy of Science of Uzbekistan, Tashkent 100128, Uzbekistan
| | - Aripov TF
- Institute of Bioorganic Chemistry, Academy of Science of Uzbekistan, Tashkent 100125, Uzbekistan
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Ribeiro G, Monge J, Postolache O, Pereira JMD. A Novel AI Approach for Assessing Stress Levels in Patients with Type 2 Diabetes Mellitus Based on the Acquisition of Physiological Parameters Acquired during Daily Life. SENSORS (BASEL, SWITZERLAND) 2024; 24:4175. [PMID: 39000954 PMCID: PMC11243842 DOI: 10.3390/s24134175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 07/16/2024]
Abstract
Stress is the inherent sensation of being unable to handle demands and occurrences. If not properly managed, stress can develop into a chronic condition, leading to the onset of additional chronic health issues, such as cardiovascular illnesses and diabetes. Various stress meters have been suggested in the past, along with diverse approaches for its estimation. However, in the case of more serious health issues, such as hypertension and diabetes, the results can be significantly improved. This study presents the design and implementation of a distributed wearable-sensor computing platform with multiple channels. The platform aims to estimate the stress levels in diabetes patients by utilizing a fuzzy logic algorithm that is based on the assessment of several physiological indicators. Additionally, a mobile application was created to monitor the users' stress levels and integrate data on their blood pressure and blood glucose levels. To obtain better performance metrics, validation experiments were carried out using a medical database containing data from 128 patients with chronic diabetes, and the initial results are presented in this study.
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Affiliation(s)
- Gonçalo Ribeiro
- Department of Information Science and Technology, Iscte-Instituto Universitário de Lisboa, Av. das Forças Armadas, 1649-026 Lisbon, Portugal
- Instituto de Telecomunicações (IT), Instituto Superior Técnico, North Tower, 10th Floor, Av. Rovisco Pais 1, 1049-001 Lisbon, Portugal
| | - João Monge
- Department of Information Science and Technology, Iscte-Instituto Universitário de Lisboa, Av. das Forças Armadas, 1649-026 Lisbon, Portugal
- Instituto de Telecomunicações (IT), Instituto Superior Técnico, North Tower, 10th Floor, Av. Rovisco Pais 1, 1049-001 Lisbon, Portugal
| | - Octavian Postolache
- Department of Information Science and Technology, Iscte-Instituto Universitário de Lisboa, Av. das Forças Armadas, 1649-026 Lisbon, Portugal
- Instituto de Telecomunicações (IT), Instituto Superior Técnico, North Tower, 10th Floor, Av. Rovisco Pais 1, 1049-001 Lisbon, Portugal
| | - José Miguel Dias Pereira
- Instituto de Telecomunicações, 3810-193 Aveiro, Portugal
- Instituto Politécnico de Setúbal, Escola Superior de Tecnologia de Setúbal, 2910-761 Setúbal, Portugal
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Shin KS, Park MS, Lee MY, Cho EH, Woo HY, Park H, Kwon MJ. Baseline glycated albumin level and risk of type 2 diabetes mellitus in Healthy individuals: a retrospective longitudinal observation in Korea. Scand J Clin Lab Invest 2024; 84:168-173. [PMID: 38634263 DOI: 10.1080/00365513.2024.2341412] [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: 12/13/2023] [Accepted: 04/07/2024] [Indexed: 04/19/2024]
Abstract
Glycated albumin (GA) reflects glycemic status for the past three weeks. GA level demonstrates a strong correlation with HbA1c level and is used as an adjunctive biomarker for diagnosis and monitoring of type 2 diabetes mellitus (T2DM). In this study, we validated the predictive performance of baseline GA for development of T2DM in healthy individuals in Korea. From August 2013 to September 2014, the medical records of 3,771 healthy Koreans were retrospectively reviewed. Each participant was categorized into tertiles based on initial GA level. During the follow-up period through May 2020, study participants were evaluated for T2DM using HbA1c, fasting glucose level, and a self-reported diagnosis history. Baseline GA level by tertile (T1 to T3) was 10.4 ± 0.8% (mean ± SD), 12.1 ± 0.3%, and 13.7 ± 0.9%, respectively. The median follow-up was 5.97 years, during which 4.9% (186 of 3,771) of the participants developed T2DM. After adjusting for confounding factors, the hazard ratio for the development of T2DM in the highest GA level group (T3) compared to the reference group (T1) was 2.46 (95% CI, 1.7 to 3.58, p < 0.001 for trend) with a Harrell's C index of 0.80 (95% CI, 0.76 to 0.83). Also, within highest group of baseline HbA1c and FG levels, higher GA levels were associated with an increased HRs for T2DM. In conclusion, Our study confirms that the risk of T2DM increases with baseline GA level. Additional follow-up of the cohort is warranted to investigate the correlations between GA and other clinical indicators including diabetic complications.
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Affiliation(s)
- Kang-Su Shin
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Min-Seung Park
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Mi Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Eun Hye Cho
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hee-Yeon Woo
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyosoon Park
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Min-Jung Kwon
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
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8
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Chang WY, Wang X, Guo DS, Nguyen LHP, Tran NH, Yang SJ, Lin HZ, Wu HC, Huang CF. Explore the effects of forest travel activities on university students' stress affection. Front Psychol 2024; 14:1240499. [PMID: 38268801 PMCID: PMC10806104 DOI: 10.3389/fpsyg.2023.1240499] [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: 06/24/2023] [Accepted: 12/20/2023] [Indexed: 01/26/2024] Open
Abstract
This study aims to explore the effects of forest travel activities on university students' stress affection. Forty volunteer university students participated in this study. All participants were asked to complete physiological (Heart Rate Variability) and psychological (Brief Profile of Mood State and State-Trait Anxiety Inventory) tests before and after the travel activities. The results reported that students' heart rates were significantly lower after the forest travel activities than before. All domains of negative mood and anxiety decreased from the pre-test to the post-test. This study found that university students could feel less stressed if they went on forest travel activities.
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Affiliation(s)
- Wei-Yin Chang
- College of Forestry, Fujian Agriculture and Forestry University, Fujian, China
| | - Xin Wang
- College of Forestry, Fujian Agriculture and Forestry University, Fujian, China
| | - De-Sheng Guo
- College of Forestry, Fujian Agriculture and Forestry University, Fujian, China
| | - Lam-Huu-Phuoc Nguyen
- Graduate Institute of Science Education and Environmental Education, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Ngoc-Huy Tran
- Graduate Institute of Science Education and Environmental Education, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Shuai-Jie Yang
- College of Forestry, Fujian Agriculture and Forestry University, Fujian, China
| | - Hui-Zhong Lin
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hsiu-Chen Wu
- Department of Food and Beverage Management, Cheng Shiu University, Kaohsiung, Taiwan
| | - Chin-Fei Huang
- Graduate Institute of Science Education and Environmental Education, National Kaohsiung Normal University, Kaohsiung, Taiwan
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Lekha PPS, Azeez EPA. Psychosocial Facilitators and Barriers to Type 2 Diabetes Management in Adults: A Meta-Synthesis. Curr Diabetes Rev 2024; 20:110-123. [PMID: 38310483 DOI: 10.2174/0115733998283436231207093250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/10/2023] [Accepted: 11/29/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Globally, the cases of type 2 diabetes are increasing, and this is largely attributed to lifestyle changes. Though diabetes is primarily a metabolic disease determined by biological factors, psychosocial aspects play a crucial role in its progression and management. However, the literature on psychosocial dimensions of diabetes management is minuscule and scattered. OBJECTIVE This synthesis sought to understand the psychosocial facilitators and barriers to type 2 diabetes management and coping among adults. METHODS We have adopted a meta-synthesis to review available qualitative studies using Pub- Med and Scopus databases. Based on inclusion criteria, we have chosen 24 studies published between 2010 and 2023. We have considered studies across countries, among which 63% of the studies included were from Western countries, and most have employed qualitative descriptive design. The selected studies were analyzed thematically using a deductive framework. RESULTS Six themes emerged as the psychosocial barriers and facilitators of managing and coping with type 2 diabetes: 1) cognitive-emotional factors, 2) faith, 3) constraints to behavioural change, 4) social constraints and support, 5) healthcare provider-patient relationship, and 6) awareness. Further, a conceptual framework was developed from the synthesis. CONCLUSION The patients' experiences evident from this synthesis signify the crucial role of psychosocial factors in diabetes management and coping. This evidence emphasizes the need for integrated care so that psychosocial aspects are addressed by healthcare providers and behavioural health professionals, which may lead to the promotion of facilitators and the minimization of barriers.
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Affiliation(s)
- P Padma Sri Lekha
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, India
| | - E P Abdul Azeez
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, India
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