Association of a Healthy Lifestyle, Life's Essential 8 Scores With Incident Macrovascular and Microvascular Disease Among Individuals With Type 2 Diabetes

Background The association of a healthy lifestyle with the prognosis of type 2 diabetes remains uncertain. We aimed to evaluate the associations of a healthy lifestyle and a higher American Heart Association's Life's Essential 8 score with incident macrovascular and microvascular diseases in type 2 diabetes. Methods and Results A total of 13 543 participants with baseline type 2 diabetes and free of macrovascular and microvascular diseases from the UK Biobank were included. A healthy lifestyle was determined based on body mass index, smoking, alcohol consumption, physical activity, sleep duration, and diet. Life's Essential 8 scores were generated from 8 metrics according to the American Heart Association's cardiovascular health advisory, ranging from 0 to 100. During a median follow-up of 12.1 years, 3279 (24.2%) incident macrovascular diseases and 2557 (18.9%) microvascular diseases were documented. Compared with those with a poor lifestyle, participants with an ideal lifestyle had significantly lower risks of incident macrovascular disease (hazard ratio [HR], 0.46 [95% CI, 0.36-0.59]) and microvascular disease (HR, 0.60 [95% CI, 0.47-0.77]). Significantly lower risks of macrovascular disease (HR, 0.20 [95% CI, 0.05-0.79]) and microvascular disease (HR, 0.24 [95% CI, 0.06-0.98]) were also found in the high cardiovascular health group (Life's Essential 8 scores: 80-100), compared to the low cardiovascular health group (scores: 0-49). Adhering to an ideal lifestyle may prevent 37.0% of macrovascular disease and 24.7% of microvascular disease, and attaining a high cardiovascular health may prevent 71.9% of macrovascular disease and 67.5% of microvascular disease. Conclusions A healthy lifestyle and a higher Life's Essential 8 score were associated with lower risks of macrovascular and microvascular diseases among participants with type 2 diabetes.

A Review on Experimental Models to Test Medicinal Plants on Postprandial Blood Glucose in Diabetes

Due to the gravity of postprandial hyperglycemia in the development of microvascular and macrovascular diseases in diabetics, many medicinal plants are tested to determine their effectiveness in glycemic control and the mechanisms of action of the products. Consequently, various diabetic models have been developed and enhanced over the years. The objective of this review is to describe some of the experimental models to study the effect of medicinal plants used to control postprandial hyperglycemia. Data was collected from PubMed, ScienceDirect, Scopus, and Google scholar (1953-2021). Fiftyseven (57) studies were included in this review article. Ten models were identified and described. For each model, we described the targets involved and their roles in postprandial blood glucose control. The experimental design and procedures described the targets such as an α-glucosidase enzyme, SGLT1, GLUT2, DPP-IV, Na+/K+ ATPase pump, or intestinal motility in the models, experiment design and procedures were described. This review will facilitate the selection of the most appropriate model for studying agents used to investigate postprandial blood glucose.

Plasma Adiponectin Levels Inversely Correlate to Clinical Parameters in Type 2 Diabetes Mellitus Patients with Macrovascular Diseases

It has been shown that adiponectin (APN) and plasminogen activator inhibitor type 1 (PAI-1) are inversely involved in the regulation of atherosclerosis formation. However, the clinical impact of APN and PAI-1 in type 2 diabetes mellitus (T2DM) with macrovascular diseases (MVD) has not been investigated. In the present study, we found that plasma APN levels were significantly lower in T2DM patients than healthy donors, with a further decrease in T2DM patients with MVD. In contrast, plasma PAI-1 levels were significantly higher in T2DM patients than healthy donors, with a further increase in T2DM patients with MVD. We observed that plasma APN levels negatively correlated to values of BMI, FBG, FINS, TG, and PAI-1 in T2DM patients. In patients with MVD, plasma APN levels were negatively associated with values of BMI, SBP, FBG, FINS, TG, and PAI-1. By multiple stepwise regression analysis, we found that values of BMI, FCP, PAI-1, and FBG independently related to plasma levels of APN in T2DM patients with MVD. Taken together, our results indicate that APN might be a promising biomarker in patients with T2DM, especially in those with MVD.