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Cao X, Chen N, Li Y. Editorial: Beta cell function and diabetes remission. Front Endocrinol (Lausanne) 2023; 14:1298101. [PMID: 38161979 PMCID: PMC10754965 DOI: 10.3389/fendo.2023.1298101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/08/2023] [Indexed: 01/03/2024] Open
Affiliation(s)
| | | | - Yanbing Li
- Department of Endocrinology, First Affiliatted Hospital, Sun Yat-sen University, Guangzhou, China
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Hirani D, Alabdulkader S, Miras AD, Salem V. What can functional brain imaging teach us about remission of type 2 diabetes? Diabet Med 2023; 40:e15235. [PMID: 37793983 DOI: 10.1111/dme.15235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023]
Abstract
AIMS With a paradigm shift in attitudes towards type 2 diabetes (T2D), 'weight loss responsive' diabetes is now thought of as a curable disease state. As a result, national programmes are being orchestrated to induce T2D remission soon after diagnosis with aggressive dietary interventions-such as very low-calorie diets (VLCD). However, dietary interventions to achieve weight loss and diabetes remission lack the same long-term sustainability and cardiovascular risk reduction evidence as bariatric surgery. This review aims to explore how brain imaging has contributed to our understanding of human eating behaviours and how neural correlates are affected by T2D. METHODS We summarise functional MRI (fMRI) studies looking at human eating behaviour and obesity. We explore how these neural correlates are affected by insulin resistance and T2D itself as well as its different treatment approaches. Finally, we comment on the need for more personalised approaches to maintaining metabolic health and how fMRI studies may inform this. CONCLUSION fMRI studies have helped to fashion our understanding of the neurobiology of human appetite and obesity. Improving our understanding of the neural implications of T2D that promote disadvantageous eating behaviours will enable prevention of disease as well as mitigation against a vicious cycle of metabolic dysfunction and associated cognitive complications.
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Affiliation(s)
- Dhruti Hirani
- Imperial College Healthcare NHS Trust, Diabetes Centre, St Mary's Hospital, London, UK
| | - Shahd Alabdulkader
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Alexander D Miras
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Hospital, London, UK
- Ulster University, School of Medicine, Faculty of Life & Health Sciences, Derry, UK
| | - Victoria Salem
- Imperial College Healthcare NHS Trust, Diabetes Centre, St Mary's Hospital, London, UK
- Department of Bioengineering, Imperial College London, London, UK
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3
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Hernández-Montoliu L, Rodríguez-Peña MM, Puig R, Astiarraga B, Guerrero-Pérez F, Virgili N, López-Urdiales R, Osorio J, Monseny R, Lazzara C, Sobrino L, Pérez-Maraver M, Pérez-Prieto M, Pellitero S, Fernández-Veledo S, Vendrell J, Vilarrasa N. A specific gut microbiota signature is associated with an enhanced GLP-1 and GLP-2 secretion and improved metabolic control in patients with type 2 diabetes after metabolic Roux-en-Y gastric bypass. Front Endocrinol (Lausanne) 2023; 14:1181744. [PMID: 37916149 PMCID: PMC10616869 DOI: 10.3389/fendo.2023.1181744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/22/2023] [Indexed: 11/03/2023] Open
Abstract
Objective To determine changes in incretins, systemic inflammation, intestinal permeability and microbiome modifications 12 months after metabolic RYGB (mRYGB) in patients with type 2 diabetes (T2D) and their relationship with metabolic improvement. Materials and methods Prospective single-center non-randomized controlled study, including patients with class II-III obesity and T2D undergoing mRYGB. At baseline and one year after surgery we performed body composition measurements, biochemical analysis, a meal tolerance test (MTT) and lipid test (LT) with determination of the area under the curve (AUC) for insulin, C-peptide, GLP-1, GLP-2, and fasting determinations of succinate, zonulin, IL-6 and study of gut microbiota. Results Thirteen patients aged 52.6 ± 6.5 years, BMI 39.3 ± 1.4 kg/m2, HbA1c 7.62 ± 1.5% were evaluated. After mRYGB, zonulin decreased and an increase in AUC after MTT was observed for GLP-1 (pre 9371 ± 5973 vs post 15788 ± 8021 pM, P<0.05), GLP-2 (pre 732 ± 182 vs post 1190 ± 447 ng/ml, P<0.001) and C- peptide, as well as after LT. Species belonging to Streptococaceae, Akkermansiacea, Rickenellaceae, Sutterellaceae, Enterobacteriaceae, Oscillospiraceae, Veillonellaceae, Enterobacterales_uc, and Fusobacteriaceae families increased after intervention and correlated positively with AUC of GLP-1 and GLP-2, and negatively with glucose, HbA1c, triglycerides and adiposity markers. Clostridium perfringens and Roseburia sp. 40_7 behaved similarly. In contrast, some species belonging to Lachnospiraceae, Erysipelotricaceae, and Rumnicocaceae families decreased and showed opposite correlations. Higher initial C-peptide was the only predictor for T2D remission, which was achieved in 69% of patients. Conclusions Patients with obesity and T2D submitted to mRYGB show an enhanced incretin response, a reduced gut permeability and a metabolic improvement, associated with a specific microbiota signature.
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Affiliation(s)
- Laura Hernández-Montoliu
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - M-Mar Rodríguez-Peña
- Hospital Universitari Joan XXIII de Tarragona, Institut d’Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)-Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Rocío Puig
- Department of Endocrinology and Nutrition Hospital de la Santa Creu i Sant Pau, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Brenno Astiarraga
- Hospital Universitari Joan XXIII de Tarragona, Institut d’Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)-Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Fernando Guerrero-Pérez
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Nuria Virgili
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Rafael López-Urdiales
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Javier Osorio
- Department of General and Gastrointestinal Surgery. Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Rosa Monseny
- Clinical Nutrition Unit. Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Claudio Lazzara
- Department of General and Gastrointestinal Surgery. Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Lucía Sobrino
- Department of General and Gastrointestinal Surgery. Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Manuel Pérez-Maraver
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - María Pérez-Prieto
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Silvia Pellitero
- Department of Endocrinology and Nutrition and Health Sciences Research Institute and University Hospital Germans Trias i Pujol, Badalona, Spain
| | - Sonia Fernández-Veledo
- Hospital Universitari Joan XXIII de Tarragona, Institut d’Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)-Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Joan Vendrell
- Hospital Universitari Joan XXIII de Tarragona, Institut d’Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)-Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Medicine and Surgery, Universitat Rovira i Virgili (URV), Reus, Spain
| | - Nuria Vilarrasa
- Department of Endocrinology and Nutrition, Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)-Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Sharma A, Bath PA, Zhang Z. Social Support in a Diabetes Online Community: Mixed Methods Content Analysis. JMIR Diabetes 2023; 8:e41320. [PMID: 36607714 PMCID: PMC9945924 DOI: 10.2196/41320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/18/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Patients with diabetes may experience different needs according to their diabetes stage. These needs may be met via online health communities in which individuals seek health-related information and exchange different types of social support. Understanding the social support categories that may be more important for different diabetes stages may help diabetes online communities (DOCs) provide more tailored support to web-based users. OBJECTIVE This study aimed to explore and quantify the categorical patterns of social support observed in a DOC, taking into consideration users' different diabetes stages, including prediabetes, type 2 diabetes (T2D), T2D with insulin treatment, and T2D remission. METHODS Data were collected from one of the largest DOCs in Europe: Diabetes.co.uk. Drawing on a mixed methods content analysis, a qualitative content analysis was conducted to explore what social support categories could be identified in users' posts. A total of 1841 posts were coded by 5 human annotators according to a modified version of the Social Support Behavior Code, including 7 different social support categories: achievement, congratulations, network support, seeking emotional support, seeking informational support, providing emotional support, and providing informational support. Subsequently, quantitative content analysis was conducted using chi-square post hoc analysis to compare the most prominent social support categories across different stages of diabetes. RESULTS Seeking informational support (605/1841, 32.86%) and providing informational support (597/1841, 32.42%) were the most frequent categories exchanged among users. The overall distribution of social support categories was significantly different across the diabetes stages (χ218=287.2; P<.001). Users with prediabetes sought more informational support than those in other stages (P<.001), whereas there were no significant differences in categories posted by users with T2D (P>.001). Users with T2D under insulin treatment provided more informational and emotional support (P<.001), and users with T2D in remission exchanged more achievement (P<.001) and network support (P<.001) than those in other stages. CONCLUSIONS This is the first study to highlight what, how, and when different types of social support may be beneficial at different stages of diabetes. Multiple stakeholders may benefit from these findings that may provide novel insights into how these categories can be strategically used and leveraged to support diabetes management.
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Affiliation(s)
| | - Peter A Bath
- Health Informatics Research Group, Information School, University of Sheffield, Sheffield, United Kingdom
| | - Ziqi Zhang
- Information Retrieval Research Group, Information School, University of Sheffield, Sheffield, United Kingdom
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Brady EM, Gulsin GS, Mirkes EM, Parke K, Kanagala P, Ng LL, Graham‐Brown MPM, Athithan L, Henson J, Redman E, Yang J, Zhao L, Argyridou S, Gray LJ, Yates T, Davies MJ, McCann GP. Fibro-inflammatory recovery and type 2 diabetes remission following a low calorie diet but not exercise training: A secondary analysis of the DIASTOLIC randomised controlled trial. Diabet Med 2022; 39:e14884. [PMID: 35587779 PMCID: PMC9543965 DOI: 10.1111/dme.14884] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 05/08/2022] [Indexed: 12/15/2022]
Abstract
AIMS To investigate the relationship between fibro-inflammatory biomarkers and cardiovascular structure/function in people with Type 2 Diabetes (T2D) compared to healthy controls and the effect of two lifestyle interventions in T2D. METHODS Data were derived from the DIASTOLIC randomised controlled trial (RCT) and includes a comparison between those with T2D and the matched healthy volunteers recruited at baseline. Adults with T2D without cardiovascular disease (CVD) were randomized to a 12-week intervention either: (1) exercise training, (2) a low-energy (∼810 kcal/day) meal-replacement plan (MRP) or (3) standard care. Principal Component and Fisher's linear discriminant analysis were used to investigate the relationships between MRI acquired cardiovascular outcomes and fibro-inflammatory biomarkers in cases versus controls and pre- and post-intervention in T2D. RESULTS At baseline, 83 people with T2D (mean age 50.5 ± 6.4; 58% male) and 36 healthy controls (mean age 48.6 ± 6.2; 53% male) were compared and 76 people with T2D completed the RCT for pre- post-analysis. Compared to healthy controls, subjects with T2D had adverse cardiovascular remodelling and a fibro-inflammatory profile (20 differentially expressed biomarkers). The 3D data visualisations showed almost complete separation between healthy controls and those with T2D, and a marked shift towards healthy controls following the MRP (15 biomarkers significantly changed) but not exercise training. CONCLUSIONS Fibro-inflammatory pathways and cardiovascular structure/function are adversely altered before the onset of symptomatic CVD in middle-aged adults with T2D. The MRP improved the fibro-inflammatory profile of people with T2D towards a more healthy status. Long-term studies are required to assess whether these changes lead to continued reverse cardiac remodelling and prevent CVD.
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Affiliation(s)
- Emer M. Brady
- Department of Cardiovascular SciencesUniversity of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
| | - Gaurav S. Gulsin
- Department of Cardiovascular SciencesUniversity of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
| | - Evgeny M. Mirkes
- School of Mathematics and Actuarial ScienceUniversity of LeicesterLeicesterUK
| | - Kelly Parke
- Department of Cardiovascular SciencesUniversity of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
| | - Prathap Kanagala
- University of LiverpoolLiverpool Centre for Cardiovascular ScienceLiverpoolUK
| | - Leong L. Ng
- Department of Cardiovascular SciencesUniversity of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
| | - Matthew P. M. Graham‐Brown
- Department of Cardiovascular SciencesUniversity of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
| | - Lavanya Athithan
- Department of Cardiovascular SciencesUniversity of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
| | - Joseph Henson
- Diabetes Research CentreNIHR Leicester Biomedical Research CentreLeicesterUK
| | - Emma Redman
- Diabetes Research CentreNIHR Leicester Biomedical Research CentreLeicesterUK
- University Hospitals of Leicester NHS TrustLeicesterUK
| | - Jang Yang
- Cardiovascular & Fibrosis Translational ResearchBristolNew JerseyUSA
| | - Lei Zhao
- Cardiovascular & Fibrosis Translational ResearchBristolNew JerseyUSA
| | - Stavroula Argyridou
- Diabetes Research CentreNIHR Leicester Biomedical Research CentreLeicesterUK
| | - Laura J. Gray
- Department of Health SciencesUniversity of LeicesterLeicesterUK
| | - Thomas Yates
- Diabetes Research CentreNIHR Leicester Biomedical Research CentreLeicesterUK
| | - Melanie J. Davies
- Diabetes Research CentreNIHR Leicester Biomedical Research CentreLeicesterUK
- University Hospitals of Leicester NHS TrustLeicesterUK
| | - Gerry P. McCann
- Department of Cardiovascular SciencesUniversity of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
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Brown A, Brosnahan N, Khazaei D, Wingrove J, Flint SW, Batterham RL. UK dietitians' attitudes and experiences of formula very low- and low-energy diets in clinical practice. Clin Obes 2022; 12:e12509. [PMID: 35068081 PMCID: PMC9286801 DOI: 10.1111/cob.12509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/07/2021] [Accepted: 01/06/2022] [Indexed: 01/13/2023]
Abstract
Despite evidence that formula very low-energy diets (VLED) and low-energy diets (LED) are both effective and safe as treatments for obesity and type 2 diabetes, these diets remain underutilized in the United Kingdom. The aim of this study was to explore UK dietitians' attitudes and experiences of using formula VLED and LED. A cross-sectional survey was disseminated between September 2019 and April 2020 through websites, social media platforms and dietetic networks using snowball sampling. In total, 241 dietitians responded to the online survey with 152 participants included in the final analysis (female [94.1%], mean age 40.8 years [SD 9.5]; median 12 years [interquartile range 8, 22] within dietetic practice). One hundred and nine (71.7%) participants reported currently using VLED/LED in clinical practice and 43 (28.3%) did not. Those with lower motivation and confidence in implementing VLED/LED in clinical practice were less likely to use them. Cost and adherence were the two highest reported barriers to use. Dietitians perceived VLED/LED were effective, but concerns remained about long-term effectiveness, particularly for some patient groups. Dietitians also reported that further education, funding and service infrastructure, including access to clinic space and administrative support, were required to help embed VLED/LED into routine clinical practice. With clinical services now regularly offering VLED/LED programmes in the United Kingdom, dietitians are ideally placed to provide long-term support. However, understanding, reporting and addressing the potential barriers (funding/infrastructure and education) appear to be key requirements in increasing the delivery of VLED/LED programmes nationally.
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Affiliation(s)
- Adrian Brown
- Centre for Obesity ResearchUniversity College LondonLondonUK
- Bariatric Centre for Weight Management and Metabolic SurgeryUniversity College London Hospital NHS TrustLondonUK
- National Institute of Health ResearchUCLH Biomedical Research CentreLondonUK
| | - Naomi Brosnahan
- School of Medicine, Dentistry & NursingUniversity of GlasgowScotlandUK
- Counterweight LtdLondonUK
| | - Dorsa Khazaei
- Centre for Obesity ResearchUniversity College LondonLondonUK
| | - Jed Wingrove
- Centre for Obesity ResearchUniversity College LondonLondonUK
- Bariatric Centre for Weight Management and Metabolic SurgeryUniversity College London Hospital NHS TrustLondonUK
- National Institute of Health ResearchUCLH Biomedical Research CentreLondonUK
| | - Stuart W. Flint
- School of PsychologyUniversity of LeedsLeedsUK
- Scaled Insights, NexusUniversity of LeedsLeedsUK
| | - Rachel L. Batterham
- Centre for Obesity ResearchUniversity College LondonLondonUK
- Bariatric Centre for Weight Management and Metabolic SurgeryUniversity College London Hospital NHS TrustLondonUK
- National Institute of Health ResearchUCLH Biomedical Research CentreLondonUK
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Rehackova L, Rodrigues AM, Thom G, Brosnahan N, Barnes AC, McCombie L, Leslie WS, Zhyzhneuskaya S, Peters C, Adamson AJ, Lean MEJ, Taylor R, Sniehotta FF. Participant experiences in the Diabetes REmission Clinical Trial (DiRECT). Diabet Med 2022; 39:e14689. [PMID: 34519099 DOI: 10.1111/dme.14689] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/11/2021] [Accepted: 08/31/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The Diabetes REmission Clinical Trial (DiRECT) has shown that sustained remission of type 2 diabetes in primary care is achievable through weight loss using total diet replacement (TDR) with continued behavioural support. Understanding participants' experiences can help optimise the intervention, support implementation into healthcare, and understand the process of behaviour change. METHODS Thirty-four DiRECT participants were recruited into this embedded qualitative evaluation study. In-person and telephone interviews were conducted before the TDR; at week 6-8 of the TDR; 2 weeks into food reintroduction (FR); and at 1 year, to learn about participant experiences with the programme. Transcribed narratives were analysed thematically, and we used interpretation to develop overarching themes. RESULTS Initiation of the TDR and transition to FR were challenging and required increased behavioural support. In general, adhering to TDR proved easier than the participants had anticipated. Some participants chose the optional extension of TDR. Rapid weight loss and changes in diabetes markers provided ongoing motivation. Further weight loss, behavioural support and occasional use of TDR facilitated weight loss maintenance (WLM). A process of behaviour adaptation to change following regime disruption was identified in three stages: (1) expectations of the new, (2) overcoming difficulties with adherence, and (3) acceptance of continuous effort and establishment of routines. CONCLUSIONS The DiRECT intervention was acceptable and regularity, continuity, and tailoring of behavioural support was instrumental in its implementation in primary care. The adaptation process accounts for some of the individual variability of experiences with the intervention and highlights the need for programme flexibility.
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Affiliation(s)
- Lucia Rehackova
- Policy Research Unit Behavioural Science, Newcastle University, Newcastle upon Tyne, UK
- Policy Innovation Research Unit, London School of Hygiene and Tropical Medicine, London, UK
| | - Angela Margarete Rodrigues
- Policy Research Unit Behavioural Science, Newcastle University, Newcastle upon Tyne, UK
- Department of Psychology, Northumbria University at Newcastle, Newcastle upon Tyne, UK
| | - George Thom
- School of Medicine Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Naomi Brosnahan
- School of Medicine Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Alison C Barnes
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Louise McCombie
- School of Medicine Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Wilma S Leslie
- School of Medicine Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Sviatlana Zhyzhneuskaya
- Magnetic Resonance Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Carl Peters
- Magnetic Resonance Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ashley J Adamson
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Michael E J Lean
- School of Medicine Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Roy Taylor
- Magnetic Resonance Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Falko F Sniehotta
- Policy Research Unit Behavioural Science, Newcastle University, Newcastle upon Tyne, UK
- Faculty of Behavioural, Management and Social Sciences (BMS), Twente University, Enschede, The Netherlands
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Han Y, Cheng B, Guo Y, Wang Q, Yang N, Lin P. A Low-Carbohydrate Diet Realizes Medication Withdrawal: A Possible Opportunity for Effective Glycemic Control. Front Endocrinol (Lausanne) 2021; 12:779636. [PMID: 34970224 PMCID: PMC8713744 DOI: 10.3389/fendo.2021.779636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/19/2021] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Multiple studies have confirmed that diet restrictions can effectively realize glycemic control and reduce metabolic risks in patients with type 2 diabetes mellitus (T2DM). In 2018, the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) stated that individuals can select a low-carbohydrate diet (LCD) according to their needs and preferences. Owing to the influence of Chinese traditional eating habits, only a small portion of patients in China have achieved their blood glucose goals. As a result, the Chinese government will incur huge expenditures. METHOD This study recruited 134 T2DM participants and randomly assigned them to the LCD group (n = 67) or the low-fat diet (LFD) group (n = 67). All of the patients had a fixed amount of exercise and were guided by clinicians. After a period of dietary washout, all of the patients received corresponding dietary education according to group. The follow-up time was 6 months. The indicators for anthropometry, glycemic control, and medication application parameters were collected and compared between the two groups. RESULTS There were 121 participants who finally entered the study. The proportions of calories from three major nutrients the participants consumed met the requirements of LCD and LFD. Compared with baseline, the pre-postdifferences of body weight, BMI, and several other indicators were significant except for dosages of insulin used in the LCD group and MES in the LFD group. After the intervention, body weight, body weight index (BMI), fasting blood glucose (FBG), postprandial 2-h blood glucose (PPG), and glycosylated hemoglobin (HbA1c) levels in the LCD group decreased significantly (p < 0.05) compared with the LFD group. The number of patients using lipid-lowering agents was significant higher in the LCD group and lower in the LFD group. However, there was no significant difference between the two groups for antihypertensive, hormone-replacement, and other agents. CONCLUSIONS The LCD diet can decrease body weight, glycemic levels, MES, and lipid-lowering agents more than the LFD diet, thus decreasing cost burden in Chinese patients with T2DM. Strict diet control and monitoring are the keys to managing diabetes.
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Affiliation(s)
- Yuxin Han
- Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Bingfei Cheng
- Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yanjun Guo
- Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qing Wang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Nailong Yang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Nailong Yang, ; Peng Lin,
| | - Peng Lin
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Nailong Yang, ; Peng Lin,
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Summers C, Curtis K. Novel Digital Architecture of a "Low Carb Program" for Initiating and Maintaining Long-Term Sustainable Health-Promoting Behavior Change in Patients with Type 2 Diabetes. JMIR Diabetes 2020; 5:e15030. [PMID: 32130113 PMCID: PMC7081139 DOI: 10.2196/15030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/29/2019] [Accepted: 09/29/2019] [Indexed: 12/11/2022] Open
Abstract
Globally, the burden of noncommunicable diseases such as type 2 diabetes is crippling health care systems. Type 2 diabetes, a disease linked with obesity, affects 1 in every 30 people today and is expected to affect 1 in 10 people by 2030. Current provisions are struggling to manage the trajectory of type 2 diabetes prevalence. Offline, face-to-face education for patients with type 2 diabetes has shown to lack long-term impact or the capacity for widespread democratized adoption. Digitally delivered interventions have been developed for patients with type 2 diabetes, and the evidence shows that some interventions provide the capacity to support hyperpersonalization and real-time continuous support to patients, which can result in significant engagement and health outcomes. However, digital health app engagement is notoriously difficult to achieve. This paper reviews the digital behavior change architecture of the Low Carb Program and the application of health behavioral theory underpinning its development and use in scaling novel methods of engaging the population with type 2 diabetes and supporting long-term behavior change.
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Affiliation(s)
| | - Kristina Curtis
- Faculty Research Centre for Advances in Behavioural Science, University of Coventry, Coventry, United Kingdom
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10
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Taylor R, Al-Mrabeh A, Zhyzhneuskaya S, Peters C, Barnes AC, Aribisala BS, Hollingsworth KG, Mathers JC, Sattar N, Lean MEJ. Remission of Human Type 2 Diabetes Requires Decrease in Liver and Pancreas Fat Content but Is Dependent upon Capacity for β Cell Recovery. Cell Metab 2018; 28:547-556.e3. [PMID: 30078554 DOI: 10.1016/j.cmet.2018.07.003] [Citation(s) in RCA: 209] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/12/2018] [Accepted: 07/06/2018] [Indexed: 01/03/2023]
Abstract
The Diabetes Remission Clinical Trial reported return and persistence of non-diabetic blood glucose control in 46% of people with type 2 diabetes of up to 6 years duration. Detailed metabolic studies were performed on a subgroup (intervention, n = 64; control, n = 26). In the intervention group, liver fat content decreased (16.0% ± 1.3% to 3.1% ± 0.5%, p < 0.0001) immediately after weight loss. Similarly, plasma triglyceride and pancreas fat content decreased whether or not glucose control normalized. Recovery of first-phase insulin response (0.04[-0.05-0.32] to 0.11[0.0005-0.51] nmol/min/m2, p < 0.0001) defined those who returned to non-diabetic glucose control and this was durable at 12 months (0.11[0.005-0.81] nmol/min/m2, p = 0.0001). Responders were similar to non-responders at baseline but had shorter diabetes duration (2.7 ± 0.3 versus 3.8 ± 0.4 years; p = 0.02). This study demonstrates that β cell ability to recover long-term function persists after diagnosis, changing the previous paradigm of irreversible loss of β cell function in type 2 diabetes.
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Affiliation(s)
- Roy Taylor
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne NE4 5PL, UK.
| | - Ahmad Al-Mrabeh
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne NE4 5PL, UK
| | - Sviatlana Zhyzhneuskaya
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne NE4 5PL, UK
| | - Carl Peters
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne NE4 5PL, UK
| | - Alison C Barnes
- Human Nutrition Research Centre, Institute of Health & Society, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Benjamin S Aribisala
- Department of Computer Science, Lagos State University, Ojo, Lagos State, Nigeria
| | - Kieren G Hollingsworth
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne NE4 5PL, UK
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow G12 8TA, UK
| | - Michael E J Lean
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow G31 2ER, UK
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