Association of gut microbiota and diabetes mellitus

Diabetes mellitus has been a common metabolic disorder in recent years across the world. It has affected approximately 463 million people worldwide, which has tripled in the last two decades. It has been forecasted to show an upward trend through 2030 and 2045 in China, India, and the United States. Few studies have been done to assess the impact of gut microbiota on human health. Diabetes mellitus is found to have an association with gut microbiota. Few animal studies are available linking the alteration of gut microbiota in diabetes mellitus. Probiotics have been found to have anti-diabetic properties. If diabetes is treated with diet modification in addition to drugs, it could change the spectrum of intestinal bacteria by boosting commensal bacteria and decreasing the harmful bacteria in the microbiome population of the gastrointestinal tract, which is highly beneficial. This could aid diabetics in managing diabetes mellitus and its complications effectively. This review has been undertaken to address the management of diabetes mellitus with a focus on the gut microbiome in addition to antidiabetic medications.

Ten-year risk assessment for type 2 diabetes mellitus using the Finnish Diabetes Risk Score in family medicine

Aim To assess ten-year risk of diabetes mellitus type 2 (T2DM) using the Finnish Diabetes Risk Score (FINDRISC) in respondents over 18, in Primary Health Centre in Banja Luka. Methods A prospective study was conducted using data from a population with undiagnosed T2DM in Primary Health Centre in Banja Luka. Eligible respondents were those aged 18 to 70 years. Sociodemographic, behavioural and anthropometric variables were those related to the risk models evaluated by FINDRISC. Results Data were collected from 520 individuals, 58.8% female and 41.2% male (p=0.005). A very high risk of developing T2DM in the next ten years was found in 5.6% females and 3.7% males. A high risk was found in 12.4% females and 15.9% males, 34.2% respondents ≥ 65 years, 28.8% with body mass index >30 kg/m2 , 26.6% who were not practicing physical activity (p=0.000), 24.0% who took antihypertensive drugs, 42.3% who were diagnosed with impaired glycaemia, 30.4% and 22.9% respondents whose parents and distant relatives, respectively, had T2DM. A moderate risk occurred in 31.4% females with waist circumference >88 cm. Half (50%) males with waist circumference >102 cm and 33.2% respondents who were not eating fruits and vegetables every day had a slightly increased risk of developing T2DM (p<0.05). Conclusion The FINDRISC may be used as a tool which would help general practitioners in everyday work, to detect patients with T2DM risk factors and to encourage them to change life style towards healthy habits.

Health coaching to promote healthier lifestyle among older people at moderate risk for cardiovascular diseases, diabetes and depression: a study protocol for a randomized controlled trial in Sweden

BACKGROUND

The challenge of an aging population in the society makes it important to find strategies to promote health for all. The aim of this study is to evaluate if repeated health coaching in terms of motivational interviewing, and an offer of wide range of activities, will contribute to positive lifestyle modifications and health among persons aged 60-75 years, with moderately elevated risk for cardiovascular disease (CVD), diabetes, or mild depression.

METHODS/DESIGN

Men and women between 60 and 75 are recruited in four regions in Sweden if they fulfill one or more of the four inclusion criteria. • Current reading of blood pressure (140-159/90-99) without medication. • Current reading of blood sugar (Hba1c 42-52 mmol/mol) without medication. • A current waist-circumference of ≥94 cm for men and ≥80 for women. • A minor/mild depression (12-20 points) according to Montgomery-Åsberg Depression Rating Scale without medication.Individuals with a worse result than inclusion criteria are treated according to regular guidelines at the PHCs and therefore not included. Exclusion criteria for the study are dementia, mental illness or other condition deemed unsuitable for participation. All participants fill out a questionnaire at baseline, and at the 6-, 12- and 18-month follow-ups containing questions on demographic characteristics, social life, HRQoL, lifestyle habits, general health/medication, self-rated mental health, and sense of coherence. At the 12-month follow-up, the health coach will give each participant a second questionnaire to capture attitudes and perceptions related to health coaching and venues/activities offered. Qualitative data will be collected twice to obtain a deeper understanding of perceptions and attitudes related to health and lifestyle/lifestyle modifications. A health economic assessment will be performed. Individual costs for health care utilisation will be collected and QALY-scores will be estimated.

DISCUSSION

Several drawbacks can be identified when conducting research in real life. However, many of the identified problems can diminish the positive results of the intervention and if the intervention shows positive effects they might be underestimated.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN01396033.